Justia Public Benefits Opinion Summaries

Articles Posted in US Court of Appeals for the Seventh Circuit
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The plaintiff, Todd Hess, applied for supplemental security income, disability insurance benefits, and disabled adult child benefits, all of which are administered by the Social Security Administration. While his claims for supplemental security income and disability insurance benefits were approved, his claim for disabled adult child benefits was denied. To qualify for disabled adult child benefits, Hess had to prove that he had a disability that continued uninterrupted from before his 22nd birthday until the filing of his application for benefits. He claimed that his depression, panic disorder, obsessive-compulsive disorder, and other impairments made him disabled during that entire period. However, after two hearings, an Administrative Law Judge disagreed, concluding that Hess was disabled as of June 9, 2009, but not before then. The ALJ's decision was based on gaps in Hess's treatment history, notes from his physicians, and occasional work he performed as an independent contractor. The Appeals Council did not assume jurisdiction, and the district court found that the ALJ's decision was supported by substantial evidence. The United States Court of Appeals for the Seventh Circuit agreed and affirmed the judgment of the district court. View "Hess v. O'Malley" on Justia Law

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Erik Bertaud, who suffered serious injuries when a tree branch fell on his head, applied for disability insurance benefits and supplemental security income from the Social Security Administration. His application was denied, and he appealed. The Appeals Council remanded the case twice, but after the third denial, Bertaud's request for review was denied, making the ALJ's decision the final decision of the Commissioner. Bertaud then sought judicial review, arguing that the ALJ had failed to develop the record of his disability, pointing to over 800 pages of new medical evidence. The district court denied Bertaud's motion for summary judgment and affirmed the Commissioner's decision, and Bertaud appealed to the United States Court of Appeals for the Seventh Circuit.The court held that although an ALJ has a duty to develop a full and fair record, this duty is limited when the claimant is represented by an attorney. The claimant's duty to submit evidence is ongoing and covers any additional related evidence they become aware of. The court noted that Bertaud was represented and his attorney had confirmed that the evidence was complete and supplemented the record when necessary. Therefore, the court concluded that the ALJ did not fail to develop Bertaud's medical record. The court affirmed the district court's decision denying Bertaud's motion for summary judgment and affirming the decision of the Commissioner. View "Bertaud v. O'Malley" on Justia Law

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The case involves the plaintiff-appellant, Chris Martin, who suffered a back injury in June 2016 and stopped working. He sought medical attention in February 2018 and was diagnosed with a spine disorder in May 2018. Martin applied for Social Security disability benefits and was awarded supplemental security income after an administrative law judge (ALJ) found him disabled under the Social Security Act's stringent definition. However, he was denied disability insurance benefits because his insured status for those benefits had expired on December 31, 2017, a few weeks before he was found to have been disabled. Martin appealed, arguing that the ALJ should have consulted an additional medical expert to determine whether he was disabled earlier, before his insured status lapsed. The United States Court of Appeals for the Seventh Circuit concluded that the ALJ did not abuse her discretion in deciding not to consult another medical expert. The court explained that Social Security Ruling 18–01p allows an ALJ to decide whether to consult an additional medical expert to answer that question. Therefore, the court affirmed the denial of disability insurance benefits. View "Martin v. Kijakazi" on Justia Law

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This is a dispute regarding a claim for Disability Insurance Benefits and Supplemental Security Income under the Social Security Act, brought by the plaintiff-appellant, Heather Tutwiler. The United States Court of Appeals for the Seventh Circuit affirmed the lower court's ruling that Ms. Tutwiler was not disabled within the meaning of the Social Security Act. The court found that the plaintiff had not engaged in substantial gainful employment since the onset date of her condition, and that her impairments significantly limited her ability to perform basic work activities. However, these impairments did not meet or equal the severity of any impairments listed in the Social Security regulations that lead to automatic findings of disability. The court noted that Ms. Tutwiler had the residual functional capacity to perform sedentary work with some additional restrictions. The court also found that jobs within Ms. Tutwiler’s abilities existed in the economy in such numbers that she was not disabled under the Social Security Act. The court held that the ALJ's decision was supported by substantial evidence and was not otherwise contrary to law. View "Tutwiler v. Kijakazi" on Justia Law

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Fitschen was diagnosed with advanced cancer and stopped working. In 2000 the Social Security Administration (SSA) found Fitschen eligible for disability benefits. Fitschen returned to work in 2001 but continued to receive benefits for a nine-month “trial work period,” 42 U.S.C. 422(c)(4). After that period, he could continue to work and receive benefits for another 36-month period if his wages did not exceed the level at which a person is deemed to be capable of engaging in substantial work activity. The SSA's 2003 review determined that Fitschen had engaged in substantial work and should not have received benefits for much of 2002-2003. The SSA notified him of his overpayment liability but his benefits continued because he had again ceased substantial work. Fitschen again returned to work in 2004 but did not report the change. The SSA initiated another review in 2007 and suspended his benefits. The SSA may waive recovery of overpayments if the recipient was without fault.In 2019 the Commissioner of Social Security found Fitschen liable for an overpayment of $50,289.70 and declined to waive recovery. The district court and Seventh Circuit affirmed, rejecting an argument that the SSA was procedurally barred from recovering the overpayment because it failed to comply with its “reopening” regulation; the overpayment assessment did not “reopen” Fitschen’s initial eligibility determination or any later determination concerning the continuation or recomputation of his benefits. Substantial evidence supports the finding that Fitschen was at fault. View "Fitschen v. Kijakazi" on Justia Law

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Following a 2013 car accident, Michelle Baptist, then 50 years old, began experiencing significant neck and shoulder pain, as well as headaches. She had one, possibly two, aneurysms. She applied for Disability Insurance Benefits and Supplemental Security Income the following year. After reviewing her medical records and conducting a hearing, an administrative law judge concluded that Baptist retained the capacity to perform light work and, therefore, was not disabled.The Seventh Circuit affirmed the decision as supported by substantial evidence. Despite initial complications from an aneurysm clipping procedure, Baptist’s medical records indicate that she made a full recovery and experienced no ongoing aneurysm-related symptoms. Two doctors reviewed Baptist’s 2018 MRI. Neither recorded any concerns nor did they observe any impact the MRI results would have on Baptist’s functional capacity. They noted that Baptist presented with full upper and lower extremity strength, normal reflexes, a normal gait, and “no overt weakness.” View "Baptist v. Kijakazi" on Justia Law

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Crowell sought Supplemental Social Security Insurance benefits in 2010, alleging that she was unable to work due to ADHD, social anxiety, fibromyalgia, bipolar disorder, borderline personality disorder, chronic pain, panic attacks, arthritis, shoulder pain, back pain, OCD, anxiety, depression, insomnia, asthma, and COPD. The ALJ agreed that certain impairments were severe as defined under the regulations: fibromyalgia, depressive disorder, anxiety disorder, and impairments of her left shoulder which remained after surgical correction, and also considered Crowell’s claims that she suffered from asthma, back problems, substance abuse, and “absence” spells, but deemed that none of those conditions met the criteria of severe impairments. The Social Security Administration denied her application.After several appeals and remands, the district court upheld the denial of benefits. The Seventh Circuit affirmed. The ALJ appropriately followed the five-step process for evaluating whether a plaintiff is disabled, 20 C.F.R. 416.920, considering whether the claimant is currently employed, has a severe impairment or combination of impairments, has an impairment that meets or equals any impairment listed as being so severe as to preclude substantial gainful activity, has residual functional capacity that leaves her unable to perform past relevant work, and is unable to perform any other work existing in significant numbers in the national economy. View "Crowell v. Kijakazi" on Justia Law

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Martinez applied for supplemental security income. An ALJ reviewed the record and found that Martinez suffered from severe impairments but could nonetheless “perform the requirements of representative unskilled occupations such as a checker, routing clerk, and mail sorter.” After the Appeals Council denied Martinez’s request to review the decision, Martinez filed suit, then notified the Commissioner that the administrative record (pages within exhibit B15F) included medical records regarding a different claimant. In filing the administrative record with the court, the Commissioner noted that it was the full record. The pages relating to the other claimant were removed and replaced with a placeholder reading: “THIS PAGE WAS REMOVED AS AN EXHIBIT BY THE APPEALS COUNCIL BECAUSE IT DOES NOT REFER TO THE CLAIMANT.” Neither Martinez nor the district court saw the omitted pages. The Commissioner refused to produce the pages. Martinez moved to compel the Commissioner to include the full exhibit in the administrative record. The district court denied that motion, stating that “[t]he ALJ [only] cited the third-party records in exhibit B15F … as additional potential evidence that Mr. Martinez had an impairment.” The district court then affirmed the denial as supported by substantial evidence.The Seventh Circuit reversed. The decision is not supported by substantial evidence because it relies on medical records belonging to someone other than Martinez; it is impossible to determine whether that error was harmless. View "Martinez v. Kijakazi" on Justia Law

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Hohman, age 53, applied for Social Security benefits after she stopped working. She suffers from fibromyalgia, PTSD, depression, and anxiety, and alleged that the combined effects of these conditions left her unable to work as a medical records clerk or patient access representative. A vocational expert testified that someone with Hohman’s limitations could work as a photocopy machine operator, small products assembler, or mail clerk. Relying on that testimony, an ALJ denied the claim for benefits, finding that despite her limitations, Hohman still had the capacity to perform light work with physical and social limitations available in significant numbers in today’s economy. The vocational expert stated that he arrived at his final numbers about jobs available in the economy through a “weighted estimate" based upon professional experience, 25 years of both placement and labor market survey work, and 2,000 labor market surveys, explaining that many of the job titles in the database had been merged or had been eliminated by technology, so he decided that the job titles should not receive equal weight.The Seventh Circuit and the district court affirmed. Substantial evidence supports the denial. The court acknowledged Hohman’s frustration with the equal distribution method and concerns about the method’s reliability but stated that it is not, by itself, reversible error for an ALJ to rely on the equal distribution method to make a job-number determination. View "Hohman v. Kijakazi" on Justia Law

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Leisgang suffers from depression, anxiety, and a personality disorder, among other conditions. He sought supplemental security income and disability insurance benefits. The ALJ concluded that Leisgang could undertake only simple, routine, and repetitive work; could not work at a rapid, production-rate pace; could tolerate few changes in routine work settings; and could interact only occasionally with supervisors, coworkers, and the public. Those limitations precluded Leisgang from performing his past work. To determine whether Leisgang could perform other available jobs, the ALJ sought assistance from a vocational expert, who testified that someone with Leisgang’s limitations could work as a kitchen helper, sweeper/cleaner, or hospital cleaner. The expert estimated that there were meaningful numbers of each job across the country, identifying job titles using the Department of Labor's 1977 dictionary, not revised since 1991. The primary data came from the Occupational Employment Quarterly, which applies the equal distribution method to estimate the distribution of job numbers within a larger group of occupations. When Leisgang asked if that method was reliable, the expert reported that it was the only method he had available. Leisgang asked no further questions about the methodology.The district court and Seventh Circuit affirmed the denial of benefits. Leisgang forfeited his argument that the ALJ should have done more to ensure the soundness of the vocational expert’s methodology by failing to object at the hearing. Substantial evidence otherwise supports the ALJ’s determination. View "Leisgang v. Kijakazi" on Justia Law