Source: http://law.justia.com/cases/federal/appellate-courts/ca7/11-2422/11-2422-2012-01-31.html
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Bjornson v. Astrue
Justia.com Opinion Summary: After a 1999 auto accident, plaintiff had severe back pains and was diagnosed with a Chiari malformation, a protrusion of brain tissue into the spinal canal. After three operations on her brain and spine, her vision and speech problems lessened, but she developed hydrocephalus, a buildup of cerebrospinal fluid in the brain that required installation of a shunt in her brain. She has not worked since the auto accident and was last insured for social security disability benefits in June 2005 (when she was 34 years old), so only if she was disabled from full-time work by that date is she eligible for benefits. An administrative law judge found her capable of sedentary work. The Seventh Circuit reversed, finding that the ALJ failed to bridge the gap between medical testimony and plaintiff's testimony and his conclusion.Receive FREE Daily Opinion Summaries by Email
No. 11-2422
C HRISTINE B JORNSON,
M ICHAEL J. A STRUE, Commissioner of Social Security,
No. 10 C 5835â��Elaine E. Bucklo, Judge.
A RGUED D ECEMBER 14, 2011â��D ECIDED JANUARY 31, 2012
Before P OSNER, M ANION, and W OOD , Circuit Judges.
P OSNER, Circuit Judge.
This is an appeal from a
decision by the district court affirming the denial of
social security disability benefits by an administrative
law judge, whose decision became final when the Social
Security Administrationâ��s Appeals Council denied the
applicant leave to appeal the Councilâ��s decision.
After an automobile accident in 1999 Christine
Bjornson began having severe back pains. Three years
later she was diagnosed with a â��Chiari malformation,â��
which is a protrusion of brain tissue into the spinal
canal. The malformation may have been caused by the
accident, but probably not; the cause, however, is irrelevant. After three operations on her brain and spine in
2002, the vision and speech problems that the Chiari
malformation had caused lessened substantially but she
developed hydrocephalusâ��a buildup of cerebrospinal
fluid in the brainâ��that required the installation of a
shunt in her brain, to drain the fluid. It took three installations to place the shunt properly, the last in 2003. To
alleviate the severe headaches caused or aggravated by
what appear to have been a total of nine brain and spinal
operations that she had undergone, she was prescribed
a number of powerful pain medications, including
OxyContin, Percoset, Lyrica, and methodone, often in
She hasnâ��t worked since the auto accident. She was
last insured for social security disability benefits in
June 2005 (when she was 34 years old), so only if she
was disabled from full-time work by that date is she
At the first of two disability hearings she testified that
since before her last-insured date she has had constant,
excruciating headaches four or five days a week, which
cause her to vomit when she stands up. She takes her
pain medications when she wakes up and then goes
back to bed for hours because she â��could not do anything else because of her pain medications.â�� She also
has severe back pain, aggravated by obesity, but it
does not appear that the back pain is disabling in itself,
though it compounds the effects of the headaches on
her ability to work.
At the first hearing the administrative law judge
decided that Bjornson should be examined by a physician
hired by the Illinois Department of Human Services,
which works with the Social Security Administration
in determining eligibility for social security disability
benefits. See Illinois Department of Human Services,
â��Disability Determination Services,â�� www.dhs.state.il.us/
page.aspx?item=29979 (visited Dec. 30, 2011). This was
done, and the physician, Dr. Muhammad Rafiq, reported
that Bjornson â��gets frequent severe headaches three to
four times per week during which she cannot stand,â�� and
that in an 8-hour day she can sit for an hour and a
half, stand for an hour, and walk for half an hourâ��the
rest of the time she has to lie down. The limitation on
standing may be caused by her back pain as well as her
headachesâ��it is unclear from Rafiqâ��s report which.
Other doctorsâ�� reports note Bjornsonâ��s â��chronic headaches, neck pain, intermittent visual problems, swallowing problems, slurred speech, and bilateral finger
numbness.â�� Dr. Ira Goodman, a pain specialist who
had treated Bjornson since 2003, noted her complaints
of constant headaches and diagnosed her with
(among other things) occipital neuralgia, a type of headache that involves piercing, throbbing, or â��electric-shocklikeâ�� chronic pain in the neck and head. He also
remarked her cervical spine pain, lower-back pain, a threeweek stretch of nonstop headaches, and daytime somnolence because of her pain medications. The administra-
tive law judge did not mention the diagnosis of occipital
All the evidence weâ��ve described thus far, except for
Dr. Rafiqâ��s, concerns diagnoses and treatments that
Bjornson received before June 2005. The record also
contains a good deal of evidence, besides Rafiqâ��s, concerning Bjornsonâ��s diagnoses and treatments since
then. None of this evidence indicates that her symptoms have worsenedâ��that if she is disabled today, nevertheless she wasnâ��t disabled before her last insured date.
Yet the governmentâ��s brief argues the irrelevance of all
post-June 2005 medical data, an argument that
both is factually mistaken and violates the Chenery rule,
because the administrative law judge ruled that postJune 2005 medical data could be consideredâ��and he was
right, as there was no reason to believe that Bjornsonâ��s
ability to work had declined since then. Ray v. Bowen,
843 F.2d 998, 1004-06 (7th Cir. 1988); Potter v. Secretary of
Health & Human Services, 905 F.2d 1346, 1348 (10th Cir.
1990) (per curiam); Dousewicz v. Harris, 646 F.2d 771, 774
(2d Cir. 1981).
One physician, Dr. Chukwuemeka Ezike, testified
that while Bjornson has a history of chronic headaches
attributable to the Chiari malformation and has been
treated for â��headaches, nausea, vomiting, and some
parasthesiaâ�� (numbness or tingling in the limbs), he â��did
not find enough . . . in the medical recordsâ�� to justify
Dr. Rafiqâ��s opinion. He believed that her â��pain was not
well substantiated after 2003,â�� and he did â��not find the
evidence that says she cannot sustain [a] sedentary job.â��
His testimony goes on and on, but what we have
quoted is the only intelligible portion of it that bears on
Bjornsonâ��s ability to hold a full-time job. Elsewhere he
did say that â��because of the persistence of the symptoms
and the fact that she was on high dose opiates, thatâ��s not
in my professional opinion based on reasonable degree
of medical certainty that physically she would be unable
to sustain unemployment at that time . . . . [W]e do not
have any evidence physically.â�� But we donâ��t know
what this passage means.
The rest of Dr. Ezikeâ��s testimony, which was
continually and confusingly interrupted by the administrative law judge, is epitomized in the following
exchange and seems, to the limited extent that it is even
intelligible, irrelevant:
BY ADMINISTRATIVE LAW JUDGE:
Q Dr. Azekee [sic], are we in the general realm of
what that chiari malformation is? Are we all, what?
A Yeah. I think you have the basic, you have the
basic correct pathology of this kind. Just basically the
brain is not supposed to be in the spinal canal.
Thatâ��s all.
A Any time you have any part of the brain which in
the spinal canal then you describe as a chiari malformation of which you have four types. Thatâ��s one
and two times and type four. At one, of course, is the
most common, which is what the patient had or had.
And they usually, they try to first [INAUDIBLE] they
donâ��t have any symptoms or they do not have any
abnormality. But when you have injuries, such as in
this case, she has a lumbar top, or a lumbar idete
surgery procedure that precipitated the, the brain to
remove a little bit more lower in the canal, resulting
in symptoms that she was experiencing. And at that
point, most doctors will recommend that you have
surgery to, to prevent further herniation down.
The problem when brain goes down more into the
canal, the spinal canal, of course, is smaller than
the brain. So the more it goes down, the more you
have strangulation.
The more youâ��
â��strangulationâ��
I think Iâ��
A â��then it goes from [INAUDIBLE] deformity is
smaller than the brain, and is pulling down. Then you
have a filter will collect and cut off some of the ceiling. And the ceiling will not result in, most of the time,
what it causes, it causes damage of the spinal tract,
neck, in the columns, of the spinal tract, so that the
most of the time it gives you symptoms of problem
with [INAUDIBLE] syndrome, the lower extremity, the
lower muscle nerve syndrome the upper extremities.
Q Okay. So it might be related to left arm weakness?
I mean itâ��s possible?
A Well, itâ��s possible, but it is absolutely I think itâ��s
more if, if the left arm was [INAUDIBLE] when they
get to, if as a result of the surgery, part of the
malformation itself.
Q Okay. Well maybe, from the surgery. But something might have gone, happened, which would cause
some left arm weakness. Right? Possibly?
Many things are possible, Your Honor.
One turns with relief to a November 2008 evaluation
by Dr. Goodman:
Christine Bjornson has been a patient of mine since
October, 2003. She is being treated for chronic headache related to multiple surgeries for Chiari malformation as well as for low back pain related to degenerative disk disease, lumbar facet arthropathy and
sacroiliitis with lower extremity pain related to
lumbar radiculopathy. She has responded some to
interventional treatments and medical management but remains unable to work primarily due to
noticeable increases in pain with prolonged sitting
or standing. The last MRI of the lumbar spine was
performed in June 2006 and showed degenerative
disk disease at both L4-5 and L5-S1 with disk protrusion. She has failed to gain significant improvement with IDET and is not willing to undergo a
lumbar spinal fusion at these levels, which I think is
appropriate. It is my opinion that she will need ongoing treatment of her pain with periodic inter-
ventional procedures, which do give benefit for up
to months at a time, as well as pharmacological management. Even with these forms of treatment she
experiences great difficulty caring for her family,
and I think that functioning in a job on a sustained
basis would be extremely difficult if not impossible
as she cannot sustain one position for any length
Bjornson testified at the second hearing, consistently
with her testimony at the first, that she needed the shunt
in her brain replaced but that the neurosurgeon she
had consulted had refused for fear that it might bring
back her hydrocephalus and require still another brain
surgery. (His report was consistent with that testimony.)
She testified that â��thereâ��s nothing more they [the doctors]
can do for me,â�� and that the pain medications help â��a
littleâ�� but â��usually . . . just knock me out and I sleep
through the headaches.â�� She testified that she spends
most of her day lying down.
The administrative law judge concluded that Bjornson
was capable of performing sedentary work (she had
been at various times before her accident a waitress, an offtrack betting teller, and a clerk in a real estate office),
albeit with some limitationsâ��mainly that she be able
to sit or stand whenever she wanted to. He asked the
vocational expert (an expert who testifies in disability
hearings about whether there is a substantial number
of jobs in the local economy that the claimant is
physically and mentally able to perform) whether
given these limitations Bjornson could satisfy the require-
ments of such a job. The vocational expert testified
that Bjornson could work as a clerk in a real estate office
because she â��could remain in a seated position long
enough to perform data entry tasks.â�� The administrative
law judge asked whether her opinion would change
if Bjornson had to lie down â��at least an hour during
the workday at irregular intervals every day differentlyâ��â��to which the vocational expert replied that in
that event â��there would be no jobs [she] could perform.â��
And in response to a further question from the administrative law judgeâ��what if Bjornson had occasional
bad headaches that caused her to miss two days of
work?â��the vocational expert answered: that too
â��would knock her out of all work.â�� Nevertheless the
administrative law judge concluded that Bjornson
Reading the administrative law judgeâ��s opinion, we
first stubbed our toe on a piece of opaque boilerplate
near the beginning, where, after reciting Bjornsonâ��s description of her medical condition, the opinion states:
â��After careful consideration of the evidence, the undersigned [administrative law judge] finds that the
claimantâ��s medically determinable impairments would
reasonably be expected to cause the alleged symptoms;
however, the claimantâ��s statements concerning the intensity, persistence and limiting effects of these
symptoms are not credible to the extent they are inconsistent with the above residual functional capacity assessment.â�� The governmentâ��s brief describes this passage as
a â��template,â�� by which it means a passage drafted by
the Social Security Administration for insertion into
any administrative law judgeâ��s opinion to which it pertains.
This â��templateâ�� is a variant of one that this court
(and not only this court) had criticized previouslyâ��that
â��after considering the evidence of record, the undersigned finds that claimantâ��s medically determinable
impairments would reasonably be expected to produce
the alleged symptoms, but that the claimantâ��s statements concerning the intensity, persistence and limiting
effects of these symptoms are not entirely credible.â�� In
Parker v. Astrue, 597 F.3d 920, 922 (7th Cir. 2010), we
called this â��meaningless boilerplate. The statement by
a trier of fact that a witnessâ��s testimony is â��not entirely
credibleâ�� yields no clue to what weight the trier of
fact gave the testimonyâ�� (emphasis in original); see
also Punzio v. Astrue, 630 F.3d 704, 709 (7th Cir. 2011);
Martinez v. Astrue, 630 F.3d 693, 696-97 (7th Cir. 2011);
Spiva v. Astrue, 628 F.3d 346, 348 (7th Cir. 2010). â��Such
boilerplate language fails to inform us in a meaningful,
reviewable way of the specific evidence the ALJ considered in determining that claimantâ��s complaints
were not credible. More troubling, it appears that the
Commissioner has repeatedly been using this same
boilerplate paragraph to reject the testimony of numerous claimants, without linking the conclusory statements contained therein to evidence in the record or
even tailoring the paragraph to the facts at hand, almost
without regard to whether the boilerplate paragraph
has any relevance to the case.â�� Hardman v. Barnhart,
362 F.3d 676, 679 (10th Cir. 2004) (citation omitted).
The present â��template,â�� which adds at the end of the
previous one â��. . . to the extent they are inconsistent with
the above RFC assessment,â�� is even worse, though
the governmentâ��s brief defends it with great vigorâ��
while at the same time both mistakenly describing it as
the identical boilerplate criticized in the previous cases
and confusing it with form orders that the Social Security
Administration has authorized when an administrative
law judge â��chooses to make a wholly favorable [to the
applicant] oral decision at the hearing.â�� Social Security
Administration, â��Oral (Bench) Decision Procedures,â��
w w w . s s a .g o v / O P _ H o m e / h a l l e x / I - 0 5 / I - 5 - 1 - 1 7 . h t m l
(visited Dec. 24, 2011), and â��Findings Integrated Templates
(FIT), Social Security Online,â�� www.ssa.gov/appeals/fit
(visited Dec. 24, 2011). The government regards the
â��templateâ�� as an indispensable aid to the Social Security
Administrationâ��s overworked administrative law judges.
Yet when we asked the governmentâ��s lawyer at
argument what the â��templateâ�� means, he confessed he
One problem with the boilerplate is that the assessment of the claimantâ��s â��residual functional capacityâ��
(the bureaucratic term for ability to work) comes later
in the administrative law judgeâ��s opinion, not
â��aboveâ��â��above is just the foreshadowed conclusion
of that later assessment. A deeper problem is that the
assessment of a claimantâ��s ability to work will often
(and in the present case) depend heavily on the credibility of her statements concerning the â��intensity, persistence and limiting effectsâ�� of her symptoms, but the
passage implies that ability to work is determined first
and is then used to determine the claimantâ��s credibility.
That gets things backwards. The administrative law
judge based his conclusion that Bjornson can do
sedentary work on his determination that she was exaggerating the severity of her headaches. Doubts about
credibility were thus critical to his assessment of ability
to work, yet the boilerplate implies that the determination of credibility is deferred until ability to work is
assessed without regard to credibility, even though it
often canâ��t be. In this regard we note the tension between
the â��templateâ�� and SSR 96-7p(4), www.ssa.gov/OP_Home/
rulings/di/01/SSR96-07-di-01.html (visited Jan. 4, 2012),
which states that â��an individualâ��s statements about the
intensity and persistence of pain or other symptoms
or about the effect the symptoms have on his or her
ability to work may not be disregarded solely because
they are not substantiated by objective medical evidence.â��
The applicantâ��s credibility thus cannot be ignored in determining her ability to work (her residual functional
capacity, in SSA-speak).
The Social Security Administration had better take a
close look at the utility and intelligibility of its â��templates.â��
The administrative law judge based his doubts about
Bjornsonâ��s credibility on his assessment of the medical
reports or testimony of the three doctors whom weâ��ve
mentioned, Goodman, Rafiq, and Ezike. He remarked that
Dr. Goodmanâ��s treatment notes report that Bjornsonâ��s
complaints about headaches had become less frequentâ��that she had complained about them only four
times in a nine-month periodâ��and that although her
headaches â��have been an ongoing problem since before
she started coming to see me in 2003 . . . she can deal with
that,â�� although she â��must sit or lie down several times
per day to control pain.â�� The administrative law judge
appears to have overlooked Bjornsonâ��s testimony that
she had concluded that the medical profession couldnâ��t
do anything more for her headachesâ��by this time
she had had multiple brain surgeriesâ��except give her
painkillers that knock her out; if that testimony
is credited, it would explain why her complaints to
doctors about headaches diminished over time. The
administrative law judge did not mention Dr. Goodmanâ��s
further statements that the headaches â��were always
presentâ�� and that Bjornson had complained of â��non-stop
headachesâ�� that had lasted for three weeks.
And it was a mistake to infer from Goodmanâ��s quoted
statement, as the administrative law judge did in ruling
that Bjornson can work as long as she has a sit-stand
option, that sitting down several times a day is all that
she would have to do in order to be able to hold a 9 to
5 job. Apart from the ambiguity not explored by the
administrative law judge of the term â��control pain,â��
Dr. Goodmanâ��s statement that Bjornson â��must sit or lie
down several times per day to control painâ�� is consistent
with Bjornsonâ��s testimony that often she must lie down,
not stand or sit down, to alleviate the pain. One does
sedentary work sitting (the word â��sedentaryâ�� is from the
Latin word â��sedere,â�� which means â��to sitâ��), but not lying
The administrative law judge rejected Dr. Rafiqâ��s evidence (remember that he opined that Bjornson could sit,
walk, or stand for a total of only three hours in an eighthour workdayâ��90 minutes (sitting) + 60 minutes (standing) + 30 minutes (walking)â��which means that she
would have to be able to lie down for the other five hours
in the workday), saying that â��those limitations are not
supported by [Dr. Rafiqâ��s] own clinical observations.â��
Well, obviously Dr. Rafiq didnâ��t conduct an eight-hour
examination of Bjornson. The administrative law judge
faulted Rafiq for â��rel[ying] on collateral evidence
in concluding that Bjornsonâ��s functioning was so
markedly limited.â�� He did not explain what he meant
by â��collateral evidence,â�� but probably he meant the
other treatment notes in the recordâ��yet Dr. Rafiq
would have been remiss not to consult them and to
weigh them in forming his own judgment.
Out of the blue the administrative law judge remarked
of Dr. Rafiq that â��doctors sometimes express an opinion
in an effort to assist a patient with whom they sympathize. While it is difficult to confirm the presence of such
a motive, it is more likely in situations where
the opinion in question departs substantially from the
rest of the evidence of record, as in the current case.â��
Actually the doctorâ��s evidence was consistent with
most of the rest of the evidence. And the suggestion that
his evidence was based on sympathy for Bjornson is
both unsupported and implausible. She is not his
patient; the Illinois state agency that works with the
Social Security Administration retained and paid him
to conduct a single examination of a total stranger. His
first medical report (of two reports) states that Bjornson
â��was informed that this examination was solely for pro-
viding information to the Bureau of Disability Determination Services and did not constitute a patient/physician relationship.â��
The administrative law judge expressed doubt about
Bjornsonâ��s credibility on the further ground of her â��activities of daily living,â�� notably that she can walk up to one
block, sit or stand for up to 15 minutes, lift 10 pounds,
bathe and dress normally, and even drive and shop.
But she had never testified that she was immobilized,
and indeed she had testified that she had one or two
good days each weekâ��for all that appears, the activities
recited by the administrative law judge are concentrated
in those days. Doubtless she dresses and bathes more
frequently than twice a week, but one can have awful
headaches yet still dress and bathe. The critical differences between activities of daily living and activities
in a full-time job are that a person has more flexibility
in scheduling the former than the latter, can get help
from other persons (in this case, Bjornsonâ��s husband
and other family members), and is not held to a
minimum standard of performance, as she would be by
an employer. The failure to recognize these differences
is a recurrent, and deplorable, feature of opinions by
administrative law judges in social security disability
cases. See Punzio v. Astrue, supra, 630 F.3d at 712; Spiva v.
Astrue, supra, 628 F.3d at 351-52; Gentle v. Barnhart, 430
F.3d 865, 867-68 (7th Cir. 2005); Draper v. Barnhart, 425
F.3d 1127, 1131 (8th Cir. 2005); Kelley v. Callahan, 133 F.3d
583, 588-89 (8th Cir. 1998); Smolen v. Chater, 80 F.3d
1273, 1284 n. 7 (9th Cir. 1996).
The administrative law judge gave decisive weight to
testimony by Dr. Ezike, even though he is not a pain
specialist, like Goodman, and, unlike both Goodman
and Rafiq, had not examined Bjornson. (So all the
evidence Dr. Ezike relied on was â��collateral,â�� unlike
Dr. Rafiq, whom the administrative law judge criticized
for relying on such evidence.) He noted with approval
Dr. Ezikeâ��s testimony that the medical evidence concerning Bjornsonâ��s condition after 2003 â��supported a
sedentary residual functional capacity finding.â�� Yet on
the previous page of his opinion he had rebuked
Dr. Goodman for saying that Bjornson â��remained unable
to work,â�� remarking that â��statements that a claimant is
disabled or unable to work are not medical opinions
but are dispositive administrative findings . . . reserved
to the Commissionerâ�� of social security. The remark is
imprecise. The pertinent regulation says that â��a statement by a medical source that you are â��disabledâ�� or
â��unable to workâ�� does not mean that we will determine
that you are disabled.â�� 20 C.F.R. Â§ 404.1527(e)(1). Thatâ��s
not the same thing as saying that such a statement is
improper and therefore to be ignored, as is further
made clear when the regulation goes on to state that
â��the final responsibility for decidingâ�� residual functional capacity (ability to workâ��and so whether the
applicant is disabled) â��is reserved to the Commissioner.â��
Â§ 404.1527(e)(2) (emphasis added). And â��we will not
give any special significance to the source of an opinion
on issues reserved to the Commissioner.â�� Â§ 404.1527(e)(3)
The second medical report that Dr. Rafiq submitted
was a form that the Illinois disability determinations
agency had asked him to fill out, and one of the questions was how long Bjornson could sit, stand, and walk
and what she did when she couldnâ��t do any of those
things. When he stated on the form that she could
sit, stand, and walk for a total of only three hours in
an eight-hour workday, he was not invading any prerogative reserved to the Social Security Administration.
But his statement inescapably implied that she canâ��t
work full time, for what employer would hire for a fulltime job someone who has to lie down for five hours
during the workday?
The administrative law judge not only forgot his dismissive view of physiciansâ�� testimony relating to
issues â��reserved to the Commissionerâ�� when he came
to Dr. Ezike, but compounded the inconsistency by
adding that he was â��assign[ing] substantial weight to
Dr. Ezikeâ��s opinions, as he is familiar with the Social
Security disability program, reviewed all available
medical evidence, listened to Bjornsonâ��s testimony [at
the second administrative hearing] regarding her symptoms and functional limitations, and issued opinions
consistent with the rest of the medical evidence record.â��
Apart from the fact that Dr. Ezikeâ��s testimony was
not â��consistent with the rest of the record,â�� his familiarity
with the social security disability program could be
relevant only if it permitted him to offer an opinion
concerning Bjornsonâ��s eligibilityâ��which the administrative law judge had just said was the prerogative of the
Social Security Administration. The regulation does
state that â��the amount of understanding of our disability
programs and their evidentiary requirements that an
acceptable medical source has . . . [is among the] relevant
factors that we will consider in deciding the weight to
give to a medical opinion.â�� Â§ 404.1527(d)(6). But the
administrative law judge seems to have forgotten
that when he dismissed Dr. Rafiqâ��s evidence. And remember that it was a sister government agency (in effect) of
the Social Security Administration that had hired
Dr. Rafiq to examine Bjornson, which implies that Rafiq
was believed to know as much as he needs to know
about the social security disability program in order to
be able to give an informed professional opinion
about the physical condition of an applicant for disability benefits.
It is impossible to tell, moreover, whether Dr. Ezike
based his skepticism about the severity of Bjornsonâ��s
pain (her â��pain was not well substantiated after 2003â��)
on the absence of corroborating objective medical
evidence, which if he did would be in tension with SSR 967p(4) (â��an individualâ��s statements about the intensity
and persistence of pain or other symptoms or about
the effect the symptoms have on his or her ability to work
may not be disregarded solely because they are not substantiated by objective medical evidenceâ��), or on his
interpretation of her report of her pain as quoted or
paraphrased in the notes of the other doctors (another
possible interpretation of â��[her] pain was not well substantiated after 2003â��). If the former, his opinion is both
implausible for there was plenty of corroborating medical
evidenceâ��and in tension with SSR 96-7p(4), as we said;
and if the latter it adds nothing to those notes and those
doctorsâ�� conclusions and does not undermine Bjornsonâ��s
testimony that she had abandoned hope of being able
to deal with her headaches other than by a combination
of painkillers that made her somnolent with (what goes
with somnolence) lots of lying down. Dr. Ezike may
have based his testimony on the fact that the other doctorsâ�� treatment notes indicated that Bjornsonâ��s complaints
about headaches were intermittent.
The Social Security Administrationâ��s administrative
law judges are overworked, but if one may judge from
the transcript in this case, the two hearings proceeded in
a leisurely, even meandering, fashion. Whatever the
cause, the administrative law judgeâ��s opinion failed to
build a bridge between the medical evidence (along
with Bjornsonâ��s testimony, which seems to have been
fully consistent with that evidence) and the conclusion
that she is able to work full time in a sedentary occupation provided that she can alternate sitting and standing. See Scott v. Astrue, 647 F.3d 734, 740 (7th Cir. 2011);
Terry v. Astrue, 580 F.3d 471, 475 (7th Cir. 2009) (per
curiam); cf. Hardman v. Barnhart, supra, 362 F.3d at 678-79.
The judgment of the district court is reversed and the
matter returned to the Social Security Administration
R EVERSED AND R EMANDED.