## 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. 11

- 2424 L AENIS E A RNET T, 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.

A pp eal from the United S t ates Di strictC our t fo r the N o rthernDi stricto f Indian a, Fo rtWayne D ivisi on. No . 1:10- CV-226 RLM

—Rob ert L. Miller, Jr. , Judge

.
A RG UE D D ECE MBE R 14, 2011

— D ECI DE D A PRI L 2, 2012

Befo re P OSNER, M A NI ON, a nd W OO D , C ircu it Judges . W OO D , C ircu it Judge. La e ni s e Ar ne t ts uffe r s fro m a num bero fm edi calpro bl em s, inc l ud i ng per i pheral vascula r dise ase , chr oni c o bstr ucti ve pu l m onar y di sea se, o st eo ar th r i ti s, o bes i ty, v as cul arde m en ti a, de pr es si o n, pan i c di so r der, a nd a nx iety . As a r es ul t, s he s o ug ht Disabi l i ty I nsurance Benefi ts (“DI B”) fro m the So ci al Se curi ty A dm i ni str ati on ( “SS A ”) , but she was u nsuc-2 N o. 11

- 2424

c es sfu l be for e t h e a ge n c y. A fte r th e A p p ea ls C ou n c il denie d rev i ew o f the A dm i ni str ati ve Law J ud ge’ s a dvers e dec i si o n, s he sou g htr ev i ew i n the di st r i ctc o ur t pur su an t t o 4 2 U .S.C . § 40 5(g ). O n c e a ga in, s h e d i d n otp re va il. S he no w appea l s to thi s co ur t, s ee k i ngt o pe r su ade us that the Ad m i ni st ra ti ve Law J ud ge ( “A LJ”) f ai l ed p r o p e r l y t o a s s e s s h e r r e s i d u a l fun c t i o n a lc a p a c i t y . We ag r ee wi thhe r, a nd s o we r emand he r c ase t o the age ncy f orfurtherpro ceedi ngs.

I A rnet t a pp l i ed f orDI B i n J u n e 2004, cl ai m i ng an onse t date o fJ une 1 4, 20 02. A fterthe SS A deni ed her ap p lica ti on, she re quested a hear i ng be f or e a n AL J

. Arn et t, who was 4 5 atthe t i m e, a sser te d tha t th e ar ra y o f m ed ica l ailm en ts w e d es c rib ed ea rlier m ad e it i m possibl e fo r her to w or k. H erappli cati on descr ibed he r pas t w ork as a sorter a n d ins p ector at a factory fro m 1 99 1 to 1 992, as a new spaper sor terfro m 19 94 to 1996 or 1997, as a hom e heal thcar e ai de fro m 1998 to 1999 , and as a c er tifi ed nursi ng as si sta nt fro m 20 01 to 2002
. A ftersur ger y in J une 20 02 and thro ugh m osto f20 03, sh e wor k ed ei g htho ur s perwee ka s a ce r ti fi ed nur sing as si st an t. S om et i m e ar o und the e nd o f2 00 3, s he f o und that she was unabl e t o continue. I n Decem ber20 04 A rnet t updated her appli cati on w ith info r m a t ion ab ou t t h e re c en t re m ov al of a ve in fro m on e o f h er legs , a p ro c ed u re th at lefth er w ith p ain an d s wel l i ng . S he a dded th ata fte r e xpe r i en cing a “ m i ni st ro ke” she al so w as havi ng m or e di ffi cul ty w i th bal ance an d e xpr es singh er thought s. Arn et t an d he r husba ndN o. 11

- 2424 3 ( w ho s ubm i tte d a wri tte n sta tem ent d es cribi ng how A rnet t’ s m edi calco nd i ti on i m peded herdai l y a cti vi tie s) b o th a s s e r t ed tha tAr ne t tc o ul d c a r e f o r h e r s e l fa nd do l i ght ho usew or k a t a sl ow p ace, bu t th at she s om eti m es wa s u n ab l e t o d o l a u n d r y o r s h o p f o r g r o c e r i e s . An S S A e m pl o y ee i nt er vi ewe d he r ar o und th i s ti m e and r epo r te d tha t Arne ttdi d no t appe art o b e expe r i en cing a n y d e b i l i t a t i n gp r o b l e m. Ar ne t th a d s ub mi t t e d m o s to fh e r me di c a l r e c o r ds fr o m 2 0 0 2 thr o ugh 2 0 0 4 b y the t i me s he r e qu e s t e d a hear i ng be f or e a n A LJ in M ay 2005
. The se r ec or ds show that she vi si ted Dr. Fr ed Rasp, a pu l m onol ogi st, se ve ra l ti m es i n l ate 20 01 com pla i ni ng ofwh eez i ng, co ughi ng, and chest ti ghtnes s, and that she w as d i agno sed with ano bs truct i ve l ungde fect an d e ar l y e m phy se m a. Abo ut a m onth l ater, A rn ettwent to Park vi ew H ospi taltwice ; th e fi r s t t i me s he wa s s e e n i n the e mer g e ncy r oo m f orco m pla i nts o fches t pai n and nausea a n d was dia gn os ed w i th ea rl y e m physem a a nd chr oni c o bstr ucti ve pul m o na r y di se as e ( “COPD” ) , a nd dur i ng th e se co nd vi sit f ora car dio l ogyco nsul tat i on s he co m pla i ned of chest pai n and shor tness of breath and w as diagnose d w i th per i pheralvas cul ardi sea se ( “PVD ”) and obe sity
. Se ve ra l m on th s la te r h e r P V D w as d es c rib ed as “s ev er e.” To address h erPVD , A rnet t underwent aor tob i fem or al by pass sur g ery i n J une 2 00 2. S he b eg anc o m pl aini ng of sw ell ing an d cram p ing in her legs l ater th at year. I n the spri ng o f 2 00 3 Arnett had an M RI, wh i ch re veal ed degener ati ve disc dise ase i n tw o thor aci c vert ebra l di scs and m i l d d eg en er ati ve f acetar thri ti s in her4 N o. 11

- 2424 l um barve rt ebr a. W hi l e c h ec king up o n A rnet t in l ate 20 0 3 , Dr

. Ra s p c o nfi r med the c a r di o l o g i s t ’ s o pi ni o n that sh e s u ffer s f r o m P V D . A b ou t s ix m on th s la te r a t h or ac ic surg eon note d i n c re ase d steno si s in so m e a rt er i es. Shor tl y there after, in J uly20 04, A rnet t underwent a b allo on an gio p las ty . A few m on th s la te r sh e w as ag ain dea l i ngwi ths te no si s an d st il l c o m pl aini ngo fl egpa i n, w hi ch herdocto rs address ed w i th se ver alpro cedures i ncl ud i ng a seco nd angi opl asty. A rnett c ontinued to c o mpl a i n o fl e gc r a mpi nga nd we a k ne s s a ft e r wa r d. Se ver alo therphysi ci ans a l so had subm i tte d consul tati on r epor ts by the t i m e Arnett re qu es ted a hear i ng. Dr. Gal en Yor dy, a consul ting psychol ogi st w ho m et w ith A rn et t, d iag n os ed h er w ith an x iet y d iso rd er , p a n ic d iso rd er , an d d ep re ss ive d iso rd er . D r. Jay a K a r n an i, a co ns ul tingphysi ci anwho pr ac ti ce s f ami l y medi cine an d m e t w i t h A rn et t, op in ed th at A rn et t’s an x iet y is contr ol l ed effecti vel y w i th m edi cati on a nd had not caused hertr oubl e co ncentr ating o r w i th so ci ali nter acti ons. On the neg ati ve si de, he fo und thatA rnet t has em p h ys em a and PVD thatpre vent her fro m st anding or w al ki ng f orm or e than two h ou rs perday. Dr. Kenn eth Bu nd z a , a c o ns ul t i ngp s y c ho l o g i s twh o me twi th Ar ne tt, foun d th at sh e w as alert bu t w as ex p eriencing d if

fi cul ty re tr i evi ng i nfo rm ati on fro m m em or y; he diagno s e d h e r wi th va s c ul a r de men t i a wi th de pr e s s e d mo o d. Dr. Yaro sl ev Pago re l ov, a consul ti ng f am i l y- prac ti ce physici an wh o had m et w i th A rnet t, o pined thatA rnet t su ffer s fro m em p h ys em a, P V D , a n x iet y, an d righ t-a n kle s we l l i nga nd i nab i l i t y t o wa l kmo r e tha n fi v e mi nu tes orst and m or e than 10 m i nutes at a t i m e. Tw o set s o fst ate
-N o. 11

- 2424 5 ag en cyphy si ci an s al so e val ua te d Arn et t’ s r ec o r ds. The fi rs t tw o opi ned th at A rnet t s uffer s fro m depres

si ve, pani c, and anxi etydi sor ders, th ou gh none of them se ver e. The s eco nd two opi ned that A rnet t has em p hy sem a a n d PV D , and that she occ asiona ll y can l ift orcar ry20 pound s, can fre quentl y l i ft o r car ry10 pound s, can sta nd o r wal kf o r a t l ea stt wo h o ur s perda y, a nd can si t forabo ut si x hours perday. Ar ne t ts ub mi t t e d mo r e me di c a l r e c o r ds t o the ALJ i n A pri l and M ay 2007, m ost l y fortr eat m en t rece i ved i n a nd a fte r 2 00 5. One s etr el at ed to he rs ec o nd angi opl asty i n l ate 20 04 and i ts f ai l ure to re sol ve her pr o bl ems. The se r ec o r ds do cumenttha t Arne ttc o ntin u ed to co m p lain of p ain i n h er legs an d be ga n ex p er ienci ng pai n i n herr i ght a rm , and that her vas c u lar su rg eo n d id n otbe liev e t h e p ain w a s o f va sc u lar orig in an d w as u ns ure of th e cau se. I n late 2005 , A rnet t ’s ar ter i es w er e a gain bl ock i ng up du e t o ste nosi s, and so she underwent a thi rd angi opl asty. B ec au se A rn et t c on t i n u e d to co m p lain of p ain in 2005 and 200 6, hervas cul arsur geo n re fer re d her to a neuro l ogi st, wh o diagnose d her w i th l um bosa c ra l neur i t i s b utdi d n o tfi nd a n e ur o l o g i c a l e xp l a na ti on f o r A r n e t t ’ s l e g a n d a r m p a i n . S h e a l s o s a w a rheum ato l ogi st, wh o thought that her l eg p ain was not a r esul t o f a rheum ato l og i cali m pai rm ent a nd thather ar m pain was pr o babl y fr o m te nni s elbo w. Dr

. A nantha Re d dy, wh o speci al i zes i n physi calm edi ci ne and r ehabi l i tat i on, sugg est ed that A rnet t’ s l eg pai n coul d be a r e s u l to fa s p i n a l p r o b l e m.6 N o. 11

- 2424 Late in 200 6, A rnet t co m pla i ned ofpai n i n herl ower bac k, hip s, an d ri gh t arm and han d

. X-rays sh o w e d narro w i ng o fA rnet t’ s l eft and ri ght knee j oi nt space s, and A rnet t’ s r heum ato l ogi st dia g no s e d he r w i th os te oa rt h rit is a n d st en os in g t en os yn ov itis (a ty p i c ally pai nfulco nd i tio n thati nvol ves a fi ngerbec om i ng stuck i n a b en t pos i ti on, and l ate r snapping backi nto a str ai ght pos i ti on)

. A rnet t was exper i enci n g b l ock age in s om e of he r arteri es again in sp ring 2007, and un d erw ent a f ourth angi opl asty. Se ve ral o fA rnet t’ s t re ating physi ci ans s ubm i tte d rep orts of he r resi d ua l fun ctiona l cap acity (“RFC ”). A rnet t’ s pri m ar y physi ci an ( unti l 2006 ) opi ned that A rnet t c an n o t lift or c ar ry ev en 10 p ou n d s, ca n n otst an d or w alk f orev en two hour s in an e igh t- hour w or kday, and m ust peri odi cal l y a l ternate between sitti ng and st anding. Dr

. Do n S ta l l m an, he r c ur r en t pr i m ar y phy si ci an, c o ncl ud ed that A rnet t ca n si t for u p to 20 m i nutes a t a st r et cha nd f o r t wo h o ur s to ta l dur i ngthe da y, s ta nd con ti nuo us l y f o r 1 5 m i nut es b utno mor e th ano ne hour tot al d u ring a day, walk30 feetbefor e s toppi ng, an d carry up to five pou nd s fre q u e n t ly bu t not m ore th an 1 0 po unds e ve n o cc as i o na l l y . Dr

. Ra sp, Arn et t’ s tr eat i ng pulm onol ogi st, co ncl ud ed that she c an si t for up to ei ght ho urs at a t i m e, can sta nd co n tin uousl y for tw o h ou rs an d a t ot al of fo u r h ou rs p er d ay , an d w alk f or15 m i nutes a t a ti m e a nd two hour s t ota l i n a work day. A t the hear i ng be f or e the A LJ o n M ay 31, 20 07, A rnet t an d a voca ti onalexper t t est i fi ed. A rnet t s ai d that he r l eg s cr amped a nd s he e xpe r i en ce d di ffi cul tyb r eathi ngN o. 11

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w hen she had tri ed to w or k as a heal th ai de afterher 2002 ao rt obi fem or alby pass s urge ry . S he r epor te d that she s ti l l has cra m ping a n d w eakness i n herl egs as a r es ul t o fhe r PVD, a nd thi s m akes it di ffi cul t to s ta nd f or m or e t h an 20 m in u te s a t a tim e. T h e o st eo ar th rit is i n h er h ip s, ar m s, and backm ake s i t di ffi cul t forherto sitfor v er y l on g, an d sh e b elie ve d th at h er os te oa rt h rit is had been g ett i ng worse . H erCOP D a t ti m es causes c he s tp a i ns a nd ty pi c a l l y l e a v e s h e r t i r e d, l i g ht

- he a de d, dizz y, and shor t o fbr eath. S he al so t est i fi ed that her ha nds c r amp an d tha t so m et i m es s he ha s trou bl e co nce nt r at i ng . The v ocat io na l e xpe r t ( “VE” ) o pi ne d tha t no j ob w ou ld be av aila b le for A r n e t t if th e A L J fu lly cre dit ed herte sti m ony. But, the VE co nti nued , i fA rnet t ca n per f o r m se den ta r y wor k, wi th th e l i m i ta ti o n th at th e j o b m us t p erm ita l te r na tingb etwee n s i tt i nga nd s ta ndi ng thr o ugho utthe wo r k da y, the n s he c a n wo r ka s a f oo d ser vic e or der c l er k, a bench worke r ( ther e a re se ver al ty pes i n the Di ct i o na r y o fOc cupa ti o na l Ti tl es , b utthe expertdi d not s peci fy which on e h e had i n m i nd ) , o r a su rveil lance m onitor. T he A L J f o und Ar ne ttno t di sabl ed afte r a na l y zing th e fi ve st eps i n 20 C. F

. R. § 40 4. 15 20
. At S te p 1, the A LJ de t e r mi ne d tha t Ar ne t t ha d no t e ng a g e d i n substa nti alga i nfulact i vi ty between the c laim ed onse t o f h e r d i s ab i l i t y a n d th e d a t e s h e wa s l a s ti n s u r e d

. At S te p 2 , the ALJ c o nc l ude d tha t Arne tt ’ s PVD a nd COPD ar e seve re , but that her anxi ety, panic, an d d epres si ve d i sor ders ar e no t; he di d not m enti on hero therphysi cal an d m en ta l i m pai r m en ts
. At S te p 3 , a fte r discus sing Li st i ng s 4. 12 ( PVD) a nd 3

. 02 ( COPD) , the ALJ f o und8 N o. 11

- 2424 that A rnet t doe s no t hav e a n “i m pai rm ent o r com bi nat i o n o f i mpa i r men t s ” mee t i ng o r med i c a l l y e qu a l i ng a l i st i ng ; he did n ot e l ab o r at e o n thi s co nc l us i o n o rc o nsi der a ny o therspeci fi c l i sting. Ne xt, the ALJ a s s e s s e d Ar ne t t a s ha v i ng the RFC to perf or m se dentaryw or k with the f ol l owing l i m i tat i ons: car ry i ng “up to 10 pound s o ccasion al l y a nd l ess than 10 pound s fre quentl y, ” s i tting f ors ix h ours o f an e i g ht

- ho ur da y, wa l k i ng f o r t wo ho ur s o fan ei g ht

- ho urda y, a nd a l te r na tingb etwee n s i tt i nga nd st an di ngthr o ug ho utthe da y . He e xpl aine d thi s co ncl usi on a s fol l ows. Fi rs t, he e valua ted the w ri tten s tatem ents subm i tte d by Arnett and her husb an d d escr ibi ng herdai l y a cti vi ti es and l i m i tat i ons, as w el l as herhusband’s st ate m ents to the S SA by te l ephone abo ut A rnet t’ s m em or y pr obl em s a nd exhausti on, and A rnet t’ s o ra l te sti m ony. But the A LJ deci ded t h a t w h at A rn et t h ad sa id w as “n oten tir ely cr ed ible ,” an d he d id n ot ad d ress th e cred ibi lity of he r hu sba nd ’s sta tem ents. The A LJ di scusse d the op ini ons ofse ver al tr eatingo r c o ns ul tingphy si ci an s an d e xpl aine d why h e a c c e p t e d o r r ej e c t e d e a c h

. Wi th o u te x p l a n a t i o n, h o weve r, he di d not m enti on Dr. Bun d za orDr. Yor dy, w ho had di agnos ed A rnet t with m entali m pai rm ents. I nd eed, atthi s s tag e the o pini on di d no t m en ti on qui te a few c o ndi ti o ns tha t ha d b ee n pr es en te d i n the ev i den ce : de pr es si ve , a nxi ety, a nd pa ni c di so r der s; v as cul ardem enti a; l um bos acr alneuri ti s; o ste oar thri ti s; degener ati ve discdi sea se; degene ra ti ve changes in her sacr oi l i ac j oi nts; o r fi nal l y hero besi ty.N o. 11

- 2424 9 F i na l l y, i n c o nc l ud i ngh i s ana l y s i s a tS t e p 4 , the ALJ ackno w l edged thatthe RFC assi gned to A rnet t pr ec ludes h er from p er for m in g h e r p as t w or k. T h is re q u ire d h im to m ove to S te p 5 , wher e th e Comm i ss i o ne r b ea r s th e bu r deno fpr o o f

. The r e, the ALJ c o nc l ude d tha t Arnett ’s RFC nev er thel ess al l ows her to perf or m seve ra l types o fj o bs whi ch, a cc o r di ngt o the VE, numbe r in th e hun

dreds i n nor theas tern I nd i ana.

II On app ealto thi s co urt, A rnet t t ake s issu e with eve ry th in g e x c ep t t h e A L J’s S te p 1 fin d in g, w h ich w as in her f avo r. A t St ep 2, she say s, the A LJ f ai l ed to ev al uate th e s e v e r i t y o fe a c h i mpa i r me n t
. AtS t e p 3 , i n h e r v i e w, the A LJ e rr ed by f ai l i ng to ev al uate her i m pai rm ents c o l l e c t i v e l y wh e n he c o ns i de r e d the l i s t i ng s . T hi r d, she a rgues t h at t he A LJ’ s RFC deter m i nati on i s fl aw ed because i t doe s no t incor pora te al l o fheri m p ai rm ents and l i m i tat i ons. Final l y, s h e argues that the A LJ e rr ed atS te p 5 b y f ai l i ngt o a cc o untf o r a l l o fher l i m i ta ti o ns inth e h y p ot h et ica l give n th e V E . A rn et t d oe s n otch all enge the A LJ’ s deci si ons to gi ve som e p h ysi ci ans’ opi ni ons l ess than fullweight. B ecau se th e A p p eals C ou nc ilde nied review , the A L J’ s d ec isio n is th e fin al d ec is i o n of th e a ge n c y. O ’C o nn o rSpin ne rv. As t r ue, 627 F. 3d 614, 618 ( 7th Cir

. 20 10 ). I n re vi ew i ng the A LJ’ s deci si on, thi s cou rt ev al uates w h et h er su b st an tia l ev id en c e s u p p or ts it. Id. I m port antl y, we m us t co ns i der o nl y th e r at i o na l e o ffer ed bythe A L J. Sc o tt v . As t r ue, 647 F.3d 734 , 739 (7th C ir. 2011).10 N o. 11

- 2424 A rnet t’ s S tep 3 cl ai m i s no t pr operly b efore thi s co urt, b ec au se sh e failed to ra ise it in th e d ist r i c t co u rt
. Sk a rbek v. B a rnh a rt, 39 0 F. 3d 500, 50 5 ( 7th Ci r. 20 04); Shra m ek v. A pfel , 226 F.3d 809 , 811 (7th C ir. 2 000). W e the refore d o not d iscus s it furth er. A l l thr ee ofA rnet t’ s o thercl ai m s a ss er t, i n one w ay orthe othe r, thatthe A L J fail ed to co nsi der the i m pact ofal l o fheri m pai rm ents tak en to gether. H erar gum en ts about St ep 2 a nd S tep 5 boi l dow n to a conte nti on that the ALJo v e r s t a t e d h e r R F C b y ma k i ngthi s mi s tak e. Bu t e ven i fther e were a m i sta ke at St ep 2, it does not m atter. Dec iding w h e t he r i m p airm en ts are severe atS t e p 2 i s a th r e s h o l d i s s u e o n l y ; a n AL J mu s tc o nt i nue on t o the r em ai ni ng st eps o fth e ev al uati on pro cess as l o nga s th er e ex i st s ev en o ne se ve re im p air m en t. C a st il e v. As t r ue, 6 17F

. 3d 9 23, 9 27

- 28 ( 7th Ci r . 2 01 0)

. Her e, the A LJ c at ego ri zed two i m pai rm ents as seve re , and so any e rr oro fo m i ssi on was har m l ess . S ee i d. A rnet t’s c o nt e nt i o n tha ta tS t e p 5 the ALJc o ns t ruc t e d a hy po th eti ca l b ui l t ar o und a fl awe d RF C adds no th i ng to her chal l en ge to the RFC. A s Arnett hers el fsa ys, “[ b] ecause the A LJ use d a fl aw ed RFC as the bas i s for th e h yp ot h et ica l qu es tio n to th e V oc at ion al E x p er t . .
. h is h yp ot h et ica l qu es tio n to th e V E w as als o flaw ed .” Th us , Ar ne t t ’ s a pp e a l co mes do wn t o wh e the r the ALJ e r r e d in a s s e s s i ngh e r R F C. A rnet t focuse s o n the A L J’s f ai l ure to consi der he r m entali m pai rm en ts in a rr i vi ng atthe RFC, as w el l as hi s l ack ofat tenti on t o her l um bos acr alneuri ti s, o besi ty, ost eoa rthri ti s, degene ra ti ve disc d i sea se, o r degener a-N o. 11

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t i v e c ha ng e s i n he r s a c r o i l i a c j o i nts. S he a l s o c o nt e nd s that the RFC does notr efl ect her need to el evat e herl egs . A n A LJ m ust e val uate al l r el evant e vi dence w hen deter m i ni ng an appli cant’ s RFC, i nclud i ng ev i dence of im p airm en ts th at are not severe. 20 C.F. R . § 404.1545(a); Craft v. A st r ue, 539 F.3d 66 8, 67 6 (7 th C ir. 20 08 ). Th is cour t uphol ds an A LJ’ s deci si on i fthe evi dence supports th e dec i si o n a nd the ALJ expl ains hi s an al y si s o fthe ev i den ce wi th eno ug h de ta i l a nd c l ar i tyt o pe r m i t m ea nin gfu l rev iew
. Eichsta dt v. As t r ue, 53 4 F

. 3d 663, 66 5- 66 ( 7th Cir. 2 008)

. A l though a n A LJ nee d not m enti on e v e r y s ni pp e to fe v i de nc e i n the r e c o r d, the ALJ m ust co nnect the ev i dence to the co ncl usi on; i n so d oin g, h e m ay n otign or e e n t i r e l in es of co n tr ar y e vid en c e. D e nt on v. As t r ue, 596 F.3d 419 , 4 2 5 (7th Cir. 2010); Si m i l a v. As t r ue, 5 73 F .3d 5 03 , 5 16 (7t h C ir. 20 09 ); Zur awsk i v. Hal t er, 24 5 F

. 3 d 8 8 1 , 8 8 8

- 8 9 ( 7 th Ci r . 2 0 0 1 )

. An ALJ m ust a l so an al yze a cl ai m ant’ s i m pai rm ents i n com bi natio n . Ter ry v . As t r ue, 580 F.3d 471 , 477 (7th C ir. 2009). The A LJ di d take i nto acco unt A rnet t’ s t est im ony that she m ust o ften e l evat e her leg s. But afterr efer ring to her tes ti m ony, the A LJ di spara ged herev i dence w i th th e a ll-to o-c om m on an d u n h elp fu l “n oten tir ely cr ed ibl e” re m ar k. S ee Parke rv. As t r ue, 59 7 F

. 3d 920 , 9 22 ( 7th Cir

. 20 10)

. A rnet t i s no t chal l engi ng the cr edibi l i ty fi nd i ng, wh i c h i s j ust a s wel l, since s he di d not r ai se thi s poi nt i n the di str i ct c ourt
. S ee Sh ram ek, 22 6 F

. 3d at 811. T h e f ir st signifi can t prob lem that w e see is the A L J’ s f a i l u r e t o i n c o r p o r a t e a d e q u a t e l y A r n e t t ’ s me n t a l i mpai rm ents i nto the RFC. Dr. Yor dy dia gnos ed A rnet t12 N o. 11

- 2424

w i th d epres si ve, anx i ety, and p ani c d i sor ders. D r. Bund za di agno sed Arne ttwi thv as cul arde m en ti a, r epo r ting th at sh e h ad so m e “ fair ly ob vio u s c og n itiv e p ro b lem s,” in c lu d in g d ifficu lty u n d er st an d in g d ire c tio n s, slo w ly resp ond ing to sim p le que stions, a l ow -average o r bord erl i ne r ang e o fi nt el l i g en ce , a nd “ f ai r l y s i g ni fi ca nt retrieval p roblem s.” Th e A L J d iscus sed Dr. Yord y’s diagnose s a t S tep 2 ofthe a n al ysi s, and the A LJ e ven say s that he “tr ansl ate d” hi s S tep 2 deter m i nati on “into w ork-rel ated fun ctions ” in assess ing A rnet t’s R FC , bu t t h e d ec isio n offe rs n o h in t a b ou t h ow h e d id so. The A LJ nev erm enti oned thatA rnet t h ad b een di agnose d w i th va scul ardem enti a. The Com m i ssi on ersuggest s th atthe se o m i ss i o ns a r e uni m po r ta nt, b ec au se the RFC i s consi ste nt w i th the l i m i tat i ons ass oci ate d w i th dem enti a. N othi ng i n th e A LJ’ s o pini on e xplains how that m ay be the case , how eve r, and the RFC m ak es n o r e fe r e n c e t o a n y w o r kl i mi t a t i o n s th a tw o u l d a c c o mmod a t e de men t i a . S y mpt o ms o fde men t i a i nc l ud e an i nabi l i ty to l ear n orr em em bernew in f or m ati on, an i nabi l i ty to re aso n, and d i ffi cul ty com m unica ti ng. M ayo C l i n i c , D e me n t i a : s y mp t o ms , h t t p : //w w w . m a y o c l i n i c . c o m/ he a l th/ de men t i a/DS 0 1 1 3 1 /DS ECT I ON= sym ptom s ( l astvi si ted M ar ch 28, 20 12)

. D r. Bund za’ s r epor t dem onst ra tes th at A rn et t w as su ffer in g fro m th es e s ym p to m s a s e ar ly as tw o yea r s b efore the h earing. A n inab il ity to learn or r em em bernew inf or m ati on co uld m ake i t i m possible f o r Arn et t to b e tr aine d f o r a ne w pos i ti o n, a nd the in ab ility to rea so n or d ifficu l t y c om m u n ica tin g c ou ld m ake si m ple ta sks diffi cul t a nd ti m e- consum i ng f or A rnet t t o com p lete. W ithou t any discu ssion of A rnet t’sN o. 11

- 2424 13 dement i a, thi s co ur t has n o id ea whatthe ALJ tho ug ht about thi s e vi dence. S ee C liffo rd v. Ap fel , 227 F. 3d 863, 87 3- 74 ( 7th Ci r. 20 00); G o d b ey v . Ap fel , 23 8 F

. 3d 803, 80 8 (7th C ir. 2000). The A LJ a l so f ai l ed to ta ke i nto ac c ou n t seve ra l o f A rnet t’ s d iagnosed physi cali m pai rm ents. A n A LJ m ay not i gnore enti re l i nes o fev i dence. S ee Zurawsk i, 245 F.3d at 88 8. T he A L J ne ver m en tioned A rnet t’s l um bos acr alneuri ti s, degene ra ti ve discdi sea se ( A rnet t al so re fer s t o thi s a s a nter i ordi sc di sea se) , o ste oar thri ti s, ordegene ra ti ve changes i n hersa cro iliac j oi nts. A rnet t ha s co m pl aine d abo utpa i n in h erb ac k, knee s, a nd hi ps; thi s pai n re du ces h er m obi l i ty and range o f m o ti o n an d make s i t di ffi cul t f o r he r t o s i t f o r l o ng per i o ds o ft i m e. The Co m m i ss i o ne r a r g ue s th atmany of t h es e d iag n os es w er e p ro v i s i on al, w er e m ad e o n ly o nc e , o r n e e d t o b e e v a l u a t e d i n c o n t e x t
. B u tthe age ncy’ s a tto rney s m ay not advance a n expla nati on the a g e nc y n e v e r ma de i ts e l fa nd ma y n o ta t t e mpt t o s up po r tthe de c i s i o n wi th e v i dence the a g e nc y a pp ar en tly d id n otco n sid er . M a rti nez v. As t r ue, 63 0 F

. 3d 69 3, 6 9 4 ( 7 th C ir. 20 11 ); Spi va v . As t r ue, 62 8 F

. 3d 346, 34 8 (7 th C ir. 20 10 ); P a rker, 59 7 F

. 3d at 922, 92 5. The Com m i ssi oneral so ar gues th at A rnet t wai ved her cl aim thatthe A LJ f ai l ed to ev al uate al l o fher physi cali m pai rm ents because , the C om m i ssi onersa ys, she has notexpl ai ned how thes e i m pai rm ents lim it he r abi l i ty to w or k. A rnet t has devote d s eve ra l pa ge s o f her bri efto ar gu ing that the A LJ di d not fully e val uate al l o f her i m pai rm ents. Thi s is s u ffi ci ent. S ee He r nan dez v. Cook14 N o. 11

- 2424 C ounty Sheri

ff ’s O ff ice, 63 4 F

. 3d 906, 91 3 ( 7th Ci r. 2011) ( r ej e c t i ngp l a i nt i ff’ s c o nt e nt i o n tha tde fe nd a nt s wa i ved i m m uni tyde fen se a t su m m ar y j udg m en t byl i m i ting d iscus sion of defen se to three pa ragrap hs ). N ex t, the ALJ f ai l ed to t ak e i nt o a cc o untArn ett’ s o be si ty
. An ALJ m us t f ac to r i n obe si tywhende te r m i ni ng the a ggr ega te i m pact o fan a pp l i can t’s i m pai rm ents. M a rtinez , 63 0 F

. 3d at 698- 99; C liffo rd, 2 27 F .3d at87 3. The Com m i ssi onerar gues th at the AL J was not re quir ed t o di s c us s di a g no s e s f o r whi c h Ar ne t t f a i l e d t o provi de evi dence ofl i m i tat i ons. A s m enti oned abo ve, how eve r, an A LJ m ust consi der al l of th e e vidence an d m us t ex pl ain i ts de ci si o n s uchthat it m ayb e m ea nin gfu lly re vie w ed . 20 C .F.R . § 40 4.1 54 5(a ); E i c h s t a dt, 534 F. 3d at 665- 66. I f the A LJ thought that A rnet t’ s obe sity has no t r esul ted in lim i tat i ons on herabi l i ty to w o r k, h e s ho ul d h a v e e xp l a i ne d h o w h e r e a c he d tha t co nc l us i o n. Th i s err o r c o ul d c o nc e i v ab l y b e h a r ml e s s i fthe ALJ i nd i re ctl y t oo k ob esi ty i nto acco unt by adopti ng l i m i tati ons sugge ste d by physi ci ans who w er e a w ar e o fo r d isc u ss ed A rn et t’s ob es ity
. P roc ha ska v. B a rnh a rt, 45 4 F.3 d 7 3 1 , 7 3 6-3 7 (7 th C ir. 20 06 ); Sk a rbek, 39 0 F

. 3d at 504. Buti t i s no t cl ea r fr o m the r ecor d tha t th e l i m i ta ti o ns the AL J adopted m et that sta nd ar d. T he A LJ di d not g i ve ful l c r edi t to the op ini o ns o fthe phy si ci an s he ment i o ne d, wi th the e xc e pt i o ns o fDr

. Ka r na nia nd Dr

. R a s p. Dr

. Kar na nino te d Arn et t’ s he i g hta nd wei g htb ut sh e n ev er m en tio n ed D r. R ob er ts on ’s o b e sit y d iag n os is orde m onst ra ted thatshe too k that di agno si s into ac-N o. 11

- 2424 15
count. Dr. Rasp char acte rized A rnet t a s m i l dlyo bese , but r efer re d to onl y Arnett’ s COPD

- re l ate d i m p ai rm ents ( and not hero st eo ar thri ti s) wh en as si gni ng work l i m i tati ons. S eve ra l o therphysi ci ans s p eci fi cal l y di scusse d A rnet t’ s o b esi ty; the A LJ, however, ei therdi sco unted the o pinio ns o fthes e physi ci ans o r neverm enti oned th em . On suc h a record , w e can not f in d h arm less erro r. S ee Sp i va , 62 8 F

. 3d at 353. Las t, we ag r ee wi thArn et t th atthe ALJ f ai l ed to f o r m ul at e an RFC that i s s uffi ci entl y s peci fi c as to how often she m ust be abl e t o si t a nd st and. The Com m i ssi oner ar gues that she w aiv ed thi s a rgum ent. But A rnet t r ai sed th e is su e o f th e A L J’s R FC d et er m in at ion ov e r a l l in th e d ist ric t c ou rt, an d th is is s u fficie n t. Sc hoe nf e l d v

. A pfel , 2 37F

. 3d 78 8, 7 93 ( 7th Ci r . 2 00 1) ( r efer r i ngt o the w aiv er of ge n er al a r g u m e n t s); E h rh a r tv . S e c ’yo f HHS , 969 F. 2d 534, 53 7 ( 7th Ci r. 19 92 ) (r efer ring to the w ai ver of“i ssues ”)

. A n RFC m ust be spec ific about the r equ i r e d fr e qu e nc y o fs t a nd i nga nd s i t t i ng . S S R 9 6

- 9 p, 1996 S SR LEX I S 6, at* 18-19 (J uly2, 19 96)

. A rnet t’ s RFC provi des tha t she m ust be abl e t o al ternate between sit tin g a n d st an d in g “ th ro u gh ou t t h e w or kd ay .” T h is does not speci fy a part i cul arfre quency, and does not r equi r e th atArn et t be abl e t o c hoose to s i t o r s ta nd w hen she feel s i t i s nec ess ar y. S ee K e t e l b oe t e rv. Ast r ue, 5 50 F

. 3d 62 0, 6 26 ( 7th Ci r . 2 00 8) ( co nc l udi ng th a tR F C s pe c i fy i nga pp l i c a ntb e ab l e t o a l t er nate between sit ti ng and st anding at appli cant’ s o pti on was ad eq u at e); Sc hm i dtv. As t r ue, 496 F.3d 833 , 845 (7th C ir. 2007 ) (sam e).16 N o. 11

- 2424 Forthes e r eas ons, we R EV ERSE the d istr i ct c ourt ’ s j ud gm ent and R EMA ND thi s ca se to the a gencyf orfurther proce edi ngs.

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