UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

FORT WAYNE DIVISION

SHELIA K. DICKINSON, )

)

 Plaintiff, )

)

 v. ) CIVIL NO. 1:16cv185

)

NANCY A. BERRYHILL, Acting )

Commissioner of Social Security, )

)

 Defendant. )

OPINION AND ORDER

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

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

Insurance Benefits (DIB) as provided for in the Social Security Act. 42 U.S.C. §416(I). Section

205(g) of the Act provides, inter alia, "[a]s part of his answer, the [Commissioner] shall file a

certified copy of the transcript of the record including the evidence upon which the findings and

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

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

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

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

conclusive. . . ." 42 U.S.C. §405(g).

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

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

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

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

abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Judge (“ALJ”) made the following findings:

1. The claimant last met the insured status requirements of the Social Security Act

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on March 31, 2011.

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

her amended alleged onset date of January 1, 2007, through her date last insured

of March 31, 2011 (20 CFR 404.1571 et seq.).

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

asthma (20 CFR 404.1520(c)).

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

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

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

404.1520(d), 404.1525, 404.1526).

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

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

perform sedentary work as defined in 20 CFR 404.1567(a), and as follows: lift,

carry, push, and pull ten pounds throughout the workday; sit six hours in an eighthour workday, and stand and/or walk two hours in an eight-hour workday;

occasional bending and stooping in addition to what is required to sit; no work

requiring concentrated exposure to extremes in heat, cold, and humidity, and

concentrated exposure to particulates such as dusts, fumes, and gases.

6. Through the date last insured, the claimant was capable of performing past

relevant work as a ticket seller and office manager. This work did not require the

performance of work-related activities precluded by the claimant’s residual

functional capacity (20 CFR 404.1565).

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

any time from March 15, 2011, the alleged onset date, or even January 1, 2007,

(the amended onset date) through March 31, 2011, the date last insured (20 CFR

404.1520(f)).

(Tr. 21-29).

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

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

Council denied review. This appeal followed.

Plaintiff filed her opening brief on December 23, 2016. On February 2, 2017, the

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

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

ALJ’s decision should be affirmed.

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

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

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

that test as follows:

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

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

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

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

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

work within the economy? An affirmative answer leads either to

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

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

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

disabled.

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

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

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

Plaintiff completed the 10th grade in school (Tr. 168). She was 51 years old as of her

alleged disability onset date and 56 years old as of her date last insured (Tr. 43, 144). Plaintiff

previously worked as (1) a ticket seller, which the vocational expert characterized as unskilled in

nature and light in exertion per the Dictionary of Occupational Titles (DOT), but sedentary as she

performed it; and (2) an office manager, which the vocational expert characterized as semi-skilled

in nature, and light in exertion per the DOT, but sedentary as she performed it (Tr. 69). 

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Plaintiff argues that the ALJ should have considered her hand tremor a serious disabling

condition. Garland D. Anderson, M.D., treated Plaintiff prior to her alleged disability onset date

and during the relevant period. The record contains Dr. Anderson’s treatment notes from 2006

(prior to Plaintiff’s alleged onset date), but those records do not contain any complaints or clinical

evidence of tremors (Tr. 476-79). 

In January 2007, Plaintiff complained of having right arm and shoulder pain, but she did

not complain of tremors (Tr. 474). Dr. Anderson noted no neurological or musculoskeletal

deficits (Tr. 474). More than a year later, in February 2008, Plaintiff followed-up with Dr.

Anderson, but, again, she did not complain of having tremors (Tr. 472). Dr. Anderson did not find

any neurological deficits, nor did he report any tremors present (Tr. 472). 

In April 2008, Dr. Anderson noted that Plaintiff “seems to have some kind of fine tremor,

which is almost a familial type of tremor,” but he did not include tremors on the list of diagnoses

or recommend any apparent treatment (Tr. 468). Nor did Dr. Anderson opine that Plaintiff had

any work-related limitations from the tremor (Tr. 468). 

Plaintiff was a “no show” at an appointment scheduled with Dr. Anderson in January

2009 (Tr. 467). In May 2009, Plaintiff reported to Dr. Anderson that she “ha[d] been very

nervous taking care of her aged mother” who had Alzheimer’s (Tr. 465). Dr. Anderson observed

no neurological deficits; rather, he found that Plaintiff was alert and responsive without

neuropathy (Tr. 465). Plaintiff did not complain of having tremors, nor did Dr. Anderson report

evidence of any such condition (Tr. 465). 

A November 2009 treatment note indicates that Plaintiff “ha[d] been very busy taking care

of her invalid mother and also her invalid aunt lives with her” (Tr. 463). It was noted that “[s]he

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has some slight familial tremor,” but Dr. Anderson noted no neurological deficits (Tr. 463). 

In September 2014, medical expert Mark Faber, M.D., filled out medical interrogatories at

the request of the ALJ (Tr. 497-99). After reviewing Plaintiff’s records, Dr. Faber indicated that

Plaintiff had “COPD/asthma” and “breast cancer – treated” (Tr. 497). He opined that Plaintiff

could work at the “sedentary level due to poor pulmonary function” (Tr. 499). He indicated that

Plaintiff could lift and/or carry 10 pounds occasionally and less than 10 pounds frequently; sit up

to 6-8 hours in an 8-hour day; and stand and or walk up to 2 hours in an 8-hour day (Tr. 499). He

assessed no further restrictions for foot or hand controls, and he expressly found that Plaintiff had

“no manipulative reductions” (Tr. 499). Dr. Faber opined that Plaintiff should have no exposure

to concentrated respiratory irritants or extremes of hot or cold; and she should not climb ropes

and ladders (Tr. 499). He indicated that Plaintiff should be limited to sedentary work “at least

back to 1/1/[2]011” (Tr. 499). 

In support of remand or reversal, Plaintiff argues that (1) the ALJ should have found

Plaintiff’s hand tremors constituted a medically determinable severe impairment at step two of the

sequential evaluation process; and (2) the ALJ should have included in his RFC finding

limitations from Plaintiff’s “hand tremor impairment” (Pl.’s Br. at 3-4, 6-9). 

The record clearly shows that Plaintiff did not meet her burden of establishing that

familial tremors constituted a severe impairment at step two of the sequential evaluation. 

Under the Commissioner’s regulations, an impairment is severe if it significantly limits the

claimant’s physical or mental ability to do basic work activities such as walking, standing, sitting,

lifting, pushing, pulling, reaching, carrying, or handling. 20 C.F.R. § 404.1521. Also, an

impairment is not severe when the medical evidence establishes only a slight abnormality or

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combination of slight abnormalities that would have no more than a minimal effect on the ability

to perform basic work activities. Social Security Ruling (SSR) 85-28, 1985 WL 56856 (SSA). As

noted above, Plaintiff has a dual burden of production and persuasion at step two; she must

produce evidence that proves that her impairment causes the functional limitations she alleges in

the severity she alleges. See Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987). Finding an

impairment not severe does not merit remand so long as the ALJ identifies other severe

impairments and continues with the sequential evaluation. Arnett v. Astrue, 676 F.3d 586, 591

(7th Cir. 2012) (citing Castile v. Astrue, 617 F.3d 923, 927-28 (7th Cir. 2010). Here, the ALJ

found that Plaintiff’s asthma was a severe impairment at step two, but he also found that the

“evidence was insufficient to establish any other severe physical or mental impairment” prior to

Plaintiff’s date last insured (Tr. 21). 

In the present case, the ALJ specifically considered Plaintiff’s complaints of hand tremors,

but found that the evidence failed to substantiate a severe impairment (Tr. 23). The ALJ discussed

a November 30, 2009 treatment note in which Dr. Anderson recorded that Plaintiff reported

having “some slight tremor” (Tr. 23, 463). As the ALJ indicated, Dr. Anderson’s examination

findings did not list “tremor,” and he did not record a diagnosis of familial tremor on that date

(Tr. 23, 463). The ALJ also discussed Plaintiff’s visit to Dr. Anderson’s office on August 4, 2011,

during which Plaintiff reported having a familial tremor “at this time” (Tr. 23, 275). Dr. Anderson

observed the presence of a tremor during his examination (Tr. 23, 275). He did not, however,

record a diagnosis of familial tremor (Tr. 23, 275). Anderson noted that although “no

medications [were] involved,” it was an issue they “could certainly address ... at a later date if

necessary” (Tr. 23, 275).

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The ALJ found that “[t]he medical evidence is insufficient to support [Plaintiff’s]

allegations of significant tremor prior to the [date last insured]” (Tr. 23). Plaintiff argues that the

ALJ “missed” the objective evidence of her alleged tremors, in particular an April 2008 treatment

record in which Dr. Anderson noted that Plaintiff “seems to have some kind of fine tremor, which

is almost a familial type of tremor” (Pl.’s Br. at 6; Tr. 468). An ALJ, however, is not required to

address “every piece of evidence or testimony in the record, [but] the ALJ’s analysis must provide

some glimpse into the reasoning behind [the] decision to deny benefits.” Zurawski v. Halter, 245

F.3d 881, 888 (7th Cir. 2001). 

In the present case, it is clear that the ALJ sufficiently articulated his reasons through his

analysis of relevant evidence (Tr. 23). The ALJ properly assessed the medical and non-medical

evidence from prior to Plaintiff’s date last insured (March 31, 2011) to determine that Plaintiff’s

tremors were not severe. During the relevant period, Dr. Anderson did not find any significant

neurological deficits (e.g., weakness, abnormal reflexes, or decreased sensation). This evidence

does not corroborate Plaintiff’s claims about her tremors. Furthermore, Dr. Anderson did not

opine on any functional limitations related to the tremors. Nor did he recommend any treatment or

therapy to address tremors. See Walker, 2016 WL 7383806, at *3 (noting that the “Plaintiff’s

sporadic treatment history supports the ALJ’s determination that Plaintiff’s gout was not

disabling). Moreover, Plaintiff’s evidence from July 2012 through April 2014 (Pl.’s Br. at 3) does

not demonstrate that the tremors constituted a severe impairment, within the meaning of the

regulations, prior to Plaintiff’s date last insured.

Plaintiff cites to information from the Mayo Clinic’s website describing common

symptoms related to “essential tremors” (Pl.’s Br. at 3). But she does not explain how the Mayo

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Clinic information demonstrates how her alleged tremors caused more than a minimal effect on

her ability to perform work-related activities during the relevant period, as was her burden. See

Walker v. Colvin, No. 4:16-cv-0033, 2016 WL 7383806, at *3 (N.D. Ind. Dec, 20, 2016) (“At step

two, the claimant has the burden to prove that his impairment is severe by showing that the

impairment significantly limits his ability to do basic work activities”) (citation omitted). Plaintiff

also argues in her brief that “[s]urely, the ALJ is not suggesting that shaky hands have no impact

on one’s ability to handle tickets, handle and make change, use a keyboard, answer a phone,

handle paperwork, among other similar functions related to” the ticket seller and office manager

jobs (Pl.’s Br. at 7). Beyond speculation, however, Plaintiff cites to no evidence showing that her

alleged tremors had such an impact on her. 

Plaintiff argues that the ALJ “justif[ied]” finding the tremors a non-severe impairment at

step two by noting that “the inability to carry a cup of coffee would not represent a limitation that

would more than minimally affect most work-related activities (outside of work in the food

services)” (Pl.’s Br. at 6, citing Tr. 28). She contends that there is no vocational expert testimony

to support the ALJ’s statement (Pl.’s Br. at 6). Plaintiff’s arguments are flawed. 

First, Plaintiff’s argument is undermined by her own testimony. By way of example,

Plaintiff testified that the tremors had been present for about ten years, during which time she

worked (Tr. 23, 60). Her work ended in 2007 because the business closed, not due to an

impairment. (Tr. 29). As the ALJ noted, Plaintiff testified “that the symptoms were

embarrassing,” but the only “work-related effect” that the tremors allegedly caused was that she

“could not transport beverages” (Tr. 23, 60). At one point, she testified that if she wanted to drink

coffee, someone else got it for her (Tr. 60). At another point during the hearing, Plaintiff admitted

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that she was able to get herself something to drink (Tr. 71). 

Second, Plaintiff explained that her ticket seller job involved taking money from ticket

purchasers (Tr. 65). She was “pretty much the money watcher all day long” (Tr. 70). She did not

report any work-related difficulties with taking money. Nor did she describe her ticket seller job

as a food services job. She testified that the Bingo Hall where she worked held dinners and

parties, but there is no indication that her job responsibilities included serving drinks or food (Tr.

66). Additionally, there is no evidence that Plaintiff’s office manager job involved food servicerelated activities (Tr. 70-71). 

This court finds that the ALJ provided an adequate discussion to permit meaningful

review of his conclusion that tremors had no more than a minimal effect on Plaintiff’s workrelated activities. Because substantial evidence supports the ALJ’s decision, it will be affirmed. 

Next, the court will consider Plaintiff’s argument that the Alj should have included hand

tremors in his RFC limitations. However, it is clear that the ALJ properly determined Plaintiff’s

RFC in light of all the evidence of record. An RFC is the most an individual can do despite her

limitations. 20 C.F.R. § 404.1545. The RFC assessment is an administrative finding, not a

medical opinion. SSR 96-5p, 1996 WL 374183, at *5 (SSA). The determination of an

individual’s RFC need not be based on a specific medical opinion because it is a determination

reserved to the ALJ as fact-finder for the Commissioner. 20 C.F.R. § 404.1527(d)(2). When

assessing a claimant’s RFC, an ALJ considers both the severe and non-severe impairments (Tr.

20). See 20 C.F.R. §§ 404.1520(e), 404.1545(a)(2). 

In this case, the ALJ found that Plaintiff had the RFC to perform: 

[S]edentary work as defined in 20 CFR 404.1567(a), and as

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follows: lift, carry, push, and pull ten pounds throughout the

workday; sit six hours in an eight-hour workday, and stand and/or

walk two hours in an eight-hour workday; occasional bending and

stooping in addition to what is required to sit; no work requiring

concentrated exposure to extremes in heat, cold, and humidity, and

concentrated exposure to particulates such as dusts, fumes, and

gases. 

(Tr. 27). The ALJ indicated that he considered the entire record, including Plaintiff’s allegations

concerning tremors, which the ALJ found to be non-severe (Tr. 23, 27-28). The ALJ noted that he

fully discussed the tremor allegations at step two of the sequential evaluation, and it was

unnecessary to repeat the discussion in detail (Tr. 23, 28). As discussed above, the ALJ evaluated

the records in which Plaintiff alleged having tremors, but there was no evidence that the

symptoms significantly affected her ability to do work-related activities. The ALJ found that

Plaintiff’s allegations concerning the intensity, persistence, and limiting effects of her symptoms

were not entirely credible (Tr. 28). See Williamson v. Colvin, No. 4:13-CV-1-JVB, 2014 WL

1317133, at *6 (N.D. Ind. Mar 28, 2014) (“An ALJ’s credibility finding is entitled to

‘considerable deference’ and will only be overturned if patently wrong.”) (citing Terry v. Astrue,

580 F.3d 471, 477 (7th Cir. 2009). As the ALJ indicated, “most of the claimant’s allegations

regarding limitations during the period between the amended onset date and the [date last insured]

are either not supported or contradicted by the objective medical evidence” (Tr. 28). The ALJ

concluded that “[t]he evidence does not suggest that additional limits were necessary” (Tr. 29).

Plaintiff contends that the ALJ should have included in the RFC a limitation involving

occasional – or less than occasional – handling and fingering because of the tremors, and had the 

ALJ done so, he “may very well have found” that she was disabled (Pl.’s Br. at 9). Plaintiff cites

to no particular evidence in which a medical source opined that Plaintiff’s tremors caused such

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manipulative limitations (Tr. 29). Rather, as noted above, records prior to Plaintiff’s date last

insured indicate that she had only “some slight familial tremor” or “some kind of fine tremor”

(Tr. 463, 468), for which she received no apparent treatment. 20 C.F.R. § 404.1529(c)(3)(iv)-(vi)

(medication, treatment, and other measures that provide relief are factors that should be

considered when evaluating symptoms). This is inconsistent with the degree of difficulty that

Plaintiff now alleges. 

Moreover, Dr. Anderson did not opine that Plaintiff had any manipulative limitations from

the tremors (see, e.g., Tr. 463, 465, 468, 472, 474). Further, the ALJ noted that the State agency

medical consultants who reviewed Plaintiff’s records found that there was insufficient evidence to

establish severe physical impairments prior to Plaintiff’s date last insured (Tr. 28, 79-80, 84-85).

They did not opine that Plaintiff had any manipulative limitations. Likewise, Dr. Faber’s

September 2014 report provides no basis to include any handling or fingering limitations in

Plaintiff’s RFC (Tr. 499). In fact, Dr. Faber expressly found that Plaintiff had “no manipulative

reductions” (Tr. 499). This substantial evidence provides support for the ALJ’s RFC finding. 

The ALJ further noted that during much of the relevant period, Plaintiff cared for her

ailing mother (and possibly her ailing aunt), which likely required exertion beyond that defined in

the RFC finding (Tr. 29). The record reveals that Plaintiff reported that she prepared meals and

helped her mother with her personal care (Tr. 51-52, 54). Further, as the ALJ noted, Plaintiff

testified that she experienced tremors for approximately ten years, including the period that she

worked (Tr. 23). Finally, the ALJ noted that Plaintiff’s work ended in 2007 due to the business

closing, not due to an impairment (Tr. 29). These factors undermine Plaintiff’s claim that the

tremors caused limitations that precluded her from doing her past relevant work. 

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This court finds that the ALJ’s RFC finding is supported by substantial evidence and, as

the ALJ indicated, “[t]he evidence does not suggest that additional limits were necessary” (Tr.

29). The ALJ posed proper hypotheticals to the vocational expert based on the evidence of record

(Tr. 71-72). See Jens v. Barnhart, 347 F.3d 209, 213 (7th Cir. 2003) (the hypothetical question

need only contain a description of the limitations supported by the medical evidence of record).

The vocational expert testified that Plaintiff could perform her past relevant work (Tr. 71-72).

The ALJ was entitled to rely on the vocational expert’s testimony as constituting substantial

evidence supporting the ALJ’s finding Plaintiff not disabled at step four of the sequential

evaluation process (Tr. 29-30). See O’Connor-Spinner v. Astrue, 627 F.3d 614, 620-21 (7th Cir.

2010) (holding that it must be clear that a vocational expert took into account all of the

impairments that the ALJ recognized to “assure reviewing courts that the [vocational expert’s]

testimony constitutes substantial evidence of the jobs a claimant can do.”). The ALJ was not

required to go beyond step four. 20 C.F.R. §§ 404.1520(a)(4)(iv), (f), 404.1560. 

Because the ALJ found Plaintiff could do her past relevant work at step four, the burden

of proof was on Plaintiff to demonstrate that her impairments and resulting limitations would

prevent her from doing that work. Plaintiff argues that her case should be remanded because the

SCO requires constant handling and fingering for a ticket taker job and frequent handling for an

office manager job (Pl.’s Br. at 6-7). But the DOT, upon which the vocational expert relied,

similarly identifies the ticket taker job as involving constant handling and fingering and the office

manager job as involving frequent handling and fingering. See DOT 211.467-030, 1991 WL

671853 (GPO); DOT 219.362-010, 1991 WL 671953 (GPO). Regardless of that fact, Plaintiff’s

argument misses a critical point: as the ALJ found, the record does not support a finding that

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Plaintiff had manipulative limitations that would have precluded her from doing either of those

jobs as she performed them or as they are performed according to the DOT (Tr. 27-30). 

Accordingly, for all the above reasons, the ALJ’s decision will be affirmed.

Conclusion

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

 Entered: June 9, 2017.

 s/ William C. Lee 

 William C. Lee, Judge

 United States District Court

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