JAMES D. PETERSON, District Judge.
Plaintiff Kathleen M. Nordlund seeks judicial review of a final decision of defendant Carolyn W. Colvin, Acting Commissioner of Social Security, finding her not disabled as defined in the Social Security Act. During oral argument, the court questioned the ALJ's handling of Nordlund's moderate limitations in concentration, persistence, or pace, and the court requested supplemental briefing on the issue.
At step three of the sequential evaluation, the ALJ determined that Nordlund experiences moderate difficulties in concentration, persistence, or pace. R. 31.
However, the ALJ did not explain how the RFC accounts for Nordlund's moderate limitations in concentration, persistence, or pace. The ALJ simply stated that "although she had ongoing issues that stemmed from her mental health impairments, the weight of the evidence did not suggest that she had additional limitations beyond those identified in the residual functional capacity statement." R. 37.
Nordlund's RFC likely does not fully account for her moderate limitations in concentration, persistence, or pace. Although the ALJ did not have to specifically include the terms "concentration, persistence, or pace" in the RFC, the phrasing must accommodate the claimant's CPP limitations. O'Connor-Spinner, 627 F.3d at 619. The Seventh Circuit has repeatedly rejected the notion that limiting a claimant to unskilled work, or simple, routine tasks, adequately accounts for moderate limitations in concentration, persistence, or pace. Yurt v. Colvin, 758 F.3d 850, 858-59 (7th Cir. 2014); see also Varga v. Colvin, 794 F.3d 809, 814 (7th Cir. 2015) ("[W]e have repeatedly rejected the notion that a hypothetical like the one here `confining the claimant to simple, routine tasks and limited interactions with others adequately captures temperamental deficiencies and limitations in concentration, persistence, and pace.'"). Additionally, "`[f]ew if any work place changes' with limited `interaction with coworkers or supervisors' deals largely with workplace adaptation, rather than concentration, pace, or persistence." Varga, 794 F.3d at 815.
Not only did the ALJ fail to explicitly account for Nordlund's moderate limitations in concentration, persistence, or pace, but the ALJ did not identify the cause of those moderate limitations or otherwise explain how the RFC is sufficient to account for Nordlund's mental limitations. Although the record indicates that Nordlund's moderate limitations in concentration, persistence, or pace are likely attributable to her schizoaffective disorder, the court has no way of knowing whether or how the ALJ's RFC accounted for Nordlund's limitations.
On remand, when determining Nordlund's RFC, the ALJ must fully account for Nordlund's moderate CPP limitations with specific references to the record. After including Nordlund's moderate CPP limitations in the RFC, the ALJ must be sure to incorporate those limitations in his hypothetical questions to the vocational expert. "As a general rule, both the hypothetical posed to the VE and the ALJ's RFC assessment must incorporate all of the claimant's limitations supported by the medical record." Yurt, 758 F.3d at 857.
The remaining issues that Nordlund raised would not, by themselves, warrant remand, although aspects of the ALJ's analysis could be improved. The ALJ's discussion of the medical opinion evidence seems conclusory viewed in isolation, but the analysis of the medical opinions makes sense in light of the particularly thorough discussion of the medical evidence in the record. Nevertheless, on remand, the ALJ should expressly identify any evidence in the record that is inconsistent with the medical opinions if the ALJ withholds controlling weight. In assigning whatever weight is appropriate, the ALJ should expressly identify and apply the pertinent regulatory factors, as required under 20 C.F.R. § 404.1527. See Clifford v. Apfel, 227 F.3d 863, 870 (7th Cir. 2000), as amended (Dec. 13, 2000) (citing 20 C.F.R. § 404.1527(d)(2)).
The court also recommends that the ALJ reconsider an aspect of his credibility determination. The ALJ discounted Nordlund's testimony largely because she received "conservative treatment." R. 37. However, not only did Nordlund undergo surgery when she had exhausted more conservative treatment options, but the mere fact that Nordlund treated her mental impairments with medication does not, without further explanation, necessarily undermine Nordlund's credibility. On remand, if the ALJ cites conservative treatment as a basis for discounting Nordlund's credibility, the ALJ should show the logical bridge from the evidence to his conclusion.
IT IS ORDERED that the decision of defendant Carolyn W. Colvin, Acting Commissioner of Social Security, denying plaintiff Kathleen M. Nordlund's application for disability benefits is REVERSED AND REMANDED under sentence four of 42 U.S.C. § 405(g) for further proceedings consistent with this opinion.
The clerk of court is directed to enter judgment for plaintiff and close this case.