# United States Court of Appeals

For the Seventh Circuit

Chicago, Illinois 60604

Argued October 15, 2009

Decided January 5, 2010

Before

KENNETH F. RIPPLE, Circuit Judge

DANIEL A. MANION, Circuit Judge

MICHAEL S. KANNE, Circuit Judge

No. 09

‐ 1132

ANGELA D. LUSTER,

Plaintiff

‐ Appellant

,

v.

MICHAEL J. ASTRUE,

Commissioner of the Social Security

Administration,

Defendant

‐ Appellee

. Appeal from the United States District

Court for the Eastern District of Wisconsin.

No. 07

‐ CV

‐ 1009

Rudolph T. Randa,

Judge

.



### O R D E R

Angela Luster applied for Supplemental Security Income benefits, claiming that

since December 5, 2003, she has not been able to work because of depression, high blood

pressure, Hepatitis C, a bone disease, and pain. An administrative law judge found that

although Luster has a severe combination of impairments, her residual functional capacity

allows for light work. Accordingly, the ALJ determined that Luster was not disabled. The

district court upheld the ALJ ʹ s determination. On appeal, Luster argues that the ALJ should

have given controlling weight to her treating physician who opined that she could not work

a full day. But because that opinion was based on Luster’s complaints of pain, the NONPRECEDENTIAL DISPOSITION

To be cited only in accordance with

Fed. R. App. P. 32.1No. 09

‐ 1132 Page 2

1 The other ailments include leiomyomas that protrude over the external uterine

surface, ventricular hypertrophy and mild to moderate diastolic dysfunction, minor stenosis

at the left renal artery, possible gout, a bone spur, possible small vessel disease, calcification

in the aorta and other vessels, an aneurysm, small kidney cysts, pleural thickening,

tendinitis, and possible ischemic disease. credibility of which the ALJ permissibly questioned, and not on objective clinical evidence,

the ALJ need not have deferred to the opinion, and we therefore affirm.

BACKGROUND

Only two witnesses testified before the ALJ. Luster, who was 50 years old and not

working at the time of her hearing, testified about her pain and its effect on her. She stated

that every day she experiences pain all over her body, can walk only about half a block

without getting short of breath, can sit continuously for about twenty to thirty minutes, can

stand for about one

‐ half hour, and can lift about ten pounds. She takes prescribed

medication to combat the pain. The other witness to testify was a vocational expert. The

expert stated that there were jobs that accommodate someone with Luster ʹ s background (a

GED and limited work history) and who had a residual functional capacity for low

‐ stress

and light or sedentary work.

The ALJ received written evaluations of Luster’s physical and mental abilities.

Luster ʹ s treating physician, M. Anjum Razzaq, M.D., completed three work

‐ capacity

evaluations. His conclusions were based on Luster’s complaints of her pain. Razzaq opined

that Luster could continuously sit for about two hours, and could continuously stand for

fifteen minutes, but that in an eight

‐ hour day the total time that Luster could stand or sit

was about two hours. In addition, Razzaq’s notations from Luster’s office visits indicate

that her muscles had “mild to moderate tenderness.” The record also contains three mental

evaluations by other professionals. Although Luster had some noted mental deficiencies,

these evaluations concluded that she was capable of sustaining simple, low

‐ stress, routine

work. In addition to these evaluations, the record contains numerous other physician notes

from Luster’s visits to Razzaq and other doctors.

The parties do not dispute that Luster’s other medical records document

impairments for chest pain (secondary to anxiety), fibromyalgia, hypertension, Hepatitis C,

and depression with anxiety. These records also describe clinical tests suggesting numerous

other possible ailments as well, but either omit a definitive diagnosis or do not explain

whether they impair Luster’s ability to work. 1 In addition, the record contains Razzaq ʹ sNo. 09

‐ 1132 Page 3

2 Razzaq’s notes refer to “CVA,” “History of CVA,” “gastritis,” “menorrhagia,”

”arthralgia,” “bilateral lower extremity pain,” and “hip pain.” notes of possible conditions, but they do not cite any clinical tests that verify these

possibilities. 2

The ALJ conducted the five

‐ step analysis required under 20 C.F.R. § 416.920(a). At

step two the ALJ found a severe combination of impairments consisting of chest pain,

fibromyalgia, hypertension, Hepatitis C, and depression with anxiety. But, after

determining Luster ʹ s residual functional capacity at step four, he found, at step five, that

adequate employment was available even accounting for her limitations. In reaching this

conclusion, the ALJ ruled that Razzaq ʹ s opinion that Luster cannot work a full day should

not be given controlling weight because it was based solely on Luster’s less than credible

complaints and had no other clinical support. The district court affirmed these rulings.

ANALYSIS

This court will affirm the ALJ ʹ s denial of disability benefits so long as the decision is

not based on legal error and is supported by substantial evidence, meaning ʺ such relevant

evidence as a reasonable mind might accept as adequate to support a conclusion. ʺ Nelms v.

Astrue

, 553 F.3d 1093, 1097 (7th Cir. 2009) (quoting Richardson v. Perales

, 402 U.S. 389, 401

(1971)); Lopez v. Barnhart

, 336 F.3d 535, 539 (7th Cir. 2003). The ALJ must build an accurate

and logical bridge between the evidence and his conclusions, and this court must confine its

review to those reasons that the ALJ supplies for the decision. Getch v. Astrue

, 539 F.3d 473,

480 (7th Cir. 2008); Steele v. Barnhart

, 290 F.3d 936, 941 (7th Cir. 2002). If an ALJ ʹ s decision

contains inadequate evidentiary support or a cursory analysis of the issues, this court will

reverse. Lopez

, 336 F.3d at 539.

Luster principally argues that the ALJ erred because he did not give controlling

weight to the opinion of her treating physician, Razzaq, that she could never work a full

day. A treating physician ʹ s opinion is entitled to controlling weight so long as it is

supported by objective medical evidence and is consistent with other substantial evidence

in the record. See 20 C.F.R. § 404.1527(d)(2); Bauer v. Astrue

, 532 F.3d 606, 608 (7th Cir. 2008);

Skarbek v. Barnhart

, 390 F.3d 500, 503 (7th Cir. 2004). But an ALJ may reject a treating

physician ʹ s opinion in the absence of such objective evidence or if substantial evidence in

the record contradicts the physician ʹ s findings. 20 C.F.R. § 404.1527(d)(2); Gudgel v.

Barnhart

, 345 F.3d 467, 470 (7th Cir. 2003). When an ALJ discounts the opinion of the

treating physician, the ALJ must articulate good reason for doing so. 20 C.F.R.

§ 404.1527(d)(2); see Schmidt v. Astrue

, 496 F.3d 833, 842 (7th Cir. 2007). This court upholdsNo. 09

‐ 1132 Page 4

all but the most patently erroneous reasons for discounting a treating physician ʹ s

assessment. See Dixon v. Massanari

, 270 F.3d 1171, 1177 (7th Cir. 2001).

Here, the ALJ provided good reasons for discounting Razzaq ʹ s conclusions. The ALJ

explained that Razzaq never supported Luster’s claimed inability to work a full day with

clinical findings or diagnostic tests; Razzaq merely recorded Luster ʹ s complaints about her

self

‐ described limitations. In particular, upon his physical examinations of Luster, Razzaq

did not find objective factors for the pain that Luster said prevented her from working.

Razzaq found only ʺ mild to moderate tenderness ʺ of her muscles. Razzaq failed to reconcile

the objective signs of moderate pain, and Luster ʹ s management of her pain through

medication, with his more extreme conclusion that Luster could not tolerate more than two

hours of standing or two hours of sitting in an eight

‐ hour period. This unexplained

inconsistency supports the ALJ ʹ s conclusion to discount Razzaq’s opinion on the ground

that he merely repeated Luster ʹ s self

‐ reported symptoms without acknowledging the

objective evidence to the contrary. See Ketelboeter v. Astrue

, 550 F.3d 620, 625 (7th Cir. 2008).

In addition, the notes that Razzaq made referring to other possible conditions do not

justify his conclusion that Luster could not work because they, too, lack clinical support.

For example, his notes about ʺ CVA ʺ and ʺ History of CVA ʺ (presumably a reference to a

cerebral stroke, S TEDMAN ʹ S M EDICAL D ICTIONARY 2330 (27th Ed. 2000)), are devoid of any

clinical foundation. In fact, as verified by Luster ʹ s counsel at the hearing, Razzaq never

diagnosed Luster with having had a stroke. And even after a CT scan revealed no sign of a

cerebral stroke, Razzaq puzzlingly continued to note ʺ CVA ʺ in Luster ʹ s records. The

absence of clinical testing, coupled with contrary objective evidence, regarding Razzaq ʹ s

notations undermine their reliability.

Luster next argues that the ALJ erred in determining her residual functional capacity

by ignoring evidence of her other ailments that did have clinical support, such as conditions

footnoted above. But Luster did not meet her burden of proving the effect of these maladies

on her ability to work. Clifford v. Apfel

, 227 F.3d 863, 868 (7th Cir. 2000); 20 C.F.R. § 404.1512

( ʺ you must furnish medical and other evidence that we can use to reach conclusions about

your medical impairment(s) and, if material to the determination of whether you are blind or

disabled, its effect on your ability to work ʺ ) (emphasis added). Nothing in the record explains

how these ailments affect her capacity to work and hold a job. For instance, nowhere does

Luster explain the effect of ʺ mild to moderate diastolic dysfunction ʺ such that the ALJ could

build the ʺ logical bridge ʺ from the ailment to the conclusion that it precludes employment.

See Jeralds v. Richardson

, 445 F.2d 36, 38

‐ 39 (7th Cir. 1971) (despite evidence showing

existence of medical conditions, claim failed because ʺ no showing was made

. . . that these

conditions rendered Plaintiff disabled ʺ ).No. 09

‐ 1132 Page 5

Last, Luster argues that the ALJ impermissibly discounted the credibility of Luster ʹ s

subjective claims about her ongoing pain and inability to work. “We defer to an ALJ ʹ s

credibility determination and shall overturn it only if it is ‘patently wrong.’” Prochaska v.

Barnhart

, 454 F.3d 731, 738 (7th Cir. 2006). Reviewing courts therefore should rarely disturb

an ALJ ʹ s credibility determination, unless that finding is unreasonable or unsupported. See

Sims v. Barnhart

, 442 F.3d 536, 538 (7th Cir. 2006).” Getch

, 539 F.3d at 483. This case is no

exception. Luster believes that if the ALJ had accepted all of the medical evidence, he

would have found her testimony credible. But, as noted above, the burden was on Luster to

show that her claimed maladies precluded gainful activity. Clifford

, 227 F.3d at 868; 20

C.F.R. § 404.1512. She did not do this, and as such the ALJ was not wrong in concluding

that her claimed limitations were not supported by the evidence in her medical records.

CONCLUSION

For the foregoing reasons, the district court ʹ s judgment upholding the decision of the

ALJ is AFFIRMED.