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Parties Involved:
Michael J. Astrue
Appellee
Margaret A. Seamon
Appellant

Document Text:

United States Court of Appeals

For the Seventh Circuit

Chicago, Illinois 60604

Argued November 18, 2009

Decided January 29,  2010

Before

DIANE P. WOOD, Circuit Judge

TERENCE T. EVANS, Circuit Judge

JOHN DANIEL TINDER, Circuit Judge    

No. 08‐4298

MARGARET A. SEAMON,

Plaintiff‐Appellant,

v.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant‐Appellee.                     

Appeal from the United States District

Court for the Western District of

Wisconsin.

No. 07‐cv‐0588‐bbc

Barbara B. Crabb,

Chief Judge.

O R D E R

Margaret Seamon first applied for disability insurance benefits in June 2002,

asserting that she had been unable to work since the beginning of that year because of

numerous physical and mental health problems, in particular chronic pain from back and

neck injuries, depression, and anxiety disorders. The administrative law judge (“ALJ”)

initially denied her claim, but she appealed to the district court and won a remand for

further proceedings. The second time around the ALJ returned a partially favorable

decision, awarding benefits as of October 6, 2006 (the date on which her advanced age

qualified her as disabled), and denying benefits for any earlier time. Upon Seamon’s second

appeal, the district court affirmed. She has now turned to this court for further review.

Because the ALJ’s decision is supported by substantial evidence, we affirm.

NONPRECEDENTIAL DISPOSITION

To be cited only in accordance with

 Fed. R. App. P. 32.1

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I

In December 2001, while working as an office clerk, Seamon (then 49 years old)

suffered a slip‐and‐fall accident on the job that resulted in injuries to her neck, arm, and

shoulder. The accident also exacerbated other underlying knee, back, and chronic pain

issues that had plagued her for years. Hoping to obtain an accurate diagnosis and an

effective treatment plan for her pain, Seamon made countless trips to various doctors.

As of the time of the accident, Seamon already had a long history of depression,

post‐traumatic stress disorder (“PTSD”), and anxiety disorders. After the accident, she lost

her job in January 2002 because of excessive absenteeism. Stress over the job loss, plus the

pain from her accident, then precipitated a marked deterioration in her mental health. Prior

to the accident, her mental health problems had been managed adequately with medication

and counseling, but by May 2002, her feelings of intense anger and hopelessness prompted

her to seek more extensive treatment from psychiatrist Dr. John Bartholow and regular

counseling services from psychologist Scott Phillips.

Seamon’s depression worsened in the fall of 2002. She continued to see Dr.

Bartholow and Phillips, to whom she described increased feelings of despair, self‐imposed

social isolation, anger, and problems with memory and concentration. Dr. Bartholow made

several adjustments to her medication. She reported some benefits from this, but she also

experienced more frequent thoughts of suicide and appeared more tearful, overwhelmed,

and frustrated at appointments. Dr. Bartholow added a diagnosis of possible bipolar

disorder after Seamon prompted Phillips to complete a screening diagnostic for that

condition. Phillips commented that Seamon took a dramatic approach to the test and

endorsed every symptom of mania or hypomania.

Around the same time, Seamon was also evaluated by a number of state agency

doctors, including Dr. Richard Fuhrer. Dr. Fuhrer found that while Seamon was generally

very pleasant, her mood fluctuated greatly, and she expressed intense anger when

discussing prior instances of mistreatment. He administered the Minnesota Multiphasic

Personality Inventory (“MMPI‐II”) and the Millon Clinical Multiaxial Inventory‐III, but he

concluded that any results were of questionable validity because Seamon exaggerated in her

responses and claimed to have a “tremendous number of symptoms” that were inconsistent

across the two tests. Yet he also reported that Seamon scored a 50 on the Global Assessment

of Functioning (“GAF”) test, indicating a serious level of depression.

Meanwhile, Seamon was becoming frustrated with her doctors and their apparent

lack of support for her disability application. In November 2002 she abruptly ended

treatment with Dr. Bartholow and Phillips after leaving an angry voice message for Phillips

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accusing him of betrayal. Seamon explained that she had stopped taking her medications

and refused to return for therapy because she could not trust anyone. The last proved to be

an overstatement: five days later, she reinitiated treatment with a former psychiatrist.

From December 2002 through February 2003, Seamon experienced severe mental

health problems. She was admitted to the emergency room twice for suicidal thoughts and

an attempted overdose of sleeping pills, and the hospital doctors reported that her mental

health had become more fragile. Her condition improved, however, and she was discharged

from the hospital several days later. After her second hospitalization Seamon stopped

taking her medications regularly and decided to have her psychiatric problems treated

exclusively by her primary care physician.

During her first hearing before the ALJ in October 2003, Seamon said that her mental

condition was improving; for that reason, she initially requested benefits only through June

of that year. She explained that it was her inability to find a job and the changes in her

medication that caused the temporary decline in her mental health. After performing the

requisite five‐step analysis, see 20 C.F.R. § 404.1520, the ALJ concluded that: (1) Seamon had

not engaged in gainful work since January 2002; (2) she had a number of severe physical

and mental health problems; (3) none of these issues either individually or in combination

met the listing requirements in 20 C.F.R. pt. 404, subpt. P, app.1; (4) Seamon had the

residual functional capacity (“RFC”) to perform unskilled work subject to a number of

postural and environmental limitations in addition to restrictions of “brief and superficial

contact with the public” and “no high production goals”; and (5) Seamon was not disabled

because a person of her age, education, work experience, and RFC could perform a

significant number of jobs.

On appeal, the district court remanded the case, because the ALJ had not obtained a

proper waiver of counsel and had given too much weight to Seamon’s un‐counseled

statements about improvements in her condition. The court also thought that the ALJ had

not defined her RFC properly, because he had restricted only her contact with the public,

and he should have included a similar restriction on contact with coworkers and

supervisors.

During the hearing on remand, the ALJ told the vocational expert (“VE”) that the key

question was whether jobs existed for someone who was limited to “brief and superficial

contact with others in the work place.” The VE concluded that there were such jobs,

including those of a shoe brusher or a cafeteria attendant. On cross‐examination Seamon’s

attorney asked the VE whether a person who could not keep pace or “do 80 percent or 75

percent of what is normally expected” would be able to perform either job. The VE replied

in the negative. Seamon pressed him to explain what percentage of work an employee must

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be able to do and the VE responded “100 percent.” Seamon also asked whether an employee

could still do the identified jobs if she was involved in altercations at work, and the VE

admitted that such behavior would also eliminate those jobs.  

In December 2006, after the second hearing but before the ALJ’s decision, Seamon

solicited a supplemental psychiatric evaluation from Dr. Paul Caillier. Dr. Caillier

conducted one clinical examination and quickly reviewed a small sample of Seamon’s

medical records through late 2002. He concluded that Seamon’s MMPI‐II results indicated

she suffered from a somatoform disorder, and that the medical records showed that

Seamon’s mental health had gradually deteriorated to a point where she was “now totally

unemployable.”

Dr. Caillier’s report was submitted to the ALJ, who again went through the five‐step

process. This time the ALJ found Seamon disabled as of October 6, 2006. In so finding,

however, he did not rely on Dr. Caillier’s report. Instead, he concluded that Seamon’s age

had become the definitive factor. The Medical‐Vocational Guidelines list new disability

criteria for people over 55, and, knowing that Seamon’s disability coverage would expire in

December of 2006, the ALJ exercised his discretion under 20 C.F.R. § 404.1563(b) to deem

Seamon of “advanced age” six months before her 55th birthday (April 6, 2007). Although the

ALJ recognized that Seamon’s condition was more severe in late 2002 and early 2003, when

she attempted suicide, that period did not meet the 12‐month durational requirement

described in 42 U.S.C. § 423(d)(1)(A), nor was it representative of the typical severity of her

mental illness. The ALJ also noted that Dr. Caillier’s findings in December 2006 were

consistent with his decision to grant disability benefits beginning in October of that year.

In reaching this result the ALJ discredited much of Seamon’s testimony, finding

numerous inconsistencies between her assertions about the severity of her mental health

problems and the objective medical evidence. Seamon’s failure to take her prescribed

medications and her decision to discontinue specialized psychiatric treatment after her

hospitalizations, in his view, indicated that her mental health problems were not disabling.

The ALJ also noted that Seamon’s doctors reported that she had exaggerated her symptoms,

and that her participation in two social outings undermined her claims of total social

isolation.

II

Seamon offers a number of reasons why we should find that the ALJ erred, but our

review is deferential, and this is a case with an extensive factual record. We ask only

whether substantial evidence supported the ALJ’s conclusion. Overman v. Astrue, 546 F.3d

456, 462 (7th Cir. 2008).

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Seamon begins with the argument that the ALJ erred when, allegedly relying only on

his own lay opinion, he formulated her RFC and included only two mental‐health

limitations, in the areas of social functioning and concentration, persistence, and pace.

Evidence in the record, Seamon urges, shows that her RFC should also have reflected her

anger, anxiety, moodiness, and social difficulties.

An ALJ may not “play doctor” by substituting his opinion for that of a physician.

Blakes ex rel. Wolfe v. Barnhart, 331 F.3d 565, 570 (7th Cir. 2005). The ALJ, however, is not

only allowed to, but indeed must, weigh the evidence and make appropriate inferences

from the record. See Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004). We conclude that

the ALJ’s determination of Seamon’s RFC is supported by substantial evidence in the

record. The opinion reflects a thorough review of Seamon’s medical records and a

reasonable weighing of the evidence both for and against greater RFC limitations. For

example, in determining that a moderate limitation on social functioning was appropriate,

the ALJ noted that although Seamon’s doctors observed moodiness, poor interpersonal

skills, and frequent anger, they also reported that she was typically bright, cooperative, and

pleasant. Similarly, the ALJ compared Seamon’s testimony about her memory problems and

inability to concentrate on a television program for more than a few minutes with reports

from Drs. Fuhrer and Caillier concluding that she demonstrated acceptable levels of

concentration. With that evidence in mind, he found that a moderate limitation in

concentration, persistence, and pace was appropriate.  

In focusing on selections from her medical records that reflect the most serious or

extreme descriptions of her mental health problems, Seamon herself ignores significant

evidence contradicting her position. In particular, we are not persuaded by Seamon’s

arguments that Dr. Caillier’s psychiatric evaluation supports more extensive RFC

limitations. Dr. Caillier was a non‐treating physician, and his supplemental report, based on

a limited examination and review of Seamon’s medical history, deserves little weight.

Second, Seamon criticizes the hypotheticals the ALJ posed to the VE. The ALJ, she

charges, did not properly account for the medical evidence documenting her most severe

mental health symptoms. Mirroring her point about the RFC determination, she argues that

the hypotheticals should have included additional restrictions targeted at her difficulty

handling anger and stress.

Ordinarily, an ALJ’s hypothetical questions to a vocational expert “must include all

limitations supported by medical evidence in the record.” Steele v. Barnhart, 290 F.3d 936,

942 (7th Cir. 2002). The reference to “all” limitations, however, does not encompass those

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that find no support in the record; the ALJ’s hypothetical should incorporate only those

limitations that he accepts as credible. Schmidt v. Astrue, 496 F.3d 833, 846 (7th Cir. 2007).   

Here, the hypotheticals reflected the two limitations the ALJ included in Seamon’s

RFC; nothing more was required. The ALJ accounted for Seamon’s moderate limitation in

social functioning by restricting her to “brief and superficial contact with others,” and the

ALJ captured her moderate limitation in concentration, persistence, and pace when he

included a restriction of “no high production goals.” Compare Britton v. Astrue, 521 F.3d

799, 802 (7th Cir. 2008) (restricting contact with public and interaction with coworkers);

Arnold v. Barnhart, 473 F.3d 816, 820 (7th Cir. 2007) (using low production standards for

moderate limitation in concentration, persistence, and pace); Schmidt, 496 F.3d at 844‐45

(using low production goals to account for problems with stress). We recognize that Seamon

suffered in the past from serious problems, but we are satisfied that the ALJ adequately

considered her overall mental health from 2002 through 2006 and included in his

hypotheticals the limitations that were supported by the record.

Next, Seamon argues that the ALJ committed reversible error at step five when he

supposedly ignored testimony from the VE stating that Seamon’s moderate limitations

rendered her incapable of performing the two jobs he identified. Although it is true that an

ALJ cannot ignore an entire line of evidence, see Diaz v. Chater, 55 F.3d 300, 307 (7th Cir.

1995), Seamon’s argument reads too much into the VE’s statement. She is referring to the

exchange mentioned above, in which the VE was asked “what percentage do you have to do

of what’s expected of you, is there a range?” The VE responded, “Well, I would think it

would be 100 percent.” Seamon interprets this exchange as a statement by the VE that a

person in the jobs that the VE identified must stay on task 100% of the time – no coffee

breaks, no lunch break, nothing. But no employer has such extreme expectations. Read

sensibly, the VE appears to have been saying only that a person must “meet expectations”

of the employer – that is, perform all aspects of the job competently, show up for work

regularly, and so forth.

Seamon also argues that the ALJ should have found her disabled at step five based

on the VE’s testimony that an employee would be unable to do the two identified jobs if she

were involved in altercations at work. But there is no evidence that Seamon’s mental health

problems would lead to altercations at work and, thus, the premise for counsel’s questions

was unsupported by the record.

Seamon’s fourth argument rests on the uncontested point that the ALJ failed to

perform his affirmative duty to ask about any conflicts between the VE’s testimony and the

descriptions of the identified jobs in the Directory of Occupational Titles (“DOT”). SSR 00‐

4p; see also Overman, 546 F.3d at 462‐63. Seamon argues that the positions of shoe brusher

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and cafeteria attendant correspond to DOT job classifications that involve either “serving”

and “taking instructions and helping.” This demonstrates, in her opinion, that both

positions require more than “brief and superficial contact with others” and thus that they

should have been excluded given her RFC. Furthermore, she argues that these positions

necessarily require frequent overhead reaching, which the ALJ also precluded in the RFC.

We do not read the DOT descriptions as expansively as Seamon does. Neither

position requires more than brief contact with others, and, even though the brusher position

may require significant lateral reaching, there is no evidence that either position would

require frequent overhead reaching. Because there is no actual conflict between the VE’s

testimony and the DOT, the ALJ’s oversight is harmless error. See Terry v. Astrue, 580 F.3d

471, 478 (7th Cir. 2009).

Finally, Seamon argues that the ALJ improperly discredited her testimony. She

challenges three of the reasons the ALJ cited for his adverse credibility finding. First,

Seamon claims that the ALJ should have considered whether her mistrust of psychiatrists

prevented her from seeking consistent treatment and from taking her medication regularly.

Next, she suggests that the ALJ failed to decide whether the evidence of symptom

exaggeration could be explained by Dr. Caillier’s diagnosis of a somatoform disorder.

Finally, she argues that the ALJ erred by finding that her participation in two social outings

was inconsistent with the social isolation she experienced as a result of her depression and

anxiety disorders.

In assessing a claimant’s credibility, the ALJ must consider several factors, including

the claimant’s daily activities, the degree of her pain or intensity of her symptoms,

aggravating factors, medications, and treatment. 20 C.F.R. § 404.1529(c); S.S.R. 96‐7p. The

ALJ is required to support his finding with specific reasons, see Villano v. Astrue, 556 F.3d

558, 562 (7th Cir. 2009), and we defer to that determination unless it is found “patently

wrong,” see Prochaska v. Barnhart, 454 F.3d 731, 738 (7th Cir. 2006). An ALJ may not ignore a

claimant’s subjective reports of pain or mental impairments simply because they are not

fully supported by objective medical evidence, but discrepancies between objective

evidence and self‐reports may suggest symptom exaggeration. See Sienkiewicz v. Barnhart,

409 F.3d 798, 804 (7th Cir. 2005).

Seamon’s point about the ALJ’s error with respect to her social outings is well taken.

Nevertheless, taken alone, this is not enough to support reversal. It is true that an ALJ must

consider whether any noted symptom exaggeration could reasonably be attributed to a

claimant’s diagnosed somatoform disorder. See Carradine v. Barnhart, 360 F.3d 751, 754‐55

(7th Cir. 2004). But in this case the ALJ properly gave Dr. Caillier’s somatoform diagnosis

limited weight because he was a non‐treating physician and his diagnosis, which was not

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made until December 2006, was of little relevance to the observations of symptom

exaggeration made years earlier by the treating physicians. In addition, although Seamon

suggests that her mistrust of doctors may have prevented her from seeking treatment, the

evidence that she restarted treatment with a new psychiatrist days after leaving Dr.

Bartholow and Phillips contradicts her claim. Overall the ALJ’s credibility determination

reflects a careful consideration of Seamon’s medical records and thus deserves deference.

We AFFIRM the judgment of the district court.

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