In the

United States Court of Appeals

For the Seventh Circuit

No. 00-2303

Joseph A. Zurawski,

Plaintiff-Appellant,

v.

William A. Halter, Acting Commissioner

of Social Security,/*

Defendant-Appellee.

Appeal from the United States District Court 

for the Northern District of Illinois, Eastern Division.

No. 99 CV 2819--Arlander Keys, Magistrate Judge.

Argued November 3, 2000--Decided April 6, 2001

 Before Flaum, Chief Judge, Easterbrook and Williams,

Circuit Judges.

 Williams, Circuit Judge. Plaintiff Joseph A.

Zurawski applied for Disability Insurance

Benefits and Supplemental Security Income, on the

ground that he had become disabled due to a back

disorder, neck pain, a loss of strength in his

legs, arms and shoulder, and depression, at the

age of thirty-five. The Social Security

Administration initially, and upon

reconsideration, denied his disability claim.

Thereafter, Zurawski requested, and was granted,

a hearing before an Administrative Law Judge

(ALJ). The ALJ determined that Zurawski was not

"disabled" as defined in the Social Security Act.

The Appeals Council denied review, and the ALJ’s

decision became the final decision of the

Commissioner of Social Security ("Commissioner").

Zurawski sought judicial review and Magistrate

Judge Arlander Keys granted summary judgment in

favor of the Commissioner. Zurawski now appeals

and, for the reasons set forth below, we reverse

and remand.

I

 Zurawski claims that he has been unable to work

since December 3, 1993, when he injured his back

while working as a foreman/laborer at his

brother’s construction company. His job/1
required him to lift heavy objects (from 50 to

100 pounds) and to walk, stand, and sit at three

hour intervals, with constant bending. Married

with four children, Zurawski has a high school

education, but no post-secondary education. Since

his on-the-job injury, Zurawski has sought

treatment for back problems, neck pain, a loss of

strength in his legs, arms and shoulder, and

depression.

 In November 1993, Zurawski saw Dr. Darren A.

Deskin, a chiropractor, concerning his back

condition. Dr. Deskin noted that Zurawski had a

fifteen-year history of chronic lower back pain.

He treated Zurawski with intersegmental traction,

axial traction, and spinal manipulation. In March

1994, Dr. Deskin recorded some improvement in

Zurawski’s back condition and opined that

Zurawski would be able to return to work. Based

on a referral from Dr. Deskin, Dr. Robert Semba

examined Zurawski, on March 16, 1994, and found

evidence of degenerative disc disease. He

prescribed Zurawski anti-inflammatory medication

and opined that Zurawski would be able to perform

limited duty work with periodic breaks to stretch

his back. In April 1994, Zurawski returned to Dr.

Deskin, who, upon further examination, concluded

that Zurawski was able to resume normal duties.

Zurawski did not return to work, however. Five

months later, at the behest of his employer’s

insurance carrier, Zurawski saw Dr. David L.

Spencer, who concluded that Zurawski was

physically capable of returning to work as a

"tile setter"/2 and that there was no evidence

to substantiate Zurawski’s complaints of pain.

Zurawski remained unemployed. The following year,

beginning in June 1995, Zurawski began treatment

with Dr. Marwaha/3 who then referred him to Dr.

Vikram Gandhi for his back condition. Dr. Gandhi

prescribed anti-inflammatory medications and

physical therapy treatments for Zurawski. 

 In July 1995, Zurawski began physical therapy

treatments for his back condition at Silver Cross

Hospital. From July to November 1995, he

regularly attended physical therapy sessions,

three times a week, with some recorded

improvements in his back condition. Around the

same time, the Mental Health Division of Will

County, Illinois diagnosed him as having an

adjustment disorder with depressed mood and

determined his Global Assessment of Functioning

(GAF) to be seventy, indicating mild symptoms.

Dr. Lozano, a psychiatrist, subsequently

confirmed this diagnosis. In October 1995, a

magnetic resonance imaging (MRI) of Zurawski’s

lumbar and cervical spine indicated that he had

a bulging disc and degenerative disc disease. As

a result, Dr. Gandhi recommended that Zurawski

continue physical therapy, attend a pain clinic
and a work rehabilitation program, and undergo a

surgical assessment. In November 1995, a physical

therapist reported that Zurawski could not

tolerate sitting and standing for more than

twenty minutes. Dr. Gandhi then referred

Zurawski to Dr. Ramsis Ghaly, a neurosurgeon.

Based on the MRI and Zurawski’s complaints of

pain in his lower back, neck, and legs, Dr. Ghaly

recommended physical therapy and epidural steroid

injections.

 At the request of the Social Security

Administration (SSA), Dr. Francis Vincent

performed a residual functional capacity

assessment on November 25, 1995. Dr. Vincent

found that Zurawski had the capacity to lift

and/or carry from ten to twenty pounds, stand

and/or walk for about six hours in an eight-hour

workday, and sit for six hours with unlimited

ability to push and/or pull. Two days later,

again at the request of the SSA, Dr. Kirk Boyenga

completed a Psychiatric Review Technique form.

Dr. Boyenga found that Zurawski suffered from a

non-severe affective disorder and a slight

restriction in his ability to perform activities

of daily living.

 In January 1996, Zurawski entered a pain clinic

program stating that he suffered from pain in his

lower back, neck, and legs. At that time,

Zurawski was on a number of pain medications and

had difficulty sleeping, eating, and socializing

with others. He also had another MRI taken of his

cervical spine, which revealed slight cervical

straightening, with some apparent degenerative

bony change at the C5-6 vertebra. Over the next

several months, Zurawski received three epidural

injections in an effort to alleviate his back

pain. Yet, the pain persisted. 

 In February 1996, Dr. Ghaly noted, "putting all

the x-rays together, there is no good explanation

for [Zurawski’s] subjective pain." As a

consequence, he released Zurawski to perform

light work. However, Zurawski did not return to

work. Two months later, Zurawski had inpatient

back treatment in combination with an aggressive

course of physical therapy at an area hospital.

Zurawski reported that his back condition was

aggravated by bending and twisting of his lower

back and prolonged sitting and standing. He also

had diminished strength in his lower extremity

and was prescribed pain and sleeping medications.

On May 15, 1996, Zurawski was discharged from the

physical therapy program.

 The following month, Zurawski participated in a

functional capacity assessment completed by ERGOS

Work Recovery, Inc., at Dr. Ghaly’s request, in

order to determine his capacity to work. ERGOS
found that Zurawski showed the potential for

performing in the Medium/Heavy physical demand,

in part, because he lifted a fifty pound box to

shelf height and a seventy pound box to bench

height. Although Zurawski registered various

complaints of pain during the evaluation,/4

ERGOS reported that Zurawski showed no

difficulties sitting, standing, walking, or

climbing. On October 9, 1996, Zurawski began

treatment with Dr. Ronald J. Lotesto, a

psychiatrist, for his pain symptoms. Dr. Lotesto

characterized Zurawski’s pain as "chronic" and

"severe" resulting in his inability to function.

He stated that Zurawski had disc herniations and

prescribed various medications for pain and

depression. 

 In November 1996, Dr. Ghaly advised Zurawski to

return to work and to continue treatment with a

psychiatrist. He also prescribed medications for

Zurawski’s pain and depression symptoms. 

 At the administrative hearing held before the

ALJ, Zurawski, then 39-years-old, was the only

witness to testify. He testified that Dr. Lotesto

was treating him for pain, not depression, and

that he considered Dr. Lotesto to be his treating

physician. He reported that his daily activities

included helping his four children prepare for

school and driving two younger children to and

from school, less than a mile each way. He stated

that he washes dishes, does some laundry,

prepares dinner, and helps his children with

their homework. He indicated that he had

difficulty finding work because of his back

condition. He explained that he cannot sit, walk,

stand, lift, carry, or bend on a prolonged basis

due to pain. He testified that, at most, he can

work from two to three hours a day while using

Tegretol, which helps to alleviate his pain

symptoms. However, he reported experiencing

memory loss and concentration deficits from using

Tegretol. And, while he once used his garage as

a shop to maintain trucks and stain cabinets,

Zurawski denied working in the shop since his

injury on December 3, 1993.

 In deciding whether Zurawski had met his burden

of establishing disability, the ALJ applied the

standard five-step inquiry, see 20 C.F.R. sec.

404.1520, which required her to evaluate, in

sequence:

(1) whether the claimant is currently

[un]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 [his] past relevant work; and (5)
whether the claimant is capable of performing

work in the national economy.

Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir.

2000) (quoting Knight v. Chater, 55 F.3d 309, 313

(7th Cir. 1995)). Under the five-part sequential

evaluation process, "[a]n 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). If a claimant reaches step 5,

the burden shifts to the ALJ to establish that

the claimant is capable of performing work in the

national economy. Id.

 In concluding that Zurawski was not "disabled"

as defined in the Social Security Act, the ALJ

reserved ruling on whether Zurawski had engaged

in substantial gainful activity since December 3,

1993, the alleged onset date of his disability.

She found that Zurawski had a "severe"

combination of impairments, namely, a disorder of

the back and depression, but did not have an

impairment, or combination of impairments, which

met or equaled in severity the requirement of any

of the impairments listed in 20 C.F.R. sec. 404,

Subpart P, Appendix 1 ("Listing"). Further, she

found that Zurawski was unable to perform his

past relevant work as a laborer, mechanic, and

carpenter. Next, she found that Zurawski’s

residual functional capacity/5 allowed him to

perform the physical exertion requirements of

light work, except for lifting or carrying more

than twenty pounds./6 In making these

determinations, the ALJ found "not entirely

credible" Zurawski’s complaints of disabling

pain. The ALJ further found that Zurawski had no

nonexertional limitations./7 She did note,

however, that Zurawski had "slight" limitations

on his activities of daily living and ability to

maintain social functioning, with "seldom"

deficiencies in concentration, persistence, or

pace, and no decompensation. 

 Based on Zurawski’s residual functional

capacity, his age, education, and work

experience, and using the Medical-Vocational

Guidelines as a framework for decision-making,

the ALJ concluded that, since Zurawski was

capable of making an adjustment to other work, he

was not "disabled" within the meaning of the

Social Security Act. After the Appeals Council

denied review, Zurawski filed a complaint seeking

judicial review in the district court. Presented

with cross-motions for summary judgment,

Magistrate Judge Keys ruled in favor of the

Commissioner, finding that substantial evidence
in the record supported the ALJ’s decision

denying Zurawski disability benefits. 

 On appeal, Zurawski argues that (1) the ALJ’s

credibility determinations were "patently wrong;"

(2) the ALJ erred in concluding that he had the

residual functional capacity to perform light

work; (3) the ALJ failed to properly weigh the

opinion of his treating physician, Dr. Lotesto;

and (4) the ALJ erred in relying on the MedicalVocational Guidelines without consulting a

vocational expert in determining his ability to

perform work in the national economy.

II

 We will affirm the ALJ’s decision if it is

supported by substantial evidence. Clifford, 227

F.3d at 869. 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).

Where, as here, the ALJ denies benefits, our

cases make it clear that the ALJ must "build an

accurate and logical bridge from the evidence to

[her] conclusion."/8 Clifford, 227 F.3d at 872.

A. Zurawski’s Credibility

 Zurawski contends that the ALJ’s credibility

determinations were erroneous. 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). Here, the ALJ found Zurawski’s complaints

of disabling pain "not entirely credible due to

the inconsistencies with the objective medical

evidence, and inconsistencies with daily

activities." Unfortunately, we are left to ponder

what exactly are these "inconsistencies" because

the ALJ provided no further explanation. Under

Social Security Ruling 96-7p, the ALJ’s

determination or decision regarding claimant

credibility "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." In

this regard it is not sufficient for the

adjudicator to make a single, conclusory

statement that "the individual’s allegations have

been considered" or that "the allegations are (or

are not) credible." Id. It is also not enough for

the adjudicator simply to recite the factors that

are described in the regulations for evaluating

symptoms. 

 While the ALJ did list Zurawski’s daily
activities, those activities are fairly

restricted (e.g., washing dishes, helping his

children prepare for school, doing laundry, and

preparing dinner) and not of a sort that

necessarily undermines or contradicts a claim of

disabling pain. See Clifford, 227 F.3d at 872

(noting "minimal daily activities . . . do not

establish that a person is capable of engaging in

substantial physical activity"). The ALJ should

have explained the "inconsistencies" between

Zurawski’s activities of daily living (that were

punctured with rest), his complaints of pain, and

the medical evidence. Id. at 870-72. 

 With respect to there being "inconsistencies"

with the medical evidence, we have instructed

that:

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 v. Shalala, 22 F.3d 687, 691 (7th Cir. 1994)

(citation omitted). But, where the medical signs

and findings reasonably support a claimant’s

complaint of pain, the ALJ cannot merely ignore

the claimant’s allegations. Id. 

 To support her decision denying benefits, the

ALJ relies on evidence that seemingly contradicts

Zurawski’s complaints of disabling pain. For

instance, she mentions the findings of four

physicians (namely, Dr. Semba, Dr. Spencer, Dr.

Deskin, and Dr. Ghaly), all of whom concluded

that Zurawski was capable of returning to work.

But the medical record also includes MRI results

showing that Zurawski had a bulging disc and

degenerative disc disease, which only Dr. Ghaly

apparently considered. In addition, Zurawski had

several epidural injections (per Dr. Ghaly’s

recommendation) and was prescribed a number of

prescription medications to alleviate pain and

depression symptoms, including Tegretol, Serzone,

Ultram, and Valium./9 "Both the evidence

favoring the claimant as well as the evidence
favoring the claim’s rejection must be examined,

since review of the substantiality of evidence

takes into account whatever in the record fairly

detracts from its weight." Bauzo v. Bowen, 803

F.2d 917, 923 (7th Cir. 1986) (citations omitted)

(emphasis added). Here, we are unable to tell

whether the ALJ investigated "all avenues" that

relate to Zurawski’s complaints of pain because

her decision offers no clue as to whether she

examined the full range of medical evidence as it

relates to his claim. 

 Because the ALJ’s decision, in its present

form, falls below the mark, we lack a sufficient

basis to sustain the ALJ’s credibility

determination. We are not suggesting that the

ALJ’s credibility determination was incorrect,

but only that greater elaboration is necessary.

Accordingly, the ALJ must conduct a reevaluation

of Zurawski’s complaints of pain with due regard

for the full range of medical evidence.

B. Residual Functional Capacity 

 Once the ALJ determined that Zurawski was

unable to perform his past relevant work, she

sought to establish (as the law requires her to

do) that Zurawski had the capability of

performing other work in the national economy.

See Clifford, 227 F.3d at 873. She found that

Zurawski retained the residual functional

capacity to engage in light work, except for

lifting or carrying more than twenty pounds. In

making the residual functional capacity

determination, Zurawski contends that the ALJ

ignored medical evidence favorable to him.

Specifically, Zurawski claims that the ALJ failed

to consider "significant" medical evidence

supporting his back pain and depression,

including, his intensive physical therapy

treatments, his heavy prescription medications,

his epidural injections, his MRI results showing

a bulging disc and degenerative disc disease, and

his treating physician’s (Dr. Lotesto’s) records

and opinions.

 It is worth repeating that "an ALJ may not

ignore an entire line of evidence that is

contrary to her findings," Henderson v. Apfel,

179 F.3d 507, 514 (7th Cir. 1999), rather she

must "articulate at some minimal level [her]

analysis of the evidence" to permit an informed

review. Clifford, 227 F.3d at 872. Here (as noted

above), the ALJ mentions only the medical

evidence favoring the denial of benefits. And

from her analysis, we are unable to discern

whether she considered the record as a whole.

Indeed, she made no mention of Zurawski’s MRI

results, and several of the medical findings that

she relied on concerning Zurawski’s capacity to
work, including that of Dr. Semba, Dr. Spencer,

and Dr. Deskin, were rendered before the MRI was

ever taken. Although the ALJ also supported her

decision with findings by ERGOS and Dr. Ghaly,

she made no attempt to explain why the other

evidence in the record, which appears to favor

Zurawski (e.g., the MRI results), was overcome by

the evidence on which she relied. For instance,

the ALJ mentioned only Dr. Ghaly’s November 14,

1996 report, which does not address (or, for that

matter, rebut in a substantial way) the objective

medical evidence favoring Zurawski’s claim. While

we have never required an ALJ to address every

piece of evidence or testimony in the record, the

ALJ’s analysis must provide some glimpse into the

reasoning behind her decision to deny benefits.

In this case, the ALJ’s decision simply fails to

permit an informed review, and therefore, a

remand for a redetermination of Zurawski’s

residual functional capacity is necessary.

C. Treating Physician

 Zurawski also argues that the ALJ erred by

failing to give any weight to the opinion of his

treating physician, Dr. Lotesto. Although Dr.

Lotesto’s speciality is psychiatry, Zurawski

maintains that Dr. Lotesto had treated him for

pain symptoms. During the course of treating

Zurawski, Dr. Lotesto opined that Zurawski’s pain

was "severe," resulting in his inability to

function. Dr. Losteto also concluded that

Zurawski suffers from disc herniation. However,

the objective medical evidence shows that

Zurawski had a bulging disc, not a herniation.

While "a treating physician’s opinion regarding

the nature and severity of a medical condition is

entitled to controlling weight if it is wellsupported by medical findings and not

inconsistent with other substantial evidence in

the record," Clifford, 227 F.3d at 870, the ALJ

does not address Dr. Lotesto’s findings one way

or another. In light of the numerous deficiencies

in the ALJ’s decision, we believe that the ALJ

should examine what weight, if any, to give to

Dr. Lotesto’s findings on remand.

D. Vocational Expert 

 In determining at step 5 of the sequential

inquiry that Zurawski has the capacity of making

an adjustment to work, the ALJ relied on the

Medical-Vocational Guidelines (the "grids") as a

framework for decision-making. Based on

Zurawski’s functional capacity, age, and

experience, the grids directed a finding of "not

disabled." Zurawski contends that the ALJ erred

in relying on the grids to find him not disabled

because he has a nonexertional limitation,

namely, pain. He argues that the ALJ should have
consulted a vocational expert in an effort to

determine whether there are a significant number

of jobs in the national economy that he can do

given his physical and mental impairments. 

 We have clearly stated that where a

nonexertional limitation might substantially

reduce a range of work an individual can perform,

the use of the grids would be inappropriate and

the ALJ must consult a vocational expert. Luna,

22 F.3d at 691. Here, as discussed earlier, the

ALJ improperly discredited Zurawski’s complaints

of disabling pain and ignored evidence that might

impact Zurawski’s ability to work. Zurawski

testified that he suffers from debilitating pain

that restricts his ability to sit, walk, stand,

lift, carry, or bend on a prolonged basis and

there is some evidence that appears to bolster

this claim. Because we have ordered a

redetermination of Zurawski’s residual functional

capacity and a reevaluation of his testimony, it

would be premature to direct the ALJ to solicit

vocational testimony from an expert. That said,

however, the ALJ must act consistent with the law

in this circuit (and the standards set forth in

this opinion) if she relies on the grids on

remand, see, e.g., Luna, 22 F.2d at 691-92.

III

 For the foregoing reasons, the judgment of the

district court, upholding the Commissioner’s

decision to deny benefits to Zurawski, is REVERSED,

and the case is REMANDED for further proceedings

consistent with this opinion.

/* William A. Halter, the acting Commissioner of

Social Security, is substituted as defendant for

Kenneth S. Apfel, the former Commissioner of

Social Security. Fed. R. App. P. 43(c)(2).

/1 Zurawski’s work involved removal and installation

of flooring and operation of floor grinders,

concrete mixers, and bobcats. He also performed

some office work.

/2 The record indicates that Zurawski also engaged

in carpentry work. 

/3 The court was unable to locate Dr. Marwaha’s

first name in the record.

/4 ERGOS recorded that Zurawski experienced muscle

spasms and tightness and shooting pain to the

lower extremities. Zurawski also walked with a

slight limp.

/5 "Residual functional capacity" is how much an

adult can do despite his impairment. Hickman v.

Apfel, 187 F.3d 683, 689 (7th Cir. 1999). 
/6 "Light work" involves (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.

20 C.F.R. sec. 404.1567(b); Social Security

Ruling 83-10.

/7 "Nonexertional limitations" affect a person’s

ability to meet the non-strength demands of a

job. 20 C.F.R. sec. 404.1569a(c)(1). Such

limitations might include difficulties in

functioning because of depression, concentration

deficits, or manipulative or postural defects.

See id.

/8 In this regard, we owe no deference to the lower

court’s review of the ALJ’s decision.

/9 At the time of the hearing, Zurawski was also

taking Amitriptyline (for sleeping) and Zantac

(for his stomach ulcers and unstable stomach).