United States Court of Appeals 

For the Seventh Circuit 

Chicago, Illinois 60604 

Argued November 18, 2020 

Decided February 2, 2021 

Before 

DIANE S. SYKES, Chief Judge 

 

MICHAEL S. KANNE, Circuit Judge 

DIANE P. WOOD, Circuit Judge

No. 19-3298 

RONDA LUCILLE STOCKS, 

 Plaintiff-Appellant, 

v. 

ANDREW M. SAUL, 

Commissioner of Social Security, 

 Defendant-Appellee.

 Appeal from the United States District 

Court for the Southern District of Indiana, 

New Albany Division. 

No. 4:18-cv-00125-DML-SEB 

Debra McVicker Lynch, 

Magistrate Judge.

ORDER 

Ronda Stocks applied for disability insurance benefits, mainly alleging posttraumatic stress disorder, depression, and anxiety. An administrative law judge 

assigned “little weight” to her treating psychologist’s opinion and denied her 

application. The district court upheld this decision. We conclude, however, that the ALJ 

did not “minimally articulate” good reasons for his decision not to give Stocks’s treating 

physician’s opinion controlling weight. We therefore vacate the judgment and remand 

for further proceedings. 

NONPRECEDENTIAL DISPOSITION 

To be cited only in accordance with Fed. R. App. P. 32.1 
No. 19-3298 Page 2 

I 

Stocks applied in October 2014 for Title II disability insurance benefits, alleging a 

host of mental and physical impairments. She later amended her onset date to 

October 9, 2014, when she first sought mental health treatment. 

After years of reporting depression and anxiety to her primary-care provider, 

nurse-practitioner Paula Scheidler, and periodically taking medication, Stocks began 

psychotherapy in October 2014 with psychologist Dr. Joan Davis, Psy.D. Stocks related 

that she has experienced suicidal ideations, depression, anxiety, panic attacks, as well as 

strong feelings of guilt and grief. She also reported sometimes having poor 

concentration, memory loss, and emotional instability. Dr. Davis described Stocks as “a 

very depressed and traumatized woman” and diagnosed her, in part, with posttraumatic stress disorder and depression. She recommended a psychiatric evaluation 

and continued therapy, but Stocks never followed up. 

In December 2014, Stocks met with state-agency psychologist John Terrell, Ph.D. 

Stocks explained that she applied for disability benefits because she “struggle[d] 

emotionally” and described her history of depression, panic attacks, and trauma. Her 

trauma stemmed from a string of serious events: being raped at knife point; seeing her 

niece “lying out on the highway” after she was killed by a drunk driver; divorcing her 

first husband; witnessing her mother die of cancer; and coping with her current 

husband’s stroke. Her trauma left her lacking energy and motivation; she “just want[ed] 

to sleep” and not be “around people.” She explained “[t]hings have gotten worse[,]” 

and, in September 2014, she had jumped out of her car while she and her husband were 

fighting. She also struggled to take her medication regularly. Dr. Terrell stated that 

Stocks had easy and appropriate interactions, excellent attention, good recall and verbal 

reasoning, and coherent thought processes, but that she seemed “generally anxious and 

depressed.” He confirmed her PTSD and depression diagnoses. 

The following week, another state-agency psychologist, Ken Lovko, Ph.D., 

reviewed Stocks’s records and made an initial determination that she was not mentally 

disabled. In Dr. Lovko’s view, Stocks had a mild restriction in activities of daily living, 

and moderate limitations in social functioning and maintaining concentration, 

persistence, or pace. He reported that Stocks was moderately limited in her ability to 

understand, remember, and carry out detailed instructions, as well as in her ability to 

complete a normal workday and interact appropriately with the general public. He also 

agreed that Stocks had anxiety and affective disorders. But because Stocks did not 

consistently seek treatment and could “understand, remember, and carry-out unskilled 

tasks[,]” her limitations were not severe enough to prevent her from working in all 
No. 19-3298 Page 3 

environments. Another agency consultant later reconsidered Dr. Lovko’s determination 

and confirmed his assessments. 

Stocks continued to see Scheidler regularly for check-up appointments. In 

December 2016, Scheidler noted under “history of present illness” that Stocks reported 

that her anxiety and depression “do[] not interfere with activities of daily living.” (The 

same note appears in Stocks’s patient history from March 2015 to June 2016.) In the 

same record, however, Scheidler noted that Stocks’s anxiety “interfere[s] with 

household activities.” 

Stocks also began regularly seeing a psychologist, Anthony Lilly, Psy.D. She met 

with Dr. Lilly eleven times from March to September 2015 and another six times from 

April to September 2016. Stocks received cognitive and supportive therapy for her 

trauma, high anxiety, family discord, and extreme anger. To treat her PTSD, Dr. Lilly 

worked with Stocks to teach her new ways to relax, manage her anger, and effectively 

communicate. 

Dr. Lilly conducted a Mental Residual Functional Capacity Assessment with 

Stocks in January 2017. First, he assessed Stocks’s limitations in sustaining 

concentration, persistence, and pace: She was markedly limited in her ability to 

maintain attention and concentration for extended periods, work without supervision, 

work with others, make simple decisions, and maintain a normal schedule; and she was 

moderately limited in her ability to maintain regular attendance. Dr. Lilly also assessed 

marked limitations in her ability to interact with the public, to accept instructions or 

criticisms, to get along with coworkers, and to maintain socially appropriate behavior; 

and he assessed a moderate limitation in Stocks’s ability to request assistance. Finally, 

Dr. Lilly noted limitations in the area of adaptation: Stocks was markedly limited in her 

capacity to respond to changes in a work setting and to travel, and moderately limited 

in her ability to make plans independently. She was not limited in understanding or 

memory. Dr. Lilly explained his reasoning by writing “see treatment notes.” 

After her application was denied again on reconsideration, Stocks appeared 

before an administrative law judge in early 2017. She testified that she could no longer 

work because of her PTSD, stress, anxiety, and depression. She reiterated that her PTSD 

stemmed from the rape and the sight of her niece after she was killed by a drunk driver. 

She has flashbacks of these events “every time [she] hear[s] a deadbolt” or “a 

helicopter.” She also responded that she suffers from regular “severe” panic attacks, “at 

least three [times] a week.” As for her treatment, Stocks testified to seeing her therapist, 

Dr. Lilly, monthly and stated that she would see him more if she could afford it. She 

also explained that she canceled her follow-up session with Dr. Davis (her first 
No. 19-3298 Page 4 

psychologist) because she was put off when the office sent her home with another 

patient’s paperwork. 

A vocational expert then testified about work available for a person with the 

mental limitations described by the ALJ: can do only simple routine tasks with “low 

stress,” meaning no production quotas, pace-rate work, or work involving “arbitration, 

confrontation, negotiation, supervision, or commercial driving”; and can have only 

superficial interactions with the public and coworkers with “no intense or intimate 

contact last[ing] more than five minutes.” The vocational expert testified that such a 

person could not do Stocks’s past work but could be a laundry worker or janitor. If she 

could not tolerate any public contact, she could work as a laundry worker, packager, or 

industrial cleaner. Under examination from Stocks’s counsel, the vocational expert then 

testified that no jobs would exist if the person were “off task 20 percent of the workday 

due to inability to concentrate.” One or two days off per month, the expert opined, 

would not preclude employment but recovering from a panic attack once per week 

would. 

The ALJ denied Stocks’s application. Applying the administration’s five-step 

analysis, 20 C.F.R. § 404.1520(a)(4), the ALJ determined that while Stocks’s disorders 

were severe, they did not meet or equal a listed impairment. The ALJ assigned a 

residual functional capacity consistent with the hypothetical claimant described to the 

vocational expert and accepted that Stocks could not perform any past relevant work. 

But because she still could perform jobs existing nationwide in significant numbers, the 

ALJ found that Stocks was not disabled. 

As relevant to this appeal, in determining Stocks’s residual functional capacity, 

the ALJ assigned “great weight” to Dr. Terrell’s reasoning, because his examination was 

“generally consistent with the other mental health evidence.” The ALJ assigned only 

“some weight” to the findings of Dr. Lovko because he did not use the agency’s new 

mental health impairment criteria. Finally, the ALJ assigned “little weight” to Dr. Lilly’s 

opinion based on (1) the six-month treatment gap; (2) the focus of the treatment on 

family discord, anger management, and coping strategies; and (3) the inconsistency of 

his assessment with Scheidler’s notation that Stocks’s anxiety did not interfere with her 

activities of daily living. The Appeals Council accepted review and affirmed the ALJ’s 

decision; the district court upheld its decision. 

II 

Although the Appeals Council reviewed the denial of benefits, we nonetheless 

look back to the decision of the ALJ, because the Appeals Council adopted it except as 

to a narrow issue regarding the period of disability. See Arbogast v. Bowen, 860 F.2d 
No. 19-3298 Page 5 

1400, 1402–03 (7th Cir. 1988). We ask whether the ALJ’s decision is supported by 

substantial evidence, which is evidence a “reasonable mind might accept as adequate to 

support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (quoting Consol. 

Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)).

On appeal, Stocks contends only that the ALJ improperly afforded “little weight” 

to the assessment of Dr. Lilly, her treating psychologist. Under the treating physician 

rule applicable to claims filed before 2017, an ALJ who chooses not to credit a treating 

source’s opinion “must offer good reasons for doing so and must address the 

appropriate weight to give the opinion.” Stage v. Colvin, 812 F.3d 1121, 1126 (7th Cir. 

2016); see 20 C.F.R. § 404.1527(c). The ALJ should weigh the opinion based on the 

length, frequency, nature, specialty, and extent of the treatment relationship, as well as 

its consistency and support in the record. Larson v. Astrue, 615 F.3d 744, 751 (7th Cir. 

2010); see 20 C.F.R. § 404.1527(c)(2)–(5). 

The ALJ discounted Dr. Lilly’s assessment for three reasons: (1) there was a gap 

of six months during Dr. Lilly’s treatment of Stocks; (2) his treatment notes focused on 

family discord, anger management, and coping strategies; and (3) Stocks reported to 

Scheidler that her anxiety did not interfere with her activities of daily living. We must 

decide whether the ALJ adequately considered the required factors under § 404.1527(c), 

and if he built an “accurate and logical bridge” from the evidence to his decision to 

discount Dr. Lilly’s opinion. See Jeske v. Saul, 955 F.3d 583, 587 (7th Cir. 2020) (quoting 

Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001)). 

The Commissioner emphasizes that the ALJ, when determining whether to give 

controlling weight to a treater’s opinion, does not need to list every factor in the 

regulation; he must only “minimally articulate” his reasons. See Elder v. Astrue, 529 F.3d 

408, 415–16 (7th Cir. 2008). Stocks gives short shrift to this standard and incorrectly 

argues that the ALJ must explain how every factor applies. The truth, however, lies 

somewhere in the middle of these two extremes. It is not the case, as the Commissioner 

seems to suggest, that any reason, if minimally articulated, automatically justifies the 

ALJ’s discounting of a treater’s opinion. The ALJ must still support his conclusions with 

“substantial evidence,” and in the context of rejecting a treater’s opinion, must provide 

“good reasons.” Stage, 812 F.3d at 1126. In this case, the ALJ fell short with respect to 

Dr. Lilly. 

First, as Stocks correctly points out, the ALJ breezed over the extent of the 

treating relationship, mentioning only the gap in treatment. See § 404.1527(c)(2)(i)–(ii). 

The ALJ’s exclusive focus on the six-month gap (which the ALJ did not ask Stocks to 

explain) paints an unbalanced picture of the relationship. Dr. Lilly and Stocks met 
No. 19-3298 Page 6 

seventeen times from March 2015 through September 2016, while Dr. Terrell, whose 

opinion was given more weight, met with Stocks only once, and Dr. Lovko did not 

examine her at all. Stocks further testified at the hearing that she continues to see 

Dr. Lilly once a month as recommended and would be seeing him more if money 

permitted. 

The ALJ’s next concern—that Dr. Lilly’s treatment focused on family discord, 

anger management, and coping strategies—also is no reason for discounting his 

opinion. It is possible that the ALJ meant to comment on the treater’s area of expertise, 

which is a regulatory factor. But that is not what the ALJ said, and without more 

explanation it is difficult to understand why his observation about Stocks’s counseling 

supports a decision to assign Dr. Lilly’s assessment little weight. Dr. Lilly’s notes are 

clear that family discord and anger issues were among the stressors that exacerbated 

Stocks’s depression, anxiety, and PTSD—the very conditions she claims are disabling. 

And the ALJ did not explain why teaching “coping strategies” is not consistent with 

treating Stocks’s mental illnesses. Further, the ALJ’s statement is not wholly accurate; 

Dr. Lilly’s treatment focused heavily on Stocks’s trauma. 

The ALJ’s final rationale—that Dr. Lilly’s opinion conflicted with Stocks’s report 

to Scheidler that her anxiety did not affect her activities of daily living—is also 

insufficient as a reason to discount Dr. Lilly’s assessment. When an ALJ discounts a 

treating psychologist’s opinion, he must explain how it was “necessarily inconsistent” 

with other medical evidence. See Gudgel v. Barnhard, 345 F.3d 467, 470 (7th Cir. 2003) 

(citing cases). Dr. Lilly’s assessment found Stocks markedly or moderately limited in 

areas of sustaining concentration, persistence, and pace, interacting socially, and 

adaptation; he did not address whether her anxiety and depression affected her 

activities of daily living. Those include things like personal hygiene, dressing, eating, 

and mobility; they are distinct from the ability to interact socially, to adapt, and to 

maintain persistence, concentration, and pace. 

Further, as Stocks points out, Dr. Lilly’s assessment is not inconsistent with much 

of the record. All the doctors (and the ALJ) agree that she suffers from PTSD and 

affective disorders. Stocks reported poor concentration and memory loss to Dr. Davis. 

Even Dr. Lovko, who opined that Stocks’s limitations were not severe enough to 

prevent her from working, found that she was moderately limited in her ability to 

understand, remember, and carry out detailed instructions, complete a normal 

workday, and interact appropriately with the general public. An ALJ must “consider all 

relevant medical evidence and cannot simply cherry-pick facts.” Denton v. Astrue, 

596 F.3d 419, 425 (7th Cir. 2010). This is crucial when assessing mental illness because 
No. 19-3298 Page 7 

she “will have better days and worse days, so a snapshot of any single moment says 

little about her overall condition.” Punzio v. Astrue, 630 F.3d 704, 710 (7th Cir. 2011). 

The Commissioner responds that the ALJ’s reasoning is clear when taken as a 

whole. The Commissioner argues that Dr. Lilly’s assessment was “at odds” with his 

own treatment records and implies that Stocks’s symptoms result from her inconsistent 

treatment and medication. But we confine our review to the rationale offered by the 

ALJ. See Scott v. Astrue, 647 F.3d 734, 739 (7th Cir. 2011). The Commissioner may not 

decide the facts, reweigh evidence, or substitute his own judgment of that for the ALJ. 

See SEC v. Chenery Corp., 318 U.S. 80, 93–95 (1943). The other rationales offered by the 

Commissioner cannot replace the three distinct reasons the ALJ provided for 

discounting Dr. Lilly’s opinion. Also, to the extent the Commissioner denigrates that 

assessment as a mere “check box” opinion, he understates it. Dr. Lilly’s opinion was 

supported by his treatment notes, which lend it “greater significance.” Larson, 

615 F.3d at 751. 

Had the ALJ afforded Dr. Lilly’s opinion significant weight, he would likely have 

found that Stocks could not work. His findings, in combination with the vocational 

expert’s testimony that no jobs would exist if Stocks lacked the ability to concentrate 

and was “off task 20 percent of the workday,” suggest that Dr. Lilly’s opinion could 

have been decisive. 

For these reasons, we VACATE the judgment and REMAND this case to the 

agency for further proceedings.