Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_06-cv-00607/USCOURTS-azd-4_06-cv-00607-1/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:205 Denial Social Security Benefits

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Bernadette Crump, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV 06-607-TUC-FRZ

ORDER

I. BACKGROUND

Pending before the Court is Plaintiff's Motion for Summary Judgment pertaining to

the denial of disability benefits by the Administrative Law Judge ("ALJ") in her case. Also

pending before the Court is Defendant's Cross-Motion for Summary Judgment regarding the

same denial of disability benefits. 

United States Magistrate Judge Jacqueline Marshall issued a Report and

Recommendation on July 7, 2008. In that Report and Recommendation, Magistrate Judge

Marshall recommended denying Plaintiff's Motion for Summary Judgment and granting

Defendant's Cross-Motion for Summary Judgment. The Report and Recommendation

indicated that any party could file written objections to the Report and Recommendation

within 10 days, and that responses to any objections were due within ten days. Plaintiff filed

objections. Defendant did not file any objections.

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As Magistrate Judge Marshall’s Report and Recommendation throughly discussed the

relevant facts and law, the Court will not repeat that entire discussion; rather, the Court will only

discuss the narrow issues specifically raised by Plaintiff’s objections.

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II. STANDARD OF REVIEW

The Court reviews de novo the objected-to portions of the Report and

Recommendation. 28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b). The Court reviews for clear

error the unobjected-to portions of the Report and Recommendation. Johnson v. Zema

Systems Corp., 170 F.3d 734, 739 (7th Cir. 1999); see also Conley v. Crabtree,

14 F. Supp. 2d 1203, 1204 (D. Or. 1998).

III. DISCUSSION1

A. Plaintiff’s Objections

A review of Plaintiff’s objections shows that she essentially raises the same arguments

that were considered by Magistrate Judge Marshall and properly resolved in the Report and

Recommendation.

Plaintiff argues that the ALJ failed to consider obesity in relation to the residual

functional capacity determination. In this regard, Plaintiff stresses that any reliance on Dr.

Soo Hoo’s consulting examiner report was misplaced as the report excluded consideration

of “body habitus” or the report was at least ambiguous as to whether it considered “body

habitus” as it relates to obesity. Plaintiff also argues that the ALJ failed to develop the record

especially as it pertained to the impact of Plaintiff’s obesity on her ability to work. These

issues were considered and appropriately resolved in the Report and Recommendation as

follows:

Plaintiff argues that despite the ALJ’s finding that Plaintiff’s obesity

was a severe impairment, the ALJ committed legal error by failing to explicitly

consider functional limitations caused or made worse by Plaintiff’s obesity. In

support, Plaintiff states that other than referring to Plaintiff’s treating

physician’s diagnosis of obesity, the word “obesity” rarely appears again in the

ALJ’s decision.

The Social Security Rules specifically address the role of obesity in

disability assessments. Social Security Ruling (“SSR”) 02-1p (2002) provides

that obesity can be a severe impairment if, when considered alone or combined

with other impairments, it causes more than a slight limitation on an

individual's ability to perform basic work. Id. at 4. In assessing the severity of

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obesity, the Commissioner has ruled that an "individualized assessment of the

impact of obesity on an individual's functioning" is necessary. Id. 

At step two of the analysis, the ALJ in this case made the requisite

findings. He found that Plaintiff had the severe impairments of obesity and

hypertension and that the “impairments cause significant limitation in the

claimant’s ability to perform basic work activities.” (Tr. 13).

SSR 02-1p also provides that, if obesity is found to be a medically

determinable impairment, "any functional limitations resulting from the

obesity" must be considered in the RFC assessment. Id. at 7.

At step five of the analysis, the ALJ found that Plaintiff had the RFC

“to lift and carry 20 pounds occasionally and 10 pounds frequently. She is able

to sit, stand, and/or walk for about six hours in an 8-hour day. She has no other

exertional or non-exertional limitations.” (Tr. 14). After setting out this finding

in bold print, the ALJ provided two-plus pages of single-spaced details to

support this finding. Twice, the ALJ refers to Plaintiff’s obesity: “Exam

findings noted in the records from the treating physician include obesity and

hypertension” (Tr. 14); and “[s]he also has mild arthritis in the hands with

some synovial thickening of the joints and is obese with a body mass index of

a least 31(Exhibits 2F & 1F/7).” (Tr. 16).

More often (seven times), the ALJ refers to Plaintiff’s hypertension but

that is because Plaintiff herself attributed her inability to work to her

symptoms of hypertension (fluid retention and dizziness), arthritis and

gynecological problems. There is simply no evidence in the record of any

functional limitations as a result of Plaintiff’s obesity that the ALJ failed to

consider.

Plaintiff also argues that the ALJ committed error by relying on a

consulting examiner’s report that failed to consider obesity. In support,

Plaintiff refers to Dr. Soo Hoo’s report wherein he states that his opinions were

made without consideration of “body habitus” or body build, in other words,

Plaintiff’s obesity.

What Dr. Soo Hoo did in his report is simply track the language of SSR

96-8P which states: “[t]he RFC assessment considers only functional

limitations and restrictions that result from an individuals medically

determinable impairment or combination of impairments, including the impact

of any related symptoms. Age and body habitus are not factors in assessing

RFC.” SSR 96-8P, 1996 WL 374184, Introduction, paragraph 1 (S.S.A.)

(emphasis added).

Having included this language in the RFC is not to say that either the

ALJ or Dr. Soo Hoo ignored Plaintiff’s obesity. Plaintiff misunderstands the

Agency’s purpose in removing obesity as a listed impairment. In 1999, the

S.S.A. deleted Obesity from the listing ofimpairments because its criteria was

not an appropriate indicator of listing-level severity and did not represent a

degree of functional limitation that would prevent an individual from engaging

in any gainful activity. SSR 2-1P, 2000 WL 628049 (S.S.A.). In other words,

the Agency wanted to ensure that weight alone was not assumed to impair

functionality. But after an ALJ identifies obesity as a medically determinable

impairment, as in the present case, then any functionality limitations resulting

from the obesity must be considered in the RFC assessment. SSR 2-1P, 2000

WL 628049, Policy Interpretation, paragraph 9 (S.S.A.).

As is evident from the ALJ’s Findings and Dr. Soo Hoo’s report,

Plaintiff’s obesity was noted and was considered at all steps of the evaluation

process. In fact, the second RFC is replete with references to Plaintiff’s

obesity. But nowhere in the record was there anything to suggest that

Plaintiff’s obesity affected her functionality or exacerbated her hypertension.

Her hypertension was adequately controlled by medication. Her obesity did not

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affect her gait or her mobility. The ALJ was generous in his finding that

because of her obesity and hypertension, Plaintiff could not perform her past

work as a nurse’s assistant but could perform other work in the economy . . .

Plaintiff [also] alleges error because the ALJ conducted only a 16

minute hearing and spent less than five pages of the hearing transcript

exploring Plaintiff’s condition. Plaintiff correctly argues that an ALJ must be

especially diligent in exploring all of the relevant facts when he is dealing with

an unrepresented claimant. Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9thCir.

2001). But according to the Plaintiff, the only way the ALJ in this case could

have discharged this heightened duty was to seek out additional information

bearing on the impact of Plaintiff’s limitations on her residual functional

capacity. That is not what case law requires. Only when presented with

ambiguous evidence or when the ALJ’s own finding that the record is

inadequate to allow for proper evaluation of the evidence, is this heightened

duty to “conduct an appropriate inquiry” triggered. Id. An “appropriate

inquiry” might involve subpoenaing and questioning the claimant’s physicians,

continuing the hearing, or keeping the record open after the hearing to allow

supplementation of the record. Id. Here, the ALJ was not confused by

ambiguous evidence. Nor did he believe that the record was insufficient to

allow him to render a decision. And unlike the ALJ in Tonapetyan, where the

medical expert used phrases such as “difficult to say” and “somewhat

depressed,” the ALJ here did not rely on medical testimony that was equivocal.

Id.

See Report and Recommendation at 9-12.

Plaintiff also argues that the ALJ erred as he failed to support his adverse credibility

finding with substantial evidence in the record. The Report and Recommendation properly

resolved this issue and found in relevant part:

Plaintiff argues that the ALJ misinterpreted much of the Plaintiff’s

testimony such that his evaluation of her credibility was in error. For

example, Plaintiff’s ability to perform some minimal level of daily activity

is no proof that she could function in a competitive work environment;

Plaintiff’s ability to walk to the consultative examination is not evidence

that she is not disabled; and the absence of weight loss and muscle atrophy

does not mean Plaintiff is not suffering chronic pain.

"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's credibility findings must be supported by

specific, cogent reasons. See Rashad v. Sullivan, 903 F.2d 1229, 1231 (9th

Cir. 1990). When the credibility of pain testimony is at issue, and there is

medical evidence of an underlying impairment, the ALJ may not discredit a

claimant's testimony as to the severity of symptoms merely because they are

unsupported by objective medical evidence. See Bunnell v. Sullivan, 947

F.2d 341, 347-48 (9th Cir. 1991). Rather, the ALJ must identify what

testimony is not credible and what evidence undermines the claimant's

complaints. Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995). The ALJ’s

findings must be supported by clear and convincing reasons why a

claimant’s testimony of excess pain is not credible and must be supported

by substantial evidence in the record as a whole. Johnson v. Shalala, 60

F3d. 1428, 1433 (9th Cir. 1995).

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Here, the ALJ found that Plaintiff’s statements concerning the

intensity, duration and limiting effects of her symptoms were “not entirely

credible” (Tr. 14) and “not fully credible” (Tr. 15). These credibility

findings, however, were not just general unsupported findings. The ALJ

provided specific and cogent reasons for discrediting Plaintiff’s pain

testimony. He noted: sporadic treatment with her primary care physician for

hypertension without complications; the lack of complaints to her primary

care doctor of hand pain; exam findings such as blood pressure readings

that while not optimal, were generally in the normal to high normal range;

no evidence of peripheral edema and no swelling in her hands or feet;

Plaintiff received minimal conservative treatment consisting primarily of

pharmacological and palliative remedies; and her hypertension was more

than adequately controlled with medication. (Tr. 14-16).

In reviewing the medical evidence as a whole, the ALJ determined

that the clinical and laboratory findings were disproportionate to the

severity of pain reported by the Plaintiff. (Id.). The fact that Plaintiff was

able to perform limited activities of daily living such as driving, shopping

and personal grooming (Id.) provided additional legitimate support to the

ALJ’s credibility finding. Bunnell, 947 F.2d at 346. Plaintiff takes issue

with the ALJ’s inclusion in his findings that Plaintiff traveled to her

examination appointment by walking for one hour and 15 minutes. When

read in the proper context, it is clear that the ALJ referred to this fact as a

way of supporting his finding that Plaintiff could perform daily living

activities in spite of her pain. (Tr. 15). These illustrations are exactly what

case law requires. Tonapetyan, 242 F.3d at 1148.

See Report and Recommendation at 12-13. Accordingly, pursuant to the foregoing

discussion, Plaintiff’s objections are rejected.

B. The Remaining Issues

As to the remaining issues that were not objected to by the parties, the Court has

reviewed the entire record and concludes that Magistrate Judge Marshall’s

recommendations are not clearly erroneous. See 28 U.S.C. § 636(b)(1); Fed. R. Civ. P.

72; Johnson v. Zema Systems Corp., 170 F.3d 734, 739 (7th Cir. 1999); Conley v.

Crabtree, 14 F. Supp. 2d 1203, 1204 (D. Or. 1998). 

IV. CONCLUSION

IT IS HEREBY ORDERED as follows:

(1) United States Magistrate Judge Marshall’s Report and Recommendation (Doc. #17) is

accepted and adopted.

(2) Plaintiff’s motion for summary judgment (Doc. #7) is denied and Defendant’s crossmotion for summary judgment (Doc. #10) is granted.

(3) This case is dismissed.

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(4) The Clerk of the Court shall enter judgment accordingly and close the file in this

matter. 

DATED this 2nd day of September, 2008.

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