# United States Court of Appeals

For the Seventh Circuit Chicago, Illinois 60604

Argued August 8

, 2018
Decided August 16 , 201 8

Before

WILLIAM J. BAUER

, C ircuit Judge

FRANK H. EASTERBROOK

, Circuit Judge

MICHAEL B. BRENNAN

, Circuit Judge

No. 18

- 1021

STEPHANIE D. WEST, Plaintiff

- Appellant

,

v.

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant

- Appellee

. Appeal from the United States District Court for the Northern District of Indiana, Fort Wayne Division.

No. 1:16

- CV

- 424

William C. Lee, Judge

.

O R D E R

Stephanie West applied for suppleme ntal security income, 42 U.S.C. § 1382c(a)(3), and child’s insurance benefits (for herself, through her father), 42 U.S.C. § 423(d), alleging disability based on numerous mental and physical impairments.
An administrative law judge (“ALJ”) found that, desp ite her impairments, she could perform a limited range of light work. West argues that the ALJ failed to consider her impairments in combination . Because substantial evidence supports the ALJ’s decision,
we affirm the judgment. NONPRECEDENTIAL DISPOSITION To be cited only in accordance with Fed. R. App. P. 32.1No. 18

- 1021 Page 2

West applied for disability benefits in October 2013, when she was 21 years old, based on bipolar disorder and a learning disability. She also suffers from chronic back and abdominal pain, migraines, asthma, obesity, anxiety, and attention deficit hyperactivity disorder, among other conditions.

During her hearing before the ALJ, West identified her chief complaints as
chronic back pain and headaches. Her back pain dated back to adolescence, when a child whom she was babysitting jumped on her and ruptured four disks in her spine.
The pain worsened around 2008, when she delivered her first child; it decreased around 2014, after she lost almo st 100 pounds. As for West’s migraine headaches, they

sometimes have required visits to the emergency room

.

At times

, West has received pain relie f from opioids and epidural

- steroid

in

jections in her back . In February 2013

, her doctor temporarily rescinded her prescription for pain medication because blood tests suggested that she had not been

t aking the drug. In July, West told her doctor that she stopped her medications because she “found out a couple months ago that she was pregnant” and had also lost he r insurance coverage. Without her medications West felt “tremendously better .... bet ter than she ever ha[d].” She soon resumed taking opioids, thou gh, and her pregnancy apparently did not result in a bir th.

West’s mental impairments also limit her functioning. She takes medications for anxiety and bipolar disorder

. In 2010 she underwent several days of inpatient treatment after she experienced suicidal ideation

. She was also a poor student, having attended special

- education classes until she dropped out of school in eighth grade. She has failed
the GED exam three times and the driver’s licen se exam seven times.

A consultative psychologist, Wayn e Von Bargen, examined West in connection with her applicati on for benefits. After administering an intelligence test, Bargen assessed her an IQ of 78, placing her in the borderline range of intelligence and in the seventh percent ile for her age. He opined that people with West’s level of intellectual abilities can perform “unskilled or semiskilled occupations, involving concrete,
relativel y repetitive tasks.” He added that although West would “usually” require supervision, “independent job functioning is p ossible.”

A physician and two psychologists also opined about West’s abilities based on their review of her medical records. The physician concluded that she had no exertional, postural, manipulative, visual, or communicat ive limitations. The two psycholo gistsNo. 18

- 1021 Page 3

concluded that West was mildly limited in her ability to maintain social functioning and maintain concentration, persistence, an d pace. But they noted no severe impairments or episodes of decompensation, and they assessed no restrictions in West’s a c tivities of daily living.

At the hearing in June 2015, West, who weighed 165 pounds and stood 5’8” tall,

was 7 months pregnant. She had been out of work since January 2015, when she had quit her full

- time job as a waitress because her employer would not a ccommodate

pregnancy

- related restrictions that her doctor had imposed, i.e., she was not supposed
to l ift heavy tables. Before that she had worked part

- time at a pizza restaurant but quit after three or four months because her back pain left her unable to lift heavy pizza dough out of a machine. She also worked “almost full

- time” for less than two months in
the drive

- thr o u gh window of a fast

- food restaurant; she quit because she had moved and because “it was just too ho t there to work.” West said that the d ifficulties she experienced performing these jobs wer e “mostly physical.”

Asked by the ALJ to estimate her abilities, West said that she could walk at least half a mile, stand for an hour, and lift ten pounds, albeit with pain. But she offered more
modest estimates when questioned by her atto rney: She estimated that there we re days
when she could walk no more than a block and stand for no more than five minutes. She added that during periods of stress it was “almost impossible” fo r her to

concentrate.

A v ocational expert testified about the number of jobs that someone with We st’s limitations could perform. The ALJ asked the VE to consider a claimant with West’s age, education, and work history who (subject to limitations for certain extreme postures and

wo rk environments) had the physical capacity to perform light work and who had the mental capacity to perform “simple, repetitive tasks on a sustained basis,” but could not perform “fast paced work or work requiring a regimented pac e of production.” The VE

t estified that such a person could work as a cashier, retail marker, dining

- room attendant, or routing clerk. The VE added that the cashier or routing

- clerk positions would still be available if the claimant needed to alternate between sitting and stand ing every half hour. And if the claimant retained the functional capacity to perform only sedentary work, she could still work as an addresser, telephone

- order cle rk, or tube operator.

The ALJ denied West’s application for disability benefits

. First, the ALJ
determined that We st appeared eligible for benefits for any period of disability throughNo. 18

- 1021 Page 4

February 2015, when she married. Then, applying the requisite five

- step analysis, the ALJ determined that (Step 1) none of West’s prior work amounted to substantial gain ful activity ; (Step 2) West’s chronic back and abdominal pain, migraines, asthma, obesity (before her recent weight loss), bipolar disorder, anxiety, attention deficit hyperactivity disorder, and borderline intellectual functioning were severe impair ments ; (Step 3) none of those impairments equaled a list ing ; (Step 4) she retained the residual functional capacity to perform light work, subject to certain postural and env ironmental limitations, if it did not require complex instructio ns or a fast pace ; and (Step 5) she could perform the jobs that th e VE identified.

The Appeals Council denied West’s request for review, and the district court upheld the ALJ’s decision.

We struggle to discern from West’s appe llate submissions any coherent challenge to the ALJ’s decision. As best we can make out, she seems mostly to fault the ALJ for failing to consider her impairments in combination. In particular, West says, the ALJ ignored certain evid ence of her mental impairments. But this argument draws on little more than a selective reading of two psychological reports, one of which dates from when she was in fifth gra de. West, citing that dated report, contends that the ALJ
should hav e specifically discussed her unwillingness to ask for help and her problems
with “visual

- motor coordination,” “spatial visualization,” and “correctl y reading printed words.”

Even if we put aside the obvious problem that West’s abilities when she was a
fif th grader may not be representative of her abilities as an adult, West does not say (in her brief, or when asked, through her counsel at oral argument) what functional limitations the ALJ should have imposed to take further account of her mental impairment s. And the ALJ seems to have erred on the side of caution in formulating West’s residual functional capacity

— Dr. Bargen opined that West was capable of semiskilled work and the two reviewing psychologists opined that she had no serious mental impairments, yet the ALJ limited her to unskilled work that did not require complex instructions or a fast pace. West, in response, highlights Dr. Bargen’s observation that she would “usually” require supervision, while ignoring his conclusion that “independent job fun ctioning is po ssible” nonetheless. In the absence of any medical opinion contradicting those of the four medical professional s who all concluded that West can work, we cannot say that the ALJ erred in relying on those opinions to deny West’s application for benefits.No. 18

- 1021 Page 5

We have considered West’s remaining arguments and none merit discussion

.

AFFIRMED