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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

Argued April 26, 2016

Decided May 5, 2016

Before

MICHAEL S. KANNE, Circuit Judge

DIANE S. SYKES, Circuit Judge

DAVID F. HAMILTON, Circuit Judge

No. 15-2578

JUTTA SPIES,

Plaintiff-Appellant,

v.

CAROLYN W. COLVIN,

Acting Commissioner of Social Security,

Defendant-Appellee.

Appeal from the United States District 

Court for the Western District of 

Wisconsin.

No. 14-cv-568-jdp

James D. Peterson,

Judge.

O R D E R

Jutta Spies applied for Disability Insurance Benefits and Supplemental Security 

Income claiming that her diabetes and related neuropathy, osteoarthritis, rheumatoid 

arthritis, and headaches prevent her from working. An administrative law judge denied 

benefits, finding that Spies could perform light work with several limitations. In this 

court Spies challenges the ALJ’s adverse credibility finding and his refusal to give 

controlling weight to a treating physician’s opinion. Because the ALJ’s decision is 

supported by substantial evidence, we affirm the district court’s order upholding the 

denial of benefits. 

NONPRECEDENTIAL DISPOSITION

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

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I. Background

In 2012 at age 47, Spies applied for DIB and SSI, alleging onset in October 2008 

(later amended to October 2012) and claiming six impairments: diabetes; neuropathy in 

the feet and hands; osteoarthritis in the neck, shoulders, and arms; nerve damage in the 

neck, shoulders, and arms; rheumatoid arthritis in the lower back and knees; and 

headaches. She had applied for benefits previously in 2008, but in 2010 an ALJ had 

rejected that application. The Appeals Council upheld the denial. Afterward Spies 

initiated a challenge under 42 U.S.C. § 405(g), but later she dismissed the action 

voluntarily. Spies v. Astrue, No. 3:12-cv-00231-wmc (W.D. Wis. Aug. 31, 2012).

Some of the evidence Spies submitted to support her current application predates 

the finding in 2010 that she was not disabled. For example, in 2009 a doctor had 

evaluated Spies after she complained of musculoskeletal pain. The doctor observed that 

Spies walked with her shoulders rounded forward and also held her head forward, but 

still he concluded that Spies’s shoulder motion was “full and pain free,” and that her 

neck motion was “nearly complete with pain-free end range” except for “rotation and 

side bending to the left.” The doctor identified trigger points in Spies’s trapezii and 

administered trigger-point injections. A back X-ray showed narrowing of disc spaces 

and some flattening of the spine, evidencing degenerative changes. Spies was prescribed 

physical therapy and gabapentin (an anticonvulsant sometimes given for nerve pain). 

A questionnaire completed in 2009 by internist Margaret Webster and a letter that 

she wrote in November 2010 are two other pieces of recycled evidence. Dr. Webster had 

first treated Spies in 2002, and in the questionnaire (completed for Spies’s former lawyer) 

she opined that Spies must elevate her feet with prolonged sitting, needed leeway to take 

unlimited breaks, and would miss more than two days of work per month. Dr. Webster 

added that she lacked information about Spies’s ability to lift weight and could not 

evaluate how long she could sit, stand, or walk continuously or in a work day. In the 

2010 letter (written in response to the same lawyer’s inquiry), Dr. Webster clarified that 

Spies experiences tingling and numbness in her legs and feet, and that elevating her feet 

would help prevent swelling. The breaks were needed, the doctor said, so that Spies 

could change position and lessen discomfort from “deconditioning” and pain in her 

upper back and neck. 

After the initial denial of benefits, Spies had continued seeing Dr. Webster for 

regular check-ups. Dr. Webster’s progress notes document treatment for Type II 

Diabetes, which was poorly controlled by Spies and prompted a referral to an 

endocrinologist. He commenced ongoing treatment in April 2011 prescribing and later 

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adjusting the amount of insulin. During the initial consultation the endocrinologist 

noted that Spies had complained of numbness and burning in her hands and feet, which, 

he initially thought, might be partially attributable to degenerative disc disease. But a 

monofilament test (used to gauge the sensitivity of a patient’s extremities) was normal 

except for “decreased sensation at the right great toe.” The endocrinologist added, in 

commenting on Spies’s reports of diabetic peripheral neuropathy affecting her hands 

and feet, that her reported symptoms were “not particularly classic” for that impairment 

though it “could be making her other neurologic conditions worse.” A second 

monofilament test performed in September 2011 also led the endocrinologist to conclude 

that Spies’s sensation was intact. That month Spies returned to Dr. Webster for another 

regular check-up and reported continuing pain in her neck and back for which she was 

not taking medication. 

In May 2012, Spies submitted a “function report” to the Social Security 

Administration asserting that she can sit, stand, or walk only for 10 minutes at a time 

and that she must elevate her legs 75% of the time. During an entire day, Spies 

continued, she can sit at most for 81⁄2 hours, stand for 41⁄2 hours, and walk for 21⁄2 hours. 

She reported difficulty lifting, bending, stooping, kneeling, and walking. Spies said that 

she cleans her house, though the task takes all day because of her need for frequent 

breaks, and she helps care for her grandson. She does laundry but cannot carry the 

clothes up or down stairs and cannot bend to vacuum. She added that she shops once a 

month for 4 to 5 hours. 

Another back X-ray in June 2012 showed mild degeneration, including some 

development of bone spurs around the thoracic and lumbar discs. That month Spies was 

examined by state-agency consulting osteopath Brian Allen and reported pain in her 

neck, shoulders, arms, back, and knees that she was treating with ibuprofen. Spies also 

reported that she could stand only for 10 minutes and walk only a block. The doctor 

found reduced range of motion in her shoulders, knees, and ankles, and swelling in her 

ankles. Spies had full strength and normal sensation in her extremities, and she could 

tandem walk, squat, and hop on each foot. The doctor concluded that her neck and back 

pain appeared to be originating from her muscles or the joints in her spine. 

The SSA initially denied benefits on June 25, 2012. Another state-agency 

consulting physician had reviewed the medical evidence and concluded that Spies could 

perform sedentary work not requiring overhead lifting. He opined that her medical 

records and daily activities suggested that Spies had exaggerated her self-reported 

functional limitations. 

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Afterward, in July 2012 while her case was before the SSA on reconsideration, 

Spies was treated by a nurse practitioner. Spies reported intermittent pain in her neck, 

pain in her shoulders, and numbness in her hands and feet. The pain, she said, ranged 

from 3 to 9 on a 10-point scale. The nurse practitioner concluded that Spies had full 

flexion, extension, and lateral rotation in her neck though extension increased her pain. 

Her trapezii were very tight, and she was experiencing muscle spasms. Spies’s shoulder 

joints were tender, and she had pain with forward flexion, internal and external rotation, 

and thumbs up and thumbs down motions. She had full strength in her extremities but 

difficulty with tandem walking and slight swelling in her legs. Spies was prescribed an 

anti-inflammatory and muscle relaxant, and the nurse practitioner recommended a 

shoulder X-ray plus physical therapy for her neck and shoulders. 

Spies received a voucher for the physical therapy from St. Clare Health Mission, 

but after just two sessions she said that she would call if she needed further assistance. 

St. Clare also filled her prescriptions and arranged for the X-ray, which showed 

straightening of the spine and moderate enlargement along the vertebral endplates. At a 

cervical spine assessment in August 2012, Spies reported that for three months she had 

been in constant pain which hindered her daily activities. She reported that the 

anti-inflammatory had helped her pain, but she later stopped taking it and the muscle 

relaxant because they upset her stomach, instead occasionally taking ibuprofen. 

At her next appointment with Dr. Webster in September 2012, Spies again 

reported persistent back and shoulder pain that impeded her daily activities. Yet Spies 

was uninsured, so rather than treat her, Dr. Webster recommended that she continue the 

treatment she was receiving elsewhere. 

Spies then submitted another “function report” to the SSA asserting that she 

could sit, stand, or walk for only 10 minutes continuously, for a total of one hour each 

per day. With her daughter’s help she could bathe and dress, and once each month shop 

for 3 hours. 

Benefits were denied on reconsideration two months later, in March 2013. A 

different state-agency consultant, Dr. Mina Khorshidi, had concluded that Spies could 

perform light work with limited overhead lifting if she avoided hazards like machinery 

and heights. Like the previous consulting physician, she opined after reviewing the 

medical evidence and Spies’s daily activities that Spies was exaggerating her 

self-reported functional limitations. 

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At current counsel’s request, Dr. Webster then wrote a “to whom it may concern” 

letter opining that Spies cannot perform competitive full-time work. For more than 75% 

of a typical workday, the doctor predicted, Spies’s “multiple medical conditions” would 

prevent her from performing job tasks. Those conditions, Dr. Webster added, had 

“progressed over time.” Dr. Webster apparently declined, however, to serve in the role 

of a consultative examiner. 

Spies appeared before an ALJ in November 2013. During the hearing she 

amended her alleged onset date to October 1, 2012. She testified that previously she had 

worked as a camera operator and preschool teacher, neither of which required much 

lifting. As a camera operator she alternated between sitting and standing, for about 

4 hours each in an average workday. She complained of constant pain in her neck and 

shoulders, headaches, swollen legs and ankles, random numbness in her hands and feet, 

and numbness in her arms so pronounced that several times a week she cannot lift them. 

She said that she could stand or walk for 5 minutes and sit for 10. She must alternate 

between sitting and standing, said Spies, and needed to elevate her feet 12 to 15 inches to 

prevent her ankles from swelling and her becoming stiff. Spies testified that her pain is 

progressively worsening. 

Spies lacked health insurance and testified that she relied upon financial 

assistance to see Dr. Webster. When asked by her lawyer if Dr. Webster would prefer to 

see her more than once a year, Spies simply replied that Dr. Webster performed her 

“yearly physical for diabetes,” and that she was to see the endocrinologist on a quarterly 

basis. Her attorney asked a series of questions about jobs that might have been available 

to Spies in October 2012, which prompted the ALJ to comment that Spies was answering 

counsel’s questions before he had completed them. 

A vocational expert also testified. The ALJ first asked if jobs classified as light 

work are available for a person who can occasionally stoop, crouch, kneel, and crawl; 

can occasionally climb stairs or ramps but not ladders, ropes or scaffolds; cannot be 

exposed to unprotected heights or large, open machinery; and is likely to be off task up 

to 10% of the day in addition to scheduled breaks. The VE replied that suitable 

employment is available, including Spies’s past jobs as a camera operator and preschool 

teacher, as well as jobs as an inspector or sorter, clerical cashier, and stock clerk. When 

questioned further, the VE said that the job of preschool teacher would be eliminated if 

the person also would need to sit or stand at will, but that a further restriction allowing 

for elevation of the person’s feet 75% percent of the day would not eliminate any more 

jobs. On the other hand, the VE acknowledged, all full-time employment would be 

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precluded if the person would require unscheduled breaks at will or would be distracted 

to the extent of being off task for more than 10% of the day. Finally, the VE opined that a 

person restricted to sedentary work with the same functional limitations could be a 

production worker, information clerk, or general office clerk. 

The ALJ issued a written decision two months later finding Spies not disabled. At 

Step 1 of the 5-step analysis, see 20 C.F.R. §§ 404.1520(a), 416.920(a), the ALJ 

acknowledged that Spies had not engaged in substantial gainful activity since the 

amended onset date in October 2012. At Step 2 the ALJ identified Spies’s impairments 

(all of them severe) as peripheral neuropathy, osteoarthritis of the back and knees, 

cervical disc disease, and obesity. Excluded from this list was diabetes and rheumatoid 

arthritis. At Step 3 the ALJ concluded that the identified impairments, alone or in 

combination, did not meet a listing for presumptive disability. Spies does not dispute 

these conclusions.

At Step 4 the ALJ partly rejected Spies’s account of disabling functional 

limitations. This adverse credibility assessment first recites boilerplate language 

rejecting as not credible Spies’s statements about the “intensity, persistence, and limiting 

effects” of her impairments. The ALJ then opined that Spies’s physical and neurological 

examinations had been “largely benign” and that X-rays had shown little beyond “mild 

degenerative changes.” He reasoned that the medical evidence contradicts Spies’s 

complaints of pain reaching 9 on a scale of 10. The ALJ accepted the view of the 

state-agency consultants that, given her daily activities and the medical evidence, Spies 

was exaggerating her limitations. Specifically, the ALJ noted, she purportedly could not 

stand or walk for more than 2 hours per day but had normal physical examinations and 

acknowledged cleaning her house, helping care for her grandson, and shopping for 

3 hours at a time. The ALJ added that during her testimony “it became evident” that 

Spies “had predetermined that her responses would be a claim of inability to perform 

any described task or activity.” Finally, he noted that Spies had said her condition was 

worsening, yet a recent cardiac stress test was favorable. Still, the ALJ included in Spies’s 

residual functional capacity that she would need to elevate her feet and switch at will 

between sitting and standing. 

The ALJ gave Dr. Webster’s opinions about Spies’s functional limitations only 

moderate weight, since the doctor had been seeing Spies typically once a year and her 

opinions were based on Spies’s self-reports instead of clinical evidence. Moreover, the 

ALJ noted, Dr. Webster had conceded in the 2009 questionnaire that she either lacked 

relevant information or could not evaluate Spies’s exertional limitations. The ALJ 

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concluded that Dr. Webster’s views were “speculative and conclusory with regard to 

issues reserved for the Commissioner.” 

Finally, at Step 5 the ALJ found that Spies could perform her past work as a 

camera operator, as well as other available jobs. 

The Appeals Council denied review, making the ALJ’s pronouncement the final 

decision of the Commissioner. The district court upheld that decision.

II. Analysis

On appeal Spies first raises several challenges to the ALJ’s adverse credibility 

finding, but none shows that the credibility finding is patently wrong. See Minnick v. 

Colvin, 775 F.3d 929, 937 (7th Cir. 2015) (noting that ALJ’s credibility finding must be 

upheld unless patently wrong). Spies contends that the finding is flawed because, she 

says, it rests entirely on boilerplate frequently criticized by this court. But Spies must 

recognize her own hyperbole because, as even she acknowledges elsewhere in her brief, 

the ALJ went beyond the boilerplate and gave specific reasons for the adverse credibility 

finding. And the mere inclusion of boilerplate does not require a remand. See Loveless v. 

Colvin, 810 F.3d 502, 507–08 (7th Cir. 2016); Pepper v. Colvin, 712 F.3d 351, 367–68 (7th Cir. 

2013).

Although greater detail would have been helpful, the ALJ touched on four 

reasons for disbelieving Spies. First, the ALJ reasoned that the medical evidence raises 

doubts about the degree of pain Spies reported because “her physical and neurological 

examinations are largely benign and x-rays show little more than mild degenerative 

changes.” Most of Spies’s attacks on the credibility finding seem to focus on this 

statement. She argues that the ALJ identified neuropathy as a severe impairment but 

then failed to acknowledge that it could have caused the pain she reported, which could 

not be confirmed by X-rays. Spies is correct that neuropathic pain need not be confirmed 

by diagnostic tests in order to be credited. See Engstrand v. Colvin, 788 F.3d 655, 660 

(7th Cir. 2015). But her contention is disingenuous: Spies complained of severe 

pain—pain that sometimes reached a 9 on a 10-point scale—in her neck and shoulders. 

She never claimed that neuropathy was causing pain in her neck or shoulders, only that 

it caused tingling, numbness, swelling, or burning in her extremities. 

Similarly, Spies argues that the ALJ could not minimize her accounts of pain 

simply because physical examinations and diagnostics provided only weak objective 

support. Spies and her doctors attributed her neck and shoulder pain to degenerative 

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disc disease and osteoarthritis. Thus, this is not a situation where a claimant’s pain was

from an undetermined source, making self-reports the only available evidence of 

severity. See, e.g., Adaire v. Colvin, 778 F.3d 685, 687 (7th Cir. 2015); Pierce v. Colvin, 

739 F.3d 1046, 1049–50 (7th Cir. 2014). And the ALJ did not disbelieve that Spies was 

experiencing pain, but only that the diagnosed impairments she and her doctors 

identified as the source of her pain were not severe enough to disable her to the extent 

alleged. See Mitze v. Colvin, 782 F.3d 879, 881 (7th Cir. 2015) (noting that ALJ had not 

denied that claimant was in pain but instead “didn’t believe that the pain was severe 

enough to disable her to the extent she claimed”). 

Spies also says that her own doctors believed and acted upon her reports of pain, 

and thus, she insists, the ALJ was “playing doctor” when he decided that the medical 

evidence undermines those self-reports. But all of the medical evidence Spies cites for 

this contention predates the amended onset date of October 2012, and most of it also 

predates the initial, unchallenged finding in 2010 that she was not disabled. What is 

missing from this record is evidence that Spies’s condition had deteriorated to the point 

of disability after 2010 because she cannot relitigate whether she was disabled before 

then. See Schmidt v. Astrue, 496 F.3d 833, 845 (7th Cir. 2007) (noting binding effect of 

previous, unchallenged finding that claimant was not disabled); Groves v. Apfel, 148 F.3d 

809, 810–11 (7th Cir. 1998) (explaining that evidence from previous denial of benefits 

cannot by itself establish disability in later case but “still might reinforce or illuminate or 

fill gaps in the evidence developed for the second proceeding”). And the only recent 

treatment of Spies’s neck and shoulder pain was by the nurse practitioner and at 

St. Clare Health Mission. The nurse practitioner had prescribed a muscle relaxant and an 

anti-inflammatory, but Spies unilaterally discontinued both because of stomach upset 

without exploring alternatives. She likewise unilaterally stopped going to physical 

therapy at St. Clare after just two sessions. The record does not support Spies’s 

contention that her doctors acted on her complaints of pain in a way that corroborates 

her claims of its severity.

Spies goes one step further and contends that her financial constraints obligated 

the ALJ not only to evaluate the resulting limitations on her medical treatment but also 

to order an MRI that could detect any soft tissue damage consistent with her allegations 

of disabling pain. Again, this contention is disingenuous. For one, the ALJ never faulted 

Spies for not pursuing additional treatment, so he did not need to inquire about her 

financial means. Cf. Craft v. Astrue, 539 F.3d 668, 679 (7th Cir. 2008). And on this record 

there is no reason to believe that Spies’s treatment would have been significantly 

different had she been insured. The medications she stopped using and the physical 

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therapy she declined were being paid for by St. Clare. Moreover, at the hearing before 

the ALJ, Spies did not give her lawyer the answer he was looking for: that Dr. Webster 

would have liked to see her more than once a year. Most importantly, nowhere in Spies’s 

medical records is there mention of a need for an MRI. Spies, who was represented by 

present counsel, did not argue before the ALJ that an MRI should be ordered and did not 

highlight any potential soft-tissue damage that such a diagnostic might reveal. 

See Thomas v. Colvin, 745 F.3d 802, 807–08 (7th Cir. 2014) (noting that ALJ’s obligation to 

develop record is not limitless); Nelms v. Astrue, 553 F.3d 1093, 1098 (7th Cir. 2009) 

(explaining that even when ALJ has duty to expand record, speculation that additional 

evidence could have been obtained does not warrant remand); Skinner v. Astrue, 478 F.3d 

836, 842 (7th Cir. 2007) (noting that counseled claimant is “presumed to have made his 

best case before the ALJ”). 

The ALJ’s second reason for disbelieving Spies is the disconnect between her 

medical evidence and daily activities, on the one hand, and her assertion that she cannot 

be on her feet for more than 2 hours total each day. Spies argues that the ALJ “did not 

even make an actual credibility finding, instead relying on the State Agency’s 

assessment of her daily activities.” Although the ALJ’s reference to Dr. Khorshidi’s 

opinion is perhaps poorly worded, the fair reading is that he incorporated the doctor’s 

reasoning. And that opinion was not, as Spies now insists, that her daily activities prove 

her capable of working full time. Instead, Dr. Khorshidi opined that Spies’s daily 

activities indicate exaggeration of her functional limitations. See Loveless, 810 F.3d at 508 

(citing 20 C.F.R. § 404.1529(c)(3)(i)). 

The ALJ next discounted Spies’s credibility because he thought her testimony 

showed a predisposition to deny her ability to perform any task or activity posed to her. 

Spies tries to refute the ALJ’s conclusion by referring to seemingly random parts of her 

testimony, but Spies’s reading of the ALJ’s comment is unreasonable. The plausible 

reading is that the ALJ had observed Spies answering her lawyer’s questions about her 

ability to work even before the attorney had completed the questions. That the ALJ did 

not say this directly does not undermine his credibility finding. See Shideler v. Astrue, 688 

F.3d 306, 312 (7th Cir. 2012) (noting that ALJ isn’t required to identify particular 

statements found not credible); Jens v. Barnhart, 347 F.3d 209, 213 (7th Cir. 2003) (rejecting 

claim that credibility finding was flawed because ALJ did not identify particular 

statements found not credible).

Last, the ALJ discredited Spies because, he concluded, Spies had not submitted 

evidence substantiating her testimony that her condition had deteriorated significantly. 

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The ALJ’s conclusion rests on Spies’s most-recent medical report, the results of a cardiac 

stress test. We do not understand the relevance of this report, since Spies’s alleged 

disability is unrelated to her cardiac health. But neither do we believe that this misstep 

by the ALJ undermines the credibility finding. See Shideler, 688 F.3d at 312 (upholding 

imperfect credibility determination); McKinzey v. Astrue, 641 F.3d 884, 890–91 (7th Cir. 

2011) (same). Although the ALJ does not cite this exchange, during the hearing he 

questioned Spies about the drastic difference in her reported ability to sit, stand, and 

walk between her first and second “function reports.” She initially reported being able to 

sit for 81⁄2 hours, stand for 41⁄2 hours, and walk for 21⁄2 hours but then reduced each to 

1 hour. Spies has not pointed to anything that would explain this rapid deterioration. In 

this court, she asserts only that her receipt of steroid injections “during the relevant 

period” proves that her condition had deteriorated. But Spies grossly misrepresents the 

record: She received one round of trigger-point injections in 2009, before the earlier 

finding that she was not disabled. There is no other evidence of injections, much less 

steroid injections. 

Accordingly, Spies’s challenge to the ALJ’s credibility assessment is 

unpersuasive, and her remaining appellate claim is even weaker. Spies contends that the 

ALJ erred by not giving controlling weight to Dr. Webster’s views about her functional 

limitations. To start, both the 2009 questionnaire and Dr. Webster’s 2010 clarifying letter 

predate the earlier determination that Spies was not disabled, and Spies does not explain 

how they are significant to this case. Indeed, the first ALJ explicitly found these 

submissions from Dr. Webster to be unreliable. Regardless, the ALJ here discussed all of 

Dr. Webster’s opinions, and he provided good reasons for discounting them. See Schaaf 

v. Astrue, 602 F.3d 869, 874–75 (7th Cir. 2010) (noting that ALJ must give good reason for 

rejecting treating physician’s opinion that is supported by medical evidence and “not 

inconsistent” with substantial evidence in record). First, Spies typically saw Dr. Webster 

just once a year. See 20 C.F.R. § 404.1527(c)(2)(i) (explaining that SSA gives greater 

weight to treating source who has seen claimant on frequent basis); Filus v. Astrue, 694 

F.3d 863, 868 (7th Cir. 2012) (acknowledging § 404.1527(c)(2)(i)). Spies now asserts that 

the infrequent contact was because of financial constraints, but she explicitly said the 

opposite at the hearing. In fact, she testified that she had been receiving financial 

assistance to pay for Dr. Webster’s treatment. 

What is more, Dr. Webster’s opinions were based on Spies’s subjective reports of 

pain instead of any clinical evidence. See Rice v. Barnhart, 384 F.3d 363, 371 (7th Cir. 2004); 

Smith v. Apfel, 231 F.3d 433, 441 (7th Cir. 2000). Dr. Webster’s progress notes document 

Spies’s reports of her symptoms and limitations, but the doctor never provided any 

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relevant treatment. And, as the ALJ noted, Dr. Webster acknowledged that she had no 

data regarding the severity of Spies’s pain. 

And, finally, the ALJ concluded that Dr. Webster’s opinions were speculative and 

conclusory on issues that are reserved for the Commissioner. In the November 2013 

“to whom it may concern” letter, Dr. Webster asserted that Spies could not work. But 

that opinion is not a medical opinion, and thus it was entitled to no weight, even coming 

from a treating physician. See 20 C.F.R. § 404.1527(d)(1); Loveless, 810 F.3d at 507; Clifford 

v. Apfel, 227 F.3d 863, 870 (7th Cir. 2000). 

III. Conclusion

We AFFIRM the district court’s judgment. 

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