53 F.4th 1089
7th Cir.2022Background
- Iris J. Durham applied for Social Security disability benefits in Sept. 2017, alleging diabetes, hypertension, neuropathy (foot pain/tingling), and cardiac arrhythmias (premature ventricular contractions/tachycardia).
- Medical records show Holter monitoring in March 2017 with PVCs/tachycardia (~30% of beats), cardiology follow-up, ER visits in Sept. 2017 and April 2019 for palpitations and exertional shortness of breath, and treatment with beta-blockers (metoprolol, later sotalol).
- Cardiology testing in 2019 (EKG, stress test, cardiac catheterization) was interpreted by treating cardiologists as showing no acute cardiac instability, normal catheterization results, and no imposed functional restrictions.
- The ALJ found severe impairments (diabetes, hypertension, nonsustained V‑tach, obesity), assessed a reduced sedentary RFC with limits (avoid extreme heat/humidity, no ladders/unsafe elevations, avoid dangerous machinery), and—relying on treatment records and agency consultants—concluded Durham was not disabled.
- The Appeals Council denied review; the district court affirmed; Durham appealed to the Seventh Circuit arguing the ALJ relied on stale consultative opinions, impermissibly "played doctor" by interpreting tests, and omitted a time‑off‑task limitation for her spells.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the ALJ impermissibly relied on outdated agency consultative opinions / "played doctor" by interpreting complex tests | Durham: consulting physicians didn’t account for her tachycardia and April 2019 hospitalization; ALJ should have obtained a new medical expert before assessing the newer tests | Commissioner: ALJ relied primarily on treatment records and treating cardiologists who interpreted the tests; consultative opinions were only "somewhat persuasive" and not dispositive | Court: Affirmed. ALJ did not "play doctor"; treating cardiologists interpreted the tests and showed no worsening that required a new consultative opinion |
| Whether the ALJ erred by omitting a time‑off‑task limitation for ventricular tachycardia "spells" | Durham: spells are frequent and require time off or ability to prop feet up, so RFC/hypothetical should include time‑off‑task | Commissioner: No medical evidence supports a time‑off‑task limitation; ALJ accommodated spells by limiting exertion, heat exposure, unsafe elevations, and dangerous machinery | Court: Affirmed. No medical support for off‑task limitation; ALJ’s hypothetical adequately accounted for limitations supported by the record |
Key Cases Cited
- Biestek v. Berryhill, 139 S. Ct. 1148 (explaining the low substantial‑evidence threshold in disability cases)
- McHenry v. Berryhill, 911 F.3d 866 (ALJ may not independently interpret complex medical tests without medical input)
- Goins v. Colvin, 764 F.3d 677 (ALJ cannot "play doctor" by interpreting new medical evidence)
- Akin v. Berryhill, 887 F.3d 314 (ALJ erred by assessing MRI without expert interpretation)
- Pavlicek v. Saul, 994 F.3d 777 (emergency‑room evidence similar to earlier records does not always require a new consultative opinion)
- Deborah M. v. Saul, 994 F.3d 785 (ALJ must include all claimant limitations supported by the medical record in hypotheticals)
- Gedatus v. Saul, 994 F.3d 893 (claimant bears the burden to produce medical evidence establishing disability)