Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_15-cv-02432/USCOURTS-caed-2_15-cv-02432-1/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:205 Denial Social Security Benefits

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UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

KIM REGINA DIXON,

Plaintiff,

v.

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security,

Defendant.

No. 2:15-cv-2432-CKD

ORDER

Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 

(“Commissioner”) denying plaintiff’s application for Supplemental Security Income (“SSI”) 

under Title XVI of the Social Security Act (“Act”). For the reasons discussed below, the court 

will deny plaintiff’s motion for summary judgment and grant the Commissioner’s cross-motion 

for summary judgment.

I. BACKGROUND

Plaintiff, born September 23, 1964, applied for SSI benefits on June 7, 2012, alleging 

disability beginning January 1, 2012. Administrative Transcript (“AT”) 27, 40, 62-63, 72-74, 83, 

147-56, 170. Plaintiff alleged she was unable to work due to high blood pressure, arthritis, gout, 

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and acid reflux. AT 62. In a decision dated May 30, 2014, the ALJ determined that plaintiff was 

not disabled.1 AT 24-30. The ALJ made the following findings (citations to 20 C.F.R. omitted):

1. The claimant has not engaged in Substantial Gainful 

Activity (SGA) since June 7, 2012, the application date.

2. The claimant has the following severe impairments: obesity, 

asthma, left knee disorder, hypertension, and right shoulder disorder 

with decreased range of motion, and disorder of the back.

3. The claimant does not have an impairment or combination 

of impairments that meets or medically equals the severity of one of 

the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1.

4. After careful consideration of the entire record, the 

undersigned finds that the claimant has the Residual Functional 

 

1 Disability Insurance Benefits are paid to disabled persons who have contributed to the 

Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income is paid to 

disabled persons with low income. 42 U.S.C. § 1382 et seq. Both provisions define disability, in 

part, as an “inability to engage in any substantial gainful activity” due to “a medically 

determinable physical or mental impairment. . . .” 42 U.S.C. §§ 423(d)(1)(a) & 1382c(a)(3)(A). 

A parallel five-step sequential evaluation governs eligibility for benefits under both programs. 

See 20 C.F.R. §§ 404.1520, 404.1571-76, 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 

137, 140-142 (1987). The following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful 

activity? If so, the claimant is found not disabled. If not, proceed 

to step two. 

Step two: Does the claimant have a “severe” impairment? 

If so, proceed to step three. If not, then a finding of not disabled is 

appropriate. 

Step three: Does the claimant’s impairment or combination 

of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 

404, Subpt. P, App.1? If so, the claimant is automatically 

determined disabled. If not, proceed to step four. 

Step four: Is the claimant capable of performing his past 

work? If so, the claimant is not disabled. If not, proceed to step 

five. 

Step five: Does the claimant have the residual functional 

capacity to perform any other work? If so, the claimant is not 

disabled. If not, the claimant is disabled.

 

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 

The claimant bears the burden of proof in the first four steps of the sequential evaluation 

process. Bowen, 482 U.S. at 146 n.5. The Commissioner bears the burden if the sequential 

evaluation process proceeds to step five. Id.

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Capacity (RFC) to perform a wide range of light work as defined in 

20 CFR 416.967(b). She can lift and/or carry 20 pounds 

occasionally and 10 pounds frequently, stand and/or walk 4 hours in 

an 8-hour workday, sit 6 hours in an 8-hour workday, use of left 

lower extremity for foot control operation is limited to frequent, 

never climb ladders, ropes, or scaffolds, occasionally climb ramps 

or stairs, crouch, or kneel, and frequently crawl and reach overhead. 

In addition, she must avoid moderate exposure to pulmonary 

irritants and poorly ventilated areas.

5. The claimant cannot perform any Past Relevant Work 

(PRW).

6. The claimant was born on September 23, 1964 and was 47 

years old, which is defined as a younger individual age 18-49, on 

the date the application was filed.

7. The claimant has at least a high school education and is able 

to communicate in English.

8. Transferability of job skills is not material to the 

determination of disability because using the Medical-Vocational 

Rules as a framework supports a finding that the claimant is “not 

disabled,” whether or not the claimant has transferrable job skills.

9. Considering the claimant’s age, education, work experience, 

and Residual Functional Capacity (RFC), there are jobs that exist in 

significant numbers in the National Economy that the claimant can 

perform.

10. The claimant has not been under a disability, as defined in 

the Social Security Act, since June 7, 2012, the date the application 

was filed.

AT 26-30.

II. ISSUES PRESENTED

Plaintiff’s sole argument is that the ALJ erred because he improperly found plaintiff’s 

testimony regarding the extent of her pain and symptoms to be less than fully credible.

III. LEGAL STANDARDS

The court reviews the Commissioner’s decision to determine whether (1) it is based on 

proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in the record 

as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial 

evidence is more than a mere scintilla, but less than a preponderance. Connett v. Barnhart, 340 

F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d 625, 630 (9th 

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Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is 

responsible for determining credibility, resolving conflicts in medical testimony, and resolving 

ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations omitted). 

“The court will uphold the ALJ’s conclusion when the evidence is susceptible to more than one 

rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008).

The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th 

Cir. 1986), and both the evidence that supports and the evidence that detracts from the ALJ’s 

conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not 

affirm the ALJ’s decision simply by isolating a specific quantum of supporting evidence. Id.; see 

also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports the 

administrative findings, or if there is conflicting evidence supporting a finding of either disability 

or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d 1226, 

1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was applied in

weighing the evidence. See Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988).

IV. ANALYSIS

A. The ALJ’s Adverse Credibility Determination was Proper and Supported by 

Substantial Evidence from the Record

Plaintiff’s sole argument is that the ALJ erred by determining that plaintiff’s testimony 

regarding the intensity, persistence, and limiting effects of her symptoms was not entirely 

credible.

The ALJ determines whether a disability applicant is credible, and the court defers to the 

ALJ’s discretion if the ALJ used the proper process and provided proper reasons. See, e.g., 

Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1995). If credibility is critical, the ALJ must make an 

explicit credibility finding. Albalos v. Sullivan, 907 F.2d 871, 873-74 (9th Cir. 1990); Rashad v. 

Sullivan, 903 F.2d 1229, 1231 (9th Cir. 1990) (requiring explicit credibility finding to be 

supported by “a specific, cogent reason for the disbelief”). 

In evaluating whether subjective complaints are credible, the ALJ should first consider 

objective medical evidence and then consider other factors. Bunnell v. Sullivan, 947 F.2d 341, 

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344 (9th Cir. 1991) (en banc). If there is objective medical evidence of an impairment, the ALJ 

then may consider the nature of the symptoms alleged, including aggravating factors, medication, 

treatment and functional restrictions. See id. at 345-47. The ALJ also may consider: (1) the 

applicant’s reputation for truthfulness, prior inconsistent statements or other inconsistent 

testimony, (2) unexplained or inadequately explained failure to seek treatment or to follow a 

prescribed course of treatment, and (3) the applicant’s daily activities. Smolen v. Chater, 80 F.3d 

1273, 1284 (9th Cir. 1996); see generally SSR 96-7p; SSR 95-5p; SSR 88-13. Work records, 

physician and third party testimony about nature, severity and effect of symptoms, and 

inconsistencies between testimony and conduct also may be relevant. Light v. Social Security 

Administration, 119 F.3d 789, 792 (9th Cir. 1997). A failure to seek treatment for an allegedly 

debilitating medical problem may be a valid consideration by the ALJ in determining whether the 

alleged associated pain is not a significant non-exertional impairment. See Flaten v. Secretary of 

HHS, 44 F.3d 1453, 1464 (9th Cir. 1995). The ALJ may rely, in part, on his or her own 

observations, see Quang Van Han v. Bowen, 882 F.2d 1453, 1458 (9th Cir. 1989), which cannot 

substitute for medical diagnosis. Marcia v. Sullivan, 900 F.2d 172, 177 n.6 (9th Cir. 1990). 

“Without affirmative evidence showing that the claimant is malingering, the Commissioner’s 

reasons for rejecting the claimant’s testimony must be clear and convincing.” Morgan v. 

Commissioner of Social Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999).

Here, the ALJ found plaintiff’s pain and symptom testimony to be less than fully credible 

based on the following rationale:

The undersigned finds [plaintiff] not credible as she did not seek 

treatment with a frequency commensurate with the alleged severity 

of her pain. To the contrary, she sought treatment on only 4 

occasions in the span of 17 months. Further, the x-rays did not 

result in any findings to explain the alleged pain. Finally, the 

evidence contains little to no symptoms or limitations resulting 

from her tobacco use or obesity. Nonetheless, the undersigned 

finds these conditions caused more than minimal impairments 

because her treating physicians repeatedly diagnosed them.

AT 28-29. These were clear and convincing reasons for discounting plaintiff’s testimony that 

were supported by substantial evidence from the record.

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First, the ALJ determined that the infrequent treatment plaintiff received did not credibly 

correspond to the degree of pain and limitation plaintiff asserted. This was a proper reason for 

discounting plaintiff’s pain and symptom testimony that was supported by substantial evidence 

from the record. See Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 2005); Flaten, 44 F.3d at 

1464; SSR 96-7p (“[T]he individual’s statements may be less credible if the level or frequency of 

treatment is inconsistent with the level of complaints . . . .”). As the ALJ noted, the record shows 

that plaintiff sought medical care from her treating physicians on only four occasions, only two of 

which occurred during the relevant period, and that there existed a roughly seven month span 

between her second and third visits, and a nine month span between her third and fourth visits.

2

 

AT 219-32, 254-60.3 Such evidence sufficiently supported the ALJ’s conclusion that plaintiff’s 

testimony that she suffered from debilitating pain and symptoms was less than fully credible.

Plaintiff argues that the ALJ could not have properly relied on the fact that plaintiff 

received sparse treatment as a reason to discount her complaints because her testimony shows that 

she suffered from flare ups in the debilitating symptoms associated with her gout about twice a 

month. Therefore, plaintiff asserts, the lack of frequent treatment was still consistent with her 

claims of debilitating pain and symptoms because the nature of her impairments required 

treatment only when she suffered flare ups. This argument, however, is not supported by the 

 

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The record also shows that plaintiff received treatment on September 19, 2014, and prior to the 

relevant period in 2007 and 2009. AT 272-90. However, plaintiff first submitted evidence of 

these visits to the Appeals Council after the ALJ had issued his decision. AT 2, 6, 272. While 

the court is required to consider this additional evidence as part of its review of the ALJ’s 

decision, Brewes v. Comm’r of Soc. Sec., 682 F.3d 1157, 1163 (9th Cir. 2012), it does not 

undermine the ALJ’s reasoning in any meaningful fashion. Indeed, the sole instance of additional 

treatment that occurred after plaintiff’s alleged onset date took place on May 2, 2014, over a year 

since plaintiff’s then-most recent appointment documented in the record. AT 273-77. 

Furthermore, the other records plaintiff submitted to the Appeals Council similarly indicate that 

plaintiff received only sporadic treatment in the years prior to her alleged onset date. See AT 

278-90. In short, this additional evidence further supports the ALJ’s determination that there 

existed large gaps in plaintiff’s treatment records that indicated that plaintiff’s impairments were 

not as debilitating as she alleged.

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Plaintiff was also seen by consultative examining physician Dr. Schwartz on November 19, 

2012. AT 242-45. However, that visit was for the sole purpose of providing an examining 

physician’s opinion in connection with plaintiff’s SSI application, not providing treatment for 

plaintiff’s impairments. 

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record, or even plaintiff’s own claims. Indeed, plaintiff’s treatment records that were before the 

ALJ show that she received treatment on only two occasions during the relevant period with a

nine month span between those visits. See AT 221-22, 254-55. Therefore, even assuming that 

plaintiff suffered twice monthly flare ups in her symptoms, the ALJ still could have reasonably 

concluded that the infrequency of plaintiff’s treatment undermined her testimony regarding the 

severity of her pain and symptoms. Moreover, plaintiff herself claimed that the cumulative 

symptoms from all of her alleged impairments caused her to suffer impairments to the disabling 

degree that she alleged on a consistent basis. See AT 62, 242. She did not claim that only her 

gout caused such limitations and only when she experienced flare ups in her symptoms stemming 

from that impairment. At the hearing, plaintiff testified as to the extent of her limitations on a 

day-to-day basis; she did not specify the degree to which she was limited on a typical day versus 

when she experienced flare-ups. See AT 48-49. In short, there is no support for plaintiff’s 

argument that it was improper for the ALJ to consider the infrequency of plaintiff’s treatment 

under the circumstances.

Second, the ALJ also properly determined that plaintiff’s x-rays did not support her claims 

of disabling pain and symptoms. Indeed, the x-ray results in the record show that plaintiff had 

“normal bilateral shoulders” and only minimal degenerative changes with regard to her knees, AT 

231-32, thus undermining plaintiff’s claims that she suffered from debilitating shoulder and knee 

impairments. Although lack of medical evidence cannot form the sole basis for discounting 

plaintiff’s subjective symptom testimony, it was nevertheless a relevant factor for the ALJ to 

consider. Burch , 400 F.3d at 681. Accordingly, in light of the ALJ’s proper determination that 

plaintiff’s sporadic treatment undermined her pain and symptom testimony, the ALJ did not err 

by considering such evidence as an additional reason in support of his adverse credibility 

determination.4

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The ALJ also provided other reasons for discounting plaintiff’s credibility. Because the reasons 

discussed above were proper and supported by substantial evidence, the court finds it unnecessary

to address the ALJ’s additional reasons.

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V. CONCLUSION

For the reasons stated herein, IT IS HEREBY ORDERED that:

1. Plaintiff’s motion for summary judgment (ECF No. 12) is denied;

2. The Commissioner’s cross-motion for summary judgment (ECF No. 13) is granted; 

and 

3. Judgment is entered for the Commissioner.

Dated: June 28, 2016

11 dixon2432.ss

_____________________________________

CAROLYN K. DELANEY

UNITED STATES MAGISTRATE JUDGE

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