April 25, 2018
from the United States District Court for the Northern
District of Indiana, South Bend Division. No. 16-CV-514 - Jon
E. DeGuilio, Judge.
Manion, Hamilton, and Barrett, Circuit Judges.
Hamilton, Circuit Judge.
2000, Anthony Kaminski fell down a flight of stairs,
suffering a head wound that caused a traumatic brain injury
and a seizure disorder. Thirteen years later, he applied
under the Social Security Act for disability insurance
benefits and supplemental security income. The Social
Security Administration denied his applications, and the
district court upheld the denial. Kaminski appeals, arguing
that the administrative law judge improperly rejected his
treating physician's opinions. We agree with Kaminski.
Because the treating physician's opinions and the
testimony of the vocational expert together show that
Kaminski is disabled, we remand the case to the agency with
instructions to award benefits to Kaminski.
Kaminski's fall in 2000, doctors determined that he had
suffered a seizure, was experiencing an intracerebral
hematoma (bleeding in his brain), and had fractured his left
jawbone. They reported that, as a result of the fall,
Kaminski had severe cognitive deficits-including problems
with memory and a change in personality-and an inability to
understand the severity of his injury.
began regularly seeing a neurologist, Dr. Richard Cristea,
who monitored his seizure disorder and prescribed him an
anticonvulsant. Over the ensuing years, Kaminski, while under
Dr. Cristea's care, suffered at least four seizures-in
2007, 2008, 2013, and 2014.
applied in 2013 for disability benefits, alleging that he
became disabled on the date of his fall. His strongest
evidence of disability consisted of a residual functional
capacity form and medical-source statements that Dr. Cristea
submitted in the summer of 2013.
Cristea reported that brain atrophy and asymmetry shown by a
2013 MRI were consistent with the traumatic brain injury that
Kaminski suffered in 2000. Dr. Cristea noted that Kaminski
had "frequent falls" and opined that seizures could
be triggered by physical activity, stress, inadequate sleep,
and dehydration, so Kaminski was incapable of performing even
low-stress work. The seizures often caused Kaminski to be
confused, irritable, and fatigued, and they impaired his
coordination, his level of alertness, and his awareness of
his surroundings. And Kaminski's brain damage, Dr.
Cristea wrote, impeded his ability to organize thoughts
(especially when listening to someone speak), as well as to
understand what he saw or heard, and it "changed"
his behavior and personality. According to Dr. Cristea,
Kaminski was "totally disabled," and it was
"unsafe [for him] to work in any capacity."
connection with Kaminski's application, a state-agency
physician and a state-agency psychologist examined him in the
spring of 2013. Much of the physical exam was normal, with
the physician recording that Kaminski reported no feelings of
weakness, dizziness, or memory loss. He displayed a stable
mood and was able to show appropriate insight and judgment.
The psychological examination, however, noted Kaminski's
poor hygiene; memory lapses and poor math skills; an
inability to interpret proverbs; and his bouts of depression,
moodiness, and anger. On the other hand, two consultants for
the state agency reviewed Kaminski's file without
actually examining him. They opined that he could do
semi-skilled medium work with some restrictions.
the Social Security Administration denied Kaminski's
claims, an administrative law judge held a hearing at which
Kaminski and his sister testified. Before his accident,
Kaminski had worked as a carpenter. When the judge asked him
why he could not work, he answered, "Because of my
seizures and me falling down and I get dizzy and I really
can't … be around people, too many people because
I get frustrated. I'll get aggravated and I'll blow
up with them." Kaminski testified that he lived alone,
and that the possibility of a seizure prevented him from
doing most activities. He could not drive, and his friends
helped him shop and clean his house. Kaminski's sister
testified about his change in personality since the accident.
Before, he had been "very independent," but he had
become unfocused, unclean, and verbally abusive, and did not
tolerate criticism or take direction.
vocational expert also testified about Kaminski's
employment prospects. The judge asked whether work was
available for a person with Kaminski's age, education,
and experience, with a residual functional capacity for
medium work, appropriate physical limitations, and a number
of other limitations related to his mental status: limited to
hearing and understanding only simple oral instructions;
limited to performing simple, routine, and repetitive tasks
(but not at production-rate pace); limited to simple
work-related decisions in dealing with changes in the work
setting; and limited to having to respond appropriately only
occasionally to coworkers and the public.
expert said that such a person would be unable to do
Kaminski's past carpentry work but could work as a
general helper, laundry laborer, or dryer attendant. But if
limits were added consistent with Dr. Cristea's opinions,
so that the person would be either off task 20 percent of the
workday, unable to accept instructions or ...