Daniel Minnick v. Carolyn Colvin

In the

United States Court of Appeals

For the Seventh Circuit

No. 13-3626

DANIEL P. MINNICK,

Plaintiff-Appellant,

v.

CAROLYN W. COLVIN, Acting

Commissioner of Social Security,

Defendant-Appellee.

Appeal from the United States District Court for the

Northern District of Indiana, Fort Wayne Division.

No. 1:12-cv-00265-JVB-RBC — Joseph S. Van Bokkelen, Judge.

ARGUED OCTOBER 28, 2014 — DECIDED JANUARY 7, 2015

Before BAUER, POSNER, and TINDER, Circuit Judges.

BAUER, Circuit Judge. Plaintiff-Appellant, Daniel P. Minnick

(“Minnick”), suffers from a number of serious medical prob-

lems, including fibromyalgia, chronic obstructive pulmonary

disease (“COPD”), and degenerative disc disease. In 2010,

he applied for disability insurance benefits under the Social

Security Act. After the Disability Determination Bureau

(“DDB”) denied Minnick’s claim in December 2010, Minnick

2 No. 13-3626

requested an administrative hearing before an Administrative

Law Judge (“ALJ”). The ALJ determined that Minnick is not

disabled within the meaning of the Social Security Act. The

Appeals Council denied Minnick’s request for review, render-

ing the ALJ’s decision final. 20 C.F.R. § 404.981. Minnick then

sought review in the district court, which affirmed the ALJ’s

decision on September 27, 2013. We conclude that the ALJ

made a number of errors in her consideration of the record and

therefore reverse and remand Minnick’s case for further

proceedings.

I. BACKGROUND

The medical records in this case demonstrate that Minnick

sought treatment for numerous health concerns over the years,

but his chronic pain and back ailments predominate. At

various times, Minnick has been assessed as having the

following ongoing ailments: degenerative disc disease,

spondylosis, COPD, fibromyalgia, migraine headaches,

intermittent headaches, hypertension, anxiety, and depression.

We confine our discussion of Minnick’s medical records to the

information most relevant to the ALJ’s decision and this

appeal.

A. Medical Evidence

Minnick sought treatment for his pain beginning in May

2008, when he saw his attending physician, Dr. Brian Zurcher.

Dr. Zurcher diagnosed severe joint pain. From September to

November of that year, Minnick was also treated for exacerba-

tion of his preexisting COPD. In December, he reported

worsening shortness of breath related to his COPD, but still felt

he could return to work.

No. 13-3626 3

In January 2009, Minnick saw Dr. Keith Harvey complain-

ing of lower back pain radiating down both legs. Dr. Harvey

believed the pain was likely muscular in nature, but secondary

to deconditioning and obesity. Dr. Harvey suggested that

Minnick may have fibromyalgia. When Minnick’s condition

did not improve, Dr. Harvey sent him for x-rays and an MRI

of the lumbar spine, which revealed lumbar spondylosis, mild

hypertrophic degenerative spur formation, and a bulging disc.

As a result of these tests, Dr. Harvey diagnosed Minnick with

lumbar spondylosis, recommended walking to get his weight

down, and prescribed Vicodin for the pain. Another round of

x-rays on December 14, 2009, showed disc space narrowing

and an MRI showed mild degrees of spinal stenosis without

evidence of spinal cord compression or nerve root compres-

sion. An MRI on December 16, 2009, analyzed this time by

Dr. Zurcher, showed evidence of a disc protrusion involving

two lumbar vertebrae, resulting in mild to moderate mass

effect upon two nerve roots.

In June 2010, Minnick saw Dr. James Hanus, D.O., who

listed daily headaches, intermittent migraines, and fibro-

myalgia as possible etiologies of Minnick’s problems. At a

follow-up in July, Dr. Hanus noted improvements with the

headaches, but reported left back pain, thoracic pain, and

carpal pedal spasms in Minnick’s arms, as well as left leg pain.

He diagnosed “[p]robably some” fibromyalgia, headaches,

migraines, and thoracic pain.

In October 2010, rheumatologist Dr. David Campbell

examined Minnick. Dr. Campbell assessed a positive straight

leg raise in both legs at 30 degrees. He found no trigger points

indicating fibromyalgia, but cautioned that he “could have

4 No. 13-3626

caught [Minnick] on a good day” and that Minnick’s pain

history was strongly suggestive of fibromyalgia. Minnick had

two follow-up appointments with Dr. Harvey in November

2010. At the first appointment, Dr. Harvey increased Minnick’s

painkiller dosage. At the second appointment, he noted that

the increased dosage had not helped manage Minnick’s pain.

Minnick also met with DDB consultant Dr. B.T. Onamusi in

November 2010. Dr. Onamusi diagnosed fibromyalgia with

generalized muscle pain and fatigue, in addition to COPD. In

his physical examination notes, Dr. Onamusi documented

Minnick’s ambulatory limitations: Minnick walked with a short

gait, appeared to be in discomfort while he walked, needed a

cane for long distance ambulation, and had difficulty transfer-

ring onto and off of the examination table due to pain. He also

noted that Minnick had “few areas of trigger points.” Another

DDB consultant, Dr. J. Sands, reviewed Minnick’s medical

records in November 2010, but never examined him. After a

review of the records, Dr. Sands opined that in an eight hour

work day, Minnick could stand or walk for two hours and sit

for six. He also stated Minnick could occasionally lift ten

pounds, frequently lift less than ten pounds, could never climb

ladders, ropes, kneel, crouch, or crawl, but could occasionally

climb ramps or stairs, or balance or stoop. Dr. Sands’ report

did not reference Minnick’s history of x-ray or MRI results.

In December 2010, Minnick saw Dr. Jose Panszi, complain-

ing of pain in his legs from the hips down. Dr. Panszi docu-

mented Minnick’s worsening pain, as well as his use of a cane

and, alternatively, a walker.

No. 13-3626 5

In January 2011, Minnick saw Dr. Jon Karl for an orthopedic

consultation. Dr. Karl noted a diminished range of motion in

the lumbar spine, an antalgic gait, and positive straight leg

raise tests in both legs. He diagnosed degenerative disc disease,

prescribed Vicodin, and advised an epidermal steroid injection,

which Minnick received a few days later. The day following

the injection, Dr. Harvey prescribed a cane and a walker to

help Minnick walk.

In February 2011, Minnick called Dr. Karl’s office to report

radiating pain up and down his spine. While visiting Dr. Karl’s

office a few days later, Minnick complained of constant pain.

Barbara Starry, a nurse practitioner in Dr. Karl’s office,

upgraded Minnick’s pain relief to Methadone. Dr. Karl also

ordered an MRI, which showed degenerative disc disease and

disc protrusions at L4-5 and L5-S1 in the lumbar vertebrae.

In April 2011, Minnick saw physical medicine and rehabili-

tation specialist Dr. Jason Sorg. Dr. Sorg noted that Minnick

demonstrated significant pain behaviors during the examina-

tion, and used a cane to steady his slow, guarded gait. He

diagnosed a central disc extrusion and concluded that spinal

surgery would likely not provide significant relief to his

widespread pain. He felt Minnick would benefit from a

multidisciplinary chronic pain program. Subsequently,

Minnick began physical therapy, which he attended from late

April through June 2011. Throughout the course of physical

therapy, Minnick continued to experience radiating pain, but

also admitted that some days the therapy seemed to help. His

therapist noted that Minnick used either a walker or a cane to

maneuver around his home.

6 No. 13-3626

In July 2011, Dr. Karl again noted Minnick’s continued

complaints of severe pain and that Methadone had not helped

alleviate the pain. He prescribed Oxycontin and Norco instead.

In August 2011, Minnick met with Dr. Rudy Kachmann, a

neurologist, to discuss his severe pain and possible surgical

options. On examination, Dr. Kachmann documented that

Minnick was hypersensitive to touch over the skin, muscula-

ture on his neck, and mid and lower back—symptoms all

consistent with fibromyalgia. Although Dr. Kachmann diag-

nosed fibromyalgia, he noted that Minnick’s x-rays did not

reveal anything connected to his pain problem and opined that

Minnick suffered from “centralized cerebral pain.” In hopes of

alleviating his pain, Dr. Kachmann recommended that Minnick

be weaned off narcotics, encouraged him to exercise, and

suggested he read books about his condition. At a follow-up

examination in October, Dr. Kachmann documented that

Minnick had reduced his narcotics use—he had stopped taking

Oxycontin entirely and was on a reduced dosage of Norco. He

also noted that Minnick appeared to be in severe pain, was

using a cane, and was still hypersensitive to touch. As a result

of these findings, Dr. Kachmann diagnosed severe fibro-

myalgia and migraines. He also stated that a person in such a

terrible pain condition could not be reeducated for work.

Finally, he concluded that Minnick was “clearly disabled” and

could not bend, twist, or lift more than five pounds on a

regular basis.

No. 13-3626 7

B. The November 16, 2011, Administrative Hearing

At the time of his hearing, Minnick was 46 years old. He

testified that he was a truck driver for 24 years until taking

short term leave in 2008 due to pain in his legs and hip. After

returning to work, he was laid off.

He also testified to his pain and impairments. He described

a state of constant pain in his hips, legs, and back of the head.

In an attempt to manage his pain, Minnick’s wife packs his legs

in ice every morning while he is still in bed, where he stays for

an hour and a half until he is he able to get up. The ice numbs

his pain for about 5 hours, after which he has to lie down again

because the pain becomes too intense. Due to the pain, he

testified that he could sit for “probably about 30 minutes at the

most” and stand for 20 minutes at a time. Occasionally, his wife

would have to dress him because he is unable to bend. He also

stated he is unable to help with any household chores.

When asked about additional limitations due to upper

extremity pain, Minnick testified that he had difficulty reaching

overhead and raising his arms to shoulder-level. He explained

that he often drops plates and glasses because of his difficulty

in grasping. He also testified that the pain limited his ability to

use his hands and fingers, and thus, limited his ability to use

his cane. Because the pain in his right hand would become so

bad, he stated that he had to use his walker instead of the cane

at least once a week. As to his lower extremities, Minnick

testified that he frequently elevated his legs to reduce strain on

his hips. He further testified that he was unable to squat, twist,

bend, and struggled to climb stairs. According to Minnick,

8 No. 13-3626

these limitations and daily severe pain episodes render him

unable to work.

At the end of the hearing, the ALJ questioned Sharon

Ringenberg, a vocational expert (“VE”). The ALJ asked the VE

whether a person of Minnick’s age, education, and work

experience could perform his past relevant work or other work

given limitations based on the assessed Residual Functional

Capacity (“RFC”). The ALJ established the RFC in reliance on

Minnick’s testimony and the opinions of several, but not all,

treating and reviewing physicians. Limitations included the

following: could lift and carry ten pounds occasionally and five

pounds frequently; could stand or walk two hours and sit for

six hours out of an eight-hour day; could occasionally balance,

stoop, and climb ramps or stairs, but never kneel, crouch,

crawl, or climb ladders, ropes, or scaffolds; had to use a cane

when walking; needed to avoid exposure to airborne irritants;

needed to avoid hazards including operational control of

moving machinery, unprotected heights, or slippery and

uneven surfaces; could not understand or remember detailed

instruction; could not tolerate sudden or unpredictable

workplace changes; and could only tolerate superficial-type

interaction with supervisors, co-workers, and the public. In

response, the VE stated that an individual with those limita-

tions could not perform Minnick’s past relevant work, but

could perform the jobs of optical final assembler, addresser,

and telephone order clerk.

No. 13-3626 9

C. The ALJ’s December 21, 2011, Decision

Applying the familiar five-step analysis laid out in 20 C.F.R.

§ 416.920(a)(4), the ALJ concluded that Minnick is not disabled.

At step one, she found that Minnick was not engaged in

substantial gainful activity since the alleged disability onset

date. At step two, the ALJ found that Minnick suffered from

several severe impairments, but at step three concluded that

Minnick’s impairments did not meet or equal any listed

impairment. In reaching her conclusion, the ALJ discredited

Minnick because his hearing testimony and manner during the

hearing were inconsistent with his earlier descriptions of his

disabling limitations. The ALJ also discredited one of Minnick’s

treating physicians, Dr. Kachmann, because, according to the

ALJ, Dr. Kachmann rendered inconsistent assessments and his

findings were beyond the scope of his expertise. At step four,

the ALJ found that Minnick cannot perform his past work, but

can hold a job that limits his activity according to the RFC.

At the fifth and final step, the ALJ relied on the VE’s testimony

and concluded that Minnick could work in various unskilled,

sedentary occupations, such as optical final assembler,

addresser, or telephone order clerk.

On January 5, 2012, Minnick filed a request for review with

the Appeals Council of the Office of Disability Adjudication

and Review. The Appeals Council denied Minnick’s request

for review, at which point Minnick filed a civil action in federal

court. The district court affirmed the ALJ’s decision on Septem-

ber 27, 2013. On appeal, Minnick argues that (1) the ALJ

committed legal error by failing to adequately articulate why

the claimant’s combined impairments did not produce findings

of equal medical significance to the criteria of Listing 1.04, and

10 No. 13-3626

(2) the ALJ erred by assessing an RFC that is not supported by

substantial evidence.

II. DISCUSSION

Because the Appeals Council declined Minnick’s request for

review, the ALJ’s ruling represents the Social Security Com-

missioner’s final decision. 20 C.F.R. § 404.981; Roddy v. Astrue,

705 F.3d 631, 636 (7th Cir. 2013). We review the ALJ’s decision

directly, without giving deference to the district court’s

assessment of the ALJ’s decision. Roddy, 705 F.3d at 636. We

will reverse an ALJ’s determination only when it is not

supported by substantial evidence, meaning “‘such relevant

evidence as a reasonable mind might accept as adequate to

support a conclusion.’” McKinzey v. Astrue, 641 F.3d 884, 889

(7th Cir. 2011) (citation omitted). Although we will not reweigh

the evidence or substitute our judgment for that of the ALJ’s,

Shideler v. Astrue, 688 F.3d 306, 310 (7th Cir. 2012), “this does

not mean that we will simply rubber-stamp the Commis-

sioner’s decision without a critical review of the evidence.”

Clifford v. Apfel, 227 F.3d 863, 869 (7th Cir. 2000). In rendering

a decision, an ALJ is not required to provide a complete and

written evaluation of every piece of testimony and evidence,

but “must ‘build a logical bridge from the evidence to his

conclusion.’” Schmidt v. Barnhart, 395 F.3d 737, 744 (7th Cir.

2005) (citation omitted).

A. The ALJ’s Listing 1.04 Analysis

Minnick first argues the ALJ committed error by failing to

adequately articulate why his combined impairments did not

meet or equal the criteria of Listing 1.04. If a claimant has an

impairment that meets or equals an impairment found in the

No. 13-3626 11

Listing of Impairments, a claimant is presumptively eligible for

benefits. 20 C.F.R. § 404.1520(d). “In considering whether a

claimant’s condition meets or equals a listed impairment, an

ALJ must discuss the listing by name and offer more than

perfunctory analysis of the listing.” Barnett v. Barnhart, 381 F.3d

664, 668 (7th Cir. 2004). The Listings specify the criteria for

qualifying impairments. Id. (citing 20 C.F.R. § 404.1525(a)). A

claimant may also satisfy a Listing by showing that his impair-

ment is accompanied by symptoms that are equal in severity

to those described in the Listing. 20 C.F.R. § 404.1526. A finding

of medical equivalence requires an expert’s opinion on the

issue. Barnett, 381 F.3d at 670.

Listing 1.04 describes spinal disorders (including herniated

nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteo-

arthritis, degenerative disc disease, and vertebral fractures),

resulting in compromise of a nerve root or the spinal cord, with

evidence of nerve root compression, spinal arachnoiditis, or

lumbar spinal stenosis resulting in pseudoclaudication. 20

C.F.R. Pt. 404, Subpt. P, App. 1, § 1.04. It also requires, in

relevant part: “Evidence of nerve root compression character-

ized by neuro-anatomic distribution of pain, limitation of

motion of the spine, motor loss (atrophy with associated

muscle weakness or muscle weakness) accompanied by

sensory or reflex loss and, if there is involvement of the lower

back, positive straight-leg raising test.” Id.

In determining Minnick’s degenerative disc disease did not

meet or equal Listing 1.04, the ALJ stated:

The claimant’s degenerative disc disease was evalu-

ated under Listing 1.04 (disorders of the spine). The

12 No. 13-3626

evidence does not establish the presence of nerve root

compression, spinal arachnoiditis, or spinal stenosis

resulting in pseudoclaudication, as required by that

listing.

This is the very type of perfunctory analysis we have

repeatedly found inadequate to dismiss an impairment as not

meeting or equaling a Listing. See Kastner v. Astrue, 697 F.3d

642, 647–48 (7th Cir. 2012) (remanding where the ALJ’s cursory

Listing analysis failed to articulate rationale for denying

benefits when record supported finding in claimant’s favor);

Barnett, 381 F.3d at 670 (concluding the ALJ’s “two-sentence

consideration of the Listing of Impairments [was] inadequate

and warrant[ed] remand.”); Brindisi v. Barnhart, 315 F.3d 783,

786 (7th Cir. 2003) (reversing because ALJ’s Listing analysis

was “devoid of any analysis that would enable meaningful

judicial review.”). The ALJ dismissed the possibility of

Minnick’s degenerative disc disease meeting or equally Listing

1.04’s criteria in two sentences. Beyond these two sentences,

she provided no analysis whatsoever supporting her conclu-

sion.

As a particular example of the Listing analysis’ inadequacy,

the ALJ failed to acknowledge several aspects of the record

that could in fact meet or equal Listing 1.04. Most notably, the

ALJ apparently ignored Minnick’s December 16, 2009, MRI,

showing mild to moderate mass effect on two nerve roots,

which can be indicative of nerve root compression. Paired with

Minnick’s testimony that his pain limited his ability to use his

fingers (motor loss accompanied by reflex loss) and the

positive straight leg tests, Minnick’s degenerative disc disease

may well have satisfied Listing 1.04A. We cannot discern from

No. 13-3626 13

the ALJ’s scant analysis whether she considered and dismissed,

or completely failed to consider, this pertinent evidence. If the

ALJ did consider and dismiss some or all of this evidence, she

never so stated. Moreover, the ALJ never sought an expert’s

opinion as to whether any of the evidence could support a

finding of equivalency. See Barnett, 381 F.3d at 670–71 (stating

ALJ’s assumption of absence of equivalency without any

relevant discussion and without consulting an expert’s opinion

could not support the decision to deny benefits). Thus, the ALJ

erred by failing to build a logical bridge from the evidence to

her conclusion. See Schmidt, 395 F.3d at 744.

B. The ALJ’s Residual Functional Capacity Assessment

Minnick also argues the ALJ erred by assessing an RFC that

was not supported by substantial evidence. Specifically,

Minnick challenges the ALJ’s consideration of both his own

credibility and the opinion evidence of treating physician,

Dr. Kachmann.

1. Minnick’s Credibility

In reaching her RFC determination, the ALJ discredited

Minnick’s testimony using the type of boilerplate language that

we have consistently criticized, see, e.g., Roddy, 705 F.3d at 635;

Filus v. Astrue, 694 F.3d 863, 868 (7th Cir. 2012); Bjornson v.

Astrue, 671 F.3d 640, 644–45 (7th Cir. 2012), stating that

although his impairments “could reasonably be expected to

cause some of his alleged symptoms … the claimant’s state-

ments concerning the intensity, persistence and limiting effects

of these symptoms are not credible to the extent they are

inconsistent with the above residual functional capacity

assessment.” By itself, “[s]uch boilerplate language fails to

14 No. 13-3626

inform us in a meaningful, reviewable way of the specific

evidence the ALJ considered in determining that claimant’s

complaints were not credible.” Bjornson, 671 F.3d at 645.

Although the ALJ did provide some explanation in support of

this boilerplate language, we remain unpersuaded that

substantial evidence supports her conclusion in light of the

record as a whole.

In support of her conclusion, the ALJ first remarked that

Minnick’s low back pain was attributed to deconditioning,

obesity, and resumption of tree trimming work, rather than his

allegedly disabling impairments. This attribution presumably

refers to the only instance in which tree trimming work is

mentioned in the record: a January 2009 assessment by

Dr. Harvey. It does not account for the record of pain, corrobo-

rated by a number of doctors, that continues from 2008 into

2011. The ALJ also focused on Minnick’s testimony that he

could “sit for 30 minutes at the most,” yet sat for over 40

minutes during the hearing, and for a full hour before a

consultative examiner. However, at least one doctor of record

opined that he “could have caught Minnick on a good day.”

So, too, could the ALJ and the consultative examiner. More-

over, Minnick’s full testimony was that he could probably sit for

30 minutes at the most, suggesting at least the possibility of

longer stretches without issue. Finally, Minnick’s ability to sit

without exhibiting pain-related behaviors at the hearing does

not undo the consistent record of pain-related behaviors

exhibited before nearly every one of Minnick’s treating

physicians. Finally, and perhaps most critically, the ALJ never

mentioned two studies in the record that indicated Minnick’s

herniated discs were affecting his nerve roots. Nerve root

No. 13-3626 15

contact provides an objective medical explanation for at least

some of his pain and weakness.

In Clifford v. Apfel, 227 F.3d 863 (7th Cir. 2000), the ALJ did

not find the claimant’s testimony credible because it was

contradicted by her daily activities and the medical evidence of

record. We reversed the ALJ’s credibility determination,

however, explaining that “the ALJ must consider a claimant’s

subjective complaint of pain if supported by medical signs and

findings.” Id. at 871. Though an ALJ’s credibility determination

may only be overturned if it is “patently wrong,” Craft v.

Astrue, 539 F.3d 668, 678 (7th Cir. 2008), a failure to adequately

explain his or her credibility finding by discussing specific

reasons supported by the record is grounds for reversal. Terry

v. Astrue, 580 F.3d 471, 477 (7th Cir. 2009); Bjornson, 671 F.3d at

649. Here, the ALJ did not provide a reason for omitting from

her analysis the objective medical evidence in the record

supporting Minnick’s subjective complaints. Without a logical

bridge between the evidence and the ALJ’s conclusion, we lack

a sufficient basis upon which to uphold the ALJ’s determina-

tion of Minnick’s credibility.

2. Dr. Kachmann’s Opinion

Minnick also argues that the ALJ improperly discounted

the opinion of treating physician Dr. Kachmann in assessing

the RFC. Dr. Kachmann treated Minnick twice. The first time,

he opined that Minnick should exercise, read up on his

condition, and be weaned off narcotic medication. He also

diagnosed centralized cerebral pain and fibromyalgia. The

second time two months later, he opined that Minnick could

not do any bending or twisting, was unable to be reeducated

16 No. 13-3626

for work, and was “clearly disabled.” Dr. Kachmann then

diagnosed severe fibromyalgia and migraines. The ALJ found

the opinions inconsistent. The ALJ also found that Dr. Kach-

mann’s opinions regarding hiring practices were outside the

scope of his expertise and that his opinions regarding

Minnick’s ability to bend and twist were unsupported by the

record. For these reasons, the ALJ gave Dr. Kachmann’s

opinion only limited weight.

Under 20 C.F.R. § 404.1527(c)(1), an ALJ should “give more

weight to the opinion of a source who has examined [the

claimant] than to the opinion of a source who has not exam-

ined [the claimant]” because of his greater familiarity with the

claimant’s conditions and circumstances. Section 404.1527(c)(2)

further provides “[i]f [the ALJ] find[s] that a treating source’s

opinion on the issue(s) of the nature and severity of [the

claimant’s] impairment(s) is well-supported by medically

acceptable clinical and laboratory diagnostic techniques and is

not inconsistent with the other substantial evidence in [the

claimant’s] case record, [the ALJ] will give it controlling

weight.” 20 C.F.R. § 404.1527(c)(2).

In discounting Dr. Kachmann’s opinion that Minnick could

not bend or twist, the ALJ stated the limitation to occasional

stooping in the RFC was better supported by the record as a

whole. The ALJ failed to explain why Dr. Kachmann’s opinion

that Minnick could not bend or twist was not supported by the

record, particular as to twisting. This was error. See Roddy, 705

F.3d at 636–37 (finding ALJ should have, but did not, explain

why treating physician’s opinion about severity of claimant’s

pain was inconsistent with record evidence indicating pain); see

also Murphy v. Astrue, 496 F.3d 630, 634 (7th Cir. 2007) (finding

No. 13-3626 17

ALJ erred in failing to explain disregard of pertinent record

evidence). First, it is unclear from the ALJ’s opinion how the

ability to occasionally stoop would mean Minnick could also

twist. Second, the record contains a number of other doctors’

opinions suggestive of Minnick’s inability to bend or twist. For

example, Dr. Karl and Dr. Onamusi, both treating physicians,

noted Minnick had a diminished range of motion in the lumbar

spine. Further, the only doctor to recommend stooping was

Dr. Sands, a non-treating physician. His recommendation was

a check-box style review of Minnick’s records, meaning

Dr. Sands was not obligated to, and indeed did not, provide

any reasons for his conclusion.

The ALJ also discounted Dr. Kachmann’s opinion due to

internal inconsistencies. Internal inconsistencies may provide

good cause to deny controlling weight to a treating physician’s

opinion, but the reasoning for the denial must be adequately

articulated. Roddy, 705 F.3d at 636–37. Though the ALJ found

inconsistencies in Dr. Kachmann’s reports, we do not see any

conflict between his two opinions. It is not unreasonable to

believe that Dr. Kachmann felt exercise could be helpful to

Minnick, but later found that he is unable to bend or twist. For

example, Minnick’s decreased usage of narcotics is noted in

the record between his August and October visits with

Dr. Kachmann; the reduced painkiller use could indicate that

Minnick was in more pain in the October meeting than in the

August one, diminishing his ability to tolerate certain move-

ments. The ALJ also took issue with Dr. Kachmann’s recom-

mendation that Minnick read a few books on his condition

compared to his later statement that Minnick could not be

reeducated for work. An inability to be reeducated for work is

18 No. 13-3626

not necessarily incompatible with the ability to educate oneself

on one’s own condition.

The ALJ has a duty to fully develop the record before

drawing any conclusions and must adequately articulate her

analysis so that we can follow her reasoning. Murphy, 496 F.3d

at 634. Without explaining how or why Dr. Kachmann’s

bending and twisting opinion was not supported by the record,

we are unable to properly review the ALJ’s opinion determina-

tion. Similarly, the ALJ did not adequately articulate why

Dr. Kachmann’s statements were internally inconsistent. In

light of these errors, the ALJ must reevaluate whether

Dr. Kachmann’s findings are entitled to controlling weight.

III. CONCLUSION

Our task is to determine whether substantial evidence

supports the ALJ’s conclusion. We believe that it does not. For

the reasons discussed above, we REVERSE the judgment of the

district court upholding the Acting Commissioner’s decision to

deny benefits to Minnick and REMAND for further proceed-

ings consistent with this opinion.