69 F.4th 428
7th Cir.2023Background
- Plaintiff Angel Combs applied for Disability Insurance Benefits alleging long‑term back pain (lumbar spondylosis), diabetes with neuropathy, migraines, and several mental‑health diagnoses; claim covered alleged onset through last insured date of December 31, 2020.
- From June 2019 to July 2020 she underwent multiple spine procedures: four medial branch blocks (June 2019, July 2019, Dec. 2019, Mar. 2020) and two radiofrequency ablations (Nov. 2019, July 2020). Procedures were brief (≈10–20 minutes) and contemporaneous records reported variable short‑term relief.
- Clinic exams during the period repeatedly documented normal range of motion, normal strength and gait, negative straight‑leg tests at times, and no narcotic prescriptions.
- ALJ found multiple severe impairments but concluded Combs retained the RFC for light work with specific physical and limited social/cognitive restrictions and therefore was not disabled through the date last insured.
- Combs argued the ALJ should have found a closed period of disability (she emphasized June 2019–July 2020), that the ALJ ignored some procedures, and that her absenteeism from procedures would exceed employer tolerances.
- District court affirmed; Seventh Circuit reviewed de novo and affirmed, holding the ALJ’s decision was supported by substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ should have found a closed period of disability (June 2019–July 2020) | Combs: multiple procedures and pain during this period show disabling condition for ≥12 months | Commissioner: record shows short procedures, intermittent relief, and largely normal exams—no evidence of disabling 12‑month continuous impairment | ALJ decision affirmed — substantial evidence does not support a closed period of disability |
| Whether ALJ ignored relevant evidence (did not discuss Dec. 2019 & Mar. 2020 blocks) | Combs: omission means the ALJ ignored an entire line of evidence supporting disability | Commissioner: ALJ discussed other branch blocks and ablations and the overall treatment pattern; not every entry must be discussed | Held — omission of two entries was not an ignoring of an entire line of evidence; ALJ adequately considered the record |
| Whether ALJ failed to consider absenteeism from procedures (would make her unemployable) | Combs: cumulative appointments/procedures would cause ≈14.5 days missed, exceeding employer tolerance | Commissioner: time estimates unsupported by record; procedures were short and contemporaneous evidence doesn’t show whole‑day absences | Held — Combs did not prove that procedures would produce employer‑disqualifying absenteeism |
| Whether ALJ should have been required to explicitly analyze a closed‑period theory | Combs: ALJ should have expressly addressed closed‑period claim | Commissioner: no objective indicators (surgeries, hospitalizations, worsening course) necessitated separate closed‑period analysis | Held — no remand needed; Reed and Jackson distinguished and record did not demand a separate closed‑period finding |
Key Cases Cited
- Butler v. Kijakazi, 4 F.4th 498 (7th Cir. 2021) (standard of appellate review of ALJ decisions).
- Biestek v. Berryhill, 139 S. Ct. 1148 (2019) (definition and application of substantial‑evidence standard).
- Simila v. Astrue, 573 F.3d 503 (7th Cir. 2009) (substantial evidence explained).
- Jones v. Astrue, 623 F.3d 1155 (7th Cir. 2010) (ALJ must not ignore an entire line of evidence supporting disability).
- Gedatus v. Saul, 994 F.3d 893 (7th Cir. 2021) (ALJ not required to mention every piece of evidence).
- Reed v. Colvin, [citation="656 F. App'x 781"] (7th Cir. 2016) (ALJ may rely on discussion of medical evidence to show closed‑period conclusion even if not separately labeled).
- Barnett v. Apfel, 231 F.3d 687 (10th Cir. 2000) (rejecting speculative full‑day absence assumptions for appointments).
- Bowen v. Yuckert, 482 U.S. 137 (1987) (burden of proving disability rests with claimant).