Opinion
No. 98 C 6196.
August 17, 2001
MEMORANDUM OPINION AND ORDER
Mary Inghram seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner") denying social security disability benefits pursuant to Title II of the Social Security Act, 42 U.S.C. § 405(g). Both Inghram and Massanari move for summary judgment.
PROCEDURAL BACKGROUND
Inghram filed her application for disability benefits on July 30, 1996 based on injuries related to a car accident in 1994. The Commissioner denied her claim, and Inghram made a timely request for a hearing before an Administrative Law Judge ("ALJ"). The ALJ dismissed her application when neither Inghram nor her representative appeared for the hearing. The appeals council initially denied her request to vacate the dismissal, but upon reconsideration, remanded the case to a new ALJ for a new proceeding. On May 14, 1999, another ALJ held a hearing at which Inghram and vocational expert Frank Mendrick testified. Inghram had amended her application for disability benefits to a closed period of disability from April 18, 1994 to October 1998, when she returned to work. The ALJ found Inghram not disabled and denied her application. The Appeals Council declined to assume jurisdiction over the case, rendering the ALJ's decision final. 20 C.F.R. § 404.955. Inghram now seeks review.
STATEMENT OF FACTS
A. Inghram's injuries
Inghram, born August 3, 1964, was injured in a car crash in April 1994. Before that time, Inghram was a systems engineer leading a project to develop a therapeutic plasma pheresis system for use in Europe. Record ("R.") at 572. Inghram holds a Bachelor of Science degree with a double major in mathematics and computer science. Id. After the accident, Inghram was taken to the Lake Forest Hospital's Emergency Room and treated for a head injury and musculoskeletal injuries. She was diagnosed with post-concussion syndrome, mild traumatic brain injury, and cognitive disorder NOS. R. at 21. Since 1994, Inghram has received primary treatment for these injuries from Dr. James P. Kelly, her treating physician, and Dr. Thomas P. Bergquist, her psychologist. R. at 384-86, 585.
B. Inghram's Testimony at the Hearing
At the hearing, Inghram testified to various symptoms and conditions she suffered after the accident. She had "horrendous headaches," and could not drive a car for a long time. R. at 581. Her headaches left her bedridden for a couple of days every week, and she had difficulty sleeping. She complained she lost hand/eye coordination, and could not do any shopping. She was repeatedly taken to the emergency room because she blacked out. R. at 586. Inghram experienced a loss in memory and had to write simple things down on a piece of paper. R. at 587. She also claimed her hearing had been distorted, and she occasionally heard "background noise". R. at 590. Additionally, Inghram's inability to return to her pre-accident levels had a great effect on her emotionally. R. at 590. As for physical injuries, she noted that she lost 70 percent of the range of motion in her arm. R. at 592. She also suffered from pain in her mouth on the left side where her head hit the car window. R. at 593. Inghram no longer was able to lift or carry objects at the level she did in her job before the accident.
Additionally, Inghram had trouble performing daily tasks. Often she could not vacuum or cook. R. at 595. She was unable to help her children with homework until the fall of 1998. R. at 596-97. She took various medications for headaches and sleep deprivation, and saw a chiropractor for neck and back injuries. R. at 592-93. Inghram did not return to work until October 1998, when she began performing part-time computer services. R at 574. In February 1999, she started a job as a manufacturing engineering manager. Id.
C. Vocational Expert Testimony
Vocational expert Mendrick testified at the hearing. In principal part, he responded to five hypotheticals posed by the ALJ. In framing the hypotheticals, the ALJ asked Mendrick to assume various factors of Inghram's condition for a person of similar age, education and work history. R. at 609-611. In all cases, Mendrick responded that Inghram would not be able to return to her prior work but could work at other light and sedentary jobs. Specifically, Mendrick testified that Inghram could perform various unskilled jobs such as office helper, library clerk or library page, or other semi-skilled jobs such as general assembly and general labor work. Id. Mendrick noted that there were 1,250 general assembly jobs in the six-county Chicago metropolitan region. R. at 610.
DISCUSSION
I. Standard of Review
Judicial review of the Commissioner's final decision is limited. The role of the reviewing court is to determine whether substantial evidence in the record as a whole supports the Commissioner's decision to deny benefits. Wolfe v. Shalala, 997 F.2d 321, 322 (7th Cir. 1993). "The findings of the Secretary, as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g). The court must affirm the Commissioner's decision if the decision is reasonably drawn from the record and is supported by substantial evidence, even if some evidence may also support the claimant's position. 42 U.S.C. § 405(g).
In determining whether the Commissioner's findings are supported by substantial evidence, the court may not reevaluate the facts, reweigh the evidence, or substitute its own judgment for that of the Commissioner. Edwards v. Sullivan, 985 F.2d 334, 336-37 (7th Cir. 1993); Brown v. Chater, 913 F. Supp. 1210, 1213 (N.D. Ill. 1996). Factual findings, if supported by substantial evidence, shall remain undisturbed unless an erroneous legal standard was applied. Nelson v. Apfel, 131 F.3d 1228, 1234 (7th Cir. 1997). Substantial evidence in this context means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). Where conflicting evidence allows reasonable minds to differ, the responsibility for determining whether a claimant is disabled falls upon the Commissioner, and not this court. Stuckey v. Sullivan, 912 F.2d 178, 181 (7th Cir. 1990). However, the ALJ must consider all relevant evidence and may not select and discuss only that evidence that favors his ultimate conclusion. Herron v. Shalala, 19 F.3d 329, 333 (7th Cir. 1994). Because the ALJ's decision became the Commissioner's final decision when the Appeals Council denied Inghram's request for review pursuant to 20 C.F.R. § 498.222, this court's review is based on the determinations of the ALJ. Id. at 332.
II. Summary Judgment standard
Summary judgment is proper when the moving papers and affidavits show there is no genuine issue of material fact and the movant is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c); Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986); King v. National Human Res. Comm., 218 F.3d 719, 723 (7th Cir. 2000). Once a moving party has met its burden, the non-movant must go beyond the pleadings and set forth specific facts showing there is a genuine issue for trial. Fed.R.Civ.P. 56(e); Silk v. City of Chicago, 194 F.3d 788, 798 (7th Cir. 1999). The court considers the record as a whole and draws all reasonable inferences in the light most favorable to the nonmoving party. Bay v. Cassens Transp., Co., 212 F.3d 969, 972 (7th Cir. 2000). A genuine issue of material fact exists when the evidence is sufficient to support a reasonable jury verdict in favor of the nonmoving party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986); Insolia v. Philip Morris, Inc., 216 F.3d 596, 599 (7th Cir. 2000). If the moving party meets this burden, the nonmovant must then respond by setting forth specific facts which demonstrate the existence of a genuine issue for trial. Fed.R.Civ.P. 56(e).
III. "Disability" under the Social Security Act
To qualify for disability benefits under the Social Security Act ("the Act"), a claimant must be disabled within the meaning of the statute. The Act defines a disabled person as one who is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve months. 42 U.S.C. § 423(d)(1)(A). To meet this definition, a claimant must have a severe impairment which makes him unable to perform his "previous work or any other substantial gainful activity which exists in the national economy." 20 C.F.R. § 404.1505. A physical or mental impairment is "an impairment that results from anatomical, physiological abnormalities which are demonstrable by medically acceptable clinical laboratory diagnostic techniques." 42 U.S.C. § 423(d)(3). In situations where a mental impairment exists, the degree of functional loss resulting from the mental impairment must be determined. This evaluation procedure is normally outlined in the Psychiatric Review Technique form. 20 C.F.R. § 404.1520a.
The Act requires the factfinder to follow a five-step process to determine whether a claimant is disabled: (1) whether the claimant is currently employed; (2) whether she has a severe impairment; (3) whether her impairment meets or equals one listed by the Commissioner; (4) whether the claimant can perform her past work; and (5) whether the claimant is capable of performing any work in the national economy. Clifford, 227 F.3d 863, 868 (7th Cir. 2000). Once the claimant has satisfied steps one and two, she will automatically be found disabled if she suffers from a listed impairment. If a claimant satisfies steps one and two, but not three, then the claimant must satisfy step four — whether the claimant can perform her past work. If step four is satisfied, the burden shifts to the Commissioner to satisfy step five. Knight v. Chater, 55 F.3d 309, 313 (7th Cir. 1995). At the fifth step, the Commissioner must consider all the claimant's physical and mental impairments, and the claimant's age, education and work experience. Wilson v. Chater, No. 95 C 6590, 1997 WL 116803, at *3 (N.D. Ill. March 11, 1997). When denying benefits, the ALJ must "build an accurate and logical bridge from the evidence to [his] conclusion." Clifford, 227 F.3d at 872.
IV. Application
Inghram disputes the findings of the ALJ. The ALJ found Inghram had not engaged in substantial gainful activity during the relevant period (step one), and had a combination of impairments that were severe under the regulations (step two). 20 C.F.R. § 404.1521. However, the ALJ found Inghram could not establish step three because she did not have an impairment listed in, or medically equal to, an impairment in the regulations. Additionally, while the ALJ found Inghram could not have returned to her past work during the relevant period because of her impairments (step four), she could have performed a number of other jobs in the national economy (step five). Thus, the ALJ concluded Inghram was not disabled.
Inghram raises four issues. First, she argues the ALJ erred in his analysis of her residual functional capacity. Second, she contends the ALJ did not adequately take into account her treating physicians' opinion. Third, she disputes the finding on her credibility. Finally, she argues the ALJ erred in framing his hypothetical questions to the vocational expert. Each of these arguments will be addressed in turn.
A. Residual Functional Capacity
Residual functional capacity is a measure of what an individual can do despite the limitations imposed by her impairments. 20 C.F.R. § 404.1545(a). This determination is a legal decision rather than a medical one. 20 C.F.R. § 404.1527(e)(2). The ALJ may not ignore an entire line of evidence that is contrary to his findings. Henderson v. Apfel, 179 F.3d 507, 514 (7th Cir. 1999). Instead, he must articulate at some minimal level an analysis of the evidence to permit an informed review. Clifford, 227 F.3d at 872.
The ALJ determined the medical evidence established Inghram had post-concussion syndrome, status post mild traumatic brain injury, with cognitive deficiencies, migraine and audiovisual symptomalogy, urethral syndrome, chronic musculoskeletal pain syndrome, and depression. R. at 23. Taking these conditions into account, the ALJ concluded Inghram's residual functional work capacity precluded the following work-related activities:
sitting, standing, and/or walking for more than a total of 6 hours each in an eight hour workday; lifting/carrying up to 20 pounds more than occasionally or 10 pounds more than frequently; performing activities such as bending, balancing, stooping, crouching, kneeling, and crawling more than occasionally; climbing ropes, scaffolds, and ladders; climbing ramps/stairs more than occasionally; working with or near dangerous moving machinery or at unprotected heights or excavations; driving a motor vehicle; performing work requiring exposure to more than moderate (such as business offices where typewriters are used, department or grocery stores) levels of noise intensity; performing work requiring the capacity to recall and attend to complex/detailed instructions or working requiring such extended attention and concentration as is required to perform complex or detailed tasks at a sustained workmanlike pace; performing work under stresses such as consistent interaction with customers, clients or members of the general public; or performing work requiring that she independently set work goals or plan daily work activities; but retains the capacity to recall and carry out simple instructions and to perform simple repetitive tasks on a sustained basis.
R. at 21.
Inghram disputes the ALJ's finding on residual work capacity because of an alleged conflict between the Psychiatric Review Technique ("PRT") form and the ALJ's written decision. Specifically, she contends the ALJ omitted the following conditions from his findings of fact that were identified in the PRT: (1) memory impairment; (2) disturbance in mood; (3) cognitive disorder; (4) depressive syndrome; (5) depression; (6) extreme fatigue; (7) incontinence; and (8) limitations related to pain.
The ALJ's findings demonstrate that Inghram's contention is unsupported by the record. The ALJ addressed all eight of the purported missing conditions in his analysis. The ALJ noted Inghram's memory in January 1996 was at least average to superior. R. at 24. The ALJ reasoned that "[t]hough a diagnosis of cognitive disorder NOS was made, and claimant may have had some diminution in capacity relative to pre-accident levels, psychometric testing results were always within normal limits." R. at 23. The ALJ addressed Inghram's depression and depressive syndromes by taking into account that she had difficulty in coping with her inability to perform at pre-accident levels. However, he concluded the record did not reflect any evidence of major depression. R. at 24. The ALJ recognized that Inghram suffered from urethal syndrome but concluded that the condition was not persistent or on-going. Id. The ALJ also noted that this syndrome was diagnosed in 1991, before the accident took place. He found the condition had improved by 1996, when Inghram suffered only occasional incontinence. Id. The ALJ relied upon a 1994 Mayo Clinic report that noted full painless motion in all joints and stated Inghram was able to do push-ups and sit-ups. R. at 22. Finally, the ALJ found that symptoms of fatigue "waxed and waned" but by August 1995, Inghram reported less fatigue with normal activity and she was not taking medication at that point. R. at 23.
The ALJ considered all of Inghram's conditions and excluded various activities based on these medical conditions in his residual functional capacity finding. R. at 28; see also Bailey v. Massanari, No. 00 C 7506, 2001 WL 800068, at *5 (N.D. Ill. 2001) ("[t]he ALJ is not required to comment on every piece of evidence presented[.]"] The district court may not reevaluate the facts or reweigh the evidence considered by the ALJ. Edwards, 905 F.2d at 336-37. The factual findings of the ALJ are supported by substantial evidence in the record and an erroneous legal standard was not applied. Nelson, 131 F.3d at 1234. Additionally, Inghram does not point to any evidence in the record that would expand the ALJ's residual capacity finding. The court finds no error in the ALJ's residual functional capacity determination.
B. Treating Physician Opinion
Inghram asserts the ALJ failed to give proper weight to the treating physicians opinion. A treating physician's opinion is entitled to controlling weight if it is well supported by medical findings and not inconsistent with other substantial evidence in the record. Clifford, 227 F.3d at 872. Inghram fails to identify in the record which opinions of Dr. Kelly and Dr. Bergquist were left out, ignored, or not given sufficient weight. To the contrary, the record reflects the ALJ considered the assessments of both her treating physician, Dr. Kelly, and her psychologist, Dr. Bergquist. R. at 24. The ALJ relied upon Dr. Kelly's November 1995 deposition testimony assessing Inghram's capacity for dealing with stress and complex matters. Id. The ALJ also relied on the conclusions of Dr. Bergquist in two depositions where he noted Inghram was not coping well with a sense of loss of prior levels of intellectual functioning. Id.
C. Credibility
Inghram contends the ALJ's credibility findings are not supported by the record and not fully explained. The ALJ's credibility determinations generally will not be overturned unless they were patently wrong. Powers v. Apfel, 207 F.3d 431, 435 (7th Cir. 2000). The decision "must contain specific reasons for the finding on credibility, supported by the evidence in the case record, and must be sufficiently specific to make clear to the individual and to any subsequent reviewers the weight the adjudicator gave to the individual's statements and the reasons for that weight." Id; see also Zurawski v. Halter, 245 F.3d 881, 887-88 (7th Cir. 2001).
The ALJ provided six reasons for his finding that Inghram's allegations were not fully consistent with the medical evidence: (1) the record revealed Inghram's treatment for her symptoms was generally successful; (2) Inghram's use of medication did not suggest the presence of impairments more limiting that the finding on residual functional capacity; (3) the record was devoid of any opinions from treating or examining physicians that substantiated her allegations; (4) any opinion pertaining to disability referred to her inability to return to her prior work only; (5) the course of treatment by her physicians was not consistent with her allegations; and (6) Inghram's work activity after 1994 provides evidence that her daily activities were not as restricted as alleged. R. at 26.
Inghram contends the ALJ erred on the second credibility determination because he took into account her use of Aleve after October 1998 when she returned to work and was no longer claiming disability benefits. However, the ALJ's credibility determination does not identify Aleve or any other medication. The ALJ noted in his findings that Inghram was occasionally taking Tylenol during 1994 to 1998. R. at 23. The ALJ also considered the fact that Inghram was not taking any pain medications for her alleged musculoskeletal or headache pains. R. at 25. Thus, the ALJ determined that Inghram's allegations about her conditions would warrant more medication than was taken. This determination is reasonable and not patently wrong.
Inghram also contests the sixth reason for the credibility determination, arguing the ALJ's use of her work activity after 1998 was erroneous. At the hearing, Inghram complained that through 1997 and 1998 she still suffered from frequent headaches, high sensitivity to noise, split concentration, dizziness, fatigue, and facial and back pain. R. at 25. She continued to experience those symptoms at the time of the hearing. Id. Inghram contended that she was unable to help her children with homework until August 1998. Id. The ALJ concluded that Inghram's ability to return to work in October 1998 as a data processor and then as a engineering manager in 1999 led to an inference that Inghram's purported symptoms and her restrictions in her daily activities were not fully credible. R. at 26. Again, this inference is a reasonable one. First, the jobs held by Inghram required more skill than the ones suggested by the vocational expert. R. at 605-607. Second, Inghram's numerous allegations of severe impairments occurred in 1997 and 1998, in close proximity to her return to work. Finally, her return to work was merely one factor among a host of others the ALJ used to determine credibility.
Contrary to Inghram's contention, the ALJ did not determine she was not credible at all. Instead, the ALJ concluded that her allegations were not fully credible; the ALJ refused to broaden the scope of his residual functional capacity finding, which was based on the objective medical evidence. R at 26. The ALJ's credibility determination is reasonable and contains sufficient elaboration for this court to conclude that it was not patently wrong.
D. Vocational Expert testimony
Inghram argues the ALJ failed to include evidence of incontinence and depression in his hypothetical to the vocational expert. If the ALJ poses hypothetical questions to a vocational expert, the questions must fully set forth the claimant's impairments to the extent the impairments are supported by medical testimony. Brown v. Chater, 913 F. Supp. 1210, 1215 (N.D. Ill. 1996) (citing Hebron v. Shalala, 19 F.3d 329 (7th Cir. 1994)). If the vocational expert testifies in response to questions that meet this standard, that testimony constitutes substantial evidence for a finding of disability or a denial of benefits. Wilson v. Chater, No. 95 C 6590, 1997 WL 116803 (N.D. Ill. March, 11, 1997). Furthermore, "the question need not take into consideration every detail of the claimant's impairments especially if the record demonstrates that [the vocational expert] reviewed all the evidence prior to the hearing." Herrron, 19 F.3d at 337; Cass, 8 F.3d at 556.
Here, the vocational expert testified he had read the file and had an opportunity to review Inghram's testimony regarding her prior work history. R. at 602. Therefore, it was unnecessary for the ALJ to include every medical condition the five hypotheticals posed to the vocational expert. R. at 604-607. Moreover, Inghram's counsel had the opportunity to pose several hypotheticals to the vocational expert. He did not include incontinence or depression in his own hypotheticals. R. at 615-619. Nor did Inghram's counsel object to any of the ALJ's hypotheticals that excluded any medical conditions. See Pizano v. Chater, No. 96 C 1198, 1997 WU 11047, at *8 (N.D. Ill. 1997). Accordingly, the ALJ's reliance on the hypotheticals posed to the vocational expert was not erroneous.
E. Additional arguments
Inghram contests the use of IQ scores by the ALJ in disposing of her diagnosis of cognitive disorder NOS. However, Inghram mistakenly confuses dismissal with the ALJ's weighing of the evidence in making his finding on residual functional capacity. R. at 24. The ALJ recognized that Inghram was diagnosed with cognitive disorder NOS but also sought to take into account her IQ scores, her ability to concentrate, and her memory. R. at 23-24.
Inghram further alleges the ALJ erred in concluding that she does not suffer from depression. Once again, the ALJ's finding is more specific than Inghram's conclusory statement. The ALJ took into account the medical evidence and concluded that, while Inghram had difficulty coping, the record contained no evidence of major or on-going depression. R. at 24. This conclusion was based, in part, on the testimony of Dr. Kelly and Dr. Bergquist, her own physicians. Id. Inghram offers nothing from the record to dispute this conclusion.
CONCLUSION
The motions for summary judgment are denied as to Inghram and granted as to Apfel.