IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

KATHLEEN HITCHCOCK, )

 )

Plaintiff, )

 )

 v. ) No. 12 C 4994

)

CAROLYN W. COLVIN, Acting ) Magistrate Judge Finnegan

Commissioner of Social Security,1 )

)

Defendant. )

MEMORANDUM OPINION AND ORDER

Plaintiff Kathleen Hitchcock seeks to overturn the final decision of the 

Commissioner of Social Security (“Commissioner” or “Defendant”) denying her

application for Supplemental Security Income (“SSI”) under Title XVI of the Social 

Security Act. 42 U.S.C. § 1381a. The parties consented to the jurisdiction of the 

United States Magistrate Judge pursuant to 28 U.S.C. § 636(c), and filed crossmotions for summary judgment. After careful review of the record, the Court now 

denies Plaintiff’s motion, grants Defendant’s motion, and affirms the decision to 

deny benefits.

PROCEDURAL HISTORY

Plaintiff applied for SSI on May 7, 2009, alleging that she became disabled 

on April 10, 2009 due to mental illness. (R. 127, 147). The Social Security 

Administration denied the applications initially on October 16, 2009, and again 

 1 Ms. Colvin became Acting Commissioner of Social Security on February 14, 

2013, and is substituted in as Defendant pursuant to Federal Rule of Civil Procedure 

25(d)(1).
2

upon reconsideration on February 17, 2010. (R. 77-83, 85-88). Plaintiff filed a 

timely request for hearing and appeared before Administrative Law Judge 

Michael Hellman (the “ALJ”) on November 4, 2010. (R. 31). The ALJ heard 

testimony from Plaintiff, who was represented by counsel, as well as from 

vocational expert James Breen (the “VE”). Shortly thereafter, on January 21, 

2011, the ALJ found that Plaintiff is not disabled because there are a significant 

number of jobs she can perform in the national economy. (R. 16-24). The

Appeals Council denied Plaintiff’s request for review on April 30, 2012, (R. 1-3), 

and Plaintiff now seeks judicial review of the ALJ’s decision, which stands as the 

final decision of the Commissioner.

In support of her request for remand, Plaintiff argues that the ALJ: (1) 

ignored medical evidence favorable to her claim; and (2) failed to account for all 

of her mental limitations in making the residual functional capacity (“RFC”)

determination, resulting in an incomplete hypothetical question to the VE. As 

discussed below, the Court finds that the ALJ’s decision is supported by 

substantial evidence and need not be reversed or remanded.

FACTUAL BACKGROUND2

Plaintiff was born on November 4, 1964, and was 46 years old at the time 

of the ALJ’s decision. (R. 127). She has a high school diploma, spent three 

years at college, and claims to have worked as a secretary, model, and Avon 

sales representative. (R. 35-38).

 2 Consistent with Plaintiff’s arguments for remand, this opinion addresses her

mental as opposed to physical impairments.
3

A. Medical History

a. 2009

The first available medical record is dated June 1, 2009, just three weeks 

after Plaintiff’s May 7, 2009 application for benefits. At that time, Plaintiff went to 

the Oak Forest Hospital (“Oak Forest”) emergency department complaining that 

she felt depressed. (R. 288). She reported being assaulted in 2002 with 

resulting head injuries, but said she did not seek medical treatment due to 

financial difficulties. (R. 288, 293). On psychiatric evaluation, Plaintiff exhibited 

pressured (excessive and rapid) speech and racing thoughts, and B. Thomas, 

Ph.D., was not certain whether she suffered from Anxiety Disorder, Depression 

or Bipolar Disorder. (R. 293). When Plaintiff returned to Oak Forest on June 15, 

2009, she continued to complain of depression, along with excessive worrying

and racing thoughts. She was diagnosed with Depressive Disorder, N.O.S. (not 

otherwise specified) and rule-out Bipolar Disorder, and prescribed Abilify. (R. 

245).

Several months later, on September 15, 2009, Mary M. Pfeiffer, Ph.D., 

conducted a psychological examination of Plaintiff for the Bureau of Disability 

Determination Services (“DDS”). (R. 211-15). Plaintiff told Dr. Pfeiffer that she 

was depressed, out of work, and “in pain,” and has crying spells once a week. 

(R. 211). She also discussed her 2002 assault and brain injury, stating that she 

was unconscious for two hours. (R. 212). During the evaluation, Plaintiff was 

cooperative but “needed constant redirection” and “would speak on and on until 

[the doctor] interrupted her.” (R. 213). Dr. Pfeiffer described Plaintiff’s 
4

interpersonal manner as sincere but intrusive, with a lack of awareness regarding 

interpersonal cues. (Id.). Though Plaintiff said she felt depressed, Dr. Pfeiffer 

found that her mood was elevated and her affect was labile (easily altered). She 

was generally coherent during the exam, but also “somewhat circumstantial and 

disorganized” and “lacking in goal direction.” (Id.).

Dr. Pfeiffer diagnosed Plaintiff with Bipolar Disorder and 

Neuropsychological Deficits Secondary to Traumatic Brain Injury. (R. 214-15). 

Plaintiff appeared to be “hypomanic and hyperverbal,” and she “demonstrated 

highly impaired boundaries and a striking lack of awareness about her own 

interpersonal behavior.” (R. 215). Dr. Pfeiffer reported that Plaintiff’s immediate 

and recent memory are intact, but that her past memory is “quite impaired.” She 

also showed “impairments in capacity to do calculations and some impairment in 

judgment and insight.” (Id.). Dr. Pfeiffer was not sure how much of Plaintiff’s 

functional impairment is due to Bipolar Disorder versus the brain injury, and 

noted that Plaintiff’s capacity to observe her own behavior “may be very impaired 

as well.” (Id.).

Approximately one month later, on October 13, 2009, M. W. DiFonso, 

Psy.D., completed a Psychiatric Review Technique of Plaintiff for DDS. (R. 221-

33). Dr. DiFonso indicated that Plaintiff suffers from Bipolar Syndrome, (R. 224), 

and that she has mild restrictions in activities of daily living, mild difficulties in 

maintaining social functioning, and moderate difficulties in maintaining 

concentration, persistence, or pace. (R. 231). In a Mental Residual Functional 

Capacity Assessment completed the same day, Dr. DiFonso stated that Plaintiff 
5

is moderately limited in the ability to: understand, remember, and carry out 

detailed instructions; and maintain attention and concentration for extended 

periods. (R. 235). (R. 235-37). Based on treatment notes from Oak Forest and 

the assessment from Dr. Pfeiffer, Dr. DiFonso concluded that Plaintiff’s “cognitive 

and attentional skills are intact and adequate for simple one-two step work 

tasks.” (R. 237). Dr. DiFonso explained that Plaintiff’s interpersonal and 

adaptive skills are both “within normal limits,” she “carries out a fair range of daily 

activities,” and she “performs well on cognitive tasks.” (Id.).

On November 20, 2009, Plaintiff went to the John H. Stroger Jr. Hospital 

(“Stroger”) emergency department complaining of depression. (R. 248-49). She 

exhibited pressured speech and flight of ideas, (R. 248), and requested a CT 

scan of her brain to help with her disability case. (R. 249). The doctor found the 

CT scan unnecessary and diagnosed Plaintiff with possible Bipolar Disorder. (R. 

249). The doctor also referred her to social services due to depression and a 

“risk of being homeless.” (R. 260). The record does not indicate whether Plaintiff 

pursued this assistance.

b. 2010

On February 10, 2010, Donald Henson, Ph.D., affirmed Dr. DiFonso’s 

October 13, 2009 assessment that Plaintiff is not disabled from her mental 

impairments. (R. 261-63). The following month, on March 31, 2010, Plaintiff 

returned to Oak Forest for a mental consultation. (R. 286-87). Carolina Garcia, 

M.S., a psychology intern under the supervision of John (Jack) N. Canzona, 

Psy.D., noted that Plaintiff’s speech was pressured and disorganized, and her 
6

thought processes were “at times tangential and disorganized with bizarre 

content.” (R. 287). Ms. Garcia diagnosed Psychotic Disorder, N.O.S. and ruleout Bipolar Disorder, and indicated that Plaintiff might benefit from a “partial 

hospitalization program.” (Id.). Plaintiff next saw Ms. Garcia on April 18, 2010 

and reported constant worries about money and marriage. Her judgment and 

insight were both impaired, her mood was exaggerated, she felt hopeless and 

helpless, her behavior was agitated, and her thoughts were disorganized. (R. 

285). Given these symptoms, Ms. Garcia referred Plaintiff for a consultation with 

a psychiatrist. (Id.).

Plaintiff saw the psychiatrist, Samina Khattak, M.D., on April 26, 2010 and 

was diagnosed with Psychosis, N.O.S. and Depressive/Bipolar Disorder, N.O.S. 

(R. 284). When Plaintiff returned to Ms. Garcia on May 7, 2010, her judgment 

and insight remained impaired, her mood was exaggerated and anxious, and her 

behavior was agitated. (R. 283). Plaintiff’s thought processes were once again 

disorganized with bizarre content, and Ms. Garcia referred her for 

neuropsychological testing. (Id.). Three days later, on May 10, 2010, Plaintiff 

saw Roy Gilliland, Ph.D., at Oak Forest. (R. 281-82). At that time, she was 

taking Abilify and Zoloft as prescribed by Dr. Khattak. Plaintiff proved to be an 

“extremely difficult historian” and had “many scraps of paper with various life 

goals and reminders for tasks.” (R. 281). Dr. Gilliland noted that Plaintiff’s 

insight was impaired and her judgment was fair, and he diagnosed Psychotic 

Disorder, N.O.S., rule-out Bipolar Disorder, rule-out Mood Disorder due to head 

injury, and rule-out Cognitive Disorder, N.O.S. (R. 281-82).
7

At an appointment with Ms. Garcia on July 1, 2010, Plaintiff’s condition 

was largely unchanged from the previous visit. Her thought content remained 

bizarre at times but Ms. Garcia praised her for “presenting her ideas in a more 

structure[d] way.” (R. 276). When Plaintiff saw Dr. Khattak a week later on July 

8, 2010, she was calm and comfortable and “verbalized a good understanding.” 

(R. 275). At a follow-up appointment with Dr. Khattak on August 2, 2010, 

however, Plaintiff exhibited fleeting thoughts and reported “pain in my brain.” (R. 

273). Dr. Khattak diagnosed Bipolar Disorder, N.O.S., and prescribed Abilify, 

sertraline, Topamax and Klonopin. (Id.). The same day, Plaintiff met with Ms. 

Garcia and expressed “helpless feelings regarding her financial situation and the 

lack of business/work.” (R. 272). Her thought processes were still disorganized 

and Ms. Garcia recommended a referral to a “day program where more 

integrated and intensive services can be provided.” (Id.).

Plaintiff canceled her next two appointments with Ms. Garcia and 

appeared at Oak Forest again on September 27, 2010. (R. 269, 270, 271). 

Jessica Mack, Ed.S., another psychology intern under Dr. Canzona’s 

supervision, examined Plaintiff and noted that she had impaired judgment, insight 

and decision-making. She also exhibited delusions and a tangential/loose 

mental status, but her mood was pleasant and stable, and she demonstrated 

appropriate behavior. (R. 269). Plaintiff complained of feelings of hopelessness 

and helplessness, financial difficulties, and cognitive deficits stemming from her 

brain injury, and her thoughts remained disorganized. (Id.).
8

On October 13, 2010, Wendy Lewis, M.A., a psychology intern under the 

supervision of Dr. Gilliland, completed a neuropsychological evaluation of 

Plaintiff. (R. 265-68). Ms. Lewis observed that Plaintiff’s “thought process was 

extremely tangential and disorganized,” (R. 266), and found her to have “average 

to below average premorbid functioning and intact memory, with notable 

impairment in the areas of executive functioning, attention, verbal fluency, 

confrontation naming, and manual fine motor skills.” (R. 268). There were 

several factors suggesting “the possibility of psychosis,” and Ms. Lewis 

concluded that Plaintiff’s “psychiatric history of delusions, depression, previous 

manic presentation, and current clinical presentation support her diagnosis of 

Schizoaffective Disorder.” (Id.). That said, it was not clear whether Plaintiff’s 

disorganization and distractibility in daily functioning would inhibit her ability to 

work. (Id.).

B. Plaintiff’s Testimony

In an August 2009 Function Report completed in connection with her

application for disability benefits, Plaintiff stated that she takes care of herself, 

her father and her dog, and she is able to bathe, dress, and prepare three meals 

a day. (R. 158-59). She also cleans the kitchen every day, does the laundry 

every week, and takes out the garbage. (R. 159). Plaintiff does not have a 

driver’s license but she does use public transportation and can manage her 

finances, though she indicated that her lack of money “changed” and “depressed” 

her. (R. 160-61). With respect to hobbies and social activities, Plaintiff stated 

that she has not done any arts and crafts in two years and sews only once in a 
9

while. She “often” tries to help her friends, however, and goes to church once a 

month. (R. 161). She can also pay attention for “pretty long,” finish what she 

starts, follow written and spoken instructions “very well,” and be “obedient” and 

“get along” with authority figures. (R. 162-63).

At the November 4, 2010 hearing before the ALJ, Plaintiff testified that she 

lives with her father and “self-educated myself for about 15 years, since the 

attack on my brain by the robbers.” (R. 34, 35). After she applied for benefits, 

she tried to find work with some 50 employers but believes her brain injury has 

prevented her from getting hired. (R. 39-40). Plaintiff said that her head is 

“foggy,” and feels like “blood in the brain.” (R. 41, 42). Her medications help to 

calm her down, (R. 44), but she gets panic attacks and has a lot of anxiety. (R. 

48). In discussing her activities, Plaintiff stated that she cleans the house, 

empties the dishwasher, brings up the laundry, vacuums, dusts, cares for her 

puppy, and cooks. (R. 50-51, 58). These activities make her feel like she’s 

“worth something.” (R. 65). Plaintiff is able to bathe and dress herself though it 

takes “a long time,” (R. 54), and she can walk to the store. (R. 56). For fun, she

watches a lot of cartoons, listens to music, and watches movies on television. 

(R. 56-57). She also goes to church, (R. 59), and says she has a lot of friends. 

(R. 61).

C. Information from Plaintiff’s Father

On August 18, 2009, Plaintiff’s father, Tom Hitchcock, submitted a 

Function Report – Adult Third Party on behalf of his daughter’s application for 

benefits. (R. 174-81). Mr. Hitchcock stated that Plaintiff helps cook and clean, 
10

has no problems with personal care, prepares her own meals each day, and 

goes outside three times a day. (R. 174-76). She is able to use public 

transportation by herself, shop for food once a week, handle money, read, watch 

television, and spend time with others. (R. 176-77). Mr. Hitchcock indicated that 

Plaintiff cannot finish what she starts and has only “medium” ability to handle 

stress and changes in her routine, but he denied noticing any unusual behavior 

or fears in his daughter. (R. 178-79).

Shortly thereafter, on October 7, 2009, Mr. Hitchcock provided a Daily 

Activities Telephone Report to DDS. (R. 182). According to the DDS 

adjudicator’s notes of the conversation, Mr. Hitchcock stated that Plaintiff has a 

good appetite, sleeps well, keeps herself neat and clean, can travel by bus alone, 

and is able to manage her own money. (Id.). She is quiet and does not talk to 

Mr. Hitchcock much, but she has a friend she “goes with about every 10 days 

and a boy friend she sees 1-2 times a week.” (Id.). Mr. Hitchcock said that he

takes Plaintiff to the library to get books and she spends a lot of time in her room 

reading, and she also watches the news and keeps up with current events. She 

does not seem depressed to her father and makes sense when she talks, but Mr. 

Hitchcock is “not sure what her mental condition is.” (Id.).

D. Vocational Expert’s Testimony

Mr. Breen testified at the hearing as a VE. The ALJ asked him to consider 

a hypothetical person of Plaintiff’s age, education and past work experience who 

can “understand, remember, and carry out short and simple, one- or two-step 

instructions, with simple decision-making required; and, who can occasionally 
11

interact with the public, co-workers and supervisors.” (R. 73). The VE testified 

that such a person would be capable of working as a janitor (approximately 

80,000 jobs available), warehouse worker (approximately 30,000 jobs available), 

or dishwasher (approximately 14,000 jobs available). (Id.). If the person could 

not “understand, remember, and carry out short and simple, one- to two-step 

tasks, or one- to two-step instructions to do such tasks on a sustained basis,” 

however, then there would be no jobs she could perform. (R. 74). The individual 

would also be precluded from all employment if she were “unable to maintain 

pace or persistence more than 15 percent of the day.” (R. 74-75).

E. Administrative Law Judge’s Decision

The ALJ found that Plaintiff’s history of traumatic brain injury, cognitive 

disorder, bipolar disorder, and psychotic disorder are severe impairments, but 

that they do not meet or equal any of the listed impairments in 20 C.F.R. Part 

404, Subpart P, Appendix 1. (R. 18-20). After reviewing the medical records, the 

ALJ determined that Plaintiff has the capacity to work at all exertional levels with 

the following restrictions: she can understand, remember and carry out only 

short and simple one- or two-step instructions with simple decision-making 

required; and she is limited to only occasional interaction with the public, coworkers, and supervisors. (R. 20).

In reaching this conclusion, the ALJ first noted Dr. Pfeiffer’s opinion that 

Plaintiff’s past memory is “quite impaired,” and that she is “hypomanic and 

hyperverbal” with “highly impaired boundaries and a striking lack of awareness 

about her own interpersonal behavior.” (R. 19-20). The ALJ also cited to Ms. 
12

Lewis’s October 13, 2010 neuropsychological evaluation that Plaintiff has deficits 

in executive functioning, attention, and verbal fluency. (R. 20). After finding that 

Plaintiff’s complaints of disabling limitations were not fully credible, the ALJ

accepted the opinions of Dr. DiFonso and Dr. Henson that she can perform 

simple one- and two-step tasks despite having moderate limitations in: 

understanding, remembering and carrying out detailed instructions; and 

maintaining concentration. (R. 22). The ALJ acknowledged that Plaintiff 

submitted evidence of a psychotic disorder that post-dated the consultative 

evaluations, but found that the diagnosis did not change the RFC assessment. 

(R. 22-23).

Based on the stated RFC, the ALJ accepted the VE’s testimony that 

Plaintiff remains capable of performing a significant number of jobs available in 

the Chicago metropolitan area, including janitor (80,000 jobs available), 

warehouse worker (30,000 jobs available), or dishwasher (14,000 jobs available). 

(R. 23). The ALJ thus concluded that Plaintiff is not disabled within the meaning 

of the Social Security Act, and is not entitled to benefits.

DISCUSSION

A. Standard of Review

Judicial review of the Commissioner’s final decision is authorized by 

Section 405(g) of the Social Security Act. See 42 U.S.C. § 405(g). In reviewing 

this decision, the Court may not engage in its own analysis of whether Plaintiff is 

severely impaired as defined by the Social Security Regulations. Young v. 

Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004) (citation omitted). Nor may it 
13

“displace the ALJ’s judgment by reconsidering facts or evidence or making 

credibility determinations.” Castile v. Astrue, 617 F.3d 923, 926 (7th Cir. 2010) 

(quoting Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 2007)). The court’s task 

is to determine whether the ALJ’s decision is supported by substantial evidence, 

which is “‘such relevant evidence as a reasonable mind might accept as 

adequate to support a conclusion.’” McKinzey v. Astrue, 641 F.3d 884, 889 (7th 

Cir. 2011) (quoting Skinner, 478 F.3d at 841).

In making this determination, the court must “look to whether the ALJ built 

an ‘accurate and logical bridge’ from the evidence to her conclusion that the 

claimant is not disabled.” Simila v. Astrue, 573 F.3d 503, 513 (7th Cir. 2009) 

(quoting Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008)). Where the 

Commissioner’s decision “‘lacks evidentiary support or is so poorly articulated as 

to prevent meaningful review,’ a remand is required.” Hopgood ex rel. L.G. v. 

Astrue, 578 F.3d 696, 698 (7th Cir. 2009) (quoting Steele v. Barnhart, 290 F.3d 

936, 940 (7th Cir. 2002)).

B. Five-Step Inquiry

To recover SSI under Title XVI of the Social Security Act, a claimant must 

establish that she is disabled within the meaning of the Act. 42 U.S.C. '

1382c(a)(3); Rapsin v. Astrue, No. 10 C 318, 2011 WL 3704227, at *5 (N.D. Ill. 

Aug. 22, 2011). A person is disabled if she is unable to perform Aany substantial 

gainful activity by reason of any medically determinable physical or mental 

impairment which can be expected to result in death or which has lasted or can 

be expected to last for a continuous period of not less than twelve months.@ 42 
14

U.S.C. § 1382c(a)(3)(A). In determining whether a claimant suffers from a 

disability, the ALJ conducts a standard five-step inquiry: (1) Is the claimant 

presently unemployed? (2) Is the claimant=s impairment severe? (3) Does the 

impairment meet or equal one of a list of specific impairments enumerated in the 

regulations? (4) Is the claimant unable to perform her former occupation? and 

(5) Is the claimant unable to perform any other work? See 20 C.F.R. ''

404.1520, 416.920; Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000).

C. Analysis

Plaintiff claims that the ALJ’s decision must be reversed because he: (1) 

ignored medical evidence favorable to her claim; and (2) failed to account for all 

of her mental limitations in making the RFC determination, resulting in an 

incomplete hypothetical question to the VE.

1. Consideration of Medical Evidence

Plaintiff first objects that the ALJ failed to consider significant evidence 

that supports her allegations of disability. For example, though Dr. Pfeiffer found 

that Plaintiff needed constant redirection, would speak on until interrupted, 

exhibited circumstantial, pressured and somewhat disorganized speech, and had 

impaired judgment and insight, the ALJ said nothing about these observations. 

(Doc. 18, at 4-5; Doc. 26, at 2). In addition, out of all the treatment records from 

Oak Forest, the ALJ cited to only one – the October 2010 neuropsychological 

evaluation from Ms. Lewis – and Plaintiff believes he did not discuss that report

in sufficient detail. (Id. at 5; Doc. 26, at 3).
15

The Seventh Circuit has long held that an ALJ “need not provide a 

complete written evaluation of every piece of testimony and evidence” as long as 

he builds a logical bridge from the evidence to his conclusion. Shideler v. Astrue, 

688 F.3d 306, 310 (7th Cir. 2012) (internal quotations omitted). See also Hodges 

v. Barnhart, 399 F. Supp. 2d 845, 859 (N.D. Ill. 2005) (“[A]n ALJ cannot be 

expected to discuss every symptom mentioned in an extensive medical history.”). 

Here, the ALJ clearly considered Dr. Pfeiffer’s evaluation, noting her description 

of Plaintiff as “‘hypomanic and hyperverbal’ with ‘highly impaired boundaries and 

a striking lack of awareness about her own interpersonal behavior.’” (R. 19, 

215). The ALJ also acknowledged that Plaintiff performed “uneven[ly]” on Dr. 

Pfeiffer’s mental status exam, exhibiting intact orientation and immediate and 

recent memory, but proving “quite impaired” in past memory. (R. 19-20, 215).

In light of this evidence, the Court is satisfied that the ALJ did not cherrypick only the positive portions of Dr. Pfeiffer’s evaluation while ignoring the 

negative findings. (Doc. 18, at 7-8) (citing Flores v. Astrue, No. 10 C 6512, 2012 

WL 1463481, at *6 (N.D. Ill. Apr. 26, 2012)) (“An ALJ may not selectively rely on 

a treating physician’s notes indicating a claimant had improved with treatment, 

while disregarding notes indicating the claimant was still markedly limited in his 

ability to work.”). This is especially true given that Dr. DiFonso discussed and 

considered Dr. Pfeiffer’s report in determining Plaintiff’s mental RFC, and the ALJ 

expressly discussed and relied on Dr. DiFonso’s assessment. (R. 22-23, 233, 

237). Plaintiff may believe that certain statements in the report evidence greater 

functional limitations, (Doc. 18, at 5), but Dr. DiFonso’s opinion to the contrary
16

(as affirmed by Dr. Henson) stands uncontroverted, and Plaintiff’s speculation in 

that regard is not a basis for remanding this case. See Elder v. Astrue, 529 F.3d 

408, 413 (7th Cir. 2008) (“[E]ven if reasonable minds could differ concerning 

whether [the plaintiff] is disabled, we must nevertheless affirm the ALJ’s decision 

denying her claims if the decision is adequately supported.”) (internal quotations 

omitted).

For similar reasons, there is no merit to Plaintiff’s claim that the ALJ 

selectively ignored records from Oak Forest that support her claim. Plaintiff is 

correct that the ALJ cited only to Ms. Lewis’s October 13, 2010 

neuropsychological assessment, which showed that Plaintiff suffers from a 

psychotic disorder with “deficits in executive functioning, attention, and verbal 

fluency.” (R. 20, 22, 268). That report, however, summarizes information from 

Plaintiff’s June 2009 emergency department visit; notes that she is currently in 

therapy at Oak Forest with “a working diagnosis of Psychotic Disorder, N.O.S. 

with R/O [rule-out] Bipolar Disorder”; confirms that she is taking medications 

prescribed by a psychiatrist who stated that Plaintiff experiences delusions and 

depressive episodes; and cites to a May 10, 2010 psychological evaluation 

indicating the presence of a thought disorder and moderate depression. (R. 

266). Notably, the official diagnosis of psychotic disorder came from notes 

provided by Ms. Garcia, Dr. Khattak and Dr. Gilliland in March, April and May 

2010, and not from Ms. Lewis. (R. 282, 284, 287). The ALJ expressly stated 

that he considered that diagnosis in determining Plaintiff’s RFC. (R. 22-23). Cf. 

Johnson v. Astrue, No. 11 C 3989, 2012 WL 3205039, at *11 (N.D. Ill. Aug. 2, 
17

2012) (ALJ erred in ignoring a diagnosis of “chronic lumbar radiculopathy with 

‘strong preponderance of back pain.’”). On this record, the Court cannot say that 

the ALJ ignored relevant treatment notes from Oak Forest.

Plaintiff’s citation to Bauer v. Astrue, 532 F.3d 606 (7th Cir. 2008), does 

not warrant a contrary finding. In Bauer, the Seventh Circuit cautioned that “[a] 

person who has a chronic disease, whether physical or psychiatric, and is under 

continuous treatment for it with heavy drugs, is likely to have better days and 

worse days . . . Suppose that half the time she is well enough that she could 

work, and half the time she is not. Then she could not hold down a full-time job.” 

Id. at 609. The facts of Bauer are easily distinguishable because the plaintiff 

there was hospitalized on a number of occasions with hallucinations, racing 

thoughts, and thoughts of suicide, and both of her treating physicians opined that 

she could not hold down a full-time job. Id. at 607. Here, conversely, there is no 

evidence that Plaintiff has ever been hospitalized for her mental condition or had 

suicidal thoughts, and no physician indicated that she is incapable of working. 

Schreiber v. Astrue, No. 10 C 50167, 2012 WL 1886468, at *11 (N.D. Ill. May 23, 

2012) (reliance on Bauer misplaced where the plaintiff was hospitalized for her 

bipolar disorder only once and then showed consistent improvement).

In sum, the ALJ adequately considered and discussed Dr. Pfeiffer’s report 

and relevant treatment notes from Oak Forest, and did not selectively ignore 

evidence favorable to Plaintiff’s claim. Her request for remand on this basis is 

denied.
18

2. RFC Determination

Plaintiff next argues that the ALJ’s RFC determination fails to account for 

her moderate limitations in social functioning, concentration, persistence or pace.

A claimant’s RFC is the maximum work that she can perform despite any 

limitations. 20 C.F.R. § 404.1545(a)(1); SSR 96-8p. The RFC determination is a 

legal decision rather than a medical one. 20 C.F.R. § 404.1527(d)(2). “When 

determining the RFC, the ALJ must consider all medically determinable 

impairments, . . . even those that are not considered ‘severe.’” Craft, 539 F.3d at 

676.

a. Social Functioning

The ALJ found that Plaintiff has moderate difficulties in social functioning 

such that she is limited to only occasional interaction with the public, co-workers 

and supervisors. (R. 19, 20). Plaintiff argues that the ALJ failed to explain how 

he reached this conclusion, and claims that she actually has greater restrictions 

in this area. (Doc. 18, at 9). By way of example, Plaintiff cites to notes from 

Stroger, Dr. Pfeiffer and Oak Forest variously indicating that she “had pressured 

speech, flight of ideas, tangential, disorganized and/or bizarre thought processes,

exaggerated, agitated, and/or anxious mood, had to be redirected frequently, and 

had a presentation of a young girl rather than a mature woman.” (Id. at 9) (citing 

R. 248, 265, 269, 272, 276, 283, 287, 293).

Though the ALJ did not mention every one of these symptoms, he did

discuss Dr. DiFonso’s report, which stated that Plaintiff is not significantly limited 

in terms of social functioning and has normal interpersonal and adaptive skills. 
19

(R. 22, 236-37). As noted, Dr. DiFonso’s opinion is based on Dr. Pfeiffer’s 

evaluation, which documented several of the behaviors Plaintiff deems important, 

including: her need for constant redirection; her circumstantial, pressured and 

somewhat disorganized speech; her marked grandiosity in thinking about career 

goals; and her labile affect. (R. 213, 215). The ALJ also discussed testimony 

from Plaintiff and her father that she has many friends, is friendly with the 

neighbors, goes to church and the grocery store, would go to the movies if she 

could afford it, and talks with her brother on the telephone. (R. 19, 57, 59-61, 

182).

Despite this evidence of minimal impairment, the ALJ found it significant 

that Dr. Pfeiffer assessed Plaintiff as “‘hypomanic and hyperverbal’ with ‘highly 

impaired boundaries and a striking lack of awareness about her own 

interpersonal behavior.’” (R. 19). The ALJ further noted that Plaintiff was 

diagnosed with psychotic disorder and expressly factored that into “assessing a 

significant limitation in social functioning.” (R. 22-23). As a result, the ALJ found 

Plaintiff capable of only occasional contact with the public, co-workers, and 

supervisors, which the Social Security Regulations define as “from very little up 

to one-third of the time.” SSR 96-9p; SSR 83-10.

Plaintiff has a different perspective on the record evidence and argues that 

the ALJ “should have considered whether her presentation at the hearing was 

consistent with the treatment notes, which it appears it was.” (Doc. 26, at 4). In 

that regard, Plaintiff stresses that she “frequently interrupted the ALJ, and the 

ALJ had to repeatedly tell her to relax, slow down in answering questions, wait 
20

for him to ask her questions, and let him talk.” (Id.). As a preliminary matter, the 

ALJ discounted Plaintiff’s credibility for a variety of reasons not challenged here

(e.g., Ms. Lewis’s observation that she “seemed to report what she thought the 

lawyers and/or judges wanted to hear in order to approve her for disability”). (R. 

21, 22, 266). Moreover, the ALJ found Plaintiff more restricted in social 

functioning than any physician of record, and Plaintiff points to no contrary 

opinion. See, e.g., Castile, 617 F.3d at 929 (finding no error where A[i]t was 

because of and not in spite of [the claimant=s] testimony that the ALJ limited her 

to a more restrictive residual functional capacity finding than any physician on the 

record.@). Once again, her unsupported belief that various symptoms reflect 

more severe limitations is insufficient to establish that the ALJ’s finding was 

erroneous. (Doc. 26, at 6).

Plaintiff cannot avoid this result by noting that “[t]here was no medical 

expert in this case.” (Doc. 18, at 8). “Where, as here, an applicant for disability 

benefits is represented by counsel, the ALJ is ‘entitled to assume that the 

applicant is making [her] strongest case for benefits.’” Phillips v. Astrue, 601 

F.Supp.2d 1020, 1031 (N.D.Ill.2009) (quoting Ray v. Bowen, 843 F.2d 998, 1006 

(7th Cir.1988)). Plaintiff does not argue that the ALJ should have obtained 

testimony from a medical expert, or that he failed to develop a full and fair record

in this case. Nor does she challenge the VE’s finding that a person with her

background and social limitations can perform a variety of jobs available in the 

regional economy. Cf. Spiva v. Astrue, 628 F.3d 346, 352 (7th Cir. 2010) (ALJ 

erred in finding unrepresented plaintiff who “hears evil spirits” capable of stocking 
21

shelves where no VE testified at the hearing). Viewing the record as a whole, the 

ALJ’s determination that Plaintiff can have only occasional contact with the 

public, co-workers, and supervisors is supported by substantial evidence.

b. Concentration, Persistence or Pace

Plaintiff finally argues that the ALJ did not adequately account for her 

moderate limitations in concentration, persistence or pace. (R. 20, 237; Doc. 18, 

at 11). Plaintiff directs the Court to Stewart v. Astrue, 561 F.3d 679 (7th Cir. 

2009), where the Seventh Circuit made it clear that limiting an individual to 

simple, routine tasks is not sufficient to account for deficiencies in concentration, 

persistence or pace. Id. at 684-85. See also Craft, 539 F.3d at 677-78 (limitation 

to unskilled work did not provide any information as to the plaintiff’s mental 

condition or abilities). According to Plaintiff, the ALJ in this case violated Stewart

by restricting her to “short and simple one or two step instructions with simple 

decision-making required.” (R. 20).

This argument ignores the fact that Dr. DiFonso found Plaintiff capable of 

“simple one-two step work tasks” despite her moderate cognitive and attentional 

limitations, (R. 237), and that Dr. Henson affirmed this finding. (R. 261-63). 

Where, as here, “a medical expert ‘translated an opinion of the claimant’s 

medical limitations into an RFC assessment’ an ALJ may rely upon that 

translation.” Adams v. Astrue, 880 F. Supp. 2d 895, 912 (N.D. Ill. 2012) (quoting 

Milliken v. Astrue, 397 Fed. Appx. 218, 221-22 (7th Cir. 2010)). See also 

Johansen v. Barnhart, 314 F.3d 283, 289 (7th Cir. 2002) (no error where 
22

physician translated moderate mental limitations into a specific RFC assessment 

that the plaintiff could still perform low-stress, repetitive work).

Plaintiff takes issue with the fact that the ALJ found her capable of one- to 

two-step instructions whereas Dr. DiFonso limited her to one- to two-step tasks. 

(Doc. 26, at 9). The Court views this as a distinction without a difference; it is 

clear that Plaintiff cannot do multi-step tasks if she cannot follow multi-step 

instructions. Plaintiff does not explain why instructions are significantly different 

from tasks in this context, and any error the ALJ made in re-phrasing the word is 

harmless. See Keys v. Barnhart, 347 F.3d 990, 994 (7th Cir. 2003) (“[T]he 

doctrine of harmless error . . . is fully applicable to judicial review of 

administrative decisions.”); Scott v. Astrue, 730 F. Supp. 2d 918, 935 (C.D. Ill. 

2010) (“Harmless errors are those that do not affect the ALJ’s determination that 

a claimant is not entitled to benefits.”).

Plaintiff next objects that Dr. DiFonso and Dr. Henson did not have access 

to evidence from Oak Forest when they rendered their opinions. (Doc. 18, at 11-

12; Doc. 26, at 5). The ALJ acknowledged as much, noting that “additional 

evidence was received after the reconsideration level in which [Plaintiff] was 

found to have a psychotic disorder.” (R. 22). Cf. Moore v. Colvin, No. 11 C 

5412, 2013 WL 2897662, at *5 (N.D. Ill. June 12, 2013) (ALJ’s “reliance on [state 

agency psychological consultant’s] assessment is problematic because [the 

physician] did not have access to [the plaintiff’s] complete medical record, and 

the ALJ did not indicate that she had considered that fact in crediting his 

opinion.”). The ALJ expressly considered the new diagnosis, as well as Ms. 
23

Lewis’s observation that Plaintiff has deficits in executive functioning and 

attention. (R. 20).

Plaintiff also speculates that she would not be able to maintain 

concentration, persistence or pace for 15% or more of the workday, but she has 

not identified any physician who suggested that she would be off-task that often. 

(Doc. 18, at 13). Nor did any physician find her incapable of performing simple 

tasks or following simple instructions as stated by Dr. DiFonso, and confirmed by 

Dr. Henson. See Compean v. Astrue, No. 09 C 5835, 2011 WL 1158191, at *8 

(N.D. Ill. Mar. 28, 2011) (citing Rice v. Barnhart, 384 F.3d 363, 370 (7th Cir. 

2004)) (the ALJ Awas entitled to rely upon the opinion of the state agency 

physician, particularly where no physician imposed any greater functional 

limitations than those found by the ALJ in her RFC determination.@). Even Ms. 

Lewis observed that “it is not clear whether [Plaintiff’s] impairments [in attention 

and executive dysfunction] are inhibiting [her] ability to work.” (R. 268). Notably, 

there is no evidence that Plaintiff followed up on Ms. Lewis’s suggestion that she 

obtain a vocational evaluation. (Id.).

Given that the ALJ properly accounted for Plaintiff’s moderate limitations 

in concentration, persistence or pace in the RFC, there is no merit to Plaintiff’s 

final argument that the hypothetical question posed to the VE was incomplete. 

(Doc. 18, at 13-14). A hypothetical question need only “set forth the claimant’s 

impairments to the extent that they are supported by the medical evidence in the 

record.” Eichstadt v. Astrue, 534 F.3d 663, 668 (7th Cir. 2008) (internal 

quotations omitted). See also Wurst v. Astrue, 866 F. Supp. 2d 951, 964-65 
24

(N.D. Ill. 2012). Moreover, in formulating such a hypothetical question, an ALJ 

“may rely on a physician’s statement if the physician has translated the 

claimant’s mental limitations into terms describing the work the claimant can 

perform.” Chandler v. Astrue, No. 08 C 2204, 2009 WL 3294791, at *5 (C.D. Ill. 

Oct. 9, 2009). See also Milliken, 397 Fed. Appx. at 221-22. As noted, Dr. 

DiFonso translated Plaintiff’s moderate limitations into an RFC, and the ALJ’s 

decision to rely on that opinion is supported by substantial evidence.

CONCLUSION

For the reasons stated above, Plaintiff’s Motion for Summary Judgment

(Doc. 18) is denied, and Defendant’s Motion for Summary Judgment (Doc. 24) is 

granted. The Clerk is directed to enter judgment in favor of Defendant.

ENTER:

Dated: June 28, 2013 _____________________________

SHEILA FINNEGAN

United States Magistrate Judge