Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_11-cv-00942/USCOURTS-casd-3_11-cv-00942-1/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

---

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

TERESA K. PALMER,

Plaintiff,

CASE NO. 11-CV-942 JLS (BLM)

ORDER (1) ADOPTING REPORT

AND RECOMMENDATION;

(2) GRANTING IN PART

PLAINTIFF’S MOTION FOR

SUMMARY JUDGMENT; AND

(3) DENYING DEFENDANT’S

MOTION FOR SUMMARY

JUDGMENT

(ECF Nos. 14, 15, 18)

vs.

MICHAEL J. ASTRUE, Commissioner of

Social Security,

Defendant.

Presently before the Court are cross motions for summary judgment by Plaintiff Teresa

Palmer and Defendant Michael J. Astrue, Commissioner of Social Security. (Pl.’s MSJ, ECF No.

14; Def.’s MSJ, ECF No. 15.) Also before the Court is a Report and Recommendation (“R&R”)

from Magistrate Judge Major advising the Court to grant in part Plaintiff’s motion and to deny

Defendant’s motion. (R&R, EFC No. 18.) Defendant has filed objections to the R&R (Objs., ECF

No. 19) and Plaintiff has replied to those objections (Reply, ECF No. 20). Having carefully

considered the parties’ filings, the R&R, and the applicable law, the Court ADOPTS Magistrate

Judge Major’s Recommendation and Report, GRANTS IN PART Plaintiff’s motion for summary

judgment, DENIES Defendant’s cross-motion for summary judgment, and REMANDS this

matter for further administrative proceedings.

- 1 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 1 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

BACKGROUND

The Court finds that the background facts contained in the R&R are both accurate and

complete. Further, Defendant has not objected to this aspect of the R&R. Therefore, the Court

incorporates the R&R’s “Procedural History” section by reference here. (R&R at 2.)

LEGAL STANDARDS

1. Review of the Report and Recommendation

Rule 72(b) of the Federal Rules of Civil Procedure and 28 U.S.C. § 636(b)(1) set forth the

duties of the district court in connection with a magistrate judge’s report and recommendation. 

“The district court must make a de novo determination of those portions of the report . . . to which

objection is made,” and “may accept, reject, or modify, in whole or in part, the finding or

recommendations made by the magistrate.” 28 U.S.C. § 636(b)(1)(C); see also United States v.

Remsing, 874 F.2d 614, 617 (9th Cir. 1989); United States v. Raddatz, 447 U.S. 667, 676 (1980). 

However, the Court has no obligation to review a legal conclusions to which neither party objects. 

Schmidt v. Johnstone, 263 F. Supp. 2d 1219, 1226 (D. Ariz. 2003); see also United States v.

Reyna-Tapia, 328 F.3d 1114, 1121 (9th Cir. 2003) (en banc).

2. Review of a Denial of Disability Claim

When an applicant’s claim for disability benefits under the Social Security Act has been

denied, she may seek judicial review of the Commissioner’s decision. 42 U.S.C. § 405(g). The

reviewing Court will reverse the Commissioner’s decision only if “it is based upon legal error or is

not supported by substantial evidence.” Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir.

2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). “Substantial evidence is such

relevant evidence as a reasonable mind might accept as adequate to support a conclusion” and is

“more than a mere scintilla but less than a preponderance.” Webb v. Barnhart, 433 F.3d 683, 686

(9th Cir. 2005) (citing Richardson v. Perales, 402 U.S. 389 (1971)); Tidwell, 161 F.3d at 601

(citing Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 1997)). This inquiry looks to the record

as a whole. Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). However, if the evidence

supports more than one interpretation, the Court must uphold the Administrative Law Judge’s

(“ALJ”) decision. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). “Where, as here, the

- 2 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 2 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Appeals Council denies a request for review of an ALJ’s decision, the decision of the ALJ

represents the final decision of the Commissioner.” Batson v. Comm'r of Soc. Sec. Admin., 359

F.3d 1190, 1193 n.1 (9th Cir 2004) (citing 20 C.F.R. § 404.981).

In order to qualify for disability benefits, an applicant must show that she is “disabled,”

meaning (1) that she suffers from a medically determinable impairment that can be expected to last

for a continuous period of twelve months or more, or would result in death, and (2) the impairment

renders applicant incapable of performing the work she previously performed or any other

substantially gainful employment that exists in the national economy. 42 U.S.C. §§ 423(d)(1)(A),

(2)(A). To evaluate the applicant's claim, an ALJ must apply a five-step analysis. 20 C.F.R.

§ 404.1520.

In step one, the ALJ determines whether a claimant is currently engaged in

substantial gainful activity. If so, the claimant is not disabled. If not, the ALJ

proceeds to step two and evaluates whether the claimant has a medically severe

impairment or combination of impairments. If not, the claimant is not disabled. If

so, the ALJ proceeds to step three and considers whether the impairment or

combination of impairments meets or equals a listed impairment under 20 C.F.R.

pt. 404, subpt. P, App. 1. If so, the claimant is automatically presumed disabled. 

If not, the ALJ proceeds to step four and assesses whether the claimant is capable

of performing her past relevant work. If so, the claimant is not disabled. If not,

the ALJ proceeds to step five and examines whether the claimant has the residual

functional capacity (“RFC”) to perform any other substantial gainful activity in the

national economy. If so, the claimant is not disabled. If not, the claimant is

disabled. 

Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). A claimant bears the burden of proof with

respect to the first four steps, but for the fifth step the burden shifts to the Commissioner. Id.

(citing Swenson v. Sullivan, 876 F.2d 683, 687 (9th Cir. 1989)).

ANALYSIS

1. Summary of R&R’s Conclusions

In the R&R, Magistrate Judge Major reviewed ALJ Muskrat’s written decision determining

Plaintiff was not disabled under sections 216(i) and 223(d) of the Social Security Act. (R&R 2.) 

The R&R recounts the ALJ’s conclusion that Plaintiff’s “medically determinable impairments

could reasonably be expected to cause the alleged symptoms; however [Plaintiff’s] statements

concerning the intensity, persistence and limiting effects of these symptoms are not credible to the

extent that they are inconsistent with the above residual functional capacity assessment.’” (Id. at

- 3 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 3 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

3.) Judge Major next turned to the task of determining whether the ALJ had properly applied the

two-part test for evaluating a claimant’s subjective claims. (Id. at 4-5.) Judge Major explained

that this two-part test requires the ALJ to have “specific, clear and convincing reasons” for

rejecting the claimant’s testimony about her subjective symptoms. (Id. at 5.) But so long as the

ALJ’s findings of specific reasons for rejecting the claimant’s testimony are “supported by

substantial evidence,” then “the Court may not second-guess his or her decision.” (Id. at 5.) 

Noting that Plaintiff’s appeal seeks to overturn the ALJ’s determination of no disability for one

reason only—that the ALJ improperly discounted her subjective testimony, failing to provide clear

and convincing reasons for doing so—Judge Major turned to summarize the four reasons the ALJ

articulated for discounting Plaintiff’s subjective testimony about her pain and symptoms.

A. Objective Medical Evidence

First, Judge Major reviewed the ALJ’s discussion of the objective medical evidence. 

(R&R 7-10.) The ALJ adopted the limitations described by the various doctors in their reports and

found these limitations were inconsistent with Plaintiff’s subjective testimony regarding her pain

and physical limitations. (Id. at 9.) Judge Major determined that the ALJ’s finding that Plaintiff’s

lymphedema is controlled by treatment and not disabling was supported by substantial evidence,

concluding that the Court should defer to that determination and uphold the decision. (Id. at 11.) 

However, with respect to Plaintiff’s disease of the lumbar spine, Judge Major did not reach the

same conclusion. Judge Major determined there was substantial evidence to support the ALJ’s

finding that the objective medical evidence did not support Plaintiff’s reported back pain

symptoms, but noted that this reason is insufficient to justify the ALJ’s decision to discredit a

claimant’s subjective symptom testimony without more. (Id. at 9.) “While the absence of

objective medical evidence to support Plaintiff’s subjective complaints is a factor the ALJ can

consider in discrediting symptom testimony, it cannot be the sole factor.” (Id.) Citing many cases

to support the proposition that absence of objective medical evidence alone is not sufficient, Judge

Major next turned to examine whether any of the other reasons provided by the ALJ justified the

rejection of Plaintiff’s subjective testimony regarding her lumbar spine pain and symptoms. (Id.) 

Ultimately, Judge Major rejected all three of the proffered reasons, as elaborated below. 

- 4 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 4 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

B. Conservative Treatment

Judge Major reviewed the ALJ’s determination that Plaintiff’s “conservative treatment”

indicated Plaintiff’s subjective testimony of disabling pain and symptoms should be disbelieved. 

(R&R 11-13.) Judge Major examined the record for evidence regarding Plaintiff’s treatment,

concluding that the ALJ’s finding was not supported by substantial evidence. (Id. at 11.) 

Specifically, Judge Major noted that Plaintiff’s treatment included medication, physical therapy,

injections, and acupuncture—a regimen which hardly forecloses the conclusion it was

implemented to combat severe pain. (Id. at 12.) Indeed, Judge Major detailed several instances in

which Plaintiff had specifically requested surgery in 2003, complaining of debilitating pain, only

to be told by various doctors that surgery would not improve her back pain or that her surgery

options were “limited.” (Id. at 12.) Judge Major reasoned that Plaintiff’s failure to undergo

surgery “does not mean that Plaintiff is not in pain or that she does not have a disabling condition.” 

(Id. at 13.) From this evidence, Judge Major found the ALJ’s reliance upon Plaintiff’s

“conservative treatment” in discounting her subjective testimony was improper. (Id. at 13.) 

C. Lack of Adverse Side-Effects from Medications

Judge Major also rejected the ALJ’s reliance on the fact that Plaintiff’s medications did not

have side effects which precluded work activities in discounting her subjective claims. (Id. at 13-

14.) Because Plaintiff never claimed to suffer any impairing side effects caused by her

medication, Judge Major concluded that the ALJ could not use her lack of side effects as a basis to

reject her subjective testimony, as it is irrelevant to her credibility. (Id.) The ALJ failed to

provide any convincing reason why the lack of adverse side effects was “inconsistent with

limitations that would preclude sustained work activity and is consistent with an ability to do a

wide range of light work activity,” which was the only explanation given by the ALJ. (Id. at 14.)

D. Plaintiff’s Vocational Rehabilitation Attempts

Finally, Judge Major turned to the ALJ’s reliance on the fact that Plaintiff was close to

finishing a vocational course and that she had been determined to be capable of returning to work. 

(R&R 14-16.) Judge Major concluded that the law does not allow the ALJ to “penalize Plaintiff

for participating in vocational rehabilitation and attempting to work in spite of her impairments.” 

- 5 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 5 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

(Id. at 15.) As in McCorduck v. Astrue, 2009 WL 783354 (D. Or. March 24, 2009) and

Lingenfelter v. Astrue, 504 F.3d 1028 (9th Cir. 2007), a claimant’s attempt to work in spite of her

impairments actually supports, rather than detracts from, the credibility of her subjective

testimony—barring some direct inconsistency. (Id. at 15.) Here, Judge Major reasoned that “[t]he

record does not indicate the Plaintiff did not experience pain or other stated limitations during her

rehabilitation or work efforts or that the performance of them proved that her pain and other

limitations did not exist.” (Id.) Further, Judge Major noted that several of the reports referenced

by the ALJ had determined Plaintiff was capable of returning to modified work only if modified

duty was available. (Id.) Significantly, Plaintiff had previously been terminated from her job

because her accommodations could no longer be met. (Id. at 15-16.) For these reasons, Judge

Major concluded that Plaintiff’s attempts at vocational rehabilitation did not provide a clear and

convincing reason for the ALJ to discredit Plaintiff ’s subjective testimony. (Id. at 16.) 

E. Conclusions

Following the analysis set forth above, Judge Major concluded that only one of the reasons

provided by the ALJ for rejecting Plaintiff’s subjective testimony was clear and convincing and

supported by substantial evidence. (R&R 16.) In the case of Plaintiff’s lymphedema, that

reason—the effectiveness of the treatment utilized—provided a sufficient basis to uphold the

ALJ’s determination. (Id.) However, with respect to Plaintiff’s claimed disease of the lumbar

spine, that reason—the absence of objective medical evidence to support Plaintiff’s subjective

complaints—cannot provide the sole basis for the ALJ’s decision to discredit Plaintiff’s testimony. 

(Id.) Rejecting all of the ALJ’s other proffered reasons, Judge Major concluded that the ALJ’s

decision to discount Plaintiff’s subjective testimony regarding her spine impairment was not

sufficiently supported by the record. (Id.) The R&R advises the Court to reverse the ALJ’s denial

of benefits. (Id.) Turning finally to whether the case should be remanded or reversed, Judge

Major reasoned that further administrative proceedings may be helpful because the record is not

developed enough to suggest that an ALJ could not find additional reasons to discount Plaintiff’s

subjective claims. (Id. at 16-17.) The R&R counsels the Court to remand the case for further

proceedings rather than simply award benefits.

- 6 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 6 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

2. Analysis

Defendant objects to Judge Major’s conclusion that the ALJ’s credibility analysis was

flawed. The Court examines each of Defendant’s specific objections in turn.

First, Defendant objects to Judge Major’s conclusion that the evidence showed Plaintiff

had a “good medical reason” for her conservative treatment, namely that surgery would not

improve Plaintiff ’s pain, and argues instead that the evidence indicates Plaintiff had relief from

the more conservative treatment. (Objs. 2.) But the evidence Defendant cites does not support this

conclusion. Defendant points to Plaintiff’s lack of symptoms as indicated by the objective medical

evidence as proof that Plaintiff had a favorable response to a conservative treatment plan. (Objs.

3.) Except to the extent that it relies upon the lack of objective support for Plaintiff’s claims

concerning the intensity, persistence, and limiting effects of her symptoms, Defendant’s argument

is unconvincing. But, as discussed above, the ALJ may not rely solely on the absence of objective

medical evidence to discredit Plaintiff’s subjective testimony. And the Court agrees with Judge

Major’s reasoning that to use the type of treatment to question Plaintiff’s credibility, especially

when there is no indication that a more aggressive treatment would be warranted if Plaintiff’s

symptoms were worse, essentially amounts to “a back door finding that Plaintiff’s statements are

not fully corroborated by objective medical evidence.” (R&R 12.) Nor does anything in the

record cited by Defendant indicate that Plaintiff’s condition was improved or her pain reduced by a

specific treatment. For these reasons, the Court rejects Defendant’s argument—premised on a lack

of objective evidence of symptoms and the theoretical existence of a more aggressive treatment

option—that the record supports finding Plaintiff’s “conservative” treatment was successful in

controlling her back pain.

In further support of its argument, Defendant cites Rollins v. Massanari, 261 F.3d 853, 856

(9th Cir. 2001) for the proposition that “[a]n ALJ may properly reject a claim of total disability, as

here, where treatment notes fail to support ‘the sort of description’ that would be expected from a

person claiming total disability.” (Objs. 3.) But Rollins is inapposite, instructing that a court may

consider treatment notes when evaluating the credibility of the testimony of the doctor who wrote

the treatment notes, in a circumstance in which the doctor’s testimony is inconsistent with the

- 7 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 7 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

treatment notes. Rollins, 261 F.3d at 856. Using a doctor’s description of a claimant in treatment

notes to discredit the claimant’s subjective testimony, in contrast, is merely a specific application

of a lack of objective medical evidence. To adopt the approach Defendant suggests would again

circumvent the rule that inconsistency with objective medical evidence cannot be the sole factor

for discrediting a claimant’s subjective claims. Accordingly, the Court adopts the R&R’s

reasoning and rejects the ALJ’s reliance upon a conservative treatment plan to discount Plaintiff’s

testimony.

Second, Defendant objects to Judge Major’s reasoning with respect to the ALJ’s

consideration of Plaintiff’s lack of adverse side effects from medication. (Objs. 3.) Specifically,

Defendant argues Judge Major was erroneously persuaded by two district court cases, Mossett v.

Astrue, 2008 WL 2783177, at *5 (C.D.Cal., July 17, 2008), and Manzo v. Astrue, 2011 WL

3962254, at *8 (C.D. Cal. Sept. 7, 2011), in concluding that side effects from medication may only

be properly considered to discount a claimant’s testimony when the claimant alleges adverse side

effects and the evidence belies those side effects. (Objs. 3.) Defendant argues that the pertinent

regulations specifically authorize the consideration of the side effects of medication where the

objective medical evidence fails to substantiate a claimant’s assertions as to the intensity and

persistence of her symptoms. (Id.) However, the regulation cited by Defendant merely informs

claimants of other factors that may be considered in evaluating a claimant’s pain or other

symptoms, including “[t]he type, dosage, effectiveness, and side effects of any medication you

take or have taken to alleviate your pain or other symptoms.” 20 C.F.R. § 404.1529(c)(3)(iv). 

The Court cannot adopt Defendant’s proffered interpretation of the regulations. The

factors condoned by the regulations in evaluating a claimant’s symptoms, namely the

consideration of a medication’s side effects, cannot reasonably include the inference that an

absence of such side effects indicates an absolute lack of pain or other symptoms. Not only has

Defendant failed to provide any authority, binding or persuasive, to support its alternative

interpretation this regulation, but it also defies logic to suppose this regulation intends that a lack

of side effects weighs against the credibility of a claimant who has never claimed to have

experienced any such side effects. The Court agrees with Judge Major that the ALJ failed to

- 8 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 8 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

explain why a lack of adverse side effects indicates Plaintiff was not credible. Consequently, the

Court again adopts the R&R here and finds that the ALJ’s reliance on Plaintiff’s lack of side

effects caused my medication was erroneous and not supported by substantial evidence.

Third, Defendant objects to Judge Major’s rejection of the ALJ’s reliance on Plaintiff’s

participation in vocational rehabilitation training. (Id. at 4.) Defendant argues that because

Plaintiff ’s doctors recommended the vocational rehabilitation and had deemed her capable of

returning to work, Plaintiff’s participation was a clear and convincing reason to discount her

testimony. (Id. at 4.) The Court agrees with the Judge Major’s conclusion that “[a]ll the record

establishes is that Plaintiff participated in a fifteen week long vocational program . . . and that she

started a vocational rehabilitation course.” (R&R 15.) In finding the ALJ’s consideration of

Plaintiff’s vocational rehabilitation improper, Judge Major correctly applied the rule from

Lingerfelter v. Astrue, 504 F.3d 1028, 1038 (9th Cir. 2007), which states that an ALJ may not

discredit a claimant for attempting to work in spite of her impairments, particularly where the

claimant tried to work and failed. (R&R 15.) Defendant’s citation of a regulation concerning

consideration of treating physician’s conclusions regarding a claimant’s symptoms misses the

point, and does nothing to alter Judge Major’s reasoning. (See Objs. 4.) Accordingly, the Court

adopts the R&R and finds the ALJ improperly relied on Plaintiff’s participation in a vocational

rehabilitation course to discredit her testimony.

Finally, Defendant does not seem to object to Judge Major’s determination regarding

remand. Accordingly, the Court reviews for legal error, finds none, and adopts the R&R’s

reasoning regarding the propriety of remand. (R&R 16-17.)

///

///

///

///

///

///

///

- 9 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 9 of 10
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

///

CONCLUSION

For the foregoing reasons, the Court ADOPTS Magistrate Judge Major’s R&R in its

entirety. Consequently, Defendant’s motion for summary judgment is DENIED, Plaintiff’s

motion for summary judgment is GRANTED IN PART, and this case is REMANDED for

further administrative proceedings consistent with this Order. 

IT IS SO ORDERED.

DATED: August 30, 2012

Honorable Janis L. Sammartino

United States District Judge

- 10 - 11cv942

Case 3:11-cv-00942-JLS-BLM Document 21 Filed 08/30/12 Page 10 of 10