Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-5_10-cv-05664/USCOURTS-cand-5_10-cv-05664-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

SAN JOSE DIVISION

ANTOINETTE AMSTEIN,

Plaintiff,

v.

CAROLYN W. COLVIN, Commissioner of 

Social Security,

Defendant.

Case No. 5:10-cv-05664 HRL

ORDER DENYING PLAINTIFF’S 

MOTION FOR SUMMARY JUDGMENT 

AND GRANTING DEFENDANT’S 

MOTION FOR SUMMARY JUDGMENT

[Re: Dkt. 18, 19]

Plaintiff Antoinette Amstein appeals a final decision by the Commissioner of Social 

Security denying her application for supplemental security income (SSI) under Title XVI of the 

Social Security Act. The parties have filed cross-motions for summary judgment, and the matter 

was submitted without oral argument. Upon consideration of the moving and responding papers, 

and for the reasons set forth below, plaintiff’s motion is denied and defendant’s cross-motion is 

granted.1

BACKGROUND

Amstein was born in 1965 and was 44 years old at the time the Administrative Law Judge 

(ALJ) rendered the decision under consideration here. She completed the 10th grade and 

previously worked as a house cleaner, prep cook, merchandise stock person, and cook. (AR 171-

 1 All parties have expressly consented that all proceedings in this matter may be heard and finally 

adjudicated by the undersigned. 28 U.S.C. § 636(c); Fed. R. Civ. P. 73.

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175).

Plaintiff previously applied for SSI in 2004, alleging an inability to work due to back pain, 

arthritis, and swelling of her lower extremities. That claim was denied initially, on reconsideration 

and, following a hearing, in an October 24, 2005 ALJ decision finding that plaintiff could perform 

her past relevant work as a housecleaner, inventory clerk, and waitress. (AR 86-90).

Plaintiff subsequently applied for SSI in 2007, alleging disability due to neck and back 

pain, foot pain, depression, obesity, and fibromyalgia, with an amended onset date of December 

10, 2007. The application was denied initially and on reconsideration, and plaintiff requested a 

hearing before an ALJ.

Following a hearing, the ALJ issued a decision concluding that Amstein is not disabled 

under the Social Security Act. He found that new and material evidence indicates that her health 

had worsened since the date of the earlier ALJ decision and that, since the filing of her last claim,

she had been diagnosed with fibromyalgia, depression, mildly bulging discs with strain of the 

cervical and lumbar spines, and plantar fasciitis. (AR 20, 22). Additionally, he found that

plaintiff had not engaged in substantial gainful activity since February 5, 2007 and that she has the 

following “severe” impairments: minimal cervical and lumbar bulging discs involving 

cervicothoracic lumbar strain; right foot plantar faciitis; fibromyalgia; and depression. (AR 22). 

He also found that Amstein has a medically determinable impairment of obesity, but that it is not 

severe and that she does not have an impairment listed in or medically equal to one listed in 20 

C.F.R., Part 404, Subpart P, Appendix 1 (20 C.F.R. § 416.925 and § 416.926). (AR 26-27). The 

ALJ concluded that, while plaintiff was unable to perform any past relevant work, she has the

residual functional capacity (RFC) to perform light work as defined in 20 C.F.R. § 416.967(b),

with certain modifications as follows:

She is able to lift and carry a maximum of 20 lbs occasionally, and a 

[sic] 10 lbs frequently; she is able to stand and walk for 6 hours, sit 

for 6 hours out of an 8 hour day; with a sit stand option, occasionally 

climb stairs and ramps but never ladders and scaffolds, frequently 

balance, and occasionally stoop, crouch, kneel and crawl; unlimited 

in manipulative functions of reaching, handling, and fingering, and 

feeling; unlimited communicative functions of hearing, seeing and 

speaking; avoid all environmental exposure to cold, heat, wetness, 

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humidity, noise, vibration, fumes, odors, dust and gases, heights and 

machinery; she is able to understand, carry out, and remember short 

and simply instructions and make simple judgments on work-related 

decisions and respond to appropriate work changes and pressures in 

a usual work setting; and, is slightly limited in understanding, remembering, and carrying out detailed instructions, in interacting 

appropriate[ly] with the public, supervisors, and co-workers.

(AR 28-29). Finally, the ALJ found that there are jobs that exist in significant numbers in the 

national economy that Amstein can perform, including clerk cashier, parking lot attendant, and 

security/lobby reception-type security. (AR 32).

The Appeals Council denied plaintiff’s request for review, and the ALJ’s decision became 

the final decision of the Commissioner. Plaintiff now seeks judicial review of that decision.

LEGAL STANDARD

A. Standard of Review

Pursuant to 42 U.S.C. § 405(g), this court has the authority to review the Commissioner’s 

decision to deny benefits. The Commissioner’s decision will be disturbed only if it is not 

supported by substantial evidence or if it is based upon the application of improper legal 

standards. Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Moncada 

v. Chater, 60 F.3d 521, 523 (9th Cir. 1995). In this context, the term “substantial evidence” means 

“more than a mere scintilla but less than a preponderance---it is such relevant evidence that a 

reasonable mind might accept as adequate to support the conclusion.” Moncada, 60 F.3d at 523; 

see also Drouin v. Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992). When determining whether 

substantial evidence exists to support the Commissioner’s decision, the court examines the 

administrative record as a whole, considering adverse as well as supporting evidence. Drouin, 966 

F.2d at 1257; Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). Where evidence exists to 

support more than one rational interpretation, the court must defer to the decision of the 

Commissioner. Moncada, 60 F.3d at 523; Drouin, 966 F.2d at 1258.

B. Standard for Determining Disability

The Social Security Act (Act) defines disability as the “inability 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 

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for a continuous period of not less than twelve months.” 42 U.S.C. § 423(d)(1)(A). Additionally, 

the impairment must be so severe that a claimant is unable to do previous work, and cannot 

“engage in any other kind of substantial gainful work which exists in the national economy,” 

considering the claimant’s age, education, and work experience. Id., § 423(d)(2)(A).

In determining whether a claimant has a disability within the meaning of the Act, an ALJ 

follows a five-step analysis, 20 C.F.R. § 416.920:

1. At step one, the ALJ determines whether the claimant is engaged in “substantial

gainful activity.” 20 C.F.R. § 416.920(b). If so, the claimant is not disabled. If not, the 

analysis proceeds to step 2.

2. At step two, the ALJ must assess whether the claimant suffers from a severe

“impairment or combination of impairments which significantly limits [the claimant’s] 

physical or mental ability to do basic work activities.” Id. at § 416.920(c). If not, the 

claimant is not disabled. If so, the evaluation proceeds to step three.

3. At step three, the ALJ determines whether the claimant’s impairments or combination 

of impairments meets or medically equals the requirements of the Listing of 

Impairments. 20 C.F.R. § 416.920(d). If so, the claimant is disabled. If not, the 

analysis proceeds to step four.

4. At step four, the ALJ determines whether the claimant has the RFC to perform past 

work despite her limitations. 20 C.F.R. § 416.920(e), (f). If the claimant can still 

perform past work, then she is not disabled. If not, then the evaluation proceeds to step 

five.

5. At the fifth and final step, the ALJ must determine whether the claimant can perform 

other substantial gainful work available in the economy, considering the claimant’s 

RFC, age, education, and work experience. 20 C.F.R. § 416.920(g). If so, the claimant 

is not disabled.

The claimant bears the burden of proof at steps one through four; the Commissioner has 

the burden at step five. Bustamante v. Massanari, 262 F.3d 949, 953-54 (9th Cir. 2001).

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DISCUSSION

Amstein contends that the ALJ erred by failing to (1) properly evaluate her obesity 

consistent with Social Security Ruling (SSR) 02-1p; and (2) provide clear and convincing reasons, 

supported by substantial evidence, for partially discounting her subjective complaints.

A. ALJ’s Obesity Evaluation

Plaintiff argues that, contrary to the requirements of SSR 02-1p, the ALJ failed to evaluate 

the effects of obesity on her ability to work. Specifically, she claims that the ALJ failed to analyze 

the functional effects of her obesity in combination with her other impairments.

Obesity is not per se disabling. Instead, “[a]s with any other medical condition, [an ALJ] 

will find that obesity is a ‘severe’ impairment when, alone or in combination with another 

medically determinable physical or mental impairment(s), it significantly limits an individual’s 

physical or mental ability to do basic work activities.” SSR 02-1p, 2002 WL 34686281 at *4 

(2002). The ruling provides that “[a]n assessment should also be made of the effect obesity has 

upon the individual’s ability to perform routine movement and necessary physical activity within 

the work environment.” Even so, SSR 02-1p also provides that, in assessing obesity, an ALJ “will 

not make assumptions about the severity or functional effects of obesity combined with other 

impairments.” Id. “Obesity in combination with another impairment may or may not increase the 

severity or functional limitations of the other impairment.” Id. Thus, an ALJ must “evaluate each 

case based on the information in the case record.” Id. The burden remains with plaintiff to 

provide evidence of her RFC and evidence proving disability. 20 C.F.R. §§ 416.912, 

416.945(a)(3).

The ALJ recognized that Amstein had been diagnosed with “exogenous obesity,” (AR 24), 

but concluded that the condition was not “severe,” stating: “There is insufficient evidence that this 

condition affects the claimant’s end organ system, or aggravates an already existing impairment, 

or otherwise affects her work-related activities.” (AR 26). And, in assessing her RFC, the ALJ 

considered plaintiff’s obesity, but found that “[w]hile the record does show evidence of obesity, as 

indicated above, the record does not establish the effect that the obesity has had on the claimant 

sufficiently to find that she cannot work because of it or because it aggravates another condition.” 

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(AR 30). This finding is supported by the record.

During examination by the ALJ at the hearing, plaintiff testified that she gained over 120 

pounds because of steroid shots to her feet. (AR 54). When the ALJ then asked for any evidence 

showing the “exacerbation by weight” or “residual damage” to any part of plaintiff’s body, her

counsel said there was none because her physicians were treating the matter as fibromyalgia:

Q: How much do you weigh now?

A: 260 pounds.

Q: How tall are you?

A: 5’7”.

ALJ: Do we have any evidence that she’s got any residual damage from---to any part of 

her body?

ATTY:From the steroids?

ALJ: Well no, from weight or from exacerbation by weight.

ATTY:No. They’re treating it as fibromyalgia.

(AR 54).

Similarly, when the ALJ asked plaintiff to identify significant evidence about her bulging 

discs, her attorney responded that plaintiff’s “primary impairment here is fibromyalgia, and not 

orthopedic type of impairment, bulging disks is---they didn’t make much of it is what I 

understand. . . . The findings of bulging disks. They don’t particularly make our case, I concede 

that.” (AR 62).

Focusing attention on her fibromyalgia, plaintiff directed the ALJ to the reports of 

neurologist Dr. Dale Helman and internist Dr. Becky Kroll. (AR 63-64). The ALJ thoroughly 

considered the records of both physicians. With respect to Dr. Helman, the ALJ correctly noted 

that after evaluating plaintiff for about 18 months, Dr. Helman diagnosed degenerative disc 

disease, but was unable to identify an underlying pathology for plaintiff’s complaints of leg pain. 

(AR 23, 234-239).

As for Dr. Kroll, the ALJ considered the Fibromyalgia Residual Functional Capacity 

Questionnaire in which she concluded that Amstein has limitations secondary to fibromyalgia. 

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(AR 25, 443). However, the ALJ also correctly noted that Dr. Kroll was unable to answer 

questions asking for clinical findings or laboratory and test results that show plaintiff’s medical 

impairment and was also unable to answer questions about the degree to which plaintiff can 

tolerate work stress; the weight in pounds plaintiff can lift in a competitive work situation; 

limitations, if any, involving plaintiff’s hands, fingers, or arms; the number of days plaintiff would 

miss work because of her condition; and whether plaintiff has any other limitations that would 

affect her ability to work. (AR 25, 443-447). Moreover, the ALJ correctly noted that “Dr. Kroll 

has recognized the insufficiency of her own evaluation because she recommends a different 

evaluation be subsequently conducted that involves a ‘formal functional disability evaluation for 

further information and recommendation.’” (AR 25, 447).2

In her summary judgment papers, plaintiff does not identify any functional limitations of 

her obesity that would have impacted the ALJ’s analysis, or that he failed to consider, or that are 

not reflected in the assessed RFC. Moreover, while several physicians noted that plaintiff is 

obese, plaintiff does not identify (and this court has not found) any who addressed any functional 

limitations due to her obesity, either alone or in combination with her other impairments. The 

ALJ also thoroughly examined other medical evidence, none of which indicated the functional 

effects of plaintiff’s obesity:

The ALJ correctly noted that Dr. Aguas, plaintiff’s family practitioner, said that Amstein 

had chronic neck pain and lumbar spine pain and was “very obese,” but that Dr. Aguas did not 

provide objective findings supporting he conclusions. (AR 22, 250, 279). Moreover, the ALJ 

noted that although some of Dr. Aguas’ records showed some objective/subjective signs of 

tenderness on three different occasions in three different areas of the body (the back, breasts, and 

at the cervical spine and over the shoulder muscle), those examinations “do not show ‘trigger 

point’ tenderness or involve other specified degrees of tenderness.” (AR 22-23). And, while the 

ALJ recognized that Dr. Aguas raised the possibility of fibromyalgia in December 2007, he 

 2 Although the ALJ partially discredited Dr. Kroll’s opinions expressed in the Fibromyalgia 

Residual Functional Capacity Questionnaire, he did consider Dr. Kroll’s observations to the extent 

that they were consistent with the examinations of other physicians. (AR 29). Plaintiff does not 

challenge the ALJ’s treatment of Dr. Kroll’s opinions.

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correctly noted that “she does not establish that as a diagnosis for the claimant.” (AR 23, 426, 

431-432, 437).

The ALJ also considered the records of podiatrist Dr. David Abdoo, who examined 

Amstein on August 22, 2006 and noted that plaintiff reported gaining over 100 pounds, but 

nevertheless found that “[h]er musculoskeletal examination of straight leg raising was negative as 

was tinel signs. Sensation, motor and strength of the extremities were normal. There was normal 

range of motion of the foot but tenderness at the plantar fascia and over foot nerves.” (AR 23, 

243-244). The ALJ acknowledged that Dr. Abdoo diagnosed Amstein with having heel pain from 

plantar fasciitis and intracalcaneal neuritis bilaterally and prescribed steroid injections, splints, 

stretching exercises, and proper shoes. (AR 23, 243-244). He also correctly noted that Dr. Abdoo 

believed that plaintiff “was ‘likely’ suffering from double crush phenomenon but did not indicate 

specifically as to what findings supported that diagnosis.” (Id.). And, the ALJ also considered Dr. 

Abdoo’s January 25, 2007 examination in which Dr. Abdoo found “pain which was generalized 

over the heel, a positive bowstring test and tenderness and palpation over the Tinel region.” (Exh. 

7F, p. 2).” (AR 23).

Several months later, on June 16, 2007, plaintiff was examined by orthopedic consulting

physician, Dr. Madireddi, who diagnosed plaintiff with “exogenous obesity” and chronic 

cervicothoracic lumbar strain. The ALJ correctly noted that Dr. Madireddi’s report nonetheless 

shows that plaintiff’s:

musculoskeletal examination was normal and showed full range of 

motion with no tenderness, normal strength with no reflex, sensory, 

or neurological deficit. Straight leg raising was normal as was gait. 

Dr. Madireddi diagnosed the claimant with having chronic 

cervicothoracic lumbar strain and exogenous obesity. (Exh. 11F, p. 

2). She advised that the claimant could lift and carry a maximum of 

50 lbs occasionally and 25 lbs frequently and otherwise had no 

restrictions in work-related activities. (Exh. 11F, p. 2).

(AR 24, 285-287).

The ALJ further considered the evaluation of consultant J.T. Bonner, who conducted a 

physical RFC evaluation on July 20, 2007. Although Bonner noted that plaintiff is obese and had 

limitations “due to pain and stiffness from [degenerative disc disease] L-spine” and from “Rt heel 

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pain” (AR 289), the ALJ correctly noted that Bonner determined that plaintiff:

could perform a light exertional work load with limitations of 

occasionally climbing ramps and stairs, but never ladders/ropes/and 

scaffolds; she was able to frequently balance, kneel, crouch, and 

crawl and occasionally stoop. All other functions were unlimited 

with the exception of advising that the claimant should avoid 

concentrated exposure to hazards. (Exh. 12F).

(AR 24, 288-292).

The ALJ acknowledged that Dr. Matthew Wedemeyer MD at the Stanford Pain 

Management Center diagnosed plaintiff with fibromyalgia in 2008, finding that she had 16 of 18 

positive tender points per the American College of Rheumatology criteria. (AR 24, 369). Dr. 

Wedemeyer’s report also acknowledged that plaintiff had a past medical history of obesity and 

depression and anxiety. (Id.). But the ALJ correctly noted that although Dr. Wedemeyer

“reviewed the MRIs previously completed of the claimant’s spine, he did not diagnose the 

claimant with having degenerative joint or disc disease. His examination findings were otherwise 

unremarkable and showed no sensory, motor, strength, reflex, or neurological deficits. He 

prescribed aerobic type exercise and medications such as Neurontin and lyrica for the pain, trigger 

point injections, and physical therapy.” (AR 24, 367-372).

Finally, the ALJ also considered the psychiatric evaluation of Dr. Christopher Sanders, 

who noted that plaintiff’s “[b]uild was overweight” and that plaintiff complained of joint pain, but 

who nevertheless found that plaintiff:

had a good ability to understand and remember very short and 

simple instructions; her ability to under and remember detailed 

instructions was fair based on her mental status examination 

performance; her ability to accept instructions from a supervisor and 

respond appropriately was fair; her ability to sustain an ordinary 

routine without special supervision was good; her ability to 

complete a normal workday/workweek without interruptions at a 

constant pace was fair; her ability to interact with coworkers was 

fair; and, her ability to deal with stress encountered in competitive

work was fair to good.

(AR 25, 363-366).

Based upon review of the record as a whole, the court finds that the ALJ properly 

considered plaintiff’s obesity and that his conclusions are rational and supported by substantial 

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evidence. As to this issue, plaintiff’s summary judgment motion is denied and defendant’s 

summary judgment motion is granted.

B. The ALJ’s Credibility Determination

As discussed, the ALJ concluded that plaintiff has the RFC to perform light work (with 

some additional modifications). In so concluding, the ALJ partially discounted the claimed 

severity of Amstein’s impairments. The parties dispute whether he provided specific clear and 

convincing reasons, supported by substantial evidence, for doing so.

An ALJ conducts a two-step analysis in assessing subjective testimony. First, “the 

claimant ‘must produce objective medical evidence of an underlying impairment’ or impairments 

that could reasonably be expected to produce some degree of symptom.” Tommasetti v. Astrue, 

533 F.3d 1035, 1039 (9th Cir. 2008) (quoting Smolen v. Chater, 80 F.3d 1273, 1281-82 (9th Cir. 

1996)). If the claimant does so, and there is no affirmative evidence of malingering, then the ALJ 

can reject the claimant’s testimony as to the severity of the symptoms “‘only by offering specific, 

clear and convincing reasons for doing so.’” Id. (quoting Smolen, 80 F.3d at 1283-84). That is, 

the ALJ must “make ‘a credibility determination with findings sufficiently specific to permit the 

court to conclude that the ALJ did not arbitrarily discredit claimant’s testimony.’” Id. (quoting 

Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002)). In weighing a claimant’s credibility, an 

ALJ may consider several factors, including (1) ordinary techniques of credibility evaluation; (2) 

unexplained or inadequately explained failure to seek treatment or to follow a prescribed course of 

treatment; and (3) the claimant’s daily activities. Id. Additionally, an ALJ may also consider the 

observations of treating and examining physicians and other third parties concerning the nature, 

onset, duration, and frequency of the claimant’s symptoms; precipitating and aggravating factors; 

and functional restrictions caused by the symptoms. Smolen, 80 F.3d at 1284. “Although lack of 

medical evidence cannot form the sole basis for discounting pain testimony, it is a factor that the 

ALJ can consider in his credibility analysis.” Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 

2005). “If the ALJ’s finding is supported by substantial evidence, the court ‘may not engage in 

second-guessing.’” Tommasetti, 533 F.3d at 1039 (quoting Thomas, 278 F.3d at 959).

The ALJ took into account plaintiff’s allegations, including those asserted in her 

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application, her function report, and at the hearing:

In terms of the claimant’s allegations, when she filed her application 

she alleged that she cannot work because she has constant burning 

pain of the spine; because of constant “hurt”, mood swings, and 

plantar fasciitis affecting her right side; headaches; because she 

cannot focus and has difficulty dealing with people; and, because 

she can’t lift and carry or use her hands too much. (Exh. 3E, p. 2). 

In her function report, the claimant’s focus was that her neck and 

foot pain prevented her activity and that her depression affected her 

daily activities. (Exh. 6E). In addition, at the hearing the claimant 

added that her weight gain causes nausea sleepiness and that she 

cannot stand for more than 10 minutes because of lower back and 

foot pain; cannot walk more than 3 blocks before resting; can sit for 

5-10 minutes because of neck pain and spends 10 hours lying flat 

because of pain which wakes her at night. (Claimant’s Testimony).

(AR 29-30). The ALJ further found that Amstein’s medically determinable impairments 

reasonably could be expected to cause the alleged symptoms. Nevertheless, he discounted the 

intensity, persistence, and functionally limiting effects of plaintiff’s allegations to the extent they 

are inconsistent with an RFC for the scope of light work he concluded she could perform.

In reaching that conclusion, the ALJ found that the claimed severity of plaintiff’s 

allegations are not supported by objective medical evidence. Although allegations of subjective 

pain and other symptoms cannot be rejected solely on that ground, medical evidence is a relevant 

factor that may be considered in determining the severity of plaintiff’s pain and its disabling 

effects. Here, the ALJ correctly noted that the medical evidence “shows one instance where 

trigger points are documented and only several instances over a 1 year period where tenderness is 

documented in relation to her physical symptoms”; “claimant’s record reveals consistently normal 

musculoskeletal examinations with one instance of a positive straight leg raising exam in 2007 

that has not been repeated. (Exh. 26F, p. 19)”; Dr. Abdoo did “not affirmatively diagnose a 

condition other than plantar fasciitis, and there is no indication that plaintiff requires assistance 

with ambulation because of the pain that may be associated with this condition or that the claimant 

cannot work because of this condition”; and the record contains “no evidence of neurological 

deficits of any kind which can explain the intensity and limiting features of the type of pain the 

claimant alleges which [sic] she experiences.” (AR 30). Moreover, as discussed above, he found 

that the record does not establish the effect Amstein’s obesity has had on her, such that he 

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sufficiently could find that she cannot work because of her obesity or because it aggravates 

another condition. (Id.).

Plaintiff argues that there are “abundant” objective findings to support her allegations, but 

merely directs the court to her statements about her claimed limitations (AR 42-43, 46, 54-60, 

162-170, 181-188); her testimony that she was told to lose 60 pounds so that she can have breast 

reduction surgery to relieve her back pain (AR 60); MRI reports showing some minimal bulging 

discs, but otherwise normal MRIs of the lumbar and cervical spine (AR 168-269); and Dr. 

Wedemeyer’s fibromyalgia diagnosis (AR 367-372). These arguments are beside the point as

there is no dispute about the existence of medically determinable impairments that could cause 

some of her alleged symptoms.

But, plaintiff is correct that credibility determinations must be based on more than just a 

lack of objective medical evidence. This is especially true of fibromyalgia because courts have 

recognized that “physical examinations will usually yield normal results---a full range of motion, 

no joint swelling, as well as normal muscle strength and neurological reactions.” Preston v. Sec’y 

of Health & Human Servs., 854 F.2d 815, 817-18 (6th Cir. 1988). As explained by the Ninth 

Circuit, fibromyalgia is “a rheumatic disease that causes inflammation of the fibrous connective 

tissue components of muscles, tendons, ligaments, and other tissue.” Benecke v. Barnhart, 379 

F.3d 587, 589 (9th Cir. 2004). Common symptoms “include chronic pain throughout the body, 

multiple tender points, fatigue, stiffness, and a pattern of sleep disturbance that can exacerbate the 

cycle of pain and fatigue associated with this disease.” Id. “Fibromyalgia’s cause is unknown, 

there is no cure, and it is poorly-understood within much of the medical community. The disease 

is diagnosed entirely on the basis of patients’ reports of pain and other symptoms.” Id. 

Nevertheless, “[t]he American College of Rheumatology issued a set of agreed-upon diagnostic 

criteria in 1990,” and the Ninth Circuit has recognized the tender point test as one way of 

diagnosing the disease, see Rollins, 261 F.3d at 855 (observing that fibromyalgia is characterized 

by multiple tender spots on the body, and that a patient must have at least 11 of them to be 

diagnosed with the disease). Even so, as noted by one court, “[s]ome people may have such a 

severe case of fibromyalgia as to be totally disabled from working, but most do not and the 

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question is whether [plaintiff] is one of the minority.” Sarchet v. Chater, 78 F.3d 305, 306 (7th 

Cir. 1996) (citations omitted).

Contrary to plaintiff’s arguments, the ALJ based his credibility determination on more than 

just a lack of objective medical evidence. With respect to plaintiff’s allegations about her 

medications, nausea, insomnia, and depression, he discredited the claimed severity of their effects 

because they were not supported by objective medical evidence, by the longitudinal record, or by 

plaintiff’s own reports to her physicians, and because plaintiff changed the focus of her allegations 

from time to time:

As to the claimant’s medications and their effects, her nausea, and 

her insomnia, the record does not sufficiently show that this is a 

debilitating factor in her ability to work. There are occasional and 

infrequent complaints of these types of factors noted in the record 

which are not addressed as factors, either singly or in combination 

with others, by the claimant’s physicians as keeping the claimant 

from her work. Finally, the undersigned is considerate of the fact

that the claimant cannot afford a psychiatrist, however, she has been 

able to procure Prozac for her depression in the past. Yet, the 

claimant’s longitudinal medical record does not establish the 

limiting effects of her depression nor did the claimant indicate that 

this is [a] significant factor when she reported her complaints to Dr. 

Sanders. In addition, as the claimant changes the focus of her 

allegations as discussed above in some respects from time to time, 

the constancy and limiting nature of any one of those allegations in 

being able to affect her ability to function is drawn into question.

(AR 30). Based upon review of the record as a whole, the court finds that the ALJ provided 

sufficiently specific reasons, supported by substantial evidence, for discrediting plaintiff’s 

subjective complaints about the effects of her medications, nausea, insomnia, and depression.

As for plaintiff’s pain allegations, in addition to lack of objective medical evidence, the 

ALJ based his credibility determination on what he found to be inconsistencies between what 

plaintiff claims she can do and what her treating physicians indicated she is capable of doing. The 

ALJ correctly notes that in the Fibromyalgia Residual Functional Capacity Questionnaire, Dr. 

Kroll did not identify any limitations with respect to plaintiff’s hands, arms, or shoulders for 

reaching, handling, or fingering, and also advised that severe pain would only “occasionally” (i.e., 

6%-33% of an 8-hour workday) interfere with plaintiff’s concentration. (AR 29, 30, 444). 

Additionally, the ALJ noted that “rather than inactivity,” Dr. Wedemeyer “prescribed aerobic 

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activity indicating that he assessed the claimant’s capability to be better than the claimant alleges 

them to be even with her condition of fibromyalgia and pain.” (AR 30). Plaintiff argues that Dr. 

Wedemeyer’s recommended exercise regimen was very limited and does not contradict her 

allegations as to the severity or functionally limiting effects of her fibromyalgia. True, according 

to Dr. Wedemeyer’s report, the recommended exercise program was to start slow; but, his overall 

prognosis was that exercise would improve plaintiff’s activity over time:

I have told her [that] aerobic exercise has been shown to be the most 

effective fibromyalgia [therapy] and that she should start slow and 

progress with this over the next few months. I have recommended 

that she start walking maybe 5 minutes per day and increasing this 

by 5 minutes every week. There may be days where she does not 

feel like it and she can take a few days off but the general trend 

should show that she is improving her activity on a weekly basis.

(AR 371). The ALJ also noted that while some of Dr. Wedemeyer’s recommendations were 

followed, neither plaintiff nor the record showed that she followed an aerobic exercise program. 

(AR 24).

Plaintiff argues that this evidence merely shows that physicians want to be optimistic about 

their patients’ abilities. Nevertheless, the ALJ is responsible for determining credibility and for 

resolving ambiguities and conflicts; and, the ALJ properly could consider such evidence in 

assessing the credibility of plaintiff’s pain allegations. While his conclusion may not be the only 

one that might be drawn, based upon review of the record as a whole, the court finds that the ALJ 

provided sufficiently specific reasons, supported by substantial evidence, for partially discrediting 

plaintiff’s subjective complaints as to the intensity, persistence, and functionally limiting effects of 

her pain. On this issue, plaintiff’s summary judgment motion is denied and defendant’s summary 

judgment motion is granted.

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ORDER

Based on the foregoing, plaintiff’s summary judgment motion is denied and defendant’s 

summary judgment motion is granted. The clerk shall enter judgment and close the file.

SO ORDERED.

Dated: March 30, 2015

______________________________________

HOWARD R. LLOYD

UNITED STATES MAGISTRATE JUDGE

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5:10-cv-05664-HRL Notice has been electronically mailed to:

Brenda Maureen Pullin Brenda.Pullin@ssa.gov, geralyn.gulseth@ssa.gov, 

ODAR.OAO.COURT.1@ssa.gov, sf.ogc.ndca@ssa.gov

Marc V. Kalagian marc.kalagian@rksslaw.com, marckalagian_rohlfinglaw@hotmail.com, 

mayra.pulido@rksslaw.com

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