Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_06-cv-00829/USCOURTS-azd-2_06-cv-00829-0/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)

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Gary Cammenga, 

Plaintiff, 

vs.

Jo Anne B. Barnhart, 

Commissioner of Social Security, 

Defendant. 

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No. CV-06-0829-PHX-MHM

ORDER

Gary Cammenga (“Plaintiff”) seeks judicial review of the Administrative Law Judge’s

(“ALJ”) decision denying her claim for disability insurance benefits and Supplemental

Security Income (“SSI”). 42 U.S.C. §§ 405(g), 1383(c).

I. Procedural History

On November 21, 2003, Plaintiff filed an application for disability insurance benefits

and Supplemental Security Income under Titles II and XVI of the Social Security Act, 42

U.S.C. §§ 401-433, 1381-1383(f). (Tr. 40-42, 179-81). The application was denied at the

initial levels and was then brought before an ALJ to be reviewed. (Tr. 193-226). On

October 24, 2005, the ALJ determined that Plaintiff was not disabled and reaffirmed the

initial decision. (Tr. 15-20). The Appeals Council denied any further review and the

ALJ’s decision became the final decision of the Commissioner of Social Security, Jo

Anne Barnhart (“Defendant”). (Tr. 6-9). 

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On March 22, 2006, Plaintiff filed a Complaint against Defendant, seeking review of

the ALJ’s denial of his social security benefits. (Doc. 1). On July 14, 2006, Defendant

submitted an answer to Plaintiff’s Complaint. (Doc. 8). Plaintiff then filed a Motion for

Summary Judgment, along with a Memorandum of Points and Authorities, on September

6, 2006. (Docs. 10, 11). In this Motion, Plaintiff contends that the ALJ erred in

disregarding the treating physician’s opinion, in rejecting Plaintiff’s credibility as to his

allegedly disabling fatigue, and in, ultimately denying the claim. Defendant subsequently

filed a Response to the Motion for Summary Judgement (Doc. 13), a Cross-Motion for

Summary Judgment (Doc. 14), and a Memorandum in Support of the Cross-Motion for

Summary Judgment (Doc. 16) on October 10, 2006. Defendant asserts that the ALJ was

in his right authority by refusing to acknowledge the treating doctor’s opinion and for

rejecting Plaintiff’s credibility. 

II. Background Facts

A. Plaintiff’s Medical History

 Plaintiff was treated by physician, George Sein, M.D., from December 2001 through

May 2004. (Tr. 114-44). During this time, Plaintiff was diagnosed and treated for

insomnia, a right shoulder strain, fatigue, gastroesophageal reflux disease, a whiplash

injury, and a hernia. (Id.). Plaintiff was also involved in an automobile accident on

December 17, 2003 and sustained a shoulder injury and was further diagnosed with a

cervical strain. (Tr. 113). He was prescribed medication for both of these ailments. (Id.). 

 On February 20, 2004, Dr. Sein ordered diagnostic work on Plaintiff and further

confirmed moderate to severe cervical strain. (Tr. 122). A followup examination

revealed moderately severe degenerative changes to his cervical injuries. (Tr. 168). 

On January 22, 2004, Dr. Thomas Rusing, M.D., examined Plaintiff’s hernia. (Tr. 98,

99). Dr. Rusing determined that Plaintiff had a small umbilical hernia without symptoms.

(Tr. 98). Plaintiff was then treated at Yavapai Regional and received physical therapy for

injuries to his right neck, shoulder, and side from January to March 2004. (Tr. 103-13). 

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Yavapai Regional discharged Plaintiff on March 3, 2004 and noted that Plaintiff had met

all of his physical therapy goals. (Tr. 104). 

In May 2004, Dr. Sein referred Plaintiff to Andrew Newton, M.D., after Plaintiff

complained of chest pains. (Tr. 148). Cardiac testing revealed normal results. (Tr. 145). 

Around this time, Plaintiff told Dr. Sein that he had retired and that he often rode a

bicycle for fitness purposes. (Tr. 150). On July 7, 2004, a non-examining State agency

physician scrutinized Plaintiff’s existing medical records, and came to the conclusion that

Plaintiff’s physical condition allowed him to perform “light work.” (Tr. 152, 153). On

August 10, 2005, Plaintiff saw yet another physician, Michael Aranda, D.O. (Tr. 170). 

Dr. Aranda diagnosed Plaintiff with cervical problems and insomnia, for which he

prescribed physical therapy. (Tr. 169). 

On August 12, 2004, Dr. Sein filled out a form report in which he assessed that

Plaintiff was capable of lifting up to ten pounds frequently or, alternatively, up to fifty

pounds occasionally. (Tr. 174). Dr. Sein also concluded that Plaintiff could sit for four

hours at a time and could stand for two hours at a time. (Id.). Dr. Sein then referred

Plaintiff to Francisco Jaume, D.O., to have his right arm examined. (Tr. 165-68). In

October 2004, Dr. Jaume diagnosed Plaintiff with “cervical spinal stenosis” and “severe

left foraminal stenosis”, but did not prescribe any medication or other treatment because

Plaintiff claimed to be “feeling pretty good.” (Tr. 165). 

B. Hearing Testimony

On October 24, 2005, an oral hearing was held to determine Plaintiff’s disability

status. (Tr. 194-226). At the hearing, Plaintiff testified that he endured neck and

shoulder pain, which prevented him from engaging in any physical activity. (Tr. 205). 

Plaintiff explained that his fatigue, coupled with the physical pain, caused him a need to

lay down for hours at a time and to take naps during the day. (Tr. 199-201). Plaintiff,

additionally, stated that, because of his fatigue, he could not shop for more than twenty

minutes and could not engage in other light activities, such as doing laundry, for more

than thirty minutes. (Tr. 202-204). Plaintiff also revealed that he was not taking any

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prescribed medications for his physical condition, that he lived independently, and that he

did a majority of his household chores. (Tr. 210-211). Also, Plaintiff stated that he still

drove a automobile and that he had helped move his brother from New York to Arizona. 

(Tr. 211-212). 

At the hearing Linda Heiland, a vocational expert, assessed Plaintiff’s medical history

and gave her opinion about his physical limitations and capabilities. (Tr. 217-224). Ms.

Heiland stated that Plaintiff was capable of activities that involved light work and could

be employed as a housekeeper, a telemarketer, or a fast food crew member. (Tr. 219-

220). She also testified that Plaintiff could engage in work as a customer service

representative or as a telephone clerk. (Tr. 220). Ms. Heiland determined, however, that

Plaintiff’s diagnosed fatigue would cause problems with maintaining concentration and

memory, and that Plaintiff would, thus, have trouble working at skilled jobs due to their

highly cognitive nature . (Tr. 222-224). 

C. ALJ’s Conclusion 

On December 2, 2005, the ALJ denied Plaintiff’s claim for disability insurance

benefits and Supplemental Security Income following the five step sequential analysis. 

(Tr. 16-20). At step one, the ALJ found that Plaintiff had not performed substantial

activity since his alleged onset date of April 1, 2001. (Tr. 16-17). At step two, the ALJ

concluded that Plaintiff’s neck, back, and left knee disorders constituted as severe

impairments within the meaning of the Social Security Act. (Tr. 17). At step three, the

ALJ found that these impairments were not severe enough to meet or equal one of the

impairments listed in Appendix 1, Subpart P, Regulations No. 4. (Id.). At step four, the

ALJ determined that Plaintiff retained the residual functional capacity to perform that

exertional requirements of light work and, thus, was capable of work he had done in the

past or “other work existing in significant numbers in the national economy.” (Id.). In

making this determination, the ALJ found that Plaintiff exaggerated his symptoms and

limitations. (Tr. 18). The ALJ, furthermore, determined that Plaintiff’s subjective

complaints went beyond the great weight of the evidence and were not to be fully

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accepted. (Id.). The ALJ also greatly relied on Dr. Sein’s conclusions that Plaintiff could

perform a range of light work, that there were no additional functional limitations due to

Plaintiff’s fatigue, and that there was not any medically determinable impairment that

could produce Plaintiff’s level of fatigue. (Id.). In addition, the ALJ took into account

Ms. Heiland’s, the impartial vocational expert, opinion that Plaintiff could perform his

past relevant work. (Tr. 19). At step five, the ALJ used Ms. Heiland’s testimony to

determine that Plaintiff, was capable of performing work found in significant numbers in

the national economy, such as telemarketing or customer service representation. (Id.). 

III. Standard of Review

An ALJ determines an applicant’s eligibility for disability benefits through the

following five stages: 

(1) determine whether the applicant is engaged in “substantial gainful activity;”

(2) determine whether the applicant has a “medically severe impairment or

combination of impairments;” 

(3) determine whether the applicant’s impairment equals one of a number of listed

impairments that the Commissioner acknowledges as so severe as to preclude

the applicant from engaging in substantial gainful activity;

(4) if the applicant’s impairment does not equal one of the “listed impairments,”

determine whether the applicant is capable of performing his or her relevant

work;

(5) if the applicant is not capable of performing his or her past relevant work,

determine whether the applicant “is able to perform other work in the national

economy in view of his [or her] age, education, and work experience.”

Bowen v. Yuckert, 482 U.S. 137, 140-141 (1987) (citing 20 C.F.R. §§ 404.1520(b)-(f)). 

The ALJ’s findings are considered legitimate if they are supported by substantial

evidence. Marcia v. Sullivan, 900 F.2d 172, 174 (9th Cir. 1990). Substantial evidence

means “more than a mere scintilla” and “such relevant evidence as a reasonable mind

might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389,

401 (1971). The Court considers the record as a whole when determining whether

substantial evidence supports a decision. Id Where evidence is inconclusive or

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“susceptible of more than one rational interpretation, it is the ALJ’s conclusion which

must be upheld.” Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). 

IV. Discussion

Plaintiff raises two issues on appeal: (1) whether the ALJ improperly misinterpreted

and rejected the opinion of Plaintiff’s treating physician, Dr. Sein, regarding the impact of

Plaintiff’s fatigue and (2) whether the ALJ erred in rejecting Plaintiff’s credibility as to

the severity of his symptoms. The Court will address these issues below. 

A. ALJ’s Interpretation and Rejection of Dr. Sein’s Opinion

Plaintiff asserts that, since the ALJ gave Dr. Sein’s “medical source statement

substantial weight,” the ALJ improperly interpreted and rejected Dr. Sein’s opinion as to

Plaintiff’s fatigue. (Doc. 10, p.3). The ALJ, however, is not required to accept

everything in a physician’s report as true in order to give the report substantial weight. 

See Magallanes v. Browen, 881 F.2d 747, 753 (9th Cir. 1989) (stating that “[i]t is not

necessary to agree with everything an expert witness says in order to hold that his

testimony contains substantial evidence”). The ALJ is allowed to discard a treating

physician’s opinion if it is based on subjective symptoms that the ALJ has already

properly rejected. See Flaten v. Sec’y of Health & Human Servs., 44 F.3d 1453, 1463-64

(9th Cir. 1995). Symptoms dealing with pain, such as fatigue are subjective and cannot

be determined objectively. See Fair v. Bowen, 885 F.2d 597, 601 (9th Cir. 1985). 

Subjective symptoms are evaluated based, in large part, on the plaintiff’s credibility. See

Flaten, 44 F.3d 1463-64. 

Here, Plaintiff’s allegation of fatigue was a subjective symptom and the ALJ,

accordingly, determined the sincerity of that allegation by evaluating Plaintiff’s

credibility. (Tr. 18). The ALJ concluded that Plaintiff did not suffer from moderately

severe fatigue and then, consequently, rejected Dr. Sein’s opinion as to the subjective

symptom. (Id.) Under the 9th Circuit’s standards, the ALJ was well within his authority

to partially reject Dr. Sein’s opinion while giving it “substantial weight” upon

consideration. Thus, the ALJ’s finding on this point must be upheld. 

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B. The ALJ’s Rejection of Plaintiff’s Credibility

Plaintiff contends that the ALJ did not sufficiently justify his rejection of Plaintiff’s

credibility pertaining to his symptoms of fatigue. (Doc. 10, p. 4). In order to reject

allegations of subjective symptoms, an ALJ must give specific and convincing reasons for

the rejection. See Thomas v. Barnhart, 278 F.3d 947, 959-60 (9th Cir. 2002). In his

reasoning, an ALJ may evaluate a plaintiff’s “reputation for truthfulness, inconsistencies

either in his testimony or between his testimony and his conduct, his daily activities, his

work record, and testimony from physicians and third parties concerning the nature,

severity, and effect of the symptoms of which he complains.” Light v. Social Security

Administration, 119 F.3d 789, 792 (9th Cir. 1997). An ALJ may further consider the

“precipitating and aggravating factors” of the pain; the “type, dosage, effectiveness, and

adverse side-effects” of any prescribed medication for the pain; and “treatment, other than

medication.” Bunnell v. Sullivan, 947 F.2d 341, 346-47 (9th Cir. 1991). 

Here, the ALJ sufficiently gave substantial reasoning for his rejection of Plaintiff’s

credibility concerning his allegedly disabling fatigue. First, the ALJ considered Dr.

Sein’s medical findings, in which the doctor could not specifically identify a medical

explanation for Plaintiff’s fatigue. (Tr. 18). The ALJ also relied on Dr. Sein’s opinion

that Plaintiff still retained the ability to perform a range of light work. (Id.). Next, the

ALJ took into account Plaintiff’s daily activities. (Id.). It was noted at the hearing that

Plaintiff rode a bicycle, did household chores, drove a car, and helped his brother move

across the country. (Tr. 210-212). The ALJ then considered the fact that Plaintiff was

not taking any prescribed medication or was otherwise engaged in any alternative forms

of therapy. (Tr. 18). Finally, the ALJ contemplated the fact that Plaintiff had told one of

his physicians that he was “feeling pretty good.” (Id.). All of these considerations are

valid reasons for determining credibility under the 9th Circuit’s standards. As such, the

ALJ’s finding that Plaintiff’s allegation of disabling fatigue as not credible is properly

supported by substantial reasoning and must be upheld. 

V. Conclusion

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The Court finds that the ALJ adequately complied with his obligation in evaluating

and rejecting Plaintiff’s treating physician’s opinion and Plaintiff’s credibility as to the

severity of his fatigue. 

Accordingly,

IT IS HEREBY ORDERED denying Plaintiff’s Motion for Summary Judgment. 

(Doc. 10).

IT IS FURTHER ORDERED granting Defendant’s Motion for Summary

Judgment. (Doc. 14).

IT IS FURTHER ORDERED directing the Clerk to enter judgment accordingly.

DATED this 31st day of August, 2007.

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