Brenda Warnell v. Martin J. O'Malley

In the

United States Court of Appeals

For the Seventh Circuit

____________________

No. 23-1632

BRENDA K. WARNELL,

Plaintiff-Appellant,

v.

MARTIN J. O’MALLEY,

Commissioner of Social Security,

Defendant-Appellee.

____________________

Appeal from the United States District Court for the

Northern District of Indiana, Fort Wayne Division.

No. 1:22-cv-00166-WCL — William C. Lee, Judge.

____________________

ARGUED FEBRUARY 8, 2024 — DECIDED APRIL 8, 2024

____________________

Before EASTERBROOK, SCUDDER, and ST. EVE, Circuit Judges.

SCUDDER, Circuit Judge. Administrative law judges who

decide claims for social security disability benefits often find

themselves overloaded with work—with many more cases to

decide than hours available in a day. With so much at stake

for applicants, the responsibility brings with it a weighty ob-

ligation of diligence. So the challenge for an ALJ becomes

2 No. 23-1632

combining diligence with efficiency, including in preparing

written orders of decision.

Before us is Brenda Warnell’s challenge to an ALJ’s deter-

mination that she is not disabled and therefore not entitled to

disability benefits or supplemental security income. By any

measure, the ALJ’s written decision is clear, thorough, and

commendable. Yet Warnell claims that the ALJ needed to do

more, including by avoiding summaries of the medical evi-

dence and instead providing hyper-detailed physician-by-

physician accounts supported by fulsome pinpoint citations

to medical records. Not only is longer better, it is legally nec-

essary to withstand appellate review—or so the argument

goes.

We reject this contention as it stands at complete odds

with what an ALJ must do to support its decision with sub-

stantial evidence, a standard that the Supreme Court has em-

phasized is light. So we decline the invitation to impose a

rigid rule of artificial completeness upon ALJ orders of deci-

sion. What the ALJ produced here was more than sufficient

and supported by substantial evidence. We affirm.

I

A

In 2006 Brenda Warnell received a disc-removal and fu-

sion surgery in her upper spine. Twelve years later, she

sought treatment from a pain-management specialist, report-

ing severe discomfort in her head, neck, and lower back. From

2018 to 2021, Warnell met regularly with physicians who

monitored her symptoms and prescribed pain-relief medica-

tions.

No. 23-1632 3

Warnell’s medical record is mixed regarding the severity

of her condition. An MRI from 2018 revealed bone spurs in

her upper spine that pinched local nerves. But the same MRI

showed no significant vertebrae narrowing, a generally

“[u]nremarkable” spinal cord, and “[n]o acute abnormality”

in the bones. A 2019 CT scan likewise indicated “[n]o acute

osseous findings,” “[n]o destructive changes,” and no “adja-

cent inflammation.”

Results from physical examinations were likewise mixed.

On at least three occasions, Warnell could not raise her leg

from a sitting position without pain. She also expressed ten-

derness in her neck, pain while performing physical-therapy

exercises, and consistent throbbing in her head and back. Phy-

sicians assessed Warnell with chronic pain syndrome and

chronic migraines.

At the same time, however, Warnell performed well on

several tests designed to measure her movement capabilities.

She exhibited normal movement, muscle strength, stamina,

range of neck and hip motion, and reflexes. She also success-

fully completed walking exercises. And at least twice she

raised her leg while seated without pain, contradicting earlier

results.

Perhaps unsurprisingly, medical experts reached differing

conclusions regarding Warnell’s condition. Three—Dr. Brian

LaMar, Dr. Daniel Roth, and Anthony Escotto, MPT—

determined that Warnell had severely limited functional ca-

pacity. But two state-agency physicians—Dr. J. Sands and Dr.

J.V. Corcoran—assessed narrower limitations, finding that

Warnell remained capable of limited physical exertion.

4 No. 23-1632

B

In September 2019 Warnell applied for disability insur-

ance benefits and supplemental security income under the So-

cial Security Act. She alleged that she could not work due to

debilitating migraines and chronic pain in her back, shoul-

ders, and neck.

The ALJ disagreed. Though the judge acknowledged that

Warnell suffered from some impairments, she determined

that “a careful review of the record does not document suffi-

cient objective medical evidence to substantiate the severity

and degree of [the] functional limitations alleged by the

claimant.” The ALJ found that Warnell’s pain symptoms did

not prevent her from performing light work with moderate

noise and limited physical requirements. Based on testimony

from a vocational expert, the ALJ concluded that a significant

number of jobs matched that description. So she denied

Warnell’s claim, finding her not disabled.

The ALJ explained her reasoning in a 17-page decision.

Summarizing the medical evidence, she emphasized several

indications that Warnell’s pain was manageable, including

the non-acute CT and MRI readings, promising internal med-

icine evaluations, and Warnell’s success during walking, leg

raising, and climbing tests. Of the five medical experts who

assessed Warnell’s functional capacity, the ALJ considered

the two state-agency examiners to be the most persuasive. The

judge rejected the conclusion reached by the three other phy-

sicians—that Warnell was more severely limited—because it

conflicted with the medical treatment records.

After the district court affirmed the ALJ’s decision,

Warnell sought our review.

No. 23-1632 5

II

A

We affirm an ALJ’s decision denying disability benefits so

long as it is supported by substantial evidence. The threshold

for substantial evidence “is not high.” See Biestek v. Berryhill,

139 S. Ct. 1148, 1154 (2019). “It means—and means only—

such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” Id. (internal quotation

marks omitted). When reviewing a disability decision for sub-

stantial evidence, “[w]e will not reweigh the evidence, resolve

debatable evidentiary conflicts, determine credibility, or sub-

stitute our judgment for the ALJ’s determination so long as

substantial evidence supports it.” Gedatus v. Saul, 994 F.3d

893, 900 (7th Cir. 2021).

The medical record substantially supports the ALJ’s deci-

sion to reject the functional-capacity assessments of Dr. La-

Mar, Dr. Roth, and Mr. Escotto. The ALJ reasonably viewed

each physician’s opinion as contradicted by multiple lines of

evidence, including imaging test results, physical examina-

tions, and treatment sessions that documented normal

strength, stamina, and reflexes. The physicians also failed to

account for the effectiveness of Warnell’s medication, which

at various times relieved between 40% and 80% of pain with-

out side effects. Nor did they provide any explanation for the

twelve-year delay in the onset of Warnell’s alleged symp-

toms.

The ALJ properly observed that the expert reports that

Warnell relies upon also contain important flaws. Dr. Roth,

for example, neglected to fill out a section of his report form

that asked him to “identify the particular medical or clinical

6 No. 23-1632

findings … which support your assessment.” And Dr. LaMar

recorded observations that undermined his own conclusions,

noting that Warnell exhibited “normal” strength and writing

“NONE” to describe Warnell’s “inflammation, pain, swelling,

[and] stiffness.”

In light of the medical evidence contradicting Warnell’s

experts, we have no trouble concluding that substantial evi-

dence supported the ALJ’s decision to reject them. See Dixon

v. Massanari, 270 F.3d 1171, 1178 (7th Cir. 2001) (stating that

“[w]hen treating and consulting physicians present conflict-

ing evidence, the ALJ may decide whom to believe, so long as

substantial evidence supports that decision”); Deborah M. v.

Saul, 994 F.3d 785, 788 (7th Cir. 2021) (emphasizing that we

will reverse an ALJ’s disability determination “only if the rec-

ord compels a contrary result” (cleaned up)).

Ordinarily our opinion would end with that conclusion.

But we need to say more in response to the surprising conten-

tion Warnell presses on appeal.

B

Warnell rejects the analysis above not by identifying any

substantive error of reasoning or medical judgment, but by

putting the ALJ’s written decision under a microscope and

then flyspecking it. Warnell insists, for instance, that the ALJ

failed to provide page numbers every time she cited the med-

ical record—and that her opinion does not always distinguish

between multiple supporting exhibits in the administrative

record. So, too, does Warnell fault the ALJ for only summa-

rizing the medical evidence instead of recounting it in full de-

tail physician-by-physician.

No. 23-1632 7

We are taken aback by this argument, for nothing in our

case law instructs ALJs that surviving appellate review re-

quires anything remotely resembling a mandate to type the

medical record into a written decision. Given the extraordi-

nary demands already on social security ALJs, we are disin-

clined to impose a novel make-work typing or appendix man-

date.

The better course is to stick to our precedent, which is all

about substance and not form. Time and time again, we have

emphasized that social-security adjudicators are subject to

only the most minimal of articulation requirements. An ALJ

need not address every piece or category of evidence identi-

fied by a claimant, fully summarize the record, or cite support

for every proposition or chain of reasoning. See Schmidt v.

Barnhart, 395 F.3d 737, 744 (7th Cir. 2005) (explaining and em-

phasizing that an ALJ “need not provide a complete written

evaluation of every piece of testimony and evidence” (cleaned

up)); Gedatus, 994 F.3d at 901 (observing that a “[p]artial sum-

mary of select evidence” is appropriate and consistent with

the articulation requirement).

All we require is that ALJs provide an explanation for how

the evidence leads to their conclusions that is “sufficient to

allow us, as a reviewing court, to assess the validity of the

agency’s ultimate findings and afford [the appellant] mean-

ingful judicial review.” Moore v. Colvin, 743 F.3d 1118, 1121

(7th Cir. 2014); see also id. (stating that we will consider an

ALJ’s opinion to be adequately explained so long as it does

not “lack[] adequate discussion of the issues”). At times, we

have put this in the shorthand terms of saying an ALJ needs

to provide a “logical bridge from the evidence to his

8 No. 23-1632

conclusion.” See, e.g., Clifford v. Apfel, 227 F.3d 863, 872 (7th

Cir. 2000).

The ALJ here provided a more than sufficient explanation

for why the medical record led her to deny Warnell’s claim.

The judge devoted considerable space to addressing the per-

suasiveness of Warnell’s experts. She highlighted specific ev-

idence that contradicted their conclusions, going so far as to

cite and describe discrete examination findings. The ALJ also

acknowledged and grappled with conflicting evidence, ulti-

mately concluding that the treatment record as a whole sup-

ports a finding of non-disability. The law required no more of

the ALJ, so we AFFIRM.