IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 

FORT WAYNE DIVISION 

HOWARD CRUTCHFIELD, ) 

 ) 

Plaintiff, ) 

 ) 

 ) 

vs. ) 

 ) NO. 1:14-CV-00009-RL-RBC 

 ) 

CAROLYN W. COLVIN ) 

COMMISSIONER OF THE ) 

SOCIAL SECURITY ADMINISTRATION, ) 

 ) 

Defendant. ) 

OPINION AND ORDER 

 This matter is before the Court for review of the 

Commissioner of Social Security’s decision denying Disability 

Insurance Benefits to the Plaintiff, Howard Crutchfield. For 

the reasons set forth below, the decision of the Commissioner is 

REVERSED and this case is REMANDED to the Social Security 

Administration for further proceedings consistent with this 

opinion pursuant to sentence four of 42 U.S.C. section 405(g). 

BACKGROUND 

 On December 31, 2010, the Plaintiff Howard Crutchfield 

(“Crutchfield”) filed an application for Disability Insurance 

Benefits (“DIB”). Crutchfield alleged his disability began on 

April 6, 2010, due to: symptoms associated with diabetes; a 
2

heart condition only operating at 45%; blindness in his right 

eye; a kidney condition only operating at 24.6%; a hernia on the 

right side; poor short-term memory; high blood pressure; and 

being prone to sinus and eye infections. (Tr. 134.) The Social 

Security Administration denied Crutchfield’s initial application 

on May 20, 2011, and on reconsideration on August 1, 2011. (Tr. 

44.) Crutchfield filed a written request for a hearing on 

August 25, 2011. (Id.) On June 22, 2012, a hearing was held 

before Administrative Law Judge Steven J. Neary (“ALJ”) in Fort 

Wayne, Indiana. (Tr. 15-38, 44-51.) Crutchfield appeared with 

counsel, Kenneth E. McVey, III. (Tr. 44.) Crutchfield and 

Marie N. Kieffer, an impartial Vocational Expert (“VE”), 

provided testimony at the hearing. (Tr. 17-37.) On August 31, 

2012, the ALJ denied Crutchfield’s DIB claim, finding that 

Crutchfield was not disabled because, after consideration of the 

record, Crutchfield has the Residual Functional Capacity (“RFC”) 

to perform the full range of light work and is capable of 

performing past relevant work despite his limitations. (Tr. 47-

51.) 

 On October 15, 2012, Crutchfield requested that the Appeals 

Council review the ALJ’s decision; his request was denied on 

October 9, 2013. (Tr. 6, 14.) Accordingly, the ALJ’s decision 

became the Commissioner’s final decision. See 20 C.F.R. § 

404.981. Crutchfield has initiated the instant action for 
3

judicial review of the Commissioner’s final decision pursuant to 

42 U.S.C. § 405(g). 

DISCUSSION1

 Crutchfield was born on March 28, 1953, and was 57 years 

old on the alleged disability date of April 6, 2010. (Tr. 120.) 

In the past fifteen years, Crutchfield’s past relevant work 

involves work as a machinist making wooden musical instruments 

at Fox Products. (Tr. 18-19, 135.) 

 The medical evidence can be summarized as follows: 

 Crutchfield was hospitalized on April 6, 2010, after 

experiencing chest pain. (Tr. 204-05.) Dr. Joseph Greenlee III, 

M.D., diagnosed Crutchfield with multivessel coronary artery 

disease, noting that he manifested inferior and lateral changes 

on his electrocardiogram with a bundle-branch pattern, and had 

suffered a significant size infarction based on troponins and 

wall motion abnormalities. (Tr. 205.) Dr. Greenlee recommended 

a surgical revascularization. (Id.) On the same date, 

Crutchfield went through cardiac catheterization, coronary 

angiography and left ventriculography. (Tr. 246-47.) The final 

impression of these tests were severe multivessel coronary 

artery disease involving the left anterior descending, 

 

1 These facts have been borrowed liberally from the parties’ 

briefs.
4

circumflex, obtuse marginal one, distal right coronary artery, 

and posterior descending artery, mild ischemic cardiomyopathy 

with inferior wall motion abnormality, ejection fraction of 45%, 

elevated left ventricular filling pressures and an end-diastolic 

pressure of 22. (Tr. 247.) On April 7, 2010, Crutchfield 

underwent an echocardiogram (“EKG”), the final impressions of 

which were a mild segmental wall motion abnormalities of the 

septum and inferolateral wall of the left ventricle consistent 

with ischemic heart disease, mild left ventricular dysfunction 

reduced ejection fraction to 45%, left ventricular hypertrophy, 

and appearance of slightly dilated left atrium. (Tr. 269-70.) 

On April 7, 2010, Crutchfield was diagnosed with diabetes 

mellitus, type 2, and was noted to have no palpable pulses in 

his feet and diffusely hypoactive reflexes generally. (Tr. 207-

08.) 

 On April 9, 2010, Crutchfield underwent coronary artery 

bypass grafting. (Tr. 219.) On April 11, 2010, Crutchfield had 

X-rays taken which showed the cardiomediastinal silhouette and 

pulmonary vessels were stable, the lungs showed stable perihilar 

infiltrates, and a left pleural effusion was seen, which 

suggested a resolving congestive heart failure with possible 

associated pneumonia. (Tr. 244-45.) Crutchfield was discharged 

on April 13, 2010, with the final diagnosis of (1) acute 

anterolateral/inferior lateral myocardial infarction likely 
5

occurring on April 5, 2010, (2) severe multilevel coronary 

artery disease, (3) mild left ventricular dysfunction secondary 

to ischemic cardiomyopathy, (4) hypertension with hypertensive 

vascular disease, and (5) diabetes mellitus. (Tr. 219.) 

 On April 30, 2010, treating cardiologist Dr. Michael J. 

Mirro, M.D., noted that Crutchfield was unable to attend formal 

cardiac rehabilitation due to cost issues. (Tr. 295-97.) 

Crutchfield was provided with instructions for a home walking 

program and guidelines to assess his heart rate and exercise 

currently at a heart rate of “no higher than 20 beats from his 

resting heart rate.” (Tr. 295.) Dr. Mirro summarized the 

diagnosis as multivessel atherosclerotic coronary artery disease 

with an un-bypassed hazy 25-50% stenosis in the mid-left main 

and non-obstructive proximal circumflex, with complete occlusion 

of the circumflex after the takeoff of the first obtuse marginal, 

with 75% proximal stenosis in the first obtuse marginal. (Tr. 

296.) Dr. Mirro further noted that Crutchfield had previously 

had 50-75% narrowing of the left anterior descending, but this 

had been grafted, as well as two serial 75% narrowing of the 

distal right coronary artery, which had also been grafted. 

(Id.) Dr. Mirro also noted that Crutchfield had mild ischemic 

cardiomyopathy with an ejection fraction of 45%. (Id.) 

 From April 16, 2010, to November 16, 2010, Crutchfield went 

to multiple treatment visits with Dr. C. Bryan Wait, M.D., and 
6

reported to be feeling “pretty good” with no dyspnea or chest 

pain. (Tr. 298-305, 310-32.) However, Crutchfield’s diabetes 

was reported as not controlled several times. (Id.) 

 On February 21, 2011, Dr. Randell Coulter, D.O., examined 

Crutchfield at the Commissioner’s request. (Tr. 266-67.) 

Crutchfield’s blood pressure was high at 164/99, and his active 

medications were Coreg, Plavix, Zocor, ASA, Lisinopril, Novolog, 

and Lantus. (Tr. 266.) Crutchfield reported numbness and 

tingling in his feet, and informed Dr. Coulter of his history of 

coronary artery bypass surgery. (Id.) Upon examination, Dr. 

Coulter noted Crutchfield’s right inguinal hernia, “grossly 

normal” gait, and decreased sensation in the feet. (Tr. 267.) 

Dr. Coulter opined that Crutchfield’s diabetes and resulting 

neuropathy in his feet may cause difficulty with prolonged 

standing and walking, and that Crutchfield is able to maintain 

balance during ambulation while carrying objects less than ten 

lbs. (Id.) Dr. Coulter further stated that Crutchfield could 

lift or carry less than ten pounds or over ten pounds 

occasionally, and is able to stand/walk two hours in an eight 

hour day. (Id.) 

 On February 26, 2011, psychologist, Dr. Amanda L. Mayle, 

Psy.D., evaluated Crutchfield at the Commissioner’s request. (Tr. 

256-64.) Dr. Mayle noted that Crutchfield mentioned his memory 

problems began after his April 2010 heart attack. (Tr. 256.) 
7

Crutchfield reported examples of his memory problems, such as: 

causing a flood in the bathroom because he forgot to turn off 

water; needing to stay with food he is cooking or he fears he 

will cause a fire; and forgetting what his wife tells him, 

despite repeating herself multiple times. (Tr. 259.) 

Crutchfield also stated he could no longer hold a job because of 

the rapid decline in his memory and not being able to remember 

instructions or what he was doing. (Id.) Crutchfield also 

needed his wife’s assistance to manage his funds. (Tr. 258.) 

Based on Dr. Mayle’s clinical evaluation, she opined that 

Crutchfield had poor immediate memory and marginal recent and 

remote memory. (Tr. 257, 259.) Based on testing with the WMSIV to assess Crutchfield’s memory function, Dr. Mayle determined 

that Crutchfield had low average memory level overall, with 

borderline function of visual working memory, low average 

function in auditory and immediate memory and average function 

in visual and delayed memory. (Tr. 259-60.) Dr. Mayle found 

“No Diagnosis” of clinical or personality disorders and a Global 

Assessment of Functioning (“GAF”) score of 50, and noted 

“[h]ealth issues, unemployment, [and] memory difficulty” in 

summarizing Crutchfield’s diagnosis. (Tr. 258.) 

 On March 3, 2011, a non-examining State agency psychologist, 

Dr. William A. Shipley, Ph.D., found that Crutchfield had no 

medically determinable impairment. (Tr. 342.) He noted 
8

Crutchfield’s “[p]oor short term memory,” as well as Dr. Mayle’s 

findings of “memory issues. Intermediate memory was poor; 

recent & remote memory were marginal. . . . Auditory memory was 

low average; visual memory was average; and visual working 

memory was borderline.” (Tr. 354.) He also noted that Dr. 

Mayle had not given Crutchfield a diagnosis. (Id.) A second 

non-examining psychologist, Dr. Joelle J. Larsen, Ph.D., 

reviewed and affirmed this opinion without comment. (Tr. 374.) 

 On April 25, 2011, Crutchfield underwent an EKG at the 

Commissioner’s request. (Tr. 357-58.) The assessment revealed 

a very mild septal hypokinesis, but with preservation of left 

ventricular systolic function, and an ejection fraction of 56%. 

(Tr. 358.) 

On May 17, 2011, Crutchfield underwent an ophthalmology 

evaluation at the Commissioner’s request. (Tr. 361-65.) 

Crutchfield’s uncorrected visual acuity was 20/70 right and 

20/50 left, but corrected with glasses was 20/40 right and 20/25 

left. (Tr. 362.) The examining ophthalmologist noted, “[a]s 

far as eyes[,] assume he could be working at something.” (Tr. 

363.) 

 On May 19, 2011, a non-examining State agency physician, Dr. 

Fernando R. Montoya, M.D., noted that Crutchfield could perform 

light exertional activity, disagreeing with Dr. Coulter’s 

opinion as “not [consistent with] the rest of the [medical 
9

evidence of record] and are given minimal weight.” (Tr. 366-

73.) On July 27, 2011, a second non-examining doctor, Dr. B. 

Whitley, M.D., reviewed and affirmed this opinion without 

comment. (Tr. 375.) On July 29, 2011, a third non-examining 

State agency physician, Dr. Nathaniel Arcega, M.D., affirmed the 

prior State agency opinion, rejecting Dr. Coulter’s opinion as 

not supported because the diagnosis of neuropathy in his feet 

was made with minimal findings and because Crutchfield’s 

ejection fraction was normalized to 56% after his bypass. (Tr. 

377.) 

 On October 24, 2011, Crutchfield was hospitalized again due 

to recurrent chest pain. (Tr. 378-81.) An EKG revealed a left 

ventricular ejection fraction of 55%. (Tr. 382, 386.) A left 

heart catheterization demonstrated severe three-vessel native 

coronary artery disease with a patent left internal mammary 

artery to the left anterior descending, and a patent saphenous 

vein graft to the obtuse marginal and saphenous vein graft to 

the posterior descending artery, with preserved left ventricular 

function. (Tr. 382.) Small vessel disease was believed to be 

the cause of his angina. (Tr. 382, 420-21.) However, after the 

heart catheterization, Crutchfield signed himself out of the 

hospital due to financial reasons. (Tr. 382, 420.) Crutchfield 

also reported difficulty obtaining medications due to lack of 

funds. (Tr. 382-83.) 
10

 Crutchfield returned to Dr. Wait on October 26, 2011, and 

November 9, 2011. (Tr. 408-15.) Crutchfield informed Dr. Wait 

that he was having difficulty affording treatment, but was 

otherwise feeling “pretty good” without chest pain. (Tr. 412.) 

Hearing Testimony 

 At the hearing on June 22, 2012, Crutchfield testified that 

he had not worked since he was laid off sometime in 2009 by Fox 

Products, where he ran machinery to make wooden musical 

instruments. (Tr. 18-19, 26.) Crutchfield said he collected 

unemployment benefits after being laid off, up until two or 

three weeks before the hearing in 2012. (Tr. 25.) Crutchfield 

said he contacted lumber companies after being laid off, but 

they told him his medical problems would be an issue in 

obtaining employment with them. (Tr. 27.) 

Crutchfield was asked if he could still do the job he held 

at Fox Products. (Tr. 19.) He responded that the job does not 

exist anymore, but that if it did, he could try but he has had 

memory problems since his second heart attack. (Id.) 

Crutchfield testified that if he did go back, it would probably 

have to be part-time because he would not be able to last a full 

day. (Tr. 32.) 

Crutchfield testified that he has memory issues, a huge 

hernia, vision problems, low kidney function and infections. 

(Tr. 20.) He further testified that he can only walk for 
11

approximately fifteen minutes before getting short of breath, 

cannot stand very long without getting numb knees, and cannot 

sit for longer than forty-five minutes because of circulation 

issues. (Tr. 21-22.) Crutchfield stated that arthritis in his 

hands requires him to take breaks when washing dishes, such that 

he has to sit down and come back to it. (Tr. 23.) He can 

vacuum, but must take breaks. (Tr. 24.) He stated he does not 

do much for fun anymore, but if he goes out, he does so with his 

family. (Id.) 

Crutchfield indicated he was taking medications but could 

not remember exactly which ones. (Tr. 24-25.) He noted that to 

work around his memory issues, he leaves his pills out in the 

open to remind himself to take them. (Tr. 31.) Crutchfield 

testified that he checks his blood sugar two to three times a 

day. (Tr. 30.) He takes two insulin medications, Novolog and 

Lantus. (Tr. 29-30.) He also takes lisinopril to keep his 

blood pressure under control. (Tr. 32.) Crutchfield claims he 

only takes nitro pills if he is fighting off a heart attack, and 

has not taken one for a year. (Tr. 31.) 

Crutchfield testified that his doctors told him that he had 

a chance at living a normal life after his second heart attack, 

but after his third heart attack, he was not able to bounce back 

like he did after his bypasses. (Tr. 28-29.) Crutchfield 

maintained that he has no stamina, and does not know how long it 
12

will take him to finish something he starts. (Tr. 29.) He 

claimed that it took him two hours to get ready for the hearing 

and that his daughter had to help him get there. (Tr. 27.) 

 The ALJ questioned Crutchfield’s assertions about his 

shortness of breath and numbness of lower extremities because he 

could not find medical evidence to support these allegations. 

(Tr. 32-33.) Crutchfield testified that he had visited Dr. Wait 

for symptoms but does not go often because of lack of funds, and 

that he had told Dr. Wait that if he was not dying, he would not 

bother him. (Tr. 33.) 

 The VE testified about a hypothetical individual consistent 

with the ALJ’s RFC determination. (Tr. 34-37.) The VE 

explained that if including only the light exertion, 

Crutchfield’s job could be performed as he performed it or as it 

is usually performed in the economy. (Tr. 35.) She stated that 

if the individual was limited to not being able to lift more 

than 20 pounds, he could still do the job, but only as 

Crutchfield performed it, not as it is typically performed in 

the economy. (Id.) If the hypothetical individual was not able 

to engage in complex or detailed tasks, but could do simple, 

routine tasks of unskilled work, the VE testified that he would 

not be able to do Crutchfield’s past work. (Tr. 36.) The VE 

also stated that with the limitations consistent with the 
13

testimony Crutchfield presented, there would be no jobs that he 

could perform that exist in significant numbers. (Id.) 

REVIEW OF THE COMMISSIONER’S DECISION 

This Court has authority to review the Commissioner’s 

decision to deny social security benefits. 42 U.S.C. § 405(g). 

“The findings of the Commissioner of Social Security as to any 

fact, if supported by substantial evidence, shall be 

conclusive . . . .” Id. Substantial evidence is defined as 

“such relevant evidence as a reasonable mind might accept as 

adequate to support a conclusion.” Richardson v. Perales, 402 

U.S. 389, 401 (1971) (citation omitted). In determining whether 

substantial evidence exists, the Court shall examine the record 

in its entirety, but shall not substitute its own opinion for 

the ALJ’s by reconsidering the facts or re-weighing the evidence. 

Jens v. Barnhart, 347 F.3d 209, 212 (7th Cir. 2003). With that 

in mind, however, this Court reviews the ALJ’s findings of law 

de novo and if the ALJ makes an error of law, the Court may 

reverse without regard to the volume of evidence in support of 

the factual findings. White ex rel. Smith v. Apfel, 167 F.3d 

369, 373 (7th Cir. 1999). A reversal and remand may also be 

required if the ALJ “based the decision on serious factual 

mistakes or omissions.” Beardsley v. Colvin, 758 F.3d 834, 837 

(7th Cir. 2014) (citation omitted). 
14

 As a threshold matter, for a claimant to be eligible for 

benefits under the Social Security Act, the claimant must 

establish that she is disabled. To qualify as being disabled, 

the claimant must be unable “to engage in any substantial 

gainful activity by reason of any medically determinable 

physical or mental impairment which can be expected to result in 

death or which has lasted or can be expected to last for a 

continuous period of not less than twelve months.” 42 U.S.C. § 

423(d)(1)(A). To determine whether a claimant has satisfied 

this statutory definition, the ALJ performs a five-step 

evaluation: 

Step 1: Is the claimant performing substantial gainful 

activity? If yes, the claim is disallowed; if no, the 

inquiry proceeds to step 2. 

Step 2: Is the claimant’s impairment or combination of 

impairments “severe” and expected to last at least 

twelve months? If not, the claim is disallowed; if 

yes, the inquiry proceeds to step 3. 

Step 3: Does the claimant have an impairment or 

combination of impairments that meets or equals the 

severity of an impairment in the SSA’s Listing of 

Impairments, as described in 20 C.F.R. § 404 Subpart P, 

Appendix 1? If yes, then claimant is automatically 

disabled; if not, then the inquiry proceeds to step 4. 

Step 4: Is the claimant able to perform his past relevant 

work? If yes, the claim is denied; if no, the inquiry 

proceeds to step 5, where the burden of proof shifts 

to the Commissioner. 

Step 5: Is the claimant able to perform any other work 

within his residual functional capacity in the 

national economy? If yes, the claim is denied; if no, 

the claimant is disabled. 

See 20 C.F.R. §§ 404.1520(a)(4)(i)-(v) & 416.920(a)(4)(i)-(v); 
15

Herron v. Shalala, 19 F.3d 329, 333 n.8 (7th Cir. 1994). 

 In this case, the ALJ found that Crutchfield met the 

insured status requirements of the Social Security Act through 

December 31, 2014. (Tr. 46.) At Step One, the ALJ found that 

Crutchfield had not engaged in substantial gainful activity 

since April 6, 2010, the alleged onset date. (Id.) At Step Two, 

the ALJ found that Crutchfield suffered from the following 

severe impairments: coronary artery disease and diabetes. (Id.) 

At Step Three, the ALJ found that the impairments or a 

combination of the impairments did not meet or medically equal 

any of those included in the listing of impairments at 20 C.F.R. 

§ 404 Subpart P, Appendix 1. (Tr. 47.) The ALJ determined that 

Crutchfield retained the RFC to perform the full range of light 

work with no limitations. (Tr. 48-49.) At Step Four, the ALJ 

determined that Crutchfield was capable of performing his past 

relevant work as a maker of musical instruments, as it does not 

require the performance of work related activities precluded by 

Crutchfield’s RFC. (Tr. 50.) 

 Crutchfield argues that the ALJ committed several errors 

requiring the reversal of his decision. (DE #15.) Crutchfield 

maintains that the ALJ erred in rejecting the opinions of the 

examining physician and examining psychologist. He further 

argues that the ALJ’s Step Four determination fails to comply 

with the Commissioner’s rules and regulations. As a result of 
16

these errors, Crutchfield requests the Court reverse and remand 

the Commissioner’s decision. 

Weight Given to the Examining Physician and Psychologist 

 Crutchfield argues that the ALJ’s rejection of the opinions 

of the examining physician, Dr. Coulter, and the examining 

psychologist, Dr. Mayle, in favor of the later reviewers’ 

opinions resulted in a flawed RFC determination and harmful 

error at Step Four. 

 “As a general rule, an ALJ is not required to credit the 

agency’s examining physician in the face of a contrary opinion 

from a later reviewer or other compelling evidence.” Beardsley, 

758 F.3d at 839. But when the ALJ rejects or discounts the 

opinion of the agency’s own examining physician that the claimant 

is disabled, a reviewing court can be expected to “take notice and 

await a good explanation for this unusual step.” Id. “An ALJ can 

reject an examining physician’s opinion only for reasons supported 

by substantial evidence in the record; a contradictory opinion of 

a non-examining physician does not, by itself, suffice.” Id. 

(quoting Gudgel v. Barnhart, 345 F.3d 467, 470 (7th Cir. 2003)). 

 Here, Crutchfield argues that the ALJ improperly rejected Dr. 

Coulter’s opinion. Upon examining Crutchfield, Dr. Coulter noted 

his history of prior myocardial infarction with high blood 

pressure and coronary artery disease, and documented his high 

blood pressure of 164/99 despite medication. (Tr. 266.) Dr. 
17

Coulter concluded that Crutchfield may have difficulty with 

prolonged standing and walking, and limited him to two hours 

standing and two hours walking in an eight hour day. (Tr. 267.) 

Dr. Coulter noted Crutchfield’s grossly normal gait, albeit with 

“[d]ecreased sensation noted to the feet” and diagnosed him with 

neuropathy in the feet. (Id.) These opinions correspond with 

Crutchfield’s subjective reports of numbness and tingling in his 

feet (Tr. 266), as well as Dr. Beyer’s earlier notation of no 

palpable pulses in Crutchfield’s feet during his 2010 

hospitalization (Tr. 207). 

 The ALJ accorded greater weight to the opinions of nonexamining State agency physicians than to Dr. Coulter’s opinion, 

relying on the fact that these physicians “had the entire record 

before them and did not have to rely on the claimant’s allegations 

of limitation that are not entirely credible to the extent that 

the one-time physical examiner [Dr. Coulter] did.” (Id.); see SSR 

96-6p (State agency medical consultant’s opinion may be entitled 

to greater weight if the opinion “is based on a review of a 

complete case record that includes a medical report from a 

specialist in the individual’s particular impairment which 

provides more detailed and comprehensive information than what was 

available to the individual’s treating source”). But the State 

agency physicians did not review “the entire record” in forming 

their opinions. Rather, their opinions were rendered prior to the 
18

addition of other objective medical evidence, including 

Crutchfield’s October 24, 2011, hospital records, EKG, and left 

heart catheterization report. (Tr. 379-81, 391-97, 406, 428-29.) 

Thus, the basis on which the ALJ afforded the State agency 

opinions greater weight, i.e., their alleged access to the entire 

record, was incorrect. However, an error is harmless “[i]f it is 

predictable with great confidence that the agency will reinstate 

its decision on remand because the decision is overwhelmingly 

supported by the record.” Spiva v. Astrue, 628 F.3d 346, 353 

(7th Cir. 2010). 

 The Commissioner argues that these records merely support 

the reviewing physicians’ and the ALJ’s finding that Crutchfield 

had coronary artery disease. 2 Crutchfield claims that the 

reviewing physicians and the ALJ improperly focused on 

Crutchfield’s ejection fraction in finding that Crutchfield was 

capable of light exertional activity, and that the additional 

records support a limitation to sedentary exertional activity. 

(See, e.g., Tr. 377 (reviewing physician notes rejecting Dr. 

Coulter’s opinion, stating in part that “following bypass[,] 

 

2 The additional records show that Crutchfield had a severe threevessel native coronary artery disease with a patent left internal 

mammary artery to the left anterior descending, and a patent 

saphenous vein graft to the obtuse marginal and saphenous vein 

graft to the posterior descending artery, with preserved left 

ventricular function. (Tr. 420-21, 428-29.) Small vessel disease 

was believed to be the cause of Crutchfield’s angina, even though 

the EKG demonstrated a normal functioning heart. (Tr. 420-21.) 
19

claimant’s EF normalized to 56%”).) According to Crutchfield, 

ejection fraction is irrelevant because the listing criteria for 

coronary artery disease do not require or discuss ejection 

fraction. See 20 C.F.R. Part 404, Subp. P, Appx. 1, Listing 

4.04(C). By allegedly focusing on ejection fraction, 

Crutchfield claims that the reviewing physicians and the ALJ 

failed to address an un-contradicted line of evidence supporting 

disability. 

 A review of the decision reveals that the ALJ considered 

Crutchfield’s ejection fraction, but found that it did not meet 

the listing criteria for any cardiovascular disease in section 

4.00 of Appendix 1. (Tr. 47.) The ALJ also specifically 

addressed the records not reviewed by the State agency 

physicians, acknowledging that Crutchfield’s heart 

catheterization found “severe three vessel native coronary 

artery disease.” (Tr. 48.) While the ALJ noted that the EKG 

showed “a normal ejection fraction of 55%,” he also listed other 

results indicating no evidence of another acute myocardial 

infarction. (Id.) Thus, it does not appear that the ALJ’s 

decision focused on ejection fraction, and specifically 

considered the records not reviewed by the non-examining State 

agency physicians. 

 The ALJ stated that he gave “greater weight to the reviewers’ 

opinions and agrees that the medical evidence does not support a 
20

finding that the claimant is as limited as the consultative 

examiner stated.” (Tr. 49.) In rejecting Dr. Coulter’s opinion, 

the ALJ found that, 

[d]espite the claimant’s decreased sensation in his 

feet, his gait was normal and his balance while 

standing was normal at the consultative exam. The 

claimant did not complain of numbness in his feet and 

legs to Dr. Wait. In fact, the claimant told Dr. Wait 

that he had been increasing his walking and bike 

riding for exercise as his cardiologist wanted him to 

do since he could not afford to be in a formal cardiac 

rehabilitation program. 

(Id.) The Court finds that the ALJ supported the decision to 

discount Dr. Coulter’s opinion with substantial evidence, that 

is, relevant evidence that “a reasonable mind might accept as 

adequate to support a conclusion.” Richardson, 402 U.S. at 401. 

 Crutchfield also challenges the ALJ’s rejection of Dr. 

Mayle’s opinion. The ALJ gave Dr. Mayle’s opinion “little weight” 

in determining Crutchfield’s RFC, stating that: 

The GAF of 50 assigned by [Dr. Mayle] is puzzling in 

light of no finding of any medically determinable 

mental impairment and mostly average memory 

functioning[], and is given little weight. The 

reviewing State Agency psychologists concluded that 

the claimant has no medically determinable mental 

impairment, and the undersigned gives these opinions 

the greatest weight by not including any mental 

limitations in the claimant’s [RFC] above. 

(Tr. 50.) While the ALJ was not required to accord weight to 

the GAF of 50, he mischaracterized Dr. Mayle’s finding of 

Crutchfield’s memory functioning as “mostly average.” (Tr. 50). 

Dr. Mayle found that Crutchfield had “poor” immediate memory, 
21

“marginal” recent memory and “marginal” remote memory. (Tr. 

257-59.) The WMS-IV test performed by Dr. Mayle indicated “low 

average” functional memory level overall, with a “borderline” 

function of visual working memory, and “low average” function in 

both auditory memory and immediate memory. (Tr. 259-60). Only 

Crutchfield’s visual memory and delayed memory were found to be 

“average” under the WMS-IV test. (Id.). Non-examining State 

agency psychologist Dr. Shipley also noted Crutchfield’s “[p]oor 

short term memory,” and Dr. Mayle’s findings of memory issues 

based on her examination and the WMS-IV test. (Tr. 354.) The 

ALJ’s decision does not explain why Dr. Mayle’s opinion 

regarding Crutchfield’s memory limitations was rejected. 

 The ALJ acknowledged that Dr. Mayle’s examination 

“suggest[s] that the claimant has some mild difficulty with his 

memory[,]” but found it “does not suggest a severe impairment in 

memory or a cognitive disorder.” (Tr. 47.) An ALJ must 

consider the aggregate effect of the entire medical record, 

including those impairments that, in isolation, are not severe. 

20 C.F.R. § 404.1523; Golembiewski v. Barnhart, 322 F.3d 912, 

918 (7th Cir. 2003). Setting aside the issue of whether 

Crutchfield’s memory impairment was severe or non-severe, the 

ALJ failed to consider evidence of this impairment in 

determining Crutchfield’s RFC limitations. 

 The ALJ found that Crutchfield could perform his past 
22

relevant work as an instrument maker, and that this work does 

not require the performance of work related activities precluded 

by his RFC. (Tr. 50.) However, the VE testified that if a 

hypothetical individual could not engage in complex or detailed 

tasks, but was limited to simple, routine tasks consistent with 

unskilled work, he would be unable to perform Crutchfield’s past 

relevant work. (Tr. 36.) The VE also testified that an 

individual with the limitations presented could not perform any 

jobs that exist in significant numbers. (Id.) This testimony 

demonstrates the significance of the ALJ’s failure to consider 

Crutchfield’s memory limitations in determining the RFC finding 

and whether Crutchfield could perform his skilled past relevant 

work. Had Crutchfield’s memory limitations been incorporated 

into the RFC finding, Crutchfield may have been deemed unable to 

perform his past skilled work. For the reasons set forth above, 

this case is REMANDED so that the ALJ may address the opinion of 

Dr. Mayle. 

Crutchfield’s Remaining Arguments 

Having found remand necessary on the basis of the ALJ’s 

inadequate finding as to Dr. Mayle’s opinion, the Court finds no 

compelling reason to address Crutchfield’s remaining arguments 

in detail. The Court makes no findings regarding the merits of 

Crutchfield’s DIB claim. On remand, the ALJ should consider all 

of the evidence in the record, and, if necessary, give the 
23

parties the opportunity to expand the record so that the ALJ may 

build a logical bridge between the evidence and his conclusions.

CONCLUSION 

 For the reasons set forth above, the Commissioner of Social 

Security’s final decision is REVERSED and this case REMANDED for 

proceedings consistent with this opinion pursuant to sentence 

four of 42 U.S.C. section 405(g). 

DATED: March 31, 2015 /s/ Rudy Lozano, Judge 

 United States District Court