IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

BONNIE K.,

1

Plaintiff,

v.

KILOLO KIJAKAZI, 

Acting Commissioner of Social Security,2

Defendant.

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No. 20 C 4778 

Magistrate Judge Beth W. Jantz

MEMORANDUM OPINION AND ORDER

This action was brought under 42 U.S.C. § 405(g) to review the final decision of the 

Commissioner of Social Security denying Plaintiff Bonnie K.’s application for Disability 

Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”). The parties have 

consented to the jurisdiction of the United States Magistrate Judge pursuant to 28 U.S.C. 

§636(c). For the reasons that follow, Plaintiff’s motion for summary judgment [dkt. 17, Pl.’s 

Mot.] is denied, and the Commissioner’s cross-motion for summary judgment [dkt. 20, Def.’s 

Mot.] is granted. The Court affirms the Commissioner’s final decision.

1 In accordance with Internal Operating Procedure 22, Privacy in Social Security Opinions, the 

Court refers to Plaintiff by her first name and the first initial of her last name.

2 Pursuant to Federal Rule of Civil Procedure 25(d), Kilolo Kijakazi has been substituted for her

predecessor.

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BACKGROUND

I. Procedural History

On November 1, 2017, Plaintiff filed a claim for DIB and SSI, alleging disability since 

March 16, 2015, due to low vision, COPD, depression, sleep apnea, congestive heart failure, and 

glaucoma. [Dkt. 16-1, R. 261-73, 294.] Plaintiff’s claim was denied initially and again upon 

reconsideration. [R. 131-32, 167-68.] Plaintiff requested a hearing before an Administrative 

Law Judge (“ALJ”), which was held on June 26, 2019. [R. 59-102.] Plaintiff personally 

appeared and testified at the hearing and was represented by counsel. [R. 61, 66-93.] Vocational 

expert (“VE”) Monica Dabrowiecka also testified. [R. 94-100.] On September 3, 2019, the ALJ 

denied Plaintiff’s claim for benefits, finding her not disabled under the Social Security Act. 

[R. 38-51.] The Social Security Administration Appeals Council denied Plaintiff’s request for 

review, leaving the ALJ’s decision as the final decision of the Commissioner. [R. 1-3.] 

II. The ALJ’s Decision

The ALJ analyzed Plaintiff’s claim in accordance with the Social Security

Administration’s five-step sequential evaluation process. [R. 38-51.] The ALJ found at step one 

that Plaintiff had not engaged in substantial gainful activity since her amended alleged onset date 

of September 1, 2016. [R. 40.] At step two, the ALJ concluded that Plaintiff had the following

severe impairments: congestive heart failure (“CHF”), chronic obstructive pulmonary disease 

(“COPD”), obesity, left eye glaucoma, and obstructive sleep apnea. [R. 40-42.] The ALJ also 

determined that Plaintiff’s right knee injury, major depressive disorder, and generalized anxiety 

disorder were non-severe impairments. [Id.] The ALJ concluded at step three that her

impairments, alone or in combination, do not meet or medically equal one of the Social Security 

Administration’s listings of impairments (a “Listing”). [R. 42-43.] Before step four, the ALJ 

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determined that Plaintiff retained the residual functional capacity (“RFC”) to perform light work 

with the following additional limitations: she cannot climb ladders, ropes, or scaffolds; she can 

occasionally climb ramps and stairs, balance, kneel, crouch, and crawl; she cannot work around 

hazards such as unprotected heights and exposed moving mechanical parts; she cannot drive a 

motor vehicle; she cannot tolerate more than occasional exposure to extreme cold or extreme 

heat, fumes, odors, dusts, gases, poor ventilation, and other pulmonary irritants; she does not 

have peripheral vision on her left side; and work should involve simple instructions, routine 

tasks, occasional changes in the workplace setting, no public interaction, and occasional 

interaction with supervisors and coworkers. [R. 43-49.] At step four, the ALJ concluded that 

Plaintiff would be unable to perform her past relevant work. [R. 49.] At step five, based upon 

the VE’s testimony and Plaintiff’s age, education, work experience, and RFC, the ALJ concluded 

that Plaintiff could perform jobs existing in significant numbers in the national economy, leading 

to a finding thatshe is not disabled under the Social Security Act. [R. 50-51.] 

DISCUSSION

I. Judicial Review

Under the Social Security Act, a person is disabled if she is unable “to engage in any 

substantial gainful activity by reason of any medically determinable physical or mental 

impairment which can be expected to result in death or which has lasted or can be expected to 

last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). To 

determine disability within the meaning of the Social Security Act, the ALJ conducts a five-step 

inquiry, asking whether: (1) the claimant has performed any substantial gainful activity during 

the period for which she claims disability; (2) the claimant has a severe impairment or 

combination of impairments; (3) the claimant’s impairment meets or equals any listed 

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impairment; (4) the claimant retains the RFC to perform her past relevant work; and (5) the 

claimant is able to perform any other work existing in significant numbers in the national 

economy. 20 C.F.R. § 416.920(a). “A finding of disability requires an affirmative answer at 

either step three or step five.” Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 352 (7th Cir. 

2005). “The claimant bears the burden of proof atsteps one through four, after which 

at step five the burden shifts to the Commissioner.” Id. 

Because the Appeals Council denied review, the ALJ’s decision became the final 

decision of the Commissioner and is reviewable by this Court. 42 U.S.C. § 405(g); Cullinan v. 

Berryhill, 878 F.3d 598, 603 (7th Cir. 2017). The Court plays an “extremely limited” role in 

reviewing the ALJ’s decision. Elder v. Astrue, 529 F.3d 408, 413 (7th Cir. 2008). Judicial 

review of the ALJ’s decision is limited to determining whether it adequately discusses the issues 

and is based upon substantial evidence and the proper legal criteria. Villano v. Astrue, 556 F.3d 

558, 561-62 (7th Cir. 2009). “Substantial evidence” is “such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 

1154 (2019) (internal quotation omitted). “To determine whether substantial evidence exists, the 

court reviews the record as a whole but does not attempt to substitute its judgment for the ALJ’s 

by reweighing the evidence, resolving material conflicts, or reconsidering facts or the credibility 

of witnesses.” Beardsley v. Colvin, 758 F.3d 834, 836-37 (7th Cir. 2014). While this review is 

deferential, “it is not intended to be a rubber-stamp” on the ALJ’s decision. Stephens v. 

Berryhill, 888 F.3d 323, 327 (7th Cir. 2018). The Court will reverse the ALJ’s finding “if it is 

not supported by substantial evidence or if it is the result of an error of law.” Id. at 327.

The ALJ has a basic obligation both to develop a full and fair record and to “build an 

accurate and logical bridge between the evidence and the result [so as] to afford the claimant 

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meaningful judicial review of the administrative findings.” Beardsley, 758 F.3d at 837. 

Although the ALJ is not required to mention every piece of evidence in the record, the ALJ’s 

analysis “must provide some glimpse into the reasoning behind [his] decision to deny benefits.” 

Zurawski v. Halter, 245 F.3d 881, 889 (7th Cir. 2001); accord Craft v. Astrue, 539 F.3d 668, 673 

(7th Cir. 2008). The ALJ “must explain [the ALJ’s] analysis of the evidence with enough detail 

and clarity to permit meaningful appellate review.” Scrogham v. Colvin, 765 F.3d 685, 695 (7th 

Cir. 2014) (quoting Briscoe, 425 F.3d at 351). Thus, even if reasonable minds could differ as to 

whether the claimant is disabled, courts will affirm a decision if the ALJ's opinion is adequately 

explained and supported by substantial evidence. Elder, 529 F.3d at 413. 

II. Analysis

Plaintiff argues that the ALJ (1) failed to adequately develop the record and seek a 

medical expert opinion regarding her knee injury, (2) improperly gave his own lay opinion in 

determining that her knee injury was not severe, and (3) did not properly assess her subjective 

complaints. [Dkt. 17, Pl.’s Mem. at 3-16; dkt. 22, Pl.’s Reply at 1-5.] The Commissioner argues 

in opposition that the ALJ reasonably concluded that Plaintiff’s knee injury was not a severe 

impairment, the ALJ had no obligation to obtain further evidence regarding Plaintiff’s knee 

injury, and the ALJ appropriately assessed Plaintiff’s subjective statements. [Dkt. 21, 

Def.’s Mem. at 2-12.] For the reasons that follow, the Court affirms the ALJ’s decision. 

A. Plaintiff’s Knee Injury

Plaintiff first argues that the ALJ should have developed the record and obtained a 

medical opinion regarding Plaintiff’s knee impairment and its effects on her functioning. 

[Pl.’s Mem. at 3-7; Pl.’s Reply at 1-3.] Plaintiff further maintains that the ALJ erred at step two 

in finding her knee injury not severe and thus not considering it when crafting her RFC. [Id.] 

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The Court concludes, however, that, based on the record before him, the ALJ’s decisions—both 

not to seek further evidence and to find Plaintiff’s knee injury not severe—were sound.

The medical evidence in the record reflects treatment for Plaintiff’s knee injury only from 

August to November 2018, as follows. On August 1, 2018, Plaintiff first went to a medical 

provider, complaining of right knee pain and swelling. [R. 1106-07.] Upon exam, she had 

decreased range of motion due to pain and stiffness in her right knee, swelling, effusion, and 

tenderness. [R. 1107.] Plaintiff was referred to orthopedics, told to use an ace bandage wrap to 

help with swelling, and advised to elevate her leg at home. [R. 1108.] On August 11, Plaintiff 

went to the emergency room for knee pain and swelling, reporting that she had twisted her right 

knee two weeks prior. [R. 1556.] She again had limited range of motion, swelling, effusion, and 

tenderness. [R. 1557.] An x-ray of her right knee revealed no evidence of dislocation, but she 

did have a “small to moderate suprapatellar effusion” and a “suggestion of lateral notch sign.” 

[R. 1558.] Plaintiff was given a knee immobilizer, crutches, and a prescription for ibuprofen

(she already had a prescription for a narcotic, Norco), and she was advised that she might need 

an MRI to evaluate her cruciate ligaments. [R. 1558-59.] Two days later, on August 13,

Plaintiff was seen by a primary care doctor for her knee injury, and she reported pain severity of 

“10/10.” [R. 983.] A physical examination revealed decreased range of motion, swelling, 

effusion, tenderness, and edema. [R. 984.] The doctor prescribed a medication for swelling and 

advised Plaintiff to return in one month or if symptoms did not improve. [R. 985, 990.]

Next, Plaintiff went to the emergency room for her knee pain on October 14. [R. 1618.] 

Upon exam, she had a “moderate suprapatellar knee effusion” and mild tenderness but full range 

of motion. [R. 1620.] Plaintiff did not want repeat imaging of her knee and instead asked for

and obtained a new knee immobilizer and orthopedic referral. [R. 1620, 1631, 1646.] On 

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October 25, Plaintiff followed up with the orthopedist, walked with crutches while there, and 

reported experiencing “persistent swelling, locking, and catching with occasional buckling 

sensation” in her right knee. [R. 1328-31.] The physical exam revealed “severe effusion,” 

tenderness, limited range of motion, crepitus, and a positive Lachman test. [R. 1330.] She was 

referred for an MRI of her right knee, which she had on November 9. [R. 1331-34.] The MRI 

revealed, among other findings, “large volume knee joint effusion and associated synovitis,” 

“diffuse edema throughout the soft tissues circumferentially above the knee,” “underlying 

tricompartmental degenerative joint disease which is at least mild in severity,” diffuse thinning 

of cartilage with diffuse grade two to three chondromalacia changes, a high-grade MCL injury at 

least grade two in severity, and a grade one to two LCL sprain. [R. 1034-35.] Plaintiff’s last 

visit for her knee was to the orthopedist on November 20, 2018. [R. 1326-28.] At that time, she 

again used crutches to walk, and the physical exam findings were the same as in her late October 

visit. [R. 1328.] The orthopedist reviewed the MRI findings and recommended using a hinged 

knee brace, attending physical therapy, and taking anti-inflammatory medications; if symptoms 

persisted, he suggested that they would discuss surgical options with a specific doctor. [Id.] 

After November 20, 2018, the only other mention of a knee condition in the medical 

records was during Plaintiff’s hospitalization for chest pain in March 2019, when she generally 

reported that she had chronic knee pain that interfered with her daily activities. [R. 1442, 1467.] 

At the administrative hearing, when Plaintiff’s attorney asked her about her “issues with [her] 

right knee,” Plaintiff responded that the condition “was in August.” [R. 81.] When asked what 

happened since then, Plaintiff testified that when they did the MRI, they found that her knee “is 

ate up with arthritis.” [Id.] Plaintiff also testified thatshe had “knee pain a lot” and cannot 

climb stairs in part because of her knee pain. [R. 81, 91.]

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Citing the medical records summarized above, the ALJ concluded that Plaintiff’s 

MCL/LCL knee injury was not severe because it did not last at least 12 continuous months as 

required under the regulations, see 20 C.F.R. § 404.1509. [R. 41.] The ALJ noted that the 

condition was “reflected in only three to four months of treatment notes, from August to 

November 2018 [ ], after which clinical abnormalities no longer appear.” [Id.] Additionally, the 

ALJ recognized that the record showed that Plaintiff walked with a normal gait and did so even 

while being treated for her knee injury. [R. 41 (citing, e.g., R. 1454, 1470, 1489, 1830).]

Turning first to Plaintiff’s argument that the ALJ was required to obtain more medical 

evidence to develop the severity of Plaintiff’s knee impairment, “a claimant represented by 

counsel is presumed to have made his best case before the ALJ.” Skinner v. Astrue, 478 F.3d 

836, 842 (7th Cir. 2007). It is Plaintiff’s obligation to prove that she is disabled, including by 

submitting “all evidence known to [her] that relates to whether or not [she is] disabled.” 

20 C.F.R. § 404.1512(a). The ALJ does, however, have a duty to develop a “full and fair 

record,” but that duty is not endless, and the Court will ordinarily defer to the ALJ’s reasoned 

judgment about how much evidence to gather. Thomas v. Colvin, 745 F.3d 802, 807-08 (7th Cir. 

2014) (quoting Smith v. Apfel, 231 F.3d 433, 437 (7th Cir. 2000)); see also Migdalia M. v. Saul, 

414 F. Supp. 3d 1126, 1136 (N.D. Ill. 2019).

Here, the ALJ reasonably concluded that he had sufficient evidence to evaluate Plaintiff’s 

knee injury. Plaintiff’s presentation of her complaints about her knee injury and lingering knee 

pain before the ALJ were extremely limited: she mentioned “knee pain” twice briefly during her 

testimony at the hearing and never highlighted the issue as one requiring further development, 

including by requesting an additional consultative examination. [SeeR. 62-66, 81, 91, 101.] 

This limited presentation undermines her current assertion that her knee impairment was critical 

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enough to determining her RFC that it mandated further development. See, e.g., Migdalia M., 

414 F. Supp. 3d at 1137.

Further, an ALJ has discretion to order a consultative examination if the evidence is 

inconsistent or insufficient to make a determination on a plaintiff’s claim. Skinner, 478 F.3d at 

844; 20 C.F.R. § 404.1519a(b). “[A]n ALJ must consult with an expert only when, in the ALJ’s 

opinion, the new evidence might cause an initial medical opinion to change.” Johnson v. 

Berryhill, 745 F. App’x 247, 250 (7th Cir. 2018) (emphasis added). Given Plaintiff’s limited 

complaints and the limited treatment records, the ALJ’s implicit conclusion that the evidence of 

Plaintiff’s knee impairment was sufficient to render a decision was a reasonable one. Following 

the last treatment record in November 2018, Plaintiff did not seek further treatment for any knee 

condition and only mentioned “chronic knee pain” once to providers in the ensuing seven 

months, despite having sought treatment for other medical conditions during this time. [R. 1442, 

1467.] And as the ALJ noted too, there were no reported abnormalities with Plaintiff’s gait after 

November 2018. [R. 41.] Lastly, even Plaintiff referred to her MCL/LCL injury in the past 

tense when testifying, instead attributing her “knee pain” to arthritis—a condition for which she 

did not seek treatment. [R. 81.] The ALJ’s decision not to follow up on an injury that the lack of 

records and subjective complaints reflected had been resolved was reasonable. See, e.g., Phillips 

v. Astrue, 601 F. Supp. 2d 1020, 1032 (N.D. Ill. 2009); Mitchel A. v. Saul, No. 19 CV 1757, 

2020 WL 2324425, at *6 (N.D. Ill. May 11, 2020).

Finally, Plaintiff characterizes the ALJ’s decision as “play[ing] doctor,” meaning

foregoing obtaining necessary medical opinion evidence and improperly interpreting “‘new and 

potentially decisive evidence’”—the November 2018 MRI—on his own. [Pl.’s Mem. at 6 

(quoting McHenry v. Berryhill, 911 F.3d 866, 871 (7th Cir. 2018)).] But this is inaccurate. 

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Although the state agency physicians rendered their administrative medical findings before

Plaintiff’s knee treatment was completed, including before the MRI was taken, and no other 

medical opinion evidence evaluated Plaintiff’s knee condition, it does not follow that the ALJ 

could not review the later treatment records to draw his own conclusions about the severity of 

Plaintiff’s condition. [R. 141-42, 145-47.] This did not amount to the ALJ interpreting the raw 

MRI data himself, as Plaintiff asserts; instead, the ALJ had the benefit of the treating medical 

professional’s November 20 review of the MRI results and the treatment recommendations that 

followed. [SeeR. 1326-28.] In any event, there is no indication that the ALJ relied on the MRI 

report’s conclusions to determine the severity of Plaintiff’s injury. Cf. McHenry v. Berryhill, 

911 F.3d 866, 871 (7th Cir. 2018) (“An ALJ may not conclude, without medical input, that a 

claimant’s most recent MRI results are ‘consistent’ with the ALJ’s conclusions about her 

impairments.”). Rather, the ALJ focused on the overall lack of treatment records even after 

Plaintiff had obtained the MRI results and the lack of reported abnormalities after 

November 2018 as an indicator that Plaintiff’s condition was not severe. [See R. 41.] The Court 

finds nothing improper about the ALJ’s consideration of the record evidence here.

Moving on to the ALJ’s step two determination, the ALJ must determine at that step

whether Plaintiff suffers from any medically determinable impairments that are “severe,” 

meaning they significantly limit Plaintiff’s ability to do basic work activities. 20 C.F.R. 

§§ 404.1520(c), 404.1522(a). Plaintiff bears the burden to prove that the impairment is severe. 

Castille v. Astrue, 617 F.3d 923, 926 (7th Cir. 2010). The ALJ concluded that Plaintiff did suffer 

from several severe impairments—CHF, COPD, obesity, left eye glaucoma, and obstructive 

sleep apnea—but that Plaintiff’s knee injury did not constitute a severe impairment. [R. 40-42.] 

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The ALJ’s reasons for finding Plaintiff’s knee injury not to be severe were valid. The 

ALJ correctly pointed out that the medical record is devoid of treatment outside of August to 

November 2018 for Plaintiff’s knee condition. [See R. 41.] Plaintiff herself described her 

MCL/LCL injury as a past condition during her testimony, characterizing her ongoing knee 

issues as related to arthritis instead. [R. 81.] And Plaintiff has not identified any treatment she 

received for knee pain, arthritic or otherwise, after November 2018. [See Pl.’s Mem. at 3-7; Pl.’s 

Reply at 1-3.] Thus, the ALJ appropriately found her knee injury to be temporary and not severe 

on this basis, as it is rational to assume a condition for which Plaintiff did not seek further 

treatment for nearly seven months afterward (measured from the late November 2018 visit to the 

hearing in late June 2019) had largely improved. 

Additionally, the ALJ reasonably found that Plaintiff’s knee injury did not significantly 

impact her ability to work overall, specifically her ability to walk. [R. 41.] The ALJ noted that 

the medical records reflected that Plaintiff had normal gait, “even during” the treatment period

for her knee condition. [Id.] To undermine that she walked with a normal gait, Plaintiff points 

to contrary evidence thatshe sometimes used crutches during treatment for her MCL/LCL injury. 

[Pl.’s Mem. at 6.] But both are true: Plaintiff had occasions from August to November 2018 

where she was reported to use crutches to walk and occasions where her gait was reported as 

normal in the medical records. [See R. 1328 (crutches on 11/20/18), 1330 (crutches on

10/25/18); R. 1235 (normal gait on 10/17/18), 1830 (normal gait on 9/6/18).] Even assuming 

that the ALJ should have acknowledged that the evidence during treatment was mixed, nothing 

undermines his broader conclusion, however, that Plaintiff otherwise walked with a normal gait

after the treatment for her knee ended in November 2018. [R. 41; see, e.g., R. 700, 707, 913, 

1454, 1470, 1489.] The lack of reported abnormalities with Plaintiff’s gait after treatment

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provides support for the ALJ’s conclusion that Plaintiff’s knee condition was not severe because 

it shows that the injury only temporarily affected her physical capabilities. Accordingly, the 

ALJ’s conclusion that Plaintiff’s knee injury was not severe is supported by substantial evidence.

In any event, “[s]tep two is merely a threshold inquiry; so long as one of the claimant’s 

limitations is found to be severe, error at that step is harmless.” Ray v. Berryhill, 915 F.3d 486, 

492 (7th Cir. 2019). The ALJ must go on to consider all of Plaintiff’s impairments, severe and 

non-severe, in crafting the RFC. Id. Here, having concluded that Plaintiff’s knee impairment 

resolved, the ALJ reasonably considered the injury’s lack of impact on Plaintiff’s ability to 

perform light work with additional limitations, specifically on her ability to walk. [See R. 41, 

45-49.] And the ALJ gave a thorough analysis of Plaintiff’s other impairments that more 

significantly impacted her ability to work. [See R. 45-49.] Although Plaintiff generally faults 

the ALJ for not incorporating in the RFC limitations that her knee impairment caused, Plaintiff 

does not explain what the ALJ overlooked or what further RFC limitations were warranted,

[Pl.’s Mem. at 7]. Paar v. Astrue, No. 09 C 5169, 2012 WL 123596, at *7 (N.D. Ill. Jan 17, 

2012) (failure to discuss medical issues not error where plaintiff did not identify any evidence 

that those issues interfered with his ability to work).

Overall, the ALJ reasonably concluded that he had sufficient evidence with which to 

evaluate Plaintiff’s knee injury. And the ALJ then appropriately determined that the knee injury 

ultimately was not severe based on the totality of the evidence. 

B. Plaintiff’s Subjective Statements

In evaluating Plaintiff’s reports of her symptoms, in addition to the objective medical 

evidence, the ALJ may also consider Plaintiff’s daily activities, intensity of pain and other 

symptoms, precipitating and aggravating factors, medications and their side effects, treatment 

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received, and any other measures used to relieve symptoms. 20 C.F.R. § 404.1529(c)(1-3). The 

Court will overturn the ALJ’s evaluation of Plaintiff’s subjective statements only if it is “patently 

wrong.” Summers v. Berryhill, 864 F.3d 523, 528 (7th Cir. 2017). The ALJ must give “specific 

reasons supported by the record.” Pepper v. Colvin, 712 F.3d 351, 367 (7th Cir. 2013); 

see Murphy v. Colvin, 759 F.3d 811, 816 (7th Cir. 2014) (explaining that patently wrong “means 

that the decision lacks any explanation or support”). Indeed, “an ALJ’s adequate discussion of

the issues need not contain a complete written evaluation of every piece of evidence.” Pepper, 

712 F.3d at 362 (internal quotation omitted).

Plaintiff challenges the ALJ’s evaluation of her subjective complaints, contending that 

the ALJ’s rejection of them as partially inconsistent with her activities and with the medical 

record was erroneous and insufficient. [Pl.’s Mem. at 7-16; Pl.’s Reply at 4-5.] Ultimately, and 

particularly given the deferential standard, the Court finds that the ALJ gave sufficient reasons to 

support his conclusion that Plaintiff’s subjective reports were “not entirely consistent” with the 

record. [R. 45.]

To evaluate Plaintiff’s alleged symptoms, the ALJ first recounted her subjective reports, 

which included “shortness of breath” as well as “difficulty standing more than five minutes, 

walking more than 50 feet/a half block, sitting, lifting more than a gallon of milk, squatting, 

bending, reaching, kneeling, talking, climbing stairs, seeing, completing tasks, concentrating, and 

getting along with others.” [R. 44.] The ALJ then summarized how Plaintiff performed her

daily activities, including that she mostly sat around with her feet up, but she can prepare simple 

meals;she can do laundry and cleaning but it takes longer than it used to; she goes out three to 

four times a week, usually with her daughter; and she goes grocery shopping for about two and a 

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half hours at a time, but she needs to stop and take breaks and she cannot push the cart the whole 

time. [Id.]

The ALJ ultimately found that Plaintiff’s “reported activities of daily living including 

some household chores, going out, riding a bicycle, and more” were not consistent with the 

“rather extreme limitations” Plaintiff alleged or “an allegation of disability.” [R. 45-46.] As the 

Commissioner concedes, [Def.’s Mem. at 9 n.3], the ALJ’s reference to “riding a bicycle” was 

(to put it mildly) puzzling because there was no record evidence that Plaintiff rode a bike during 

the relevant period. Butsetting aside the erroneous, stray reference to bike riding, the rest of the 

ALJ’s conclusion properly points to an apparent mismatch between Plaintiff’s daily activities 

and reported symptoms. For example, Plaintiff reported performing chores such as cleaning the 

bathroom, making simple meals, and grocery shopping (albeit, taking longer with breaks) but 

also said she had difficulty standing for more than five minutes or walking more than 50 feet. 

[See R. 72, 75, 82-83, 313-15.] Equating daily activities with an ability to perform full-time 

work is impermissible error, but the ALJ did not do that here. See Green v. Saul, 781 F. App’x 

522, 527 (7th Cir. 2019). Instead, the ALJ appropriately partially discounted Plaintiff’s 

subjective reports on the ground that her daily activities were not as limited as her dire reports of 

her capabilities would suggest. See Prill v. Kijakazi, 23 F.4th 738, 748 (7th Cir. 2022); 

Regina P. v. Saul, No. 19 C 3155, 2020 WL 4349888, at *5 (N.D. Ill. Jul. 29, 2020) (“The ALJ 

was permitted to consider [the] mismatch between [plaintiff's] daily activities and her symptom 

description.”). The ALJ then went on to craft an RFC that accounted for the limitations Plaintiff 

required, though not to the full extent to which she testified. [See R. 46.]

Next, Plaintiff’s criticisms concerning the ALJ’s reliance on the medical evidence are 

without merit. Plaintiff focuses on the ALJ’s analysis of the objective medical evidence, 

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contending that the ALJ could not discount her symptoms solely on that basis. [Pl.’s Mem. at 

10-11.] That is indeed true, but the ALJ may consider “discrepancies between the objective 

evidence and self-reports [because they] may suggest symptom exaggeration.” Jones v. Astrue, 

623 F.3d 1155, 1161 (7th Cir. 2010). Thus, it was proper for the ALJ to note the ways in which 

the objective evidence did not support Plaintiff’s testimony about her condition, and the ALJ did 

more than simply summarize the medical evidence, as Plaintiff asserts. [Pl.’s Mem. at 10-11; 

Pl.’s Reply at 4-5.] Aside from the objective medical evidence, the ALJ also appropriately 

considered the treatment rendered, precipitating and aggravating factors of Plaintiff’s symptoms,

and her medications and their side effects. 20 C.F.R. § 404.1529(c)(1-3).

As to Plaintiff’s congestive heart failure, the ALJ discussed the improvement shown in 

the record following a cardiac catheterization in March 2015, specifically that Plaintiff’s left 

ventricular ejection fraction had improved from 20 percent to between 45 and 60 percent, most 

recently 45 to 50 percent in April 2019. [R. 45.] The ALJ pointed out that Plaintiff’s medical 

providers managed her complaints of shortness of breath and chest pain through medications, 

and that cardiac imaging had not shown acute abnormalities. [Id.] The ALJ recounted Plaintiff’s 

short trip to the emergency room in March 2019, during which her chest pain resolved after 

administration of sublingual nitroglycerin. [Id.] And, as to Plaintiff’s lower extremity swelling 

and edema, providers had noted those issues at times, but Plaintiff nevertheless walked with a 

normal gait and had no reported strength deficiencies. [Id.] 

In finding Plaintiff’s subjective reports not as severe as she alleged given this evidence, 

the ALJ nonetheless concluded that Plaintiff had a continued reduced ejection fraction, some 

degree of edema at times, and some shortness of breath on exertion, and accordingly limited 

Plaintiff to performing light work. [R. 45-46.] Additionally, due to the shortness of breath, the 

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ALJ found that further restrictions were warranted: no climbing of ladders, ropes, or scaffolds; 

occasional climbing of ramps and stairs, balancing, kneeling, crouching, and crawling; and 

avoiding hazards like unprotected heights or exposed moving mechanical parts. [R. 46.]

The ALJ also thoroughly considered Plaintiff’s history of treatment for COPD, noting 

that she had received regular and emergency treatment for respiratory complaints such as 

coughing, wheezing, rhonchi, and bronchitis. [R. 46.] The ALJ characterized the physical 

examination findings of rhonchi, diminished breath sounds, and wheezing to be “sporadic,”

recognized she had received diagnoses of COPD exacerbations and periodic bronchitis, and 

acknowledged too that she was prescribed inhalers and nebulizers to manage symptoms. [Id.] 

Additionally, the ALJ acknowledged that Plaintiff had gone to the emergency room about one to 

three times per year with COPD exacerbations and bronchitis. [Id.] The ALJ identified 

Plaintiff’s smoking as an aggravating factor of her coughing, noting that she had been smoking 

one to two packs of cigarettes a day, although she had at the time of the hearing reduced her 

smoking to just one to two cigarettes a day. [R. 46-47.] Turning to the objective imaging, the 

ALJ explained that an August 2018 radiology study showed minimal bronchial thickening as 

well as moderate emphysematous changes and a CT angiogram in April 2019 showed only mild 

obstructive changes with the lungs otherwise clear. [R. 47.] And the ALJ specifically asserted 

that Plaintiff’s pulmonary function tests were not consistent with the rather extreme respiratory 

limitations that Plaintiff alleged because they showed normal lung volumes and spirometry but 

with mild airway obstruction. [Id.] 

Overall, the ALJ concluded that Plaintiff’s “respiratory impairments were consistent with 

shortness of breath on exertion that develops from time to time particularly during an 

exacerbation,” and that the pulmonary testing did not support more severe limitations. [Id.] 

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Thus, the ALJ accounted for the periodic wheezing, decreased breath sounds, and rhonchi found 

during the physical exams and the pulmonary function and radiology findings by limiting 

Plaintiff to light work with the same postural and environmental limitations imposed for her 

heart condition as well as a restriction to no more than occasional exposure to extreme cold or 

heat, fumes, odors, gases, poor ventilation, and other pulmonary irritants. [Id.]

Rather than simply summarize the medical evidence, as discussed above, the ALJ 

considered the relevant treatment history, physical examination findings, and objective imaging 

in determining the extent to which the medical record supported Plaintiff’s subjective symptoms. 

The ALJ then properly tied the RFC to those findings. See, e.g., Green, 781 F. App’x at 527. To 

the extent that Plaintiff contends the ALJ’s conclusion regarding her reported symptomsis 

“factually inconsistent with medical records,” Plaintiff recounts entire swaths of evidence that 

the ALJ considered that she essentially wishes the ALJ weighed differently. [Pl.’s Mem. at 11-

15.] But this amounts to nothing more than a request for the Court to “reweigh the evidence or 

substitute its judgment for that of the ALJ’s,” which it is not permitted to do. Pepper v. Colvin, 

712 F.3d 351, 362 (7th Cir. 2013); Michelle M.L. v. Kijakazi, No. 20 C 6793, 2022 WL 3297619, 

at *10 (N.D. Ill. Aug. 11, 2022). Because the ALJ reasonably weighed the record evidence in 

determining that Plaintiff’s limitations from her impairments were not as severe as she alleged,

and then in ultimately concluding that her limitations warranted an RFC of light work with 

additional postural and environmental limitations, the ALJ’s decision is supported by substantial 

evidence.

The ALJ’s analysis of Plaintiff’s subjective complaints does not have to be “perfect,” it 

only must not be “patently wrong.” See Schreiber v. Colvin, 519 F. App’x 951, 961 (7th Cir. 

2013). Aside from the ALJ’s erroneous, brief mention of bicycle riding as a daily activity, he 

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gave sufficient reasons supported by the record for finding Plaintiff’s subjective symptoms not 

entirely consistent with the record. See Joyce C. v. Kijakazi, No. 19 CV 8514, 2021 WL 

4264274, at *9 (N.D. Ill. Sept. 20, 2021) (“Even a flawed symptom assessment may survive 

remand, however, where the ALJ reasonably evaluated [the claimant’s] symptoms by 

considering the requisite factors.”) (internal quotation marks omitted). Even if Plaintiff contends 

that the evidence should have been weighed differently in the first instance, the ALJ’s analysis 

was not “patently wrong,” and thus the Court cannot disturb the ALJ’s finding. Summers, 

864 F.3d at 528. 

CONCLUSION

For the foregoing reasons, Plaintiff’s motion for summary judgment [dkt. 17] is denied, 

and the Commissioner’s cross-motion for summary judgment [dkt. 20] is granted. The Court 

affirms the Commissioner’s final decision. 

SO ORDERED. 

Date: 3/15/23

BETH W. JANTZ

United States Magistrate Judge

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