United States Court of Appeals

For the Seventh Circuit

Chicago, Illinois 60604

Submitted May 21, 2021

Decided June 22, 2021

Before

DIANE S. SYKES, Chief Judge 

KENNETH F. RIPPLE, Circuit Judge

DAVID F. HAMILTON, Circuit Judge

No. 20-2597

JENNIFER L. CHAMBERS,

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-00780-bbc

Barbara B. Crabb,

Judge.

O R D E R

Jennifer Chambers applied for Social Security disability insurance benefits and 

supplemental security income based on a variety of physical and mental health 

impairments, including depression, anxiety disorder, and post-traumatic stress 

disorder. An administrative law judge (ALJ) denied the applications on the ground that, 

despite severe mental and physical impairments, Ms. Chambers retained the residual 

 We granted the parties’ joint motion to waive oral argument for this case, agreeing that this appeal 

could be resolved on the briefs and record and that oral argument would not significantly aid the 

decisional process. Fed. R. App. P. 34(f).

NONPRECEDENTIAL DISPOSITION

To be cited only in accordance with Fed. R. App. P. 32.1
No. 20-2597 Page 2

functional capacity to perform simple, routine tasks in a low-stress environment, with

only infrequent changes to work routine, occasional interaction with coworkers, and

limited contact with the general public. The district court upheld that decision. 

On appeal, Ms. Chambers narrows her arguments. She argues that the ALJ erred 

in considering the severity of her mental impairments and in weighing the conflicting 

medical and non-medical opinions concerning her condition. As with many Social 

Security disability cases that we see on judicial review, conflicting evidence here could 

have supported reasonable decisions to grant benefits or to deny them. The ALJ’s 

decision to deny benefits was supported by substantial evidence, so we affirm. The ALJ 

resolved conflicts in the evidence in reasonable ways. She explained sufficiently why 

she discounted the more restrictive opinions of Ms. Chambers’ treating therapists.

I. Background

A. Ms. Chambers’ Relevant Medical History 

Jennifer Chambers applied for disability insurance benefits and supplemental 

security income in July 2015, alleging that she became disabled on January 5, 2015, 

when she was twenty-six years old. Ms. Chambers claimed that she was unable to work 

because she suffered from post-traumatic stress disorder, severe depression, panic 

attacks, anxiety and sleep disorders, and paranoia.

From 2012 through 2018, Ms. Chambers sought regular psychiatric and 

psychotherapeutic care. Most notably, she attended weekly psychotherapy sessions 

with her treating therapist, social worker Amanda Kalisz. Ms. Chambers had a history 

of suicidal ideation and had twice been admitted to voluntary inpatient care—once in 

May 2012 and again in July 2013. In February 2015, Ms. Chambers reported to a 

physician assistant that she had been experiencing worsening symptoms of depression. 

But Ms. Chambers said that her medication was working, and the physician assistant 

did not identify any risk factors for suicide. From March 2015 through April 2016, Ms. 

Chambers continued to suffer from depression, anxiety, and difficulty sleeping. Her 

mental status examinations during this period indicated normal thought processes and 

content, good insight and judgment, and, on a few occasions, suicidal ideation.

In April 2016, Ms. Chambers took a Continuous Performance Test. Her results 

were within the normal range on all indices, and the administering psychologist found 

that she had “no apparent problems with focusing her attention, sustaining that focus 

or problems with impulsivity.” The results indicated, however, that Ms. Chambers 
No. 20-2597 Page 3

lacked ego development and strength and that she showed a strong need for support 

and attention. The psychologist recommended counseling to help her develop a sense of 

self and coping skills.

From August 2016 through August 2017, Ms. Chambers continued to see Ms. 

Kalisz, other therapists, physicians, and physician assistants for regular psychiatric and

psychotherapeutic care, pre-natal and post-natal care, and medication management. In 

July and August 2017, Ms. Chambers reported thoughts of self-harm and worsening 

depression, but she was neither admitted nor sought admittance to a hospital.1

Throughout September 2017, however, Ms. Kalisz and other healthcare providers found 

that Ms. Chambers exhibited normal thought processes and content, mostly good 

insight and judgment, and no suicidal, homicidal, or paranoid ideation. In October 

2017, Ms. Chambers discussed her ongoing anxiety with multiple therapists. The 

discussions involved “themes of safety,” encouraging her to pursue positive self-talk

and release of anxious energy through meditation and exercise.

In November 2017, Ms. Chambers’ treating psychiatrist, Dr. James Lean, found 

that she exhibited normal thought processes and content, good insight and judgment, 

and no suicidal ideation. In January 2018, Ms. Chambers said that she was “less 

agitated, less frustrated, more laid back, [and] more ambitious” since starting a new 

medication, Lamictal. At follow-up visits in March, May, and July 2018, Ms. Chambers 

repeated these positive developments. Dr. Lean’s mental status examinations during 

these visits indicated that Ms. Chambers had normal thought processes and content and

good insight and judgment and that she was calmer and alert. Mental status 

examinations performed by Ms. Kalisz from June through September 2018 also reflected

that Ms. Chambers had normal thought content and processes, normal mood and affect, 

and no psychosis.

B. State Agency Assessments and Administrative Proceedings 

In September 2015, state agency psychologist Beth Jennings, Ph.D., assessed Ms. 

Chambers’ residual functional capacity. She found that Ms. Chambers was not 

1 Ms. Chambers’ treating physician assistant identified several “suicide protective factors,” including

“responsibility for children, duty to others, supportive [significant] other, fear of death/pain, pets, 

religious prohibition, help-seeking behaviors, restricted access to lethal means, engagement in ongoing 

mental health care, willingness to engage in treatment.” During a July 2017 appointment, Ms. Chambers 

agreed to a “contract” with the physician assistant that if she had any thoughts of harming herself or 

others, she would immediately report to a hospital emergency room. She renewed this commitment in 

later appointments.
No. 20-2597 Page 4

significantly limited in remembering very short and simple instructions, maintaining 

regular attendance, and making simple work-related decisions. Dr. Jennings opined 

that Ms. Chambers would perform better in jobs that did not require extended time 

around peers. Dr. Jennings also opined that “periodic exacerbations” of mental health 

symptoms might limit Ms. Chambers’ capacity to perform work at a consistent pace.

In December 2015, state agency psychologist John Warren, Ed.D., reassessed Ms. 

Chambers’ residual functional capacity. He also opined that Ms. Chambers was not 

significantly limited in carrying out very short and simple instructions and maintaining 

regular attendance, but found that she was moderately limited in getting along with coworkers.

At her hearing before the ALJ in August 2018, Ms. Chambers, then twenty-nine

years old, described her family, personal relationships, daily schedule, and work 

history. She had an eighteen-month-old son and a nine-year-old daughter with 

developmental and cognitive disabilities. Ms. Chambers also testified that she was 

going through a divorce and that she and her children had recently moved in with her 

physically disabled mother. Ms. Chambers clarified, however, that she was looking for 

her own apartment.

Ms. Chambers testified that on a typical day, she cared for her children and dog, 

cleaned the house, managed her medications and appointments, and spent a few hours 

on Facebook. Three days a week, she worked part-time as a grocery store cleaner, 

between twelve and sixteen hours per week. Before her alleged disability onset date,

she had done full- and part-time work in manufacturing, cashiering, and cleaning.

A vocational expert also testified at the hearing. The ALJ asked about jobs that 

could be done by a person who was a high-school-educated, twenty-nine-year-old with 

no relevant past work, capable of performing medium work consisting of simple tasks 

in a low-stress environment with only infrequent changes to routine, occasional 

interaction with co-workers, and incidental interaction with the public. The expert 

opined that such a person could work as an industrial cleaner, a laundry laborer, and a 

stuffer.2

The ALJ applied the familiar five-step analysis for assessing disability and 

concluded that Ms. Chambers was not disabled. See 20 C.F.R. §§ 404.1520(a)(4), 

2 “Stuffer” is defined as “bulk sausage stuffing machine operator.” U.S. Dep’t of Labor, Dictionary of 

Occupational Titles § 520.685-210 (4th ed. 1991) (cleaned up).
No. 20-2597 Page 5

416.920(a)(4). At step one, the ALJ found that Ms. Chambers had not engaged in any 

substantial gainful activity since her alleged disability onset date. At step two, the ALJ 

identified her severe mental impairments as depression, anxiety, post-traumatic stress 

disorder, and personality disorder.

At step three, the ALJ concluded that these impairments, individually or in 

combination, did not satisfy a listing for presumptive disability. In interacting with 

others, the ALJ determined, Ms. Chambers had no more than a moderate limitation. She

regularly drove her children to school and the public swimming pool, went grocery 

shopping, attended doctor’s appointments, and spent time with family, friends, and her 

partner. The ALJ also cited Ms. Chambers’ mental status examinations, which generally 

described her as presenting with intact “memory, attention, and concentration without 

mention of difficulties cooperating or completing examinations.” With respect to 

adapting and managing herself, the ALJ found that Ms. Chambers was independent

and effective and had no limitations. 

In determining Ms. Chambers’ residual functional capacity, the ALJ found that 

the objective medical evidence, including Ms. Chambers’ normal results on her 

Continuous Performance Test and “mostly unremarkable” mental status examinations, 

was inconsistent with her allegations of disability. While recognizing that Ms. 

Chambers’ psychological symptoms fluctuated in severity, the ALJ emphasized that 

periods of worsening symptoms were temporary and coincided with “significant life 

stressors,” such as her daughter’s diagnosis, issues related to her husband’s alcoholism 

and their impending divorce, her mother’s overdose on prescription medication, and 

her grandmother’s death. The ALJ further noted the blunting effects of proper 

medication and regular psychotherapy sessions on Ms. Chambers’ symptoms. 

The ALJ also considered and assigned weight to the opinions of the two state 

agency psychologists and Ms. Chambers’ treating therapist, Ms. Kalisz, and treating 

psychiatrist, Dr. Lean. Most relevant, while the ALJ did not adopt all the state agency 

psychologists’ respective opinions, she found them consistent with the finding that Ms.

Chambers could perform unskilled work with limited social interaction and limited 

changes in work routine.

Critical for this appeal, the ALJ also explained why she gave little weight to the 

opinions of Ms. Kalisz and Dr. Lean that would, if credited, support a finding that Ms. 

Chambers was disabled within the meaning of the Social Security Act. The ALJ 

discounted Ms. Kalisz’s opinions that Ms. Chambers was incapable of even low stress 

work and was extremely limited in her daily life, social functioning, maintaining 
No. 20-2597 Page 6

concentration and pace, and getting along with peers. The ALJ noted that the records of 

Ms. Kalisz’s own mental status examinations of Ms. Chambers—which were generally 

normal with intact cognition—indicated otherwise.

The ALJ similarly discounted Dr. Lean’s opinion that Ms. Chambers’ social and 

mental limits rendered her incapable of completing a full workday. In particular, the 

ALJ discounted Dr. Lean’s finding that Ms. Chambers had “a history of more than one

year of an inability to function outside a highly supportive living environment.” The 

ALJ emphasized that Ms. Chambers had been caring for her children since her alleged 

disability onset date. The ALJ further disagreed with the respective opinions of both 

Ms. Kalisz and Dr. Lean that Ms. Chambers had suffered four or more episodes of 

decompensation within a twelve-month period. The preponderance of the medical 

evidence, the ALJ reasoned, simply did not support such restrictive opinions.

At step four, the ALJ concluded that Ms. Chambers had no past relevant work. 

At step five, relying on the vocational expert’s testimony, the ALJ found that Ms. 

Chambers could perform a number of unskilled jobs in the national economy, such as 

industrial cleaner, laundry laborer, and stuffer. The ALJ therefore found that Ms.

Chambers was not disabled. The Appeals Council denied review. Ms. Chambers then

sought review in the district court, which upheld the ALJ’s decision. 

On appeal to this court, Ms. Chambers contends that the ALJ failed to assess and 

weigh properly the opinions of the state agency psychologists and the opinions of her 

treating therapists, Ms. Kalisz and Dr. Lean. She also argues that the ALJ “played 

doctor” by making findings about her mental health impairments that were not 

supported by these opinions.

II. Discussion

We will uphold an ALJ’s decision if it is supported by substantial evidence. See 

42 U.S.C. § 405(g); Biestek v. Berryhill, 139 S. Ct. 1148, 1152 (2019). Our review is 

deferential: we will not reweigh the evidence, resolve conflicts in the record, decide 

questions of credibility, or substitute our judgment for that of the ALJ. Summers v. 

Berryhill, 864 F.3d 523, 526 (7th Cir. 2017); Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 

2004). We will, however, “examine the ALJ’s decision to determine whether it reflects a 

logical bridge from the evidence to the conclusions” that gives us a sufficient basis to 

“assess the validity of the agency’s ultimate findings and afford [the claimant] 

meaningful judicial review.” Moore v. Colvin, 743 F.3d 1118, 1121 (7th Cir. 2014).
No. 20-2597 Page 7

Here, the ALJ’s decision is supported by substantial evidence and built the 

needed “logical bridge.” The balance of the objective medical evidence, opinion 

evidence, and Ms. Chambers’ own testimony detailing her daily activities support the 

ALJ’s determination that Ms. Chambers could perform medium work consisting of 

simple, routine tasks in a low-stress environment, with only occasional interactions 

with peers and incidental interactions with the public.

First, the ALJ appropriately considered the objective medical evidence in the 

record in reaching her findings. 20 C.F.R. §§ 404.1529(a), 416.929(a). Notably, Ms.

Chambers’ mental status examinations during the relevant period—particularly after 

September 2015—were mostly unremarkable with regard to her thought content and 

processes, cognition, and insight and judgment. Her 2016 Continuous Performance Test 

yielded normal results on all indices. Her claims of worsening symptoms were 

temporary and corresponded to periods of significant stress.3

Further, as the ALJ noted, Ms. Chambers’ treatment history was “relatively 

conservative” and did not support Ms. Kalisz’s and Dr. Lean’s respective opinions that 

Ms. Chambers had suffered four episodes or more of decompensation within a twelvemonth period. Medical opinions may be discounted if they are inconsistent with the 

record as a whole, and Dr. Lean’s opinion that Ms. Chambers suffered multiple 

episodes of decompensation was inconsistent with the treatment record. See 20 C.F.R. 

§§ 404.1527(c)(4), 416.927(c)(4); cf. Knight v. Chater, 55 F.3d 309, 313–14 (7th Cir. 1995)

(“The ALJ must give substantial weight to the medical evidence and opinions 

submitted, unless specific, legitimate reasons constituting good cause are shown for 

rejecting it.”). Ms. Chambers’ medical records revealed fluctuating psychological 

symptoms, but her mental impairments never deteriorated to the point of disabling her 

within the meaning of the Social Security Act, which requires complete disability for not 

less than twelve months. See 42 U.S.C. § 416(i). For example, in July and August 2017, 

when Ms. Chambers reported thoughts of self-harm and worsening depression, she was 

neither prescribed a significantly more aggressive treatment plan nor admitted to a 

hospital. And by January 2018, following adjustments to her medications, she reported 

3 Ms. Chambers also reported that her symptoms worsened whenever she decreased or ceased taking 

medications. Symptoms that abated once she resumed medication were not disabling. E.g., Curvin v. 

Colvin, 778 F.3d 645, 651 (7th Cir. 2015) (rejecting claimant’s argument that sleeping disorder prevented 

her from working where claimant testified that “medication kept it under control”).
No. 20-2597 Page 8

feeling less agitated, more relaxed, more ambitious, and better overall. These positive 

developments continued through July 2018.

Second, Ms. Chambers’ own description of her daily activities conflicted with 

Ms. Kalisz’s opinion that she was incapable of even low stress work and Dr. Lean’s

medical opinion that she was “markedly limited in activities of daily living” and unable 

to complete a full workday. Ms. Chambers testified that she cared for her two children 

and dog, performed household chores, and managed her medications and 

appointments. She also went grocery shopping, drove her children to school and the 

public pool, spent time with family, friends, and her partner, and even attended larger 

gatherings such as family weddings and birthday parties. We and other courts have 

often cautioned against unrealistic and exaggerated reliance upon such evidence of 

daily activities to determine a person’s ability to engage in full-time employment. See, 

e.g., Bjornson v. Astrue, 671 F.3d 640, 647 (7th Cir. 2012) (collecting cases). Such evidence 

of daily activities is relevant, however, and it can be helpful in evaluating conflicting 

evidence about a person’s limitations. Given our deferential standard of review, we do 

not see anything unreasonable in the ALJ’s consideration of the evidence of Ms. 

Chambers’ activities of daily living in this case.

Additionally, the level of independence and effectiveness shown by Ms. 

Chambers in her daily activities belied Dr. Lean’s opinion that she had a “history of 

more than one year of an inability to function outside a highly supportive living 

environment.” As of the hearing in August 2018, Ms. Chambers was living with her 

disabled mother and was the primary caregiver for her two children. The ALJ did not 

err by discounting Dr. Lean’s opinion because it was controverted by both the objective 

medical evidence and Ms. Chambers’ own testimony.

Accordingly, the judgment of the district court affirming the denial of disability 

insurance benefits and supplemental security income is AFFIRMED.