UNITED STATES DISTRICT COURT 

NORTHERN DISTRICT OF INDIANA 

SOUTH BEND DIVISION 

CHRISTINE L. KING, 

Plaintiff, 

 v. 

CAROLYN W. COLVIN, 

Acting Commissioner of Social Security, 

Defendant. 

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Case No.: 3:14-CV-1515 

OPINION AND ORDER 

 This is a social security appeal. The Claimant, Christine King, applied for social security 

disability benefits, but the Social Security Administration denied her application. So, she filed 

this action seeking review of the Commissioner’s decision. The parties have now briefed the 

matter and it is ripe for review.1 [DE 15]; [DE 22]. For the foregoing reasons, the Court 

REMANDS this matter to the Commissioner for further proceedings. 

FACTS 

 King filed for social security disability benefits on June 19, 2012, alleging a disability 

onset date of June 1, 2011. Tr. 19. Her claim was denied once initially and again on 

reconsideration. Tr. 62, 64. At King’s request, Administrative Law Judge Romona Scales (the 

ALJ) then held a hearing on August 20, 2013, at which King was represented by counsel. 

 1. King’s Testimony

 At the hearing, King testified that she works about twenty hours per week as an 

administrative assistant and has done so since 2010. Tr. 38-39. Generally she works two four-

 

1

 King did not file a reply brief, but her time to do so has lapsed. In accordance with the Court’s order of May 14, 

2015 [DE 21], her reply brief was due on June 23, 2015. 
2 

to-five-hour days at a time, followed by a rest day. Tr. 52. She previously worked as an interior 

designer for about five years. Tr. 40. 

 While she worked forty hours per week prior to 2010, she is no longer able to do so. Tr. 

38-39, 43. She has lupus, which causes her significant fatigue and prevents her from working 

two eight-hour days in a row. Tr. 43-44. It is exacerbated by stress, fluorescent lights and 

physical activity such as walking up or down stairs three or four times a day. Tr. 45. On days 

when her symptoms are bad, she cannot do anything other than sleep and watch TV. Tr. 45-46. 

That happens between two to four days a week. Tr. 46. 

 Her employer allows her to alter her schedule as her condition requires. Tr. 46. She 

takes advantage of that flexibility to stay home on a day that she is scheduled to work about once 

a week. Tr. 46. She has not worked a complete work week as scheduled in the last two years. 

Tr. 48. 

 King further testified that her fatigue prevents her from walking more than ten or fifteen 

minutes at once or standing for more than twenty to thirty minutes at a time. Tr. 50-51. She can 

lift about ten pounds, but has problems with numbness and lack of coordination in her fingers. 

Tr. 51. She can do some household chores, such as folding laundry and assisting with grocery 

shopping, though fatigue prevents her from doing chores after work. Tr. 52-53. When she does 

housework, she alternates working for half-an-hour and resting for half-an-hour. Tr. 44. Her 

husband has to help her with tasks that require lifting. Tr. 52-53. 

 2. King’s Husband’s Testimony 

King’s husband, Jack Carter King, also testified. He indicated that his wife gets tired 

easily. Tr. 54. Working exhausts her; it can take her as long as a day to recover from half a day 

of work. Tr. 55. At least three or four times a month she is “completely down” after working a 
3 

half day. Tr. 55. She has difficulty doing chores around the home, so he handles most of the 

housework. Tr. 53-54. 

 3. The Vocational Expert’s Testimony

 Vocational expert Ray Burger (the VE) also testified at the hearing. The ALJ asked him 

to consider several hypothetical individuals. She first asked him to consider a hypothetical 

individual with King’s age, education and past work experience. Tr. 57. The hypothetical 

individual could perform no more than light work and was limited to frequent balancing, 

stooping and kneeling; frequent crawling; frequent climbing of ramps and stairs; occasional 

climbing of ladders, ropes or scaffolding and occasional crouching. Id. The individual also had 

to avoid concentrated exposure to extreme temperatures and hazards. Id. The VE stated that 

such an individual could perform King’s past work. Id. He further testified that interior design 

skills are very specific and would not transfer to other light-exertion work. Id. King’s 

administrative assistant skills, however, would transfer to other sedentary occupations such as a 

receptionist or data entry position. Id. 

The ALJ next asked the VE to consider a hypothetical individual with all of the 

previously mentioned limitations but who was also limited to occasional posturals. Tr. 58. The 

individual would also be limited to frequent handling and bilateral fingering, occasional bilateral 

overhead reach and no more than four hours of standing or walking and six hours of sitting per 

day. Id. The VE testified that such an individual could work in an administrative assistant, 

receptionist or data entry position, but could not work in interior design. Id. The ALJ asked if 

an individual who had such limitations but was restricted to sedentary work could work as an 

administrative assistant. Id. The VE testified that she could. 
4 

The VE further testified that none of the jobs he discussed could be performed by an 

individual that was off-task for fifteen to twenty percent of the work week due to fatigue, pain or 

discomfort or by an individual that missed two or more days of work per month. Tr. 59. 

4. The Medical Evidence 

Prior to issuing an opinion, the ALJ considered the medical evidence. It shows that King 

has a history of lupus, Sjogren’s syndrome, irritable bowel syndrome and bursitis. Tr. 313. 

 On January 12, 2010, King presented to her primary care physician, Dr. Walter 

Anglemeyer, complaining of dry mouth, sores on her tongue and mouth and trouble swallowing. 

Id. At that visit, Dr. Anglemeyer noted that King had a moderate activity level and did not have 

bone or joint symptoms, muscle weakness or fatigue. Tr. 313-14. He noted that King had a dry 

mouth, which he concluded was likely a side effect of lupus and Sjogren’s syndrome. Tr. 315. 

 On February 24, 2010, King went to the emergency department at Elkhart General 

Hospital for right upper quadrant abdominal and epigastric pain. Tr. 243. She was treated for 

probable gastritis and released. Tr. 244. 

On July 27, 2010, King saw Dr. Nicholas Straniero, her rheumatologist. Dr. Straniero 

noted that King’s medical history included lupus, Sjogren’s syndrome, irritable bowel syndrome 

and migraines. Tr. 286. King reported losing a tooth due to the Sjogren’s syndrome, but Dr. 

Straniero noted that she had an otherwise stable clinical appearance and no other degenerative 

changes. Id. 

On August 25, 2010, King saw Dr. Anglemeyer and asked to change one of her 

medications, Gabapentin, since it was causing her to have a dry mouth. Tr. 310-11. Dr. 

Anglemeyer instructed King to gradually stop taking it. He also noted that King did not have 

fatigue, muscle weakness or bone or joint symptoms. Tr. 310-11. King returned to Dr. 
5 

Anglemeyer on September 14, 2010 and complained of stomach pains and insomnia. Tr. 307. 

At that time, she had completely stopped taking Gabapentin and indicated that her dry mouth had 

improved. Tr. 307. She came back on November 29, 2010, still complaining of stomach pains. 

Tr. 304. Dr. Anglemeyer referred her to Dr. Gary Cornette, a gastroenterologist. Tr. 305. He 

also noted that she did not have any joint deformities or abnormalities. Tr. 305. 

King consulted with Dr. Cornette on January 6, 2011. Tr. 254. She reported that she had 

experienced abdominal pain for approximately four months. Id. Dr. Cornette ordered a CT scan, 

which revealed moderate atrophy in King’s left kidney. Tr. 258. He also found her to have 

malaise. Tr. 255. 

King saw Dr. Anglemeyer again on January 11, 2011 due to hip pain and abdominal pain. 

Tr. 301. King informed him that she could not afford the diagnostics recommended by Dr. 

Cornette: an “upper and lower scope” and another CT scan. Id. Dr. Anglemeyer noted 

tenderness in King’s left and right hips and found her to have bone and joint symptoms, but 

found that she was not fatigued. Tr. 302-03. 

 On January 25, 2011, King saw Dr. Straniero for a rheumatology reassessment. Tr. 285. 

He found her to be “clinically stable.” Id. He also found that she had Raynaud’s phenomenon, 

some signs of bursitis and that her joints showed “scattered mild degenerative change.” Id. He 

noted that she had stopped taking Gabapentin due to problems with oral dryness, which had 

caused her to lose teeth. Tr. 285. 

 On May 9, 2011, King saw Dr. Anglemeyer and complained of back pain and depression. 

Tr. 297. Dr. Anglemeyer found that she had fatigue and bone and joint symptoms. Id. 

King returned to Dr. Straniero on July 26, 2011. Tr. 283. At that visit, Dr. Straniero 

noted that King’s lupus and Sjogren’s syndrome had “been relatively mild and stable in nature.” 
6 

Id. He found that she had lateral hip pain, but that it responded well to osteopathic 

manipulations. Id. He also noted that her abdominal pain had resolved and that she did not 

report any joint swelling, though he observed some degenerative change in her joints. Id. 

On January 24, 2012, King saw Dr. Anglemeyer again and complained of back pain 

(apparently linked to issues with her right hip) and neck pain. Tr. 294. Following a cervical 

exam, Dr. Anglemeyer noted King had tenderness in her thoracic and lumbar spine. Tr. 295. 

This time he did not find her to exhibit fatigue, though did note that she had bone and joint 

symptoms. Tr. 294. 

 King saw Dr. Straniero on January 31, 2012. Tr. 279. She told him that she had a “good 

energy level” and was “gradually improving” after switching from working full time to working 

twenty hours per week. Id. She complained of mild fatigue, though Dr. Straniero found that she 

did not present with fatigue or Raynaud’s phenomenon. Tr. 279-80. King returned to Dr. 

Straniero on July 31, 2012. She indicated that she felt well with “minor complaints”, though 

reported, among other things, decreasing energy levels and joint stiffness and hip pain that 

increased with pressure and climbing stairs. Tr. 275. She also complained of oral dryness with 

accompanying dental damage and tooth loss. Id. Dr. Straniero noted that King’s hips were 

tender and had a reduced internal range of motion, which caused her some pain. Tr. 277. He 

formulated an assessment and plan for King’s lupus, which included ordering several urine and 

blood tests. Tr. 278. 

On October 25, 2012, Dr. Anglemeyer wrote a letter opining on King’s condition. Tr. 

397. He indicated that she has lupus, Sjogren’s syndrome and possible Raynaud’s disease. Id. 

He further stated that “[t]hese diseases are stable and disabling for her . . . [though] tend to wax 

and wane. During the times that they [flare up], she is unable to work full-time. She does, 
7 

indeed, experience fatigue and difficulty using her hands during these times.” Id. He concluded 

that part-time work seems to work well for her. Id. 

 On August 31, 2012, King saw Dr. Frances Dwyer, an agency doctor. Tr. 329. King 

told Dr. Dwyer that she began experiencing symptoms of lupus in 1994 and was diagnosed with 

it in 1998. Id. She indicated that she began taking medication for it at that time and her 

functioning is now “50% improved over baseline”, though said that her symptoms had grown 

worse with time. Id. She also noted issues with Raynaud’s syndrome and Sjogren’s syndrome. 

Id. Dr. Dwyer found that King has numerous symptoms, including joint pain associated with 

lupus flare ups. Tr. 330-31. He also noted that she has headaches precipitated by exhaustion, 

but did not otherwise mention her fatigue. Id. Ultimately, Dr. Dwyer concluded that King did 

“not appear to have any significant disability at the time” of her exam. Tr. 332. 

Dr. Louise Wunsch, an agency medical consultant, reviewed King’s medical records and 

completed an assessment of her residual functional capacity on September 12, 2012. Tr. 350-57. 

He found that King has lupus, Sjogren’s syndrome, Raynaud’s syndrome and bursitis. Tr. 350-

51. Dr. Wunsch opined that King was partially credible, but that the record did not support the 

severity of symptoms she alleged, particularly with regard to her ability to stand and walk for 

significant periods. Tr. 355. Ultimately, he concluded that King can stand or walk for about six 

hours in an eight-hour workday and sit for about six hours per eight-hour workday. Tr. 351. 

Two other agency medical consultants then reviewed the record and affirmed Dr. Wunsch’s 

opinion as written. Tr. 358, 359. 

On January 17, 2013, King returned to Dr. Straniero and complained of decreased 

energy; dry mouth; joint pain in her hands, wrists, hips and knees and fatigue that aggravated the 

frequency of her migraines. Tr. 362. Dr. Straniero noted that King’s dry mouth was placing her 
8 

dental health at risk and that she had lost six teeth. Tr. 362. 

 King visited Dr. Anglemeyer shortly thereafter on January 31, 2013 and complained of 

pain and swelling in her right ankle and elbow, which Dr. Anglemeyer noted may be due to her 

autoimmune disorders. Tr. 393-94. She did not present with fatigue. Id. 

On February 17, 2013, Dr. Straniero authored a medical opinion summarizing King’s 

condition. He found that she suffers from lupus and Sjogren’s syndrome and noted that she 

complained of numerous symptoms including “profound, persistent fatigue, limiting joint pain 

[and] recurrent migraines aggravated by fatigue.” Tr. 360. He further noted that King has flare 

ups in her condition which exacerbate her symptoms and that she has difficulty focusing due to 

fatigue. Id. He concluded that “problems associated with her underlying systemic rheumatic 

disease” prevent King from working full time and that it is difficult for her to work even part 

time. Id. King saw Dr. Straniero once more on July 31, 2013 and complained of decreasing 

energy levels; fatigue; recurrent headaches and joint pain in her hands, wrists, hips, knees and 

lower back. Tr. 398. She reported that she had taken six weeks off of work due to medical 

difficulties and had tried to return to part-time work, though was having difficulty doing so. Id. 

Dr. Straniero found her to have fatigue, dry mouth and migraines. Tr. 399. 

5. The ALJ’s Decision 

After reviewing this medical evidence and hearing King’s testimony, the ALJ issued a 

written opinion which upheld the decision to deny King benefits. The ALJ found that King met 

insured status requirements through December 31, 2017 and had not engaged in substantial 

gainful activity since her alleged onset date. Tr. 19. She further found that King was severely 

impaired by lupus, Raynaud’s syndrome, Sjorgen’s syndrome, irritable bowel syndrome, bursitis 

and migraine headaches. Tr. 21. The ALJ concluded, however, that none of King’s impairments 
9 

met or equaled the severity of one of the impairments listed in 20 C.F.R. Part 404, Subpt. P, 

Appendix 1. She then evaluated King’s residual functional capacity (RFC) and found that King 

was able to: 

[P]erform light work as defined in 20 CFR 404.1567(b) which includes the ability to lift and/or 

carry and push and/or pull up to 20 pounds occasionally and up to 10 pounds frequently, stand 

and/or walk six hours in an eight hour workday, and sit six hours in an eight hour workday. She 

can frequently balance, stoop, kneel, or crawl. [She] can occasionally crouch. She can frequently 

climb ramps or stairs. [She] can occasionally climb ladders, ropes, or scaffolds. She must avoid 

concentrated exposure to extreme temperatures and hazards. 

Tr. 23. In arriving at this RFC, the ALJ assigned little evidentiary weight to the medical 

opinions of Dr. Anglemeyer and Dr. Straniero. Tr. 26. She found that they were not “supported 

by the totality of the evidence” and appeared “to be based purely on the claimant’s subjective 

complaints.” Id. In contrast, the ALJ gave substantial evidentiary weight to the opinions of the 

agency medical consultants and agency medical examiner since they were “within the purview of 

their expertise and consistent with the record as a whole.” Id. 

 The ALJ also found that King’s allegations as to the intensity, persistence, and limiting 

effects of her symptoms were “not entirely credible.” Tr. 24. The ALJ noted that King (1) 

frequently reported no pain and a full range of motion in her upper extremities, wrists, fingers, 

bilateral knees and ankles; (2) had received unemployment benefits after her alleged onset date, 

which required her to certify that she was physically and mentally able to work full time; (3) was 

unable to squat, but could walk, sit, had clear speech and had not been to the emergency room 

for migraines in the past year; (4) was able to engage in several activities of daily living such as 

dressing herself, weeding her flowerbed and washing windows; (5) only required treatment from 

Dr. Straniero once every six months and (6) had never been prescribed a cane. Tr. 24-25. 

 The ALJ then determined that King could perform light work and was capable of 

returning to her past work as an interior decorator. Tr. 26. As a result, the ALJ determined that 
10 

King was not disabled. Tr. 27. The Appeals Council denied a request for review of that 

decision, thereby making it the final determination of the Commissioner. 20 C.F.R. § 404.981; 

Schomas v. Colvin, 732 F.3d 702, 707 (7th Cir. 2013). 

 STANDARD OF REVIEW 

The Court will affirm the Commissioner’s denial of disability benefits if it is supported 

by substantial evidence. Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008). Substantial 

evidence consists of “such relevant evidence as a reasonable mind might accept as adequate to 

support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971). It must be “more than 

a scintilla but may be less than a preponderance.” Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 

2007). Thus, even if “reasonable minds could differ” about the disability status of the claimant, 

the Court will affirm the Commissioner’s decision as long as it is adequately supported. Elder v. 

Astrue, 529 F.3d 408, 413 (7th Cir. 2008). 

 In this substantial-evidence determination, the Court does not reweigh evidence, resolve 

conflicts, decide questions of credibility or substitute the Court’s own judgment for that of the 

Commissioner. Lopez ex rel. Lopez v. Barnhart, 336 F.3d 535, 539 (7th Cir. 2003). The Court 

does, however, critically review the record to ensure that the ALJ’s decision is supported by the 

evidence and contains an adequate discussion of the issues. Id. The ALJ must evaluate both the 

evidence favoring the claimant as well as the evidence favoring the claim’s rejection; she may 

not ignore an entire line of evidence that is contrary to his findings. Zurawski v. Halter, 245 F.3d 

881, 887 (7th Cir. 2001) (citation omitted). The ALJ must also “articulate at some minimal level 

his analysis of the evidence” to permit informed review. Id. Ultimately, while the ALJ is not 

required to address every piece of evidence or testimony presented, she must provide a “logical 

bridge” between the evidence and his conclusions. Terry v. Astrue, 580 F.3d 471, 475 (7th Cir. 
11 

2009). Furthermore, conclusions of law are not entitled to deference. So, if the Commissioner 

commits an error of law, reversal is required without regard to the volume of evidence in support 

of his factual findings. Binion v. Chater, 108 F.3d 780, 782 (7th Cir. 1997). 

ANALYSIS 

 Disability benefits are available only to individuals who are disabled under the terms of 

the Social Security Act. Estok v. Apfel, 152 F.3d 636, 638 (7th Cir. 1998). A claimant is 

disabled if he or she is 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 12 

months.” 42 U.S.C. § 423(d)(1)(A). The Social Security regulations contain a five-step test to 

ascertain whether the claimant has established a disability. 20 C.F.R. § 404.1520(a)(4). These 

steps require the Court to sequentially determine: 

 1. Whether the claimant is currently engaged in substantial gainful activity; 

 2. Whether the claimant has a medically severe impairment; 

 3. Whether the claimant’s impairment meets or equals one listed in the regulations; 

 4. Whether the claimant can still perform relevant past work; and 

 5. Whether the claimant can perform other work in the community. 

20 C.F.R. § 404.1520(a)(4); Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001). At step 

three, if the ALJ determines that the claimant’s impairment or combination of impairments meets 

or equals an impairment listed in the regulations, the Commissioner acknowledges disability. 20 

C.F.R. § 404.1520(a)(4)(iii). However, if a listing is not met or equaled, the ALJ must assess the 

claimant’s residual functional capacity (RFC) between steps three and four. The RFC is then 

used to determine whether the claimant can perform past work under step four and whether the 
12 

claimant can perform other work in society at step five. 20 C.F.R. § 404.1520(e). The claimant 

has the burden of proof in steps one through four, while the burden shifts to the Commissioner at 

step five to show that there are a significant number of jobs in the national economy that the 

claimant is capable of performing. Young v. Barnhart, 362 F.3d 995, 1000 (7th Cir. 2004). 

 King argues that the ALJ erred in conducting this analysis in three respects. First, she 

says that the ALJ neglected to address fatigue, her primary symptom. Second, she says that the 

ALJ did not provide a sufficient justification for not giving controlling weight to the opinions of 

her treating physicians. Third, she says that the ALJ mistakenly concluded that she was capable 

of performing her past work as an interior designer without considering how the tools of that 

trade have changed since King last performed it. The Court will address each of these arguments 

in turn. 

1. Fatigue 

King contends that the ALJ improperly disregarded evidence that she suffered from 

fatigue and failed to consider that impairment in determining her residual functional capacity. 

The Commissioner responds that the ALJ addressed fatigue through her treatment of King’s 

credibility. The Commissioner says that the ALJ found several reasons to discredit King, which 

amounted to a rejection of King’s fatigue allegations, since those allegations were predicated on 

King’s testimony (and her physicians’ opinions, which the ALJ found to be based exclusively on 

King’s subjective complaints). 

 The Court finds that the ALJ did not adequately address fatigue. It is well-established 

that, while the ALJ need not address every piece of evidence in the record, she cannot ignore an 

entire line of evidence that contradicts her findings. Zurawski, 245 F.3d at 888. Fatigue was a 

central issue in this case. King testified that it was her worst symptom and that it prevented her 
13 

from working a full-time schedule. Tr. 44, 46-47. Moreover, she said her part-time work was 

only possible because her employer provided her with substantial accommodations and a flexible 

schedule. Tr. 40, 48-49. That is because even working part time she had days where her fatigue 

was so severe that she could do “absolutely nothing.” Tr. 46. 

 King’s testimony also had some support in the record. She complained of fatigue to Dr. 

Straniero on January 31, 2012 and July 31, 2013. Tr. 279, 398. On the latter date, Dr. Straniero 

also found her to have fatigue. 2 Tr. 398. Dr. Straniero then issued an opinion letter on February 

17, 2013, in which he noted that King complained “of profound, persistent fatigue” and that 

fatigue interfered with her ability to stay on task. Tr. 360. Dr. Anglemeyer also noted King’s 

problems with fatigue. He found King to be positive for fatigue on May 9, 2011 and, several 

months later, stated in an opinion letter that King experiences fatigue when her autoimmune 

diseases flare up. Tr. 297, 397. 

 Remarkably, the ALJ did not address any of this evidence. After describing King’s 

alleged impairments, the ALJ never again mentions fatigue in her decision. That is inexplicable 

given that fatigue was King’s primary complaint and the main topic at her hearing. It is also 

contrary to Seventh Circuit precedent. Golembiewski v. Barnhart, 322 F.3d 912, 917 (7th Cir. 

2003) (remanding in part because the ALJ ignored evidence of several of the claimant’s 

purported symptoms). 

 Moreover, the Commissioner’s argument that the ALJ implicitly addressed fatigue 

through her assessment of King’s credibility is not well founded for four reasons. First, it is 

 

2

 The Court notes that Dr. Straniero found King, contrary to her complaints, not to have fatigue on January 31, 2012. 

Tr. 280. The reason for this discrepancy is unclear and, in light of it, it will be up the ALJ on remand to determine 

what weight (if any) to give to King’s complaint on this date. 
14 

inappropriate to impute any rationale to the ALJ’s treatment of fatigue, since there is no 

indication that she conducted any analysis of that symptom whatsoever. See Parker v. Astrue, 

597 F.3d 920, 922 (7th Cir. 2010) (noting that SEC v. Chenery Corp., 318 U.S. 80, 87-88 (1943) 

“forbids an agency’s lawyers to defend the agency’s decision on grounds that the agency itself 

has not embraced.”).3

 Second, even if the ALJ did consider fatigue and intended to address it 

implicitly (an odd way to address a claimant’s primary asserted symptom), that would still be 

impermissible because it would not allow for meaningful appellate review. See Herron v. 

Shalala, 19 F.3d 329, 333 (7th Cir. 1994) (“Our cases consistently recognize that meaningful 

appellate review requires the ALJ to articulate reasons for accepting or rejecting entire lines of 

evidence.”) Third, even if the ALJ had made explicit that she considered King’s testimony in 

analyzing fatigue, the ALJ’s treatment of that evidence would not have provided a sound basis 

for concluding that King did not suffer from fatigue. As the Commissioner notes, the ALJ 

considered several factors that could detract from King’s credibility. But ultimately the ALJ 

found only that King’s “allegations regarding the limiting effects of her impairments [were] not 

entirely credible.” 4 Tr. 25. That boilerplate language “yields no clue to what weight the trier of 

 

3

 The Court recognizes, as the Commissioner notes, that the Court must give the ALJ’s opinion “a commonsensical 

reading rather than nitpicking at it.” Rice v. Barnhart, 384 F.3d 363, 369 (7th Cir. 2004). But it is not “nitpicking” 

to decline to presume that the ALJ analyzed a symptom where she devoted absolutely no substantive discussion to it. 

4

 On remand, in addition to clarifying her conclusion as to the credibility of King’s testimony, the ALJ should refine 

the methodology she uses to evaluate it. The ALJ raises several issues in analyzing King’s credibility that would 

seem to have no connection to her credibility whatsoever. For example, she noted that King was unable to squat and 

had not been to the emergency room for migraines in the past year. Further, if the ALJ again includes a description 

of King’s daily activities, she should explain how and whether they are “consistent or inconsistent with the pain and 

limitations [King] claim[s].” Villano v. Astrue, 556 F.3d 558, 562 (7th Cir. 2009). Next, if the ALJ believes it 

questionable that King only required treatment from her rheumatologist about every six months, she should indicate 

why she believes this to be a sparse treatment history and any potential explanations for it (such as King’s apparent 

financial constraints, tr. 301). See Pierce v. Colvin, 739 F.3d 1046, 1050 (7th Cir. 2014). Lastly, while the ALJ 

mentions that there is “no evidence to indicate a cane has ever been prescribed or deemed to be medically necessary 

for the claimant,” tr. 25, the Seventh Circuit has repeatedly indicated that this is not suspicious. See, e.g., Parker, 

597 F.3d at 922. 
15 

fact gave [King’s] testimony” and thus no insight as to how the ALJ might have applied it to the 

fatigue analysis. Parker, 597 F.3d at 922. And fourth, even if the ALJ’s assessment of King’s 

credibility was sufficiently clear to be relevant to the fatigue calculus, it would not account for 

the opinions of King’s treating physicians, which, as articulated below, were not simply 

regurgitations of King’s subjective complaints. As such, remand is required so that the ALJ can 

adequately assess King’s allegations of fatigue. See Golembiewski, 322 F.3d at 917. But while 

this misstep alone justifies vacating the ALJ’s decision, the Court nevertheless addresses the 

parties’ remaining arguments in the interest of thoroughness and to guide the ALJ’s further 

treatment of this matter. 

2. Treating Physicians 

King also says that the ALJ committed reversible error by giving “little evidentiary 

weight” to the opinions of her treating physicians, Dr. Anglemeyer and Dr. Straniero. Tr. 26. 

The Commissioner responds that the ALJ properly discounted these opinions because they were 

based entirely on King’s subjective complaints and were not otherwise consistent with the 

totality of the evidence. 

Treating physician opinions are afforded special deference in disability proceedings. The 

regulations governing social security proceedings instruct claimants to that effect: 

Generally, we give more weight to opinions from your treating sources, since these sources are likely to be 

the medical professionals most able to provide a detailed, longitudinal picture of your medical 

impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the 

objective medical findings alone or from reports of individual examinations, such as consultative 

examinations or brief hospitalizations. If we find that a treating source's opinion on the issue(s) of the 

nature and severity of your impairment(s) is well-supported by medically acceptable clinical and laboratory 

diagnostic techniques and is not inconsistent with the other substantial evidence in your case record, we 

will give it controlling weight. 

20 C.F.R. § 404.1527(c)(2). Treating physician opinions are not entitled to controlling weight, 

however, if they are not supported by the objective medical evidence, where they are inconsistent 
16 

with other substantial evidence in the record or where they are internally inconsistent. See 

Clifford v. Apfel, 227 F.3d 863, 871 (7th Cir. 2000) (citing Knight v. Chater, 55 F.3d 309, 314 

(7th Cir. 1995)). Ultimately, the Court defers to the ALJ's decision to give less than controlling 

weight to a treating physician opinion so long as the ALJ provides “good reasons” for doing so. 

Scott v. Astrue, 647 F.3d 734, 739 (7th Cir. 2011). 

 King’s treating physicians, Dr. Straniero and Dr. Anglemeyer, opined that King was 

unable to work full time due to lupus-related symptoms including fatigue and joint pain. Tr. 360, 

397. The ALJ determined that those opinions were not entitled to controlling weight because 

they were “not supported by the totality of the evidence and appear[ed] to be based purely on the 

claimant’s subjective complaints.” The latter observation, as articulated below, is incorrect. The 

ALJ did not err, however, in concluding that King’s physicians’ opinions were inconsistent with 

other substantial evidence in the record. In particular, the ALJ noted that they were not 

consistent with the opinions of the agency medical consultants and agency medical examiner. 

Tr. 26. That was a permissible reason to not give them controlling weight. Skarbek v. Barnhart, 

390 F.3d 500, 503 (7th Cir. 2004) (“An ALJ may discount a treating physician's medical opinion 

if it is inconsistent with the opinion of a consulting physician”); Bauer v. Astrue, 532 F.3d 606, 

608 (7th Cir. 2008). 

But when “an ALJ decides not to give controlling weight to a treating physician’s 

opinion, the ALJ is not permitted simply to discard it.” Scrogham v. Colvin, 765 F.3d 685, 697 

(7th Cir. 2014). Rather, the ALJ is “required by regulation to consider certain factors in order to 

decide how much weight to give the opinion[.]” Id. These factors, set forth in 20 C.F.R. § 

404.1527, are: (1) the “length of the treatment relationship and the frequency of examination;” 

(2) the “[n]ature and extent of the treatment relationship;” (3) “[s]upportability;” (4) consistency 
17 

“with the record as a whole;” and (5) whether the treating physician was a specialist in the 

relevant area. Id. 

 The ALJ did not properly apply those factors in weighing Dr. Straniero’s and Dr. 

Anglemeyer’s opinions. She did note that Dr. Straniero had described the physical impact of 

King’s condition as only mild and moderate. Tr. 26. That could, perhaps, be interpreted as 

inconsistent with his conclusion that King could not work full time and thus provide some 

justification for discounting his opinion. The ALJ also considered a number of instances where 

King failed to demonstrate certain symptoms that could be associated with lupus. Tr. 24.5

But the ALJ discussed none of the evidence that weighed in favor of crediting King’s 

treating physicians’ opinions. That included the observations of both of King’s physicians that 

her symptoms wax and wane, tr. 360, 397, which might explain why King sometimes did not 

present with certain symptoms. See Groskreutz v. Barnhart, 108 F. App’x 412, 418 (7th Cir. 

2004) (noting that it was problematic for an ALJ to find a claimant not credible because she did 

not report pain on some occasions where the ALJ did not consider that the claimant’s symptoms 

waxed and waned and that she did report pain on other occasions). Furthermore, contrary to the 

findings of the ALJ, Dr. Straniero and Dr. Anglemeyer do not appear to have relied entirely on 

King’s subjective complaints in forming their opinions. Rather, their notes also reflect objective 

findings including the results of urine and blood tests, tr. 278, lupus-related dry mouth and tooth 

loss, tr. 315, 362, and joint effusion and degeneration. Tr. 285, 394. Moreover, the ALJ failed to 

consider the length of King’s relationship with Dr. Straniero and Dr. Anglemeyer (which dates to 

 

5

 King also argues that the ALJ improperly considered the results of King’s 2013 anti-neutrophil antibody (ANA) 

test to conclude that she did not have lupus. But the ALJ expressly found that lupus was among King’s severe 

impairments. Tr. 21. Nevertheless, on remand the ALJ should ensure that she only discusses King’s ANA test 

“through the perspective of the various doctors who reviewed” it, rather than playing doctor herself. Turner v. 

Astrue, 390 F. App’x 581, 584 (7th Cir. 2010). 
18 

at least 2010), the nature of the treatment she received (which included a hydroxychloroquine 

prescription for lupus, see, e.g., tr. 296) and Dr. Straniero’s specialty as a rheumatologist. See 

Scrogham, 765 F.3d at 697 (noting an ALJ’s error in failing to consider these factors). Given 

these oversights, the Court “cannot assess whether [the ALJ] appropriately chose not to give 

much weight to the treating physicians’ opinions.” Id. at 697-98. On remand, the ALJ should 

clearly articulate the weight due to King’s physicians’ opinions and how that determination is 

justified given all relevant 20 C.F.R. § 404.1527 considerations. 

3. Ability to Return to Interior Design Work 

 Finally, the Court notes that King contests the ALJ’s step-four determination that she is 

able to return to her past work as an interior designer. King argues that she is unable to return to 

that position since interior design has changed considerably since she last worked in that field in 

2010. As such, she contends that she does not possess the required skills for that work under 20 

C.F.R. § 404.1568. 

 But, at King’s hearing, the vocational expert testified that an individual with King’s 

limitations and experience would be able to work as an interior designer. King did not object to 

that determination. So, it is improper for her to now raise arguments as to the integrity of the 

VE’s findings to this Court. As numerous cases make clear, “[w]hen no one questions the 

vocational expert’s foundation or reasoning, an ALJ is entitled to accept the vocational expert’s 

conclusion.” Donahue v. Barnhart, 279 F.3d 441, 446 (7th Cir. 2002); see also Liskowitz v. 

Astrue, 559 F.3d 736, 744 (7th Cir. 2009); Barrett v. Barnhart, 355 F.3d 1065, 1067 (7th Cir. 

2004).6 Nevertheless, since this matter will be remanded for the above-discussed reasons, King 

 

6

 That said, King would still be free to argue that the VE’s testimony was invalid since, in light of the abovediscussed analytical errors, it was based on a faulty RFC. Barrett, 355 F.3d at 1067. 
19 

will have another opportunity to challenge the VE’s testimony, should she disagree with it, at her 

next hearing. 

CONCLUSION 

 For the foregoing reasons, the decision of the Commissioner denying King’s claim for 

benefits is REVERSED, and this matter is REMANDED for to the Commissioner for further 

proceedings consistent with this opinion. 

 SO ORDERED. 

 ENTERED: March 9, 2016 

 /s/ JON E. DEGUILIO 

 Judge 

 United States District Court