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Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 

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United States Court of Appeals 

For the Seventh Circuit 

Chicago, Illinois 60604 

Submitted March 13, 2020*

Decided March 17, 2020 

Before 

FRANK H. EASTERBROOK, Circuit Judge 

ILANA DIAMOND ROVNER, Circuit Judge 

AMY C. BARRETT, Circuit Judge

No. 19-1725 

KURT D. MARQUARDT, 

Plaintiff-Appellant, 

v. 

ANDREW M. SAUL, 

Commissioner of Social Security, 

 Defendant-Appellee.

 Appeal from the United States District 

Court for the Eastern District of Wisconsin. 

No. 17-cv-1489 

David E. Jones, 

Magistrate Judge. 

O R D E R 

Kurt Marquardt challenges the denial of his application for disability benefits. 

Marquardt contends that, in assessing his capacity for work, an administrative law 

judge improperly discredited medical opinions issued after he was last insured in 2013. 

These opinions diagnosed him with a longstanding cognitive impairment that limits 

him to jobs involving one task at a time, breaks, and no distractions. Because the judge 

did not adequately justify discounting these opinions, we vacate the judgment. 

*

 We have agreed to decide the case without oral argument because the briefs and 

record adequately present the facts and legal arguments, and oral argument would not 

significantly aid the court. FED. R. APP. P. 34(a)(2)(C). 

NONPRECEDENTIAL DISPOSITION 

To be cited only in accordance with Fed. R. App. P. 32.1 

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No. 19-1725 Page 2 

Marquardt was diagnosed in 2012 with systemic lupus erythematosus, a chronic 

disease that causes the immune system to attack virtually any organ, producing diverse 

symptoms. Treatment focuses on managing symptoms, as there is no cure. Lupus, MAYO 

CLINIC, https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc20365789?p=1 (last visited Mar. 6, 2020). After his diagnosis, Marquardt’s doctors 

treated him for various physical ailments and tested him regularly. He reported fatigue 

and short-term memory loss, which required evaluation. His doctors attributed the 

fatigue to attention-deficit disorder, for which he received helpful medicine. As for the 

memory loss, his rheumatologist did not see evidence of “lupus-type cerebritis” (brain 

inflammation), but wanted “further evaluation,” and referred him to a neurologist. 

Two reports followed, in 2015 and 2016. The first, in April 2015, came about two 

years after the date Marquardt was last insured (July 2013). A neurologist wrote that 

“Marquardt reportedly began to experience gradual-onset, worsening problems with 

concentration about 7-8 years ago” and concluded that “[i]n the context of his clinical 

history of cognitive concerns and intact activities of daily living, impressions are 

consistent with a diagnosis of Mild Cognitive Impairment ....” The impairment caused 

“Moderate” weaknesses in Marquardt’s “mental flexibility.” The neurologist also 

opined that lupus may contribute to his cognitive deficits. To “maximize daily cognitive 

functioning,” the doctor recommended that Marquardt: 

Reduce visual and verbal distractions by ensuring that the environment is 

quiet, workspaces are clear, and clutter is minimized[.] 

Focus on one thing at a time[.] Minimize interruptions by turning off the 

ringer on the phone when trying to focus on a task, and communicate 

with others that interruptions should be minimized. 

Take breaks when completing a long task ... 

Minimize multitasking. 

 The neurologist reaffirmed this diagnosis in 2016. She reported that Marquardt 

still had “Borderline” limitations in mental flexibility, and “severe” limitations in motor 

speed. The doctor opined that Marquardt’s “[c]linical history of cognitive concerns is 

significant for gradual-onset, worsening problems with concentration beginning about 

8-9 years ago in the context of worsening fatigue.” She repeated her earlier list of 

recommendations “to maximize daily cognitive functioning.” 

 In Marquardt’s application for benefits, he contended that he became disabled 

before 2013. He cited his lupus, and lupus-related symptoms—including “short-term 

memory and cognitive problems” as well as chronic fatigue, rashes, and arthritis. 

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No. 19-1725 Page 3 

Marquardt also submitted his treatment records and a brain scan from November 2013 

that showed areas of brightness known as white-matter hyperintensities—a condition 

consistent with cognitive deficits. José G. Merino, M.D., White Matter Hyperintensities on 

Magnetic Resonance Imaging: What Is a Clinician to Do?, 94 MAYO CLINIC PROC. 380 (2019). 

Marquardt also wrote that although he could do all his own house and yard work, he 

“often” delayed completing it because of his “fatigue and mental fog,” which makes 

him “often turn circles before getting my task focus back.” 

After the Commission initially denied benefits (its consulting doctors did not 

think that the record showed cognitive deficits), Marquardt asked for a hearing and 

submitted new evidence. In addition to the neuropsychological evaluations from 2015 

and 2016, he submitted a report from Angela Dellise, a licensed professional counselor 

who had treated him for nearly two years, beginning in late 2014. Dellise opined that 

Marquardt had “marked” limitations in his abilities to “understand ... and [c]arry out 

simple instructions,” to “make judgments on simple work-related decisions,” and to 

“[r]espond appropriately to usual work situations and to changes in a routine work 

setting.” She also stated that “[r]umination keeps him from moving forward with tasks” 

and that he “gets distracted by details.” Dellise saw these behaviors at her first session 

with Marquardt in 2014; he told her that they arose “much earlier.” Marquardt 

(proceeding pro se) also testified. He repeated that he was able to do housework, but 

often lost his focus. “I’ll start three other projects ... and I just never seem to get 

anything accomplished” because of the fatigue, he explained. On a normal day, he 

would take a brisk morning walk then return home “to get as much done as I can before 

my entire cognitive shuts down, and I lose the rest of my day.” 

The administrative law judge then heard testimony from a vocational expert. The 

judge asked the expert whether jobs existed for someone who could “perform simple, 

routine tasks with simple short instructions, make simple decisions and have few 

workplace changes” in a setting that was not fast-paced. The judge also added 

restrictions about physical exertion. She did not, however, ask the expert to restrict the 

job to one that was “quiet,” did not require “multitasking,” and granted “breaks” 

during tasks—as the neurologist had advised. The expert opined that the person the 

judge described could work as a mail clerk in a non-postal setting, a cashier, or sales 

attendant. But if the person were off task for 20% of the workday, the worker would 

likely be fired. 

Following the five-step evaluation process, see 20 C.F.R. § 404.1520(a)(4), the 

judge ruled that Marquardt could perform light work. Marquardt passed step one, as he 

had not worked regularly since his onset date; his medical condition was severe (step 

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two); but it was not presumptively disabling (step three). At step four, the judge 

ruled—given the caveats posed to the vocational expert that Marquardt could perform 

only simple tasks with simple instructions, make simple decisions, and tolerate few 

workplace changes—that Marquardt could perform light work. The judge did not 

discuss the 2015 and 2016 neuropsychological assessments (limiting Marquardt to 

single-tasks jobs with breaks and no distractions) or the 2013 brain scan that suggested 

cognitive impairment. Nor did she address the vocational expert’s opinion that 

someone who was off task for more than 20% of the day would likely be fired. She gave 

“little weight” to Dellise’s opinion about Marquardt’s cognitive abilities because “it was 

rendered three years after the date last insured, and Ms. Dellise did not see the claimant 

until more than two years after the date last insured.” “Further,” the judge continued, 

“evidence of the claimant’s activities of daily living show that his mental limitations are 

not as severe as assessed by Ms. Dellise.” The judge then concluded that Marquardt 

could do the jobs identified at the hearing (step five). The district court affirmed this 

ruling. 

On appeal, Marquardt argues that the administrative law judge erroneously 

ignored the two reports from the neurologist. He explains that, even though they were 

created after the date that he was last insured, they show that he had a cognitive 

impairment before that date. We agree. An administrative law judge should consider 

retrospective medical opinions (created after the date last insured) that are consistent 

with past symptoms. See Bjornson v. Astrue, 671 F.3d 640, 642 (7th Cir. 2012); Estok 

v. Apfel, 152 F.3d 636, 640 (7th Cir. 1998). A judge need not mention every piece of 

evidence in the record, Denton v. Astrue, 596 F.3d 419, 425 (7th Cir. 2010), but she “must 

confront the evidence that does not support her conclusion and explain why that 

evidence was rejected.” Moore v. Colvin, 743 F.3d 1118, 1123 (7th Cir. 2014). The two 

neuropsychological assessments from 2015 and 2016 meet this standard. They opine 

that, for several years before he was last insured, Marquardt had feeble concentration, 

weak “mental flexibility,” and frequent fatigue. In order to function, they concluded, he 

needed to avoid “multitasking,” receive “breaks,” and have a “quiet” place. These 

reports are also consistent with the brain scan. The scan was taken just a few months 

after the last insured date; we have no reason to think that it depicts something new. 

In addition, the two reasons that the judge gave for discounting Dellise’s opinion 

are unsound. The judge first explained that the opinion “was rendered three years after 

the date last insured.” But as mentioned above, that is not a valid basis for discounting a 

medical opinion that is consistent with evidence of disability during the insured period. 

See Estok, 152 F.3d at 640. And Dellise’s opinion that Marquardt’s “[r]umination keeps 

him from moving forward with tasks” and that he “gets distracted” is consistent with 

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Marquardt’s reports about his “fatigue and mental fog” during the insured period. The 

second reason for discounting the opinion—that the “evidence of the claimant’s 

activities of daily living show that his mental limitations are not as severe as [Dellise] 

assessed”—is also flawed. We have cautioned against reading too much into a 

claimant’s activities of daily living because people have more flexibility in scheduling 

and executing them than they do for the activities of a full-time job. See, e.g., Bjornson, 

671 F.3d at 647. And the neuropsychological reports specifically accounted for these 

activities in concluding that Marquardt suffered from a mild cognitive limitation. 

We have considered the additional argument that the ALJ should have 

incorporated the limitations that the neurologist identified (jobs should avoid 

“multitasking” but include “breaks” and take place in a “quiet” setting) into the 

hypothetical posed to the vocational expert. On remand, the ALJ may consider these 

limitations, which are set forth in the 2015 and 2016 reports, when posing a new 

hypothetical to a vocational expert. 

Therefore, we VACATE the judgment and REMAND for further proceedings. 

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