Samantha J. Underwood v. MICHAEL J. ASTRUE, Commissioner of Social Security

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Argued June 6, 2011
Decided July 13, 2011
Before
MICHAEL S. KANNE, Circuit Judge
TERENCE T. EVANS, Circuit Judge
DIANE S. SYKES, Circuit Judge
No. 10‐3778
SAMANTHA J. UNDERWOOD,
Plaintiff‐Appellant,
v.
MICHAEL J. ASTRUE,
Commissioner of Social Security,
Defendant‐Appellee.
Appeal from the United States District
Court for the Central District of Illinois.
No. 2:09‐cv‐02072
David G. Bernthal,
Magistrate Judge.
O R D E R
Samantha Underwood has suffered from mental health problems throughout her life. Since
2001, she has seen numerous treatment providers, and about the only thing those providers
have agreed on is that Underwood suffers from an affective mood disorder. Whatever
Underwood’s exact diagnosis, complications from her mental health problems led her to apply
for social security disability benefits in early 2004. After two hearings, the administrative law
judge (“ALJ”) concluded that Underwood was not disabled. Underwood then petitioned for
review in the district court, claiming that the ALJ’s decision was not supported by substantial
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with
Fed. R. App. P. 32.1

-- 1 of 5 --

No. 10‐3778 Page 2
evidence. The district court affirmed the determination of the ALJ. Underwood now brings
her case to us, arguing (yet again) that the ALJ erred. We affirm.
The ALJ’s disability analysis was guided by a five‐step regulatory framework. See 20 C.F.R.
§§ 404.1520, 416.920. Step one asks whether the claimant is engaging in substantial gainful
activity. If she is, she is not disabled and the analysis ends; if she is not, the analysis continues.
Step two goes to whether the claimant has an impairment that qualifies as severe. If the
impairment is not severe, the claimant is not disabled; if the impairment is, the ALJ proceeds
to the next step. Step three deals with whether the claimant’s impairment meets or equals one
of the impairments listed in the regulations. If the claimant’s impairment matches the list, the
claimant is disabled; if it does not, the ALJ must determine the claimant’s ability to do work
activities on a sustained basis despite limitations from her impairment. Step four deals with
this residual functional ability—the ALJ must determine whether the claimant has the ability
to perform the requirements of past work. If she can, she is not disabled; if she cannot, the
analysis proceeds to the fifth and final step. Step five asks whether the claimant can engage in
any other work considering her functional ability. If she can, she is not disabled.
Underwood’s case turned, in large part, on step three. For Underwood’s impairment to
equal or match the listing under that step, her disorder must have caused two of the following
functional impairments: a marked restriction of activities of daily living; a marked difficulty
in social functioning; a marked difficulty in concentration, persistence, or pace; or repeated
episodes of extended decompensation. See 20 C.F.R. Pt. 404, Subpart P, App.1 § 12.04(B).
Whether Underwood’s impairments were marked or mild depended upon her treatment
record, a record that painted a somewhat confusing—and in pockets inconsistent—picture of
Underwood’s impairments. Some experts opined that Underwood’s affective disorder did not
cause marked impairments in any area, but instead resulted in more mild ones.
Others—including Dr. Ramirez, Underwood’s treating psychiatrist—concluded that
Underwood’s disorder caused marked impairments in numerous areas, including social
functioning and concentration. A medical expert, Dr. Marquis, was called to review
Underwood’s record and offer a comprehensive opinion about her impairments. Dr. Marquis
initially determined that Underwood’s impairments were mild, but amended his opinion
towards more marked impairments after he was presented with Dr. Ramirez’s summary report.
Dr. Marquis did insert one caveat: he had not seen Dr. Ramirez’s treatment notes, and thus
could not say whether Dr. Ramirez’s conclusions were supported by his records.
In progressing through his step‐by‐step analysis, the ALJ found that there were
inconsistencies between Dr. Ramirez’s conclusions and his notes, as well as inconsistencies
between Dr. Ramirez’s conclusions and the opinions of other providers. He also found
Underwood’s credibility lacking, and accordingly discredited some of her subjective reports
to her providers. Based on these problems, the ALJ discounted Dr. Ramirez’s conclusions and

-- 2 of 5 --

No. 10‐3778 Page 3
Dr. Marquis’s amended opinion. Instead, the ALJ gave more weight to other experts’ reports
and to Dr. Marquis’s original assessment, which supported more mild functional impairments.
And because Underwood could perform the requirements of past work despite these mild
impairments, the ALJ found that she was not disabled under the Social Security Act.
Underwood’s primary argument is that the ALJ’s finding of mild impairments was not
supported by substantial record evidence. We disagree. Substantial evidence is only “such
relevant evidence as a reasonable mind might accept as adequate to support [the ALJ’s
judgment],” Richardson v. Perales, 402 U.S. 389, 401 (1971), and it was present here. The record
shows that Underwood left her home six to eight times per month, that she talked to
acquaintances on the phone, that she had close friends with whom she kept in regular contact,
that she maintained a good relationship with her mother, and that she maintained generally
appropriate interaction with her children. In reviewing her treatment records, the state
psychologists concluded that Underwood’s social functioning was adequate. This was enough
to support the ALJ’s determination that Underwood had mild social impairments.
The ALJ’s conclusion that Underwood had only mild restrictions in concentration,
persistence, or pace was also supported by substantial evidence. Underwood’s treatment
providers often described her concentration and attentiveness as adequate. Her providers also
noted that Underwood was cognitively intact, was cooperative, and was generally able to take
directions. Psychological testing showed that Underwood had adequate recall. Her therapist
gave her instructions on several occasions and noted that Underwood was able to understand
and implement those instructions. Based on their review of most of Underwood’s records, the
state psychologists also concluded that Underwood did not have a marked impairment in
concentration, persistence, or pace. This was sufficient to support the ALJ’s conclusion.
To be sure, there was evidence in the record that went the other way, and Underwood
challenges the ALJ’s treatment of that evidence. She initially suggests that the ALJ ignored the
evidence that supported marked impairments and an inability to work, thereby committing
legal error. See Campbell v. Astrue, 627 F.3d 299, 306 (7th Cir. 2010). Our review of the record,
however, leaves us convinced that the ALJ analyzed all of the evidence put forth. The ALJ did
not ignore the evidence in question, but instead weighed and discredited it.
Underwood devotes the rest of her arguments to attacking the way the ALJ weighed the
evidence that swung in her favor. Before we deal with those arguments, we pause to note that
the ALJ is the factfinder in a disability proceeding—it is for him to weigh evidence and
determine credibility. See White v. Barnhart, 415 F.3d 654, 659 (7th Cir. 2005). On appeal, we
review the ALJ’s assessment of the evidence deferentially, and we will not upset that
assessment by reweighing evidence, reevaluating credibility, or otherwise substituting our
judgment for the ALJ’s. Jens v. Barnhart, 347 F.3d 209, 212 (7th Cir. 2003). All that said, there
are limits to the ALJ’s power as factfinder. He cannot, for instance, flout social security

-- 3 of 5 --

No. 10‐3778 Page 4
regulations that impose evidentiary rules upon him, nor can he conclude that a party lacks
credibility without a reasoned basis. See Punzio v. Astrue, 630 F.3d 704, 709‐10 (7th Cir. 2011).
Underwood seizes on both of these limitations, arguing first that the ALJ discredited the
conclusions of Dr. Ramirez in violation of social security regulations. The regulation at issue,
20 C.F.R. § 404.1527(d)(2), provides that the ALJ must give the treating physician’s conclusions
controlling weight unless they are not supported by the treating physician’s records or are
otherwise inconsistent with the reports of other providers. “An ALJ who does not give
controlling weight to the opinion of the claimant’s treating physician must offer ‘good reasons’
for declining to do so.” Larson v. Astrue, 615 F.3d 744, 749 (7th Cir. 2010).
Contrary to Underwood’s arguments, the ALJ offered good reasons for declining to give Dr.
Ramirez’s conclusions controlling weight. After delving into the record, the ALJ first observed
that a number of Dr. Ramirez’s treatment notes did not mesh with his ultimate conclusion that
Underwood was disabled. For instance, around a week before issuing a letter instructing
parties that Underwood could not work, Dr. Ramirez noted that Underwood was stable, was
maintaining a good relationship with her family, was cognitively intact, and appeared to have
good judgment. Second, the ALJ noted that Dr. Ramirez’s conclusions did not harmonize with
the conclusions of other providers, who had often noted that Underwood was stabilized on
medication, proceeding well in treatment, able to work, and so on. Both of these were sufficient
reasons for discrediting the treating psychiatrist’s determinations, as well as the amended
opinion from Dr. Marquis that was based upon those determinations.
Underwood also contends that the ALJ erred in finding her not credible and in discounting
some of her subjective reports to treatment providers based on that lack of credibility. An ALJ’s
power to discount credibility is not unlimited: he must consider a number of factors imposed
by regulation, see 20 C.F.R. § 404.1529(c), and must support his credibility findings with
evidence in the record, see Villano v. Astrue, 556 F.3d 558, 562 (7th Cir. 2009). Once he does,
however, his credibility determinations are entitled to “special deference” and will not be
overturned unless “patently wrong.” Jones v. Astrue, 623 F.3d 1155, 1160 (7th Cir. 2010).
We conclude that the ALJ’s credibility determination was reasoned, supported by evidence,
and not clearly incorrect. The ALJ noted a number of discrepancies in Underwood’s reports
to her treatment providers, including inconsistencies about her prior psychiatric admissions,
her ability to care for her children, her reasons for leaving various jobs, and her drug use. The
ALJ also observed a strange change in Underwood’s symptomology that suggested a credibility
problem: after Underwood obtained counsel to pursue her disability claim, she began reporting
more intense manic episodes, new psychotic symptoms, and novel concerns about multiple
personality disorder and attention‐deficit hyperactivity disorder. These problems were enough
to permit the ALJ to doubt Underwood’s credibility and to discount some of her subjective
reports to her providers based upon that lack of credibility.

-- 4 of 5 --

No. 10‐3778 Page 5
In the end, this is a case with inconclusive facts. The question is not whether we believe
Underwood was disabled, but whether the ALJ’s determination was supported by substantial
evidence. It was. The ALJ also acted within his discretion in weighing the conflicting evidence:
he offered adequate reasons for discrediting Dr. Ramirez’s conclusions and doubting
Underwood’s credibility. We therefore AFFIRM the judgment of the district court.

-- 5 of 5 --