Opinion ID: 3004583
Heading Depth: 2
Heading Rank: 1

Heading: The ALJ’s Listing 1.04 Analysis

Text: Minnick first argues the ALJ committed error by failing to adequately articulate why his combined impairments did not meet or equal the criteria of Listing 1.04. If a claimant has an impairment that meets or equals an impairment found in the No. 13-3626 11 Listing of Impairments, a claimant is presumptively eligible for benefits. 20 C.F.R. § 404.1520(d). “In considering whether a claimant’s condition meets or equals a listed impairment, an ALJ must discuss the listing by name and offer more than perfunctory analysis of the listing.” Barnett v. Barnhart, 381 F.3d 664, 668 (7th Cir. 2004). The Listings specify the criteria for qualifying impairments. Id. (citing 20 C.F.R. § 404.1525(a)). A claimant may also satisfy a Listing by showing that his impairment is accompanied by symptoms that are equal in severity to those described in the Listing. 20 C.F.R. § 404.1526. A finding of medical equivalence requires an expert’s opinion on the issue. Barnett, 381 F.3d at 670. Listing 1.04 describes spinal disorders (including herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, and vertebral fractures), resulting in compromise of a nerve root or the spinal cord, with evidence of nerve root compression, spinal arachnoiditis, or lumbar spinal stenosis resulting in pseudoclaudication. 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 1.04. It also requires, in relevant part: “Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test.” Id. In determining Minnick’s degenerative disc disease did not meet or equal Listing 1.04, the ALJ stated: The claimant’s degenerative disc disease was evaluated under Listing 1.04 (disorders of the spine). The 12 No. 13-3626 evidence does not establish the presence of nerve root compression, spinal arachnoiditis, or spinal stenosis resulting in pseudoclaudication, as required by that listing. This is the very type of perfunctory analysis we have repeatedly found inadequate to dismiss an impairment as not meeting or equaling a Listing. See Kastner v. Astrue, 697 F.3d 642, 647–48 (7th Cir. 2012) (remanding where the ALJ’s cursory Listing analysis failed to articulate rationale for denying benefits when record supported finding in claimant’s favor); Barnett, 381 F.3d at 670 (concluding the ALJ’s “two-sentence consideration of the Listing of Impairments [was] inadequate and warrant[ed] remand.”); Brindisi v. Barnhart, 315 F.3d 783, 786 (7th Cir. 2003) (reversing because ALJ’s Listing analysis was “devoid of any analysis that would enable meaningful judicial review.”). The ALJ dismissed the possibility of Minnick’s degenerative disc disease meeting or equally Listing 1.04’s criteria in two sentences. Beyond these two sentences, she provided no analysis whatsoever supporting her conclusion. As a particular example of the Listing analysis’ inadequacy, the ALJ failed to acknowledge several aspects of the record that could in fact meet or equal Listing 1.04. Most notably, the ALJ apparently ignored Minnick’s December 16, 2009, MRI, showing mild to moderate mass effect on two nerve roots, which can be indicative of nerve root compression. Paired with Minnick’s testimony that his pain limited his ability to use his fingers (motor loss accompanied by reflex loss) and the positive straight leg tests, Minnick’s degenerative disc disease may well have satisfied Listing 1.04A. We cannot discern from No. 13-3626 13 the ALJ’s scant analysis whether she considered and dismissed, or completely failed to consider, this pertinent evidence. If the ALJ did consider and dismiss some or all of this evidence, she never so stated. Moreover, the ALJ never sought an expert’s opinion as to whether any of the evidence could support a finding of equivalency. See Barnett, 381 F.3d at 670–71 (stating ALJ’s assumption of absence of equivalency without any relevant discussion and without consulting an expert’s opinion could not support the decision to deny benefits). Thus, the ALJ erred by failing to build a logical bridge from the evidence to her conclusion. See Schmidt, 395 F.3d at 744. B. The ALJ’s Residual Functional Capacity Assessment Minnick also argues the ALJ erred by assessing an RFC that was not supported by substantial evidence. Specifically, Minnick challenges the ALJ’s consideration of both his own credibility and the opinion evidence of treating physician, Dr. Kachmann.
In reaching her RFC determination, the ALJ discredited Minnick’s testimony using the type of boilerplate language that we have consistently criticized, see, e.g., Roddy, 705 F.3d at 635; Filus v. Astrue, 694 F.3d 863, 868 (7th Cir. 2012); Bjornson v. Astrue, 671 F.3d 640, 644–45 (7th Cir. 2012), stating that although his impairments “could reasonably be expected to cause some of his alleged symptoms … the claimant’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.” By itself, “[s]uch boilerplate language fails to 14 No. 13-3626 inform us in a meaningful, reviewable way of the specific evidence the ALJ considered in determining that claimant’s complaints were not credible.” Bjornson, 671 F.3d at 645. Although the ALJ did provide some explanation in support of this boilerplate language, we remain unpersuaded that substantial evidence supports her conclusion in light of the record as a whole. In support of her conclusion, the ALJ first remarked that Minnick’s low back pain was attributed to deconditioning, obesity, and resumption of tree trimming work, rather than his allegedly disabling impairments. This attribution presumably refers to the only instance in which tree trimming work is mentioned in the record: a January 2009 assessment by Dr. Harvey. It does not account for the record of pain, corroborated by a number of doctors, that continues from 2008 into 2011. The ALJ also focused on Minnick’s testimony that he could “sit for 30 minutes at the most,” yet sat for over 40 minutes during the hearing, and for a full hour before a consultative examiner. However, at least one doctor of record opined that he “could have caught Minnick on a good day.” So, too, could the ALJ and the consultative examiner. Moreover, Minnick’s full testimony was that he could probably sit for 30 minutes at the most, suggesting at least the possibility of longer stretches without issue. Finally, Minnick’s ability to sit without exhibiting pain-related behaviors at the hearing does not undo the consistent record of pain-related behaviors exhibited before nearly every one of Minnick’s treating physicians. Finally, and perhaps most critically, the ALJ never mentioned two studies in the record that indicated Minnick’s herniated discs were affecting his nerve roots. Nerve root No. 13-3626 15 contact provides an objective medical explanation for at least some of his pain and weakness. In Clifford v. Apfel, 227 F.3d 863 (7th Cir. 2000), the ALJ did not find the claimant’s testimony credible because it was contradicted by her daily activities and the medical evidence of record. We reversed the ALJ’s credibility determination, however, explaining that “the ALJ must consider a claimant’s subjective complaint of pain if supported by medical signs and findings.” Id. at 871. Though an ALJ’s credibility determination may only be overturned if it is “patently wrong,” Craft v. Astrue, 539 F.3d 668, 678 (7th Cir. 2008), a failure to adequately explain his or her credibility finding by discussing specific reasons supported by the record is grounds for reversal. Terry v. Astrue, 580 F.3d 471, 477 (7th Cir. 2009); Bjornson, 671 F.3d at 649. Here, the ALJ did not provide a reason for omitting from her analysis the objective medical evidence in the record supporting Minnick’s subjective complaints. Without a logical bridge between the evidence and the ALJ’s conclusion, we lack a sufficient basis upon which to uphold the ALJ’s determination of Minnick’s credibility.
Minnick also argues that the ALJ improperly discounted the opinion of treating physician Dr. Kachmann in assessing the RFC. Dr. Kachmann treated Minnick twice. The first time, he opined that Minnick should exercise, read up on his condition, and be weaned off narcotic medication. He also diagnosed centralized cerebral pain and fibromyalgia. The second time two months later, he opined that Minnick could not do any bending or twisting, was unable to be reeducated 16 No. 13-3626 for work, and was “clearly disabled.” Dr. Kachmann then diagnosed severe fibromyalgia and migraines. The ALJ found the opinions inconsistent. The ALJ also found that Dr. Kachmann’s opinions regarding hiring practices were outside the scope of his expertise and that his opinions regarding Minnick’s ability to bend and twist were unsupported by the record. For these reasons, the ALJ gave Dr. Kachmann’s opinion only limited weight. Under 20 C.F.R. § 404.1527(c)(1), an ALJ should “give more weight to the opinion of a source who has examined [the claimant] than to the opinion of a source who has not examined [the claimant]” because of his greater familiarity with the claimant’s conditions and circumstances. Section 404.1527(c)(2) further provides “[i]f [the ALJ] find[s] that a treating source’s opinion on the issue(s) of the nature and severity of [the claimant’s] impairment(s) is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the claimant’s] case record, [the ALJ] will give it controlling weight.” 20 C.F.R. § 404.1527(c)(2). In discounting Dr. Kachmann’s opinion that Minnick could not bend or twist, the ALJ stated the limitation to occasional stooping in the RFC was better supported by the record as a whole. The ALJ failed to explain why Dr. Kachmann’s opinion that Minnick could not bend or twist was not supported by the record, particular as to twisting. This was error. See Roddy, 705 F.3d at 636–37 (finding ALJ should have, but did not, explain why treating physician’s opinion about severity of claimant’s pain was inconsistent with record evidence indicating pain); see also Murphy v. Astrue, 496 F.3d 630, 634 (7th Cir. 2007) (finding No. 13-3626 17 ALJ erred in failing to explain disregard of pertinent record evidence). First, it is unclear from the ALJ’s opinion how the ability to occasionally stoop would mean Minnick could also twist. Second, the record contains a number of other doctors’ opinions suggestive of Minnick’s inability to bend or twist. For example, Dr. Karl and Dr. Onamusi, both treating physicians, noted Minnick had a diminished range of motion in the lumbar spine. Further, the only doctor to recommend stooping was Dr. Sands, a non-treating physician. His recommendation was a check-box style review of Minnick’s records, meaning Dr. Sands was not obligated to, and indeed did not, provide any reasons for his conclusion. The ALJ also discounted Dr. Kachmann’s opinion due to internal inconsistencies. Internal inconsistencies may provide good cause to deny controlling weight to a treating physician’s opinion, but the reasoning for the denial must be adequately articulated. Roddy, 705 F.3d at 636–37. Though the ALJ found inconsistencies in Dr. Kachmann’s reports, we do not see any conflict between his two opinions. It is not unreasonable to believe that Dr. Kachmann felt exercise could be helpful to Minnick, but later found that he is unable to bend or twist. For example, Minnick’s decreased usage of narcotics is noted in the record between his August and October visits with Dr. Kachmann; the reduced painkiller use could indicate that Minnick was in more pain in the October meeting than in the August one, diminishing his ability to tolerate certain movements. The ALJ also took issue with Dr. Kachmann’s recommendation that Minnick read a few books on his condition compared to his later statement that Minnick could not be reeducated for work. An inability to be reeducated for work is 18 No. 13-3626 not necessarily incompatible with the ability to educate oneself on one’s own condition. The ALJ has a duty to fully develop the record before drawing any conclusions and must adequately articulate her analysis so that we can follow her reasoning. Murphy, 496 F.3d at 634. Without explaining how or why Dr. Kachmann’s bending and twisting opinion was not supported by the record, we are unable to properly review the ALJ’s opinion determination. Similarly, the ALJ did not adequately articulate why Dr. Kachmann’s statements were internally inconsistent. In light of these errors, the ALJ must reevaluate whether Dr. Kachmann’s findings are entitled to controlling weight.