Nancy Thomas v. Carolyn Colvin
2016 U.S. App. LEXIS 11323
| 7th Cir. | 2016Background
- Nancy Thomas applied for SSI in 2010, alleging disability from Graves’ disease, depression, and later diagnosed fibromyalgia, plus degenerative changes of the left shoulder and lumbar spine.
- Treatment records (2010–2012) include primary-care and endocrinology notes, imaging showing minimal degenerative changes, physical-therapy evaluations documenting movement limitations and pain, and treating physicians (Dr. Blankenstein and Dr. Rashid) diagnosing or suspecting fibromyalgia and prescribing Lyrica/Cymbalta.
- State-agency medical consultants (Drs. Ruiz and Sands) reviewed the file in early 2011 and concluded Graves’ disease was not severe; they did not evaluate later 2011 records or the fibromyalgia diagnosis.
- The ALJ credited the consultants, rejected the fibromyalgia diagnosis because treating doctors were not rheumatologists and did not document tender-point testing, found Thomas’s impairments (including Graves’, shoulder, and lumbar degenerative changes) caused no more than minimal limitations, and denied benefits at Step 2. The Appeals Council denied review and the district court affirmed.
- On appeal, Thomas argued the ALJ erred by excluding fibromyalgia, improperly weighing treating source opinions and state consultants, failing to consider physical-therapy findings, and making an inadequate credibility finding.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ erred in excluding fibromyalgia as a medically determinable impairment | Treating doctors diagnosed fibromyalgia; ALJ wrongly discounted them for lack of rheumatology specialty and tender-point testing | ALJ permissibly relied on absence of tender-point exam and lack of specialist diagnosis | Court: ALJ erred—cannot discount treating physicians solely for not being rheumatologists and ALJ failed to address 2010 ACR criteria (which do not require tender-point exam) |
| Whether ALJ’s Step-2 conclusion that physical impairments are non-severe is supported by substantial evidence | Dr. Rashid’s treating opinion and PT records show more than minimal limitations; state reviewers lacked later records | State consultants’ opinions support minimal limitations; error harmless because ALJ considered objective evidence | Court: Not supported—ALJ gave undue weight to dated non-examining reviewers, failed to address treating opinions and PT evidence, so conclusion not supported by substantial evidence |
| Whether ALJ permissibly discounted treating physician’s opinion | Dr. Rashid’s opinion to community college reflected long treating relationship and functional limits | ALJ reduced weight due to perceived normal range-of-motion note, fibromyalgia skepticism, and treatment gap | Court: ALJ’s reasons inadequate or erroneous; failed to give proper weight or to probe treatment gap |
| Whether ALJ’s credibility finding was adequate | Thomas’s reported limitations consistent with treating records and PT notes; ALJ ignored favorable evidence and didn’t explore treatment-gap reasons | ALJ relied on lack of objective support and daily activities | Court: Credibility finding inadequate—ALJ ignored significant supporting evidence and improperly equated limited daily activities with ability to work full-time |
Key Cases Cited
- Roddy v. Astrue, 705 F.3d 631 (7th Cir. 2013) (ALJ must build an accurate and logical bridge from evidence to conclusions)
- SEC v. Chenery Corp., 318 U.S. 80 (1943) (agency decisions must be reasoned and explain basis for conclusions)
- Beardsley v. Colvin, 758 F.3d 834 (7th Cir. 2014) (ALJ must consider reasons for gaps in treatment)
- Craft v. Astrue, 539 F.3d 668 (7th Cir. 2008) (daily activities do not equal ability to do full-time work; credibility assessment standards)
- Stage v. Colvin, 812 F.3d 1121 (7th Cir. 2016) (non-examining reviewers’ opinions cannot substitute for later treating records)
- Goins v. Colvin, 764 F.3d 677 (7th Cir. 2014) (weight of non-examining consultants limited when they lack later evidence)
- Allord v. Astrue, 631 F.3d 411 (7th Cir. 2011) (court may remand but not direct award of benefits when factual issues remain)