Seventh Circuit: ALJ Impermissibly “Played Doctor” In Denying Fibromyalgia Disability Claim
Andrew Bryant & Jennifer Danish
On April 4, 2018, the Seventh Circuit Court of Appeals issued an opinion vacating the denial of a Supplemental Security Income disability claim brought by 47-year-old Rebecca Ann Akin, who suffered from fibromyalgia, back and neck pain, and headaches. Akin v. Berryhill, 887 F.3d 314 (7th Cir. 2018).
On appeal, Akin argued that the administrative law judge wrongly discounted her allegations of back pain, improperly credited the opinions of agency doctors who had not reviewed all the medical records (including MRI scans) and disregarded her history of headaches. In its opinion, the Seventh Circuit described in detail Akin’s history of chronic back and neck pain, headaches, and other symptoms associated with her fibromyalgia diagnosis. The court then noted that the agency doctors whose opinions were relied upon by the ALJ did not review about 70 pages of medical records, including relevant MRI results. Rather, in denying the claim, the ALJ interpreted the MRI results himself. The Seventh Circuit found that this evaluation of the MRI results was flawed because the ALJ impermissibly “played doctor.” Akin, 887 F.3d at 317, citing, Goins v. Colvin, 764 F.3d 677, 680 (7th Cir. 2014). The lower court’s decision denying benefits was vacated and the case was remanded to the agency for further proceedings.
In commenting on Akin’s additional arguments, the Seventh Circuit further addressed and criticized the ALJ’s finding that Akin’s testimony was “not entirely credible” as “meaningless boilerplate.” In this discussion, the court noted that the disabling pain caused by fibromyalgia cannot be evaluated or ruled out by objective medical tests, as relied upon by the ALJ. Akin, 887 F.3d at 318, citing, Vanprooyen v. Berryhill, 864 F.3d 567, 572 (7th Cir. 2017).
Further, the court noted that the ALJ improperly discredited Akin’s testimony regarding her preference to delay undergoing a series of injections. The court noted that the ALJ did not consider Akin’s stated reasons for preferring a conservative course of treatment, as those stated reasons did not undermine the legitimacy of her complaints of disabling pain. Id, citing Beardsley v. Colvin, 758 F.3d 834, 840 (7th Cir. 2014).
Finally, the court noted that based on the opinions of two state-agency consultants, the ALJ discounted Akin’s complaints of headaches, despite Akin’s persuasive arguments to the contrary based on CT scans and other evidence. Akin, 887 F.3d at 318.
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