United States Court of Appeals

For the Seventh Circuit

Chicago, Illinois  60604

Argued June 6, 2011

Decided July 13, 2011

Before

MICHAEL S. KANNE, Circuit Judge

TERENCE T. EVANS, Circuit Judge

DIANE S. SYKES, Circuit Judge

No. 10‐3778

SAMANTHA J. UNDERWOOD,

Plaintiff‐Appellant,

v.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant‐Appellee.

Appeal from the United States District

Court for the Central District of Illinois.

No. 2:09‐cv‐02072

David G. Bernthal,

Magistrate Judge.

O R D E R

SamanthaUnderwoodhas sufferedfrom mental healthproblems throughoutherlife.  Since

2001, she has seen numerous treatment providers, and about the only thing those providers

have agreed on is that Underwood suffers from an affective mood disorder.    Whatever

Underwood’s exact diagnosis, complications from her mental health problems led herto apply

for social security disability benefits in early 2004.  After two hearings, the administrative law

judge (“ALJ”) concluded that Underwood was not disabled.  Underwood then petitioned for

review in the district court, claiming that the ALJ’s decision was not supported by substantial

NONPRECEDENTIAL DISPOSITION

To be cited only in accordance with

Fed. R. App. P. 32.1
No. 10‐3778 Page 2

evidence.  The district court affirmed the determination of the ALJ.  Underwood now brings

her case to us, arguing (yet again) that the ALJ erred.  We affirm.

The ALJ’s disability analysis was guided by a five‐step regulatory framework.  See 20 C.F.R.

§§ 404.1520, 416.920.  Step one asks whether the claimant is engaging in substantial gainful

activity.  If she is, she is not disabled and the analysis ends; if she is not, the analysis continues.

Step two goes to whether the claimant has an impairment that qualifies as severe.   If the

impairment is not severe, the claimant is not disabled; if the impairment is, the ALJ proceeds

to the next step.  Step three deals with whether the claimant’s impairment meets or equals one

of the impairments listed in the regulations.  If the claimant’s impairment matches the list, the

claimant is disabled; if it does not, the ALJ must determine the claimant’s ability to do work

activities on a sustained basis despite limitations from her impairment.  Step four deals with

this residual functional ability—the ALJ must determine whether the claimant has the ability

to perform the requirements of past work.  If she can, she is not disabled; if she cannot, the

analysis proceeds to the fifth and final step.  Step five asks whether the claimant can engage in

any other work considering her functional ability.  If she can, she is not disabled.

Underwood’s case turned, in large part, on step three.  For Underwood’s impairment to

equal or match the listing under that step, her disorder must have caused two of the following

functional impairments: a marked restriction of activities of daily living; a marked difficulty

in social functioning; a marked difficulty in concentration, persistence, or pace; or repeated

episodes of extended decompensation.  See 20 C.F.R. Pt. 404, Subpart P, App.1 § 12.04(B).

Whether Underwood’s impairments were marked or mild depended upon her treatment

record, a record that painted a somewhat confusing—and in pockets inconsistent—picture of

Underwood’s impairments.  Some experts opined that Underwood’s affective disorder did not

cause marked impairments in any area, but instead resulted in more mild ones.

Others—including Dr. Ramirez, Underwood’s treating psychiatrist—concluded that

Underwood’s disorder caused marked impairments in numerous areas, including social

functioning and concentration.    A medical expert, Dr. Marquis, was called to review

Underwood’s record and offer a comprehensive opinion about herimpairments.  Dr. Marquis

initially determined that Underwood’s impairments were mild, but amended his opinion

towardsmoremarkedimpairments afterhewaspresented withDr.Ramirez’s summary report.

Dr. Marquis did insert one caveat: he had not seen Dr. Ramirez’s treatment notes, and thus

could not say whether Dr. Ramirez’s conclusions were supported by his records.

In progressing through his step‐by‐step analysis, the ALJ found that there were

inconsistencies between Dr. Ramirez’s conclusions and his notes, as well as inconsistencies

between Dr. Ramirez’s conclusions and the opinions of other providers.    He also found

Underwood’s credibility lacking, and accordingly discredited some of her subjective reports

to her providers.  Based on these problems, the ALJ discounted Dr. Ramirez’s conclusions and
No. 10‐3778 Page 3

Dr. Marquis’s amended opinion.  Instead, the ALJ gave more weight to other experts’ reports

andtoDr.Marquis’s original assessment, whichsupported moremildfunctionalimpairments.

And because Underwood could perform the requirements of past work despite these mild

impairments, the ALJ found that she was not disabled under the Social Security Act.

Underwood’s primary argument is that the ALJ’s finding of mild impairments was not

supported by substantial record evidence.  We disagree.  Substantial evidence is only “such

relevant evidence as a reasonable mind might accept as adequate to support [the ALJ’s

judgment],” Richardson v. Perales, 402 U.S. 389, 401 (1971), and it was present here.  The record

shows that Underwood left her home six to eight times per month, that she talked to

acquaintances on the phone, that she had close friends with whom she kept in regular contact,

that she maintained a good relationship with her mother, and that she maintained generally

appropriate interaction with her children.    In reviewing her treatment records, the state

psychologists concludedthatUnderwood’s socialfunctioning was adequate.  This was enough

to support the ALJ’s determination that Underwood had mild social impairments.

The ALJ’s conclusion that Underwood had only mild restrictions in concentration,

persistence, or pace was also supported by substantial evidence.  Underwood’s treatment

providers often described her concentration and attentiveness as adequate.  Her providers also

noted that Underwood was cognitively intact, was cooperative, and was generally able to take

directions.  Psychological testing showed that Underwood had adequate recall.  Her therapist

gave her instructions on several occasions and noted that Underwood was able to understand

and implement those instructions.  Based on theirreview of most of Underwood’s records, the

state psychologists also concluded that Underwood did not have a marked impairment in

concentration, persistence, or pace.  This was sufficient to support the ALJ’s conclusion.

To be sure, there was evidence in the record that went the other way, and Underwood

challenges the ALJ’s treatment of that evidence.  She initially suggests that the ALJ ignored the

evidence that supported marked impairments and an inability to work, thereby committing

legal error.  See Campbell v. Astrue, 627 F.3d 299, 306 (7th Cir. 2010).  Our review of the record,

however, leaves us convinced that the ALJ analyzed all of the evidence put forth.  The ALJ did

not ignore the evidence in question, but instead weighed and discredited it.

Underwood devotes the rest of her arguments to attacking the way the ALJ weighed the

evidence that swung in herfavor.  Before we deal with those arguments, we pause to note that

the ALJ is the factfinder in a disability proceeding—it is for him to weigh evidence and

determine credibility.  See White v. Barnhart, 415 F.3d 654, 659 (7th Cir. 2005).  On appeal, we

review the ALJ’s assessment of the evidence deferentially, and we will not upset that

assessment by reweighing evidence, reevaluating credibility, or otherwise substituting our

judgment for the ALJ’s.  Jens v. Barnhart, 347 F.3d 209, 212 (7th Cir. 2003).  All that said, there

are limits to the ALJ’s power as factfinder.    He cannot, for instance, flout social security
No. 10‐3778 Page 4

regulations that impose evidentiary rules upon him, nor can he conclude that a party lacks

credibility without a reasoned basis.  See Punzio v. Astrue, 630 F.3d 704, 709‐10 (7th Cir. 2011).

Underwood seizes on both of these limitations, arguing first that the ALJ discredited the

conclusions of Dr. Ramirez in violation of social security regulations.  The regulation at issue,

20 C.F.R. § 404.1527(d)(2), provides that the ALJ must give the treating physician’s conclusions

controlling weight unless they are not supported by the treating physician’s records or are

otherwise inconsistent with the reports of other providers.    “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, 749 (7th Cir. 2010).

Contrary toUnderwood’s arguments,theALJ offeredgoodreasons fordeclining to giveDr.

Ramirez’s conclusions controlling weight.  After delving into the record, the ALJ first observed

that a number of Dr. Ramirez’s treatment notes did not mesh with his ultimate conclusion that

Underwood was disabled.  For instance, around a week before issuing a letter instructing

parties that Underwood could not work, Dr. Ramirez noted that Underwood was stable, was

maintaining a good relationship with herfamily, was cognitively intact, and appeared to have

good judgment.  Second, the ALJ noted that Dr. Ramirez’s conclusions did not harmonize with

the conclusions of other providers, who had often noted that Underwood was stabilized on

medication, proceeding well in treatment, able to work, and so on.  Both ofthese were sufficient

reasons for discrediting the treating psychiatrist’s determinations, as well as the amended

opinion from Dr. Marquis that was based upon those determinations.

Underwood also contends that the ALJ erred in finding her not credible and in discounting

some of her subjective reports to treatment providers based on thatlack of credibility.  AnALJ’s

power to discount credibility is not unlimited: he must consider a number of factors imposed

by regulation, see 20 C.F.R. § 404.1529(c), and must support his credibility findings with

evidence in the record, see Villano v. Astrue, 556 F.3d 558, 562 (7th Cir. 2009).  Once he does,

however, his credibility determinations are entitled to “special deference” and will not be

overturned unless “patently wrong.”  Jones v. Astrue, 623 F.3d 1155, 1160 (7th Cir. 2010).

We conclude thattheALJ’s credibilitydetermination was reasoned, supportedby evidence,

and not clearly incorrect.  The ALJ noted a number of discrepancies in Underwood’s reports

to her treatment providers, including inconsistencies about her prior psychiatric admissions,

her ability to care for her children, her reasons for leaving various jobs, and her drug use.  The

ALJ also observeda strange change inUnderwood’s symptomology that suggesteda credibility

problem: afterUnderwoodobtainedcounseltopursueherdisability claim, she began reporting

more intense manic episodes, new psychotic symptoms, and novel concerns about multiple

personalitydisorder andattention‐deficithyperactivitydisorder.  Theseproblems were enough

to permit the ALJ to doubt Underwood’s credibility and to discount some of her subjective

reports to her providers based upon that lack of credibility.
No. 10‐3778 Page 5

In the end, this is a case with inconclusive facts.  The question is not whether we believe

Underwood was disabled, but whetherthe ALJ’s determination was supported by substantial

evidence.  It was.  The ALJ also acted within his discretion in weighing the conflicting evidence:

he offered adequate reasons for discrediting Dr. Ramirez’s conclusions and doubting

Underwood’s credibility.  We therefore AFFIRM the judgment of the district court.