of frequent ear infections or drainage on a daily basis.? (R.
at 17.) The ALJ also doubted Plaintiff’s claims of dry and
cracking skin on her hands, because she had not sought treatment
from a dermatologist. (R. at 17.)

The ALJ acknowledged that Plaintiff does not have any
skills that are transferable to other work. (R. at 19.); 20
C.F.R. § 404.1568. Given Plaintiff's RFC, age, skill level, and
education, the ALJ stated that, according to VE Ghehrig, there
were still more than 9,000 jobs that Plaintiff could perform in
the Chicago area, which constitutes a significant number in the
national economy. (R. at 18.) The ALJ further noted that Rule
202.13 of the Medical-Vocational Guidelines, Appendix 2, Subpart
P, Part 404, further supports her conclusion that Plaintiff was
not disabled.‘ (R. at 18.); 20 C.F.R. § 404.1569.

The ALJ found that Plaintiff was not disabled on or before

* The Court notes that this claim is apparently
inconsistent with the ALJ's earlier finding, in describing
Plaintiff's RFC, that Plaintiff needed to remove her hearing aid
on a daily basis.

‘ The Court questions the ALJ’s use of the Grids in this
case. The medical evidence and findings of ALJ Dougherty
indicate that Plaintiff suffers from both exertional and non-
exertional limitations, including pain and hearing loss. When
the claimant suffers from both exertional and non-exertional
limitations, the Grids will not be used unless there is a rule
that directs a conclusion of disabled based only on strength
limitations. 20 C.F.R. § 404.1569a. There is not a rule that
directs that conclusion and, therefore, the Grids are not
applicable to Plaintiff’s case.

19


both thumbs, and arthritic sclerosis at the carpal articulations.
(R. at 151.) The ALJ did not even mention Dr. Barnett’s findings
in her opinion.

Next, Dr. Kale observed that Plaintiff’s fingers appeared
slightly swollen and that she conducts finger motions slowly and
carefully.® (R. at 158.) Dr. Kale stated his “best-fit
diagnosis” as chronic RSD. (R. at 159.) While Dr. Kale did
state that it was unclear to him why she should continue having
such pain, he opined that she could not perform her current job,
which required hand manipulation and strength. (R. at 159.) He
also stated that her Tinel's test and Phalen's sign were positive
on the left. (R. at 158.)

Dr. Artinian’s report also supports Plaintiff’s claim. Dr.
Artinian observed synovial membrane thickening of both PIP joins,
a deformity in her fingers in both hands, severe pain and
stiffness in the left forearm and wrist, the inability to make a
fist, a fungus in her fingernails for the last five years, anda
skin disorder of both hands that causes a cracking of the skin

and severe burning pain, for which he says nothing seems to help.

° The Commissioner argues that this is simply an
observation made by Dr. Kale and not a limitation placed on
Plaintiff's ability to use her fingers. While the Court cannot
state Dr. Kale's intent in the statement, the statement was made
as part of a medical physical examination and therefore, the
Court reads Dr. Kale's statement about how she moves her fingers
as a statement about her observed ability and not just writing
out a complaint.

36


her forearm, which radiated to her shoulder, to Dr. Schenck on
September 30, 1988. (R. at 138.) Dr. Schenck, a specialist in
hand surgery, believed that she had tendonitis and not carpal
tunnel syndrome. (R. at 139.)

Dr. Pierson, of University Orthopaedics, examined Plaintiff
in June of 1988 and April of 1989. (R. 142, 145) Dr. Pierson
found that she presented “a rather unusual pattern of complaints
and findings." (R. at 142-144.) X-Rays revealed anterior
osteophytes at the C4-5 and C5-6 articulations. (R. At 143.)
Dr. Pierson determined that her symptoms were primarily due to
chronic medial epicondylitis and recommended a prophylactic
muscle rehabilitation program. (R. at 146.)

In June of 1989, Plaintiff was examined by Dr. Casini, an
orthopaedic surgeon, also from University Orthopaedics. (R. at
147.) Plaintiff reported tingling, radiating pain, and weakness
in her hands. Id. Based on an examination and X-Rays, Dr.
Casini found no objective evidence to support Plaintiff's
subjective complaints of hand pain. (R. at 148.) Spinal X-Rays
demonstrated osteophytes anterior at the C5-6 and C6-7
articulations, but the X-Rays taken of her wrists were
unremarkable. Id.

b. Dr. Barnett

In July 1992, Plaintiff was examined by Dr. Barnett. (R. at

149-151.) Plaintiff again complained of pain and numbness in

13


The ALJ added an additional paragraph to the opinion,
discussing the "clarified" RFC and VE Mendrick's testimony. (R.
at 301.) The ALJ stated that, based upon an RFC precluding
Plaintiff from performing repetitive constant fingering with
either hand or reaching above the shoulder with either arm,
Plaintiff could still perform over 10,000 jobs in the Chicago
area, based on testimony from VE Mendrick. (R. at 301.) Because
this represents a significant number of jobs, Plaintiff was not
considered disabled, as defined by the Social Security Act.

STANDARD OF REVIEW

In reviewing the ALJ’s decision, the Court may not decide
the facts, reweigh the evidence, or substitute its own judgment
for that of the ALJ. Herron v. Shalala, 19 F.3d 329, 333 (7
Cir. 1994). Where conflicting evidence allows reasonable minds
to differ, the responsibility for determining whether a claimant
is disabled falls upon the Commissioner, not the courts. Herr v.
Sullivan, 912 F.2d 178, 181 (7 Cir. 1990); see also Stuckey v.
Sullivan, 881 F.2d 506, 509 (7° Cir. 1989) (the ALJ has the
authority to assess medical evidence and give greater weight to
that which she finds more credible). Rather, the Court must
accept findings of fact that are supported by “substantial
evidence,” 42 U.S.C. § 405{g), where substantial evidence is
“such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” Herron, 19 F.3d at 333

23


hand or both and, if both hands are severely disabled, to
consider whether benefits should be awarded." Id at *5.

On September 7, 2000, ALJ Dougherty conducted another
hearing to clarify the issue, and on October 27, 2000, ALJ
Dougherty issued her second opinion, again finding that Plaintiff
was not disabled at anytime through December 31, 1994. (R. at
295~-320.) ALJ Dougherty adjusted her RFC determination to
include the limitation that Plaintiff cannot "perform constant,
repetitive fingering with either hand." (R. at 297.) The Appeals
Council affirmed the ALJ's decision, making the ALJ's second
decision, issued on October 27, 2000, the final decision of the

Commissioner. (R. at 284-286.)

BACKGROUND

The evidence before the ALJ, at the September 12, 1995
hearing, included testimony from Plaintiff and VE Ghehrig, and
medical records. Subsequent to the ALJ’s December 29, 1995
decision, but before consideration by the Appeals Council,
Plaintiff submitted a letter from VE Grzesik that was added to
the record. On remand from the Seventh Circuit, ALJ Dougherty
conducted a second hearing on September 7, 2000 and obtained

additional testimony from Plaintiff and from VE Mendrick.


explanation must take into account material evidence that would
support the opposite conclusion, so that a reviewing court has
some idea as to why the judge rejected it. Id. at 874. The ALJ
may not substitute his own judgment for that of a doctor. Rohan,
98 F.3d at 970.

In her second opinion, ALJ Dougherty found that Plaintiff
suffers from RSD of the hands bilaterally and xerosis of the
hands. (R. at 296). The ALJ acknowledged that Dr. Artinian
noted Plaintiff's complaints of severe pain in both hands, with
morning stiffness in her fingers and fungus and cracking of the
fingernails. Upon examination, Dr. Artinian noted that Plaintiff
had severe pain in her left forearm and wrist, that she could not
make a fist, and that she had synovial thickening of both PIP
joints of both hands and deformity of the fingers. (R. at 298.)
Dr. Artinian diagnosed a history of RSD, with deformity and
arthritis in the fingers on both hands. (R. at 298.) The ALJ
also noted that Dr. Kale examined Plaintiff for pain in her
hands, which was aggravated with use. (R. at 298.) Dr. Kale
noted pain in the third and fourth digits on the palmar surface,
which was made worse by repetitive grasping and holding. (R. at
298.)

However, the ALJ discounted the reliability of these reports
based upon her assessment that they were based upon Plaintiff’s

subjective complaints, were not based upon objective evidence,

34


her date last insured, as defined by the Social Security Act,
and, therefore, denied Plaintiff's benefits. (R. at 18, 20.)

Plaintiff appealed the ALJ's decision to the Appeals
Council. (R. at 10.) Prior to filing her appeal, Plaintiff
submitted additional evidence and a statement from VE Grzesik, in
support of her claim of disability. (R. at 278-83.)
Nevertheless, the Appeals Council denied Plaintiff’s appeal and
the ALJ’s decision stood as the final decision of the
Commissioner. (R. at 4-5.) Plaintiff then appealed the
Commissioner’s decision to the District Court for the Northern
District of Illinois, and Judge Denlow affirmed the
Commissioner’s decision on June 12, 1998. Gulo, 1998 WL 321457.
Plaintiff appealed that decision to the Seventh Circuit Court of
Appeals.
4. The Decision of the Seventh Circuit Court of Appeals

In an unpublished decision, the Seventh Circuit affirmed
Judge Denlow’s decision in most respects, but took issue with the
ALJ's finding regarding Plaintiff’s ability to perform repetitive
fingering. Gulo, 1999 WL 133084, at *5. The Seventh Circuit
remanded the case to the ALJ to clarify whether Plaintiff's
fingering limitation affected one hand, or both. Id. at *4.

The Seventh Circuit identified three hypothetical scenarios
with respect to the fingering issue, and the corresponding job

availabilities as estimated by VE Ghehrig. Id. The Seventh

20


individual of the claimant’s age, education, and work experience
could engage in substantial gainful activity. See 20 C.F.R. Part
404, Subpart P, Appendix 2. The Grid is a chart that classifies
a claimant as disabled or not disabled, based on the claimant’s
physical capacity, age, education, and work experience. Walker
v. Bowen, 834 F.2d 635, 640 (7 Cir. 1987). If the use of the
Grid is appropriate, the Commissioner or ALJ may rely upon it for
determining disability, and, in such a case, the Grid alone
constitutes substantial evidence sufficient to uphold the
decision of the Commissioner. Id.

However, where a plaintiff suffers from significant non-
exertional impairments, the ALJ may not rely upon the Grid. See
SSR 83-14. “When a plaintiff’s non-exertional impairments
significantly diminish his ability to work . . . the Commissioner
must introduce the testimony of a vocational expert (or other
similar evidence) that jobs exist in the economy which plaintiff
can obtain and perform.” Bapp v. Bowen, 802 F.2d 601, 603 (2d
Cir. 1986).

DISCUSSION

Plaintiff contends that the ALJ’s conclusion that she is not
disabled is contradicted by the testimony of the Vocational
Experts (“VE”) and the medical evidence. Plaintiff first argues
that the ALJ erred by failing to consider and discuss the VEs’

testimony and other evidence that was contrary to her decision.

26


obtain additional testimony from VE Mendrick. (R. at 307-20.)
Plaintiff also testified briefly at the hearing. (R. at 310-
11.)

The ALJ issued an eight-page decision on October 27, 2000.
(R. at 295-303.) This opinion is almost identical to the first
opinion issued by the ALJ, except for the ALJ’s discussion of
Plaintiff”s RFC. (R. at 295-303.) The ALJ explained that
Plaintiff cannot "perform constant, repetitive fingering with
either hand.” (R. at 297.) Based on the RFC that included "no
repetitive fingering with either hand," the ALJ once again
mischaracterized VE Ghehrig’s testimony by claiming that VE
Ghehrig identified over 9,000 jobs that Plaintiff could perform.°®
(R. at 300.) Using Rule 202.13 of the Medical-Vocational
Guidelines, Appendix 2, Subpart P, Part 404 as a framework for
decision-making, in combination with VE Ghehrig's testimony, the

ALJ again declared that Plaintiff was not disabled. (R. at 300.)

° The ALJ did not obtain any additional testimony from VE
Ghehrig, and relied upon VE Ghehrig’s original testimony in
reaching her decision, despite the Seventh Circuit’s finding that
such a conclusion could not be drawn from VE Ghehrig's testimony.
VE Ghehrig testified that a person who could not perform
repetitive fingering with the right dominant hand would still be
able to work. The ALJ listed the restriction as no repetitive
fingering, but did not limit it to her right hand. Therefore,
unless the ALJ used the RFC that matched the scenario that VE
Ghehrig testified about, his testimony cannot support the ALJ’s
conclusion that Plaintiff would be able to work. This is the
exact mistake that the ALJ made the first time, and she repeated
it here.

22


and were otherwise insufficient. The ALJ noted that, although
Plaintiff has been diagnosed with RSD, "she only demonstrates
signs of mild swelling in her fingers episodically." (R. at
299.) The ALJ added that Plaintiff has not received significant
treatment for her condition, and that the medication she takes is
of a mild sort. (R. at 300.) Also, the ALJ stated that
"although the claimant complains of dry skin with cracking that
is so painful she cannot use her fingers, she has not sought
treatment specifically from a dermatologist." (R. at 300.)
Finally, the ALJ concluded that the only abnormality supported by
objective evidence was that Plaintiff's fingers were slightly
swollen. (R. at 298.)

However, the Court finds significant amounts of objective
medical evidence in the record, which was not addressed by the
ALJ, and that supports Plaintiff’s otherwise subjective claims of
pain. In 1992, Dr. Barnett found "objectively" that Plaintiff
has restricted wrist motions, numbness in all fingers of both
hands, difficulty fully flexing her fingers, diminished sensation
in the palmar aspect of all fingers in the left hand, positive
Phalen sign bilaterally, positive Tinel sign on the left and
slightly positive on the right, weakness in both hands and
atrophy of the left forearm. (R. at 150.) X-Rays examined by
Dr. Barnett show a small loose bone fragment at the base of the

lst metacarpal and arthritic sclerosis, osteophyte formation in

35


Artinian wrote a letter summarizing Plaintiff’s condition at that
time. Id. He stated that she had severe arthritis in her
fingers, fungal infection of both fingernails, severe skin
dyshydratic dermatitis, which causes severe cracking of the
fingers and renders her hands useless for any gainful employment,
and the RSD of the left forearm continues. Id,

3. ALJ Dougherty’s December 29, 1995 Decision

ALJ Dougherty found that Plaintiff met the disability
insured status requirements of the Social Security Act on her
alleged onset date and through December 31, 1994. (R. at 14.)
The ALJ determined that Plaintiff has not been employed since her
alleged onset date of September 16, 1988. (R. at 14.); 20 C.F.R.
§ 404.1520(b). Next, the ALJ noted that the claimant has severe
mixed hearing loss bilaterally, with recurrent drainage in the
left ear, osteoarthritis in the cervical and lumbar spines,
reflex sympathetic dystrophy of the hands bilaterally, calcific
tendonitis of the shoulders, a history of labyrinthitis and
vertigo, obesity, and xeroris of the hands. (R. at 14.)

Although the ALJ determined that these impairments are
severe, as defined in the Social Security Act, the ALJ further
determined that these impairments do not satisfy the requirements
of any section of the Listing of Impairments, Appendix 1, Subpart
P, Part 404 of the regulations, including sections 1.02, 1.04,

1.05, 2.07, 2.08, 8.02, 9.09 or 11.17, whether considered alone

17


reaching with either arm, and must work be permitted to change
positions from sitting to standing and vice versa every hour; who
could not perform repetitive fingering with the right dominant
hand; and who must be allowed to periodically remove her hearing
aid during the day, making her functionally deaf during those
periods. (R. at 312.) VE Mendrick testified that this
hypothetical person could perform work as a cashier, mail clerk,
and hand packer with thousands of jobs in the Chicago area. (R.
at 312-313.)

The ALJ added that the hypothetical person could not do
repetitive fingering with either hand, and VE Mendrick testified
that that would reduce the number of cashier jobs, but nothing
else. (R. at 313.) The ALJ added that the hypothetical person
could not perform repetitive forceful gripping first with only
the left non-dominant hand, and then with both hands. (R. at
313.) VE Mendrick testified that the first would reduce the
total hand packing jobs to about 3,000, and that the person with
both hands unable to perform repetitive forceful gripping would
only be able to perform about 500 jobs. (R. at 313-14.)

Plaintiff's attorney questioned VE Mendrick about the
meaning of the fingering limitation in relation to the mail clerk
positions. (R. at 314-15.) VE Mendrick testified that the
Dictionary of Occupational Titles ("DOT") does not use the term

“repetitive.” (R. at 315.) The DOT uses “constant,” “frequent,”


c. Vocational Expert Grzesik

ALJ Dougherty failed to discuss VE Grzesik’s testimony,
which contradicted her conclusion. VE Grzesik wrote a letter on
December 10, 1996, based on the RFC set forth by ALJ Dougherty in
her December 29, 1995 decision.® VE Grzesik stated that the
requirement for Plaintiff to remove her hearing aids, which makes
Plaintiff functionally deaf, would eliminate virtually all
service, sales, and clerical positions that are unskilled with a
sit/stand option. (R. at 280, 282.) The remaining unskilled
positions are related to production, and are unavailable to
Plaintiff because of the repetitive fingering restriction. Based
upon these two restrictions, VE Grzesik found that there are no
positions that the Plaintiff is able to perform. {R. at 283.)

Clearly, VE Grzesik’s testimony supports Plaintiff’s claim

of disability, because he states that, even based on ALJ

® The letter was written to Plaintiff's attorney in an
effort to have Plaintiff's case considered by the Appeals
Council. However, when the Appeals Council declined to consider
the case, the decision of ALJ Dougherty became the final decision
of the Commissioner. Because the ALd's decision was final, on
appeal to the Federal District Court, Judge Denlow and the
Seventh Circuit only looked at evidence that was part of the
record that was before the ALJ. Eads v. Secretary of the
Department of Health and Human Services, 983 F2d 815, 817-818
(7th Cir. 1993); Gulo, 1998 WL 321457. This did not include VE
Grzesik's letter, because it was submitted after the ALJ's
decision. However, once the case was remanded, the letter was
part of the record as it was before ALJ Dougherty, and ALJ
Dougherty was required to either use the opinion or explain
reasons for rejecting it.

32


Despite her conclusion that Plaintiff was incapable of
repetitive fingering, the ALJ inappropriately cited to VE
Ghehrig’s testimony to support her conclusion that Plaintiff was
able to work and not disabled. The Seventh Circuit declared that
the ALJ’s conclusion was not supported by VE Ghehrig’s testimony.
Because the RFC that the ALJ listed did not match the
hypothetical questions posed to VE Ghehrig, the Seventh Circuit
remanded for further consideration.

Despite the remand, the ALJ relied upon this same testimony
to support the same conclusion in her second opinion. During the
hearing, VE Ghehrig explained that, if Plaintiff was unable to
perform repetitive fingering with the right dominant hand only,
then there were a significant number of jobs that Plaintiff could
perform. If Plaintiff lacked good hand and finger dexterity with
both hands, then there were no jobs that she could perform.
Inexplicably, the ALJ found that the Plaintiff was unable to
perform constant, repetitive fingering with both hands, but was,
nevertheless, able to perform work.

Based on these limitations, VE Ghehrig’s testimony
contradicts the ALJ’s finding that Plaintiff is not disabled.

The Seventh Circuit instructed the ALJ that, if she concluded
that Plaintiff was unable to perform repetitive fingering with
either hand, the ALJ must either procure evidence supporting the

conclusion that there are a sufficient number of jobs available

29


shoulders, arms, and back. The pain can last for days or even
weeks, and frequently extends down her back into her left leg.
(R. at 43, 54-55.) She has received shots in her back for the
pain. (R. at 44.)

Plaintiff also experiences pain in her feet, which limits
her ability to walk to no more than ten minutes at a stretch, and
affects her ability to stand and sit. (R. at 44-45.) The pain
in her legs prevents her from standing or sitting down for
extended periods, and the pain in her back affects her sleeping.
(R. at 44-45, 60.) The doctor has given her Naprosyn and Anaprox
for the pain. (R. at 61).

In describing her typical day, Plaintiff explained that she
watches TV and reads books. (R. at 46.) Either her husband's
daughter cooks for her and her husband, or they simply eat frozen
dinners. (R. at 47.) Her husband does most of the grocery
shopping, although Plaintiff does accompany him at times. (R. at
47.) Her husband's daughter comes to their home to clean two or
three times per week. (R. at 59.)

During the second hearing on September 7, 2000, Plaintiff
testified briefly, only to clarify to VE Mendrick her duties
during her last job. (R. at 309.) She stated that, in her
former job, she held screws while an automated screw driver
machine would crush the screws. (R. at 311.) Plaintiff claimed

that this work caused her fingers to swell, inflicting a great


A. Testimony
1. Plaintiff

During the first hearing on September 12, 1995, Plaintiff
testified that she was 51 years old at the time of the hearing
that she had received a high school education in Palestine. (R.
at 37.) She can speak and read English. (R. at 37.) She
testified that she wears hearing aids in both ears, but explained
that she must remove them after only one half hour, due to

leakage caused by infections. (R. at 38-39.) When she removes

the aids, she must leave them out for at least an hour. (R. at
38.) Without her hearing aids, Plaintiff is partially deaf in
her left ear, and completely deaf in her right ear. (R. at 39.)

She has problems with dizziness, which affects her driving. (R.
at 58).

Plaintiff complained that she has debilitating pain in both
hands. (R. at 40.) She said that the skin on her hands cracks
and bleeds, that she suffers from arthritis, and that she has a
painful fungus under her finger nails. (R. at 40-41, 45-46.) She
uses Vaseline and an ointment from a doctor to treat the cracking
skin, which has plagued her for 28 years. (R. at 41-42, 50.)

She explained that she has had the fungus for seven and a half
years, and that the pain is growing progressively worse. (R. at
49.)

Plaintiff explained that arthritic pain also afflicts her


or in combination. (R. at 14.); 20 C.F.R. ' 404.1520 (c) (da).

In determining Plaintiff’s RFC, the ALJ noted that, between
September 1988 and December 1994, Plaintiff was unable to lift
more than 20 pounds at a time and 10 pounds frequently; she could
not perform activities requiring overhead reaching; she required
a job that allowed a sit/stand option so that she could change
position every hour; she could not perform activities requiring
repetitive fingering; and she needed to periodically remove her
left hearing aid during the course of the day, even though that
rendered her deaf. (R. at 14.); 20 C.F.R. §404.1545. The ALJ
found that Plaintiff was unable to perform her past work. (R. at
18.); 20 C.F.R. § 404.1520(e).

Given these limitations, the ALJ found that Plaintiff was
capable of performing only light work. (R. at 17.) Moreover,
the ALJ determined that the Plaintiff’s testimony regarding the
degree of limitations she was experiencing and her inability to
work on or before December 31, 1994, lacked credibility. (R. at
17.); 20 C.F.R. § 404.1529. In making this determination, the
ALJ stated that the record did not support the significant
limitations Plaintiff described at the hearing. (R. at 17.) The
ALJ noted that there was very little objective evidence
supporting Plaintiff’s subjective claims. (R. at 17.)

Specifically, there was very little evidence to support her claim

18


positions, but that the hypothetical person would still be able
to perform many jobs. (R. at 68.)

Finally, the ALJ added that the hypothetical person "can't
use their fingers such as [Plaintiff] described, having such pain
as she can't touch things." (R. at 68.) VE Ghehrig testified
that this would eliminate all of the jobs that he had mentioned.
(R. at 68.)

Plaintiff's attorney then asked VE Ghehrig if his answer to
the ALJ’s first hypothetical would change if the individual
described also experienced dizziness. VE Ghehrig opined that
dizziness would eliminate some jobs, but he couldn't say exactly
how many. (R. at 70.) Plaintiff's attorney then asked if the
remaining jobs would be eliminated by a "lack of good hand and
finger dexterity and coordination." (R. at 71.) VE Ghehrig
testified that such a restriction would "absolutely" eliminate
the remaining jobs. (R. at 71.)

3. Frank Mendrick - Vocational Expert

Frank Mendrick testified as a VE during Plaintiff’s second
hearing, on September 7, 2000. (R. at 307-320.) VE Mendrick
classified Plaintiff's past work as unskilled and light work.

(R. at 312.)

The ALJ proposed a hypothetical person resembling Plaintiff

to VE Mendrick, who could lift up to twenty pounds occasionally,

and ten pounds frequently; who could not perform overhead


(quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)).

The Court is limited to determining whether the
Commissioner’s final decision is supported by substantial
evidence and based upon proper legal criteria. Ehrhart v. Sec’y
of Health and Human Servs., 969 F.2d 534, 538 (7 Cir. 1992).
This does not mean that the ALJ is entitled to unlimited judicial
deference, however. The ALJ must consider all relevant evidence
and may not select and discuss only that evidence that favors her
ultimate conclusion. Herron, 19 F.3d at 333. In addition to
relying on substantial evidence, the ALJ must articulate her
analysis at some minimal level. See Young v. Sec’y of Health and
Human Servs., 957 F.2d 386, 393 (7 Cir. 1992) (ALJ must
articulate her reason for rejecting evidence “within reasonable
limits” in order for meaningful appellate review). The ALJ must
build “an accurate and logical bridge” from the evidence to her
conclusion. Clifford v. Apfel, 227 F.3d 863, 872 (7 Cir.

2000).

Finally, although Plaintiff bears the burden of
demonstrating her disability, “[i]t is a basic obligation of the
ALJ to develop a full and fair record.” Thompson v. Sullivan,
933 F.2d 581, 585 (7° Cir. 1991) (quoting Smith v. Sec’y of HEW,
587 F.2d 857, 860 (7 Cir. 1978)). “Failure to fulfill this
obligation is ‘good cause’ to remand for gathering additional

evidence.” Smith v. Apfel, 231 F.3d 433, 437 (7 Cir. 2000)

24


TESTS:

+ Sea ae — -:

Minute ¢rder Form (06/0)

\S ( 0 United States District Court, Northern District of Illinois
‘s

Nami igned Jud Sitting Judge if Other
vor Magistrate Judge Arlander Keys than Assigned Judge
CASE NUMBER 01 C 3040 DATE 8/13/2002
CASE Linda Gulo vs. Jo Anne Barnhart
TITLE

[in the following box (a) indicate the party filing the motion, eg. plaintiff, defendant, 3rd party plaintiff, and (by state briefly the nature

of the motion being presented.]

dl)

MOTION:
DOCKET ENTRY:
(ql) o Filed motion of [ use listing in “Motion” box above.]
(2) a Brief in support of motion due
(3) o Answer brief to motion due___. Reply to answer brief due.
(4) iat} Ruling/Hearing on___——_eset fort
(5) ima} Status hearing[held/continued to] [set for/re-set for]on____—_ssetfor___— at
(6) Oo Pretrial conference[held/continued to] [set for/re-set for]on____setfor__—at__
(7) oO Trial[set for/re-set for]on___—_att
(8) a {Bench/Jury trial] [Hearing] held/continuedto___—_ at
(9) Oo This case is dismissed [with/without] prejudice and without costs[by/agreement/pursuant to]
OOFRCP4(m) (Local Rule 41.1 OFRCP41(a)\(1) CM FRCP41(a\(2).
ao) = [Other docket entry] Memorandum Opinion and Order entered. Plaintiff’s Motion for Summary

Judgment [#12] is granted in part; the Commissioner’s Cross-motion for Summary Judgment [#19] is
denied; the case is remanded to the Commissioner for further proceedings consistent with this Opinion4

a [For further detail see order attached to the original minute order.]

No notices required, advised in open court.
2

‘No notices required. number of notices:

Notices mailed by judge’s staff. AUG 1 4 2002

Notified counsel by telephone. date dosketed

‘ Y/ 7

8/13/2002

Docketing to mail notices.

Mail AO 450 form.

isia ‘sn
3008 S54

Copy to judge/magistrate judge.

date mailed notice

courtroom c A
FT/ deputy’s 7 : Fr
initials

Date/timbyeceivedin 1-1 ti x
central Clerk’s Office mailing deputy initials



any unskilled light assembler or inspector/checker jobs that do
not require repetitive fingering. (R. at 279.) He added that,
because Plaintiff must periodically remove her hearing aids,
which makes Plaintiff functionally deaf, she is incapable of
performing virtually all service, sales, and clerical related
occupations that are unskilled with a sit/stand option. (R. at
280, 282.) The remaining unskilled work positions are production
positions and were unavailable to Plaintiff because of her
repetitive fingering restriction. (R. at 280, 282.) In
conclusion, VE Grzesik stated that, based upon the hypothetical
set forth by the ALJ, "it is my opinion as a VE that [Plaintiff]
would be unable to perform any occupation that she would
otherwise be qualified to perform," because of Plaintiff's
hearing problems and inability to perform repetitive fingering.
(R. at 283.)
B. Medical Records

The record contains reports from numerous physicians, from
whom the Plaintiff sought treatment on only one or two occasions.
For the purpose of clarity, the Court will examine the reports as
they relate to Plaintiff’s primary ailments: hearing loss,
obesity, and hand and back pain. The section on hand and back
pain, which involves more in depth treatment, will discuss the

treatment provided by each physician.

11


and “occasional.” (R. at 315.) VE Mendrick testified that, to
him, “repetitive” is the same as “constant,” and “frequent” is
less than “repetitive.” (R. at 315.) Based on questioning from
Plaintiff's attorney, VE Mendrick testified that, if that
hypothetical person were incapable of “frequent” fingering, then
the person would be unable to work as a mail clerk. (R. at 315.)
He also added that, if a person were incapable of “frequent” use
of both hands, then that person could not perform the cashier or
hand packer jobs either, which would eliminate all of the
positions. (R. at 316.)

4. Thomas Grzesik - Vocational Expert

Thomas Grzesik did not testify directly before either ALJ,
but he did offer his professional opinion regarding Plaintiff's
employability in the form of a letter to Plaintiff's Attorney.
(R. at 278-283.) In a letter written on December 10, 1996, VE
Grzesik responded to the September 12, 1995 hearing, and to ALJ
Dougherty's December 29, 1995 decision. (R. at 278.)

VE Grzesik based his assessment of Plaintiff's RFC on the
description given by ALJ Dougherty in her December 29, 1995
decision. VE Grzesik rejected VE Ghehrig's professional opinion,
that Plaintiff could perform over 9,000 assembler and
inspector/checker jobs in the Chicago area, as having "no basis
in fact, logic or even common sense.” (R. at 279.) VE Grzesik

stated that, despite his substantial experience, he is unaware of

10


ability to perform frequent, but not constant fingering.’ This
issue is potentially determinative of Plaintiff's case, and the
ALJ, at a minimum, had an obligation to articulate how, despite
the medical evidence supporting Plaintiff's claim of restricted
fingering, she concluded that Plaintiff could perform frequent,
but not constant fingering and what evidence she used to support
this determination. Clifford, 227 F.3d at 873 (“If the ALJ
believes that he lacks sufficient evidence to make a decision, he
must adequately develop the record and, if necessary, obtain
expert opinions.”).

Plaintiff also argues that VE Mendrick made four additional
concessions during his testimony, independent of the frequent and
constant distinction. However, the Court finds that these

arguments are lacking in merit and do not warrant discussion.

7 It is not even clear from the record that the distinction
between frequent and constant was properly defined and
understood. The distinction was brought up by VE Mendrick on
cross-examination by Plaintiff’s attorney and was not solicited
by the ALJ. (R. at 315.) VE Mendrick clarified that the DOT
does not use the term repetitive, but rather the terms constant,
frequent, and occasional. He equaled constant with repetitive in
his testimony, but did not offer a definition of frequent other
than that it is less than constant or repetitive. Because there
is no evidence in the record that objective definitions were
used, the Court is unable to see the logic that the ALJ used in
determining that Plaintiff could perform frequent, but not
constant fingering. The DOT defines constant as an activity or
condition that occurs for 2/3 or more of the time and frequent as
an activity or condition that occurs 1/3 to 2/3 of the time.
Dictionary of Occupational Titles, Appendix C, (4th Ed., Rev.
1991).

31


to a person with Plaintiff’s limitations or award benefits. The
ALJ apparently misunderstood the Seventh Circuit’s instruction
when she once again relied upon VE Ghehrig’s testimony to support
a conclusion of not disabled.®
b. Vocational Expert Mendrick

The ALJ's second opinion also failed to address concessions
made by VE Mendrick during cross-examination. Specifically, the
opinion fails to explain why Plaintiff was able to do frequent
fingering but not constant fingering. VE Mendrick testified
that, if Plaintiff is able to do frequent fingering, but not
constant fingering, then there were jobs available. But on
cross-examination, VE Mendrick conceded that, if Plaintiff was
unable to do constant or frequent fingering, then there were no
jobs available. Based upon VE Mendrick's testimony, the
distinction between frequent and constant significantly impacts
the outcome of Plaintiff's case.

Despite the significance of this distinction, the ALJ’s
decision does not reveal how she arrived at the conclusion that
Plaintiff could perform frequent fingering, and fails to discuss

evidence that would permit her to distinguish between Plaintiff’s

© Further, the ALJ must address the concession by VE
Ghehrig that if Plaintiff lacked “good hand and finger dexterity
and coordination,” then the Plaintiff was disabled.

30


deal of pain. (R. at 40.)
2. Ronald Ghehrig - Vocational Expert

Ronald Ghehrig testified as the VE during Plaintiff’s first
hearing, on September 12, 1995. (R. at 63-71.) VE Ghehrig
testified that Plaintiff’s past work was unskilled, with the
exertional level being medium to sedentary work, but most of it
being light work. (R. at 64).

The ALJ proposed a hypothetical to VE Ghehrig, describing a
person of the same age, education, and work experience as
Plaintiff. (R. at 65.) The hypothetical further assumed that
the person could lift 20 pounds occasionally and ten pounds
frequently; could sit, stand, or walk for six hours during an
eight hour day; was unable to do repetitive fingering with her
dominant right hand; and must work in a quiet environment due to
her hearing problems. (R. at 65.) VE Ghehrig testified that the
hypothetical person could work as a cashier, receptionist, order
clerk, file clerk, record clerk or assembler, and that the number
of these jobs in the Chicago area totaled more than 50,000. (R.
at 65.)

Next, the ALJ added a sit/stand option, and assumed that the
hypothetical person could not lift weights or do work above the
shoulders, and could not do quick scanning. (R. at 66-67.) VE
Ghehrig testified that these additional requirements would

eliminate the cashier positions and fractions of the other


Circuit explained that, based upon the evidence in the record, if
the hypothetical person can perform "repetitive fingering" with
one hand, then there are over 9,000 jobs available in the Chicago
area. Id. However, if the hypothetical person cannot touch
things, then there are no jobs available. Id. Finally, if the
hypothetical person lacks "good hand and finger dexterity," then
there are likewise no jobs available. Id. The Seventh Circuit
found that, according to VE Ghehrig’s testimony, if the ALJ meant
that Plaintiff could perform repetitive fingering with one hand,
then there would be over 9,000 jobs available. Id. However, if
the ALJ meant that Plaintiff could not perform repetitive
fingering with either hand, the ALJ would either have to conclude
that Plaintiff was in fact disabled based on the hypothetical
questions asked of the VE, or gather more evidence to
substantiate that Plaintiff could still work, despite being
unable to perform repetitive fingering with either hand. Id.

The Seventh Circuit rejected Plaintiff's other arguments,
and remanded the case for the ALJ to "specify whether [Plaintiff
is unable to perform repetitive fingering with only her right
hand or whether she is unable to perform repetitive fingering
with either hand, in which case more evidence must be taken or
benefits awarded." Id. at *5.

5. ALJ Dougherty’s October 27, 2000 Decision

The ALJ held a supplemental hearing on September 7, 2000, to

21


second administrative hearing, the Commissioner issued a new
regulation that specifically requires ALJs to consider the impact
of obesity during an RFC assessment. SSR 00-3p. Plaintiff also
cites to Seventh Circuit caselaw, which supports her argument
that ALJs must consider obesity in combination with other
impairments when making a disability determination. Clifford,
227 F.3d at 873 (An ALJ must consider the aggregate effect of a
claimants obesity with her other impairments.)

While the Court does not disagree with the legal principles
cited by Plaintiff in support of this argument in general, they
are not applicable in this case. Because the Seventh Circuit
affirmed this case on every issue except for the fingering issue,
the legal principle of res judicata limits the Court to that
issue. Gulo, 1999 WL 133084, at *5 ("The decision is AFFIRMED in
all respects except as it relates to the repetitive fingering
issue"). Because all issues except repetitive fingering were
affirmed by the Seventh Circuit, the Court does not have the
authority to revisit the issue.

CONCLUSION

By not addressing evidence and testimony contrary to her
decision, the ALJ failed to "build a logical bridge" between the
evidence and her decision. Clifford, 227 F.3d at 872 ("Most
importantly, [the ALJ] must build an accurate and logical bridge

from the evidence to [her] conclusion."). The Court is unable to

38


determine whether the ALJ considered all of the evidence
supporting Plaintiff's claims. Because the Court is unable to
trace the ALJ's path of reasoning, this case must be remanded to
the ALJ. On remand, the ALJ must either articulate her reasons
for rejecting the concessions of VE Ghehrig and VE Mendrick, and
for rejecting the entire opinion of VE Grzesik, or issue a
decision consistent with these opinions.

IT IS HEREBY ORDERED that Defendant’s Motion for Summary Judgment
be, and the same hereby is, DENIED.

IT IS FURTHER ORDERED that Plaintiff's Motion for Summary
Judgment be, and the same hereby, is GRANTED IN PART, and DENIED

IN PART.

DATED: August 13, 2002 E N T & R:

Qlande, boyd

ARLANDER KEYS
United States Magistrate Judge

39


Lo’

Next, Plaintiff takes issue with the ALJ’s failure to consider
medical evidence that supported her claim that she was incapable
of frequent fingering. Finally, Plaintiff argues that the ALJ
erred by failing to consider her obesity in combination with her
other impairments. The Court will address each argument in turn.

1. The ALJ erred by failing to consider and discuss testimony
and evidence that was contrary to her decision.

The ALJ failed to reconcile evidence that was contrary to
her ultimate decision, and to discuss relevant concessions made
by the VEs during cross-examination. While the Seventh Circuit
does not require a written examination by the ALJ of every piece
of evidence, the ALJ must "sufficiently articulate his assessment
of the evidence" to enable the reviewing court to trace the path
of the ALJ's reasoning. Rohan v. Chater, 98 F.3d 966, 971 (7th
Cir. 1996). The Seventh Circuit imposes this requirement to
assure the reviewing court that the ALJ considered the important
evidence. Books v. Chater, 91 F.3d 972, 980 (7th Cir. 1996).

The ALJ may not simply select evidence that favors her ultimate
conclusion, but must, at a minimum, articulate her analysis of
the evidence, particularly where there is considerable evidence
that counters the agency's position. Nelson v. Apfel, 131 F.3d
1228, 1237 (7th Cir. 1997); Henderson v. Apfel, 179 F.3d 507, 514
(7th Cir. 1999) (The "ALJ may not ignore an entire line of

evidence that is contrary to her findings.")

27


included a "limitation to lifting no more than 20 pounds
occasionally or ten pounds frequently, a sit/stand option so that
she can change position every hour, no repetitive fingering, no
overhead reaching, and the ability to episodically during the
course of the day remove her hearing aid, functionally making her
deaf during those periods.” (R. at 18.); 20 C.F.R. § 404.1545-46
(2001). The ALJ determined that Mr. Ghehrig, the Vocational
Expert ("VE"), identified jobs that Plaintiff could perform with
that RFC. (R. at 18.)

Plaintiff filed a request for review of the ALJ's decision
on January 16, 1996. (R. at 10.) The Appeals Council denied her
request on July 14, 1997, making the ALJ's decision the final
decision of the Commissioner. (R. at 4-5.)

Plaintiff sought review of the Commissioners decision in the
District Court, and Judge Denlow affirmed the ALJ's decision on
June 12, 1998. Gulo v. Apfel, No. 97 C 6239, 1998 WL 321457
(N.D. Ill. June 12, 1998). Plaintiff appealed that decision to
the Seventh Circuit Court of Appeals ("Seventh Circuit"). In an
unpublished opinion issued on March 1, 1999, the Seventh Circuit
affirmed the decision of the ALJ in all respects, except for an
issue relating to the repetitive fingering limitation in the RFC.
Gulo v. Apfel, No. 98-2982, 1999 WL 133084 (7'* Cir. March 1,
1999). The Seventh Circuit remanded the case to the ALJ to

"clarify whether [Plaintiff's] fingering limitation affected one


both of her hands and wrists. (R. at 149.) In his objective
findings, Dr. Barnett concluded that Plaintiff had restricted
wrist motion, numbness in all fingers of both hands, diminished
sensation in the palmar aspect of all fingers in the left hand,
positive Phalen sign bilaterally, positive Tinel sign on the left
hand and slightly positive on the right hand, weakness in both
hands, atrophy of the left forearm, and the inability to fully
flex her fingers into her palms. (R. at 150.) X-Rays showed a
small loose bone fragment at the base of the left lst metacarpal,
arthritic sclerosis at the carpal articulations, and arthritic
sclerosis and osteophyte formation in the joints of both thumbs
and the distal joint of the right index finger. (R. at 151.)
Dr. Barnett stated that the symptoms and findings suggested
carpal tunnel syndrome in both hands and wrist areas. (R. at
150-51.) Dr. Barnett opined that Plaintiff had “moderate loss of
use of both hands on an industrial basis.” (R. at 151.)

ec. Dr. Kale

In June 1992 and August 1993, Plaintiff was examined by Dr.
Kale, who worked in an arthritic and internal medicine specialist
office. (R. at 152.) He found her range of motions for her
back, shoulders, elbows, wrists, and fingers to be normal. (R.
at 158.) He stated that her fingers appeared slightly swollen
and that she conducts finger motions slowly and carefully. (R.

at 158.) He also stated that she has bilateral, lateral, and

14


pain. (R. at 162, 183.) She has been evaluated by multiple
dermatologists, and they have no etiology and no way of treating
her. (R. at 183.) He stated that Plaintiff has severe cervical
degenerative arthritis, lumbosacral degenerative arthritis, with
left sciatica syndrome, severe arthritis in fingers on both
hands, which are degenerative, reflex dystrophy of the left
forearm, bilateral pedal edema, bilateral deafness, with
associated labyrinthitis, and severe vertigo, unresponsive to
medical therapy, and an ezcematoid reaction in the ear canal,
which makes her unable to use her hearing aids. (R. at 183.)

In treatment notes from July 1994, Dr. Artinian noted that

Plaintiff still suffered from severe cracking of her hand from
dryness, and that nothing was helping. (R. at 203.) In August
and September of 1994, Plaintiff complained of left lumbar pain
radiating down to her left ankle, with numbness in her thigh.
(R. at 203.) He stated that she suffers from left lumbar
radicular syndrome. (R. at 205.) In February 1995, Dr. Artinian
diagnosed Plaintiff with right carpal tunnel syndrome. (R. at
204, 226.) Based upon her X-Rays, Dr. Artinian concluded that
she has degenerative disc changes in the C4-C7 levels and that
she has calcific tendonitis in her right shoulder. (R. at 204,
226, 262.)

Dr. Artinian continued treating Plaintiff through the time

of the second hearing in September, 2000. (R. at 394-395.) Dr.

16


PROCEDURAL HISTORY

On April 15, 1994, Plaintiff applied for Disability
Insurance Benefits ("DIB"), alleging that she became disabled and
has been unable to work since September 16, 1988, due to
tendinitis in both hands, leakage in her ears, back pain, pain in
her left leg, and fungus under the nails of both hands. (R. at
73-75, 78.) Plaintiff's application was denied initially on July
5, 1994, and again upon reconsideration on September 21, 1994.

(R. at 78-81, 86-88.)

On October 18, 1994, Plaintiff requested a hearing before an
Administrative Law Judge (“ALJ”). (R. at 89.) The hearing took
place on September 12, 1995 before ALJ Maren Dougherty.’ On
December 29, 1995, ALJ Dougherty issued a decision finding that
Plaintiff was not disabled at any time through December 31, 1994,
the date that she last met the disability insured status
requirements. (R. at 13-20.) In her decision, ALJ Dougherty

determined that Plaintiff's Residual Functional Capacity ("RFC")

2 There is a discrepancy in the record. The record
indicates that the hearing on September 12, 1995 took place
before ALJ Joyce Joy. (R. at 32, 72.) Defendant refers to the
hearing as before ALJ Joyce Joy. (Def. Mot. Summ. J. at 1.)
However, Plaintiff refers to the hearing as before ALJ Maren
Dougherty. (Pl. Mot. Summ. J. at 1.) The notification letter
for the hearing from November 3, 1994 and the decision of the ALJ
signed on December 29, 1995 were both from Maren Dougherty. {R.
at 30-31, 13-20.) For the sake of clarity, the Court will refer
only to ALJ Dougherty.


(R. at 162, 183, 203.) Dr. Artinian also stated that Plaintiff
has been evaluated by multiple dermatologists, and that they have
no etiology and no way of treating it. (R. at 183.) Dr.
Artinian’s observation that Plaintiff has sought treatment from
dermatologists directly contradicts the ALJ’s finding that
Plaintiff’s subjective claims are not credible because she has
not sought treatment from a dermatologist. (R. at 183.)

Dr. Barnett stated that Plaintiff has a moderate loss of
both hands "on an industrial basis," Dr. Kale stated that
Plaintiff is not capable of work that requires hand manipulation
and strength, and Dr. Artinian stated that Plaintiff's hands are
useless for any gainful employment. (R. at 151, 159, 394.)

These opinions contradict the ALJ’s conclusion. The ALJ cannot
substitute her judgment for the judgment of these doctors. The
ALJ has not cited any medical evidence that contradicts the
opinions of these three doctors. The ALJ must either obtain more
medical evidence to make a determination of Plaintiff's fingering
abilities or provide her reasoning for rejecting the medical
opinions in the record that favor Plaintiff.

2. The ALJ did not fail to consider Plaintiff's obesity in
combination with her other impairments.

Plaintiff argues that the ALJ failed to consider her
obesity in combination with her other impairments in determining
whether Plaintiff was disabled. Plaintiff points out that she is

61 inches tall and weighs approximately 210 lbs. Prior to the

37


(finding that, if the ALJ found the evidence before him
insufficient, he should have obtained more evidence.)
SOCIAL SECURITY REGULATIONS

The Social Security Regulations prescribe a sequential five-
part test for determining whether a claimant is disabled. See 20
C.F.R. §§ 404.1520 and 416.920. The ALJ must consider: (1)
whether the claimant is presently unemployed; (2) whether the
claimant has a severe impairment or combination of impairments;
(3) whether the claimant’s impairment meets or equals any
impairment listed in the regulations as being so severe as to
preclude gainful activity; (4) whether the claimant is unable to
perform his past relevant work; and (5) whether the claimant is
unable to perform any other work existing in significant numbers
in the national economy. See 20 C.F.R. §§ 404.1520 and 416.920;
see also Young, 957 F.2d at 389. A finding of disability
requires an affirmative answer at either step 3 or step 5. A
negative answer at any step (other than step 3) precludes a
finding of disability. Id. The claimant bears the burden of
proof at steps 1-4, but the burden shifts to the Commissioner at
step 5. Id.

At Step 5, the ALJ evaluates the claimant’s RFC to perform a
particular category of work (i.e. sedentary, light, medium,
heavy, or very heavy work), in combination with the Medical-

Vocational Guidelines (“the Grid”), to determine whether an

25


UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION DOCKETED
AUG 1 4 2099
LINDA GULO,
Plaintiff, Case No. 01 C 3040

vs.
Magistrate Judge Keys
JO ANNE B. BARNHART’,

COMMISSIONER OF SOCIAL SECURITY

Defendant.

MEMORANDUM OPINION AND ORDER

Plaintiff, Linda Gulo moves this Court for summary judgment,
pursuant to Rule 56(a) of the Federal Rules of Civil Procedure,
reversing the final decision of the Commissioner of Social
Security ("Commissioner"), which denied her application for
Social Security Disability Insurance Benefits under the Social
Security Act. See 42 U.S.C. §§ 405(g), 1383(c) (3) (West 2002).
In the alternative, Plaintiff requests that this Court reverse
the decision of the Commissioner and remand for further
proceedings. The Commissioner has filed a Cross-Motion for
Summary Judgment. For the reasons set forth below, the Court
grants Plaintiff's Motion in part and remands this matter for
further proceedings consistent with this Opinion. The

Commissioner's Motion is denied.

1 On November 9, 2001, Jo Anne B. Barnhart became the
Commissioner of Social Security. Barnhart is automatically
substituted for Larry Massanari as the Defendant in this action.
Fed. R. Civ. P. 25 (d) (1); 42 U.S.C. § 405(g) (2002).

ane)


Dougherty’s RFC determination, there are no positions that
Plaintiff is able to perform. While the ALJ was not required to
credit VE Grzesik’s testimony, she was obligated to discuss this
significant testimony, which contradicts her conclusion.
Henderson v. Apfel, 179 F.3d 507, 514 (7thCir. 1999) (“An ALJ
may not ignore an entire line of evidence that is contrary to her
findings.”). The Seventh Circuit requires ALJs “to articulate
reasons for accepting or rejecting entire lines of evidence.”
Herron, 19 F.3d at 333 (citing Carson v. Shalala, 999 F.2d 180,
181 (7th Cir. 1993)). On remand, the ALJ must consider VE
Grzesik’s letter, and, at a minimum, articulate reasons for
accepting or rejecting his opinion.
d. Medical Evidence

The Court further finds that the ALJ failed to build a
logical bridge from the relevant medical evidence to her
conclusion that Plaintiff is capable of frequent but not constant
fingering, and that Plaintiff is incapable of repetitive forceful
gripping. While the ALJ is not required to address every piece
of evidence in the record, she must explain why evidence in the
record, which favors Plaintiff, was overcome by the evidence on
which she relied. Zurawski v. Halter, 245 F.3d 881, 889 (7th
Cir. 2001). The ALJ cannot simply "select and discuss only that
evidence which favors his ultimate conclusion." Clifford, 227

F.3d at 871 (quoting Herron, 19 F.3d at 333). The ALJ's

33


When the testimony of a VE is essential to the ALJ's
conclusion, the ALJ must address the concessions made by the VE
during cross-examination. Conner v. Shalala, 900 F. Supp. 994,
1003-04 (N.D. Ill. 1995). Because the ALJ failed to address
concessions made by the VE's during cross-examination, and
entirely disregarded the professional opinion of VE Grzesik, who
opined that Plaintiff is disabled based upon the RFC listed by
the ALJ, the Court finds that remand is warranted.

a. Vocational Expert Ghehrig

In her opinion, the ALJ found that, even though Plaintiff
was incapable of repetitive fingering, she was not disabled. The
ALJ purportedly based her conclusion upon VE Ghehrig’s testimony.
However, VE Ghehrig’s testimony, viewed in its entirety, does not
provide substantial evidence supporting the ALJ’s conclusion.

VE Ghehrig testified that, if Plaintiff could not do
repetitive fingering with her right dominant hand, then there
were a significant number of jobs that Plaintiff could perform.
VE Ghehrig further opined that, if Plaintiff could not "use [her]
fingers such as Plaintiff described, having such pain that she
can't touch things," then there were no jobs that Plaintiff could
perform. During cross-examination, VE Ghehrig conceded that, if
Plaintiff lacked "good hand and finger dexterity and
coordination," then there were no jobs that Plaintiff could

perform.

28


1. Hearing Loss-Dr. Miller and Dr. Daou

In 1971, Plaintiff was diagnosed with bilateral moderate
mixed hearing loss. (R. at 129.) In 1973 and 1974, she
underwent surgery on her right ear for otoscelerosis, which was
performed by Dr. Weingarten. (R. at 125-126, 137.) In 1988, Dr.
Miller diagnosed Gulo with vertigo related to chronic otitis
media. (R. at 141.)

In 1994, Dr. Daou, an adult otologist, diagnosed Plaintiff
with severe to profound mixed hearing loss, and noted that she
needs hearing aids. (R. at 185, 188.) Dr. Daou further
explained, however, that she cannot wear hearing aids continually
due to secondary ear infections. Dr. Daou noted that Plaintiff
has recurrent drainage in her better-hearing left ear due to a
tympanic membrane perforation. (R. at 185.)

2. Obesity-Dr. Pierson and Dr. Artinian

Plaintiff also has noted problems with obesity. (R. at 145,

160, 164, 192, 202, 204, 220, 231, 354.) In 1988, Dr. Pierson

described Plaintiff as a woman with a medical history significant

for obesity. (R. at 145.) On several occasions, Dr. Artinian
recommended weight loss and exercise to Plaintiff. (R. at 202,
204, 231.)

3. Hand and Back Pain
a. Dr. Schenck, Dr. Pierson, and Dr. Casini

Plaintiff first complained of left-hand weakness and pain in

12


medial epicondylitis. (R. at 158.) He concluded that
Plaintiff's complaints were most compatible with left carpal
tunnel syndrome and possible carpal tunnel syndrome on the right
and myofascial discomfort in both hands, but he added that it is
unclear why she should continue having such pain. (R. at 159.)
His "best fit" diagnosis at the time was chronic reflex
sympathetic dystrophy ("RSD"). (R. at 159.) Dr. Kale stated
that Plaintiff could not perform her current job, which required
hand manipulation and strength. (R. at 159.) He reexamined
Plaintiff in 1993 and found no clear etiology for her complaints,
but he did state that she might suffer from RSD. (R. at 155.)
He suggested a bone scan and stellate ganglion blocks to test his
diagnosis, but there is no evidence in the record that these
tests were ever conducted. (R. at 155.)

d. Dr. Artinian

In May 1994, Plaintiff was examined by Dr. Artinian for her
Social Security Disability Evaluation. (R. at 162.) Dr.
Artinian found synovial membrane thickening of both PIP joints on
both hands, a deformity of the fingers in both hands, but mostly
on the left, severe pain, and stiffness in the left forearm and
wrist, inability to make a fist, and limited motion in her left
elbow and arm. (R. at 162.) He stated that she has had a fungus
in her fingernails for the last five years and a skin disorder of

both hands that causes cracking of the skin and a severe burning

15