Cole v. Colvin, 2016 U.S. App. LEXIS 13559

Background

Cole, a 41-year-old former welder/foreman, sustained serious elbow and wrist injuries (2000 and 2008) with persistent pain after multiple surgeries and therapies, plus gastrointestinal issues and enlarged lymph nodes.
Multiple medical opinions conflicted: some consultants (Gadiraju, Barbour, Martin, Roth) found severe functional limits or disability; other reviewers (D.-Neal, Coats, Kashyap) found fewer limitations or essentially normal exam findings.
Psychologists diagnosed depressive disorder with a GAF of 58. A vocational expert retained by Cole said he could not perform any work; the SSA vocational expert identified several light, unskilled jobs.
At hearing Cole reported severe, constant pain limiting use of his arms, difficulty sitting, and limited sleep; he had previously received unemployment benefits and then applied for SSDI when those ran out.
The ALJ denied benefits, discounting Cole’s statements (noting timing of application with end of unemployment benefits and a treatment gap from 2009–2011) and giving little weight to treating/consulting opinions such as Barbour’s.
The Seventh Circuit reversed, finding the ALJ’s reasons for discounting Cole’s symptom statements and medical opinions were legally inadequate and amounted to improper cherry-picking and speculation about motives.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether ALJ properly evaluated symptom evidence/credibility	Cole argued ALJ failed to properly evaluate intensity and persistence of symptoms and improperly inferred malingering from timing of claim and treatment gap	SSA defended ALJ’s inferences that timing and lack of treatment undercut credibility	Reversed — ALJ’s timing/treatment-gap reasoning was speculative and required further inquiry; symptom statements cannot be disregarded solely for lack of objective evidence
Whether ALJ properly weighed treating/consulting medical opinions (Barbour, Roth)	Cole argued ALJ improperly rejected Barbour and other clinicians whose exams supported severe limitations	SSA relied on other examiners (Coats, Kashyap) and internal inconsistencies to discount Barbour	Reversed — ALJ cherry-picked favorable records and failed to give reasoned explanation for discounting Barbour and related opinions
Whether ALJ permissibly relied on gaps in treatment as negative evidence	Cole argued lack of treatment was explained by lack of insurance and prior physician’s view that further treatment would not help	SSA treated gap as evidence against disability	Reversed — ALJ should have asked about or considered reasons (e.g., lack of insurance) for treatment gaps before using them to discredit claims
Whether vocational findings supported denial despite medical conflicts	Cole argued record and his expert showed inability to perform work; SSA relied on vocational testimony assuming lesser limitations	SSA argued VE jobs were available given ALJ’s RFC findings	Remanded — ALJ’s RFC and credibility findings were flawed; vocational conclusions could not stand without a proper RFC/medical assessment

Key Cases Cited

Sarchet v. Chater, 78 F.3d 305 (7th Cir. 1996) (applicants often delay applying for benefits until other support ends)
Voigt v. Colvin, 781 F.3d 871 (7th Cir. 2015) (DSM-5 abandoned reliance on GAF scores)
Hill v. Colvin, 807 F.3d 862 (7th Cir. 2015) (good work record supports claimant's credibility)
Garcia v. Colvin, 741 F.3d 758 (7th Cir. 2013) (ALJ should inquire about gaps in treatment before drawing adverse inferences)
Hall v. Colvin, 778 F.3d 688 (7th Cir. 2015) (symptom statements cannot be disregarded solely for lack of objective medical corroboration)
Price v. Colvin, 794 F.3d 836 (7th Cir. 2015) (ALJ may not cherry-pick medical evidence)
Yurt v. Colvin, 758 F.3d 850 (7th Cir. 2014) (rejecting selective reliance on parts of medical record)
Bates v. Colvin, 736 F.3d 1093 (7th Cir. 2013) (opinions must be weighed consistently and with reasons)