894 F.3d 870
7th Cir.2018Background
- In 2000 Kaminski suffered a traumatic brain injury and later developed a seizure disorder; he treated long-term with neurologist Dr. Richard Cristea and experienced multiple seizures (2007, 2008, 2013, 2014).
- Kaminski applied for disability insurance and SSI in 2013; Dr. Cristea submitted a 2013 RFC and medical-source statements describing significant cognitive and seizure-related limitations and concluding Kaminski was "totally disabled."
- State-agency examiners (one physician and one psychologist) evaluated Kaminski in 2013; consulting file reviewers (non-examining) concluded he could do semi-skilled medium work with restrictions.
- An ALJ denied benefits, giving little weight to Dr. Cristea and substantial weight to the non-examining consultants; a vocational expert testified some jobs existed under the ALJ’s RFC, but would be precluded if Dr. Cristea’s limits were credited.
- The district court affirmed; on appeal the Seventh Circuit addressed whether the ALJ improperly discounted the treating physician’s opinion and whether the record compels an award of benefits.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the ALJ permissibly discounted treating-physician opinions under the treating-physician rule | Kaminski: ALJ erred by misreading claimant statements as inconsistent, failing to appreciate that some physical limits were seizure-preventive, and cherry-picking evidence | SSA: ALJ reasonably found treating opinions inconsistent with treatment notes, claimant statements, and MRI interpretation; non-examining consultants supported denial | Court: ALJ erred—discounting was improper because claimant’s self-reports can reflect frontal-lobe unawareness, physical limits were preventive, and ALJ cherry-picked and "played doctor." |
| Whether the ALJ fulfilled the regulatory factors for weighing a treating physician (length, frequency, specialty, support, consistency) | Kaminski: Dr. Cristea treated him for years, is a neurologist, and his opinions are supported and consistent with records | SSA: ALJ implicitly relied on inconsistencies and non-examining opinions to downweight treating opinion | Court: ALJ failed to apply the required factors and gave no adequate reasons; error requires remedy. |
| Whether the vocational expert’s testimony supports finding jobs available if treating opinion is credited | Kaminski: VE said Dr. Cristea’s limits would preclude full-time work | SSA: ALJ relied on VE testimony under a more favorable RFC to find jobs | Court: Crediting Dr. Cristea plus VE testimony shows no full-time jobs available, so agency failed its burden at step five. |
| Appropriate remedy after ALJ error | Kaminski: Remand for award of benefits because record resolves factual issues and compels disability finding | SSA: Remand for further proceedings | Court: Unusual case where record and VE testimony compel award of benefits; remand with instruction to calculate and award benefits. |
Key Cases Cited
- Gerstner v. Berryhill, 879 F.3d 257 (7th Cir. 2018) (treating-physician rule principles)
- Meuser v. Colvin, 838 F.3d 905 (7th Cir. 2016) (ALJ may not rely on incorrect interpretation of medical evidence)
- Moon v. Colvin, 763 F.3d 718 (7th Cir. 2014) (ALJs cannot "play doctor"; must rely on expert opinions)
- Hill v. Colvin, 807 F.3d 862 (7th Cir. 2015) (same principle restricting ALJ medical interpretation)
- Larson v. Astrue, 615 F.3d 744 (7th Cir. 2010) (factors for weighing a treating physician and when benefits may be awarded)
- Allord v. Astrue, 631 F.3d 411 (7th Cir. 2011) (standard for awarding benefits when record compels disability finding)
- Cole v. Colvin, 831 F.3d 411 (7th Cir. 2016) (prohibition on cherry-picking evidence)
- Vargas v. Sullivan, 898 F.2d 293 (2d Cir. 1990) (awarding benefits where ALJ ignored or misinterpreted treating physician)