SSI denied where applicant did not follow-up with care and failed to prove disability

Walter alleged that he had bipolar disorder, depression, bulging discs, and chronic obstructive pulmonary disease and that he had been disabled sine January 1, 2012. He applied for Supplemental Security Income (SSI) on May 4, 2018. He was denied eligibility by SSI and then by an Administrative Law Judge (ALJ) and that decision was affirmed by the acting Commissioner. Walter appealed to the District Court (N.D. Ill., Case No. 20 C 5304, June 7, 2022) seeking either reversal or remand of that decision.

Regarding findings of fact, the Court held that it must uphold (affirm) the Commissioner’s decision if it is supported by more than a scintilla of evidence, which the Court found.

The ALJ issued a decision on April 3, 2020 denying Walter’s application. The ALJ followed the five step process outlined in 20 C.F.R. § 416.920(a). At step one, the ALJ found that Walter had not engaged in substantial gainful activity since May 4, 2018. Id. at 24. At step two, the ALJ found that Walter had the severe impairments of bipolar disorder, depression, alcoholic neuropathy, lumbar degenerative disk disease, and chronic obstructive pulmonary disease. Id. At step three, the ALJ determined that Walter did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§ 416.920(d), 416.925, 416.926). Id.

The ALJ then concluded that Walter retained the residual functional capacity (“RFC”) to perform light work as defined in 20 C.F.R. § 416.967(b), with the following additional limitations: occasional climbing ramps, stairs, ropes, and scaffolds; occasional balancing, stooping, kneeling, crouching, and crawling; no ladders, concentrated exposure to weather, humidity, wetness, or dusts, odors, fumes, gasses, or other pulmonary irritants; simple routine tasks and simple work-related decisions; and no more than occasional interaction with coworkers, supervisors, and the public. As a result of the RFC finding, the ALJ determined at step four that Walter has no past relevant work. Id. at 29. However, at step 5 the ALJ found that Walter has the RFC to perform occupations such as sorter, packager, and inspector. Id. at 30. Because of this determination, the ALJ found that Walter was not disabled. Id. The Appeals Council denied Walter’s request for review on July 9, 2020, leaving the ALJ’s decision as the final decision of the Commissioner. Id. at 8-10; Prater v. Saul, 947 F.3d 479, 481 (7th Cir. 2020).

Disability is defined as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). To determine whether a claimant is disabled, the ALJ conducts a five-step inquiry: (1) whether the claimant is currently unemployed; (2) whether the claimant has a severe impairment; (3) whether the claimant’s impairment meets or equals any of the listings found in the regulations, see 20 C.F.R. § 404, Subpt. P, App. 1 (2004); (4) whether the claimant is unable to perform her former occupation; and (5) whether the claimant is unable to perform any other available work in light of her age, education, and work experience. 20 C.F.R. § 416.920(a)(4); Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000). These steps are to be performed sequentially. 20 C.F.R. § 416.920(a)(4). “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.” Clifford, 227 F.3d at 868 (quoting Zalewski v. Heckler, 760 F.2d 160, 162 n.2 (7th Cir. 1985)).

One of the issues with Walter’s objection to the prior order was that he had gaps in his treatment. An ALJ may consider infrequent treatment in support of an adverse credibility finding where the claimant does not have a good reason for the infrequency of treatment. See Primm v. Saul, 789 F. App’x 539, 545-46 (7th Cir. 2019); Craft v. Astrue, 539 F.3d 668, 679 (7th Cir. 2008). An ALJ is not required to ask a claimant about the failure to seek treatment, but the ALJ is required to consider possible reasons for the failure to seek treatment. Deborah M. v. Saul, 994 F.3d 785, 790 (7th Cir. 2021). In Walter’s case, there was no evidence in the record that Walter’s gap in treatment was because he did not have medical insurance or because he was unable to cover the cost of treatment. Regarding gaps in Walter’s treatment for mental illness, there were notes in the record supporting a conclusion that he was stable while managing his mental illness with medication. Likewise, the medical records reviewed by the ALJ allowed the conclusion that, while Walter had limitations regarding his ability to work, he had the ability to perform sedentary tasks. Since more than a scintilla of evidence existed supporting the ALJ’s decision, the case was affirmed.

Walter O. v. Kijakazi, 2022 U.S. Dist. LEXIS 101414 (Northern District of Illinois, Eastern Division, Case No. 20 C 5304, June 7, 2022)