Rogers v. Barnhart (446 F. Supp. 2d 828, 2006)

MEMORANDUM OPINION AND ORDER

JEFFREY COLE, United States Magistrate Judge.

This case involves a review of the final decision of the Commissioner (“Commissioner”) of the Social Security Administration (“Agency”) denying Ms. Rogers’ application for Supplemental Security Income (“SSI”) under Title XVI of the Social Security Act (“Act”), 42 U.S.C. § 1382c(a)(3)(A). Ms. Rogers seeks a reversal and remand of the Commissioner’s decision, while the Commissioner seeks an order affirming the decision. For the following reasons, the plaintiffs motion is denied and the Commissioner’s motion is granted.

I.

INTRODUCTION

The system of judicial review carefully crafted by the Congress necessarily reposes substantial discretion in the administrative law judge to make the threshold determination of witness credibility and issues of fact and application of law to fact. Cf. Sarchet v. Chater, 78 F.3d 305, 308-309 (7th Cir.1996). In reviewing the opinions of an administrative law judge in granting or denying social security benefits, the question is always whether the decision of the ALJ is supported by substantial evidence. If it is, the findings of the ALJ are “conclusive,” and the decision must be affirmed. 42 U.S.C. § 405(g). Substantial evidence is such relevant evidence as a reasonable mind might accept to support a conclusion. A court may not reweigh the evidence or substitute its judgment for that of the Social Security Administration. Resolution of conflicts in evidence is for the Commissioner. White v. Barnhart, 415 F.3d 654 (7th Cir.2006).

But deference is not obeisance. In order for the court to affirm an ALJ’s denial of benefits, the ALJ must have articulated the reasons for his decision and clearly expressed the ■ reasoning process that led from the evidence to the ultimate conclusion. Cf. 42 U.S.C. § 405(b); 20 C.F.R. 404.1527(d)(2), 416.927(d)(2). Requiring administrative law judges to explain their conclusions is a recognition that administrative law judges are not exempt from the requirement that applies to courts at all levels of the federal system, namely that judicial decisions should not be based on some ineffable intuition or unarticulated hunch. Cf. Henry M. Hart, Jr., Foreword: The Time Chart Of The Justices, 73 Harv.L.Rev. 84, 98-99 (1959)(“In the end, however, ipse dixits are futile as instruments for the exercise of ‘the judicial Power of the United States.’ ”); Joint Anti-Fascist Refugee Committee v. McGrath, 341 U.S. 123, 171, 71 S.Ct. 624, 95 L.Ed. 817 (1951)(Frank-furter, J., concurring)(“The validity and moral authority of a conclusion largely depends on the mode by which it was reached.”).

In the instant case, the ALJ did precisely what the law mandated she do: In a careful, 20-page opinion, she meticulously reviewed and analyzed the wealth of medical evidence in the case' — 'that which favored Ms. Rogers, as well as that which did not, Herron v. Shalala, 19 F.3d 329, 333 (7th Cir.1994) — and she carefully explained the reasoning that underlay her conclusions, including why she discounted the opinion of Ms. Roger’s treating physician. There were no illogical or erroneous statements by the ALJ like those that have occurred in some cases and which demonstrated the invalidity (or absence) of reasoning by the ALJ. See, e.g., Sarchet, 78 F.3d at 306. The record in this case is more than adequate to allow a reviewing court to assess the overall validity of the ALJ’s findings and the logical connection between the evidence and her conclusions and to afford the plaintiff a meaningful judicial review.

The same care and balance exhibited by the ALJ in evaluating the medical evidence was exercised by the ALJ in evaluating Ms. Rogers’ credibility. Ms. Rogers testified that her noncompliance with her medical regimen stemmed from her lack of bus fare to go to the hospital to have her prescriptions refilled. This testimony bore on a significant issue: Failure to follow a prescribed course of remedial treatment without good cause can be grounds for denying an application for benefits, 20 C.F.R. § 416.930(a) and (b); Johnson v. Apfel, 240 F.3d 1145, 1148 (8th Cir.2001); Kisling v. Chater, 105 F.3d 1255, 1257 (8th 1997), and can weigh against a claimant’s credibility. Guilliams v. Barnhart, 393 F.3d 798, 802 (8th Cir.2005).

“[0]f course, the Administrative law judge did not have to believe” Ms. Rogers, Sarchet, 78 F.3d at 307, or accept her testimony at face value. Under the Social Security Act, administrative law judges are not inert and wooden participants in an empty ritual, the preordained end of which is to award benefits to those in distress, regardless of whether they qualify under the Act. The purpose of a social security hearing is to enable the ALJ to determine where the truth lies and to administer the Act in conformity with Congress’s carefully crafted statutory framework. Administrative law judges are functionally comparable to Article III judges, Cleavinger v. Saxner, 474 U.S. 193, 201, 106 S.Ct. 496, 88 L.Ed.2d 507 (1985); Tennessee Student Assistance Corp. v. Hood, 541 U.S. 440, 457, 124 S.Ct. 1905, 158 L.Ed.2d 764 (2004), and thus, there is nothing inappropriate about an ALJ’s questioning of a witness to gauge the truthfulness of testimony. Indeed, in the non-adversarial setting of a social security hearing there is no one else to perform that indispensable task, and questioning witnesses is consistent with and demanded by the ALJ’s basic obligation to develop a full and fair record and to scrupulously and conscientiously explore all relevant facts that bear on the claimant’s capacity to work or his or her entitlement to benefits. Cf. Heckler v. Campbell 461 U.S. 458, 103 S.Ct. 1952, 76 L.Ed.2d 66 (1983); Johnson v. Barnhart, 449 F.3d 804 (7th Cir.2006); Madrid v. Barnhart, 447 F.3d 788 (10th Cir.2006).

Thus, the ALJ asked Ms. Rogers if she could have borrowed bus fare from a member of her family. This simple inquiry underlies the contention that the ALJ was insensitive to the plight of the poor and that she used Ms. Rogers’ poverty against. (.Plaintiff’s Memorandum at 17). If true, the allegation could scarcely be more serious. If false, it could scarcely be more irresponsible. As discussed in greater detail below, the evidence would lead inexorably to the conclusion that Ms. Rogers’ testimony was false and was designed to conceal her long-standing cocaine habit (R. 327, 403-417) so as to avoid potential application of the prohibitions against an award of benefits where a claimant has failed to follow medical treatment or where a claimed disability is linked to drug addiction. 42 U.S.C. § 423(d)(2)(C). In short, far from demonstrating an insensitivity on the part of the ALJ to the plight of the poor, the record reveals a calculated attempt to deceive the ALJ.

What is disturbing about the allegations against the ALJ are not their lack of merit. There is nothing unusual about lawyers including fecMess arguments that actually detract from the presentation of the case. See, e.g., United States v. Mahoney, 247 F.3d 279, 282 (D.C.Cir.2001); Walker v. Abbott Laboratories, 416 F.3d 641, 643 (7th Cir.2005); Rehman v. Gonzales, 441 F.3d 506, 508-09 (7th Cir.2006). The more troubling aspect of the argument is its resort to the “ostrich-like tactic” of pretending that critical components of the record essentially do not exist. That tactic is as “unprofessional ... [and] pointless” as ignoring potentially dispositive authority that is contrary to one’s contentions. Hill v. Norfolk & Western Ry. Co., 814 F.2d 1192, 1198 (7th Cir.1987). Indeed, in some ways it is even more so.

II.

PROCEDURAL HISTORY

Plaintiff has filed three applications for Supplemental Security Income. The first was denied after a hearing in September of 1996, and she did not seek review of that decision. (Administrative Record (“R.”) at 22). In her second application, filed on September 17, 1999, the plaintiff claimed that he had been disabled since August 29, 1999, due to high blood pressure, bleeding ulcer, asthma, and arthritis. (R.150-51, 181). The Agency denied this application on November 4, 1999 (R. 115— 118), and plaintiff chose not to seek reconsideration. Instead, she filed a third application on March 1, 2000. (R. 152-53). This application was denied at the both the initial level of administrative review (R. 119-22), and upon reconsideration. (R. 125-27). Plaintiff requested an administrative hearing. (R. 128-29).

On March 13, 2002, an administrative law judge conducted a hearing at which plaintiff, represented by counsel, appeared and testified. (R.45-111). In addition, Richard Hamersma testified as a vocational expert. (R. 45, 101-10). In a decision dated October 22, 2002, the ALJ found that plaintiff was not disabled because she retained the ability to perform a range of unskilled, light work. (R.22-41). This became the final decision of the Commissioner when the Appeals Council denied plaintiffs request for review of the decision on August 7, 2003. (R. 7-9). See 20 C.F.R. §§ 416.1455; 416.1481. Plaintiff has appealed that decision to the federal district court under 42 U.S.C. § 405(g), and the parties have consented to the jurisdiction of the magistrate judge pursuant to 28 U.S.C. § 636(c).

III.

THE EVIDENCE ADDUCED AT THE HEARING

The plaintiff was born on December 12, 1949. She was fifty-two years old at the time of the ALJ’s decision. (R. 152). She is 5' 1" and weighs 176 pounds. (R. 345). She has a seventh-grade education (R. 72-73). Plaintiff is able to write her name, read a grocery list, and make change (R. 73), but claims difficulty in reading “a lot of words” in the newspaper. (R. 73). She worked part-time as a housekeeper from 1995 to 1999 (R. 182), and as a baby-sitter in 1999. (R. 181). In 2000 she worked in housekeeping at a hotel. (R. 344).

She testified under oath — falsely as it turned out — in conformity with her lawyer’s representation to the ALJ, that she had been drug-free for at least 15 years, and that her 19-day stay at the Haymark-et Center in May 2002 had absolutely nothing to do with drug addiction and related only to her problems with alcohol. (R. 54, 96). She admitted to a 3-pack-a-day cigarette habit for 35 years and to being an alcoholic for as many years and to purchasing alcohol on a daily basis. (R. 61, 252). These addictions were in place during the period that she claimed that she could not get to the hospital to refill her prescriptions because she lacked bus fare. (R. 67, 84-85, 353). These addictions were also in place when Ms. Rogers claimed that she had to quit her babysitting job because she did not have bus fare. (R. 84-85).

A.

The Medical Evidence

The relevant medical evidence dates from July 27, 1999, when plaintiff was treated in the emergency room of Provident Hospital of Cook County for some shortness of breath, a cough, and intermittent abdominal pain (R. 240). She was initially diagnosed with asthma, peptic ulcer disease, and athlete’s foot. (R. 240). A chest x-ray revealed mild interstitial lung density — calcified lymph nodes — and old granulomatous disease without significant change from a previous study in March of 1998. (R. 247-51). The discharge diagnosis was asthma exacerbation, indigestion (dyspepsia), and athlete’s foot (R. 242).

Plaintiff returned to Provident Hospital for a scheduled follow-up visit at the Seng-stacke Clinic on September 8, 1999. (R. 242, 244). She complained of constipation and said she was occasionally dizzy and saw spots. (R. 244). Her blood pressure was 160/104. (R. 244, 310). The assessment was hypertension, chronic obstructive pulmonary disease or asthma, peptic ulcer disease, and athlete’s foot. (R. 245). When plaintiff returned to Sengstacke Clinic for her next follow-up visit on September 15, 1999, she initially complained that she had lost the strength in her hand; later she said she had “stiffness of hands, but no further complaints.” (R. 243).

The Agency arranged for Dr. Angelito Bernardo to perform a consultative examination on October 20, 1999. (R. 252-64). Plaintiff related a history of high blood pressure, breathing difficulties, and pain in her back and right hip. (R. 252). She admitted to having been a three-paek-a-day smoker for thirty-five years, but added that she had recently cut down to about a third of a pack per day. (R. 252). She also informed the doctor that she had been treated for a bleeding ulcer in 1998, but had not had an episode since then. (R. 253). Plaintiffs blood pressure was 130/90. (R. 253). Abdominal exam was normal. (R. 254, 255). Dr. Bernardo reported that he could hear wheezing when plaintiff spoke or exhaled. (R. 253-54). A pulmonary function study yielded a forced vital capacity of 2.40 liters and a forced expiratory volume of 1.80 liters in one second — both about 95% of predicted values, with improvement after bronchodila-tors were administered. (R. 258, 260).

Dr. Bernardo also reported tenderness of the right hip area with decreased range of motion because of pain. (R. 254). Plaintiffs gait was mildly antalgic and she had some difficulty walking 50 feet, walking on her toes, walking on her heels, tandem walking, squatting, and rising. (R. 254). An x-ray of the right hip was normal. (R. 264). Her grip strength, and gross and fine dexterity were said to be normal bilaterally. (R. 254). Dr. Bernardo felt that plaintiff “may have chronic obstructive pulmonary disease (COPD) with her symptomatology.” (R. 255). He also noted a history of hypertension, chest pain, ulcer, and right hip joint pain. (R. 255).

On January 12, 2000, plaintiff returned to the Provident Hospital ER complaining of sharp pains in the left side of her chest. (R. 265). Her medical history was noted to be positive for hypertension and lung disease. (R. 265). Upon examination, there was chest wall tenderness, but no wheezing, rales, or rhonci. (R. 265). A chest x-ray showed a left posterior lung lesion and “CA left hilar node.” (R. 265). On discharge, plaintiff was advised to take Tylenol as needed. (R. 265). On February 9, 2000, plaintiff went to Seng-stacke Clinic with complaints that included periodic joint stiffness lasting 30-60 minutes periodically throughout the day, as well as occasional chest discomfort and lower back stiffness. (R. 309). Blood pressure was 152/76. (R. 309). Plaintiff returned to the Provident Hospital ER on February 11, 2000, to for PPD test results. (R. 266, 268). It was noted to be reactive and plaintiff was told to return in a week. (R. 268).

The next week, plaintiff reported that Pepcid had helped with her gastrointestinal symptoms, although on examination there was slight epigastric pain with deep palpation. (R. 304-05). Her hypertension was “uncontrolled” with a blood pressure reading of 176/106 (R. 304), and her glucose level was elevated. (R. 305). The positive PPD was noted, as were plaintiffs calcified nodes. (R. 305). Both diabetes and sarcoidosis needed to be ruled out. (R. 305).

Plaintiff returned to the Sengstacke Clinic on March 15, 2000, complaining of joint pain and swelling in her right thumb. This was accompanied by stiffness, which was worse in the morning. There was some limitation of movement noted. Tylenol was recommended. Her blood pressure was normal at 119/80. (R. 294-295).

On March 22, 2000, Dr. Nelson — who examined plaintiff at the Sengstacke Clinic a week earlier, completed a series of forms for the Agency. (R. 269-76). He noted a diagnosis of asthma, hypertension, arthritis, and peptic ulcer disease. (R. 269). The doctor graded plaintiffs grip strength and gross and fine manipulation as 5/5 in the left hand but only 1/5 in the right hand. (R. 269). In addition, he reported that plaintiff had “poor pincer grasp and fine manipulation,” in her right hand. (R. 270). Dr. Nelson stated that plaintiff was unable “to use hands for fine movement, pincer grasp and manipulation of objects. Hence, this impairs her activities in daily living.” (R. 272). In the respiratory section of the forms, Dr. Nelson noted wheezing and that x-rays from February 11, 2000, had shown calcified nodes and mild interstitial lung disease. (R.271). He did not indicate that this affected her ability to perform work-related activities. (R. 271). He reported that plaintiffs hypertension was essentially asymptomatic. (R.273-76).

On March 28, 2000, Dr. E.C. Bone, an Agency physician, reviewed the medical record. (R. 232-239). He found that plaintiff could essentially perform light work, but was limited in her ability to grasp or perform fine manipulation with her right hand. (R. 233). He felt plaintiff could never climb or crawl, and should avoid concentrated exposure to pulmonary irritants and work around hazardous machinery and heights. (R. 236).

Plaintiff was treated for contact dermatitis on July 5, 2000. (R. 277-79). At that time her blood pressure was 124/80. (R. 278). She returned to the clinic on August 9, 2000, complaining of peeling and itchiness of both feet. (R. 302). She also said she always felt thirsty. (R. 302). She had run out of medication and wanted a refill. (R. 302). Treatment notes indicated there were scaly lesions on plaintiffs feet. (R. 303). Her blood pressure was elevated at 156/100. (R. 302). The assessment was hypertension, peptic ulcer disease (PUD), arthritis, athlete’s foot, COPD/asthma and complaints of polydipsia with diabetes needing to be ruled out (R. 303).

Plaintiff was at the clinic once again on September 6, 2000, this time complaining of shortness of breath when she walked, a headache, and dizziness. (R. 298). She also said she would cough during the night, waking her from sleep three to four times a week. (R. 298). This had been worse the week before. (R. 298). The assessment was essentially unchanged: hypertension, PUD, arthritis, COPD/asthma, and diabetes mellitus that needed to be ruled out. (R. 299-300). Along with these clinical notes was a comment from Dr. Nelson:

Patient Annie Rogers is under my care for Asthma, COPD, Hypertension, Arthritis, and Peptic Ulcer Disease. Her arthritis is oftentimes quite disabling. She is under medical therapy and physical therapy. The patient is using various inhalers for Asthma care and therapy-

(R. 301). Plaintiffs medications were then listed as: Celebrex, Maalox, Adalat and HCTZ, Pepcid, and Combivent MDI. (R. 301).

Plaintiff went to the clinic again on October 25, 2000. (R. 289-90). She had again run out of medication. She complained of shortness of breath at night and when she walked. (R. 289). Her blood pressure was 168/103. (R. 289). She also complained of a severe headache and some blurred vision. (R. 289). The assessment was diabetes mellitus type 2, hypertension, PUD, asthma, and arthritis (R. 290). An upper gastro-intestinal study on November 17, 2000, was consistent with mild gastritis. (R. 297).

By December 13, 2000, plaintiff had again run out of some of her medications and returned to the clinic for a refill. (R. 287). She complained of dizziness. (R. 287). Her blood pressure was stable at 115/62. (R. 287-88). She was given extra strength Tylenol for her arthritis, Prevacid for her gastrointestinal complaints, and Al-buterol and Atrovent for her COPD. (R. 288).

On April 10, 2001, plaintiff went to Provident Hospital’s ER because she had again run out of blood pressure medication and experienced some dizziness (R. 282). Blood pressure was 140/78. (R. 283). Her medication was refilled (R. 283) and 1-2 days of bed rest was recommended. (R. 284). Plaintiff returned on April 20, 2001, complaining of lightheadedness and an episode of nose bleeding. (R. 329). There was no diabetic reaction, headache, or dizziness. (R. 329). Blood pressure was 126/87. (R. 331). The discharge diagnosis was hyperglycemia. (R. 332).

On May 11, 2001, plaintiff went to Provident Hospital for “routine diabetic foot care” and it was noted that she had been living in a homeless shelter for the past two months (R. 326-27). It was also noted that plaintiff reported she had recently quit drinking and had a history of cocaine abuse. (R. 327)(Emphasis supplied). Two days later, plaintiff checked into the Hay-market Center’s in-patient program for cocaine and alcohol addiction. (R. 397). She again reported cocaine abuse and explained in detail the extent of her habit: she reported spending about $40 a day on cocaine over the previous year and $100 a day in prior years. (R. 405). She spent about $8 a day on alcohol. (R. 405). She reported she last used cocaine and alcohol on May 8, 2001. (R. 405). She claimed to have experienced blackouts for fifteen years. (R. 405). She also reported having been homeless for about ten months (R. 409). She was diagnosed both at the time of admission and at the time of release, as suffering from cocaine and alcohol dependency. (R. 407).

Plaintiff spent about three weeks undergoing “intensive residential treatment” at the facility (R. 416-17). Upon discharge to a recovery facility, no significant medical findings were noted. (R. 416). The medical professionals concluded that she did not need psychiatric evaluation or treatment. (R. 31). The diagnoses were confirmed by a physician. (R. 31).

On May 24, 2001, while still at Hay-market Center, plaintiff began seeing Dr. Lori Riley at Cook County Hospital’s clinic. (R. 356, 364). At that time, plaintiffs blood pressure was stable but her diabetes was not well-controlled. (R. 355). Dr. Riley added a diabetes medication to plaintiffs regimen. (R. 355). Dr. Riley’s treatment notes from August 7, 2001, reported that plaintiff had acute sinusitis, asthma with wheezing, and a skin rash of unknown etiology for which she prescribed Predni-sone. (R. 357). On August 28, 2001, Dr. Riley noted that plaintiffs diastolic blood pressure was mildly elevated at 120/100, and that, once again, her type 2 diabetes was not well-controlled. (R. 355). Plaintiff explained to Dr. Riley that her finances were limited and that she had to eat what was available at her son’s home. (R. 355). The doctor also referred plaintiff to the eye clinic for her complaint of blurred vision. (R. 354).

On December 7, 2001, plaintiff returned to the Cook County Hospital clinic and reported that she had lost consciousness after “sneezing in rapid succession.” (R. 353). Dr. Riley noted that plaintiffs blood pressure was well-controlled at 130/78 despite lack of medication, although Dr. Riley thought the loss of consciousness might have been due to uncontrolled blood pressure “since [she was] not compliant with meds.” (R. 353). Plaintiffs asthma was “moderately well controlled,” although, again, plaintiff had run out of medication. (R. 353). Dr. Riley reported that plaintiffs diabetes was poorly controlled, noting “social problems have impacted dietary adherence.” (R. 353). What these problems were, Dr. Riley chose not to say. She complained of having difficulty getting to the clinic, and Dr. Riley referred her to transportation services. (R. 353).

The Agency arranged for plaintiff to be examined by Dr. Paul Belich, an orthopedist, on December 11, 2001. (R. 344-50). Dr. Belich examined Ms. Rogers and reviewed the material provided by the Bureau of Disability Determination Services. Plaintiff reported that her chief complaints were arthritis in both hips and both hands, and related her history of ulcers, hypertension, diabetes, and asthma. (R. 344). She also reported that she took numerous medications, including extra strength Tylenol for her arthritis, although she was not on any medications for arthritis at the time of the examination. (R. 344-345).

Dr. Belich reported that plaintiff was appropriate, polite, pleasant and cooperative. Her affect was normal and there were no signs of depression or anxiety. Her gait was non-antalgic, and that her hips showed no signs of tenderness. He reported that range of motion in the hips was essentially symmetrical: 95 degrees of flexion, 45 degrees of external rotation, 15 degrees of internal rotation, 50 degrees abduction, 25 degrees abduction. There was mild tenderness in the base of plaintiffs right thumb, as well as bony prominence in the area. Nevertheless, Dr. Be-lich reported that plaintiff had good hand grips bilaterally and was able the make closed fists, and open and close her hands without any difficulty. (R. 345).

Dr. Belich’s impression was chronic hip and knee pain without clinical evidence of degenerative arthritis and basilar joint arthritis of the right thumb. (R. 346). According to the doctor, plaintiff had no limitations whatsoever from lifting, carrying, standing, walking, sitting, pushing, or pulling: in fact, he thought she could lift and carry 100 pounds or more, and could stand and walk for six hours during an eight-hour workday. (R. 347-48). He did, however, report that plaintiff could only occasionally climb, balance, kneel, crouch, crawl, and stoop. (R. 348). He further reported that plaintiff had unlimited ability to reach, handle, finger and feel with both hands. (R. 349). Finally, despite noting plaintiffs history of asthma, Dr. Belich reported that plaintiff had no environmental limitations, i.e., no restrictions as to temperature extremes, humidity, hazards, fumes, odors, chemicals or gases. (R. 350).

On December 11, 2001, plaintiff underwent an x-ray of her right hand after complaining of pain for two weeks. (R. 351). The study revealed mild degenerative osteoarthritic changes at the first metacarpal and first metacarpal joint. (R. 351). The remainder of the bones of the hand were normal. (R. 351).

Plaintiff returned to see Dr. Riley on March 1, 2002, complaining of pain in her leg muscles, numb fingers, and “tingling on tips of fingers on [left] hand.” (R. 352). Plaintiffs blood pressure was 172/100, and Dr. Riley noted that her hypertension was uncontrolled but there were no symptoms. (R. 352). Dr. Riley also noted that plaintiffs diabetes was not well controlled, and that she was experiencing symptoms of neuropathy and polyuria. (R. 352). Plaintiff reported experiencing asthma symptoms on a daily basis, which were triggered by strong odors, cold air, dust, and cat and dog dander. (R. 352). Her medication at that time included Combivent, Albuterol, and Aerobid (asthma), HCTZ and Captopril (hypertension), Acetornino-phen ES, and Metformin (diabetes). (R. 362). Dr. Riley also proscribed an Acro-chamber, a precision monitor and monitor strips. (R. 362).

Dr. Riley also completed a residual functional capacity questionnaire at that time. (R. 358-61). She reported a diagnosis of hypertension, type 2 diabetes, moderately persistent asthma, and osteoarthritis; she called plaintiffs prognosis “fair.” (R. 358). She said that plaintiffs symptoms were nerve pain and numbness in her fingertips, pain in her hips that travels down her legs, and blurred vision. (R. 358). These symptoms, according to Dr. Riley, constantly interfered with plaintiffs attention and concentration. (R. 359). She needed reading glasses, and also needed to avoid asthma triggers of “dust, dry temperature extremes strong odors.” (R. 361). Dr. Riley reported that the hip pain was related to the degeneration of plaintiffs hip joint and the finger pain and discomfort was the result of nerve damage. (R. 358). She also reported that, due to the medications she took, plaintiff experienced side effects of nausea and diarrhea. (R. 358). According to the doctor, plaintiff was not a malingerer. (R. 359).

Dr. Riley also felt that depression affected plaintiffs physical condition. (R. 359). She did not elaborate on this non-specific conclusion, and more importantly, she did not prescribe any anti-depressant medication or refer Ms. Rogers for any kind of counseling or other therapy. Finally, she did not conclude that Ms. Rogers’ “depression” prevented her from working.

Dr. Riley opined that plaintiff was capable of tolerating only “low stress” in a job situation. (R. 359). Dr. Riley also reported that plaintiff could stand for no more than 45 minutes at a time and stand/walk a total of less than two hours during an eight-hour workday. (R. 359-60). Plaintiff could sit for an hour at a time for a total of about four hours during an eight-hour work day and would have to be able to shift at will between sitting, standing and walking. (R. 360). Along these lines, Dr. Riley felt that plaintiff would need to be able to walk around for 15 minutes every half an hour and that she would likely need three unscheduled 10-minute breaks throughout the work-day. (R. 360). During prolonged sitting, plaintiff would need to elevate her legs 6-8 inches. (R. 360). Despite plaintiffs degenerative hip impairment, Dr. Riley reported that plaintiff could bend and twist for 75% of an eight-hour workday. (R. 361). Dr. Riley opined that plaintiff could lift and carry up to 20 pounds, but that she could use her hands for grasping, fine manipulation, and reaching for only about a third of a workday. (R. 360-61). Dr. Riley also estimated that plaintiff would likely be absent from the workplace once a month. (R. 361).

B.

The Plaintiffs Testimony At The Hearing

Ms. Rogers testified that her diabetes caused her to feel dizzy about three or four times a week, when she would have to lie down for an hour and a half. (R. 64). She said she experienced a tingling or a numbness in the fingertips of her left hand, and a pain in her right thumb. (R. 64). She is right-handed. (R. 92). Plaintiff said she had “a little bit” of problem using her right hand, explaining she had trouble combing her hair and washing dishes. (R. 64). Her hands were stiff in the morning when she woke up. (R. 74). She was able to make a fist and carry some things, but could not peel potatoes or cut things up. (R. 91-92). All this was consistent with her prior complaints to doctors and with the empirical medical evidence.

She said that both her hips hurt when she lay down, but also that they mostly hurt when she walked too much. (R. 65). She could walk about a block before her hips began to hurt. (R. 65). But she went on to say that she typically walked around the block every day (R. 70), and she was somewhat equivocal as to whether her ability to walk was limited by pain in her hip or simply because she just tired easily. (R. 66). She did state that her hips also hurt when she climbed stairs or stood in one place. (R. 75). According to plaintiff, her bleeding ulcer affected her when she got up in the morning to go to the bathroom. (R. 68). Her ulcers have improved, however, since she stopped drinking. (R. 93). She testified that she got headaches three or four times a week, each lasting about an hour. (R. 68).

Although the plaintiff was frightened when she suffered asthma attacks (R. 61), she still smoked a pack of cigarettes every few days. (R. 61). Her asthma was worse when the weather was too hot or too cold or when it was humid. It was also affected by strong odors. (R. 74-75). Plaintiff stated that she took Tylenol for her headaches (R. 68), and extra strength Tylenol for her pain. (R. 91). She explained that she did not always take her other medication because she had to make it “stretch” until she could get to the Provident Hospital clinic for refills. (R. 67).

She sought to account for her noncompliance with her medical regimen by claiming that she lacked bus fare and could not get to the hospital to refill her prescriptions. (R. 67; 77-78). She also reported that she was finally getting glasses to correct her vision. (R. 92).

At the time of the hearing, plaintiff was living with her sister. (R. 70). Prior to that, plaintiff lived with her mother until her mother died. (R. 79). Plaintiff also related that she would stay with her son when she and her sister argued. (R. 79). There were times, plaintiff explained, that she was homeless when no one in her family would let her stay with them. (R. 80). She had difficulty getting along with her family. (R. 95). She has five adult children — four sons and a daughter — ranging in age from 23 to 36. (R. 80). Plaintiff testified that she lived for a time at a shelter and at the Haymarket Center while being treated. (R. 95-96). This was contraiy to statements made in May 2001 to the staff at the Haymarket Center, to whom she reported perfectly amicable relations with her entire family.

She claimed that she was only at the Haymarket Center because of alcohol abuse and that her involvement at the Haymarket had absolutely nothing to do with drugs. (R. 96). This testimony would be belied by records from the Hay-market, which were obtained after Ms. Rogers’ testimony. Ms. Rogers claimed that since she left the Haymarket, she has not been drinking, so she does not bother going to meetings. (R. 97). This sudden cessation of drinking represented a dramatic recovery from 35 years of chronic alcoholism.

While discussing her living situation with the ALJ, plaintiff became tearful and rocked back and forth in her chair. (R. 25, 98). Plaintiff later testified that she has crying spells such as these two or three times a day. (R. 98-99). She said that she spoke about this sadness with Dr. Riley and that this helped. She conceded that Dr. Riley had never referred her for counseling or prescribed antidepressant medication of any kind. (R. 98-99).

Plaintiff said she would typically spend the morning watching television, and would also usually walk around the block and play cards. (R. 70). She drinks a lot of water, and estimated that she went to the bathroom about twenty to thirty times a day. (R. 71). Plaintiff testified that she has worked in a laundry, and at a seatbelt factory, but that those jobs were long ago. (R. 58, 81-82). After those jobs, she explained:

I met a — -this guy and he — I had three children by him. He wouldn’t let me work so that was that.

(R. 82). Then, in 1995, she worked as a live-in housekeeper for a friend. (R. 83). That arrangement lasted five years until the man died. (R. 83). Most recently, she babysat at the home of a family with six children, but had to quit when the family decided she should have child-care training to do the job. (R. 85-86). She again claimed that she was unable to afford bus fare to get to the job. (R. 86). According to plaintiff, she then worked as a hotel maid for two or three months in 2000. (R. 60, 87). After that, she felt she could no longer work because her “legs were hurting. [She] found out [she] had bleeding ulcers and [her] hands — ...” (R. 87).

C.

The Vocational Expert’s Testimony

The vocational expert (“VE”) testified that plaintiffs past relevant work in the laundry was unskilled and medium in exer-tional level, while her housekeeping job was unskilled and light. (R. 102). He considered plaintiffs brief stints as a bartender and a babysitter to be unsuccessful work attempts. (R. 102). The ALJ asked the VE to consider a hypothetical, right-handed individual with a vocational background similar to plaintiffs who could perform a full range of light work but: could not climb ladders or scaffolds; could only occasionally climb stairs or ramps; could only occasionally bend, stoop, kneel, or crawl; could not tolerate extremes of temperature or humidity or respiratory irritants; could not work around unprotected heights or hazardous equipment; and who suffered occasional decreased feeling in the left hand. (R. 103).

When asked whether such an individual could perform any of plaintiffs past relevant work, the VE replied in the negative. (R. 104). The VE went on to state, however, that such an individual could perform 10,000 cashier jobs, 8,000 assembly jobs, and 7,000 hand packaging jobs. (R. 104). As such, the numbers he cited reflected a 50% reduction in the overall number of jobs at these positions. (R. 105). The VE explained that the restrictions set forth by the ALJ “would be more of a sit/stand type of variety,” and that the jobs he cited involved “sitting a fair amount of time.” (R. 104). If such a person had the further limitations of being unable to stand and walk more than two hours a day, unable to use her hands for manipulation for more than 30% of the day, requiring three ten minute breaks each day, needing to elevate her legs while seated and needing to miss one day of work each month, the VE said the individual could not perform any jobs. (R. 107). The VE also testified that if an individual experienced pain that frequently interfered with attention and concentration, she could perform none of the jobs he had cited. (R. 105-06). He added that there was not a significant discrepancy between the jobs he cited and the descriptions in the Dictionary of Occupational Titles. (R. 105). On cross-examination, the VE noted that problems would arise if a cashier needed to take breaks during busy periods (R. 108). In addition, the assembly and packaging jobs require the worker to maintain a competitive pace, “usually what’s called an industrial minimum.” (R.108).

IV.

THE ADMINISTRATIVE LAW JUDGE’S DECISION

The ALJ found that plaintiff had not engaged in substantial gainful activity since 1999, when she alleges she became disabled. (R. 24, 40). Next, she determined that plaintiff had several severe impairments: asthma and/or COPD; non-insulin dependent diabetes; hypertension; arthritis; peptic ulcer disease; obesity; and a history of substance abuse, reported to be in remission. (R. 25, 40). These impairments, according to the ALJ, met the Agency’s requirement that a severe impairment significantly limit the ability to perform basic work activities. (Id.). See 20 C.F.R. § 416.920(c). The ALJ concluded that while the record suggested that plaintiff was depressed, she did not suffer from a medically determinable severe mental impairment — other than substance dependence (R. 25, 40), which is excluded by the Act. She further determined, however, that none of the plaintiffs impairments, either singly or in combination, met or equaled an impairment listed in the Agency’s regulations as disabling. (R. 25-27, 40). See 20 C.F.R. Pt. 404, Subpt.’ P, App. 1, Listing of Impairments.

The ALJ then assessed plaintiffs residual functional capacity (“RFC”). She reviewed in detail the medical evidence, beginning with the plaintiffs emergency room visit in July of 1999. She provided a summary of each instance of plaintiffs medical treatment, including emergency room visits, hospital and rehabilitation clinic stays, and her various consultative examinations. (R. 27-33). She noted plaintiffs clinical and laboratory test results, including the Julyl999 and January 2000 chest x-rays demonstrating calcified lymph nodes since at least March of 1998, studies showing both normal and reduced strength and range of motion in plaintiffs hands, an upper GI examine consistent with mild gastritis, a normal x-ray of plaintiffs right hip, a near normal x-ray of plaintiffs right hand, a pulmonary function study showing reduced lung capacity, elevated glucose level readings, and alternately elevated and stable blood pressure readings.

This elaborate review led the ALJ to conclude that overall the record demonstrated that Ms. Rogers:

has received some routine primary care for her chronic impairments, but that she has had significant periods during which she was treated most often in emergency rooms, and did not have regular or routine visits with a doctor or clinic. The overall record shows that [plaintiff] has admitted often that she has run out of prescribed medications, that she has difficulty following the prescribed diet, and that she has adjusted doses of the prescribed medications to make prescriptions last longer. [Plaintiff] has continued to smoke cigarettes, in spite of her asthma and COPD, and continued to smoke cocaine regularly, further exacerbating her respiratory problem until May, 2001. (R. 27).

The ALJ also considered the medical opinions in the record. She related Dr. Riley’s assessment that plaintiff was rather severely limited by her impairments and Dr. Belich’s far more benign evaluation. She also reviewed Dr. Bone’s evaluation of the medical evidence as of March of 2000. The ALJ felt that Dr. Riley’s opinion was not necessarily supported by objective medical findings or the doctor’s own progress notes. The ALJ said that those notes neither reflected complaints of significant problems with ambulation or the use of either hand prior to March, 2002 nor mentioned examinations finding significant abnormalities affecting plaintiffs extremities. The ALJ chose to give some, but not controlling, weight to Dr. Riley’s opinion. (R. 34-35).

On the other hand, she gave greater weight to Dr. Belich’s opinion. The ALJ explained that Dr. Belich reported objective medical findings which were normal or near normal, and therefore consistent with his opinion of plaintiffs essentially unlimited residual functional capacity for at least certain kinds of work. (R. 35). She gave little weight to the opinion of Dr. Bone, who neither treated nor examined plaintiff. (R. 35).

The ALJ assessed plaintiffs symptoms and complaints and considered the factors in 20 C.F.R. § 416.929(c) and Social Security Ruling 96-7p. (R. 35). According to the ALJ, plaintiffs testimony about the nature and degree of her physical limitations was not fully consistent with, nor well-supported by, the other evidence of record. (R. 36). The ALJ said that the record did not establish that plaintiff complained frequently to Dr. Riley or other treating doctors that she had trouble using her hands or had problems walking due to pain. (R. 36). She also thought the record did not support a finding that plaintiff had an impairment that required her to keep her legs elevated. (R. 36). She also noted that plaintiff “has not needed prescription strength pain medication during the relevant period.” (R. 37). Cf. Schmidt v. Barnhart, 395 F.3d 737, 747 (7th Cir.2005)(among the factors court of appeals discussed was that plaintiff was not taking prescription medication).

The ALJ quite properly expressed concern about Ms. Rogers’ testimony and her lawyer’s representation that plaintiff had not used cocaine for the last 15 years and that her stay at the Haymarket had nothing to do with drugs. Those claims, the ALJ correctly emphasized, were dramatically at odds with the records of the Provident Hospital and the Haymarket Center. (R. 37). The ALJ noted that there was no evidence that plaintiff had abused drugs or alcohol since she left the Center in 2001. (R. 37).

After considering the totality of the evidence, the ALJ found that plaintiff retained the capacity to perform “most light work” (R. 37, 41), which the regulations define as involving:

occasionally lifting no more than twenty pounds with frequent lifting or carrying of objects weighing up to ten pounds, or it may involve infrequent lifting but require substantial walking or standing or sitting with the pushing or pulling of arm or leg controls.

20 C.F.R. § 416.967(b). The ALJ found that plaintiff was further restricted insofar as she could not climb ladders, ropes, or scaffolds, and could only occasionally climb ramps and stairs, balance, stoop, kneel, crouch, or crawl. In addition, she determined that plaintiff should not be exposed to extremes of temperature, humidity, respiratory irritants, unprotected heights, or unguarded hazardous equipment. The ALJ added that plaintiff had a slight reduction in sensation of her non-dominant left hand, but otherwise had normal ability to use her hands for fine and gross manipulation, and did not need to elevate her feet while seated. Finally, the ALJ found that plaintiffs mental ability to perform unskilled work was not significantly limited, and that she could sustain the demands of such work despite her pain and feelings of depression, which would seldom interfere with her concentration, persistence or pace for work of that kind. (R. 37-38).

The ALJ then reviewed plaintiffs limited work history. (R. 38). She noted that plaintiffs housekeeping work had been light and unskilled, and that the other jobs she held were so short in duration that they were not vocationally relevant. (R. 38). The ALJ adopted the VE’s opinion that the plaintiff could not perform her past work as a housekeeper because of the frequent stooping required. (R. 39, 41). Next, she considered whether plaintiff could perform other jobs that existed in significant numbers in the economy. Considering the fact that the plaintiff was approaching advanced age, had a seventh grade education and was able to read and write, had no transferable skills from past work, and had the capacity to perform a significant range of light work, the ALJ employed the Medical-Vocational guidelines as a framework to find that plaintiff was not disabled. (R. 39, 41). Finally, the ALJ relied upon the VE’s testimony that a hypothetical person with the plaintiffs limitations could perform jobs such as cashier — (10,000 such jobs in the Chicago region) — light assembly — (8,000 such jobs)— and hand packer — (7,000 such jobs) — despite her postural, environmental, and other limitations. (R. 40). As a result, the ALJ found that plaintiff was not disabled and was not entitled to SSI under the Act. (R. 17,18).

V.

ANALYSIS

A.

The Standard Of Review

The applicable standard of review of the Commissioner’s decision is a familiar one: a court must affirm the decision if it is supported by substantial evidence. 42 U.S.C. §§ 405(g). Substantial evidence is such relevant evidence as a reasonable mind might accept to support a conclusion. Binion v. Chater, 108 F.3d 780, 782 (7th Cir.1997), citing Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971). Substantial evidence is more than a scintilla and something less than a preponderance. See Ehrhart v. Secretary of Health & Human Services, 969 F.2d 534, 538 (7th Cir.1992); Young v. Secretary of Health & Human Services, 957 F.2d 386, 389 (7th Cir.1992). The court may not reweigh the evidence or substitute its judgment for that of the Social Security Administration. Where conflicting evidence would allow reasonable minds to differ as to whether the plaintiff is disabled, the Commissioner has the responsibility for resolving those conflicts. Conclusions of law are not entitled to such deference, however, so where the Commissioner commits an error of law, the court must reverse the decision regardless of the volume of evidence supporting the factual findings. Binion, 108 F.3d at 782.

While judicial review is deferential, Wilder v. Chater, 64 F.3d 335, 337 (7th Cir.1995), the court cannot act as a mere “rubber stamp” for the Commissioner’s decision. Scott v. Barnhart, 297 F.3d 589, 593 (7th Cir.2002). In order for the court to affirm a denial of benefits, the ALJ must have articulated the reasons for his decision at some minimal level. Rice v. Barnhart, 384 F.3d 363, 371 (7th Cir.2004); Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir.2001). Although the ALJ need not address every piece of evidence, the ALJ cannot limit his discussion to only that evidence that supports his ultimate conclusion. Herron v. Shalala, 19 F.3d 329, 333 (7th Cir.1994). The ALJ’s decision must allow the court to assess the validity of his findings and afford the plaintiff a meaningful judicial review. Scott, 297 F.3d at 595.

B.

The Required Five-Step Sequential Analysis

Social Security Regulations require a five-step sequential inquiry by the ALJ to determine whether a plaintiff is disabled:

1) is the plaintiff currently unemployed;

2) does the plaintiff have a severe impairment;

3) does the plaintiff have an impairment that meets or equals one of the impairments listed as disabling in the Commissioner’s regulations;

4) is the plaintiff unable to perform his past relevant work; and

5) is the plaintiff is unable to perform any other work in the national economy.

20 C.F.R. §§ 404.1520; Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351-52 (7th Cir.2005). Scheck v. Barnhart, 357 F.3d 697, 700 (7th Cir.2004). An affirmative answer leads either to the next step or, on steps 3 and 5, to a finding that the plaintiff is disabled. 20 C.F.R. § 416.920; Briscoe, 425 F.3d at 352; Stein v. Sullivan, 892 F.2d 43, 44 (7th Cir.1989). A negative answer at any point, other than step 3, stops the inquiry and leads to a determination that the plaintiff is not disabled. 20 C.F.R. § 404.1520; Stein, 892 F.2d at 44. The plaintiff bears the burden of proof through step four; if it is met, the burden shifts to the Commissioner at step five. Briscoe, 425 F.3d at 352, Brewer v. Chater, 103 F.3d 1384, 1391 (7th Cir.1997).

C.

The Record Demonstrates That The ALJ Did Not Use Plaintiffs Poverty Against Her

The first of the several issues plaintiff contends requires a remand is that the ALJ improperly used her poverty against her and manifested a “sociologic inability to appreciate the circumstance of an individual without the financial means to even afford bus fare.” (Pl.Mem. at 17). As Learned Hand said in another context, the only thing about the argument we can commend is the hardihood in supposing it could possibly succeed. United States v. Minneci, 142 F.2d 428, 429 (2nd Cir.1944).

At the outset of the hearing, the ALJ explained to Ms. Rogers that under current law, if a claimant cannot work because of a substance problem, he or she was not entitled to benefits. (R. 52). In her opening statement, Ms. Rogers’ lawyer stressed that “there’s been no illegal substance abuse in at least the last 15 years, perhaps even longer than that,” and that the case did not involve drugs and alcohol. (R. 54). Consistent with that theme, Ms. Rogers emphatically denied that her 19-day stay at the Haymarket Center in May 1991 stemmed from any drug usage. (R. 96). She also testified with equal solemnity that she often was forced to allow her prescriptions to remain unfilled because she could not afford bus fare to go to the hospital to refill them, even though they were vital to the treatment of her medical ailments.

“[0]f course, the Administrative law judge did not have to believe” Ms. Rogers. Sarchet, 78 F.3d at 307. Accord Johnson v. Barnhart, 449 F.3d 804, 805 (7th Cir. 2006). She was entitled' — indeed she was obligated — to determine the validity of Ms. Rogers’ testimony since under the Act, benefits may not be awarded for disabilities causally linked to drug usage. But, making judgments about who is telling the truth is a tricky business. The reviewing court lacks direct access to the witnesses, lacks the trier’s immersion in the case as a whole, and lacks the specialized tribunal’s experience with the type of case under review. See Carradine v. Barnhart, 360 F.3d 751, 753 (7th Cir.2004). Compare Ashcraft v. Tennessee, 322 U.S. 143, 171, 64 S.Ct. 921, 88 L.Ed. 1192 (1944) (Jackson, J., dissenting) (“a few minutes observation of the parties in the courtroom is more informing than reams of cold record.”). That is why appellate review of credibility determinations, especially when made by specialists such as the administrative law judges of the Social Security Administration, is entitled to “special deference.” Powers v. Apfel, 207 F.3d 431, 435 (7th Cir.2000).

Judges often overestimate their ability to sift true from false testimony by assessing demeanor, “which is a form of lie detector without the electrodes and graph paper.” Djedovic v. Gonzales, 441 F.3d 547, 551 (7th Cir.2006). Judge Posner has cautioned that it is extremely difficult to determine whether a witness is testifying truthfully, and, much pious lore to the contrary notwithstanding, demeanor is often an unreliable guide to truthfulness. See Consolidation Services v. KeyBank National Association, 185 F.3d 817, 820 (7th Cir.1999); United States v. Wells, 154 F.3d 412, 414 (7th Cir.1998); Carradine, 360 F.3d at 751.

Nonetheless, demeanor continues to be thought a significant component of credibility determinations. See Thornton v. Snyder, 428 F.3d 690, 697 (7th Cir.2005), cert. denied sub nom, — U.S. --, 126 S.Ct. 2862, 165 L.Ed.2d 896 (2006). Cf. United States v. Bruscino, 687 F.2d 938, 941 (7th Cir.1982) (en banc )(ability of judge to observe demeanor of jurors). Indeed, the Supreme Court has said that the demeanor of a witness may satisfy the tribunal not only that the witness’ testimony is not true but that the truth is the opposite of his story, “for the denial of one, who has a motive to deny, may be uttered with such hesitation, discomfort, arrogance or defiance, as to give assurance that he is fabricating, and that, if he is, there is no alternative but to assume the truth of what he denies.” NLRB v. Walton Mfg. Co., 369 U.S. 404, 408, 82 S.Ct. 853, 7 L.Ed.2d 829 (1962). See also Anderson v. Bessemer City, 470 U.S. 564, 575, 105 S.Ct. 1504, 84 L.Ed.2d 518 (1985); Johnson v. Apfel, 240 F.3d 1145, 1147-48 (8th Cir.2001)(“completely proper in making credibility determinations” in social security case for ALJ to rely on claimant’s demeanor).

Perhaps the ALJ in this case was sensitive to the inherent difficulty in making credibility judgments based solely on demeanor. Or perhaps she just was not sure enough about Ms. Rogers’ affect and demeanor to feel comfortable about either accepting or rejecting certain portions of her testimony. Whatever the reason, the ALJ chose to follow the most responsible of courses and to request that medical records from Provident Hospital and the Haymarket Center be produced. This is the kind of careful attention to matters of credibility that is encouraged by social security regulations and reviewing courts alike.

SSR 96-7p counsels ALJs to look to extrinsic documents in making credibility determinations. The Seventh Circuit has stressed that credibility involves more than demeanor, Indiana Metal Products v. NLRB, 442 F.2d 46 (7th Cir.1971), and that documents or objective evidence may contradict the witness’ story, or the story itself may be so internally inconsistent or implausible on its face that a reasonable fact-finder would not credit it. See Pinpoint Inc. v. Amazon.Com, Inc., 347 F.Supp.2d 579, 583 (N.D.Ill.2004) (Posner, J.) (sitting by designation). Indeed, where such factors are present, a court of appeals can find clear error in a finding of credibility based on demeanor, even though such determinations are, as a matter of practice, usually insulated from appellate review. Ginsto Products, Inc. v. Dart Industries, Inc., 786 F.2d 260, 263 (7th Cir.1986).

Thus, at the close of the hearing in this case, the ALJ noted that since there had been “significant testimony” about the Provident and Haymarket Center hospitalizations, she thought it appropriate to examine the records from these facilities “to corroborate [Ms. Rogers] testimony.” (R. 110). Ms. Rogers’ attorney did not object to this request, and promised she would provide the records. The ALJ thus held the administrative record open for 30 days. (R. 110). The Provident Hospital records were produced, and the ALJ obtained the Haymarket records.

The Haymarket records were as detailed as they were revealing. They reflect Ms. Rogers’ 15-year history of crack cocaine usage (coupled with her 35 years of alcohol abuse). The diagnosis of cocaine addiction made by the Haymarket staff were based on the very precise statements made by Ms. Rogers in “an in-person interview” with her. (R. 411; 409-413). For example, Ms. Rogers said that she noticed in 2000 that she was spending a lot of time using drugs; that she had tried on March 8, 2001 to stop but was unable to do so; that in 1999 she noticed certain effects of the drugs; and that she had experienced blackouts for 15 years as a consequence of her drug use. (R. 403^417). She gave very precise cost figures for her cocaine purchases which ranged from $40 per day when she was 36 years old to $100 per day when she was 40 years old and then back to $40 per day for her “several times per week” crack cocaine usage in the preceding 12 months. She explained that she smoked the cocaine. (R. 404-405). She explained the reasons for her 2 months of sobriety in 2001 and discussed the reason for her relapse. She denied using any other drugs besides cocaine. (R. 406-407). The Haymarket staff was certain that Ms. Rogers was truthful in her reporting about her drug problem and its history and that she had a profound drug problem. (R. 411).

The Provident and Haymarket records proved two things: first, during the time the plaintiff swore under oath she had trouble finding $3 or 4 dollars per/month for bus fare, she had enough money to fund what was at least her several hundred dollar per month drug addiction. (R. 31, 410-413). Second, that Ms. Rogers’ claim that she was drug-free for 15 years and that her stay at the Haymarket did not involve drug abuse was knowingly false.

In her decision, the ALJ emphasized that although they had the opportunity to comment and give closing argument as it related to these records (R. 23), “neither claimant nor Ms. Goldbloom [plaintiffs lawyer at the hearing and in these proceedings] offered any explanation, post-hearing, for [the] glaring discrepancy between claimant’s testimony and the treatment records. These material inconsistencies in claimant’s testimony about her substance history cases significant doubt on claimant’s credibility.” (R.37)(Emphasis supplied). The ALJ concluded that Ms. Rogers’ allegations regarding her physical limitations were not totally credible since they were inconsistent with record evidence and her lies about drug dependency. (R. 41).

In addition to offering no explanation during the extended period that the hearing remained open for the glaring and disturbing inconsistencies between her client’s sworn testimony and the production of the Haymarket records, the plaintiffs opening brief ignored these inconsistencies and the ALJ’s credibility determination based on those records. Saving the least for last, the reply brief for the first time contended that the ALJ’s conclusion that Ms. Rogers was not a credible witness is faulty because the ALJ “utterly failed to consider the context of plaintiffs association with the Haymarket facility.” (Reply Memorandum at 6). “Objections to [this] startling thesis crowd the mind.” Posner, Overcoming Law, 211 (1995).

First, the ALJ’s credibility determination cannot be overturned because the plaintiffs lawyer has hypothesized a implausible version of events that posits that Ms. Rogers lied to the Haymarket staff but not to the ALJ. The question is not whether Ms. Rogers gulled the Haymarket staff, but whether the ALJ’s credibility determination is “patently wrong” and whether there is substantial evidence to support the determination that Ms. Rogers lied at the hearing. Schmidt v. Barnhart, 395 F.3d 737, 746-47 (7th Cir.2005); Skarbek v. Barnhart, 390 F.3d 500, 504 (7th Cir.2004). It is frivolous to suggest that the ALJ’s credibility determination in this case is patently wrong, that it is not supported by substantial evidence, or that the ALJ did not build an accurate and logical bridge between the evidence and her ultimate conclusion. Carradine, 360 F.3d at 753; Shramek v. Apfel, 226 F.3d 809 (7th Cir.2000); Macia v. Bowen, 829 F.2d 1009, 1011 (11th Cir.1987).

Second, the belatedly advanced argument that Ms. Rogers lied to the Hay-market staff was never presented to the ALJ and thus is it waived. Skarbek v. Barnhart, 390 F.3d 500, 504 (7th Cir.2004); Johnson v. Apfel, 189 F.3d 561, 562 (7th Cir.1999). See also United States v. L.A. Tucker Truck Lines, Inc., 344 U.S. 33, 35-36, 73 S.Ct. 67, 97 L.Ed. 54 (1952).

Third, the “I lied to the Haymark-et staff but not to the ALJ” theory was first advanced in Ms. Goldbloom’s reply brief, although it could easily have been raised in the opening brief—which in fact alluded to the Haymarket records. (Plaintiff’s Memorandum, at 6, n. 7-8). Hence it is waived on that basis also. Carter v. Tennant Co., 383 F.3d 673, 679 (7th Cir.2004).

Fourth, even if I were authorized to weigh the competing merits of the alternative lie theory, the ALJ’s credibility determination is be