In the

United States Court of Appeals

For the Seventh Circuit ____________________

No. 17-1287

MARGARET CULLINAN,

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 Illinois, Eastern Division.

No. 15 C 11499 — Mary M. Rowland, Magistrate Judge.

____________________

ARGUED DECEMBER 12, 2017 — DECIDED DECEMBER 28, 2017

____________________

Before BAUER, RIPPLE, and SYKES, Circuit Judges.

SYKES, Circuit Judge. Margaret Cullinan appeals the denial 

of her application for Disability Insurance Benefits and 

Supplemental Security Income. She based her claim for 

benefits on several impairments, most of which arose after 

she suffered a stroke: anxiety, depression, peripheral blindness in one eye, diabetes, obesity, and sleep apnea. An 

administrative law judge determined that although Cullinan 
2 No. 17-1287

has several impairments, she is not disabled. Cullinan 

argues that the ALJ erroneously discredited both her testimony and the opinion of her treating psychologist. We 

vacate the judgment and remand for further administrative 

proceedings. 

I. Background

Cullinan applied for disability benefits and social security income in March 2012 alleging vision problems, side 

effects from a stroke, diabetes, difficulty balancing, cervical 

cysts, and fatigue. The Social Security Commission denied 

Cullinan’s application for benefits both initially and on 

reconsideration. She requested a hearing before an administrative law judge.

Cullinan worked as a live-in-home certified nurse’s aide 

for 15 years. In May of 2011, she went to the hospital for 

headaches and blurred vision and was diagnosed with a 

possible occipital stroke. Initial tests showed 20/40 vision in 

her right eye and 20/25 in her left, and that she could walk 

normally. Follow-up examinations showed reduced peripheral vision in her right eye.

Cullinan’s treating neurosurgeon, Dr. George Cybulski, 

completed a Medical Source Statement in October 2011 

describing Cullinan’s ability to work. Dr. Cybulski reported 

that Cullinan suffered from blindness in her right eye and 

weakness in her right arm and leg, needed a cane to walk, 

could occasionally lift and carry up to ten pounds, and could 

not sit, stand, or walk for more than one hour in an eighthour workday without needing to lie down.
No. 17-1287 3

In August 2012 two of the Social Security Administration’s consultative doctors examined Cullinan: psychologist 

Michael E. Stone performed a mental status exam, and 

internist Albert Osei conducted a physical exam. Based on 

Cullinan’s report that she had vision and balance problems, 

anxiety, depression, and diabetes that collectively prevented 

her from working, Dr. Stone diagnosed her with depression 

and generalized anxiety disorder with panic attacks, and 

stated that she had a guarded prognosis, meaning she was 

unlikely to improve. Dr. Osei determined that Cullinan 

could walk up to half a block, stand, sit, and walk down 

stairs without difficulty, and that she had good balance 

while walking. His impression was that Cullinan had impaired peripheral vision in her right eye, diabetes, depression, and anxiety.

Two nonexamining state-agency consultants evaluated 

Cullinan’s medical records and opined on her residual 

functional capacity. Psychologist Phyllis Brister completed a 

form assessment in September 2012 and opined that

Cullinan had mild restrictions in daily activities and social 

functioning, and moderate difficulties maintaining concentration and interacting with the general public. In March 

2013 psychologist David Gilliland mostly agreed with 

Dr. Brister’s conclusions, except that he found that Cullinan 

had moderate difficulties in social functioning instead of 

mild. 

Cullinan began treatment with Dr. John Canzona, a psychologist, in February 2013. (This was shortly before she 

received the decision denying her request for reconsideration of the Agency’s initial denial of her claim.) During their 

initial appointment, Cullinan reported that the stroke “ru-
4 No. 17-1287

ined [her] life”: she moved back in with her parents who 

“pick on [her],” she cannot work, and she watches television 

in her room all day. She said that because of the stroke and 

her various medications, she lost peripheral vision in her 

right eye, had difficulty balancing, and was often fatigued. 

Dr. Canzona found Cullinan’s concentration adequate and 

diagnosed her with a major depressive disorder, and he 

rated her at a Global Assessment of Functioning (“GAF”) 

score of 55, indicating moderate symptoms from her mental 

impairments.1 Also, in February 2013 Cullinan had a hysterectomy and subsequently developed an infection. 

Cullinan continued therapy with Dr. Canzona about once 

every two weeks through the end of 2013. She discussed her 

daily activities, mentioning that she did her parents’ laundry 

and was “helpful around the house,” cared for her cousin 

who lived in a nursing home, and occasionally attended

concerts. During one session, she said that she wanted to 

reconnect with her former boyfriend, and in another she said 

she “met a man and spent some time with him.” She mentioned helping her friend care for foster children with “developmental problems” and helping to care for one of her 

grandmothers. She said that she attended her parents’ 

anniversary party and her cousin’s wake and that she was 

anxious with “chest pressure” before both events. Finally, 

 1 The GAF is a 100-point metric formerly used to rate overall psychological, social, and occupational functioning. AM. PSYCHIATRIC ASS’N,

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS 32–34 (4th 

ed., Text Rev. 2000). In 2013 the American Psychiatric Association 

abandoned the flawed GAF system. See Lanigan v. Berryhill, 865 F.3d 558, 

561 n.1 (7th Cir. 2017). Though noted by the ALJ, the GAF scores did not 

appear to factor into her analysis.
No. 17-1287 5

she reported wanting to work as a live-in nurse for the 

elderly and wanting to volunteer at an animal shelter.

In May 2013 Cullinan had a follow-up appointment with 

Dr. Regina Hall-Ngorima, her psychiatrist, and reported 

fatigue, pain, sleep problems, and feeling more depressed

and anxious. Dr. Hall-Ngorima diagnosed Cullinan with 

insomnia and an adjustment disorder with depressed mood 

and assigned a GAF score of 65, reflecting mild symptoms.

Cullinan went to the emergency room in November with 

right-sided weakness and inability to walk without a walker. 

An examining physician concluded these were symptoms of 

Cullinan’s anxiety.

In January 2014 Cullinan’s treating internist, Dr. Lorenzo 

Monterubianesi, completed a physician’s report.

Dr. Monterubianesi had seen Cullinan quarterly since May 

2011, shortly after her stroke. He said that her balance had 

returned to normal, she could lift up to ten pounds frequently, and she had full capacity to walk, stand, and sit. But

Dr. Monterubianesi noted that her ability to perform activities of daily living was reduced up to 20% and she had a 20% 

to 50% reduced capacity for climbing and using public 

transportation.

Dr. Canzona, the treating psychologist, completed a 

Medical Source Statement in April 2014, and he rated 

Cullinan’s ability to complete a normal workday or workweek as poor. He reported that she was unable to maintain 

attention and concentration for extended periods of time, 

perform at a consistent pace, or travel in unfamiliar places

and use public transit. 
6 No. 17-1287

At her administrative hearing in April 2014, Cullinan testified that twice after her stroke she tried to go back to work 

but was unable to keep up with her patients and stopped 

working after four days. She explained that she has no 

peripheral vision in her right eye; she cannot see her right 

hand when held next to her face. She testified that she could 

not see her representative sitting to her right. She said that 

her glasses help her keep balance, but she still stumbles 

every other day. Regarding her anxiety and depression, she

stated that she suffers neck and chest pain, her legs get 

weak, and she does not like to leave the house. Cullinan

explained that she naps one to four hours each day because 

her medications leave her feeling groggy, she does not sleep 

well at night, and her parents wake her up from sleeping on 

the couch every morning between 5:30 and 6 a.m. She testified that she suffers weekly from severe headaches that last 

up to five days and prevent her from being able to read or 

watch television. 

Cullinan also testified about her daily activities and 

physical and mental limitations. She said she can only stand 

for 20 minutes, sit for 40, and walk half a block. She testified 

that while at home she makes beds, brews coffee, and loads 

and unloads the dishwasher. She added that she visits her 

cousin in the nursing home up to three nights per week and 

that while visiting she tidies up but does not lift anything. 

The ALJ then questioned a vocational expert, who reviewed the record and was present during Cullinan’s testimony. The expert said that given Cullinan’s health limitations, she would not be able to resume work as a nurse’s 

aide. The ALJ posed a hypothetical question about the 

employment options of someone who was limited to light 
No. 17-1287 7

work that did not require operating heavy machinery or

driving, or climbing ladders, ropes, or scaffolding; had mild 

social functioning limitations and moderate difficulty concentrating; and could perform only routine tasks and follow 

simple instructions. Notably, the ALJ did not list peripheral 

blindness as a limitation. The vocational expert answered 

that such a person would be able to work as a laundry aide, 

cleaner/polisher, or marker/labeler. The expert also said that 

needing to take a two-hour nap every day would rule out all 

work. 

In her written decision denying benefits, the ALJ applied 

the five-step analysis required by 20 C.F.R. § 404.1520(a) and 

concluded that Cullinan was not disabled. The ALJ determined that Cullinan had not worked since her occipital 

stroke on May 3, 2011 (step 1); that only her anxiety and 

depression constituted severe impairments (step 2); that 

these impairments, individually or collectively, did not 

equal a listed impairment (step 3); that she had the residual 

functional capacity to perform light work involving simple 

instruction and routine tasks that did not entail operating 

heavy machinery or driving, or climbing ladders, ropes, or 

scaffolds; that she could not perform her former work as a 

certified nursing aide (step 4); and that she could work as a 

laundry aide, cleaner/polisher, or marker/labeler (step 5). 

In determining Cullinan’s residual functional capacity, 

the ALJ determined that Cullinan’s testimony concerning the 

intensity, persistence and limiting effects of her symptoms 

was “not entirely credible.” Regarding Cullinan’s psychological impairments, the ALJ gave no weight to her testimony 

or the opinion of Dr. Canzona, the treating psychologist who 

had concluded that Cullinan would be unable to complete a 
8 No. 17-1287

normal workday due to her difficulties maintaining concentration, traveling in unfamiliar places, and using public 

transit. 

The ALJ’s adverse credibility determination and her decision to discount Dr. Canzona’s opinion were each based on

Dr. Canzona’s treatment notes. In discrediting Cullinan the 

ALJ said that the notes show that Cullinan is “very active”:

she does household chores; cares for her cousin, grandmother, and a friend’s foster child; goes to concerts; attended her 

parents’ anniversary party and her cousin’s wake; wants to 

resume working and to volunteer at an animal shelter; and

goes on dates. Regarding Dr. Canzona’s credibility, the ALJ 

said his report was inconsistent with his treatment notes and 

so was untrustworthy.

The ALJ instead gave “great weight” to the opinion of 

Dr. Brister, one of the nonexamining psychologists who had 

determined that Cullinan had only mild limitations in daily 

living activities and social functioning, and moderate difficulty maintaining concentration. The ALJ noted that 

Dr. Brister’s assessment of Cullinan’s residual functional 

capacity was consistent with her own. The ALJ also gave 

great weight to the other consulting psychologist, 

Dr. Gilliland, to the extent that he “generally affirmed” 

Dr. Brister, but she gave little weight to his finding that 

Cullinan had moderate difficulties in social functioning 

because, the ALJ said, it was not consistent with treatment 

records and Cullinan’s activities. 

Regarding Cullinan’s physical impairments, the ALJ gave 

some weight to the opinions of the two state-agency physicians who had physically evaluated Cullinan; the ALJ accepted their assessment that Cullinan had only nonsevere 
No. 17-1287 9

physical impairments. But the ALJ gave controlling weight 

to Dr. Monterubianesi’s opinion about Cullinan’s inability to 

lift heavy objects, so she limited Cullinan’s residual functional capacity to light exertional work. 

The Appeals Council denied review, making the ALJ’s 

decision the final decision of the Commissioner. See Ghiselli 

v. Colvin, 837 F.3d 771, 776 (7th Cir. 2016). Cullinan sought 

judicial review, and a magistrate judge, presiding by consent, see 28 U.S.C. § 636(c), affirmed the decision of the 

Commissioner. We review the magistrate judge’s decision de 

novo and assess whether the ALJ ‘s decision is supported by 

substantial evidence in the record. Lanigan v. Berryhill, 

865 F.3d 558, 563 (7th Cir. 2017).

II. Analysis

Cullinan primarily argues that the ALJ erred by discrediting her testimony about the limitations caused by her 

impairments and the opinion of her treating psychologist, 

Dr. Canzona, and instead giving great weight to the Agency’s nonexamining doctors. She challenges the conclusion

that both her testimony and Dr. Canzona’s opinion were 

inconsistent with Dr. Canzona’s notes, which, the ALJ said, 

showed she was “very active.”

We will overturn an ALJ’s decision to discredit a claimant’s alleged symptoms only if the decision is “patently 

wrong,” meaning it lacks explanation or support. Murphy v. 

Colvin, 759 F.3d 811, 816 (7th Cir. 2014). A credibility determination lacks support when it relies on inferences that are 

not logically based on specific findings and evidence. Id.

Here the ALJ’s decision to discredit Cullinan and 

Dr. Canzona is unsupported by the record because the ALJ’s 
10 No. 17-1287

examples of Cullinan’s daily activities and social interactions 

do not remotely describe a “very active” lifestyle. In Murphy

we decided that the ALJ erred in concluding that the claimant’s vacation undermined her claim of stroke-related 

impairments. Id. at 817. We noted that the ALJ did not 

determine what the claimant did on vacation, and we suggested a vacation relaxing on the beach would have been 

consistent with the claimant’s testimony regarding the 

severity of her impairments. Id. 

The ALJ in Cullinan’s case drew similar impermissible 

inferences from her activities. For example:

• Cullinan performed household chores. The treatment 

notes say that Cullinan did her parents’ laundry and 

was “helpful around the house.” At the hearing she 

testified that she made beds, brewed coffee, and loaded and unloaded the dishwasher. Daily activities may 

be used to discredit a claimant’s testimony. See Loveless v. Colvin, 810 F.3d 502, 508 (7th Cir. 2016) (citing 

20 C.F.R. § 404.1529(c)(3)(i); SSR 96–7P, 1996 WL 

374186, at *3; Pepper v. Colvin, 712 F.3d 351, 368–69 

(7th Cir. 2013)). But the ALJ did not explain why doing these household chores was inconsistent with 

Cullinan’s description of her pain and limited mobility. Nor is any inconsistency obvious, so the ALJ did 

not substantiate the finding that Cullinan’s daily activities reveal any exaggeration of Cullinan’s limitations. See Ghiselli, 837 F.3d at 777–78; see also Bjornson 

v. Astrue, 671 F.3d 640, 647 (7th Cir. 2012) (“The failure to recognize [the] differences [between activities 

of daily living and activities of a full-time job] is a re-
No. 17-1287 11

current ... feature of opinions by administrative law 

judges in social security disability cases.”).

• Cullinan cared for her cousin in the nursing home. 

Dr. Canzona’s notes do not contain what Cullinan did 

for her cousin other than to encourage him to eat 

healthily; she added at the hearing that she straightened up his room but did not do anything that required lifting. This is similar to the work she did 

around the house. The dearth of information about 

what Cullinan did, how she got to the nursing home, 

and how long a period of time she assisted her cousin 

renders the ALJ’s reliance on this activity unreasonable. See Murphy, 759 F.3d at 817; see also Clifford v. 

Apfel, 227 F.3d 863, 872 (7th Cir. 2000) (requiring the 

ALJ assessing the claimant’s credibility to “build an 

accurate and logical bridge from the evidence to [the]

conclusion”).

• Cullinan helped a friend care for young foster children. Again, the record is silent about how Cullinan 

helped her friend, so this activity gave the ALJ no information to factor into a credibility determination.

• Cullinan provided care for her ill grandmother who 

required “total care.” Dr. Canzona’s note contradicts 

this point: Cullinan did not attend to the grandmother

who required total care because she was already caring for another grandmother. The record does not describe what this care entailed, so there was no basis 

upon which to infer that it was “total” care. 

• Cullinan attended concerts. The record suggests that 

Cullinan attended two concerts in 2013, but again the 
12 No. 17-1287

record provides no details suggesting that this was 

particularly “active” or social behavior, or that 

Cullinan used public transportation.

• Cullinan attended her parents’ anniversary party and 

her cousin’s wake. The record does not describe these 

family events, how Cullinan traveled to them, or her 

activity when there. Moreover, she expressed having 

chest pressure before each occasion. Going to these 

two events to fulfill family obligations is not indicative of a high level of social or physical activity.

• Cullinan discussed looking for work and wanting to 

volunteer at an animal shelter. Cullinan testified that 

twice after her stroke she tried to resume working as a 

nursing aide but stopped after four days each time 

because she was unable to keep up with the patients. 

A positive work history makes a claimant more credible, Stark, 813 F.3d at 689, and a desire to resume 

work similarly makes a claimant more credible, not 

less, see Ghiselli, 837 F.3d at 778 (“Persisting in looking 

for employment even while claiming to suffer from a 

painful disability might simply indicate a strong work 

ethic or overly-optimistic outlook rather than an exaggerated condition.”); see also Hill v. Colvin, 807 F.3d 

862, 868 (7th Cir. 2015) (noting that a desire to work is 

consistent with an inability to work). The expressed 

desire to do volunteer work is simply unenlightening.

• Cullinan went on dates. The record says that Cullinan 

wanted to reconnect with her ex-boyfriend and that at 

one point she “met a man and spent some time with 

him.” These statements do not describe a pattern of 

dating that demonstrates a “very active” lifestyle. 
No. 17-1287 13

Moreover, Cullinan was likely “spending time with” 

several people during her alleged period of disability—her parents, for example. Perhaps the ALJ believed this interaction with one person was evidence 

of social functioning, but she did not say so; and in 

any case spending time with someone is too vague a 

descriptor to contradict Cullinan’s alleged impairments.

In citing these questionable examples of a “very active” 

lifestyle to discredit Cullinan’s account of how she is limited 

by her impairments, the ALJ did not rely on substantial 

evidence. Moreover, the ALJ did not discuss any of 

Cullinan’s testimony in analyzing her residual functional 

capacity, so it appears that she gave the testimony no weight 

despite implying that it was at least partially credible (i.e., 

“not entirely credible”).

Relatedly, Dr. Canzona’s opinion of Cullinan’s limitations, contrary to what the ALJ said, was not inconsistent 

with his own treatment notes, so the ALJ should not have 

ignored it. A treating doctor’s opinion is entitled to controlling weight unless it is unsupported by the record. 

Vanprooyen v. Berryhill, 864 F.3d 567, 572 (7th Cir. 2017). An 

inadequate evaluation of a treating physician’s opinion 

requires remand. See Meuser v. Colvin, 838 F.3d 905, 912 (7th 

Cir. 2016); Scott v. Astrue, 647 F.3d 734, 739–40 (7th Cir. 2011). 

Dr. Canzona treated Cullinan every other week for almost 

all of 2013. The ALJ said that Dr. Canzona’s opinion should 

not carry controlling weight because it was contradicted by 

Cullinan’s level of activity and thus lacked support in the 

record. Instead, the ALJ gave great weight to the opinions of 

nonexamining agency consultants.
14 No. 17-1287

But just as Dr. Canzona’s treatment notes did not show 

that Cullinan was “very active” and therefore not believable, 

the notes also do not contradict Dr. Canzona’s opinion of 

Cullinan’s limitations. Attending concerts and family functions and spending some time with a man does not show 

that she is able to work, travel, or use public transportation. 

Further, his notes that she was able to focus during sessions 

do not conflict with his opinion that she cannot focus “for 

extended time periods.” Because the ALJ did not adequately 

explain the conclusion that Dr. Canzona’s notes were inconsistent with his opinion, the ALJ’s decision to assign no 

weight to Dr. Canzona’s opinion was error.

We are also troubled by the fact that the ALJ did not consider Cullinan’s daily extended naps and frequent debilitating headaches in determining her residual functional capacity. No evidence in the record contradicted Cullinan’s testimony about these limitations, so only the adverse credibility 

determination could explain the ALJ’s omission. But if the 

credibility finding was erroneous, Cullinan could well be 

adjudged disabled: the vocational expert said that needing 

to take a two-hour nap every day would rule out all work. 

And no one mentioned the headaches, but if they were 

factored in, the case for disability would be stronger still. 

The ALJ has the burden to develop the record and assess 

whether symptoms are disabling. See Yurt v. Colvin, 758 F.3d 

850, 860 (7th Cir. 2014). 

Cullinan’s remaining arguments are unpersuasive. First,

she argues that the ALJ did not consider her sleep apnea

when determining her RFC, but the ALJ expressly incorporated this limitation into her evaluation of Cullinan’s attention and concentration. Cullinan also argues that the ALJ 
No. 17-1287 15

should have given more weight to Dr. Cybulski, another 

treating physician, but Dr. Cybulski examined Cullinan only 

shortly after her stroke in 2011, and a treating physician 

without a longitudinal view is not entitled to controlling 

weight. 20 C.F.R. § 404.1527(c)(2); see Scheck v. Barnhart, 

357 F.3d 697, 702 (7th Cir. 2004). Cullinan’s status soon after 

her stroke does not shed light on her physical and mental 

limitations years later. Finally, Cullinan challenges the

hypothetical question posed to the vocational expert as 

incomplete because it did not include her partial blindness.

To the extent the ALJ’s exclusion of partial blindness from 

the RFC and hypothetical question was based on the flawed 

credibility assessment, the ALJ should reconsider the effect 

of Cullinan’s partial blindness on remand.

To conclude, the ALJ’s determinations that neither 

Cullinan nor her treating psychologist were credible are not 

based on substantial evidence. Because the determinations 

led the ALJ to deny Cullinan’s application for benefits, they 

are not harmless errors. See Ghiselli, 837 F.3d at 778–79.

We VACATE the judgment and REMAND for further proceedings.