Dudley v. Colvin

Filing 17

ORDER signed by Chief Judge William C Griesbach on 3/5/18.The decision of the Commissioner is AFFIRMED. The Clerk is directed to enter judgment in favor of the Commissioner. (cc: all counsel)(Griesbach, William)

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF WISCONSIN

BONNIE DUDLEY,
Plaintiff,
v.

Case No. 16-C-1721

NANCY A. BERRYHILL,
Defendant.

DECISION AND ORDER

This is an action for judicial review of a decision of the Commissioner of Social Security
denying Plaintiff Bonnie Dudley’s application for a period of disability and disability insurance
benefits under Title II of the Social Security Act. Dudley contends that the Administrative Law
Judge (ALJ) erred by failing to properly account for limitations on her ability to maintain
concentration, persistence, and pace when articulating her Residual Functional Capacity (RFC) and
by failing to assign appropriate weight to the opinion of an examining psychologist. For the reasons
set forth below, the decision of the Commissioner will be affirmed.
BACKGROUND
Plaintiff filed her application for disability and disability insurance benefits (DIB) on May 9,
2013, alleging that she has been disabled since July 24, 2012, as a result of anxiety, panic attacks,
depression, attention-deficit disorder, arthritis, chronic back pain, and pain in her hip and leg. R. 77.
At the time of her application, Plaintiff was 47 years old and lived in Gillett, Wisconsin, with her
husband, daughter, and four granddaughters. R. 46. Her last insured date for purposes of DIB was
December 31, 2013. R. 45. Prior to 2012, she worked in nursing homes, primarily as a cafeteria

cook but also periodically cleaning dishes or doing laundry and other housekeeping. R. 48, 63–65.
Her application was denied both initially in October 2013 and on reconsideration in April 2014.
R. 91, 108. She requested a hearing before an ALJ, and ALJ Edward Studzinski held a hearing on
October 9, 2015. R. 41, 156–57.
Both Plaintiff, who was represented by counsel, and a vocational expert (VE) testified at the
hearing. Plaintiff testified that she lived in Gillett, Wisconsin in a mobile home with her husband,
who was receiving disability, her 31-year-old-daughter, and four grandchildren. She was five feet,
two inches tall and weighed 190 pounds, though her normal weight was 145 pounds. She had a high
school diploma and a technical college degree in dietary management. Plaintiff testified that she last
worked in 2012 doing cooking, dishes, and laundry at a nursing home, but the last substantial gainful
employment she had was in 2002. R. 46–48.
Plaintiff testified that she was unable to work because of pain and anxiety. She testified that
she had pain all over depending on what she was doing. She had pain in her lower back when she
worked with her arms and had constant pain in her legs, hips, and upper back that worsened with
activity. On a scale of one to ten, with ten meaning she needed to be at the hospital, she said her
pain was at an eight. She testified she had been treating her pain with Vicodin for about three years
which was prescribed by Dr. Asma, who she was seeing with the help of Medical Assistance. R.
49–50. She had previously tried physical therapy and a chiropractor, but had declined injections
because she’d “heard bad things about injections.” R. 51.
Plaintiff testified she could sit for only 30 minutes before her legs would fall asleep and she
would have to readjust to lessen the pain. The pain was always there, however, and she testified she
normally would not sit for 30 minutes. She testified she could stand for 15 minutes and then had to
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sit down to take the pressure off her back. She estimated the total amount of time she could stand
in an eight-hour day at two hours, but would probably be unable to do even that five days in a row.
She estimated she could lift a gallon of milk, but not if she had to do it off and on for two hours. If
she attempted to exceed those limitations she would hurt more. R. 51–53. During the course of a
day, Plaintiff testified that she would lie down off and on for two hours over an eight hour period.
She would rotate between sitting, standing, and lying down all day long, but seldom sleep. Even
with Vicodin, her pain remained at a level eight. She was unable to bend down to tie her shoes or
pick something up from the floor, though she could pick things up if she crouched. She also had
difficulty reaching with her arms. R. 54–55.
For her anxiety, Plaintiff testified that she took Alprazolam, Zoloft, and Adderall. She said
she had difficulty focusing or concentrating, and comprehending what she was reading. She had only
basis computer skills. Everything made her anxious—leaving the house, driving, people. She would
go grocery shopping with her husband but only at certain times of the day. She seldom drove other
than to the grocery store or to pick up her grandson. When she went to meet her mother in De Pere,
she said her husband drove. R. 56–57. She had panic attacks a couple times a week that could last
more than thirty minutes. R. 59.
Plaintiff testified she was able to cook a meal and make the kids cereal for breakfast. She
seldom cleaned because it was difficult to work with her arms in front of her. Her main activity or
entertainment was watching TV, though she also tried to attend her grandchildren’s events at school.
No doctor, however, had ever limited her activity for medical reasons. R. 60–61.
In an eleven page decision dated December 10, 2015, the ALJ determined that Plaintiff was
not disabled. R. 22–31. The ALJ’s decision followed the five-step sequential process for
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determining disability prescribed by the Social Security Administration (SSA). At step one, the ALJ
concluded that Plaintiff had not engaged in substantial gainful activity between July 24, 2012, her
alleged onset date, and December 31, 2013, her date last insured. R. 24. At step two, the ALJ
concluded that Plaintiff had five severe impairments during the period of time under review: anxiety
disorder, depression, attention deficit hyperactivity disorder (ADHD), degenerative disc disease, and
degenerative joint disease. R. 24 At step three, the ALJ concluded that none of Plaintiff’s severe
impairments met or medically equaled the severity of any of the impairments listed in 20 C.F.R. Part
404, Subpart P, Appendix 1. R. 24.
Before proceeding to step four, the ALJ assessed Plaintiff’s RFC and found that she is
capable of “perform[ing] a range of light work” as defined in 20 C.F.R. § 404.1567(b), subject to
a lengthy set of limitations:
After careful consideration of the entire record, I find that the claimant has the
residual functional capacity to lift and/or carry up to 20 pounds occasionally and 10
pounds frequently, and has no limitations in her ability to sit, stand or walk
throughout an 8-hour workday. The claimant needs to alternate her position
between sitting, standing, and walking for no more than five minutes out of every
hour. While doing so, she would not need to be off task. The claimant can
occasionally climb ramps and stairs, and she can occasionally stoop, kneel, balance,
crouch and crawl, but [she] can never climb ladders, ropes or scaffolds. The claimant
is limited to working in non-hazardous environments, i.e., no driving at work,
operating moving machinery, working at unprotected heights or around exposed
flames and unguarded large bodies of water, and [she] should avoid concentrated
exposure to unguarded hazardous machinery. The claimant is further limited to
simple, routine and repetitive tasks, work involving no more than simple decisionmaking, no more than occasional and minor changes in the work setting, and work
requiring the exercise of only simple judgment. She can tolerate an average
production pace, but not above average or variable pace. She is further precluded
from work involving direct public service, in person or over the phone, although the
claimant can tolerate brief and superficial interaction with the public, which is
incidental to her primary job duties. She is unable to work in crowded, hectic
environments. The claimant can tolerate brief and superficial interaction with
supervisors and co-workers, but is not to engage in tandem tasks.
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R. 26. In arriving at this RFC, the ALJ found Plaintiff’s testimony and statements concerning the
intensity, persistence, and limiting effects of her pain and other symptoms less than credible. The
ALJ noted that “[w]hile medical records including examination observations and findings, and
prescribed treatment, support the existence of medically determinable impairments, they do not
document conditions which could reasonably be expected to give rise to the degree of limitation
alleged.” R. 27.
Following this statement of Dudley’s RFC, the ALJ found at step four that Dudley would not
be capable of performing her past relevant work as a cafeteria cook. R. 29. This determination
relied on the VE’s characterization of Dudley’s previous work as performed at the medium
exertional level. R. 29–30. At step five, however, the ALJ found that as of December 31, 2013,
Dudley was capable of performing other jobs that exist in significant numbers in the national
economy. R. 30. Relying on further testimony from the VE, the ALJ found that Dudley is capable
of performing work as an address clerk, account clerk, or bench sorter, all of which are sedentary
positions. R. 30–31. Consequently, the ALJ determined that Dudley is not disabled.
LEGAL STANDARD
The statute authorizing judicial review of decisions of the Commissioner of Social Security
states that the findings of the Commissioner “as to any fact, if supported by substantial evidence,
shall be conclusive.” 42 U.S.C. § 405(g); Jelinek v. Astrue, 662 F.3d 805, 811 (7th Cir. 2011).
Substantial evidence is “such relevant evidence as a reasonable mind could accept as adequate to
support a conclusion.” Schaaf v. Astrue, 602 F.3d 869, 874 (7th Cir. 2010) (quoting Richardson
v. Perales, 404 U.S. 389, 401 (1971)). Although a decision denying benefits need not discuss every
piece of evidence, remand is appropriate when an ALJ fails to provide adequate support for the
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conclusions drawn. Jelinek, 662 F.3d at 811. The ALJ must provide a “logical bridge” between the
evidence and his conclusion. Clifford v. Apfel, 227 F.3d 863, 872 (7th Cir. 2000).
The ALJ is also expected to follow the SSA’s rulings and regulations in making a
determination. Failure to do so, unless the error is harmless, requires reversal. Prochaska v.
Barnhart, 454 F.3d 731, 736–37 (7th Cir. 2006). In reviewing the entire record, the court does not
substitute its judgment for that of the Commissioner by reconsidering facts, reweighing evidence,
resolving conflicts in evidence, or deciding questions of credibility. Estok v. Apfel, 152 F.3d 636,
638 (7th Cir. 1998). Finally, judicial review is limited to the rationales offered by the ALJ. Shauger
v. Astrue, 675 F.3d 690, 697 (7th Cir. 2012) (citing SEC v. Chenery Corp., 318 U.S. 80, 93–95
(1943); Campbell v. Astrue, 627 F.3d 299, 307 (7th Cir. 2010)).
ANALYSIS
Plaintiff offers two reasons why this court should reverse the ALJ’s decision and remand for
further consideration. She does not challenge the ALJ’s finding that despite her allegations of almost
constant severe and disabling pain from her physical impairments, she retained the capacity to
perform light work. Instead, she argues, first, that the ALJ failed to properly account for limitations
on her ability to maintain concentration, persistence, and pace due to her mental impairments when
formulating her RFC and when posing the hypothetical to the VE. Second, she argues that the ALJ
failed to assign weight to the opinion of Dr. Sandra King, a psychologist who examined her. Neither
basis warrants reversal.
A. Concentration, Persistence, and Pace in the RFC and Hypothetical
Plaintiff’s primary argument is that the ALJ’s RFC formulation and hypothetical posed to the
VE, which were essentially the same, failed to adequately account for the ALJ’s finding that she
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experiences moderate limitations on her ability to maintain concentration, persistence, and pace
(CPP). Pl.’s Br., ECF No. 15 at 11–21. For purposes of this argument, Plaintiff is not challenging
the ALJ’s assessment of the medical sources and other evidence he evaluated to arrive at the RFC.
His argument instead is that having found that Plaintiff had moderate difficulties in CPP, the ALJ
erred in translating this limitation into the RFC he formulated. As Plaintiff’s brief demonstrates, this
is a common, and unfortunately confusing, issue in Social Security disability appeals. What does it
mean to say that a claimant has moderate difficulties in her ability to maintain concentration,
persistence, or pace?
A finding that a claimant has moderate difficulties with regard to concentration, persistence
or pace is made in almost every case involving a severe mental impairment. “Concentration,
persistence or pace” is one of the four broad functional areas the SSA rates, using its “special
technique,” to determine whether a claimant’s alleged mental impairment meets or medically equals
the criteria for presumptive disability under one of the mental disorders in the SSA’s Listings of
Impairments, and if not, whether or not it is nevertheless severe. 20 C.F.R. § 404.1520a. The other
three broad functional areas are activities of daily living, social functioning, and episodes of
decompensation. Id. § 404.1520a(c)(3). The first three are rated on a five-point scale: none, mild,
moderate, marked, and extreme. The fourth broad functional area, episodes of decompensation, is
rated on a four-point scale: none, one or two, three, four or more. Id. § 404.1520a(c)(4). If the
SSA rates the first three broad functional areas as “none” or “mild “ and “none” in the fourth area,
it generally concludes that the impairment is not severe. Id. § 404.1520a(d)(1). If not, then the
impairment is considered severe and the SSA determines whether it meets or is equivalent in severity
to a mental impairment in the SSA’s Listing of Impairments, 20 C.F.R. Part 404, Subpart P,
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Appendix 1, 12.01. If the mental impairment is severe, but does not meet or equal in severity any
listing, the SSA then assesses the mental RFC. 20 C.F.R. § 404.1520a(d)(3).
SSA adjudicators are told that the limitations they identify using the “psychiatric review
technique” are “not an RFC assessment” but are instead “used to rate the severity of the mental
impairment(s) at steps 2 and 3 of the sequential evaluation process.” SSR 96-8p, 1996 WL 374184,
at *4 (July 2, 1996). As the Ruling makes clear, “[t]he mental RFC assessment used at steps 4 and
5 of the sequential evaluation process requires a more detailed assessment by itemizing various
functions contained in the broad categories found in paragraphs B and C of the adult mental
disorders listings in 12.00 of the Listing of Impairments, and summarized on the PRTF.” Id. Thus,
it is to the more detailed assessment of the various functions set forth in the Mental Residual
Functional Capacity Assessment (MRFCA) form, as well as all the other evidence in the record
bearing on the issue, that the ALJs look to in formulating a claimant’s mental RFC.
“As a general rule, both the hypothetical posed to the VE and the ALJ’s RFC assessment
must incorporate all of the claimant’s limitations supported by the medical record.” Yurt v. Colvin,
758 F.3d 850, 857 (7th Cir. 2014) (citing O’Connor–Spinner v. Astrue, 627 F.3d 614, 619 (7th Cir.
2010); Indoranto v. Barnhart, 374 F.3d 470, 473–74 (7th Cir. 2004)). In particular, the Seventh
Circuit has found fault when the ALJ translates a medical source’s finding of moderate limitations
in concentration, persistence, or pace into an RFC limiting the claimant to simple, routine, and
repetitive tasks. See O’Connor–Spinner, 627 F.3d at 620 (rejecting argument that “an ALJ may
account generally for moderate limitations on concentration, persistence or pace by restricting the
hypothetical to unskilled work”). But where a medical source, whose opinion the ALJ reasonably
accords great weight, translates his own finding that the claimant may have moderate difficulties in
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one of the broad areas of functioning into an ultimate conclusion that the claimant can nevertheless
perform simple, routine, and repetitive work, the ALJ does not err. Thus, in Johansen v. Barnhart,
the court held that the ALJ did not err in finding that despite the plaintiff’s moderate limitations in
his ability to maintain a regular schedule and attendance, and in his ability to complete a normal
workday and workweek without interruptions from psychologically-based symptoms, he could still
perform repetitive, low-stress work:
The ALJ did not err in relying on Dr. Matkom’s assessment of Johansen’s mental
RFC. Both Dr. Matkom and Dr. Berney found that Johansen was essentially
“moderately limited” in his ability to maintain a regular schedule and attendance, and
in his ability to complete a normal workday and workweek without interruptions
from psychologically-based symptoms. Dr. Matkom, however, went further and
translated those findings into a specific RFC assessment, concluding that Johansen
could still perform low-stress, repetitive work. Dr. Berney, on the other hand, did not
make an RFC assessment (nor did state-agency physician Ingison). Thus, because Dr.
Matkom was the only medical expert who made an RFC determination, the ALJ
reasonably relied upon his opinion in formulating the hypothetical to present to
Goldsmith.
314 F.3d 283, 288–89 (7th Cir. 2002); see also Capman v. Colvin, 617 F. App’x 575, 578–79 (7th
Cir. 2015) (holding ALJ did not err in limiting plaintiff “to simple, routine tasks that did not require
working with the public or in close proximity or cooperation with others,” notwithstanding finding
moderate limitations in CPP).
Similarly in this case, state agency consultant Dr. Chang-Wuk Kang reviewed Dudley’s
mental RFC at the initial level. R. 86–88. With regard to sub-categories pertaining to her ability to
maintain concentration, persistence, and pace, Dr. Kang opined that she is moderately limited in her
ability to perform activities within a schedule, maintain regular attendance, be punctual within
customary tolerances, sustain an ordinary routine without special supervision, and complete a normal
workday and workweek at a consistent pace without an unreasonable frequency and length of rest
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periods due to psychological symptoms. R. 87. Dr. Kang nevertheless concluded in his narrative
description of Plaintiff’s mental RFC that even though she may have some difficulty in focusing on
a detailed task, “she can maintain concentration and persistence to complete workdays and
workweeks in performance of simple repetitive tasks.” R. 87. The ALJ assigned significant weight
to this opinion. R. 29.
State agency consultant Dr. David Biscardi also completed a MRFCA at the reconsideration
level. R. 104–05. Like Dr. Kang, Dr. Biscardi found that Dudley is moderately limited in her ability
to maintain attention and concentration for extended periods and in her ability to complete a normal
workday and workweek at a consistent pace without an unreasonable frequency and length of rest
periods due to psychological symptoms. R. 104. Despite these difficulties, however, he concluded
in his narrative description:
[Claimant] retains the capacity to understand, remember, carry out and sustain
performance of 1–3 step tasks (but would become overwhelmed if the procedures
were more complicated), complete a normal workday, interact briefly/superficially
with coworkers/supervisors and adapt to changes/stressors associated with simple
routine competitive work activities.
R. 105. The ALJ also assigned significant weight to this opinion. R. 29.
Plaintiff cites Varga v. Colvin, 794 F.3d 809 (7th Cir. 2015), and Yurt v. Colvin, 758 F.3d
850 (7th Cir. 2014), as support for her contention that the ALJ in this case erred in her formulation
of the RFC. In Varga, the ALJ found that the plaintiff had moderate limitations in CPP and in
various functional areas within that broader category, but then adopted an RFC that only limited her
to “simple, routine, and repetitive tasks in a work environment free of fast paced production
requirements.” Id. at 811–13. Similarly in Yurt, the ALJ found that the claimant had moderate

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difficulties in CPP, but then accommodated that difficulty by simply limiting him to unskilled work.
758 F.3d at 858. In both cases, the Commissioner’s decisions were reversed.
Plaintiff seems to read Varga, and Yurt as well, to say that an RFC limiting a claimant to
simple, routine, repetitive work is never appropriate when moderate difficulties in CPP are found.
But this is not what these cases say. In Yurt, the court declined to adopt the blanket rule, based on
the instructions in the SSA’s MRFCA form, that the boxes checked by the reviewing psychologist
in the worksheet section of the form do not constitute the RFC assessment, which the Third Circuit
had applied in Smith v. Commissioner of Social Security, 631 F.3d 632, 637 (3d Cir. 2010). Yurt,
758 F.3d at 858. But Yurt did not say that the worksheet observations always control over the
doctor’s narrative RFC assessment.
And Varga explicitly recognized that “in some cases, an ALJ may rely on a doctor’s narrative
RFC, rather than the checkboxes, where that narrative adequately encapsulates and translates those
worksheet observations.” 794 F.3d at 816 (citing Johansen, 314 F.3d at 286). The problem in
Varga was that the doctor’s narrative RFC was missing. Under those circumstances, the court held
that it was error not to rely on the worksheet observations. Id. But where the examiner’s narrative
is included and is not inconsistent with the worksheet findings, the ALJ may reasonably rely on it.
See also Capman, 617 F. App’x at 579 (“So the ALJ may reasonably rely on the examiner’s
narrative in Section III, at least where it is not inconsistent with the findings in the Section I
worksheet.”).
The recent case of Lanigan v. Berryhill, cited by Plaintiff in her reply, does not change the
law on this issue. 865 F.3d 558 (7th Cir. 2017). Lanigan recounted that the court had said that “an
ALJ must explicitly address those [CPP] limitations in the hypothetical unless one of three exceptions
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applies: (1) the vocational expert was independently familiar with the claimant’s medical file; (2) the
hypothetical adequately apprised the vocational expert of the claimant’s underlying mental
conditions; or (3) the hypothetical otherwise accounted for the limitations using different
terminology.” Id. at 565 (citing O’Connor–Spinner, 627 F.3d at 619–20). The court found that
none of the three exceptions applied in that case. Id. Here, by contrast and as explained above, the
same medical sources that found Plaintiff had moderate difficulties in CPP translated that limitation
into a mental RFC that was even less generous than the RFC the ALJ adopted.
Although the electronic forms used by state agency consultants for assessing Plaintiff’s
mental impairments in this case are not the same as those used in Yurt and Varga, the law has not
changed. A claimant’s RFC is “the most [the claimant] can still do despite [the claimant’s]
limitations,” 20 C.F.R. § 404.1545(a)(1) (emphasis added), not what she can do with ease or without
moderate difficulty. This is particularly important to note when one considers what the term
“moderate” is intended to mean in this context. The recent rule revisions by the SSA clarify that a
“moderate” limitation means that a claimant’s “functioning in this area independently, appropriately,
effectively, and on a sustained basis is fair.” SSA, Revised Medical Criteria for Evaluating Mental
Disorders, 81 Fed. Reg. 66138, 66164 (Sept. 26, 2016) (effective January 17, 2017). Although the
revised regulations became effective after the hearing was held in this case, the definitions “are
consistent with how [SSA’s] adjudicators have understood and used those words in [SSA’s]
program since [SSA] first introduced the rating scale in 1985.” 81 Fed. Reg. 66147. As a result,
the definitions set forth in the new rules “do not represent a departure from prior policy.” Id.; see
also Capman, 617 F. App’x at 579 (“A moderate limitation is not a complete impairment.” (citing

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Roberson v. Astrue, 481 F.3d 1020, 1024 (8th Cir. 2007))). Thus, moderate difficulty does not
mean that the claimant is unable to perform the activity or task.
It is also important to note that where, as here, a case proceeds to a hearing, it is the
responsibility of the ALJ, not the medical experts, to assess the claimant’s RFC. 20 C.F.R.
§ 404.1546(c). Although the ALJ must consider opinions from medical sources in assessing issues
such as a claimant’s RFC, “the final responsibility for deciding these issues is reserved to the
Commissioner.” Id. § 404.1527(d)(2).
That is what the ALJ did here. As the Commissioner notes, “the ALJ included a robust set
of mental limitations that virtually mirrored (and exceeded) the opinions of the state-agency doctors,
the only sources to opine on the issue of Plaintiff’s functional work-related limitations.” Commr.’s
Br., ECF No. 15 at 8. Notwithstanding his finding that Plaintiff had moderate difficulties in CPP,
a finding based on the opinions of the state agency psychologists, the ALJ found that Plaintiff could
perform work that fell within the long and detailed RFC set forth in his decision (R. 26), an RFC
even more limited than the same medical sources thought her capable. In doing so, the ALJ noted
that he “afforded the claimant considerable benefit of the doubt, and included additional limitations
reflecting evidence submitted after these opinions.” R. 29. Plaintiff’s insistence that this court find
that the ALJ’s RFC fails to capture the limitations of a person with moderate difficulties in CPP is
an invitation for the court to both “play doctor” and usurp the function of the ALJ. Neither is
allowed under the law governing judicial review of the Commissioner’s decisions. See 42 U.S.C.
§ 405(g) (“The findings of the Commissioner of Social Security as to any fact, if supported by
substantial evidence, shall be conclusive . . . .”).

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Finally, it is worth noting that Plaintiff does not suggest any alternative RFC that she believes
would have more accurately conveyed to the VE and a reviewing court what “moderate difficulties”
in CPP really means. The phrase is not self-defining, and it seems doubtful that a VE would find a
hypothetical with the limitation “moderate difficulties in CPP” very useful in attempting to name jobs
that a claimant with such an RFC could perform. If the ALJ may not rely on the medical sources that
offer opinions on what it means, the issue will likely continue to be a troubling one in social security
disability cases. Clarity would greatly help both the claimants and the Commissioner.
B. Dr. King’s Opinion
Plaintiff also argues that the ALJ erred by failing to expressly assign weight to the opinion
of Dr. Sandra King, who examined Plaintiff in October 2013. R. 490–93. Dr. King’s written report
included a statement regarding Plaintiff’s capacity to work:
Ms. Dudley is not expected to have difficulties understanding directions, but she may
have difficulty remembering and carrying out directions due to lack of
concentrations/distractibility. She is predicted to have mild difficulties in responding
appropriately to supervisors and co-workers due to irritability. Her ability to
maintain concentration and attention appear to be mildly impaired. Ms. Dudley is
expected to have moderate to severe difficulties withstanding routine work stress and
adapting to change.
R. 493. After briefly summarizing Dr. King’s report and noting that Dr. King “assessed the claimant
with major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, and
ADHD,” the ALJ explained that he “assigned the claimant functional limitations to accommodate
these conditions.” R. 28.
“An ALJ may not selectively consider medical reports, especially those of treating physicians,
but must consider ‘all relevant evidence.’” Myles v. Astrue, 582 F.3d 672, 678 (7th Cir. 2009) (per
curiam) (quoting Clifford v. Apfel, 227 F.3d 863, 871 (7th Cir. 2000)). Furthermore, “[a]n ALJ can
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reject an examining physician’s opinion only for reasons supported by substantial evidence in the
record.” Gudgel v. Barnhart, 345 F.3d 467, 470 (7th Cir. 2003). Plaintiff takes particular issue with
the ALJ’s alleged rejection of Dr. King’s opinion that Plaintiff “is expected to have moderate to
severe difficulties withstanding routine work stress and adapting to change.” R. 493.
A close examination of the RFC, however, reveals that, far from selectively ignoring Dr.
King’s opinions, the ALJ incorporated them into the RFC, as he stated he did in his decision.
Plaintiff primarily focuses on Dr. King’s opinion that she will have “moderate to severe difficulties
withstanding routine work stress and adapting to change.” R. 493. The RFC is most obviously
consistent with Dr. King’s opinion regarding Plaintiff’s ability to adapt to change, as it limits her to
“no more than occasional and minor changes in the work setting.” R. 26. Although the RFC does
not expressly limit Plaintiff to a certain degree of stress, in its entirety it is clearly directed at
minimizing her stress by limiting her to “simple, routine and repetitive tasks,” “work involving no
more than simple decision-making,” “work requiring the exercise of only simple judgment,” as well
as precluding her from public-facing work, crowded or hectic environments, and more than brief or
superficial interactions with supervisors and co-workers. R. 26. What is more, these limitations that
would, collectively, minimize work stress also speak to other individual opinions that Dr. King
expressed concerning Plaintiff’s limited abilities to carry out directions, interact with co-workers, and
maintain concentration and attention. The ALJ’s opinion does not expressly assign a “weight” to
Dr. King’s opinion, but it is clear that the ALJ did follow through on his statement that when
formulating the RFC he would accommodate the limitations identified by Dr. King. Plaintiff’s
argument that the ALJ disregarded Dr. King’s opinion therefore fails.

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CONCLUSION
For the reasons given above, the Plaintiff’s motion for summary judgment is denied, and the
decision of the Commissioner is AFFIRMED. The Clerk is directed to enter judgment in favor of
the Commissioner.
SO ORDERED this 5th day of March, 2018.
s/ William C. Griesbach
William C. Griesbach, Chief Judge
United States District Court

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