Nicole Trost v. Frank Bisignano

from degenerative disc disease, degenerative joint disease, headaches, fibromyalgia, osteoarthritis with a history of sacroiliitis, obesity, post-traumatic stress disorder, attention deficit hyperactivity disorder, anxiety, depression, and obstructive sleep apnea. Because Trost's arguments on appeal focus only on the ALJ's determination about her sleep apnea, we limit our discussion of her medical records to that impairment.

Trost was diagnosed with obstructive sleep apnea in 2015. In June 2021, Trost reported that she had daytime fatigue and sleepiness, which interfered with her ability to function during the day. In December, she sought treatment for her daytime fatigue and sleepiness. Trost reported that she could not safely drive because of her excessive daytime sleepiness, and she requested that the doctor fill out a form to help her renew her driver's license. The doctor noted that he would write Trost a recommendation to drive again after she underwent sleep tests. The doctor later ordered sleep tests, which found that Trost had daytime sleepiness that "could be caused by many pathologies."

The doctor recommended that Trost resume using her CPAP machine (a medical device that treats sleep apnea by keeping the patient's airways open during sleep) and follow up with the sleep clinic.

In March and April 2022, Trost continued to complain about daytime sleepiness. She reported that her excessive daytime sleepiness was causing her to fall asleep during driving tests, and she was unable to renew her driver's license. She was sent a new CPAP machine and was waiting for a prescription for medication that promotes wakefulness, modafinil, to treat her excessive daytime sleepiness. In June, Trost reported that modafinil was helping her daytime functioning and that she wanted to start driving again. In July, she underwent another sleep test, this time while taking modafinil, but the results "redemonstrated" her inability to maintain wakefulness. She also reported that modafinil helped her daytime sleepiness but admitted to not using the CPAP machine at night because she could not tolerate it. During a September virtual visit, a speech pathologist noted that Trost was driving during the beginning of the session. In October, Trost again reported that modafinil was partially helping her daytime fatigue and sleepiness.

In June 2023, Trost filed a claim for disability insurance benefits, alleging disability since October 31, 2015. Trost's claim was initially denied and upon reconsideration, an administrative law judge held a hearing where Trost testified and was represented by counsel. A vocational expert also testified. Trost later amended her alleged onset date to May 26, 2021. The last day upon which she met the insured eligibility criteria for Title II benefits was December 31, 2021.

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In June 2024, the ALJ denied Trost's claim for benefits, finding her not disabled under the Social Security Act. The ALJ analyzed the evidence and applied the required five-step analysis. See 20 C.F.R. § 416.920(a). At step one, the ALJ found that Trost had not engaged in substantial gainful activity from May 26, 2021, to December 31, 2021. At step two, the ALJ found that Trost had sleep apnea, among other impairments, and noted that Trost admitted to not wearing her CPAP machine at night. The ALJ then found that there was no evidence that Trost's sleep apnea was causing or would be expected to cause any functional limitation ongoing for a continuous twelve-month period on or before December 31, 2021.

At step three, the ALJ concluded that none of Trost's severe impairments, alone or in combination, resulted in more than mild functional limitations lasting or being expected to last at least twelve months. The ALJ determined that Trost had the residual functional capacity to perform sedentary work with limitations. The ALJ considered a December 2021 medical record where Trost reported that her daytime fatigue and sleepiness were interfering with her ability to function during the day. The ALJ found that there was no evidence that her daytime sleepiness lasted or was expected to last for twelve continuous months. The ALJ pointed out that Trost reported that modafinil had been helping her daytime functioning—she resumed driving and was able to take her child to preschool and medical appointments. The ALJ also noted that at the hearing, Trost did not allege being limited due to daytime sleepiness. Still, based on Trost's complaints of fatigue and daytime sleepiness throughout the record, the ALJ limited Trost to avoiding "all exposure to dangerous moving machinery" and "unprotected heights" as a safety precaution.

At step four, the ALJ determined that Trost was unable to perform her past relevant work as a photomapping technician. And finally, at step five, the ALJ found that there were jobs that existed in significant numbers in the national economy that Trost could have performed, so Trost was not disabled under the Social Security Act. The Social Security Administration Appeals Council denied Trost's request for review, and Trost then sought judicial review of the denial of her benefits. See 42 U.S.C. § 405(g). Trost argued that the ALJ's decision was erroneous because the ALJ's consideration of her fatigue and daytime sleepiness was not supported by substantial evidence. By the parties' consent under 28 U.S.C. § 636(c), a magistrate judge reviewed the appeal and found that the ALJ adequately considered and accounted for Trost's fatigue and daytime sleepiness throughout his decision and accommodated it in his residual functional capacity assessment. The magistrate judge concluded that Trost was asking the court to reweigh the evidence and declined to do so.

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Analysis

Trost appeals and argues that the ALJ's decision was not based on substantial evidence. We review de novo the district court's affirmance of the ALJ's decision and reviews directly the decision of the ALJ. Lincoln v. Bisignano, 173 F.4th 886, 891 (7th Cir. 2026). We will reverse the ALJ's decision only if it was based on incorrect legal standards or unsupported by substantial evidence. Id. Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. (citation omitted). We "will not reweigh evidence, resolve debatable evidentiary conflicts, determine credibility, or substitute [its] judgment for the ALJ's determination" if it is supported by substantial evidence. Id.

Trost contends that the ALJ did not consider a critical line of objective evidence and therefore overlooked evidence that Trost's daytime sleepiness was a medically determinable impairment. Trost points to two sleep studies that the ALJ did not consider—one on December 31, 2021, and one on July 9, 2022.

But the ALJ did consider the objective evidence of Trost's obstructive sleep apnea. The ALJ considered records reporting that Trost has obstructive sleep apnea (that she believed impacted her daily functioning), has undergone sleep studies, and was prescribed modafinil to treat daytime sleepiness. And, as the ALJ noted, Trost did not testify at the hearing about how her daytime sleepiness was affecting her daily functioning.

Further, the omitted sleep studies that Trost highlights do not reveal any substantially different information about her daytime sleepiness than did the records that the ALJ addressed, so it was not improper for the ALJ to omit specific discussion of them. See Deborah M. v. Saul, 994 F.3d 785, 789 (7th Cir. 2021). In the December sleep study, a doctor noted that Trost underwent sleep tests, and he found that her sleepiness could be caused by many pathologies. In the July sleep study, a doctor noted that Trost underwent a sleep test after initiating modafinil. He found that Trost had an "[i]nability to maintain wakefulness redemonstrated on this study." These records are not substantially different from the other medical records that the ALJ considered. And an ALJ's adequate discussion of the issues need not contain a "complete written evaluation of every piece of evidence." Deborah M., 994 F.3d at 788 (citation omitted). Trost next argues that when the ALJ established Trost's residual functional capacity, he mentioned only fatigue and not daytime sleepiness. Trost contends that the

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ALJ therefore conflated Trost's fatigue with excessive daytime sleepiness and thus failed to consider the evidence of daytime sleepiness independently. But Trost's argument is contradicted by the ALJ's analysis. In the paragraph at issue, the ALJ starts by noting that Trost reported to specialists that her "snoring, daytime fatigue, and sleepiness" were interfering with her ability to function during the day. The ALJ did not find Trost's statement to be persuasive because the limitation did not last for twelve continuous months. The ALJ pointed to records from June and September 2022 where Trost reported that medication was helping and that she began driving again. To be sure, at the end of the paragraph, the ALJ mentioned only

"complaints of fatigue" when he limited Trost's exposure to dangerous moving machinery and unprotected heights. But it is clear from the context of the entire paragraph that the ALJ was discussing both Trost's fatigue and daytime sleepiness and was establishing her residual functional capacity in reference to both. And although the ALJ did not use the phrase "daytime sleepiness," in the last sentence of this paragraph, he amply discussed the evidence about Trost's daytime sleepiness and thus did not ignore a line of evidence. See Yokosh v. Bisignano, 170 F.4th 631, 638 (7th Cir. 2026). Trost next contends that the magistrate judge did not evaluate whether the ALJ considered daytime sleepiness because the judge, like the ALJ, conflated fatigue and daytime sleepiness. But because the ALJ committed no error in this regard, we need not address this argument. See Yokosh, 170 F.4th at 637 n.2.

Next, Trost argues that the ALJ improperly discounted her reports about daytime sleepiness because she did not use her CPAP machine. Trost contends that the ALJ did not make a finding as to whether Trost failed to follow prescribed treatment and therefore cannot use the fact that Trost did not use her CPAP machine as the basis to find that Trost was not severely limited by her sleep apnea. But a holistic review of the decision reveals that the ALJ did not base his findings related to Trost's daytime fatigue and sleepiness on her failure to use her CPAP machine. See Chrisman ex rel. N.R.C. v. Bisignano, 137 F.4th 618, 624 (7th Cir. 2025) The ALJ noted only that Trost did not tolerate using a CPAP machine, which was supported by the medical records. The ALJ then concluded that there was no evidence that the impairment caused any functional limitations for a continuous twelve-month period on or before the date last insured because Trost reported that her medication was helping her daytime functioning.

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Trost next argues that the ALJ erred by conflating her ability to drive with sustaining regular employment, which are not comparable in terms of the functional capacity they require. But the focus of the ALJ's analysis was on Trost's reports about how the medication had improved her daily functioning, with driving being an example of the improvement. The ALJ did not base his decision merely on the fact that Trost was able to resume driving.

Finally, Trost contends that the ALJ failed to consider her daytime sleepiness in combination with her other impairments. But the ALJ did consider Trost's daytime sleepiness in combination with her other impairments. The ALJ found that the severity of Trost's impairments, alone or in combination, did not meet the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1.

AFFIRMED

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