Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_18-cv-00908/USCOURTS-casd-3_18-cv-00908-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:0402 Social Security Benefits

---

1 

18-CV-908-JLS(WVG) 

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 

SOUTHERN DISTRICT OF CALIFORNIA 

MICHELLE AIKEN 

Plaintiff,

v. 

NANCY A. BERRYHILL, 

Defendant.

 Case No.: 18-CV-908-JLS(WVG) 

REPORT AND 

RECOMMENDATION ON CROSSMOTIONS FOR SUMMARY 

JUDGMENT 

[Doc. Nos. 9, 10.] 

 This is an action for judicial review of a decision by the Acting Commissioner of 

Social Security, Nancy A. Berryhill (“the Commissioner,” or “Defendant”), denying 

Plaintiff Michelle Aiken supplemental security income (“SSI”) benefits under Title XVI 

of the Social Security Act (the “Act”) and Social Security Disability Insurance under Title 

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

is before the undersigned Magistrate Judge for preparation of a Report and 

Recommendation. For the reasons stated below, the Court RECOMMENDS that Plaintiff’s 

motion for summary judgment be DENIED and Defendant’s cross-motion for summary 

judgment be GRANTED. 

/ / / 

/ / / 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 1 of 14
2 

18-CV-908-JLS(WVG) 

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

I. OVERVIEW OF SOCIAL SECURITY CLAIM PROCEEDINGS

Pursuant to the Social Security Act, the Social Security Administration (“SSA”) 

administers the SSI program. 42 U.S.C. § 901. The Act authorizes the SSA to create a 

system by which it determines who is entitled to benefits and by which unsuccessful 

claimants may obtain review of adverse determinations. Id. §§ 423 et seq. Defendant, as 

Acting Commissioner of the SSA, is responsible for the Act’s administration. Id. 

§ 902(a)(4), (b)(4). 

A. The SSA’s Sequential Five-Step Process 

The SSA employs a sequential five-step evaluation to determine whether a claimant 

is eligible for benefits. 20 C.F.R. §§ 416.920, 404.1520. To qualify for disability benefits 

under the Act, a claimant must show that (1) he or she suffers from a medicallydeterminable impairment1

 that can be expected to result in death or that has lasted or can 

be expected to last for a continuous period of twelve months or more and (2) the impairment 

renders the claimant incapable of performing the work that he or she previously performed 

or any other substantially gainful employment that exists in the national economy. See 42 

U.S.C. §§ 423(d)(1)(A), (2)(A); 1382(c)(3)(A). 

A claimant must meet both of these requirements to qualify as “disabled” under the 

Act, id. § 423(d)(1)(A), (2)(A), and bears the burden of proving that he or she “either was 

permanently disabled or subject to a condition which became so severe as to create a 

disability prior to the date upon which [his or] her disability insured status expired.” 

Johnson v. Shalala, 60 F.3d 1428, 1432 (9th Cir. 1995). An administrative law judge 

(“ALJ”) presides over the five-step process to determine disability. See Barnhart v. 

Thomas, 540 U.S. 20, 24-25 (2003) (summarizing the five-step process). If the 

Commissioner finds that a claimant is disabled or not disabled at any step in this process, 

                                                                

1

 A medically-determinable physical or mental impairment “is an impairment that results 

from anatomical, physiological, or psychological abnormalities, which can be shown by 

medically acceptable clinical and laboratory diagnostic techniques.” 42 U.S.C. § 423(d)(3). 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 2 of 14
3 

18-CV-908-JLS(WVG) 

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

the review process is terminated at that step. Corrao v. Shalala, 20 F.3d 943, 946 (9th Cir. 

1994). 

 Step one in the sequential evaluation considers a claimant’s “work activity, if any.” 

20 C.F.R. § 404.1520(a)(4)(i). An ALJ will deny a claimant disability benefits if the 

claimant is engaged in “substantial gainful activity.” Id. §§ 404.1520(b), 416.920(b). 

 If a claimant cannot provide proof of gainful work activity, the ALJ proceeds to step 

two to ascertain whether the claimant has a medically severe impairment or combination 

of impairments. The so-called “severity regulation” dictates the course of this analysis. Id. 

§§ 404.1520(c), 416.920(c); see also Bowen v. Yuckert, 482 U.S. 137, 140-41 (1987). 

An ALJ will deny a claimant’s disability claim if the ALJ does not find that a 

claimant suffers from a severe impairment or combination of impairments which 

significantly limits the claimant’s physical or mental ability to do “basic work activities.” 

20 C.F.R. § 404.1520(c). The ability to do “basic work activities” means “the abilities and 

aptitudes necessary to do most jobs.” Id. §§ 404.1521(b), 416.921(b). 

However, if the impairment is severe, the evaluation proceeds to step three. At step 

three, the ALJ determines whether the impairment is equivalent to one of several listed 

impairments that the SSA acknowledges are so severe as to preclude substantial gainful 

activity. Id. §§ 404.1520(d), 416.920(d). An ALJ conclusively presumes a claimant is 

disabled so long as the impairment meets or equals one of the listed impairments. Id. 

§ 404.1520(d). 

If the ALJ does not deem a claimant disabled—but before formally proceeding to 

step four—the ALJ must establish the claimant’s Residual Functional Capacity (“RFC”). 

Id. §§ 404.1520(e), 404.1545(a). An individual’s RFC is his or her ability to do physical 

and mental work activities on a sustained basis despite limitations from his or her 

impairments. Id. §§ 404.945(a)(1), 404.1545(a)(1). The RFC analysis considers “whether 

[the claimant’s] impairment(s), and any related symptoms, such as pain, may cause 

physical and mental limitations that affect what [the claimant] can do in a work setting.” 

Id. §§ 404.1545(a)(1), 416.945(a)(1). In establishing a claimant’s RFC, the ALJ must 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 3 of 14
4 

18-CV-908-JLS(WVG) 

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

assess relevant medical and other evidence, as well as consider all of the claimant’s 

impairments, including impairments categorized as non-severe. Id. § 404.1545(a)(3), (e). 

If an ALJ does not conclusively determine a claimant’s impairment or combination of 

impairments is disabling at step three, the evaluation advances to step four. 

At step four, the ALJ uses the claimant’s RFC to determine whether the claimant has 

the ability to perform the requirements of his or her past relevant work. Id. § 404.1520(f). 

So long as a claimant has the RFC to carry out his or her past relevant work, the claimant 

is not disabled. Id. § 404.1560(b)(3). Conversely, if the claimant either cannot perform or 

does not have any past relevant work, the analysis presses onward. 

 At the fifth and final step of the SSA’s evaluation, the ALJ must verify whether the 

claimant is able to do any other work in light of his or her RFC, age, education, and work 

experience. Id. § 404.1520(g). If the claimant is able to do other work, the claimant is not 

disabled. However, if the claimant is not able to do other work and meets the duration 

requirement, the claimant is disabled. Id. Although the claimant generally continues to have 

the burden of proving disability at step five, a limited burden of going forward with the 

evidence shifts to the SSA. At this stage, the SSA must present evidence demonstrating 

that other work that the claimant can perform—allowing for his RFC, age, education, and 

work experience—exists in significant numbers in the national economy. Id. §§ 404.1520, 

1560(c), 416.920, 404.1512(f). 

B. SSA Hearings and Appeals Process 

 In accordance with Defendant’s delegation, the Office of Disability Adjudication 

and Review administers a nationwide hearings and appeals program. SSA regulations 

provide for a four-step process for administrative review of a claimant’s application for 

disability payments. See id. §§ 416.1400, 404.900. Once the SSA makes an initial 

determination, three more levels of appeal exist: (1) reconsideration, (2) hearing by an ALJ, 

and (3) review by the Appeals Council. See id. §§ 416.1400, 404.900. If the claimant is not 

satisfied with the decision at any step of the process, the claimant has sixty days to seek 

administrative review. See id. §§ 404.933, 416.1433. If the claimant does not request 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 4 of 14
5 

18-CV-908-JLS(WVG) 

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

review, the decision becomes the SSA’s—and hence Defendant’s—binding and final 

decree. See id. §§ 404.905, 416.1405. 

 A network of SSA field offices and state disability determination services initially 

process applications for disability benefits. The processing begins when a claimant 

completes both an application and an adult disability report and submits those documents 

to one of the SSA’s field offices. If the SSA denies the claim, the claimant is entitled to a 

hearing before an ALJ in the SSA’s Office of Disability Adjudication and Review. Id. 

§§ 404.929, 416.1429. A hearing before an ALJ is informal and non-adversarial. Id. 

§ 404.900(b). 

 If the claimant receives an unfavorable decision by an ALJ, the claimant may request 

review by the Appeals Council. Id. §§ 404.967, 416.1467. The Appeals Council will grant, 

deny, dismiss, or remand a claimant’s request. Id. §§ 416.1479, 404.979. If a claimant 

disagrees with the Appeals Council’s decision or the Appeals Council declines to review 

the claim, the claimant may seek judicial review in a federal district court. See id.

§§ 404.981, 416.1481. If a district court remands the claim, the claim is sent to the Appeals 

Council, which may either make a decision or refer the matter to another ALJ. Id. 

§ 404.983. 

II. BACKGROUND

A. Procedural History 

Plaintiff is a 57-year-old woman who alleges to be too disabled to work. (AR 156.) 

On July 3, 2014, Plaintiff protectively filed for Disability Insurance Benefits and 

Supplement Security Income. (AR 13.) In both applications, Plaintiff alleged her disability 

began on April 1, 2009. (AR 13.) In August 2014, the SSA denied these initial applications 

(AR 89-96), and the SSA denied her applications for reconsideration in February 2015. 

(AR 100-105.) Plaintiff then requested a hearing before an ALJ, which occurred on 

December 20, 2016. (AR 26-42.) The ALJ issued an unfavorable decision for Plaintiff in 

February 2017. (AR 10-25.) The Appeals Council denied Plaintiff’s request for review of 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 5 of 14
6 

18-CV-908-JLS(WVG) 

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

the unfavorable decision in March 2018. (AR 1.) In May 2018, Plaintiff filed the 

Complaint in the instant case seeking review of the AJL’s decision. 

B. Plaintiff’s Testimony 

Plaintiff testified at the hearing before the ALJ that she suffers from scoliosis, which 

prevents her from working. (AR 32.) She reported she was in pain all the time, but she took 

a muscle relaxer that helped with the pain. (AR 32.) However, because the medication 

made her drowsy she took it at night and was not able to feel the therapeutic effects during 

the daytime. (AR 33.) 

 Additionally, Plaintiff testified that her heart “fluctuates” and wears her out. (AR 

33.) This caused her to become tired easily, and she suffered the occasional headache. (AR 

34.) Plaintiff also claimed to have numbness in her right hand and left arm and experiencing 

a burning needle sensation in her feet. (AR 39.) She believed this was caused by her heart 

and spine issues. (Id.) 

C. Examining Doctor 

“In order to understand the nature and scope of the claimant’s impairments and their 

potential impact on her ability to perform work-related tasks,” a consultative examination 

of Plaintiff by Amy L. Kanner, M.D. was scheduled. (AR 16.) Plaintiff underwent a 

Complete Internal Medicine Evaluation by Dr. Kanner. (Id.) Dr. Kanner’s diagnostic 

findings were as follows: lower back pain with severe scoliosis, history of mitral valve 

prolapse, atypical chest pain, neck pain, numbness of all limbs, history of anemia, and 

swelling of the hands. (AR 17.) Based on these limitations, Dr. Kanner opined that Plaintiff 

“could perform a wide range of sedentary work.” (Id.) However, she stated Plaintiff should 

be restricted from “climbing ropes, ladders or scaffolds, be around moving machinery or 

unprotected heights.” (Id.) The ALJ gave Dr. Kanner’s assessment great weight. (Id.) 

D. ALJ’s Findings 

 At step one of the sequential evaluation process described above, the ALJ found 

Plaintiff had not engaged in substantial gainful activity since June 30, 2012, the amended 

onset date. (AR 15.) At step two, the ALJ found Plaintiff had severe impairments of (1) a 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 6 of 14
7 

18-CV-908-JLS(WVG) 

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

spinal impairment and (2) a cardiac impairment. (Id.) At step three, the ALJ found Plaintiff 

did not have an impairment, or combination of impairments, that met or medically equaled 

the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. 

(Id.) 

 Between steps three and four—in his RFC assessment—the ALJ found Plaintiff 

could perform a wide range of sedentary work as defined in 20 C.F.R. Part 404.1567(a) 

and 416.967(a). (AR 18.) Specifically, Plaintiff is able to lift and carry up to 10 pounds 

frequently or occasionally. (Id.) Plaintiff is able to sit up to 6 hours in an 8-hour workday 

with normal breaks. (Id.) Plaintiff is able to stand or walk up to 2 hours in an 8-hour

workday. (Id.) Additionally, Plaintiff can bend, stoop, climb, crouch, crawl, kneel or 

balance on occasion but should not climb ropes, ladders or scaffolds. (Id.) 

 At step four, the ALJ found Plaintiff was able to perform her past relevant work as 

a “telephone solicitor.” (AR 19.) Comparing Plaintiff’s residual function capacity with the 

physical and mental demands of this work, the ALJ found Plaintiff is able to perform this 

job. (AR 20.) 

III. STANDARD OF REVIEW

 A district court will not disturb the Commissioner’s decision unless it is based on 

legal error or not supported by substantial evidence. Smolen v. Chater, 80 F.3d 1273, 1279 

(9th Cir. 1996). Substantial evidence means more than a scintilla, but less than a 

preponderance. Id. Substantial evidence is evidence that a reasonable mind would consider 

adequate to support a conclusion. Id. The ALJ is responsible for determining credibility, 

resolving conflicts in medical testimony, and resolving ambiguities. Andrews v. Shalala, 

53 F.3d 1035, 1039 (9th Cir. 1995). If the evidence is subject to more than one rational 

interpretation, the ALJ’s conclusion must be upheld. Burch v. Barnhart, 400 F.3d 676, 679 

(9th Cir. 2005). 

IV. DISCUSSION

Plaintiff challenges the ALJ’s adverse decision on two grounds. First, she contends 

the ALJ erred in posing an incomplete hypothetical to the vocational expert, thus 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 7 of 14
8 

18-CV-908-JLS(WVG) 

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

invalidating the vocational expert’s testimony on Plaintiff’s ability to perform past relevant 

work. Second, Plaintiff contends the ALJ incorrectly assessed her RFC by relying too 

heavily on Dr. Kanner’s evaluation. The Court addresses each assignment of error in turn. 

A. Although the ALJ Erred in Failing to Include All of Plaintiff’s Limitations in 

the Hypothetical Posed to the Vocational Expert, the Error was Harmless 

Plaintiff argues the ALJ failed to pose a hypothetical question to the vocational 

expert that contained all of Plaintiff’s limitations. Defendant contends that the hypothetical 

question was proper, and any minor discrepancy was harmless. The Court agrees with 

Defendant. 

1. Legal Background: Vocational Expert Testimony Evaluation 

“The ALJ’s depiction of the claimant’s disability must be accurate, detailed and 

supported by the medical record.” Tackett v. Apfel, 180 F.3d 1094, 1101 (9th Cir. 1999). 

“Hypothetical questions posed to the vocational expert must set out all the limitations and 

restrictions of the particular claimant, including, for example, pain and an inability to lift 

certain weights.” Embrey v. Bowen, 849 F.2d 418, 422 (9th Cir. 1988) (emphasis in 

original). Based on the ALJ’s hypothetical, “[t]he vocational expert then responds to 

hypothetical factual scenarios and opines, by testifying on the record, to what jobs the 

claimant can still perform and whether there is a sufficient number of those jobs available 

in the claimant’s region or in other regions of the economy to support a finding of ‘not 

disabled.’” Epps v. Astrue, No. 09CV1380-WQH(WVG), 2010 U.S. Dist. LEXIS 95519, 

at *28 (S.D. Cal. Aug. 13, 2010) (citing Tackett v. Apfel, 180 F.3d 1094, 1101 (9th Cir. 

1999). 

2. Vocational Expert Testimony 

Here, the ALJ found Plaintiff had the residual functional capacity to perform a wide 

range of sedentary work, and more specifically, is able to lift and carry up to 10 pounds 

frequently or occasionally, sit up to 6 hours in an 8 hour work day, walk up to 2 hours in a 

8 hour work day, and bend, stoop, climb, crouch, crawl, kneel, or balance on an occasional 

basis. (AR 18.) Moreover, Plaintiff should avoid climbing ropes, ladders, or scaffolds and 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 8 of 14
9 

18-CV-908-JLS(WVG) 

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

should not be exposed to unprotected heights or dangerous machinery. (Id.) However, the 

ALJ asked the vocational expert the following incomplete hypothetical question: 

If we find somebody with the claimant’s age, education, past work who can 

perform a full range of sedentary work with occasional postural capabilities 

and let me just further clarify that. . . . And we need to avoid unprotected 

heights and dangerous moving machinery. Can past work or other work be 

performed? 

(AR 40-41.) This hypothetical did not completely reflect Plaintiff’s residual functional 

capacity, as it failed to include Plaintiff’s inability to lift more than 10 pounds, sit up to 6 

hours and walk up to 2 hours a day in an 8-hour work day. In addition, it did not mention 

Plaintiff’s need to avoid climbing ropes, ladders or scaffolds. The vocational expert 

responded that the person from the hypothetical could perform their past work as a 

telephone solicitor. (AR 41.) At face value, the ALJ erred by not including the missing 

functional capabilities identified above. However, as explained below, because the ALJ 

used shorthand terms of art that are widely understood by vocational experts in Social 

Security cases, this error was harmless. 

3. Harmless Error 

Harmless error applies in the Social Security context. The error is harmless “where 

the mistake was nonprejudicial to the claimant or irrelevant to the ALJ’s ultimate disability 

conclusion,” Stout v. Comm’r, 454 F.3d 1050, 1055 (9th Cir. 2006), or where it is “clear 

from the record that ‘the ALJ’s error was inconsequential to the ultimate nondisability 

determination.’” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008); see Parra v. 

Astrue, 481 F.3d 742, 747 (9th Cir. 2007); see also Batson v. Comm’r, 359 F.3d 1190, 1197 

(9th Cir. 2004) (finding an error harmless where it did not negate the validity of the ALJ’s 

ultimate conclusion). Moreover, “a reviewing court cannot consider [an] error harmless 

unless it can confidently conclude that no reasonable ALJ, when fully crediting the 

testimony, could have reached a different disability determination.” Stout, 454 F.3d at 

1055-56.

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 9 of 14
10 

18-CV-908-JLS(WVG) 

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

Here, the ALJ’s error was harmless. Although the hypothetical and RFC were not a 

verbatim match, there was no “clear discrepancy” as Plaintiff claims. The hypothetical 

question stated that the person could “perform a full range of sedentary work.” The Social 

Security Rulings define “sedentary work” as “involving lifting no more than 10 pounds at 

a time” and “periods of standing or walking should generally be limited to 2 hours of an 8-

hour work day, and sitting should generally total approximately 6 hours of an 8-hour 

workday.” SSR 83-10. Thus, when the ALJ told the vocational expert that Plaintiff could 

perform the full range of “sedentary work,” the ALJ implicitly incorporated the specific 

exertional limitations set forth in the Social Security Rulings for “sedentary work.” 

The only possible remaining “discrepancy” between the hypothetical and Plaintiff’s 

RFC was the hypothetical’s omission of the specific limitation of not climbing of ropes, 

ladders, or scaffolds. However, Plaintiff specifically stated her past work as a telephone 

solicitor required no climbing of any kind. (AR 204.) In addition, the Dictionary of 

Occupational Titles states that climbing is “not present” and the “activity or condition does 

not exist” for telephone solicitor jobs. DOT 2.99.357-014, 1991 WL 672624. Thus, the 

ALJ’s error in excluding Plaintiff’s climbing limitation was harmless because the 

vocational expert’s conclusion that Plaintiff could perform her past work as a telephone 

solicitor did not require her to be able to climb, and the ALJ would have reached the same 

conclusion had this limitation been expressly included in the hypothetical. As a result, the 

exclusion of this limitation was harmless because it was inconsequential to the ultimate 

nondisability determination.

B. ALJ Properly Relied on the Examining Physician’s Opinion 

Plaintiff next challenges the ALJ’s RFC finding, claiming that the ALJ improperly 

weighed the opinion of consultative examiner Amy Kanner, M.D. because her examination 

was not supported by the record as a whole. Plaintiff contends that “[w]hile the evaluation 

seemed thorough, Dr. Kanner was not privy to any of Ms. Aiken’s medical records, and 

findings from the evaluation conflicted with recorded evidence.” (Doc. No. 9 at 16.) 

Plaintiff claims this led to an incorrect assessment of her RFC since the RFC finding was 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 10 of

 14
11 

18-CV-908-JLS(WVG) 

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

largely based on Dr. Kanner’s opinion. The question then is “whether the record, read as a 

whole, yields such evidence as would allow a reasonable mind to accept the conclusions 

reached by the ALJ.” Gallant v. Heckler, 753 F.2d 1450, 1453 (9th Cir. 1984). 

Upon reviewing the record, this Court concludes that the ALJ appropriately 

evaluated the record as a whole and properly weighted Dr. Kanner’s findings and opinion, 

which was supported by Plaintiff’s medical history. 

1. The Medical Record Supports Dr. Kanner’s Assessment 

Dr. Kanner performed a complete internal medicine evaluation of Plaintiff in August 

2014. (AR 335-43.) At that time, Plaintiff self-reported back, neck and chest pain, 

numbness of arms, fingers and legs, abnormal sensation in hips and feet, and heart 

murmur/mitral valve prolapse. (AR 335.) Dr. Kanner observed Plaintiff was a welldeveloped female in no acute distress, that she could get in and out of a chair without 

difficulty, and that there was no apparent ataxia or dyspnea.2 (AR 338.) 

Upon physical examination, Dr. Kanner noted tenderness to palpation at the base of 

her lumbar spine, but no cerebrovascular tenderness, no muscle spasm, normal muscle 

tone, negative straight leg raising test in both sitting and supine positions, and normal range 

of motion of the back. (AR 339-40.) Further, Dr. Kanner noted no cyanosis, clubbing, or 

edema, and intact peripheral pulses in the upper and lower extremities.3 Neurologically, 

Plaintiff had good motor tone, good active motion and normal motor strength. (AR 341.) 

                                                                

2

 “Ataxia describes a lack of muscle control or coordination of voluntary movements, such 

as walking or picking up objects.” https://www.mayoclinic.org/diseases-conditions/ 

ataxia/symptoms-causes/syc-20355652. Dyspnea is the shortness of breath. 

https://www.webmd.com/lung/shortness-breath-dyspnea#1. 

3

 “Cyanosis is a bluish color in the skin, lips and nail beds caused by a shortage of oxygen 

in the blood.” http://www.childrenshospital.org/conditions-and-treatments/conditions/ 

c/cyanosis. “Clubbing is changes in the areas under and around the toenails and fingernails 

that occur with some disorders.” https://medlineplus.gov/ency/article/003282.htm. 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 11 of

 14
12 

18-CV-908-JLS(WVG) 

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

She also had intact sensation, normal reflexes as well as normal gait, could stand on heels 

and toes, and walk across the exam room without the use of an assistive device. (Id.)

Although Dr. Kanner did not review Plaintiff’s medical records for her assessment, 

her findings above were consistent with Plaintiff’s overall medical history. As the ALJ 

noted (AR 15-17, 19), Dr. Kanner’s assessment was supported by the generally normal 

diagnostic, physical and neurological examination findings, including the doctor’s own 

findings. For example, a July 2014 x-ray examination of Plaintiff’s thoracolumbar spine 

showed only moderate degenerative changes of the right facet joints of the lumbar spine. 

(AR 15, 616.) Moreover, a November 2014 CT scan of Plaintiff’s lumbar spine revealed 

no acute abnormality of the lumbar spine, degenerative changes of the lumbar spine, and 

no significant spinal canal or neuroforaminal narrowing at the disc levels. (AR 16, 615.) 

The Ninth Circuit has upheld ALJ decision under similar circumstances where diagnostic 

x-rays did not reveal severe spinal conditions. See, e.g., Burch v. Barnhart, 400 F.3d 676, 

681 (9th Cir. 2005) (finding the ALJ properly discounted the claimant’s allegations of 

severe low back pain because “the MRI and x-rays show only mild degenerative disc 

disease at L5-S1, and mild dextroscoliosis” and there “was no apparent disc herniation or 

nerve root impingement”). 

Similarly, Plaintiff’s physical examinations reflected generally benign findings. For 

example, consistent with Dr. Kanner’s examination findings discussed above, upon 

musculoskeletal and neurologic examinations, Plaintiff had no joint pain, swelling or 

redness, no decreased range of motion, no focal weakness or numbness, normal gait, no 

cyanosis, clubbing or edema, normal pulses, no sensory or motor deficits, and intact cranial 

nerves. (AR 352-53, 355-57, 359, 423, 487, 491, 500, 593.) 

Finally, as the ALJ noted, medication successfully controlled Plaintiff’s heart 

condition. (AR 16.) Plaintiff’s treatment records repeatedly show that since starting 

medication, her chronic palpitations were “minimal,” “improved,” or “markedly 

improved.” (AR 451, 457, 460, 466.) The record’s indication that medication effectively 

controlled Plaintiff’s palpitations is not inconsistent with Dr. Kanner’s report. See 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 12 of

 14
13 

18-CV-908-JLS(WVG) 

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

generally Warre v. Comm’r of Soc. Sec., 439 F.3d 1001, 1006 (9th Cir. 2006) 

(“Impairments that can be controlled effectively with medication are not disabling for the 

purpose of determining eligibility for SSI benefits”), citing Odle v. Heckler, 707 F.2d 439, 

440 (9th Cir. 1983). 

2. Dr. Kanner’s Silence on Lightheadedness and Fatigue 

Plaintiff also claims that Dr. Kanner’s failure to account for her symptoms of 

reoccurring lightheadedness and fatigue renders the doctor’s assessment unreliable. It bears 

noting that Dr. Kanner’s report contains extensive self-reported complaints from Plaintiff 

herself, but it does not mention lightheadedness or fatigue. (AR 335-37.) The fact that the 

thorough report does not contain reports of dizziness or lightheadedness is telling. 

Although Plaintiff attempts to assign blame for this omission to Dr. Kanner, it is just as 

likely that Plaintiff did not report these symptoms to Dr. Kanner. 

In any event, regardless of whether Plaintiff failed to report these symptoms or Dr. 

Kanner omitted them, Plaintiff’s prior treatment records do not support Plaintiff’s 

contention that the exclusion of lightheadedness or fatigue from Dr. Kanner’s report 

renders it unreliable. The records show that Plaintiff denied both lightheadedness and 

dizziness in the past (AR 451, 546, 552), and that her lightheadedness had “markedly 

improved” and become less frequent since starting medication (AR 460, 559, 565). Indeed, 

these symptoms were described at one point as “likely benign.” (AR 460.) And elsewhere, 

Plaintiff reported that she had “mild episodes of lightheadedness only every one to 2 

weeks.” (AR 457.) Similarly, Plaintiff’s records show that upon examination, she had no 

excessive fatigue. (AR 352, 356, 358, 420, 513, 592, 594.) Thus, contrary to Plaintiff’s 

contention, the record does not establish an unequivocal history of uncontrolled 

lightheadedness and fatigue. Accordingly, Dr. Kanner’s report was not rendered unreliable 

because it did not contain these symptoms. 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 13 of

 14
14 

18-CV-908-JLS(WVG) 

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

3. Conclusion 

The ALJ did not err in relying on Dr. Kanner’s opinions, which did not conflict with 

the medical records. Because the ALJ’s conclusion is rational and was supported by the 

record, the Court should affirm the ALJ’s decision.

C. Plaintiff is Not Entitled to Summary Judgment 

Based on the foregoing recommendation that Defendant’s Cross-MSJ be 

GRANTED, this Court necessarily recommends that Plaintiff’s MSJ be DENIED. 

V. CONCLUSION

This Court RECOMMENDS that Plaintiff’s MSJ be DENIED and that Defendant’s 

Cross-MSJ be GRANTED. 

 This Report and Recommendation is submitted to the United States District Judge 

assigned to this case, pursuant to the provisions of 28 U.S.C. § 636(b)(1) and Federal Rule 

of Civil Procedure 72(b). 

 IT IS ORDERED that no later than July 12, 2019, any party to this action may file 

written objections with the Court and serve a copy on all parties. The document shall be 

captioned “Objections to Report and Recommendation.” 

 IT IS FURTHER ORDERED that any reply to the objections shall be filed with the 

Court and served on all parties no later than July 29, 2019. The parties are advised that 

failure to file objections within the specified time may waive the right to raise those 

objections on appeal of the Court’s order. Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991). 

IT IS SO ORDERED. 

DATED: June 21, 2019 

Case 3:18-cv-00908-JLS-WVG Document 13 Filed 06/21/19 PageID.<pageID> Page 14 of

 14