Oberoi v. Saul

UNITED STATES DISTRICT COURT “A.R.” 66.) After her DIB claim was denied initially and upon reconsideration, (id. NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION at 72, 81), Sabita was granted a hearing before an administrative law judge (“ALJ”). SABITA O., 1 ) Because Sabita’s insured status expired on March 31, 2011, five years before she ) 19 CV 5822 Plaintiff, ) filed her application, the ALJ was tasked with determining whether she established ) v. ) Magistrate Judge Young B. Kim that she was disabled in the period between her June 2006 alleged onset date and ) ANDREW M. SAUL, Commissioner of ) March 2011. The ALJ issued a decision concluding that she did not. (Id. at 15-23.) Social Security, ) ) April 29, 2021 The Appeals Council denied Sabita’s request for review, (id. at 1-3), making the Defendant. ) ALJ’s decision the final decision of the Commissioner, see Prater v. Saul, 947 F.3d MEMORANDUM OPINION and ORDER 479, 481 (7th Cir. 2020). Sabita then filed this lawsuit seeking judicial review of the This case illustrates the evidentiary challenges a claimant faces when she Commissioner’s decision, and the parties consented to this court’s jurisdiction. applies for social security disability benefits years after her date last insured has (R. 11); see 28 U.S.C. § 636 (c). passed. Sabita O. seeks disability insurance benefits (“DIB”) based on her claim Facts that she is disabled by rheumatoid arthritis and its resulting symptoms. She filed Sabita relies on her documentary evidence and hearing testimony to support her DIB application five years after her date last insured, and the Commissioner of her claim for DIB. Social Security denied her claim. Sabita now seeks judicial review of that decision. A. Medical Evidence See 42 U.S.C. § 405 (g). Before the court are the parties’ cross-motions for summary The bulk of documentary evidence Sabita submitted in support of her DIB judgment. For the following reasons, Sabita’s motion is denied and the claim post-dates her date last insured by several years. Documents from 2013 Commissioner’s is granted: through 2018 show that Sabita received regular treatment from Dr. Monika Background Starosta, a rheumatologist. During that period Dr. Starosta reported varying Sabita filed her DIB application in September 2016, claiming that she degrees of success in treating Sabita’s rheumatoid arthritis-related pain and became disabled in June 2006, when she was 49 years old. (Administrative Record stiffness with steroids and other medications. Under her care Sabita at times 1 Pursuant to Internal Operating Procedure 22, the court uses only the claimant’s reported improvement and only mild or minimal pain in her hands, neck, and feet. first name and last initial throughout this opinion to protect her privacy to the extent possible. [2] (See, e.g., A.R. 724-25, 833, 837, 882, 896.) But at other times in this period Sabita wrist and ankle pain had been present “for years, getting worse,” (id. at 305). The reported daily, generalized pain without relief, (id. at 757, 811), and Dr. Starosta bone scan results were consistent with polyarthritis. (Id. at 305.) consistently wrote that Sabita had abnormalities in her fingers and wrists with In January 2010 Sabita’s long-time physician, Dr. I. Singh, prescribed reduced flexion, (id. at 721, 737, 749, 826, 831, 835, 839, 843). prednisone, a steroid used to treat arthritis. (Id. at 786.) A week later Sabita In April 2018 Dr. Starosta submitted a residual functional capacity (“RFC”) reported that she was feeling better on prednisone. (Id.) In January 2011―just two questionnaire on behalf of Sabita’s DIB application and opined that she has months before her date last insured―Sabita had a consultation with Dr. Stacy Ban, significant functional limitations, including standing for only five minutes, sitting who noted that without medications Sabita had significant pain tied to rheumatoid for ten minutes, walking for one block, and lifting and carrying less than five arthritis, but after starting prednisone she was “currently without symptoms.” (Id. pounds. She also wrote that Sabita has trouble with fine manipulation and at 257.) In June 2011―three months after her date last insured―Sabita told her grasping because of hand pain and stiffness. (Id. at 994.) However, Dr. Starosta doctor she was doing well. (Id. at 254.) In May 2012 Sabita was again hospitalized was not able to say whether those limitations existed before Sabita’s March 2011 for pneumonia, but a musculoskeletal exam at that time showed no swelling, no date last insured. In fact, she wrote that she had no access to records or ability to tenderness, normal range of motion, and normal strength. (Id. at 511.) address Sabita’s limitations before March 2011. (Id. at 995-96.) In 2017 two consulting physicians reviewed Sabita’s medical records and Although her treatment for rheumatoid arthritis is well documented starting concluded that there was insufficient evidence on which they could evaluate her in 2013, records reflecting Sabita’s symptoms during the relevant period―from June claim of disability prior to her date last insured. (Id. at 69, 78.) In May 2018 2006 through March 2011―are comparatively meager. Sabita’s alleged disability Dr. Singh submitted an RFC questionnaire on Sabita’s behalf, noting that their onset date closely followed a 2006 hospitalization for pneumonia, and in 2008 she treatment relationship extended back to 1995. (Id. at 997.) Dr. Singh opined that had her first consultation with rheumatologist Dr. Robert Hozman. Her chief Sabita has significant limitations in all domains. He wrote that she is unable to complaint at that consultation was foot pain, but she also complained of achy hands stand for more than five minutes or sit for more than ten to fifteen minutes and and wrists. (Id. at 372.) Dr. Hozman noted that Sabita “would benefit from that she must lie down at least every three hours. He further opined that Sabita physical therapy,” (id.), and ordered a bone scan because Sabita reported that her can walk only one block and lift and carry less than five pounds. Dr. Singh also wrote that Sabita has trouble with fine manipulation and grasping, noting that she 3 4 has joint disease in her hands and wrists. (Id. at 998.) Unlike Dr. Starosta, polyarthropathy during that period. (A.R. 17.) At step three the ALJ determined Dr. Singh did opine on Sabita’s condition prior to her date last insured and wrote that Sabita’s impairment was not of listings-level severity. (Id. at 18.) that the limitations in his RFC assessment applied since before March 31, 2011, Before turning to step four, the ALJ determined that during the relevant and that they have “been slowly more disabling.” (Id. at 999-1000.) period Sabita retained the RFC for light work, but that she was limited to frequent B. Hearing Testimony grasping. (Id.) In explaining that determination, the ALJ wrote that the medical At her June 2018 hearing before the ALJ, Sabita testified that she stopped evidence documenting her condition before her date last insured is minimal—even working after her 2006 hospitalization and a subsequent dental surgery because she though she had health insurance during that period—and does not support Sabita’s had to be home for three months and was laid off. (A.R. 37-38.) She testified that contention that she was so limited prior to March 2011 that she could sit or stand she tried looking for a new job after her layoff but that she was not able to work for no longer than ten minutes. (Id. at 19-20.) The ALJ pointed to Sabita’s 2006 eight-hour days. (Id. at 40.) Sabita said that in 2011 her pain was so bad it was hospitalization records showing that she denied rheumatoid arthritis flares, had no hard to focus or get out of bed, and that she could stand for only five to ten minutes edema and 5/5 strength throughout, and reported being very active. (Id. at 20.) and sit for only ten minutes before needing to lie down. (Id. at 39, 45, 49.) She The ALJ commented that many of the treatment notes from the relevant period are testified that medication prescribed by a rheumatologist helped somewhat with difficult to decipher but noted that they appear to demonstrate that Sabita had no pain, but only for about an hour. (Id. at 44, 46.) Sabita acknowledged that she had neurological, motion, or strength deficits. (Id.) She also noted that Sabita failed to medical insurance coverage from 2006 through 2011. (Id. at 35.) follow through with recommended physical therapy and told a physician in January C. The ALJ’s Decision 2011 that she had “no current symptoms.” (Id.) The ALJ engaged in the standard five-step evaluation process in considering In weighing the opinion evidence the ALJ gave some weight to the consulting Sabita’s DIB claim. See 20 C.F.R. § 404.1520 (a). At steps one and two the ALJ physicians’ opinions that the evidence from the relevant period is insufficient, but found that Sabita did not engage in substantial gainful activity between her 2006 only little weight to the RFC opinions of Drs. Starosta and Singh. (Id. at 21-22.) alleged disability onset date and her March 2011 date last insured, and that she The ALJ explained that because Dr. Starosta was unable to provide any insight into suffered from the severe impairment of rheumatoid arthritis/inflammatory Sabita’s condition prior to the date last insured, her opinion was of little utility. (Id. at 22.) With respect to Dr. Singh’s opinion regarding Sabita’s condition before 5 6 March 2011, the ALJ was unpersuaded by it because she found it to be inconsistent 1148, 1154 (2019) (quotation and citations omitted). This is a deferential standard with the objective evidence—including Sabita’s report of no arthritis flares in 2006, that precludes the court from reweighing the evidence or substituting its judgment her limited treatment history, and practitioners’ benign findings—as well as for that of the ALJ, allowing reversal “only if the record compels a contrary result.” Dr. Singh’s own notes indicating that she had no neurological deficits. The ALJ Deborah M. v. Saul, __ F.3d __, 2021 WL 1399281 , at *2 (7th Cir. Apr. 14, 2021) noted that Dr. Singh’s records are not wholly legible, but she found it notable that (quotation and citation omitted). he did not refer Sabita to a rheumatologist until two years after her alleged A. Dr. Singh’s Opinion disability onset date. (Id.) In short, the ALJ determined that the record was Sabita argues that the ALJ was wrong to assign only little weight to insufficient to support a finding that prior to her date last insured Sabita’s Dr. Singh’s opinion, taking issue with each of the reasons the ALJ provided in rheumatoid arthritis was as severe as she and Dr. Singh alleged. explaining that decision. The applicable regulations allow the ALJ to consider At step four, the ALJ concluded that based on her RFC Sabita was able to several factors in weighing a treating physician’s opinion, including the nature and perform her past relevant work as a quality control worker prior to her date last length of the treating relationship, the supportability of the opinion, and its insured. (Id.) Accordingly, the ALJ decided that Sabita was not disabled during the consistency with the overall record. See 20 C.F.R. § 404.1527 (c) (applicable to relevant period and denied her DIB claim. (Id. at 23.) claims filed before March 27, 2017). The ALJ only needs to “minimally articulate” Analysis how she weighs the treating physician’s opinion, see Schmidt v. Astrue, 496 F.3d Sabita raises two challenges to the ALJ’s decision in her motion for summary 833, 842 (7th Cir. 2007) (citation omitted), and the court will “uphold all but the judgment: (1) the ALJ improperly discounted Dr. Singh’s opinion; and (2) she erred most patently erroneous reasons” the ALJ provides for discounting the opinion, in concluding that Sabita was capable of frequent grasping before her date last Stepp v. Colvin, 795 F.3d 711, 718 (7th Cir. 2015) (quotation and citation omitted). insured. In reviewing the ALJ’s decision, this court asks only whether the ALJ In challenging the ALJ’s assessment of Dr. Singh’s opinion, Sabita faults the applied the correct legal standards and whether the decision has the support of ALJ for noting that the extreme limitations assigned by Dr. Singh were not substantial evidence. See Burmester v. Berryhill, 920 F.3d 507, 510 (7th Cir. 2019). supported by any neurological findings, without explaining why such findings would Substantial evidence means only “such relevant evidence as a reasonable mind be meaningful in a patient with rheumatoid arthritis. (R. 20, Pl.’s Mem. at 11-12.) might accept as adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. To be clear, the ALJ wrote that Dr. Singh’s opinion was inconsistent with the 7 8 totality of the objective record before Sabita’s date last insured, including his own 2006, the ALJ pointed to relatively benign findings from other practitioners and notes regarding her absence of neurological deficits. (A.R. 22.) Sabita does not Sabita’s limited treatment history. (A.R. 22.) point to any records from the relevant period supporting the extreme limitations Reading the ALJ’s decision in its entirety, see Rice v. Barnhart, 384 F.3d 363 , Dr. Singh assigned. As the government concedes, musculoskeletal findings might 370 n.5 (7th Cir. 2004), the court concludes that the ALJ provided an adequate be more directly relevant to Sabita’s condition, but neurological findings with basis for those observations. The ALJ pointed out that the available records note no respect to gait or sensation appear to be relevant to Dr. Singh’s opinion that Sabita motion or strength deficiencies, which directly contradicts Dr. Singh’s opinion. could walk for no more than one block and had limitations in fingering and grasping (A.R. 20.) The ALJ further observed that in January 2011, less than three months prior to 2011.2 Accordingly, Sabita has not shown that this reason for discounting before her date last insured, Sabita told a doctor she had “no current symptoms” Dr. Singh’s opinion was patently wrong. See Stepp, 795 F.3d at 718 . while taking prednisone. (Id.) Finally, she noted that Sabita’s physician Sabita also faults the ALJ for pointing to evidence from 2006 to 2008 to recommended that she engage in physical therapy during the relevant period, but discount Dr. Singh’s opinion with respect to her condition prior to March 31, 2011. she failed to follow through with this recommendation despite having health Specifically, she faults the ALJ for noting that she had no arthritic flares in 2006 insurance. (Id.) These observations support the ALJ’s conclusion that the objective and for highlighting that Dr. Singh did not refer her to a rheumatologist until 2008. evidence does not support Dr. Singh’s opinion with respect to her walking, sitting, (R. 20, Pl.’s Mem. at 12.) Sabita argues that her condition in 2006 had no bearing standing, and grasping limitations before March 31, 2011. Accordingly, Sabita has on her limitations in 2011 and that the 2008 referral illustrates that her condition failed to show that the ALJ erred in explaining why she assigned only little weight deteriorated between 2006 and 2008. The court disagrees because although Sabita to Dr. Singh’s opinion. states in her brief that her hearing counsel informed the ALJ that she would accept B. RFC Assessment a disability finding as of any date before her 2011 date last insured, (id. at 8-9), her Sabita also challenges one aspect of the ALJ’s RFC assessment―the alleged onset date was in 2006. The ALJ was entitled to review evidence from that limitation to frequent bilateral hand grasping.3 According to Sabita, the ALJ failed period in weighing the physician’s opinion. Also, in addition to a lack of flares in 2 Rheumatoid arthritis can have neurologic manifestations. See Ruffing, Victoria & 3 Sabita also objects to the VE’s testimony that a significant number of jobs are Bingham, Clifton, Rheumatoid Arthritis Signs and Symptoms, available in certain job categories. This testimony does not pertain to Sabita’s past https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-symptoms/ relevant work, but instead to job categories the ALJ might have considered had she (last visited April 29, 2021). proceeded to step five of the sequential analysis. Because the ALJ ended the 9 10 to support the conclusion that she was able to engage in grasping for two-thirds of indicating that she told a doctor in 2012 that she was very active. (Id. at 20.) The the day before her date last insured. As an initial matter, Sabita bears the burden ALJ further relied on records demonstrating that during the relevant period Sabita of demonstrating that her condition was disabling prior to March 31, 2011. See did not have swelling in her extremities, demonstrated 5/5 motor strength, and Summers v. Berryhill, 864 F.3d 523, 527 (7th Cir. 2017). In challenging the RFC, reported no complaints of weakness. The ALJ also relied on Sabita’s January 2011 Sabita does not argue that the ALJ overlooked or mischaracterized evidence, played statement that she had no current symptoms. doctor, failed to articulate her reasons, made logical errors, or cherry-picked the Sabita’s arguments with respect to the RFC largely mimic those she raised record in reaching her conclusion with respect to Sabita’s grasping limitations regarding Dr. Singh’s opinion―that the ALJ should have given more weight to during the relevant period. Rather, she only takes issue with respect to the ALJ’s Dr. Singh’s opinion, that comments from 2006 have little bearing on her condition judgment regarding the level of limitation the record supports. The standard of in 2011, and that the ALJ failed to explain how normal neurological findings review does not allow this court to second-guess the ALJ’s judgment in this respect, undermine her rheumatology symptoms. Those arguments are unpersuasive with and if the ALJ builds a logical bridge between the evidence and her conclusion, the respect to the RFC determination for the same reasons described above. Although court must affirm the decision. See Deborah M., 2021 WL 1399281 , at *2; Rice, 384 reasonable minds may disagree about what the evidence from the relevant period F.3d at 369. shows with respect to Sabita’s grasping abilities, the ALJ properly supported her That logical bridge exists here. The ALJ rested her conclusion on the conclusion with substantial evidence. See Burmester, 920 F.3d at 510 . relatively limited treatment record from the relevant period and the lack of records The only aspect of Sabita’s argument that gives the court pause is her supporting a greater grasping limitation. The ALJ also found a mismatch between observation that the ALJ characterized some of the medical notes from the relevant Sabita’s description of her pain before 2011 and her testimony that during that time period as being illegible, and her argument that nothing in the regulations allows she was able to cook meals, drive, and perform light house work (which included, an ALJ to reject evidence because it is impossible to decipher. (R. 20, Pl.’s Mem. at according to her testimony, activities that require grasping, like folding laundry, 10.) But Sabita neither develops this argument nor argues that there are notes the loading and unloading the dishwasher, and dusting). (A.R. 21, 50-51.) The ALJ ALJ found to be illegible that would support greater grasping limitations during the pointed to Sabita’s failure to pursue recommended physical therapy and the record relevant period. Sabita does not argue that the ALJ should have re-contacted any analysis at step four and did not make an alternative step-five finding, Sabita has no basis for challenging this aspect of the VE’s testimony. 11 12 physicians to seek clarification! In fact, in an attending footnote Sabita seems to Conclusion suggest that the problem is not that the ALJ found some of the records to be For the foregoing reasons, Sabita’s motion for summary judgment is denied, illegible, but that she cited certain records that were typed or computer-generated the government’s is granted, and the decision of the Commissioner is affirmed. in making that assertion. (Id. at 10 n.4.) In other words, Sabita seems to cast ENTER: doubt on the idea that the records the ALJ cited were in fact illegible. aides Some courts in this circuit have stated that an ALJ confronted with Sited States Magistrate Judge indecipherable doctors’ notes should contact those doctors for clarification. See Lauren J. v. Saul, No. 17 CV 8138, 2019 WL 5864833 , at *6 n.3 (N.D. III. Nov. 7, 2019) (collecting cases). But in at least one instance, the Seventh Circuit held that an ALJ is not required to accept a physician’s opinion where the notes in support were of such poor quality that they were impossible to decipher. Gildon v. Astrue, 260 Fed. Appx. 927, 929 (7th Cir. 2008). Sabita’s two-sentence reference to illegible records fails to address any of this authority or the principles discussed therein, and her argument with respect to how the ALJ should have handled any illegible records is conclusory and underdeveloped. Accordingly, the court concludes that she has waived this aspect of her argument as a basis for reversal. See Carter v. Astrue, 413 Fed. Appx. 899, 906 (7th Cir. 2011) (noting that a claimant’s failure to develop an argument or presentation of conclusory analysis results in waiver). 4 In her brief, Sabita references the fact that her rheumatologist during the relevant period had retired years prior to her hearing before the ALJ, so as a practical matter, contacting that doctor may not have been a possibility. (R. 20, Pl.’s Mem. at 5.) 13 14