UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

FORT WAYNE DIVISION

KURT A. WELLS, )

)

Plaintiff, )

)

v. ) CAUSE NO. 1:16-cv-00022-SLC

)

COMMISSIONER OF SOCIAL )

SECURITY, sued as Nancy A. )

Berryhill, Acting Commissioner of SSA,1 )

)

Defendant. )

OPINION AND ORDER

Plaintiff Kurt A. Wells appeals to the district court from a final decision of the

Commissioner of Social Security (“Commissioner”) denying his application under the Social

Security Act (the “Act”) for Disability Insurance Benefits (“DIB”) and Supplemental Security

Income (“SSI”).2 (DE 1). For the following reasons, the Commissioner’s decision will be

REVERSED, and the case will be REMANDED to the Commissioner for further proceedings in

accordance with this Opinion and Order.

I. PROCEDURAL HISTORY

Wells applied for DIB and SSI in August 2012, alleging disability as of April 13, 2012. 

(DE 8 Administrative Record (“AR”) 193-202). Wells was last insured for DIB on

December 31, 2012 (AR 20, 220), and thus, with respect to his DIB claim, he must establish

1 Nancy A. Berryhill is now the Acting Commissioner of Social Security, see Casey v. Berryhill, — F.3d

—, 2017 WL 398309 (7th Cir. Jan. 30, 2017), and thus, she is automatically substituted for Carolyn W. Colvin in

this case, see Fed. R. Civ. P. 25(d). 

2

 All parties have consented to the Magistrate Judge. (DE 11); see 28 U.S.C. § 636(c).
that he was disabled as of that date. See Stevenson v. Chater, 105 F.3d 1151, 1154 (7th Cir.

1997) (explaining that with respect to a DIB claim, a claimant must establish that he was

disabled as of his date last insured in order to recover DIB). 

The Commissioner denied Wells’s application initially and upon reconsideration. (AR

137-52). After a timely request, a hearing was held on November 8, 2013, before Administrative

Law Judge Patricia Melvin (“the ALJ”), at which Wells, who appeared pro se; James Adams,

Wells’s case manager at the Bowen Center; and a vocational expert, Sharon Ringenberg (the

“VE”), testified. (AR 39-86). On May 14, 2014, the ALJ rendered an unfavorable decision to

Wells, concluding that he was not disabled because despite the limitations caused by his

impairments, he could perform a significant number of unskilled jobs at all exertional levels in

the economy. (AR 20-30). 

After the hearing, Wells retained counsel to represent him. (AR 20; DE 17 at 1). The

Appeals Council denied Wells’s request for review (AR 1-15), at which point the ALJ’s decision

became the final decision of the Commissioner. See 20 C.F.R. §§ 404.981, 416.1481. 

Wells filed a complaint with this Court on January 21, 2016, seeking relief from the

Commissioner’s final decision. (DE 1). Wells advances three arguments in this appeal: (1) that

the ALJ improperly evaluated the opinion of Candace Lemke, a psychiatric nurse practitioner;

(2) that the ALJ improperly discounted his symptom testimony; and (3) that the ALJ improperly

weighed the opinions of Drs. Hill and Horton, the state agency psychologists. (DE 17 at 7-13). 

2
II. FACTUAL BACKGROUND3

At the time of the ALJ’s decision, Wells was 57 years old (AR 30, 193); had a GED and

a real estate appraiser’s license (AR 225); and possessed past relevant work experience as a real

estate appraiser and an account manager (AR 225). He alleges disability due to generalized

anxiety disorder with agoraphobia, specific phobia of needles, degenerative changes in the right

knee, degenerative changes in the lumbar spine, degenerative disc disease mostly at L4-L5 level,

and a degree of central canal stenosis in the lower lumbar region. (DE 17 at 2). 

A. Wells’s Testimony at the Hearing

 At the hearing, Wells, who is six feet tall and weighed 275 pounds at the time, testified

that he is divorced and lives alone in a subsidized apartment. (AR 46). He was on Medicaid and

was receiving food stamps. (AR 48). He stated that he was a self-employed real estate appraiser

for eight years, which was a full-time job; however, he had never actually worked full time

because he always had jobs where he could go home if he had a panic attack. (AR 49). He is

independent with his self care and performs all of the household tasks, including shopping,

laundry, vacuuming, cleaning, and taking out the garbage. (AR 71-72). He has a driver’s

license and used to drive almost every day, but he no longer does so because he lost his car. (AR

71). In his spare time, he enjoys watching mysteries and documentaries on the computer. (AR

71). 

When asked why he thought he could not work, Wells indicated that his most severe

problem is his phobia of injections. (AR 52). He stated that this phobia causes him to have up to

a dozen panic attacks every day. (AR 52-54). Most of these attacks are minor, lasting just a few

3

 In the interest of brevity, this Opinion recounts only the portions of the 803-page administrative record

necessary to the decision.

3
minutes, but some can last several hours. (AR 53). When he has an attack, he quickly becomes

very hot and sweaty and then loses his breath, so he quickly finds a way to cool down, such as

going to his car, which is his “safe zone,” and running the air conditioning. (AR 53). He also

has agoraphobia, stating that his “only safe place is at home.” (AR 57). He has panic attacks

when leaving home; however, since being involved in therapy, he has done “pretty well” with

riding the bus, as he has had to get off the bus only a few times due to panic attacks. (AR 57). 

He has no problems getting along with people but tries to avoid them by staying home; the only

people he goes anywhere with are his sister, his mother, and his son. (AR 70-71). 

Wells was taking two anti-anxiety medications and was participating in counseling, in

which he was learning coping skills. (AR 54-56). He indicated that this treatment is effective,

but that even with his medications, he still has four to five panic attacks a day. (AR 55-56, 58,

61). He had never been to a hospital for a panic attack because hospitals present his “biggest

fear”; he did, however, admit himself to St. Joe Behavioral Center for alcohol detoxification in

2002. (AR 56; see AR 378). 

As to his physical problems, Wells complained of sharp pain in his low back that radiates

to his legs, which had started about six months earlier. (AR 62-63). The pain, which he rated as

an “eight or a nine” on a 10-point scale, occurs when he walks or stands “too long” and goes

away almost instantly when he sits down. (AR 63, 65-67). He estimated that he could walk up

to 400 feet and stand for 15 minutes before needing to sit down; he has no pain when sitting and

can sit indefinitely. (AR 67). He thought that he could lift 20 pounds, and he had no difficulty

with reaching, gripping, handling, pushing or pulling with his arms, or climbing stairs; his

balance, however, “has been bad” for the last 10 years, causing him to fall on a few occasions, so

4
he uses a shower chair. (AR 68-69). He takes Naproxen and Tylenol for his back pain and

denied any medication side effects. (AR 63-65). He stated that he has a “bad knee,” but it does

not keep him from working. (AR 67). He also complained of vision problems that affect his

reading, but he still is able to use a computer. (AR 69).

B. Testimony of Wells’s Case Manager 

James Adams, Wells’s case manager at the Bowen Center, also testified at the hearing. 

(AR 74-79). He had been treating Wells two to three times per week for the past seven months. 

(AR 76). He stated that Wells has made amazing progress, but that his phobia is so severe that

on an outing to the Art Museum, he glanced at a picture of a flower that vaguely resembled a

needle and he had a full panic attack. (AR 75-78). Adams estimated that he had witnessed

Wells have a dozen severe panic attacks that lasted for several hours and caused him to shake;

sometimes Wells has to lie on a tile floor in a public place during a panic attack because he

needs to feel the cold. (AR 76-78). Adams stated that when they were working on

desensitization therapy, Wells was having 10 to 12 panic attacks a day. (AR 77). When they

first started therapy, Wells could not get on a bus by himself, but he has progressed enough to do

so. (AR 77). It takes Wells one to two hours of preparation to be able to leave his home. (AR

78). 

C. Summary of the Relevant Medical Evidence Pertaining to Wells’s Physical Health 

In September 2012, Wells underwent a physical examination by Dr. Venkata Kancherla

at the request of the state agency. (AR 358-60). Wells claimed that his anxiety was so bad that

he could not function. (AR 359). On exam, his far vision was blurry in the right eye and 20/60

in his left eye, and his near vision was 20/20 with glasses. (AR 359). His muscle strength and

5
tone were normal, but he had some fine tremors in his hands. (AR 359). His gait was normal,

and he was able to squat and walk on his heels and toes. (AR 359). He became anxious and was

hyperventilating at times during the examination. (AR 359). Dr. Kancherla’s impression was

that it was a normal physical examination with normal gait and medication-controlled

hypertension, except that Wells needed a ophthalmology evaluation and a psychiatric evaluation. 

(AR 360). 

That same month, Dr. J.V. Corcoran, a state agency physician, reviewed Wells’s record

and concluded that his physical impairments were not severe. (AR 91-92). Dr. M. Ruiz, another

state agency physician, affirmed Dr. Corcoran’s opinion in December 2012. (AR 116-17). 

In March 2013, Wells visited Dr. Robert Wilkins, his family practitioner, due to back

pain. (AR 750-51). The pain occurred with motion and was relieved by medication and sitting,

and it caused some limitation of his normal activity. (AR 750). He appeared to be in pain during

the examination. (AR 751). Wells reported that his pain had worsened in the past few months

because he had been walking more and using the bus system. (AR 750). He weighed 268

pounds at the time. (AR 750). A chair test was positive, but a straight leg raise test was

negative; no muscle atrophy or tenderness was observed. (AR 751). Dr. Wilkins prescribed

Naproxen. (AR 751). An X-ray of Wells’s lumbar spine showed degenerative disc disease

mostly at L4-L5, and bony landmarks suggested a degree of central canal stenosis in the lower

lumbar region; there was no acute bone pathology. (AR 744-45).

In July 2013, Wells returned to Dr. Wilkins for his back pain. (AR 748-49). Wells

reported that his pain extended down both legs and that his thighs felt numb. (AR 748). 

Although Naproxen had helped previously, it was not currently helping. (AR 748). He stated

6
that standing causes his back pain and that lifting and carrying his laundry increases his pain; Dr.

Wilkins observed that his gait was stiff upon getting up. (AR 748-49). He weighed 286 pounds

at the time. (AR 749). A chair test and a straight leg raise test were negative. (AR 749). Dr.

Wilkins’s impression was that Wells’s back pain was mostly from arthritis of the facet joints. 

(AR 749). 

In September 2013, Wells returned to Dr. Wilkins for his back pain. (AR 746). He

described his low back pain as “burning,” stating that it caused some limitation of his activity. 

(AR 746). He appeared to be in pain and demonstrated a limping gait; he had no associated leg

weakness. (AR 746-47). He weighed 291 pounds at the time. (AR 746). Dr. Wilkins

prescribed Tramadol. (AR 747). An MRI of Wells’s lumbar spine revealed a moderate bulge at

L4-L5, and a mild bulge, mild facet arthropathy, and moderate foraminal narrowing at L5-S1. 

(AR 742-43).

D. Summary of the Relevant Medical Evidence Pertaining to Wells’s Mental Health

In April 2012, Dr. Wilkins documented that Wells had a generalized anxiety disorder,

described as moderate. (AR 332). Dr. Wilkins indicated that Wells’s symptoms were worsening

and that he had a lot of anxiety, but he was no longer having panic attacks. (AR 332). Dr.

Wilkins stated that Wells’s condition interferes with his daily functioning and impedes his

concentration. (AR 332). Dr. Wilkins opined that Wells’s anxiety and depression render him

unable to work and not a good candidate for rehabilitation services. (AR 331). 

In September 2012, Wells underwent a mental status examination by Wayne Von Bargen,

Ph.D., at the request of the state agency. (AR 362-64). Wells related his severe phobia of

needles, stating that he had self-medicated for years by drinking alcohol or stealing his wife’s

7
medication. (AR 362). He indicated that his phobia had contributed to his divorce and his

vocational difficulties. (AR 362). He had become increasingly anxious and reclusive over the

years, but was not housebound. (AR 364). His affect was moderately anxious, but his

verbalizations were logical, relevant, and coherent; his alertness and activity level were normal

overall. (AR 362). Dr. Von Bargen opined that Wells’s history and current presentation

revealed an anxiety disorder, manifested by a specific fear of needles, panic attacks, and

generalized anxiety, and likely a personality disorder with avoidant and obsessive-compulsive

features. (AR 363). Dr. Von Bargen’s diagnoses included an anxiety disorder, NOS; a specific

phobia; and a personality disorder NOS (provisional). (AR 364). He assigned a Global

Assessment of Functioning (“GAF”) score of 55.4

 (AR 364). 

Later in September 2012, Stacia Hill, Ph.D., a state agency psychologist, reviewed

Wells’s record and concluded that he had a mild restriction in activities of daily living and

moderate difficulties in maintaining social functioning and in maintaining concentration,

persistence, or pace. (AR 92-93). On a mental RFC assessment form, Dr. Hill opined that Wells

was moderately limited in understanding, remembering, and carrying out detailed instructions;

working in coordination with or in proximity to others without being distracted by them;

4 GAF scores reflect a clinician’s judgment about the individual’s overall level of functioning. Am.

Psychiatric Ass’n, Diagnostic & Statistical Manual of Mental Disorders 32 (4th ed., Text Rev. 2000). A GAF score

of 41 to 50 reflects serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any

serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job). Id. A GAF

score of 51 to 60 reflects moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or

moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or coworkers). 

“The American Psychiatric Association no longer uses the GAF as a metric.” Spencer v. Colvin, No. 13-cv1487, 2015 WL 684545, at *17 n.5 (C.D. Ill. Feb. 17, 2015) (citing Am. Psychiatric Ass’n, Diagnostic & Statistical

Manual of Mental Disorders 16 (5th ed. 2013)). However, several medical sources of record used GAF scores in

assessing Wells, so they are relevant to the ALJ’s decision. See id. (citing Bates v. Colvin, 736 F.3d 1093, 1099 (7th

Cir. 2013)). 

8
interacting appropriately with the general public; accepting instructions and responding

appropriately to criticism from supervisors; and responding appropriately to changes in the work

setting. (AR 94-96). Wells was not significantly limited in the remaining mental categories. 

(AR 94-96). In her narrative, Dr. Hill concluded that while Wells would likely have difficulty

with complex tasks, he could “complete simple tasks on a sustained basis without special

considerations preferably in an environment with limited social interaction.” (AR 96). In

December 2012, B. Randal Horton, Psy.D., reviewed Wells’s record and reached the same

conclusions as Dr. Hill. (AR 117-20). 

In February 2013, Wells was evaluated by Ashley Radtke, a clinician at the Bowen

Center. (AR 596-99). He felt anxious and disoriented because he did not have his car as an

escape route. (AR 596). He reported that his anxiety began as a teenager, that his family has a

history of mental illness, and that he has tried to self-medicate with marijuana and abusing

prescription medication. (AR 596). He had participated in mental health treatment on and off

for a long time. (AR 596). He had financial concerns and was seeking disability, as he reported

not being able to work because of his anxiety. (AR 596, 598). Ms. Radtke observed that Wells’s

mood and affect were anxious, and his activity level was restless. (AR 596). His memory,

perception, and orientation were normal, and his attitude was cooperative. (AR 596). He had

coherent thinking, but racing thoughts; his speech was rapid and pressured, but normal. (AR

596). He was taking Alprazolam, Ambien, Ziac, Lisinopril, and Zoloft, which were all

prescribed by his family practitioner. (AR 597). He had suicidal ideation a year earlier and had

researched ways to commit suicide; he had no homicidal ideation. (AR 597). Ms. Radtke’s

diagnostic impression was panic disorder with agoraphobia; generalized anxiety disorder; and

9
specific phobia of blood, injection, injury type. (AR 598). She assigned him a fair prognosis. 

(AR 599). 

In April 2013, Wells was evaluated by Candace Lemke, a psychiatric nurse practitioner

at the Bowen Center. (AR 378-82). She noted his past hospitalization for alcohol detoxification

and that he had been in and out of psychiatric care most of his adult life. (AR 378). He appeared

severely anxious throughout the interview, as he was clenching the chair with white knuckles

and his legs were jittering. (AR 379). His thought content and stream of thought were normal;

he had no delusions, paranoia, or suicidal or homicidal ideation. (AR 379). His affect and mood

were congruent. (AR 379). He had fair judgment and insight, average intellect, and adequate

concentration. (AR 380). She indicated the following diagnoses: generalized anxiety disorder;

panic disorder with agoraphobia; specific phobia of needles; alcohol dependence, full sustained

remission; cannabis dependence, full sustained remission; and opioid dependence, early

remission. (AR 381). She assigned him a current GAF of 50 and a highest-in-the-past-year

GAF of 50. (AR 381). 

In September 2013, Ms. Lemke wrote a letter on Wells’s behalf. (AR 630). She stated

that he had been undergoing psychiatric care for several years, but that despite intensive

psychotherapy, hypnotherapy, and antidepressant, antipsychotic, and antianxiety treatment, he

had made “very little progress in the way of conquering his agoraphobia, social phobia and his

intense fear of needles.” (AR 630). She stated that Wells “truly cannot work outside of his

home.” (AR 630). 

Wells participated in treatment at the Bowen Center from February 2013 through

December 2013. He was seen approximately four times by Ms. Lemke (AR 378-81, 398-99,

10
401-02, 754-57) and 16 times by Dr. Klinton Krouse (AR 383-88, 413-18, 477-84, 719-20, 756-

59) for medication management. He was seen more than 100 times by three mental health

clinicians or case managers at the Bowen Center for mental health counseling, desensitization

therapy, and coping skills for his agoraphobia and panic attacks. (See AR 421-803). In

September 2013, Wells’s anxiety and panic attacks were described as “Improved, Not

Controlled.” (AR 395).

III. STANDARD OF REVIEW

Section 405(g) of the Act grants this Court “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 cause for a rehearing.” 42 U.S.C. § 405(g). The

Court’s task is limited to determining whether the ALJ’s factual findings are supported by

substantial evidence, which means “such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” Schmidt v. Barnhart, 395 F.3d 737, 744 (7th Cir. 2005)

(citation omitted). The decision will be reversed only if it is not supported by substantial

evidence or if the ALJ applied an erroneous legal standard. Clifford v. Apfel, 227 F.3d 863, 869

(7thCir. 2000) (citation omitted).

To determine if substantial evidence exists, the Court reviews the entire administrative

record but does not reweigh the evidence, resolve conflicts, decide questions of credibility, or

substitute its judgment for the Commissioner’s. Id. Rather, if the findings of the Commissioner

are supported by substantial evidence, they are conclusive. Jens v. Barnhart, 347 F.3d 209, 212

(7th Cir. 2003) (citation omitted). “In other words, so long as, in light of all the evidence,

reasonable minds could differ concerning whether [the claimant] is disabled, we must affirm the

11
ALJ’s decision denying benefits.” Books v. Chater, 91 F.3d 972, 978 (7th Cir. 1996).

IV. ANALYSIS

A. The Law 

Under the Act, a claimant is entitled to DIB or SSI if he establishes 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), 423(d)(1)(A), 1382c(a)(3)(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), 1382c(a)(3)(D).

The Commissioner evaluates disability claims pursuant to a five-step evaluation process,

requiring consideration of the following issues, in sequence: (1) whether the claimant is

currently unemployed; (2) whether the claimant has a severe impairment; (3) whether the

claimant’s impairment meets or equals one of the impairments listed by the Commissioner, see

20 C.F.R. § 404, Subpt. P, App’x 1; (4) whether the claimant is unable to perform his past work;

and (5) whether the claimant is incapable of performing work in the national economy.5 See

Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001) (citations omitted); 20 C.F.R. §§

404.1520, 416.920. An affirmative answer leads either to the next step or, on steps three and

five, to a finding that the claimant is disabled. Zurawski v. Halter, 245 F.3d 881, 886 (7thCir.

2001) (citation omitted). A negative answer at any point other than step three stops the inquiry

5 Before performing steps four and five, the ALJ must determine the claimant’s RFC or what tasks the

claimant can do despite his limitations. 20 C.F.R §§ 404.1520(e), 404.1545(a), 416.920(e), 416.945(a). The RFC is

then used during steps four and five to help determine what, if any, employment the claimant is capable of. 20

C.F.R. §§ 404.1520(e), 416.920(e).

12
and leads to a finding that the claimant is not disabled. Id. (citation omitted). The burden of

proof lies with the claimant at every step except the fifth, where it shifts to the Commissioner. 

Clifford, 227 F.3d at 868 (citation omitted).

B. The Commissioner’s Final Decision

On May 14, 2014, the ALJ issued the decision that ultimately became the

Commissioner’s final decision. (AR 20-30). At step one of the five-step analysis, the ALJ found

that Wells had not engaged in substantial gainful activity since his alleged onset date. (AR 21). 

At step two, the ALJ found that Wells’s anxiety disorder and depression were severe

impairments, but his mild degenerative changes of the right knee, degenerative disc disease of

the lumbar spine, hypertension, and obesity were non-severe impairments. (AR 21). At step

three, the ALJ concluded that Wells did not have an impairment or combination of impairments

severe enough to meet or equal a listing. (AR 23). Before proceeding to step four, the ALJ

determined that Wells’s symptom testimony was not entirely credible (AR 26), and the ALJ

assigned him the following RFC: 

[T]he claimant has the [RFC] to perform a full range of work at all exertional

levels but with the following non-exertional limitations: he is limited to simple,

routine, and repetitive tasks, with simple defined as specific vocational

preparation levels one and two. In addition, the claimant is limited to low stress

jobs, defined as those that require only occasional decision-making, with only

occasional changes in the work setting and with no strict production quotas. 

Instead, the emphasis would be on a per shift, rather than per hour, basis. Finally,

the claimant is limited to jobs that require only occasional interaction with the

general public, co-workers, and supervisors.

(AR 24-25). 

At step four, the ALJ found that Wells was unable to perform any of his past relevant

work. (AR 29). Based on the RFC and the VE’s testimony, the ALJ concluded at step five that

13
Wells could perform a significant number of unskilled jobs at all exertional levels in the

economy, including industrial cleaner, laundry worker, and dishwasher. (AR 30). Therefore,

Wells’s applications for DIB and SSI were denied. (AR 30).

C. The ALJ’s Consideration of Wells’s Symptom Testimony Will Be Remanded

Wells argues, among other things, that the ALJ improperly discounted his symptom

testimony concerning his physical and mental limitations. Wells’s arguments ultimately have

merit, necessitating a remand of the ALJ’s decision.

An ALJ’s credibility determination concerning a claimant’s symptom testimony is

entitled to special deference because the ALJ is in the best position to evaluate the credibility of

a witness. Powers v. Apfel, 207 F.3d 431, 435 (7th Cir. 2000). If an ALJ’s determination is

grounded in the record and she articulates her analysis of the evidence “at least at a minimum

level,” Ray v. Bowen, 843 F.2d 998, 1002 (7th Cir. 1988) (citation omitted), creating “an

accurate and logical bridge between the evidence and the result,” Ribaudo v. Barnhart, 458 F.3d

580, 584 (7th Cir. 2006) (citation omitted), her determination will be upheld unless it is “patently

wrong,” Powers, 207 F.3d at 435; see Carradine v. Barnhart, 360 F.3d 751, 754 (7th Cir. 2004)

(remanding an ALJ’s credibility determination because the ALJ’s decision was based on “serious

errors in reasoning rather than merely the demeanor of the witness”). 

Here, the ALJ found Wells’s symptom testimony “not entirely credible” for essentially

two reasons. (AR 30). The ALJ stated that the alleged severity of Wells’s symptoms and his

degree of limitation with respect to his back pain and anxiety, panic, and phobia are not

supported by objective medical evidence. (AR 26-27). The ALJ also cited Wells’s performance

of a range of daily living activities as undermining his symptom testimony. (AR 23-24, 26). 

14
As to the first reason, “[o]bjective medical evidence . . . is a useful indicator to assist [the

Commissioner] in making reasonable conclusions about the intensity and persistence of [the

claimant’s] symptoms and the effect those symptoms, such as pain, may have on [the claimant’s]

ability to work.” 20 C.F.R. §§ 404.1529(c)(2), 416.929(c)(2). “The discrepancy between the

degree of pain [and other symptoms] attested to by the witness and that suggested by the medical

evidence is probative that the witness may be exaggerating [his] condition.” Powers, 207 F.3d at

435-36. 

With respect to Wells’s back pain, the ALJ first cited Dr. Kancherla’s exam in September

2012 reflecting normal physical examination findings, including a normal gait, no deformity or

tenderness of the lumbosacral spine, and straight leg raising to 70 degrees bilaterally. (AR 27

(citing AR 358-60)). Wells’s symptom testimony is consistent with these objective findings, as

he stated that his back pain started about six months before the November 2013 hearing.6

 (AR

62-63). 

In 2013, however, Wells saw Dr. Wilkins in March, July, and September due to back

pain. Wells complained of sharp, burning pain in his low back that extended down both legs and

caused numbness in his thighs. (AR 748). Standing, walking, lifting, and carrying all increased

his pain, and he exhibited a limping gait. (AR 746-49). A chair test was positive at one visit, but

straight leg raising tests were negative; there was no evidence of atrophy or leg weakness. (AR

749, 751). Dr. Wilkins prescribed several medications. (AR 747-48, 751). X-rays revealed

degenerative disc disease at L4-L5 and a degree of central canal stenosis in the lower lumbar

6 As such, Wells’s back pain is relevant only to his SSI claim, as he conceded that his back pain started in

early 2013—that is, after his DIB-eligibility expired on December 31, 2012. 

15
spine, but no acute bony pathology. (AR 744-45). An MRI of Wells’s lumbar spine revealed a

moderate bulge at L4-L5, and a mild bulge, mild facet arthropathy, and moderate foraminal

narrowing at L5-S1. (AR 742-43). 

When considering this objective medical evidence from 2013, the ALJ stated:

On March 27, 2013, inspection of the claimant’s lumbar spine showed no muscle

atrophy, tenderness, or swelling. Although a chair test was positive, straight leg

raising was negative. The same day, x-rays of his lumbar spine showed

degenerative disc disease, mostly the L4-L5 level, with the bony landmarks

suggesting a “degree of central canal stenosis in the lower lumbar region.” 

However, there was no indication of acute bony pathology. Later, on July 22,

2013, both chair testing and straight leg raising were negative. On that occasion,

Dr. Wilkins stated that the claimant’s back pain seemed to be “mostly from

arthritis of the facet joints.” 

(AR 28 (citations omitted)). 

The ALJ’s rationale for finding the objective medical evidence from 2013 inconsistent

with Wells’s complaints of back pain is difficult to trace. It is unclear how the lack of “acute

bony pathology” negates Wells’s complaints of back pain where the X-rays revealed

degenerative disc disease in the lumbar spine and central canal stenosis in the lower lumbar

region, as Dr. Wilkins did not opine to that effect. Nor did the ALJ explain how Dr. Wilkins’s

opinion that Wells’s back pain seemed to be “mostly from arthritis of the facet joints”

undermines his complaints of back pain. Furthermore, the ALJ never mentioned the results of

Wells’s 2013 MRI that revealed a moderate bulge at L4-L5, and a mild bulge, mild facet

arthropathy, and moderate foraminal narrowing at L5-S1, much less explained how the MRI

results are inconsistent with Wells’s complaints of back pain. (AR 742-43). 

In weighing the medical source opinion evidence, the ALJ assigned “great weight” to the

opinion of Dr. Corcoran, as affirmed by Dr. Ruiz, the reviewing state agency physicians who

16
found that Wells’s physical impairments were “non-severe.” (AR 28; see AR 91-92, 116-17). 

These state agency doctors, however, never saw Dr. Wilkins’s treatment notes from 2013 or the

X-rays and MRI results, as Dr. Corcoran issued his opinion in September 2012, and Dr. Ruiz

affirmed it in December 2012. (AR 91-92, 116-70). The ALJ’s failure to submit the evidence

from 2013 to medical scrutiny is fatal in this particular instance, because this evidence “was new

and potentially decisive medical evidence.”7 Goins v. Colvin, 764 F.3d 677, 680 (7th Cir. 2014)

(collecting cases) (remanding case where the MRI results “undermined the reasoning of the

second consulting physician, whose ground for disregarding the plaintiff’s allegation that her

condition had worsened was the lack of new supporting medical evidence in the file).

To explain, the 2013 medical evidence pertaining to Wells’s back pain was potentially

decisive because the ALJ assigned Wells an RFC for “a full range of work at all exertional

levels,” which included medium work. (AR 24). Medium work requires lifting up to 50 pounds

occasionally and 25 pounds frequently, standing or walking six hours out of an eight-hour

workday, and frequent bending or stooping. SSR 83-10, 1983 WL 31251, at *6 (Jan. 1, 1983). 

“[S]tooping” is a type of bending in which a person bends his or her body downward and

forward by bending the spine at the waist.” SSR 83-10, 1983 WL 31251, at *6 (Jan. 1, 1983). 

“Flexibility of the . . . torso is important for this activity.” SSR 83-10, 1983 WL 31251, at *6

(Jan. 1, 1983). In contrast, light work requires lifting no more than 20 pounds occasionally and

10 pounds frequently; standing or walking six hours out of an eight-hour workday; and

occasional, rather than frequent, stooping. SSR 83-10, 1983 WL 31251, at *5-6 (Jan. 1, 1983). 

7

 The Court also observes that Wells weighed 268 pounds in March 2013 and 291 pounds in September

2013, evidencing an increase in his obesity. (AR 746, 750); see Gentle v. Barnhart, 430 F.3d 865, 868-69 (7th Cir.

2005) (noting the aggravating effect of obesity on degenerative disc disease and in combination with psychiatric

problems). 

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The distinction between medium and light work is “critical” in this case. Dimmett v.

Colvin, 816 F.3d 486, 488 (7th Cir. 2016). This is because Wells is of advanced age (55 to 59

years), and there is no evidence that he has any transferable skills, as there is no VE testimony to

that effect. (See AR 29, 298). “[A] person of [advanced age] who has no skills transferable to

light or sedentary work is presumptively disabled.” Dimmett, 816 F.3d at 488 (citations

omitted). Therefore, if the ALJ had limited Wells to light or sedentary work, instead of “all

exertional levels,” and he had no transferable skills, he would have been deemed disabled under

Grid Rule 202.06. See 20 C.F.R. § 404, Subpt. P, App’x 1; Table No. 2, Rule 202.06. 

The ALJ was charged with building an accurate and logical bridge from Dr. Wilkins’s

2013 treatment notes, the X-rays, and the MRI results revealing degenerative disc disease and

back pain, to his conclusion that Wells could perform medium work. See, e.g., Pope v. Colvin,

No. 14 C 643, 2016 WL 1060280, at *3 (N.D. Ill. Mar. 11, 2016) (remanding case where the

ALJ “failed to draw a logical bridge from his discussion of the medical evidence to his ultimate

findings regarding [c]laimant’s RFC that she could perform medium work”). In doing so, “an

ALJ cannot play the role of doctor and interpret medical evidence [such as X-rays and MRI

results] when he or she is not qualified to do so.” Murphy v. Astrue, 496 F.3d 630, 634 (7th Cir.

2007) (citations omitted); see Goins, 764 F.3d at 680 (finding that the ALJ improperly played

doctor by summarizing the MRI results and failing to submit the MRI to medical scrutiny);

Moon v. Colvin, 763 F.3d 718, 722 (7th Cir. 2014) (“This mistaken reading of the evidence

illustrates why ALJs are required to rely on expert opinions instead of determining the

significance of particular medical findings.”); Hoyt v. Colvin, 553 F. App’x 625, 627-28 (7th Cir.

2014) (finding that the ALJ improperly substituted his own medical judgment in place of the

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claimant’s treating physician by interpreting a lumbar MRI as inconsistent with the claimant’s

complaints of pain, observing that the state agency doctors did not review the test results and

their dated opinions could not account for how the claimant’s condition might have deteriorated). 

Here, the ALJ failed to build the necessary bridge. See, e.g., Robinson v. Astrue, No. 10 C 2304,

2012 WL 1144821, at *15 (N.D. Ill. Apr. 5, 2012) (remanding case where the ALJ failed to

explain how he arrived at an RFC for medium work in light of the claimant’s degenerative disc

disease). 

 There are other problems, as well, with respect to the ALJ’s consideration of Wells’s

activities of daily living. The ALJ did not build a logical bridge between Wells’s performance of

rather minimal, light daily living tasks—such as watching television, spending time on the

computer, doing laundry, light cleaning, cooking, attending medical appointments, taking the

bus, and grocery shopping (AR 23-24, 26)—and an RFC for medium work. See, e.g., Castaneda

v. Colvin, No. 14 C 7023, 2016 WL 427511, at *2 (N.D. Ill. Feb. 4, 2016) (remanding case

where “[s]imply put, the ALJ did not build the bridge between the Plaintiff’s ability to perform

certain daily activities and its bearing on his ability to work a full-time medium exertional level

job”).

Similarly, with respect to his mental impairments, the ALJ suggested that Wells must

have overstated the effects of his panic attacks, anxiety disorder, and agoraphobia because he

lives alone, could drive a car, is independent with his self care and household tasks, grocery

shops, takes the bus, watches television, spends time on the computer, attends medical

appointments, and is involved in “a lot of activities” relating to his treatment at the Bowen

Center. (AR 23-24, 26). However, there are “critical differences between activities of daily

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living and activities in a full-time job.” Bjornson v. Astrue, 671 F.3d 640, 647 (7th Cir. 2012). 

“[A] person has more flexibility in scheduling the former than the latter, can get help from other

persons . . . , and is not held to a minimum standard of performance, as [he] would be by an

employer.” Id. Also, “[t]here is a significant difference between being able to [leave home and]

work a few hours a week and having the capacity to work full time.” Larson v. Astrue, 615 F.3d

744, 752 (7th Cir. 2010) (citations omitted) (finding that the claimant’s part-time work for a

friend did not undermine her testimony that she is afraid to go out in public); Bauer v. Astrue,

532 F.3d 606, 609 (7th Cir. 2008) (“Suppose that half the time [the claimant] is well enough that

she could work, and half the time she is not. Then she could not hold down a full-time job.”

(citations omitted)). 

In the past, Wells accommodated his panic attacks and agoraphobia by working in jobs,

such as a self-employed real estate appraiser, that afforded him flexibility of schedule and

unscheduled breaks: 

Most of my working life I have been in positions that would allow me to leave

and go home to rest in the event of having a panic attack especially in the past ten

years where I was a Residential Real Estate Appraiser and only had to leave my

home a few times a week for about an hour and then return home to do the report

a little at a time over several days until it was finished. This is a major problem

with working at this time as I could and would have a panic attack at any time

that would require me to just have to drop what I’m doing and go home to

decompress. This decompression process could last anywhere from several hours

to a few days.

(AR 299; see also AR 53-54, 57, 61, 73, 75-78); see Larsen, 615 F.3d at 752 (“[T]he ALJ’s

conclusion that Larsen accommodated her fear of going out in public does not discredit her

testimony that she has a fear of going out in public and gives in to that fear regularly.”). 

Although the ALJ limited Wells to jobs “with no strict production quotas” (AR 25), the ALJ

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never addressed Wells’s likely need for unscheduled breaks or absences due to his panic attacks. 

See Jelinek v. Astrue, 662 F.3d 805, 812-13 (7th Cir. 2011) (“The activities the ALJ mentioned

reflected only her willingness and ability to stay engaged in commendable but limited endeavors

part-time or at her own pace.”).

The Court’s above-stated concerns are heightened by the fact that Wells appeared

unrepresented at the administrative hearing. The ALJ’s duty to develop a full and fair record is

enhanced when a claimant appears without counsel at the hearing. See Nelms v. Astrue, 553 F.3d

1093, 1098-99 (7th Cir. 2009); Nelson v. Apfel, 131 F.3d 1228, 1235 (7th Cir. 1997). 

 For these reasons, the ALJ’s decision will be remanded for the purpose of submitting the

medical evidence from 2013 to medical scrutiny and reassessing Wells’s symptom testimony. 

D. Upon Remand, the ALJ Should Also Revisit the Weight 

Applied to the Opinions of Drs. Hill and Horton 

Upon remand, the ALJ should also revisit the “great weight” applied to the opinions of

Drs. Hill and Horton, the reviewing state agency psychologists. These doctors rendered their

opinions in 2012, and thus, they never saw the treatment records from 2013 documenting

Wells’s more than 100 mental health visits to the Bowen Center doctors and counselors,

including Ms. Lemke’s GAF score of 50 and Wells’s continued issues with panic attacks. See

Campbell v. Astrue, 627 F.3d 299, 309 (7th Cir. 2010) (remanding case where the ALJ relied on

the state agency psychologists’ opinions, but these doctors did not have the benefit of reviewing

a 15-month period of mental health treatment records that included GAF ratings never higher

than 50); see also Meuser v. Colvin, 838 F.3d 905, 912 (7th Cir. 2016) (remanding case where

the ALJ had assigned significant weight to the opinions of the state agency psychologists, but

they had reviewed only a fraction of the claimant’s treatment records that were available before

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the claimant submitted additional evidence). When concluding that Wells could perform simple

tasks on a sustained basis, Drs. Hill and Horton both relied upon, at least in part, an April 2012

note from Dr. Wilkins stating that Wells was “not having panic attacks anymore but still a lot of

anxiety.” (AR 93, 118, 332). 

The Bowen Center’s treatment records, however, were “the most recent professional

word” on Wells’s mental impairments. Jelinek, 662 F.3d at 812 (remanding case where the ALJ

cast aside the recent treating doctor’s opinion on Jelinek’s mental impairments in favor of stateagency opinions that were two years old); Coppage v. Colvin, No. 2:13-CV-405-PRC, 2015 WL

1243321, at *12 (N.D. Ind. Mar. 17, 2015) (remanding the case and noting that “the significant

weight the ALJ gave to the consultative reviewers’ opinions is suspect in light of the time that

elapsed between their June and July 2011 opinions and the August 2012 hearing given the

intervening medical records, the subsequent treating physician opinions, and Plaintiff’s

testimony”). These 2013 records reveal that Wells was diligently participating in mental health

treatment and making progress in accommodating his symptoms, but that he was still

experiencing some panic attacks, which were described as “Improved, Not Controlled.” (See,

e.g., AR 394-95, 398, 401, 415, 423, 438, 450, 452, 456). These records could have affected the

opinions of the state agency psychologists.8

 See Buechel v. Colvin, No. 11 C 4348, 2013 WL

1200611, at *12 (N.D. Ill. Mar. 25, 2013) (collecting cases that remanded because the ALJ relied

8 With respect to Wells’s DIB claim, “[a]s a simple matter of logic, even if medical evidence . . . did not

exist at the date last insured, that fact standing alone does not mean that such evidence lacks probative value as to a

plaintiff’s pre-date last insured impairments.” Freismuth v. Astrue, 920 F. Supp. 2d 943, 951 (E.D. Wis. 2013)

(citing Estok v. Apfel, 152 F.3d 636, 640 (7th Cir. 1998); Allord v. Barnhart, 455 F.3d 818, 822 (7th Cir. 2006)); see

also Phelps v. Colvin, No. 13-cv-1211-CJP, 2014 WL 7360196, at *5 (S.D. Ill. Dec. 23, 2014) (stating that medical

treatment rendered after the date last insured can be considered if it helps to illuminate the claimant’s condition

during the insured period).

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upon state agency doctors’ opinions that were not based on a complete review or accurate

summary of all the relevant medical evidence); Ivey v. Astrue, No. 2:11-CV-83, 2012 WL

951481, at *13 (N.D. Ind. Mar. 20, 2012) (recognizing that an ALJ’s decision to give more

weight to a reviewing state agency doctor’s opinion “cannot stand where it lacks evidentiary

support and is based on an inadequate review of [the claimant’s] subsequent medical record”).

 Therefore, upon remand, the ALJ should also submit the mental health evidence from

2013 to medical scrutiny for the purpose of reassessing Wells’s symptom testimony,

reconsidering the medical source opinion evidence, and reassessing the RFC.9

V. CONCLUSION

For the foregoing reasons, the decision of the Commissioner is REVERSED, and the case

is REMANDED to the Commissioner for further proceedings in accordance with this Opinion

and Order. The Clerk is directed to enter a judgment in favor of Wells and against the

Commissioner.

SO ORDERED. 

Entered this 28th day of March 2017.

/s/ Susan Collins 

Susan Collins,

United States Magistrate Judge

9 Because a remand is warranted on these grounds, the Court need not reach his remaining arguments. 

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