## 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. 08

- 1774 T HEO D IS N E L MS, J R ., Plai nt i f f

-Appe l l ant, v. M ICHAEL J. A S T RUE, D efend a nt-A pp ellee.

Appeal from the United States District Court fo r the E astern Di stricto f Wisc onsin
. No . 2:0 6-cv-00 273-CNC

—Charle s N . Cleve rt, Jr. , Judg e.
A RG UE D O CT OB ER 16, 2008

— D ECI DE D J AN UA RY 28, 2009

Befo re R IPPLE, E VANS, a nd T INDER, C ircu it Judges. T INDER, C ircu it Judge. Theodis N el m s, J r. , so ught S oci al Se c u rity di sabi l i ty benefi ts, but an adm i ni str ati ve l aw j u d g e d e t e r mi n e d th a t h e c a n p e r f o r m l i g h t wo r k

. On ap p eal N elm s, w ho w as w ithou t cou ns el before th e A L J, co nt en ds th atthe ALJ di d no t adequ ate l y de ve l o p the re cor d i n vi ol ati on o fhi s duty t o unrepre sente d cl ai m ants. A d d itio n ally , N elm s a rg u es th at th e A L J ig n o r e d ce rt ain e nv i r o nme nt a lr e s t r i c t i o ns wh e n a s s e s s i ngNe l ms’ s r e s i d-2 N o. 08

- 1774

ua lfunc ti o na lc apa ci ty. W e ag r ee wi thNel m s th atthe re cor d i s i nadequ ate and there f or e re m and forfu rt her proce edi ngs b ef or e the ag ency.

B a c kg r o und Ne l ms a p p l i e d f o rS u p p l e me n t a lS e c ur i t y In c o me benefi ts i n J une 200 2. H e li ste d as i m pai rm ents pneum oni a, re c ov er y fro m op en -h ea rtsu rg er y, an d a s t h m a. Inh is appli cati on N el m s wrot e, “I fIwalk, l i ft o r do anythi ng to o str enuous Ige t o ut o fbr eath. ” Afte r the Soc ial Se curi ty Ad mi n i s t r a t i o n t wi c e d e n i e d h i s a p p l i c a t i o n, N e l ms re quested a hear i ng.

A. He a r i ng N el m s appe ar ed athi s he ar i ngi n J une 2 00 5 wi th o ut counsel

. A ftera few q uesti ons about N el m s’ s workhi sto ry, th e AL J a ddr es se d the po ss ibi l i tyo fr epr es en tati on, expla i ni ng tha t “ Id on’ t gi ve som ebo dy cre ditj ust be cause th eyha ve a n a tt o r ne y ”; s ti l l, the ALJ c o nt i nue d , the So ci alS ecuri ty A dm i ni str ati on bel i eve s “ that havi ng an att or ney i s a go od i dea. ” The AL J expl ai ned the r ol e o fan att or ney b u t also not ed the A LJ’ s ind ependent duty to c r e a t e a r e c o r d: Ithi nk the thi nki ng m u st be that an at torney c an tal k t o you, keep you com pany at the hear i ng, as k addi t i o na lque s t i o ns wh e n I ’ m do ne , l o o ko ver yourfi l e, see ifit l oo ks re aso nabl y com ple te and so on . I t loo ks p r et ty co m p let e. Y ou ’v e b ro u gh t inN o. 08

- 1774 3

a d d i t i o n a li n f o r ma t i o nh e r e a n d s o o n . We do m uch ofthatanyway. A fterthe A LJ desc ribed the cos ts typi cal l y a sso ci ate d w i th a n a t t o r ne y i n the S o c i a lSec ur i t y s e t t i ng, Ne l ms r e pl i e d, “I’d rat h er ta lk to you .” Pro cee d ing with the hear i ng, the A LJ a ske d N el m s t o ran k his m ed ical p roblem s. N elm s st a t e d that his heart w a s t h e w or st, follow ed by h is b ac k, h is leg s, an d h is as th m a, i n th ato r der

. Re g ar di nghi s he ar t N el m s ex p l a i n e d , “ Ih a v e s h o r tn e ss ofth e b r e a th a n d , y o u kn o w, th a ta l s o ha pp e n [ s ] w i th a s th ma a n d p l u s th e y c u tme open. I g ot a s tent i n m y hea rt, yo u know.” N el m s descr ib e d a n inab il ity to sleep at nightbecau se of severe p a i n, w h i c h h e b e l i e v e s t o b e th e o n s e to fa r th r i t i s . N e l ms al so r epo r te d th at hi s do ct o r ha d pr es cr ibed M etha do ne to al l evi ate the pai n i n hi s ba ck an d in h is l egs , al though th e me d i c a t i o n w a s “ n o th e l p i n gth a tmu c h

. ” N e l ms te st ified , m or eo ve r, th at h e e x p e r i e n c es so re n es s in h is l ower ba ck “[ a] l l d ay eve ryday, ” with a b ri efr espi te on ly im m ed iat ely aft er ta kin g th e m ed ica tio n . A s fo r h is r e s pi r a t o r y p r o b l e ms , N e l ms me n t i o n e d th a th i s a s th ma str i kes wh en he i s nea r du st orpol l en o utsi de and w hen he i s h o t o r c o l d

. Ne v e r th e l e s s , Ne l ms e x e r c i s e s a nd w al ks eve ryday perhi s doct or ’ s instr ucti ons, a lbei t with l i mi t a t i o n s . “ Ic a n wa l kpr o b ab l y ab o u ta g o o d t wo bl o ck s be f o r e I r ea l l y g etmess ed up, ” N el m s te st i fi ed, “ but h e r e l a t e l y, y o u kn o w, s i n c e I ’ v e b e e n h u r t i n g, y o u kn o w, Ic an ’ t wal k hal fa bl ock

. ” F urther m or e, N el m s s tat ed th ats i nc e su r g ery he ha s do ne “ l i tt l e o dd j o bs , ” i nc l udi ng ra kin g l ea ve s an d sh ov elin g sn ow . N elm s d es c rib e d h is4 N o. 08

- 1774 daily a cti vi ti es i n deta il

— h ow each m or ni ng he coo ks h im se lf br eak f ast, cl eans up , go es f ora w al k, does laun d ry, and , l a ter, p erha p s goes to the grocery store w ith his step -m oth er before cooking him self d inn er. A l tho ugh Ne l ms “ us e d t o pa r t y a l o t, ” he t e s t i fi e d that hi s dr i nk i ngi s d o wn to t wo o rthr ee b ee r s ea chda y a nd h e i s g e n e r a l l y h o me b y 9 : 0 0 p . m. A fterapproxi m ate l y tw enty m i nut es o fquesti oni ng, the AL J r em ar ked, “Ican’ t thi nk o fanythin g el se to ask

. A nythi ng el se I shoul d know?” N el m s cl ar i fi ed a few poi nts about hi s e du cati on a nd work hist or y, and w i th tha tthe h e a r i nge nd e d.

B. M edica l Evi den ce In M ay 20 02 N elm s w as ad m itt ed to a h os p ita l in M ilw aukee , W i sco n sin , afterhe was f ound un re sponsi ve i n hi s ho m e. H e was d iag n ose d w i th pneum oni a, r espi ra tory f ai l ure, ove rhea ti ng ( hypertherm i a) , infl am m ati on ofthe he ar t ( endocar dit i s) , del i ri um l i kely c aused by alc oh ol w ith d ra w al (d eliriu m tre m en s), an ab n or m ally low con cen tration of sod ium in th e blood ( hy p ona trem ia) , an d low blo od p re ss u re (h y p ot en sio n ). D u rin g h is hos p ital stay, N elm s’s d octors replaced his m itralvalve (a he ar t va l ve ) wi tha mech an i ca ls ubs ti tu te , a nd the su r g ery was a s ucc es s. Nel m s was di sc ha r g ed from the hospi tali n J une 200 2. Over the ne xt f our m onth s N el m s a tte nd ed c ar d iop u lm on ar y re h ab ilita tio n se ss ion s, w h er e h e w ou ld w alk on a tread m il l, l ift w eights, and ri d e a stationa ryN o. 08

- 1774 5 b icy c le. T h e p ar tie s a g r e e t h at “M r. N elm s g en er ally to ler at ed th e e x er c ise s w ell.” I n De ce m be r2 00 2 Dr
. Pa tr i ci a Cha n, a no n- ex ami ni ng sta te- age ncy physi ci an, asse sse d N el m s’ s r esi du alfunctio n al c ap ac i t y . D r. C h an op in ed th at N elm s c ou ld p er for m th e liftin g, sit tin g, an d st an d in g e x er tio n s a ss oc iate d w i th l i ght work

. N el m s was hospi tal i zed aga i n i n M ar ch 200 3

— th i s t i me f o ri nt r a- ab do m i na lb l ee di ng, o ve r - an ti co agul at i o n, a nd k i d n e y f a i l ur e ( r e n a li n s u ffi c i e n c y ) r e s u l t i n gfr o m a mi x t u r e o fal c o h o la n d p r e s c r i p t i o n a n t i c o a g u l a n t s . He wa s di s c ha r g e d o ne we e k l a t e r wi th i ns t r uc t i o ns to ab st ain from alc oh ol an d “n otto d ou b le d os e.” F i ve m onths l at erDr
. Ro be r t Cal l ea r, a no th erno nex am ining state -agenc y ph ysician, assessed N elm s’s re si du al functi onal capaci ty. Lik e Dr. Ch an, Dr. C all ear c o nc l ud e d tha tNe l ms c o ul d p e r f o r m t he du t i es assoc iated w ith li gh t w ork. Dr. Callear did note, how ever, that N el m s s houl d a vo i d concentr ate d exposure to fum es , o do r s, dus t, g as es , a nd po o rv en ti l at i o n. Fr om 20 02 to 2003 Nelm s m et w i th a num bero fo ther doctor s, o ften t o see k pai n re l i efo r f orcheck

- up s r el ate d to h is s u rg er y. O ft h os e v isit s, tw o a p p ea r to be sign ific a n t
. I n Ap r i l2 0 0 3 D r . Ij a z Ma l i kr e p o r t e d th a tN e l ms w as no t y etr ea dy to r etur n t o wor kf o l l o wi ng se v e r a l e pi s o de s o f i nt e r na l b l e e di ng . And i n M ay 2003 Dr. M ar ci n Tureck ipre scr ibed a str onge r presc ri pti on pai n m edi cati on wh en Tyl enolpro ved in su ffi ci ent t o tr ea t N el m s’ s ba ckpa i n.6 N o. 08

- 1774 The re cor d i s si l ent on N el m s’ s condi ti on fro m m i d-20 03 to 2005 ( hi s hear i ng date) with o ne exce pti on

— a f o ur - l i ne re p or t fro m N elm s’s p rim ar y-c ar e p h ys icia n, D r. P ab lo Bozov ich , date d A pri l20 05. Dr. Bozo vi ch w ro te that N elm s’s co n d itio n is “s ta b le” w ith res p ec t t o h is m itr alv a l v e r epl a c e men t
. F ur the r mor e , Dr
. Bo z o v i c h no t e d, N el m s s uffer s fro m m i l d s pinalst enos i s a nd chr oni c ba ck pain, b uthi s pain i s “c o nt ro l l ed w/ o r almedi ca ti o n, ” an d h is a st h m a is st ab le a s w ell.

C. ALJ D eci si on The ALJ b eg an h i s wri tt ende ci si o n b y a ckno wl edg i ng that N el m s had n ot enga ged i n substa nti alga i nfulact i vi ty si nce hi s a l l ege d onsetdate. S ti l l, the A L J n ote d that N elm s’s h ea rtsu rg er y w en t “ b ea u tifu lly w ell,” t h at h is re h ab ilita tio n ind ica te d a sm oo th rec ov er y, an d th at h is co m pl aint s o fde bi l i ta tingpa i n wer e spo r adi c. Acco r di ng t o th e A L J, th e me d i c a lr e c o r d d o c u me n t e d s t e a d y i mprove m ent s i nce N el m s’ s ho spi tal i zati on in 200 2: [ T h e r eco rd] pai nts a pi cture o fa bad m edi cal epi sode i n the Sp rin g o f20 02, wh i ch l ast ed m uch l ess than a y ear . I t a l so pai nts a p icture o fr eco ver ed c ap ac i ty f orwork eve n w i th the co nti nued substa nce abuse a nd pai nts a pi cture o fa si tuati on w el lwithi n the sco p e of the l i ght c apaci ty voca ti o na lr ul es . I t al so s ho ws s tr o ngc au sa lc o nt r ib uti ons ofsubstance abuse to the c l ai m ant’ s r educed c on d itio n bu t n otan yt h in g lik e a d isa b lin g c on d iti on even w i th the substance abuse. M or e than that,N o. 08

- 1774 7 the r eco rd sho w s that, were the cl ai m ant no t t o dr i nka nd no t t o sm o k e, to f o l l o w a b et te rdi et, a nd to use hi s m edi ci nes as presc ribed, h is c apaci ty m i ght e ven a pp ro ach fullm edi um exer ti onal lev els

. The ALJ c o m par ed the f av o r ab l e r epo r ts ofDrs
. Chan an d Cal l e a rwi th th e l e s s e rc a p a c i t y a l l e g e d b y Ne l ms b ut d iscoun ted N elm s’s testim ony becau se “h e i s not very c r e d ib l e . ” N e l ms ’ s t e s t i mo n y r e g a r d i ngh i s s y mp t o ms w as unconvi nci n g an d i nconsi ste nt, the A LJ wrot e. A ccor ding to the AL J, N el m s’ s r esis ta nce t o m edi caladvi ce an d hi s co nt i nue d dri nk i ng

— how eve r re du ced

— al so u n d e r mi n e d h i s c l a i m. U lti m ately the A L J a g r e ed w ith N elm s tha t his hea rt c on d itio n, his as th m a, h is a lco h ol ab u se , an d h is b ac k p ain ar e s eve re i m pai rm ents

—but the se i m pai rm ents do not, acco rdi ng to the A LJ, m eeto r othe rwis e e qual a l i ste d i m pai rm ent. N ext the A LJ found that Nelm s ca nnot perf or m a n y ofhi s pastr el evantwork, wh i ch w as “m edium o r gr eat eri n exer ti on al d em ands and had other dem an d s. ” But, the ALJ c o nt i nue d, Nel m s r et ains the re sid u al fu n c tio n al c ap ac ity “fo r a fu ll ran ge or n ea rly fullr ange ofl i ght j obs and f orso m e m edi um j obs at th e e x er tio n ally low er en d of th e m ed iu m ran ge .” The ALJc o nc l ud e d tha tNe l ms’ s a s thma do e s n ot preve nt hi m fro m li ght workbec ause i t i s “ sl i ght” and not a “ si gni fi cant e nviro nm entali m pai rm ent. ” N el m s l i ste d hi s a sthm a a s the l eas t s i gni fi c an t ofhi s i m pai rm ents. A nd i t is n ot a n ew pro bl em , acc or ding to the AL J, nor di d i tp r e v e ntNe l ms fr o m wor k i ngi n the p a s t
. T he ALJ8 N o. 08

- 1774 did, however, acknow l ed ge thatheatand so m e o utdoor c on d itio n s c an ag gr av at e N elm s’s co n d itio n . “[ E ] v e n if th e c l a i ma n ts h o u l d a v o i d o u t d o o rw o r ko n w a r m, hu mi d d a y s o ra v o i d wo r ki n ho two r kp l aces , ” the ALJ wr o t e , “ ne v e r the l e s s the s e de nt a r y a nd l i g htc a t e gor i es ofwork conta i n gr eatn um ber s o fj obs and m any o ccupati o na lo ppo r tu nities s ti l lo pent o the c l ai m an t. ” Thus , the A L J fou n d t h at N elm s is n otd isa b led on ac c ou n t o f h is ab i l i tyt o pe r f o r m l i g htwor kf o und in the na ti o na l ec o nom y. The Appea l s Cou nc i lde ni ed N el m s’ s su bs eque nt re q u es t fo r re vie w . Th e d ist ri c t co u rtaffirm ed th e d ec ision of the C om m issi one r.

A n alysis If th e A p p ea l s C ou n c il d en ies a re q u es t fo r re vie w , as it did her e, the A LJ’ s deci si on be com es th e fin aldeci si on ofthe Com m i ssi onero f S oc ial Se curi ty. Ge t ch v. As t r ue, 539 F. 3d 473, 48 0 ( 7th Cir. 2008)

. Thi s co urt w i l lr eve rs e an A L J’s d en ial of d isa b ility be n efit s o n ly if th e d ec isio n is not su p p orted bysubst anti alev i dence ori s ba sed o n an er ro r ofl aw . 42 U
. S. C
. § 405(g); Skinne rv. As t r ue, 47 8 F.3 d 83 6, 84 1 (7 th C ir. 20 07 ); R ice v. B a rnh a rt, 38 4 F
. 3d 363, 368- 69 ( 7th Ci r. 2004)
. S ubstanti alev i dence i ncl ud es “s uchr el ev an t ev i den ce a s a r ea so nabl e m i nd mi g ht accept as adequate to s up porta concl usi on. ” Ric har ds on v. P erales , 40 2 U.S. 38 9, 401 ( 1971 ) ( ci tat i on a nd quotat i on m ar ks om itt ed ); se e G et ch , 53 9 F
. 3d at 480. N elm s firs t a ss er ts th a t t h e A L J d id n otad eq u at ely d evelop th e record

— an obl i gat i on that w as hei ghtene d byN o. 08

- 1774 9 N el m s’ s d eci si on to procee d w i thout counsel

. In parti cul ar N elm s takes issue w ith th e abs en ce, save f or Dr. Bozov ich’s note , o fany m edi calr ec or ds fro m m i d-20 03 to 2005

— a peri od i n w hi ch, N el m s a rgues, so m e o fhi s i m pai rm ents wo r s e n e d

. Me d i c a ld o c u me n t s fr o m th a tp e r i o d , N e l ms c on te n d s, at te stto se ve r e d eg en er at ive ch an ge s in N el m s’ s ba ck and hips a nd “str ongl y supp or t” a fi nd i ng o f d isabil ity. N elm s also points to the lengt h o f th e hea ri ng

— 25 m i nutes

— as furtherpro ofthatthe A LJ di d not fully a nd f ai rl y deve l op the re cor d i n thi s ca se. W hi l e a cl ai m ant be ar s the burden ofpro vi ng di sabi l i ty, the AL J in a Soci alSecuri ty hear i ng has a du ty to devel op a fu ll an d fair re c or d

. See Sm ith v. A pfel , 23 1 F
. 3d 433, 43 7 (7t h C ir. 20 00 ); Thom ps on v. Su lliv an , 93 3 F
. 2d 581, 58 5 ( 7th C i r . 1 9 9 1 )
. T h i s d u t y i s e n h a n c e d wh e n a c l ai m an t appe a r s wi th o u tc o u n s e l ; th e n th e AL J mu s t“ ‘ s c r u pul o us l y a nd c o ns ci en ti o us ly [ ] pr o be i nt o , i nqui r e o f, a nd ex p lore for a ll th e re lev an t fa c ts .’ ” Thom ps on , 9 33 F. 2d at 585- 86 ( quoti ng Sm ith v . S ec. o f H eal th, E du c. & Welfa re, 58 7 F.2 d 85 7, 86 0 (7 th C ir. 19 78 )); s e e Ne l s on v. A pfel , 131 F. 3d 1228 , 12 35 ( 7th Ci r. 19 97). A lthough pro se l i ti gants m ust fu rn ish so m e m ed ica l e v id en c e t o s u p p or t t h eir cla im , see Johns on v. Bar nhart, 4 49 F
. 3d 80 4, 8 08 ( 7th Ci r . 2 00 6) , the A LJ i s r equi re d to supp l em ent the r eco rd, as nece ssa ry, by ask i ngde t a i l e d que s t i o ns , o r de r i nga ddi t i o na le xa mi na ti ons, and conta cti ng tr eati ng physi ci ans a nd m edi cal so ur ce s to r eque st addi ti o na l r ec o r ds an d i nfor m at i o n. 20 C .F.R
. §§ 41 6.9 12 (d )-(f), 41 6.9 19 , 416 .92 7(c )(3) ; see Reefer v. B a rnh a rt, 326 F. 3d 376, 38 0 (3d C i r. 20 03) ( hol ding 700- pag e r ec o r d i na d equa te b ec au se i t l ac k ed det ai labo ut certain i m p airm en ts); Thom ps on , 93 3 F
. 2d at 587.10 N o. 08

- 1774 This cour t g ener al l y uphol ds the re aso ned j ud gm ent o f the Com m i ssi oner on how m uch evi dence to ga ther, ev en w h en th e c laim an t la c ks rep re se n ta tio n . SeeLu na v. Shalala , 22 F.3d 68 7, 69 2 (7 th C ir. 19 94 ); Bi n i on v . S ha l al a , 13 F. 3d 243, 246 ( 7th Cir
. 1994 )
. A ccor dingl y, “a si gni fi cant om issi on i s u su ally r equi re d bef or e thi s co urt w i l lfi nd that the [ Com m i ssi oner ] f ai l ed to as si st pro secla im an ts in devel opi ng the r eco rd fully a nd f ai rl y. ” Lun a , 2 2 F
. 3d at 692
. A n d an om iss ion is sig n ifica n t o n ly if it is p rej u d icia l. See Ne l s on , 1 31 F. 3d at 1235
. “M er e co nj ectur e o r specul ati on that a dd i ti onalev i dence m igh t have be en o btained in the case i s insuffi ci ent t o w ar ra nt a re m and.” Bini on , 13 F. 3d at 246. Instea d a cl aim an t m ust s et f or th sp ecifi c, r el evantfacts

— s uch as m edi calev i dence

— th atthe A L J d id n otco n sid er . Ne l s on , 131 F.3d at12 35 ; s e eBin i on , 1 3 F
. 3 d a t 2 4 5 ( “ P r ej u d i c e ma y b e d e mo n s t r a t e d b y s h o wing th at th e AL J f ai l ed to e l i ci t al lo fthe r el ev an t i nf o rm ation from the claim an t.”) ; Eche var r i a v. Se c’y of He al t h & H um a n S ervs. , 68 5 F
. 2d 75 1, 75 5 ( 2d Ci r . 19 82 ) ( signi fi ca nt gaps in the re cor d m ay precl ud e a f ai r and adequate he aring). N elm s a rgues that the tw o- yea r evi denti ar y gap i s a sig n ifica n t o m iss ion, an d w e a g r ee . N elm s filed , in th is cour t, a separ ate append i x ofm edi calr eco rds fro m 20 03, 20 04, a nd 2 00 5 f o rthe l i m i te d pur po se o fde m o ns tr at i ng prej ud i ce. That a pp endix co ntai n s vari ous e xam i nati on re port s a nd di agno ses fro m the sam e W i sco nsin h ospita l w he re N elm s ha d his su rgery. T he doc um en ts, m oreover, supp or t Nelm s’ s theor y that the A LJ l i kely would haveN o. 08

- 1774 11

T h e g o v er n m en t a cc u se s N el m s o f “s el ec tiv el y o m itt [in g ]” 1 som e m edical evidence from 2003 to 2005 that suggest s that his back pain w as m anageab le ( w ith m edicat ion)
. Bu t that c har ge i s b as el es s , an d i tm i s s es the poi nt
. Nel m s doe s no t pu rport t o ente r new evid en ce int o the rec ord at this s tage; ra the r, he fur ni s he s j u st enough e vi denc e t o e s t abl i s h thatthe A LJ did not fulfil l his du ty t o cre ate a fai r and full rec ord

— one that w ill i nclude both f avorab le and u nf avorab le i nf orm ati on once com plet e. f ound N el m s di sabl ed ha d he cons i dered the m

— orev en 1 i fhe ha d s i m pl y a sk ed m o r e que st i o ns abo utr ec en t d ev elo p m en ts
. See B inion , 13 F .3d at24 6. Fo r ex am p le, a CT s ca n in J an ua r y 2 00 4 r ev ea l ed, f o rthe fi r stt i m e, de g en er at i o n o fNel m s’ s th o r ac i c an d l um ba rs pi ne wi tha “diffuse di sk bu lge” and “post er i orspurr i ng. ” Altho ugh subsequent note s co nvey that N el m s “ has g oo d contr ol[ of hi s b a c kp a i n] w i th U l t r a n 5 0 mg o nc e da i l y a s n e e de d” and “thi s pai n i s g ett i ng bette r, ” N el m s l ate r re port ed that “[ i ] t i s wor se when[h e] si ts a nd g et s be tt erwhenhe sta nd s up . ” A nd byFebruar y 2 005, N el m s’ s ba ck pai n w as acute, “e speci al l y when he st ands up. H e fee ls w eak, especi al ly w h en h e has to do that.

. . . Thi s i s due to di sc dise ase . ” M or eov er, N el m s be gan t o experie n ce a l i m i ted r ange ofm oti on in his h i ps so m eti m e in 200 4, w hi ch tur ned out t o be fro m “[ s] eve re degene ra ti ve ch an ges of both h ips.” A n ex am ination r e v e a led “severe j o i nts pac e na r r o wi ng, a lon gwi ths pur r i ngo fthe fem or alhead” i n N elm s’ s l eft hi p, as wellas “m ar ked j oi nt space narr owing, al ong w i th fem or al spurri n g” in Ne l ms’ s r i g hth i p.12 N o. 08

- 1774 These a re pre ci sel y the so rto fsp eci fi c, r el evantf acts that anALJ i s ex pec te d t o c o ns i derwhende te r m i ni ng d isa b ility in a p ro se cla im an t. S e eBi ni on , 1 3 F
. 3d at 246. N o d ou b t a “c om p let e” re c or d is alw a y s e l u siv e, s e eJohns on , 449 F.3d at80 8; Lun a , 22 F .3d at69 2; Kendri ck v. Shalala , 99 8 F
. 2d 45 5, 4 56

- 57( 7th Ci r . 1 99 3) , a nd the r e i s no abso l ute r equi re m ent that a n A LJ update the m edi cal re c or d s to t h e tim e of th e h ea rin g, s e eLu na , 22 F. 3d at 692- 93. Bu t here the A LJ w as aw ar e that N el m s w as st ill re cei vin g tr eat m ent in 200 5 a nd thathi s ba ck pai n w as seve re and contin uing
. H i s l eg pai n pers i ste d as wel l

. Yet the AL J d id n ot prob e, i n any depth, N el m s’ s r ecentpast at th e hea ring or gather any m ed ica l ev id en c e t o fill th e two
- y ea rg ap i n the r ec o r d. Had the ALJ do ne s o , he w ou ld h av e u n c ov er ed d oc u m en ta tio n of ort h op ed ic d ecline. T his is p articu larl y t roub ling i n li gh t of th e A L J’ s ass u ra nces that he would i nd ependentl y a sse m bl e a “r eas onabl y c om ple te” r eco rd. U nl i ke i n previ ous c ase s, thi s was not a “m ar gi nalhear i ng” that nev er thel ess p rovide d “a fairl y com p lete pictu re” of N elm s’s i m p airm en ts
. Se eNe l s on , 1 3 1 F
. 3 d a t1 2 3 6
. No rwa s i ta si tuati o n in whi cha n un r epr es en te d c l ai m an t r ea ss ur ed th e A L J t h a t n o ad d itio n al m ed ica l rec or d s e x ist
. Se eJohns on , 449 F. 3d at 808. Thus, we cannot say that the A LJ a dequ a t e l y de v e l o pe d the r e c o r d. T h e r e i s a s e c o n d a r y m a t t e rth a ta l s o d e s e r v e s c o mm en t. Nel m s al so a r g ue s th atthe A LJ di d no t co ns i derthe com b i ned effects of N elm s’s i m p airm en ts w he n d eterm i ni ng disabi l i ty. H e ass er ts i n hi s bri ef, “i t w as illogic al f orthe A LJ t o on o ne hand fi nd Pl ai nti ff’ s a sthm a was a se ve r e im p airment, b uto n the o th erha nd, i nc l ude no sym p tom s or li m itations related to asth m a in Plaintiff’sN o. 08

- 1774 13 RF C. ” N el m s i ns i st s furthe rtha t “the ALJ i nc l ude d no envi ro nm entalr est ri cti ons i n[ ] Pl ai nti ff’ s r esi du alfuncti onalcapaci ty ass ess m ent. ” B ut the A LJ’ s o pini on devo tes consi derabl e a tte nti on t o N el m s’ s r espira tory l i m i tati o ns

— an d c on c lu d es th at “e ve n if th e c laim an t s h ou ld avoid ou td oor w ork on w arm , hu m id d ays or avoid w ork i n h o t wor kpl ac es , ne ve rthe les s th e se den ta r y a nd l i g ht ca te g o r i es o fwor kc o nt ain g r ea t number s of j o bs a nd ma ny o c c u p a t i o n a lo p p o r t u n i t i e s s t i l lo p e n t o th e c l a i mant. ” To thi s N el m s o ffer s e sse nti al l y tw o re sponses : fi rs t, that the AL J sho uld have expl i ci tl y a dd re sse d his need t o avo i d concentr ate d exposure to d ust, pol l en, fum es, o dors, a n d g a s e s , an d s e c o n d , th a tth e A L J c o u l d n o ta s s u me that such j obs exi st w i thout th e ass i sta nce o fa voca ti onal expert
. Ne l ms ’ s a r g u me n t s o n th i s p o i n t a r e u n p e r s u a s i ve . The A LJ pr ess ed N el m s o n hi s e nvi ro nm en talr est ri cti ons at l ength

— a n d N e l ms h i ms e l fem p h a s i z e d th a th i s a s th ma m ani fest s when he i s e xposed to dust and pol l en o utsi de. W hen i t doe s, N elm s overheats , and hi s s ol uti on i s t o go i ns i de

. T he ALJ ’ s di scus s i o n o fr e s t r i c t i o ns o n o ut s i de w or k in w ar m envi ro nm ents speaks di re c tl y t o these resp iratory lim itat ions, an d i t is clear fr om the record that the AL J co nsidere d N el m s’ s e nvi ro nm entalr est ri cti ons i n tandem with hi s o theri m pai rm ents
. S eeGetch , 539 F. 3d at48 1 ( A LJ doe s no t hav e t o provi de com ple te w rit te n ev alu at ion of ev e ry p iec e o f te st im on y a n d ev id en ce). N el m s ci tes Wa rm o th v . B o w en , 7 98 F.2d 11 09 (7th C ir. 1986 ), i n su p p ort of his argu m en t tha t a vocation al exp ert was ne ede d. In War m ot h th is court rej ecte d an A L J’ s14 N o. 08

- 1774

c o nc l us o r y de t e r mi na t i on tha tmo s ts e de nt a r y j o b s do not expose w or ker s t o anyen vir on m en ta l irrita n ts
. Id. at 1110
. Aft era n a cciden t i n whi cha n indus tr i almachine sp illed to x ic c h em ica ls on h is fa c e , W a r m ot h w as u n ab le to t o l er at e ev enthe s li gh te sta m o unto fs ec o nd- ha nd sm ok e o r p er fu m e. Id. at 11 10 -11 . N ot ab ly, th ou gh , th is cour t di d not r equi re thatthe A LJ c onsu lt a vocat i onal experto n re m and: “w e o nl y r equi re thatt h er e be re l i abl e e vi dence ofso m e k i nd thatwould pers uade a re aso nabl e per so n that the l i m i tat i ons i n questi on do no t si gni fi cantl y di m i ni sh the em plo ym ent o pp or tuni ti es o the r wi s e a v a i l ab l e. ” Id. at 1112; see also 2 0 C. F
. R. § 4 16 .96 6(e ); Binion , 13 F. 3d at 246 ( expla i ni ng tha t use o f a voca tional exp ert is d iscretionary). T h is case i s no t s o seve re . In ess ence the AL J as sum ed th a ts o me l i ght w or k ex i sts i n the nati onaleco nom y that d oes not pres en t a threa t of conc entrat e d exposure to du s t, p o l l e n, fume s , g a s e s , o do r s , o rp o o rv e nt i l ati on . Of cour se, a voca ti onalexp er t w oul d be uni quel y qual i fi ed to answ erthi s quest i on

— and the AL J m ay w i sh t o enl i st o ne o n r emand

—but the A LJ’ s assum pti on al one i s no t s o o u t l a n d ish as to w ar ra n t re ve rs al. Se eLu na , 2 2 F
. 3 d a t 69 1 ( “thi s co urt h as sai d tha t i n c as es wher e a no nexer ti onall i m i tat i on m i ght s ub s t ant i al l y re du c e a range of w o r k a n ind ivid u al c an p er for m , th e A L J m u stco n su lt a vo cati onalexper t. ”) (em phasi s a dd ed); S oci alS ecuri ty R uling 85-15, 1985 W L 56857, at * 8 (N ov. 30, 1984) ( “W he re a p e r s o n ha s a me di c a lr est ri c t i o n t o a v o i d exc e s s i ve am ou n ts of no ise , d u st, et c ., th e im p ac t o n th e b ro ad w or ld o f wor k woul d be m i ni m al be ca us e m o st j ob en vi r o nm e nt s do no t i nv o l v e g r e a t no i s e , a mou nt s o f du s t, et c. ”) (em p ha sis add ed ).N o. 08

- 1774 15 So , al though the A LJ’ s t re atm ent o fthe com bi ned effects of N elm ’s im p air m en ts d oe s no t j u st ify re ve rs al, h is f ai l ure to de ve l op the re cor d as di scusse d above does

. T he refore, becau se su bsta nt ialeviden ce d oes not sup p ort the AL J ’ s deci si on, we R EV ERSE th e j udg m en t of th e di s t r i c tc o ur ta nd R EMA ND f orfurtherpro ceedi ngs bef or e the ag ency.

R IPPLE, Cir cu i tJudg e, co nc ur r i ng . I am pl ea se d t o j o i n the j ud gm ent a nd the com prehensi ve op in ion o fthe cour t. I w rite separa tely si m p ly to un d erline the inh eren t un fai rne ss i n the ALJ ’ s h aving a ss ur ed M r . Nel m s th atthe j udg e ha d a n inde pen den t r es po ns ibi l i tyt o de ve l o p the r e c o r d a nd the n l e a v i ng such a wi de g a p i n the de v e l o pm ent o fthe re l evantm edi calhi sto ry . A lth ou gh the co l d rec or d i s di ffi cul t t o ass ess o n this m att er, Iam co ncer ned here thatt he A LJ’ s co l l oquy with M r. N el m s m ay w el lhave had the uninte n tional effect of diss uading hi m fro m r eta i ni ng co unsel

. A n A LJ m u st be ver y c i rcum spect, a n d even- hand ed, i n hi s a dvic e t o a l i ti gant and, here , M r. N el m s m ay w el lh av e inter prete d the AL J ’ s a dvic e a s express i ng the A LJ’ s per sonalvi ew that no a t t o r ne y wa s n e e de d.

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