Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_15-cv-02196/USCOURTS-casd-3_15-cv-02196-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:0405id Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT 

SOUTHERN DISTRICT OF CALIFORNIA 

MARIA G. MUNOS CONTRERAS,

 Plaintiff, 

v. 

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security, 

 Defendant. 

Case No.: 15cv2196-AJB-MDD 

REPORT AND 

RECOMMENDATION ON 

CROSS MOTIONS FOR 

SUMMARY JUDGMENT

[ECF NOS. 14, 16] 

 Plaintiff Maria Munos Contreras (“Plaintiff”) filed this action 

pursuant to 42 U.S.C. § 405(g) for judicial review of the decision of the 

Commissioner of the Social Security Administration (“Commissioner”) 

denying Plaintiff’s application for disability insurance benefits under 

Title II for supplemental security income payments under Title XVI of 

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the Social Security Act. Plaintiff moves the Court for summary 

judgment reversing the Commissioner and ordering an award of 

benefits, or, in the alternative, to remand the case for further 

administrative proceedings. (ECF No. 14). Defendant has moved for 

summary judgment affirming the denial of benefits. (ECF No. 16). 

 For the reasons expressed herein, the Court recommends that 

Plaintiff’s motion be DENIED and Defendant’s motion be GRANTED. 

I. BACKGROUND 

 Plaintiff alleges that she became disabled on February 10, 2011, 

due to osteoarthritis, disorder of the spine, disorder of the right knee, 

and diabetes. (A.R. 24).1 Plaintiff’s date of birth of May 10, 1957, 

categorizes her as an individual closely approaching advanced age as of 

the date of alleged disability onset. (A.R. 31); 20 C.F.R. §§ 404.1563 and 

416.963. 

A. Procedural History 

 On October 4, 2011, Plaintiff filed an application for social 

security disability insurance benefits. (A.R. 22). This claim was 

initially denied on February 15, 2012, and denied upon reconsideration 

on October 18, 2012. (Id.). On March 4, 2014, Plaintiff appeared and 

testified in San Diego, California before Administrative Law Judge 

(“ALJ”) Nancy M. Stewart. Plaintiff was represented by attorney 

Steven Rosales. (Id.). Plaintiff and impartial Vocational Expert (“VE”) 

Harlona S. Stock also appeared and testified at the hearing. (Id.). 

 

1 “A.R.” refers to the Administrative Record filed on January 19, 2016, 

and is located at ECF No. 11. 

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On April 2, 2014, the ALJ issued a written decision finding 

Plaintiff not disabled. (A.R. 22). Plaintiff appealed and the Appeals 

Council declined to review the ALJ’s decision. (A.R.1-6). Consequently, 

the ALJ’s decision became the final decision of the Commissioner. (Id.). 

On October 1, 2015, Plaintiff filed a Complaint with this Court 

seeking judicial review of the Commissioner’s decision. (ECF No. 1). 

On January 19, 2016, Defendant answered and lodged the 

administrative record with the Court. (ECF Nos. 10, 11). On April 14, 

2016, Plaintiff moved for summary judgment. (ECF No. 14). On May 4, 

2016, the Commissioner cross-moved for summary judgment. (ECF No. 

16). On May 4, 2016, the Commissioner responded in opposition to 

Plaintiff’s motion. (Id.). 

II. DISCUSSION 

A. Legal Standard 

 The supplemental security income program provides benefits to 

disabled persons without substantial resources and with little income. 

42 U.S.C. § 1383. To qualify, a claimant must establish an inability to 

engage in “substantial gainful activity” because of a “medically 

determinable physical or mental impairment” that “has lasted or can be 

expected to last for a continuous period of not less than 12 months.” 42 

U.S.C. § 1383(a)(3)(A). The disabling impairment must be so severe 

that, considering age, education, and work experience, the claimant 

cannot engage in any kind of substantial gainful work that exists in the 

national economy. 42 U.S.C. § 1383(a)(3)(B). 

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 The Commissioner makes this assessment through a process of up 

to five-steps. First, the claimant must not be engaged in substantial, 

gainful activity. 20 C.F.R. § 416.920(b). Second, the claimant must 

have a “severe” impairment. 20 C.F.R. § 416.920(c). Third, the medical 

evidence of the claimant’s impairment is compared to a list of 

impairments that are presumed severe enough to preclude work. 20 

C.F.R. § 416.920(d). If the claimant’s impairment meets or is 

equivalent to the requirements for one of the listed impairments, 

benefits are awarded. 20 C.F.R. § 416.920(d). If the claimant’s 

impairment does not meet or is not equivalent to the requirements of a 

listed impairment, the analysis continues to a fourth and possibly fifth 

step and considers the claimant’s residual functional capacity. At the 

fourth step, the claimant’s relevant work history is considered along 

with the claimant’s residual functional capacity. If the claimant can 

perform the claimant’s past relevant work, benefits are denied. 20 

C.F.R. § 416.920(e). At the fifth step, reached if the claimant is found 

not able to perform the claimant’s past relevant work, the issue is 

whether claimant can perform any other work that exists in the 

national economy, considering the claimant’s age, education, work 

experience, and residual functional capacity. If the claimant cannot do 

other work that exists in the national economy, benefits are awarded. 

20 C.F.R. § 416.920(f). 

 Section 1383(c)(3) of the Social Security Act, through Section 

405(g) of the Act, allows unsuccessful applicants to seek judicial review 

of a final agency decision of the Commissioner. 42 U.S.C. §§ 1383(c)(3), 

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405(g). The scope of judicial review is limited and the Commissioner’s 

denial of benefits “will be disturbed only if it is not supported by 

substantial evidence or is based on legal error.” Brawner v. Sec’y of 

Health & Human Servs., 839 F.2d 432, 433 (9th Cir. 1988) (quoting 

Green v. Heckler, 803 F.2d 528, 529 (9th Cir. 1986)). 

 Substantial evidence means “more than a mere scintilla” but less 

than a preponderance. Sandqathe v. Chater, 108 F.3d 978, 980 (9th Cir. 

1997). “[I]t is such relevant evidence as a reasonable mind might accept 

as adequate to support a conclusion.” Id. (quoting Andrews v. Shalala 

53 F.3d 1035, 1039 (9th Cir. 1995)). The court must consider the record 

as a whole, weighing both the evidence that supports and detracts from 

the Commissioner’s conclusions. Desrosiers v. Sec’y of Health & Human 

Servs., 846 F.2d 573, 576 (9th Cir. 1988) (Pregerson, J. concurring). If 

the evidence supports more than one rational interpretation, the court 

must uphold the ALJ’s decision. Allen v. Heckler, 749 F.2d 577, 579 

(9th Cir. 1984). When the evidence is inconclusive, “questions of 

credibility and resolution of conflicts in the testimony are functions 

solely of the Secretary.” Sample v. Schweiker, 694 F.2d 639, 642 (9th 

Cir. 1982). 

 The ALJ has a special duty in social security cases to fully and 

fairly develop the record in order to make an informed decision on a 

claimant’s entitlement to disability benefits. DeLorme v. Sullivan, 924 

F.2d 841, 849 (9th Cir. 1991). Because disability hearings are not 

adversarial in nature, the ALJ must “inform himself about the facts 

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relevant to his decision,” even if the claimant is represented by counsel. 

Id. (quoting Heckler v. Campbell, 461 U.S. 458, 471 n.1 (1983)). 

 Even if a reviewing court finds that substantial evidence supports 

the ALJ’s conclusions, the court must set aside the decision if the ALJ 

failed to apply the proper legal standards in weighing the evidence and 

reaching his or her decision. Benitez v. Califano, 573 F.2d 653, 655 (9th 

Cir. 1978). Section 405(g) permits a court to enter a judgment 

affirming, modifying or reversing the Commissioner’s decision. 42 U.S. 

C. § 405(g). The reviewing court may also remand the matter to the 

Social Security Administration for further proceedings. Id. 

B. The ALJ’s Decision 

 The ALJ concluded Plaintiff was not disabled, as defined in the 

Social Security Act, from February 10, 2011, through the date of the 

ALJ’s decision of April 2, 2014. (A.R. 21). 

 The ALJ found Plaintiff’s osteoarthritis, disorder of the spine, 

disorder of the right knee and diabetes to be severe impairments. (A.R. 

24). Plaintiff’s alleged mental limitations were found not severe. The 

ALJ determined Plaintiff did not have an impairment or combination of 

impairments that meets or was medically equivalent to the severity of 

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

Appendix 1 (20 C.F.R. 404.1520(d), 404.1525 and 404.1526). (A.R. at 

25). The ALJ noted that the “evidence does not support that [Plaintiff] 

has the severity of symptoms required either singly or in combination to 

meet or equal the conditions found under the medical [l]istings.” (A.R. 

25). 

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The ALJ found that Plaintiff has the residual functional capacity 

(“RFC”) to: 

[P]erform medium work . . . except [Plaintiff] can lift 

and carry 25 pounds frequently, 50 pounds occasionally; 

she can push and pull within these weight limits on an 

occasional basis with the lower and upper extremities; 

standing and walking 6 hours out of 8 with no 

prolonged walking greater than two hours; standing and 

walking 6 hours out of 8 with no prolonged walking 

greater than 2 hours; sitting 6 hours out of 8 with the 

ability to stand and stretch not to exceed 10% of the day; 

no ladders, ropes or scaffolds; and no work around 

hazards such as working at unprotected heights, 

operating fast or dangerous machinery or driving 

commercial vehicles. 

(Id.). The ALJ supported his RFC finding by explaining: 

The [Plaintiff’s] records do not support finding that the 

[Plaintiff] requires greater work restrictions beyond 

those in the residual functional capacity herein. . . .The 

[Plaintiff’s] examination and treatment providers have 

noticed inconsistencies in her claims. The [Plaintiff’s 

longitudinal records establish that the [Plaintiff] is not 

as limited as alleged and is able to perform work within 

the residual functional capacity herein. The impression 

of the [Plaintiff’s] right knee study was posterior medial 

meniscus tear. The [Plaintiff] appears to have only 

reported pain and limitations due to this impairment to 

her workers’ compensation treatment and examination 

providers. The [Plaintiff’s] knee surgery had to be 

postponed due to her diabetes which was not under 

control. She did not report pain or limitations due to 

this or other physical impairments to her primary 

treatment provider. The [Plaintiff’s] gait and balance 

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were found to be normal while awaiting medical 

clearance for her surgery. 

(A.R. 27). 

 The ALJ found that Plaintiff’s allegations of disability are greater 

than expected in light of the medical evidence of record. For example, 

the ALJ cites to Plaintiff’s medical history wherein she reported that 

“she seldom checks her blood sugar.” (Id.). Plaintiff’s treatment 

provider adjusted her insulin, and her appointment reports from 

September through November 2011, show at that time she was in no 

acute distress, her balance and gait were normal, she was oriented to 

time, place, person and situation and she behaved appropriately for age. 

(A.R. 341). Her diagnosis at that time was Diabetes Mellitus without 

mention of complication. (A.R. 353). 

 The ALJ noted that during Plaintiff’s workers’ compensation 

examinations in March and May of 2012, she reported “complaints that 

she has not asserted in these proceedings or reported to her primary 

treatment providers.” (A.R. 28). Specifically, in March 2012, Plaintiff 

stated she had constant severe pain in the mid low back, radiating to 

the right buttocks and right lateral hip compounded by stabbing pain 

with burning in her low back. (A.R. 394). However, upon examination 

“motor function, sensation, reflexes and gait were unremarkable.” (A.R. 

28, 399). In May of 2012, the physician reported that Plaintiff (through 

an interpreter) stated she was a nondiabetic. (A.R. 28, 415). The 

workers’ compensation physician reported his impressions of Plaintiff’s 

exam as “normal,” with the perineal nerves on each side having a 

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somewhat low amplitude and the “rest of the exam was perfectly 

normal.” (A.R. 417). 

 In December 2012, Plaintiff underwent a further workers’ 

compensation consultation. At that time Plaintiff’s main complaint 

were neck pain radiating down her left arm and low back pain radiating 

to her left hip. (A.R. 29). Contrary to her complaints, the examining 

physician found that Plaintiff’s cervical spine had normal and full range 

of motion but did have tenderness bilaterally over the suprascapular 

areas. (A.R. 434). It was further found that she likely did aggravate 

her back, cervicotrapezius and neck, which Plaintiff should treat with 

continuing physical therapy. (A.R. 439). 

The ALJ found that Plaintiff’s allegations are greater than 

expected in light of the medical evidence in the record. The ALJ found 

that Plaintiff has not been fully compliant with her diabetes treatment 

but that there appears to be no complications due to that impairment. 

(Id.). The ALJ cited to Plaintiff’s testimony regarding her knee, 

gallbladder, and back. Plaintiff testified that all of these ailments cause 

her pain. (A.R. 46-47). Plaintiff further testified that removal of her 

gall bladder was recommended but it cannot be done because her 

diabetes “is very out of control.” (AR. 45). Additionally, Plaintiff 

testified that her knee hurts a lot but she could not have the knee 

surgery due to her uncontrolled diabetes. (A.R. 46-47). She further 

testified that her back pain prevents her from working but cannot be 

treated with injections because of her uncontrolled diabetes. (Id.). 

Specifically, the ALJ explained that “[t]he Plaintiff’s examination 

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findings do not support many of the claims asserted or establish 

additional impairments to be medically determinable under the rules 

and regulations binding on this decision.” (A.R. 26). The ALJ found the 

objective medical evidence inconsistent with Plaintiff’s allegations of 

severely disabling pain preventing her from working. The ALJ found 

Plaintiff’s statements are not entirely credible regarding the intensity, 

persistence and limiting effects of her symptoms due to her work 

history and inconsistencies between her testimony and the objective 

medical record. (A.R. 27). 

Considering the record evidence and Plaintiff’s testimony elicited 

by the VE, the ALJ found that Plaintiff is capable of performing past 

relevant work as an artificial flower maker at step four in the 

sequential evaluation. (A.R. 30). The ALJ further stated, however, 

“[a]lthough the [Plaintiff] is capable of performing past relevant work, 

there are other jobs existing in the national economy that she is also 

able to perform. Therefore, I make the following alternative findings for 

step five of the sequential evaluation process.” (A.R. 31). Specifically, 

the ALJ determined that based on Plaintiff’s RFC, age, education, and 

work experience there are other jobs that exist in significant numbers 

in the national economy that Plaintiff can also perform. (Id.). The ALJ 

noted that Plaintiff’s RFC takes into consideration her inability to 

perform all or substantially all of the requirements of [a medium] level 

of work due to additional limitations. The ALJ sought assistance from 

the VE regarding the extent that Plaintiff’s additional limitations erode 

jobs in the “unskilled medium occupational base.” (Id.). The VE 

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testified that given Plaintiff’s age, education, work experience, and 

residual functional capacity, Plaintiff “would be able to perform the 

requirements of representative occupations such as linen room 

attendant, DOT 222.387-030, medium, 81,000 jobs in the national 

economy, 5,000 jobs in the region defined as San Diego, San Marcos and 

Carlsbad; and laundry worker I, DOT 361.684-014, 50,000 jobs in the 

national economy and 1,400 jobs in the region.” (Id.). Ultimately, the 

ALJ concluded, “[b]ased on the testimony of the vocational expert, I 

conclude that, considering the claimant’s age, education, work 

experience, and residual functional capacity, the claimant is capable of 

making a successful adjustment to other work that exists in significant 

numbers in the national economy. A finding of not ‘disabled’ is 

therefore appropriate under the framework of the above-cited rules.” 

In determining that Plaintiff is not disabled, the ALJ specifically 

noted the following to be of particular relevance: 

 1. Plaintiff’s Mental Impairments 

 The ALJ found Plaintiff’s mental impairment of depressed and 

anxious mood nonsevere. (A.R. 24). The ALJ noted that “her medically 

determinable mental impairment . . . does not cause more than minimal 

limitation in [her] ability to perform basic mental work activities. . . .” 

(Id.). The ALJ also found that the evidence does not establish more 

than mild limitations in the first three “paragraph B” criteria and 

Plaintiff has not suffered any episodes of decompensation that have 

been of extended duration. (A.R. 25). 

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2. Dr. Neil Halbridge, M.D. 

In March of 2012, the Plaintiff had an orthopedic evaluation by 

Dr. Neil J. Halbridge, M.D., as “part of her workers’ compensation 

claim.” (A.R. 394). The exam covered multiple body parts “including 

the lumbar spine, right knee, right lower extremity, right hip and 

psyche complaints. . . .” (Id.). With respect to her lower back 

complaints Dr. Halbridge found that subjective factors include right hip 

and right lower extremity with constant slight to moderate pain 

increased with bending and lifting and partially temporarily relieved 

with Tramadol.” (A.R. 401). Dr. Halbridge noted that the objective 

factors regarding Plaintiff’s lumbar spine “include asymmetrical 

limitation of motion in the frontal plane.” (A.R. 402). Regarding 

Plaintiff’s right knee complaints, Dr. Halbridge noted that subjective 

factors include constant slight to moderate medial joint line pain and 

anterior knee pain increased with squatting, kneeling and prolonged 

walking. Partial temporary relief experienced with Tramadol. (A.R. 

401). The objective factors of disability regarding the right knee include 

“positive patellofemoral compression and positive patellofemoral 

crepitation consistent with a posterior horn medical meniscal tear with 

the tear extending through the superior and inferior articular surface of 

the meniscus with a parameniscal cyst present. There was also mild 

tricompartmental osteoarthritis with chondromalacia right knee.” (A.R. 

at 402). 

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3. Dr. Robert S. Warren, M.D. 

In May 2012, Plaintiff underwent nerve conduction/EMG testing 

by Dr. Warren, M.D., a board certified Neurologist. (A.R. 415). 

According to Dr. Warren, Plaintiff reported that “she’s a nondiabetic 

with low back pain and radicular leg pain.” (Id.). Dr. Warren’s 

impressions were that Plaintiff’s exam was “perfectly normal.” (A.R. 

417). “The perineal nerves on each side have a somewhat low 

amplitude, this was a non-specific, nonlocalizing finding.” (Id.). 

4. Dr. Mike Khoury, M.D. 

Also in May 2012, the Plaintiff underwent a series of MRIs. The 

first was of the pelvis for low back pain. (A.R. 421). No fracture or 

dislocation was identified. No visible soft tissue swelling was noted. 

(Id.). The second MRI was of the lumbosacral spine completeflexion/extension views with bending. Bones were normal with no 

significant spondylosis, scoliosis, fracture or visible bony lesion. Disc 

spaces were normal, with no significant disc height narrowing, 

subluxation, or endplate abnormality. No paraspinous abnormality was 

seen. Dr. Khoury concluded there was no evidence of acute disease. 

(A.R. 422). The third MRI was of the lumbar spine. (A.R. at 423). 

Findings showed normal paraspinal area with no visible mass. No bone 

fractures, defects, or osseous lesion. (Id.). The cord/cauda equine was 

normal caliber, contour and signal intensity. Dr. Khoury concluded 

there was disc bulge and vertebral ridging at L5-S1 level with right 

paracentral annular tear. 

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5. Dr. William Previte, D.O. 

In December 2012, Plaintiff had an orthopedic consult with Dr. 

Previte, D.O., as part of her workers compensation claim. (A.R. 29, 

428). Based upon her slip and fall on February 20, 2011, Dr. Previte 

diagnosed Plaintiff with low back sprain and strain with discogenic 

syndrome and right lower extremity rediculitis, right knee sprain/strain 

with probable internal derangement, preexisting. Based upon her slip 

and fall on October 23, 2012, Dr. Previte diagnosed Plaintiff with left 

arm sprain and strain, cervicotrapezius strain, exacerbation of low back 

with new onset left lower extremity radiculitis. (A.R. 438). Dr. Previte 

did note that Plaintiff has normal and full cervical spine range of 

motion in all planes and passively there is normal shoulder motion. 

(A.R. 434). Dr. Previte noted in his report that he did not have 

Plaintiff’s medical records to review. (A.R. 433). 

6. Dr. Gary DeVoss, Ph.D 

Dr. DeVoss, a licensed psychologist examined Plaintiff on 

February 26, 2013. (A.R. 532). This was Dr. DeVoss’ second 

examination of Plaintiff, the first examination having occurred on 

March 6, 2012. (Id.). Dr. DeVoss was able to review her medical 

records back to March 2011. (A.R. 535-544). Dr. DeVoss noted that 

Plaintiff’s mental status is almost identical to her mental status in 

March of 2012. (A.R. 546). Dr. DeVoss stated “her credibility is more of 

an issue on this date due to the fact that Plaintiff’s psychological 

complaints and distress are no different than one year ago, but on this 

date she blames her emotional problems on her left shoulder, arm and 

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hand rather than on her back, hip and right leg.” (Id.). Dr. DeVoss 

opined that Plaintiff does not appear to be malingering but she does not 

meet the criteria for a specific mood disorder. (A.R. 548). Plaintiff does 

seem to be suffering from “Pain Disorder” since the main criterion is 

pain as the focus of the presenting problems. (Id.). Dr. DeVoss 

assigned Plaintiff a GAF of 67.2 (Id.). 

7. State Agency Physicians 

Dr. F. Kalmar, M.D., found Plaintiff had the medically 

determinable impairments of Osteoarthritis and Allied Disorder and 

Diabetes Mellitus, all severe. (A.R. 80). Dr. Kalmar stated in a 

Personalized Decision Notice “although you have discomfort you remain 

able to move about and can use your hands and arms and legs in a 

satisfactory manner to do activities that do not require heavy exertion.” 

(A.R.84). 

Dr. M. Gleason, M.D., the other State Agency physician found 

that, despite decreased range of motion and right knee tenderness, 

Plaintiff had a normal gait with strength and sensation intact. (A.R. 

92). According to Dr. Gleason, there appeared to be no worsening of the 

objective findings, thus leaving her medium RFC unchanged. (Id.). 

Both State Agency physicians opined that Plaintiff could perform 

her past relevant work of factory worker, specifically including the titles 

of Assembly Line Laborer, Production Line and Flower Arranger. (A.R. 

93). 

 

2 GAF stands for Global Assessment Functioning. On a scale of 0-100 

with higher scores indicating a greater level of functioning. 

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8. Vocational Expert (VE) 

The ALJ also consulted with and took testimony from Harland 

Stock, a Vocational Expert (VE).3 In this case, the VE listened to 

Plaintiff’s testimony, examined Plaintiff at the hearing and reviewed 

Plaintiff’s medical records. In response to the ALJ’s hypotheticals, the 

VE testified that based upon Plaintiff’s residual functional capacity she 

was capable of performing work as an artificial flower maker as she 

actually performed it and as per the DOT (Dictionay of Occcupational 

Titles). (A.R. 31). The VE also testified that other work exists in the 

national and regional economy at the medium exertion level and in the 

unskilled category. (A.R. 68). The first job identified by the VE was 

linen room attendant DOT 222.387-030 and the second job was laundry 

worker I, DOT 361-684-014. (A.R. 68-69). After inquiry by the ALJ 

whether there were jobs in the national and regional economy at the 

light exertion level that Plaintiff could perform, the VE testified that 

Plaintiff could perform work as a blending tank helper DOT 520.684-

066 and cleaner, housekeeper, DOT 323.687-014. (A.R. 70). 

 

3 “The vocational expert is called to testify at a disability hearing. At the 

hearing, the ALJ uses a series of hypothetical questions to ‘set out all of 

the claimant’s impairments’ for the vocational expert’s consideration ... 

The vocational expert is then called upon to ‘translate factual scenarios 

into realistic job market probabilities’ by testifying, on the record, to 

what kinds of jobs the claimant still can perform and whether there is a 

sufficient number of those jobs available in the claimant’s region or in 

several other regions of the economy to support a finding of ‘not 

disabled.’” Desrosiers, 846 F.2d at 578. 

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C. Issues on Appeal 

1. Past Relevant Work 

Plaintiff argues that the ALJ erred at step four because her prior 

work was not performed at the substantial gainful activity level (SGA), 

one of the requirements used to define whether her previous work 

qualifies as past relevant work (PRW) that she is capable of performing. 

Defendant argues Plaintiff has misinterpreted the law regarding 

SGA and that a review of the applicable regulations and case law 

demonstrate that the ALJ did not err when she found Plaintiff capable 

of performing her past relevant work at step four of the sequential 

evaluation. Defendant further argues that even had the ALJ erred at 

step four, the ALJ continued her analysis through step five and found 

Plaintiff not disabled because she could perform a significant number of 

jobs in the national economy. (ECF 16 at 5). 

“At step four [of the sequential evaluation] the claimant bears the 

burden of showing that he or she does not have the residual functional 

capacity to engage in ‘past relevant work.’” Lewis v. Apfel, 236 F.3d 

503, 515 (9th Cir. 2001). “If a claimant can perform his or her past 

relevant work, then he or she is not disabled. If not, or if he or she did 

not do past relevant work, then the ALJ moves to step five, in which he 

or she determines if the claimant has the residual functional capacity to 

do other substantial gainful work.” Id. 

Defining prior work activity as “past relevant work” for purposes 

of the step four analysis, the Commissioner must find that that prior 

work activity “was substantial gainful activity.” 20 C.F.R. §§ 

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404.1560(b)(1), 416.960(b)(1). “A job qualifies as past relevant work 

only if it involves substantial gainful activity.” Lewis, 236 F.3d at 515. 

 “Substantial gainful activity is work done for pay or profit that 

involves significant mental or physical activities. . . . Earnings can be a 

presumptive, but not conclusive, sign of whether a job is substantial 

gainful activity.” Id. “The presumption that arises from low earnings 

shifts the step-four burden of proof from the claimant to the 

Commissioner.” Id. “With the presumption, the claimant has carried 

his or her burden unless the ALJ points to substantial evidence, aside 

from earnings, that the claimant has engaged in substantial gainful 

activity.” Id. 

 Here the ALJ found Plaintiff was capable of performing her PRW 

as an artificial flower maker. (A.R. 30). A job qualifies as PRW only if 

it involved substantial gainful activity. Lewis, 236 F.3d at 515. In this 

case, for the years 2006-2012 Plaintiff’s earnings were sporadic. For 

example, in 2006, Plaintiff made $14,984.69, which is above the SGA 

amount.4 However, in 2007 Plaintiff made substantially less, falling 

below the SGA monthly threshold amount for that year. Plaintiff 

testified that in 2008 she worked full time at the same location 

(Contractor Yard) for twenty-four months, however, the earnings 

information presented in the record shows she worked there only for 

2008. (A.R. 183). Plaintiff later testified that she did not work full time 

 

4 It should be noted that while Plaintiff’s 2006 earnings exceeded the 

monthly SGA, she was employed during that year at three different 

companies. 

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from 2009 through 2012 and her earnings reflected she earned less than 

the monthly SGA for those years. (A.R. 55). Therefore, her monthly 

average earnings did not rise to the level at which the Defendant 

“[would] consider that [her] earnings from [her] work activities as an 

employee show that [she] engaged in substantial gainful activity.” 20 

C.F.R. §§ 404.1574(b)(2), 416.972(b)(2). 

 Nevertheless, the inquiry of whether work constituted SGA does 

not end with earnings, “substantial work activity” is defined in the 

regulations as work that “involves doing significant physical or mental 

activities” and “is the kind of work usually done for pay or profit.” 20 

C.F. R. § 416.972(a),(b). “‘[W]ork may still be substantial even if it is 

done on a part-time basis....’” Byinton v. Chater, 76 F.3d 246, 250 (9th 

Cir. 1996) (internal citations omitted). “Work activity is gainful if it is 

the kind of work usually done for pay or profit, whether or not a profit is 

realized.” 20 C.F.R. §§ 404.1572(b), 416.972(b). Thus, the ALJ 

considered other information in addition to Plaintiff’s earnings. See 20 

C.F.R. § 404.1574(b). 

Here, the ALJ elicited testimony from Plaintiff regarding her prior 

work. Specifically, Plaintiff testified that she did not work full time 

from 2009-2012 and that her hours varied. (A.R. 52). Plaintiff testified 

that in 2008 she worked putting together artificial flowers, in an 

assembly line situation. (A.R. 53). Plaintiff also testified that she 

worked in 2006 in an assembly helper capacity and she would also 

fasten parts together with screws using a screw driver and power drill. 

(A.R. 60). Later in the hearing, the ALJ elicited additional testimony 

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from Plaintiff regarding her most recent position creating flowers. 

Plaintiff testified she stood in one spot and did not have to lift more 

than 10 pounds. (A.R. 67).5 

While Plaintiff may not have had earnings at the SGA level after 

2006, there is substantial evidence that her past work activities 

constituted substantial gainful activity for purposes of the step-four 

analysis. A review of the record shows that the ALJ did not err in 

finding Plaintiff had past relevant work based upon her earnings 

records and her testimony. 

 Plaintiff’s related argument that the ALJ erred by failing to 

properly evaluate the demands of Plaintiff’s past relevant work and her 

ability to perform that work is unpersuasive. At step four, the ALJ 

must determine the demands of Plaintiff’s previous work against her 

current ability. 20 C.F.R. § 404.1520(e). The ALJ satisfied this 

requirement here. For example, as previously noted, the ALJ cited to 

Dr. Halbridge, who examined Plaintiff in March 2012. Those records 

showed examination of her knees and hips unremarkable. Her motor 

function, sensation, reflexes and gait were also unremarkable. (A.R. 

28). The ALJ cited to the records of Dr. Warren who found Plaintiff’s 

whole body scan was negative for any abnormalities in the lumbar spine 

or pelvis. (A.R. 28). In addition, the ALJ noted Dr. Warren documented 

 

5 The Court notes that Plaintiff was somewhat inconsistent in her 

recollection of where she worked and the duration of her work in 

specific years. For example, Plaintiff testified that she worked for 24 

months at Contractor Yard, but her earnings record show she worked 

there only in 2008. (AR at 183). 

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disc bulge and vertebral bridging with no significant spinal stenosis. 

(A.R. 28). The ALJ also noted the opinion of Dr. Previte, who examined 

Plaintiff in December 2012. Dr. Previte found some abnormality but 

Plaintiff’s range of motion of the elbows was normal, inspection of her 

back was normal, her hips had normal strength and almost full range of 

motion. (A.R. 29). Additionally, the ALJ considered the opinions of the 

two State Agency doctors, both of whom found Plaintiff could perform 

her past relevant work despite some limitation in the performance of 

certain work activities. (A.R. 83, 93). The ALJ also indicated he 

“considered additional evidence, including more recent records, the 

claimant’s testimony and the effects of her right knee impairment.” 

(A.R. 30). 

The ALJ fully considered Plaintiff’s functional capacity against 

the above cited record medical evidence and the testimony in the case. 

(A.R. 25-31). The ALJ stated “the credible evidence continues to 

establish the claimant is able to perform medium work consistent with 

the residual functional capacity herein.” (A.R. 30). The ALJ 

determined that Plaintiff had the residual functional capacity to 

perform medium work except she can lift/carry 25 pounds frequently, 50 

pounds occasionally; she can push and pull within these weight limits 

on an occasional basis with the lower and upper extremities; standing 

and walking 6 hours out of 8 with no prolonged walking greater than 

two hours; sitting 6 hours out of 8 with the ability to stand and stretch 

not to exceed 10% of the day: no ladders, ropes or scaffolds; and no work 

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around hazards such as working at unprotected heights, operating fast 

or dangerous machinery or driving commercial vehicles. (A.R. 25). 

 The medical evidence cited by the ALJ does not support Plaintiff’s 

claim that she was incapable of performing her past relevant work. The 

record medical evidence shows Plaintiff’s subjective complaints are not 

substantiated to the degree Plaintiff alleges. The ALJ articulated 

sufficient reasons for rejecting her subjective disability allegations. In 

sum, the ALJ properly concluded that Plaintiff retained the functional 

capacity to perform her past work as a flower assembler. 

 2. The ALJ’s Determination at Step Five 

 Notwithstanding the ALJ’s determination that Plaintiff could 

perform her past relevant work, the ALJ also moved to step five of the 

disability evaluation process to show that there were a significant 

number of jobs in the national economy Plaintiff is able to do. Tackett v. 

Apfel, 180 F.3d 1094, 1098-1099 (9th Cir. 1999); 20 C.F.R. § 416.920(e), 

(g). 

 Plaintiff contends that the ALJ erred in failing to properly apply 

the medical/vocational guidelines at step-five of the sequential 

evaluation. Specifically, Plaintiff argues that “an individual who does 

not have past work, who is ... limited to medium exertion work, who is 

unable to communicate in English or illiterate, and who is over the age 

of 55, is disabled ... as mandated at 20 C.F.R., Part 404, Subpt. P, 

Appendix 2 Medical-Vocational Rule § 203.10.” (ECF 14 at 8). Plaintiff 

further contends that the application of the medical-vocational 

guidelines is mandatory for persons suffering exclusively from 

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exertional limitations. Id. (citing Lounsburry v. Barnhart, 468 F.3d 

1111, 1114-1116 (9th Cir. 2006)). Thus, Plaintiff asserts that she 

became disabled when she turned age 55. Id. 

 Defendant argues that “[s]ubstantial evidence supports the ALJ’s 

step five finding because the VE identified a significant number of jobs 

that Plaintiff could perform.” (ECF 16 at 5). Defendant did not 

address Plaintiff’s allegation that her non-English speaking status, 

among other relevant factors, would categorize her as disabled pursuant 

to the medical-vocational guidelines. 

 “Once a claimant has established that he or she suffers from a 

severe impairment that prevents the claimant from doing any work he 

or she has done in the past, the claimant has made a prima facie 

showing of disability.” Tackett, 180 F.3d at 1100. If the claimant 

successfully makes a prima facie showing of disability at step five of the 

sequential evaluation process “the burden shifts to the Commissioner to 

show that the claimant can perform some other work that exists in 

‘significant numbers’ in the national economy, taking into consideration 

the claimant’s residual functional capacity, age, education, and work 

experience.” Id. (quoting 20 C.F.R. § 404.1560(b)(3)). “‘[W]ork which 

exists in the national economy’ means work which exists in significant 

numbers either in the region where [the claimant] lives or in several 

regions of the country.” 42 U.S.C. § 423(d)(2)(A). 

 There are two ways for the Commissioner to meet the burden of 

showing that there is other work in “significant numbers” in the 

national economy that claimant can do: (1) by the testimony of a 

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vocational expert, or (2) by reference to the Medical-Vocational 

Guidelines at 20 C.F.R. pt. 404, Subpt. P, App 2. If the Commissioner 

meets this burden, the claimant is “not disabled” and therefore not 

entitled to disability insurance benefits. See 20 C.F.R. §§ 404.1520(f), 

404.1562. If the Commissioner cannot meet this burden, then the 

claimant is “disabled” and therefore entitled to disability benefits. 

Tackett, 180 F.3d at 1099. 

a. Vocational Expert 

 “The ALJ may meet his burden at step five by asking a vocational 

expert a hypothetical question based on medical assumptions supported 

by substantial evidence in the record and reflecting all the claimant’s 

limitations, both physical and mental, supported by the record.” Hill v. 

Astrue, 698 F.3d. 1153, 1161 (9th Cir. 2012) (citing Valentine v. Comm’r 

of Soc. Sec. Admin., 574 F.3d 685, 690 (9th Cir. 2009)); Thomas v. 

Barnhart, 278 F.3d 947, 956 (9th Cir. 2002); Desrosiers, supra, 846 F.2d 

at 578). “The ALJ’s depiction of the claimant’s disability must be 

accurate, detailed, and supported by the medical record.” Desrosiers, 

846 F.2d at 578 (citing Gamer v. Sec’y of Health & Human Servs., 815 

F.2d 1275, 1279-80 (9th Cir. 1987)). “The vocational expert is then 

called upon to ‘translate[] factual scenarios into realistic job market 

probabilities’ by testifying, on the record, to what kinds of jobs, the 

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

those jobs available in the claimant’s region or in several other regions 

of the economy to support a finding of ‘not disabled.’” Desrosiers, 846 

F.2d at 578 (quoting Gamer, 815 F.2d at 1280). 

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b. Medical-Vocational Guidelines (the grids) 

 Alternatively, the ALJ may satisfy the step five burden of showing 

that a claimant can perform work by relying on the Medical-Vocational 

Guidelines, commonly referred to as “the grids.” See C.F.R. Pt. 404, 

Subpt. P, App. 2; Lockwood v. Comm’r Soc. Sec. Admin., 616 F.3d 1068, 

1071 (9th Cir. 2010) (citing Tackett, 180 F.3d at 1101). The grids 

“present in table form, a short-hand method for determining the 

availability and numbers of suitable jobs for claimant.” Lounsberry v. 

Barnhart, 468 F.3d 1111, 1114 (9th Cir. 2006) (citing Tackett, 180 F.3d 

at 1101). The grids categorize jobs based on exertional or physical 

strength requirements.6 Each table sets forth combinations of age, 

education, and work experience, and for each combination directs a 

finding of either “disabled” or “not disabled” based upon the number of 

jobs in the national economy for someone with listed characteristics. Id.

at 1115; see also Lockwood, 616 F.3d at 1071 (“The grids are matrices of 

the “four factors identified by Congress—physical ability, age, 

education, and work experience—and set forth rules that identify 

whether jobs requiring specific combinations of these factors exist in 

significant numbers in the national economy.’” (quoting Heckler, 461 

U.S. at 461-62). Reliance on the grids “allows the Commissioner to 

 

6 “The grids categorize jobs by their physical-exertional requirements 

and consist of three separate tables-one for each category: ‘[m]aximum 

sustained work capacity limited to sedentary work,’ ‘[m]aximum 

sustained work capacity limited to light work,’ and ‘[m]aximum 

sustained work capacity limited to medium work.’” Tackett, 180 F.3d at 

1101 (quoting 20 C.F. R. Pt. 404, Subpt. P, App. 2, Rule 200.00). 

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streamline the administrative process and encourages uniform 

treatment of claims.” Tackett, 180 F.3d at 1101 (citing Heckler, 461 

U.S. at 460-62). 

 When a claimant suffers only exertional limitations, the ALJ must 

use the grids. Lounsberry, 468 F.3d at 1115; 20 C.F.R. § 404.1569a(b). 

If a claimant alleges only non-exertional limitations7 “the grids are 

inappropriate, and the ALJ must rely on other evidence.” Id. If a 

claimant has both exertional and non-exertional limitations, the grids 

may be used as a framework for decision making. 20 C.F.R. § 

404.1569a(d). 

 Here, the ALJ determined that Plaintiff suffers from exertional 

impairments only. (A.R. at 24). In moving from the step four 

evaluation to step five the ALJ found that during the time her case was 

before the ALJ she moved from the age category defined as an 

individual closely approaching advanced age into the advanced age 

category. (A.R. at 31, citing 20 C.F.R.§ 404.1563). The ALJ further 

determined: 

 The claimant is not able to communicate in English, 

and is considered in the same way as an individual who 

is illiterate in English (20 C.F.R. 404.1564). 

Transferability of job skills is not material to the 

determination of disability because using the MedicalVocational Rules as a framework supports a finding that 

claimant is “not disabled,” whether or not the claimant 

 

7 Non-exertional limitations are “limitations that do not directly affect a 

claimant’s strength.” Burkhart v. Bowen, 856 F.2d 1335, 1340 (9th Cir. 

1988) 

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has transferable job skills. (Id. citing 20 C.F.R. Part 404, 

Subpart P, Appendix 2). 

 In the alternative, considering the claimant’s age, 

education, work experience, and residual functional 

capacity, there are other jobs that exist in significant 

numbers in the national economy that the claimant can 

also perform. (Id. citing 20 C.F.R. 404.1569 and 

404.1569(a)). 

 The ALJ concluded that if Plaintiff was able to perform the full 

range of medium work, Medical-Vocational Rule 203.19 and Rule 203.12 

apply and a finding of “not disabled” would be appropriate. (Id.). 

Realizing, however, that Plaintiff’s ability to perform medium work had 

been impeded by additional limitations, the ALJ elicited testimony from 

the VE, in the form of two hypotheticals. (Id.). The ALJ asked the VE 

whether, in addition to Plaintiff’s past work, other jobs would exist in 

the national economy that Plaintiff could perform. The VE noted that a 

person with the RFC as presented in both hypotheticals could be a linen 

room attendant, DOT 222.387-030.8 The VE also testified that the 

position of laundry worker I, DOT 361.684-014, would be consistent the 

hypothetical RFC.9 The ALJ then moved to the range of light work 

using the same hypothetical as presented for a person performing 

medium work. (A.R. at 69). The VE testified that a person capable of 

performing a range of light work using the same hypotheticals could 

 

8 This job has approximately 81,000 jobs in the national economy, 

approximately 5,000 jobs in the regional economy. 

9 This job has approximately 50,000 jobs in the national economy, 

approximately 1,400 jobs in the regional economy. 

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manage the job of blending tank helper, DOT 520.684-06610 and the job 

of cleaner, housekeeping, DOT 323.687-014.11 

Disregarding, the hypotheticals and testimony of the VE, Plaintiff 

argues that the ALJ failed to apply the correct grid rule. Plaintiff cites 

to Pt. 404, Subpt. P, App. 203.00(c), which states: 

 [T]he absence of any relevant work experience 

becomes more significant adversity for persons of 

advanced age (55 and over). Accordingly, this factor, in 

combination with a limited education or less, militates 

against making a vocational adjustment to even this 

substantial range of work and a finding of disabled is 

appropriate. 

Specifically, Plaintiff argues that Medical-Vocational Rule 203.10 

is the applicable rule in her case, rather than rule 203.12 applied by the 

ALJ.12 

 Plaintiff’s conviction that 203.10 applies is based on her claim that 

she has no prior work experience and is functionally illiterate in 

English. Plaintiff’s argument is misplaced. First, this Court finds that 

the ALJ presented substantial evidence that Plaintiff did have past 

relevant work. As noted herein, the ALJ referred to Plaintiff’s earnings 

 

10 70,000 jobs in the national economy and 4,200 in the regional 

economy. 

11 Approximately 98,000 jobs in the national economy and 

approximately 3,000 jobs in the regional economy. 

12 Rule 203.10 provides for a finding of disabled for a person of advanced 

age, limited or less education and no previous work experience. Rule 

203.12 provides for a finding of not disabled for a person of advanced 

age, limited or less education and skilled or semi-skilled (skills not 

transferable) previous work experience. 

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records and her own testimony which demonstrates a relevant work 

history dating back to 2006. 

Second, the limitations related to illiteracy are already accounted 

for in the Grids. For example, 20 C.F.R. Pt. 404, Subpt. P, App. 2, §§ 

201.00(i) and 202.00(g) state that illiteracy or inability to communicate 

in English may limit an individual's vocational scope, but is least 

significant in considering the ability to perform the work functions of 

unskilled work. “While illiteracy or the inability to communicate in 

English may significantly limit an individual’s vocational scope, the 

primary work functions in the bulk of unskilled work relate to working 

with things (rather than with data or people) and in these work 

functions at the unskilled level, literacy or ability to communicate in 

English has the least significance.” 20 C.F.R. Pt. 404, Subpt. P, App. 2 

§ 201.00(i); see also 20 C.F.R. Pt. 404, Subpt. P, App. 2 § 202.00(g). 

A plain reading of § 203.00, the medical-vocational guidelines for 

medium exertional work, makes it clear that Rule 203.00 is not 

augmented by the specific text contained in Rules 201.00(i) and 

202.00(g) specifically addressing the issue of illiteracy or the inability to 

communicate in English. As noted previously, the ALJ had made her 

own determination that “[t]he claimant is not able to communicate in 

English, and is considered in the same way as an individual who is 

illiterate in English.” (A.R. at 31). Thus, the ALJ recognized Plaintiff’s 

non-English speaking status when she determined medical-vocational 

Rule 203.12 accurately represented Plaintiff’s limitations. 

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 Assuming for the sake of argument, that the ALJ should have 

applied rule 203.1113 which would have assessed Plaintiff’s previous 

work experience as unskilled, the jobs identified at step five by the VE 

in response to the ALJ’s hypotheticals are within the unskilled light or 

medium occupational base. (A.R. at 31). “Approximately 2,500 

separate sedentary, light and medium occupations can be identified, 

each occupation representing numerous jobs in the national economy 

which do not require skills or previous experience and which can be 

performed after a short demonstration or within 30 days.” 20 C.F.R. Pt. 

404, Subpt. P, App. 2 § 203.00. Thus, any error was harmless as it had 

no effect at step five because the ALJ properly concluded that Plaintiff 

could perform work currently available in the national and regional 

economies as demonstrated by the jobs identified by the VE. 

3. Substantial Evidence Supports the ALJ’s Decision 

A review of the record presented demonstrates that substantial 

evidence supports the ALJ’s decision finding Plaintiff not disabled and 

that she has the residual functional capacity to perform her past 

relevant work as an artificial flower maker. (A.R. at 31). In this case, 

the ALJ reviewed the record and found little objective evidence that 

Plaintiff was suffering such great pain that she could not engage in any 

type of substantial gainful work. “That a job is found to be tedious or 

uncomfortable cannot constitute substantial evidence that a person is 

 

13 Rule 203.11 provides for a finding of not disabled for a person of 

advanced age, limited or less education and unskilled previous work 

experience. 

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disabled from doing any work.” Sorenson v. Weinberger, 514 F.2d 1112, 

1117 (9th Cir. 1975). With the exception of Plaintiff’s own allegations, 

all opinion evidence in the record supports the ALJ’s decision. 

The ALJ clearly relied on the findings of the treatment record and 

reports cited in the administrative record. The ALJ’s findings are 

consistent with the record as a whole. Title 20 C.F.R. § 416.920b states 

“after the [ALJ] review[s] all of the evidence relevant to your claim, 

including medical opinions [the ALJ] make[s] findings about what the 

evidence shows.” (Id.). Further, Title 20 C.F.R. § 416.927(6)(d)(1) states 

in part, “[the ALJ is] responsible for making the determination or 

decision about whether [a claimant] meet[s] the statutory definition of 

disability.” “The ALJ is the final arbiter with respect to resolving 

ambiguities in the medical evidence.” Tommasetti v. Astrue, 533 F.3d 

1035, 1041-1042 (9th Cir. 2008). 

The Court’s review revealed no ambiguity or error indicating that 

the ALJ’s decision was based on less than substantial evidence. 42 

U.S.C. § 405(g). Accordingly, the Court finds the ALJ’s findings of fact 

and conclusions of law, including Plaintiff’s residual functional capacity, 

are supported by substantial evidence and free of legal error. For these 

reasons, it is recommended Plaintiff’s motion for summary judgment on 

her claim that the ALJ committed error for failing to fully credit her 

allegations of disabling limitations be DENIED and the 

Commissioner’s motion for summary judgment be GRANTED. 

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IV. CONCLUSION 

The Court RECOMMENDS that Plaintiff’s Motion be DENIED

and that Defendant’s Motion be GRANTED, and the case be

DISMISSED. This Report and Recommendation of the undersigned 

Magistrate Judge is submitted to the United States District Judge 

assigned to this case, pursuant to the provisions of 28 U.S.C. § 

636(b)(1). 

IT IS HEREBY ORDERED that any written objection to this 

REPORT must be filed with the Court and served on all parties no later 

than September 30, 2016. The document should be captioned 

“Objections to Report and Recommendations.” 

IT IS FURTHER ORDERED that any reply to the objections 

shall be filed with the Court and served on all parties no later than 

October 7, 2016. The parties are advised that failure to file objections 

within the specific 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: September 13, 2016 

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