## In the



# U n ited S ta tes Co urt o f Ap p ea ls

F o rth eS e v e n th C ir cu it
N o. 09

- 4037 L Y NN M ARI E L A R S ON, Plai nt i f f

-Appe l l ant, v. M ICHAEL J. A S T RUE, Com m i ssi onero fS oci alS ecuri ty, D efend a nt-A pp ellee. Appeal from the United States District Court fo r the Western Di stricto f Wisc onsin
. No . 09 -cv-67-bbc

—Barb ara B. C rab b , Judge .
A RG UE D J UNE 9, 2010

— D ECI DE D A UGUS T 3, 2010

Befo re P OSNER, W OO D , a nd H A MI L T ON, C ircu it Judges. W OO D , C ircu it Judge. Ly nnMar i e La r s o n c o nt e nd s th at sh e is d isa b led by a n x i e ty , d ep re ss ion, an d an kle p a i n . S h e a p p l i e d f o r S u p p l e me n t a l S e c u r i t y In c o me ( “S S I ”) , b uta n Adm inistra ti ve La w J udg e ( “ALJ ”) c o ncl ud ed that her i m pai rm ents, al though s eve re, ar e no t d isa b lin g. T h e d ist ric t c ou rtu p h eld th e a ge n c y ’s d ec isio n, La rson v. A strue, N o. 09

- cv- 067-bbc, 20 09 W L 33791 44, at* 1 ( W
. D. W i s. Oct. 19 , 2 00 9) , a nd La r so n a ppea l s. Am o ng2 N o. 09

- 4037

o th erthi ng s, s he ar g ue s tha t the A LJ e r r ed bydi sc r edi ting he r t es ti m o ny a nd no t g i vingc o nt r o l l i ngwei g ht to the opi ni on o fher lo ng- ter m tr eat i ng psychi atr i st. W e a gr ee w i th herthatthe evi dence supports an a w ar d ofbene fi ts.

I N ow 3 8, L ar son w as educated thr ough three ye ar s o f coll ege an d has p ast w ork exp erience a s a barten d er. She has be en under the car e o fm entalheal th speci al i sts si nce atl eas t 1 998, wh en she beg an se ei ng Dr. Bruce Rhoad es , a psychi atr i st. H e di agno sed Lars on with “maj o r de pr es si o n ( r ec ur r en t) m o der at e. ” H i s tr ea tment no te s fr o m 19 99 thr o ug h 2 00 3 sh o w tha t he pr es cr ibe d a nd re gul ar l y a dj usted the d osa ges o fse ver alanti

- depressa nts and anxie ty m edi cati ons. M at te r s wentf rom b ad to wor se f o r La r so n in J an ua r y 2 0 0 4 , whe n s he wa s r a pe d b y the g r a nd f a ther o f o ne o fhe r c hi l dr ena nd suffer ed a br o k enha nd a nd inj ured thum b. S he dates the onse t o fherdi sabi l i ty f ro m that i nci dent. A fterthe ass aul t a so ci alworke r provi ded ther apy f ordepres si on a nd post
- tr aum ati c st re ss disor der ( “PTSD”). The so ci alworke r sco re d Larso n at 50 on th e G lobal A ssess m en t of Fu nc tioning (“G A F”), whi chm easur es a pe r so n’ s o ve r al l abi l i tyt o func ti o n. A MERI CAN P SY CHI AT R I C A S S OC IA T I ON, D I AGN OS T I C AN D S TATI S TI CAL M ANUAL OF M ENTAL D ISORD ERS, 30 ( 4th ed. 19 94)
. ( A GA F o f50 i n d ica tes se ri ous s ym ptom s o r functi onall i m i tat i ons. Id. at 32. ) Lars on a l so consul ted Dr. Rhoades, w ho obs er ved thatherm oo d w as depresse d though s he appeared “pl eas ant a nd se ttl ed. ” He diagnose dN o. 09

- 4037 3 L ar so n w ith ge n er aliz ed a n x iet y d iso rd er an d p os sib le PTSD, re new ed herpre scr i pti ons f oranti

- depressa nts, an d i nc r ea se d the do sa g e o fhe r a nt i

- an xi ety medi ca ti o n. A few m onths l ate r Dr. Rhoades concl ud ed that Larso n w as doi ng m uch bett erand sco re d her at 70 on the GA F; ne v e r the l e s s , h e c o nfi r med h i s di a g no s i s o fP TS D. I n A pri l 20 04, Lars on t ri pp ed outs i de a b ar afterfi ve o r s i x dr i nk s an d fractu r ed he r a nk l e i n thr ee pl ac es . The s a me o r tho pe di s twh o h a d t r e a t e d h e r aft e r the r a pe su rgi ca l l y r epa i r ed th e an k l e f r ac tu r es . A m o nth l at erhe co nc l ude d tha t th e an k l e was he al i ngwel l

. Aro und the sa m e ti m e, La r son c o nfes se d t o Dr
. Rho ade s th ats he had star te d d rinki ng m or e hea vi l y a nd questi oned w hether h er depres si on was the re aso n. Dr. Rhoades re sponded byadj usti ng herm edi cati ons; he decr eas ed the dos age o fheranti-dep re ssa nts b ut, ga ugi ng her an x iet y lev el a s “ fair ly h igh ,” h e i n c r ea se d h er an tianxi etym edi cati on. H erGA F wa s b ack dow n to 50
. Dr. R h oad es l ate r re port ed that Larso n’s anxi etywas “u n d er rea so n ab le c on tr ol,” a vie w th at p ro m p te d h im to c ha ng e he r medi ca ti o n a g ain. I n June 20 04 s he appli ed for be nefi ts. H eri ni ti alappli cati on was l i m i ted to al leg at ions re l ati ng to the pai n fro m herbr oke n an k l e; l at ers he a dded al l eg at i o ns o fdi sabi l i tys te m m i ng f ro m m entali m pai rm ents. A m onth l ate r, Lars on’ s s tepf atherbea t herand re

i nj ured herankl e. X- ra ys showed n o ev i dence ofa new f ra cture , but Larso n to l d her or thopedi st th at she was4 N o. 09

- 4037 ha vingdi ffi cul tywal k ing wi th o uta n a nk l e br ac e. S he al so saw D r. Rhoades, wh o re confi rm ed the diagn osi s o f m aj ordepress ion and pre scr ibed additi onalanti

- depressants and anti

- anxi etym edi cati ons. Othe r i s s ue s i n 2 0 0 4 a nd 2 0 0 5 l e d t o fur the r c o ns ul tati ons w i th Dr. Rhoades and Jen n i ferH er i nk, a psychother api st. In A ugust 2 004 Dr. Rhoades note d that Lar son w as “not d oing ver y wel l ” a nd pre scr ibed additi onal m edi cati on t o tr eatherdepres si on a nd anxi ety
. S he had a “ nerv ous b re akdown ” a nd m i sse d al m ost t w o w eek s o f w or k a t the H ead S tar t pr ogr am wh er e s he had bee n w or ki ng par t- ti m e a s a bus dr i ver . A nephew she had been ra i si ng was pl aced i n f oster car e a ftera soc i al se r v i c e s a g e nc y i nv e s t i g a t e d a n a l l e g a t i o n o f c hi l d negl ect. A nd she w as ar re ste d for dri vi ng w hi l e u n der the infl uence. She re port ed to H er i nk tha t s he had sto pp ed tak i ng herpre scr i pti on m ed icati on a nd st ar ted ( o r, i t se ems, c o nt i nue d) s el f

- m edi ca ti ngwi thmar ij ua na an d a lcoho l

. La r so n r epo r te d t o Dr
. Rho ade s th ats he wa s n o tg e t t i n go u to fb e d , and s o h e p r e s c r ib e d t wo add i ti onalanti

- depressa nts. Throu gh out the l asthal fo f 20 04 and 20 05, Dr. Rhoades docum ented that Lar son w a s de pr e s s e d, a s s e s s e d he r GAF a t 5 0 t o 6 0 , a nd pre scr ibed additi onalm ed icati ons to contr olheranxi ety a nd mo o d. L ar so n ’s a p p lica tio n f o r SS I w as d en ied init ially in A ugust 2 004 and up on r eco nsi derat i on in A ugus t 2005. A st ate
- age ncy psychol og i st had rev i ew ed the m edi cal re cor d shor tl y b ef or e the se cond denia l and had asse ss ed L arso n’s m en tal i m p airm en ts us ing a stan d ard f ormN o. 09

- 4037 5 “Psychi atr i c Revi ew Techni que, ” s ee 20 C.F
. R. § 404. 1520 a. H e d iagnose d L arson w ith an “ a ff e c t iv e d is o rd er”

— speci fi cal l y dep re ssi on

— unde r Li st i ng1 2. 04 a nd an “a nxie ty- re l ate d diso rder ” un d erLi sting 12
. 06, se e 2 0 C.F
. R. § Pt. 404, Subpt. P. A pp . 1. I n hi s opi n ion n eit h er ofthe i m pai rm ents w as seve re . H e co ncl ud ed that L a r s o n h a d n o ts u ffe r e d a n e x t e n d e d e p i s o d e o fd e c o mpen sati o n ( a so m ewha t va g ue t er m who se mean i ng we e xp l o r e bel o w) a nd wa s e xp e r i e nc i ngo nl y “ mi l d” re s t r i c t i o ns o n da i l y l i v i nga c t i v i t i e s a nd “ mod e r a te” di ffi cul ti es i n the r ealm s o fs o ci alfunc ti o ni nga nd c o ncent r a t i o n, p e r s i s t e nc e , o r p a c e . He tho ughttha tLa r son coul d p er f or m si m ple , r epeti ti ve, l ow-st re ss w or k e ven though s he would pro babl y hav e t ro ubl e deal i ng with l ar ge gr oups ofpeopl e o r str ess ful si tuati ons. I n Decem ber20 05, Dr. Rhoades com ple ted a M ental I m pai r m en t Que st i o nna i r e. H e r epo r te d th er e th at he h ad be en t r e at in g L ar so n sin c e 1 99 8 o n rou gh ly a m o nthl y b as i s. Hi s di agno si s was s ev er e, r ec ur r en t depr es si o n a nd dis so ci at e i den ti tydi so r der

. Herc ur r en t GA F s co r e, he s ai d, was 5 0. O bs er vingtha t sh e avo i ds m ostso ci alsi tuati ons, he no ted that Lars on was e xp e r i e nc i ngr e pe a t e d ( i.e. , thr ee orm or e) epi sodes of decom pensati on. H e a lso check ed a b ox i nd i cating tha t sh e had “sl i ght” re str i cti ons i n acti vi ti es ofdai ly l i ving, “ m ar k ed” di ffi cul ti es i n s o ci alfunc ti o ni ng, a nd “fre quent” defi ci enci es ofcon c entr ati on, per si ste nce, orpace. I n J an ua r y 2 00 6, L arso n r epo r te d t o Her i nktha t sh e was ha vingi nc r ea sed th o ug ht s o fs ui ci de. Her i nke n-6 N o. 09

- 4037

cour a g e d h e rt o g o t o the h o s pi t a l, b uts he di d n o tf ol l ow that advi ce. H er i nk l ate r ask ed the pol i ce t o c h ec k o n Larso n. They d i d so and, acco rdi ng to H er i nk’ s pro gr ess note s, theyto ok her to the ho spi tal

. T h e adm i ni str ativ e re c or d co n ta in s n o ot h er info rm at ion ab ou t t h is ho spi ta l i za ti o n. Lar so n b r i efl y t es ti fi ed be f o r e th e AL J athe r he ar i ng in M ar c h 20 07 . Tw ice d u rin g th e q u es tio n i n g s h e s aid th at sh e want ed to “g o ho m e. ” M uch of her te st i m o ny f ocuse d on hereff or ts to hol d a j ob si nce heralleged onse t date . T h e m onth be f or e the hear i ng, Lars on had quita part- ti m e j ob at a g as sta ti on , w h er e she o ccasi onal l y had t o hi de i n the b at h ro om , apparent l y t o avoi d c us to m er s. S i nc e 20 04 s he a l so ha d b ee n wo r k i ng abou t tw o hou rs p er w eek at a restau ran t, ten d in g b a r, co o k i ng, a nd wai tingta bl es . Al th o ug h s he dr o ve the H ead S t a r ts c ho o l b us f o r a s ho r tp e r i o d, s he wa s fi re d fro m thatj ob aftersuffer i ng a bre akdown thatal er ted her em plo yerto t h e d rugs she w as tak i ng. Lars on i nsi ste d that s he co uld notwork full

- ti m e be cause sh e su ffer s pan i c at ta ck s an d unc o nt r o l l ab l e cr y i ng spel l s that l astas l i ttl e a s 1 5 m i nutes t o as l ong as se ve r alho ur s. S he ha d s ucceed ed i n k ee pi ngthe restau ran t j ob, sh e e x p lai ne d , only becau se th e ow ne r, Pa ulCa l l i ss , was a fr i en d. La r so n e xpl aine d thats he w as car i ng for her f our chi l dren ( then r angi ng i n age from 6 to 17), cooking fo r t h e fam il y, an d doin g l au nd ry a n d o th e r h o u s e h o l d c h o r e s . I f s h e n e e d e d t o s h o p, s he went w ith C al l i ss o r e l se wai te d unt i l l at e i n the e ve ni ng to avo i d encounteri ng o therpeopl e. Final l y, she re port ed that she was ta ki ng m edi cati ons ( she d id n ot sayN o. 09

- 4037 7 whato r f o r whi chc o nditi o n) tha t m ade he r dr o wsy a nd re quir ed herto nap duri ng the day. Call i ss, Larson ’s fri end and em plo yer, co nfi rm ed that L ar so n w or ke d for h im “v er y p ar t t im e ,” so m et im es all day i fther e was a sp eci alev ent b ut o n ave ra ge l ess than two hour s perweek. H e e xplai ned that Larso n ty pi ca l l y ne ede d a b r ea ka fter a shor t ti m e be ca us e sh e w as nerv ous a ro und st ra nger s. The A LJ c all ed Dr. S tev en Cart er, a psychol ogi st, as a me d i c a l e xp e r tt o t e s t i fy ab o u tL a r s o n ’ s me n t a l i mpai rm ents. Dr. Cart erco nsi dered wh ethe r Larso n m et the c ri ter i a f ora per se disabi l i ty und erL isti ng 12
. 04 for depres si on. A cl ai m ant s uffer i ng fro m an a ffecti ve diso r de r me e t s the l i s t e d s e v e r i t y l e v e l f o r a de pr e s s i ve syn d rom e ifenou gh l isted f acto rs (the “ A criteri a”) are p resen t. 20 C
. F.R . § Pt. 404, Subp art P. A p p . 1, § 12. 04(A ); see R abbe rs v. Co m m ’rSoc. Se c. Adm in
. , 58 2 F.3d 647, 65 3 (6t h C ir. 20 09 ); H o lo ha n v . M a ssa na ri, 24 6 F
. 3d 1195 , 12 03 ( 9th Ci r. 20 01)
. There i s no di spute thatLars on’ s depre ss i o n qu alifie d as se ve re for p u rp os es of th e “ A cr ite ria .” Bu t the “ A c r i t e r i a ” a l o ne a r e no t e no ugh; i n o r der to be c o n s i d e r e d per se di sabl ed, a t l ea stt wo o fthe f o l l o wi ng “B cri ter i a” m ust a l so be prese nt: ( 1) “m ar ked” r est ri cti on ofact i vi ti es i n dai l y l i vi ng, ( 2) “m ar ked” di ffi cul ti es i n m aintai ni ng so ci alfuncti oni ng, ( 3) defi ci enci es of c on c en tr at ion , p er sis te n c e o r p ac e, or (4 ) “re p ea te d ep iso d es of d ec om p en sa tio n ea c h of ex te n d ed d u ra tio n .” 20 C.F
. R. § Pt. 40 4, S ubpart P . A p p . 1 , § 12. 04( B); se e C raft v. Astr ue, 539 F.3d 66 8, 67 4-7 5 (7 th C ir. 20 08 ); Randol ph v. B a rnh a rt, 386 F.3d 835 , 840 (8th C ir. 2004).8 N o. 09

- 4037 Dr. Cart erte sti fi ed tha t Lar son m et the “ A cr i ter i a” but had not sat i sfi ed the “B cri ter i a. ” He thought ( er ro neousl y, as we have pointed out) thatL ar so n had not been hospi tal i zed orbee n i n a g rou p hom e, and on that basi s he concl ud ed that she had neve r experi enced an ex te nde d e pi so de o fde com p ens at i o n. He was wi l l i ng t o c on c ed e t h at sh e h ad “m ar ke d ” re st ric tio n s in so ci ala cti vit i es , b uthe s aw o nl y “ m i l d” r es tr i ct i o ns on dai l y a cti vi tie s a nd no si gni fi cant l i m i tat i ons w i th re spect to concent ra ti on, per si ste nce, o r pace. H e o pined that Larso n shoul d work i n a l ow-st re ss, alc ohol- f re e envi ro nm ent t h at d id noti nvol ve l ar ge cro w ds. Dr. Cart erdi d not t ryto r eco nci l e his as sum pti on that L arson had not bee n h osp itali zed w ith H e r in k ’s prog re ss note r epor ti ng tha t Lar son had been t ake n to th e ho spi ta l by the po l i ce . Nordi d he c o nfr o nt Dr. Rho a de s ’ s c o nt r a di c t o r y fi nd i ngtha tLa r s o n had s u ffe r e d “ r e p e a t e d ” e pi so d e s o fd e c o mpe n s a t i o n . He al so sai d nothi ng ab out the rel evance to Li sting 12
. 04 of th e fr e q u e n ta dj u s t me n t s t o h e r me d i c a t i o n s . And alt h ou gh D r. C ar te r h ad be en p re se n t fo r L ar so n ’s t es tim o ny, he di d no t co m m en t o n h era ss er tion th ats he had suffe re d a ner vous bre akdown wh i l e work i ng as a bus dri vero r the f act that she had b ee n fi re d fr om th at p ositi on sh ortly thereafter. Aft e r th e h e a r i n g, th e ALJ de n i e d L a r s o n ’ s c l a i m. At St ep 1 of t h e fiv e-s te p a n aly sis p re sc rib ed in 20 C. F
. R. § 4 04. 15 20 , the A LJ found that Lar son had not e ngage d i n g a i n fu l e mpl o y m en ts i n c e h e r 2 0 0 4 o n s e td a t e . At St ep 2 the A LJ c oncl ud ed t h at Larso n suffer ed fro m seve re i m pai rm ents, nam el y, l eft an kle pai n, a l eft wri st f r ac tu r e, r i g htha nd o st eo ar th r i ti s, a ffec ti ve di sord er, a ndN o. 09

- 4037 9 anxi etydi sor der. A t S tep 3, h ow ev er, the A LJ c oncl ud ed th atno ne o fthe i m pai r m en ts was medi ca l l y e quivalent to anythi ng on t he l i sts
. A fterexpl ai ni ng tha t he w as adopti ng the o pini on o fDr. Cart er, the A LJ a ss er ted th at “the r e i s no ev i den ce i n th e r ec o r d th at th e cl ai m an t ha s ev ers uffer ed ane pi so de o fd ec o m pen sa ti o n o fe xte n d ed d u ra tio n d u e t o h er p sy c h ol o g i c al s ym p to m s.” The ALJ a ckno wl edg ed th atLa r so n was e xpe r i en cing re st ri cti ons i n so ci alfuncti oni ng, but he r eas oned that th o se r es tr i ctions wer e o nl y “ m o der at e” b ec au se s he att ended d oct or ’ s a pp oi ntm ents on a r egul arbas i s, was abl e t o go to the g ro cer y s tor e a l one if s h e w ent a t ni g ht, a nd ha d g o o d r el at i o ns hi ps wi th tw o fr i en ds. The AL J pe g g ed he r di ffi cul ti es m aint aini ngc o nc en tr at i o n, p er sis te n c e, an d p ac e a t t h e “ m od er at e” lev el. AtS t e p 4 the AL J s t a t e d th a th e h a d g i v e n “ s o me wei g ht ” to Dr
. Rho ade s’ s o pi ni o n tha t Lar so n metthe cri ter i a in the l i sting, but he f ound that R h oa d es’s as ses sm en t ofthe seve ri ty ofLars on’ s s ym ptom s was notsuffici en tly c o r r o bo r at ed. La r so n’ s t es ti m o ny abo utthe se ve r i tyo fhe r i m pai r m en ts , the A LJ tho ug ht, was i nc o nsi st en t wi thhe r a cc o untof her dai l y a ct i vi ti es . The A LJ c oncl ud ed that her“psyc hol ogi calsy m ptom s wax an d wane b as ed o n s i tu at i o nal st r es so r s. ” At S te p 5 , the ALJ c o nc l ud e d b a s e d o n the t e s t i mon y o fa v o c a t i onal expertthatLars on co uld workas a h an d package r or electron ics w orker.

II O n ap p ea l, L ar so n fir st arg u es th at th e A L J sh ou ld have gr anted co ntro l l i ng weight to the opi ni on o f10 N o. 09

- 4037 Dr. R hoades, w ho e asi l y qual i fi ed as her tr eat i ng psychi atrist, and fo und h erdi sabl ed atS te p 3
. La r so n mai nt ains th atthe a ss es smentg i ve n b y Rho ade s i s co ns i st en t

— or atl ea stno t i nc o ns i st en t

— w i th t h e evidence i n the re co r d. A tr ea tingphy si ci an ’ s o pi ni o n i s en ti tl ed to “c o ntr ollin g w eig h t” if it i s “ w ell-s u p p or te d by m ed ica lly acceptabl e cl i ni caland lab or ato rydi agno sti c te chniques an d is n otinc on sis te n t w ith oth er s u b st an tia l ev id en c e.” 20 C.F
. R. § 404. 1527 ( d)( 2) ; se e Sc haaf v. A s t r ue, 60 2 F
. 3d 86 9, 87 5 (7 t h C ir. 20 10 ); D e nt on v. As t r ue, 59 6 F
. 3d 419, 42 4 ( 7th Ci r . 2 01 0)
. An ALJ who do es no t g i ve c o ntr o l l i ngwei g htt o the o pi ni o n o fthe c l aim an t’ s tr ea ting physi ci an m ust o ffer“g oo d rea sons” f ordecl i ni ng to do so

. 20 C. F. R. § 404. 1527 ( d)( 2) ; se e Sc ha a f, 602 F. 3d at 875; Schm i dtv. As t r ue, 496 F.3d 833 , 842 (7th C ir. 2007). I fthe ALJ ha d g i ve n D r. Rho ade s’ s o pi ni o n c o nt r o l l i ng w ei ght, Lars on’ s co nd i ti on w oul d have be en r eco gni zed as a l i st ed i m pai r m en t an d s he woul d ha ve b ee n f o und disabl ed at St ep 3. S ee 20 C .F .R . § 40 4.1 52 0a (d )(1) ; C raft, 539 F. 3d at 675. A l l m edi calexper ts agr eed thatLars on m et the “ A c rit er i a” f ordepres si on, and Dr. Rhoades opi ned that she s ati sfi ed the “B cri ter i a” as w el l

. W i th re gar d to the l att er, D r. Rhoades saw “m ar ked” di ffi cul ti es i n Larso n’s abi l i ty to functi on s oci al l y. The A LJ offer ed s e v e r a l r e a s o n s f o r r ej e c t i n g R h o a d e s ’ s v i e w. F i r st, he f o und Dr

. Ca r te r’s op i ni o n mor e per su as i ve . In a ddi ti o n, he wa s im press ed by the e vi dence showingthatLars on at te nde d do ct o rs ’ a ppo i nt m en ts , wentg r o ce r y s ho ppi ng at n igh t, an d h ad goo d r ela tio n sh ip s w ith tw o frie n d s. A ll ofthi s ind i cate d to hi m that h er d i ffi cul ti es w er e j ust “m od erate.” Bu t the A L J m ischa r a c terized Dr. Carte r’sN o. 09

- 4037 11 opi ni on; Dr. Cart er, l ike Dr. Rhoades, had concl ud ed th at L ar so n ex p er i e n c ed “m ar ke d ,” n ot“m od er at e,” l i m i ta ti o ns i n thi s ar ea . W he th er by m i st ak e o r de si g n, the A L J d isr eg ar d ed th is m ed ica l ev id en c e a n d im p r o p e rly sub st i tuted hi s o w n opi ni on. S ee M urphy v. As t r ue, 49 6 F.3d 6 3 0 , 634 (7th C ir. 2007) (“[ A ]n A L J can not disregard m edi ca l ev i den ce si m pl y be ca us e i t i s at o dds w ith the A L J’s o w n u n q u alifie d op in ion .”); C liffo rd v. A pfel , 22 7 F. 3d 863 , 8 70 ( 7th Ci r. 20 00)
. The Com m i ssi onertr i es to sal vage the A LJ’ s co ncl usi on bypoi nti ng to o ne instance i n 200 4 when D r. R h oa d es described Larso n’s dem eanor as “pl eas ant a nd se ttl ed” and by re cal l i ng tha t the st ate
a g e nc y p s y cho l o g i s ttho ughttha tLa r s o n ha d o nl y “ mod

er ate ” l i m i tat i ons i n so ci alfunction in g. But thes e a re not re aso ns thatappear i n th e A L J ’ s o pini on, and thus they cannot be use d here

. S ee SE Cv. C hen ery C o rp . , 318 U
. S. 80 , 87-8 8 (1 94 3); Parke rv. As t r ue, 59 7 F.3 d 920, 92 2 ( 7th C ir. 20 10 ); St e wartv. As t r ue, 561 F.3d 679 , 684 (7t h Cir. 2009 ). Dr. Rhoades al so sta ted that Larso n h ad exper i enced re peated (by w hi ch he m eant at lea st thre e) epi sodes of d ecom p en sation. T he A L J d isagreed , insisting th a t th ere w as “no evi dence i n the re cor d that the cl ai m ant has eve r suffer ed an epi sode ofd ec om pensati on o fexte nd ed dur at i o n due to he r psy ch o l o g i ca l sy m pto m s. ” The A L J’ s concl usi on f ollow ed Dr. Cart er ’ s. But, as we noted ea rlier , bot h th e A L J an d D r. C ar t er ov er loo ke d th e e vidence f ro m H er i nk of Larso n’s sui ci dal thi nki ng an d trip to the ho spi tali n 200 6. Altho ug h ev ery o ne s ee m ed to thi nktha t he o r s he kn ew w h at is m ea n t b y “ ep iso d es o f d ec om p en sa tio n,” th is12 N o. 09

- 4037 i s n o ta s e l f

- de fi ningp hras e . Dr
. Ca r t e r t o o ka n a ppr o ac h tha t was t o o na r r o w i n l i g hto fthe de fi ni ti o ns th atthe S o ci alS ec ur i tyAdm i ni st r at i o n us es . The l i st i ng defi ne s “e pi so des o fde co m pen sa ti on” a s “e xa ce rba ti o ns o r t e m p o r a r y i n c r e a s e s i n s y m p t o m s o r s i g n s a c c o mpanie d by a l os s of a dap ti ve functi oni ng, as m ani fest ed by diffi cul ti es i n perf or m i ng ac ti vi ti es ofdai l y l i vi ng, m aint aini ngs o ci alr el at ionsh i ps, o r mai nt aini ngc o ncentr ati on, per sis te n c e, o r pace. ” 2 0 C. F. R. § Pt. 40 4, SubpartP. A pp . 1, § 12. 00; se e a l so S T ED MAN ’ S M ED I CAL D ICTIO NA RY, 49 7 ( 28th ed. 20 06) ( defini ng decom pensati on a s the “a pp ea rance o r exacerbati on o fa m ental d iso rd er d u e t o fa ilu re of d efe n se m ec h a n ism s” ); Z abala v. As t r ue, 59 5 F.3 d 402, 40 5 ( 2d Cir

. 20 10) ( sta ti ng tha t d ecom p en satio n i s a tem p orary i nc rease in sym p tom s); Kohl e rv. As t r ue, 546 F.3d 260 , 266 n.5 (2d C ir. 2008) (sam e). An inci den t

— su c h as h os p ita liza tio n or p lac em en t in a hal fw ay house

— that si gnal s th e n eed f ora m or e s tr ucture d psychol ogi calsupport syste m would qual i fy a s a n epi so de o fde co m pen sa ti o n, 2 0 C. F
. R. § Pt
. 40 4, S ubpa r t P. App. 1 , § 1 2. 00 , b uts o woul d m an y ot hers ce na r i o s. The l i s t i ng r e c o g ni z e s tha t a n e pi s o de may b e i nfe r r ed f ro m med i c a l r e c o r ds s ho wi ng a s i g ni fi c a nta l t e r a t i o n i n med

i cati on, se e 2 0 C. F. R. § Pt. 40 4, S ubpart P. A pp . 1, § 12. 00. Larso n has a l ong hi sto ry of probl em s that ha ve led to si gni fi cant al ter ati ons i n herm edi cati ons. S ee R a bbers , 58 2 F.3 d at66 0 (o b se rv in g t h at tre a t i n g p h ys icia n ’s t es tim ony that side effects of m ed ication affects claim a nt ’s abi l i ty to functi on i s co nsi ste nt with a fi nd i ng o fr epeate d epi so des o fde co m pen sa ti o n) ; Na ta le v. C o m m ’r of So c. Sec ., 651 F. S up p. 2d 43 4, 45 1- 53 ( W
. D. Pa. 200 9) (st ating thatN o. 09

- 4037 13 i t was e r r o r f o r ALJ t o r ej ec t tr ea tingphy si ci an ’ s co nc lu si on that cl ai m ant s uffer ed re peated e pis odes of decom pensati on wh er e c laim ant had hi sto ryo fadj ustm ents t o m edi cati on a nd fl uctuati ng m oo d); 3 S OCI AL S EC URITY L AW & P RACTI CE § 4 2 : 1 2 4 ( 2 0 1 0 ) ( “ Ep i sodes of dec o m p en sation m ay be d em ons trated by an ex acerb at ion in s ym p to m s o r sig n s th at w ou ld ord in ar ily re quir e incre ase d tre atm ent o r a less stre ssful si tuati on ( o r a c o m bina ti o n o fthe t wo)
. ”)
. Dr
. Ca r te r, de spi te b eing pr es en t f o r Lar so n’ s te st i m o ny, ne ve r ment i o ne d the n e r v o u s b r e a k do wnth a tc a u s e d h e r t o mi s s a l mo s tt wo we e k s o fwo r k ; tha ti nc i de ntqua l i fi e d as a n e pi s o de ofdecom pensati on, se e Lan kf or d v
. Sul l i van , 94 2 F
. 2d 301, 307-08 (6th Cir. 1991). I n additi on, al though the l i sting defi nes “ re pe at ed ep iso d es of d ec om p en sa tio n ” a s t h r e e e p iso d es w ith in one yea r oran a verag e ofo ne ev er y four m onths ( each l ast i ng f oratl eas t tw o w eek s) , the l i st ing a l so sta tes that f or cl ai m ants w ho experi ence m or e fre quent epi sodes o fs ho r te r dur at i o n, the ALJ shou ld det er m i ne i fthe du ra ti on a nd the fu n c ti onaleffects ar e o fequalse ver i ty. 20 C .F.R . § P t. 40 4, Su b p ar t P . A p p . 1, § 1 2.0 0. A fair re adingo fthe r ec ord i nd i cate s that Dr. Rhoades re ached ex ac tly the l at te r c o nc l us i o n abo utLa r so n. I n r es pons e, the Co m m i ss i o ne r make s m ucho fthe f ac t t ha t D r . Rho ade s di d no t ex pl ain o n the que st i o nna i r e h i s c o nc l us i o n tha tLa r s o n ha d e xp e r i enced re peated epi sodes ofdecom pensati on. But i n eve ryse cti on on th e qu estionn a ir e tha t all ow ed f or com m en ts, D r. R hoa d es m ad e the m ; the q ue stion d ealing w ith L arso n ’s functi onall i m i tat i on s a nd epi sodes ofdecom pensati on14 N o. 09

- 4037 did noti nvi te furtherexpl an at ion or i ncl ud e s pace f or com m en ts
. Al th o ug h b y i ts el fa c he ck

-bo x f o r m might be weak evi dence, the f or m ta kes o n gr eat ersi gni fi cance w h en it is su p p or te d by m ed ica l rec or d s. M ason v. Shalala , 99 4 F.2d 1058, 10 65 ( 3d Cir

. 19 93) ; se e a l so Jo h n s o n v. A pfel , 189 F .3 d 561, 564 (7th Cir. 1999) (up hold ing A L J’ s rej ecti on o fphysi ci an’s check-box f or m wh er e i t was contr adic ted byev i dence i n the re cor d). H er e, ther e i s a lon g re cor d oftr eat m ent b y Dr. Rhoades that supp or ts h i s n o t a t i o n s o n th e f o r m. I n ar gui ng tha t “ the A L J a lso pre m i sed hi s wei ghi ng o f Dr
. Rho ade s’ s as se ssmento n the f ac t th athi s tr ea tment no te s r efl ec te d ‘ waxi nga nd wan i ngs y m pto m s’ de pen di ng on par ti cul arsi tuati onalst ress or s, ” the Com m i ssi oner dist or ts the AL J ’ s r eas oni ng. The A LJ s i m plyst ate d th at“ th e cl ai m an t’ s psy ch o l o g i ca l s y m pto m s wax a nd w an e b a se d on sit u at ion al s tr es so rs ” w ith ou t t yin g t h is observ ation to D r. Rh oad es’s t reatm en t note s. M ore i m port antl y, sym ptom s that “ w ax and w ane” ar e no t i nconsi ste nt with a di agno si s o fr ecurr ent, m aj ordepres

si on. “A perso n w h o h as a chr oni c di sea se, wh ether physi calo r psychi atr i c, and i s under contin u ou s t re atm en t for i t with heavydrugs, i s l i kel y t o have bett er days a nd worse days. ” Ba u e rv . A s t r ue, 5 32 F. 3d 606, 60 9 ( 7 t h C i r . 2 0 0 8 )
. N o d o c t o r c o n c l u d e d th a tL a r s o n ’ s s y mptom s were j ust a r esp onse to si tuati onalst re sso rs as opposed to ev i dence ofdepres sion . T he A LJ’ s co ncl usi on t o the c o nt r a r y thu s fi nd s no supp o r ti n the r e c o r d. Se e Hopgoo d ex re l
. L. G. v. As t r ue, 57 8 F
. 3d 696, 70 2 ( 7th C ir. 2009).N o. 09

- 4037 15 Even i fthe A LJ had ar ti cul ate d goo d rea sons f or re j ecti ng Dr. Rhoades’ s o pini on, i t s ti l l would have been necess ar y t o deter m i ne wh at w ei ght his o pini on was due u nd er the a ppl i cabl e r egul at i o ns . S ee 2 0 C. F
. R. § 4 04. 1527 ( d)( 2)
. A n A LJ m ust consi der the l ength, natur e, and extent ofthe tr eat m ent r el ati onshi p; fre quency ofexam i nati on; the physi ci an’ s sp ec ialty ; the types of tes ts perf or m ed; and the consi ste ncy a nd support f or th e p h ys icia n ’s o p in ion
. M os s v. As t r ue, 555 F
. 3d 556, 56 1 (7t h C ir. 20 09 ); El d e r v. As t r ue, 52 9 F
. 3d 408, 41 5 ( 7th C ir. 20 08 ); H o

fslien v . B a rnh a rt, 439 F. 3d 375, 3 7 7 (7 t h Cir. 2006 )
. These f acto rs support D r. R hoades: he ha d tr ea te d L ar so n for s ev er al y ea rs on a m on th ly b as is; h e is a p sy c h iat ris t, n ota p sy c h olo gis t ; a n d h is op in ion is c on si ste nt with the e vi dence i n the re cor d. A part f ro m th e AL J ’ s unhe l pfuls tatem enttha t Dr
. Rho ade s’ s o pi ni o n was entitled t o “ so m e wei ght, ” th e AL J s ai d no th i ng r eg ar di ngthi s r equi r ed che ck l i sto ff ac to r s. S ee 2 0 C. F
. R. § 4 04. 1527 ( d)(2 ); M o ss , 555 F.3d at56 1; B a uer, 53 2 F
. 3d at 60 8-0 9. Thus , the ALJ e r red b y fa i l i ngt o g i ve c o nt r o l l i ng w eight to Dr. Rhoades’ s o pini on about the l i m i tat i ons on Larso n’s so ci al functi oni ng and herexper i ence w i th epi sodes ofdecom pensati on. Once we gi ve hi s o pini on th e p ro p er w eig h t, th e re c or d sh ow s t h at L ar so n ’s c on d iti on m eet s the s ta n dards o fthe List i ng, and thus that the AL J sho uld have f ound her di sabl ed at St ep 3.16 N o. 09

- 4037 III O u r c oncl usi on i s r ei nfo rce d by the pro bl em s we see in the approach the AL J to ok i n hi s a sse ssm ent o f Larso n’s cr edibi l i ty. N or m al l y, w e g i ve an A LJ’ s cr edibi l i ty d et er m in at ion s s p ec ial d efe re n c e b ec au se th e A L J is i n the bestposi ti on t o see an d h earthe w i tness
. S ee Eic hs t adt v
. As t r ue, 534 F.3d 663 , 667-68 (7th C ir. 2008). Bu t i t is n eve rthel ess poss ibl e t o up seta cre dibi l i ty fi nd i ngi f, a ft e r e xa mi ningthe ALJ ’ s rea s o ns f o r di s c r e ditin g t e s t i m o n y, w e c on c lu d e t h at th e fin d in g is patentl y wrong. S ee Sc ha a f, 60 2 F .3d at87 5; Proc has ka v
. B a rnh a rt, 4 54 F
. 3d 73 1, 7 38 ( 7th Ci r . 2 00 6); S i m s v. B a rnh a rt, 442 F.3d 536 , 538 (7th C ir. 2006). H er e, the ALJ r ej ec te d Lars o n’ s te st i m o ny abo utthe seve ri ty ofher sym ptom s. The A LJ s ugges ted thatLars on m ust hav e o ver sta ted the effec ts ofheri m pai rm ents b e c a u s e s h e h a d d e v e l o p e d r e l a t i o n s h i p s wi th t wo f ri ends w hom she vi si ted o ften, she had “hel d d ow n” a ser i es of p art- ti m e j obs , and she had accom m odated her fearo fthe pu bl i c bygo i ng to the gr oce ryst or e a t ni ght. But La rs on ’ s abi l i ty to m ai ntai n a s m al l num ber o fc l o se fr i en dsh i ps do es no t un d er m i ne he r t es ti m o ny th at sh e is a fr a id o f going ou t in pu bli c. A nd the A L J’ s a s s e r t i o n th a tL a r s o n h a s s u c c e e d e d i n ho l d i n gd o wn a se r i es o f par t- ti m e j o bs st r et ch es th e ev i dence bey o nd the b re aking p oint. There i s a si gni fi cant di ffer ence betwe enb eingabl e to wor ka few h ou rs a wee ka nd ha ving t h e c a p a c i t y t o w o r k fu l l t i m e . S e e S S R 9 6

- 8 p , 1 9 9 6 WL 37 41 84 , at *1 ; Di a z v . Pr u d e n t i a l In s . Co
. o f A m. , 49 9 F
. 3d 640, 64 8 (7 th C ir. 20 07 ); C a rrad ine v . B a rnh a rt, 36 0 F
. 3d 751, 75 5N o. 09

- 4037 17 ( 7th Ci r . 2 0 0 4 )
. La r s o n wa s ab l e t o wo r k f o r Ca l l i s s part
ti m e o nl y b ec au se he was a fr i en d who to l er at ed f r eque nt b re ak s a n d ab se n c es th at an o rd in ar y e m p loy er w ou ld have f ound un acceptabl e. Thi s doe s no t c on tradic t her cl ai m o fdi sabi l i ty. S ee Hend erson v. B a rnh a rt, 34 9 F. 3d 434, 43 5 ( 7th Ci r. 20 03)
. In f act, i t i s no t a ccurat e t o say that L ar so n “hel d dow n” ( m eani ng k ept) thes e par tti me j o b s . S h e t e s t i fi e d wi th o u tc o n t r a d i c t i o n th a ts he w as fi re d fr om herj ob at H ead S tar t beca u se of her nerv ous b re akdown and the m edi cati ons she was ta ki ng, an d s he qui t he r j o b at th e g as s ta ti o n b ec au se o fthe st r es s i n de al i ngwi thunf ami l i arc us to m er s. La st, the AL J ’ s co nc l us i o n tha t Lar so n ac co m m odate d her fearo f g o i ng o ut i n publ i c do es no t di sc r edi t he r testi m o ny that she ha s a fea r ofgo i ng o ut i n publi c and gi ves i n to th atfea r r egul arly

. Nothi ngi n the r ec o r d s uppo r te d the A L J’ s inference that there w ere w ays in w hi c h L arson ’s condi ti on co uld be tr eat ed orm an ag ed

. S ee M yl e s v. Ast r ue, 582 F.3d 672 , 677-78 (7th C ir. 2009). T he A L J’ s r ea so ns f o r hi s adv er se c r edibi l i tyr ul ing fi nd no su ppo r t, o n c l o se e xa m i na ti o n, a nd for tha t r ea so n, the c r e dib i l i t y de t e r mi na t i o n c a nn o ts t a nd

.
IV Forthes e r eas ons, we fi nd thatLars on i s e ntitl ed to an award ofbene fi ts. The A L J’s d eci si on i s R EVER S ED and the ca se i s R E MANDED f o r e nt r y o fa n o r derc o nsi st en t wi ththi s o pi ni o n.

8- 3- 10