United States District Court, N.D. Illinois, Eastern Division
JOSEPH M. Plaintiff,
ANDREW SAUL, Commissioner of Social Security,  Defendant.
MEMORANDUM OPINION AND ORDER 
I. SCHENKIER UNITED STATES MAGISTRATE JUDGE.
Joseph M., moves for summary judgment seeking reversal or
remand of the final decision of defendant, the Commissioner
of Social Security ("Commissioner"), denying his
applications for disability insurance benefits
("DIB") and supplemental security income
("SSI") (doc. # 17: Pl.'s Summ. J. Mot; doc. #
18: Pl.'s Summ. J. Mem.). The Commissioner has filed a
cross motion for summary judgment asking us to affirm his
decision (doc. # 28: Def.'s Summ. J. Mot.; doc. # 29:
Def.'s Summ. J. Mem.), and Mr. M. has filed a reply (doc.
#31: Pl.'s Reply). For the following reasons, we deny Mr.
M.'s motion, grant the Commissioner's motion, and
affirm the Commissioner's decision.
November 17, 2014, Mr. M. applied for DIB and SSI, alleging
disability beginning on January 21, 2013 due to a meniscus
tear in his right knee, high blood pressure, and vision
problems (R. 76, 86, 96-97, 124-25, 130, 135, 255). The
Social Security Administration ("SSA") denied Mr.
M.'s applications at the initial and reconsideration
stages of review, after which Mr. M. requested a hearing
before an Administrative Law Judge ("ALJ") (R.
96-97, 124-35, 142-46, 148-49). On July 26, 2017, the ALJ
held a hearing at which Mr. M., represented by counsel, and a
vocational expert ("VE") testified (R. 39-75). On
November 16, 2017, the ALJ issued a decision denying Mr.
M.'s DIB and SSI claims (R. 17-38). The Appeals Council
denied Mr. M.'s request for review, making the ALJ's
decision the final word of the Commissioner (R. 1-5). See
Varga v. Colvin, 794 F.3d 809, 813 (7th Cir. 2015); 20
C.F.R. §§ 404.981, 416.1481.
was born on November 11, 1954 (R. 204). He obtained his
GED in 1979 and served in the National Guard (R. 46-47,
50-51, 256). He has worked as a home healthcare provider, an
electrician, and, most recently, a truck driver (R. 257).
appears that Mr. M. worked steadily (for the most part) as a
truck driver from 2007 through January 2013 (R. 52-53,
231-32, 257, 299). On January 21, 2013, Mr. M. suffered a
work-related injury to his right knee and stopped working (R.
248, 257; see R. 61-62 (testimony from Mr. M. that
he originally injured his right knee while working in 2013);
R. 486 (May 30, 2015 consultative examination report that Mr.
M. "stated that he had right knee joint pain from injury
at work about two years ago")). He remained unemployed
until May 2014, when he went back to work as a truck driver
for a different company (R. 232, 238, 248, 257). Mr. M.'s
return to work was short-lived, as he was laid off a month
later (R. 238, 241, 248). Mr. M. tried again to work as a
truck driver in August 2014, but he was laid off from this
job in September 2014 because "he was too slow" and
could not keep up (Id.). After not working in 2015,
Mr. M. worked as a truck driver again from early 2016 through
September or October of that year, when he stopped working
for good (see R. 45-47, 54-55, 221, 233-34).
asserts that his conditions (right-knee meniscus tear, high
blood pressure, and vision problems) became severe enough to
keep him from working on January 21, 2013 (R. 255). On that
date, which is also the date Mr. M. suffered his work-related
right-knee injury, Mr. M. had an x-ray taken of his right
knee (R. 248, 364). The x-ray indicated mild degenerative
change and no fracture or effusion (R. 364). The following
month, an MRI showed a meniscus tear, Assuring of cartilage,
and mild edema in a knee fat pad (R. 363).
September 2013, Mr. M. presented to Titilayo Abiona, M.D.,
complaining of headaches and dizziness (R. 426, 435-36). He
reported occasional chest tightness, although he was not
experiencing any at the time of the visit (R. 436). Dr.
Albiona requested a cardiac stress test, which Mr. M.
underwent in November 2013 (R. 453-54). During the stress
test, Mr. M. experienced no chest pain, but the test had to
be stopped due to Mr. M.'s fatigue (R. 454). The
impressions from the stress test were a normal stress EKG,
negative for ischemia; hypertensive blood pressure response
to exercise; and below-average exercise capacity for age
December 2013, Mr. M. presented to Lorena Monterubianesi,
M.D., to establish a primary care physician relationship (R.
455-56; see also R. 498 (July 2015 note reporting
that Mr. M. identified Dr. Monterubianesi as his primary
physician)). A review of Mr. M.'s musculoskeletal system
was negative, but he was diagnosed with uncontrolled
hypertension (R. 456, 458). At the time, Mr. M. was taking
two medications, metoprolol tartrate and amlodipine, which
are used to treat hypertension (R. 457). Dr.
Monterubianesi reinforced the need for Mr. M. to maintain a
low sodium diet and to take his medications (R. 458).
followed up with Dr. Monterubianesi in June 2014 (R. 459-63).
Mr. M.'s musculoskeletal system review was once again
negative (R. 460). Dr. Monterubianesi noted that Mr. M. had
been out of his medications for the past two weeks, and she
reinforced her advice about medication compliance (R. 460,
undergoing some diagnostic tests in December 2014 (R.
467-74), Mr. M. followed up with Dr. Monterubianesi again in
January 2015 (R. 475-76). Although Mr. M. had a lump on his
right wrist, a review of Mr. M.'s musculoskeletal system
was otherwise negative (R. 476, 478). In addition to noting
Mr. M.'s hypertension and wrist lump, Dr. Monterubianesi
noted that Mr. M. had experienced two episodes of vasovagal
syncope in 2014 (R. 479). Mr. M. showed up without taking his
medications and, like his last visit, he had run out of his
medications two weeks before (R. 476, 479). Dr.
Monterubianesi changed Mr. M.'s blood pressure
medications to losartan and hydrochlorothiazide and advised
Mr. M. to take his medications and return the next week (R.
January 11, 2015, Mr. M. was admitted to the emergency room
after he became dizzy and lightheaded and passed out for a
couple seconds (R. 259, 373, 376-77). Mr. M. reported that
this had happened in the past, but he did not report any
concerning symptoms (R. 381). Mr. M. also denied joint pain
and, upon physical examination, exhibited good range of
motion in his musculoskeletal system (R. 379). The emergency
room records note that after being admitted, Mr. M. was
"continuously ambulating the hallways and even went
outside to make a phone call," where he was pacing while
talking on his cell phone (R. 376, 381). Mr. M. was
discharged a few hours after his admission to the emergency
room (R. 373, 381).
followed up with Dr. Monterubianesi in March 2015 and, again,
in April 2015 (R. 591-98). At the March visit, Mr. M. had
been out of his medications for two weeks and had stopped
taking losartan and hydrochlorothiazide due to his belief
that these medications caused his past syncope episodes (R.
593, 595, 597). Instead, he was taking clonidine, another
medication for hypertension, for which Dr. Monterubianesi
upped the dosage (R. 597). Dr. Monterubianesi reinforced
medication compliance; nevertheless, Mr. M. showed up for his
April visit again being out of medications for two weeks (R.
591, 597). Dr. Monterubianesi again reinforced medication
compliance (R. 593). Other than the lump on his right wrist,
review of Mr. M.'s musculoskeletal system was negative at
each visit (R. 591, 593, 595, 597).
30, 2015, Mr. M. presented to Albert Osei, M.D., for an
internal medicine consultative examination (R. 486-94). Dr.
Osei identified Mr. M.'s chief complaints (i.e.,
what allegedly caused Mr. M.'s disability) as knee pain
and hypertension (R. 486). Mr. M. told Dr. Osei "that he
had right knee joint pain from [an] injury at work about two
years ago," that he experienced pain daily, and that,
for the past two years, he had used a cane that was given to
him when he had his right knee x-rayed in January 2013
(Id.)According to Mr. M., he had also undergone
a few sessions of physical therapy and surgery had been
recommended; however, surgery "was not done because the
company went into bankruptcy" (Id.). Mr. M.
also told Dr. Osei that he could only walk "one half
blocks," stand for 20 minutes, and sit for one hour
(Id.). Mr. M. further reported that his hypertension
had been controlled for the most part with clonidine, which
he was currently taking, and that he did not experience
syncope episodes on standing while taking clonidine, whereas
he did with other antihypertensive medications he previously
took (R. 486-87).
physical examination, Dr. Osei noted that Mr. M. could get on
and off the examination table and get up from a seated
position with no difficulty (R. 488). Range of motion was
normal in Mr. M.'s spine, although it was reduced in his
right knee joint due to pain (R. 489). Mr. M. could walk more
than 50 feet using a cane; without the cane, he could still
walk more than 50 feet, but he did so at a slow to moderate
pace and with a limp (Id.). Mr. M. could perform
toe/heel/tandem walk with moderate difficulty, could only
partially squat because of right-knee pain, and was able to
stand on either leg unsupported, although he could not hop on
either leg (Id.). Dr. Osei's impressions were a
right knee injury and pain, with an MRI finding of a torn
meniscus; uncontrolled hypertension; and obesity (R. 490).
2015, non-examining state agency consultant Prasad Kareti,
M.D., reviewed Mr. M.'s medical evidence, including Dr.
Osei's examination, at the initial stage of SSA review
(R. 76-97). Dr. Kareti opined that Mr. M. could lift and/or
carry 50 pounds occasionally and 25 pounds frequently; stand,
walk, or sit for about six hours in an eight-hour workday;
and occasionally kneel, crouch, crawl, and climb ramps,
stairs, ladders, ropes, or scaffolds (R. 81-83, 91-93). Dr.
Kareti also opined that although Mr. M. had severe loss of
central visual acuity, he did not experience any
corresponding visual limitations (R. 80, 83, 90-91, 93).
1, 2015, Mr. M. went to the emergency room complaining of
chest pain (R. 317, 495-96, 498). He denied any muscle pain
and, upon examination, did not exhibit any back tenderness
(R. 500). Mr. M. also admitted that he had missed a few doses
of clonidine, and he was educated for medication compliance
(R. 504, 508). Mr. M. was admitted overnight and discharged
the next day (R. 495, 497). Two weeks later, Mr. M. saw
Pankaj Jain, M.D., at Pulmonary and Sleep Associates for
assessment of a lung nodule that had been shown by imaging
during Mr. M.'s July 1-2 emergency room stay (R. 496,
501-02, 504, 548-50). Dr. Jain identified "back
ache" as one of Mr. M.'s ongoing medical problems
August 10, 2015, Mr. M. presented to Dr. Monterubianesi for a
follow-up visit (R. 587-90). Mr. M. had been out of his
hypertension medication (clonidine) for the past two weeks,
and Dr. Monterubianesi, once again, reinforced medication
compliance (R. 587, 589). At this visit, Mr. M. complained of
intermittent lower back pain on his right side that had begun
two years ago and which he rated as an eight out often for
pain (R. 587 ("today c.o lbp off and on, started 2 years
ago, no radiated, it is on the right side, 8/10")). He
also complained of right-knee pain and requested a knee brace
(Id.). Dr. Monterubianesi's review of Mr.
M.'s musculoskeletal system noted bilateral knee
crepitus, lower back pain, and muscles tender to palpation
(R. 589). Dr. Monterubianesi diagnosed Mr. M. with chronic
lower back pain and, presumably referring to Mr. M.'s
right knee, joint pain (Id.).
same day, Mr. M. underwent a series of x-rays for his reports
of back and right knee pain (R. 571-76, 589). The knee x-ray
showed mild degenerative joint disease ("DJD") in
the medial compartment of the right knee (R. 571). The x-rays
of Mr. M.'s spine showed a normal thoracic spine but DJD
of the facet joints and mild degenerative disc disease
("DDD") in the lumbosacral region (R. 573, 575).
saw Dr. Jain again in September 2015 (R. 554-56). Dr. Jain
again identified "back ache" as one of Mr. M.'s
ongoing medical problems (R. 556). The following month, Mr.
M. returned to see Dr. Monterubianesi (R. 582-86). At this
October 2015 follow-up visit, Mr. M. still complained of
intermittent right-side lower back pain (R. 582). As was the
case at Mr. M.'s last visit (in August 2015), Dr.
Monterubianesi's review of Mr. M.'s musculoskeletal
system noted bilateral knee crepitus, lower back pain, and
muscles tender to palpation (R. 584). Dr. Monterubianesi also
repeated her diagnosis of chronic lower back pain and joint
pain and she listed, for the first time, chronic lower back
pain as a problem (compare R. 583-85, with
R. 588-89). Furthermore, Dr. Monterubianesi noted that Mr. M.
could walk up to three blocks and that he walks with a cane
(R. 582, 584). The notes from this visit indicate that Dr.
Monterubianesi intended to or did refer Mr. M. to physical
therapy for his lower back pain (R. 584). Dr. Monterubianesi
prescribed Mr. M. tramadol (a pain reliever) and also
increased the dosage of Mr. M.'s clonidine prescription
November 5, 2015, Mr. M. underwent a CT scan of his lumber
spine (R. 579-80). The scan showed moderately severe to
severe DJD of the facet joints throughout the lumbar spine
with disc bulging at various levels, but no foraminal
narrowing (R. 579).
same month, non-examining state agency consultants Jerda
Riley, M.D., and Anne Prosperi, D.O., evaluated Mr. M.'s
medical evidence at the reconsideration stage of SSA review
(R. 98-125). Dr. Riley evaluated the evidence regarding Mr.
M.'s visual abilities and determined that Mr. M.'s
loss of central visual acuity was not severe (R. 104-05,
117-18). Dr. Prosperi evaluated the evidence regarding Mr.
M.'s other physical abilities and came to the same
conclusion about Mr. M.'s functional limitations as the
consultant who reviewed Mr. M.'s evidence at the initial
stage of SSA review, Dr. Kareti (compare R. 106-08,
119-21, with R. 81-83, 91-93).
January 2016, Mr. M. visited the emergency room after hurting
his wrist while climbing into a truck (R. 608-09). Review of
his musculoskeletal system was positive for arthralgias, but,
upon physical examination, Mr. M. moved all extremities
equally and had full range of motion in all extremities (R.
611-12). It was also noted that, upon discharge, Mr. M.
ambulated with a slow, steady gait (R. 610).
little more than six months later, in July 2016, Mr. M. was
at the emergency room again, this time with chest pain (R.
618-20). The attending physician noted that Mr. M. had run
out of his blood pressure medication (clonidine) two weeks
before (R. 620, 628, 630). Mr. M. denied back pain, and he
was noted to have "[g]ood range of motion in all major
joints" with "[n]o tenderness to palpation . . .
noted" (R. 621-22). According to the emergency room
records, the discharging physician suspected that his
symptoms were related to uncontrolled hypertension (R. 628).
It was further noted that Mr. M. was only taking clonidine
daily, which is not appropriate, and that his poor compliance
also made clonidine more difficult to use
(Id.).[] As a result, Mr.
M.'s blood pressure medication was changed from clonidine
to Procardia (Id.).
saw Dr. Monterubianesi again in March 2017 (R. 659-65). The
visit record noted that Mr. M. complained of right knee pain
and said that his knee "sometimes gives [out] when [he]
tries to walk" (R. 661). Upon examination, Mr. M.
exhibited right knee crepitus with a mild decreased
extension, and he was diagnosed with chronic knee pain (R.
663-64). Although chronic lower back pain was also diagnosed,
Mr. M.'s musculoskeletal review was negative and he
exhibited normal range of motion and no tenderness upon
examination outside of his right knee (R. 661, 663-64). Dr.
Monterubianesi further noted that Mr. M. had missed physical
therapy in the past and that he was walking unassisted,
although he would need a cane for stability (R. 665). Mr.
M.'s hypertension was also uncontrolled, and he reported
that he had no blood pressure medications other than
clonidine, and that he had run out months ago (R. 661, 664).
Dr. Monterubianesi continued Mr. M. on clonidine and had him
resume taking losartan and hydrochlorothiazide (R. 664). Dr.
Monterubianesi also had Mr. M. continue to take tramadol (R.
than a month later, on April 5, 2017, Mr. M. was admitted to
the emergency room after experiencing two short-lived
episodes of chest pain (R. 670-73). He reported that he was
compliant with his medications, which included Cozaar (a
brand name for losartan) and Procardia, although his
discharge summary noted that "[i]t is not clear that he
has been taking" his hypertension medications (R. 673,
680). The discharge summary also noted Mr. M.'s report
that "[h]e has not taken some medicines in the past
because of the 'side effects'" (R. 680). Review
of his musculoskeletal system was negative for back pain,
joint pain, or muscle pain and showed normal range of motion
(R. 673, 675, 686-87). When Mr. M. went to the bathroom the
night of his admission, his gait was observed to be steady,
and the notes do not refer to any use of a cane by Mr. M. (R.
679). Mr. M. was discharged two days after he was admitted
already noted, the ALJ held a hearing where Mr. M.,
represented by counsel, testified. When the ALJ asked Mr. M.
why he stopped driving trucks in 2016, Mr. M. replied that
back pain and fainting episodes (preceded by overheating)
prevented him from working (R. 54-55). Mr. M. testified that
his back pain is about an eight or nine out often (R. 55-56).
He was not prescribed physical therapy for his back, but he
was prescribed pain medication (R. 55-57). The pain
medication sometimes helped to reduce his back pain to about
a five out often, although Mr. M. indicated that he took
three or four more pills than prescribed to achieve this
level of relief (Id.). When asked whether this pain
medication caused any side effects, Mr. M. testified that he
did not know (Id.). Mr. M. was also prescribed a
back brace, but the brace "somehow [went] missing"
(R. 57). Mr. M. further testified that he did not know the
cause of his overheating and fainting episodes, but that his
doctors told him they resulted from Mr. M. eating at truck
stops and getting food poisoning (R. 57-58).
questioning from his attorney, Mr. M. also identified his
right knee as a source of pain (R. 61-62). The pain comes
"[e]very now and then" and can reach the level of a
seven or eight out often (R. 63). He was prescribed
medication that sometimes helps to alleviate his knee pain
(R. 63-64). Mr. M. is supposed to take the medication once
every time he needs it, but sometimes he takes the medication
twice because of the pain, even though he does not "like
taking too many pills" (R. 63). His knee also sometimes
"gives out" when he tries to walk (R. 62). Mr. M.
testified that he was prescribed physical therapy and given a
cane when he hurt his right knee in January 2013 (R. 57,
61-62, 218, 248). Mr. M. had a cane with him at the hearing
and testified that he had been using it ever since it was
given to him (R. 61).
testified that he can stand for, at most, 30 minutes, and he
sometimes has difficulty sitting (R. 61). During the day, he
walks around for a little bit, and then he will sit down for
a while (R. 58). He has trouble showering and getting dressed
(R. 58-59). He does not clean, do laundry, or work outside
(R. 59). If Mr. M. goes grocery shopping, he goes with
someone (Id.). Mr. M. is sometimes compliant with
taking all his medications (and sometimes not), and he
indicated that he sometimes overmedicates (R. 56-58, 63).
also testified at the hearing. The VE testified that an
individual who could perform medium work; frequently climb
ramps and stairs, balance, stoop, kneel, crouch, and crawl;
occasionally climb ladders, ropes, or scaffolds; and
occasionally work at unprotected heights and around moving
mechanical parts could perform Mr. M.'s past work as a
truck driver "per the DOT and as typically
performed" (R. 66-67). The VE further testified that
an individual with these capabilities could perform work as a
packager, order picker, or machine feeder (R. 67-68).
denying Mr. M.'s claims, the ALJ followed the familiar
five-step process for assessing disability. See 20
C.F.R. §§ 404.1520(a), 416.920(a). As an initial
matter, the ALJ determined that Mr. M.'s date last
insured was September 30, 2020 (R. 22). Then, at Step One,
the ALJ determined that Mr. M. had not engaged in substantial
gainful activity since his alleged disability onset date,
January 21, 2013 (R. 22-23). At Step Two, the ALJ
determined that Mr. M. suffered from the following severe
impairments: osteoarthritis, degenerative disc disease in the
lumbar spine, obesity, and hypertension with chest pain (R.
23). At Step Three, the ALJ determined that none of Mr.
M.'s impairments, individually or in combination, met or
equaled a listed impairment (Id.).
Steps Three and Four, the ALJ evaluated Mr. M.'s residual
functional capacity ("RFC"). See 20 C.F.R.
§§ 404.1520(a)(4), 416.920(a)(4). The ALJ concluded
that Mr. M. retains the RFC to perform medium work as defined
in 20 C.F.R. §§ 404.1567(c) and 416.967(c) except
that he can frequently climb ramps and stairs, balance,
stoop, kneel, crouch, and crawl; occasionally climb ladders,
ropes, and scaffolds; and occasionally work at unprotected
heights and around moving mechanical parts (R.
23-24). At Step Four, the ALJ found that Mr. M.
could perform his past relevant work as a truck driver (R.
31-32). The ALJ also proceeded to Step Five and found, in the
alternative, that Mr. M. could perform other ...