Tracie L. Ellison v. KILOLO KIJAKAZI, Acting Commissioner of Social Security

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted November 3, 2023
Decided December 20, 2023
Before
THOMAS L. KIRSCH II, Circuit Judge
CANDACE JACKSON-AKIWUMI, Circuit Judge
DORIS L. PRYOR, Circuit Judge
No. 22-3134
TRACIE L. ELLISON,
Plaintiff-Appellant,
v.
KILOLO KIJAKAZI,
Acting Commissioner of Social Security,
Defendant-Appellee.
Appeal from the United States District
Court for the Eastern District of Wisconsin.
No. 1:21-cv-00821
Stephen C. Dries,
Magistrate Judge.
O R D E R
An administrative law judge ruled that Tracie L. Ellison was not eligible for
Social Security disability benefits. The ALJ recognized that she suffered from nine
severe and several non-severe impairments, which made her unable to perform her past
relevant work, but denied her benefits because she could perform sedentary work with
additional limitations. On appeal, Ellison argues that the ALJ: (1) discounted the impact
of some of her impairments, including the limitations from her severe and non-severe
impairments in combination, in conducting the residual functional capacity (RFC)
assessment, (2) improperly rejected her primary care doctor’s medical source statement,
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with Fed. R. App. P. 32.1

-- 1 of 6 --

No. 22-3134 Page 2
and (3) failed to obtain another medical opinion of her 2019 medical imaging results.
Because we find that substantial evidence supports the ALJ’s decision, we affirm.
I
In June 2017, Tracie L. Ellison applied for disability benefits due to several
impairments, including depression and anxiety, carpal tunnel syndrome, obesity, and
fibromyalgia, among others. She alleged that these health problems prevented her from
lifting anything that weighed more than ten pounds, standing or sitting for extended
periods, and walking long distances. She testified that she had trouble reaching with
either arm, using her hands, and maintaining her grip. And she claimed that she
experienced anxiety around groups of people and did not handle stress well. The Social
Security Administration denied Ellison’s claims initially and on reconsideration, and
Ellison appeared before an ALJ at a video hearing in February 2020. Ellison and
vocational expert Thomas A. Gusloff testified at the hearing. The ALJ also considered
the medical opinions of various doctors, including medical consultants, psychological
consultants, a psychologist, and Ellison’s primary care physician, but noted that none of
these opinions could be given controlling weight. The ALJ found Ellison’s primary care
physician’s opinion that Ellison could not work to be “conclusory.”
The ALJ concluded that Ellison was not disabled under the Social Security Act
from the alleged onset date in January 2015 through March 16, 2020, the date of the
decision. The ALJ applied the five-step evaluation for disability claims. 20 C.F.R.
§ 404.1520. At step one, the ALJ found that Ellison had not engaged in substantial
gainful employment since the alleged onset date. At steps two and three, the ALJ found
that while Ellison had several severe and non-severe impairments, none of the
impairments alone or in combination resulted in more than mild, if any, functional
limitations. However, in assessing Ellison’s RFC, the ALJ determined that Ellison can
perform work that requires no more than a sedentary level of exertion with additional
limitations. At step four, the ALJ ascertained that Ellison could not perform her past
relevant work because the exertional level required for those occupations exceeded the
exertional limit provided in the RFC assessment. At step five, the ALJ found that
considering Ellison’s age, education, work experience, and RFC, there were jobs that
existed in significant numbers in the national economy that Ellison could perform, such
as order clerk (food-and-beverage), telephone information clerk, and document
preparer. The ALJ thus held that Ellison was not disabled and denied Ellison’s claim for
disability benefits. The district court affirmed the ALJ’s decision, and Ellison now
appeals.

-- 2 of 6 --

No. 22-3134 Page 3
Ellison raises three issues on appeal. First, Ellison argues that the ALJ erred by
disregarding the limitations from her severe and non-severe impairments in
combination in the RFC assessment. Second, Ellison asserts that the ALJ improperly
rejected the medical source statement from her treating physician. Third, Ellison
disagrees with the ALJ’s decision to not obtain another medical opinion on her 2019
medical imaging results.
In conducting our review, we ask whether substantial evidence supports the
ALJ’s decision and review de novo the district court’s decision. 42 U.S.C. § 405(g);
Stephens v. Berryhill, 888 F.3d 323, 327 (7th Cir. 2018). Substantial evidence is only “such
relevant evidence as a reasonable mind might accept as adequate to support a
conclusion[,]” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (quotation omitted), and
“the threshold for such evidentiary sufficiency is not high,” id.
II
On appeal, Ellison argues that the ALJ overlooked the degree of some of her
impairments and failed to consider the limitations of her severe and non-severe
impairments in combination in conducting the RFC assessment. She further asserts that
the ALJ committed reversible error by not adopting her primary care doctor’s medical
source statement and by failing to obtain another medical opinion on her 2019 medical
imaging results. We address each argument in turn.
A
First, Ellison argues that the ALJ downplayed the severity of some of her
impairments and failed to consider the combined effect of her severe and non-severe
impairments in conducting the RFC assessment. Ellison is correct that “an ALJ must
consider the combined effects of all of the claimant's impairments, even those that
would not be considered severe in isolation.” Terry v. Astrue, 580 F.3d 471, 477 (7th Cir.
2009). Here, the ALJ properly weighed and considered Ellison’s combined impairments,
and, under the deferential standard controlling our review, we cannot say the ALJ's
decision lacks support. Albert v. Kijakazi, 34 F.4th 611, 614 (7th Cir. 2022).
Depression and anxiety. Ellison opposes the ALJ’s finding that her depression and
anxiety disorders were non-severe impairments. Specifically, Ellison asserts that the
ALJ was playing doctor by disregarding medical evidence. Yet the ALJ’s opinion
discusses Ellison’s mental health history in detail, describing her visits with an

-- 3 of 6 --

No. 22-3134 Page 4
anesthesiologist (where she reported thoughts of suicide), a psychological evaluation
(where she was diagnosed with major depressive disorder), and her primary care
physician (where she discussed her anxiety). But, as the ALJ noted, these doctors also
did not document any abnormality in her presentation, found her memory to be normal
and intact, and noted that medication had stabilized the issues related to her depression
and anxiety disorder. Further, the ALJ found persuasive two reports from psychological
consultants concluding that Ellison did not have a severe mental impairment. The ALJ
did not ignore medical evidence but reached a different conclusion than Ellison desired.
“[E]ven if reasonable minds could differ,” we must affirm the ALJ’s decision because it
is “adequately supported” by the evidence. Elder v. Astrue, 529 F.3d 408, 413 (7th Cir.
2008) (quotation omitted). Therefore, the ALJ appropriately considered and addressed
the effect of this non-severe impairment in the RFC assessment.
Carpal tunnel syndrome. Ellison argues that the ALJ’s finding that she is able to
frequently use her bilateral hands for handling and fingering lacks substantial evidence
and that the ALJ ignored the effects of carpal tunnel syndrome on both her hands. But
the ALJ appropriately considered the medical records related to Ellison’s carpal tunnel
syndrome, found that carpal tunnel syndrome in both hands was a severe impairment,
and assessed lifting, carrying, and manipulative limitations on both of Ellison’s hands.
The ALJ also considered Ellison’s recovery post-surgery and her personal activities,
such as making beaded bracelets. We find that substantial evidence supports the ALJ’s
finding that Ellison’s carpal tunnel syndrome in combination with her other
impairments is not disabling.
Obesity. Ellison alleges that the ALJ failed to acknowledge Ellison’s obesity. But
the record shows otherwise. In her decision, the ALJ explicitly considered the
exacerbating effect Ellison’s weight could have in combination with her symptoms of
fibromyalgia, lumbar spine, and left knee impairments when limiting Ellison to
sedentary work. The ALJ also accounted for the stress imposed by her weight when
finding that Ellison can stand for one to two minutes after sitting for thirty minutes.
Further, the ALJ noted Ellison’s weight when she found as reasonable the limitation
that Ellison never climb ladders, ropes, or scaffolds and only occasionally climb ramps
or stairs or balance, twist, stoop, bend, crouch, kneel, or crawl. Thus, the ALJ did more
than just mention Ellison’s obesity “in passing.” Martinez v. Astrue, 630 F.3d 693, 698
(7th Cir. 2011). Rather, she appropriately “consider[ed] its significance in relation to”
her other symptoms. Id. Moreover, the fact that the ALJ placed Ellison in the categories
of Level II and Level III obesity (with Level III being the highest level) reveals that the
ALJ acknowledged and considered the degree of Ellison’s obesity.

-- 4 of 6 --

No. 22-3134 Page 5
Fibromyalgia. The ALJ adequately evaluated the effect of Ellison’s fibromyalgia in
combination with her other impairments. The ALJ considered Ellison’s fibromyalgia
combined with the exacerbating effect of her weight when imposing a limitation of
sedentary work. The ALJ also accounted for Ellison’s fibromyalgia in combination with
her weight when finding that it was reasonable to provide a limit on Ellison’s climbing
and movements like bending and kneeling. That Ellison would have preferred a finding
that she can sit for only fifteen minutes at a time is insufficient for reversal. This is
especially true for fibromyalgia cases, where we have recognized that “[a]lmost any
conclusion an ALJ reaches in such situations may be inconsistent with some evidence in
the record and consistent with other evidence.” Kolar v. Berryhill, 695 F. App’x 161, 162
(7th Cir. 2017).
Ellison also challenges the ALJ’s finding that any perceived complexity of the
treatment history was a consequence of how the treatment evidence was presented,
rather than a reflection of the complexity of the information contained therein. She
asserts that this finding constitutes the ALJ’s own medical opinion interposed to
convince the reader that her impairments have no interactive or cumulative effect on
each other and that the record is not worth examining in detail. But we read this
statement as contending that the medical evidence was documented in a complex way,
not the ALJ offering her own medical opinion on the evidence. Further, an ALJ “is not
required to mention every piece of evidence.” Craft v. Astrue, 539 F.3d 668, 673, 678 (7th
Cir. 2008). Thus, the ALJ examined and discussed Ellison’s record in the appropriate
level of detail.
B
Next, Ellison asserts that the ALJ committed reversible error by not adopting her
primary care doctor’s medical source statement—concluding that Ellison cannot
maintain employment—and by failing to assign it controlling weight. But the ALJ
reasonably discounted Dr. Johnson’s opinion for three reasons. First, in evaluating
claims filed March 27, 2017 or later, an ALJ cannot assign specific evidentiary weight,
including controlling weight, to any medical opinions. 20 C.F.R. §§ 404.1520c(a),
416.920c(a). Second, Dr. Johnson’s finding that Ellison cannot maintain employment is
an improper legal conclusion; a doctor’s opinion on a claimant’s disability status is not
entitled to any weight. See 20 C.F.R. § 404.1520b(c)(3)(i) (explaining that “statements
that you are or are not … able to work, or able to perform regular or continuing work”
are “inherently neither valuable nor persuasive” because such issues are reserved to the
Commissioner); Albert, 34 F.4th at 616 (“[T]he ultimate determination of disability is

-- 5 of 6 --

No. 22-3134 Page 6
reserved for the Commissioner, and summarily asserting that the claimant is disabled
does not suffice under the Commissioner’s regulations.”). Third, Dr. Johnson did not
link his findings to specific treatment records, so it is unclear whether his conclusions
stem from his own analysis of the medical evidence or Ellison’s self-reports. Because an
ALJ may discount medical opinions that are “conclusory and not supported by any
clinical basis,” Cooley v. Berryhill, 738 F. App’x 877, 880 (7th Cir. 2018), the ALJ did not
err.
C
Lastly, Ellison challenges the ALJ’s decision to not obtain another medical
opinion on her 2019 medical imaging results. Ellison argues that an ALJ may not
interpret and give medical opinions on medical testing results without help from a
specialist. See Goins v. Colvin, 764 F.3d 677, 680 (7th Cir. 2014). But that is not what the
ALJ did here. Instead, the ALJ relied on the radiologist’s opinion that there had been no
significant interval changes compared to the prior testing results. Because the 2019
results do not “contain[] new, significant medical diagnoses [that] reasonably could
have changed the reviewing physician’s opinion,” Moreno v. Berryhill, 882 F.3d 722, 728
(7th Cir. 2018), the “older assessments can still constitute ‘substantial evidence’
supporting the ALJ’s decision,” Bakke v. Kijakazi, 62 F.4th 1061, 1067 (7th Cir. 2023). See
also Durham v. Kijakazi, 53 F.4th 1089, 1095 (7th Cir. 2022) (finding that resubmission to a
consulting physician was unwarranted where a 2019 hospital visit bore a “significant
resemblance” to an earlier visit). Thus, the ALJ did not err in declining to submit
Ellison’s 2019 test results to a medical expert.
AFFIRMED

-- 6 of 6 --