Contreras v. Colvin

Filing 25

MEMORANDUM Opinion and Order Signed by the Honorable Young B. Kim on 8/21/2017. (ma,)

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
CARISSA CONTRERAS,
Plaintiff,
v.
NANCY A. BERRYHILL, Acting
Commissioner, Social Security
Administration,1
Defendant.

)
)
)
)
)
)
)
)
)
)
)

No. 16 CV 9037
Magistrate Judge Young B. Kim

August 21, 2017

MEMORANDUM OPINION AND ORDER
Carissa Contreras seeks Social Security Disability Insurance Benefits (“DIB”)
and Supplemental Security Income (“SSI”) based on her claim that the combination
of her multiple sclerosis (“MS”), migraines, optic neuritis, and anxiety attacks
renders her unable to perform full-time work. After the Commissioner of the Social
Security Administration denied her applications, Contreras filed this suit seeking
judicial review. See 42 U.S.C. § 405(g). Before the court are the parties’ crossmotions for summary judgment. For the following reasons, Contreras’s motion for
summary judgment is denied and the government’s is granted:
Procedural History
Contreras filed her DIB and SSI applications on March 28, 2012, claiming a
disability onset date of March 8, 2012. (Administrative Record (“A.R.”) 272-73.)
After her claim was denied initially and upon reconsideration, (id. at 132-33, 160Pursuant to Federal Rule of Civil Procedure 25(d), Nancy A. Berryhill is
automatically substituted as the named defendant in this case.
1

61), Contreras sought and was granted a hearing before an administrative law
judge (“ALJ”), which took place on December 22, 2014, (id. at 30-77). On February
23, 2015, the ALJ issued a decision concluding that Contreras is not disabled and
therefore not entitled to DIB or SSI. (Id. at 163-184.) When the Appeals Council
denied Contreras’s request for review, (id. at 1-6), the ALJ’s decision became the
final decision of the Commissioner, see Minnick v. Colvin, 775 F.3d 929, 935 (7th
Cir. 2015).

Contreras timely filed this lawsuit seeking judicial review of the

Commissioner’s final decision, see 42 U.S.C. § 405(g), and the parties have
consented to this court’s jurisdiction, see 28 U.S.C. § 636(c); (R. 11).
Background
At her December 2014 hearing before the ALJ, Contreras submitted both
documentary and testimonial evidence in support of her claims.
A.

Medical Records
After going to the hospital for sudden left-sided blurred vision and pain in

February 2012, Contreras was diagnosed with optic neuritis, a condition
characterized as the “inflammation of the optic nerve.”

See Dorland’s Medical

Dictionary (“Dorland’s”), available at http://www.dorlands.com (last visited Aug. 4,
2017); (A.R. 465, 479). In the course of her treatment, she underwent an MRI which
revealed numerous nodular lesions in the white matter regions of her brain,
suggesting the presence of a demyelinating disease such as MS.

(A.R. 472-73.)

Along with her eye pain, Contreras reported that she had experienced headaches
every other day since age 14. (Id. at 465.) At her follow-up appointment a few

2

weeks later with Dr. Marquess Wilson, Contreras showed overall improvement with
regard to her optic neuritis with the help of medication. (Id. at 498-99.) Dr. Wilson
also noted that Contreras complained of low-back pain. An MRI of her lower spine
revealed mild facet arthritis in her lumbar spine. (Id. at 498.)
On July 24, 2012, Contreras underwent a Mental Status Examination
performed by Michael E. Stone, Psy.D., who noted that her thought content was
positive for depression, anxiety, and panic attacks before diagnosing her with
generalized anxiety disorder with panic, depression, migraine headaches, MS, and
optic neuritis. (Id. at 544-47.) Dr. Stone opined that Contreras would be unable to
manage benefits on her own. (Id. at 547.)
Following Contreras’s mental status examination, a state consulting
physician filled out a disability determination explanation in connection with her
initial DIB and SSI applications.

(Id. at 78-85.)

The consulting physician

acknowledged Contreras’s headaches, back pain, and MS, but determined that her
headaches were “controlled” and that she was “able to move about and use her
hands, legs, and arms in a satisfactory manner” as to permit her to perform light
work.

(Id. at 84-85.)

The consulting physician also noted that Contreras was

generally credible, in that she experienced some symptoms of anxiety and
depression, but that these symptoms resulted in no additional limitations. (Id. at
82.)
Through the remainder of 2012 Contreras presented for at least three more
follow-up appointments.

(Id. at 550-51, 585-88.)

3

In September 2012 Contreras

returned to Dr. Wilson with complaints of frequent headaches which interfered with
her concentration and had occurred regularly for the six weeks preceding her
appointment.

(Id. at 550.)

She explained that her headaches were pounding,

throbbing, and radiating in nature and accompanied by photophobia. (Id.) At the
same appointment, Contreras complained about intermittent weakness and
numbness in her left leg, but her gait was found to be normal. (Id.) In December
2012, Contreras reported twice to Dr. Surendra Gulati, relaying that her headaches
had increased in frequency to daily and were accompanied by nausea, photophobia,
and phonophobia.2 (Id. at 587.) Contreras also continued to complain of a heavy
feeling in her legs, and explained that her balance was not right. (Id. at 585.)
Dr. Gulati recommended she take Avonex, an anti-inflammatory medication used to
treat MS and, unlike Dr. Wilson, Dr. Gulati found that Contreras demonstrated
mild difficulty with tandem gait. (Id.)
The following month Contreras reported that Avonex had caused her to
experience nausea. (Id. at 583.) Dr. Wilson confirmed that her headaches were
consistent with migraines and prescribed her Maxalt, but did not take her off
Avonex despite the reported side effects. (Id. at 583-84.) By March 2013 Contreras
discontinued the Avonex on her own because of the side effects, which she reported
could last up to a few hours. (Id. at 604.) Dr. Wilson expressed to her that it was
Phonophobia is an anxiety disorder which manifests as a fear of loud sounds.
Zamzil Amin Asha’ari, et al., Phonophobia and Hyperacusis: Practical Points from a
Case Report, U.S. National Library of Medicine, National Institutes of Health
(2010), available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216140/ (last
visited Aug. 4, 2017).
2

4

extremely important that she keep her appointments and follow up immediately
regarding any adverse medical side effects. (Id.)
In 2013 two state consulting physicians completed a disability determination
explanation in connection with Contreras’s request for reconsideration after her
initial denial.

(Id. at 135-46.)

The consulting physicians noted that since the

previous disability determination explanation, Contreras had reported changes to
her conditions, including that her legs and knees gave out causing her to fall, daily
migraines, trouble concentrating, memory loss, back and spine aches, and trouble
with balance and coordination. (Id. at 136.) They reached conclusions identical to
those of the consulting physician who reviewed Contreras’s record initially, who
opined that her headaches were controlled and that she retained the capacity for
light exertional work. However, they additionally opined that Contreras retained
the capacity to perform unskilled, one- to two-step tasks and that she was
moderately limited in her ability to accept instructions and respond appropriately to
criticism from supervisors. (Id. at 142-44.)
Ten months later in January 2014, Contreras returned to Dr. Gulati and
reported that she was pregnant.

(Id. at 615).

She complained that she still

experienced headaches every other day—although they could last up to four days—
but she explained that she no longer experienced nausea, vomiting, or photophobia.
(Id.) With regard to her leg, she reported a sharp, shooting pain from her hip to her
toes. (Id.) Dr. Gulati expressed that he wished to resume her Avonex treatment

5

following her delivery and limited her to Ibuprofen for her MS and headaches
during her pregnancy. (Id. at 618-19.)
Shortly after she resumed care with Dr. Gulati, Contreras began physical
therapy for pain in her low back and hips and for persistent left-leg weakness. (Id.
at 629.) Over the initial six-week treatment program beginning in March 2014,
Contreras attended eight out of twelve sessions. (Id. at 631.) Her therapist noted
that she had made slow gains over the course of her treatment, but that she should
continue with physical therapy. (Id. at 631-32). Also in March 2014, Contreras
underwent a Psychological Evaluation of her functioning supervised by Edgar
Ramos, Psy.D. (Id. at 635.) Dr. Ramos administered several examinations which
evaluated her intellectual ability and the level of her depression and social anxiety.
(Id. at 638-43.) As a result of his testing, Dr. Ramos opined that Contreras suffered
from severe symptoms of depression and anxiety and that she would benefit from
ongoing treatment. (Id. at 646-49.)
After the delivery of her child in July 2014, Contreras returned to Dr. Gulati
in September 2014 for a follow up regarding her MS and headaches. (Id. at 656.)
Because she continued to report intermittent headaches, Dr. Gulati instructed her
to begin Topamax and to resume Avonex for her MS. (Id.)
With respect to her low-back and neck pain, Dr. Bartosz Wojewnik’s
examinations revealed that Contreras had a normal gait without instability, normal
strength and range of motion in her lumbar and cervical spines, but some decreased
sensation in her legs. (Id. at 673.) Dr. Wojewnik prescribed Contreras Voltaren for

6

her pain and migraines, but Contreras had not filled the prescription by her next
appointment in November 2014. (Id. at 667, 680.)
Contreras also returned to physical therapy. (Id. at 659.) Over an eightweek treatment period beginning in October 2014, she attended 12 of her 16
sessions. (Id. at 659, 719-20.) With treatment, her headache frequency decreased
to two times per week and her back and neck pain also improved. (Id. at 659.) In
late 2014, Contreras continued to report depression, coupled with feelings of
worthlessness. (Id. at 684.) By December 2014, she was diagnosed with bipolar
disorder. (Id.)
B.

Contreras’s Testimony
At her December 2014 administrative hearing, Contreras described her past

work history, symptoms, and daily routine. Contreras testified about two previous
jobs, one as a baby-sitter and the other as a sales associate at Wal-Mart. (A.R. 4243.) She also briefly mentioned one other position as a checkout clerk, but did not
explain the details of that employment. (Id. at 44.)
In describing her symptoms, Contreras first detailed her back problems. She
testified that her pain starts in her lower back then radiates up through her neck,
sometimes resulting in headaches. (Id. at 47-48.) She reported that the pain is
present “all the time,” and prevents her from sitting for more than 30 minutes at a
time, so she must lie down flat in order to alleviate her symptoms. (Id. at 47-48,
51.) She testified that she also tried to relieve her back pain by taking Voltaren, but

7

she discontinued this medication after one month when she experienced nausea and
sickness as side effects from the medication. (Id. at 54)
With regard to Avonex, Contreras testified that she experiences a burning
sensation when she injects the needle and that the residual pain of the injection is
severe for several days afterward. (Id. at 46.) She explained that the pain is so
intense it wakes her up at night and causes her to cry. (Id.) Despite her pain from
Avonex, she stated that she knows she has to take it, so she resumed the medication
in September 2014 at Dr. Gulati’s recommendation after her son was born. (Id. at
46-47.) Contreras then stated that her medication side effects are a major reason
she fails to attend her physical therapy appointments. (Id. at 48.) As of the date of
her hearing, she testified that she only takes Ibuprofen. (Id. at 50.)
In connection with her mental health symptoms, Contreras explained that
she asked her friends and family for financial support in order to see a psychologist.
(Id. at 65.)

She explained that she has not followed Dr. Ramos’s suggestion of

obtaining ongoing psychiatric therapy because she does not have the financial
ability to do so. (Id. at 66.) She testified that she plans to seek psychiatric therapy
and is actively researching providers who will accept Medicaid, but wishes to wait
until she has completed physical therapy before she begins psychiatric treatment.
(Id. at 66-67.)
Contreras lives with her mother, younger siblings, and her two children, and
she testified that she is the primary caregiver of her children. (Id. at 40.) She

8

further testified that she often does the laundry if no one else is around, and
sometimes cooks microwavable foods or cleans her daughter’s room. (Id. at 55-56.)
C.

The Vocational Expert’s Testimony
The ALJ also received testimony from a Vocational Expert (“VE”) at the

hearing. The VE described Contreras’s past work as equivalent to a retail sales
clerk and child monitor, both classified as semi-skilled with an SVP of 3. (A.R. 7172.)

The ALJ then presented the VE with a hypothetical individual with

Contreras’s same work history, age, and education who was restricted to light work
with no climbing of ladders, ropes, or scaffolding, who could occasionally balance
and operate foot controls, could perform simple instructions and routine tasks,
tolerate occasional changes in the workplace setting, could have occasional
interaction with both the public and supervisors, and was limited to one- or twostep tasks. (Id. at 72-73.) The VE opined that such a hypothetical individual could
perform light duty jobs such as a small parts assembler, labeler, and mail clerk.
(Id. at 73.)
D.

The ALJ’s Decision
The ALJ evaluated Contreras’s claims under the required five-step analysis.

See 20 C.F.R. §§ 404.1520(a), 416.920(a). As an initial matter, the ALJ determined
that Contreras met the insured status requirement of the Social Security Act
through December 31, 2016.

(A.R. 168.)

At step one, the ALJ concluded that

Contreras had not engaged in substantial gainful activity since March 8, 2012, her
alleged onset date. (Id.) At step two, the ALJ concluded that Contreras suffered

9

from severe impairments related to MS, migraine headaches, depression, anxiety,
and bipolar disorder. (Id.) At step three, the ALJ determined that Contreras did
not have an impairment or combination of impairments that met or medically
equaled a listed impairment. (Id. at 169.) Before turning to step four, the ALJ
considered Contreras’s residual functional capacity (“RFC”) to perform full-time
work in spite of her limitations. The ALJ determined that she had the RFC to
perform light work, except that she could only occasionally balance, operate foot
controls, interact with supervisors and the public, or have changes in the workplace
setting.

(Id. at 171.)

She additionally limited her to work involving simple

instructions and routine one- to two- step tasks and never climbing ladders, ropes,
or scaffolds. (Id.)
In making her RFC determination, the ALJ determined that Contreras’s MS
was “stable” and that she offered only “few abnormal examination findings.” (Id. at
174.) She went on to highlight Contreras’s noncompliance with her medications,
her inconsistent appearances at physical therapy, the absence of records supporting
her assertion that she missed therapy because of her medication side effects, her
lack of psychiatric care, and her activities of daily living to support her conclusion
that Contreras’s allegations of pain were not entirely credible. (Id. at 175.) The
ALJ also explained that she gave great weight to the opinions expressed by the
state agency reviewing consultants because they are experts on the social security
disability program, but the ALJ included additional postural limitations in her

10

ultimate RFC analysis to account for Contreras’s documented left-leg weakness.
(Id.)
At step four, the ALJ determined that Contreras is unable to perform any of
her past relevant work, but at step five, the ALJ concluded that she was able to
perform jobs existing in significant numbers in the national economy. (Id. at 17677.) Accordingly, the ALJ concluded that Contreras is not disabled. (Id. at 178.)
Analysis
Contreras argues that the ALJ erred in assessing her symptom descriptions
and in failing to account for her migraine headaches. (R. 17, Pl.’s Mem. at 6-14.)
The court reviews the ALJ’s decision only to ensure that it is supported by
substantial evidence, meaning “such relevant evidence as a reasonable mind might
accept as adequate to support a conclusion.” See Shideler v. Astrue, 688 F.3d 306,
310 (7th Cir. 2012) (internal quotation and citation omitted). The court’s role is
neither to reweigh the evidence nor to substitute its judgment for the ALJ’s. See
Pepper v. Colvin, 712 F.3d 351, 362 (7th Cir. 2013). That said, if the ALJ committed
an error of law or “based the decision on serious factual mistakes or omissions,”
reversal may be required. Beardsley v. Colvin, 758 F.3d 834, 837 (7th Cir. 2014).
A.

Credibility Determination
Contreras first urges the court to reverse the ALJ’s decision because,

according to her, the ALJ improperly assessed the credibility of her testimony and
other statements describing her condition. (R. 17, Pl.’s Mem. at 8-14.) This court’s
review of an ALJ’s analysis of a claimant’s credibility is particularly deferential

11

because that determination will only be overturned if it is “patently wrong,” or
“divorced from the facts contained in the record.” Berger v. Astrue, 516 F.3d 539,
546 (7th Cir. 2008). It should be noted, however, that since the ALJ’s decision was
issued, the social security ruling governing the credibility analysis, SSR 96-7p, was
superseded by SSR 16-3p, which clarifies that in evaluating a claimant’s symptom
descriptions the ALJ is not to consider the credibility of the claimant’s character.
SSR 16-3p, 2016 WL 1020935, at *14167 (effective March 28, 2016). Instead, as the
Seventh Circuit has recognized, the SSA will “focus on determining the ‘intensity
and persistence of the [claimant’s] symptoms.’” Cole v. Colvin, 831 F.3d 411, 412
(7th Cir. 2016) (citing SSR 16-3p, 2016 WL 1020935, at *14167).

So although

“administrative law judges will continue to assess the credibility of pain assertions
by applicants,” the ruling clarifies that the emphasis is on the supportability of the
claimant’s symptom descriptions rather than the ALJ’s impression of the credibility
of the claimant’s overall character. See id. (emphasis in original). The factors an
ALJ is to consider in taking on this evaluation, including daily activities, treatment,
medications and their side effects, methods used to relieve pain, etc., remain the
same. See SSR 16-3p, 2016 WL 1020935, at *14169-70; 20 C.F.R. §§ 404.1529(c)(3)
& 416.929(c)(3).
Contreras’s strongest argument in challenging the ALJ’s discussion of her
symptoms is that the ALJ disbelieved that her pain and MS-related symptoms are
as severe as Contreras claims based on “her lay misconceptions” about Contreras’s
noncompliance with her medication. (R. 17, Pl.’s Mem. at 12.) A claimant’s failure

12

to accept treatment is a reason to think she may be exaggerating her symptoms, see
Mitze v. Colvin, 782 F.3d 879, 882 (7th Cir. 2015), but before reaching her
conclusion, the ALJ was required to properly consider Contreras’s explanations for
noncompliance, see Roddy v. Astrue, 705 F.3d 631, 638 (7th Cir.2013). Contreras
testified that she was noncompliant with her medication and physical therapy
because of medication side effects. (A.R. 46-48, 54.) The ALJ acknowledged that
testimony but permissibly pointed out that there was no documented evidence to
support that Contreras missed physical therapy because of medication side effects.
(Id. at 175.) Moreover, while Contreras was instructed to cease her medications
during her pregnancy in the first seven months of 2014, the ALJ noted that she had
not filled her Voltaren prescription by November 2014, well after her delivery date.
(Id.) Similarly, the ALJ highlighted the inconsistency between this evidence and
Contreras’s testimony that she had taken Voltaren for one month in the fall of 2014,
but discontinued her use because it caused her to feel nauseous. (Id.) With regard
to her MS, the ALJ noted that after Contreras discontinued her use of Avonex in
March 2013 without consulting her doctor, she was “extensively counseled on the
importance of keeping her appointments” and instructed to follow up immediately
in regard to any adverse medical reactions.

(Id. at 173.)

This discussion was

adequate to show that the ALJ considered Contreras’s explanation for her
noncompliance with medication and physical therapy, and gave reasons supported
by the record for discounting that explanation.

13

In setting aside Contreras’s side-effects testimony the ALJ also wrote that “it
would be hard to imagine [Contreras] would be prescribed . . . medication again if it
was causing such significant side-effects as she alleges.” (Id. at 175.) While this
statement gives the court pause, as it borders on the ALJ impermissibly “playing
doctor” by relying on her own lay impressions of an appropriate course of treatment,
Rohan v. Chater, 98 F.3d 966, 970 (7th Cir. 1996), the Seventh Circuit has made
clear that not all of the ALJ’s reasons for disbelieving a claimant have to be valid
“as long as enough of them are.” See Halsell v. Astrue, 357 Fed. Appx. 717, 722 (7th
Cir. 2009) (emphasis in original); see also Jones v. Astrue, 623 F.3d 115, 1161 (7th
Cir. 2010).

And as described below, the ALJ provided several reasons for

discounting Contreras’s testimony that find record support.
For example, the ALJ considered Contreras’s failure to pursue psychiatric
treatment in evaluating the credibility of her statements regarding depression and
anxiety. Contreras argues that the ALJ failed to account for her explanation that
she could not afford psychiatric treatment and wanted to complete her physical
therapy before turning to psychiatric care. (R. 17, Pl.’s Mem. at 12-13.) Contreras
complains that the ALJ impermissibly “neither accept[ed] nor reject[ed]” her
explanations, (A.R. 12), but her argument carefully ignores the fact that the ALJ
noted that she was insured by Medicaid and “had only recently researched
therapists near her who will accept Medicaid and she is going to look into getting
therapy,” (id. at 66-67, 175). In other words, the ALJ found a disconnect between
Contreras’s allegations of the severity of her depression and anxiety and her

14

admission that she had only researched potential therapy options, and even that
she had only done “recently.” (Id. at 175.) In evaluating this aspect of Contreras’s
testimony the ALJ also drew attention to the fact that none of her treating
neurologists had expressed any concern over her mental health.

(Id.)

Because

these reasons are adequately explained and find support in the record, the ALJ’s
decision on this aspect of her testimony cannot be considered “patently wrong.” See
Pepper, 712 F.3d at 367.
Contreras next argues that the ALJ placed undue weight on her ability to
care for her children, cook, and clean, thereby falsely equating her household
activities to the ability to carry out full-time work. (R. 17, Pl.’s Mem. at 13-14.) In
considering Contreras’s daily activities, a factor specifically set forth in the
regulations governing symptom evaluation, see 20 C.F.R. §§ 404.1529(c)(3) &
416.929(c)(3), the ALJ was careful to note that she did not equate Contreras’s
ability to perform these activities to an ability to perform light work, but instead
simply considered them as one factor among many in evaluating her testimony,
(A.R. 175). And although the Seventh Circuit has “criticized ALJs for equating
activities of daily living with an ability to work,” it has nonetheless recognized the
appropriateness of an ALJ considering a claimant’s “description of his daily
activities in assessing whether his testimony about the effects of his impairments
was credible or exaggerated.” Loveless v. Colvin, 810 F.3d 502, 508 (7th Cir. 2016).
Because that is all the ALJ did here, Contreras’s argument is unavailing.

15

Next Contreras faults the ALJ for characterizing her MS as being “stable,”
because, according to Contreras, her MS could be stable yet still be disabling.
(A.R. 174.; R. 17, Pl.’s Mem. at 9.) But again, Contreras’s stable MS was just one of
several pieces of evidence the ALJ considered when making her credibility
determination. The ALJ pointed out that the overall medical evidence supports a
finding that her MS was stable and that she exhibited “few abnormal examination
findings.”

(A.R. 174.)

Contreras has not pointed to any evidence that would

undermine the ALJ’s characterization of her MS. Accordingly, she has not shown
any error in the ALJ’s description of her condition, let alone that it was patently
wrong.
Finally, Contreras argues that the ALJ committed reversible error in
analyzing the credibility of her symptoms because, she says, the ALJ
mischaracterized her headache complaints as “sporadic” and mistakenly focused on
her use of over-the-counter medications for headache relief rather than her largely
unsuccessful attempts to treat with a variety of migraine medications. (R. 17, Pl.’s
Mem. at 9-10.) But the ALJ recognized that Contreras had a history of headaches
since she was a teenager, and elsewhere in her decision cited medical records
reporting that Contreras herself described her headaches as “occasional” and
reported that they decreased in frequency with physical therapy. (A.R. 173, 175.)
The ALJ also cited Contreras’s testimony that she had only taken over-the-counter
medications in the fall of 2014 despite having been prescribed headache medication.
(Id.)

Contreras asserts that the ALJ’s reference to over-the-counter medication

16

“ignores the prescription medications she has tried without success,” but none of the
record pages she cites in support of that assertion demonstrate that prescription
medication failed her. (R. 17, Pl.’s Mem. at 10 (citing A.R. 498 (noting that “Fioricet
usually relieves the headache”), A.R. 584 (prescribing Maxalt and advising her to
return for evaluation after prescription trial), A.R. 585 (noting that Contreras has
used Excedrin Migraine and “has never taken any headache prophylaxis except for
occasion use of amitriptyline”), A.R. 613 (noting that Contreras “takes Excedrin
with relief in 2 hours”), A.R. 656 (recommending that Contreras initiate Topamax
for her headaches and advising her to follow up in four months after keeping a
record of headaches), A.R. 659 (noting a decrease in the frequency of her headaches
and that her headaches improved since she started physical therapy), and A.R. 661
(noting Contreras reported a history of headaches without any discussion of
headache medication).)

Accordingly, Contreras has not shown that the ALJ

mischaracterized the record in describing her headaches and course of treatment for
those symptoms. For all of these reasons, Contreras has not shown that the ALJ’s
evaluation of the credibility of her symptom statements was patently wrong.
B.

Migraine Headaches
Contreras also argues that the ALJ’s decision should be reversed because,

according to her, the ALJ improperly omitted from the RFC assessment any
limitation related to her migraine headaches.

(R. 17, Pl.’s Mem. at 7-8.)

She

asserts that the ALJ’s step-two finding that her headaches are a “severe
impairment” necessarily means they cause work-related functional limitations, see

17

20 C.F.R. §§ 404.1520(c) & 416.920(c), but the RFC fails to account for any such
limitation. An ALJ need only include those limitations in the RFC assessment that
the record supports. Yurt v. Colvin, 758 F.3d 850, 857 (7th Cir. 2014). The ALJ has
done that here.

First, she acknowledged Contreras’s established history of

migraines, listed her associated symptoms including difficulty concentrating,
photophobia, and nausea, and described her treatment attempts involving mostly
over-the-counter medications and physical therapy. (A.R. 173-74.) The ALJ later
explained that much of the evidence demonstrated that Contreras was
noncompliant with her medications, reported inconsistently for her physical therapy
appointments, and that her documented reports did not support her allegations of
absences due to medication side effects. (Id. at 175.) The ALJ then accorded great
weight to the opinions expressed by the state agency reviewing physicians in their
2013 disability determination explanation, and adopted their finding that Contreras
could perform work at a light exertional level, with some additional mental
limitations.

(Id. at 171-75.)

The ALJ’s complete assessment of Contreras’s

headaches and her reliance on the opinions of the agency consultants together
provide substantial evidence to support her RFC determination.
Moreover, Contreras does not point to any evidence of record which suggests
that she lacked the RFC to perform at the level determined by the ALJ, see Fischer
v. Barnhart, 129 Fed. Appx. 297, 303 (7th Cir. 2005), or evidence that her migraine
headaches would result in limitations beyond those set out in the RFC assessment.
Without the presence of conflicting evidence in the record revealing that Contreras’s

18

headaches would result in additional limitations, the ALJ was not required to
explain her reasons for adopting the uncontradicted opinions of the reviewing
physician consultant. See Scheck v. Barnhart, 357 F.3d 697, 701 (7th Cir. 2004)
(holding it was “unnecessary for the ALJ to articulate her reasons for accepting the
state agency physicians’ determination of not disabled” when there was no evidence
which would support the position that plaintiff met or equaled a listing).

And

importantly, Contreras has not explained in her brief what headache-related
limitations the ALJ should have included but omitted. That is especially relevant
given that Contreras has experienced migraines since she was a teenager and
managed to work full-time for years despite those headaches. (A.R. 318-25, 465.) It
is Contreras’s burden to show that she is disabled, see Scheck, 357 F.3d at 702, and
her failure to explain how her migraines limited her functional ability beyond that
described in the ALJ’s RFC assessment renders her RFC argument unpersuasive.
Accordingly, this court concludes that the ALJ did not commit any reversible error
in assessing Contreras’s RFC.
Conclusion
For the foregoing reasons, Contreras’s motion for summary judgment is
denied, the government’s is granted, and the final decision of the Commissioner is
affirmed.
ENTER:
____________________________________
Young B. Kim
United States Magistrate Judge
19