IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

DEBBIE H.,1

Plaintiff,

v.

KILOLO KIJAKAZI, Acting

Commissioner of Social Security,2

Defendant.

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No. 20 C 5121

Magistrate Judge

Maria Valdez

MEMORANDUM OPINION AND ORDER

This action was brought under 42 U.S.C. § 405(g) to review the final decision 

of the Commissioner of Social Security denying Plaintiff Debbie H.’s claims for 

Disability Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”). 

The parties have consented to the jurisdiction of the United States Magistrate 

Judge pursuant to 28 U.S.C. § 636(c). For the reasons that follow, Plaintiff’s motion 

to reverse to Commissioner’s decision [Doc. No. 19] is granted in part and denied in 

part, and the Commissioner’s cross-motion for summary judgment [Doc. No. 21] is 

denied.

1

 In accordance with Internal Operating Procedure 22 – Privacy in Social Security 

Opinions, the Court refers to Plaintiff only by her first name and the first initial of her last 

name.

2

 Kilolo Kijakazi has been substituted for her predecessor pursuant to Federal Rule of Civil 

Procedure 25(d).

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BACKGROUND

I. PROCEDURAL HISTORY

On May 31, 2017, Plaintiff filed claims for DIB and SSI, alleging disability 

since August 31, 2012. The claims were denied initially and upon reconsideration, 

after which she timely requested a hearing before an Administrative Law Judge 

(“ALJ”), which was held on September 19, 2019. Plaintiff personally appeared and 

testified at the hearing and was represented by counsel. A vocational expert (“VE”)

also testified. At the hearing, Plaintiff amended her alleged onset date to May 5, 

2017.

On October 2, 2019, the ALJ denied Plaintiff’s claims for benefits, finding her

not disabled under the Social Security Act. The Social Security Administration 

Appeals Council then denied Plaintiff’s request for review, leaving the ALJ’s 

decision as the final decision of the Commissioner and, therefore, reviewable by the 

District Court under 42 U.S.C. § 405(g). See Haynes v. Barnhart, 416 F.3d 621, 626 

(7th Cir. 2005). 

II. ALJ DECISION

Plaintiff’s claims were analyzed in accordance with the five-step sequential 

evaluation process established under the Social Security Act. See 20 C.F.R. § 

404.1520(a)(4). The ALJ found at step one that Plaintiff had not engaged in 

substantial gainful activity since her amended alleged onset date of May 5, 2017. 

At step two, the ALJ concluded that Plaintiff had the following severe impairments: 

multiple sclerosis; peripheral neuropathy; and Huntington’s disease. The ALJ 

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concluded at step three that Plaintiff’s impairments, alone or in combination, do not 

meet or medically equal any listed impairments. 

Before step four, the ALJ determined that Plaintiff retained the residual 

functional capacity (“RFC”) to perform sedentary work with the following additional 

limitations: can sit for 45 minutes at a time and stand for 20 minutes at a time 

before changing position; can sit for a total of 4 hours and stand and/or walk for a 

total of 4 hours in an 8-hour day; can frequently lift 10 pounds and occasionally lift 

20 pounds; and can occasionally stoop or crouch and can rarely climb ladders or 

stairs. At step four, the ALJ concluded that Plaintiff would be unable to perform her 

past relevant work as a photographer helper or cashier checker. However, at step 

five, based upon the VE’s testimony and Plaintiff’s age, education, work experience, 

and RFC, the ALJ found that Plaintiff can perform jobs existing in significant 

numbers in the national economy, leading to a finding that she is not disabled 

under the Social Security Act. 

DISCUSSION

I. ALJ LEGAL STANDARD

Under the Social Security Act, a person is disabled if she has an “inability to 

engage in any substantial gainful activity by reason of any medically determinable 

physical or mental impairment which can be expected to result in death or which 

has lasted or can be expected to last for a continuous period of not less than twelve 

months.” 42 U.S.C. § 423(d)(1)(a). In order to determine whether a plaintiff is 

disabled, the ALJ considers the following five questions in order: (1) Is the plaintiff

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presently unemployed? (2) Does the plaintiff have a severe impairment? (3) Does 

the impairment meet or medically equal one of a list of specific impairments 

enumerated in the regulations? (4) Is the plaintiff unable to perform her former 

occupation? and (5) Is the plaintiff unable to perform any other work? 20 C.F.R. § 

416.920(a)(4). 

An affirmative answer at either step three or step five leads to a finding that 

the plaintiff is disabled. Young v. Sec’y of Health & Human Servs., 957 F.2d 386, 

389 (7th Cir. 1992). A negative answer at any step, other than at step three, 

precludes a finding of disability. Id. The plaintiff bears the burden of proof at steps 

one to four. Id. Once the plaintiff shows an inability to perform past work, the 

burden then shifts to the Commissioner to show the plaintiff’s ability to engage in 

other work existing in significant numbers in the national economy. Id. 

II. JUDICIAL REVIEW

Section 405(g) provides in relevant part that “[t]he findings of the 

Commissioner of Social Security as to any fact, if supported by substantial evidence, 

shall be conclusive.” 42 U.S.C. § 405(g). Judicial review of the ALJ’s decision is thus 

limited to determining whether the ALJ’s findings are supported by substantial 

evidence or based upon legal error. Clifford v. Apfel, 227 F.3d 863, 869 (7th Cir. 

2000); Stevenson v. Chater, 105 F.3d 1151, 1153 (7th Cir. 1997). Substantial 

evidence is “such relevant evidence as a reasonable mind might accept as adequate 

to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971); Skinner v. 

Astrue, 478 F.3d 836, 841 (7th Cir. 2007). An ALJ’s decision should be affirmed even 

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in the absence of overwhelming evidence in support: “whatever the meaning of 

‘substantial’ in other contexts, the threshold for such evidentiary sufficiency is not 

high. Substantial evidence is . . . ‘more than a mere scintilla.’ . . . It means – and 

means only – ‘such relevant evidence as a reasonable mind might accept as 

adequate to support a conclusion.’” Biestek v. Berryhill, 139 S. Ct. 1148, 1154, (2019)

(citations omitted). This Court may not substitute its judgment for that of the 

Commissioner by reevaluating facts, reweighing evidence, resolving conflicts in 

evidence, or deciding questions of credibility. Skinner, 478 F.3d at 841; see also 

Elder v. Astrue, 529 F.3d 408, 413 (7th Cir. 2008) (holding that the ALJ’s decision 

must be affirmed even if “‘reasonable minds could differ’” as long as “the decision is 

adequately supported”) (citation omitted).

However, even under this relatively lenient standard, an ALJ is not absolved 

of her duty to support the decision with record evidence. See Meuser v. Colvin, 838 

F.3d 905, 910 (7th Cir. 2016) (“We will uphold an ALJ’s decision if it is supported by 

substantial evidence, but that standard is not satisfied unless the ALJ has 

adequately supported his conclusions.”). The ALJ is not required to address “every 

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

some glimpse into the reasoning behind her decision to deny benefits.” Zurawski v. 

Halter, 245 F.3d 881, 889 (7th Cir. 2001). In cases where the ALJ denies benefits to 

a plaintiff, “he must build an accurate and logical bridge from the evidence to his 

conclusion.” Clifford, 227 F.3d at 872. The ALJ must at least minimally articulate 

the “analysis of the evidence with enough detail and clarity to permit meaningful 

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appellate review.” Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351 (7th Cir. 

2005); Murphy v. Astrue, 496 F.3d 630, 634 (7th Cir. 2007) (“An ALJ has a duty to 

fully develop the record before drawing any conclusions . . . and must adequately 

articulate his analysis so that we can follow his reasoning . . . .”); see Boiles v. 

Barnhart, 395 F.3d 421, 425 (7th Cir. 2005). 

Where conflicting evidence would allow reasonable minds to differ, the 

responsibility for determining whether a plaintiff is disabled falls upon the 

Commissioner, not the court. See Herr v. Sullivan, 912 F.2d 178, 181 (7th Cir. 

1990). However, an ALJ may not “select and discuss only that evidence that favors 

his ultimate conclusion,” but must instead consider all relevant evidence. Herron v. 

Shalala, 19 F.3d 329, 333 (7th Cir. 1994). 

III. ANALYSIS

Plaintiff argues that the ALJ’s decision was in error for several reasons, 

including: (1) the ALJ failed to subject a substantial line of evidence to medical 

expert scrutiny; and (2) the ALJ failed to adequately consider treating and 

examining medical opinions.

Pertinent to Plaintiff’s first argument, on May 3, 2019, Dr. Padmaja Vittal –

noting Plaintiff’s reports of slurred speech and short-term memory loss – diagnosed 

Plaintiff with Huntington’s disease and “[d]ementia due to Huntington’s disease 

without behavioral disturbance.” (R. 1460.) Huntington’s disease is a hereditary 

neurodegenerative disorder characterized by progressively worsening motor, 

cognitive, behavioral, and psychiatric symptoms. Ash v. Kijakazi, No. 21-06061, 

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2022 U.S. Dist. LEXIS 98426, at *4 (W.D. Mo. June 2, 2022). Huntington’s disease 

is a fatal condition typically characterized by involuntary movements and dementia. 

(Pl.’s Mot. at 5 n.1.) There is no cure or treatment to stop, slow, or reverse the 

progression of Huntington’s disease. Ash, 2022 U.S. Dist. LEXIS 98426 at *4. Adultonset Huntington’s disease is a “compassionate allowance” condition. Id. With 

compassionate allowance conditions, the ALJ “may, but is not required to, 

determine that a claimant [with such a condition] meets a listing and is therefore 

disabled simply by having the condition.” Emily W. v. Saul, No. 6:19-cv-1336, 2021 

U.S. Dist. LEXIS 85205, at *8 (D. Or. May 4, 2021) (citations omitted and emphasis 

removed).

Plaintiff argues that the ALJ committed reversible error by failing to resubmit Plaintiff’s case to medical expert scrutiny in light of later evidence 

concerning her diagnoses of worsening Huntington’s disease and Huntington’srelated dementia. The Court agrees. As stated by the Seventh Circuit, “[a]n 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) 

(citations omitted); see also Massaglia v. Saul, 805 F. App’x 406, 410 (7th Cir. 2020)

(“An ALJ may rely on a reviewing physician’s assessment unless later evidence 

containing new, significant medical diagnoses ‘changed the picture so much’ that it 

reasonably could have changed the reviewing physician’s opinion.”) (citation 

omitted). When new “treatment records [are] potentially decisive in that they 

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introduce[] a new symptom and diagnosis in [the claimant’s] case and provide[] 

objective support” for a claimant’s impairments, an ALJ errs by continuing to rely 

on outdated medical assessments. Annette S. v. Saul, No. 19 C 6518, 2021 U.S. Dist. 

LEXIS 92322, at *24-25 (N.D. Ill. May 14, 2021). That is what happened here. The 

ALJ noted Dr. Vittal’s May 2019 diagnoses of worsening Huntington’s disease and

Huntington’s-related dementia, but otherwise relied, inter alia, on two consultative 

examinations from November 2017. (R. 22-23.) Notably, despite Plaintiff’s 

neurodegenerative diagnoses, including dementia, the ALJ’s RFC assessment does 

not include any accommodations for mental impairments.

Ultimately, the Court finds that Dr. Vittal’s later treatment records –

supporting irreversible conditions that would progressively get worse – are 

potentially decisive and changed the picture to an extent that additional medical 

scrutiny is required. See Kemplen v. Saul, 844 F. App’x 883, 887 (7th Cir. 2021) 

(“Although a close question, we conclude that the ALJ erred by not soliciting an 

updated medical opinion interpreting Kemplen’s July and September 2017 Xrays.”); Heredia v. Colvin, No. 14 CV 5644, 2015 U.S. Dist. LEXIS 78773, at *14 

(N.D. Ill. June 18, 2015) (“These [additional] records reflect ongoing psychological 

problems and, importantly, a new diagnosis of borderline personality disorder (in 

combination with major depressive disorder). No expert considered the diagnosis of 

borderline personality disorder, or the impact of that disorder combined with major 

depressive disorder, so the ALJ was without a medical foundation on those issues.”) 

(citations omitted). The need for updated medical scrutiny requires that this matter 

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be remanded. See Nichole M. S. v. Saul, No. 19 C 7798, 2021 U.S. Dist. LEXIS 

26993, at *41 (N.D. Ill. Feb. 12, 2021) (“In sum, the ALJ erred in relying on 

outdated opinions of the state agency psychological consultants and on his own lay 

interpretation of the subsequent mental health records. A remand is required so the 

ALJ can reevaluate Nichole’s mental RFC based upon opinion evidence from 

psychological experts who have considered the entire record.”). With respect to 

Plaintiff’s Huntington’s disease, the only substantive argument Defendant raises is

that Plaintiff’s “diagnosis of Huntington’s disease” does not mean “a finding of 

disability is automatic” and the “decision to allow or deny the claim [still] rests with 

the adjudicator.” (Def.’s Memo. at 11-12.) That is true, but it does not change the

requirement that an ALJ render a decision based on up-to-date medical opinions.

Based on its conclusion that remand is necessary for the above reasons, the 

Court need not explore in detail the remaining errors claimed by Plaintiff. The 

Court emphasizes that the Commissioner should not assume these issues were 

omitted from the opinion because no error was found. Indeed, the Court admonishes 

the Commissioner that, on remand, special care should be taken to ensure that all 

treating and examining medical opinions are properly evaluated.

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CONCLUSION

For the foregoing reasons, Plaintiff’s motion to reverse to Commissioner’s 

decision [Doc. No. 19] is granted in part and denied in part, and the Commissioner’s 

cross-motion for summary judgment [Doc. No. 21] is denied. The Court finds that 

this matter should be remanded to the Commissioner for further proceedings 

consistent with this Order. In keeping with the conclusions reached herein, an 

updated medical expert review must be undertaken before the ALJ renders a new 

decision. 

SO ORDERED. ENTERED: 

 

DATE: June 23, 2022 ________________________________ 

 HON. MARIA VALDEZ

United States Magistrate Judge

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