Brookins v. Saul

Filing 21

ORDER signed by the Honorable Sheila M. Finnegan on 7/29/2022. For reasons stated in the accompanying Order, Plaintiff's request to reverse or remand the ALJ's decision is denied, and Defendant's Motion for Summary Judgment 18 is granted. The Clerk is directed to enter judgment in favor of the Commissioner.Civil case terminated. Mailed notice (sxw)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
CALVIN B.,
Plaintiff,
v.
KILOLO KIJAKAZI, Acting
Commissioner of Social Security, 1
Defendant.

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No. 20 C 3404
Magistrate Judge Finnegan

ORDER
Plaintiff Calvin B. seeks to overturn the final decision of the Commissioner of Social
Security (“Commissioner”) denying his applications for Disability Insurance Benefits
(“DIB”) and Supplemental Security Income (“SSI”) under Titles II and XVI of the Social
Security Act. The parties consented to the jurisdiction of the United States Magistrate
Judge pursuant to 28 U.S.C. § 636(c), and Plaintiff filed a brief explaining why the
Commissioner’s decision should be reversed or the case remanded. The Commissioner
responded with a competing motion for summary judgment in support of affirming the
decision. After careful review of the record and the parties’ respective arguments, the
Court affirms the ALJ’s decision.
BACKGROUND
Plaintiff applied for DIB and SSI on March 9, 2018, alleging in both applications
that he became disabled on August 19, 2017 due to a heart attack and a shoulder rotator
cuff injury. (R. 205, 233). Born in 1965, Plaintiff was 52 years old at the time of his

Kilolo Kijakazi became the Acting Commissioner of Social Security on July 9, 2021. She
is automatically substituted as the named defendant pursuant to FED. R. CIV. P. 25(d).
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applications and 53 years old as of the December 31, 2018 date last insured, making him
at all times a person closely approaching advanced age (age 50-54). (R. 205); 20 C.F.R.
§ 404.1563(d); 20 C.F.R. § 416.963(d). He completed one year of college and lives with
his daughter and 8-year-old granddaughter. (R. 41-42, 234). Plaintiff’s work history dates
back to 1985 but his most recent long-term job was maintenance supervisor for a senior
assisted living facility, a position he held from June 2000 to November 2013. (R. 228,
234, 244-45). He then worked for a temp service until August 19, 2017 when he suffered
a heart attack. (R. 30-31, 233). Plaintiff has not engaged in any substantial gainful activity
since that date.
The Social Security Administration denied Plaintiff’s applications initially on April
12, 2018, and again upon reconsideration on July 16, 2018. (R. 63-114). Plaintiff filed a
timely request for a hearing and appeared before administrative law judge Victoria A.
Ferrer (the “ALJ”) on February 27, 2019. (R. 26). The ALJ heard testimony from Plaintiff,
who was represented by counsel, and from vocational expert Heather Mueller (the “VE”).
(R. 28-61). On April 24, 2019, the ALJ found that Plaintiff’s status-post myocardial
infarction with subsequent stenting, asthma, history of alcohol abuse, and history of right
shoulder rotator cuff tear are severe impairments, but that they do not meet or equal any
of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (R. 15-16). After
reviewing the evidence, the ALJ concluded that Plaintiff has the residual functional
capacity (“RFC”) to perform light work involving: occasional climbing of ramps and stairs;
no climbing of ladders, ropes, or scaffolds; occasional reaching above shoulder level with
the right arm; and no working at high, exposed places. (R. 17). Plaintiff must also avoid
irritants or hazardous machines with exposed, moving, mechanical parts. (Id.).

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The ALJ accepted the VE’s testimony that a person with Plaintiff’s background and
this RFC could perform a significant number of jobs available in the national economy,
including office helper, order caller, and mail clerk. (R. 20-21). As a result, the ALJ
concluded that Plaintiff was not disabled at any time from the August 19, 2017 alleged
disability onset date through the date of the decision. (R. 21). The Appeals Council
denied Plaintiff’s request for review on April 28, 2020. (R. 1-5). That decision stands as
the final decision of the Commissioner and is reviewable by this Court under 42 U.S.C.
§§ 405(g). See Haynes v. Barnhart, 416 F.3d 621, 626 (7th Cir. 2005); Whitney v. Astrue,
889 F. Supp. 2d 1086, 1088 (N.D. Ill. 2012).
In support of his request for reversal or remand, Plaintiff argues that the ALJ: (1)
erred in finding that the opinion from his treating nurse practitioner Sandre Crain, APN
was not persuasive or supported by the record evidence; and (2) improperly evaluated
his subjective statements regarding the limiting effects of his symptoms. For reasons
discussed in this opinion, the Court finds that the ALJ’s decision is supported by
substantial evidence.
DISCUSSION
A.

Standard of Review
Judicial review of the Commissioner’s final decision is authorized by the Social

Security Act. 42 U.S.C. §§ 405(g), 1383(c)(3). In reviewing this decision, the Court may
not engage in its own analysis of whether 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 “‘displace the ALJ’s judgment by reconsidering facts or evidence or making
credibility determinations.’” Castile v. Astrue, 617 F.3d 923, 926 (7th Cir. 2010) (quoting

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Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 2007)). See also L.D.R. by Wagner v.
Berryhill, 920 F.3d 1146, 1151-52 (7th Cir. 2019). The Court “will reverse an ALJ’s
determination only when it is not supported by substantial evidence, meaning ‘such
relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.’” Pepper v. Colvin, 712 F.3d 351, 361-62 (7th Cir. 2013); Biestek v. Berryhill,
139 S. Ct. 1148, 1154 (2019).
In making its determination, the Court must “look to whether the ALJ built an
‘accurate and logical bridge’ from the evidence to her conclusion that the claimant is not
disabled.” Simila v. Astrue, 573 F.3d 503, 513 (7th Cir. 2009) (quoting Craft v. Astrue,
539 F.3d 668, 673 (7th Cir. 2008)). The ALJ need not, however, “‘provide a complete
written evaluation of every piece of testimony and evidence.’” Pepper, 712 F.3d at 362
(quoting Schmidt v. Barnhart, 395 F.3d 737, 744 (7th Cir. 2005) (internal citations and
quotation marks omitted)). When the ALJ’s decision “‘lacks evidentiary support or is so
poorly articulated as to prevent meaningful review,’ a remand is required.” Hopgood ex
rel. L.G. v. Astrue, 578 F.3d 696, 698 (7th Cir. 2009) (quoting Steele v. Barnhart, 290
F.3d 936, 940 (7th Cir. 2002)).
B.

Five-Step Inquiry
To recover DIB or SSI, a claimant must establish that he is disabled within the

meaning of the Social Security Act. 2 Shewmake v. Colvin, No. 15 C 6734, 2016 WL
6948380, at *1 (N.D. Ill. Nov. 28, 2016). A claimant is disabled if he 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
Because the regulations governing DIB and SSI are substantially identical, for ease of
reference, only the DIB regulations are cited herein.
2

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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, an ALJ must
conduct a standard five-step inquiry, which involves analyzing: “(1) whether the claimant
is currently employed; (2) whether the claimant has a severe impairment; (3) whether the
claimant’s impairment is one that the Commissioner considers conclusively disabling; (4)
if the claimant does not have a conclusively disabling impairment, whether he can perform
his past relevant work; and (5) whether the claimant is capable of performing any work in
the national economy.” Kastner v. Astrue, 697 F.3d 642, 646 (7th Cir. 2012) (citing 20
C.F.R. § 404.1520). If the claimant meets his burden of proof at steps one through four,
the burden shifts to the Commissioner at step five. Moore v. Astrue, 851 F. Supp. 2d
1131, 1139-40 (N.D. Ill. 2012).
C.

Analysis
1.

Ms. Crain’s Opinion

Plaintiff argues that the case must be reversed or remanded because the ALJ
erred in finding that the opinion from his treating nurse practitioner Sandre Crain was not
persuasive or supported by the record. Since Plaintiff filed his claims in March 2018, the
treating source rule used for claims filed before March 27, 2017 does not apply. This
means the ALJ was not required to “defer or give any specific evidentiary weight” to any
medical opinion, including a treating physician’s opinion. 20 C.F.R. § 404.1520c(a). See
also Social Security Administration, Revisions to Rules Regarding the Evaluation of
Medical Evidence, 2017 WL 168819 (Jan. 18, 2017). Instead, the ALJ was required to
“evaluate the persuasiveness of each medical opinion based on certain factors: (1)
supportability; (2) consistency; (3) the medical source’s relationship with the claimant; (4)

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specialization; and (5) other factors, including the source’s familiarity with other evidence
in the claim or an understanding of Social Security disability policies and requirements.”
Michelle D. v. Kijakazi, No. 21 C 1561, 2022 WL 972280, at *4 (N.D. Ill. Mar. 31, 2022)
(citing 20 C.F.R. § 404.1520c(c)(1)-(5)). An ALJ must explain how she considered the
first two factors (supportability and consistency) and may but is not required to explain
her consideration of the other factors. 20 C.F.R. § 404.1520c(b)(2). “Supportability
measures how much the objective medical evidence and supporting explanations
presented by a medical source support the opinion.” Michelle D., 2022 WL 972280, at *4
(citing 20 C.F.R. § 404.1520c(c)(1)). “Consistency assesses how a medical opinion
squares with other evidence in the record.” Id. (citing 20 C.F.R. § 404.1520c(c)(2)).
Ms. Crain completed a Cardiac Residual Functional Capacity Questionnaire for
Plaintiff on July 11, 2018. (R. 512-14). Plaintiff had a heart attack and underwent an
emergency angioplasty and stenting of the coronary artery on August 22, 2017. (R. 316,
323). Ms. Crain indicated that since that event, Plaintiff suffers from sharp, left-sided
chest pain that comes and goes, as well as fatigue, palpitation, dyspnea, or anginal
discomfort causing marked limitation in his ability to engage in even ordinary physical
activity. (R. 512). More specifically, Plaintiff can: walk only 2 city blocks without rest or
severe pain; sit for no more than 5 minutes at a time before needing to stand up; stand
for no more than 5 minutes at a time before needing to sit down or walk around; sit, stand,
and walk for a total of less than 2 hours in an 8-hour workday; and never lift more than 5
pounds. (R. 513). When sitting for a prolonged period of time, Plaintiff needs to elevate
his legs to the height of one pillow for at least 1-2 hours during an 8-hour workday in order
to send blood flow back to the heart. (Id.). In addition, the medications he takes often

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cause dizziness, and he suffers from depression that exacerbates his physical condition.
(R. 512). According to Ms. Crain, Plaintiff’s cardiac symptoms are so severe that they
would frequently interfere with the attention and concentration needed to perform even
simple work tasks during a typical workday. (R. 512). He is likely to have good days and
bad days, would be absent from work more than 4 days per month, and must avoid
temperature extremes, humidity, dust, fumes, and pollen. (R. 514).
In finding Ms. Crain’s opinion unpersuasive, the ALJ first explained that it was not
supported by the overall record. (R. 19). The Court finds no error in this conclusion.
Plaintiff went to the Ingalls Memorial Hospital emergency department (“Ingalls ED”) on
August 22, 2017 complaining of chest pain. A coronary angiogram showed ejection
fraction of 45%, 30-40% narrowing in the left circumflex coronary artery, 10-20%
narrowing in the left anterior descending artery (“LAD”), and 30% proximal lesion of the
first diagonal artery. (R. 18, 317). Sandy Sundram, M.D. performed an emergency left
heart catheterization, left ventriculography, bilateral selective angioplasty, and
angioplasty and stenting of the coronary artery. (Id.). An EKG taken the next day showed
normal sinus rhythm and nonspecific inferior T-wave changes. (R. 18, 369). Plaintiff’s
condition “rapidly improved” following the surgery and he was discharged home in good
condition. 3 (R. 325)
On August 28, 2017, Plaintiff saw family medicine specialist Jerome Buster, M.D.
and reported that he was doing well with no chest pain, cough, trouble breathing, back
pain, depression, or other symptoms. (R. 530, 532). A physical exam was normal, and
Dr. Buster instructed Plaintiff to continue taking his medications. (R. 533). About a month

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The exact date of discharge is not recorded in the treatment notes.

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later on September 24, 2017, Plaintiff returned to the Ingalls ED due to near
syncope/dyspnea (fainting/difficulty breathing).

(R. 364, 366, 373).

Plaintiff denied

having chest pain, palpitations, or shortness of breath, and a physical exam was largely
normal, though a chest x-ray showed hyperexpansion with clear lung fields. (R. 18, 36869, 419). Doctors diagnosed near syncope likely due to dehydration and admitted Plaintiff
for observation. A series of diagnostic tests administered on September 25, 2017 were
all essentially normal.

An echocardiogram showed normal ejection fraction, an

electrocardiogram revealed improved inferior T-wave changes with no angina, and a CT
angiogram of the head and neck and CT of the brain were both unremarkable with no
acute findings. (R. 369, 415, 417). Plaintiff had a normal EEG on September 27, 2017
(R. 412), and was discharged that day in stable condition with a final diagnosis of
vasovagal syncope. (R. 371).
Plaintiff saw Ms. Crain on November 8, 2017 for medication refill (this is the first
documented appointment with her in the record). (R. 495). Plaintiff denied having chest
pain, palpitations, wheezing, or shortness of breath (R. 496), and a physical exam
likewise produced normal heart auscultation without murmurs, rubs, or gallops, and
normal breath sounds with no wheezing, rales/crackles, or rhonchi. (R. 497). Plaintiff did
report muscle aches, but he denied having joint pain, back pain, or swelling in the
extremities, and on exam Ms. Crain found normal motor strength and tone, normal gait
and station, intact nerves and sensation, normal movement of all extremities, no edema,
and normal mood and affect. (R. 496-497). A few months later on February 18, 2018,
Plaintiff went to the Ingalls ED for near syncope after drinking heavily and was admitted
for evaluation. (R. 18, 423, 433-34). While there, he had another near syncopal episode

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when he tried to get up to use the bathroom. (R. 433, 457). A 12-lead EKG showed sinus
tachycardia and no acute findings (R. 18, 425), but a chest CT revealed left lower lobe
infiltrates. (R. 433, 477). Doctors agreed that Plaintiff had pneumonia and that his
complaints of left-sided chest pain were likely due to that condition. (R. 423, 425, 42829). He was discharged on February 21, 2018 with a final diagnosis of left lower lobe
pneumonia, and chest pain with cough likely due to pneumonia. (R. 431).
At his next visit with Ms. Crain on February 28, 2018, Plaintiff was feeling better
with no complaints of chest pain, palpitations, cough, shortness of breath, swelling,
muscle aches, weakness, dizziness, fatigue, or depression. (R. 491). A physical exam
was largely normal:

no dyspnea, wheezing, rales/crackles, rhonchi; normal breath

sounds; normal heart auscultation with no murmurs, rubs, or gallops; normal gait and
station; normal motor strength and tone; normal movement of all extremities; normal
reflexes; and normal mood and affect. (R. 491-92). During exams on April 11, 2018 and
May 30, 2018, Ms. Crain documented identical findings, except that Plaintiff complained
of chest pain “every now and then” at the April visit. (R. 565-67, 569-70). Despite these
overwhelmingly normal results with no evidence of fatigue, dyspnea, palpitation,
dizziness, depression, or difficulties walking and concentrating, Ms. Crain opined on July
11, 2018 that Plaintiff suffers from all of those symptoms and can barely sit, stand, and
walk. (R. 512-13). Notably, when Plaintiff saw Ms. Crain on September 28, 2018 and
February 13, 2019, he continued to deny having chest pain, shortness of breath,
coughing, wheezing, palpitations, fatigue or depression, and exams remained normal.
(R. 557, 558, 561).

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Plaintiff largely ignores Ms. Crain’s treatment notes, focusing instead on the
abnormal diagnostic tests that led to his heart surgery. (Doc. 17, at 4) (citing R. 369).
But aside from the two near fainting episodes (one in September 2017 due to dehydration
and one in February 2018 due to alcohol consumption and pneumonia), Plaintiff had no
documented problems after the August 2017 angioplasty and stenting of the coronary
artery. Though Plaintiff presented with coughing, wheezing, dizziness, and rales during
his brief hospital stays (particularly when he had pneumonia), those conditions resolved
prior to discharge and were not observed during subsequent exams in April 2018, May
2018, September 2018, and February 2019. (R. 18) (citing 323, 368, 373, 383, 429, 432,
456, 570). In such circumstances, the ALJ did not err in discounting Ms. Crain’s opinion
in part based on “normal chest and lung sounds.” (R. 19).
The ALJ also found it significant that Plaintiff consistently presented with normal
strength, range of motion, gait, and sensation and only occasionally complained of chest
pain (R. 18, 19), which contradicts Ms. Crain’s opinion that Plaintiff basically cannot sit,
stand, walk, or lift. Plaintiff disagrees, citing his own testimony that he: has sharp,
unpredictable chest pains every week; was instructed by his cardiac surgeon to not “do
too much” to avoid another heart attack; and struggles with shortness of breath with
weather changes and prolonged walking. (Doc. 17, at 5) (citing R. 31-32, 47, 48, 53). In
Plaintiff’s view, the fact that he has disabling symptoms even when he engages in very
little physical activity supports Ms. Crain’s conclusion that any exertion would be
precluded. (Doc. 20, at 4).
This argument is not persuasive because Plaintiff affirmatively denied having any
chest pains, wheezing, coughing, or shortness of breath when he saw Ms. Crain on

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November 8, 2017, February 28, 2018, April 11, 2018, May 30, 2018, September 28,
2018, and February 13, 2019. (R. 491, 496, 557, 561, 566, 569). And while Plaintiff
claims he could barely comb his hair, brush his teeth, or shave without chest pain or
shortness of breath, and needed to lie down for 10-15 minutes to relieve the pain (R. 267,
268), he never reported such problems to Ms. Crain or any other medical provider. In
fact, Ms. Crain advised Plaintiff to exercise by walking for 30 minutes 3 to 5 times per
week at the May 2018, September 2018, and February 2019 appointments. (R. 558, 561,
567). Moreover, contrary to Ms. Crain’s July 2018 opinion that Plaintiff cannot sit for more
than 5 minutes at a time, Plaintiff himself reported in a March 2018 Function Report that
he can sit for at least 2 hours without having to get up and stand or walk. (R. 266). There
were no documented changes to Plaintiff’s condition between March and July 2018 that
would account for the vast difference in functioning. This, too, undermines the limitations
set forth in Ms. Crain’s opinion.
Plaintiff next objects that the ALJ committed reversible error by failing to address
the length, extent, and nature of his treatment relationship with Ms. Crain, or the frequency
of his visits with her. (Doc. 17, at 8). To begin, the ALJ was not required to specifically
discuss any of these factors in her decision. 20 C.F.R. § 404.1520c(b)(2). In addition,
the ALJ was clearly aware of the length and scope of the treatment relationship as
reflected in her recitation of the medical record. (R. 18-19). Since the Court is able to
trace the ALJ’s reasoning regarding Ms. Crain’s opinion, she has sufficiently built a logical
bridge between the evidence and her conclusion. Charles M. v. Comm’r of Soc. Sec.,
No. 19-CV-1178-JES-JEH, 2021 WL 779979, at *3 (C.D. Ill. Mar. 1, 2021) (“The ALJ need
not draft a novel to explain her reasoning. She must minimally articulate it, such that a

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reviewing court can trace her reasoning and her decision can be subjected to meaningful
review.”).
A final reason the ALJ gave for rejecting Ms. Crain’s opinion is less compelling,
namely, that Plaintiff was unable to explain why he did not have his cardiologist complete
the Cardiac RFC Questionnaire. (R. 19). As Plaintiff notes, it does not appear that State
agency examiner Liana G. Palacci, D.O. specializes in cardiology, but the ALJ found her
April 2018 evaluation persuasive as to Plaintiff’s physical functioning. (R. 19, 501-02).
The ALJ also accepted the opinions from State agency consultants Vidya Madala, M.D.
and Marion Panepinto, M.D., neither of whom is a cardiologist. (R. 19, 69-71, 80-82, 9496, 107-09).
That said, the ALJ also explained that all of the State agency opinions (called prior
administrative medical findings under the new regulations) were consistent with the
record evidence, something not true of Ms. Crain’s evaluation. (R. 19). Dr. Palacci
performed an Internal Medicine Consultative Exam of Plaintiff on April 4, 2018 and
reported that he had normal heart and lung sounds with no evidence of rubs, murmurs,
rales, rhonchi, or wheezes. Plaintiff also had full strength of 5/5 in all extremities, normal
range of motion, normal ability to walk, and normal affect. (R. 501). Dr. Palacci opined
that Plaintiff can sit, stand, handle objects, lift, and carry. (R. 502). On April 8, 2018, Dr.
Madala found Plaintiff capable of light work involving: occasional lifting of 20 pounds;
frequent lifting of 10 pounds; sitting, standing, and walking for about 6 hours in an 8-hour
workday; and occasional climbing of ramps, stairs, ladders, ropes, and scaffolds. (R. 6970, 80-81). Dr. Panepinto affirmed these findings on July 12, 2018. (R. 94-95, 107-08).
The ALJ reasonably concluded that the opinions from the State agency examiner and

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consultants were supported by, and consistent with objective evidence showing largely
normal exams after the angioplasty and stenting procedure, aside from two brief episodes
of near syncope. The ALJ thus did not err in incorporating these limitations into the RFC
determination, a decision Plaintiff does not separately challenge.
Viewing the record as a whole, the ALJ did not err in concluding that Ms. Crain’s
opinion is neither persuasive nor supported by the record. Plaintiff may have liked a more
detailed discussion of the evidence, but the ALJ provided a sufficient analysis to allow the
Court to trace her reasoning. See Fisher v. Bowen, 869 F.2d 1055, 1057 (7th Cir. 1989)
(“No principle of administrative law or common sense requires [this court] to remand a
case in quest of a perfect opinion unless there is reason to believe that the remand might
lead to a different result.”). As the Supreme Court has noted, “[s]ubstantial evidence is
not a high hurdle to clear – it means only ‘such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.’” Bruno v. Saul, 817 F. App’x 238,
241 (7th Cir. 2020) (quoting Biestek, 139 S. Ct. at 1154). The ALJ’s decision satisfies
this threshold and Plaintiff’s request to remand the case for further consideration of Ms.
Crain’s opinion is denied.
2.

Plaintiff’s Subjective Statements

Plaintiff argues that the case still requires remand because the ALJ erred in
assessing his objective statements regarding his symptoms. In evaluating a claimant’s
subjective symptom allegations, an ALJ must consider several factors including: the
objective medical evidence; the claimant’s daily activities; the location, duration,
frequency, and intensity of the claimant’s pain or other symptoms; precipitating and
aggravating factors; type, dosage, effectiveness, and side effects of medication;

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treatment and other measures besides medication taken to relieve pain or other
symptoms; and functional limitations due to pain or other symptoms.

20 C.F.R. §

404.1529(c); SSR 16-3p, 2017 WL 5180304, at *5, 7-8 (Oct. 25, 2017). “‘An ALJ need
not discuss every detail in the record as it relates to every factor,’ but an ALJ may not
ignore an entire line of evidence contrary to her ruling.” Benito M. v. Kijakazi, No. 20 C
5966, 2022 WL 2828741, at *8 (N.D. Ill. July 20, 2022) (quoting Grotts v. Kijakazi, 27
F.4th 1273, 1278 (7th Cir. 2022)). “As long as an ALJ gives specific reasons supported
by the record, [the Court] will not overturn a credibility determination unless it is patently
wrong.” Grotts, 27 F.4th at 1279; Murphy v. Colvin, 759 F.3d 811, 816 (7th Cir. 2014)
(patently wrong “means that the decision lacks any explanation or support.”). “Subjective
statements by claimants as to pain or other symptoms are not alone conclusive evidence
of disability and must be supported by other objective evidence.” Grotts, 27 F.4th at 1278.
Plaintiff first argues that the ALJ applied the wrong legal standard in evaluating his
symptoms. Specifically, the ALJ began by reciting the following language: Plaintiff’s
“statements concerning the intensity, persistence and limiting effects of [his] symptoms
are not entirely consistent with the medical evidence and other evidence in the record for
the reasons explained in this decision.” (R. 17-18). Plaintiff insists that the phrase “not
entirely consistent” is meaningless boilerplate and even indicates that the ALJ placed a
higher evidentiary burden on him than the law allows. (Doc. 17, at 9-10; Doc. 20, at 7-9).
This Court disagrees. The Seventh Circuit has made clear that “[t]he fact that the ALJ
used boilerplate language does not automatically undermine or discredit the ALJ’s
ultimate conclusion if he otherwise points to information that justifies his credibility
determination.”

Burmester v. Berryhill, 920 F.3d 507, 510 (7th Cir. 2019) (internal

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citations and quotations omitted). As discussed below, the ALJ provided several valid
reasons for rejecting Plaintiff’s statements.
In addition, the ALJ’s decision contains language demonstrating her use of the
correct preponderance standard. For example, she “considered all symptoms and the
extent to which these symptoms can reasonably be accepted as consistent with the
objective medical evidence and other evidence, based on the requirements of 20 CFR
404.1529 and 416.929 and SSR 16-3p.” (R. 17). This court follows the majority of courts
in this district that “have repeatedly rejected the argument that th[e] boilerplate language
changes the claimant’s evidentiary burden.” Nina Joyce H. v. Saul, No. 18 C 4913, 2020
WL 212771, at *8 (N.D. Ill. Jan. 14, 2020); Aitmus R. v. Saul, No. 18 C 5735, 2019 WL
4923208, at *7 n.13 (N.D. Ill. Oct. 4, 2019) (collecting cases).
Turning to the substantive analysis, as noted, Plaintiff testified at the February
2019 hearing that he suffers from sharp and unpredictable chest pain on a weekly basis
and cannot lift more than 5 pounds. (R. 19, 31, 49). He struggles with shortness of breath
due to asthma, particularly when the temperature changes or he engages in prolonged
walking, and estimates that he can walk about a block and a half. (R. 17, 47-49). In a
March 23, 2018 Function Report, Plaintiff stated that he has trouble lifting, bending,
reaching, kneeling, hearing, stair climbing, completing tasks, remembering things, and
getting along with others. At that time, he estimated that he could walk only half a block
before needing to rest for 5 minutes. (R. 17, 261). In a March 24, 2018 Cardiac
Questionnaire, Plaintiff indicated that he gets short of breath after climbing a flight of
stairs, requiring 2-3 minutes to recover, and he can only “sometimes” comb his hair, brush
his teeth, and shave without experiencing chest pain or shortness of breath. (R. 267).

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The ALJ first discounted Plaintiff’s testimony because it was inconsistent with the
objective medical evidence. (R. 18). For reasons stated earlier, the Court finds no error
in this assessment. After Plaintiff’s heart surgery, he consistently denied having any
problems with chest pain, palpitations, wheezing, coughing, or shortness of breath. The
only exceptions were the two times he was briefly hospitalized for observation following
near fainting episodes in September 2017 and February 2018, and his symptoms
resolved prior to his discharge. Moreover, Ms. Crain saw Plaintiff five times after the
February 2018 hospitalization, including on February 28, 2018, April 11, 2018, May 20,
2018, September 28, 2018, and February 13, 2019, and her examination findings were
entirely normal. (R. 492, 570, 558, 561, 567). Plaintiff fails to explain how these records
support his assertion that he can barely sit, stand, walk, or comb his hair. See Thorps v.
Astrue, 873 F. Supp. 2d 995, 1006 (N.D. Ill. 2012) (citing Arnold v. Barnhart, 473 F.3d
816, 823 (7th Cir. 2007)) (“[A] patient’s subjective complaints are not required to be
accepted insofar as they clashed with other, objective medical evidence in the record.”).
For similar reasons, the ALJ did not err in finding Plaintiff’s statements
unpersuasive because he received minimal treatment after his heart attack. (R. 18).
Receipt of conservative treatment is a legitimate reason to find a claimant not entirely
credible, Sienkiewicz v. Barnhart, 409 F.3d 798, 804 (7th Cir. 2005), and here, Plaintiff
received only routine medication management. Plaintiff objects that the ALJ should have
articulated “what type of treatment she expected an individual with Plaintiff’s reported
symptoms and limitations to pursue.” (Doc. 17, at 10; Doc. 20, at 11-12) (citing Monique
B. v. Saul, No. 19 C 652, 2020 WL 4208112, at *7 (N.D. Ill. July 22, 2020)) (ALJ erred in
characterizing the plaintiff’s treatment as conservative where she received steroid

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injections in both knees for pain and her doctors anticipated she would need surgical
intervention). But since Plaintiff repeatedly denied experiencing any symptoms at all, the
ALJ reasonably concluded that his assertions of disabling chest pain and breathing
problems were not credible regardless of any other treatment options. And nothing in the
record supports Plaintiff’s suggestion that he did not pursue more aggressive treatment
due to financial difficulties, as evidenced by his SSI application. (Doc. 17, at 10-11; Doc.
20, at 12). Rather, it is apparent from the record that doctors never recommended more
aggressive treatment because Plaintiff had no symptoms and exams were normal.
The same analysis applies to Plaintiff’s complaints of disabling fatigue and
dizziness. Plaintiff once again cites to his two brief hospitalizations for near fainting, and
to Ms. Crain’s opinion that he experiences fatigue, weakness, and dizziness requiring him
to lie down. (Doc. 17, at 12-13; Doc. 20, at 13-14). As explained earlier, Plaintiff’s
symptoms resolved prior to discharge, he did not make further complaints of dizziness or
fatigue to his treaters, and the ALJ reasonably rejected Ms. Crain’s opinion since it was
unsupported by the medical evidence, including her own treatment notes showing normal
exams from February 28, 2018 forward.
Plaintiff finally objects that the ALJ improperly equated his ability to perform certain
activities of daily living with an ability to work. (Doc. 17, at 11-12; Doc. 20, at 12-13). This
is incorrect. The ALJ simply determined that Plaintiff’s ability to shop on his own, manage
his hygiene, take care of his dogs, and watch his granddaughter is one factor weighing
against the reliability of Plaintiff’s statements that he is largely incapacitated by chest pain
and breathing problems.

(R. 18).

The Court finds no error in this analysis.

See

Burmester, 920 F.3d at 510 (“The ALJ did not equate Burmester’s ability to perform

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certain activities of daily living with an ability to work full time. Instead, he used her
reported activities to assess the credibility of her statements concerning the intensity,
persistence, or limiting effects of her symptoms consistent with the applicable rules.”).
“The ALJ’s credibility assessment need not be perfect; it just can’t be patently
wrong.” Dawson v. Colvin, No. 11 C 6671, 2014 WL 1392974, at *10 (N.D. Ill. Apr. 10,
2014) (citing Schreiber v. Colvin, 519 F. App'x 951, 961 (7th Cir. 2013)). Viewing the
record as a whole, the ALJ provided several valid reasons for discounting Plaintiff’s
complaints of disabling symptoms, and that decision is supported by substantial evidence.
CONCLUSION
For reasons stated above, Plaintiff’s request to reverse or remand the ALJ’s
decision is denied, and Defendant’s Motion for Summary Judgment [18] is granted. The
Clerk is directed to enter judgment in favor of the Commissioner.
ENTER:

Dated: July 29, 2022

____________________________
SHEILA FINNEGAN
United States Magistrate Judge

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