Court: Court of Appeals for the Seventh Circuit; October 27, 2004; Federal Appellate Court
Sandra Collins applied for social security disability insurance benefits in 2000, citing disabilities from scleroderma and Raynaud’s phenomenon. Her claim was initially denied, as well as upon reconsideration and after a hearing by an administrative law judge (ALJ). The Appeals Council declined to review, making the ALJ’s decision final. Collins subsequently appealed to the district court, which affirmed the ALJ's ruling. She argues that the ALJ misinterpreted her medical condition, leading to erroneous conclusions regarding the opinions of her treating physicians, her credibility, and her Residual Functional Capacity (RFC).
Collins suffers from diffuse scleroderma, characterized by skin thickening and hardening, and Raynaud’s phenomenon, which causes digital artery spasms leading to pain and color changes in the fingers. Although Collins first reported Raynaud’s symptoms in the mid-1980s, she did not find the condition bothersome until late 1992, shortly before her scleroderma diagnosis. She claims her combined conditions rendered her disabled as of March 13, 1993, when she left her part-time waitress job. Her insured status under Title II of the Social Security Act ended on September 30, 1995, requiring proof of disability by that date.
The record first noted Raynaud’s phenomenon in 1992 by Dr. Warren Brauer, one of Collins’ treating physicians, though his observations lacked supporting medical tests. Dr. Dale Buegel, who had been Collins' physician since 1989, referred her to Dr. Sanford Baim, a rheumatologist, in 1993. Dr. Baim diagnosed Collins with scleroderma and Raynaud’s phenomenon in April 1993 after clinical evaluations and laboratory tests revealing positive ANA and rheumatoid factor results. Further testing indicated only slight mitral valve regurgitation. Additional assessments in July 1993 measured her grip strength at sixty-five pounds and her pinch strength between nineteen and twenty pounds. Dr. Buegel and other doctors continued to report symptoms consistent with scleroderma and Raynaud’s phenomenon. In August 1993, Dr. Buegel noted swelling in Collins' hands, while in February 1994, he observed purple and swollen fingers. Later, Dr. Siefert from the Marsho Clinic noted tenderness in Collins’ forearm and purplish discoloration of her fingers, with symptoms exacerbated by cold conditions.
Collins rejected Dr. Siefert's prescribed Nifedipine treatment in favor of homeopathic remedies. In April 1995, she visited Dr. Buegel, reporting chest discomfort and breathing issues, though he observed her shoveling snow. At a 2002 hearing, Collins claimed her health had deteriorated since her last job in 1993, citing symptoms like finger ulcerations, reduced mobility, fatigue from decreased lung capacity, and muscle spasms. She provided letters from Drs. Brauer and Buegel indicating her inability to work since 1993.
Following the five-step disability analysis outlined in 20 C.F.R. 404.1505 and 404.1520, the ALJ ruled Collins was not disabled. The ALJ found she hadn’t worked since 1993, had Raynaud’s phenomenon and mild scleroderma until September 1995, and her impairments did not meet any listings in 20 C.F.R. pt. 404, subpt. P. app. 1. The ALJ discredited Collins’ claims of severe pain, citing exaggeration and identified her limitations as mainly due to cold and vibration exposure, noting her past relevant work as an accounts payable clerk and similar roles did not involve these limitations.
The decision of the ALJ can be upheld if the correct legal standard was applied and supported by substantial evidence, which is defined as evidence a reasonable mind would accept as adequate to support a conclusion. Collins argued for disability benefits based on her treating physicians' assessments, claiming their opinions were consistent and should have been given controlling weight. However, treating physician opinions are granted controlling weight only if well-supported and consistent with the overall evidence. The ALJ's determination to not accord controlling weight to her doctors' opinions was supported by substantial evidence, including inconsistencies in Dr. Brauer’s opinion compared to treatment notes from the relevant period.
Collins had references to Raynaud’s phenomenon and scleroderma in treatment notes prior to 1995, but these were made in the context of cold and flu-like symptoms and did not indicate exertional limitations that would support a conclusion of complete disability as assessed by Dr. Brauer in 2001. Dr. Buegel's assertion that Collins "has been unable to work since 1993" was given less weight by the ALJ due to inconsistencies with treatment records, which documented only minor scleroderma-related complications before September 1995. The ALJ accurately noted the absence of exertional limitations in Collins’ medical records and appropriately relied on the opinion of a nonexamining source from Wisconsin DDS.
Collins contends that the ALJ's credibility determination was flawed for not adhering to Social Security Ruling 96-7p, which requires consideration of medical evidence and physician statements. She argues that the ALJ selectively referenced inconsistencies between her daily activities and her claims of inability to work. Although ALJ credibility determinations are given significant deference, they must be sufficiently detailed for meaningful appellate review and not "patently wrong." The ALJ's review of medical evidence and Collins’ testimony led him to determine that her claims of limitations were not credible, supported by inconsistencies in her descriptions of activities related to work with horses and household tasks.
While scleroderma and Raynaud’s phenomenon can cause pain and limitations, the presence of these conditions does not automatically equate to functional disability during the relevant period. The ALJ's findings regarding household and equine tasks were consistent with the record, affirming the credibility determination. Collins also contends that the ALJ failed to comply with Social Security Ruling 96-8p, which requires a function-by-function analysis of her Residual Function Capacity (RFC). She argues that her RFC did not reflect the exertional and manipulation limitations she described, including fatigue and difficulties with typical clerical tasks.
Collins contends that if certain limitations had been included in the Residual Functional Capacity (RFC), the Administrative Law Judge (ALJ) would have concluded she could not return to her prior work as a clerk. The burden is on Collins to demonstrate her inability to perform past relevant work, as established in Bowen v. Yuckert. Although an ALJ cannot disregard evidence contradicting her findings, it is sufficient for her to provide a minimal level of analysis regarding the evidence. The ALJ fulfilled this requirement under Social Security Ruling 96-8p by detailing limitations caused by exposure to cold and vibration related to Collins' medical conditions, her post-employment activities, and her past work requirements. The ALJ determined that Collins' conditions did not impose exertional limitations as of September 1995, allowing her to return to her previous work. Although there is ambiguity regarding whether the ALJ needed to acknowledge the light exertional nature of Collins' past jobs without referencing a vocational manual, the RFC did not restrict her to light exertional work, only prohibiting exposure to cold and vibration. Ultimately, the ALJ's assessment of Collins' functional limitations adequately supported the conclusion that she could perform her past jobs as described. The decision is affirmed, with substantial evidence backing the ALJ's determination.
