MARY M. ROWLAND, Magistrate Judge.
Plaintiff Michele Babette Lamantia filed this action seeking reversal of the final decision of the Commissioner of Social Security denying her applications for Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) under Title II and XVI of the Social Security Act (Act). 42 U.S.C. §§ 405(g), 423 et. seq., 1381 et seq. The parties have consented to the jurisdiction of the United States Magistrate Judge, pursuant to 28 U.S.C. § 636(c), and filed cross-motions for summary judgment. For the reasons stated below, the Commissioner's decision is affirmed.
To recover DIB or SSI, a claimant must establish that he or she is disabled within the meaning of the Act. York v. Massanari, 155 F.Supp.2d 973, 977 (N.D. Ill. 2001).
20 C.F.R. §§ 404.1509, 404.1520, 416.909, 416.920; see Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000). "An affirmative answer leads either to the next step, or, on Steps 3 and 5, to a finding that the claimant is disabled. A negative answer at any point, other than Step 3, ends the inquiry and leads to a determination that a claimant is not disabled." Zalewski v. Heckler, 760 F.2d 160, 162 n.2 (7th Cir. 1985). "The burden of proof is on the claimant through step four; only at step five does the burden shift to the Commissioner." Clifford, 227 F.3d at 868.
Plaintiff applied for DIB and SSI benefits on December 3, 2009, alleging that she became disabled on September 15, 2008, due to grand mal seizures, prior heart attack, depression, high blood pressure, asthma, allergies, and left ankle problems. (R. at 20, 424). The application was denied initially and upon reconsideration, after which Plaintiff filed a timely request for a hearing. (Id. at 20, 163-66, 216-24). Plaintiff, represented by counsel, appeared and testified at a hearing before an Administrative Law Judge (ALJ) on February 15, 2012, and at a supplemental hearing on October 16. (Id. at 20, 84-162). The ALJ denied Plaintiff's request for benefits on November 30, 2012. (Id. at 20, 170-81). After Plaintiff filed a request for review, the Appeals Council (AC) vacated the November 30 decision and remanded the case for further proceedings. (Id. at 20, 190-92).
On May 12, 2014, Plaintiff, represented by counsel, testified at a remand hearing before a different ALJ. (R. at 20, 42-83). The ALJ also heard testimony from Thomas A. Gusloff, a vocational expert (VE), Judy Panek, M.D., a medical expert (ME), and David L. Biscardi, Ph.D., another ME. (Id. at 20, 42-83, 351-55).
The ALJ denied Plaintiff's request for benefits on September 18, 2014. (R. at 20-33). Applying the five-step sequential evaluation process, the ALJ found, at step one, that Plaintiff has not engaged in substantial gainful activity since September 15, 2008, the alleged onset date. (Id. at 24). At step two, the ALJ found that Plaintiff's seizure disorder, degenerative cervical spine arthritis, arthralgias, left ankle fracture history, history of coronary artery disease, depression, and history of substance abuse are severe impairments. (Id.). At step three, the ALJ determined that Plaintiff's impairments, including the substance abuse disorder, meet listing 12.09. (Id. at 24-25). If Plaintiff stopped the substance use, the ALJ found the remaining limitations would cause more than a minimal impact on Plaintiff's ability to perform basic activities. (Id. at 26). Further, if Plaintiff stopped the substance use, the ALJ determined that Plaintiff does not have an impairment or combination of impairments that meet or medically equal the severity of any of the listings enumerated in the regulations.
The ALJ then assessed Plaintiff's Residual Functional Capacity (RFC)
(R. at 27; see id. at 27-31). Based on Plaintiff's RFC and the VE's testimony, the ALJ determined at step four that if Plaintiff stopped the substance use, she would be unable to perform any past relevant work. (Id. at 31). At step five, based on Plaintiff's RFC, her vocational factors, and the VE's testimony, the ALJ determined that if Plaintiff stopped the substance use, there are jobs that exist in significant numbers in the national economy that Plaintiff can perform, including photocopy machiner, inserting machine operator, and bagger of garments. (Id. at 31-32). Even if Plaintiff was limited to sedentary work with the same nonexertional limitations, the VE testified there are jobs that exist in significant numbers in the national economy that Plaintiff can perform, including cutter and paster, information clerk, and toy stuffer. (Id. at 32). Accordingly, the ALJ concluded that the substance use disorder is a contributing, material factor because Plaintiff would not be disabled if she stopped the substance use. (Id.). Therefore, Plaintiff is not suffering from a disability as defined by the Act. (Id. at 32-33).
The Appeals Council denied Plaintiff's request for review on November 10, 2015. (R. at 6-8). Plaintiff now seeks judicial review of the ALJ's decision, which stands as the final decision of the Commissioner. Villano v. Astrue, 556 F.3d 558, 561-62 (7th Cir. 2009).
Judicial review of the Commissioner's final decision is authorized by § 405(g) of the Act. In reviewing this decision, the Court may not engage in its own analysis of whether the plaintiff is severely impaired as defined by the Social Security Regulations. Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004). Nor may it "reweigh evidence, resolve conflicts in the record, decide questions of credibility, or, in general, substitute [its] own judgment for that of the Commissioner." Id. The Court's task is "limited to determining whether the ALJ's factual findings are supported by substantial evidence." Id. (citing § 405(g)). Evidence is considered substantial "if a reasonable person would accept it as adequate to support a conclusion." Indoranto v. Barnhart, 374 F.3d 470, 473 (7th Cir. 2004); see Moore v. Colvin, 743 F.3d 1118, 1120-21 (7th Cir. 2014) ("We will uphold the ALJ's decision if it is supported by substantial evidence, that is, such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.") (citation omitted). "Substantial evidence must be more than a scintilla but may be less than a preponderance." Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 2007). "In addition to relying on substantial evidence, the ALJ must also explain his analysis of the evidence with enough detail and clarity to permit meaningful appellate review." Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351 (7th Cir. 2005).
Although this Court accords great deference to the ALJ's determination, it "must do more than merely rubber stamp the ALJ's decision." Scott v. Barnhart, 297 F.3d 589, 593 (7th Cir. 2002) (citation omitted). "This deferential standard of review is weighted in favor of upholding the ALJ's decision, but it does not mean that we scour the record for supportive evidence or rack our brains for reasons to uphold the ALJ's decision. Rather, the ALJ must identify the relevant evidence and build a `logical bridge' between that evidence and the ultimate determination." Moon v. Colvin, 763 F.3d 718, 721 (7th Cir. 2014). Where the Commissioner's decision "lacks evidentiary support or is so poorly articulated as to prevent meaningful review, the case must be remanded." Steele v. Barnhart, 290 F.3d 936, 940 (7th Cir. 2002).
Plaintiff first began experiencing seizures at age 16, following a fall. (R. at 862). They became worse but by 2009, she experienced them only three times per year. (Id. at 857, 862).
On May 17, 2007, Plaintiff presented to the emergency room after passing out at home. (R. at 694). She reported drinking more than usual. (Id.). On June 5, she presented to the emergency room for an evaluation of psychosis. (Id. at 629). She acknowledged drinking heavily for the prior two weeks. (Id. at 629-30). She was diagnosed with alcohol intoxication, possible medication reaction, and possible psychosis. (Id. at 630). On June 8, Plaintiff was admitted to the hospital with a diagnosis of acute alcohol intoxication. (Id. at 627). On July 15, 2008, she was admitted to the hospital after complaining of shakiness. (Id. at 730). Her boyfriend reported that she had been drinking heavily the night before; her blood alcohol concentration (BAC) in the emergency room was 0.40.
On January 6, 2009, Roopa K. Kari, M.D., performed an internal medicine consultative examination on behalf of the Commissioner. (R. at 856-60). Plaintiff was able to get on and off the exam table and ambulate 50 feet without support. (Id. at 859). Her gait was nonantalgic, range of motion normal, and straight leg test negative. (Id.). Dr. Kari's diagnostic impression included a history of grand mal seizures, history of coronary artery disease, depression, history of asthma, history of hypertension, and history of alcoholism. (Id.).
On the same day, Barbara F. Sherman, Psy.D., performed a psychological examination on behalf of the Commissioner. (R. at 862-67). Plaintiff admitted to prior daily use of alcohol before entering a rehabilitation program; she had been in remission but relapsed recently following her mother's sudden death. (Id. at 863, 866). In the prior year, she was hospitalized after unintentionally taking an overdose of sleeping medications. (Id. at 866). Plaintiff reported no problems with socialization and generally can take care of herself but needs supervision at all times because of her seizure history. (Id. at 864). She cries often, is sometimes lethargic, has impaired concentration, appetite and sleeping, but denied hallucinations, delusions, and suicidal or homicidal ideations. (Id. at 864-65). On examination, Plaintiff was not fully time oriented, but was oriented to person and place. (Id. at 864). Her speech, concentration, memory, fund of knowledge, and conceptual and calculation abilities were all normal. (Id. at 865). She did exhibit some attention and judgment deficits. (Id.). Dr. Sherman diagnosed alcohol abuse disorder, posttraumatic stress disorder, major depression, single episode, and seizure disorder. (Id. at 866).
Plaintiff was admitted to the Good Samaritan Hospital on January 12, 2009, after complaint of shortness of breath. (R. at 875). She acknowledged that she had stopped taking her seizure medicines six to eight weeks prior. (Id. at 875). She was diagnosed with alcohol intoxication, along with chest pain and seizure disorder. (Id. at 878). The attending physician advised her to stop drinking and resume her seizure medications, which he advised her should be inexpensive since they are generic. (Id. at 879).
On January 16, 2009, Elizabeth Kuester, M.D., a nonexamining DDS physician, completed a Psychiatric Review Technique report. (R. at 884-97). She concluded that Plaintiff was mildly limited in activities of daily living, maintaining social functioning, and maintaining concentration, persistence or pace. (Id. at 894).
On January 30, 2009, George Andrews, M.D., a nonexamining DDS physician, completed a physical RFC assessment. (R. at 898-905). He opined that Plaintiff could occasionally lift 50 pounds, frequently 25 pounds, and stand, walk or sit six hours in an eight-hour workday. (Id. at 899). He concluded that Plaintiff has no postural, manipulative, visual, or communicative limitations, but should avoid concentrated exposure to fumes and hazards. (Id. at 900-02). On April 6, 2010, Reynaldo Gotanco, M.D., another nonexamining DDS physician, largely affirmed Dr. Andrews's assessment, but opined that Plaintiff should also avoid concentrated exposure to cold. (Id. at 1083-90). On September 10, 2010, Bharati Jhaveri, M.D., another nonexamining DDS physician, affirmed Dr. Gotanco's assessment. (Id. at 1302-04).
On October 31, 2009, Plaintiff was admitted to Central DuPage Hospital following a generalized tonic clonic seizure. (R. at 939). Her boyfriend reported that she had been drinking alcohol the night before and had a brief seizure before going back to bed. (Id.). The attending physician assessed seizures. (Id.). The physician could not conclude whether it was an alcohol withdrawal seizure "but clearly if she has epilepsy then she is noncompliant with her medications, as her Dilantin level shows a very low level as well as the Depakote." (Id.).
Plaintiff presented to the emergency room for another possible seizure on November 9. (R. at 977). The attending physician concluded that the seizure was caused by being noncompliant with her medications along with alcohol intoxication. (Id.). The doctor explained to Plaintiff that any quantity of alcohol will lower her seizure threshold. (Id.). She returned to the emergency room on December 29 for a seizure, after drinking heavily. (Id. at 1023). The attending physician explained that alcohol not only lowers the seizure threshold but that heavy drinking can also trigger an alcohol withdrawal seizure. (Id.).
On February 17, 2010, Ravikiran N. Tamragouri, M.D., performed a physical examination on behalf of the Commissioner. (R. at 1065-67). The examination was largely unremarkable. Plaintiff had full range of motion without difficulty, no ankle or leg edema, full power and strength, and normal gait and ambulation. (Id. at 1066-67). Dr. Tamragouri's diagnostic impression included seizures that increased in frequency because of medication noncompliance and alcohol abuse; myocardial infarction history and hypertension; asthma history; and left ankle flat foot—but no gait disturbance during examination. (Id. at 1067).
On March 5, Plaintiff was unresponsive and was transported to Central DuPage Hospital. (R. at 1145). Henry C. Echiverri, M.D., noted an underlying history of seizure disorder and alcohol abuse. (Id.). As recently as December 2009, Plaintiff was reported to be drinking up to one pint of vodka daily. (Id. at 1146). She has been hospitalized "multiple times for episodes of seizure that were presumed to be at least partially contributed to by alcohol." (Id.). A CAT scan of the brain was normal. (Id. at 1145). Dr. Echiverri's diagnostic impression was "probable alcohol-induced breakthrough seizures in a patient who most likely has an underlying seizure disorder." (Id.). He also found that Plaintiff has hyperammonemia.
Sunil Matiwala, M.D., also examined Plaintiff while she was in the hospital. (R. at 1146-47). He noted that Plaintiff has a history of alcohol abuse, coronary heart disease and a seizure disorder, and was admitted with a profoundly altered mental status. (Id. at 1147). Dr. Matiwala opined that with Plaintiff's low platelets and her alcohol history and hyperammonemia, "the clinical picture suggests that of alcohol cirrhosis." (Id.).
James B. Augustinsky, M.D., was also consulted while Plaintiff was in the hospital. (R. at 1150-51). He noted that Plaintiff has a long history of alcohol abuse and hepatic encephalopathy. (Id. at 1150). His assessment included alcohol abuse, hepatic encephalopathy, seizure disorder, and coronary artery disease. (Id. at 1151). On March 10, 2010, Joseph Martin Nemeth III, M.D., performed a psychiatric evaluation on behalf of the Commissioner. (R. at 1081-82). Plaintiff did not exhibit any postural abnormalities or gait disturbances. (Id. at 1081). She acknowledged a history of alcohol abuse but denied drinking "in some time." (Id.). She reported feeling depressed, anxious and agitated, but denied suicidal ideations and denied auditory or visual hallucinations. (Id.). Dr. Nemeth diagnostic impression included depression and chronic alcoholism. (Id. at 1082). He opined that Plaintiff was incapable of handling her own funds. (Id.).
On April 15, 2010, Howard Tin, Psy.D., a nonexamining DDS physician, completed a Psychiatric Review Technique form. (R. at 1091-104). He concluded that Plaintiff has depression NOS and alcoholism, chronic type. (Id. at 1094, 1099). He opined that Plaintiff was mildly limited in activities of daily living but moderately limited in maintaining social functioning and maintaining concentration, persistence or pace. (Id. at 1101). Dr. Tin also completed a mental RFC assessment. (Id. at 1105-07). He opined that Plaintiff was moderately limited in her ability to understand, remember and carry out detailed instructions; maintain attention and concentration for extended periods; perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerances; work in coordination with or proximity to others without being distracted by them; interact appropriately with the general public; and set realistic goals or make plans independently of others. (Id. at 1105-06). Dr. Tin concluded that Plaintiff is capable of performing simple tasks that do not require interaction with the general public. (Id. at 1107). On September 9, 2010, Donald Henson, Ph.D., another nonexamining DDS physician, affirmed Dr. Tin's assessment. (Id. at 1302-04).
On May 3, Plaintiff went to the Central DuPage Hospital emergency room complaining of nausea, vomiting and diarrhea and being unable to keep her seizure medicine down. (R. at 1192-93). She denied current alcohol intake but acknowledged occasional binge drinking. (Id. at 1193). She later admitted that she had been drinking the day before after a blood test indicated a serum ethanol level of 68 mg/dl.
Plaintiff was admitted to Central DuPage Hospital on May 5, 2010, after she attempted suicide by overdosing on alcohol and trazodone. (R. at 1203-05). Her serum ethanol level on admission was 345 mg/dl, which is equivalent to a BAC of 0.35.
Nadeem Hussain, M.D., conducted a psychiatric examination. (R. at 1204-05). He assessed multiple stressors related to loss of function from a chronic seizure disorder and social stressors including the death of her mother, estrangement from her family, divorce, job loss, all of which caused her to become depressed and suicidal. (Id. at 1205). Dr. Hussain diagnosed major depressive disorder, with possible PTSD, and assigned a Global Assessment of Functioning (GAF) score of 30.
On June 1, Plaintiff attempted suicide after drinking heavily and taking a handful of Lunesta tablets. (R. at 1243). Her serum ethanol level on admission was 406 mg/dl, which is equivalent to a BAC of 0.41. (Id. at 1245). Andrew Korcek, M.D., assessed her with an altered mental status associated with drug and alcohol abuse and recommended a psychiatric evaluation. (Id.). Upon discharge on June 8, Dr. diagnosed Plaintiff with alcohol dependence and major depressive disorder, with possible PTSD, and assigned a GAF score of 35.
On July 12, Plaintiff voluntarily admitted herself to Central DuPage Hospital for a psychiatric evaluation after expressing suicidal ideations. (R. at 1284). The attending physician diagnosed psychotic suicidal ideation, history of suicidal ideation, clinical alcohol ingestion, and alcohol intoxication. (Id. at 1285).
On February 9, 2012, Helga Sommer-Perry, a Mental Health Professional (MHP), completed a mental health assessment. (R. at 1486-97). Plaintiff reported intermittent crying spells, insomnia, anorexia, obsessive behavior, recurring seizures, and lack of self-care. (Id. at 1486). Current psychosocial stressors include mother's death, family conflicts, financial challenges, homelessness, illness, medicine noncompliance, recent hospitalizations, substance abuse, and unemployment. (Id. at 1487). A mental status evaluation was largely unremarkable. (Id. at 1493-94). The MHP diagnosed major depressive disorder, recurrent, severe without psychotic features and assigned a GAF score of 53.
Plaintiff was admitted to Central DuPage Hospital on July 30, 2013, after experiencing malaise and breakthrough seizure.
At the May 2014 hearing, Dr. Panek testified as a medical expert. (R. at 54-64). She reviewed the medical record and opined that Plaintiff's impairments include seizure disorder, cervical spine degenerative arthritis, arthralgias, history of left ankle fracture, and history of coronary artery disease. (Id. at 55, 57-58). Dr. Panek concluded that Plaintiff's physical impairments do not meet or equal any of the listings, including listings 1.02, 1.04, 4.0, 11.02 or 11.03. (Id. at 58-59). She opined that Plaintiff is capable of lifting 20 pounds occasionally and 10 pounds frequently, can stand or walk six hours in an eight-hour workday, and requires a pedal for her left foot. (Id. at 60-61). Upon questioning by Plaintiff's attorney, Dr. Panek explained that she gave a light rather than a sedentary RFC because of examinations that found a nonantalgic gait, normal sensory response, and normal neurological results. (Id. at 62-63).
Dr. Biscardi also testified at the hearing as a medical expert. (R. at 64-70). He reviewed the medical record and noted that since 2012, Plaintiff has been drug- and alcohol-free since and her mental status exams have been grossly normal. (Id. at 64, 67-68). He opined that Plaintiff retains the mental capacity to understand, remember, and carry out one- to three-step tasks, interact occasionally with coworkers and supervisors, and adapt to stressors and changes in this type of workplace. (Id. at 67). He concluded that Plaintiff's moderate limitations in concentration, persistence, and pace would require her to be limited to simple, routine competitive work. (Id. at 69). Finally, Dr. Biscardi opined that as of the time of the hearing, alcohol dependence would not be a contributing factor material to Plaintiff's disability. (Id. at 82).
In support for her request for reversal, Plaintiff argues that the ALJ's step three and RFC determinations were erroneous. (Dkt. 17 at 1, 6-15).
A person who is otherwise disabled cannot receive SSI or DIB benefits if alcoholism or drug addiction is a "contributing factor material to the Commissioner's determination that the individual is disabled." 42 U.S.C. § 423(d)(2)(C). Thus, "[w]hen an applicant for disability benefits both has a potentially disabling illness and is a substance abuser, the issue for the administrative law judge is whether, were the applicant not a substance abuser, she would still be disabled." Kangail v. Barnhart, 454 F.3d 627, 628 (7th Cir. 2006); see 20 C.F.R. § 404.1535(b)(1) ("The key factor we will examine in determining whether drug addiction or alcoholism is a contributing factor material to the determination of disability is whether we would still find you disabled if you stopped using drugs or alcohol."). If the ALJ finds that the claimant would still be disabled if she stopped using drugs or alcohol, "she is deemed disabled `independent of [her] drug addiction or alcoholism' and is therefore entitled to benefits." Kangail, 454 F.3d at 629 (quoting 20 C.F.R. § 404.1535(b)(2)(ii)).
Plaintiff erroneously contends that the ALJ "committed legal error by proceeding to the ultimate conclusion [that Plaintiff's alcoholism was a contributing factor material to the determination of disability] without first finding the plaintiff was disabled, based upon an assessment of all the medical evidence and all of the impairments in combination." (Dkt. 17 at 7-8). When evaluating a claimant whose medical evidence includes drug addiction or alcoholism, the ALJ first determines the claimant's abilities when she is not sober. 20 C.F.R. § 1535(a). Consistent with the regulations, the ALJ first evaluated Plaintiff's condition with her alcoholism included. (R. at 24-25). He considered her history of hospitalizations related to her substance abuse, seizure disorder, and depression and concluded that Plaintiff's impairments, including her alcoholism, meet listing 12.09. (Id.). Thus, the ALJ properly determined that when considering all of Plaintiff's impairments, including her alcoholism, she was disabled. Zalewski, 760 F.2d at 162 n.2 (an affirmative answer at step three means that a claimant is disabled).
Plaintiff asserts that the ALJ's conclusion that she was not disabled if she stopped abusing alcohol was "not the result of an assessment of the record but a common sense generalization." (Dkt. 17 at 8). Plaintiff argues that the ALJ's determination was "based on the perception that anyone under the influence of alcohol is generally unable to function normally until he or she `sobers up.'" (Id.). Specifically, she contends that the ALJ failed to fully account for her depressive disorder and seizures. (Id. at 8-9).
Plaintiff questions the ALJ's finding that absent substance abuse, she has only mild limitations in activities of daily living, moderate limitations in social functioning, and moderate limitations in maintaining concentration, persistence or pace, arguing that the ALJ failed to support his determination with substantial evidence. (Dkt. 17 at 13; see R. at 26-27). To the contrary, the ALJ supported his findings with record evidence, noting for example that Plaintiff bikes, volunteers at the PADS organization, rides the bus, attends AA meetings, reads, sews, does crossword puzzles, cooks, drives, and does laundry. (R. at 26-27; see id. at 864, 865, 1203, 1595). The consultative examiner noted that Plaintiff's socialization skills are unproblematic and opined that Plaintiff has adequate memory and concentration. (Id. at 26-27; see id. at 864-65). A psychiatric evaluation in March 2010 found that Plaintiff's mental status was within normal limits; she had good short-term memory and good concentration skills. (Id. at 29; see id. at 1081-82). The ME reviewed the medical record and after factoring in Plaintiff's depression opined that since Plaintiff became sober in 2012, she has a mild limitation in activities of daily living, a moderate limitation in social functioning, and a moderate limitation in concentration, persistence, or pace with no episodes of decompensation. (Id. at 29; see id. at 67-69).
Plaintiff contends that the ALJ failed to take into consideration that not all of her hospitalizations for seizures were alcohol related. (Dkt. 17 at 9-12). But the ALJ correctly noted that Plaintiff's denials of alcohol abuse were contradicted by the record. For example, in May 2010, she presented to the emergency room complaining of nausea, vomiting, and diarrhea and being unable to keep her seizure medicine down. (R. at 1192-93). She denied current alcohol use but later admitted that she had been drinking the day before after a blood test revealed a BAC of 0.07. (Id. at 1193-94). And in April 2012, as the ALJ noted, Plaintiff's physician concluded that Plaintiff's reports of alcohol use were not credible:
(Id. at 30) (quoting id. at 1511). As one of Plaintiff's doctors admonished her, alcohol not only lowers the seizure threshold but also that heavy drinking can trigger an alcohol-withdrawal seizure. (Id. at 1023). Thus, the ALJ concluded that in Plaintiff's case, "[a]lcohol is shown to exacerbate seizures and/or reduce the efficacy of seizure medications." (R. at 25).
Plaintiff argues that while alcohol abuse was present, it was not "the only precipitant of Plaintiff's seizures, and hospital admissions therefor." (Id. at 12) (emphasis in original). But the ALJ acknowledged that other issues were present besides alcohol use. Indeed, the ALJ reported that Plaintiff's hospitalizations for treatment of seizure disorder reflected not only the presence of heavy alcohol abuse but included other diagnoses. (R. at 24-25, 29) (noting the presence of not only alcohol use but also psychosis, depression, anxiety, suicidal ideation, medicine noncompliance, and PTSD). And the ALJ concluded that even in the absence of substance abuse, Plaintiff has other severe impairments, including seizure disorder, degenerative cervical spine arthritis, arthralgias, and depression. (Id. at 24).
The ALJ also noted multiple occasions where Plaintiff's seizures were exacerbated by medication noncompliance. (R. at 25, 29, 30) (citing id. at 962, 977, 1708; see also id. at 1067). Plaintiff argues that during her October 2009 hospitalization, her physician was not able to determine whether alcohol induced her seizure. (Dkt. 17 at 11). But she failed to note, as the ALJ observed, that her physician also concluded that "she is noncompliant with her medications, as her Dilantin level shows a very low level as well as the Depakote." (Id. at 939, see id. at 25). And while Plaintiff had a breakthrough seizure in July 2013, after she became sober, her physician concluded that she may have missed some anticonvulsant dosing.
Plaintiff contends that the ALJ failed to take her left ankle fracture, back pain, and obesity into effect when determining her RFC. (Dkt. 17 at 13-15). "The RFC is an assessment of what work-related activities the claimant can perform despite her limitations." Young, 362 F.3d at 1000; see 20 C.F.R. § 404.1545(a)(1) ("Your residual functional capacity is the most you can still do despite your limitations."); Social Security Ruling (SSR) 96-8p, at *2 ("RFC is an administrative assessment of the extent to which an individual's medically determinable impairment(s), including any related symptoms, such as pain, may cause physical or mental limitations or restrictions that may affect his or her capacity to do work-related physical and mental activities.").
After carefully examining the record, the Court finds that the ALJ's determination of Plaintiff's RFC was thorough, thoughtful, and fully grounded in the medical evidence. Reviewing the ALJ's decision "as a whole in order to give it the most sensible reading," Carter v. Colvin, No. 12 CV 745, 2014 WL 4825272, at *4 n.1 (S.D. Ill. Sept. 29, 2014), the ALJ appropriately considered the combined impact of Plaintiff's severe and nonsevere impairments, see Rice v. Barnhart, 384 F.3d 363, 369 (7th Cir. 2004) ("we will nonetheless give the opinion a commonsensical reading rather than nitpicking at it") (citation omitted).
The ALJ acknowledged her left ankle fracture history, including tenderness, pain, and limited range of motion. (R. at 26, 28-29). The ME reviewed the medical record and opined that Plaintiff is capable of light work and requires a pedal for her left foot. (Id. at 60-61). The ALJ adopted the ME's testimony, restricting Plaintiff to light work with only occasional operation of foot controls with her left foot. (Id. at 27). And even if Plaintiff was limited to sedentary work with the same nonexertional limitations, the VE testified there are jobs that exist in significant numbers in the national economy that Plaintiff can perform. (Id. at 32, 74-75).
As to Plaintiff's complaints of back pain, the ALJ noted that her consultative examination was unremarkable. (R. at 28-29; see id. at 859). Plaintiff had full range of motion without difficulty, no ankle or leg edema, full power and strength, and normal gait and ambulation. (Id. at 1066-67). Plaintiff does not identify any medical evidence to the contrary.
Finally, Plaintiff contends that the ALJ failed to take into account the impact of her obesity on her ability to sustain full-time work. (Dkt. 17 at 14-15). The ALJ noted Plaintiff's height and weight and the ME's testimony that Plaintiff is mildly obese. (R. at 26, 60). The ALJ considered the entire, longitudinal record, which included Plaintiff's mild obesity, when determining her RFC. (Id. at 26-31); see Sienkiewicz v. Barnhart, 409 F.3d 798, 802-03 (7th Cir. 2005) (ALJ found claimant was obese and nothing suggests that he then disregarded that finding when evaluating her RFC).
Plaintiff appears to confuse conditions with disabilities. "A person can be depressed, anxious, and obese yet still perform full-time work." Gentle v. Barnhart, 430 F.3d 865, 868 (7th Cir. 2005). As the Seventh Circuit explained:
Id. (citation omitted) (emphasis in original). Plaintiff fails to demonstrate how her mild obesity combined with her other impairments impacts her ability to work. Hisle v. Astrue, 258 F. App'x 33, 37 (7th Cir. 2007) (claimant bears the burden to "articulate how her obesity limits her functioning and exacerbates her impairments"); Prochaska v. Barnhart, 454 F.3d 731, 737 (7th Cir. 2006) (claimant must "specify how his obesity further impaired his ability to work") (citation omitted); see also Skarbek v. Barnhart, 390 F.3d 500, 504 (7th Cir. 2004) ("Skarbek does not explain how his obesity would have affected the ALJ's five-step analysis.").
For the reasons stated above, Plaintiff's Motion for Summary Judgment [16] is
