Jones v. Colvin

Filing 23

MEMORANDUM Opinion and Order Signed by the Honorable Mary M. Rowland on 9/12/2017. Mailed notice. (dm, )

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
STEVEN JONES,
Plaintiff,
v.
NANCY A. BERRYHILL, 1 Acting
Commissioner of Social Security,

No. 16 C 5819
Magistrate Judge Mary M. Rowland

Defendant.
MEMORANDUM OPINION AND ORDER
Plaintiff Steven Jones filed this action seeking reversal of the final decision of
the Commissioner of Social Security denying his application for Social Security
Income under Title XVI of the Social Security Act (Act). 42 U.S.C. §§ 405(g), 423 et
seq. The parties have consented to the jurisdiction of the United States Magistrate
Judge, pursuant to 28 U.S.C. § 636(c), and filed cross motions for summary
judgment. For the reasons stated below, the case affirmed.
I. THE SEQUENTIAL EVALUATION PROCESS
To recover Social Security Income (SSI), a claimant must establish that he or she
is disabled within the meaning of the Act. 2 York v. Massanari, 155 F. Supp. 2d 973,
Nancy A. Berryhill, who became Acting Commissioner of Social Security on January
23, 2017, is substituted for her predecessor as the proper defendant in this action. Fed. R.
Civ. P. 25(d).
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The regulations governing the determination of disability for Disability Income
Benefits (DIB) are found at 20 C.F.R. § 404.1501 et seq. The standard for determining DIB
is virtually identical to that used for SSI. Craft v. Astrue, 539 F.3d 668, 674 n.6 (7th Cir.
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977 (N.D. Ill. 2001). A person is disabled if he or she is unable to perform “any
substantial gainful activity by reason of any medically determinable physical or
mental impairment which can be expected to result in death or which has lasted or
can be expected to last for a continuous period of not less than 12 months.” 20
C.F.R. § 404.1505(a). In determining whether a claimant suffers from a disability,
the Commissioner conducts a standard five-step inquiry:
1. Is the claimant presently unemployed?
2. Does the claimant have a severe medically determinable physical or
mental impairment that interferes with basic work-related
activities and is expected to last at least 12 months?
3. Does the impairment meet or equal one of a list of specific
impairments enumerated in the regulations?
4. Is the claimant unable to perform her or her former occupation?
5. Is the claimant unable to perform any other work?
20 C.F.R. §§ 404.1509, 404.1520; see Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir.
2000). “An affirmative answer leads either to the next step, or, on Steps 3 and 5, to
a finding that the claimant is disabled. A negative answer at any point, other than
Step 3, ends the inquiry and leads to a determination that a claimant is not
disabled.” Zalewski v. Heckler, 760 F.2d 160, 162 n.2 (7th Cir. 1985). “The burden of
proof is on the claimant through step four; only at step five does the burden shift to
the Commissioner.” Clifford, 227 F.3d at 868.

2008) (“Although the Code of Federal Regulations contains separate sections for DIB and
SSI, the processes of evaluation are identical in all respects relevant to this case.”).
Accordingly, this Court cites to both DIB and SSI cases.

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II. PROCEDURAL HISTORY
Plaintiff applied for SSI on August 7, 2012, alleging that he became disabled on
March 12, 2010, due to mental conditions. (R. at 261–266, 276). The application was
denied initially and upon reconsideration, after which Plaintiff filed a timely
request for a hearing. (Id. at 142–165, 176–78). On August 26, 2014, Plaintiff,
represented by counsel, presented at a hearing before an Administrative Law Judge
(ALJ). (Id. at 35–86). The ALJ also heard testimony from Larry M. Kravitz, Psy.D.,
a medical expert (ME), and Linda Gels, a vocational expert (VE). (Id.).
The ALJ denied Plaintiff’s request for benefits on December 22, 2014. (R. at 16–
34). Applying the five-step sequential evaluation process, the ALJ found, at step one
that Plaintiff has not engaged in substantial gainful activity since August 7, 2012,
his application date. (Id. at 21). At step two, the ALJ found that Plaintiff has the
severe impairments of depression, personality disorder, obesity, hypertension, and
osteoarthritis. (Id.). At step three, the ALJ determined that Plaintiff does not have
an impairment or combination of impairments that meets or medically equals the
severity of any of the listings enumerated in the regulations. (Id. at 21–24).
The ALJ then assessed Plaintiff’s Residual Functional Capacity (RFC) 3 and
determined that Plaintiff has the RFC to perform light work, except:
[H]e can occasionally lift and carry twenty pounds; can frequently lift
and carry ten pounds; can be on his feet standing and walking for at
least six hours in an eight hour workday, with normal rest periods; can
Before proceeding from step three to step four, the ALJ assesses a claimant’s residual
functional capacity. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). “The RFC is the maximum
that a claimant can still do despite his mental and physical limitations.” Craft, 539 F.3d at
675–76.
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sit for at least six hours in an eight hour work day, with normal rest
periods; occasionally climb ladders, ropes, scaffolds, ramps or stairs;
occasionally kneel, crouch or crawl; can constantly understand
remember and carryout very short and simple instructions; can
constantly maintain attention and concentration for extended periods
for the work stated above; can constantly make simple work-related
decisions and use judgment; can constantly complete a normal
workday and workweek without interruptions from psychologically
based symptoms and to perform at a consistent pace without an
unreasonable number and length of rest periods; can occasionally
interact appropriately with the general public with superficial contact;
can constantly accept instructions and respond appropriately to
criticism from supervisors; can occasionally get along with coworkers
and peers without distracting them or exhibiting behavioral extremes,
but no joint tasks; and no jobs that require meeting strict production.
(R. at 24; see id. at 24–28). Based on Plaintiff’s RFC and the VE’s testimony, the
ALJ determined at step four that Plaintiff cannot perform any past relevant work.
(Id. at 28). At step five, based on Plaintiff’s RFC, his vocational factors, and the VE’s
testimony, the ALJ determined that there are jobs that exist in significant numbers
in the national economy that Plaintiff can perform, including cleaner/housekeeper,
machine tender, and hand packager. (Id. at 29). Accordingly, the ALJ concluded
that Plaintiff is not under a disability, as defined by the Act. (Id. at 30).
The Appeals Council denied Plaintiff’s request for review on March 22, 2016. (R.
at 1–6). Plaintiff now seeks judicial review of the ALJ’s decision, which stands as
the final decision of the Commissioner. Villano v. Astrue, 556 F.3d 558, 561–62 (7th
Cir. 2009).
III. STANDARD OF REVIEW
Judicial review of the Commissioner’s final decision is authorized by § 405(g) of
the Act. In reviewing this decision, the Court may not engage in its own analysis of
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whether the plaintiff is severely impaired as defined by the Social Security
Regulations. Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004). Nor may it
“reweigh evidence, resolve conflicts in the record, decide questions of credibility, or,
in general, substitute [its] own judgment for that of the Commissioner.” Id. The
Court’s task is “limited to determining whether the ALJ’s factual findings are
supported by substantial evidence.” Id. (citing § 405(g)). Evidence is considered
substantial “if a reasonable person would accept it as adequate to support a
conclusion.” Indoranto v. Barnhart, 374 F.3d 470, 473 (7th Cir. 2004); see Moore v.
Colvin, 743 F.3d 1118, 1120–21 (7th Cir. 2014) (“We will uphold the ALJ’s decision
if it is supported by substantial evidence, that is, such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion.”) (citation
omitted). “Substantial evidence must be more than a scintilla but may be less than
a preponderance.” Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 2007). “In addition
to relying on substantial evidence, the ALJ must also explain his analysis of the
evidence with enough detail and clarity to permit meaningful appellate review.”
Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351 (7th Cir. 2005).
Although this Court accords great deference to the ALJ’s determination, it “must
do more than merely rubber stamp the ALJ’s decision.” Scott v. Barnhart, 297 F.3d
589, 593 (7th Cir. 2002) (citation omitted). “This deferential standard of review is
weighted in favor of upholding the ALJ’s decision, but it does not mean that we
scour the record for supportive evidence or rack our brains for reasons to uphold the
ALJ’s decision. Rather, the ALJ must identify the relevant evidence and build a
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‘logical bridge’ between that evidence and the ultimate determination.” Moon v.
Colvin, 763 F.3d 718, 721 (7th Cir. 2014). Where the Commissioner’s decision “lacks
evidentiary support or is so poorly articulated as to prevent meaningful review, the
case must be remanded.” Steele v. Barnhart, 290 F.3d 936, 940 (7th Cir. 2002).
IV. RELEVANT MEDICAL EVIDENCE
Plaintiff was born on September 4, 1962, and was 51 years old as of the date of
his August 2014 administrative hearing. (R. at 42). He dropped out of school in the
eleventh grade and has not obtained his GED or any other vocational training. (Id.
at 42–43).
Plaintiff’s records reflect that he reported throughout 2010 for treatment and
management of his established hypertension 4 and bilateral knee pain. (R. at 387–
96). At one of his earliest recorded appointments, Plaintiff’s height was 6΄2" and his
weight was 263, resulting in a body mass index (BMI) 5 of 33.8. 6 (Id. at 387). At the
same appointment, his blood pressure was recorded as 159/93. (Id.). In February
2010, it was noted that he had been depressed since his mother’s death ten years
earlier, leading his examining doctor to diagnose him with major depression. (Id. at
Hypertension is “high arterial blood pressure; various criteria for its threshold have
been suggested, ranging from 140 mm Hg systolic and 90 mm Hg diastolic to as high as 200
mm Hg systolic and 110 mm Hg diastolic.” Dorland’s Medical Dictionary, available at
https://www.dorlands/com.
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“BMI is the ratio of an individual’s weight in kilograms to the square of his or her
height in meters (kg/m2).” SSR 02-1p, 2002 WL 34686281, at *2. “For adults, both men and
women, the Clinical Guidelines describe . . . a BMI of 30.0 or above as obesity.” Id. (internal
quotations omitted).
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Plaintiff’s records indicate that his BMI was 32, however when the calculation is
applied to Plaintiff’s statistics, the resulting BMI is 33.8.
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390–91). Although his weight remained relatively stable during the following seven
months, by August 2010, his blood pressure had been reduced to 140/78. (Id. at 387,
395).
Almost one year later, in August 2011, Plaintiff sought additional treatment for
his bilateral knee pain, which he stated had worsened over the preceding months.
(R. at 343). Although Plaintiff demonstrated a normal range of motion and normal
musculoskeletal strength, Reena Paul, M.D., assessed osteoarthritis/degenerative
joint disease. (Id. at 344). At the same visit, Plaintiff admitted that he skipped his
medication and did not monitor his own blood pressure, in part because he had run
out of medication three days prior. (Id. at 343). Dr. Paul determined that Plaintiff’s
hypertension was “poorly controlled,” then counselled him on the importance of
complying with his medication. (Id. at 343–45).
Plaintiff’s next period of treatment was from June 2012 to September 2012,
where he generally reported for management of his hypertension and refills of his
hypertension medication, which was noted to be well-controlled. (R. at 337–341,
372). In September 2012, Plaintiff returned for a follow-up appointment and
reported that he had not taken his medications because he had run out the day
prior. (Id. at 372). Plaintiff’s weight was recorded as 127.1 kilograms (or 280.2
pounds), resulting in a BMI of 36, and his blood pressure was 149/94. (Id. at 373). In
May 2013, Plaintiff’s diagnoses included hypertension, major depression, and

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osteoarthritis, which his doctor treated with medications. 7 (Id. at 376). By
November, his hypertension symptoms had worsened due to emotional stress,
exertion, and missed medication; however, his doctor opined that it was still wellcontrolled. (Id. at 381–83).
In August 2014, Plaintiff returned for management of his hypertension and
osteoarthritis, and stated that he felt well. (R. at 398). Upon examination,
Bhrandon Harris, M.D., noted that he had a cautious gait with limited range of
motion in both of his knees. (Id. at 399). After his examination, the doctor
prescribed Naproxen, an anti-inflammatory drug used to treat pain. (Id.); see also
https://www.drugs.com/naproxen.html. With regard to Plaintiff’s hypertension, Dr.
Harris stated that it was uncontrolled, but noted that Plaintiff had not been
compliant with his medication. (Id. at 399–400). In contrast, Plaintiff’s depression
was controlled at the time of Dr. Harris’s examination. (Id.). However, Plaintiff was
diagnosed with bipolar disorder on a hospital discharge form a few weeks later and
prescribed medication. (Id. at 400–03).
A. Disability Determination Services
On October 12, 2012, Rochelle Hawkins M.D., a nontreating physician,
completed an Internal Medicine Consultative Examination Report. (R. at 359–62).
At the examination, Plaintiff explained that he had a history of hypertension, knee
pain, and depression. (Id. at 359). Dr. Hawkins noted that Plaintiff measured 73
Plaintiff’s medications included Amlodipine, used to treat high blood pressure;
Citalopram, used to treat depression; Ibuprofen, an anti-inflammatory drug used to treat
pain, and Trazodone, an antidepressant medication. (R. at 376). See https://www.drugs.com.
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and 3/4th inches tall (around 6΄2") and weighed 274 pounds, and described him as
obese. (Id. at 360). 8 Upon examination, Plaintiff had full range of motion in his
knees, but he complained of pain on movement; therefore Dr. Hawkins ultimately
opined that he would have some difficulty in prolonged standing, walking, lifting,
and carrying due to his obesity and chronic knee pain. (Id. at 361–62).
Two weeks later on October 24, 2012, Lenore Gonzalez, M.D., a nonexamining
DDS consultant, reviewed Plaintiff’s record and completed a Physical RFC
Assessment. (R. at 142–49). Upon consideration of Plaintiff’s activities of daily
living, the location, duration, and frequency of his pain and symptoms, medications,
and treatment, Dr. Gonzalez opined that Plaintiff retained that ability to perform
work at a light exertional level, except that he could only occasionally kneel, crouch,
crawl, or climb ladders, ropes, or scaffolds. (Id. at 148–49). Dr. Gonzalez
acknowledged Dr. Hawkins’s finding that Plaintiff’s obesity and chronic knee pain
would result in several work-related exertional limitations; and although her
opinion was consistent with the other medical evidence, he assigned it only “some
weight” because she was a non-treating source. (Id. at 143, 147). Dr. Gonzalez’s
findings were later affirmed by Phillip Galle, M.D., another nonexamining state
agency consultant, on March 28, 2013. (Id. at 153–61).

At the same appointment, Plaintiff’s blood pressure was recorded as 136/90. (R. at
360).
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B. Plaintiff’s Testimony
At his administrative hearing, Plaintiff testified that he experiences severe
bilateral knee pain which is not alleviated by medication. (R. at 45, 58–59). As a
result of his knee pain, Plaintiff testified that he can walk only one block and lift 15
pounds. (Id. at 45; 52). Because Plaintiff’s left knee pain is greater than his right
knee pain, his doctor prescribed him a left knee brace, which he uses two to three
times to week when his knee “really get[s] to hurting.” (Id. at 59–60). Plaintiff rated
his left knee pain a nine of ten on the pain scale. (Id. at 59).
Plaintiff further testified that he felt depressed over his reduced physical
abilities. (R. at 54). In regard to his medications, Plaintiff takes pills for both his
blood pressure and his depression. (Id. at 53–54). Plaintiff stated that during the
day his usually watches TV, but does not grocery shop or perform chores around the
house. (Id. at 55–56).
V. DISCUSSION
Plaintiff raises three arguments in support of his request for reversal of the
ALJ’s determination that he is not disabled: (1) the ALJ’s RFC determination was
unsupported by substantial evidence; (2) the ALJ’s subjective symptom evaluation
was erroneous; and (3) the ALJ failed to consider the aggregate effect his obesity
has on his other impairments in violation of SSR 02-1p.
A. The ALJ’s RFC determination was supported by substantial evidence.
Plaintiff first contends that the ALJ committed reversible error when he based
his RFC assessment upon the 2012 and 2013 findings of DDS consultants, Drs.
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Gonzalez and Galle, who did not have access to Dr. Harris’s 2014 medical evidence
at the time of their reports. (Dkt 13 at 7–11). This argument lacks merit. Because
Dr. Harris’s statements do not constitute an opinion, there was no evidence that
conflicted with the findings of the DDS consultants which the ALJ failed to consider
when formulating his RFC.
In his report, Dr. Harris detailed that Plaintiff had a “cautious gait” and limited
range of motion in his knees. This statement does not constitute a medical opinion.
See 20 C.F.R. § 404.1527(a)(2) (“Medical opinions . . . reflect judgments about the
nature and severity of your impairment(s), including your symptoms, diagnosis and
prognosis, what you can still do despite impairment(s), and your physical or mental
restriction.”). In particular, Dr. Harris’s notation does not specify any work-related
restrictions Plaintiff may have as a result of his knee problems, or indicate what
activities Plaintiff could still perform despite his limitations. See 20 C.F.R. §
404.1545(a)(1) (“Your residual functional capacity is the most you can still do
despite your limitations”). Further, as the ALJ noted, Plaintiff felt well and was in
no acute distress. (R. at 26). Dr. Harris adjusted Plaintiff’s medications to control
his knee pain. (Id.). Because the doctor did not offer an opinion about Plaintiff’s
ability to tolerate exertional activities, his report was not inconsistent with the
findings of the DDS consultants that Plaintiff was capable of walking and standing
for six hour in an eight-hour work day. Therefore, Dr. Harris’s statements presented
no conflict that the ALJ was required to address before he adopted the findings of
Drs. Gonzalez and Galle.
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Plaintiff also contends that the ALJ should have secured an updated expert
opinion in light of Dr. Harris’s examination. (Dkt. 13 at 8–10). The authority
governing the purchase of new examinations is discretionary and provides that the
SSA “may purchase a consultative exam to try to resolve an inconsistency in the
evidence, or when the evidence as a whole is insufficient to allow [the SSA] to make
a determination or decision on [a claimant’s] claim.” See 20 C.F.R. § 404.1519a(b).
Neither is at issue here. First, neither party argues that the evidence of record was
insufficient to make a determination. Second, because the notations made by Dr.
Harris did not conflict with the findings of the DDS consultants, there was no
inconsistency in the evidence for the ALJ to resolve. Accordingly, the ALJ did not
abuse his discretion in deciding not to order an additional examination.
Moreover, an ALJ is entitled to assume that a claimant, who is represented by
counsel, has presented his strongest case for benefits. See Skinner, 478 F.3d at 84.
Following Dr. Galle’s March 2013 report, Plaintiff’s record contains no additional
examinations or opinions that indicate that he had greater functional limitations
than those opined by the DDS consultants. As a result, Plaintiff has failed to meet
his burden to show the ALJ’s RFC determination was unsupported by the evidence
of record.
Finally, Plaintiff alleges the ALJ had a duty to discuss the possibility of
Plaintiff’s deteriorating impairments. (Dkt. 13 at 10). The court is not persuaded. In
making his argument, Plaintiff relies on two cases where the Seventh Circuit
remanded because the ALJs failed to consider the possibility of the claimants’
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deteriorating condition before according weight to the medical source opinions. See
Clifford, 227 F.3d at 870–71 (finding remand was appropriate because the ALJ did
not consider the possibility of Plaintiff’s deteriorating condition before he evaluated
the opinion of an examining physician which was inconsistent with an earlier
examiner’s opinion); see also Roddy v. Astrue, 705 F.3d 631, 634–37 (7th Cir. 2013)
(remanding where the ALJ did not discuss the treating physician’s deposition
statement that the claimant’s degenerative disc disease had deteriorated since
beginning treatment before rejecting this physician’s opinion.). Here, Plaintiff fails
to point to any evidence which “sugget[s] that his level of functioning may have
deteriorated over time.” (Dkt. 13, at 10). Accordingly, the Court concludes that the
ALJ’s RFC determination was proper.
B. The ALJ’s Subjective Symptom Evaluation Was Not “Patently Wrong.”
The Social Security Administration determined recently that it would no longer
assess the “credibility” of a claimant’s statements, but would instead focus on
determining the “intensity and persistence of [the claimant’s] symptoms.” Social
Security Ruling (SSR) 16-3p, at *2. 9 “The change in wording is meant to clarify that
administrative law judges aren’t in the business of impeaching claimants’ character;
obviously administrative law judges will continue to assess the credibility of pain

SSRs “are interpretive rules intended to offer guidance to agency adjudicators. While
they do not have the force of law or properly promulgated notice and comment regulations,
the agency makes SSRs binding on all components of the Social Security Administration.”
Nelson v. Apfel, 210 F.3d 799, 803 (7th Cir. 2000) (internal citations omitted); see 20 C.F.R.
§ 402.35(b)(1). While the Court is “not invariably bound by an agency’s policy statements,”
the Court “generally defer[s] to an agency’s interpretations of the legal regime it is charged
with administrating.” Liskowitz v. Astrue, 559 F.3d 736, 744 (7th Cir. 2009).
9

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assertions by applicants, especially as such assertions often cannot be either
credited or rejected on the basis of medical evidence.” Cole v. Colvin, 831 F.3d 411,
412 (7th Cir. 2016) (emphasis in original).
The regulations describe a two-step process for evaluating a claimant’s own
description of his or her impairments. First, the ALJ “must consider whether there
is an underlying medically determinable physical or mental impairment(s) that
could reasonably be expected to produce the individual’s symptoms, such as pain.”
SSR 16-3p, at *2; see also 20 C.F.R. § 416.929. “Second, once an underlying physical
or mental impairment(s) that could reasonably be expected to produce the
individual’s symptoms is established, we evaluate the intensity and persistence of
those symptoms to determine the extent to which the symptoms limit an
individual’s ability to perform work-related activities . . . .” SSR 16-3p, at *2.
In evaluating the claimant’s subjective symptoms, “an ALJ must consider
several factors, including the claimant’s daily activities, her level of pain or
symptoms, aggravating factors, medication, treatment, and limitations, and justify
the finding with specific reasons.” Villano, 556 F.3d at 562 (citations omitted); see
20 C.F.R. § 404.1529(c); SSR 16-3p. An ALJ may not discredit a claimant’s
testimony about his symptoms “solely because there is no objective medical evidence
supporting it.” Villano, 556 F.3d at 562 (citing 20 C.F.R. § 404.1529(c)(2)); see
Johnson v. Barnhart, 449 F.3d 804, 806 (7th Cir. 2006) (“The administrative law
judge cannot disbelieve [the claimant’s] testimony solely because it seems in excess
of the ‘objective’ medical testimony.”). Even if a claimant’s subjective symptoms are
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not supported directly by the medical evidence, the ALJ may not ignore
circumstantial evidence, medical or lay, which does support the claimant’s
subjective symptoms. Lopez ex rel. Lopez v. Barnhart, 336 F.3d 535, 539–40 (7th
Cir. 2003). Indeed, SSR 16-3p, like former 96-7p, requires the ALJ to consider “the
entire case record, including the objective medical evidence, the individual’s own
statements about symptoms, statements and other information provided by treating
or examining physicians or psychologists and other persons about the symptoms
and how they affect the individual, and other relevant evidence in the case record.”
Arnold v. Barnhart, 473 F.3d 816, 823 (7th Cir. 2007) (citation omitted).
The Court will uphold an ALJ’s subjective symptom evaluation if the ALJ gives
specific reasons for that finding, supported by substantial evidence. Moss v. Astrue,
555 F.3d 556, 561 (7th Cir. 2009). The ALJ’s decision “must contain specific
reasons” for the subjective symptom evaluation; “the ALJ may not simply recite the
factors that are described in the regulations.” Steele, 290 F.3d at 942 (citation omitted). “Without an adequate explanation, neither the applicant nor subsequent
reviewers will have a fair sense of how the applicant’s testimony is weighed.” Id.
Plaintiff testified that his daily activities are limited to watching television and
napping. (R. at 55, 57). His pain and depression limit his ability to get along with
people and take instructions. (Id. at 65–66). When he is in pain, he often gets into
arguments with people. (Id. at 65).
In his decision, the ALJ found that Plaintiff’s allegations “are not entirely
credible.” (R. at 25). Specifically, the ALJ found Plaintiff’s statements not credible
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because (1) the record reflects significant gaps in Plaintiff’s treatment; (2) Plaintiff’s
treatment has been “routine and conservative in nature;” (3) and Plaintiff has not
been entirely compliant with his prescribed medications. (Id.).
Not all of these reasons are legitimate. The ALJ drew improper inferences about
Plaintiff’s subjective symptoms based on gaps in his medical treatment without first
determining whether Plaintiff had good reasoning for his lack of medical care. Craft
v. Astrue, 539 F.3d 668, 679 (7th Cir. 2008) (“[T]he ALJ ‘must not draw any
inferences’ about a claimant’s condition from this failure unless the ALJ has
explored the claimant’s explanations as to the lack of medical care.”). Nevertheless,
the ALJ otherwise supported his credibility determination with specific findings
and substantial evidence. See Bates v. Colvin, 736 F.3d 1093, 1098 (7th Cir. 2013)
(“But the standard of review employed for credibility determinations is extremely
deferential, and the ALJ did provide some evidence supporting her determination.”).
The Seventh Circuit has stated that “[n]ot all of the ALJ’s reasons must be valid as
long as enough of them are,” Halsell v. Astrue, 357 F. App’x 717, 722–23 (7th Cir.
2009) (emphasis in original). The ALJ’s subjective symptom evaluation need not be
“flawless”; it just need not be “patently wrong.” Simila v. Astrue, 573 F.3d 503, 517
(7th Cir. 2009)).
Here, the ALJ primarily discounted Plaintiff’s subjective symptom allegations
due to their inconsistency with the routine and conservative treatment Plaintiff
received. At his administrative hearing, Plaintiff testified that the arthritis in his
knees prevented him from walking more than one block or lifting more than 15
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pounds. He also testified that his depression was compounded by his reduced
physical abilities. In general, Plaintiff asserted that his arthritis, depression, and
hypertension were disabling. Upon review of the medical evidence, the ALJ found
that Plaintiff consistently demonstrated a normal range of motion and strength in
his knees, had no physical or mental abnormalities, and his conditions were wellcontrolled with medication. (R. at 25–27) (citing id. at 343–44). Plaintiff had never
been referred to a specialist for his pain, nor had he required any emergency care or
inpatient treatment for any of his impairments. (Id. at 25). The ALJ also noted that
Plaintiff’s record contained no mental health records, other than the discharge
instruction diagnosing him with bipolar disorder. (Id. at 25–27). Based on these
findings the ALJ determined that Plaintiff’s subjective symptom statements were
“not entirely credible.” (Id. at 25); see Sienkiewicz v. Barnhart, 409 F.3d 798, 804
(7th Cir. 2005) (“routine and conservative” treatment, including seeking medical
treatment “only seven times in the eight years [claimant] claims to have been
totally disabled” and never seeking treatment for her headaches despite her
complaints about their severity” provided support for ALJ’s adverse credibility
finding); Loveless v. Colvin, 810 F.3d 502, 508 (7th Cir. 2016) (“routine and
conservative treatment” supported ALJ’s adverse credibility finding).
Moreover, in accordance with the regulations, the ALJ did not base his adverse
subjective symptom evaluation solely on a lack of objective medical evidence. SSR
16-3p at * 5, (“[O]bjective medical evidence is one of the many factors we must
consider in evaluating the intensity, persistence, and limiting effects of an
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individual’s symptoms.”). The ALJ explored possible reasons Plaintiff did not
comply with his medical treatment before permissibly drawing a negative inference
about his non-compliance. SSR 16-3p at *8. The ALJ pointed to two occasions where
Plaintiff’s hypertension was reported as uncontrolled because he had failed to take
his prescribed medication. (R. at 25–26). He also noted that Plaintiff failed to
monitor his own blood pressure and pointed to several instances where he had run
out of his medications. (Id. at 25). In total, the ALJ properly found that this
evidence “suggest[ed] that the symptoms may not have been as limiting as
[Plaintiff] alleged.” (Id.).
Plaintiff complains that the ALJ “failed to articulate any specific reason” for
discounting his subjective symptom allegations. (Dkt. 13 at 11). While ALJs must
consider several factors when assessing a claimant’s credibility, including the
claimant’s daily activities, reports of pain and symptoms, aggravating factors,
medication, treatment, and other limitations, SSR 16-3p, at *7, their duty is
minimal and does not require them to “specify which statements were not credible.”
Shideler v. Astrue, 688 F.3d 306, 312 (7th Cir. 2012); Scivally v. Sullivan, 966 F.2d
1070, 1076 (7th Cir. 1992) (An ALJ need only “minimally articulate reasons for
crediting or rejecting evidence of disability”).
Under these circumstances, the Court cannot conclude that the ALJ’s subjective
symptom evaluation was patently wrong. The ALJ supported his decision with
specific findings, supported by substantial evidence. Moss, 555 F.3d at 561.

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C. The ALJ Properly Accounted for the Aggravating Effects of Plaintiff’s
Obesity on his Co-Existing Impairments.
Finally, Plaintiff argues that the ALJ failed to sufficiently address the impact of
his obesity on his functional capacity. (Dkt. 13 at 13–16). The Seventh Circuit has
stated that an ALJ should consider the effect of an applicant’s obesity on his
“underlying impairments, even if the individual does not claim obesity as an
impairment.” Prochaska v. Barnhart, 454 F.3d 731, 736 (7th Cir. 2006) (citation
omitted). The ALJ explicitly acknowledged this requirement and took Plaintiff’s
obesity into account “even though no treating or examining medical source has
specifically attributed additional or cumulative limitations to [Plaintiff’s] obesity.”
(R. at 22). Indeed, the ALJ found that Plaintiff’s obesity was a severe impairment
and considered the entire, longitudinal record, which included Plaintiff’s obesity,
when determining his RFC. (Id. at 21, 24–28); see Sienkiewicz v. Barnhart, 409 F.3d
798, 802–03 (7th Cir. 2005) (ALJ found claimant was obese and nothing suggests
that he then disregarded that finding when evaluating her RFC). Plaintiff appears
to confuse conditions with disabilities. “A person can be depressed, anxious, and
obese yet still perform full-time work.” Gentle v. Barnhart, 430 F.3d 865, 868 (7th
Cir. 2005). As the Seventh Circuit explained:
Conditions must not be confused with disabilities. The social security
disability benefits program is not concerned with health as such, but
rather with ability to engage in full-time gainful employment. A person
can be depressed, anxious, and obese yet still perform full-time work.
This point is obscured by the tendency in some cases to describe
obesity as an impairment, limitation, or disability. It is none of these
things from the standpoint of the disability program. It can be the
cause of a disability, but once its causal efficacy is determined, it drops
out of the picture. If the claimant for social security disability benefits
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is so obese as to be unable to bend, the issue is the effect of that
inability on the claimant’s capacity for work.
Id. (citation omitted) (emphasis in original). Plaintiff fails to demonstrate how his
obesity combined with his other impairments impacts his ability to work. Hisle v.
Astrue, 258 F. App’x 33, 37 (7th Cir. 2007) (claimant bears the burden to “articulate
how her obesity limits her functioning and exacerbates her impairments”);
Prochaska v. Barnhart, 454 F.3d 731, 737 (7th Cir. 2006) (claimant must “specify
how his obesity further impaired his ability to work”) (citation omitted); see also
Skarbek v. Barnhart, 390 F.3d 500, 504 (7th Cir. 2004) (“Skarbek does not explain
how his obesity would have affected the ALJ’s five-step analysis.”).
Further, in assessing Plaintiff’s RFC, the ALJ gave great weight to the findings
of DDS consultants Drs. Gonzalez and Galle, each of whom respectively pointed to
the Internal Medicine Consultative Examination Report performed by Dr. Hawkins
and recited her finding that Plaintiff would experience difficulty with prolonged
standing, walking, lifting, and carrying due to his obesity and chronic knee pain. (R.
at 143, 155); Prochaska, 454 F.3d at 736–37 (ALJ’s “failure to explicitly consider the
effects of obesity [is] harmless error” where the ALJ adopts “the limitations
suggested by the specialists and reviewing doctors who were aware of the
condition”); Skarbek, 390 F.3d at 504 (holding that an ALJ’s failure to explicitly
discuss a plaintiff’s obesity resulted in harmless error when the ALJ “adopted the
limitations suggested by the specialists and reviewing doctors, who were aware of
[the claimant’s] obesity.”). Later in their reports, both doctors explained that Dr.
Hawkins’s opinion was consistent with the rest of the medical evidence; however,
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they accorded her findings only some weight, as she was a nontreating source. (Id.
at 147, 159). Because the ALJ adopted the findings of Drs. Gonzalez and Galle, he
indirectly factored their review and weighting of Dr. Hawkins’s opinion into his
ultimate RFC assessment. Skarbek, 390 F.3d at 504 (where the claimant “does not
specify how his obesity further impaired his ability to work [and] . . . the ALJ
adopted the limitations suggested by the specialists and reviewing doctors, who
were aware of [the claimant’s] obesity, . . . [the obesity] was factored indirectly into
the ALJ’s decision as part of the doctors’ opinions”).
VI. CONCLUSION
For the reason’s stated above, Plaintiff’s Motion for Summary Judgment [13] is
DENIED and Defendant’s Motion for Summary Judgment [17] is GRANTED.
Pursuant to sentence four of 42 U.S.C. § 405(g), the Commissioner’s decision is
affirmed.

Dated: September 12, 2017

E N T E R:

MARY M. ROWLAND
United States Magistrate Judge

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