UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

JANETTE M. ILIFF, )

)

 Plaintiff, )

)

 v. ) CIVIL NO. 3:15cv153

)

CAROLYN W. COLVIN, )

Acting Commissioner of the )

Social Security Administration, )

)

 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 Disability

Insurance Benefits as provided for in the Social Security Act. 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 last met the insured status requirements of the Social Security Act

on December 31, 2013.

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2. The claimant did not engage in substantial gainful activity during the period from

her alleged onset date of March 8, 2011 through her date last insured of December

31, 2013 (20 CFR 404.1571 et seq.)

3. Through the date last insured, the claimant had the following severe impairments: 

degenerative disc disease lumbar spine; status post left foot tarsal tunnel release

on 8/24/2011; status post left foot tarsal tunnel release on 9/19/2013; and

neuropathy lower extremities (20 CFR 404.1520(c)).

4. Through the date last insured, the claimant did not have an impairment or

combination of impairments that met or medically equaled the severity of one of

the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR

404.1520(d), 404.1525 and 404.1526).

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

through the date last insured, the claimant had the residual functional capacity to

perform sedentary work as defined in 20 CFR 404.1567(a) except lift/carry 10

pounds occasionally and lesser weights frequently; sit 6 hours in an 8-hour

workday; stand/walk 2 hours in an 8-hour workday; occasionally climb ramps and

stairs; never climb ladders, ropes or scaffolds; occasionally balance, stoop, or

crouch; never kneel or crawl; occasionally use the left foot to operate foot

controls; avoid concentrated exposure to wetness, including wet, slippery, uneven

surfaces; and avoid concentrated exposure to hazards, such as unprotected heights

and dangerous machinery.

6. Through the date last insured, the claimant was unable to perform any past

relevant work (20 CFR 404.1565).

7. The claimant was born on March 4, 1963 and was 48 years old, which is defined

as a younger individual age 45-49, on the alleged disability onset date. The

claimant subsequently changed age category to closely approaching advanced age

(20 CFR 404.1563).

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

English (20 CFR 404.1564).

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

the claimant was a younger individual age 45-49, because using the MedicalVocational Rules as a framework supports a finding that the claimant is “not

disabled,” whether or not the claimant had transferable job skills (See SSR 82-41

and 20 CFR Part 404, Subpart P, Appendix 2).

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

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functional capacity, there were jobs that existed in significant numbers in the

national economy that the claimant could have performed, while the claimant was

a younger individual age 45-49 (20 CFR 404.1569 and 404.1569(a)).

11. The claimant has acquired work skills from past relevant work (20 CFR

404.1568).

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

functional capacity, the claimant had acquired work skills from past relevant work

that were transferable to other occupations with jobs existing in significant

numbers in the national economy (20 CFR 404.1569(a) and 404.1568(d)). As of

March 4, 2013, the claimant attained age 50, or was closely approaching advanced

age.

13. The claimant was not under a disability, as defined in the Social Security Act, at

any time from March 8, 2011, the alleged onset date, through December 31, 2013,

the date last insured (20 CFR 404.1520(g)).

(Tr. 21-31).

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 January 4, 2016. On April 12, 2016, the defendant

filed a memorandum in support of the Commissioner’s decision. Plaintiff has not filed a reply. 

Upon full review of the record in this cause, this court is of the view that the ALJ’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

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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

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 DIB in July 2012, alleging disability beginning March

2011. The Agency denied Plaintiff's application initially and upon reconsideration, and Plaintiff

requested a hearing. In October 2013, an Administrative Law Judge (ALJ) held a video hearing

during which Plaintiff, who was represented by an attorney, and a vocational expert testified. In a

January 2014 decision, the ALJ found that Plaintiff retained the residual functional capacity

(RFC) to perform a reduced range of sedentary work. See 20 C.F.R. § 404.1520. The Appeals

Council denied Plaintiff's request for review in February 2015 (Tr. 1-3), thereby making the ALJ's

decision the final decision of the Commissioner. 20 C.F.R. § § 404.1555, 404.1581. 

Plaintiff testified that she was born on March 4, 1963 and was 50 years old on the date of 

the hearing. She lives with her husband and her 13 year old son in a single-level home She is 5'5''

tall and weighs 155 pounds. She completed the 12th grade and is able to read and write. She has

never had any additional vocational training. Plaintiff stated that she has not worked since March

2011. Her most recent work was for Dollar General as a cashier/stocker. She was also

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considered fourth key management. Her job required her to run the cash register, stock

merchandise on the shelves, open and close the store and deal with the money. She estimated that

the most she had to lift and carry was about 20 pounds She was mostly on her feet when

performing her job. Before she worked at Dollar General, she worked for Adkev operating a

plastic injection molding machine. That job required her to lift and carry 10 to 15 pounds and she 

was required to be on her feet the entire day.

Prior to working for Adkev, Plaintiff ran her own licensed day care. Her duties included 

cooking meals, watching the children, and taking care of them. She stated that she typically

had about five children in the summer months but she also had some part-time after school and at 

other times. She estimated the most she had to lift was probably about 25 pounds. She usually

spent half the day on her feet and half the day sitting. In 1998 and 1999 she worked for two

printing companies. Her duties involved running the printing machines and sometimes cutting

paper. The most she had to lift or carry was approximately 30 pounds. The job required her to be

on her feet the entire day.

Plaintiff testified that she is unable to work because of problems with her spine. She has 

bulging discs, herniated discs and "like a hole or something" in the spinal cord in the cervical 

area. She also has issues with the nerves in her feet. They are pinched off and she has tarsal

tunnel syndrome. She reported that her conditions cause her pain in her neck, shoulders, back,

hips and feet. The pain is always there and she described it as stabbing, burning and severe. She

has previously received injections in her neck and feet but they did not always provide relief. She

stated that she had surgery on her left foot the week before the hearing and even with all of the

6
treatment she has received, she believes her conditions are getting worse. 

Plaintiff testified that being on her feet, bending, and stooping makes her pain worse. 

The only thing that gives her some relief is to lie down with a pillow under her neck and a pillow 

propping up her feet. She frequently lies down and elevates her legs above her heart. She is

currently on medication for her thyroid, high blood pressure, potassium issues, nerve pain, muscle

pain, and overactive bladder. In addition, she is on hormone replacement, B12 medication,

Omeprazole, and inhalers for her COPD. Some of her medications make her very tired . They

also cause severe dry mouth.

Plaintiff stated that she sometimes did household chores such as dusting and straightening

up the house. However, she could only do an activity for a half an hour before needing a break 

She then has to rest for 15 to 20 minutes. She was able to prepare meals but only a couple of

times a week. She occasionally plays cards but she does not have any hobbies. She has not been

on vacation in the last two and a half years. Her husband looks after the dog. She occasionally

drives to her doctor's appointments but she has not been out shopping in a while. She does not

attend parent/teacher meetings for her son. She also does not do any outside chores such as

mowing the lawn or planting a garden. 

Plaintiff estimated that she could lift or carry not much more than five pounds 

repetitively; however, she would not be able to lift that much several times an hour over a two

hour period . She could walk about one small town block before needing to stop and take a

break. She is not able to sit very long before needing to stand. She noted that since she was on

crutches she was forced to stay in her seat throughout the hearing. Typically, she will sit for

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about 20 minutes and then lie down. She cannot bend at the waist very well and she is unable to

squat. She has difficulty using her hands to grip, feel and manipulate things because they lock up

on her. She is most comfortable when lying down and spends approximately 90% of her day

lying down. She has difficulty sleeping.

The medical evidence of record shows that on January 4, 2011, Plaintiff presented to 

Gregory Schweikher, DPM, at Lafayette Podiatry with complaints of generalized bilateral foot 

pain. It was noted that she was scheduled for an epidural injection with pain management on 

January 18, 2011 and any further treatment would be delayed until after the injection. She

returned to Dr. Schweikher on February 8, 2011 for a follow-up of her bilateral plantar fasciitis. 

She complained that her pain continued. On exam, she had positive Tinel's sign in the porta

pedis bilaterally as well as pain with palpation. On February 10, 2011, x-rays of the lumbar spine

showed moderate facet sclerosis and hypertrophy at L5-S1. The overall impression was

moderate facet degenerative changes at L5-S1. 

On April 21, 2011, Plaintiff continued to complain of the signs and symptoms of tarsal

tunnel compression neuritis bilaterally. She again had a positive Tinel's sign in the porta pedis

bilaterally. She was administered injections in the peripheral nerve at the porta pedis bilaterally. 

On May 5, 2011, Plaintiff reported to Dr. Schweikher that she noticed improvement for one week

after the injection but then the pain returned. An exam showed, among other things, positive

Tinel's sign in the porta pedis bilaterally. She was diagnosed with plantar fasciitis, right greater

than left. It was noted that her treatment would consist of bilateral injections in the peripheral

nerves at the porta pedis. 

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On May 20, 2011, Plaintiff reported that her last injections were not effective. An exam 

revealed a positive Tinel's sign bilaterally proximal to the porta pedis/abductor hallucis. She 

was diagnosed with bilateral tarsal tunnel syndrome and bilateral foot injections were

administered. On June 3, 2011, she had a follow-up appointment and reported continued cramps. 

 She stated that the previous injections had barely helped. Dr. Schweikher noted that it appeared 

that each successive set of injections had been less effective. On exam she had a positive Tinel's 

sign in the porta pedis bilaterally and pain on palpation in the medial calcaneal tuberosity. She 

was again diagnosed with bilateral tarsal tunnel syndrome. 

On July 18, 2011, Plaintiff presented to Nicholas Costidakis, DPM, due to bilateral arch 

pain in her feet. She reported pain with ambulation and post-static dyskinesia. She described the 

pain as sharp and aching that was intermittent. She experienced pain both with and without her 

shoes and stated it was aggravated by activity. On exam, she had pain with ambulation and she 

had plantar fasciitis in both feet. She also had pain on palpation of her bilateral arches. Dr. 

Costidakis diagnosed bilateral plantar fasciitis. 

On August 1, 2011, an MRI of the left foot showed severe edema and atrophy of the 

quadratus plantae muscle, moderate edema and mild atrophy within the abductor hallucis muscle, 

and mild edema in the digitorum brevis and abductor digiti minimi muscles. There was bipartite 

medial sesamoid of the first metatarsophalangeal joint with underlying cystic changes and 

edema. There was also bifid appearance of the plantar branch of the peroneus longus tendon and 

a small amount of tenosynovial fluid about the posterior tibialis tendon. John Fiederlein, MD,

interpreted the MRI findings as suggestive of neuropathy of the tibial nerve proximal to its

9
branching and therefore consistent with tarsal tunnel syndrome. Alternatively, there might be a

multifocal process involving both the medial and lateral plantar nerves. The same day, an MRI of

the right foot showed severe edema and atrophy of the quadratus platae muscle, mild edema and

atrophy in the abductor hallucis muscle and flexor digitorum brevis muscle, and minimal edema

in the abductor digiti minimi muscle. There was thickening of the proximal 3cm of the central

cord of the plantar fascia with overlying fat pad edema and edema in the subjacent calcaneus. 

There was also bipartite medial sesamoid of the first metatarsophalangeal joint with underlying

edema. Fluid was seen in the internal bursal fluid between the second and third metatarsal heads.

In addition, a small bone fragment was present about the medial malleolus, which was 

likely reflective of a remote avulsion injury. Inhomogeneous bone marrow signal was seen 

within the distal tibia, which like represented islands of hematopoietic bone marrow. There was 

also tenosynovial fluid around the anterior tibialis tendon at the level of the navicular, which was 

consistent with tenosynovitis. 

On August 22, 2011, Plaintiff was given medical clearance for a non-motorized

wheelchair since she would not be able to bear weight on her lower extremities and be unable to

ambulate due to surgery on her foot. On August 24, 2011, Dr. Costidakis performed tarsal tunnel

release surgery on Plaintiff's left foot due to tarsal tunnel syndrome. 

On September 12, 2011, Plaintiff reported the middle of her incision was red and possibly

infected. On September 14, 2011, Plaintiff phoned Dr. Costidakis's office due to bleeding and

redness around her incision every time she showered. She also said the area was very red and

black. 

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On October 4, 2011, Plaintiff presented to Dr. Costidakis for a post-op visit and wound 

care. She described her pain as stinging and it was exacerbated by walking and direct pressure. 

The sites affected included the left ankle medial aspect. On exam, she had edema on the left. She

had a healing ulcer on the left medial aspect of the calcaneus bone. Findings included

granulation, fibrotic tissue, and exposed dermis. Her treatment plan included crutches, a

below-knee walking boot, and partial weight bearing. 

On October 13, 2011, she returned to Dr. Costidakis because her surgical wound was not 

healing. She was compliant with treatment but there had been poor symptom control. Active 

problems were listed as cramp in limb and mid back pain. An exam revealed an ulcer (the

incision site remained open but clean), and pain on palpation of the foot. She was again

diagnosed with tarsal tunnel syndrome. 

On December 12, 2011, Plaintiff was released from wound care but she reported that her

toes were feeling stiff. She had tenderness around the incision site. Lower extremity sensory

evaluation revealed tibial nerve abnormalities (hypesthesia). Dr. Costidakis noted that she was 

progressing slowly. She had an antalgic gait in her walking boot and decreased response to light

touch. Her diagnosis was tarsal tunnel syndrome. 

On February 28, 2012, Plaintiff had a consultation with Douglas K. Blacklidge, DPM. 

She reported previous back surgery in 1992 and problems with her left foot persisting since 

2008. She reported that even after her tarsal tunnel release was performed she has not had 

significant relief of her symptoms. She also had some wound healing complications. Most of her 

pain was now paresthesia along the plantar lateral foot more so than plantar medial but she did 

11
have paresthesia along both the medial and lateral plantar nerves. An examination revealed

localized venous stasis changes in the tarsal tunnel area, left greater than right. She had some

paresthesia in the left plantar foot lateral plantar nerve more so than in the medial plantar nerve. 

The distal tarsal tunnel area and abductor hallucis muscle origin area was painful to compression

and there was tingling on percussion. She also had mild hallux valgus deformity on the left ankle

joint. Dorsiflexion was restricted with the knee extended more so than flexed. She also had some

diffuse pain in the left dorsolateral lateral column. 

Dr. Blacklidge diagnosed tarsal tunnel syndrome persisting status post previous 

attempted release with compression neuropathy in the lateral plantar nerve greater than the

medial plantar nerve. There was questionable associated plantar fasciitis and lateral column 

overload. She also suffered from equinus. 

On March 5, 2012, Plaintiff underwent an ankle/foot initial evaluation at Lafayette 

Rehabilitation Services. She complained of bilateral foot problems, left greater than right, for 

many years. She had surgery in August 2011 but it did not help. She reported that her pain 

increased with walking and even with just putting her feet on the floor. Her ankles felt weak and 

she was very cautions with walking over uneven ground. On exam, her gait was antalgic and she

had decreased stance time on the left lower extremity. She was tender over her surgical incision 

and she had bilateral plantar fascia. After her evaluation, it was noted that she demonstrated 

significant deficits in bilateral ankle dorsiflexion and general left ankle motion and strength. She 

was diagnosed with bilateral equinus, plantar fasciitis, and tarsal tunnel syndrome.

On March 27, 2012, Plaintiff returned to Dr. Blacklidge. She reported that she had been 

12
participating in physical therapy but her pain continued to persist. She also complained that her 

ankle swelled as the day progressed. On exam, there was evidence of continued tarsal tunnel 

syndrome especially at the lateral plantar nerve. There was evidence of venous insufficiency and 

she had restricted ankle in dorsiflexion with the knee extended and pain on palpation of the 

plantar fascia origin. She was diagnosed with tarsal tunnel syndrome with slight compression

neuropathy in the lateral plantar nerve, equinus, and plantar fasciitis. 

On April 27, 2012, Plaintiff went to the Pain Clinic due to long-standing lower back pain, 

neck pain, hip pain, bilateral posterior leg pain and severe burning in her feet. It was noted she 

had a laminectomy in 1992 and she was currently undergoing physical therapy for her feet. She 

described her pain as constant, sharp and annoying. On exam, her lungs were diminished

bilaterally. Her gait was slow and guarded and standing up required a lot of time and effort. She

had a lack of lordotic curve. Lumbar flexion was limited to 20 degrees with pain coming back up

and extension was reduced to zero degrees due to pain. Her thoracic back was tender, and the

lumbar area, axially, was tender to palpation. The thoracic and lumbar paraspinal muscles were

tender to direct palpation. Straight leg raise testing was positive bilaterally at 60 degrees. Motor

strength of the lower extremities was 3/5 bilaterally with hip flexion, knee extension, and knee

flexion. Her sacroiliac joints were tender bilaterally. 

Leta Bennison, CFNP, diagnosed lumbago, lumbar degenerative disc disease, lumbar 

facet arthropathy, lumbar radiculopathy, failed back syndrome status post lumbar surgery in 

1992, bilateral hip pain, cervical spondylosis, cervical degenerative disc disease, tobacco use 

disorder, asthma, hypertension (resolved), leg cramps/toe cramps, status post thyroidectomy/ 

13
non-toxic goiter, urge incontinence, fatigue (improved), hypokalemia (all electrolytes were 

normal on January 27, 2011), and fibromyalgia (18/18 trigger points were tender). 

On May 22, 2012, Plaintiff presented to Dr. Blacklidge with continued foot pain. Her

tarsal tunnel release had not been helpful and neither had her orthotics. On exam, she had 

continued pain in the plantar fascia and tarsal tunnel. On June 8, 2012, Plaintiff returned to Dr.

Blacklidge with complaints of considerable bilateral foot pain. She had pain and paresthesia in

the left foot tarsal tunnel area. She reported she was unable to sleep or maintain regular

household duties but that her back currently was hurting worse than her feet. On exam, she had

pain in the region of the tarsal tunnel. Dr. Blacklidge diagnosed tarsal tunnel syndrome versus

lumbar spine radiculopathy versus both. 

On June 19, 2012, Plaintiff presented to Timothy Fisher, MD, with multiple medical 

problems including chronic pain syndrome. Her chief complaint was of chronic worsening low 

back pain with bilateral sciatica and paresthesia of the feet. Her pain was moderate to severe

and worse with certain movements. It limited her activity. Her feet felt numb and tingled at 

times. On exam, she moved gingerly when getting up on to the exam table. She had mid lumbar 

spine tenderness and could straight leg raise to only 5 degrees bilaterally due to back pain. Dr. 

Fisher diagnosed bilateral feet paresthesia, chronic low back pain with bilateral sciatica, and 

chronic tobacco dependence. X-rays showed disc space narrowing at L5-S1, L4-L5, and L3-L4

and the overall impression was multilevel degenerative discogenic changes with no acute osseous

abnormality. 

On June 27, 2012, Plaintiff underwent a nerve conduction study and electromyography. 

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She presented to the study with numbness, paresthesia, and pain involving her bilateral feet. 

She also complained of lower back pain. Khaled Hammoud, MD, concluded it was an abnormal

study that demonstrated a moderate axonal sensorimotor neuropathy in the lower extremities. 

On July 16, 2012, Plaintiff presented to Margaret Laycock, MD, for evaluation and

treatment of peripheral neuropathy. She continued to have low back pain that radiated from the

back to the feet. She also complained of paresthesia in the feet. She had sharp pain in her legs

and feet and the soles of her feet hurt. She had cramps in her feet and some cramps in her hands

and pain in the forearms. Dr. Laycock noted that her plain films of the lumbosacral spine showed

diffuse degenerative changes. An exam revealed decreased range of motion of the cervical spine

in all directions of movement. She was tender to palpation of the cervical and lumbosacral

paraspinous musculature. She had decreased pinprick sensation in the right index finger. 

Reflexes were diffusely diminished in the bilateral upper and lower extremities. The final

impression was extremity pain of uncertain etiology, neck pain (degenerative joint disease), 

and low back pain. 

On July 30, 2012, Plaintiff underwent an MRI of the lumbar spine due to bilateral upper 

and lower extremity numbness. It showed mild disc desiccation at L3-4 and L4-5. At L3-4, 

there was an annular disc bulge. At L4-5 there was moderate diffuse annular disc bulging with a 

superimposed moderate sized central disc protrusion that indented the ventral aspect of the thecal 

sac and produced narrowing of the central canal. At L5-S1 there was minimal annular disc 

bulging but a laterally bulging disc produced leftward foraminal narrowing. The same day, an

MRI of the cervical spine revealed anterior osteophytic spurring at C4-5 and C5-6 and the discs

15
were mildly desiccated. There was a tiny syrinx at the C6-7 level. At C6-7 there was also a

broad-based left paracentral protrusion and disc. On September 6, 2012, Plaintiff returned to Dr.

Laycock for a follow-up examination. Dr. Laycock concluded that the EMG was suggestive of an

L5 radiculopathy. Plaintiff was noted to be holding the left side of her back with her hands and

she stood to rise slowly. She was diagnosed with chronic back pain and neck pain and a cervical

syrinx. 

Also on September 6, 2012, Plaintiff underwent a consultative examination with James 

Auckley, MD. She reported that she suffered from degenerative disc disease, herniated discs, 

osteoarthritis, chronic back pain, neuropathy, plantar fasciitis and tarsal tunnel. She has 

difficulty sitting, standing, and walking and she stated she was unable to do much of anything. 

The muscles on the right side of her body were weak and she suffered from burning and 

cramping in her bilateral feet. She is at risk for falling often and she has previously been 

diagnosed with fibromyalgia. Dr. Auckley noted that she moved slowly and poorly, especially

with the left leg. He diagnosed degenerative disc disease and degenerative joint disease,

hypothyroidism post op, chronic obstructive pulmonary disease/asthma with a history of tobacco

abuse, gastroesophageal reflux disease, and a history of hypertension. 

Range of motion testing revealed deficits with cervical extension, lateral flexion, and 

bilateral rotation. Lumbar extension and bilateral lateral flexion was also decreased. In addition, 

knee flexion was reduced as was bilateral hip abduction, flexion, internal rotation, external 

rotation, and extension. Ankle dorsiflexion and plantar flexion were reduced to zero. Dr.

Auckley opined that she was able to sit for at least two hours and handle objects for at least two

16
hours but she was unable to stand or walk for at least two hours, lift or carry less than 10 pounds

frequently, or lift or carry more than 10 pounds occasionally.

On October 4, 2012, at a physical therapy session at Indiana University Health Arnett, 

Plaintiff reported that she had an episode where she became lightheaded and her vision became 

like a "kaleidoscope." She continued to be lightheaded. She also reported that she did not feel 

physical therapy was helping very much. It was noted that she was moving very slow and 

holding on to objects and walls when walking in and out of therapy. Erin Wohlfert, PT, assessed 

that Plaintiff continued to exhibit decreased flexibility/strength/posture that led to altered 

function.

On January 29, 2013, Plaintiff returned to Dr. Schweikher due to pain and paresthesia in 

her left foot. She complained of heel pain, and paresthesia to her heel and plantar foot. She had 

pain in all shoes, when lying in bed, and post rest. She continued to use her orthotics but was 

otherwise living with the pain. On exam, she had a positive Tinel's sign at the porta pedis, left 

greater than right. She had paresthesia that radiated to the medial heel and lateral plantar foot 

and pain on palpation of the medial calcaneal tuberosity. She was diagnosed with tarsal tunnel 

syndrome and plantar fasciitis of the left foot. 

On March 27, 2013, she complained of pain in her bilateral medial heels. The pain had 

increased significantly in intensity, frequency and duration over the past two months. On exam, 

she had a positive Tinel's sign with percussion / palpation of the porta pedis, left greater than 

right, as well as paresthesia to the digits. She also had mild to moderate pain on palpation to the 

medial calcaneal tuberosity, left greater than right. Dr. Schweikher diagnosed her with bilateral 

17
tarsal tunnel syndrome and administered injections in the medial plantar and lateral plantar 

nerves at the porta pedis bilaterally.

On June 5, 2013, Plaintiff complained of increased pain and paresthesia to the bilateral

heel and toes. She again had a positive Tinel's sign with palpation of the porta pedis bilaterally

and pain on palpation of the medial calcaneal tuberosity bilaterally. Dr. Schweikher diagnosed 

bilateral tarsal tunnel syndrome. She again underwent injections in both feet. 

On August 30, 2013, Plaintiff underwent a consultation regarding another surgery on her 

left foot. She continued to complain of pain and paresthesia radiating to the heel and the mid

arch bilaterally. On exam, she had a strong Tinel's sign with palpation of the porta pedis on the 

left as well as Tinel's sign present with percussion of the tibial nerve on the right. Dr. 

Schweikher diagnosed bilateral tarsal tunnel syndrome and administered injections into the right 

and left tarsal tunnel. 

On September 3, 2013, Dr. Schweikher opined that Plaintiff could stand/walk for less 

than 15 minutes at one time and for a total of less than 60 minutes in a workday. She could sit 

for six hours at one time for a total of six hours in a workday. She could lift less than five 

pounds occasionally and less than five pounds frequently. She could rarely bend, stoop, or 

balance. She would need to elevate her legs during an eight hour workday. He opined that the 

pain she suffers from is severe and that her experiences of pain or other symptoms would be 

severe enough to occasionally interfere with attention and concentration. Lastly, he opined that, 

on average, she would be absent from work as the result of her impairments or treatment more 

than four days per month. 

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On September 12, 2013, Leta Bennison, FNP, opined that Plaintiff would need to elevate 

her legs during an eight hour workday. She believed that Plaintiff suffered from severe pain and 

that her experiences of pain or other symptoms were frequently severe enough to interfere with 

attention and concentration. Lastly, Plaintiff would be absent from work, on average, more than 

four days per month as a result of her impairments or treatment. 

On September 18, 2013, Plaintiff presented to Dr. Schweikher for a preoperative 

appointment. On exam, she had positive Tinel's sign with percussion to the tibial area and a 

strong Tinel's sign with percussion to the porta pedis on the left. She also had paresthesia that 

radiated to the medial heel and lateral plantar foot, and pain on palpation to the medial calcaneal 

tuberosity on the left. She was diagnosed with tarsal tunnel syndrome. 

On September 19, 2013, Plaintiff underwent another tarsal tunnel release surgery on her 

left foot. On September 27, 2013, she returned to Dr. Schweikher. She complained of pain at

times and that she tried to keep her left foot elevated. She was ambulating on crutches and was

not to bear weight on her left foot. She had mild edema. Dr. Schweikher wanted her to continue

to not bear weight on her left foot. 

In support of remand or reversal, Plaintiff argues that the ALJ improperly discredited the

opinion of her treating physician, Dr. Schweikher. Pursuant to the regulations, a treating source

opinion is entitled to controlling weight only if it is "well-supported by medically acceptable

clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial

evidence in [the] case record." 20 C.F.R. § 404.1527(c)(2); Schmidt v. Astrue, 496 F.3d 833, 842

(7th Cir. 2007); see also Knight v. Chater, 55 F.3d 309, 314 (7th Cir. 1995) (ALJ reasonably

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discounted opinion that was not supported by doctor's own treatment notes); Luster v. Astrue, 358

F.App'x 738, 740 (7th Cir. 2010) ("This court upholds all but the most patently erroneous reasons

for discounting a treating physician's assessment"). In determining the weight of medical source

opinions not entitled to controlling weight, an ALJ will evaluate the following factors: the length,

nature, and extent of treatment relationship; evidence in support of the opinion; consistency with

the record as a whole; and the physician's specialization. 20 C.F.R. § 404.1527(c)(2)-(5). 

Although the regulations provide factors for weighing physician opinions, they do not mandate

that an ALJ must always adopt the opinion of a treating source. 20 C.F.R. § 404.1527(c). 

 Plaintiff argues that the ALJ erred by not giving Dr. Schweikher's opinion "controlling

weight". Plaintiff also argues that the ALJ failed to provide "good reasons" for assigning "little

weight" to Dr. Schweikher's opinion. 

Dr. Schweikher completed a form in September 2013, in which he opined that Plaintiff

could stand/walk less than 15 minutes at one time and for 60 minutes total in a workday; sit 6

hours at one time and for 6 hours total in a workday; occasionally or frequently lift less than 5

pounds; and rarely bend, stoop, and balance. Dr. Schweikher also opined that Plaintiff needed 

to elevate her legs during an 8-hour workday. Dr. Schweikher further opined that Plaintiff

suffered from pain that was severe, that her pain or other symptoms were severe enough 

to occasionally interfere with her attention and concentration, and that she would be absent more 

than four days per month. 

In his decision, the ALJ discussed Dr. Schweikher's opinion and gave it "little weight"

because it was not consistent with the evidence, including Dr. Schweikher's own treatment

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records and other evidence. The ALJ acknowledged that Dr. Schweikher treated Plaintiff for her

tarsal tunnel release and noted his treatment during several visits. The ALJ also found that Dr.

Schweikher's opinion was not consistent with Dr. Schweikher's findings and with Plaintiff's

statements one week post-op that her pain was 3-4 out of 10 with medications. The ALJ also

noted that there were no indications in Dr. Schweikher's records regarding a need for Plaintiff to

keep her legs elevated, other than during the post-operative period when Plaintiff reported she

was trying to do so. 

Further, the ALJ found that Dr. Schweikher's opinion was inconsistent with the objective

evidence in the record. The ALJ discussed and weighed the record evidence earlier in the

decision before weighing the medical opinions, and cited evidence that was inconsistent with Dr.

Schweikher's opinion. For example, in September 2012, Plaintiff was seen by Dr. James Auckely

for a physical consultative examination. Plaintiff reported a history of hypertension that was not

well controlled, but also reported she was not taking medications for it. Dr. Auckely found that

Plaintiff was able to get on and off the table without difficulty, had no ulcerations or edema, had

5/5 muscle strength with intact sensation, and had negative straight leg raises. Plaintiff also had a

normal gait and station not using an assistive device, was able to walk on her heels/toes, and bend

all the way forward, was able to squat, but moved slowly and poorly, especially her left leg. 

 Additionally, Plaintiff also saw Dr. Margaret Laycock in September of 2012. Dr. Laycock

noted Plaintiff had some improvement after pain clinic treatment, but had been wanting opioidtype medications that were not an option because she failed to take the drug test in 2010. Dr.

Laycock opined that the majority of Plaintiff’s pain was coming from muscle spasm, and advised

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that physical therapy was the best means for improvement in her chronic back pain symptoms.

Clearly, the ALJ identified sufficient good reasons to discount Dr. Schweikher's opinion.

When summarizing the medical evidence, the ALJ discussed Dr. Schweikher's 

treatment notes, which were inconsistent with Dr. Schweikher's restrictive opinion that Plaintiff 

suggests shows she is disabled. The ALJ noted that Dr. Schweikher treated Plaintiff with

corticosteroid injections in March 2013. Dr. Schweikher noted that findings had improved to

mild in a follow-up visit in June 2013, gave Plaintiff corticosteroid injections again in June and

August 2013, and performed a tarsal tunnel release of Plaintiff's left foot in September 2013. The

ALJ pointed out that one week post-op, Plaintiff reported to Dr. Schweikher that her pain was

3-4 out of 10 with medications. 

 The ALJ also noted that there were no indications in Dr. Schweikher's own treatment 

records supporting his opinion that Plaintiff needed to elevate her legs, other than during the

post-operative period when Plaintiff stated that she was trying to keep them elevated. The ALJ

found when summarizing the medical evidence that there was no need to include a leg elevation

requirement so soon after surgery consistent with the treatment record and improvement from her

first tarsal tunnel release. Specifically, the ALJ noted that the record indicated that Plaintiff was

off crutches, using a walking boot, and released to use gym shoes as tolerated four months after

Plaintiff's prior tarsal tunnel release in 2011. 

Plaintiff contends that Dr. Schweikher's findings do support his opinion and that the ALJ

gave no examples of the inconsistencies between Dr. Schweikher's opinion and his findings. 

However, Plaintiff fails to show that the ALJ impermissibly considered Dr. Schweikher's

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treatment notes. As discussed above, the ALJ's decision noted Dr. Schweikher's treatment

records did not indicate Plaintiff needed to keep her legs elevated other than during the

post-operative period, and thus the treatment records were inconsistent with Dr. Schweikher's 

opinion. The ALJ reasonably considered Plaintiff's treatment history with Dr. Schweikher, noted

the lack of consistency between his opinion with other record evidence, and cited these factors in

rejecting Dr. Schweikher's opinion. Clearly, the ALJ did discuss and cite Dr. Schweikher's

treatment records, and Plaintiff fails to show how Dr. Schweikher's treatment records support his

opinion. Plaintiff also ignores that the ALJ discounted Dr. Schweikher's opinion for other reasons

in addition to noting that the opinion was inconsistent with his treatment records. 

The ALJ's decision discussed and weighed the physical exam and diagnostic clinical 

findings in the record, and reasonably found the objective medical evidence was not consistent 

with Dr. Schweikher's restrictive opinion. For example, the ALJ noted Plaintiff's improvement 

after her August 2011 left foot tarsal release, and considered the medical findings and treatment 

records of Plaintiff's physician Nicholas Costidakis, D.P.M., after this procedure. While Dr.

Costidakis diagnosed bilateral plantar fasciitis one month before Plaintiff's left foot tarsal tunnel

release, Dr. Costidakis also found that Plaintiff had normal gait and 5/5 muscle strength. During

Plaintiff's post-operative follow-up in October 2011, Dr. Costidakis noted that Plaintiff's

condition was improving, musculoskeletal findings were negative, and he permitted partial weight

bearing with crutches and a walking boot. Further, although Plaintiff reported that her toes felt

stiff in December 2011, Dr. Costidakis found that Plaintiff's range of motion was as expected

post-operatively, and permitted Plaintiff to use gym shoes as tolerated, showed her ankle

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exercises to strengthen, and advised a 3-month follow-up appointment. 

The ALJ also considered Plaintiff's diagnostic medical findings, including mild/moderate

MRI, nerve conduction study, and EMG findings. A lumbar spine MRI in July 2012 showed mild

to moderate degenerative discogenic findings. A cervical spine MRI that same day showed

degenerate changes with small paracentral disc protrusion at C6-C7, but without focal neural

impingement, and a tiny syrinx in the lower cervical cord that was noted to be "an incidental

finding of doubtful clinical significance". In June 2012, a nerve conduction study showed

moderate axonal sensorimotor neuropathy in the lower extremities, and an EMG of bilateral L4-5

and L5-S1 was unremarkable. 

The ALJ also considered physical exam findings and treatment by Douglas Blacklidge, 

D.P.M., which primarily included recommendations for physical therapy, compression stockings, 

and rigid soled shoes. In February 2012, Dr. Blacklidge noted that Plaintiff reported pain along

the plantar left foot, and paresthesias along both the medial and lateral plantar nerves. Dr.

Blacklidge also observed that sensorium was mostly intact with some paresthesias in the plantar

foot left lateral nerve, more than in the medial plantar nerve, no weakness or spasticity, and

restricted ankle joint dorsiflexion. Dr. Blacklidge recommended aggressive stretching of the

muscles and wearing shoes that did not flex at the midfoot. In March 2012, Dr. Blacklidge noted

that Plaintiff had not purchased the shoes he recommended, and diagnosed tarsal tunnel

syndrome, slight compression neuropathy lateral plantar nerve, and plantar fasciitis. Dr.

Blacklidge recommended compression stockings, rigid soled shoes with elevated heel, and

continued physical therapy. Dr. Blacklidge recommended a modification of Plaintiff's orthotic

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device in May 2012, and noted that Plaintiff reported her back hurt more than her foot in June

2012. 

The ALJ further considered the physical exam findings by Timothy Fisher, M.D., James 

Auckely, M.D., and Margaret Laycock, M.D. In July 2012, Dr. Fisher observed that Plaintiff had

normal strength and muscle tone, symmetric reflexes but diffusely diminished in the upper and

lower extremities, gait and station within normal limits, normal free gait and base, normal toe and

heel walk, and negative straight leg raise. Consultative examining physician Dr. Auckely

examined Plaintiff in September 2012, and observed that Plaintiff could get on and off the table

without difficulty, had 5/5 muscle strength with intact sensation, no ulcerations or edema, and had

negative straight leg raise. Dr. Auckely also found decreased range of cervical spine extension

and rotation, lumbar forward flexion, knee flexion, hip adduction, and ankle dorsiflexion and

plantar flexion. Dr. Auckely observed that Plaintiff moved slowly and poorly, especially her left

leg, yet he also found that she had normal gait and station not using an assistive device, and was

able to walk on her heels/toes, bend all the way forward, and squat. That same month, Dr.

Laycock noted that the majority of Plaintiff's chronic back pain was coming from muscle spasm,

and that her options for treatment were physical therapy and pain management through a pain

clinic. In light of all the above, this court finds that the ALJ reasonably discounted Dr.

Schweikher's opinion because it was unsupported by the physical exam findings and other

objective medical evidence. 

Plaintiff argues that her previous tarsal tunnel release "clearly did not fix her problems 

and the relief it provided was only temporary," as she needed to "continually seek treatment for 

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her tarsal tunnel syndrome and have another tarsal tunnel release in September 2013" (Pl. Br. 

25). However, Plaintiff does not show how her improvement after her first procedure and 

continuing treatment supports Dr. Schweikher's restrictive opinion. In discussing the medical 

evidence after Plaintiff's first tarsal tunnel release, the ALJ also noted that the evidence

suggested noncompliance with her other doctors' recommendations. In February 2012, Dr.

Blacklidge indicated that Plaintiff had no stretching exercises or physical therapy, and 

no compression stockings, and in March 2012, Plaintiff had not purchased the shoes 

recommended by Dr. Blacklidge the prior month. In March 2012, the physical therapist noted

deficits in bilateral ankle dorsiflexion and left ankle general motion, but also noted that it was

unclear whether Plaintiff had ever performed her home exercises. 

Plaintiff cites medical evidence in support of her argument, but fails to show how the 

objective medical evidence supports Dr. Schweikher's opinion or how the ALJ erred in 

evaluating his opinion. Plaintiff's argument essentially asks this Court to re-weigh the evidence 

anew and resolve conflicts of fact that the ALJ already reasonably resolved, which it cannot do 

on appeal. See Powers, 207 F.3d at 434-35 (stating that because the Commissioner is 

responsible for weighing the evidence, resolving conflicts and making independent findings of

fact, the court may not decide the facts anew, re-weigh the evidence or substitute its own

judgment). Plaintiff also criticizes the ALJ's statement that Dr. Schweikher's opinion appeared 

to give greater walking limitations than are supported by Plaintiff's testimony. Even if the ALJ

could have further clarified this reason and inquired how long it took Plaintiff to walk a block, the

ALJ provided sufficient reasons to discredit Dr. Schweikher's opinion as discussed above. The

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ALJ already reasonably considered the objective evidence, including evidence cited by Plaintiff,

in determining not to adopt Dr. Schweikher's opinion. 

Moreover, to the extent Plaintiff suggests that the ALJ was required to discuss or cite 

every piece of evidence in his decision, Plaintiff is wrong. As the Seventh Circuit has explained, 

the "ALJ is not required to discuss every piece of evidence but is instead required to build a 

logical bridge from the evidence to her conclusions." Simila v. Astrue, 573 F.3d 503, 513-16 

(7th Cir. 2009). Here, the ALJ built a logical bridge between his decision and the evidence by

evaluating the evidence in the record and explaining his rationale by citing the facts discussed 

above. Accordingly, it was reasonable for the ALJ to conclude that Dr. Schweikher's opinion

was not consistent with the record. 

In any event, Plaintiff testified that she can probably walk a small town block before

taking a break and can stand maybe a half hour before having to sit down. She further testified

that her activities of daily living include cooking meals a couple times a week, sweeping the floor,

helping with laundry, watching television, using the computer to play games, go on Facebook, or

look things up, playing cards and driving occasionally. As the ALJ noted, these activities are

consistent with the residual functional capacity to sit 6 hours and stand/walk 2 hours in an 8-hour

day. Thus Dr. Schweikher’s opinion is not consistent with Plaintiff’s own testimony and, further,

her testimony supports the ultimate conclusion that she is not disabled because she can perform

sedentary work.

In sum, the ALJ properly applied the regulations and considered several factors in 

discounting Dr. Schweikher's opinion. The ALJ reasonably declined to accept the opinion and 

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explained that it was not supported by Dr. Schweikher's own treatment notes or other record 

evidence. Thus, the ALJ provided sufficient reasons for discounting Dr. Schweikher's opinion, 

and the decision will be affirmed. 

Conclusion

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

 Entered: June 15, 2016.

 s/ William C. Lee 

 William C. Lee, Judge

 United States District Court

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