UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

FORT WAYNE DIVISION

HEATHER M. COX, )

)

 Plaintiff, )

)

 v. ) CIVIL NO. 1:15cv3

)

CAROLYN W. COLVIN, Acting )

Commissioner of Social Security )

)

 Defendant. )

OPINION AND ORDER

This matter is before the court for judicial review of a final decision of the defendant

Commissioner of Social Security Administration denying Plaintiff's application for Supplemental

Security Income and Disability Insurance Benefits, 42 U.S.C. § 401 et seq. Section 205(g) of the

Act provides, inter alia, "[a]s part of his answer, the [Commissioner] shall file a certified copy of

the transcript of the record including the evidence upon which the findings and decision

complained of are based. The court shall have the power to enter, upon the pleadings and

transcript of the record, a judgment affirming, modifying, or reversing the decision of the

[Commissioner], with or without remanding the case for a rehearing." It also provides, "[t]he

findings of the [Commissioner] as to any fact, if supported by substantial evidence, shall be

conclusive. . . ." 42 U.S.C. §405(g).

The law provides that an applicant for disability insurance benefits must establish an

"inability to engage in any substantial gainful activity by reason of any medically determinable

physical or mental impairment which can be expected to last for a continuous period of not less

than 12 months. . . ." 42 U.S.C. §416(i)(1); 42 U.S.C. §423(d)(1)(A). A physical or mental
impairment is "an impairment that results from anatomical, physiological, or psychological

abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic

techniques." 42 U.S.C. §423(d)(3). It is not enough for a plaintiff to establish that an

impairment exists. It must be shown that the impairment is severe enough to preclude the

plaintiff from engaging in substantial gainful activity. Gotshaw v. Ribicoff, 307 F.2d 840 (7th

Cir. 1962), cert. denied, 372 U.S. 945 (1963); Garcia v. Califano, 463 F.Supp. 1098 (N.D.Ill.

1979). It is well established that the burden of proving entitlement to disability insurance

benefits is on the plaintiff. See Jeralds v. Richardson, 445 F.2d 36 (7th Cir. 1971); Kutchman v.

Cohen, 425 F.2d 20 (7th Cir. 1970).

Given the foregoing framework, "[t]he question before [this court] is whether the record

as a whole contains substantial evidence to support the [Commissioner’s] findings." Garfield v.

Schweiker, 732 F.2d 605, 607 (7th Cir. 1984) citing Whitney v. Schweiker, 695 F.2d 784, 786

(7th Cir. 1982); 42 U.S.C. §405(g). "Substantial evidence is defined as 'more than a mere

scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to

support a conclusion.'" Rhoderick v. Heckler, 737 F.2d 714, 715 (7th Cir. 1984) quoting

Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1410, 1427 (1971); see Allen v. Weinberger,

552 F.2d 781, 784 (7th Cir. 1977). "If the record contains such support [it] must [be] affirmed,

42 U.S.C. §405(g), unless there has been an error of law." Garfield, supra at 607; see also

Schnoll v. Harris, 636 F.2d 1146, 1150 (7th Cir. 1980).

In the present matter, after consideration of the entire record, the Administrative Law

Judge (“ALJ”) made the following findings:

1. The claimant has not engaged in substantial gainful activity since February 29,

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2012, the application date (20 CFR 416.971 et seq.).

2. The claimant has the following severe impairments: hypertension/high blood

pressure, history of cerebrovascular accident in 2005, major depressive disorder,

migraines that are not intractable, Addison’s disease, and Lupus anticoagulant (20

CFR 416.920(c)).

3. The claimant does not have an impairment or combination of impairments that

meets or medically equals the severity of one of the listed impairments in 20 CFR

Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 416.925 and 416.926).

4. After careful consideration of the entire record, the undersigned finds that the

claimant has the residual functional capacity to perform sedentary work as defined

in 20 CFR 416.967(a) in that the claimant is able to lift, carry, push and pull up to

ten pounds occasionally and less than ten pounds frequently. The claimant would

be able to stand and walk, with normal breaks, for approximately two hours per

eight-hour workday and would be able to sit, with normal breaks, for

approximately six hours per eight-hour workday. However, the claimant would

be limited to only occasionally climbing ramps, stairs, ladders, ropes, or scaffolds,

and only occasionally balancing, stooping, crouching, kneeling, and crawling. 

The claimant should avoid all exposure to unprotected heights, the operation of

motor vehicles, and the use of dangerous machinery. Further, the claimant would

require work in a low stress job, which is defined as having only occasional

decision making required and only occasional changes in the work setting. While

the claimant would be unable to engage in complex or detailed tasks, she would

be able to perform simple, routine, and repetitive tasks, consistent with unskilled

work, and could sustain such work and attend to task throughout the workday. 

The claimant would be limited to superficial interaction with co-workers,

supervisors, and the public, with superficial interaction defined as occasional and

casual contact not involving prolonged conversation or discussion of involved

issues. The claimant would be able to tolerate contact with supervisors involving

necessary instruction.

5. The claimant is unable to perform any past relevant work (20 CFR 416.965).

6. The claimant was born on September 24, 1986 and was 25 years old, which is

defined as a younger individual age 18-44, on the date the application was filed

(20 CFR 416.963).

7. The claimant has at least a high school education and is able to communicate in

English (20 CFR 416.964).

8. Transferability of job skills is not material to the determination of disability

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because using the Medical-Vocational Rules as a framework supports a finding

that the claimant is “not disabled,” whether or not the claimant has transferable

job skills (See SSR 82-41 and 20 CFR Part 404, Subpart P, Appendix 2).

9. Considering the claimant’s age, education, work experience, and residual

functional capacity, there are jobs that exist in significant numbers in the national

economy that the claimant can perform (20 CFR 416.969 and 416.969(a)).

10. The claimant has not been under a disability, as defined in the Social Security Act,

since February 29, 2012, the date the application was filed (20 CFR 416.920(g)).

(Tr. 11-24)

Based upon these findings, the ALJ determined that Plaintiff was not entitled to disability

insurance benefits. The ALJ’s decision became the final agency decision when the Appeals

Council denied review. This appeal followed.

 Plaintiff filed her opening brief on August 24, 2015. On November 30, 2015, the

defendant filed a memorandum in support of the Commissioner’s decision. The Plaintiff has

declined to file a reply. Upon full review of the record in this cause, this court is of the view that

the Commissioner’s decision should be affirmed.

A five step test has been established to determine whether a claimant is disabled. See

Singleton v. Bowen, 841 F.2d 710, 711 (7th Cir. 1988); Bowen v. Yuckert, 107 S.Ct. 2287,

2290-91 (1987). The United States Court of Appeals for the Seventh Circuit has summarized

that test as follows:

The following steps are addressed in order: (1) Is the claimant

presently unemployed? (2) Is the claimant's impairment "severe"? 

(3) Does the impairment meet or exceed one of a list of specific

impairments? (4) Is the claimant unable to perform his or her

former occupation? (5) Is the claimant unable to perform any other

work within the economy? An affirmative answer leads either to

the next step or, on steps 3 and 5, to a finding that the claimant is

disabled. A negative answer at any point, other than step 3, stops

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the inquiry and leads to a determination that the claimant is not

disabled.

Nelson v. Bowen, 855 F.2d 503, 504 n.2 (7th Cir. 1988); Zalewski v. Heckler, 760 F.2d 160, 162

n.2 (7th Cir. 1985); accord Halvorsen v. Heckler, 743 F.2d 1221 (7th Cir. 1984). From the nature

of the ALJ's decision to deny benefits, it is clear that step five was the determinative inquiry. 

Plaintiff filed an application for Supplemental Security Income (SSI) and Disability

Insurance Benefits (DIB) alleging disability since January 26, 2012. The claim was denied

initially and upon reconsideration. On May 22, 2013, ALJ Maryanne Bright convened a hearing,

and on September 13, 2013, ALJ Bright issued a decision finding that Plaintiff was not disabled.

On November 10, 2014, the Appeals Council affirmed ALJ Bright’s finding that Plaintiff was not

disabled . 

Born in September 1986, Plaintiff was 25 years old as of the alleged onset date. She had at

least a high school education. In the 15 year look back period, she worked as a Personal Care

Aide which is classified as a semi-skilled job with a medium exertional level.

Plaintiff suffers primarily from Antiphospholipid Antibody Syndrome (APS) and

Systemic Lupus Erythematosus (SLE). She also alleges she suffers/suffered from a multitude of

other medical problems, most of which are probably secondarily or tertiarily related to APS and

SLE; including, hypertension, central nervous system vasculitis, deep vein thrombosis,

cerebrovascular accident/cortical based stroke with frontoparietal encephalomalacia and gliosis,

renal infarct/renal insufficiency, Addison Disease/adrenal insufficiency, and high parathyroid

hormone/hypocalcemia. After her strokes, Plaintiff also suffered from epilepsy/seizures,

headaches, memory loss, and major depressive disorder. She also experienced episodes of

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syncope/orthostatic hypotension, Raynaud’s phenomenon, hypomagnesemia, and normocytic

anemia. Additionally, Plaintiff is obese and has erosive gastritis and asthma. 

In support of remand, Plaintiff first argues that the ALJ improperly overemphasized daily

activities. The Seventh Circuit has repeatedly cautioned that a person's ability to perform daily

activities, especially if they can be done only with significant limitations, does not necessarily

translate into an ability to work full-time. Bjornson v. Astrue, 671 F.3d 640, 647 (7 Cir. 2012); th

Punzio v. Astrue, 630 F.3d 704, 712 (7th Cir.2011); Gentle v. Barnhart, 430 F.3d 865, 867–68

(7th Cir.2005); An ALJ cannot disregard a claimant's limitations in performing household

activities. Moss v. Astrue, 555 F.3d 556 (2009); Mendez v. Barnhart, 439 F.3d 360, 362 (7th

Cir.2006).

Plaintiff claims that the ALJ’s discussion of her daily activities ignores that there was a

worsening of her conditions from January 2012 through May 2013. Specifically, her headache

frequency increased and she required hospitalization and intravenous stress doses of steroids.

By the time of the hearing, she could only do household activities with the extensive help of her

mother and father.

Plaintiff argues that the ALJ glosses over the fact that Plaintiff accomplished her daily

goals by interspersing rest periods with periods of low exertional activity. Plaintiff states that this

pattern is consistent with her medical conditions, especially the fatigue problems associated with

Addison Disease, SLE, and APS.

However, as the Commissioner points out, the ALJ reasonably found that Plaintiff’s

subjective statements were not entirely credible (Tr. 15). The ALJ took various factors into

consideration when evaluating Plaintiff’s credibility, including the objective medical evidence,

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Plaintiff’s treatment history, her activities of daily living, and the other factors set forth in the

regulations and SSR 96-7p (Tr. 9-24). See 61 Fed. Reg. 34,483-34,488 (July 2, 1996). “An ALJ is

in the best position to determine a witness’s truthfulness and forthrightness; thus, this court will

not overturn an ALJ’s credibility determination unless it is ‘patently wrong.’” Skarbek v.

Barnhart, 390 F.3d 500, 505 (7th Cir. 2004). 

When discussing the evidence of record, the ALJ reasonably pointed out that Plaintiff

performed a range of activities during the relevant period. In May 2012, during a physical

consultative examination, Plaintiff reported that she could perform housework, do laundry, shop

for groceries, and complete personal grooming activities (Tr. 16, 305). During her psychological

consultative examination, Plaintiff again reported that she could complete personal hygiene on a

daily basis, do laundry, prepare simple meals, and manage her own money (Tr. 21, 309). Contrary

to Plaintiff’s contention, the ALJ did not overemphasize or equate Plaintiff’s activities to

full-time work. She properly considered this evidence when assessing her credibility. See 20

C.F.R. § 416.929(c)(3); Social Security Ruling (SSR) 96-7p, 1996 WL 374186 (stating that the

adjudicator may consider evidence of an individual’s daily activities when assessing credibility). 

Plaintiff also asserts that her ability to perform activities of daily living worsened from

January 2012 to May 2013. Plaintiff made the above statements to the consultative examiners in

May 2012, four months after January 2012. During the hearing in May 2013, Plaintiff’s testimony

did not show a significant decrease in her ability to perform activities of daily living compared to

her May 2012 statements. Plaintiff testified that she performed household chores during her good

days, washed dishes every now and then, and didn’t really cook besides preparing “a sandwich or

something” (Tr. 51). She stated that her parents did not have a washer and dryer at their house so

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they would do her laundry for her if she did not feel good (Tr. 51). The primary difference

between Plaintiff’s situation prior to January 2012 and after January 2012 was that she went from

living with her boyfriend to living with her parents (Tr. 51-52). 

The Plaintiff further contends that the ALJ erred in not incorporating in the hypothetical

and RFC the limiting effects related to her headache impairment and related to the

anticoagulation treatment. Again, however, as the Commissioner notes, the ALJ did not have to

include limitations related to Plaintiff’s headaches and anticoagulation treatment that were not

credible and not supported by the record in her residual functional capacity assessment and

hypothetical question. An “ALJ is required only to incorporate into h[er] hypothetical question

those impairments and limitations that [s]he accepts as credible.” Schmidt v. Astrue, 496 F.3d

833, 846 (7th Cir. 2007). Regarding her headaches, Plaintiff complained that light and sound

triggered her headaches. The ALJ discussed Plaintiff’s reported headaches at length (Tr. 14-22).

The ALJ noted that Plaintiff reported mild headaches in April and July of 2012 (Tr. 16-17). The

ALJ also noted that a July MRI showed chronic ischemic lesions in Plaintiff’s right parietal lobe

in the anterior right caudate nucleus; however, her intracranial vasculature was grossly intact and

there was no extracranial stenosis or dissection (Tr. 17, 395-96). A three-day EEG study was

normal during the awake, drowsiness, and sleep portions of the study with no epileptiform

activity and no clinical events (Tr. 17-18, 587). Plaintiff continued to report headaches through

December 2012 (Tr. 18-19). The ALJ noted that her headaches improved with medication (Tr. 19,

488-89, 491, 493, 495). She also reported having a headache in April 2013, but diagnostic

imaging of her head was negative (Tr. 19-20, 378). Additionally, Plaintiff did not follow her

prescribed treatment and take her medications regularly during the entire relevant period (Tr. 15,

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488-89, 498-99). As the ALJ’s decision reflects, she analyzed the relevant medical evidence and

reasonably determined that Plaintiff’s headaches were not as debilitating as she claimed, and the

medical documentation noted that they improved with medication.

Further, there is no evidence that light and sound were triggers for Plaintiff’s headaches.

Importantly, despite her complaints, no physician found that Plaintiff’s headaches were triggered

by light and sound and did not identify any such restrictions. Likewise, despite Plaintiff’s claim

that she could not use sharp tools or objects due to her anticoagulation treatment, no physician

indicated such a functional limitation. 

In sum, the ALJ reasonably considered the entire case record in her credibility analysis,

ultimately concluding that Plaintiff’s pain or its impact on her functionality was not as severe as

she alleged. The ALJ did, however, credit Plaintiff’s allegations of increased pain at least to some

extent because she limited Plaintiff to a restricted range of sedentary work (Tr. 14). 

Lastly, Plaintiff asserts that the ALJ failed to build an accurate and logical bridge between

the evidence of impairments, the hypothetical, and the RFC. When making her decision, the ALJ

must build a logical bridge from the evidence to her conclusion. Haynes v. Barnhart, 416 F.3d

621, 626 (7th Cir. 2005). In doing so, the ALJ must “connect the dots” between the claimant’s

impairments – as supported by substantial evidence in the record – and the residual functional

capacity finding. Young v. Barnhart, 362 F.3d 995, 1002-03 (7th Cir. 2004). In the present case,

the ALJ explained that, in making her residual functional capacity finding, she considered the

objective medical evidence, the medial opinion evidence, the state agency opinions, and

Plaintiff’s allegations (Tr. 14, 22).

The ALJ found that Plaintiff’s impairments limited her to a range of sedentary work with

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the following restrictions: occasional climbing ramps, stairs, ladders, ropes, or scaffolds, and

occasional balancing, stooping, crouching, kneeling, and crawling; no exposure to unprotected

heights, operation of motor vehicles, and use of dangerous machinery; low-stress work defined as

having only occasional decision making and occasional changes in the work setting; no complex

or detailed tasks, but could perform simple, routine, and repetitive tasks consistent with unskilled

work, and could sustain such work and attend to task throughout the workday; superficial

interaction with coworkers, supervisors, and the public, with superficial interaction defined as

occasional and casual contact not involving prolonged conversation or discussion of involved

issues, but would be able to tolerate contact with supervisors involving necessary instruction (Tr.

14). 

The ALJ found that Plaintiff would be able to stand and walk, with normal breaks, for

approximately two hours per eight-hour workday and would be able to sit with normal breaks for

approximately six hours per eight-hour workday (Tr. 14). The ALJ reached this residual

functional capacity finding by weighing the record evidence as a whole, including the opinions

and findings of the treating, examining, and non-examining physicians (Tr. 9-24).

Plaintiff objects to the ALJ’s residual functional capacity finding, arguing that the ALJ’s

limitation to occasional climbing of ladders, ropes, and scaffolds is inconsistent with her seizure,

syncope, and hypotension impairments. She specifically argues that such activities could lead to a

fall or serious bleeding episodes. Additionally, Plaintiff asserts that “occasional” means an

individual could spend a third of the workday climbing ladders, ropes, and scaffolds. As the

Commissioner points out, however, this argument is illogical because the sedentary exertional

level dictates that approximately 6 hours be spent sitting.

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Additionally, Plaintiff cites no evidence or authority to support her argument.

Significantly, no physician of record found that she could never climb ladders, ropes, or scaffolds.

Further, the state agency physician indicated that she could perform sedentary work as well as

occasional climbing of ladders, ropes, and scaffolds (Tr. 331). A second state agency physician

affirmed this opinion as written (Tr. 347).

Plaintiff’s argument that the ALJ opined that she could spend a third of the workday

climbing ladders, ropes and scaffolds is erroneous and unsupported. Sedentary work involves

lifting no more than ten pounds at a time and occasionally lifting or carrying articles like docket

files, ledgers, and small tools. 20 C.F.R. § 416.967(a). SSR 83-10 provides:

“Occasionally” means occurring from very little up to one-third of the time. Since

being on one’s feet is required “occasionally” at the sedentary level of exertion,

periods of standing or walking should generally total no more than about 2 hours

of an 8-hour workday, and sitting should generally total approximately 6 hours of

an 8-hour workday. Work processes in specific jobs will dictate how often and

how long a person will need to be on his or her feet to obtain or return small

articles. 

1983 WL 31251, *5. Thus, an individual limited to sedentary work requiring sitting

approximately 6 hours of an 8-hour workday, could be on her feet “very little up to one-third of

the time.” This does not equate with spending two or mor hours climbing ladders, ropes and

scaffolds. 

An ALJ is directed to call upon a vocational expert in cases when the claimant, as in this

case, has a combination of both exertional and nonexertional limitations. See SSR 83-14, 1983

WL 31254, *4. In the present case, because Plaintiff had a combination of exertional and

nonexertional limitations, the ALJ consulted with a vocational expert, who identified a significant

number of sedentary jobs in the national economy that an individual with Plaintiff’s specific

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functional limitations could perform (Tr. 23, 70-71). Accordingly, the ALJ appropriately relied on

the vocational expert testimony that Plaintiff could perform the sedentary occupations that existed

in significant numbers in the national economy.

In any event, Plaintiff’s argument is irrelevant because none of the three jobs that the

vocational expert identified require climbing of any type. See Dictionary of Occupational Titles

(DOT) No. 713.687-026, Optical Final Assembler; DOT No. 739.687-082, Table Worker; DOT

No. 209.587-010, Addresser (all indicating “Climbing: Not Present - Activity or condition does

not exist”). Therefore, to the extent Plaintiff argues she could not perform climbing of ladders,

ropes, and scaffolds, the Commissioner still met her burden at step five because Plaintiff could

perform the occupations identified by the vocational expert, which did not require any climbing.

Plaintiff also contends that the ALJ erred by not including a limitation restricting the use

of sharp objects or tools because a puncture from such items could lead to “a life threatening

bleeding episode”. Despite Plaintiff’s testimony that she was advised not to shave her legs with a

razor or use knives due to her anti-coagulant treatment (Tr. 49), there is no medical source

statement from a physician of record precluding Plaintiff from working in the presence of sharp

objects. Nor did any of the state agency physicians indicate that Plaintiff had such a limitation

(Tr. 329-36, 347).

There is no evidence that individuals receiving anti-coagulant therapy are isolated from all

potential injury. Clearly, even if they do not work outside their homes, such persons encounter

numerous hazards in the course of their daily lives, from kitchen knives to shaving razors.

Hazards are also present in the workplace; some are acceptable risks for those taking

anticoagulant medication, and some are not. With the exception of the table worker position, the

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vocational expert did not identify hazardous jobs that would result in a high probability of skin

injuries to Plaintiff; rather, he identified work such as an optical final assembler and an addresser,

that do not involve using sharp instruments (such as knives, razors, or scissors), and are

reasonably safe and an acceptable risk. The ALJ reasonably relied on that testimony. Therefore,

substantial evidence supported the ALJ’s determination.

Based on the above-mentioned evidence, the ALJ adequately articulated her reasoning for

her findings, and built a “logical bridge” from the evidence to her conclusion, and “connected the

dots” between Plaintiff’s impairments and her functional capacity finding. See Haynes, 416 F.3d

at 626; Young, 362 F.3d at 1002-03.

Conclusion

On the basis of the foregoing, the decision of the Commissioner is hereby AFFIRMED.

 

 Entered: February 8, 2016.

 s/ William C. Lee 

 William C. Lee, Judge

 United States District Court

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