In the

United States Court of Appeals

For the Seventh Circuit

No. 99-3831

Donna J. Clifford,

Plaintiff-Appellant,

v.

Kenneth S. Apfel, Commissioner

of Social Security,

Defendant-Appellee.

Appeal from the United States District Court

for the Southern District of Indiana, Indianapolis Division.

No. IP 98-1695-C-Y/S--Richard L. Young, Judge.

Argued May 18, 2000--Decided September 14, 2000

 Before Posner, Diane P. Wood, and Williams, Circuit

Judges.

 Williams, Circuit Judge. Donna J. Clifford

applied for supplemental security income ("SSI")

under Title XVI of the Social Security Act, 42

U.S.C. sec.sec. 1381 et seq., alleging a

disability resulting from high blood pressure,

depression, double vision, arthritis in her legs,

pain in her hands, and back and nerve problems.

Clifford’s claim was denied initially, upon

reconsideration, and after a hearing before an

Administrative Law Judge ("ALJ"). The ALJ

determined that Clifford was not "disabled"

within the meaning of the Social Security Act.

The Appeals Council declined review and the ALJ’s

decision became the final decision of the

Commissioner of Social Security ("Commissioner").

Clifford sought judicial review of the

Commissioner’s decision denying her SSI benefits,

and the district court affirmed the Commissioner.

We reverse. 

I

A. Administrative Hearing

 At the time of the administrative hearing,

Clifford was 53 years old, 5’3" tall, and weighed

199 pounds. She testified that she has a twelfth

grade education. Her only work experience was as

a waitress in 1965. She stated that she shared a

three room apartment with her husband, where she
does some housework, including cooking,

vacuuming, making the bed, washing dishes, and

grocery shopping. She is able to take a shower

and dress herself. She further stated that she

does not engage in many social activities outside

of visiting her daughter and grandchildren. She

testified that on a few occasions she babysat her

grandchildren. At her doctor’s suggestion,

Clifford stated that she walks for exercise. She

testified that she walks six blocks to visit her

daughter’s house in the summertime. During the

walks (six blocks each way), she stated that she

must sit and rest (near the fourth or fifth

block) due to pain in her legs. 

 According to Clifford, she is unable to work

because of nerve and vision problems and her

inability to lift significant weight or sit,

stand or walk on a sustained basis. She explained

that she is nervous around people and often cries

for no apparent reason. She further reported that

she wears an eye patch to avoid double vision.

She testified that she experiences pain in both

hands and often drops things due to numbness in

her left hand. She also testified that she can

lift a 20 pound sack of potatoes. She stated that

she experiences pain in both her legs, which

requires her to sit or lie down periodically

throughout the day. However, she testified that

she can sit for about two hours at a time.

Clifford further reported that she is taking

prescription medications for depression, sinus,

arthritis, and pain problems.

B. Medical Evidence

 1. Ball Memorial Hospital

 From 1994 to 1996, Clifford made frequent

visits to the emergency room ("ER") at Ball

Memorial Hospital./1 In 1994, she made several

ER visits because she experienced symptoms of

high blood pressure; each time she was treated

with medication and released. In January 1995,

Clifford returned to the ER complaining of

shoulder and back pain. The attending ER

physician, Dr. Gary Gaddis, M.D., prescribed pain

medication and released her. Six months later (in

July), she made another ER visit, this time

complaining of knee pain. On examination, Dr.

Iguban Querubin, M.D., found positive tenderness

in both of her knees. Dr. Querubin diagnosed

arthralgia (joint pain) in Clifford’s right knee

and prescribed medication. Later that month,

Clifford returned to the ER complaining of arm

pain. She received a diagnosis of radiculopathy

(nerve root disease) with cervical and left arm

pain. 

 The following January (1996), Clifford went to
the ER after she slipped and fell on her right

knee. An x-ray showed no acute abnormalities but

indicated a marked amount of degenerative change.

On April 7, 1996, she entered the ER complaining

about leg pain. Dr. Max H. Rudicel, M.D.,

indicated that her problems were associated with

degenerative arthritis. In November of that year,

Clifford returned to the ER complaining of a

possible cerebrovascular accident (i.e., a

stroke). She was admitted and referred to a

clinical neurologist, Dr. Jay G. Panszi, M.D.,

who reported that her problems were caused by

microvascular brain stem disease that was

aggravated by her high fat diet. At one point

during her many ER visits, Clifford was described

as a "well-developed, well-nourished" woman. 

 2. Dr. Jeffrey A. Heavilon, M.D.

 On August 10, 1995, Clifford saw Dr. Jeffrey A.

Heavilon at Central Indiana Orthopedics, P.C.,

complaining of left arm and neck pain. At that

examination, Clifford wore a cervical collar and

a wrist splint. Dr. Heavilon described Clifford

as a "healthy appearing" woman who was in no

acute distress. He reviewed x-rays of her

cervical spine and noted that they showed

degenerative arthropathy (joint disease), with

some radiculopathy (nerve root disease) in her

left shoulder. He recommended continued

conservative treatment, including use of a

Prednisone Dosepak. Dr. Heavilon later reported

that Clifford’s left shoulder pain improved with

the use of the Prednisone Dosepak, but noted that

Clifford also complained about pain in her right

foot. 

 3. Dr. Cheryl Keech, M.D.

 At the request of the Social Security

Administration, Clifford saw Dr. Cheryl Keech, a

consulting physician, on August 16, 1995. Dr.

Keech described Clifford as an "obese" woman who

moved about the examination room without

difficulty and showed no signs of shortness of

breath or fatigue. Dr. Keech indicated that

Clifford had no anatomical deformities,

inflammation, or swelling. She noted that

Clifford’s range of bodily motions was normal and

that her grip strength was intact. She also

recorded Clifford as having no loss of hand

functioning. Dr. Keech did find pain with

palpation in Clifford’s right ankle and both knee

joints. She also found mild muscle spasm in

Clifford’s upper cervical area across her

shoulder. She reported that Clifford had

arthritis and "very high" blood pressure. She

further stated that Clifford had a pinched nerve

in her neck that caused pain, but indicated that
the pinched nerve had not caused any loss of

functioning or any nerve damage. Dr. Keech

recommended that Clifford consult an

ophthalmologist for her vision problems.

 4.Open Door Health Clinic/Dr. Arnold L. Carter,

M.D.

 In February 1996, Clifford saw Dr. Arnold L.

Carter at the Open Door Health Clinic, a

community health clinic where she sought medical

treatment from 1981 until the hearing. On

examination, Dr. Carter diagnosed arthritis in

Clifford’s knee joints and probable carpal tunnel

syndrome in her left wrist (but a treatment note

from a prior visit to the clinic indicated that

Clifford had "good grip" strength in her left

hand). Dr. Carter recommended that Clifford

continue taking medication for arthritis and that

she continue using her carpal tunnel brace. A

month later, Dr. Carter noted that Clifford still

had problems with pain in her wrists and knees.

That April, Dr. Carter examined Clifford and

found tenderness in her knee joints. Dr. Carter

observed that Clifford had "marked excessive

weight" and recommended that she monitor her

dietary fat intake. Three weeks later, Clifford

returned to Dr. Carter complaining about

bilateral knee pain and swelling and shortness of

breath. The following December, Dr. Carter

observed that Clifford walked with an unsteady

gait and noted that she could not perform tandem

walking. A treatment note from the clinic dated

December 30, 1996, indicated that Clifford

experienced pain in her left knee that extended

to her thigh after she walked three blocks.

Clifford also complained about numbness in her

left hand and tightening of her fingers.

 5. Dr. Andrew H. Combs, M.D.

 In September 1996, Clifford saw her treating

physician, Dr. Andrew H. Combs, an orthopedic

specialist at Central Indiana Orthopedics, P.C.,

for pain in her right knee. Following an

examination, Dr. Combs diagnosed right knee

arthritis and suggested that Clifford would

eventually require a total knee replacement. Four

months later (January 1997), Clifford returned to

Dr. Combs for left knee and bilateral hand pain

that had persisted for at least a year. On

examination, Dr. Combs opined that Clifford’s

history of bilateral knee osteoarthritis limited

her ability to stand. Based on x-rays, he stated

that her left knee showed degenerative arthritis

in the medial joint space. Dr. Combs noted that

this finding was similar to Clifford’s right knee

osteoarthritis. He also reviewed x-rays of both
her wrists. He noted that her hands showed mild

joint osteoarthritis. He also diagnosed right arm

paresthesias, but he indicated that this

condition did not warrant electromyographic (EMG)

testing. He recommended that if her paresthesias

worsened, she could start using her wrist

splints. 

 Consistent with his examination in September

1996, Dr. Combs indicated that Clifford would

eventually require a knee replacement. According

to him, Clifford’s medical condition severely

limited her ability to perform any work that

required standing or walking. Dr. Combs also

opined that Clifford was unable to perform work

that required repetitive use of her hands. He

further predicted that her double vision would

severely limit her ability to perform reading and

computer monitor work.

 6. Dr. S.L. Rumschlag, O.D.

 Following the hearing before the ALJ (but while

the record remained open), Clifford saw Dr. S.L.

Rumschlag on February 3, 1997. Dr. Rumschlag

reported that Clifford’s prior stroke had

paralyzed the third and fourth nerve to her left

eye. He opined that she had permanent double

vision with no depth perception, which required

her to wear a patch on each eye alternatively. He

further indicated that Clifford could not see to

her left or right depending upon which eye has

the patch. 

C. Other Evidence

 1. Psychological Evaluations 

 

 In May 1995, Clifford saw Bob B. Hatfield,

Ph.D., and Barbara Umberger, Ph.D., for a

psychological evaluation in order to determine

her eligibility for medicaid benefits. Clifford

was tearful throughout the evaluation. Based on

the results of the evaluation, which included a

Weschsler Adult Intelligence Scale-Revised (WAISR IQ) test, Clifford was found to have a verbal

IQ of 82 and a performance IQ of 88, which put

her in the "low average" range of global

intelligence. Clifford was also diagnosed as

suffering from major depression, for which she

was prescribed the anti-depressant medication

Paxil. 

 In January 1997, Clifford saw Bill Frederick,

Ph.D., a social worker and case coordinator at

Comprehensive Mental Health Services for an

emotional/behavioral assessment. Dr. Frederick

described Clifford as an "overweight" woman. He
indicated that Clifford and her husband led a

somewhat "active" social life because they played

cards with friends and are involved with their

grandchildren. He noted that Clifford’s selfesteem was diminished and that she has had

suicidal ideas. Dr. Frederick further reported a

diagnosis consistent with dysthymic disorder (a

chronic depressive mood). 

 2. Activity Reports

 During the SSI eligibility determination

process, Clifford filled out a number of reports

that described her daily activities. She

indicated that she cooks "simple" meals that do

not require her to read a recipe. According to

her, the meals she cooks only take thirty to

sixty minutes to prepare. She also reported that

she dusted and did laundry and that her household

chores took about two hours to complete. She

indicated that she had to rest while doing her

household chores because of discomfort in her

legs. She further indicated that her husband

helps her cook and do household chores whenever

possible. 

D. The Administrative Law Judge’s Decision

 In determining whether Clifford suffered from a

disability as defined in the Social Security Act,

the ALJ conducted the standard five-step inquiry.

See 20 C.F.R. sec. 404.1520. The five-step

inquiry required the ALJ to evaluate, in

sequence: 

(1) whether the claimant is currently employed;

(2) whether the claimant has a severe impairment;

(3) whether the claimant’s impairment meets or

equals one of the impairments listed by the

[Commissioner], see 20 C.F.R. sec. 404, Subpt. P,

App. 1; (4) whether the claimant can perform her

past work; and (5) whether the claimant is

capable of performing work in the national

economy. 

Knight v. Chater, 55 F.3d 309, 313 (7th Cir.

1995). "An affirmative answer leads either to the

next step, or, on Steps 3 and 5, to a finding

that the claimant is disabled. A negative answer

at any point, other than Step 3, ends the inquiry

and leads to a determination that a claimant is

not disabled." Zalewski v. Heckler, 760 F.2d 160,

162 n.2 (7th Cir. 1985) (citation omitted). The

burden of proof is on the claimant through step

four; only at step five does the burden shift to

the Commissioner. Knight, 55 F.3d at 313.

 In conducting the sequential analysis, the ALJ

determined that Clifford had not engaged in
substantial gainful activity since June 1, 1995.

He also found that Clifford had a "severe"

combination of impairments consisting of

hypertension, arthritis, disorders of the spine,

monocular vision, and affective disorders, but

did not have an impairment, or a combination of

impairments, which met or equaled in severity the

requirements of any of the impairments listed in

20 C.F.R. sec. 404, Subpart P, Appendix 1

("Listing"). As a result, the ALJ concluded that

Clifford could not meet her burden at step three

of the evaluation.

 The ALJ then went on to discredit Clifford’s

testimony regarding her subjective complaints of

pain, as well as her allegation of a total

inability to work. Next, he determined that

Clifford had no past relevant work or

transferable work skills, which, in turn, led him

to find that Clifford had the residual functional

capacity to perform low stress light work,/2 but

with certain limitations./3 Because of

Clifford’s residual functional capacity, her age,

education, and work experience, the MedicalVocational Guidelines ("guidelines") directed a

conclusion that Clifford was not "disabled" as

defined in the Social Security Act. Since

Clifford’s limitations did not allow her to

perform the full range of light work, the ALJ

alternatively relied on the guidelines as a

framework for decision-making in conjunction with

vocational expert testimony at step five of the

evaluation. The ALJ found that there are

significant jobs in the national economy that

Clifford could perform. These jobs in Indiana

include a hand packer, cook helper, and assembly

worker. 

 On appeal, Clifford argues that (1) the ALJ

improperly rejected the opinion of her treating

physician, Dr. Andrew Combs; (2) the ALJ

improperly evaluated her testimony regarding her

subjective pain symptoms; (3) the ALJ erred in

determining that she had the residual functional

capacity to perform light work; and (4) the ALJ

erred in failing to afford appropriate weight to

the findings of other agencies regarding

disability. 

II

 The Social Security Act, 42 U.S.C. sec. 405(g),

requires the Commissioner’s findings to be

sustained if supported by substantial evidence.

Therefore, we will reverse the Commissioner’s

findings only if they are not supported by

substantial evidence or if the Commissioner

applied an erroneous legal standard. Rohan v.

Chater, 98 F.3d 966, 970 (7th Cir. 1996).

Substantial evidence 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). In our

substantial evidence determination, we review the

entire administrative record, but do not reweigh

the evidence, resolve conflicts, decide questions

of credibility, or substitute our own judgment

for that of the Commissioner. See Powers v.

Apfel, 207 F.3d 431, 434-35 (7th Cir. 2000); Diaz

v. Chater, 55 F.3d 300, 305, 308 (7th Cir. 1995);

Luna v. Shalala, 22 F.3d 687, 689 (7th Cir.

1994). However, this does not mean that we will

simply rubber-stamp the Commissioner’s decision

without a critical review of the evidence./4 See

Ehrhart v. Secretary of Health and Human Servs.,

969 F.2d 534, 538 (7th Cir. 1992). 

A. Dr. Combs’s Opinion

 Clifford contends that the ALJ improperly

rejected the disability findings of her treating

physician, Dr. Combs. In his January 1997 report,

Dr. Combs opined that Clifford was severely

limited in her ability to perform any work

requiring standing and walking. He also stated

that Clifford could not perform any repetitive

work due to her hand osteoarthritis and

paresthesias. The ALJ declined to accord

controlling weight to Dr. Combs’s 1997 report on

the grounds that it was unsupported by medical

evidence and inconsistent with Clifford’s

description of her daily activities. 

 Prior to reaching this determination, the ALJ

properly noted that more weight is generally

given to the opinion of a treating physician

because of his greater familiarity with the

claimant’s conditions and circumstances. See

Whitney v. Schweiker, 695 F.2d 784, 789 (7th Cir.

1982); 20 C.F.R. sec. 404. 1527(d)(2). A treating

physician’s opinion regarding the nature and

severity of a medical condition is entitled to

controlling weight if it is well supported by

medical findings and not inconsistent with other

substantial evidence in the record. See 20 C.F.R.

sec. 404.1527(d)(2). A claimant, however, is not

entitled to disability benefits simply because a

physician finds that the claimant is "disabled"

or "unable to work." Under the Social Security

regulations, the Commissioner is charged with

determining the ultimate issue of disability. See

20 C.F.R. sec. 404.1527(e). 

 Here, the ALJ stated that Clifford’s description

of her daily activities did not appear to

preclude "all competitive work." In support of

this contention, the ALJ noted that Clifford

walks six blocks, performs household chores, and

shops. According to the ALJ, these activities

were inconsistent with Dr. Combs’s opinion
regarding Clifford’s limitation on performing

work that requires standing or walking. We have

repeatedly stated, however, that an ALJ must

"minimally articulate his reasons for crediting

or rejecting evidence of disability." Scivally v.

Sullivan, 966 F.2d 1070, 1076 (7th Cir. 1992).

The ALJ did not provide any explanation for his

belief that Clifford’s activities were

inconsistent with Dr. Combs’s opinion and his

failure to do so constitutes error. 

 We have likewise insisted that an ALJ must not

substitute his own judgment for a physician’s

opinion without relying on other medical evidence

or authority in the record. Rohan, 98 F.3d at 968

("[A]s this Court has counseled on many

occasions, ALJs must not succumb to the

temptation to play doctor and make their own

independent medical findings."); see 20 C.F.R.

sec. 404.1527(d)(2) ("We will always give good

reasons . . . for the weight we give your

treating source’s opinion."). The record

indicates that Dr. Combs found that Clifford

suffers from degenerative knee arthritis that

severely limits her ability to walk or stand on

a sustained basis. In giving little or no weight

to this finding, the ALJ did not cite to any

medical report or opinion that contradicts Dr.

Combs’s opinion. In effect, the ALJ substituted

his judgment for that of Dr. Combs and left

unexplained why Clifford’s activities were

inconsistent with Dr. Combs’s opinion. That was

error. See Herron v. Shalala, 19 F.3d 329, 333

(7th Cir. 1994) (noting that ALJ cannot, without

adequate explanation, discount an uncontradicted,

dispositive medical opinion). Moreover, it

appears that the ALJ’s view of Dr. Combs’s

opinion may have been affected by the ALJ’s

failure to consider Clifford’s complaints of

disabling pain (an error to be discussed later).

 The ALJ also declined to give controlling

weight to Dr. Combs’s finding that Clifford is

unable to perform repetitive work due to her hand

osteoarthritis and paresthesisas. The ALJ noted

that Dr. Combs indicated that Clifford has "mild"

hand osteoarthritis and that her paresthesisas

did not warrant an EMG test. The ALJ further

noted that Clifford had no loss of hand

functioning when examined August 16, 1995 (by Dr.

Keech), and that a treatment note (from the Open

Door Health Clinic) indicated that Clifford had

"good grip" on January 18, 1996.

 We note that Dr. Combs’s 1997 report indicated

that Clifford’s bilateral hand pain had persisted

for a year and a half before her examination

(January 31, 1997). Dr. Keech’s examination of

Clifford apparently fell within that time period.

In her report, Dr. Keech noted Clifford’s
complaint of left arm pain, but she found no loss

of hand functioning on the part of Clifford. Dr.

Combs, on the other hand, determined that

Clifford was unable to perform repetitive work

due to her hand osteoarthritis and paresthesisas.

Dr. Keech, unlike Dr. Combs, did not render any

clinical findings with respect to Clifford’s hand

osteoarthritis and paresthesisas. This strongly

suggests that Clifford’s hand condition may have

worsened after her examination by Dr. Keech./5

It does not appear from the record that the ALJ

considered this possibility. Instead, the ALJ

discounted Dr. Combs’s disability finding because

Dr. Combs stated that Clifford’s hand

osteoarthritis was "mild" and her paresthesisas

did not warrant an EMG test. He apparently

believed that Dr. Combs’s 1997 report was

inconsistent. 

 While internal inconsistencies may provide good

cause to deny controlling weight to a treating

physician’s opinion, Knight, 55 F.3d at 314

("Medical evidence may be discounted if it is

internally inconsistent or inconsistent with

other evidence" in the record), the ALJ here did

not adequately articulate his reasoning for

discounting Dr. Combs’s opinion. Diaz, 55 F.3d at

308. In particular, the ALJ did not explain why

these statements were necessarily inconsistent

with Dr. Combs’s finding regarding the disabling

effect of Clifford’s combined hand osteoarthritis

and paresthesisas. Moreover, the ALJ did not, but

should have, considered all relevant evidence

(including Clifford’s complaints of disabling

pain) in weighing whether Clifford is disabled

from repetitive work as found by Dr. Combs.

Herron, 19 F.3d at 333 (noting that ALJ may not

"select and discuss only that evidence that

favors his ultimate conclusion"). In light of

these errors, the ALJ must reevaluate whether Dr.

Combs’s disability findings are entitled to

controlling weight. 

 

B. Clifford’s Testimony

 Clifford contends that the ALJ improperly

evaluated her testimony regarding her disabling

pain. The ALJ supposedly did not find Clifford’s

testimony credible because it was contradicted by

her daily activities and the medical evidence of

record. However, the ALJ must consider a

claimant’s subjective complaint of pain if

supported by medical signs and findings.

Scivally, 966 F.2d at 1077; 20 C.F.R. sec.

404.1529./6 And even if the claimant’s complaint

is not fully supported by objective medical

evidence, the court has instructed:

If the allegation of pain is not supported by the
objective medical evidence in the file and the

claimant indicates that pain is a significant

factor of his or her alleged inability to work,

then the ALJ must obtain detailed descriptions of

claimant’s daily activities by directing specific

inquiries about the pain and its effects to the

claimant. She must investigate all avenues

presented that relate to pain, including

claimant’s prior work record information and

observations by treating physicians, examining

physicians, and third parties. Factors that must

be considered include the nature and intensity of

claimant’s pain, precipitation and aggravating

factors, dosage and effectiveness of any pain

medications, other treatment for the relief of

pain, functional restrictions, and the claimant’s

daily activities. 

Luna, 22 F.3d at 691 (citation omitted). Although

an ALJ’s credibility determination is usually

entitled to deference, "when such determinations

rest on objective factors or fundamental

implausibilities rather than subjective

considerations [such as a claimant’s demeanor],

appellate courts have greater freedom to review

the ALJ’s decision." Herron, 19 F.3d at 335. 

 Here, the ALJ stated, in a conclusory manner,

that Clifford’s testimony regarding the

limitations placed on her daily activities was

unsupported by the medical evidence. However, the

record is replete with instances where Clifford

sought medical treatment for pain symptoms

related to her physical impairments, including

the arthritic condition for which she is taking

pain medication. While the ALJ is not required to

address every piece of evidence, he must

articulate some legitimate reason for his

decision. See id. at 333. Most importantly, he

must build an accurate and logical bridge from

the evidence to his conclusion. Green v. Apfel,

204 F.3d 780, 781 (7th Cir. 2000); Groves v.

Apfel, 148 F.3d 809, 811 (7th Cir. 1998). 

 In this case, the ALJ does not explain why the

objective medical evidence does not support

Clifford’s complaints of disabling pain. Rather,

the ALJ merely lists Clifford’s daily activities

as substantial evidence that she does not suffer

disabling pain. This is insufficient because

minimal daily activities, such as those in issue,

do not establish that a person is capable of

engaging in substantial physical activity. See

Thompson v. Sullivan, 987 F.2d 1482, 1490 (10th

Cir. 1993) (ruling that the ALJ may not rely on

minimal daily activities as substantial evidence

that claimant does not suffer disabling pain).

For example, Clifford testified that her typical

household chores took her only about two hours to

complete. Clifford indicated that she had to rest
while doing household chores. She stated that she

cooks, but only simple meals. She also indicated

that she could vacuum, but it hurts her back. She

stated that she goes grocery shopping about three

times a month and "sometimes" carries groceries

from the car to the apartment. She further stated

that she could lift a twenty pound sack of

potatoes, but she "wouldn’t carry it long."

Clifford testified that her husband helps her

with the household chores whenever possible.

While she babysits her grandchildren, she

indicated that her depression is aggravated while

watching them. In regard to walking, Clifford

stated that she walked to get exercise at her

doctor’s suggestion. However, she stated that she

must rest after walking anywhere between three

and five blocks. Clifford further indicated that

she plays cards (two rounds) about twice a month.

Thus, her testimony on her daily activities does

not undermine or contradict her claim of

disabling pain. 

 At this juncture, we lack a sufficient basis

upon which to uphold the ALJ’s credibility

determination. On remand, the ALJ must conduct a

reevaluation of Clifford’s complaints of pain,

with due regard for Dr. Combs’s opinion and the

full range of medical evidence.

C. Residual Functional Capacity

 Clifford further contends that the ALJ’s finding

that she had the residual functional capacity/7

to perform light work is unsupported by the

record evidence. Before we address this argument,

however, we revisit step three of the sequential

analysis because we believe further proceedings

are necessary for a redetermination of a multiple

impairments analysis. 

 From the record, it appears that the ALJ failed

to consider at step three the disabling effect of

Clifford’s weight problem on her overall

condition. The regulations require the agency to

consider the combined effect of all of the

claimant’s ailments, regardless of whether "any

such impairment, if considered separately, would

be of sufficient severity." 20 C.F.R. sec.

404.1523; see Green, 204 F.3d at 782. While

Clifford did not claim obesity as an impairment

when filing her Disability Report, the evidence

should have alerted the ALJ that Clifford had

another relevant impairment that could contribute

to the cumulative effect of her other

impairments. Cf. Fox v. Heckler, 776 F.2d 738,

740-42 (7th Cir. 1985) (medical expert should

evaluate combined effect of claimant’s

impairments where evidence fairly raises issue);

20 C.F.R. sec. 404.1512(a) (Commissioner "will

consider only impairment(s) you say you have or
about which we receive evidence."). There are

numerous references in the record to Clifford’s

"excessive" weight problem. For example, Dr. Jay

G. Panszi, a clinical neurologist, reported that

Clifford’s stroke symptoms were caused by

microvascular brain stem disease that was

aggravated by her high fat diet. Dr. Keech

described Clifford as "obese," and Dr. Carter

suggested that Clifford lose weight because of

her medical condition. The record also indicates

that Clifford has long had a weight problem.

Indeed, before her doctor put her on a diet,

Clifford testified that she normally weighed 224.

Moreover, Clifford suffers from severe arthritis

of the knees and high blood pressure, which are

significantly related to obesity under Listing

9.09, 20 C.F.R. Part 404, Subpart P, Appendix 1.

While Clifford may not meet the Listing

requirements for obesity,/8 she is 5’3" and

significantly overweight at 199 pounds. The ALJ,

rather than blind himself to this condition (and

other relevant evidence), should have considered

the weight issue with the aggregate effect of her

other impairments. See Scott v. Heckler, 770 F.2d

482, 486 (5th Cir. 1985) (200 pounds on a 5’4"

woman is significant obesity when present with a

related impairment). 

 Because the record does not indicate that the

ALJ properly considered the aggregate effect of

all Clifford’s ailments, we believe a

redetermination of a multiple impairments

analysis is necessary. If the ALJ believes that

he lacks sufficient evidence to make a decision,

he must adequately develop the record and, if

necessary, obtain expert opinions. See Nelson v.

Apfel, 131 F.3d 1228, 1235 (7th Cir. 1997); Luna,

22 F.3d at 692-93. 

 Turning to Clifford’s argument on the residual

functional capacity, once the ALJ determined that

Clifford had no past relevant work, he was

required to establish that Clifford has the

capability of performing other work in the

national economy. Tom v. Heckler, 779 F.2d 1250

(7th Cir. 1984). The ALJ determined that Clifford

retained the residual functional capacity to do

a limited range of light work during an eighthour workday. This finding must be supported by

substantial evidence in the record. Here, the

ALJ, without sufficient reason, disregarded

significant conflicting evidence--for example,

Dr. Combs’s opinion, Clifford’s complaints of

pain, her weight problem, and her limited

activities--in making his residual functional

capacity determination. For meaningful appellate

review, however, we must be able to trace the

ALJ’s path of reasoning. See Rohan, 98 F.3d at

971 (noting that ALJ’s explanation must take into

account significant evidence that would support
the opposite conclusion so that a reviewing court

has some idea why the judge rejected it); Herron,

19 F.3d at 333. The ALJ’s decision is riddled

with inarticulate reasons for the result. 

 Because we believe that the ALJ erred in giving

little or no weight to (1) Dr. Combs’s opinion

and (2) Clifford’s complaints of pain (as well as

other conflicting evidence), further proceedings

are necessary for redetermination of Clifford’s

residual functional capacity should the ALJ’s

reevaluation reach step five. 

D. Disability Finding of Other Agencies

 Clifford finally contends that the ALJ should

have assigned some weight to the fact that an

Indiana state agency found her disabled and

eligible for medicaid benefits. However, the ALJ

is not bound by findings made by either a

governmental or nongovernmental agency concerning

whether the claimant is disabled. See 20 C.F.R.

sec. 416.904. As we stated earlier, the ALJ must

independently determine if a claimant is

"disabled" as defined solely in the Social

Security Act. See Books v. Chater, 91 F.3d 972,

979 (7th Cir. 1996). Therefore, the ALJ is not

required to (but may) consider the disability

finding of other agencies.

III

 For the reasons stated above, the judgment of

the district court, upholding the Commissioner’s

decision to deny benefits to Clifford, is REVERSED,

and the case is REMANDED for further proceedings

consistent with this opinion. We also suggest

that the Social Security Administration transfer

the case to a different ALJ on remand. See

Sarchet v. Chater, 78 F.3d 305, 309 (7th Cir.

1996).

/1 Clifford has had hypertension (high blood

pressure) since 1974 and she suffered a stroke in

1989.

/2 According to Social Security regulations, "light

work" is generally characterized as (1) lifting

or carrying ten pounds frequently; (2) lifting

twenty pounds occasionally; (3) standing or

walking, off and on, for six hours during an

eight-hour workday; (4) intermittent sitting; and

(5) using hands and arms for grasping, holding

and turning objects. See 20 C.F.R. sec.

404.1567(b); Social Security Ruling 83-10. The

use of the term "low stress" is somewhat of a

misnomer because stress lies in the individual

not in the job. See Social Security Ruling 82-62.
/3 The ALJ found that Clifford retained the ability

to perform light work that can be performed by "a

person with monocular vision that requires an eye

patch." The work could not require her to walk

more than thirty minutes at one time or sit for

more than two hours at one time. Other

limitations on her ability to perform light work

included "no operation of foot controls; no

continuous grasping with the left hand; no

operation of heavy machinery; no driving; no

unprotected heights; avoidance of slippery and

uneven surfaces; and limited contact with the

public."

/4 We also review the final decision of the

Commissioner without giving any deference to the

district court’s review of that decision. Groves

v. Apfel, 148 F.3d 809, 811 (7th Cir. 1998).

/5 A month after the January 1996 treatment note,

for example, Dr. Carter, who is also associated

with the Open Door Health Clinic, diagnosed

Clifford with probable carpal tunnel syndrome.

Dr. Carter further noted that Clifford continued

to have pain in her wrists in March 1996. 

/6 The Social Security regulations provide that

"there must be medical signs and laboratory

findings which show that [the claimant] ha[s] a

medical impairment(s) which could reasonably be

expected to produce the pain or other symptoms

alleged and which, when considered with all of

the other evidence (including statements about

the intensity and persistence of [the claimant’s]

pain or other symptoms which may reasonably be

accepted as consistent with the medical signs and

laboratory findings), would lead to a conclusion

that [the claimant] is disabled. In evaluating

the intensity and persistence of [the claimant’s]

symptoms, including pain, we will consider all of

the available evidence, including [the

claimant’s] medical history, the medical signs

and laboratory findings and statements about how

[the claimant’s] symptoms affect [the claimant].

. . . We will then determine the extent to which

[the claimant’s] alleged functional limitations

and restrictions due to pain or other symptoms

can reasonably be accepted as consistent with the

medical signs and laboratory findings and other

evidence to decide how [the claimant’s] symptoms

affect [the claimant’s] ability to work." 20

C.F.R. sec. 404.1529(a).

/7 "Residual functional capacity" is that which a

claimant can still do despite her physical and

mental limitations. Hickman v. Apfel, 187 F.3d

683, 689 (7th Cir. 1999); 20 C.F.R. sec.

404.1545(a). The ALJ considers the claimant’s

ability to lift weight, sit--stand, walk, push--

pull, etc., in reaching this determination. 20
C.F.R. sec. 404.1545(b). The claimant’s residual

functional capacity is used to determine her

ability to engage in various levels of work

(sedentary, light, medium, heavy, or very heavy).

See id. sec. 404.1567.

/8 Under the regulations, a woman of Clifford’s

height is disabled if she weighs 250 pounds and

also suffers from either persistent high blood

pressure or arthritis in a weight-bearing joint.

See 20 C.F.R. Part 404, Subpart P, Appendix 1,

sec. 9.09 (Table II-Women).