United States Court of Appeals

For the Seventh Circuit

Chicago, Illinois 60604

Argued October 30, 2020 

Decided January 19, 2021 

Before

DANIEL A. MANION, Circuit Judge

ILANA DIAMOND ROVNER, Circuit Judge

MICHAEL Y. SCUDDER, Circuit Judge

No. 19-3544 

ADAM RECHA,

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. 3:19-cv-00317 

James D. Peterson, 

Chief Judge.

O R D E R

Adam Recha suffered a serious head injury during a car crash in November 2014. 

In the months that followed, he noticed an increase in the auditory hallucinations that 

he had first started experiencing in high school. Recha sought treatment and, at age 24, 

was diagnosed with schizophrenia. He is now 30 and seeks to reverse a decision of the 

Social Security Administration denying him disability benefits. While sympathetic with 

Recha’s condition, we conclude he has failed to show that the ALJ’s decision lacked the 

support of substantial evidence. We therefore affirm the denial of benefits.

NONPRECEDENTIAL DISPOSITION

To be cited only in accordance with Fed. R. App. P. 32.1
No. 19-3544 Page 2 

I 

A 

Adam Recha was 24 on November 24, 2014 when he crashed his car on an icy 

road in Wisconsin. The seatbelt he was wearing broke, and Recha hit his head on the 

windshield. He was transported to St. Joseph’s Hospital where a CT scan proved 

unremarkable. 

While hospitalized Recha saw a neurologist, Dr. Sarah Kortenkamp, who 

evaluated his cognitive ability. Dr. Kortenkamp noted some deficits, recommended that 

Recha refrain from working or driving, and instructed him to follow up with her in a 

few weeks. During the follow-up exam, Recha told Dr. Kortenkamp that he was 

experiencing some confusion and memory loss and could not recall the two years prior 

to the accident. Dr. Kortenkamp’s examination, however, revealed that Recha was “able 

to answer interview questions by referring to what his fianc[é] had recently told him 

about what occurred during the past two years.” It was during this exam that Recha 

first reported having auditory illusions (hearing screaming voices) and seeing 

“shadows and figures” that he knew were not real. Recha would later recount that he 

first started experiencing these hallucinations in high school.

A short time later, on January 23, 2015, Recha sought hospital admission because 

he was hearing voices telling him to kill himself and his cats. During his three-day stay, 

Recha was diagnosed with “Schizophrenia, not otherwise specified,” a cognitive 

disorder due to head injury, and “Cluster A personality traits.” After his discharge, 

Recha sought treatment from Randall Ahrens, a Licensed Clinical Psychologist, and 

Dr. Carol Barber, a psychiatrist.

Since approximately February 2015, Recha has seen Ahrens every two weeks and 

Dr. Barber monthly. He has consistently reported auditory and occasionally visual 

hallucinations that have waxed and waned primarily in conjunction with his stress 

level. Dr. Barber has frequently adjusted Recha’s medications based on his reported 

symptoms. Relevant to this appeal, in nearly every treatment record submitted as part 

of Recha’s application for disability benefits, Ahrens or Dr. Barber noted that Recha’s 

concentration was “clinically intact,” he was “able to participate in [the] interview with 

no more than average distractibility,” and his memory remained “clinically intact” with 

“no obvious short or long term memory deficits.”
No. 19-3544 Page 3 

B

On January 27, 2015, two days after being discharged from the hospital, Recha 

filed for disability benefits, alleging an onset date of September 28, 2014. After the 

agency denied the application, a hearing ensued before an ALJ in November 2017. 

Recha testified at the hearing regarding his symptoms, prior work history, and 

daily activities. He stated that, despite taking medications and receiving other 

treatment, he continued to hear voices several times a day. He added that he had 

difficulty sleeping, was uncomfortable in crowds of more than ten people, had trouble 

with his short-term memory, and struggled with authority figures. In response to 

questions about his daily activities, Recha testified that he helped with household 

chores, went to the grocery store a couple times a month, used the internet, and 

socialized with a few good friends and his girlfriend.

The ALJ also questioned a vocational expert and posed two hypothetical 

questions with varying restrictions to the VE. He first asked her the following: 

[A]ssume we have an individual who doesn’t have any 

significant exertional or other physical limitations; the individual 

could perform simple, routine, repetitive tasks; work that 

involves only brief, superficial contact with supervisors or the 

public; and the individual is able to tolerate simple changes in 

routine, avoid hazards, travel independently, and make or carry 

out simple plans.

The VE testified that someone with these limitations could perform Recha’s previous 

work as a “laborer of stores.” She further testified that someone with these limitations 

and Recha’s “vocational profile relative to age, education, and work history” could 

work as a housekeeper, cleaner, and stock clerk. 

The ALJ then asked the VE this second question:

[A]ssume it’s found that in addition to the restrictions we 

considered in our first hypothetical that due to the effects of 

concentration difficulties, occasional auditory hallucinations 

would cause the individual to be off task [and] unproductive 

25 percent or more of the workday, how would that [a]ffect the 

ability to do the jobs previously cited? 
No. 19-3544 Page 4 

This time the VE answered that there would be no competitive full-time employment 

positions available. 

After the hearing, the ALJ requested another psychological evaluation of Recha, 

which was performed by Dr. Brenda Reed. Upon reviewing Dr. Reed’s report, the ALJ 

issued his decision and concluded that Recha was not disabled. As part of applying the 

requisite five-step process, the ALJ crafted a residual functional capacity, or RFC, for 

Recha which attempted to capture the limitations on his daily work abilities. He found 

that Recha “can perform simple, routine, repetitive tasks; work that involves only brief 

superficial contact with supervisors or the public; and is able to tolerate simple changes 

in routine, avoid hazards, travel independently and make and carry out simple plans.” 

The ALJ also relied on the medical opinions of two agency psychiatrists, Dr. Lisa 

Fitzpatrick and Dr. Reed. Both doctors not only found that Recha had mild to moderate 

limitations in concentration, persistence, and pace, but also recommended only the 

types of restrictions the ALJ ultimately included in the RFC determination. The ALJ 

gave little weight to a short letter submitted by Recha’s psychologist, Randall Ahrens, 

offering the opinion that “Mr. Recha’s condition [has] a considerable and negative effect 

on his ability to be gainfully employed. More specifically, I see Mr. Recha’s condition 

[as] preventing, or at the very least making it extremely difficult, for him to obtain and 

retain any employment position.” The ALJ saw the letter as unsupported by the medical 

record, and, in any event, opining on an issue reserved to the agency. 

Recha appealed to the district court, arguing that the ALJ erred in crafting the 

RFC. He contended that the ALJ did not sufficiently account for his moderate 

limitations in concentration, persistence, and pace. The district court affirmed the ALJ’s 

determinations. Recha now appeals to our court.

II

At the heart of this appeal is whether the ALJ adequately accounted for 

limitations in Recha’s concentration, persistence, and pace, often shorthanded as CPP. 

As its name implies, CPP “refers to the abilities to focus attention on work activities and 

to stay on-task at a sustained rate.” 20 C.F.R. § Pt. 404, Subpt. P, App. 1, Listing 

12.00E(3). An ALJ’s RFC findings are intended to capture “the most [a claimant] can still 

do despite [his] limitations.” 20 C.F.R. § 416.945(a)(1); see also Moon v. Colvin, 763 F.3d 

718, 720 (7th Cir. 2014), as amended on denial of reh’g (Oct. 24, 2014) (“Residual 

functional capacity is the extent to which a person can still work despite having health 

problems.”). Recha asserts that the ALJ’s RFC determination did not sufficiently 
No. 19-3544 Page 5 

identify the difficulties he has related to the ability to concentrate over an entire 

workday.

Our review of the ALJ’s decision is deferential. We will reverse only upon a 

showing that the ALJ committed a legal error or rested its determination on less than 

substantial evidence. See Martin v. Saul, 950 F.3d 369, 373 (7th Cir. 2020). The substantial 

evidence requirement does not present a high hurdle: the ALJ’s decision need only 

identify “such relevant evidence as a reasonable mind might accept as adequate to 

support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). The ALJ’s 

determination here meets this benchmark.

Our case law makes clear that boilerplate “limitations of concentration, 

persistence, and pace” including limiting a claimant’s abilities to “simple, routine tasks 

that do not require constant interactions with coworkers or the general public” may be 

insufficient to address a claimant’s capacity. Stewart v. Astrue, 561 F.3d 679, 685 (7th Cir. 

2009). Recha seizes on this language and argues that the ALJ, by using such boilerplate 

language here, committed reversible error.

The problem for Recha is that our case law has clarified that an ALJ has some 

latitude with the exact wording of an RFC as long as it conveys in some way the 

restrictions necessary to address a claimant’s limitations. While we require “that the 

ALJ must account for the ‘totality of a claimant’s limitations’ in determining the proper 

RFC,” we have “decline[d] to provide a glossary of adjectives for use in RFC 

determinations.” Martin, 950 F.3d at 374 (citing Moreno v. Berryhill, 882 F.3d 722, 730 

(7th Cir. 2018) as amended on reh’g (Apr. 13, 2018)). Put another way, we have never 

required an ALJ to use the “specific terminology” of CPP in all cases and “have let 

stand an ALJ’s hypothetical omitting the terms ‘concentration, persistence and pace’ 

when it was manifest that the ALJ’s alternative phrasing specifically excluded those 

tasks that someone with the claimant’s limitations would be unable to perform.” 

Moreno, 882 F.3d at 730 (internal citations omitted). 

We assess whether an ALJ’s decision adequately accounts for an applicant’s 

limitations against the evidence in the record before the ALJ. The medical records 

submitted by Recha are replete with references to his self-reported hallucinations. But 

no medical opinion recommends limitations beyond those included in the RFC set by 

the ALJ. For example, Dr. Fitzpatrick noted that Recha was “able to maintain attention 

for two hours at a time and persist at simple tasks over eight- and forty-hour periods 

with normal supervision” but that his “symptoms would preclude persistence at more 

complex tasks over time.” Agency psychiatrist Dr. Susan Donahoo recommended 
No. 19-3544 Page 6 

similar limitations. These observations contradict the more restrictive CPP limitations 

that Recha contends the ALJ should have included in the RFC determination. 

Even more, the agency psychiatrist, Dr. Reed, noted that during her examination 

Recha “reported [the] ability to spend 1 hour on his models at a time without a break,” 

and concluded that Recha had only mild CPP limitations. Dr. Reed, too, did not suggest 

any additional limitations on Recha’s functional capacity beyond those determined by 

the ALJ. These medical opinions adequately support the ALJ’s decision.

Recha also challenges the weight the ALJ gave to the opinions of Dr. Fitzpatrick 

and Dr. Reed. He contends that Dr. Fitzpatrick’s opinion from November 2015 was 

outdated by the time the ALJ issued his opinion because the subsequent two years of 

treatment notes from Mr. Ahrens and Dr. Barber showed that his symptoms and 

medications continued to change. Recha also argues that the ALJ improperly gave 

significant weight to Dr. Reed’s opinion even though her accompanying report stated 

that she only reviewed 29 pages of medical records. Recha explained that he had 

submitted records totaling 697 pages. 

The difficulty for Recha, however, is that an ALJ does not commit an error when 

“there is no doctor’s opinion contained in the record which indicated greater limitations 

than those found by the ALJ.” Rice v. Barnhart, 384 F.3d 363, 370 (7th Cir. 2004). And 

here Recha has not provided any other credible medical evidence indicating that his 

symptoms required additional RFC restrictions to account for CPP limitations beyond 

those included in the ALJ’s decision. 

We recognize that Recha submitted a medical opinion letter from his treating 

psychologist, Ahrens, that noted “marked restrictions in [Recha’s] activities of daily 

living, difficulties with social functioning, difficulties maintaining concentration and 

repeated episodes of decompensation.” But this letter did not suggest any specific 

work-related restrictions. Additionally, the ALJ was correct to afford little weight to this 

evidence because many of the statements included in the letter—including references to 

Recha’s “illogical thinking” and “difficulties maintaining concentration”—were 

contradicted by Ahrens’s own treatment notes which almost universally indicated that 

Recha’s thinking was logical and coherent and reflected intact concentration. Dr. Barber 

recorded these same observations.

In the absence of any credible medical opinion or testimony to the contrary, the 

ALJ did not err in relying on the opinions of agency physicians which did not 

recommend any additional limitations beyond those the ALJ included in his RFC 
No. 19-3544 Page 7 

determination. Though we do not doubt Recha suffers from serious mental health 

challenges, the ultimate disposition of his appeal is tied to the record before the ALJ. 

Based on that record, we cannot say the ALJ’s decision limiting Recha to simple, 

routine, repetitive work with only simple changes in his daily work routine was not 

supported by substantial evidence.

For these reasons, we AFFIRM.