IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

OLIVIA COLLINS,

 Plaintiff,

v.

ANDREW M. SAUL, Commissioner

Of Social Security,

 Defendant.

Case No. 20 C 2277

Judge Harry D. Leinenweber

MEMORANDUM OPINION AND ORDER

The Commissioner’s motion for summary judgment (Dkt. No. 18)

is denied. The Court vacates the findings of the Administrative 

Law Judge and remands this case to the Social Security 

Administration for proceedings consistent with this Opinion. The 

Clerk shall remand this case forthwith. Civil case closed.

I. BACKGROUND

In October 1993, at age 14, Olivia Collins was found to be 

disabled due to affective disorder. (Admin. R. at 62, 64, 70, Dkt. 

No. 15-1.) She began receiving benefits as a result of this 

disorder, which continued into adulthood. In July 2012, when 

Collins was 33, a periodic review of Collins’ benefits explained 

that Collins experienced “auditory command hallucinations” (Id. at 

615.) The assessment also noted that Collins reported having “no 

outside friends and no outside activities.” (Id.) The report 
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expressed some skepticism regarding the credibility of these 

statements, observing that Collins had three children and 

therefore “must have been at least somewhat socially active.” (Id.) 

Ultimately, the assessment concluded that there had been no medical 

improvement, and Collins continued to be identified as disabled. 

(Id. at 613–15.) 

Starting from November 2014 through at least September 2018, 

Collins was treated by Certified Nurse Practitioner Elsy Joseph, 

MSN, PMHNP-BC. (Id. at 332–54, 427, 492.) Nurse Practitioner 

Joseph’s notes from Collins’ four visits from April 2015 to June 

2016 reflect largely the same information. (Id. at 333, 337, 343, 

348.) For each visit, Nurse Practitioner Joseph noted that Collins 

was consistently taking her medication and not experiencing any 

side effects. (Id.) The notes state that Collins reported that she 

was not experiencing mood swings, racing thoughts, hallucinations, 

paranoia, suicidal ideations, or homicidal ideations. (Id.) 

According to the notes, at each visit Collins also reported that 

she did not feel depressed, worthless, helpless, or hopeless. (Id.) 

In 2016, Collins underwent another review of her benefits and 

completed a Function Report, dated June 16, 2016. (Id. at 231–39.) 

Question 5 of the Function Report asks: “How do your illnesses, 

injuries, or conditions limit your ability to work?” (Id. at 231.) 

In response, Collins only replied “affective disorders.” (Id.) In 
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the report Collins stated that she may leave the house once a week 

to “hang out with friends.” (Id. at 234–35.) She further explained 

that she is able to drive but does not do so because she gets 

dizzy. (Id.) Consequently when she leaves the house, she is 

escorted by her mother. (Id.) Collins further explained that she 

has trouble concentrating and handling stress, and occasionally 

struggles to get along with others. (Id. at 236–37.) Collins also 

stated that she fears “people I don’t know approaching me or 

talking to me.” (Id. at 237.) 

In connection with the 2016 review of Collins’ benefits, Dr. 

Glen Pittman performed a Psychiatric Review. (Id. at 355–68.) Dr. 

Pittman reviewed Collins’ Function Report, as well as the records 

of Collins’ visits with Nurse Practitioner Joseph. (Id. at 367.) 

Dr. Pittman’s report, dated August 17, 2016, ultimately concluded 

that Collins’ impairment was “not severe.” (Id. at 355.) 

On August 26, 2016, the Social Security Administration (the 

“Agency”) denied Collins’ continuation of benefits, concluding 

that she had medically improved. (Id.) Collins appealed the 

Agency’s cessation of benefits and the matter was referred to a 

Disability Hearing Officer. Following the notice of cessation of 

benefits, Collins’s mother Margaret Sanders completed a revised 

Function Report dated September 30, 2016. (Id. at 252–64.) This 

time, in response to question 5, Ms. Sanders reported that Collins 
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suffers from “auditory and visual hallucinations,” and at times 

“stares into space, talks to herself or someone/something, she 

sees things.” (Id. at 252, 257–58.) In contrast to the June report, 

Ms. Sanders reported that her daughter “does not have any friends.” 

(Id. at 255.) Consistent with the June report, Ms. Sanders reported 

that her daughter “cannot go out alone” and does not leave the 

home often. (Id.) In October 2016, Dr. Russell Taylor also 

performed a Psychiatric Review. (Id. at 391–405.) Dr. Taylor’s 

report relies on the same information as Dr. Pittman, as well as 

notes from Collins’ visit with Nurse Practitioner Joseph on 

September 21, 2016. (Id. at 403.) The records from Collins’

September 2016 visit were consistent with Nurse Practitioner 

Joseph’s notes from 2015 and 2016, with one exception. (Id. at 

379.) In September 2016, Collins reported that she skipped her 

medication for two days, during which time she started to hear 

voices. (Id.) The voices stopped when she resumed taking her 

medication. (Id.) 

Despite considering these additional medical records, Dr. 

Taylor’s notes make no mention of Collins temporarily hearing 

voices. (Id. at 403.) Dr. Taylor also continued to rely on Collins’

June Function Report, making no mention of the September report 

submitted by Ms. Sanders. (Id.) Even so, Dr. Taylor broke with Dr. 

Pittman and concluded that Collins continues to suffer from severe 
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impairment as a result of her affective disorder. (Id. at 391.) 

Dr. Taylor went on to conclude that despite Collins’ impairment, 

she has the mental capacity to carry out one to two step tasks, 

sustain a normal workday, make simple work related decisions, 

interact with others in a setting with reduced social demands, and 

adapt to simple changes and pressures in the work environment. 

(Id. at 407.) 

While the Disability Hearing Officer considered Collins’

appeal, she again visited Nurse Practitioner Joseph. Notes from 

Collins’ February 22, 2017 visit state that Collins again reported 

she was taking her medication with no side effects. (Id. at 419.) 

She also reported no mood swings, racing thoughts, hallucinations, 

paranoia, suicidal ideations, or homicidal ideations. (Id.) 

According to the notes, Collins also stated that she did not feel 

depressed, worthless, helpless, or hopeless. (Id.)

On May 23, 2017, the Disability Hearing Officer also concluded 

that Collins had experienced improvement and was no longer 

disabled. (Id. at 94–104.) Collins again appealed the decision and 

sought review by an Administrative Law Judge (“ALJ”). Two days 

after the Disability Hearing Officer’s decision, Collins saw Nurse 

Practitioner Joseph. (Id. at 409–10.) The notes from this visit 

largely track with her prior visits, with one exception. (Id.) 
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During the May 2017 visit, Collins reported that she sometimes 

feels depressed. (Id.) 

Collins returned to Nurse Practitioner Joseph on August 17, 

2017. During this visit she reported feeling more depressed, and 

at times helpless, worthless, and hopeless. (Id. at 538.) She also 

reported having mood swings and racing thoughts every day. (Id.) 

Collins stated that while she had no active plans to harm herself 

or others, she had had passive suicidal thoughts, including one 

such thought the week before. (Id.) Collins further stated that 

she hears male voices when she is alone, and they tell her to do 

bad things. (Id.) She also reported seeing shadow people “all the 

time.” (Id.) Collins explained that she is paranoid and has 

hallucinations, both of which are causing her not to sleep. (Id.

at 538–39.) Finally, Collins stated that as a result of her 

paranoia she stays home. (Id. at 538.) Collins acknowledged that 

this was the first time she was reporting these symptoms and 

explained that she did not previously report any of this to Nurse 

Practitioner Joseph because she feared being hospitalized. (Id.) 

Collins continued to see Nurse Practitioner Joseph, with 

visits on October 25, 2017, February 21, 2018, July 5, 2018, and 

September 24, 2018. During these visits, Collins continued to 

report hearing male voices that belittle her and seeing shadowing 

people. (Id. at 492–93, 503–04, 516, 527.) Collins also continued 
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to report feeling depressed and paranoid that people were trying 

to hurt her, as well as experiencing mood swings and racing 

thoughts (although no longer daily). (Id.) Collins further 

continued to report that she remained at home as a result of her 

paranoia. (Id.) Each of the October 25, 2017, February 21, 2018, 

July 5, 2018, and September 24, 2018 visits report that Collins 

was not having any suicidal or homicidal ideations. (Id.) And by 

July 2018, Nurse Practitioner Joseph’s reports no longer stated 

that Collins was experiencing hallucinations. (Id. at 492–93, 503–

04.)

Collins also received health care from providers at the 

Friends and Family Health Center (“FFCH”). During her annual exam 

in June 2017, Collins’ depression and anxiety screenings did not 

detect any problems. (Id. at 480.) Even so, the FFCH provider 

conducting Collins’ exam referred her to their behavioral health 

group for follow-up. (Id. at 483.) Collins was seen by an FFCH 

behavioral health provider on August 5, 2017. (Id. at 624.) During 

this appointment, Collins “acknowledged symptoms of paranoia, 

auditory hallucinations and suicidal ideations with no plan or 

intent.” (Id.) Collins also explained that she continued to 

experience a depressed mood and psychosis. The provider 

characterized Collins as “somewhat guarded, particularly 

surrounding symptoms and her desire to not be psychiatrically 
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hospitalized.” (Id. at 624–25.) Following this appointment, 

Collins began meeting with FFHC Behavioral Health Care Coordinator 

Tia Nix approximately once per week. (Id. at 697.) During these 

meetings, Collins and Nix discuss Collins’ current mental health 

status and treatment goals, among other things. (Id.)

Collins returned to FFHC for two additional behavioral health 

appointments on March 27, 2018 and September 4, 2018. In March, 

Collins saw a Licensed Clinical Social Worker (“LCSW”) and reported 

feeling anxious and overwhelmed. (Id. at 622.) The LCSW observed 

that during the appointment Collins appeared “fidgety and 

anxious.” (Id.) In September 2018, Collins’ depression screening 

concluded that she suffered from “major depression.” (Id. at 618.)

During her testimony before the ALJ on November 27, 2018, 

Collins testified that she continues to hear and see things, even 

when taking her medication. (Id. at 27.) She explained that she 

suffers from mood swings and remains paranoid that people are 

always behind her. (Id.) Collins testified that she continues to

hear men’s voices telling her to do bad things. (Id.at 27, 31.) 

Collins also stated that she has no friends, infrequently leaves 

the house, and, when she does leave, she is accompanied by her mom 

or sister. (Id. at 27–28, 31, 33.) Collins further testified that 

she has not always been forthright with Nurse Practitioner Joseph 

regarding the mental health symptoms she is experiencing. (Id. at 
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45.) Collins explained she held back because she did not want to 

be admitted to the hospital. (Id.) 

In support of her continuing disability, Collins also 

submitted to the ALJ a medical opinion from Nurse Practitioner 

Joseph, dated November 15, 2018. (Id. at 602–05.) Nurse 

Practitioner Joseph’s report concluded that Collins had only mild 

difficulties understanding and remembering simple instructions and 

carrying out the same. (Id. at 602.) Nurse Practitioner Joseph 

concluded that Collins experienced marked difficulties in the 

remaining areas, including understanding and carrying out complex 

instructions, making judgments on simple and complex work-related 

decisions, interacting with coworkers, supervisors, or the public, 

and responding appropriately to work situations. (Id. 602–03.) 

Nurse Practitioner Joseph’s report explained that Collins is 

“scared and paranoid when she goes outside or in public,” she 

“hears voices almost every day,” and she “sees shadows of people 

and kids almost every day.” (Id. at 603.) The report further 

explained that Collins “feels depressed and helpless all the time.” 

(Id.)

On February 21, 2019 the ALJ issued her decision. (Id. at 70–

78.) The ALJ concluded that Collins’ disability ended on August 1, 

2016 and she had not become disabled again since that date. (Id.

at 70.) In reaching her decision, the ALJ followed the seven-step 
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evaluation process outlined in 20 C.F.R. 416.994. stated that 

depression screenings from FFHC during this same period were 

“consistently negative.” (Id.) To assist in reaching her opinion 

the ALJ considered three medical opinions: (1) the 2016 opinion 

from Dr. Pittman; (2) the 2016 opinion from Dr. Taylor; and (3) 

the 2018 opinion from Nurse Practitioner Joseph. (Id. at 76.) The 

ALJ ultimately gave the greatest weight to Dr. Taylor’s opinion. 

(Id. at 76.) She reasoned that Dr. Taylor’s conclusions were 

consistent with Collins’ medical records “when viewed as a whole.” 

(Id.) 

The ALJ gave little weight to Dr. Pittman’s opinion, 

concluding the record did not support his assessment that Collins’

disability was not severe. (Id.) The ALJ also gave little weight 

to Nurse Practitioner Joseph’s opinion. (Id.) First she concluded 

that Nurse Practitioner Joseph was “not an accepted medical 

source.” (Id.) She further explained that Nurse Practitioner 

Joseph’s assessment was “inconsistent with her own medical status 

exam findings and mostly moderate diagnoses.” (Id.) The ALJ also 

noted that Collins’ visits to Nurse Practitioner Joseph were 

“infrequent” and “at most four times in a year.” (Id.) She was 

also “mindful of the possibility that a treatment provider may 

express an opinion in an effort to assist a patient with whom he 

or she sympathizes for one reason or another.” (Id.) The ALJ also 
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gave little weight to the Function Report completed by Ms. Sanders, 

because it was inconsistent with Collins’ own report and the 

medical records at the time. (Id.)

Relying on Dr. Taylor’s opinion and her own review of Collin’s 

lengthy medical records, the ALJ concluded that Collins’

disability ended on August 16, 2016. Collins appealed the ALJ’s 

decision to the Agency’s Appeals Counsel. On March 9, 2020, the 

Appeals Counsel denied Collins’ request for review. (Id. at 1) On 

April 11, 2020 Collins filed her Complaint seeking review by this 

Court. (Dkt. No. 1.) On November 19, 2020 the Government moved for 

summary judgment. (Dkt. No. 18.)

II. LEGAL STANDARD

Judicial review of the Agency’s decisions is permitted 

pursuant to 42 U.S.C. § 405(g), which provides that the Agency’s 

findings of fact are conclusive “if supported by substantial 

evidence.” 42 U.S.C. § 405(g). Courts reviewing decisions under 

the substantial evidence standard look to an existing 

administrative record and ask, “whether it contains sufficient 

evidence to support the agency’s factual determinations.” Biestek 

v. Berryhill, 139 S.Ct. 1148, 1154 (2019) (internal quotations 

omitted). The threshold for evidentiary sufficiency is not high; 

it means “such relevant evidence as a reasonable mind might accept 

as adequate to support a conclusion.” Id. The reviewing court is 
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not “to reweigh evidence, resolve conflicts, decide questions of 

credibility, or substitute its judgment for that of the 

Commissioner.” Burmester v. Berryhill, 920 F.3d 507, 510 (7th Cir. 

2019) (citing Lopez ex rel. Lopez v. Barnhart, 336 F.3d 535, 539 

(7th Cir. 2003)). If substantial evidence supports the disability 

determination, the reviewing court must affirm even if “reasonable 

minds could differ” concerning whether the petitioner is disabled. 

Id. 

III. DISCUSSION

Collins argues that the ALJ failed to give proper weight to 

Nurse Practitioner Joseph’s opinion. In response, the Government 

argues that the ALJ provided “at least five valid reasons for 

discounting the opinion of the nurse practitioner.” (Mot. at 5, 

Dkt. No. 19.) The Court does not, however, reach an opinion on the 

proper weight that should be accorded Nurse Practitioner Joseph’s 

opinion. Instead, the Court concludes that the ALJ improperly 

relied on Dr. Taylor’s outdated 2016 opinion. 

Nurse Practitioner Joseph’s opinion provides the most up to 

date assessment of Collins’ mental health. Under the Agency’s 

regulations, however, for cases arising prior to March 27, 2017, 

Nurse Practitioners are not considered an “acceptable medical 

source.” 20 C.F.R. § 416.902(a)(7). For this reason, and others, 

the ALJ gave little weight to Nurse Practitioner Joseph’s opinions. 
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(Admin. R. at 76.) Instead, the ALJ gave great weight to Dr. 

Taylor’s 2016 opinion. (Id.) As a basis for her reliance on Dr. 

Taylor’s opinion, the ALJ explained that his assessment is 

“consistent with the records when viewed as a whole.” (Id.) 

Dr. Taylor’s 2016 opinion could not have incorporated any of 

the reported changes in Collins’ symptoms from 2017 to the present. 

Indeed, Dr. Taylor’s 2016 opinion notes that Collins’ medical 

records reflect that she “denied feeling depressed” and “denied 

having paranoia, hallucinations, or suicidal/homicidal thoughts.” 

(Id. at 403.) But a review of Collins’s treatment notes from 2017 

to the present reveal significant and new developments in her 

reported symptoms, including reports of depression, 

hallucinations, and paranoia. (See id. at 492–93, 503–04, 516, 

527, 538–39, 618, 622, 624–25.) The presence of these symptoms 

contradicts the factual basis for Dr. Taylor’s opinion and thus 

bears on the criteria considered in forming his opinion. And the 

Seventh Circuit has consistently held that an ALJ “should not rely 

on an outdated assessment if later evidence containing new, 

significant medical diagnoses reasonably could have changed the 

reviewing physician’s opinion.” Moreno v. Berryhill, 882 F.3d 722, 

728 (7th Cir. 2018), as amended on reh’g (Apr. 13, 2018) 

(collecting cases). As a result, Collins’ medical records from 

2017 to the present “certainly could have altered [Dr. Taylor’s] 
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conclusion regarding the existence and severity of [Collins’] 

affective disorder.” Id. at 729. The Court thus concludes that the 

ALJ erred by relying on Dr. Taylor’s opinion.

The ALJ’s own analysis of the significance of Collins’

increased symptoms does not change this outcome. (Admin. R. at 

75.) In reaching a determination, the ALJ must “rely on expert 

opinions instead of determining the significance of particular 

medical findings themselves.” Moon v. Colvin, 763 F.3d 718, 722 

(7th Cir. 2014), as amended on denial of reh’g (Oct. 24, 2014). 

The ALJ observed that Collins first began reporting feeling 

depressed following the cessation of her benefits in August 2016. 

(Id.) The ALJ then downplayed Collins’ reports of feeling depressed 

and paranoid and experiencing hallucinations, by noting that they 

were not consistently present during visits in 2017 and 2018. (Id.) 

She further observed that during her medical visits, providers

reported Collins as appearing “alert, oriented, attentive, and 

cooperative.” (Id.) But it was not for the ALJ to interpret the 

symptoms reflected in notes from Collins’ visits with Nurse 

Practitioner Joseph and behavioral health professionals with FFHC. 

Rohan v. Chater, 98 F.3d 966, 970 (7th Cir. 1996) (“ALJs must not 

succumb to the temptation to play doctor and make their own 

independent medical findings.”)
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For these reasons, the Court concludes that the record lacks 

sufficient evidence to support the ALJ’s determination. We 

therefore vacate the ALJ’s findings and remand to the Agency for 

a new mental-health assessment on which Collins’ functional 

capacity reasonably can be determined. 

IV. CONCLUSION

For the reasons stated herein, the Court denies the 

Commissioner’s motion for summary judgment (Dkt. No. 19), vacates 

the ALJ’s findings and remands to the Agency for proceedings 

consistent with this opinion. 

IT IS SO ORDERED.

Harry D. Leinenweber, Judge

United States District Court

Dated: 6/22/2021