DEBBIE A. STAGE, Plaintiff-Appellant,
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant-Appellee
Argued November 17, 2015,
Appeal from the United States District Court for the Northern District of Indiana, Hammond Division. No. 2:13-CV-414-JVB -- Joseph S. Van Bokkelen, Judge.
For DEBBIE A. STAGE, on behalf of BRIAN C. MCCARTY, deceased, Plaintiff - Appellant: Barry Schultz, Attorney, Law Offices of Barry A. Schultz, P.C., Evanston, IL.
For CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant - Appellee: Meghan L. O'Callaghan, Attorney, Social Security Administration, Office of the General Counsel, Region V, Chicago, IL.
Before FLAUM, EASTERBROOK, and HAMILTON, Circuit Judges.
Hamilton, Circuit Judge.
Debbie Stage appeals the district court's judgment upholding the denial of her application for supplemental security income, disability insurance benefits, and disabled widow's benefits. Stage was 56 years old at the time of the decision. She suffers from chronic back and hip problems exacerbated by obesity, caused in turn by hypothyroidism. She argues that the administrative law judge erred by discounting significant new evidence she submitted after an agency doctor had reviewed her medical records, by giving little weight to her treating physician's opinion, by discrediting her testimony about her pain without adequate support, and by overstating her residual functional capacity. We agree with Stage that the ALJ's evaluation of her medical evidence was unreasonable and that substantial evidence does not support his finding that she remained capable of performing light work. We reverse the district court's judgment and remand this case to the agency for further consideration.
Stage's back problems began when she slipped two discs while working in a factory in 1985. She continued working, though, and her pain became more severe over the years. By 2007, she had been diagnosed with arthritis in her back, hips, left leg, and shoulders, as well as spinal degeneration, a tear in a disc joint, and mild degenerative disc disease. Stage is 5'6" tall and at the time of the ALJ's decision weighed over 200 pounds, giving her a body mass index of about 33, indicating obesity. Stage also suffered from a host of other health problems, including hyperlipidemia, hypertension, and hypothyroidism--a condition that has made her obesity especially difficult to control.
Stage applied for benefits claiming that debilitating back and hip pain rendered her unable to work after October 2009. Her last job was general kitchen work at a residentialcare facility. Before that she had worked as a cook, bartender, and factory laborer. Stage's extensive medical records show that she began seeking frequent treatment for worsening hip and back pain late in 2010. X-rays taken by a family practitioner revealed reduced blood flow to her legs and feet due to calcification, as well as spinal disc narrowing and joint narrowing. The doctor noted that Stage walked with an antalgic gait (compensating for pain while walking) and experienced muscle spasms. She was referred to a painmanagement clinic. An anesthesiologist specializing in spinal pain took an MRI and diagnosed a lumbar disc bulge, annular tear, and degenerative disc disease. The doctor recommended an epidural steroid injection for pain relief. Stage declined the injection because she had experienced no relief from an earlier one.
During monthly visits in 2011 to her primary care physician, Dr. Fernando Rivera, Stage consistently complained of debilitating pain. She was prescribed numerous pain medications, including Percocet, Vicodin, Norco, Tylenol--Codeine #3, Flexeril, Mobic, tramadol, Ultram, and Valium. She was also prescribed a back brace and a shower chair because she was unable to stand while bathing.
In March 2011, a consulting physician for the agency examined Stage. He noted that she arrived wearing a prescribed back brace and that she complained she could not stand or walk for any length of time due to constant pain. He observed that she walked with a hunch, had a restricted range of motion in her lumbar region, could not stoop or squat, had difficulty walking heel-to-toe, and had difficulty both rising from a sitting position and getting off the examination table. Her straight-leg test was positive, indicating radiating back pain.
That same month, a non-examining physician for the agency reviewed Stage's medical records and completed a Physical Residual Functional Capacity Assessment. This doctor concluded that Stage could occasionally lift or carry 20 pounds, frequently carry 10 pounds, and sit, stand, or walk for six hours in an eight-hour work day. He found Stage's claims of pain only partially credible.
Seven months later, after an acute flare-up of pain led to an emergency room visit and prescriptions for oxycodone and Valium, Stage visited Dr. Richard Oni, a board-certified orthopedic surgeon. She complained that the worsening pain prevented her from doing normal daily activities. Dr. Oni spent 80 minutes examining Stage. He reported a severe restriction of the range of motion of her hip, a strongly positive " Patrick's sign" (a test for pain in the hip), moderately severe degenerative arthritis, degenerative disc disease, a shortening of her left leg due to her antalgic gait, and the other spinal problems already diagnosed by Dr. Rivera. Dr. Oni ordered new MRIs that revealed degenerative changes in her spine.
Dr. Oni wrote Dr. Rivera that Stage needed a total left hip replacement " because of disabling symptoms." He also prescribed additional pain medication. In April 2012, Dr. Rivera completed a Physical Residual Functional Capacity Questionnaire for Stage's application for benefits. He included the diagnoses from Dr. Oni listed above. He also described Stage's pain as severe, constant, and radiating down her legs, and he opined that she was not capable of working even low-stress jobs because of her pain and its effects on her concentration. He doubted that Stage could walk a single city block without resting, and he added that she could sit or stand continuously for only five minutes at a time, after which she should lie down while elevating her legs on ...