Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_02-cv-02431/USCOURTS-cand-3_02-cv-02431-0/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

For the Northern District of California

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United States District Court

For the Northern District of California

 

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

CARMEN A GRIFFITH-ORTIZ,

Plaintiff,

 v

JO ANNE B BARNHART, Commissioner

of Social Security,

Defendant.

 /

No C-02-2431 VRW

 ORDER

Plaintiff Carmen A Griffith-Ortiz brings this action

under 42 USC section 405(g), challenging the final decision of the

Social Security Administration (SSA) granting her disability

benefits from December 25, 1996 to December 30, 1998, but denying

them for the periods before and after those dates. Plaintiff

contends that her disability began earlier – on or about March 16,

1994 – and never ended during the period at issue. Plaintiff

claims disability based on orthopedic and psychiatric conditions. 

Now before the court are the parties' cross-motions for summary

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judgment. The court GRANTS plaintiff’s motion and DENIES the

government’s motion. 

 I

 A

Plaintiff was born on May 25, 1955. She alleges that she

has been unable to work since March 16, 1994 due to physical and

mental ailments. Her work history includes experience as a

restaurant manager, a floral manager, an office manager and an

executive secretary. AR 188. 

Plaintiff was examined by numerous physicians during the

five-year period covered by the voluminous administrative record on

the instant appeal. A consulting physician’s review of medical

records performed in June of 1999 listed sixteen different

physicians and one psychologist, as well as other providers such as

hospitals. AR 765-69. Reports from numerous other medical

professionals not mentioned in the summary appear in the

administrative record. In a psychiatric consultative examination

report prepared in January of 1999, plaintiff is quoted as saying

“[M]y medical history is unbelievable,” and reporting seventeen

surgeries in the course of her life. AR 825. Plaintiff’s

medications at the time of that report included Flexeril, Soma,

Vicodin, Paxil, Trazodone and Premarin. Id. The administrative

record for this case contains several consultative medical

examinations ordered by the SSA in connection with plaintiff’s

claim for benefits as well as treatment records dating back as far

as 1985.

Plaintiff’s medical records contain references to

childhood problems including spina bifida, AR 761, treatment for

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rabies after being bitten by a rat, AR 725, 773, a head injury at

age ten, id, and verbal, physical and sexual abuse. Id, AR 824. 

Plaintiff’s medical history includes a hysterectomy at the age of

28. Eg, AR 825.

In 1985, plaintiff underwent surgery for a hemorragic

ovarian cyst. AR 357-360. Her medical records from that procedure

indicated that she had previously had a hysterectomy, a cesarean

section and two laparoscopic procedures. AR 357. 

In 1990, 1991 and 1992, plaintiff sought medical

treatment for severe headaches, diagnosed as migraines and

variously described as “persistent,” “continuous” and “constant for

1-1/2 months.” AR 433-39. For these headaches, plaintiff was

prescribed Cafergot, Darvocet, Naprosyn, Motrin, and Vicodin. AR

436. These records also refer to a diagnosis of temporomandibular

joint syndrome. Id. 

In 1993, plaintiff sought medical care for “abdominal

pain with vomiting.” AR 428. The clinic notes from one such

consultation describe, based on plaintiff’s report, “a history of a

colicky kind of pain, lasting for twenty minutes to an hour,

usually precipitated by eating, occasionally precipitated by

anxiety.” Id. The same notes also describe a hospitalization, in

1987, for abdominal pain and rectal bleeding, and “according to

[plaintiff] twelve operations * * * based on adhesions between the

bladder, ovarian cysts, and basically female problems.” Id. Dr

Stanley Rockman wrote “[i]t is difficult to ascertain exactly what

the patient’s symptoms are. They [sic] are lots of possibilities;

her history is suggestive of cholecystitis [but] her physical

examination does not corroborate that.” Id at 429. 

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On March 17, 1994, the day after plaintiff’s alleged

onset date of disability, plaintiff sought medical care for pain in

her neck and back after she lifted a heavy box of yams at her job

at Safeway. AR 768. Over the next seven months, plaintiff had an

MRI, physical therapy, and at least nine doctor visits related to

pain in her shoulder. Imaging studies showed disc degeneration in

plaintiff’s C5-6 vertebra, AR 491, elsewhere described as a “small

disc bulge.” AR 420. Several physicians recommended conservative

management, but plaintiff reported increasing pain and numbness in

her neck and right arm. Id, AR 768-69. “Due to the severe nature

of the ongoing symptoms despite conservative treatment * * * a

repair of the C5-6 disc was suggested as an alternative” by

orthopedic surgeon Dr Kenneth Light. AR 491.

Plaintiff’s case was reviewed by a neurologist, Dr

Richard Gravina, who generally disagreed with the plan to perform

surgery on plaintiff’s neck. Dr Gravina highlighted a portion of

the radiologist’s report noting no “evidence of cord compression,”

the mild nature of the disc bulge, and the fact that the “disc

asymmetry is lateralized to the left, but the patient describes

pain lateralized to the right arm.” AR 232. Dr Gravina concluded:

“[t]here is, therefore, no clinical correlation between the minor

disc asymmetry at C5-6 and the patient’s complaints.” Id. Dr

Gravina concluded that plaintiff was “temporarily totally

disabled.” AR 238. 

A second opinion letter dated October 26, 1994 concluded

that it was “reasonable” to perform the planned surgery. AR 366. 

On October 31, 1994, four days after Dr Gravina’s report was

written, Dr Light performed “discectomy and fusion” surgery on this

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area of plaintiff’s neck. “Postoperatively, the function of her

hand improved immediately.” AR 491. 

In August of 1995, plaintiff underwent a lengthy

“independent orthopedic evaluation” in connection with her workers’

compensation claim. Dr Alan Zacharia diagnosed “upper extremity

repetitive strain” as the cause of plaintiff’s continuing

“cervical, shoulder girdle, and right upper extremity discomfort.” 

AR 369. Dr Zacharia explicitly disagreed with Dr Light’s decision

to proceed with surgery:

The diffuse nature of her complaints (while localized

to the right side) and the diffuse nature of her

cervical discographic findings and cervical imaging

findings were all strong reasons not to undergo

limited surgery in this case. All of Dr Light’s

disclaimers concerning the success rate of multiple

level fusion were quite correct and should have

convinced him not to perform surgery in this patient. 

I view with consternation the fact that he eventually

did do surgery which, given the facts, could not have

been successful in relieving Ms Ortiz. 

Id. 

In December 1995, plaintiff sought medical treatment for 

a respiratory infection. She reported her medications to be

Premarin only. AR 633. Other notes indicate she was taking Zoloft

during this time. AR 627. Clinic notes over the early months of

1996 referred frequently to heart palpitations. AR 626-32. 

Plaintiff underwent an exercise stress test to evaluate possible

heart problems; the results proved essentially normal. AR 653. 

In May 1996, plaintiff went to a hospital emergency room

with pelvic pain. AR 624. Clinic notes also indicate plaintiff

complained of left hip and sacroiliac pain. AR 623. Follow-up xrays in June 1996 showing no abnormalities. AR 643. Vicodin was

nonetheless prescribed for the pain. AR 623, 286. After

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gynecological examinations failed to explain the pains, plaintiff

was referred for a gastrointestinal consultation with Dr Stanley

Rockman in July 1996 at which she stated she was “worried about the

possibility of colon cancer. Her father had colon cancer and

grandfather and a number of people on her father’s side.” AR 282. 

She also told the doctor that her then-sixteen-year-old son might

have a brain tumor. Id. The doctor believed plaintiff to have

irritable bowel syndrome but referred her for colonoscopy because

of the family history of colon cancer, id; the colonoscopy results

were normal. AR 279. In August 1996, plaintiff still complained

of left side pelvic pain, now “radiat[ing] around back.” AR 621.

In October 1996, plaintiff saw Dr Gershan at the North

County Health Center in San Mateo for pain following an incident in

which she “torqued” her neck, AR 620, the causes later variously

noted to be “to prevent [a] piece of furniture from falling,” AR

618, and “tripped over dog.” AR 404. The doctor diagnosed acute

tendonitis and injected cortisone and an analgesic. AR 620. On

follow-up in November 1996, plaintiff reported “excruciating pain”

in her right shoulder and neck. AR 618. The doctor then ordered

MRI and prescribed Vicodin. Id. The MRI report observed small

disc bulges at C4-5 and C6-7, but “no definite findings are seen to

explain the patient’s right radicular symptoms.” AR 294. In early

December, Dr Gershan saw plaintiff and discussed the MRI results. 

His clinic notes recorded pain and tenderness in plaintiff’s neck

and shoulder and a loss of sensation in her right hand. AR 614. A

few days after this visit, Dr Gershan saw plaintiff again as a

follow-up to an emergency room visit precipitated by a bee sting

for which plaintiff received adrenaline injections. AR 613. On

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December 19, Dr Gershan referred plaintiff to a Dr Greenwald for

her shoulder and neck pain. AR 302. Plaintiff missed three

scheduled appointments with Dr Gershan in the latter half of

December 1996. AR 612.

On January 3, 1997, plaintiff saw Dr Gershan and reported

that she had fallen on Christmas Day, hitting her right shoulder

and hip. AR 301. She reported pain in her right shoulder and neck

and in her lower back/sacral area. Dr Gershan continued to follow

plaintiff for these complaints, which no treatment seemed to

alleviate over the next several months. AR 603-606. In addition,

plaintiff was referred to orthopedic specialists. 

In January 1997, plaintiff consulted an orthopedic clinic

for “parasthesias in the ulnar side of her hands,” tingling and

numbness in both hands and a stiff neck. AR 420. The examining

physician, Dr Stanford Pollack, wrote that plaintiff “is really not

that much better from [the fusion surgery]” and referred her to

neurology, commenting that treatment options were limited. On

follow-up, Dr Pollock stated “There is nothing we really have to

offer this lady. She has a chronic pain syndrome.” He prescribed

two dozen Vicodin, “not to be refilled.” AR 419. Dr Gershan,

however, refilled the Vicodin prescription several times. AR 605. 

In June 1997, plaintiff had MRI of her right shoulder, which

revealed “no evidence of a tear through the rotator cuff tendons,”

“slight impingement” and “no further anomalies.” AR 411. 

Meanwhile, in connection with her application for Social

Security benefits filed February 7, 1997, plaintiff was referred

for an occupational disability assessment with Qualified Medical

Examiner Dr Michael Mosely, PhD, a psychologist. Dr Mosely found

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plaintiff to have an IQ of 94 and a Global Assessment of

Functioning (GAF) score of 90. He gave no Axis I diagnosis, but

gave an Axis II diagnosis of “301.9 personality disorder NOS with

marked histrionic and hypochondriacal features.” AR 307, 309-310. 

Under test results, Mosely noted “[h]er protocol shows a neurotic

triad. Hysteria is scored at 97, hypochondriasis at 90, and

depression at 71. These patients typically manifest a variety of

clinical symptoms in response to daily life stresses. In cases

where there are actual physical or mental conditions, their

symptomatic responses are often greatly exaggerated.” AR 309. He

observed “no pain related behaviors during the course of the

examination.” AR 307. 

On June 29, 1997, according to clinic notes, plaintiff

fell at a garage sale and landed on her left hip with her right

knee “flexed behind.” AR 401. The notes further stated that it

took four paramedics to help plaintiff into an ambulance, in which

she was taken to the emergency room. Id. X-rays were taken, a CT

scan of her knee ordered, and a variety of palliative measures

recommended for pain. Id. In addition the clinic notes stated

“stop Vicodin (she is hooked on this med),” noted that a refill

request had been refused and that plaintiff told the examiner she

“got some from a friend.” AR 399. “She is abusing this med.” Id. 

 Plaintiff went to numerous medical appointments for her

knee and lower back discomfort in the months following the June 29

accident. Eg, AR 385-399. 

In early 1998, plaintiff saw doctors for heart tests, a

further MRI of her spine, bronchitis, knee problems and depression.

AR 375-76; 585-86; 665. On January 12, 1998, a letter addressed

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“to whom it may concern” from a Dr Colin L Fox, MD stated “Ms

Griffith is currently under my care for treatment of her

Depression. She will be disabled for the next 6 months.” AR 797. 

There are no other records in the adminstrative record from Dr Fox.

In April 1998, plaintiff had a full orthopedic exam at

UCSF medical center in San Francisco, where she reported constant

“moderate to occasionally severe” low back pain, “shooting and

stabbing” left leg pain with both spasm and stiffness in back and

leg most days. AR 814. Lumbosacral sprain/strain was diagnosed

for these complaints, with conservative treatment including

physical therapy recommended. AR 816. 

On July 15, 1998, plaintiff saw orthopedic surgeon Philip

Bernstein in San Mateo. He diagnosed her with fibromyalgia, left

knee effusion, and cervical disk disease with “failed” cervical

fusion. AR 675-76. He prescribed a TENS (Transcutaneous Nerve

Stimulation) unit for the pain. His memorandum stated “[t]his

patient is unable to work on a permanent basis.” AR 675. 

On August 21, 1998, plaintiff went to the emergency room

in San Mateo. Her discharge diagnoses were: fibromyalgia, chronic

degenerative joint disease, cervical strain and back strain. AR

672-74. She was released with a supply of both Soma and Vicodin

and directed to follow up with Dr Bernstein. AR 673. 

In the autumn of 1998, plaintiff moved to John Day,

Oregon, apparently because a close friend lived there. AR 772. 

She sought public benefits from the state of Oregon and continued

her quest for social security disability payments. AR 752.

In December 1998, plaintiff began seeing Dr John G

Jackson, a general practitioner. AR 866. She reported being on

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Vicodin, Soma, Flexeril, Paxil, Trazodone and Premarin. She

reported “a multitude of complaints, all centered around pain” in

her neck, lower back, down the left leg. Id. She told the doctor

she had been diagnosed with “impingement syndrome on the right

shoulder, lateral epicondylitis in the right elbow and

osteoarthritis to the right wrist * * * a left knee problem * * *

had been talking to orthopedic surgeons about fusing more of her

neck * * * [and] fibromyalgia.” Id. The doctor refilled

plaintiff’s medications and referred her to a mental health agency. 

The following week plaintiff returned, complaining of

“severe pain in her back radiating into her right hip and into the

right leg” as well as left hip and left leg. AR 863. “She

essentially is complaining of pain almost everywhere, but really

concentrates on pain in the low back radiating into her hips.” Id. 

The doctor gave her handouts on fibromyalgia and encouraged her to

see neurosurgeon Dr Mark Belza. He warned her that he “did not

think the disc bulges were a cause of her pain and that surgery

probably would not be helpful.” Id. 

On December 30, 1998, plaintiff saw Dr Belza, a

neurosurgeon, who saw her “for evaluation of her multitude of pain

complaints.” AR 725. Dr Belza wrote: “[plaintiff] describes

severe pain and spasm in the left hip with distribution into the L5

distribution down the lateral aspect of the left thigh, anterior

calf and ankle. She has so much pain that she can’t lie on her

left side.” Dr Belza’s report stated “it is very difficult * * *

to ascertain the source of her [neck] problems,” recommending

further tests, AR 726. Futher, “[w]ith regards to her low back,

again her symptomatology can only be explained on the basis of her

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bursitis that I find in the left hip.” AR 727. The doctor noted

that plaintiff’s “radicular type symptoms” were unusual with hip

bursitis, and recommended an injection into the affected bursa. 

Id. During a follow-up appointment with Dr Belza the following

month, plaintiff stated that her right hand bothered her more than

her left. She also told the doctor that “[s]he has been to lots of

doctors and * * * just wants to take her Social Security and live

in peace without any further diagnostic work-up.” AR 724.

On January 5, 1999, plaintiff underwent a comprehensive

psychological evaluation by David R Starr, PhD, a licensed

psychologist. This consultation was ordered by the Oregon Branch

of Senior and Disabled Services Division in connection with

plaintiff’s application for disability benefits. Dr Starr prepared

a six-page report with several pages of attachments consisting of

the results of psychological tests administered. AR 823-33. Dr

Starr diagnosed plaintiff with Major Depressive Disorder (DSM IV,

296.20) and Undifferentiated Somatoform Disorder (DSM IV, 300.81).

AR 827. He assessed her GAF to be 60. Id. In explanatory

comments, Starr wrote: “Carmen Griffith is depressed. 

Furthermore, she has a tendency to spend an inordinate amount of

her time obsessing about her physical functioning.” He recommended

treatment for her psychological problems and a review by her

physician of her regime of numerous medications. 

On January 29, 1999, pursuant to a referral by Dr

Jackson, plaintiff underwent an assessment at a mental health

clinic in John Day. Carol L Norton, M Ed completed a written

evaluation based on plaintiff’s visit. It consisted of a threepage form filled out with dense, neat handwriting, AR 836-38, and a

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Multiaxial Evaluation Report Form filled out in the same hand,

signed on January 29 by Ms Norton and later, on March 3, 1999 by

psychiatrist Dr Thomas Heriza, MD. AR 839. The latter report

listed three Axis I clinical disorders: major depressive disorder,

single episode, unspecified; undifferentiated somatoform disorder;

and bereavement. Id. Ms Norton scheduled plaintiff for

“supportive mental health services” and a psychiatric assessment.

In March 1999, Dr Heriza performed a psychiatric

assessment and produced a report. AR 840-43. Under “impression,”

the report stated: “She has a history of recurring multiple and

clinically somatic complaints. Some of the complaints are

excessive but criteria for a somatization disorder would not be

met. However her symptoms are associated with both psychological

and medical conditions. * * * Psychological factors, primarily her

current depression plays a major role in the severity of her pain

symptoms.” AR 842. The stated Axis I diagnoses were “major

depressive disorder, moderate severity, single episode without

psychosis” and “Pain Disorder associated with both psychological

and general medical conditions.” Id. The report recommended that

plaintiff avoid all narcotics and pursue alternative therapies for

pain. Also, the report stated “[b]enefit of consistent

psychotherapy could not be over emphasized. If the patient can

deal with many of her psychological problems in a safe and ordered

manner, she is likely to experience fewer somatic complaints and

have less exacerbation of her symptoms.” AR 842.

On March 29, 1999, plaintiff visited Dr Jackson

complaining of lower back pain, left lower quadrant abdominal pain

and some urinary incontinence. AR 753. Plaintiff reported a

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history of diverticulitis, and the doctor began treating her for

this illness. 

Within the next week, plaintiff went to the emergency

room on a weekend complaining of pain in “left lower quadrant.” AR

753. On April 6, plaintiff returned to Dr Jackson, still

complaining of abdominal pain. The doctor referred her for

ultrasound and a barium enema. Id. Neither test revealed any

cause for plaintiff’s pain. AR 752.

On April 29, 1999, Dr Jackson signed a letter to

plaintiff’s attorneys diagnosing her with “chronic pain” with a

“poor” prognosis and stating that her condition was expected to

last her “lifetime.” AR 845.

On June 16, 1999, plaintiff was seen, at Dr Jackson’s

request, by Dr Richard Koller, a neurologist. He performed an

electroneurographic exam pursuant to which he diagnosed plaintiff

with carpal tunnel syndrome in her left arm. AR 729-33.

On June 18, 1999, plaintiff went for an agency-ordered

consultative examination with Dr Frank A Trostel, MD, an

orthopedist. His report noted that plaintiff was then back on

three Vicodin per day, AR 757, and that she mounted the examining

table without difficulty and displayed few notable limitations on

exam. Dr Trostel noted that the records showed possible orthopedic

abnormality in the “right upper extremity and cervical spine,” but

that “in both areas when the patient is distracted nearly full

range of motion is possible.” AR 759. The neurological

examination was “entirely within normal limits.” Id. The report

also noted some possible discrepancies: “[a]lthough her grip

strength on the right is only 4 kg, when departing she gives a very

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firm handshake,” AR 758; “[s]he is observed ambulating from the

office without a limp, carrying a rather large purse. She can hold

the purse in either of her upper extremities * * *. She bends and

twists her head, apparently looking for a cigarette and lighter,

which she proceeds to manipulate with both hands.” AR 759. 

In late June, plaintiff was taken to the emergency room

by ambulance after “a false wall fell on top [of] her” “at the

Fairgrounds.” AR 771, 851. She subsequently saw Dr Jackson and

reported numbness in her left foot. AR 851. 

On July 13, 1999, plaintiff underwent a further agencyordered consultative examination with a psychologist she had not

seen before, Dr William Trueblood, PhD. Plaintiff then reported

her medications to be Vicodin, Paxil, Flexoril and hormones. AR

771. The report noted that plaintiff’s hygiene and grooming were

“very good,” but that she “seemed to be in pain, shifting some in

her chair and standing for part of the interview.” AR 772. Dr

Trueblood concluded: that plaintiff was depressed, largely because

of her pain and physical limitations; that she did not have a

personality disorder; that she had no substantive cognitive

impairment, but possible “inefficiency in cognition due to pain and

medication effects;” and that plaintiff did not malinger. AR 774-

75. Dr Trueblood diagnosed Depressive Disorder NOS and

“psychological factors affecting physical condition” with a GAF of

60. Id. 

On August 12, 1999, plaintiff visited Dr Jackson

complaining of “left hip and buttock pain radiating to the left leg

* * * going on for a couple of weeks,” stating that at the

fairgrounds she had to lean against a pavilion for twenty minutes

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before she could walk because of the pain. AR 850. Plaintiff

returned on August 23 with “continued pain in her left lower back

radiating to the left leg” and incontinence. AR 849. 

Soon after, plaintiff returned to the San Francisco Bay

area “very precipitously because she was beat up by her boyfriend.” 

AR 869. On October 5, 1999, she paid a first visit to Dr Patrick

Pennock, MD in South San Francisco. On that and two subsequent

visits the same month, plaintiff complained of severe low back pain

radiating down her left leg. AR 869-73. On the last of these,

plaintiff was “sitting on the table writhing in agony, crying” and

was referred to a neurosurgeon for MRI and sent to the hospital

emergency room. AR 873. 

There the medical evidence in the record ends. 

B

On February 4, 1997, plaintiff submitted an application

for social security benefits. AR 144. Her application stated that

other disability benefits ended on November 1, 1996. Id. She gave

as the bases for her disability claim “back fusion [and] pain

(neck, shoulder, r[igh]t arm/hand),” heart palpitation and anxiety. 

AR 127. The SSA denied plaintiff’s claim, stating, inter alia,

that the back and arm conditions “do no significantly limit your

ability to engage in ordinary activities” and that plaintiff could

return to work as a restaurant manager. Id. On July 19, 1997, the

SSA denied plaintiff’s request for reconsideration. AR 132. 

Plaintiff requested a hearing, which took place on

November 17, 1999 before an Administrative Law Judge (ALJ) in

Pendleton, Oregon. (It was while her request for benefits was

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pending that plaintiff moved to John Day, Oregon, then back to the

Bay area. Instead of requesting a new hearing date in the Bay

area, she drove back to Oregon for the hearing. AR 101.) AR 55. 

Plaintiff stated at this hearing that she suffered pain in several

places, including her arms, shoulders, neck, left hip and back,

preventing her from sitting or standing for long periods of time. 

AR 70, 73-75. Plaintiff also reported suffering fatigue, impaired

concentration, panic attacks, difficulty making decisions,

difficulty sleeping, kidney problems and carpel tunnel syndrome. 

AR 80, 82-85, 87, 96-97. Plaintiff testified that she was then

taking Paxil, Premarin, Vicodin, Trasidel and receiving injections

of Toretol to her hips, AR 76-77, and that their side effects

included confusion and fatigue. AR 88. 

In closing, plaintiff’s counsel argued at length that

somatoform disorder, or, alternatively, affective

disorder/depression should form the basis for a finding that

plaintiff was disabled:

Ms[] Griffith is not capable of competitive

employment in a full-time basis anymore for a

number of reasons. The first reason is because

I believe she meets listing 12.07 for

somatoform disorder * * *. The somatoform

disorder is mentioned throughout the record,

particularly by a state consultative examiner

in Exhibit 57F at page five as well by her own

treating psychiatrist in 59F, page four.

AR 117-120. The ALJ questioned the applicability of somatoform

disorder because plaintiff was thirty-eight years old in 1994, the

alleged onset date, and plaintiff’s attorney represented that she

had no records documenting somatoform disorder prior to age

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1

 Onset before age thirty is one of the criteria for somatoform

disorder in the Listing of Impairments in the social security

regulations, 20 CFR Part 404, Subpt B, App I § 12.07, discussed infra.

17

thirty.1

A vocational expert (VE) testified that the past jobs

plaintiff had held fell into the sedentary – skilled or light work

– skilled categories. AR 102-03. In response to the ALJ’s

questions, the VE testified that a person could form these jobs if

able to sit for six of eight hours per day, but that carpal tunnel

syndrome limiting fine manipulation could rule out many of them, as

would the inability to tolerate moderate levels of stress. AR 105-

08. The VE considered telemarketer jobs possible with the abovestated limitations, but not when the hypothetical was changed to

include the side effects of drowsiness, nausea, impaired

concentration, irritability and memory loss. AR 109-10. Upon

questioning by plaintiff’s attorney, the VE testified that

telemarketer jobs in which people got angry at the caller would be

too stressful for someone unable to tolerate moderate levels of

stress, and that an individual who was subject to bouts of anger

due to pain and/or consistently late to work and missing two or

three days of work per month due to pain and depression would not

be able to maintain competitive employment. AR 116.

On February 10, 2000, the ALJ issued a decision

concluding that plaintiff was disabled on – but not prior to –

December 25, 1996, and that plaintiff’s disability ceased on

December 30, 1998. AR 22. The ALJ made the following findings:

(1) plaintiff was disabled within the meaning of the Social

Security Act beginning December 25, 1996, and had not engaged in

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substantial gainful activity through the date of the ALJ’s

decision; (2) plaintiff had degenerative disk disease, carpal

tunnel syndrome, and depression; (3) as of December 25, 1996,

plaintiff’s impairments prevented her from performing sustained or

prolonged standing, walking, sitting and lifting, rendering

plaintiff disabled as of December 25, 1996; (4) there was medical

improvement as of December 30, 1998, which was related to

plaintiff’s ability to perform work; (5) prior to December 25,

1996, and after December 30, 1998, plaintiff had the residual

functional capacity to lift ten pounds, walk or stand for two hours

in an eight-hour day, but could not work at heights; (6) prior to

December 25, 1996 and after December 28, 1998, plaintiff’s past

relevant work as an account executive, office manager and executive

secretary did not require the performance of work-related

activities precluded by the stated limitations; (7) prior to

December 25, 1996 and after December 28, 1998, plaintiff’s

impairments did not prevent plaintiff from performing her past

relevant work; and (8) plaintiff was entitled to a closed period of

disability, commencing December 25, 1996 and ceasing on December

30, 1998. AR 30-31.

The ALJ attempted to summarize plaintiff’s voluminous

medical records. Regarding fibromyalgia, the ALJ stated only:

“Upon examination later that month * * *, although the claimant

reported multiple joint pain, there were no significant orthopedic

or neurological objective findings, and the examiner suggested

fibromyalgia.” AR 25. Regarding somatoform disorder, the ALJ

stated only this: “[i]n January 1999, the claimant underwent

initial evaluation at the Grant County Mental Health Center. 

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Although accompanying notes suggest depression and a somatoform

disorder, these notes do not contain any significant objective

findings, or the results of psychological testing.” AR 26. (The

“notes” referred to actually consisted of the Multiaxial Evaluation

Report completed by Ms Norton and signed by Dr Heriza at AR 839.)

Regarding pain, the ALJ stated that she found plaintiff’s

subjective complaints of pain “not fully credible.” Id at 28. The

ALJ summarized plaintiff’s pain testimony thus: 

the [plaintiff] alleged that since her alleged

date of disability, that she has experienced

persistent pain in her neck, back, arms, and

hands. The claimant also stated that she can

only sit for 20-30 minutes, and walk or stand

for 30 minutes, before she develops extreme

pain. Moreover, the claimant reported that she

continues to experience difficulty using her

right hand for activities such as writing,

holding, and gripping. The claimant also

alleged symptoms such as fatigue, and poor

concentration, and stated that she has

difficulty making decisions.

AR at 28. 

For the period prior to December 1996, the ALJ found the

medical reports to lack objective findings of any underlying

impairment, noting, inter alia: that after the fusion surgery,

November 1994 x-rays of plaintiff’s cervical spine displayed good

fusion at the surgical site; absence of evidence of diagnostic

testing “from October 1994, through December 1996, such as X-rays,

tomography, magnetic resonance imaging, or nerve conduction

studies, [showing] any significant abnormality;” lack of any

“specialized course of treatment for [plaintiff’s] complaints after

her surgery * * * through December 1996;” an August 1995

comprehensive examination revealing “no serious findings;” and lack

of documentation showing that plaintiff could not perform sedentary

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work activity prior to December 1996. AR 28-29. While citing Dr

Zacharia’s August 1995 report in support of the conclusion that

plaintiff was not disabled prior to December 1996, the ALJ

unaccountably failed to mention Dr Zacharia’s conclusion that

plaintiff could not return to her usual and customary job and that

she was a “medically qualified injured worker.” AR 371.

For the period December 1998 to the date of decision, the

ALJ similarly found “no objective findings” in the record in

support of plaintiff’s subjective complaints, noting that the

December 1998 examination by Dr Belza revealed no motor strength

deficits in any extremity and that plaintiff was “neurologically

intact” with no signs of muscle wasting or atrophy, usually

associated with inactivity. AR 29. The ALJ further found the

record “devoid of any significant orthopedic or neurological

findings,” concluding that pain of the asserted level of severity

would have resulted, after the passage of five years, in muscle

atrophy or de-conditioning. Id. The ALJ further noted that

plaintiff was independent in her activities of daily living; in

January 1999, she reported gourmet cooking, walking, reading and

sewing. Id at 29. Regarding Dr Jackson’s April 1999 note stating

that plaintiff was disabled for a “lifetime” by pain, the ALJ gave

the opinion “minimal weight” because Dr Jackson “did not submit any

objective evidence which supports this extreme opinion.” AR 26. 

The ALJ did not mention Dr Bernstein’s July 1998 memorandum

reaching essentially the same conclusion. 

While the bulk of the ten-page decision focused on

plaintiff’s orthopedic complaints, the ALJ addressed more briefly

plaintiff’s “mental status and her ability to perform the mental

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demands of work.” AR 26-27, 29. The ALJ described the 1997 report

by Dr Mosely as “normal.” AR 26. Regarding the January 1999

clinic notes from the Grant County Mental Health Center, the ALJ

stated that “[a]lthough accompanying notes suggest depression and a

somatoform disorder, these notes do not contain any significant

objective findings, or the results of psychological testing.” Id. 

The ALJ summarized the January 1999 evaluation by Dr Starr as

finding normal speech, thought process, memory, attention, and

concentration, and “claimant’s ability to perform the mental

demands of work * * * intact,” id, but failed to mention Starr’s

diagnoses of undifferentiated somatoform disorder and major

depressive disorder. Id. Regarding the March 1999 evaluation by

Dr Heriza, the ALJ noted findings of normal speech, memory,

attention and concentration. Id at 27. Acknowledging the

diagnosis of “major depression,” the ALJ stated that Heriza “did

not suggest any special mental limitations, and indicted [sic] that

the claimant’s ability to make social and occupational adjustment

was only mildly limited.” Id. 

The ALJ discussed the “B” criteria for finding a mental

impairment of disabling severity as set forth in the social

security regulations at 20 CFR Part 404.1520a: activities of daily

living; social functioning; concentration, persistence, or pace;

and episodes of decompensation, that is, “exacerbations or

temporary increases in syptoms or signs accompanied by a loss of

adaptive functioning.” The ALJ noted that plaintiff was

independent in her activities of daily living, prepared gourmet

dishes, walked, read, and sewed. AR 29. ALJ discounted

plaintiff’s claim of serious mental limitations, stating that “the

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record does not show that she has been referred for more aggressive

therapy or been hospitalized for her symptoms. * * * it would seem

reasonable that if the claimant’s allegations were considered

credible, that her treating sources would attempt more aggressive

treatment.” Id. ALJ acknowledged that “the claimant may

experience some occasional depressive symptoms related to physical

problems [but was] not persuaded that her complaints are fully

credible.” Id. 

 The ALJ concluded that plaintiff had been disabled from

December 25, 1996 to December 30, 1998, and was otherwise capable

of performing sedentary work as an office manager, account

executive or executive secretary. Id at 30. 

On February 11, 2000, plaintiff requested review of the

ALJ’s decision. Id at 16. On March 28, 2002, the Appeals Council

denied plaintiff’s request for review, and the ALJ’s decision

became final. Id at 7. On December 17, 2002, plaintiff commenced

the instant action for judicial review of the final decision. 

II

The court's jurisdiction is limited to determining

whether the SSA's denial of benefits is supported by substantial

evidence in the administrative record. 42 USC § 405(g). A

district court may overturn a decision to deny benefits only if the

decision is not supported by substantial evidence or if the

decision is based on legal error. See Andrews v Shalala, 53 F3d

1035, 1039 (9th Cir 1995); Magallanes v Bowen, 881 F2d 747, 750

(9th Cir 1989). The Ninth Circuit defines "substantial evidence"

as "more than a mere scintilla but less than a preponderance; it is

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such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion." Andrews, 53 F3d at 1039. 

Determinations of credibility, resolution of conflicts in medical

testimony and all other ambiguities are to be resolved by the ALJ. 

See id; Magallanes, 881 F2d at 750. The decision of the ALJ will

be upheld if the evidence is "susceptible to more than one rational

interpretation." Andrews, 53 F3d at 1040.

“Disabled” is defined as “unable to do 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 for a continuous period

of not less than 12 months.” 20 CFR § 404.1527.

To determine whether a claimant is disabled and entitled

to benefits, the SSA conducts a five-step sequential inquiry. 20

CFR § 404.1520; 20 CFR § 416.920. Under the first step, the ALJ

considers whether the claimant is currently employed in substantial

gainful activity. If not, the second step examines whether the

claimant has a “severe impairment” that significantly affects his

or her ability to conduct basic work activities. In step three,

the ALJ determines whether the claimant has a condition which

“meets” or “equals” the conditions outlined in the Listings of

Impairments in Appendix 1, Subpart P, Regulations No 4. 20 CFR §

404.1520. If the claimant does not have such a condition, step

four asks whether the claimant can perform her past relevant work. 

If not, in step five, the ALJ considers whether the claimant has

the ability to perform other work which exists in substantial

numbers in the national economy. 20 CFR §§ 404.1520(b)-(f); §§

404.920(b)-(f). 

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In this circuit, cases distinguish among the opinions of

three types of physicians: (1) treating physicians; (2) nontreating examining physicians; and (3) those who neither examine

nor treat the claimant. Lester v Chater, 81 F3d at 830. As a

general rule, more weight should be given to the opinion of a

treating source than a non-treating one. Id. Where the treating

doctor’s opinion is not contradicted by another doctor, it may be

rejected only for “clear and convincing reasons.” Baxter v

Sullivan, 923 F2d 1391, 1396 (9th Cir 1991). Even if the treating

doctor’s opinion is contradicted by another doctor, the ALJ may not

reject this opinion without providing “specific and legitimate

reasons.” Murray v Heckler, 722 F2d 499, 502 (9th Cir 1983). 

Conditions contained in the “Listing of Impairments” are

considered so severe that they are irrebuttably presumed disabling,

without any specific finding as to the claimant’s ability to

perform his past relevant work or any other jobs. Lester v Chater,

81 F3d 821, 828 (9th Cir 1995); 20 CFR § 404.1520(d). Claimants

are conclusively disabled if their condition either meets or equals

a listed impairment. Id. To “meet” a listed mental impairment,

the SSA must find that diagnostic criteria in paragraph A of the

impairment definition and a specified number of functional

restrictions in paragraph B are met. Id. The purpose of the

functional criteria in paragraph B is to measure the severity of

the claimant’s impairment. 20 CFR Part 404, subpart P, App 1 §

12.00C. 

Even if a claimant’s mental impairment does not meet the

criteria specified in the listings, however, she must be found

disabled if “the combination of [her] impairments is medically

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equal to any listed impairment.” Lester, 81 F3d at 829; 20 CFR §

404.1526(a). As especially relevant here, the claimant’s illnesses

“must be considered in combination and must not be fragmentized in

evaluating their effects.” Lester, 81 F3d at 829, citing Beecher v

Heckler, 756 F2d 693, 694-95 (9th Cir 1985). 

Plaintiff makes two general arguments in support of her

appeal. First, she asserts that the ALJ gave insufficient weight

to evidence in the record from treating orthopedist Dr Hart, AR

223-25, neurologists Drs Gravina and Zacharia, neurosurgeons Drs

Baiz and Belza and treating general practitioner Dr Jackson and

treating orthopedist Bernstein; and that the ALJ should have

recontacted Drs Jackson and Koller for clarification of the basis

for their “fibromyalgia diagnosis.” Doc # 10, Pl’s br at 23-27. 

Second, plaintiff asserts that the ALJ’s conclusion that she

retained the RFC to do full-time sedentary work ignores evidence

that she could not sit for long periods of time and that she lacks

the mental capacity to deal with the stresses of work. 

Based on a careful review of the entire record, the court

concludes that this case must be remanded to the SSA because (1)

the ALJ failed to make proper findings in support of her decision

that plaintiff’s pain complaints were not credible; (2) the ALJ

impermissibly ignored medical evidence in the record suggesting

that plaintiff’s pain complaints might be due to somatoform

disorder and/or fibromyalgia; and (3) the ALJ failed to consider

plaintiff’s mental and physical impairments in combination in

determining the extent of plaintiff’s functional limitations. 

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A

This complicated case, reduced to its essence, turns on

the apparent disparity between plaintiff’s subjective pain symptoms

and the underlying medical signs and findings. The Social Security

Act directly addresses such cases: 

An individual’s statement as to pain or other

symptoms shall not alone be conclusive evidence of

disability as defined in this section; there must be

medical signs and findings, established by medically

acceptable clinical or laboratory diagnostic

techniques, which show the existence of a medical

impairment that results from anatomical,

physiological, or psychological abnormalities which

could reasonably be expected to produce the pain or

other symptoms alleged and which, when considered

with all evidence required to be furnished under this

paragraph * * * would lead to a conclusion that the

individual is under a disability.

42 USC § 423(d)(5)(A). See also 20 CFR § 404.1529(b)(symptoms such

as pain, fatigue, shortness of breath, weakness and nervousness

will not be found to affect ability to do basic work activities

absent medical signs or laboratory findings showing a medically

determinable impairment). 

The law governing the ALJ’s responsibilities in cases

involving excess pain is well-developed in this circuit. “Excess

pain” is “pain at a level above that supported by medical

findings.” Chavez v Department of Health and Human Services, 103

F3d 849 (9th Cir 1996). If a claimant is able to produce objective

medical evidence of an underlying impairment, an ALJ may not reject

his subjective complaints based solely on lack of objective medical

evidence to corroborate the alleged severity of pain. Moisa v

Barnhart, 367 F3d 882, 885 (9th Cir 2004). If the ALJ finds the

claimant’s pain testimony not to be credible, the ALJ “must

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specifically make findings that support this conclusion.” Id. 

Absent “affirmative evidence that the claimant is malingering,” the

ALJ must provide clear and convincing reasons for rejecting the

claimant’s testimony regard the severity of symptoms. Id. 

Contrary to the ALJ’s assertion, at no time during the

period under consideration has the record been entirely devoid of

medical signs and findings that could account for some degree of

pain. According to the medical reports in the administrative

records, plaintiff was diagnosed with degenerative disc disease in

her neck, upper extremity repetitive strain, and, later, bursitis

in her hip, carpal tunnel syndrome in her left arm and

fibromyalgia. The ALJ identified no “affirmative evidence that the

claimant is malingering” and was therefore required to provide

clear and convincing reasons for rejecting plaintiff’s testimony

regarding the severity of her pain. The ALJ did not do so, but

merely concluded that all the doctors who examined plaintiff were

unable to identify clinical findings that could account for the

degree of plaintiff’s pain. Indeed, the ALJ’s determination that

plaintiff was “not credible” turned entirely on the absence of

corroborating medical findings. This is a legally insufficient

basis for rejecting a claimant’s subjective complaints of pain. 

“If an adjudicator could reject a claim for disability

simply because a claimant fails to produce medical evidence

supporting the severity of the pain, there would be no reason for

an adjudicator to consider anything other than medical findings.” 

Bunnell v Sullivan, 947 F2d 341, 347 (9th Cir 1991). 

Finally, the ALJ appears improperly to have drawn the

conclusion from plaintiff’s ability to carry on routine activities

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of daily life that she was capable of full-time employment. “The

mere fact that a plaintiff has carried on certain daily activities

* * * does not in any way detract from her credibility as to her

overall disability. One does not need to be ‘utterly

incapacitated’ in order to be disabled.” Benecke v Barnhart, 379

F3d 587, 594 (9th cir 2004). Moreover, “[i]n evaluating whether

the claimant satisfies the disability criteria, the Commissioner

must evaluate the claimant’s ‘ability to work on a sustained

basis.’” Lester, 81 F3d at 833; 20 CFR 404.1512(a). In other

words, plaintiff’s admission that she spends some evenings sewing

does not, as the ALJ suggested, mean that she could spend forty

hours a week typing despite her diagnosed carpal tunnel syndrome. 

B

The ALJ, moreover, ignored evidence in the record

offering alternative explanations for plaintiff’s myriad complaints

– alternative, that is, to the explanation that plaintiff is

exaggerating or fabricating her pain symptoms: that plaintiff may

have suffered from somatoform disorder and/or fibromyalgia. As the

foregoing discussion of the medical evidence and the ALJ decision

suggest, however, the ALJ’s mischaracterizations and omissions of

evidence are not limited to that relating to somatoform and

fibromyalgia. The omission of these two diagnoses is particularly

troubling because either would be sufficient to explain plaintiff’s

pain, and both are mentioned repeatedly by plaintiff’s medical

providers. It is not necessary for purposes of this order,

however, for the court to catalog the ALJ’s other omissions

exhaustively. 

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1

The social security Listing of Impairments defines

somatoform disorders, and the criteria for making a disability

determination based on such a diagnosis, as follows:

12.07 Somatoform disorders: Physical symptoms for

which there are no demonstrable organic findings

or known physiological mechanisms * * * . 

A. Medically documented by evidence of one of

the following: 

1. A history of multiple physical symptoms of

several years duration, beginning before age

30, that have caused the individual to take

medicine frequently, see a physician often

and alter life patterns significantly; or 

2. Persistent nonorganic disturbance of one of

the following: 

 a. Vision, or 

 b. Speech; or 

 c. Hearing; or 

 d. Use of a limb; or 

 e. Movement and its control (eg,

coordination disturbance, psychogenic

seizures, akinesia, dyskinesia; or 

 f. Sensation (eg, diminished or

heightened). 

3. Unrealistic interpretation of physical signs

or sensations associated with the

preoccupation or belief that one has a

serious disease or injury; 

20 CFR Part 404, Subpt B, App I § 12.07. The one “A” finding must

be combined with, and be the cause of, two of the four “B” factors

(marked restriction of activities of daily living; marked

difficulties in maintaining social functioning; marked difficulties

in maintaining concentration, persistence, or pace; or repeated

episodes of decompensation, each of extended duration).

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The ALJ addressed plaintiff’s claim of a disabling mental

disorder in general terms, by finding plaintiff’s claim “not

credible” because she was not referred for “more aggressive

treatment,” AR 29. This finding rests on an inaccurate reading of

the record: the record contained two recent evaluations

recommending further treatment for her mental condition. One of

these evaluations, moreover, diagnosed plaintiff with somatoform

disorder. Dr Starr stated “[s]he has not been adequately treated

for her depression and it is recommended that she participate in

treatment apart from the medical therapy that she has been

receiving,” AR 827. Dr Heriza stated “[b]enefit of consistent

psychotherapy could not be over emphasized * * * [as] she is likely

to experience fewer somatic complaints * * *.” AR 842.

Furthermore, whether plaintiff actually sought

psychotherapy for her physical problems is not persuasive regarding

the existence of disabling somatoform disorder. It is in the

nature of somatoform disorders that those afflicted do not think

the key to resolving their physical complaints lies with a mental

health provider; instead, they continually seek the assistance of

physicians who treat physical disorders. Plaintiff’s voluminous

medical file bears out, at least, that her experience of physical

pain – and her search for physical cures – was nearly continuous

throughout the period of claimed disability.

 Because of the special characteristics of somatoform

disorder, the ALJ’s mental health analysis concluding that plaintiff

was not disabled by other mental conditions such as depression was

insufficient to reach the possibility that plaintiff was afflicted

with somatoform disorder. Somatoform disorder is a mental illness

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whose primary manifestation is physical symptoms, and could in this

case have been an independent cause of plaintiff’s otherwise

unexplained affliction with severe, chronic pain. 

Significantly, the ALJ disregarded the medical reports in

which plaintiff was diagnosed with somatoform disorder. 20 CFR §

404.1520(a)(3) provides: “We will consider all evidence in your

case record when we make a determination or decision whether you are

disabled” (emphasis added). The ALJ either ignored, or merely

mentioned in passing, the opinions of examining physicians. But the

ALJ must set out in the record the reasoning and the evidentiary

support for interpreting the medical evidence, Tackett v Apfel, 180

F3d 1094, 1102 (9th Cir 1999), and must set forth clear and

convincing reasons for rejecting the uncontradicted opinion of an

examining physician. Lester v Chater, 81 F3d 821, 830 (9th Cir

1996). 

In Albalos v Sullivan, 907 F2d 871, 874 (9th Cir 1990),

the Ninth Circuit explained:

while we do realize that ALJs are required to

process a large number of cases, it is important

that they make determinations after application

of the proper law to all pertinent evidence in

the record, and that they fully explain the

legal and factual bases for these

determinations. A failure to do so makes

appropriate review almost impossible.

(emphasis added).

The mental health evaluations in the record do not all

agree regarding the diagnosis of somatoform disorder, but all appear

to agree that plaintiff’s physical symptoms had a somatic component. 

At least one evaluator diagnosed plaintiff with somatoform disorder. 

The ALJ did not consider any of this evidence, even though

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plaintiff’s attorney urged at the hearing that the somatoform

diagnosis be considered.

If the basis for a medical opinion is unclear, moreover,

the ALJ is required to obtain additional evidence about that opinion

by, for example, issuing a subpoena to the physician, submitting

questions to the physician or continuing the hearing to augment the

record. Smolen v Chater, 80 F3d 1273, 1288 (9th Cir 1996).

2

Fibromyalgia, previously called fibrositis, is "a

rheumatic disease that causes inflammation of the fibrous connective

tissue components of muscles, tendons, ligaments, and other tissue." 

Benecke v Barnhart, 379 F3d 587, 589-90 (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. 

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. The American College of

Rheumatology issued a set of agreed-upon diagnostic

criteria in 1990, but to date there are no

laboratory tests to confirm the diagnosis.

Id at 590. 

Regarding fibromyalgia, the ALJ stated only that “[in

December 1998], although the claimant reported multiple joint pain,

there were no significant orthopedic or neurological objective

findings, and the examiner suggested fibromyalgia.” AR 25. The ALJ

neither rejected nor accepted this medical opinion, which was from

plaintiff’s treating physician. 

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The administrative record contains at least three

different medical opinions by treating physicians (Bernstein,

Jackson and Belza) stating that plaintiff suffered from

fibromyalgia. This medical evidence, however, is not as strong as

it could be. None of these records sets forth in any detail the

basis for a fibromyalgia diagnosis. It does not appear, moreover,

that plaintiff was ever referred to a rheumatologist for follow-up

by a physician in the relevant field of specialty. Nonetheless,

there is no contradictory evidence in the record stating that

plaintiff did not have fibromyalgia. The ALJ, therefore, was

required to set forth “clear and convincing” reasons for rejecting

these three medical opinions by treating sources. 

As previously stated, moreover, if the basis for a medical

opinion is unclear, the ALJ is required to obtain additional

evidence about that opinion. Smolen v Chater, 80 F3d at 1288.

As with the somatoform evidence, the ALJ made passing

reference to only one of several medical records containing the

fibromyalgia diagnosis, ignoring the others. It was legal error to

ignore the evidence of three treating physicians regarding a

diagnosis that could explain plaintiff’s pain and thus bear directly

on her eligibility for benefits. 

C

In a case in which a claimant appears to be suffering from

both mental and physical ailments, the ALJ may not conduct a

disability analysis that isolates each ailment from the others —

which is precisely what the ALJ did here. Rather, the ALJ is

required to “review the symptoms, signs, and laboratory findings

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about [the claimant’s] impairments to determine whether the

combination of * * * impairments is medically equal to any listed

impairment.” 20 CFR § 404.1526(a)(emphasis added). The ALJ erred

as a matter of law in isolating the effects of plaintiff’s physical

impairments from those of her mental impairment. Lester v Chater,

81 F3d at 830. Where somatoform disorders are concerned, proper

consideration of the one without the other is not only legally

impermissible, it is from a practical standpoint impossible. 

III

Having determined that the ALJ committed legal errors

requiring reversal, the court must now determine the proper remedy. 

42 USC section 405(g) provides: “The court shall have power to

enter, upon the pleadings and transcript of the record, a judgment

affirming, modifying, or reversing the decision of the [SSA], with

or without remanding the cause for a rehearing.” In the normal case

in which the ALJ is determined to have committed legal errors, a

district court will remand the case for redetermination applying the

correct legal standard or for enhancement of the record if

appropriate. Benecke v Barnhart, 379 F3d 587, 593. Where the

record has been fully developed and further administrative

proceedings would serve no useful purpose, the district court should

remand for an immediate award of benefits. Id. 

Where, as here, the ALJ improperly rejects the claimant’s

testimony regarding her limitations, and the claimant would be

disabled if the testimony were credited, remand for the purpose of

having the ALJ make findings regarding that testimony is

inappropriate. Lester, 81 F3d at 834. Furthermore, where the ALJ

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improperly rejects the opinion of a treating or examining physician,

that opinion is credited “as a matter of law.” Id.

Thus crediting the disregarded evidence, and taking into

account the evidence in the record as a whole, the court concludes: 

(1) that the ALJ erred at step #3 of the analysis and that plaintiff

was disabled throughout the period for which she seeks benefits by

pain caused by the combination of her mental and physical ailments;

(2) that applying the undisputed testimony of the VE to the credited

evidence regarding plaintiff’s limitations, plaintiff would not be

able to perform her past work or any other work available in

substantial numbers in the national economy; and (3) there is no

reason to augment the already voluminous record in this matter nor

to delay further the resolution of a benefits application that has

already been pending for nearly eight years. The plaintiff is

entitled to an award of benefits. 

This matter is remanded to the SSA for payment of benefits

to plaintiff. The clerk is directed to close the file and terminate

all pending motions. 

IT IS SO ORDERED.

 

VAUGHN R WALKER

United States District Chief Judge

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