In the

United States Court of Appeals

For the Seventh Circuit

____________

No. 07-2303

ROGER A. CRAFT,

Plaintiff-Appellant,

v.

MICHAEL J. ASTRUE, Commissioner of

Social Security,

Defendant-Appellee.

____________

Appeal from the United States District Court 

for the Northern District of Illinois, Eastern Division.

No. 05 C 1569—Blanche M. Manning, Judge.

____________

ARGUED JANUARY 24, 2008—DECIDED AUGUST 22, 2008

____________

Before POSNER, RIPPLE, and TINDER, Circuit Judges.

TINDER, Circuit Judge. Roger Craft filed an application

in August 2001 for Disability Insurance Benefits (“DIB”)

and an application in September 2001 for Supplemental

Security Income (“SSI”), alleging a disability due to

diabetes mellitus and affective/mood disorders. Both

claims were denied initially and upon reconsideration.
2 No. 07-2303

Neuropathy is a nerve injury and can be sensory, motor, or 1

autonomic in nature. A sensory neuropathic injury results in the

sensation of pain, numbness, tingling, or burning. The sensation

often begins in the feet and progresses toward the center of the

body as the condition worsens. See Peripheral Neuropathy,

http://www.nlm.nih.gov/medlineplus/ency/article/000593.htm

(last visited July 17, 2008). Neuropathy is also a common

(continued...)

Craft timely requested a hearing before an Administrative Law Judge (“ALJ”), which was held on October 7,

2003. The ALJ determined that Craft did not qualify for

DIB or SSI because he could perform a significant

number of jobs despite his limitations. The Appeals

Council denied review of the ALJ’s decision. The district

court affirmed the ALJ’s decision and denied Craft’s

motion to alter or amend the judgment. Upon review, we

conclude that the ALJ erred in evaluating Craft’s mental

impairments and in making the credibility determination;

accordingly, we reverse.

I. Background

In 1994, Craft was injured at work when a forklift

crushed his left foot. He experienced pain in his foot for the

next three years, at which time his podiatrist, Dr.

Santangelo, referred him to neurologist Dr. Sicotte. Dr.

Sicotte noted that Craft had decreased sensation and

strength in his foot, and the results of an EMG nerve

conduction test indicated a neuropathy which was

sensory in nature. He did not have wide-spread

1
No. 07-2303 3

(...continued) 1

complication of diabetes. See Diabetic Neuropathy, http://

www.nlm.nih.gov/medlineplus/ency/article/000693.htm

(last visited July 17, 2008).

The record does not indicate that Craft had a primary care 2

physician, but he typically visited Cook County Hospital and

the VISTA Health Center of Cook County for his medical needs.

peripheral neuropathy. In May 1998, Craft underwent an

operation on his foot, and he continued to see his podiatrist

regularly until discharged from post-operative care in

August 1998. Craft was also diagnosed with Type I diabetes mellitus in May 1998, after complaining of thirst,

frequent urination, weight loss, and blurred vision.2

Craft’s medical records do not indicate that he visited

any doctors in 1999, but he visited Dr. Nichols for his

diabetes once in September 2000. Craft applied for disability in August 2001, at the age of forty-two. On September 25, 2001, Craft reported to the emergency room at Cook

County Hospital, complaining of muscle pain, frequent

urination, thirst, weight loss, and weakness for the previous six months. He was given insulin and released. On

October 19, 2001, Dr. Rodriguez completed a physical

assessment form, finding that Craft suffered from

diabetes, was twenty percent limited in several areas of

physical activity, and had mild mental impairments. He

was hospitalized on the same day and diagnosed with

hyperglycemia secondary to medicine noncompliance.

Craft reported that he had not been taking his medication

due to unpleasant side effects and an inability to afford

the medication.
4 No. 07-2303

Retinopathy is damage to the retina of the eye and can be 3

caused by long-term or poorly controlled diabetes. Retinopathy

results in blurry vision and can cause blindness. See Diabetic

Retinopathy, http://www.nlm.nih.gov/medlineplus/ency/article/

001212.htm (last visited July 17, 2008).

Dysthymia is a chronic form of depression. See Dysthymia,

4

http://www.nlm.nih.gov/medlineplus/ency/article/000918.htm

(last visited July 17, 2008).

On October 23, 2001, Dr. Shaikh examined Craft at the

request of Disability Determination Services (“DDS”); Craft

again reported that he had previously stopped taking

his medication because he could not afford it. Dr. Shaikh

noted that Craft had uncontrolled diabetes, scabbing on

his left leg and varicose veins in both legs, decreased

range of motion in his left knee, hip pain with normal

range of motion, early retinopathy, neuropathy in the 3

left hand, loss of sensation in the left foot and lower third

of the leg, and decreased memory. Dr. Frey completed a

psychiatric examination of Craft on the same day, also at

the request of DDS. Dr. Frey noted Craft’s physical and

mental complaints and diagnosed him with dysthymic

disorder.4

On November 29, 2001, a non-examining state agency

psychiatrist, Dr. Tomassetti, completed a Psychiatric

Review Technique Form and a mental Residual Functional

Capacity evaluation. Dr. Tomassetti noted that Craft had

dysthymic disorder, he had mild impairments in three

areas of mental functional limitation, and he was moderately limited in several areas relevant to his ability to work.
No. 07-2303 5

Craft visited Dr. Rodriguez again on December 31, 2001,

and received prescriptions for his diabetes and neuropathy.

He visited a doctor to complain that his diabetes medication was not working on April 4, 2002, and he was prescribed a different medicine. On May 4, 2002, Craft visited

a doctor to complain about additional symptoms associated with his new medicine. He visited a doctor again on

May 20, 2002, at which time his glucose levels were

elevated.

On June 27, 2002, Craft complained about pain in his

extremities, which the doctor noted might indicate neuropathy. He was again diagnosed with probable diabetic

neuropathy on July 27, 2002, after he complained about

pain in his extremities. On September 19, 2002, he complained of severe leg pain and an inability to sleep. On

November 14, 2002, he was diagnosed with peripheral

neuropathy, and he received another prescription for his

neuropathy on February 13, 2003.

Dr. Dang performed a psychiatric examination of Craft

by request of DDS on May 9, 2003. Dr. Dang diagnosed

Craft with dysthymia and noted that Craft experienced

depression, anger, difficulty with concentration, and

tiredness. Dr. Dang completed a mental analysis form

for Craft’s ability to do work-related activities, and he

found Craft to have mild and moderate limitations in

several areas. On July 7, 2003, Craft reported improvement in symptoms of his neuropathy; the doctor noted a

rash on Craft’s legs and renewed the prescription for

Craft’s neuropathy medication. On October 8, 2003, Craft

visited Dr. Escalona, who diagnosed Craft with diabetes,
6 No. 07-2303

Paresthesia refers to a burning or prickling sensation that 5

usually occurs in the hands, arms, legs, or feet. Chronic

paresthesia can be a symptom of traumatic nerve damage. See

National Institute of Neurological Disorders and Stroke Paresthesia

Information Page, http://www.ninds.nih.gov/disorders/

paresthesia/paresthesia.htm (last visited July 17, 2008).

uncontrolled diabetic neuropathy, and depression. Dr.

Escalona also noted that Craft continued to have

paresthesia and pain in his arms and legs despite the

neuropathy medication.5

The hearing for Craft’s disability claims was held on

October 7, 2003. Craft was forty-four years old at the time.

The ALJ heard testimony from Craft and his landlord,

Vivian Hedemark. Craft testified that he experienced

paresthesia in his arms, legs, and back, which caused him

to have difficulty sleeping at night. He also complained

of loss of teeth, memory loss, and weight loss. The ALJ

questioned Craft as to the extent of his daily activities.

Craft testified that daily activities left him exhausted. He

cooked his own meals, walked to the mailbox daily,

vacuumed once a week, and occasionally drove until

his vehicle needed repairs that he could not afford.

Hedemark testified about Craft’s weight loss, memory loss,

and rages that he would go into “when his diabetes [was]

high.” She also confirmed that Craft could not sleep at

night because she could hear him walking around and

watching television. After consulting with a vocational

expert (“VE”), the ALJ concluded that Craft was not

disabled.
No. 07-2303 7

Although the Code of Federal Regulations contains separate 6

sections for DIB and SSI, the processes of evaluation are identical in all respects relevant to this case. For simplicity, we

will cite only to the DIB sections.

II. Analysis

Where the Appeals Council has denied review of the

ALJ’s decision, we review the ALJ’s decision as the final

decision of the Commissioner. Schmidt v. Astrue, 496 F.3d

833, 841 (7th Cir. 2007). We review the ALJ’s legal conclusions de novo. Id. We deferentially review the ALJ’s factual

determinations and affirm the ALJ if the decision is

supported by substantial evidence in the record. Id.

Substantial evidence is “such relevant evidence as a

reasonable mind might accept as adequate to support a

conclusion.” Barnett v. Barnhart, 381 F.3d 664, 668 (7th Cir.

2004). The ALJ is not required to mention every piece of

evidence but must provide an “accurate and logical

bridge” between the evidence and the conclusion that the

claimant is not disabled, so that “as a reviewing court,

we may assess the validity of the agency’s ultimate findings and afford [the] claimant meaningful judicial review.” Young v. Barnhart, 362 F.3d 995, 1002 (7th Cir. 2004).

A claim of disability is determined under a sequential

five-step analysis. See 20 C.F.R. § 404.1520 (DIB); 20 C.F.R.

§ 416.920 (SSI). The first step considers whether the 6

applicant is engaging in substantial gainful activity. The

second step evaluates whether an alleged physical or

mental impairment is severe, medically determinable,

and meets a durational requirement. The third step
8 No. 07-2303

compares the impairment to a list of impairments that

are considered conclusively disabling. If the impairment

meets or equals one of the listed impairments, then the

applicant is considered disabled; if the impairment does

not meet or equal a listed impairment, then the evaluation

continues. The fourth step assesses an applicant’s residual

functional capacity (“RFC”) and ability to engage in past

relevant work. If an applicant can engage in past relevant

work, he is not disabled. The fifth step assesses the applicant’s RFC, as well as his age, education, and work experience to determine whether the applicant can engage

in other work. If the applicant can engage in other work,

he is not disabled.

In this case, at steps one and two, the ALJ determined

that Craft had not engaged in substantial gainful activity

and that he had severe impairments due to insulin dependent diabetes mellitus with neuropathy and early

retinopathy, a history of crush injury to the left foot, and

dysthymia. At step three, the ALJ determined that the

impairments did not meet or equal the listed impairments.

The ALJ next determined that Craft’s RFC was for a full

range of light work, limited to simple, unskilled tasks. The

ALJ reasoned that the RFC was appropriate because no

greater or additional limitations were justified by the

medical evidence and Craft’s complaints were not

entirely credible. At step four, the ALJ concluded that

Craft could not return to his past relevant work, which

consisted of driving trucks and HVAC installation. The

ALJ consulted a VE who opined that Craft could engage

in work as a hand packager or assembler. At step five, the

ALJ agreed that Craft could engage in this work, and,

therefore, concluded he was not disabled.
No. 07-2303 9

A. Mental Limitations

Craft first argues that the ALJ failed to use the “special

technique” to assess his mental impairments. The special

technique is set forth in 20 C.F.R. § 404.1520a, and it is

used to analyze whether a claimant has a medically

determinable mental impairment and whether that impairment causes functional limitations. If a limitation is of

listings-level severity, then the claimant is conclusively

disabled. Thus, the special technique is used to evaluate

mental impairments at steps two and three of the five-step

evaluation. See SSR 96-8p.

The special technique requires that the ALJ evaluate the

claimant’s “pertinent symptoms, signs, and laboratory

findings” to determine whether the claimant has a medically determinable mental impairment. 20 C.F.R.

§ 404.1520a(b)(1). If the claimant has a medically determinable mental impairment, then the ALJ must document

that finding and rate the degree of functional limitation

in four broad areas: activities of daily living; social functioning; concentration, persistence, or pace; and episodes

of decompensation. Id. § 404.1520a(c)(3). These functional

areas are known as the “B criteria.” See 20 C.F.R. pt. 404,

subpt. P, app. 1, § 12.00 et seq.

The first three functional areas are rated on a five-point

scale of none, mild, moderate, marked, and extreme. 20

C.F.R. § 404.1520a(c)(4). The final functional area is rated

on a four-point scale of none, one or two, three, and four

or more. Id. The ratings in the functional areas correspond

to a determination of severity of mental impairment. Id.

§ 404.1520a(d)(1). If the ALJ rates the first three functional
10 No. 07-2303

areas as none or mild and the fourth area as none, then

generally the impairment is not considered severe. Id.

Otherwise, the impairment is considered severe, and the

ALJ must determine whether it meets or is equivalent

in severity to a listed mental disorder. Id. § 404.1520a(d)(2).

If the mental impairment does not meet or is not

equivalent to any listing, then the ALJ will assess the

claimant’s RFC. Id. § 404.1520a(d)(3). The ALJ must document use of the special technique by incorporating the

pertinent findings and conclusions into the written decision. Id. § 404.1520a(e)(2). The decision must elaborate on

significant medical history, including examination and

laboratory findings, and the functional limitations that

were considered in reaching a conclusion about the

mental impairment’s severity. The decision must also

incorporate “a specific finding as to the degree of limitation

in each of the functional areas.” Id.

In this case, the ALJ determined at step two that Craft

had “severe” limitations due to insulin dependent diabetes

mellitus with neuropathy and early retinopathy, a history

of crush injury to the left foot, and dysthymia. As the

government concedes, the ALJ did not apply the special

technique to determine the severity of Craft’s mental

impairments. The ALJ implicitly found that Craft’s

dysthymia was a medically determinable impairment but

then apparently jumped to the conclusion that the

dysthymia was severe without discussing Craft’s mental

medical history or rating the severity of the four functional

areas of limitation. The ALJ did recite some of Craft’s

mental medical history in the RFC analysis; however, the

RFC analysis is not a substitute for the special technique,
No. 07-2303 11

even though some of the evidence considered may overlap. See SSR 96-8p. The ALJ explicitly stated that Craft’s

limitations from his physical and mental impairments did

not individually or in combination meet or equal a listed

impairment.

The government argues that the ALJ’s failure to use the

special technique is harmless because Craft has not shown

that consideration of the B criteria would have resulted

in a determination of disability due to a listings-level

impairment. After all, the ALJ did determine that Craft

had a severe mental impairment and considered whether

it met or equaled a listed impairment, as required by the

final step of the special technique. Under some circumstances, the failure to explicitly use the special technique

may indeed be harmless error. See, e.g., Keys v. Barnhart, 347

F.3d 990, 994 (7th Cir. 2003) (finding harmless error where

an older version of a regulation was used because the

outcome would have been the same under the new regulation). We cannot conclude that it was harmless here

because the ALJ’s failure to consider the functional impairments during the special technique analysis was compounded by a failure of analysis during the mental RFC

determination, as we will discuss further. Ultimately, the

ALJ gave short shrift to potential limitations caused by

Craft’s mental impairments, and that error requires a

remand.

Craft next argues that the ALJ failed to determine a

proper mental RFC for Craft, resulting in the VE being

given a flawed hypothetical, which affected the ALJ’s

determination of Craft’s non-disability at step five of the
12 No. 07-2303

analysis. The RFC is the maximum that a claimant can

still do despite his mental and physical limitations. 20

C.F.R. § 404.1545(a)(1); SSR 96-8p. It is based upon the

medical evidence in the record and other evidence, such

as testimony by the claimant or his friends and family.

20 C.F.R. § 404.1545(a)(3). The ALJ is required to determine which treating and examining doctors’ opinions

should receive weight and must explain the reasons for

that finding. Id. § 404.1527(d), (f).

When determining the RFC, the ALJ must consider all

medically determinable impairments, physical and mental,

even those that are not considered “severe.” Id.

§ 404.1545(a)(2), (b), (c). Mental limitations must be part

of the RFC assessment, because “[a] limited ability to

carry out certain mental activities, such as limitations in

understanding, remembering, and carrying out instructions, and in responding appropriately to supervision, coworkers, and work pressures in a work setting, may

reduce [a claimant’s] ability to do past work and other

work.” Id. § 404.1545(c).

In explaining the basis for the RFC, the ALJ first listed

Craft’s alleged symptoms and limitations. She discussed

Craft’s daily activities and Hedemark’s testimony. As is

relevant to the mental analysis, the ALJ stated that Craft

and Hedemark testified about Craft’s memory loss. The

ALJ stated that Hedemark also testified that Craft had

mood swings and would go into rages “when his diabetes

[was] high.” The ALJ then recited some of Craft’s medical

history.

With respect to possible mental limitations, the ALJ

noted that treating physician Dr. Rodriguez had found
No. 07-2303 13

The GAF scale reports a clinician’s assessment of the individ- 7

ual’s overall level of functioning. Sims v. Barnhart, 309 F.3d 424,

427 n.5 (7th Cir. 2002). A GAF of 50 indicates serious symptoms

or functional limitations. American Psychiatric Association,

Diagnostic and Statistical Manual of Mental Disorders 32 (4th ed.

1994).

Craft to have mild limitations in activities of daily living,

social functioning, and concentration, persistence, and

pace. The ALJ noted that Dr. Frey’s psychiatric examination found Craft to be mildly depressed, frustrated, and

helpless, and that Craft believed it was due to his diabetes

and his inability to pay for medication. Dr. Frey also

noted that Craft’s memory was within normal limits, and

he diagnosed Craft with dysthymic disorder. The ALJ

noted that Dr. Dang’s psychiatric examination reported

that Craft’s mood was depressed, he appeared tired, and

he had a problem with concentration. Dr. Dang diagnosed

Craft with dysthymia and assigned a global assessment of

functioning (“GAF”) of 50. Finally, the ALJ noted that 7

treating physician Dr. Escalona diagnosed him with

depression and also stated that he suffered from mood

swings.

The ALJ concluded that Craft’s RFC was:

a full range of light work, which involves lifting no

more than 20 pounds at a time with frequent lifting

or carrying of objects weighing up to 10 pounds, except

that he can only walk occasionally, cannot climb, and

cannot perform more than simple, unskilled tasks. The

limitation to simple, unskilled task[s] is based on the
14 No. 07-2303

claimant’s history of dysthymia and complaints of

ongoing fatigue due to an inability to sleep well.

Based upon the VE’s opinion that Craft’s previous jobs

required a medium to very heavy level of exertion, the

ALJ concluded that Craft could not perform past relevant

work. The ALJ asked the VE the following hypothetical

for a claimant aged 39-44 with Craft’s prior work experience: “can lift up to 20 pounds occasionally, 10 pounds

frequently. Sit, stand, or walk as required. Can occasionally

walk. Cannot climb. Can perform simple unskilled tasks,

which by definition can be detailed but not require a lot

of variables to them.” The VE concluded that the

claimant could perform work as a hand packager and

assembly line worker, of which there were 15,000

positions in the Chicago area, and the ALJ ultimately

adopted this finding in her decision. The ALJ asked the

VE additional hypotheticals with varying physical limitations, but no mental limitations were added.

The ALJ’s mental RFC analysis is troubling in several

respects. Most significantly, the ALJ’s RFC and the

hypotheticals given to the VE ostensibly accounted for

Craft’s mental impairments by limiting him to simple,

unskilled work. However, the Social Security Administration has explained: “[b]ecause response to the demands of

work is highly individualized, the skill level of a position

is not necessarily related to the difficulty an individual will

have in meeting the demands of the job. A claimant’s

[mental] condition may make performance of an unskilled

job as difficult as an objectively more demanding job.” SSR

85-15.
No. 07-2303 15

The government directs our attention to Johanson v.

Barnhart, 314 F.3d 283, 289 (7th Cir. 2002), in which the ALJ

adopted a medical opinion where a doctor had “translated” the checkmarks on a mental RFC assessment form

into a suggested RFC that the claimant could engage in

repetitive, low-stress work. Here, the only doctor to fill

out a mental RFC assessment checklist was Dr. Tomassetti,

whose opinion the ALJ never mentioned. Dr. Tomassetti

placed checkmarks in boxes to indicate that Craft had

moderate and slight limitations in several areas, and the

narrative portion of the form “translated” that Craft

had the ability to understand and recall instructions, his

mood moderately interfered with his concentration and

pace, and he enjoyed people but had a difficult time

controlling his temper. In Johanson, the RFC reflected some

work requirements that were relevant to mental abilities

(i.e., repetition and stress); here, the RFC was for “unskilled” work, which by itself does not provide any information about Craft’s mental condition or abilities. The

Social Security Administration has stated that where the

claimant has the ability to understand, carry out, and

remember simple instructions; respond appropriately to

supervision, coworkers, and usual work situations; and

deal with changes in a routine work setting, then an RFC

of “unskilled” work would be appropriate. See 20 C.F.R.

§ 404.1545(c); SSR 85-15.

Here, the use of the term “unskilled” is unhelpful

because we cannot discern whether the ALJ actually

found Craft to have those abilities. Most of the ALJ’s

discussion of Craft’s medical history is merely a recitation of information contained in his medical records. The
16 No. 07-2303

ALJ implicitly found that Dr. Rodriguez’s opinion deserved less weight, and she explicitly found that two nonexamining state agents’ opinions should be accorded some

weight (only one was a psychiatric assessment, by Dr.

Frey). The rest of the medical opinions were recited

without a determination of weight; therefore, we cannot

determine the significance of Dr. Dang’s opinion, and, as

noted previously, Dr. Tomassetti’s opinion was never

mentioned at all. All three psychiatric assessments (by

Dr. Frey, Dr. Dang, and Dr. Tomassetti) indicate that Craft

had some level of difficulty with memory, concentration,

or mood swings. We conclude that the there is not an

“accurate and logical bridge” between the ALJ’s recitation

of the mental medical evidence and the decision to

account for Craft’s mental impairments by limiting him

to unskilled work.

Although the ALJ is not required to mention every piece

of evidence, we note for future reference some of the

unmentioned mental evidence that seemed particularly

critical to the mental RFC analysis. Dr. Tomassetti found

Craft to be moderately limited in two of the B Criteria

(social functioning and concentration, persistence, or

pace), as well as moderately limited in the ability to

understand, remember, and carry out detailed instructions,

the ability to maintain attention and concentration for

extended periods, the ability to complete a normal workday without interruptions from psychologically based

symptoms, and the ability to get along with coworkers or

peers without distracting them or exhibiting behavioral

extremes. The ALJ certainly is entitled to give non-examining psychiatrist Dr. Tomassetti’s opinion whatever
No. 07-2303 17

weight that it is due; however, the failure to mention

this detailed mental assessment is cause for concern. The

ALJ also failed to note that Dr. Frey’s evaluation mentioned that Craft’s mental functioning had “been reduced

80-90%.” Although this statement seems inconsistent

with some of Dr. Frey’s other conclusions about Craft, we

cannot tell whether the ALJ considered and rejected

this piece of evidence because she did not mention it.

Finally, the ALJ discussed Dr. Dang’s evaluation but

failed to mention any of the moderate and slight mental

limitations that Dr. Dang found Craft to possess.

B. Physical Limitations

Craft also asserts that the ALJ erred in assessing his

physical limitations because of a negative credibility

finding. An ALJ is in the best position to determine the

credibility of witnesses, and we review that determination

deferentially. Sims v. Barnhart, 442 F.3d 536, 538 (7th Cir.

2006). We overturn a credibility determination only if it is

patently wrong. Prochaska v. Barnhart, 454 F.3d 731, 738 (7th

Cir. 2006). The determination of credibility must contain

specific reasons for the credibility finding. Arnold v.

Barnhart, 473 F.3d 816, 822 (7th Cir. 2007) (citing SSR 96-

7p). The finding must be supported by the evidence and

must be specific enough to enable the claimant and a

reviewing body to understand the reasoning. Id. Where

the credibility determination is based upon objective

factors rather than subjective considerations, we have

greater freedom to review the ALJ’s decision. Clifford v.

Apfel, 227 F.3d 863, 872 (7th Cir. 2000) (quoting Herron v.

Shalala, 19 F.3d 329, 335 (7th Cir. 1994)).
18 No. 07-2303

An ALJ must consider a claimant’s subjective complaints of pain if the claimant has a medically determined

impairment that could reasonably be expected to produce

that pain. 20 C.F.R. § 404.1529(c)(1). Here, the ALJ determined that the objective medical evidence did not provide strong support for Craft’s claimed symptoms and

limitations. The ALJ’s conclusion that Craft’s complaints

were not supported by the medical evidence was based

upon three considerations.

First, the ALJ found that Craft’s complaints were not

entirely credible because he “did not seek any treatment

from 1998 to 2001.” While reciting Craft’s medical history,

the ALJ acknowledged that Craft was treated several times

during 1998 and 2001—which left only 1999 and 2000

without treatment. The ALJ failed to note, however, that

Craft was also treated on September 28, 2000. The government asserts that this was harmless error because the

doctor’s report from the visit in 2000 did not contain any

information of substance, and it still demonstrates Craft’s

“dearth of treatment” during that time period. Several of

Craft’s medical records noted, however, that Craft had

been out of compliance with his medicine and did not seek

regular treatment because of his inability to cover the

associated costs. In assessing credibility, infrequent

treatment or failure to follow a treatment plan can support

an adverse credibility finding where the claimant does not

have a good reason for the failure or infrequency of

treatment. SSR 96-7p. However, the ALJ “must not draw

any inferences” about a claimant’s condition from this

failure unless the ALJ has explored the claimant’s explanations as to the lack of medical care. Id. An inability to
No. 07-2303 19

afford treatment is one reason that can “provide insight

into the individual’s credibility.” Id. Here, although the

ALJ drew a negative inference as to Craft’s credibility

from his lack of medical care, she neither questioned him

about his lack of treatment or medicine noncompliance

during that period, nor did she note that a number of

medical records reflected that Craft had reported an

inability to pay for regular treatment and medicine.

Second, the ALJ claimed in her written decision that

Craft had “a litany of complaints that were not noted in

the treatment records until the day after the hearing. . . .

Specifically, the claimant was asked at the hearing if he

had ever addressed the various complaints to his doctors

and he said he raised them every time. . . . [This] does not

enhance his credibility.” This statement by the ALJ

is completely without foundation.

Craft’s complaints at the hearing included: pain and

tingling in his legs (his left leg had been bothering him

for a few years and his right leg began to bother him in

June 2002), knee pain, open sores on his ankles and calves,

pain and tingling in his left arm, pain and tingling in his

upper back, a lack of energy, sleeping during the day

because of pain at night, loss of teeth, weight loss, and

memory loss. The ALJ asked Craft to estimate when he

first talked to a doctor about his neuropathy. The ALJ also

asked Craft what his doctor said about the open sores. The

ALJ did not ask Craft about reporting any of his other

complaints to his doctors—the only reference Craft

made to complaining to his doctors “every time” was in

reference to the question about neuropathy, and his

answer was consistent with the medical records.
20 No. 07-2303

Further, the medicalrecords show that Craft raised these

complaints long before the hearing with the ALJ. The

hearing with the ALJ was on October 7, 2003. Craft’s

medical records note complaints of pain or numbness as

early as October 11, 2001, and it is subsequently noted at

nearly every visit during 2002 and 2003. He complained

of memory loss in 2001 and 2002. He complained of

vision problems in 2001, 2002, and May 2003. He complained of a lack of energy in 2001. He complained of

weight loss in 2001. He complained of sores on his legs

in July 2003. He complained of being unable to sleep at

night in 2002 and May 2003. The record simply does not

reflect the ALJ’s contention that Craft raised a “litany of

complaints” at the hearing without first complaining of

them to his doctors. Not only did Craft complain

about these ailments, but the doctors often made relevant

diagnoses. Craft was repeatedly diagnosed with neuropathy with symptoms in his legs and left arm, and he was

regularly prescribed medication for it. Craft’s records

also indicate diagnoses of early retinopathy or vision

loss on several occasions. The only complaints not

evident in the medical records were loss of teeth and

back pain.

The credibility determination affected the ALJ’s findings

as to the extent of Craft’s limitations, which directly

impacted the outcome at step five. The ALJ asked the

VE more restrictive hypotheticals based upon some of

Craft’s physical complaints, which the ALJ did not ultimately adopt. The VE testified that if Craft were limited

to occasional use of his left hand, then work would be

precluded. The VE also testified that if Craft were re-
No. 07-2303 21

quired to lie down during the workday outside of normal

break times, then work would be precluded. Because

two of the three reasons the ALJ listed for finding Craft

incredible are contradicted by the objective evidence, we

conclude that the credibility determination was patently

wrong, and the error cannot be deemed harmless.

In light of the remand, we make one additional note

with respect to the ALJ’s third reason for finding Craft

incredible. An ALJ can appropriately consider a claimant’s

daily activities when assessing his alleged symptoms. See

20 C.F.R. § 404.1529. However, “[w]e have cautioned the

Social Security Administration against placing undue

weight on a claimant’s household activities in assessing

the claimant’s ability to hold a job outside the home.”

Mendez v. Barnhart, 439 F.3d 360, 362 (7th Cir. 2006). Here,

the ALJ questioned Craft about his ability to prepare

meals, make his bed, clean his apartment, take walks, and

shop for groceries. The ALJ concluded that Craft’s activities “belie his assertion of incapacity.” The ALJ ignored

Craft’s qualifications as to how he carried out those activities: Craft’s so-called “daily walk” was merely to the

mailbox at the end of the driveway, his vacuuming took

only four minutes, and his grocery shopping was done

on a motorized cart at the store and he was able to carry

only one grocery bag in each hand into the house. Each

activity left him exhausted. Unless the ALJ properly

finds Craft’s testimony to be incredible on remand, any

such testimony about how Craft copes with his daily

activities should be considered in the RFC assessment.
22 No. 07-2303

C. VE Testimony

For completeness, we also address Craft’s final argument, that the VE’s testimony conflicted with the jobs she

cited from the Dictionary of Occupational Titles (“DOT”)

and was unsupported because she was unable to substantiate her testimony on demand.

Craft contends that the VE chose two occupational

categories containing 103 jobs and was unable to provide the occupational codes for those jobs. Without the

occupational codes, Craft’s counsel was prevented from

exploring whether Craft could truly perform any of

those jobs with the limitations that he had. We agree

with the district court’s conclusion that Craft’s counsel did

not sufficiently challenge the VE’s testimony. Counsel

asked whether the VE had the “DOT code here with you

today?” The VE responded: “The actual Dictionary of . . .

publication?” to which counsel responded affirmatively.

The VE replied that she keeps copies of a range of DOT

titles with her throughout the day as she attends hearings.

Craft’s counsel then asked what the VE was reading

from when she gave her opinion to the ALJ, and she

replied that she was reading from notes she took while the

ALJ was talking. Craft now explains that counsel was

asking for the occupational codes, not the DOT itself, and

argues that the VE’s reply that she was reading from

notes taken while the ALJ was speaking demonstrates

that her testimony was without foundation. Even if

counsel was asking for the occupational codes, it does not

appear that the VE understood the request. Counsel’s

oblique references to the VE bringing the code and reading
No. 07-2303 23

from her notes did nothing to inform the ALJ or VE that

counsel’s ability to challenge the job requirements was

hampered by not knowing which particular jobs were

included in the broad categories of hand packager or

assembly line worker.

When a VE provides evidence about the requirements

of a job or occupation, the ALJ has an affirmative duty to

ask about potential conflicts between that evidence and

the DOT. Prochaska, 454 F.3d at 735; SSR 00-4p. The ALJ

must obtain a reasonable explanation for any apparent

conflict. Prochaska, 454 F.3d at 735; SSR 00-4p. In Prochaska,

the claimant contended that each job in the occupational

categories identified by the VE would require her to stoop

or reach above the shoulder level, which the ALJ found

that she could not do. On appeal, we could not determine

whether the requirements of bending or stooping were

actually inconsistent with the DOT, but we stated that

there was an “unresolved potential inconsistency” which

should have been explored by the ALJ. Prochaska, 454

F.3d at 736.

Here, the ALJ asked whether the characteristics of the

jobs were consistent with the DOT, and the VE responded

that they were. However, the VE had previously volunteered that the hypothetical’s requirement of a position

that allowed for occasional walking would preclude

some, but not all, of the job titles she had identified. On

remand, the ALJ should further explore any potential

conflicts between the VE’s testimony and the DOT to

ensure that the jobs’ requirements are consistent with

Craft’s abilities.
24 No. 07-2303

III. Conclusion

Because the ALJ erred in assessing Craft’s mental and

physical limitations, we REVERSE the judgment of the

district court and REMAND for proceedings consistent

with this opinion.

8-22-08