United States Court of Appeals 

For the Seventh Circuit 

Chicago, Illinois 60604 

Argued October 3, 2019 

Decided November 12, 2019 

Before 

DIANE P. WOOD, Chief Judge 

AMY C. BARRETT, Circuit Judge 

MICHAEL Y. SCUDDER, Circuit Judge

No. 18-3673 

PAUL PYTLEWSKI, 

Plaintiff-Appellant, 

v. 

ANDREW M. SAUL, 

Commissioner of Social Security, 

 Defendant-Appellee.

 Appeal from the United States District 

Court for the Western District of 

Wisconsin. 

No. 17-cv-0810-slc 

Stephen L. Crocker, 

Magistrate Judge. 

O R D E R 

Paul Pytlewski, now 42, who suffers from mental impairments (anxiety, 

depression, and anger issues) and physical impairments (chronic back pain and pain in 

his neck and arms), challenged the denial of his application for Social Security disability 

benefits and supplemental social security income. An administrative law judge denied 

Pytlewski’s application after finding that he lacked sufficient medical evidence that he 

was disabled. The district court upheld the ALJ’s decision. On appeal, Pytlewski 

principally contends that the ALJ afforded too little weight to his treating physician’s 

opinion about his mental impairments. Because the ALJ’s decision was supported by 

substantial evidence, we affirm. 

NONPRECEDENTIAL DISPOSITION 

To be cited only in accordance with Fed. R. App. P. 32.1 
No. 18-1629 Page 2 

I 

 Pytlewski applied in mid-2015 for Title II disability insurance benefits and 

supplemental social security income, alleging a host of mental and physical 

impairments. (Because he confines this appeal to only his mental impairments, we focus 

mainly on those.) Pytlewski previously worked as a mortgage clerk, auto detailer, tire 

builder, and cleaner; his professional activities, however, were derailed by his temper 

and anxiety, which he says lost him at least thirty jobs in three years. In May 2015, 

Pytlewski ceased working because of his back and neck pain and his inability to deal 

with people. Two months later, he began treatment with a mental-health therapist. At 

intake, the therapist recorded Pytlewski’s history of anxiety and depression and 

diagnosed him with intermittent explosive disorder. 

Upon referral from the Disability Determination Bureau, consultative 

psychologist Dr. Steven Benish saw Pytlewski in September 2015 and diagnosed him 

with post-traumatic stress disorder, panic disorder, and “some symptoms” of bipolar 

disorder. Dr. Benish recounted that the examination was “certainly one of the more 

unusual” ones that he had conducted: Pytlewski was “dramatic in presentation,” “acted 

in a quite peculiar manner,” “entered without saying a word,” wore dark glasses, 

refused to be seen without his girlfriend present, and requested frequent breaks. 

Regarding work capacity, Dr. Benish opined that Pytlewski could understand, recall, 

and carry out instructions; that his concentration and cognitive pace were average or 

slightly limited; that his ability to respond to supervisors or coworkers was moderately 

affected; and that he responded to stress with angry outbursts and “agitation.” Dr. 

Benish posited that Pytlewski’s unusual behavior, if not “partly explained” by an 

unspecified personality disorder, could be attributable to malingering with the intent to 

influence the examiner’s opinion. 

 Between July 2016 and March 2017, Pytlewski saw psychiatrist Dr. John Whalen 

eight times. At an early stage of his care, in September 2016, Dr. Whalen opined that 

Pytlewski had a personality disorder (sociopathic traits) and a possible diagnosis of a 

bipolar disorder; he stated that Pytlewski’s prognosis was “poor.” He described 

Pytlewski as “probably noncompliant” with his medications and noted “some 

malingering for benefits from SSI.” Dr. Whalen observed that Pytlewski could function 

in a regular, competitive work setting 8 hours per day, 5 days per week for more than 6 

months, so long as Pytlewski took his medications. Dr. Whalen described Pytlewski’s 

“potential and capacity for work” as “limited only by his motivation to continue a 

treatment plan.” He assessed Pytlewski’s functional limitations as “none-mild” in every 

category. 
No. 18-1629 Page 3 

Meanwhile, the state-agency psychologists who reviewed Pytlewski’s medical 

records found him capable of working. In September 2015, Dr. Susan Donahoo 

concluded that Pytlewski could “maintain[] concentration and persistence to complete 

workdays and workweeks in performance of simple repetitive tasks,” might have 

“some difficulty dealing appropriately w/the general public, supervisor’s [sic] and 

coworkers,” and would have “moderate” limitations with workplace stress or adapting 

to change. In January 2016, Dr. Russell Phillips found that Pytlewski could “maintain[] 

concentration and persistence to complete workdays and workweeks in performance of 

simple repetitive tasks”; “maintain attention for two hours at a time and persist at 

simple tasks over eight- and forty-hour periods with normal supervision”; and “tolerate 

simple changes in routine ... and make/carry out simple plans.” 

After the Social Security Administration twice denied benefits, Pytlewski 

testified at a hearing before an ALJ in late 2016 that he could no longer work because of 

his mental impairments and back and neck pain. He explained that he was being 

treated by Dr. Whalen for “Bipolar I, PTSD,” he had trouble “being around others,” and 

on about twenty occasions he had become so “frustrated” that he “walk[ed] off the job.” 

Six days after the hearing, in November 2016, Dr. Whalen saw Pytlewski again. 

This assessment differed significantly from Dr. Whalen’s assessment of Pytlewski two 

months earlier. In September, Dr. Whalen described Pytlewski as having “none-mild” 

functional limitations; now, he rated Pytlewski’s functional limitations as “extreme” in 

every category. In September, Dr. Whalen opined that Pytlewski could work full-time 

in a competitive setting with adherence to a treatment plan; now, he said that Pytlewski 

was incapable of tolerating even a “low stress” job and that his level of occupational 

and social impairment was “total.” Dr. Whalen also recorded that Pytlewski was 

suffering back and neck pain and that he demonstrated some “loose associations” in his 

thought process. Dr. Whalen diagnosed Pytlewski with intermittent explosive disorder, 

bipolar disorder and multiple learning disabilities. 

At Pytlewski’s request and after receiving additional medical evidence 

(including Dr. Whalen’s November 2016 report), the ALJ in May 2017 held a 

supplemental hearing with a new vocational expert. Asked what work would be 

available to a person of Pytlewski’s age with his experience and limitations, the VE 

responded that this person would be restricted to simple, routine, and repetitive tasks; 

no fast-paced work; only simple work-related decisions and occasional workplace 

changes; and only occasional interaction with the public, coworkers, and supervisors. 

This person, the VE continued, would be restricted from performing Pytlewski’s past 
No. 18-1629 Page 4 

work, but could perform sedentary, unskilled jobs, such as “addressing clerk,” 

“telephone quotation clerk,” “charge-account clerk,” and “inspector of film touch-up.” 

Applying the administration’s five-step analysis, 20 C.F.R. § 404.1520(a)(4), the 

ALJ first determined that Pytlewski had not engaged in substantial gainful activity 

since his alleged onset date (Step 1). The ALJ next found that although Pytlewski’s 

impairments were severe (Step 2), they did not meet or equal a listed impairment (Step 

3). The ALJ assigned a residual functional capacity consistent with the hypothetical 

claimant described to the VE, (Step 3), and then found Pytlewski unable to perform any 

past relevant work (Step 4). Finally, the ALJ concluded that because Pytlewski could 

perform jobs existing nationwide in significant numbers, he was not disabled (Step 5). 

For purposes of this appeal, the crucial step was the ALJ’s assessment of 

Pytlewski’s RFC, and particularly the ALJ’s decision to give more weight to the stateagency psychologists’ opinions than to the opinions of either Dr. Benish or Dr. Whalen. 

The ALJ assigned “significant weight” to the opinions of state-agency psychologists 

Drs. Donahoo and Phillips, finding their assessment “in line” with the RFC limitations 

that the VE described and the medical evidence. The ALJ assigned “some weight” to Dr. 

Benish’s opinion; his consultative examination was “clouded” by Pytlewski’s “possible 

factitious/malingering behaviors,” but his opinion “allowed” for the assessed RFC and 

was consistent with the medical evidence. 

The ALJ accorded the least weight to Dr. Whalen’s reports. The ALJ assigned 

“limited weight” to the doctor’s September 2016 opinion, which identified no more than 

mild mental and social limitations. He assigned “little weight” to Dr. Whalen’s 

November 2016 opinion, which (1) factored in Pytlewski’s back and neck 

impairments—ailments beyond the doctor’s expertise; (2) was “entirely incompatible” 

with his prior opinion and gave no explanation for this incompatibility, including the 

doctor’s prior concerns of malingering; (3) relied on Pytlewski’s unsupported statement 

that he had lost thirty jobs in recent years; (4) conflicted with his own contemporaneous 

treatment notes that reflected good grooming, cooperative behavior, euthymic 

(tranquil) mood, normal speech, as well as good cognition, memory, judgment and 

reality testing; and (5) was “extreme” and “not in keeping” with other evidence that 

Pytlewski could tend to basic daily activities without experiencing “episodes of 

decompensation as shown by hospitalizations.” 

 After the Appeals Council denied review, the district court upheld the denial of 

benefits. Of relevance here, the court concluded that the ALJ’s reasons for assigning 

little weight to Dr. Whalen’s second opinion were logical and supported by substantial 
No. 18-1629 Page 5 

evidence. The court rejected Pytlewski’s argument that Dr. Whalen’s second opinion 

sought to account for new evidence of physical difficulties, stating that Dr. Whalen, a 

psychiatrist, “appeared merely to have credited Pytlewski’s subjective reports of [back] 

pain,” which was outside his area of specialty. 

II 

On appeal, Pytlewski first generally contends that the ALJ erred by improperly 

giving more weight to the state-agency psychologists’ opinions (Dr. Donahoo’s and Dr. 

Phillips’s) than to a treating physician’s opinion (Dr. Whalen’s). 

Under the treating-physician rule, ALJs may assign greater weight to the 

opinions of treating physicians, who are more familiar with a claimant’s conditions than 

non-treating physicians. Gudgel v. Barnhart, 345 F.3d 467, 470 (7th Cir. 2003); 20 C.F.R. 

§ 404.1527(d)(2). “An ALJ who does not credit [a treating source’s] opinion must offer 

good reasons for doing so and must address the appropriate weight to give the 

opinion.” Stage v. Colvin, 812 F.3d 1121, 1126 (7th Cir. 2016); see also 20 C.F.R. 

§ 404.1527(c)(2). We review an ALJ’s decision to give more weight to state-agency 

doctors’ opinions than a treating physician’s for substantial evidence. 42 U.S.C. § 405(g); 

Ketelboeter v. Astrue, 550 F.3d 620, 625 (7th Cir. 2008). 

Substantial evidence supports the ALJ’s decision here to give more weight to the 

state-agency psychologists’ opinions than to Dr. Whalen’s. The ALJ appropriately 

discounted Dr. Whalen’s second opinion because he found that the “extreme” 

assessment of Pytlewski’s “total occupational and social impairment” was “entirely 

incompatible” with Dr. Whalen’s opinion two months earlier. A reasonable person 

would accept the ALJ’s conclusion, particularly given that Dr. Whalen’s second opinion 

did not explain the marked change or account for his earlier concerns about Pytlewski’s 

malingering. 

Pytlewski next argues that the narrative findings from the state-agency 

psychologists did not include all the limitations that they marked in the checklists 

accompanying their reports. For example, the two state-agency psychologists wrote that 

Pytlewski could maintain concentration and persistence to complete workweeks 

performing simple repetitive tasks—even though both found him moderately limited in 

maintaining attention and concentration for extended periods. 

This argument fails because the state physicians’ checklists in fact are consistent 

with their narratives. Consider: in the checklist, Dr. Donahoo found that Pytlewski was 
No. 18-1629 Page 6 

“not significantly limited” in his ability to “carry out very short and simple 

instructions,” “sustain an ordinary routine without special supervision,” and “make 

simple work-related decisions.” These findings are consistent with Dr. Donahoo’s 

narrative that Pytlewski is “capable of maintaining concentration and persistence to 

complete workdays and workweeks in performance of simple repetitive tasks.” Nor are 

Dr. Phillips’s narrative sections inconsistent with his checklist observations. For 

example, Dr. Phillips’s narrative that Pytlewski could “maintain attention for two hours 

at a time and persist at simple tasks over eight- and forty-hour periods with normal 

supervision,” is consistent with his checklist findings that Pytlewski was “not 

significantly limited” in his ability “to ask simple questions or request assistance” or “to 

maintain socially appropriate behavior,” and only “moderately limited” in his ability 

“to interact appropriately with the general public,” “to accept instructions and respond 

appropriately to criticism from supervisors,” and “to get along with coworkers or peers 

without distracting them or exhibiting behavioral extremes.” 

Pytlewski next contends that the ALJ formulated the RFC and hypothetical 

question with restrictions that did not adequately account for his moderate limitations 

in concentration, persistence, and pace. The hypothetical that the ALJ posed to the VE 

contained the following mental restrictions: 

 Limitation to simple, routine and repetitive tasks; 

 No fast-paced work; 

 Only simple, work-related decisions; 

 Occasional workplace changes; and 

 Occasional interaction with the public, coworkers or supervisors 

Pytlewski argues that restricting him to occasional interaction with the public, 

coworkers, or supervisors does not adequately account for his intermittent explosive 

disorder—and so failed to properly orient the VE. 

We see no error in the ALJ’s assessment. The ALJ tied the RFC to the evidence in 

the record—he tailored Pytlewski’s workplace setting to accommodate for Pytlewski’s 

anxiety, depression, and anger issues by limiting his interaction with people and 

restricting him from making high-stakes decisions. See Jozefyk v. Berryhill, 923 F.3d 492, 

497–98 (7th Cir. 2019). Although we often reject the idea that a hypothetical confining 

the claimant to “simple, routine tasks and limited interactions with others adequately 

captures temperamental deficiencies and limitations in concentration, persistence, and 

pace,” Moreno v. Berryhill, 882 F.3d 722, 730 (7th Cir. 2018), such a hypothetical may be 

adequate when it restricts a claimant with “stress- or panic-related” limitations, as is the 
No. 18-1629 Page 7 

case here, given Pytlewski’s recurring anxiety, to low-stress work. O’Connor-Spinner v. 

Astrue, 627 F.3d 614, 619 (7th Cir. 2010) (collecting cases). Pytlewski cites no evidence 

that his moderate limitations in concentration, persistence, and pace prevent him from 

completing “simple, routine and repetitive tasks” while being restrained to occasional 

interaction with others. See Jozefyk, 923 F.3d at 498. Under the substantial-evidence 

standard, a reasonable person would accept the ALJ’s conclusion that these mental 

restrictions were consistent with Dr. Whalen’s monthly treatment notes reflecting “good 

cognition, memory, insight/judgment,” and, most importantly, given Pytlewski’s 

concern regarding his intermittent explosive disorder, “cooperative behavior.” 

One last note. Although ultimately harmless, the ALJ engaged in circular 

reasoning when he evaluated the weight of medical opinions based on their consistency 

with the RFC assessment. The ALJ noted, for instance, that Dr. Donahoo’s and Dr. 

Phillips’s opinions were “in line” with the RFC’s limitations, that Dr. Benish’s 

assessment “generally does allow” for the assigned RFC, and that Dr. Whalen’s opinion 

“generally allows for the work articulated” in the assigned RFC. These statements put 

the cart before the horse: "the determination of [RFC] must be based on the evidence”; 

medical opinions should not be forced into a “foregone conclusion.” Filus v. Astrue, 

694 F.3d 863, 868 (7th Cir. 2012); see also Bjornson v. Astrue, 671 F.3d 640, 644–46 (7th Cir. 

2012). The RFC is constructed from medical assessments; justifying the weight of those 

same medical assessments by their consistency with the RFC is circular. See 20 C.F.R. 

§§ 404.1527(b), 404.1545(a)(3). This error, however, was harmless, given the ALJ’s 

careful review of the record and tying of the RFC to the record evidence.

 AFFIRMED