Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_15-cv-02498/USCOURTS-cand-3_15-cv-02498-3/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

---

ORDER (No. 3:15-cv-02498-LB)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

San Francisco Division

GREGG R. CAHILL,

Plaintiff,

v.

COMMISSIONER OF THE SOCIAL 

SECURITY ADMINISTRATION,

Defendant.

Case No. 3:15-cv-02498-LB 

ORDER GRANTING PLAINTIFF'S 

MOTION FOR SUMMARY JUDGMENT 

AND DENYING DEFENDANT'S 

MOTION FOR SUMMARY JUDGMENT

[ECF Nos. 45 & 50]

INTRODUCTION

Plaintiff Gregg Cahill moves for summary judgment, seeking judicial review of a final 

decision by the Social Security Administration denying him disability benefits for his claimed 

disability of a spine disorder, exacerbated by winging scapula and plantar fibromatosis.1The 

Administrative Law Judge (“ALJ”) found that Mr. Cahill did have the severe impairment of 

chronic neck- and back-pain disorder, but held that the severity was insufficient to qualify for 

Social Security Disability Insurance (“SSDI”) benefits.2The Commissioner opposes Mr. Cahill’s 

motion for summary judgment and cross-moves for summary judgment.3

 

1 Motion for Summary Judgment ‒ ECF No. 32 at 11-12. Citations are to the Electronic Case File 

(“ECF”); pinpoint citations are to the ECF-generated page numbers at the tops of the documents.

2 Administrative Record (“AR”) 31.

3 Cross-Motion ‒ ECF No. 50.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 1 of 36
ORDER (No. 3:15-cv-02498-LB) 2

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

Pursuant to Civil Local Rule 16-5, the matter is deemed submitted for decision by this court 

without oral argument. All parties have consented to magistrate jurisdiction.4 Upon consideration 

of the administrative record, the parties’ briefs, and the applicable legal authority, the court grants

the plaintiff’s motion, denies the Commissioner’s cross-motion, and remands for further 

administrative proceedings.

STATEMENT

1. Procedural History

Mr. Cahill filed his initial disability claim on September 6, 2011, alleging disability beginning 

June 29, 2009.

5

The Social Security Administration (“SSA”) stated that Mr. Cahill’s disability was 

not severe enough to keep him from working and consequently denied his claim on October 26, 

2011.

6

Mr. Cahill timely appealed from the SSA’s decision and requested a hearing before the ALJ.7

The ALJ held the hearing in January 2013, in Pittsburgh, Pennsylvania.8 Mr. Cahill attended the 

hearing unrepresented; ALJ Lamar W. Davis and impartial vocational expert (“VE”) Danielle 

Shula also attended the hearing.

9 ALJ Davis addressed the issues of whether Mr. Cahill met the 

SSA’s definition of “disabled” and also whether Mr. Cahill was disabled within the applicable 

disability period of June 29, 2009 to March 31, 2012.10 The ALJ found that Mr. Cahill was not 

disabled.11

Mr. Cahill requested review of the ALJ’s decision by the Appeals Council.12 The Appeals 

Council denied his request, finding insufficient evidence of abuse of discretion, error of law, or a 

 

4 Consent Forms ‒ ECF Nos. 20, 34.

5 AR 82.

6 AR 89

7 AR 95-97.

8 AR 29. 

9 AR 29, 75.

10 Id.

11 Id.

12 AR 16.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 2 of 36
ORDER (No. 3:15-cv-02498-LB) 3

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

major public-policy concern.13 The Appeals Council also found substantial evidence to support the 

decision.

14 The Appeals Council noted that the new evidence that Mr. Cahill submitted did not 

apply to their decision because they applied to dates after the last date insured.15

The Appeals Council later set aside its initial denial because Mr. Cahill submitted additional 

new evidence; the Appeals Council again denied Mr. Cahill’s request for review.16 The Appeals 

Council rejected Mr. Cahill’s assertion that the ALJ was biased and again noted that the new 

evidence was not relevant to the applicable time period.17

After receiving an extension of time to file a federal suit,18 Mr. Cahill appeared in the United 

States District Court for the Western District of Pennsylvania by filing his complaint and moving 

for leave to file in forma pauperis.

19 The SSA answered the complaint and moved for summary

judgment.20 Mr. Cahill twice moved for an extension of time to file a summary-judgment motion 

and the court granted those motions.21

In May 2015, Mr. Cahill filed a notice of change of address, a motion to transfer venue, and a 

third motion for an extension of time to file his summary-judgment motion; the court granted both 

motions, moving the case to the Northern District of California.22 The court denied the SSA’s first 

motion for summary judgment and granted another motion by Mr. Cahill to extend time.23

Once in this court, Mr. Cahill moved for summary judgment.24 The SSA responded and cross-

 

13 Id.

14 Id.

15 AR 17.

16 AR 10. 

17 AR 11.

18 AR 1, 2. 

19 Motion to Proceed In Forma Pauperis ‒ ECF No. 1; Complaint ‒ ECF Nos. 1-1 and 2.

20 Answer ‒ ECF No. 3; Motion for Summary Judgment ‒ ECF No. 8.

21 Motions for Extension of Time ‒ ECF Nos. 6 & 10. 

22 Notice of Change of Address ‒ ECF No. 12; Motion for Extension of Time ‒ ECF No. 14, 

granted at ECF No. 15; Motion to Transfer Venue ‒ ECF No. 13, granted at ECF No. 17.

23 Motion for Extension of Time ‒ ECF No. 25; Order ‒ ECF No. 22.

24 Motion for Summary Judgment ‒ ECF No. 45; see also Exhibits and Supplemental Briefs ‒ 

ECF Nos. 37, 37-1, 38, 40, 41, 43, & 44.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 3 of 36
ORDER (No. 3:15-cv-02498-LB) 4

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

moved for summary judgment.

25 Mr. Cahill then responded to the SSA’s motion.26

2. Summary of Record and Administrative Findings

2.1 Medical Records

2.1.1 Dr. Richard Kasdan: Neurological Consultant

Mr. Cahill met with Dr. Kasdan in August 2008 on a referral by his primary care physician, 

Dr. Vidhu Sharma.

27 Mr. Cahill saw Dr. Kasdan three and a half months after his car accident 

because his back pain worsened with pulsatile twitching in both legs, his hands were ice cold, and 

he had headaches and difficulties finding words.28 Dr. Kasdan examined Mr. Cahill and found that 

his blood pressure was 138/80, that he had a supple neck and good range of back motion, no 

straight-leg raising pain, and no weakness, sensory loss, or reflex change.29 Dr. Kasdan also found 

that Mr. Cahill’s brain MRI was normal and that his lumbar MRI showed no significant 

pathological symptoms.30 Dr. Kasdan noted that he did not think the unknown cause of sudden 

neurological symptoms was serious.31

2.1.2 Dr. Vidhu Sharma: Primary-Care Physician

Mr. Cahill first saw Dr. Sharma in August 2008.32 At this visit, Dr. Sharma noted that Mr. 

Cahill had not sought medical treatment following his car accident.33 Mr. Cahill’s symptoms at the 

time included twitching in his legs, numbness and pins and needles in his hands and feet, 

shakiness in his hands, and pressure in his back.34 Dr. Sharma referred to Mr. Cahill’s complaints 

as “vague” and “bizarre” and described his pain as “generalized back pain and radiculopathy down 

 

25 Motion for Summary Judgment and Opposition ‒ ECF No. 50.

26 Response ‒ ECF Nos. 51 & 53.

27 AR 242.

28 Id.

29 Id.

30 Id; see also AR 245-46.

31 Id.

32 AR 249.

33 Id.

34 Id.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 4 of 36
ORDER (No. 3:15-cv-02498-LB) 5

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

the arms and legs.”35

Mr. Cahill returned to Dr. Sharma’s office following the referral to Dr. Kasdan.36 At this visit, 

Dr. Sharma noted that Mr. Cahill sought additional referrals to specialists, including a 

neurosurgeon and an orthopedist.37 Dr. Sharma also noted that Mr. Cahill needed an MRI of his 

thoracic spine.38

Dr. Sharma later examined the results of Mr. Cahill’s thoracic spine MRI and found the results 

to be “essentially unremarkable.”39

2.1.3 Dr. Alexander Kandabarow: Orthopedics Specialist

Mr. Cahill first saw Dr. Kandabarow in November 2008, and Dr. Kandabarow evaluated him 

for his neurological symptoms caused by the car accident, including his leg and arm twitching.40

Dr. Kandabarow noted that Mr. Cahill was stiff, which made it difficult for him to bend forward or 

backward.41 Dr. Kandabarow also noted that Mr. Cahill had difficulty abducting his shoulders, that 

his ability to bend forward was 80% of normal, and that he had symptoms of degenerative disc 

disease at C5-6 and C6-7.42 Dr. Kandabarow also examined Mr. Cahill’s consultation with Dr. 

Michael McQuillen at Stanford University Medical Center, and found that Mr. Cahill’s scans 

showed no significant abnormalities other than the degenerative disc disease.43

Later that month, Mr. Cahill returned to Dr. Kandabarow’s office, seeking more information 

regarding whether he had a fracture in the thoracic spine.44 Dr. Kandabarow found that there was 

no fracture, that Mr. Cahill’s bone scan was normal, and that there were no surgical indications.45

 

35 Id.

36 AR 247.

37 Id.

38 Id.

39 AR 250.

40 AR 253.

41 Id.

42 AR 254.

43 Id.

44 AR 252.

45 Id.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 5 of 36
ORDER (No. 3:15-cv-02498-LB) 6

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

Mr. Cahill saw Dr. Kandabarow next in December 2008, because although his range of motion 

had increased, the pain remained the same.46 Dr. Kandabarow ordered a cervical MRI for further 

information and recommended continued physical therapy.47 He took an MRI of Mr. Cahill’s 

cervical spine and found that osteophyte complexes were present at C5-6 and C6-7, but that no 

other abnormalities were present.48

2.1.4 Dr. Michael McQuillen: Neurological Consultant

Mr. Cahill traveled to California from his home in Pennsylvania in October 2008 to be seen by 

a neurologist at Stanford University Medical Center, where Dr. McQuillen examined him.

49 Dr. 

McQuillen noted that weeks after the car accident, Mr. Cahill started to feel tingling, numbness, 

shakiness, and experienced vision problems.50 Dr. McQuillen also noted that Mr. Cahill had severe 

headaches, which were successfully treated with Indocin, a medication.51 He also noted a bulge in 

the right plantar region, as well as a lack of notable symptoms regarding ataxia, tremor, sensations, 

blood pressure, and coordination.52 Dr. McQuillen examined the results of the previous MRI scans 

and found no abnormalities, but noted that the images covered only the lower part of Mr. Cahill’s 

spine and therefore more scans were necessary of his thoracic spine.53 He also referred Mr. Cahill 

to the Pain Management Center.54 In a note, Dr. McQuillen examined an x-ray done on Mr. 

Cahill’s thoracic spine, and found degenerative disc disease and a wedge compression fracture on 

T1.55 However, this second finding was contradicted by a follow-up appointment with Dr. Huy Do 

at Stanford in April 2009, which showed that there was no compression deformity in T1.56

 

46 AR 251.

47 Id.

48 AR 376, 378.

49 AR 257.

50 AR 258.

51 Id.

52 AR 259.

53 Id.

54 Id.

55 AR 260.

56 AR 262.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 6 of 36
ORDER (No. 3:15-cv-02498-LB) 7

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

Mr. Cahill returned to Dr. McQuillen’s office in January 2009, following the visits to Dr. 

Kandabarow in Pennsylvania and months of physical therapy.57 Dr. McQuillen noted 

improvement on the previous symptoms, attributing it to physical therapy.58 He acknowledged, 

however, that Mr. Cahill continued to have pain in his spine, between his shoulder blades, and 

running up and down his back, and that this pain was exacerbated by bending and reaching.59

Dr. McQuillen referred Mr. Cahill to Dr. Wendye Robbins.60 Dr. Robbins noted that Mr. 

Cahill functioned best in the mornings, but that spasms and myalgias developed throughout the 

course of the day and he had severe pain in his mid-thoracic spine.61 She noted that Mr. Cahill 

took only NSAIDs regularly, had refused Vicodin, and had stopped taking Flexeril.62 At the time, 

Mr. Cahill was still working, but struggled with working and spent most of his lunch hour in his 

car sleeping.63 After examination, Dr. Robbins found that Mr. Cahill suffered from thoracic 

medial-branch disease and recommended that he undergo medial-branch blocks.64

2.1.5 Dr. Joshua Pal: Treating Physician 

In March 2009, at Stanford Hospital and Clinics, Dr. Joshua Pal and Dr. Raymond Gaeta 

performed a T1-T4 medial-branch-block procedure.

65 Dr. Pal noted that Mr. Cahill tolerated the 

procedure well and there were no complications.66 Dr. Pal, writing a note two weeks after the 

procedure, noted that although initially pain levels were the same following the procedure, Mr. 

Cahill felt a “significant difference in his pain-free range of motion and ability to ambulate with a 

more normal posture” three days after the procedure.67 However, Dr. Pal noted that this was likely 

 

57 AR 255.

58 Id.

59 Id.

60 AR 367.

61 AR 368.

62 Id. 

63 Id. 

64 Id.

65 AR 366.

66 Id.

67 AR 363.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 7 of 36
ORDER (No. 3:15-cv-02498-LB) 8

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

related only to the steroid injection, because after the steroid wore off, Mr. Cahill’s pain level 

returned to the same as it was before the procedure.68 Dr. Pal also noted that the procedure was 

capable of repetition and referred Mr. Cahill to Dr. Huy Do for examination regarding potential 

vertebroplasty.69 Dr. Pal stated that the pain was causing Mr. Cahill a number of symptoms, 

including insomnia, which could be exacerbating his symptoms, and suggested muscle relaxants, 

sleep medication, and a few other pain medications.70

Dr. Do later performed another MRI.

71 Dr. Do determined that a vertebroplasty was not 

appropriate and that the compression deformity noticed by other doctors almost certainly did not 

exist.72

Dr. Pal and Dr. Ian Carroll discussed Mr. Cahill’s symptoms, and compiled their findings into 

a follow-up note.

73 Dr. Pal noted that Mr. Cahill continued to experience discomfort.74 Dr. Pal 

administered a number of maneuver tests that showed a large difference in the contour of the 

scapula.75 The left side of the scapula winged out more than the right and the soft tissue on the left 

side of the thoracic spine, at T5, was tender.76 Dr. Pal noted that the winged scapula may indicate a 

neuropathy in the dorsal scapula nerve, the long thoracic nerve, or the spinal accessory nerve.77

Dr. Pal referred Mr. Cahill to Dr. Alpana Gowda to determine which nerve was injured.78 In 

June 2009, Dr. Gowda performed an electrodiagnostic study on Mr. Cahill and found a right ulnar 

neuropathy at the elbow.79 The study showed no evidence of long thoracic neuropathy, spinal-

 

68 Id.

69 AR 363-64.

70 AR 364-65.

71 AR 361-62.

72 Id.

73 AR 359-61.

74 AR 359.

75 AR 360.

76 Id. 

77 Id. 

78 Id.

79 AR 358. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 8 of 36
ORDER (No. 3:15-cv-02498-LB) 9

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

accessory neuropathy, carpal-tunnel syndrome, or cervical radiculopathy.80 

Dr. Pal also referred Mr. Cahill for specialized electrical stimulation to strengthen the serratus 

anterior on the left side.81 In July 2009, Dr. Carroll reexamined Mr. Cahill.82 Mr. Cahill displayed 

continued winging of the scapula on the left side.83 Dr. Carroll went over the use of the muscle 

stimulator and advised Mr. Cahill to continue using the muscle stimulator for two weeks to 

strengthen the serratus muscle.84 In August 2009, Mr. Cahill stated that he had not experienced a 

benefit after using the muscle stimulator for approximately 11 days.85 Dr. Carroll advised Mr. 

Cahill to continue using the muscle stimulator for a few additional weeks.86

2.1.6 Dr. Stephen Coleman: Treating Physician

In September 2009, Dr. Stephen Coleman and Dr. Garrett Morris evaluated Mr. Cahill at 

Stanford.

87 Dr. Coleman noted that Mr. Cahill used the electrical muscle stimulator, but felt no 

significant alteration in his pain level.

88 Upon examination, Dr. Coleman found tenderness of the 

left paraspinal muscles in the mid thoracic region, slight tactile allodynia, hyperesthesia,

hyperalgesia, and decreased range of motion of the left shoulder.

89 Dr. Coleman noted only mild 

scapular winging on the left side, contrary to previous reports of profound scapular winging.

90

Although Mr. Cahill denied improvement in pain, physical examination suggested improved 

serratus anterior strength.91 Dr. Coleman recommended left-sided medial-branch blocks and 

continued use of the muscle stimulator.92

 

80 Id. 

81 AR 360.

82 AR 353. 

83 Id.

84 Id.

85 AR 352.

86 Id.

87 AR 350. 

88 Id.

89 Id.

90 Id.

91 Id.

92 Id.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 9 of 36
ORDER (No. 3:15-cv-02498-LB) 10

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

In September 2009, Dr. Gerald Matchett and Dr. Timothy Dawson performed the left thoracic 

medial-branch block.93 Dr. Matchett noted the Mr. Cahill tolerated the procedure well and 

experienced no complications.94

Dr. Coleman saw Mr. Cahill for a follow-up appointment in November 2009.95 Dr. Coleman 

noted that the medial-branch-block procedure, administered in September 2009, relieved pain on 

the left side by approximately 50%.

96 Mr. Cahill appeared to be in no apparent distress and 

displayed no pain behaviors.97 Dr. Coleman noted a slight prominence of the interior aspect of the 

left scapula with internal rotation of Mr. Cahill's shoulders.98 Mr. Cahill displayed tenderness 

paraspinally from T3-T6 bilaterally, no decreased sensation, and hyperesthesia over the paraspinal 

muscles medial to the scapula.99 Dr. Coleman advised Mr. Cahill to continue using the electrical 

muscle stimulator and gradually start increasing his activity by swimming and stretching.100

Dr. Coleman saw Mr. Cahill for an additional follow-up appointment in February 2010 for 

ongoing posterior thoracic chest pain.101 Mr. Cahill complained of worsened pain between the 

scapula, exacerbated by abducting his shoulders and performing activities with his arms in front of 

him.102 Upon examination, Dr. Coleman noted no pain behaviors, obvious asymmetry, allodynia, 

sensory changes to ice, or tenderness over the scapula.

103 Mr. Cahill displayed hyperpathia over 

the medial aspect of the scapula bilaterally and tenderness over the rhomboids.104 Dr. Coleman 

noted that most of the pain appeared to be in the rhomboid muscles.105 He recommended starting 

 

93 AR 348.

94 AR 347.

95 AR 345.

96 Id.

97 Id.

98 Id. 

99 Id. 

100 Id. 

101 AR 342.

102 AR 343. 

103 Id. 

104 Id.

105 Id.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 10 of 36
ORDER (No. 3:15-cv-02498-LB) 11

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

Mr. Cahill on Neurontin titrate, trigger-point injections, and physical therapy after the triggerpoint injections.

106

2.1.7 Dr. David Barrows: Treating Physician 

In February 2010, Dr. Vanila Singh performed a trigger-point injection of the bilateral 

shoulder area.107 After the injection, Dr. David Barrows and Dr. Gowda saw Mr. Cahill for a 

follow-up appointment.108 Mr. Cahill claimed the trigger-point injection in February did nothing to 

relieve pain.

109 Dr. Barrows noted the left-side paraspinal area was larger than the right-side and 

very tender to palpation.110 Mr. Cahill exhibited decreased left-side rhomboid muscle mass and 

hyperpathia.111 His right-side shoulder displayed full range of motion and the left side showed 

decreased abduction to approximately 20 degrees above horizontal.112 Dr. Barrows noted no 

evidence of impingement, tenderness, or pain in the shoulder.113

Dr. Barrows noted no evidence of winging scapula and recommended a repeat of the left-sided 

medial-branch blocks.

114 In April 2010, Dr. Jennifer Hah and Dr. Matthew Wedemeyer performed 

thoracic medial-branch blocks at left T3, T4, and T5.115

2.1.8 Nurse Practitioner Theresa Malick-Searle: Treating NP 

Mr. Cahill first saw Nurse Practitioner (“NP”) Theresa Malick-Searle at Stanford in April 

2010, for a follow-up appointment after the repeat left medial-branch block.116 Mr. Cahill reported 

a 50% reduction in left-side thoracic back pain and an increase in right-side thoracic back pain.117

 

106 Id.

107 AR 342.

108 AR 339.

109 AR 340.

110 Id.

111 Id.

112 AR 340-41.

113 AR 341.

114 AR 340. 

115 AR 336. 

116 AR 332-33.

117 AR 333. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 11 of 36
ORDER (No. 3:15-cv-02498-LB) 12

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

NP Malick-Searle noted that Mr. Cahill expressed his “typical pain complaints” and denied any

change in quality, characteristic, or location of pain.118 Mr. Cahill expressed no new neurosensory 

deficits, weakness, or pain.119 Mr. Cahill continued to use the e-Stim muscle stimulator and was 

taking Ibuprofen and Zantac.120 NP Malick-Searle offered and recommended prescriptions for 

Lyrica, Celebrex, Zantac, and Lidoderm patches.121 She also scheduled Mr. Cahill for a repeat 

right-side T3, T4, T5 medial-branch block.122

Later in April 2010, Dr. Matthew Wedemeyer and Dr. Mark Gjolaj performed a right-side 

medial-branch block on T3, T4, and T5.123 In July 2010, Mr. Cahill saw NP Malick-Searle for a 

follow-up appointment.124 Mr. Cahill reported a greater than 50% reduction in right-side midthoracic back pain.125 NP Malick-Searle offered Mr. Cahill new prescriptions for Lyrica, Celebrex, 

and Lidoderm patches, as well as recommended pulsed radiofrequency ablation on the right T3-T5 

medial branches and pulsed radiofrequency ablation on the left T3-T5 medial branches.126

In July 2010, Dr. Wedemeyer and Dr. Scanlon performed thoracic medial-branch pulseradiofrequency neuroplasty at right T3, T4, and T5.127 In August 2010, Mr. Cahill returned to 

undergo thoracic medial-branch pulse-radiofrequency neuroplasty on left T3, T4, and T5.128 Dr. 

Wedemeyer and Dr. Sam Lahidjl performed the procedure.129 The procedure was successful at 

T4.130 However, at T3 and T5, Dr. Wedemeyer was unable to obtain appropriate sensory 

 

118 Id. 

119 Id. 

120 Id. 

121 AR 334. 

122 Id. 

123 AR 328-32.

124 AR 326-28. 

125 AR 326.

126 AR 326-27. 

127 AR 320. 

128 AR 312-19. 

129 AR 312-13. 

130 AR 313.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 12 of 36
ORDER (No. 3:15-cv-02498-LB) 13

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

stimulation, so he proceeded with a thoracic medial-branch block to left T3 and T5.131 In August 

2010, Mr. Cahill saw Dr. Meredith Brooks and Dr. Wendye Robbins for a follow-up 

appointment.132 Mr. Cahill reported effective pain control on the right side following the 

procedure and less improvement in pain on the left side.133 Mr. Cahill continued to use his 

electronic stimulator and conduct physical therapy exercises at home.134 Dr. Brooks noted 

tenderness along the T3-T5 vertebrae, increased tenderness on the left greater than the right, left 

scapula slightly more prominent than the right, symmetric shoulders, and non-antalgic gait.135 Dr. 

Brooks recommended no interventions in care plan at that time.136

In January 2011, Mr. Cahill saw NP Malick-Searle again for a follow-up appointment.137 Mr. 

Cahill expressed that he was battling with his insurance company for his last two procedures and 

that he was interested in trialing new medications.138 NP Malick-Searle recommended starting Mr. 

Cahill on Desipramine.139

In February 2011 Dr. Paul Ford treated Mr. Cahill for a left-medial-knee injury.

140 Dr. Ford 

prescribed brace immobilization, took an MRI, and referred him to physical therapy.141 Dr. Ford’s 

diagnosis was an acute meniscal tear of the left lower knee and an MCL sprain.142 In March 2011, 

Mr. Cahill saw NP Malick-Searle for a follow-up appointment.143 Mr. Cahill reported that he 

experienced profound dizziness as a side effect of Desipramine, which caused him to lose balance 

 

131 Id. 

132 AR 308-11. 

133 AR 309. 

134 AR 310. 

135 Id. 

136 Id. 

137 AR 304-05

138 Id.

139 AR 305. 

140 AR 300-03.

141 AR 302.

142 Id.

143 AR 298-300.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 13 of 36
ORDER (No. 3:15-cv-02498-LB) 14

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

and suffer a level-two MCL tear in his left knee.144 Mr. Cahill discontinued the use of 

Desipramine and was not interested in any new medications that may alter cognition.145 NP

Malick-Searle noted that Mr. Cahill’s musculoskeletal and neurosensory exam was unchanged 

from his prior follow-up visit.146 NP Malick-Searle made no new medication recommendations, 

scheduled Mr. Cahill for a repeat left T3-T5 pulsed radiofrequency ablation, and scheduled 

acupuncture treatments to be performed by Dr. Kong.147

In May 2011, NP Malick-Searle scheduled Mr. Cahill for both right-side and left-side thoracic 

medial-branch blocks of T3-T5, and acupuncture therapy.148 Mr. Cahill’s musculoskeletal and 

neurosensory exam was essentially unchanged.149

2.1.9 Dr. Jiang-Ti Kong: Acupuncture Specialist 

In July 2011, Mr. Cahill first saw Dr. Jiang-Ti Kong for a consultation.150 Dr. Kong noted that 

Mr. Cahill appeared to be otherwise healthy, except the following: (1) longstanding axial thoracic 

pain; (2) thoracic medial-branch disease from T2-T4; (3) long-thoracic neuropathy bilaterally 

post-traumatic; and (4) insomnia.151 Dr. Kong recommended medial-branch blocks (already 

scheduled at the time), physical therapy, continued acupuncture treatments, and no new 

medications.

152

Dr. Kong provided Mr. Cahill’s first acupuncture treatment with electrical stimulation in July 

2011.

153 Mr. Cahill received four more acupuncture treatments from Dr. Kong on August 4, 11, 

18, and 25, 2011.154 At the August 4 treatment, Dr. Kong noted that Mr. Cahill’s pain worsened 

 

144 AR 298. 

145 AR 298-99. 

146 AR 299. 

147 AR 299-300. 

148 AR 296-97. 

149 AR 296. 

150 AR 291-94.

151 AR 293. 

152 AR 294. 

153 AR 290-91. 

154 AR 278-90. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 14 of 36
ORDER (No. 3:15-cv-02498-LB) 15

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

for a few days following the first acupuncture procedure and then returned to the baseline.155 Mr. 

Cahill presented with upper-back pain, bilateral T3-T5 medial branch disease, and bilateral longthoracic neuropathy.156 At the August 11 treatment, Mr. Cahill reported that his pain was 

exacerbated by the previous acupuncture procedure.157 At the August 18 treatment, Mr. Cahill 

reported no improvement in pain from the previous acupuncture treatments.

158 At the August 25

treatment, Dr. Kong noted that the procedure “worked moderately” the week before, but that Mr. 

Cahill had the same upper-back pain between his shoulder blades.159

2.1.10 Dr. Matthew Wedemeyer and Dr. Stephen Coleman: Surgeons

In September 2011, Dr. Matthew Wedemeyer and Dr. David Peng performed thoracic medialbranch blocks at right T3-T5.160 Later in September 2011, Dr. Stephen Coleman and Dr. Alan 

Hagstrom performed thoracic medial-branch blocks at left T3-T5.161 Mr. Cahill saw NP MalickSearle for a follow-up appointment.162 At this appointment, Mr. Cahill presented “typical pain 

complaints” and denied any change in quality, characteristic, or location of pain.163 Mr. Cahill 

reported no sustainable benefit from acupuncture treatments, and a 40% to 50% reduction in 

localized pain form the recent right-side and left-side thoracic-medial-branch-block procedures.164

NP Malick-Searle noted all of Mr. Cahill’s extremities moved without difficulty, he displayed 

symmetrical strength and muscle development, and his neurosensory evaluation was 

unchanged.165 Mr. Cahill’s insurance continued to deny coverage for any future bilateral-pulse-

 

155 AR 288. 

156 AR 289. 

157 AR 285. 

158 AR 282. 

159 AR 278. 

160 AR 273-78.

161 AR 267-73. 

162 AR 264-66. 

163 AR 264. 

164 AR 264-65. 

165 AR 265. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 15 of 36
ORDER (No. 3:15-cv-02498-LB) 16

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

radiofrequency-ablation treatment.166 NP Malick-Searle recommended no medication changes, but 

advised Mr. Cahill to continue using Ibuprofen and lidocaine.167

2.1.11 Dr. Gregory P. Mortimer: SSA Evaluating Physician 

Dr. Mortimer, an SSA evaluating physician, completed a disability-determination analysis on 

Mr. Cahill dated October 25, 2011.168 During the medical portion of the disability determination, 

Dr. Mortimer noted that Mr. Cahill had a normal gait, normal strength and reflexes, and that his 

“sensory” [sic] was intact.

169 Dr. Mortimer also noted the medically determinable impairment of 

severe disorders of back (discogenic and degenerative).170 Dr. Mortimer “considered” applying the

1.04 “Spine Disorders” listing in his analysis.171

Dr. Mortimer noted that the medically determinable impairment could reasonably be expected 

to produce Mr. Cahill’s symptoms and pain.172 However, the intensity, persistence, and 

functionally limiting effects of the symptoms were not substantiated by the objective medical 

evidence alone.173

Dr. Mortimer found that Mr. Cahill had the following exertional limitations: (1) can 

occasionally (one-third or less of an eight-hour day) lift or carry (including upward pulling) twenty 

pounds; (2) can frequently (more than one-third up to two-thirds of an eight-hour day) lift or carry 

(including upward pulling) ten pounds; (3) can stand or walk, with normal breaks, for a total of six 

hours in an eight-hour day; (4) can sit, with normal breaks, for a total of six hours in an eight-hour 

day; (5) can push or pull, including hand and foot controls, for an unlimited time.174

Dr. Mortimer also found that Mr. Cahill had postural limitations with the ability to 

 

166 Id. 

167 AR 266. 

168 AR 82-88. 

169 AR 84. 

170 Id. 

171 Id. 

172 Id. 

173 Id. 

174 AR 85. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 16 of 36
ORDER (No. 3:15-cv-02498-LB) 17

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

occasionally: (1) climb ramps or stairs; (2) climb ladders, ropes, or scaffolds; (3) balance; (4) bend 

at the waist or “stoop”; (5) kneel; (6) crouch; or (7) crawl.175 Dr. Mortimer noted no manipulative, 

visual, communicative, or environmental limitations.176

Based on the record evidence, Dr. Mortimer found that treatment for Mr. Cahill’s symptoms, 

including radiofrequency ablation, were generally successful.177 Dr. Mortimer also found that Mr. 

Cahill did not require an assistive device to “ambulate” and that the prescribed medications were 

relatively effective in controlling his symptoms.178 Dr. Mortimer noted that Mr. Cahill’s 

statements were partially credible.179

Assessing relevant vocational factors, Dr. Mortimer found that Mr. Cahill had no past relevant 

work.180 Dr. Mortimer found that even with his impairment, Mr. Cahill was not limited to 

unskilled work.181 Dr. Mortimer also found that Mr. Cahill could sustain “light” work based on 

“strength factors” including: lifting or carrying, standing, walking, sitting, pushing, and pulling.182

Dr. Mortimer found that non-exertional limitations did not exist.183

Dr. Mortimer determined that Mr. Cahill was “not disabled.”184

2.2 Mr. Cahill’s Testimony

Mr. Cahill testified before the ALJ in January 2013.185 The ALJ first asked Mr. Cahill about 

his educational background and work history.186 Mr. Cahill completed 170 college credits over the 

course of six years in a variety of majors. 

187 Between 2003 and 2009, Mr. Cahill worked at a 

 

175 AR 86.

176 Id. 

177 Id. 

178 Id. 

179 Id. 

180 AR 87. 

181 Id. 

182 AR 87-88. 

183 AR 88. 

184 Id. 

185 AR 44-75. 

186 AR 45-47. 

187 AR 45. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 17 of 36
ORDER (No. 3:15-cv-02498-LB) 18

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

mortgage company in various positions including compliance officer, auditor, loan coordinator, 

loan processor, underwriter, and post-closing specialist.188 Mr. Cahill also worked as a titleclearance specialist at a title company.189 In 2008, Mr. Cahill was involved in a motor-vehicle 

accident where he sustained injuries to his ribs, shoulder, left knee, and the thoracic area.190

The ALJ questioned Mr. Cahill about what parts of his body continue to trouble him after the 

motor-vehicle accident, specifically his thoracic-nerve injury.191 Mr. Cahill responded that the 

focal point of his pain is the thoracic area between the shoulder-blade and the spine.

192 He stated 

that he was diagnosed with winging scapula, meaning the area between the spine and the scapula 

protruded because the muscles were not holding it in place.193 Mr. Cahill experienced weakness 

and pain in that area with everything he did.194

The ALJ then questioned Mr. Cahill about his ability to do certain tasks.195 Mr. Cahill stated 

that he used the left hand, the hand that was affected, as much as he could tolerate.

196 He was 

unable to wash a pan of dishes, even with his elbow supported.197 Mr. Cahill also supported his 

elbow when he drove his car.198 He was precluded completely from attempting tasks such as 

washing walls or windows because of shooting pain and numbness.199 The ALJ then asked Mr. 

Cahill if his doctors had encouraged him to increase his amount of exercise.200 Mr. Cahill 

responded that his doctors said physical therapy was “tolerable.”

201 He also said that the doctors he 

 

188 AR 46. 

189 Id. 

190 AR 49-50. 

191 Id.

192 AR 50.

193 AR 50-51. 

194 Id.

195 AR 52-53. 

196 AR 52.

197 Id. 

198 Id.

199 AR 55-56. 

200 AR 57. 

201 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 18 of 36
ORDER (No. 3:15-cv-02498-LB) 19

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

saw “discounted anything in the cervical area” even though two previous MRIs showed that the 

cervical C6 and C7 disks “caus[ed] a problem.”

202 Mr. Cahill also testified that he had 

osteophytes, or “bone spurs coming in from the back,” and stenosis.203 He said he had “pressure 

on the back of the spine coming in from the vertebrae,” and ruptured disks in C6 and C7.204

The ALJ asked Mr. Cahill if the doctors ever told him that he had “any neural compression or 

root compression.”205 Mr. Cahill responded no, but stated that he had been using an electric 

stimulator on his side for three and a half years that was “just enough to kind of maintain that.”

206

Mr. Cahill testified that without the electronic stimulator his side was “even worse” and 

“everything just droops.”207 The electronic stimulator helped “[innervate] the muscles” and 

provided stability.208 Mr. Cahill testified that in the months preceding the ALJ hearing, a new MRI 

showed “that C6 and C7 are inn[er]vate the bracho plexis nerves” and “in turn innervate the 

[INAUDIBLE] muscles and the dorsal scapular muscles.”209

The ALJ asked Mr. Cahill what treatments had been offered after the latest discovery.210 Mr. 

Cahill responded that he had received an epidural steroid injection to relieve inflammation and 

reduce pain in the area.211 Mr. Cahill also stated that he had received “numerous nerve blocks in 

the thoracic area,” radiofrequency ablation,

212 and a spinal-cord stimulator.213 Mr. Cahill testified 

that the next step was for him to see a neurosurgeon and an orthopedist.214 He also testified that his 

 

202 Id. 

203 Id. 

204 Id. 

205 Id. 

206 AR 58. 

207 Id.

208 Id. 

209 Id. 

210 Id. 

211 Id. 

212 Transcript says “greater frequency of ablation” which the court assumes to mean 

“radiofrequency ablation.”

213 AR 59. 

214 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 19 of 36
ORDER (No. 3:15-cv-02498-LB) 20

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

doctors are considering a discectomy laminectomy.215 The ALJ then asked if the decision to have 

surgical intervention was up to Mr. Cahill.216 Mr. Cahill’s responded that he would get the 

procedures because he “can’t function like this.”217

The ALJ asked Mr. Cahill what medications he had been prescribed.

218 Mr. Cahill’s response 

was “[n]ever, never opioids.” Mr. Cahill further stated that he had been offered medical marijuana, 

but that he didn’t want it and didn’t want anything that could be addictive.219 Mr. Cahill testified 

that he had previously been on Gabapentin, Neurontin, and Lyrica and the side effects to those 

medications had been “terrible.”220 Mr. Cahill testified that while on these medications he split his 

head open and suffered a knee injury.221 He stated that “with no warning, sometimes [he’d] get a 

shooting pain down [his] back and just get thrown.”222 The ALJ then asked Mr. Cahill if after 

those incidents the doctors took Mr. Cahill off the medications.223 Mr. Cahill responded yes, and 

that they additionally prescribed Gabapentin, Dicipromine, and Cymbalta.224 Mr. Cahill testified 

that he could not afford to take Cymbalta, as it was over $500 for one prescription.

225 Mr. Cahill 

testified that he had been taking 800 milligrams of Ibuprofen for the last four and a half years up 

to three or four times a day.226 Mr. Cahill also testified to using Lidoderm patches and Lidocaine 

gel.227

 

215 Id. 

216 Id. 

217 Id. 

218 AR 60. 

219 Id. 

220 Id.

221 Id. 

222 Id. 

223 AR 61. 

224 Id.

225 Id.

226 AR 61-62. 

227 AR 62. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 20 of 36
ORDER (No. 3:15-cv-02498-LB) 21

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

The ALJ asked Mr. Cahill if he had trouble walking and how far he could walk.228 Mr. Cahill 

responded that he had trouble walking “any distance” and he could manage about a quartermile.229 He walked with his head down because looking up or out interfered with his balance and 

he would “teeter.”230 The ALJ asked Mr. Cahill if he did physical therapy and how it went.231 Mr. 

Cahill responded that he did therapy including: physical therapy, massage therapy, and the use of a 

TENS unit.232 However, Mr. Cahill testified that about two hours after therapy his muscles would 

lock up.233 The ALJ then asked if he did any home exercises as part of physical therapy.234 Mr. 

Cahill testified that he did, until he received MRI results that he believed indicated that physical 

therapy may have worsened the situation.235 Mr. Cahill testified that he would “move a little bit 

just to keep some range of motion.”236

Mr. Cahill testified that he had to completely change his lifestyle.237 He used to be active, 

work out six days a week, swim ten miles a week, mountain-climb, bike, and hike.238 The ALJ 

asked Mr. Cahill what he did to occupy himself during waking hours.239 Mr. Cahill responded that 

he spent his time on the internet, playing video games, and reading.240 Mr. Cahill alternated 

between sitting, standing, and lying down.241 He spent as much time in one position as possible 

before moving, and slept no more than three hours at a time because the pain would wake him 

 

228 AR 63.

229 Id.

230 Id.

231 Id. 

232 Id. 

233 Id. 

234 AR 64. 

235 Id. 

236 Id. 

237 AR 65. 

238 Id.

239 AR 66. 

240 Id.

241 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 21 of 36
ORDER (No. 3:15-cv-02498-LB) 22

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

up.

242 Mr. Cahill testified to having constant feelings of fatigue.243

The ALJ then questioned Mr. Cahill about his daily routine.244 This included browsing the 

computer, lunch, napping, dinner, watching TV, cooking, washing dishes, shopping for groceries, 

laundry, running errands, feeding the cats, and talking to the neighbor.245 The ALJ asked Mr. 

Cahill how he spent his time on the internet.246 Mr. Cahill responded that he read “everything” 

about his injuries.247 Mr. Cahill was not encountering any problems with authority figures or 

stressful situations, and he testified that he did not develop an emotional condition.248 The ALJ 

then posed a question to Mr. Cahill that if someone watched him during the course of his average 

16-hour day, doing what he felt comfortable doing around the house, how much time would they 

observe he spent doing absolutely nothing that was productive.

249 Mr. Cahill responded that 7

hours out of a 16-hour day would be “downtime.”250

Lastly, the ALJ asked Mr. Cahill about his settlement.251 Mr. Cahill testified that his settlement 

was approximately $74,000 for past medical bills.252 Mr. Cahill also testified that the settlement 

did not include lost wages or pain and suffering.253

2.3 Vocational-Expert Testimony 

Vocational Expert Danielle Shula testified at the hearing on January 9, 2013.254 The ALJ first 

asked Ms. Shula to classify Mr. Cahill’s past work.255 Ms. Shula stated that Mr. Cahill had been a 

 

242 Id.

243 Id. 

244 AR 67. 

245 Id. 

246 AR 68. 

247 Id. 

248 Id. 

249 AR 70-72. 

250 AR 72.

251 AR 73. 

252 Id. 

253 AR 74. 

254 AR 75-79. 

255 AR 75. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 22 of 36
ORDER (No. 3:15-cv-02498-LB) 23

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

loan officer, mortgage-closing clerk, title specialist, mortgage-loan processor, and a lifeguard.256

The ALJ then posed a hypothetical question to the VE whether an individual of Mr. Cahill’s same 

education and vocational history, could perform any of his past relevant work if that person had 

the following limitations: (1) capable of no more than light exertional activity, provided a 

discretionary sit-or-stand option is afforded; (2) precluded from the use of the left dominant upper 

extremity to any more than incidental (no more than one-sixth of an eight-hour day) overhead 

reaching, or unsupported forward reaching; (3) no task entailing rapid repetitive motion; (4) 

precluded from any task entailing unprotected heights or dangerous machinery; (5) restricted to 

simple, routine, repetitive tasks, with no more than incidental (no more than one-sixth of an eighthour day) exercise of independent judgment or discretion; (6) no more than incidental change in 

work process; (7) and no piecework production, rate, and pace.

257 The VE testified that such a 

person could not perform Mr. Cahill’s past work.258 That person could perform work as a ticket 

taker, ticket seller, or a mail clerk.259

The ALJ then added to the hypothetical that the person would need unscheduled rest breaks 

throughout the course of an eight-hour day.260 The breaks would be indeterminate in number, 

frequency, or duration.261 On average the rest breaks would be 15 minutes per hour.262 The VE 

testified that a person with those limitations could not perform the above-mentioned work of a 

ticket taker, ticket seller, or mail clerk and it would eliminate other jobs in the national 

economy.263

 

256 Id. 

257 AR 76-77. 

258 AR 77. 

259 Id. 

260 AR 78. 

261 Id. 

262 Id. 

263 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 23 of 36
ORDER (No. 3:15-cv-02498-LB) 24

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

2.4 Administrative Findings 

The ALJ held that Mr. Cahill was not disabled within the meaning of the Social Security Act 

from June 29, 2009 through March 31, 2012 (the date last insured).264

The Social Security Administration has established a five-step evaluation process to determine 

if an individual is disabled.265 At step one, the ALJ must determine if the individual is engaging in 

“substantial gainful activity.”

266 At step two, the ALJ must determine whether the individual has a 

“medically determinable impairment” that is “severe” or a combination of impairments that is 

“severe.”267 At step three, the ALJ must determine if the individual’s impairments are severe 

enough to meet a listed impairment.268 At step four, the ALJ must determine the individual’s 

“residual functional capacity” and determine if the individual can perform “past relevant work.”269

At step five, the ALJ must determine if the individual can perform any other work.270

At step one, the ALJ found that that Mr. Cahill did not engage in substantial gainful activity 

from June 29, 2009 to March 31, 2012.271

At step two, the ALJ found that Mr. Cahill had the following severe impairments: “chronic 

neck and back pain disorder.”272 The ALJ found that the condition reduced Mr. Cahill’s ability to 

do some basic physical work activities.273

At step three, the ALJ found that Mr. Cahill did not have an impairment or combination of 

impairments that met or medically equaled a listed impairment.274 In making this determination, 

the ALJ found that Mr. Cahill did not “demonstrate loss of motion, radiculopathy, impaired use of 

 

264 AR 29. 

265 AR 30.

266 Id. 

267 Id.

268 Id.

269 Id.

270 AR 31.

271 Id. 

272 Id. 

273 Id. 

274 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 24 of 36
ORDER (No. 3:15-cv-02498-LB) 25

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

any extremity, or impairment of gait and station, and therefore did not satisfy any of the

musculoskeletal listings.”

275

Before considering the fourth step, the ALJ determined that Mr. Cahill had the residual 

functional capacity to perform light work.276 Mr. Cahill must be afforded the opportunity to 

alternate between sitting and standing as needed to relieve his pain.277 The ALJ determined that 

Mr. Cahill was not able to use his “dominant left upper extremity for more than incidental 

overhead reaching or unsupported forward extension at or above shoulder level.”278 The ALJ also 

found that Mr. Cahill was unable to perform tasks requiring repetitive motion of his affected arm 

and he could not work at unprotected heights or around dangerous moving machinery.279 The ALJ 

determined that Mr. Cahill was restricted to “simple routine repetitive tasks involving only the 

incidental use of independent judgment or discretion.”280 The ALJ found that Mr. Cahill should 

work with few changes in work process, and without a “piecework-style” production rate.281

The ALJ followed a two-step process in which he (1) determined whether there was 

underlying medically determinable physical or mental impairments that could reasonably be 

expected to produce Mr. Cahill’s pain or symptoms, and (2) determined the extent to which the 

impairments limited Mr. Cahill’s functioning.282 The ALJ considered Mr. Cahill’s testimony 

regarding his ability to work, pain level, injuries, pain treatment, daily activities, and abilities.283

After considering the evidence, the ALJ determined that Mr. Cahill’s impairments could 

reasonably cause his symptoms, but the ALJ did not accept Mr. Cahill’s statements about the 

intensity, persistence, and limiting effects of these symptoms.284

 

275 Id. 

276 Id. 

277 Id. 

278 Id. 

279 AR 32.

280 Id.

281 Id. 

282 Id. 

283 Id.

284 AR 33. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 25 of 36
ORDER (No. 3:15-cv-02498-LB) 26

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

The ALJ considered Mr. Cahill’s work history and categorized it as “extremely sporadic.”285

The ALJ determined that the evidence did not allow “a comfortable presumption that he would be 

working now even if unimpaired.”286 The ALJ also considered the evidence that Mr. Cahill did not 

take two prescribed medications because they were too expensive.287 The ALJ determined that Mr. 

Cahill had some financial resources from his personal-injury suit that “could be used to relieve his 

pain.”288 The ALJ found that “if he has not used his money to obtain symptom relief, an obvious 

conclusion is that the pain simply is not severe enough to motivate him to take this action” and 

that this undercut Mr. Cahill’s credibility of his reported symptoms.289

The ALJ determined that Mr. Cahill demonstrated “few abnormal clinical findings.”290 The 

ALJ relied on medical evidence that showed “only right ulnar neuropathy without evidence of 

damage to the long thoracic nerve, the spinal accessory nerves, the carpal tunnels, or the areas 

innervated by the cervical root.”291 The ALJ found that Mr. Cahill had never demonstrated 

abnormalities of gait, moved all extremities without difficulty, and demonstrated normal muscle 

strength, tone, and bulk.292 The ALJ determined that Mr. Cahill showed no atrophy and 

consequently found that that proved he remained physically active.293

The ALJ further found that Mr. Cahill’s daily living activities were not as drastically limited as 

he portrayed.294 The ALJ relied on evidence that Mr. Cahill played video games, participated in 

more passive hobbies, could go on a two-mile bike ride on a paved trail, and was able to run 

errands, keep appointments, and do housework so long as he broke tasks down into parts.295 The 

 

285 Id. 

286 Id. 

287 Id. 

288 Id. 

289 Id. 

290 Id. 

291 AR 34.

292 Id. 

293 Id. 

294 Id. 

295 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 26 of 36
ORDER (No. 3:15-cv-02498-LB) 27

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

ALJ also relied on evidence that Mr. Cahill had no significant mental disorder.296 The ALJ 

determined that Mr. Cahill had greater day-to-day functioning than he was willing to admit.297 The 

ALJ found that Mr. Cahill had no problem tolerating stress, dealing with authority figures, or 

managing ordinary activities.298 The ALJ considered evidence that Mr. Cahill could walk three 

quarters of a mile without stopping, his day was not interrupted by pain amelioration, and he spent 

most of his time on a computer.299

Based on this evidence, the ALJ determined that Mr. Cahill did not have “markedly disruptive 

pain.”300 The ALJ concluded that Mr. Cahill could not perform any work that required him to lift

and carry more than 20 pounds.

301 The ALJ found that Mr. Cahill could not use his dominant hand 

and arm for repetitive motions or overhead reaching or lifting.

302 The ALJ also found that Mr. 

Cahill’s pain may interfere “with the ability to understand, remember, and carry out any[thing] but 

simple instruction, or to handle varied tasks.”303 The ALJ determined that Mr. Cahill could sustain 

competitive levels of concentration, task persistence, and work pace if he had only routine 

assignments.304 The ALJ determined that Mr. Cahill could do such a job for five eight-hour days a 

week, or an equivalent schedule.305

At step four, for the reasons provided above, the ALJ determined that Mr. Cahill was unable to 

perform any past relevant work.306 The ALJ determined that Mr. Cahill’s past relevant work 

exceeds the limitations provided above.307

 

296 Id. 

297 Id. 

298 Id. 

299 Id.

300 Id. 

301 AR 35. 

302 Id. 

303 Id.

304 Id. 

305 Id. 

306 Id. 

307 Id.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 27 of 36
ORDER (No. 3:15-cv-02498-LB) 28

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

At step five, the ALJ found that Mr. Cahill had the residual functional capacity to perform 

unskilled light work with additional limitations.308 The ALJ considered Mr. Cahill’s residual 

functional capacity, age, education, and work experience.309

The ALJ credited the VE’s testimony that Mr. Cahill could perform “the requirements of 

repetitive occupations such as ticket taker, ticket seller, or mail clerk.”310 The ALJ found the 

number of available jobs “significant” within the meaning of 20 C.F.R. §§ 404.1560(c) and 

416.960(c).311 The ALJ therefore determined that Mr. Cahill was not disabled from June 29, 2009, 

the alleged onset date, through March 31, 2012, the date last insured.312

ANALYSIS

1. Standard of review 

Under 42 U.S.C. § 405(g), district courts have jurisdiction to review any final decision of the 

SSA commissioner if the claimant initiates the suit within 60 days of the decision. District courts 

may set aside the commissioner’s denial of benefits only if the ALJ’s “findings are based on legal 

error or are not supported by substantial evidence in the record as a whole.” 42 U.S.C. § 405(g); 

Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009) (internal quotation omitted). “Substantial 

evidence means more than a mere scintilla but less than a preponderance; it is such relevant 

evidence as a reasonable mind might accept as adequate to support a conclusion.” Andrew v. 

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). If the evidence in the administrative record supports 

both the ALJ’s decision and a different outcome, the court must defer to the ALJ’s decision and 

may not substitute its own decision. See id.; Tackett v. Apfel, 180 F.3d 1094, 1097–98 (9th Cir. 

1999).

 

308 AR 36. 

309 AR 35.

310 AR 36. 

311 Id.

312 Id. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 28 of 36
ORDER (No. 3:15-cv-02498-LB) 29

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

2. Applicable law

An SSI claimant is considered disabled if he suffers from a “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 twelve months,” and the “impairment or 

impairments are of such severity that he is not only unable to do his previous work but cannot, 

considering his age, education, and work experience, engage in any other kind of substantial 

gainful work which exists in the national economy.” 42 U.S.C. § 1382c(a)(3)(A) & (B).

2.1 Five-step analysis to determine disability 

There is a five-step analysis for determining whether a claimant is disabled within the meaning 

of the Social Security Act. See 20 C.F.R. § 404.1520. The five steps are as follows:

Step One. Is the claimant presently working in a substantially gainful activity? If 

so, then the claimant is “not disabled” and is not entitled to benefits. If the claimant 

is not working in a substantially gainful activity, then the claimant case cannot be 

resolved at step one, and the evaluation proceeds to step two. See 20 C.F.R. § 

404.1520(a)(4)(i). 

Step Two. Is the claimant’s impairment (or combination of impairments) severe? If 

not, the claimant is not disabled. If so, the evaluation proceeds to step three. See 20 

C.F.R. § 404.1520(a)(4)(ii).

Step Three. Does the impairment “meet or equal” one of a list of specified 

impairments described in the regulations? If so, the claimant is disabled and is 

entitled to benefits. If the claimant’s impairment does not meet or equal one of the 

impairments listed in the regulations, then the case cannot be resolved at step three, 

and the evaluation proceeds to step four. See 20 C.F.R. § 404.1520(a)(4)(iii).

Step Four. Considering the claimant’s residual functional capacity (“RFC”), is the 

claimant able to do any work that he or she has done in the past? If so, then the 

claimant is not disabled and is not entitled to benefits. If the claimant cannot do any 

work he or she did in the past, then the case cannot be resolved at step four, and the 

case proceeds to the fifth and final step. See 20 C.F.R. § 404.1520(a)(4)(iv).

Step Five. Considering the claimant’s RFC, age, education, and work experience, 

is the claimant able to “make an adjustment to other work?” If not, then the 

claimant is disabled and entitled to benefits. See 20 C.F.R. § 404.1520(a)(4)(v). If 

the claimant is able to do other work, the Commissioner must establish that there 

are a significant number of jobs in the national economy that the claimant can do. 

There are two ways for the Commissioner to show other jobs in significant 

numbers in the national economy: (1) by the testimony of a vocational expert or (2) 

by reference to the Medical-Vocational Guidelines at 20 C.F.R., part 404, subpart 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 29 of 36
ORDER (No. 3:15-cv-02498-LB) 30

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

P, app. 2. See 20 C.F.R. § 404.1520(a)(4)(v).

For steps one through four, the burden of proof is on the claimant. Tackett, 180 F.3d at 1098. At 

step five, the burden shifts to the commissioner. Id.

3. Application 

Mr. Cahill alleges that the ALJ erred in his decision by failing to consider all the evidence 

when making his residual-functional-capacity finding, and by failing to weigh the evidence 

properly when making his decision.

313

3.1 The ALJ did not err by finding the relevant period under review to be from June 29, 

2009 through March 31, 2012

As a preliminary issue, Mr. Cahill applied for Title II Social Security Disability (“SSD”) 

benefits on September 7, 2011, alleging disability starting on June 29, 2009.314 To be eligible for 

Title II benefits, an individual must “have disability insured status in the quarter in which [they]

become disabled or in a later quarter in which [he is] disabled.” 20 C.F.R. § 404.131(a). An 

individual must establish a disability on or before the date the individual was last insured for 

disability benefits. Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). 

Mr. Cahill was last insured March 31, 2012; he therefore must have established disability 

before this date.315 Mr. Cahill submitted medical evidence that postdated March 31, 2012.

316

Because the evidence postdated the date last insured, the ALJ did not err when he chose to 

disregard the postdated evidence and when he found the relevant period of review from June 29, 

2009 through March 31, 2012. 

3.2 The ALJ erred in his residual-functional-capacity finding

The ALJ erred in his residual-functional-capacity finding by failing to provide clear and 

convincing reason for neglecting the opinions of treating physicians, and for disregarding the 

entirety of the VE’s testimony. 

In determining whether a claimant is disabled, the ALJ must consider each medical opinion in 

 

313 Motion for Summary Judgment – ECF No. 32

314 AR 138-39.

315 AR 31. 

316 AR 435-508. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 30 of 36
ORDER (No. 3:15-cv-02498-LB) 31

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

the record, together with the rest of the relevant evidence. 20 C.F.R. § 416.927(b); Zamora v. 

Astrue, No. C 09-3273 JF, 2010 WL 3814179, at *3 (N.D. Cal. Sept. 27, 2010). Social Security 

regulations distinguish between three types of physicians: treating physicians; examining 

physicians; and non-examining physicians. 20 C.F.R. § 416.927(c), (e); Lester v. Chater, 81 F.3d 

821, 830 (9th Cir. 1995). “Generally, a treating physician’s opinion carries more weight than an 

examining physician’s, and an examining physician’s opinion carries more weight than a 

reviewing physician’s.” Hollohan v. Massanari, 246 F.3d 1195, 1202 (9th Cir. 2001) (citing 

Lester, 81 F.3d at 830). The opinion of a treating physician is given the greatest weight because, 

again, the treating physician is employed to cure and has a greater opportunity to understand and 

observe a claimant. See Smolen v. Chater, 80 F.3d 1273, 1285 (9th Cir. 1996); see also 

Magallanes, 881 F.2d at 751.

Accordingly, “[i]n conjunction with the relevant regulations, [the Ninth Circuit has] developed 

standards that guide [the] analysis of an ALJ’s weighing of medical evidence.” Ryan v. Comm’r of 

Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008) (citing 20 C.F.R. § 404.1527). “To reject [the] 

uncontradicted opinion of a treating or examining doctor, an ALJ must state clear and convincing 

reasons that are supported by substantial evidence.” Id. (quotation and citation omitted).

After considering only part of the relevant evidence in the record, the ALJ found that Mr. 

Cahill had the residual functional capacity to perform “light work.”317 The ALJ found that Mr. 

Cahill’s severe neck and back pain reduced his ability to do “basic physical work.”318

Furthermore, the ALJ found that Mr. Cahill had the following limitations: (1) he must be afforded 

the opportunity to alternate between sitting and standing; (2) he could not use his dominant left 

arm for “more than incidental overhead reaching or unsupported forward extension at or above 

shoulder level”; (3) he could not perform tasks requiring repetitive motion of his affected arm; and 

(4) he could not work at unprotected heights or around dangerous moving machinery.319 The ALJ 

determined that Mr. Cahill was restricted to “simple routine repetitive tasks involving only the 

 

317 AR 31.

318 AR 31. 

319 AR 31-32.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 31 of 36
ORDER (No. 3:15-cv-02498-LB) 32

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

incidental use of independent judgment or discretion,” and that he should work with few changes 

to work process and without a “piece-work style” production rate.320

The ALJ found that Mr. Cahill was unable to perform past relevant work because of his abovementioned limitations; however, he could sustain competitive levels of concentration, task 

persistence, and work pace if he had only routine assignments.321 The ALJ concluded that Mr. 

Cahill could do such a job for five eight-hour days a week, or an equivalent schedule.322

In making this residual-functional-capacity finding, the ALJ failed to address each medical 

opinion in the record and failed to provide clear and convincing reasons for neglecting the 

opinions of treating physicians. The ALJ considered medical evidence that showed “only right 

ulnar neuropathy without evidence of damage to the long thoracic nerve, the spinal accessary 

nerves, the carpal tunnels, or the areas innervated by the cervical root.”323 The ALJ considered that 

Mr. Cahill had never demonstrated abnormalities of gait, that he moved all extremities without 

difficulty, and that he demonstrated normal muscle strength, tone, and bulk.324 The ALJ also 

considered relevant evidence that Mr. Cahill played video games, participated in more passive 

hobbies, could go on a two-mile bike ride on a paved trail, and was able to run errands, keep 

appointments, and do housework so long as he broke tasks down into parts.325 The ALJ also 

considered evidence that Mr. Cahill had no significant mental disorder.326 The ALJ considered 

evidence that Mr. Cahill could walk three quarters of a mile without stopping, that his day was not 

interrupted by pain amelioration, and that he spent most of his time on a computer.327

However, the ALJ failed to address in his decision Dr. Kandabarow’s assessment that Mr. 

Cahill had difficulty abducting his shoulders, that his ability to bend forward was 80% of normal, 

 

320 AR 32.

321 AR 35.

322 Id.

323 AR 34, 358.

324 AR 34, 416. 

325 AR 34. 

326 Id. 

327 Id.

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 32 of 36
ORDER (No. 3:15-cv-02498-LB) 33

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

and that he had symptoms of degenerative disc disease at C5-6 and C6-7.328 The ALJ also failed to 

include in his decision the MRI of Mr. Cahill’s cervical spine on December 22, 2008, that showed 

osteophyte complexes present at C5-6 and C6-7, with no other abnormalities.329 The ALJ failed to 

address and include Dr. Robbins’s assessment that Mr. Cahill suffered from thoracic medialbranch disease.330 The ALJ further failed to include in his decision Dr. Carroll’s assessment that 

Mr. Cahill displayed continued winging of the scapula on the left side.331 The ALJ did not address 

or include Dr. Coleman’s assessment finding tenderness of the left paraspinal muscles in the midthoracic region, slight tactile allodynia, hyperesthesia, hyperalgesia, and decreased range of 

motion of the left shoulder.332

The ALJ further failed to consider all the relevant evidence from the VE in its totality. The 

ALJ posed two hypothetical questions to the VE.333 The first hypothetical contained Mr. Cahill’s 

educational and vocational history, as well as his physical limitations.334 The ALJ credited the 

VE’s testimony that Mr. Cahill could perform “the requirements of repetitive occupations such as 

ticket taker, ticket seller, or a mail clerk.”335 The second hypothetical contained the limitations that 

Mr. Cahill described in his testimony, including the need for unscheduled rest breaks.336 The VE 

testified that these limitations would prohibit the ability to perform the tasks of a ticket taker, 

ticket seller, or a mail clerk and it would eliminate other jobs in the national economy.337 Although 

the ALJ credited the VE’s initial conclusion that Mr. Cahill could perform these tasks, he 

disregarded and completely failed to acknowledge the VE’s testimony eliminating these jobs as a 

possibility. 

 

328 AR 254.

329 AR 376, 378.

330 AR 368.

331 AR 353.

332 AR 350.

333 AR 75-79.

334 AR 76-77. 

335 AR 77. 

336 AR 78. 

337 AR 78. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 33 of 36
ORDER (No. 3:15-cv-02498-LB) 34

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

The ALJ erred in his residual-functional-capacity finding because he failed to consider the 

VE’s testimony in its totality and failed to address the opinions of Mr. Cahill’s treating physicians. 

The evidence is not substantially contradicted by the rest of the doctors’ opinions, and therefore 

should be given controlling weight. The record does not contain “clear and convincing” evidence 

required to circumvent the treating physician’s uncontradicted opinion. Even if the ALJ’s finds 

that the opinion of a treating physician is contradicted, the ALJ must provide “specific and 

legitimate reasons supported by substantial evidence in the record.” Reddick v. Chater, 157 F.3d 

715, 725 (9th Cir. 1998) (internal quotations and citations omitted). The ALJ failed to do so by 

failing to address the treating physician’s opinion at all. 

After considering all the relevant evidence excluded from the initial ALJ decision, the ALJ 

may very well come to the same conclusion. However, the plaintiff is entitled to fair consideration 

by the ALJ. 

3.3 The ALJ erred in his adverse credibility finding

Congress prohibits an ALJ from granting disability benefits based on a claimant’s subjective 

complaints alone. 42 U.S.C §423(d)(5)(A) (“An individual’s statement as to pain or other 

symptoms shall not alone be conclusive evidence of disability”); 20 C.F.R. § 404.1529(a) (an ALJ 

will consider “all [claimant’s] symptoms, including pain, and the extent to which [claimant’s] 

symptoms can reasonably be accepted as consistent with the objective medical evidence and other 

evidence”). An ALJ is required to consider the entire case record when making specific credibility 

findings. See Social Security Ruling (SSR) 96-7p (the credibility finding “must be specifically 

sufficient to make clear to the individual and to any subsequent reviewers the weight the 

adjudicator gave to the individual’s statements and the reasons for that weight”); see also Thomas 

v. Barnhart, 278 F.3d 947, 958-59 (9th Cir. 2002). An 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.” Thomas, 278 F.3d at 958 (citing Bunnell v. Sullivan, 947 F.2d 341, 

345-46 (9th Cir. 1991) (en banc)). 

The ALJ discredited Mr. Cahill’s statements about the intensity, persistence, and limiting 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 34 of 36
ORDER (No. 3:15-cv-02498-LB) 35

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

effects of his symptoms.338 The ALJ based this credibility determination on Mr. Cahill’s testimony 

regarding his work history, pain levels, injuries, pain treatment, daily activities, and abilities.339

However, the ALJ failed to use sufficiently specific finding in making his decision. 

The ALJ found Mr. Cahill’s work history to be “extremely sporadic.” However, the ALJ failed 

to elaborate or explain what constituted this “extremely sporadic” work history. Mr. Cahill 

testified that he worked at a mortgage company between 2003 and 2009 as a compliance officer, 

auditor, loan coordinator, loan processor, underwriter, and post-closing specialist.340 Without 

further explanation from the ALJ, it is unrealistic to conclude that Mr. Cahill’s work history was 

sporadic. 

The ALJ found that Mr. Cahill’s pain was “not severe enough to motivate him to take 

action.”341 The ALJ based this conclusion on Mr. Cahill’s testimony that he settled a personalinjury law suit and therefore presumably had “financial resources that could be used to relieve his 

pain.”342 However, the ALJ failed to explain how these presumed financial resources would allow 

Mr. Cahill to relieve his pain. Again, the ALJ failed to take into account Mr. Cahill’s testimony as 

a whole. Mr. Cahill testified that he received approximately $74,000 for past medical bills 

alone.343 And the settlement was not meant to include lost wages or pain and suffering.344

Additionally, the ALJ discredited Mr. Cahill’s level of pain based on his rejection of opioid 

medications and surgery.345 However, the ALJ failed to address Mr. Cahill’s testimony that he 

didn’t want to take anything addictive, and that he had “terrible” side effects to his previous 

medications.

346 In March 2011, Mr. Cahill discontinued the use Desipramine after he experienced 

 

338 AR 33. 

339 AR 32. 

340 AR 46. 

341 AR 33. 

342 Id. 

343 AR 73-74. 

344 Id. 

345 AR 33. 

346 AR 60. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 35 of 36
ORDER (No. 3:15-cv-02498-LB) 36

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

profound dizziness and lose of balance.347 The ALJ also failed to address or credit the extensive 

medical records documenting pain-management procedures, including steroid injections, medialbranch blocks, physical therapy, radiofrequency ablation, acupuncture, muscle e-stimulator, and 

non-opioid medication regiments.348

The ALJ failed to provide sufficiently specific reasons for discrediting Mr. Cahill’s pain 

complaint and therefore the ALJ erred in his adverse-credibility finding. 

CONCLUSION

Mr. Cahill’s motion for summary judgment is granted, the Commissioner’s cross-motion for 

summary judgment is denied, and the case is remanded for further proceedings consistent with the 

order. 

IT IS SO ORDERED.

Dated: July 27, 2016

______________________________________

LAUREL BEELER

United States Magistrate Judge

 

347 AR 298. 

348 AR 33. 

Case 3:15-cv-02498-LB Document 54 Filed 07/27/16 Page 36 of 36