P u rsu an t to R u le 43 (c) (2) of t h e F e d era l R u les of A p p ellate  Pr oc edur e, we ha ve s ubs t i t ut ed Ca ro l yn W
. C olv in for M ic hael J
. Astr ue as the nam ed d efendan t- app el le e. The Hon or ab le Rober tL. M i l l er, J r. , Dis t ri c tJ udge ofthe  Uni t ed S t ates D i s t ri c tCour tf or the Northe rnDis t ri c tof I ndi ana , s i t t i ng by des i gna t i on.



## In the 

# U n ited S ta tes Co urt o f Ap p ea ls

F o rth eS e v e n th C ir cu it
N o. 12

- 2261 R EB EC CAE . P EPPER, Plai nt i f f

-Appe l l ant, v. C ARO LYN W . C O LV IN, Act i ng  Com m i ssi onero fS oci alS ecuri ty, D efend a nt-A pp ellee.

A pp eal from the United S t ates Di strictC our t fo r the C entral D istricto f Illino is. No . 1:11- cv-01007-JES

—Jam es E . Sh adid, Chief Ju dge .
A RG UE D J AN UA RY 16, 2013

— D ECI DE D A PRI L 4, 2013

Befo re B AUERa nd H A MI L T ON, C ircu it Judges , a nd M IL LER , D i s t r i ctJudg e . 2 N o. 12

- 2261 B AUER, Cir cu i tJudg e . Rebe c c a E
. Pepper s uffer s fro m num e r o us p hy s i c a la nd me nt a li mpa i r men t s tha ta ffect her abi l i ty to functi on. In 200 8, she ap p lied fordi sabi l i ty benefi ts, but the Ad m i ni str ati ve Law J ud ge ( A LJ) deni ed her cl ai m . N ow, afterunsuccess fully s eek i ng r el i effro m the di str i ct c ourt, Pepp er t u rns to us c onte nd i ng tha t th e A L J’s ru lin g is b ot h su b st an tiv e ly a n d p ro c ed u ra lly fl a we d. S pe c i fi c a l l y, P e pp e r a r g ue s : fi r s t, thatthe ALJ m ad e nu m erou s errors w he n ad d ress in g Pep p er’s residua lfunc ti o n c apa ci ty( RF C) , a nd s ec o nd, tha t th e ALJ ’ s c r e dib i l i t y de t e r mi na t i o n wa s i na de quat e l y s up port ed and patently w ro ng. W e be l i eve thatsubsta nti alev i dence supports the A LJ’ s den ial ofbene fi ts a n d a ffi r m.

I . B AC KGR OUND I n Se ptem ber2008, Pepper, then 54 yea rs o l d, appli ed f orS up ple m entalS ecuri ty Disabi l i ty I nsurance Benefi ts wi ththe S o ci alS ec ur i tyAdm i ni st r at i o n ( S S A), a l l eg i ng that she b ecam e unabl e t o w or k i n N ove m ber19 98 as a r esul t o fnum er ous physi caland m entali m pai rm ents. ( The al l ege d onsetdate w as l ate r am ende d t o O c tob er18 , 2 0 0 2 , th e d a t e P e p p e r l a s t wo r k e d

. ) T h e c r i t i c a li nq u i r y i s w h e th e r P e p p e r b e c a me d i s ab l e d a ta n y t i me pr i o r t o De c e mbe r 3 1 , 2 0 0 7, the da t e Pe pp e r wa s l ast i n s u re d

. Se eEichs t adtv. As t r ue, 5 3 4 F
. 3 d 6 6 3 , 6 6 6 ( 7th C ir. 2008). The S S A deni ed Pe pper ’s cl ai m b ut gr anted hera hear i ng with an A LJ, wh i ch w as hel d on October26 , 20 09.N o. 12

- 2261 3 A. Me di c a l Re c o r ds The extensi ve m edi calr eco rds in thi s ca se dem onst ra te th atPe ppers o ug htt r ea tmentf o r numer o us he al thc o ncer ns o verthe yea rs . A t va riou s t i m es, Pepper has bee n ass ess ed as havi ng the f ol l owing ongo i ng ai l m en ts : neck pai n and l i m i ted range ofm oti on in her neck, degene ra ti ve di scdi se as e i n h ers pi ne , l eft k ne e pr o bl ems, mig r aine headac h es , pro bl em s with hervi si on, di abet es, as thm a, m itral valve p rolapse , sciatica, d ysli p idem ia, h yp ergl ycem i a, hyper tensi on, al l er gi c rhi n itis , obesi ty, pl antar f as ci i ti s i n h erl eft he el, c ar egiv ers tr es s, a nd de pr es si o n. W e c o nfi ne o urdi s c us s i o n o fP e pp e r ’ s me di c a lr e c o r ds to th e inf or m ati on m ostr el evantto the A LJ’ s ul ti m ate d et er m in at ion an d th is a p p ea l.

1. Ph ysical Im p airm en ts
a. Kn ee,Back,and N eck Pro blems Pepp ersa i d that he r l eft knee pai n began i n 199 8 when s h e w a s g oin g u p an d d ow n a lad d er . Sh e t oo k a n tii nfl amm at o r y medi cine b utc l ai m ed i t di d no t r el ie ve the disc om f ort. A 20 00 m agnet i c r eso nance i m aging sc an ( M RI ) was ne g at i ve e xc eptfor s m al le ffus i o n a t th e kn ee. I n Jan ua ry 2003, Dr. C hristop h e r K afka, Pe p p er’s cousin, not ed that Pepp erhad a c hro ni c probl em with he r leftkn ee an d d ec re as ed ran ge of m ot ion, w h ich h e e st im ate d to be 1 0-2 5 d egr ees and opi ned that Pepp er wa l k e d wi th a l i mp a n d h a d b a c kp a i n a s a re su l t. An exam i nati on in Decem ber200 3 re veal ed the knee co ul d o nl y fl ex 2 0 deg r ee s an d m ade a c r ea k i ngs o und4 N o. 12

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T he pat i en ti s as ke d t o pe rfor m a s er i es ofm ane u v ers, 1 (co n tin u ed ...) wi th m o ve m en t, but th er e was no l o ca l ede m a (e xcess fluid). Pe p p er began seeing D r. X iaolu L i, a f am il y pra ctitioner, i n J an ua r y 2 00 4. S he no te d tha t Pe pp er c o ul d no t be nd he r l e ftkne e v e r y we l la nd h a d b a c kp ai n o n he r l e fts i de th at rad iated to h e r l eft knee. Pep p er com p lai ne d of a new knee pai n i n J uly20 05. A n x-raythatm onth was ne gative. In A ug us t 2 005, Pep p er saw Dr. Susan Go od ne r, a VA st affphysi ci an, wh o n ot ed t h at Pepp er“would not l et her m ove [ P ep p er ’s] l eft knee” and she “c oul d not for c e itint o flex ion .” P ep p er h ad an ap p oin tm en t w ith D r. J an elle R eg ier , a V A rh eu m a to log y fe llow , in O c to b er 20 05 . Pe p p er sa id the knee pai n had g one aw ay but that she coul d n ot flex her knee past 1 5 degr ees . Dr. Regi ernot ed that Pepper “wal k s wi tha l i m p a nd wal k s o n the l at er als i de o fthe ri ght foo t. ” Pepper coul d stan d w ith bo th feetfl at on the fl o o r wi tho utp a i n, “ wa l kh e e l

- t o e , ” a nd s t a nd o n he r h ee l s. S he had diffi cul ty sta nd i ng o n herti ptoes
. Dr. Rebec ca Tuetk en, a VA st affphysi c ian, ag re ed w i th Dr. Regi er ’ s a sse ssm ent. A l so i n Octobe r 2005 , Dr. S haun Ch ri ste nson , a V A r esi dent, not ed that P e p p e r f a v o r e d h e r l e ft l e g wh e n wa l k i n g “ d u e t o [ an ] old kn ee inj ury.” D r. J am es Pu tm an, a VA staff p h ys icia n, no te d in A p ril 20 06 th at P ep p er h ad art h rit is i n herknee s a nd bac k. I n Oc tobe r 2 00 7, Pe pperwas able to pe r f o r m a “ Get

- up an d Go Te st
. ” T ha t m o nth, Dr
. M i k e H ac k m ann, a VA 1N o. 12

- 2261 5

(
. . . c on t i nu e d) 1 i ncl udi ng s i t t i ng, s t andi ng up, an d wal ki ng a ro und. The p u rp ose of th e test is to assess a p erso n’s m ob ility an d ev alu ate th e i n d iv id u a l ’s ris k o f fall in g . S ee“G et U p an d G o T es t,” A m er i can A cadem y of

Neuro l ogy, htt p://w w w . aan. com /practi ce/ g u id el in e/u p lo a d s/2 7 3 .p d f (las t v isi te d A p r. 1 , 20 1 3 ). sta ffphysi ci an, not ed that P ep per’ s e xerci se tol er ance w as “ok ay. ” A progr ess not e fro m Decem ber20 07 stat es, “[ Pepp er ] was i nstr uc te d to e xerci se aer obi cal l y for20

- 30 m i nut es thr ee t i m es wee k l y a s di r ec te d by[ he r ] phy si ci an ” an d “t o in c re as e p h ys ica l ac tiv ity .” Pe pper to ld he r do ct o r s th ats he b eg ane xpe r i en cing l eft nec k pai n in 1994 when she was answeri ng phones w hi l e work i ng as a secr eta ry . In J an u ar y 2 003, Dr. Kafk a note d that P ep p er co uld o nl y r ota te her neck 5 deg r e e s t o the l e fta nd 7 5 de g r e e s t o the r i g ht

. He s a i d P e pper ’ s fl ex io n was wi th i n n o r m all i m i ts
. Exa m i na ti o ns i n F eb r ua r y 2 00 4 an d J an ua r y 2 00 5 did no t r ev ea la ny abnor m al i ti es. P ep p er sa id in Ju ly 20 05 th at sh e “h as to sita c e r ta in w a[ y] and turn her he ad t o see pro perl y. ” N eck x-r ays that m onth r eve al ed degener ati ve discdi sea se at C 5-6

— d isc spa ce n arrow ing an d a nt erior osteop hy te form at i o n. In Aug us t 20 05, P ep p ers aw Dr
. Go o dne r who w ro te , “ Testing ROM o fneckwas near l y i m possibl e. Ei th erthe pa ti en t co ul d no t under st an d m y di r ec ti o ns o r s he s i m pl y c o ul d no t m ak e he r ne ckmove a s Ii nst ru c te d h er to d o.” D r. G oo d n er fu rt h er st a t e d , “ [T ]h is al mo s t s t r i k e s me a s d e l ib e r a t e , b u t c a n n o t r u l e o ut early m ovem en t d isorder or rheu m atologic disord er[. ]”6 N o. 12

- 2261 InO c to b er 20 05 , D r. R eg i e r n o te d th at P ep p er co u ld no t r o ta te he r ne ckpa st3 5 deg r ee s ev entho ugh she no lon ge r h ad p ain . Pe p p er d id n otkn ow w h y s h e c ou ld not m ove herneck despit e the absence o fpai n. Dr. Regi er cou l d no t ex pl ain P eppe r ’ s l ac ko fr an g e o fmot i o n a nd sa id th at th e d e ge n er at ive d isc d ise as e d id n otex p lain P e p p e r ’ s s y mp t o ms . T h a tmo n th, P e p p e r t o l d D r . D e e ma Fat ta l, a V A s t a ffp hy s i c i a n, tha ts he “ he a r s c r a c k i ng/ noi ses ” in herneckand that, i n 199 8, hernecki ssues wer e ex as per at ed when c ar r y i nga he av y b o x wi tha cow or ker

. Fur therexam i nati ons by Dr. Chri ste nson r ev ea l ed 5/5 str en g thi n P eppe r ’ s uppe r a nd l o were xtr em i t i es, nor m al r ef l exes, and nor m al se nsati on despit e fi nd i ngs that ( 1) Pepper had “som e” cer vi cal os te oa rt h rit is; (2) h er righ t s te rn oc leid om as to id m u sc le ( l ar ge m uscl e o n the si de ofherneck ) was “hyper tr ophi ed” ; ( 3) sh e ha d dys to ni c po stur i ng ( he r ri g ht s ho ul de r wa s h i g he r tha n he r l e ft ) ; a nd ( 4 ) she ha d a hi nt o fl eft l ate ro col l i s ( ti l ti ng o fher h ea d). Pepper coul d onl y m ove hernecki n a “j er ky/n onstrai ght” path. In Octobe r 2005 , D r. Fa tta land Dr. Chri ste nson r ecom m ended Pepp erge t Bot ox inj ecti ons f orherneck probl em s. A n M RI o fPepper’ s s pine i n N ove m ber 2 00 5 reve al ed m i l d de g en er at i ve di se as e th r o ug ho utPe pper’s cer vic alspi ne with f or am i nalnar ro w i ng atC5- 6. Pepper saw D r. Ergun Uc, a VA s ta ffneuro l ogi st, the day after her M RI
. Pepper had a lim ited range o fm oti on in her neck that she c l ai m ed i m peded herdri vi ng and led to othe r com pensato rym eas ures . Pepper deni ed a n y si g-N o. 12

- 2261 7 ni fi cant pain. Dr. U c r epeate d D r. Chri ste n son’ s fi nd i ngs re ga rd i ng Pepper’ s hea d ti l t, abi l i ty to ro tat e her head, and el evat ed ri ght shoul der, and noted the J uly20 05 x-r ay fi nd i ngs. Dr. U c al so sta ted thatan e l ectr om yogr am (E M G) a nd ner ve study o fPepper’ s ce rv i cal paras pina l m uscl es w as nor m al, but that i t was notcl ear ho w m ucho fPe pper ’ s po stur e ab no rm ali ti es wer e due to the de g e ne r a t i v e j o i ntdi s e a s e . Dr
. Uc tho ughtBo tox i nj ec ti o ns mighti m pr o ve Pe pper ’ s ne ckr an g e o fmot i o n. I n Decem ber20 05, Dr. U c co ntacte d Pepp er with he r M RI r esul ts an d suggest ed that she t ryBoto x. Pepper sa id sh e w as n o t in te re st ed in t h e B ot ox injec tio n s. In N ov em b er 20 06 , D r. P u tm an w ro te th at P ep p er co u ld do a c t i v i t i e s o fda i l y l i v i ng“ o k a y . ” In De c e mbe r 20 07, D r. H ac km an n n ot ed th at P ep p er h ad a n “e p iso d e” in N ove m ber20 07 ofshar p pains al ong the l eft s i de ofher neck and back but thatPepper was “feel i ng m uch bett er . ” Dr. H ackm ann sai d this ep iso de w as m ost l i kelythe re sul t o fa m uscl e s tr ai n and re com m ended Pe p p er ap p ly he at an d perform range of m otion ex erci ses to r el i eve di sco m f or t.

b . V i s i o n P r o b l e ms P ep p er sa w D r. Jill B ro d y, an op h th alm olo gis t, ap p ro x im ate l y eve rysi x m onths fro m 19 97 to N ove m ber20 07. D r. B ro dy dia gnos ed Pepper with num er ous, l ongst an d in g v isio n iss u es , in c lu d in g c on ge n ita l es ot ro p ia (crossed eyes), nyst agm us ( rap id eye m ovem en ts), double vi si on, ve rt i go, suspect ed gl aucom a, the effects8 N o. 12

- 2261 ofm i gr ai ne headaches , and “m i l d” cata ra cts. A si de fro m cata ra cts, wh i ch Dr. Bro dy dis cove re d i n 200 4, Pepp er ha d m ost of these p ro b lem s at birth or several years bef or e s he st opped w or ki ng in 200 2. Du ring appoi ntm ents i n 199 9, 20 03 , and 200 5, Pepper tol d D r. Bro dy that she per i odi cal l y s ees ye l l ow spots. I n Se ptem ber19 99 and M ay 20 06 , Pe pp erco m pla i ned to D r. B ro d y of d iff i c u l t y r ea d in g a t t im es d u e t o b lu rriness. Pepper s aid “s m al lpri nt was m or e di ffi cul t t o see ” in N ove m ber20 07. A t va riou s a pp oi ntm ents fro m 19 98 to 2008 , Pepper had vi sualacui ty of20 /2 0 t o 20/30 i n each eye with g l a s s e s . ( 2 0 /2 0 i s n o r malv i si o n)
. In 2 0 0 8 , Dr
. Br o dy opi ned that Pepp erco uld r ead fi ne print o ccasi onal l y, am bul ate sa fel y, avo i d com m on haz ards i n the w or kpla ce, dri ve safel y, and perfor m a c ti vi ti es that re qui r e g o o d di st an t, de ta i l ed visi o n. S he de sc r ibe d the p ro gn os is for P ep p er ’s rig h t a n d leftey e a s “ fair .” Dr. Brod y also co ncl ud ed that Pepp erhas no depth perce pti on, has poorhand/e ye coo rdi nati on, and ge ts headaches fro m hernyst agm us.

c. R esp ir atory A il m en ts I n Decem ber20 03, Rod H yde, a VA physi ci an as si sta nt, note d Pepp erhad asthm a that w as “s tabl e o n i nhal er s” an d m ed ication. I n M ay 2005 , Dr. Li not e d that Pep p er’s as th m a was “ w o r se ni ng ” an d tha t Pe pperwas ha ving m or e c ou gh in g , w h ee zin g, an d sh or tn es s o f br ea th . InN o. 12

- 2261 9 October20 05, Dr. Goodner described Pepper’ s a l l er gi es as b eing“ y ea r r o und b utwor se i n s pr i ng, s um m er, a nd f al l

. ” Dr. Putm an not ed Pepper’ s a sthm a a nd al l er gi es i n Apr i l2 00 6. At tha t ti m e, Pe pper s aid he r b r ea th i ng w as stabl e, she got “g oo d rel i ef” fro m heri nhal er s, an d s he di d no t ha ve a ny c o ug h. Dr
. Put m annoted the s a me o b s e r v a t i o n s a ta n o th e r a p p o i n t me n ti n N o v e mber20 06. In M ay 2007, Dr. H ackm ann d es cribed P ep p er ’s a st h m a a s “ w ell c on tr o l l ed ” o n m ed ica tio n . In Se ptem ber20 07, Pepper c om ple ted a pu l m on ar y functi on t e s t, wh i c h r e s ul t e d in a “ no r malv e nt i l a t o r fun cti on” fi nd i ng.

d. M i gr ai ne H eadaches T h e m ed ica l rec or d s d em on st ra te co m p lain ts of m igr ai ne headaches to Dr. B ro dy as ear l y a s J anuary19 99. In J a n u a ry 20 03 , D r. K afk a n ot ed th at P ep p er h ad m igraines. H yd e note d that Pep p er’s m igrai ne s w ere “st abl e” on m edi cati on in Decem ber20 03. Dr. Li wrote that Pepp erhad bee n having m i gr ai nes in M ar ch 200 4, but th e y we r e “ b e t t e r ” i n Apr i l2 0 0 4
. P e pp e r t o l d Hy de i n Decem ber20 04 that her m i gr ai nes were bet ter c o n t r o l l e d a n d th a ts h e h a d n o c o n c e r n s r e g a r d i n gth e m. D r. Li note d Pep p e r had head ach es “on ce every 3-4 m onth[ s]” in Jul y 2 005. In A ugust 2 005, Dr. Goodner sa i d Pe pperha s m i g r aine s se ve r altimes monthl y b ut th ats he had g o ne s ev er almonths wi th o uta he ada ch e and gets “g oo d rel i ef” fro m m edi cati on. In Octobe r 2005 , D r. Fattal noted that Pep p er has f ou r m igrai n es p er year. I n A pri l20 06, and aga i n i n N ove m ber20 06, Dr. Putm an10 N o. 12

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m ade a no te o fPe pper ’ s p ast hi st o r y o fmig r aine s but d id n ot d iscus s the m furt he r.

e. O b esity I n Feb ruar y 2 000, Pepper w as 5' 1" and w ei ghed 158 pound s. H erbo dy m as s index ( BM I ) was 29. 9, wh i ch i s consi dered “over w ei ght” but not “obese

. ” See S. S. R. 02

- 01p, 20 02 SS R LE XI S 1, at *4-6
. A fterPepper s topped w or ki ng i n 200 2, herweight fl uctuated. In J anuary20 03, Dr. Kafk a s ai d he coul d not e val uate P ep p er’ s l um bar spi ne be cause she was o ver w ei ght. In Decem b er20 03, H yd e s a id P ep p er ’s w eig h t h ad inc re as ed ap p ro x im at ely 100 pound s s i nce 19 98 and she w as now m orbi dlyo bese

. I n Feb ruar y 2 004, Pepper wei ghed 192 pound s a nd had a BM Io f3 6. 4. In De ce m be r 2 00 4, Hyde s ai d Pe pp er’s ob es ity w as “w or se n in g,” P ep p er w as “m orb id ly o b es e,” and Pe pp e r ’ s o b e s i t y wa s a ddingt o h e r “ l i pi d/ s ug ar an d ba c k p ro b lem s.” I n Dec embe r 20 05 , Pe pper wei g he d 18 3 po und s and had a 3 5
. 1 BMI
. I n No v e mbe r 2 0 0 6 , s he we i g he d 174 poun d s, w i th a BM Io f33
. 0. In M ay 2007, Pepper was d ow n to 16 9.4 p ou n d s, w i t h a 32 .1 B M I. P ep p er w as to ld inO c to b er 20 07th at m ain ta in in g a h ea lth y w ei gh t w ou ld hel p control som e o fherai l m ents. On Decem ber6, 20 07, shor tl y b efo re Pepper’ s date l ast ed i nsured, Pepper w eig h ed 15 9.2 p o u n d s a n d h ad a B M I of 30 .1. T h is w as ap proxi m ate l y the sa m e wei ght Pe pp erweighed w hen she w as w or ki ng i n 200 2.N o. 12

- 2261 11 2. M enta l I m pairm ents T h e me d i c a lr e c o r d s d e mo n s t r a t e P e p p e r h a s c o mpl aine d of m en ta li m pai r m en ts o ve r the y ea r s. In J an uar y 2 003, Dr. Kafk a di agno sed Pepper with de press i on and anxie ty. H e no ted thatPep p erhad bee n str ess ed sin c e 1 99 4 b ec au se s h e f eltsh e m igh t los e h er j ob . In Dec embe r 2 00 3, Hyde no te d Peppe r ’ s depr es si o n b ut w ro te that i t was “s tabl e o n Paxi l

. ” H e d es c ribed heras
“ a l e r t, o r i e nt e d[ , ] a nd c he e r ful ” but wr o t e tha ts he h a d a “so m ew hat a nxio us m anner. ” In J anuary2004, Pepper com pla i ned off ati gue, poorm em or y, poor concentr ati o n, i r r i tabi l i ty, a nd b eingte arful ; Dr
. Lide te ct ed no abnor m al i ti es ofi nsi ght, j ud gm ent, o ri entat i on, m em or y, orm oo d at that t i m e. Dr. L i s i m i l ar l y dete cted no abnor m al i ti es i n M ar ch, A p ril, J uly, and N ove m ber20 04, th o ug h P epper agai n c o m pl aine d o fde pr es si o n a nd f a t i g ue a tthe No v e mbe r 2 0 0 4 e xa mi na t i o n. A d e pr essi on s c r e e ningwa s p o s i t i v e i n De c e mbe r 2 0 0 4 , b utHy de said P epper’ s depre ssi on was “s tabl e” and w ro te that i t was be tte r contr ol l ed and that Pepp erhad no c oncerns. I n J anuary, M ay, and J uly 2005 , Dr. Li descr ibed Pepper as ale rtan d int ac t a n d d e t ec te d n o a b n or m alit ies in her j ud g men t o r i ns i g ht

. Pe pp e r s a i d he r f a t i g ue was bett eri n J uly 2 005. In A ugust 2 005, Dr. Goodner note d that Pepp erhad “car egi verstre ss” afterPepper desc ribed “feeli ng blue, li ke he r l ife is over” bec au se it w as ha rd t o fi nd s o m eo ne t o wa t c h o v e r h e r di s ab l e d h usb a nd

. Dr
. Goo dn e r a l s o wr o t e th a tP e p p e r s e e me d “ s a d

. ” Ho weve r, Pepper decl i ned m edi cati on and co unsel i ng be cause12 N o. 12

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N aturopathy is a typ e ofa lternat ive m edici ne that f ocuses 2 o n th e r es to ra tio n o f he a lth th ro u g h v ita lis m o r th e n a tu ra l se lfh ea lin g p ro ce sse s. S ee“N aturop athy, ” Wik ip ed ia , h tt p :// en .w ik ip ed ia .o rg /w ik i/N a tu ro p a th y (la st v isi te d A p r. 1 , 20 1 3 ). sh e was wor k i ngwi tha na tu r o path a t ho m e. Abo ut 2 tw o w eek s l ate r, Pepp er tol d Li sa St ri tes ky, a s oc i al w or ker, thats h e coul d not workbec ause her husband n ee d s s up er vi si on a nd thatshe w oul d “feelr el i e v e d” o nc e the y h a d mo v e d. I n Octobe r 200 5 , Pepp er to l d D r. Chri ste nson her moo d wa s “ fi ne . ” In De c e mbe r 2 0 0 5 , P e pp e r t o l d D r . Li that she was under a lot ofst re ss tak i ng ca re o fher parents ; howe ve r, h erener gy w as bett er, and she w as sl eepi ng be tter. A t that a pp oi ntm ent, Dr. Li to l d Pepp er ab o u tth e r e l a t i o n s h i p b e t we e n P e p p e r ’ s h o r mo n a li mba l an ce a nd he r b o dy phy si o l o g y a nd func ti o n, a nd checke d t o see i fPepper was usi ng herhor m one cre am c o r r e c t l y . ( D r . L id i s c u s s e d th i s w i th P e p p e r o n n u mer ous occa si ons between 2004 and 2 007)
. I n A p ril 2006, Dr. Putm an noted thatPepper di spl aye d app ro pri ate i n s i g h t, j u d g me n t, mo o d , a n d a ffe c t ; D r . L ima de si m i l aro bser vati ons i n N ove m ber20 06, al though Dr. Putm an not ed d ep re ssi on a s a n acti ve probl em dur i nga no th erNov embe r 2 00 6 ex ami na ti o n. In M ay 2007, a depressi on s cre eni ng was nega ti ve. In O c to b er 20 07, a lice n se d p ra c tic al n u rs e s ai d P ep p er d id no th a v e a n a l t e r e d c o g ni t i v e s t a t us . Ata s e pa r a t e a ppo i nt m en t i n Oc tobe r 2007, Dr
. Lidi d no t det ec t an yN o. 12

- 2261 13 abnor m al i ti es w i th Pepper’ s m em or y, m ood, affect, in sig h t, or ju d gm en t. In Ja n u ar y 2 00 9, H ow ar d T in, a psychol ogi st, r evi ew ed Peppe r’s m edi cali nfo rm ati on fro m befor e herl asti nsured date. H e co ncl ud ed that ther e was “[ n]o psychi atr i c tr ea tm ent a nd no m ental m edi ca lt r ea tment ” be f o r e th ena nd “ th er e i s i ns uffi ci en t m ed ica l info rm at ion to es ta b lish an y k in d of m en ta lly d isa b elin g [s ic] im p air m en t b efo re th e D L I.”

B. Octo ber 26,20 09 H eari ng A t the hear i ng with th e AL J, Pepper t est i fi ed that sh e i s m ar ri ed w i thout chi l dren and the pri m ar y c ar egi verto herdi sabl ed h usband, wh o suffer s fro m schi zop hreni a. S he i s 5 ' 1" and w ei ghs a pp ro xi m ate l y 1 70 pound s. S he i s a hi gh sc hoolgr adua te and re cei ved secr eta ri altr ai ni ng ata j unio r col l ege . S he i s r i ghthand ed and has a dri ver ’ s l i cense. The onl y re st ri cti on on herl i cense i s that s he m u st wear g l ass es. Pepper stat e d t h a t she w orked as a un it secretary in surge ry at M cDonough Dis tr i ct Hospit alunt il s h e qu i t in 200 2. Other em plo ym ent duri ng her26 ye ar s a t the hos pital en c om p as se d d iffer en t t a s k s a n d p os itio n s b u t m ain ly i nc l ud e d o ffi c e c l e r k, da t a e nt r y, mi c r o fi l m i ng, me di calr eco rds, adul t day car e, and publi c r el ati ons. T he A L J aske d P e p p er abou t her p hy sical i m p airm ents. Pri orto Decem ber31 , 20 07, Pepper t es tifi ed that she had di abet es, hypothy ro i dism , al l er gies, as thm a, an gioede m a, hives, neu rocar d iogenic syn cop e (f ainting), bone spurs, ar thri ti s in herl ower ba ck and l eft knee, bu lgi ng d iscs, m itral valve p rolapse , a he a r t m urm ur,14 N o. 12

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Pe ppe r s pe c i fi c a l l y t e s t i fi e d tha t, to he l p a l l e vi a t e h e r s ymp- 3 tom s, she rec eiv ed p hy sica l th era p y thro u g h th e V A ho sp ital, w he re she w as trea te d b y D r. Lefler, an in tern ist, ab ou t tw o to thre e t im es a m onth fro m 1 9 82 until2003. Pepp er al so s tat ed thats he w a s re ferred to D r. W hit e, an orthop edist, f or her k n ee in 19 9 8 , b u t h e d id n o t r ec o m m en d an y tr ea tm en t. ao r ti c val ve s te no si s, a nd a ha i r l i ne fr ac tu r e i n h err i g ht f oo t. Pepp er ’ s counsel sta ted that Pepp er al so h ad h yp er te n sio n, hig h ch ole st er ol, d iab et es m ellit u s, m ig r aine he ada ch es , ur ti ca r i a ( hi ve s), c r o ss ed ey es , a nd tem p orom an d ibular j oint d isorder (j aw pa in). The ALJa s k e d P e pp e r i fthe s e c o nd i t i o ns a ff ecte d basi c work functi ons lik e s tandi ng and w al ki ng, to wh i ch Pepp ersa i d yes. Peppe r te sti fi ed that her backm ake s it d ifficu lt for h e r t o sit“[f]o r ve ry lon g p er iod s o f tim e.” She al so sai d that her back causes her diffi cul ty w h en l i fti ng, car ry i ng, and bendi ng. Then, afterPepper descr ibed the doctor s s he sa w f orherv ar ious physi cal ail m en ts, the A L J asked Pep p er i f an y of th e d octors

3 pu t s p eci fi c r est ri cti ons on herphysi calact i vi ti es. Pepper sa i d Dr

. M ax Re xr o at, he r po di at r i st, g av e he r a wal k i ng l i m i tat i on, but she c oul d not pro vide m or e deta i lo ther than s h e w as supp ose d to re m ai n offherfeet
. Pepper a l s o t e s t i fi e d t o we i g htg a i n a s a si de e ffe c to fthe me di cati ons she t oo k. P ep p er w as as ke d ab ou t a ty p ica l d ay . P e p p e r sa id she g ets up at about 8: 00 or8: 30 a. m . , ta kes herm edi catio n s w ith h er br ea kfa st, a n d ge ts h er h u sb an d ’s p ills tog ether

. Pepper then tur ns herat tenti on t o her pets

— o neN o. 12

- 2261 15 dog a nd f our cats

— fr o m abo ut8 : 30 to 9:30. Dur i ng th at tim e, sh e fe ed s h er an im als an d giv es h er d o g h is m edi cati on. A fterthat , s he ta kes herdog outsi de to pl a y . S he a l s o g e t s a do g fr o m a ne i g hb o r ’ s ho use t o pla y w i th her dog. Pepp er sai d s he cl eans her c at s’ li tte r box duri ng tha t t i m e a s wel l

. Pepper s pend s the r esto f th e m or n in g re ad in g “ p ap er s.” A ro u n d n o on , Pe p p er p re p ar es lun c h, w h ich u su ally co ns i st s o f“ fi x[ ed] pa ck ag ed s tu ffo r TV di nne r s. ” Dur i ng th e afternoon hou rs, Pe p p er said sh e looks at m ore papers and m aga zi nes, ta l ks on the phone w i th i nsurance c om p an ie s , a n d trie s t o w at c h O p ra h W in fre y’s te lev isi on s h ow . W hi l e doing thi s, she str etche s herbac k b y b en ding ove r tw o pil l ows on her bed. She al so uses th is t i me t o do l a un dr y a nd v i s i th e r mo the r, wh o li ve s a pproxi m ate l y 4 0 m i nutes a w ay. S he dri ves to see her m ot h e r o n e t o th re e t im es a m on th . A ro u n d 4:30 p .m ., P e p p er brings in her p ets an d prep ares d inn er forherse l fa nd herhusba nd. Af te r di nne r, Pe ppers pen ds th e re st ofthe eve ni ng watchi n g t el evi si on, l oo ki ng at m ore papers, and so rt i ng thr ough s om e bo xes. S he go es to bed ar ound m i dn i ght. The ALJ a sk ed Pe ppermor e g en er al q uest i o ns abo ut h er d a i l y l i fe. P ep p er te st ified th at sh e c an d re ss h er se lf but has tr oubl e putti ng o n hersho es, p an ts , a nd sho rt s. She i s abl e t o m anage m osto fherp er so n al hy gi ene; h ow ev er , sh e c an n otw as h h er h air or c lip h er to en ails because she i s un abl e to bend ove r i n the b athtub. Pepper al so t es ti fi ed to b eingabl e to g r o ce r y s ho p b y he rself, th o ug h he r hus ba nd do es th e ho us eh o l d di sh es and16 N o. 12

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sw eepi ng. Pepper doe s physi calther apy exe rci ses at hom e. She see s her f am i l y eve ry few m onths at h olid ays l i ke Thanksgivin g a nd Chri stm as. Pepper t est i fi ed that sh e p re fer s t o go ou t t o e at w ith frien d s o r fam ily on ly w hen g i v e n a tl e a s ta we e ko r t wo we e k s ’ n o t i c e b ecause sh e is afra id s h e m igh t fa in t fro m fat igu e. P ep p er sa id sh e fa in te d ap p ro x im at ely five tim es in 2 00 7 . Sh e s aid her hear t s tops w hen she fain ts, and she w or ri es that the peo ple ar ound her wil lnotkno w w h at t o do w hen i t happens. W hen ask ed i f she had a ny psychol ogi cal c ondit i ons, Pe ppers ai d s he was di agno se d wi th d epr es si o n a nd po ss ibl y po st
- tr au m at i c st r es s di so r der

. S he s ai d s he d o es not trust peo p le and w ou ld “rath er be w ith [her] an i m al s th anpeop le

. ” Pe ppera l so ha s a fea r o fl ea ving her house because she i s a fra i d ofr unning into f or m er co- w or ker s. S he does notbel ong to any s oci alo rg ani zations o ra c hur ch

. Pe ppers ai d s he r ec ei ve d c o uns el i ng f o r he r ps y ch o l o g i ca lc o ndi ti o ns dur i ngthe r el ev an t cl ai m pe r i o d, whi chi nc l ude d seeing so m eo ne wi tha M ast er’ s Degr ee i n Counsel i ng ab out eve rym onth for an hour

. Pepper s ai d she ha s troubl e co ncentr ating at hom e be cause ther e i s a l w ays so m et h in g el se to be done. S he al so has probl em s s l eepi ng. Pe pperwas a sk ed ab o uthe r phy si ca l p ai n. S he te st i fi ed to ha vingpa i n in h erj aw j o i nt s, ne ck, a nd l eft l o werb ac k

. S he ha s tr o ubl e ea tinga nd c he wi ng becau se o fs ha r p pa i ns s he g et s i fs he e at s so m ethi ng c h ew y or op en s h er m ou th to o w id e. Sh e h as n ec k p ain o n h erl efts i de th atr adi at es i nt o he r a r m pi t, e lbo w, a ndN o. 12

- 2261 17 fi nger s. Thi s pai n occ urs w hen she does cer tain thi ngs l i ke si tting atthe com puter too l ong orl i fting heav y b o x e s . P e p p e r e x p e r i e nc e s b a c kp a i n o r mu s c l e s p a s ms w hen she bends ov ero r engag es i n a l ot ofactivit y. Sh e a l so has t ro ubl e kneel i ng. H eat, i ce, m edi cati ons, an d i njections p rovide tem p orary rel ief

. Pepp erte sti fi ed tha t sh e c an l i ft a 17

- pound bago fdog orcat fo od b u t tri es not to l i ft m or e than 20 pound s. Pri orto 20 07, Pepper e sti m at ed that, duri ng an ei ghthour day, she coul d wal k one m i l e i n 30 m i nutes, th re e tim es a d ay ; sta n d for 1 5 m in u te s e ve ry h ou r; an d sit for an h ou r an d a h alf, th re e t im es a d a y . S h e w ou ld ra thersi t than sta nd , however, a n d w al ki ng o n uneven su rfa c es bo th er s h er ba c k a n d kn ee . Pe p p er h as tro u b le re achi ng the pedal s in h er car b ecause o fherhei ght, buts he s ai d she c an d r i ve the c ara nd o per at e th e s t e e r i n gw h e e lw i th o u ta n y p r o b l e ms

— the l i m i ted r ange of m ot ion in h er n e c k m ak es it d ifficu lt t o s ee tra ffic on h er l eft s i de, but the c ondit i on has notcause d a t ra ffi c ac ci dent. Pepp er s aid h ervi si on r equi re s herto have a com pu ter m oni tor“r ealcl ose ” t o her so she c an se e it, and herneck re qui r e s i t t o b e po s i t i o ne d t o he r r i g ht

. S he a l s o has m i gr ai nes tw o to thr ee ti m es a m onth, wh i ch cause “v om itin g , n au se a a n d tro u b les w ith so u n d an d

. . . bri gh t l i ghts. ” Pepper sai d m edi ci ne m ake s them go aw ay, but that “[i]t usual l y t ake s the day and som eti m es i nto the ne xt day. ” Pepper tes ti fi ed that her m i gr ai nes and dep re ssi on would cause h erto m i ss w or k m or e than th re e d ay s a m on th . Pe p p er als o t es tifie d th at sh e c ou ld18 N o. 12

- 2261 not do any ofherf or m erj obs bec au se she was “m ental l y, em oti onal l y, and physi cal l y exhausted ” p ri or to 2007
. The A LJ quest i oned Frank M endri ck, a voca ti onal ex per t ( VE) , a t th e en d o fthe he ar i ng . T he A LJ a sk ed th e VE , hyp ot h etic al l y, wh etherPepper woul d be abl e t o p er f or m any j obs i fhe found Pepp er ’ s t est i m ony full y cr edible an d a l lthe i m pai r m en ts wer e su ppo r te d b y the m edi cal evi dence. The VE sai d no bec ause Pepp er cl ai m ed she w ou l d have t o m i ss m or e than thr ee days of w or k p er m on th an d th at n u m b er is be y o n d w h at is nor m al l y pr ovi ded to an e m plo yee . Pepper’ s co unsel did notas k the VE any addit i onalquesti ons.
C. ALJ’ s D eci si on The A LJ deni ed Pep p er ’s cl ai m o n N ove m ber24, 20 09. I n the w ri tte n deci si on, the A LJ fol l ow ed t he fi ve- ste p proce ss as outl i ned i n 20 C.F
. R. § 404. 1520. A t s tep o ne, he f ound that Pepper had not e ngage d i n substa nt i al gainfulacti vi ty du ring the p er i od befo re the al l ege d onset da t e , O c t o b e r 1 8 , 2 0 0 2 , th r o u g h h e r d a t e l a s ti n s u r e d, Dec embe r 3 1, 2 00 7. At s te ps two a nd thr ee , he f o und th at Pe p p er had a com binat ion of sev ere im p airm ents

— d egenera ti ve discdi sea se w i th sc i ati ca, o besi ty, hypertensi on, hyper gl ycem i a, hypothy ro i dism , vi si on p r o b l e ms , a n d a s th ma

—but thatnone ofthem m et or eq ua led an i m p airm en t in 20 C.F.R . § § 404.1520(d ), 404.1525 , or 404.1526
. Th e A L J also f ou nd that Pep p er’s me n t a li mpa i r me n to fd e p r e s s i o n wa s n o ts ev e r e . AtN o. 12

- 2261 19

P ep p er s p en d s con sid era b le tim e exp lain ing ho w the d is- 4 t ri c tc our tm ade num er ous m i s t ake s whenr ev iew i ng the (co n tin u ed ...) st ep f o ur, the ALJ de te r m i ne d tha t Pep p er ha d the RF C t o per f o r m l i g htwor k, a s defi ne d i n 2 0 C. F
. R. § 40 4. 15 67, wi ththe e xc ept i o n tha t sh e av o i d c o ncentr ate d exposure to pulm onar y i rrit an ts and hazar ds. I n m aking hi s RFC deter m i nati on, th e AL J co nsi dered Pepp er ’ s v ar i ous p h ysi caland m entali m pai rm ents and the r el evantm edi calr eco rds and te sti m ony fro m Pe pper . The ALJ a l so no te d tha t Pep p er ’ s te st i m o ny r eg ar di ngthe “ i nt en si ty, pe r si st en ce, and l i m i ting effec ts o f[ he r ] s y m pto m s” was no t ful l y c r edibl e. The A L J th en conc lud ed t h a t P ep p er w as cap able of p erform ing her p ast relevan t w ork as a se c r etary, dat a ent ry c l e r k, an d o ffi c e c l e r kp r i o r t o D e c e mb e r 3 1 , 2 0 0 7
. As a r esul t, Pepper was notunder a dis abi l i ty pri orto her da t e l a s ti ns ur e d, a nd h e r c l a i m was de ni e d. The A pp eal s Counci ldeni ed Pepper’ s r equest f or re vi ew o f t h e AL J ’ s deci si on o n N ove m ber3, 20 10, so th e AL J ’ s r ul i ngb eca m e th e S S A’s fi na lde ci si o n o n the m at te r . Pe pperthe n fi l ed th i s su i t se ek i ngr ev i ew o fthe SS A ’ s deci si on under 4 2 U.S
. C. § 4 05( g)
. The di str i ct cour t ffi rm ed the A LJ’ s deci si on o n M ar ch 29, 20 12.

I I . DI S C US S I ON Because we r evi ew the dis tr i ct c ourt ’ s a ffi rm ance deno vo , w e re vi ew the A LJ’ s deci sion d ire ctl y. Jone s v. 420 N o. 12

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(
. . . c on t i nu e d) 4 ALJ ’ s dec ision , butthe s e c ont en t i ons ar e i rr el eva ntt o o ur in q u ir y h er e. Ast r ue, 623 F.3d 11 55 , 11 6 0 ( 7 t h C ir. 20 10 ). W e w ill r e v e r s e a n AL J ’ s d e t e r mi n a t i o n o n l y wh e n i t i s n o t s up po r te d b y s ubs tanti ale vi den ce , mean i ng“ su chr el ev an t evi dence as a re aso nabl e m i nd m i ght a c c ep t as a dequ ate to su pp or t a co ncl usi on. ” M cKi nzey v . As t r ue, 64 1 F
. 3d 884, 88 9 ( 7th C i r. 20 11) ( quoti ng R ich a rdso n v . P erales , 402 U
. S. 38 9, 40 1 ( 1971 ) ) (internalquotat i on m ar ks om i tted)

. W e wil lnot , h owever, r ew ei gh the ev i dence or su b st itu te ou r j u d gm en t fo r th at of th e A L J’s. Shi de l e rv. Ast r ue, 68 8 F
. 3d 30 6, 31 0 ( 7th Ci r . 20 12 )
. I n ren d er i ng a deci si on, an AL J “m us t b u il d a l ogi calbr i dge fro m the e v i de nc e t o h i s c o nc l us i on, buth e n e e d n o tp r o v i de a c om p let e w rit te n e v alu at ion of ev er y p iec e o f te st im ony and evi dence. ” Sc hm idtv. B a rnh a rt, 3 95 F. 3d 737, 744 ( 7th Ci r. 20 05) ( i nter nalci tat i ons and quotati on m arks om itted ). Pe p p er’s app eal f ocu ses on tw o m ain issues : the A L J’ s RF C de te r m ina ti o n and the A L J’ s cred ibi li ty d eterm ina ti o n.

A . R esid u al Fu n ction C ap acity Pepp erchal l enges the A LJ’ s RFC deter m i nati on o n a num bero fground s. A t s tep f our, the A LJ m ust deter m i ne the i nd i vi du al ’ s RFC, o r “w hat a n i nd i vi du al c a n s t i l ldo de s pi t e h i s o r h e r l i mi t a t i o ns . ” S
. S
. R. 9 6

- 8 p, 19 96 SS R L E X IS 5, at *5. T h e RF C re p re se n ts t h e m a x i-N o. 12

- 2261 21

mum a p e r s o n c a n do

— des pi te hi s l i m i ta ti o ns

— o n a
“ r e gu lar an d co n tin u in g b as is,” w h ich m ea n s ro u gh ly eig h t h ou rs a d a y f o r f i v e d ay s a w ee k. Id. T h e A L J in th is case con clud ed that Pep p er had t h e R FC to perform l i g htwo r k, wi th the c a v e a ttha ts he a v o i d c o nc e nt r ate d ex po su r e to pul m o na r y i rr i ta nt s an d ha za r ds. 2 0 C. F
. R. § 4 04. 1567 ( b) pro vi des the defini ti on f orl i ght work : Li g htwo r ki nv o l v e s l i ft i ngn o mo re than 2 0 p o un ds at a t i m e with fre quent l i fti ng o r c ar ryi ng o fo bj ects wei g hi ngup to 1 0 po unds

. Ev enthou gh the wei g ht m ay be very l i ttl e, a j ob i s i n thi s cate gory w he n it re qu i r e s a g o o d d e a lo fwa l k i ngo r s t a nd i ng, o r when i t i nv o l ve s si tt i ng m o sto fthe t i m e wi ths o m e pus hi ng and pu l l i ng o far m o r l eg contr ol s. To b e co nsi dered ca pab l e o fp erf o r m i nga ful lo r wi de r an g e o fl i g ht w or k, yo u m u st h av e th e ab ility to d o s u b s t an tia lly al lo fthes e a cti vi ti es. I fso m eone can d o l i ght work, w e d eter m i ne tha t he o r s he c ana l so do s ede nt ary w ork, un less there ar e ad d iti ona l li m iti ng f acto rs s uc h a s l o s s o f fi ne de xt e r i t y o r i nab i l i t y t o s i t f or l ong peri ods o fti m e. W e addr es s ea cho fPe pper ’ s RF C c ha l l en g es i n tur n.

1. A ssessment o ft he I nfo r m at i on Pepp erfi rs t a rgues that the A LJ’ s RFC determ i nati on w as “e rro n eo u s” as a w h ole be c au se th e A L J “m er ely sum m ar i zed s om e ofthe m edi calev i dence w i thout asse s s me n t o r d i s c u s s i o n s p e c i fy i n g h o w th e me d i c al a nd othe r evi dence sup p orted hi s co ncl usi ons, ” a nd ther e-22 N o. 12

- 2261 f o r e , i tdi d n o ts a t i s fy the r e qu i r e men t s o fS
. S
. R. 96

- 8 p. W e di sa g r ee . Af te r s et tingf o r thhi s RF C de te r m inati o n, th e A L J p ro vi d e d a len gt h y d isc u ss ion of P ep p er ’s t es tim ony re gar ding al lheri m pai rm ents and the info rm ation in the m ed ical record s. T he A L J d escribed Pep p er’s j aw , f oot, ch est, n eck, and shou lder p ains; her fear of nearf ain ting epi sodes; herr espi ra tory i ssues ; herm ental i m pai rm ents ( m ai nl y, depres si on) ; herm i graines; her w ei ght g ain and ob esi ty; and hervi si on probl em s. A fter do i ng s o , he c o nc l ud e d tha t e a c h o f the i mpa i r men t s o r ailm en ts su p p or te d th e ligh t w or k lim ita t i o n . Th is is con sisten t w it h ou r repea ted assertion th at “an A L J’ s ‘ad eq u at e d i s c u ss ion ’ of th e is su es n ee d n otco n ta in ‘a c o m p l e te w rit te n ev alu at ion of ev er y p iec e o f ev idence. ’ ” M cK inz ey, 64 1 F
. 3d at 891 ( quoti ng Sc hm i dt, 395 F. 3d at 744)
. The A LJ’ s di scussi on her e was adequate. To the exte nt Pepper ar gues that the decr eas ed ra nge ofm oti on in hernec k an d h erabi l i ty to si t foro nl y a sh ort per i od ofti m e a re i nconsi ste nt with the AL J ’ s RFC as se ss m en t, th is a rg u m en t is u n c on vin c in g. T h e o n ly doctorto o fferan o pini on about Pepp er ’ s abi l i ti es tha t a r g uab l y c o ul d b e i nc o ns i s t e nt wi th he r c a pa c i ty to do l i g htwor kwas Pe pper ’ s co us i n, Dr. K afk a, i n 2 00 3. But even Dr. K afka d id n o t exp li citly op ine th at Pe p p er’s i m pai rm ents, i nd i vi du al l y or i n the agg re gat e, p re vente d her fro m co m p leting the ce nt r al ta sk s o f “ligh t w or k:” l i fti ng, walk i ng, st anding, and pushing and pu l l i ng with on e’s arm s an d legs

. See 20 C .F.R . § 40 4.1 56 7(b ); see a lso D ia z v . C ha ter, 55 F. 3d 300, 30 6- 07 ( 7th Ci r. 19 95) (des cr ib in g the evid en ce th e A L J con side red i n d eterm i ni ngthe c l ai m aintha d the RF C t o d o lighta ndN o. 12

- 2261 23 sed en tary w ork, i nc lud ing evid e nc e of one doc tor’s op in ion th at th e c laim ain t’s im p air m en ts “a ffe c te d h is abi l i ty to re ac h, push, and pull ”)
. The A LJ has the re spo ns ibi l i tyo fr es o l vinga ny c o nfl i ct s be twe enthe m ed ica l ev id en c e a n d th e c laim ain t ’ s t es tim on y. See Sh a uge rv. As t r ue, 6 7 5 F
. 3 d 6 9 0 , 6 9 8 ( 7 th Ci r . 20 12) ( quoti ng Ha ck er v. B a rnh a rt, 459 F.3d 934 , 936 (8th C ir. 2006 ) )
. H e di d that. Ou r tas k i s t o d eterm i ne wh ether su bs ta nt i ale vi den ce s uppo r ts the ALJ ’ s RF C con clusi on. W e be l i eve thati t doe s.

2. M i gr ai ne H eadaches Pe pp e r ’ s n e xta r g ume nti s tha tthe ALJdi d n o tadequa te l y c o ns i derhe r migrai ne he ada ch es i n de te r m i ni ng he r R F C. T hi s a r g ume nti s equ al l y u na v a i l i ng . T he ALJ men t i o ne d D r . F a t t a l ’ s Oc t o b e r 20 05 n o t e r e g a r di ngP e pper ’ s c o mpl a i nto fmi g r a i ne s o c c ur r i ngab o utf o urti m es per yea r. The A LJ a l so m enti one d D r. Putm an’ s no te that Pepp erco m pla i ned ofm i gr ai nes in 200 6, i n add ition to hi s obs er vati on that Pepp er com pla i ned of m igr ai nes t o Dr
. Br ody o n nu mer o us o c c a s i o ns . P e pp e r c o nt e nd s thi s was notsuffi ci ent b ecause herm igrai nes “ occur re d seve ra l t i m es a m onth a nd i n each i nstance i ncapaci tat ed he r f o r a tl e a s to ne da y . ” Bu tP e pp e r ’ s me di c a lr e c o r ds do not su p portthatco ntenti on, and an AL J i s no t re quir ed to disc u ss every s ni pp et ofi nfo rm ati on fro m th e m edi ca lr ec o r ds th at m i g htb e i nc o ns i st en t wi ththe re st of t h e o b j ec tiv e m ed ica l ev id en c e. Se eSi m i l a v. Ast r ue, 5 7 3 F
. 3 d 5 0 3 , 5 1 6 ( 7 th Ci r . 2 0 0 9 )
. T he o nly me di calr eco rd supporting Pepper’ s s tat em ent i s a not e24 N o. 12

- 2261 fro m A ugust 2 005 by Dr. G oo dn erthatsa ys, “[ Pati ent] has m i gr ai ne se ver alti m es m onthly, tho ugh she h as now g o ne 3 months wi th o uto ne . ” I n the di agno si s se ct i o n, h o we v e r, Dr
. G o o d n e r fu r th e r s t a t e s , “ MI GR AI NE

— quie t for now , good rel iefw ith m ed s w he n th ey d o occu r[. ]” Thi s st at ementi s i n a cc o r dan ce wi ththe r est ofthe m edi ca le vi den ce tha t i ndi ca te s Pep perha d m i g r aine he ada ch es a ppr o xi m at ely e ve r y few m o nths a nd the sy m pto m s wer e r el i ev ed wi thmedi ca ti o n, w hi chthe A LJ a p p ro pri ate l y found to b e m or e cr edibl e than P ep p er ’s t es tim on y (a s w e a d d re ss be low ). See M cK inz ey, 641 F
. 3 d a t8 9 0 ( c r e dib i l i t y de t e r mi na t i o ns mus tb e s up port ed by sub st anti alev i dence)

. To fi nd support f or thi s co nc l us i o n, o ne n e e d l o o kn o fur the r tha n the me di calr eco rd not es fro m the m onths before and after Dr. Goodner’ s Au gust 2005 not e: Dr. Li wrote i n her J ul y 2 0 0 5 n o t e tha tP e pp e r s a i d s he h a s h e adaches “once ev er y 3 to 4 m onth[s]”; and i n Octobe r 2005 , D r. Fa tt al w ro te th at P ep p er h as “4 m igr ain es p er y[e a]r .” This i s no t a situati on l i ke Ind o ran to v. B a rnh a rt, 374 F. 3d 470, 47 3- 74 ( 7th Ci r. 20 04) , wh er e the A LJ f ai l ed to d iscus s “ c h ronic seve re head ach es every d ay,” or Vil l ano v. As t r ue, 5 56 F.3d 55 8, 5 63 ( 7th Ci r . 2 00 9) , wher e th e AL J pe r f o r m ed a cur so r y a na l y si s an d di smi ss ed a l i ne of evid en ce w ithou t any discu ssion. W e beli eve th e A L J’ s di sc us si o n s uffi ci en tly a ddr es se d Pe pper ’ s m i g rai ne headaches and w as supp or ted bysubst anti alev i dence fr o m t he r e c o r d.N o. 12

- 2261 25 3 . V i s i o n P r o b l e ms Pe pp e r fur the r c o nt e nd s the ALJe r r e d wh e n discus singher vi si o n l i m i ta ti o ns b y o nl y r ely i ngo n a do cum en t t h at p os t-d at ed P ep p er ’s d a t e las t in su re d an d in not ad e q u ately exp lai nin g how Pep p er’s vi sion im p airm ents ar e add re sse d i n the RFC. A gain, we disa gr ee. Fi rs t, the docum ent a t i ssue w as fro m an e xam i nati on w i th Dr. Bro dy on Novem ber12 , 20 08. Dr. Bro dy sta ted that Pepp er ’ s eyesi ght with cor re cti ve l enses r anged fro m 20 /2 0 t o 20/30. Thi s a ssess m en t is co nsi ste nt with D r. B r od y’s prev ious eye ex am inations of Pe p p er’s ey es i g ht f r o m 1 99 8 to 2 00 7. Addi ti o na l l y, a l lb uto ne o fPe pper ’ s do cument ed ey e i m pai r m en ts were pr es en t seve ra lye ar s be f or e Pepper sto pp ed w or ki ng i n 200 2, whi chthe ALJ no te d i n h i s wri tt ende ci si o n. T hes e i ncl ud ed conge ni tales otr opi a, poss ibl e g l aucom a, vi sual ob sc u ra tio n, ny st ag m u s, an d t h e effe c t of m igr ain es . M ild cata ra cts w er e no ti ced i n 200 4, but they did notchange P e p p er’s vi su al acuity. T he A L J also noted Pep p er’s c om p lain ts to D r. B ro d y a b ou t h er d i f f icu lty se ein g s m all pri nt, di ffi cul ty re ading, se ei ng bl ack spots and fl ashes , an d seeing yell ow , allof w hich occu rred before Pe p p e r ’s date la s ti ns ur e d. We fi nd n o e r r o r s i n the i nfo r mati on the A LJ c onsi d er ed o r the AL J ’ s e xplanat i on wh en add re ssing Pepper’ s v i si on l i m i tat i ons. Furtherm or e, ther e i s no ev id en ce o fPepper’ s e ye i m pai rm ents substa nti al l y wors eni ng o r al ter i ng her abi l i ty to w or k duri ng the r el evantclai m per i od, wh i ch c ou ld h av e a lte re d th e A L J’s d et er m in at ion
. Se eEichs t a dt, 534 F. 3d at 666 ( sta ti ng tha t ce rt ai n condi ti ons p re -26 N o. 12

- 2261 dati ng the clai m ant’ s ins ured status w er e ir re l evantwh en evaluatin g the cl ai m ant’ s a pp l i cati on f orbene fi ts because th e cl ai m an t “ w as ab l e to e ng ag e i n s ubs ta nt i alg ainful em plo ym ent du ring and a fter experi enci ng these p robl em s”). Despit e Dr. Bro dy’s co ncl usi on that Pepper had no depth perc epti on a nd poo r hand /e ye coo rdi nati on i n 2 00 8, the r e i s no e vi den ce o fDr. Br o dy ev ero pi ni ng that Pepp erc ou ld not workdue to herey e i m pai rm ents. A nd si m i l ar l y, Pepper doe s no t direct us to any sour ce orautho ri ty to supp ort a contenti on that the effects o f h e r v i s i o n i mp a i r me n t s w o u l d p r e v e n th e r fr o m c o mp let in g a n y j ob in th e li gh t w or k c at eg or y. C f. S
. S
. R. 8 5

- 1 5 p, 1985 S SR LEX I S 20, at* 20- 21 ( “A s a ge nera lr ule, ev en if a p er so n ’ s v isu al im p air m en t(s ) w er e t o e lim in at e a ll j o bs t h a ti n v o l v e v e r y g o o d v i s i o n ( s u c h a s wo r k i ng wi ths m al lo bj ec ts o r r ea di ngs m al lpr i nt ) , a s lon g as he or sh e re ta in s s u fficie n t v isu al a c u ity to be a b l e to h an d le and w or k with ra therl ar ge obj ects ( and has the vi sual fi elds to avoid ord inary ha zard s in a w orkp lace), there w oul d be a subst anti alnum bero fj obs r em ai ni ng ac ro ss al lexer ti onall ev els .”)
. Thi s info rm ati on l eads us to ea si l y c o nc l ude tha t su bs ta nt i ale vi den ce s uppo r ts the AL J ’ s vi si o n de te r m i na ti o n.

4. O b esity W e m ove to Pepper’ s contenti on that the A LJ v i ol ate d S. S. R. 02

- 01p bynotpro perl y c ons id er i ng hero besi ty w h en f o r m u l at in g t h e R FC
. See S. S. R
. 02-01p , 2002 SSR LE XI S 1. The A LJ m ade a fi nd in g that Pe pp er ’ s obesi ty is severe

— i. e. , “s i gni fi cantl y l i m i ts [ Pepp er ’ s] abi l i ty toN o. 12

- 2261 27 engag e in w or k a cti vi ty. ” Acc or d in gl y, the A LJ was re q uir ed to di scuss “any functi onall i m i tat i ons re sul ti ng fro m the obe si ty” wh en f or m ula tin g his RFC as se ss m en t. Se ei d. at* 19. W e a gr ee w i th P ep p erthat the AL J di d not s peci fi cal l y undert ake such a n an al ysi s. W e hav e hel d, how eve r, thatthi s typ e o fer ro r m ay be h ar m l e s s w h en th e R FC is ba se d on lim ita tio n s id en tifi ed bydo ct o r s who spe ci fi ca l l y no te d o be si ty as a c o ntr ibut i ngf ac to r t o the e xa ce rba ti o n o fo th eri m pairm en ts
. S ee P roc ha ska v. B a rnh a rt, 45 4 F
. 3d 731, 73 6- 37 ( 7th Ci r. 20 06)
. That i s what occ urr ed her e. The A LJ no ted Dr. Kafka ’ s 2 003 obs er vati on that Pepp erhad decre ase d range o fm ot ion i n herl um bar sp ine bu t tha t Pep p er w as overw eight a n d i t w as d if

fi c ul tt o ful l y e v a l ua t e h e r ra nge o fmo t i o n. T he ALJ al so disc ussed Dr. Li’ s 2004 ass ess m ent of Pepp er ’ s a cti ve p roblem s: elevated li ver en zym es, hy p erli p idem ia, hyp ergl ycem i a, and ar ti fi ci alm enopause. Pepper com pla i ned to Dr
. Liabo utwei g htg ai n, a nd e ac h o ftho se c o ndi ti o ns c a n b e a g g r a v a t e d b y o b e s i t y . F ur the r mor e , the ALJ des cribed Dr. Put m an ’ s 20 06 a ss es smento fPe ppera nd h e r “ a c t i v e p r o b l e ms , ” w h i c h a l s o i nc l u d e d o b e s i t y . We believe thes e d iscus sions, com bined w ith Pep p er’s f ai l ure to speci fy ho w her obesi ty furtheri m pai re d her a b i l ity to w or k, d em on st ra te th at th e A L J ad eq u at ely c on sid er ed P ep p er ’ s o b e sit y. See Sk a rbek v . B a rnh a rt, 39 0 F.3d 500 , 504 (7th C ir. 2004) ( c o n c lu d ing tha t the A L J’ s f ai l ure to expli ci tl y c onsi der the cl ai m ant’ s ob es i ty w as incon seq ue nt ialbecau se th e claim an t d id n ot sp ecify ho w hi s o be si tyfur th erim p air ed hi s ab i l i tyt o wor ka nd th e A L J a d d ressed the li m itations su ggeste d by d octors28 N o. 12

- 2261

w ho oth erw ise consid ered the claim an t’s w eight). Any er ro r w as ther ef or e har m l ess .
5. Dep r essi on Pepp er ’ s o therar gum ents re l ating to the RFC fo cus o n th e A L J’ s tr ea tmento fhe r de pr es si o n. Hermai n c o nt en ti on i s th at t h e A LJ e rr ed by f ai l i ng to f ol l ow the pro

c ed u re for e va lu at in g m en ta l lim ita tio n s d es c rib ed in 20 C .F.R . § 40 4.1 52 0a , kn ow n as th e “ sp ec ial te c h n iqu e.” Thi s ar g um en t ha s so m e tr ac ti o n. T he sp ecial techn iqu e requ ires the A L J to fi rst d eterm in e w h et h er a c laim an t h as a m e d i c ally d et er m in ab le m en ta li m pai r m en t( s)
. § 4 04. 15 20 a(b) ( 1)
. Thi s i s do ne by evaluatin g the cl ai m ant’ s “ pertinent s ym ptom s, si gns, and l abor ato ryfi nd i ngs. ” Id. I fthe cl ai m ant has a med i c a l l y de t e r mi nabl e me di c a li mpa i r men t, the ALJ m u st d ocum ent that fi nd i ng and r ate the degre e o f fu n c tio n lim ita tio n in fo u r b ro ad “ fu n c tio n al a re as :” acti vi ti es ofdai l y l i vi ng; soc i alfuncti oni ng; co ncentr ati on, persi ste nce, or pace; and e pis odes ofd ec om pensatio n . § 40 4.1 52 0a (c )(3) ; Craf tv. As t r ue, 53 9 F
. 3d 668, 674 (7t h C ir. 20 08 ). Th es e a re as a r e k n ow n as th e “ B cr ite ria .” SeeCraft, 53 9 F
. 3d at6 74 ( ci ting 20 C. F
. R. pt
. 4 04, s ubpt

. P, app. 1, §§ 12
. 00 et. s eq ). The fi r st th r ee func ti o na l ar ea s ar e r at ed o n a fi ve - po i nt scal e: none, m i l d, m oder ate , m ar ked, and e xtre m e. § 40 4. 15 20 a( c)(4). The fi na la r ea i s r at ed o n a f o ur - po i nt sc ale : n o n e, on e o r tw o, th re e, fou r or m or e. Id. The ra ting as signed to e ach functi onalar ea cor re sponds toN o. 12

- 2261 29 a dete rm i nati on o fse ver i ty ofm enta li m pai rm ent. § 4 04. 1520 a( d)( 1)
. I fthe i m pai rm ent i s co nsi dered se ve r e, the ALJ m us t det er m i ne whethe r the i m pai r m en t m eet s o r i s e quiva l ent in sev er i ty to a l i ste d m entaldi so r der

. § 4 04
. 15 20 a( d) ( 2)
. I fthe ment ali m pai rm en t ne i th ermeet s no r i s equivalent i n s ev er i tyt o a ny l i sti ng, the ALJwi l la s s e s s the c l a i man t ’ s R F C. § 4 04. 1520a(d)( 3)
. The A LJ m ust docum ent hi s use o f th e te ch ni que , i nc o r po r at i ngthe re l ev an t fi ndi ng s an d con clus ion s into the w ritten d ecision. § 404.1520a (e)( 4). The dec i si o n m us t ade qua te l y di sc us s “the si g ni fi ca nt hi sto ry, i ncl ud i ng exam i nati on a nd l abor ato ryfi nd i ngs, and the functi onall i m i tat i ons that w er e con sidere d i n r e a c h i n ga c o n c l u s i o n ab o u tth e s e v e r i t y o fth e [ c l a i mant’ s] m entali m pai rm ent( s)
. ” Id. Th e de c i s i o n m ust i ncl ud e “ a s peci fi c fi nd i ng as to the degre e o fl i m i tat i on i n eac h ofthe functi onalar eas [
. ] ” Id. The A L J di d no t ex pl i ci tly a ppl y the s pec i alt ec hni que w hen eva l uati ng Pepper’ s depre ssi on. This is cl earfro m th e w rit te n d ec isio n . Th e C om m is s i on er co n c ed es th is poi nt , i nstea d arguingthatPepper was nothar m ed by th i s o m i ss i o n. Inde ed, “ [ u] nde r s o m e ci r cum stanc es , the f ai l ure to expli ci tl y use the sp ecialte chnique m ay . . . be harm l ess er ro r. ” C raft, 5 39 F .3d at675. W e a gr ee w i th th e C om m issi one r. A t s tep t w o, th e A L J m ade the re quir ed sev er e o r no ts e v e r e fi nd i ng, c o nc l ud i ngtha tP e pp e r ’ s “ men t al i m pai rm en t of dep re ssi on” w as not seve re . H e di d not, h ow ev er , in te gr at e t h e re q u isit e p oin t s c ale s in to h is deci si on o r expli c itly referto the functi onalar eas . N one-30 N o. 12

- 2261 thel ess , we bel i eve the A LJ pr ovi ded eno ugh i nfo rm at i o n t o s up po r t the “ no t s e v e r e ” fi nd i ng . Th e AL J ci ted th e ab se nc e of p sychi at r i c o r ment almedi ca lt r ea tment pri orto the date l asti nsured, Pepper’ s g oo d res ponse to m edi cati on, and the agg ra vati on o fherco nd i ti on by h er res p on sib ilitie s a t h om e. T h e r ec or d m ed ica l ev ide nc e s up po r t s the s e a s s e r t i o ns . F o r e xa mpl e , Hy de st at ed th at P ep p er ’s d ep re ss ion in 20 03 w as st ab le onP ax il. Se ePr oc has ka , 45 4 F
. 3d at 73 7 ( “[ C] o nt r o l lable c o ndi ti o ns do ‘ n o te n t i t l e o n e t o b e n e fi t s o r b o o s to n e ’ s e n t i t l e men t bya g g r av at i nga no th ermedi ca lc o ndi ti o n. ’ ” ( quo ting B a rrett v. B a rnh a rt, 355 F. 3d 1065 , 1068 (7th Cir . 2 0 0 4)))
. In J anuary20 04, Dr. L i noted Pepper co m pla i ned off ati gue, po o r mem o r y, po o r c o nc en tr at i o n, i r r i tabi l i ty, b eing tea rful, and other sym ptom s; but her exam i nati on r eveal ed no abnor m ali ti es i n Pepper’ s insi ght o r j ud gm ent, or ien t at ion, m em or y or im p air m en t, an d m oo d . In O c to b er 2 00 5, P ep p er s ta te d h er m oo d w as “ fin e.” E x am in at ion s b y D r. P u tm an in A p ril 20 06 an d D r. L i in October20 07 al so re veal ed that Pepp erhad appropri ate i nsi ght, j ud gm ent, m oo d, and affect. Even a M ay 2007 scr eeni ng f ordepres si on was nega ti ve. T h e A LJ di d not fully c om plywith the speci alte chn ique at thi s j uncture, but subs tanti alev i dence sup port s the A LJ’ s co ncl usi on at ste p tw o that Pepp er ’ s m entali m pai rm ent was not s e v e r e . P e pp e r wa s n o th a r med b y the ALJ ’ s mi s s t e p. Lik ew i se, as the Com m i ssi onerco rr ectly points o ut, th e A L J d id n ot s t o p t he re w he n an alyzing Pep p er’s depr ess i o n. Af te r a “ no t se ve r e” fi ndi nga t st ep two , the speci alte chnique re quir es th e A L J to as ses s the m ental i m pai rm ent in conj uncti on with the i nd i vi du al ’ s RFCN o. 12

- 2261 31 at st ep fo u r. See § 404. 1520 a( d)( 3)
. The A LJ di d that he re , co nc l udi ngtha t Pe pper ’ s depr es si o n di d no t pr ev en t her fro m co m ple ti ng l i gh t w or k. H e ci ted H yde’ s 2 003 exam i nati on a nd Pepper’ s fol l ow up with Dr. Li i n 200 4. H e al so r efer r ed to Pe pperde cl i nin g m edi ca ti o n a nd c ou n se lin g at he r ap p oin tm en t w ith D r. G oo d n e r in A ugust 2005 and f ai l i ng to und er go si gni fi can t d ep re ssio n tre at m en t d u rin g t h e re lev an t c l a i m p er iod . In ad d ition, th e A L J d iscus sed i nform atio n regard ing Pep p er’s men t a ls t a t e o ut s i de o fthe s pe c i fi c p a r a gr aph a ddr e s s ingP e pp e r’ s depre ssi on m edi calr e c o r ds

— D r. K afka’s op i ni on that Pepper had “l ow sel f

- est eem ” in 200 3, D r. Pu tm an ’s dep ression n ote in 2 0 06, and Pep p er’s t e s t i mon y r e g a r di ngh e r me nt a ls t a t e . A g a i n, the ALJ did notm ake expl i ci t fi nd in gs r efer enci ng the f our functi onalar eas , but a pl ai n re adingo fthe A LJ’ s wri tte n deci si on dem onst ra tes the A LJ g ener al l y di scu sse d ( 1) Pepper’ s dai l y a cti vi ti es; ( 2) Pepper’ s m en talst ate when ar o und pe o pl e; ( 3) Pe pper ’ s di ffi cul tyf o cus i ng w h en co m p let in g h ou se w or k; an d (4) th e la c k of e vidence ofany speci fi c, period i c epi sodes ofdecom pensati o n ( i
. e. , a pe r i o d o fe xa spe r at ed sy m pto m s)
. I n do i ng so , it is appa r en t th e AL J c o ns i der ed al lthe r el ev an t in for m at ion an d fac to rs req u ire d

. See § 404.1520a(c)(1). Sub stan tial evid en ce sup p orts th e A L J’ s m en tal im p airm en t fin d in g a t s te p fou r as w ell. The A LJ’ s a pp l i cati on o fthe speci alte chnique i s no t a m odel f or com pli ance, but w e w i l l not re m an d a c ase f o r fur th ers pec i fi ca ti o n whe n we ar e co nv i nc ed th atthe A L J w ill rea c h th e s am e re su lt. See M cK inz ey, 64 1 F
. 3d at8 92
. W e be l i ev e th atwould occu r i n thi s ca se . The32 N o. 12

- 2261 AL J ’ s f ai l ur e to e xpl i ci tly ap p lythe s pec i alt ec hni que w as harm l ess . Forco m ple tenes s, we bri efly add re ss Pepp er ’ s undeve l o ped ar g um en ts tha t th e AL J err ed by( 1) us i ng his “h un ch es” to reach his con c lu sion th at Pe p p er’s depressi on w as n ot seve re ; ( 2) f ai l i ng to i nquir e a s t o w hy Pepper did noto btain tr eat m ent forherdepres

si o n pr i o r t o he r da te l as t in su re d; a nd ( 3) i g no r i ngthe evi dence ofa depressi on diag nosi s a nd tr eat m ent pr i or to Pepp er ’ s date l asti nsured, wh i ch i s co rr obo ra ted by e v i de nc e tha tp o s t
- da t e s P e pp e r ’ s da t e l a s ti ns ur e d. Fir st, w e h av e a lre ad y c on c lu d ed t h at su b st an tia l ev id en ce s u p p orts the A L J’ s d eterm ination th at Pe p p er’s depr es si o n di d no t pr ev en t he r f rom pe r f o r m i ngl i g ht w or k; w e d o n otse e h o w t h e A L J w as “p lay in g d oc to r,” as P ep p er ins in u at es . Cf. M yl e s v. As t r ue, 58 2 F
. 3d 672, 67 7 ( 7th Ci r. 20 09)
. N ext, wh y a cl ai m ant f ai l ed to un dergo tr eat m ent i s o ne f acto r to consi der when asse ssing an i m p a i r m en t, bu t t h e b u rd en w as on P ep p er to ex p lain w h y s h e w as d isa b led as a re su lt of h er d ep re ss ion
. See Sc hec kv. B a rnh a rt, 3 57F
. 3d 69 7, 7 02 (7th Ci r . 2 00 4) ( ci ting 20 C .F.R . § 40 4. 1 5 12 (c ); B o w en v . Yu ck ert, 48 2 U.S
. 13 7, 14 6 n.5 (1987)). P ep p er failed t o s a t i sfy h er bu rd en . Th is is especi al l y t rue consi deri n g Pe pp erwas re prese nted by c ou n se l th ro u gh ou t t h e p en d en c y of t h e p ro c ee d i n gs . See Ski nne rv. As t r ue, 4 78 F
. 3d 83 6, 8 42 ( 7th Ci r . 2 00 7) ( ex pla i ni ng tha t “ a cl ai m ant r epres ented byco unseli s pre su m ed to have m ad e his bes t c a s e b efore the A L J”). Lastl y, as o ur pre vi ous di scu ss ion show s, we do not be l i ev e th e AL J i g no r ed an y pe r tine nti nf o r m at i o n.N o. 12

- 2261 33 B. Cr edibi l i ty Determ i nati on Pepp er ’ s fi nalar gum ent i s that the A LJ’ s credibi l i ty deter m i na ti on m ust be o ver turned. A n A LJ’ s cr edibi l i ty d et er m in at ion m ay be ov er t u r n ed on ly if it is “p at en tly w ro ng. ” C raft, 53 9 F .3d at 678
. H owever, an AL J m ust ade qu atel y e xpl ain h i s cr edibi l i tyfi ndi ngb y di sc us sing sp ec ific re a s o n s s u p p or te d by th e re c or d

. Ter ry v . As t r ue, 580 F. 3d 471, 47 7 ( 7th Ci r. 2 009). A f ai l ure to do so c ou ld als o b e g ro u n d s fo r re ve rs al. Se eBjo r ns on v. Ast r ue, 671 F.3d 640 , 649 (7th C ir. 2012). Pe pperc o nt en ds th e AL J ’ s ex p l an at i o n a s to why he f ound Pepp er ’ s s tat em ents “not cre dibl e” w as i nadeq u at e b e c a u se th e A L J u se d bo ilerp lat e la n gu ag e in h is op in ion an d , th er efo re , faile d to p ro vid e a rea so n ab le basi s forhi s dete rm i nati on. The A LJ s tat ed i n part, Aft erc ar efulc o ns i der at i o n o fthe ev i den ce , the und ersigned find s tha t t h e claim an t’s m ed icall y d eterm i nabl e i m pai rm ents c oul d rea sonab l y b e e xpected t o c a u s e th e a l l e g e d s y mp t o ms; ho we v e r, th e c l a i mant’ s s tat em ents concerni ng the i ntensi ty, per sistence, and l i m i ti ng effects o fthes e s ym ptom s a re not cre dibl e t o the e xtent they a re in c onsis tent w i th the above functi onalcapaci ty ass ess m ent. W e ac kn owledge thi s i s the sa m e l anguage we have re peatedl y desc ribed as “m eani ngl ess bo i l er pla te” bec a us e i tf ai l s t o l i nkthe c o nc l us o r y s t a t e men t s ma de w ith ob j ec tiv e e vid en c e in th e re c or d

. Se e, e . g. , id. a t6 4 5. I t doe s no t e xplain, o r dir ect a re vie w i ng co urt to, wh at th e AL J r el i ed o n whe n mak in ghi s det er m i na ti o n. Parke rv. As t r ue, 597 F. 3d 920, 922 ( 7th Cir. 2010). H ow ever,34 N o. 12

- 2261 the s i m ple f act that an A LJ use d boi l er pla te l anguage d oes not au tom aticall y un d erm ine or d iscred it th e A L J’s ult i m ate co ncl us ion i fhe o ther w i se poi nts t o i nfo rm ati on th at j u st ifies h is c re d ibilit y d et er m in at i o n . See Sh ideler, 688 F. 3d at 311- 12; s e eal s o Ge t ch v. As t r ue, 5 3 9 F
. 3 d 473, 48 3 (7 t h C i r . 2 00 8) (“ R ev iew in g c ou rt s . . . sh ou ld rar ely disturb a n A LJ’ s cr edibi l i ty deter m i n atio n, unl ess that fi nd i ngi s u nr e a s o nab l e o r u ns up po r ted. ” )
. T he ALJ did thather e. I mm e di a t e l y f o l l o wi ng the u s e o fb o i l e r pl a t e , the ALJ p ro vid ed a p ar ag ra p h d isc u ss in g P ep p er ’s t e s t i m on y in c onj u n c tio n w ith th e R FC st at em en t. T h e A L J ac kn ow ledg ed Pe pper ’ s ab i l i tyt o l i ft, s ta nd, s i t, a nd wal ka nd how “ ea chf al l s wi th i n the c at eg o r y o fl i g htwor k

. ” The ALJthe n de s c r ib e d P e pp e r ’ s t e s t i mon y r e g a r di ngher da i l y a c t i v i t i e s , wh i c h wa s c o r r o b o r a t e d b y h e r h usb a nd , and the p a i n a nd s y mpt o ms e xa c e rb a t e d wh e n Pe pp er si ts orst ands f orexte nd ed peri ods o fti m e o r engag es i n “exce ssi ve bending

. ” Se eJe l i ne k v. As t r ue, 6 6 2 F
. 3 d 8 05, 812 (7th Cir. 2011) (“A n A L J m ay con side r a cl aim a n t ’s daily a cti vi ti es w hen as ses si ng cr edibi l i ty, but A LJs m ust ex p lai n p erceived i nc ons istenc ies betw een a clai m an t’s acti vi ti es and the m edi calev id ence. ”) ( i nter nalci tat i on om itted ). H e note d that Pep p er’s R F C did not req uire ei ther

. See S. S. R
. 83-14, 1983 SSR L E X I S 33, at *6-7 ( “[ T]o per f or m subst anti al l y a l lo fthe exer tion al requi re m en ts of m os t s ed en ta ry an d ligh t job s , a p er so n w ou ld no tn e e d t o c r o uc h a nd wo ul d n e e d t o s t o o p o nly o ccasi onal l y (fro m ve ryl i ttl e up to o ne- thi rd o fthe ti m e, depend i ng o n that parti cul arj ob)

. ”). T h e AL J al so discussed Pepper’ s t est i m ony that her m edi cati on wasN o. 12

- 2261 35 “so m ew hat e ffecti ve” and she c ou ld m ai ntai n herabi l i ty t o c a r r y o u td a i l y a c t i v i t i e s b y s t r e t c h i n ga n d c o mpl eti ngphy sic althe r apye xe r ci se s. La st l y, the ALJ e xpl aine d ho w the onl y medi ca lo pi ni o ns r eg ar di ng Pe pper ’ s ab i l i tyt o wor kpr i o r to h erda te l as t i nsure d w er e fro m st ate a ge n c y m edi calco nsul tants after th at d ate had passed. N one ofthem o pined thatPepper wa s di s ab l e d p r i o r t o h e r da t e l a s ti ns ur e d. These r efer ences al l ow us to s uffi ci entl y e xam i ne wh at the AL J r el i ed on when concl ud i ng Pepper w as not fu l l y c r e d ible

. Se ePr oc has ka , 4 54 F
. 3d at7 38 ( co nc l udi ng that the A LJ appropri ate l y consi dered dive rs e f acto rs in his cred ibi li ty d eterm ination, inc lud ing the clai m an t’s hear i ng te sti m ony and the obj ecti ve m edi calr eco rds, eve n though al lthe cl ai m ant’ s a l l ega ti ons w er e n ot di scu ssed i n th e A L J’s w ritten op inion). A s w e p re vio u sly ex p lai ne d, Pe ppert es ti fi ed to e ng ag i ngi n n um er o us acti vi ti es thro ughout the co urse o fan o rd i naryday that in vo lve d foc u se d th in kin g a n d p h ys ica l ac tiv ity (e.g., d rivi ng at l east 40 m inu tes to see her m om , read ing p ap ers and m aga zi nes, tal ki ng o n the phone w i th i nsurance c om p an ies , sh op p in g, an d p re p ar in g m e als ). Th is t es tim o n y i s in direct con trast to P ep p er’s repea ted asserti o n tha t sh e co ul d no t en gage i n anyo fthe acti vi ti es re quir ed by her f or m erem plo ym ent, i ncl ud i ng si tting, sta nd i ng, o r concen trating. Fur ther m or e, ev en so m e o f the doct or s who ex am i ned Pepp erwere confused as to w h y th e m edi calexam i nati ons did notr eve althe sour ce ofPepper’ s s ym ptom s. Fo r exam ple , Pe pp erar gues that her neck pai n and l i m i ted r an ge of m oti on hi nd er ed he r abi l i tyt o wor k, b utDr
. Go o dne r s ta te d, “ [ Pe p p er’s36 N o. 12

- 2261 sym ptom s] al m ostst ri ke[ ] m e a s del iber ate
. ” ( Only her c o us i n, D r . K a fk a , i n 2 0 0 3 a ffi r ma t i v e l y s a i d th e r e “ a ppe a r s t o b e n o s y mpt om m ag ni fi c a t i o n. ” ) And the me di ca lr ec o r ds l i k ewi se do no t sup p or t Pe pper ’ s te st i m o ny re gar ding the fre quency oreffec ts ofherm i gr ai nes or fain tin g ep iso d es , w h ich se em ed to for m t h e ba sis for t h e V E ’s “ n o w or k” d et er m in at ion
. SeeSie nkiewicz v. B a rnh a rt, 4 0 9 F
. 3 d 7 9 8 , 8 0 4 ( 7 th Ci r . 20 0 5 ) ( “ [ A] di s c r e pa nc y b e t we e n the d egr ee o fp a i n c l a i med b y the a ppli cant a nd thatsugg est ed by m edi calrec or d s i s probative of ex aggerat ion.”)
. The A L J c o nc l ude d tha t, t ak ent o g ethe r, the a m o unt of daily acti v iti es Pe p p er perform ed , the level ofexerti on nece ssa ryto enga ge i n th os e types ofact i vi ti es, a nd the n ume r o us n o t a t i o ns i n Pe pp e r ’ s me di c a lr ec o r ds r eg ar di nghe r abi l i tyt o e ng ag e i n a ct i vi ti es ofdai l y l i ving u n d er m i ned Pepp er ’ s cr edibi l i ty w hen descr ibi ng her su bj ective com p lai nt s of p ain an d disab il ity. Th ese are ex actly th e ty pe o ff ac to r s th e AL J was r equi r ed to c o nsid er . See S. S. R . 9 6-7 p , 1 996 SS R LE XI S 4, at* 7- 8. I t i s true the AL J co uld have bee n m or e speci fi c as to wh i ch phy si ca l an d m en ta l i m pai r m en ts an d sy m pto m s he th ou gh t w ere exa g g e r a t ed , as opp osed to generally r eferenci ng l ar ge- scal e por ti ons ofPepper’ s dai l y- acti vi ty te st im on y, bu t th at fac t d oe s n otch an ge th e re su lt h er e. T h e A L J ’ s ex p lan at ion w as su fficie n t t o re as on ab ly c o n c l u d e th a tP e p p e r e x a g g e r a t e d th e e ffe c t s o fh e r i mp air m en ts . I t a lso w as n ot“p at en tly w ro n g.” W e fi nd no e r r o r s i n the ALJ ’ s cr edibi l i tyde te r m i na ti o n.N o. 12

- 2261 37 I I I . C ONC L US I ON W e a c k no wl e dg e tha tP e pp e r ’ s c o nd i t i o n mayhave w or sened since D ec em ber31 , 20 07, but the S oci al S ec ur i tyr egul at i o ns r equi r e a “di sabi l i ty ” fi ndi ng be f o r e a cl ai m an t’ s dat e l as t i ns ur ed. F o r the r ea so ns disc ussed abo ve, we A FFIRM the j ud gm ent o fthe distr i ct c ourtand the A LJ’ s deni alo fbene fi ts.

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