Nordness, Lisa v. Berryhill, Nancy

Filing 20

ORDER affirming Commissioner decision denying plaintiff's application for disability and disability insurance benefits. Signed by District Judge William M. Conley on 9/30/2019. (arw)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
LISA NORDNESS,
Plaintiff,

OPINION AND ORDER

v.
18-cv-357-wmc
ANDREW M. SAUL, Commissioner of
Social Security,
Defendant.
Claimant Lisa Nordness seeks judicial review of a final decision of defendant
Andrew Saul, the Commissioner of Social Security, under 42 U.S.C. § 405(g), which
denied her application for disability and disability insurance benefits. She contends that
remand is necessary because Administrative Law Judge Ahavaha Pyrtel (“the ALJ”): (1)
improperly weighed the opinions of claimant’s treating psychiatrist and licensed therapist;
(2) failed to evaluate claimant’s obesity appropriately; and (3) adopted an assessment of
claimant’s symptoms and mental impairments lacking in evidentiary support. The court
held oral argument on this case on August 20, 2019, at which counsel for both sides
appeared. For the reasons addressed below, the Commissioner’s decision will now be
affirmed.

BACKGROUND
On November 21, 2014, Nordness filed an application for disability and disability
insurance benefits, alleging an onset date of October 25, 2012.

(See AR 15.)

Her

application was initially denied on April 8, 2015, and then again on reconsideration on

July 28, 2015. (Id.) She then appeared before the ALJ for a hearing on February 14, 2017.
(Id.)

A. Hearing Testimony
At her hearing, Nordness testified that she was approximately 5’ 7” and 290 pounds.
(AR 44.) While she could drive, Nordness explained that she did not drive daily and only
drove locally. (AR 45-46.) Even so, her most recent employment had been as a bus driver
for the City of Madison Metro.
concentration problems.

(AR 47.)

(AR 58-59.)

She testified to having memory and

Nordness added that she could “make little

decisions,” but had assigned her daughter with power of attorney to control her finances
and make larger decisions. (AR 59.) She also described physical limitations, including
being unable to lift heavy things, limited reach, and an inability to bend over. (AR 57-58.)
She also identified balance problems and an inability to kneel or stoop. (AR 58.)
Despite her limitations, Nordness explained that she was taking classes to pursue a
degree in human resources. (AR 60.) Since her accident, the Division of Vocational
Rehabilitation required her to go to school and take classes. (Id.) She also had to retake
classes “because [she] flunked.” (Id.) That said, Nordness had approximately six more
classes to take for the degree and had previously been on the dean’s list. (AR 61.) She
acknowledged taking a hiatus on her classes explaining that “going to school and sitting in
a classroom for two hours is very, very hard for [her].” (AR 62.) She further acknowledged
taking care of her grandchildren “maybe [a] couple of days a week.” (AR 64-65.) Although
Nordness emphasized that she was only responsible for caring for the grandkids after her

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granddaughter started crawling, because she was unable to pick her up. (AR 65-66.) She
testified that the grandkids had a nanny before that. (AR 66.)

B. ALJ Decision
The ALJ issued an unfavorable decision on April 18, 2017. (Id.) Concluding that
Nordness met the insured status requirements through December 31, 2018, the ALJ
initially determined that she had not engaged in substantial gainful activity since October
25, 2012.

(AR 17.)

The ALJ also found that Nordness had a number of severe

impairments: degenerative disk and joint disease, depression, and anxiety with features of
claustrophobia. (Id.) While recognizing that Nordness was obese, the ALJ did not find
this to be a severe impairment, as there was “no evidence that the claimant’s excessive
weight significantly limits her ability to function.”1 (AR 18.) At the same time, disagreeing
with the state disability psychological consultants, the ALJ found Nordness’s psychological
impairments to be severe. (AR 21.) However, the ALJ did not find them to be disabling
because she was perceived as having a pleasant demeanor, with appropriate mood and
affect, and had reported improvement with Wellbutrin. (Id.)
As a result, the ALJ concluded that Nordness had moderate limitations in
understanding, remembering, or applying information based on claimant’s pursuit of
higher education and her reports of difficulty with her memory and concentration, but no
difficulty understanding or following instructions. (Id.) The ALJ also found that she had
moderate limitations in her ability to interact with others based on her alleged difficulties

The ALJ also found Nordness’s diabetes, hypertension and sleep apnea to be non-severe
impairments. (AR 19.) Plaintiff is not challenging these findings on appeal.
1

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socializing contrasted with her seeking a degree to work as a human resources manager,
that she had never been fired because of an inability to get along with others, and her
reports that she regularly ate at restaurants, accompanied a friend to Florida,
communicated with others using the computer, shopped weekly, and got along fine with
authority figures. (AR 22.)
As to concentration, persistence and pace, the ALJ found Nordness had only mild
limitations because of: her two years of college since her alleged onset date; her strong
academic performance; and her reports that she could finish what she started, but had
trouble concentrating and remembering, and her ability to handle finances. (Id.) Her
reports that she had trouble with concentration and her memory were related to her pain
and medication side effects -- not her mental health. (Id.) Finally, as to adapting or
managing herself, she had no limitations: she completed two years of college since her
alleged onset date and she reported handling stress and changes to her routine well. (AR
22-23.)
Finally, the ALJ concluded that Nordness could perform sedentary work, with
specific limitations, including that she could not reach overhead with her left arm, nor
could she crouch or crawl. (AR 23.) Claimant was also precluded from working in small,
enclosed spaces and was limited to occasional interaction with others. (Id.) Ultimately,
the ALJ determined that Nordness was not disabled. (AR 32.)2

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Other aspects of the ALJ’s decision are addressed in detail below.

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OPINION
This court defers to an ALJ’s decision to deny benefits unless unsupported by
substantial evidence or based on an error of law. Terry v. Astrue, 580 F.3d 471, 475 (7th
Cir. 2009). Substantial evidence means “such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389,
401 (1971). In addition, the ALJ must build an “accurate and logical bridge” between the
evidence and the legal conclusion that the claimant is not disabled. McKinzey v. Astrue,
641 F.3d 884, 889 (7th Cir. 2011) (citing Lopez ex rel. Lopez v. Barnhart, 336 F.3d 535, 539
(7th Cir. 2003)). Given these strictures, a reviewing court is not to “reweigh the evidence,
resolve conflicts, decide questions of credibility, or substitute [its] own judgment for that
of the commissioner.” Clifford v. Apfel, 227 F.3d 863, 869 (7th Cir. 2000) (citations
omitted). Still, the court must conduct a “critical review of the evidence” before affirming
a decision to deny benefits. McKinzey, 641 F.3d at 889. Here, plaintiff identifies three
flaws in the ALJ’s reasoning which, she argues, require remand. For the reasons explained
below, the court finds the ALJ has built a sufficient logical bridge between the evidence
and her legal conclusions with respect to each.

I. Treatment Providers
Claimant first argues that the ALJ failed to articulate good reasons for rejecting the
opinions of Jane Gogan, Ph.D., her treating psychiatrist, and Carla Eichinger, LPC, her
treating therapist. (Pl.’s Br. (dkt. #11) 14.) The court will address their opinions in turn.

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A. Dr. Jane Gogan
An ALJ who does not give controlling weight to the opinion of the claimant’s
treating physician must offer ‘good reasons’ for declining to do so.” Larson v. Astrue, 615
F.3d 744, 751 (7th Cir. 2010) (citing 20 C.F.R. § 404.1527(d)(2)).

Generally, the

opinions of a claimant’s treating physician are “give[n] more weight” because he or she is
“likely to be the medical professional[] most able to provide a detailed, longitudinal picture
of [a claimant’s] medical impairment(s) and may bring a unique perspective to the medical
evidence that cannot be obtained from the objective medical findings alone or from reports
of

individual

examinations,

§ 404.1527(d)(2) (2011).

such

as

consultative

examinations.”

20

C.F.R.

Even where a treating physician’s opinion is not given

controlling weight, a number of factors must be considered by the ALJ to determine how
much weight to give different medical opinions, including “[l]ength of treatment
relationship and the frequency of examination”; “[n]ature and extent of the treating
relationship”; supportability; consistency; specialization; and “[o]ther factors . . . which
tend to support or contradict the medical opinion.” 20 C.F.R. § 404.1527(d) (2011).
Nordness began seeing Dr. Jane Gogan once or twice per month beginning on
December 31, 2014, until changing providers because of “scheduling conflicts” on
December 8, 2015; she began seeing Gogan again on December 20, 2016. (AR 2926.) On
December 26, 2016, Gogan then provided a mental impairment questionnaire. (See AR
2925.) When asked for her clinical findings demonstrating the severity of Nordness’s signs
and symptoms on the questionnaire, Dr. Gogan noted the following: “Appetite disturbance
with increase weight change”; “Decreased energy”; “Difficulty thinking or concentrating”;

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“Easy distractibility”; “Feelings of guilt or worthlessness”; “Panic attacks”; “Sleep
disturbance / frequent nightmares” and “Persistent restlessness, agitation, anxiety[,] social
withdrawal, rumination, [and] poor self-care.” (AR 2926) Dr. Gogan further opined that
Nordness was extremely limited in her: activities of daily living; maintaining social
functioning; and concentration, persistence or pace. (AR 2927.) Gogan also considered
Nordness’s limitations and symptoms to be “[l]ongstanding -- since childhood” with “[n]o
periods of sustained improvement.” (AR 2928.) As such, Dr. Gogan concluded that
Nordness would miss at least four days of work each month. (AR 2927.)
Ultimately, the ALJ assigned Dr. Gogan’s opinion “little weight” because “the
limitations Dr. Gogan [found we]re unsupported by the great weight of the evidence,
including her own treatment records.” (AR 28.) First, the ALJ noted the glaring disconnect
between Dr. Gogan’s opinion that the limitations applied “since childhood” and the fact
that claimant Nordness had worked full-time for many years, plus the fact that she
successfully pursued college courses even after the alleged onset date. (Id.) Second, the
ALJ found that Dr. Gogan’s opinions as to Nordness’s “dramatic limitations are simply not
supported by her own records.” (Id.) For example, Gogan’s own medical records noted
that claimant missed appointments because she was too busy with schoolwork, but failed
to assess Nordness’s situation stressors such as her cervical surgery, her daughter blaming
Nordness for her husband’s child-abuse investigation, and Nordness serving as temporary
guardian for her special needs grandson. (AR 28-29.) Third, the ALJ found treatment
records from different providers “have consistently demonstrated that the claimant is able
to grasp treatment recommendations and education appropriately.” (AR 28.) Fourth, the

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ALJ found Dr. Gogan’s reliance on a possible learning disability to be inconsistent with
Nordness’s history of academic success and the fact that she did not even allege a learning
disability before the Social Security Administration. (Id.)
Whether or not this court would have come to the same conclusion, the ALJ’s
decision to give little weight to Dr. Gogan’s opinions is supported by substantial evidence.
Although Dr. Gogan was Nordness’s treating psychologist and saw her with relative
frequency, at least up to one year before being asked to fill out the mental impairment
questionnaire, the ALJ appropriately concluded that her opinions of extreme limitations
were not supportable in light of substantial, conflicting evidence in the record, including
in Dr. Gogan’s own medical records. In particular, Gogan’s contemporaneous treatment
records note that Nordness was studying business and human relations at MATC, where
she received good grades. (AR 1798; AR 1834.) Nordness was so enmeshed in her studies
that she “totally forgot about [an] appointment,” having been “[u]p late doing homework.”
(AR 1834.) Through her education, Nordness reported being “[m]ore socially connected
outside of family now that she is on campus more.” (Id.) At that time, she also reported
that her medications were “helping a lot” and put her “on a more even keel,” so that she
could “deal[] with stress better.” (Id.) Those same records also show Nordness continued
pursuing her education after becoming her grandson’s temporary guardian, although she
was “having a difficult time completing assignments.” (AR 1702.)
While later in 2015, Nordness reported difficulty attending class after being
interviewed by the police regarding her son-in-law, Nordness still expressed “some
confidence that she can complete her group projects.” (AR 1934-35.) Further, Gogan’s

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treatment notes show that Nordness’s daughter was “very dependent on her for childcare.”
(AR 1934.) Dr. Gogan next noted that Nordness became the “full-time care provider for
her granddaughter” in May 2016 and was still “hoping to resume classes in August” at that
time. (AR 1966.) Additionally, the bulk of Dr. Grogan’s mental status observations were
within normal limits. (See e.g., AR 1909, 1915, 1948, 1967.) Finally, and likely most
telling for the ALJ, Nordness worked for many years before her alleged onset date, including
four years in which she earned over $35,000 (AR 225), substantially undermining Dr.
Gogan’s conclusion that Nordness’s work-preclusive symptoms started in childhood.
Accordingly, the court cannot fault the ALJ’s decision to give Dr. Gogan’s opinions little
weight.

B. Therapist Carla Eichinger
The ALJ also afforded “little weight” to therapist Carla Eichinger’s December 2016
assessment. (AR 30.) Eichinger indicated that she started treated Nordness on three
occasions beginning in August 2016. (AR 2889.) In her assessment, Eichinger listed the
following clinical findings:

“Impaired social and emotional functioning,” “Impaired

concentration,” “Difficulties asserting self, [and] interpersonal conflict.” (Id.) Eichinger
identified Nordness’s symptoms as “Difficulty thinking or concentrating”; “Easy
distractibility”; “Feelings of guilt or worthlessness”; and “Memory impairment -- short,
intermediate or long term.”

(Id.)

Accordingly, Eichinger opined that Nordness was

moderately limited in her activities of daily living and markedly limited in her ability to
maintain social functioning, as well as maintain concentration, persistence or pace. (AR
2890.) Eichinger did not know how many days of work each month Nordness would miss

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and also did not know whether she was a malingerer. (Id.) Finally, Eichinger opined that
these symptoms and limitations were first documented on August 4, 2016, just a few
months before she saw Nordness for therapy. (AR 2891.)
The ALJ found that Eichinger’s opinions of marked difficulties in maintaining social
functioning and concentration, persistence or pace were not supported by the evidence.
(AR 30.) In so finding, the ALJ relied on Eichinger’s own notes taken at Nordness’s second
appointment, describing her as “fully alert, talkative, and tangential, with just slight
disorganization in her speech.”

(Id.)

Additionally, the ALJ expressed concern that

Eichinger seemed to accept “claimant’s subjective reports of losing SSI payments and being
unable to pay her bills on face value,” while “the evidence establishes that the claimant lost
disability benefits she was receiving through her former employer’s insurance carrier
because she failed to follow through with medical appointments.” (Id.)
Moreover, Nordness recognizes that as a therapist, Eichinger is not an “acceptable
medial source.” (Pl.’s Br. (dkt. #11) 16 (citing SSR 06-3p: Titles II and XCI: Considering
Opinions and Other Evidence from Sources who are Not “Acceptable Medical Sources” in Disability
Claims; Considering Decisions on Disability by other Governmental and Nongovernmental
Agencies).) While the Social Security Administration can consider opinions from nonacceptable medical sources, such as a therapist, the regulations “do not explicitly address
how to consider relevant opinions and other evidence from ‘other sources’”; instead, the
regulations direct that such sources are to be “evaluated on key issues such as impairment
severity and functional effects, along with the other relevant evidence in the file.” SSR 06-

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3p. Regardless, the same factors that apply to acceptable medical sources can be applied
to other opinions. SSR 06-3p.
Here, the ALJ’s decision to afford little weight to therapist Eichinger’s opinion is
also supported by substantial evidence.

First, the treatment relationship was short.

Eichinger began treating Nordness in August 2016, and provided her opinion in December,
which Eichinger identifying just three dates of treatment in between. The administrative
record similarly contains few treatment records from Eichinger. Second, as the ALJ noted,
Eichinger appears to accept at face value Nordness’s reports of “numerous financial
concerns since [losing] SSI,” her inability “to budget, pay bills, [or] remember to take
medications,” and “difficulty cooking and meal planning.” (AR 2010.) Eichinger also
notes that Nordness “lost disability status due to avoiding medical appointments in March
and April.”

(AR 1987.)

Third, Eichinger apparently bases her opinion of marked

limitations on Nordness’s self-reported symptoms. In an assessment following Nordness’s
first appointment, for example, Eichinger notes that she reported having “[q]uite a bit of
difficulty” managing her daily life, tackling her problems, and concentrating, as well as that
in the past week she had spent “[a] little of the time” getting along with others in social
situations and “[n]one of the time” felt close to another person. (AR 1988.) In the notes
from her second appointment, Nordness apparently self-reported that in the past month
she did not want to be around people, including her friends, was having “[m]uch” trouble
concentrating or paying attention, was having “[m]ost trouble remembering things, and
often had arguments or physical fights. (AR 1998.) Each of these so-called assessments
only record Nordness’s responses to the questions, without any elaboration or evidence of

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evaluation by Eichinger. On the other hand, her mental status evaluations are largely
normal. (See AR 1987, 1995, 2010.)
For all these reasons, the court finds that the ALJ’s treatment of the medical opinion
evidence from Dr. Grogan and therapist Eichinger is supported by substantial evidence.

II. Symptoms and Mental Impairments
Next, Nordness complains that the ALJ’s assessment of her mental impairments and
physical symptoms were not supported by substantial evidence. (Pl.’s Br. (dkt. #11) 17,
23.)

Specifically, Nordness challenges the ALJ’s determination that she could

“occasionally” interact with others and the ALJ’s reliance on her activities of daily living to
conclude that she could work full-time. (Pl.’s Br. (dkt. #11) 18-19, 23-26.) The ALJ also
found that Nordness had moderate limitations in her ability to interact with others. (AR
22.)
As set out in her written decision, the ALJ reached her ultimate conclusions about
claimant’s ability to interact with others by considering: Nordness’s alleged difficulties
socializing; her seeking a degree to work as a human resources manager; her having never
been fired because of an inability to get along with others; her reports of regularly eating
at restaurants; her accompanying a friend to Florida; her communicating with others over
the computer; her weekly shopping; and her getting along fine with authority figures. (AR
22.) Nordness’s medical records also include notes indicating that she attended a retreat.
(Id.)
Further, looking at claimant’s own reported daily activities, in 2013 and 2014, she
engaged in water aerobics, got good grades in school, attempted to regularly exercise, and

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was able to live alone. (AR 24.) In 2015, even though she reported difficulty with
vacuuming and yardwork, she also reported being able to shop for household goods, doing
laundry, preparing meals, caring for her cats, and loading the dishwasher. She also swam
twice a week and cared for her grandson every afternoon. In 2016, as previously noted,
the record shows that Nordness became the full-time caretake for her granddaughter and
reported caring for both grandchildren for approximately 12 hours each day.
Understandably, the ALJ found claimant’s testimony of significant limitations in her
activities of daily living to be “inconsistent with the totality of the evidence.” (AR 25.)
Likewise, the ALJ found no medical support for her claimed need for an assistive device to
walk, and she found that Nordness’s allegations of chronic pain were not fully corroborated
by objective medical evidence. (AR 25-26.)
While Nordness testified that she did not “like to be around people and interact”
(AR 62) and that she had “lost a lot of friends” (AR 60), as already described, there is
plenty of other evidence in the record to substantiate the ALJ’s finding that she could
appropriately interact with others occasionally. For example, since her alleged onset date,
she has been pursuing a degree to work in human resources. (See AR 268-69, 1320, 1627.)
In fact, she was largely successful in her pursuit, despite her testimony that she had flunked
a number of classes.

(See AR 1834 (in March 2015, she was “[c]ompleting school

assignments, getting good grades”); AR 61 (testifying she was on the dean’s list and
required only six more classes for the degree); AR 1721 (in November 2015, she reported
having “some confidence that she can complete her group projects at school”).) Similarly,
in a March 2015 adult function report, Nordness described using the “phone and computer

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to keep in touch with others.” (AR 253.) She also accompanied a friend to Florida and
went on a retreat. (See AR 969, 1909.) Further, Nordness reported having never been
fired because of an inability to get along with others and that she got along “fine” with
authority figures. (AR 255.) As the ALJ noted, she reported frequently dining out. (AR
593.) Finally, state agency psychologist Esther Lefevre concluded that Nordness had only
mild difficulties in maintaining social functioning.
Similarly, the ALJ’s reliance on Nordness’s activities of daily living to conclude that
she could work is no basis for a remand. First, as already discussed, Nordness made
significant progress towards a degree in business/human resources management since her
alleged onset date. Second, contrary to her hearing testimony, her treatment notes not
only show that her grandson lived with her, but she cared for two children up to twelve
hours a day and took both children to the doctor. (AR 1892, 1955, 1973.) In fact, she
identified “babysitting her daughter’s children” -- along with going to classes -- as her main
responsibilities in August 2016. (AR 2645.)
In fairness, Nordness also noted that she was limited in other activities of daily
living in her March 2015 function report. For example, while she prepared meals daily,
Nordness explained that she could not “make food from scratch or big meals,” because she
could not stand long enough and she also noted her inability to lift heavy pots. (AR 251.)
Likewise, while she acknowledged being able to do laundry, she said it took her “several
hours.” (Id.) So, too, she could place the dishes in the dishwasher, but she could not put
them away. (Id.) And she disclaimed any ability to mop or vacuum or perform lawn work.
(AR 251-52.) However, the ALJ took these limitations into consideration in formulating

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the limitations as reflected in the RFC, which, among other things, limits Nordness to
sedentary work and precludes her from overhead reaching with her left arm.
Accordingly, the ALJ’s findings as to Nordness’s RFC is amply supported in this
record.

III. Obesity
Finally, Nordness complains that the ALJ failed to appropriately evaluate her
obesity, which, if done correctly, “may have led to a more restrictive RFC finding.” (Pl.’s
Br. (dkt. #11) 22.) This issue was the focus of the parties’ oral argument. Specifically,
Nordness contends that the ALJ was wrong in rejecting evidence indicating that her obesity
was significantly limiting and in failing to evaluate the impact of her obesity on other
impairments. (Id. at 20-21.) The Commissioner disagrees. (Def.’s Br. (dkt. #15) 14-15.)
While recognizing that Nordness was obese, the ALJ did not find this to be a severe
impairment as there was “no evidence that the claimant’s excessive weight significantly
limits her ability to function.” (AR 18.) The ALJ also explained that while obesity “is a
risk factor that increases an individual’s chances of developing impairments in most body
systems,” she was unable simply to “make assumptions about the severity or functional
effects of obesity combined with other severe impairments.” (AR 18-19.) The ALJ further
noted that while Nordness “indicated having trouble with daily activities” on August 8,
2016, obesity questionnaire, she also indicated that “these seemed more related to her left
shoulder dysfunction than her excessive weight.” (AR 20.) Likewise, when encouraged to
lose weight to help control her diabetes, she reported that her left shoulder impacted her
ability to exercise without reference to her weight. (Id.)

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Regardless, the ALJ still considered Nordness’s obesity during Steps 3 through 5.
(Id.) As the ALJ noted, Nordness completed an Obesity Questionnaire in August 2016.
(See AR 367-69.) In response to a question about how her weight affected her, Nordness
explained that: (1) she could not take baths because she was unable to get out of the tub;
(2) she could only eat a “bland diet” because she had trouble swallowing; (3) she only wore
“loose clothes and pants w/o elastic”; (4) her grocery shopping was limited due to fatigue
and her driving was limited to local driving; (5) she could not do any cleaning or mopping;
and (6) she was limited in her cooking due to fatigue. (AR 367.)3 More specifically,
Nordness explained that she: was “unable to walk more than 15 mins without taking a
break, especially in hot weather”; could sit, but would fall asleep; could not “stand for more
than 20 mins without having to sit”; would be unable to stand up from an armless chair;
and could not lift, pull, push, or carry over 10 pounds. (AR 368.) She added that her
obesity caused a hip issue that impacted her balance, prevented her from stooping,
crouching or climbing. (AR 368-69.) Finally, she explained that she became fatigued
easily, needed to nap, found breathing difficult “due to weight,” which required “many
breaks.” (AR 369.)
Given this litany of impacts, the discussion during claimant’s oral argument focused
on whether the ALJ adequately dealt with claimant’s alleged fatigue. In the decision, the
ALJ recognized claimant’s report that “she was easily fatigued with activity” from her
obesity questionnaire (AR 24-25), but claimant claims this is not enough in light of the

As for the other limitations she identified, Nordness attributed them to her shoulder injury, not
to her obesity. (See AR 367 (explaining she could only wash her hair with one hand because her
“left arm is not able to rise above head” and she had to dress using only one arm).)
3

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uncontradicted evidence that she lays down multiple times a day and the references to
fatigue throughout her medical records. However, as the ALJ noted, the only support the
court can locate in the administrative record for reports of varying levels of fatigue are from
Nordness herself.4 (See AR 760 (reporting “no unexplained fatigue” in February 2012); AR
1428 (reporting no fatigue in February 2013); AR 1017-18 (reporting increased fatigue
“specifically after eating” in February 2014); AR 1489 (reporting “[p]ersistent or pervasive
fatigue” in July 2014).) Accordingly, this record is factually distinguishable from Lopez ex
rel. Lopez v. Barnhart, 336 F.3d 535, 539-40 (7th Cir. 2003), where the ALJ concluded that
there was no medical evidence supporting claimant’s right-hand problem, while improperly
disregarding the objective medical evidence of that impairment. More broadly, the ALJ
rejected claimant’s allegations of fatigue in light of her significant other activities, such as
babysitting her grandchildren and pursuing higher education.
As to the other alleged limitations identified in Nordness’s obesity questionnaire,
the evidence is contradictory and again not directly tied to her obesity. First, looking at
her claimed difficulty walking and shortness of breath, she has self-reported mixed
symptoms and causes since February 2012. (AR 726 (reporting that she got “dizzy if [she]
walks far [and] gets out of breath too”); AR 764 (reporting “shortness of breath with
exertion walking across a room”).) But, at that time she also reported being able to “walk
up 2 flights of stairs without difficulty, but if she is carrying something, she would be out
of breath[.]” (AR 1207.) Nordness repeated her complaints about shortness of breath,

She also identifies drowsiness as one of the side effects from her gabapentin. (AR 256.) At her
hearing before the ALJ, Nordness blamed napping after every meal on her diabetes and pain
medications. (AR 63.)
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including when walking upstairs, again in April 2012, June 2015 and September 2016.
(AR 808, 1304, 2674.) Although the reasons for this are less clear, Nordness’s daughter
also opined that her mother “is not able to walk very long without her hip bothering her.”
(AR 510.)5
Relatedly, throughout most of 2014, Nordness was described as having a normal
gait, but in December 2014, she reported walking with a limp for months.

(See AR

627,1110, 1504.) In early 2015, she was described as having “[d]ecreased gait speed,
decreased B foot clearance essentially dragging feet across floor, patient with heavy
weightbearing.” (AR 1127; see also AR 1132 (“Gait Description: slow speed.”).) In October
2015, she was again “ambulatory with a steady gait.” (AR 2529.) But then in August
2016, she had “[a]ntalgic right lower extremity, Decreased pelvic rotation, Decreased
speed, Decreased stride length right, increase toe out ankle,” as well as “Decreased
weightbearing on R LE.” (AR 2646.) This was described as “severely slowed and antalgic
gait.” (AR 2648.) Finally, later that month, however, she reported improvement in her gait.
(AR 2666.) Even so, it was noted that “[s]he continues to be limited due to reduced weight
bearing, ankle stiffness, antalgic gait, and lower extremity weakness.” (AR 2667.) Again,
the record suggests multiple causes for this, not just obesity.
Second, Nordness was repeatedly advised to engage in “moderate exercise daily,
ideally 30 minutes or more on most, preferably all days of the week.” (See e.g., AR 1828,

As an example, while grocery shopping, Nordness’s daughter explained that Nordness “will need
to sit down 5-6 times for 5 mins each.” (Id.) To be fair, however, at other times she denied having
difficulty breathing or shortness of breath. (See AR 1153, 1191, 2732.) In 2014, for example, she
reported having to walk a long distance while at school, but complained that it was difficult because
of pain. (AR 1160.)
5

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1845.) Over time, her reports of exercise varied. (See e.g., AR 572, 587, 627, 1072, 1164,
1171, 1747, 2646.) In February 2015, her short-term goal was identified as “[r]estart[ing]
exercise for weight loss.” (AR 1089.) The following month, she reported “doing water
aerobics.” (AR 1316.) In mid-2015, she reported “doing water aerobics several days per
week.” (AR 1577.)
Third, it is possible that claimant’s condition may have worsened over time. By
August 2016, she reported “having trouble keeping up with daily tasks,” such as walking
and going to the grocery store. She reported being unable to take her grandchildren to the
park and consistent dull pain. (AR 2645.) Her symptoms were “consistent with a PT
diagnosis of ankle strength deficits.” (AR 2648.) However, an independent medical
examiner in May 2016 opined that she could squat “without difficulty” and had “normal
twisting and bending movements.” (AR 1749.) He also concluded that there was “no
objective evidence of any specific pathophysiological or structural condition that would
physically prohibit standing and walking up to 8 hours a day.” (AR 1750.) Finally, when
the ALJ asked what prevented her from working, Nordness once again identified her
shoulder injury, which limits the use of her left arm, as well as problems getting dizzy from
bending over, but did not mention her weight or how it impacted her other physical
conditions. (AR 52.)
In sum, the ALJ created a logical bridge, and the court cannot fault the ALJ for her
treatment of Nordness’s obesity. Accordingly, the final decision of the Commissioner is
affirmed.

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ORDER
IT IS ORDERED that the decision of defendant Andrew M. Saul, Commissioner of
Social Security, denying Lisa A. Nordness’s application for disability and disability
insurance benefits is AFFIRMED. The clerk’s office is directed to enter judgment and close
this case.
Entered this 30th day of September, 2019.
BY THE COURT:
/s/
__________________________________
WILLIAM M. CONLEY
District Judge

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