Case Name in Social Security Case - Unavailable

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF INDIANA
INDIANAPOLIS DIVISION
ADRIENNE S.,1 	)
)
Plaintiff, 	)
)
v. 	) 	No. 1:24-cv-01919-TWP-MJD
)
FRANK BISIGNANO, 	)
)
Defendant. 	)
REPORT AND RECOMMENDATION
Claimant Adrienne S. requests judicial review of the final decision of the Commissioner
of the Social Security Administration ("Commissioner") denying her application for Disability
Insurance Benefits ("DIB") under Title II of the Social Security Act. See 42 U.S.C. § 423(d).
For the reasons set forth below, the undersigned recommends the District Judge REVERSE the
decision of the Commissioner.
I. 	Background
Claimant applied for DIB in November 2021, alleging an onset of disability as of
December 31, 2018. [Dkt. 9-2 at 18.] Claimant's application was denied initially and again upon
reconsideration, and a hearing was held before Administrative Law Judge Kevin Walker ("ALJ")
on October 19, 2023. [Id. at 39-71.] On January 31, 2024, the ALJ determined that Claimant
1 In an effort to protect the privacy interests of claimants for Social Security benefits, the
Southern District of Indiana has adopted the recommendations put forth by the Court
Administration and Case Management Committee of the Administrative Office of the United
States Courts regarding the practice of using only the first name and last initial of any non-
government parties in Social Security opinions. The Undersigned has elected to implement that
practice in this Order.
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was not disabled, and the Appeals Council denied her request for review on August 27, 2024.
[Id. at 2-4, 18-30.] Claimant timely filed her Complaint on October 30, 2024, seeking judicial
review of the ALJ's decision. [Dkt. 1.]
II. 	Legal Standards
To be eligible for benefits, a claimant must have a disability pursuant to 42 U.S.C. § 423.
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 Commissioner, as represented by the
ALJ, employs a sequential, five-step analysis: (1) if the claimant is engaged in substantial gainful
activity, she is not disabled; (2) if the claimant does not have a "severe" impairment, one that
significantly limits her ability to perform basic work activities, she is not disabled; (3) if the
claimant's impairment or combination of impairments meets or medically equals any impairment
appearing in the Listing of Impairments, 20 C.F.R. pt. 404, subpart P, App. 1, the claimant is
disabled; (4) if the claimant is not found to be disabled at step three, and is able to perform her
past relevant work, she is not disabled; and (5) if the claimant is not found to be disabled at step
three, cannot perform her past relevant work, but can perform certain other available work, she is
not disabled. 20 C.F.R. § 404.1520. Before continuing to step four, the ALJ must assess the
claimant's residual functional capacity ("RFC") by "incorporat[ing] all of the claimant's
limitations supported by the medical record." Crump v. Saul, 932 F.3d 567, 570 (7th Cir. 2019)
(citing Varga v. Colvin, 794 F.3d 809, 813 (7th Cir. 2015)). If, at any step, the ALJ can make a
conclusive finding that the claimant either is or is not disabled, then he need not progress to the
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next step of the analysis. Young v. Barnhart, 362 F.3d 995, 1000 (7th Cir. 2004) (citing 20 CFR
§ 404.1520(a)(4)).
The Seventh Circuit recently set forth the proper standard of review in an appeal of the
denial of disability benefits as follows:
[W]e review the ALJ's decision deferentially, affirming if its conclusions are
supported by substantial evidence. 42 U.S.C. § 405(g); Deborah M. [v. Saul, 994
F.3d 785, 788 (7th Cir. 2021)]; Clifford v. Apfel, 227 F.3d 863, 873 (7th Cir. 2000)
(ALJ's 	residual 	functional 	capacity 	determination 	"must 	be 	supported 	by
substantial evidence in the record"). 	Substantial evidence is "such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion."
Biestek v. Berryhill, 587 U.S. 97, 103, 139 S.Ct. 1148, 203 L.Ed.2d 504 (2019),
quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83
L.Ed. 126 (1938). While we do not reweigh evidence, we conduct a critical review
because a decision "cannot stand if it lacks evidentiary support or an adequate
discussion of the issues." Lopez ex rel. Lopez v. Barnhart, 336 F.3d 535, 539 (7th
Cir. 2003). In addition, an ALJ must "build an accurate and logical bridge from
the evidence to [her] conclusion." Clifford, 227 F.3d at 872. That logical bridge
can assure a reviewing court that the ALJ considered the important evidence and
applied sound reasoning to it. See Hickman v. Apfel, 187 F.3d 683, 689 (7th Cir.
1999).
Moy v. Bisignano, 142 F.4th 546, 552 (7th Cir. 2025). This is the standard the Court will apply
in this case.
III. 	ALJ Decision
The ALJ first determined that Claimant had not engaged in substantial gainful activity since
the alleged onset date on December 31, 2018. [Dkt. 9-2 at 20.] At step two, the ALJ found that
Claimant had the following severe impairments: casiplagia fasciitis and plantar fasciitis in the feet,
left foot surgery, degenerative joint disease in the bilateral knees, knee replacement, migraines,
and obesity. 	[Id.] 	At step three, the ALJ found that these impairments did not meet or equal a
listed impairment during the relevant time period. [Id. at 23.] The ALJ then found that, during
the relevant time period, Claimant had the residual functional capacity to perform
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sedentary work as defined in 20 CFR 404.1567(a) except she can lift and carry ten
pounds occasionally and less than ten pounds frequently. 	She can perform
unlimited pushing and pulling, except for the weight limitations. The claimant can
stand or walk for up to two hours in an eight-hour workday and can sit for up to six
hours in an eight-hour workday. She can frequently balance (as defined in the
SCO); occasionally stoop, kneel, crouch, crawl, and climb ramps and stairs; and
never climb ladders, ropes, or scaffolds. The claimant can have no exposure to
unprotected heights or hazardous machinery. She must use a cane to ambulate.
[Id. at 23-24.]
At step four, the ALJ found that Claimant was able to perform her past relevant work
during the relevant time period. [Id. at 28.] Accordingly, the ALJ concluded that Claimant
was not disabled. [Id. at 29-30.]
IV. 	Discussion
Claimant raises the following issues for the Court's review: (1) whether the ALJ erred in
conducting the subjective symptom analysis; (2) whether the ALJ erred in assessing the
credibility of medical experts; and (3) whether the ALJ erred by failing to account for her
limitations in concentration, persistence, and pace. [Dkt. 11 at 1-2.] The Court finds that
Claimant has demonstrated reversible error on the first issue and thus needs not address her
arguments under the remaining issues.
When assessing a claimant's subjective symptoms, an ALJ will complete a two-step
process. First, the ALJ will "consider whether there is an underlying medically determinable
physical or mental impairment(s) that could reasonably be expected to produce an individual's
symptoms, such as pain." SSR 16-3p (S.S.A. Oct. 25, 2017), 2017 WL 5180304, at *3. 	Second,
"once an underlying physical or mental impairment(s) that could reasonably be expected to
produce an individual's symptoms is established," the ALJ will "evaluate the intensity and
persistence of those symptoms to determine the extent to which the symptoms limit an individual's
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ability to perform work-related activities." Id. The ALJ will not evaluate an individual's
symptoms based solely on objective medical evidence unless the objective medical evidence
supports a finding that the claimant is in fact disabled. Id. at *4-5. The ALJ will consider factors
including but not limited to the claimant's daily activities and the effectiveness of the claimant's
medication or treatment. Id. at *7-8. The court must afford the ALJ's determination special
deference, and it will only reverse if the ALJ's determination is patently wrong. Larson v.
Astrue, 615 F.3d 744, 751 (7th Cir. 2010); Engstrand v. Colvin, 788 F.3d 655, 660 (7th Cir.
2015).
Claimant described her symptoms in multiple documents and in testimony during an oral
hearing before the ALJ. Her disability report stated that she suffers from migraine headaches,
casiplagia and plantar fasciitis, bilateral knee issues, anxiety, and depression and that these
conditions caused her to stop working on December 31, 2018. [Dkt. 9-6 at 3.] Her headache
questionnaire stated that she experiences "at least 3-4" migraines a week, which typically last
about 2 to 4 hours, but which may last as long as 24 hours or more. [Id. at 13-14.] These
migraines are debilitating and require her "to lay down with an ice pack on forehead and on back
of neck with lights off, no talking[,] no TV[,] no nothing, and I do lay real still." [Id. at 14.]
Her function report dated February 2022 stated that her knee pain makes it impossible to climb
stairs, squat, bend, kneel, or lift more than 10 pounds, and her function report dated October
2022 stated that she cannot lift more than 5 pounds. [Id. at 21, 50.] She cannot walk further than
a block without needing to rest for about 15 minutes. [Id. at 21.] During the oral hearing before
the ALJ in October 2023, she testified that her pain on a typical day is 8/10. [Dkt. 9-2 at 51.]
She experiences constant swelling in her knees, feet, and ankles, which requires her to elevate
her legs for most of the day and "hinder[s] [her] from doing anything." [Id. at 63-64.] She also
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spends about half of each day laying down. [Id. at 66.] She takes about 26 or 27 different
medications, which cause drowsiness and make her feel like she "do[esn't] know if [she's]
coming or going." [Id. at 67.]
The ALJ determined that "claimant's medically determinable impairments could
reasonably be expected to cause the alleged symptoms; however, the claimant's statements
concerning the intensity, persistence, and limiting effects of these symptoms are not entirely
consistent with the medical evidence and other evidence in the record." [Id. at 24.] In
explaining his reasoning, the ALJ first summarized Claimant's medical records, which showed
that she underwent five surgeries to repair torn menisci in her left and right knees in July 2018,
January 2020, July 2020, January 2021, and September 2023. [Id. at 24-26.] She also underwent
two foot surgeries—a left plantar fasciotomy in August 2021; and a multi-part surgery involving
a left Evans calcaneal osteotomy, flexor digitorum long tendon transfer, and plantar fasciectomy
in October 2022. [Id. at 25-26.] In addition to prescription medication, her pain was treated with
knee injections, botox injections, occipital nerve blocks, the implantation of a spinal catheter and
pain pump, and an epidural blood patch. [Id.] The ALJ also noted that she "participated in a
considerable amount of physical therapy on multiple occasions," that "multiple MRIs of the
knees showed objective abnormalities, including meniscus tears, consistent with [her] subjective
reports of knee pain[,]" and that "[e]xaminers observed that [she] used a cane and had an
unsteady or antalgic gait on multiple occasions[.]" [Id. at 26.] However, he made two findings
that caused him to discredit her claims about the intensity, persistence, and limiting effects of her
conditions. First, "examiners . . . observed that [she] nonetheless was able to ambulate, and even
that [she] retained a normal gait on multiple occasions." [Id. at 27.] Second, "she reported that
[Botox injections] [were] effective" at treating her migraines. [Id. at 26.] Because of these
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findings, the ALJ determined that Claimant's symptoms were not as intense, persistent, or
limiting as she claimed and that she was capable of performing sedentary work. [Id. at 26.]
The Court finds that the ALJ erred in conducting the subjective symptom analysis by
overstating claimant's reports about the effectiveness of botox injections as a treatment for
chronic migraines. In considering the effectiveness of a claimant's medical treatment, "[t]he key
is not whether one has improved (although that is important), but whether they have improved
enough to meet the legal criteria of not being classified as disabled." Murphy v. Colvin, 759 F.3d
811, 819 (7th Cir. 2014); see also Jarnutowski, 48 F.4th 769, 775 (7th Cir. 2022) (improvement
in pain after surgery did not support ALJ's assessment of claimant's RFC). Here, Claimant's
medical records support a finding that her migraines improved with Botox injections, but they
also show that she continued to experience frequent migraines that required regular neurology
visits, injections, and medication. [See, e.g., dkt. 9-9 at 514, 515, 604; dkt. 9-12 at 27, 53, 77,
104, 134, 166.] Despite this evidence, the ALJ assessed an RFC that does not account for any
limitations arising from Claimant's migraines. [Dkt. 9-2 at 23-24.] Thus, the ALJ appears to
have found that Claimant's migraines were so infrequent, non-severe, and non-limiting that they
had no impact on her ability to engage in full-time work. See Deborah M. v. Saul, 994 F.3d 785,
791 (7th Cir. 2021) (the ALJ must "include all of a claimant's limitations supported by the
medical record" in the RFC and in the hypotheticals posed to the VE). Such a finding is simply
not supported by Claimant's medical records, and the ALJ erred in concluding otherwise.2
2 The ALJ's only consideration of the impact that Claimant's chronic migraines could have on her
ability to work appears in his third hypothetical to the VE: "And then if we added to either of
those first two hypotheticals that the individual would be off task 15% of the duty day and have
unscheduled absences of two days a month, would there be any competitive employment for that
individual?" [Dkt. 9-2 at 69.] The VE answered, "No, that would be work preclusive." [Id.]
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The ALJ also erred by relying on medical records showing that Claimant "was able to
ambulate" and "retained a normal gait on multiple occasions" to discredit her claims about the
severity and limiting effects of her knee and foot pain. [Dkt. 9-2 at 27.] First, Claimant never
alleged that she was unable to ambulate. Instead, she alleged that her ability to walk was
significantly limited; that she needed to rest for 15 minutes after walking one block; that she
needed to keep her legs elevated for most of the day to reduce swelling; that she could not climb
stairs, squat, bend, or kneel; and that she could not lift more than five pounds. [Dkt. 9-2 at 63-
64, 66; dkt. 9-6 at 21, 50.] These allegations are not contradicted by the fact that she "was able
to ambulate" during medical exams. Second, Claimant's medical records are replete with notes
that she had an abnormal gait, [see, e.g., dkt. 9-7 at 275, 278, 287, 290, 293, 296, 299; dkt. 9-8 at
20, 24, 25, 172, 190, 198; dkt. 9-9 at 328, 339, 371; dkt. 9-10 at 33, 72, 75, 79, 87, 179, 327, 368;
dkt. 9-12 at 206, 211; dkt. 9-13 at 50, 312, 314], and her need for five knee surgeries, two foot
surgeries, considerable physical therapy, medications, and a surgically implanted spinal catheter
and pain pump all indicate that she was experiencing severe and limiting chronic pain during the
period of alleged disability. Further, occasional exam findings stating that Claimant had a
normal gait do not contradict other alleged limitations, such as her professed inability to squat,
bend, kneel, or lift more than five pounds.
Given these circumstances, the Court finds that the ALJ committed reversible error in
conducting Claimant's subjective symptom analysis and that his decision should be reversed and
remanded to the SSA for further proceedings.
Ultimately, the ALJ did not incorporate any time-off-task limitations or unscheduled absences
into Claimant's RFC, nor did he incorporate any other limitations arising from her chronic
migraines. [Id. at 24-25.]
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V. 	Conclusion
For the reasons described above, the Magistrate Judge recommends that the District
Judge REVERSE and REMAND the Commissioner's decision that Claimant was not disabled.
Any objections to this Report and Recommendation must be filed in accordance with 28 U.S.C. §
636(b)(1) and Fed. R. Civ. P 72(b). The failure to file objections within 14 days of this Order
will constitute a waiver of subsequent review absent a showing of good cause for that failure.
SO ORDERED.
Dated: 10 NOV 2025
Distribution:
Service will be made electronically on
all ECF-registered counsel of record via
email generated by the Court's ECF system.
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