Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_12-cv-02673/USCOURTS-casd-3_12-cv-02673-0/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)

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

CAROL A. COOPER, Civil No. 12-cv-2673-AJB (DHB)

Plaintiff,

REPORT AND

RECOMMENDATION

REGARDING CROSS-MOTIONS

FOR SUMMARY JUDGMENT

[ECF Nos. 11, 15]

v.

CAROL W. COLVIN, Acting

Commissioner of Social Security,

Defendant.

I. INTRODUCTION

On November 2, 2012, Plaintiff Carol A. Cooper (“Plaintiff”) filed a complaint

pursuant to 42 U.S.C. § 405(g) of the Social Security Act requesting judicial review of

the final decision of the Commissioner of the Social Security Administration

(“Commissioner” or “Defendant”) regarding the denial of Plaintiff’s claim for disability

benefits. (ECF No. 1.) On February 1, 2013, Defendant filed an answer (ECF No. 8) and

the administrative record (“A.R.”). (ECF No. 9.) On April 2, 2013, Plaintiff filed a

motion for summary judgment seeking reversal of Defendant’s denial and an award of

disability benefits or, alternatively, remand for further administrative proceedings. (ECF

No. 11.) Plaintiff contends the Administrative Law Judge (“ALJ”) committed reversible

error by: (1) improperly rejecting the opinions of Plaintiff’s treating physician, Gayle

Jensen, Psy.D.; and (2) failing to provide legally sufficient reasons for rejecting

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Plaintiff’s testimony. (ECF No. 11-1 at 6:14-21:3.)1 On May 14, 2013, Defendant filed

a cross-motion for summary judgment and opposition to Plaintiff’s motion for summary

judgment. (ECF Nos. 15, 16.) Plaintiff did not file an opposition to Defendant’s crossmotion or reply to Defendant’s opposition, despite a June 13, 2013 deadline to do so. 

Accordingly, the Court took the pending cross-motions under submission on June 27,

2013. (ECF No. 17.)

For the reasons set forth herein, after careful consideration of the administrative

record and the applicable law, the Court hereby RECOMMENDS that Plaintiff’s motion

for summary judgment be GRANTED and that Defendant’s cross-motion for summary

judgment be DENIED, and the case be REMANDED for further administrative

proceedings.

II. PROCEDURAL BACKGROUND

On March 17, 2009, Plaintiff protectively filed an application for social security

disability benefits pursuant to Title II of the Social Security Act. (A.R. 137-140, 182.) 

Plaintiff alleged a disability beginning on April 2, 2008. (A.R. 137.) Plaintiff’s

application asserted that she was unable to work due to severe depression, anxiety

disorder, and post-traumatic stress disorder (“PTSD”). (A.R. 174.) After an April 30,

2009 denial at the initial determination (A.R. 72-75) and a September 24, 2009 denial on

reconsideration (A.R. 32, 81-85), Plaintiff filed a timely request for hearing before an

ALJ. (A.R. 86-87.) On November 9, 2010, Plaintiff testified at an administrative hearing

before ALJ Larry B. Parker. (A.R. 46-69.) Plaintiff was represented at the hearing by

an attorney, Harold McNeil. (A.R. 46.) On November 24, 2010, the ALJ denied Plaintiff

benefits after finding that Plaintiff was not disabled, as defined by the Social Security

Act. (A.R. 29-41.) The Commissioner’s decision became final on July 27, 2012 when

the Appeals Council denied Plaintiff’s request for review of the ALJ’s decision. (A.R.

8-11.) Thereafter, Plaintiff filed the instant action on November 2, 2012. (ECF No.1.)

1

 Page numbers for docketed materials cited in this Report and Recommendation generally refer to those imprinted by the Court’s electronic case filing system. The exception is the Court’s citation to the specific page numbers of the administrative record.

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III. LEGAL STANDARDS

A. Determination of Disability

To qualify for disability benefits under the Social Security Act, a claimant must

show two things: (1) she suffers from a medically determinable physical or mental

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 the claimant incapable of

performing the work she previously performed or any other substantial gainful

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

423(d)(2)(A). A claimant must meet both requirements to be classified as “disabled.” 

Id.

The Commissioner makes the assessment of disability through a five-step

sequential evaluation process. If an applicant is found to be “disabled” or “not disabled”

at any step, there is no need to proceed further. Ukolov v. Barnhart, 420 F.3d 1002, 1003

(9th Cir. 2005) (quoting Schneider v. Comm’r of the Soc. Sec. Admin., 223 F.3d 968, 974

(9th Cir. 2000)). The five steps are:

1. Is claimant presently working in a substantially gainful activity? If so, then the claimant is not disabled within the meaning of the Social Security Act. If not, proceed to step two. See 20 C.F.R. §§ 404.1520(b), 416.920(b).

2. Is the claimant’s impairment severe? If so, proceed to step three. If not, then the claimant is not disabled. See 20 C.F.R. §§ 404.1520(c), 416.920(c).

3. Does the impairment “meet or equal” one of a list of specific impairments described in 20 C.F.R. Part 220, Appendix 1? If so, then the claimant is

disabled. If not, proceed to step four. See 20 C.F.R. §§ 404.1520(d), 416.920(d).

4. Is the claimant able to do any work that he or she has done in the past? If so, then the claimant is not disabled. If not, proceed to step five. See 20

C.F.R. §§ 404.1520(e), 416.920(e).

5. Is the claimant able to do any other work? If so, then the claimant is not

disabled. If not, then the claimant is disabled. See 20 C.F.R. §§ 404.1520(f), 416.920(f).

Bustamante v. Massanari, 262 F.3d 949, 954 (9th Cir. 2001) (citing Tackett v. Apfel, 180

F.3d 1094, 1098-99 (9th Cir. 1999)).

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Although the ALJ must assist the claimant in developing a record, the claimant

bears the burden of proof during the first four steps, while the Commissioner bears the

burden of proof at the fifth step. Tackett, 180 F.3d at 1098 & n.3 (citing 20 C.F.R. §

404.1512(d)). At step five, the Commissioner must “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. at 1100 (quoting 20 C.F.R. § 404.1560(b)(3)).

B. Scope of Review

The Social Security Act allows unsuccessful claimants to seek judicial review of

the Commissioner’s final agency decision. 42 U.S.C. §§ 405(g), 1383(c)(3). The scope

of judicial review is limited. The Court must affirm the Commissioner’s decision unless

it “is not supported by substantial evidence or it is based upon legal error.” Tidwell v.

Apfel, 161 F.3d 599, 601 (9th Cir. 1999) (citing Flaten v. Sec’y of Health & Human

Servs., 44 F.3d 1453, 1457 (9th Cir. 1995)); see also Bayliss v. Barnhart, 427 F.3d 1211,

1214 n.1 (9th Cir. 2005) (“We may reverse the ALJ’s decision to deny benefits only if

it is based upon legal error or is not supported by substantial evidence.”) (citing Tidwell,

161 F.3d at 601).

“Substantial evidence is more than a mere scintilla but less than a preponderance.” 

Tidwell, 161 F.3d at 601 (citing Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir.

1997)). “Substantial evidence is relevant evidence which, considering the record as a

whole, a reasonable person might accept as adequate to support a conclusion.” Flaten,

44 F.3d at 1457 (citing Tylitzki v. Shalala, 999 F.2d 1411, 1413 (9th Cir. 1993)). In

considering the record as a whole, the Court must weigh both the evidence that supports

and detracts from the ALJ’s conclusions. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir.

1985) (citing Vidal v. Harris, 637 F.2d 710, 712 (9th Cir. 1981); Day v. Weinberger, 522

F.2d 1154, 1156 (9th Cir. 1975)). The Court must uphold the denial of benefits if the

evidence is susceptible to more than one rational interpretation, one of which supports

the ALJ’s decision. Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005) (“Where

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evidence is susceptible to more than one rational interpretation, it is the ALJ’s conclusion

that must be upheld.”) (citing Andrews v. Shalala, 53 F.3d 1035, 1039-40 (9th Cir.

1995)); Flaten, 44 F.3d at 1457 (“If the evidence can reasonably support either affirming

or reversing the Secretary’s conclusion, the court may not substitute its judgment for that

of the Secretary.”) (citing Richardson v. Perales, 402 U.S. 389, 401 (1971); Matney v.

Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992)). However, even if the 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 a conclusion. Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978) (quoting

Flake v. Gardner, 399 F.2d 532, 540 (9th Cir. 1968)). 

Section 405(g) permits the Court to enter a judgment affirming, modifying or

reversing the Commissioner’s decision. 42 U.S.C. § 405(g). The matter may also be

remanded to the Social Security Administration for further proceedings. Id.

IV. FACTUAL BACKGROUND

Plaintiff alleges she became disabled on April 2, 2008 due to severe depression,

anxiety disorder, and PTSD. (A.R. 174.) Prior to her alleged disability, Plaintiff was

employed as a medical technician. (A.R. 175.)

A. Medical Evidence

1. Treating Physician Evidence

a. Dr. Gayle Jensen

Plaintiff began seeing psychologist Dr. Gayle Jensen on April 25, 2008,

complaining of migraine headaches, severe anxiety, depression, PTSD, and obsessivecompulsive disorder (“OCD”), as well as grief and severe relational difficulties. (A.R.

62, 302, 306.) Plaintiff continued treatment with Dr. Jensen two to four times per month

until April 6, 2011. (A.R. 795.) 

On April 24, 2009, Dr. Jensen completed a Mental Disorder Questionnaire Form

indicating that Plaintiff was complaining of the illnesses and symptoms stated above. 

(A.R. 301-306.) At that time, according to Dr. Jensen, Plaintiff’s attitude and behavior

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ranged “widely from pleasant [and] helpful to critical, hostile [and] demanding,” and

“[s]he seems to look for conflict.” (A.R. 303.) With respect to intellectual functioning,

Dr. Jensen indicated that Plaintiff is able to concentrate and has no disturbance of

thinking or perception, Plaintiff has good judgment about practical caretaking of concrete

things, Plaintiff’s “judgment in social [and] intimate relationships can be poor” and “[s]he

has limited insight into these problems,” and Plaintiff’s intelligence and intellectual

functioning and memory “appear normal,” although no testing has been performed. (A.R.

303.) Dr. Jensen also listed numerous symptoms of OCD, mood swings, depression and

PTSD. (A.R. 304.) Dr. Jensen further indicated that Plaintiff “maintains [activities of

daily living] but in an unenthusiastic, negative manner.” (A.R. 304.) Dr. Jensen stated

that Plaintiff’s social functioning was diminished, that she is “very sensitive to

misunderstandings, disagreements [and] neglect,” but that it is “[u]known how she

behaves at work.” (A.R. 305.) Dr. Jensen noted that Plaintiff is usually capable of

sustained attention, she follows written and oral directions well, she can complete

household tasks, and she is capable of performing as assigned, although her mood and

attitude are variable. (A.R. 305.) Finally, Dr. Jensen reported that Plaintiff is allergic to

all the psychiatric medications she has tried except for Celexa and Xanax, but that she

was not currently taking any medications because she was breast-feeding. (A.R. 306.) 

On October 20, 2011, Dr. Jensen completed a medical statement concerning

Plaintiff in which she opined that as a result of her psychiatric conditions, Plaintiff

experiences mild restrictions of activities of daily living and moderate difficulty in

maintaining social functioning. (A.R. 788.) Dr. Jensen also indicated that Plaintiff does

not have deficiencies of concentration resulting in frequent failure to complete tasks in

a timely manner or repeated episodes of deterioration in work or work-like settings, and

that Plaintiff does not have a complete inability to function independently outside the area

of Plaintiff’s home due to panic attacks. (A.R. 788-789.) With respect to work

limitations related to Plaintiff’s psychiatric state, Dr. Jensen classified Plaintiff as being

moderately impaired in her ability to (1) maintain attention and concentration for

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extended periods, and (2) accept instructions and respond appropriately to criticism from

supervisors. (A.R. 789-790.) Dr. Jensen also classified Plaintiff as being markedly

impaired in her ability to (1) perform activities within a schedule, maintain regular

attendance, and be punctual within customary tolerances, and (2) complete a normal

workday and workweek without interruptions from psychologically based symptoms and

to perform at a consistent pace without an unreasonable number and length of rest

periods. (A.R. 789.) However, Dr. Jensen found that Plaintiff was not significantly

impaired in all other areas. (A.R. 789-790.)

On April 13, 2011, Dr. Jensen completed a Mental Work Restriction Questionnaire

regarding Plaintiff’s medical conditions. (A.R. 792-793.) Dr. Jensen diagnosed Plaintiff

with major depressive disorder (recurrent, moderate to severe), OCD, panic disorder

without agoraphobia, PTSD, and insomnia. (A.R. 792.) Dr. Jensen noted that Plaintiff

experiences moderate impairment in (1) completing a normal work day without

interruptions from psychologically based symptoms and in performing at a consistent

pace without an unreasonable number of and length of rest periods, and (2) accepting

instructions and responding appropriately to criticism from supervisors. (A.R. 793.) Dr.

Jensen also noted that Plaintiff experiences marked impairment in maintaining regular 

attendance and punctuality. (A.R. 792.) However, Dr. Jensen found that Plaintiff had

no impairments in all other areas. (A.R. 792-793.) Finally, Dr. Jensen noted that

Plaintiff “is very sensitive to medication [and] has had severe side effects from all the

depression [and] anxiety medications she has tried. She is not on any of these meds

now.” (A.R. 793.)

Dr. Jensen also completed an Evaluation Form for Mental Disorders on April 13,

2011. (A.R. 795-798.) Dr. Jensen noted that Plaintiff “can be emotionally labile” and

“very sensitive to criticism [and] become defensive.” (A.R. 796.) Dr. Jensen also noted

that “[p]rolonged concentration (e.g., for reading) can be difficult for [Plaintiff] if she is

poorly rested, anxious, tearful or experiencing a migraine.” (A.R. 796.) Dr. Jensen

indicated that Plaintiff can perform all activities of daily living “although sometimes it

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is very effortful.” (A.R. 797.) Dr. Jensen noted that Plaintiff’s “[s]ocial functioning is

usually good with some exceptions of conflict.” (A.R. 797.) Dr. Jensen additionally

noted that Plaintiff can perform tasks “unless she has a migraine or a flare up of

fibromyalgia,” but that her ability to adapt to work or work-like situations is “unknown.” 

(A.R. 797.) Finally, Dr. Jensen noted that Plaintiff’s “inability to tolerate medication

makes it unlikely for her symptoms to improve.” (A.R. 798.) 

b. Dr. Elizabeth Pendragon2

Dr. Elizabeth Pendragon is Plaintiff’s primary care physician. (A.R. 56.) Between

June 25, 2009 and April 4, 2011, Dr. Pendragon treated Plaintiff on at least eighteen

occasions, with the majority of the occasions relating to Plaintiff’s back pain. (A.R. 328,

340, 392, 406, 414, 596, 605, 616, 624, 705, 712, 719, 725, 742, 748, 762, 781, 818, 824,

863.) On nine of these occasions, Dr. Pendragon specifically treated Plaintiff for

fibromyalgia. (A.R. 332, 600, 609, 628, 723, 752, 785, 822, 867.) Despite Plaintiff’s

repeated health problems, Dr. Pendragon consistently released Plaintiff without

limitations. (A.R. 332, 344, 396, 408, 418, 600, 609, 628, 707, 718, 724, 729, 746, 752,

767, 785, 823, 867.)

On October 19, 2010, Dr. Pendragon completed a Medical Statement Regarding

Fibromyalgia in which she specified that Plaintiff has a history of widespread pain for

three or more months, pain in eleven or more pressure points, stiffness, irritable bowel

syndrome, tension headaches, paresthesias, sensation of swollen hands, sleep disturbance,

chronic fatigue, memory loss, and inability to ambulate effectively (e.g., inability to walk

a block at a reasonable pace on rough or uneven surfaces). (A.R. 787.) Dr. Pendragon

indicated that as a result of these symptoms, Plaintiff cannot stand or sit during a

workday, bend or stoop, or raise either arm above shoulder level. (A.R. 787.) Dr.

Pendragon also noted that Plaintiff is able to lift up to twenty pounds on an occasional

basis, but Plaintiff cannot lift any weight on a frequent basis. (A.R. 787.) Dr. Pendragon

2

 As Plaintiff does not appeal the ALJ’s rejection of Dr. Pendragon’s treating opinion, the Court’s discussion of Dr. Pendragon’s medical findings will be limited. 

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additionally indicated that Plaintiff is only able to either sit or stand for fifteen minutes

at a time. (A.R. 787.) Accordingly, Dr. Pendragon’s opines that Plaintiff is not able to

work any hours per day. (A.R. 787.)

c. Other Treating Physician Evidence

In addition to Dr. Pendragon, Plaintiff visited a number of other healthcare

professionals at the Naval Medical Center and Naval Branch Health Clinic, NTC between

March 18, 2009 and May 11, 2011, for a variety of reasons including migraine headaches,

prenatal care, back pain, and knee pain. (A.R. 328-512, 572-785.) Plaintiff underwent

knee surgery on March 19, 2010 after complaining of knee pain. (A.R. 745.) 

2. Examining Physician Evidence: Dr. H. Douglas Engelhorn

Plaintiff underwent a psychiatric consultation with Dr. H. Douglas Engelhorn on

June 1, 2010. (A.R. 528.) On June 2, 2010, Dr. Engelhorn issued a summary of his

findings to the Department of Social Services. (A.R. 529-532.) In this summary, Dr.

Engelhorn indicated that Plaintiff is “fully capable of taking care of her basic needs” and

that “[s]he is fully responsible for the care of her 14 month old son.” (A.R. 531.) Dr.

Engelhorn noted that Plaintiff performs a variety of light household chores, including

laundry and occasional trips to the grocery store with her mother. (A.R. 531.) 

Dr. Engelhorn noted that Plaintiff “is probably of average intelligence . . . [and] she

appears to be in excellent physical health and is fully ambulatory without assistance.” 

(A.R. 531.) Dr. Engelhorn observed no evidence of psychosis, active depression, or

excessive levels of anxiety, and no cognitive impairment. (A.R. 531.) He noted that

Plaintiff’s “[c]oncentration and attention were adequate,” and her “[i]nsight and judgment

seemed fully intact, although not formally tested.” (A.R. 531.) 

Dr. Engelhorn diagnosed Plaintiff with recurrent major depression, PTSD, and

probable anxiety disorder. (A.R. 531.) Dr. Engelhorn also noted Plaintiff’s chronic pain

due to her history of fibromyalgia and migraine headaches. (A.R. 532). Dr. Engelhorn

additionally observed other conditions from Plaintiff’s medical history, including

thyroiditis, hypothyroidism, gastroesophageal reflux, and her condition post-knee

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surgery. (A.R. 532). 

Based on his observations from Plaintiff’s consultation and a review of a mental

health questionnaire, Dr. Englehorn concluded that Plaintiff “could perform simple,

repetitive tasks. She could also perform complex and detailed work.” (A.R. 529, 532.) 

However, Dr. Engelhorn noted that “[t]here is at least some possibility that her physical

health problems and chronic pain might interfere with all of these acivities.” (A.R. 532.) 

Dr. Englehorn indicated Plaintiff “could adequately relate to peers and supervisors in the

workplace. She could be expected to make routine adjustments in the workplace.” (A.R.

532.) 

In addition to the summary of his findings, Dr. Engelhorn completed a Medical

Source Statement of Ability to Do Work-Related Activities on June 11, 2010. (A.R. 534-

536.) In this statement, Dr. Engelhorn indicated Plaintiff has no limitations

understanding and remembering simple instructions, carrying out simple instructions,

making judgments on simple work-related decisions, or interacting appropriately with the

public, supervisors, or co-workers. (A.R. 534-535.) However, Dr. Engelhorn noted

Plaintiff has mild limitations understanding and remembering complex instructions,

carrying out complex instructions, making judgments on complex work-related decisions,

and responding appropriately to usual work situations and to changes in a routine work

setting. (A.R. 534-535.) 

3. Non-Examining Physician Evidence: Dr. F. Kalamar

Dr. F. Kalamar, a non-examining physician, completed a Physical Residual

Functional Capacity Assessment on September 14, 2009. (A.R. 513-517.) In this

assessment, Dr. Kalamar indicated that with regard to exertional limitations, Plaintiff is

capable of occasionally lifting or carrying twenty pounds and frequently lifting or

carrying ten pounds. (A.R. 514.) Dr. Kalamar further noted that Plaintiff is able to sit

and stand and/or walk with normal breaks for a total of about six hours out in an eighthour workday, and that Plaintiff has unlimited ability to push and pull, other than the

mentioned limitations for lifting and carrying. (A.R. 514.) 

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Dr. Kalamar indicated that with regard to postural limitations, Plaintiff cannot

climb ladders, ropes, or scaffolds, but that she has only occasional limitations climbing

ramps and stairs, balancing, stooping, kneeling, crouching, and crawling. (A.R. 514-

515.) Dr. Kalamar indicated that Plaintiff has no manipulative, visual, or communicative

limitations. (A.R. 515-516.) With regard to environmental limitations, Dr. Kalamar

opined that Plaintiff has no limitations with exposure to extreme heat, wetness, humidity,

noise, fumes, odors, dust, gases, or poor ventilation, but that she should avoid

concentrated exposure to extreme cold, vibration, and hazards. (A.R. 516.) 

B. The Hearing

1. Plaintiff’s Testimony

Plaintiff testified at a hearing before ALJ Larry B. Parker on November 9, 2010. 

(A.R. 46-69.) Plaintiff was born on May 12, 1973 and has at least twelve years of

education. (A.R. 49-50.) Plaintiff lives with her husband and her son, who was born in

early 2009. (A.R. 53.) Plaintiff’s husband is in the military. (A.R. 53.) Plaintiff testified

that she has not worked since the alleged onset date of her disability, April 2, 2008, and

that she currently suffers from depression, anxiety, PTSD, migraines, fibromyalgia,

gastroesophageal reflux disease, irritable bowel syndrom, and lower extremity pain. 

(A.R. 51, 55.) Plaintiff believes it was Dr. Pendragon who diagnosed her with

fibromyalgia through a pressure point check where Dr. Pendragon found thirteen pressure

points. (A.R. 64.) 

Plaintiff testified her anxiety disorder sometimes causes her to not want to go

outside, and also to be irritable toward people. (A.R. 52.) Plaintiff experiences these

symptoms three to four times per week, and when she does she goes home or stays inside. 

(A.R. 53.) Due to her son, Plaintiff does not drive when she is feeling anxious. (A.R.

54.) Plaintiff testified her psychiatric impairments interfere with her ability to take care

of her son, and that when this occurs she does not want to get dressed and her son will

stay in his pajamas all day. (A.R. 54.) Plaintiff testified that when she has an anxiety

attack while taking care of her son she “just [has] to deal with it.” (A.R. 54-55.) Plaintiff

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indicated her depression affects her by making her tearful and agitated. (A.R. 55.) 

Plaintiff noted that sometimes she will be in a store, and will have to leave because she

starts crying. (A.R. 55.) Plaintiff additionally testified she has panic attacks a few times

per week. (A.R. 57.) Plaintiff does not take medication as she is allergic to antidepressants, but she sees her psychologist, Dr. Jensen, once a week. (A.R. 57, 62.) 

Plaintiff indicated that Dr. Jensen helps her work through her issues, and gives her “tools

to help deal with the panic attacks and anxiety.” (A.R. 63.) Plaintiff has no past history

of alcohol or drug abuse. (A.R. 63.) 

Plaintiff additionally testified she experiences migraine headaches two times a

week but that around the “stressful” time of the hearing before the ALJ she experienced

a migraine headache almost every day. (A.R. 57.) Plaintiff described her migraine

headaches as very painful, and she indicated they cause her nausea, dizziness, and

occasional loss of vision in her left eye. (A.R. 57.) When Plaintiff experiences a

migraine, she has to “go into a dark place where it’s quiet.” (A.R. 57.) Plaintiff testified

she takes Imitrex for her migraine headaches, which helps her. (A.R. 57-58.) 

In addition to migraine headaches, Plaintiff experiences neck and back pain due

to her fibromyalgia, injuries from a car accident, an incident where she was attacked in

a grocery store, and an incident of domestic violence. (A.R. 58.) Plaintiff further

testified she had meniscectomy surgery on her right knee on March 19, 2010. (A.R. 58-

59.) Plaintiff stated that she still has a tear and cyst in that knee, and that it is “still in a

lot of pain.” (A.R. 59.) 

Plaintiff testified that the greatest amount of weight she can lift at any one time on

a continuing basis is between five and ten pounds, and that although she is able to lift her

child she tries not to because it is “very painful.” (A.R. 60.) Plaintiff also indicated she

can only sit for two to five minutes before having to change position, and she is only able

to walk about a block and a half before her entire back starts “burning” and her

surgically-repaired knee begins “giving out and hurting.” (A.R. 60-62.) Plaintiff also

testified that if she is carrying anything her arms “really start to hurt” and her “hand starts

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to go numb.” (A.R. 62.)

Plaintiff testified she visits her psychologist, Dr. Jensen, once a week, and that Dr.

Jensen helps her “work through [her] issues, and gives [her] tools to help deal with the

panic attacks and anxiety.” (A.R. 62-63.) According to Plaintiff, these unspecified

“tools” work “sometimes.” (A.R. 63.) Plaintiff further testified she is allergic to antidepressants and when she tries to take them she experiences migraines, severe vertigo and

vomiting. (A.R. 63.) 

2. The Vocational Expert’s Testimony

Vocational expert Connie Guillory testified at Plaintiff’s hearing before the ALJ. 

(A.R. 64-68.) After Plaintiff stated that during her entire career she was employed as a

medical technician, medical assistant, and critical care technician, Ms. Guillory testified

that medical technician and medical assistant work are both described in the Dictionary

of Occupational Titles as light duty, skilled, with a skilled vocational preparation time of

five. (A.R. 64-66.) Ms. Guillory indicated that if Plaintiff’s testimony governed the case,

Plaintiff would not be able to perform her past relevant work. (A.R. 66.) The ALJ then

asked Ms. Guillory to consider a hypothetical claimant who was (1) younger than

Plaintiff, with at least twelve years of education and training; (2) limited to lifting twenty

pounds occasionally and ten pounds frequently; (3) limited to standing, sitting, and

walking six out of eight hours a day; (4) unable to be exposed to extreme cold, vibration,

and hazards; (4) mildly restricted in daily activity in non-exertional mental limitation; (5)

moderately limited in social functioning; and (6) not deficient in concentration,

persistence, or pace. (A.R. 67.) Ms. Guillory testified that this hypothetical person

would not be able to perform Plaintiff’s past relevant work due to the social aspects of

that work, but that there were unskilled jobs in the local and national economy that this

hypothetical person could perform, including production inspector, hand packager, and

production assistant. (A.R. 67-68.) 

/ / /

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C. The ALJ’s Findings

After considering all of the evidence, the ALJ concluded Plaintiff has not been

under a disability, as defined by the Social Security Act, from April 2, 2008, through the

date of his decision. (A.R. 41.) Specifically, at step one of the sequential evaluation

process, the ALJ concluded that Plaintiff has not engaged in substantial gainful activity

since April 2, 2008, the alleged onset date. (A.R. 34.) At step two, the ALJ concluded

that Plaintiff has the following severe impairments: headache syndrome; right knee

internal derangement; fibromyalgia; depressive disorder; and anxiety disorder. (A.R. 34.) 

At step three, the ALJ concluded that Plaintiff does not have an impairment or

combination of impairments that meet or exceed the impairments contained in the Listing

of Impairments. (A.R. 35.) Prior to considering step four, the ALJ determined that

Plaintiff has the residual functional capacity to perform light work limited to performing

simple tasks with avoidance of concentrated exposure to cold, vibrations, and hazards. 

(A.R. 36.) At step four, the ALJ found that Plaintiff is unable to perform her past relevant

work as a medical technician or medical assistant. (A.R. 39-40.) Finally, at step five, the

ALJ concluded that, considering Plaintiff’s age, education, work experience and residual

functional capacity, there are jobs that exist in significant numbers in the national

economy that Plaintiff can perform. (A.R. 40.) Specifically, the ALJ found Plaintiff is

capable of performing the work of a production inspector, hand packager and production

assistant. (A.R. 40-41.) Therefore, the ALJ concluded Plaintiff was not disabled as

defined by the Social Security Act. (A.R. 41.)

V. DISCUSSION

In her motion for summary judgment, Plaintiff contends the ALJ committed two

reversible errors: (1) improperly rejecting the medical opinion of Plaintiff’s treating

psychologist, Dr. Jensen; and (2) improperly rejecting Plaintiff’s testimony. (ECF No.

11-1 at 5:12-14.) In the cross-motion for summary judgment, Defendant counters that

the ALJ (1) gave valid reasons for discounting Dr. Jensen’s form opinion and properly

concluded Dr. Jensen’s conclusions were contrary to the great weight of evidence, and

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(2) properly determined that Plaintiff was not fully credible, and Plaintiff’s disagreement

is not evidence of error. (ECF No. 15-1 at 3:13-14, 4:1-2, 5:7-8.) The Court addresses

each argument in turn.

A. The ALJ’s Rejection of Treating Physician’s Opinion

1. Parties’ Arguments

Plaintiff contends the ALJ erred by failing to provide legally sufficient reasons for

rejecting Dr. Jensen’s treating opinion.3

 Specifically, Plaintiff argues that the ALJ’s

rejection of Dr. Jensen’s opinion was improper because: (1) Dr. Jensen’s form opinion

was accompanied by detailed narrative descriptions of Plaintiff’s mental impairments; (2)

the ALJ improperly relied on the opinions of Plaintiff’s examining physician over the

treating physician; and (3) the opinion of the examining physician was consistent with

Dr. Jensen’s opinion. (ECF No. 11-1 at 7:25-10:18.) 

In response, Defendant argues the ALJ’s rejection of Dr. Jensen’s opinion was

proper because the ALJ set forth three specific and valid reasons for discrediting Dr.

Jensen’s form opinion, namely, that the opinion was (1) not accompanied by objective

evidence; (2) self-contradictory; and (3) in conflict with the other medical evidence in the

record. (ECF No. 15-1 at 4:1-5:6.)

2. Legal Standards

In assessing a disability claim, an ALJ may rely on medical “opinions of three

types of physicians: (1) those who treat the claimant (treating physicians4

); (2) those who

examine but do not treat the claimant (examining physicians); and (3) those who neither

examine nor treat the claimant (nonexamining physicians).” Lester v. Chater, 81 F.3d

821, 830 (9th Cir. 1995). The Commissioner applies a hierarchy of deference to these

3 Plaintiff does not appeal the ALJ’s rejection of Dr. Pendragon’s treating opinion. Accordingly, the Court does not address the ALJ’s findings in this regard. 

4 A treating physician is one who has provided treatment to a claimant on more than one occasion. A physician qualifies as a treating source if the claimant sees her with a frequency consistent with accepted medical practice for the type of treatment and/or evaluation required for the medical condition. Benton v. Barnhart, 331 F.3d 1030, 1036

(9th Cir. 2003).

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three types of opinions. The opinion of a treating doctor is generally entitled to the

greatest weight. Id. (“As a general rule, more weight should be given to the opinion of

a treating source than to the opinion of doctors who do not treat the claimant.”) (citing

Winans v. Bowen, 853 F.2d 643, 647 (9th Cir. 1987)); 20 C.F.R. § 404.1527(c)(2). “The

opinion of an examining physician is, in turn, entitled to greater weight than the opinion

of a nonexamining physician.” Lester, 81 F.3d at 830 (citing Pitzer v. Sullivan, 908 F.2d

502, 506 (9th Cir. 1990); Gallant v. Heckler, 753 F.2d 1450 (9th Cir. 1984)). However,

“the findings of a nontreating, nonexamining physician can amount to substantial

evidence, so long as other evidence in the record supports those findings.” Saelee v.

Chater, 94 F.3d 520, 522 (9th Cir. 1996), cert. denied, 519 U.S. 1113 (1997) (citing

Andrews, 53 F.3d at 1041; Magallanes v. Bowen, 881 F.2d 747, 752 (9th Cir. 1989)). 

“The opinion of a treating physician is given deference because ‘he is employed

to cure and has a greater opportunity to know and observe the patient as an individual.’” 

Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595, 600 (9th Cir. 1999) (quoting

Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987)). “However, the opinion of the

treating physician is not necessarily conclusive as to either the physical condition or the

ultimate issue of disability.” Id. (citing Magallanes, 881 F.2d at 751; Rodriguez v.

Bowen, 876 F.2d 759, 761-62 & n.7 (9th Cir. 1989)); see also Tonapetyan v. Halter, 242

F.3d 1144, 1148 (9th Cir. 2001) (“Although a treating physician’s opinion is generally

afforded the greatest weight in disability cases, it is not binding on an ALJ with respect

to the existence of an impairment or the ultimate determination of disability.”) (citing

Magallanes, 881 F.2d at 751). 

If the treating physician’s opinion is not well-supported by medically acceptable

clinical and laboratory diagnostic techniques, or is inconsistent with other substantial

evidence in the record, it is not entitled to controlling weight. Orn v. Astrue, 495 F.3d

625, 631-32 (9th Cir. 2007) (quoting Social Security Ruling 96-2p). In that event, the

ALJ must consider the factors listed in 20 C.F.R. § 404.1527(c) to determine what weight

to accord the opinion. See Social Security Ruling 96-2p (stating that a finding that a

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treating physician’s opinion is not well supported or inconsistent with other substantial

evidence in the record “means only that the opinion is not entitled to ‘controlling weight,’

not that the opinion should be rejected. Treating source medical opinions are still entitled

to deference and must be weighed using all of the factors provided in 20 C.F.R. §

404.1527.”). The factors include: (1) the length of the treatment relationship and the

frequency of examination; (2) the nature and extent of the treatment relationship; (3)

supportability of the opinion; (4) consistency of the opinion with the record as a whole;

(5) the specialization of the treating source; and (6) any other factors brought to the ALJ’s

attention that tend to support or contradict the opinion. 20 C.F.R. § 404.1527(c)(2)(I)-

(ii), (c)(3)-(6).

Opinions of treating physicians may only be rejected under certain circumstances. 

“[W]here [a] treating doctor’s opinion is not contradicted by another doctor, it may be

rejected only for ‘clear and convincing’ reasons.” Lester, 81 F.3d at 830 (quoting Baxter

v. Sullivan, 923 F.2d 1391, 1396 (9th Cir. 1991)). However, “if the treating doctor’s

opinion is contradicted by another doctor, the Commissioner may not reject this opinion

without providing ‘specific and legitimate reasons’ supported by substantial evidence in

the record for so doing.” Id. at 830 (quoting Murray v. Heckler, 722 F.2d 499, 502 (9th

Cir. 1983)).

3. Analysis

The ALJ gave four reasons for giving Dr. Jensen’s October 2010 checklist form

“little weight.” (A.R. 39.) The ALJ dismissed this form on the basis that it: (1)

contradicted Dr. Jensen’s own report completed in April 2009; (2) contradicted Dr.

Engelhorn’s evaluation; (3) contained internal inconsistencies; and (4) was not supported

by objective evidence. (A.R. 39.) For the reasons discussed below, after considering the

record as a whole, the Court finds the ALJ committed legal error by rejecting Dr. Jensen’s

opinion.

/ / /

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a. Inconsistencies Among Dr. Jensen’s April 2009 and October 2010

Reports

The first reason provided by the ALJ for discrediting Dr. Jensen’s October 2010

opinion is that the opinion contradicts her April 2009 opinion. (A.R. 39.) “The Ninth

Circuit has found that when a doctor’s conclusions are not consistent with his own

findings, that is a specific and legitimate reason for rejecting that opinion.” Jones v.

Colvin, No. 1:12-cv-1283- BAM, 2013 U.S. Dist. LEXIS 143425, at *16 (E.D. Cal. Sept.

30, 2013) (citing Young v. Heckler, 803 F.2d 963, 968 (9th Cir. 1986) (per curiam)). 

“However, the ALJ must explain how the findings are inconsistent.” Id. It is insufficient

for the ALJ to simply assert that the doctor’s findings are inconsistent without explaining

how they are inconsistent. Id. at 17 (“[T]he ALJ asserts that Dr. Ahmed’s findings of

Plaintiff are inconsistent, but fails to explain how they are inconsistent with the overall

evidence.”). 

In the instant case, the ALJ did not summarize the conflicting evidence contained

within Dr. Jensen’s reports. Rather, he simply stated in a conclusory manner that Dr.

Jensen’s April 2009 and October 2010 were internally inconsistent. (A.R. 39.) Indeed,

“[t]he ALJ’s interpretation of the facts, conflicting clinical evidence, and [his] findings

based on the conflicting medical evidence are missing.” Jones v. Colvin, 2013 U.S. Dist.

LEXIS 14325, at *18-19 (citing Orn, 495 F.3d at 632). 

In its cross-motion for summary judgment Defendant attempts to provide an afterthe-fact justification for the ALJ’s conclusion. (ECF No. 15-1 at 4:12-19.) However,

“[w]hile the Court can draw reasonable inferences from the ALJ’s opinion, Magallanes,

881 F.2d at 755, the Court cannot consider Defendant’s post hoc rationalizations. The

Ninth Circuit has repeatedly emphasized that the ‘bedrock principle of administrative

law’ is that a ‘reviewing court can evaluate an agency’s decision only on the grounds

articulated by the agency.’” Jones v. Colvin, 2013 U.S. Dist. LEXIS 14325, at *17-18

(quoting Ceguerra v. Sec'y of Health & Human Servs., 933 F.2d 735, 738 (9th Cir. 1991)

(citing Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003)). The Court “cannot

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affirm the decision of an agency on a ground that the agency did not invoke in making

its decision.” Pinto v. Massanari, 249 F.3d 840, 847-48 (9th Cir. 2001) (citing SEC v.

Chenery Corp., 332 U.S. 194, 196 (1947)).

In sum, the ALJ’s conclusory statement that Dr. Jensen’s reports are internally

inconsistent fails to provide specific and legitimate reasons supported by substantial

evidence for rejecting Plaintiff’s treating physician’s opinion. 

b. Contradiction With Dr. Engelhorn’s Opinion

The second reason provided by the ALJ for discrediting Dr. Jensen’s October 2010

opinion is that the opinion contradicts the opinion of Plaintiff’s examining physician, Dr.

Engelhorn. (A.R. 39.) Although a treating physician’s opinion is not entitled to

controlling weight if inconsistent with other substantial evidence in the record, Orn, 495

F.3d at 631, “[t]o reject the opinion of a treating physician which conflicts with that of

an examining physician, the ALJ must ‘make findings setting forth specific, legitimate

reasons for doing so that are based on substantial evidence in the record.’” Magallanes,

881 F.2d at 751 (quoting Winans, 853 F.2d at 647) (citing Murray, 722 F.2d at 502). 

“The ALJ can meet this burden by setting out a detailed and thorough summary of the

facts and conflicting clinical evidence, stating his interpretation thereof, and making

findings.” Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir. 1986) (per curiam) (citing

Swanson v. Sec’y of Health & Human Servs., 763 F.2d 1061, 1065 (9th Cir. 1985)); see

also Embrey v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988) (“The ALJ must do more

than offer his conclusions. He must set forth his own interpretations and explain why

they, rather than the doctors’, are correct. . . . It is incumbent on the ALJ to provide

detailed, reasoned, and legitimate rationales for disregarding the physician’s findings.”).

Here, the ALJ did not meet his burden of setting forth specific, legitimate reasons

for rejecting Dr. Jensen’s opinion in favor of Dr. Engelhorn’s opinion. Indeed, the ALJ

failed to set forth a detailed and thorough summary of the conflicting opinions and his

interpretation thereof. Rather, the ALJ simply concluded that the two opinions were

contradictory. (A.R. 39.) The ALJ’s failure in this regard amounts to legal error. 

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“Although legitimate reasons for the ALJ’s reliance on Dr. [Engelhorn’s] opinions over

those of Dr. [Jensen] may exist, this Court is only permitted to review the explanation

offered by the ALJ in his written opinion.” Langdon v. Astrue, No. 12-CV-2624 AJB

(NLS), 2013 U.S. Dist. LEXIS 147138, at *35 (S.D. Cal. July 9, 2013) (citing Connett,

340 F.3d at 874). “If the ALJ’s explanation is inadequate, the reviewing court may not

search the record for reasons that support his decision.” Id. (citing Connett, 340 F.3d at

874); see also Smolen v. Chater, 80 F.3d 1273, 1286 (9th Cir. 1996) (failing to offer

reasons for disregarding opinions of two of claimant’s treating physicians and making

contrary findings was error).

c. Internal Inconsistencies in Dr. Jensen’s October 2010 Report

The third reason provided by the ALJ for discrediting Dr. Jensen’s October 2010

opinion is that the opinion is internally contradictory. (A.R. 39.) Specifically, the ALJ

reasoned that this form contradicted itself because “Dr. Jensen claims [Plaintiff] cannot

complete a normal workweek, yet she also states the claimant has no difficulties

whatsoever completing both simple and complex tasks and has no deficiencies of

concentration, persistence or pace resulting in frequent failure to complete tasks in a time

[sic] manner.” (A.R. 39.) However, the Court finds that the ALJ’s conclusion is not

supported by substantial evidence. Indeed, Dr. Jensen’s October 2010 form does not state

that Plaintiff cannot complete a normal workweek. Rather, the form states that Plaintiff’s

“ability to complete a normal workday or workweek without interruptions from

psychologically based symptoms and to perform at a consistent pace without an

unreasonable number and length of rest periods” is “markedly impaired.” (A.R. 789.) 

Further, although the October 2010 form does not provide a definition for “markedly

impaired,” the Court notes that Dr. Jensen’s April 2011 opinion indicates that “marked

impairment” means that the “[a]bility to function is seriously limited but not severe.” 

(A.R. 794.) Thus, the ALJ’s conclusion that Dr. Jensen opined that Plaintiff was unable

to complete a normal workweek is not supported by substantial evidence.

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d. Objective Evidence

The fourth and final reason provided by the ALJ for discrediting Dr. Jensen’s

October 2010 opinion is that Dr. Jensen provided no objective medical records or clinical

findings to support this form. (A.R. 39.) The Court disagrees. Although checklist forms

may be rejected when unsupported by objective medical findings, Crane v. Shalala, 76

F.3d 251, 253 (9th Cir. 1996), such is not the case here. While not submitted at the time

of the October 2010 form, Dr. Jensen did complete a five-page Mental Disorder

Questionnaire Form dated April 24, 2009. (A.R. 302-306). Dr. Jensen included in this

questionnaire detailed descriptions of Plaintiff’s symptoms, along with multiple

diagnoses of Plaintiff’s mental health issues. (A.R. 302-306). Dr. Jensen additionally

completed a Mental Work Restriction Questionnaire and an Evaluation Form for Mental

Disorders on April 13, 2011 which also included descriptions of Plaintiff’s symptoms and

diagnoses. (A.R. 792-98.) The Court finds these forms sufficient to constitute

“medically acceptable clinical and laboratory diagnostic techniques” within the meaning

of 20 C.F.R. § 404.1527(c)(2). See Bilby v. Schweiker, 762 F.2d 716, 719 (9th Cir. 1985)

(per curiam) (finding doctor’s report which described the clinical evidence and symptoms

of the claimant’s mental illness sufficient as supportive objective findings); see also

Henderson v. Astrue, 634 F. Supp. 2d 1182, 1192 (E.D. Cal. 2009) (rejecting ALJ’s

assertion that check-box forms should be accorded little weight where record contained

doctors’ detailed narrative reports setting forth “results of objective tests conducted,

interview notes, and detail[ing] the bases for their findings.”); cf. Batson v. Comm’r of

Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004) (finding that ALJ properly rejected

a treating physician’s opinion that “was in the form of a checklist, [and] did not have

supportive objective evidence”).

In sum, the Court finds the ALJ committed legal error by rejecting Dr. Jensen’s

medical opinion. Even if the record here supported the ALJ’s decision by substantial

evidence, the ALJ’s failure to apply the proper legal standard in rejecting Dr. Jensen’s

opinion in his decision is a reversible error. Tidwell, 161 F.3d at 601 (noting that an

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ALJ’s decision to deny disability benefits may be set aside “if that decision is not

supported by substantial evidence or it is based upon legal error.”) (emphasis added)

(citing Flaten, 44 F.3d at 1457); Flake v. Gardner, 399 F.2d 532, 540 (9th Cir. 1968)

(“Even though the findings be supported by substantial evidence, the decision should be

set aside if the proper legal standards were not applied in weighing the evidence and

making the decision.”).

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

1. Parties’ Arguments

Plaintiff argues that the ALJ erred by failing to articulate clear and convincing

reasons for rejecting her testimony. (ECF No. 11-1 at 12:8-17.) Specifically, Plaintiff

posits that the ALJ erred because (1) his “decision is void of any sufficient rationale at

all as to why [he] ignores and disregards [Plaintiff’s] testimony,” (2) he improperly

discredited Plaintiff’s testimony on the sole basis that it was inconsistent with objective

medical evidence in the record, (3) he improperly discredited Plaintiff’s testimony due

to her ability to maintain activities of daily living, and (4) he found Plaintiff’s testimony

to be both credible and non-credible at the same time.5

 (ECF No. 11-1 at 13:5-7, 14:22-

25, 16:12-15, 18:5-6.) 

In response, Defendant contends the ALJ properly articulated four specific reasons

for discounting Plaintiff’s credibility: (1) “Plaintiff’s activities of daily living were

inconsistent with her claims of disability;” (2) “overwhelming medical evidence . . . 

showed Plaintiff was within normal limits, there was no distress, and neurological

5 With respect to Plaintiff’s fourth argument, the Court has reviewed the Seventh

Circuit case cited in Plaintiff’s motion, Carradine v. Barnhart, 360 F.3d 751, 754-56 (7th Cir. 2004), in support of this argument. However persuasive that analysis might be,

“[t]he decisions in other circuits are not binding upon this court.” The Dauntless, 129 F.

715, 717 (9th Cir. 1904). Moreover, Carradine suggests that an ALJ should be prohibited from believing some, but not all, of a disability claimant’s testimony. This

reasoning appears to be at odds with the extensive body of Ninth Circuit case law

addressing an ALJ’s analysis of a claimant’s credibility. Plaintiff has not cited, nor has the Court found, a single Ninth Circuit case that requires an ALJ’s adverse credibility

analysis to be an all-or-nothing determination.

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examination revealed no deficits;” (3) the medical records showed Plaintiff was receiving

conservative treatment; and (4) Plaintiff refused treatment that was offered to her. (ECF

No. 15-1 at 6:3-7:24.)

2. Legal Standards

“An individual’s statement as to pain or other symptoms shall not alone be

conclusive evidence of disability.” 42 U.S.C. § 423(d)(5)(A). Indeed, “[a]n ALJ cannot

be required to believe every allegation of [disability], or else disability benefits would be

available for the asking, a result plainly contrary to the [Social Security Act].” Fair v.

Bowen, 885 F.2d 597, 603 (9th Cir. 1989). “The ALJ is responsible for determining

credibility and resolving conflicts in medical testimony.” Magallanes, 881 F.2d at 750

(citing Allen v. Heckler, 749 F.2d 577, 579 (9th Cir. 1984)). 

The credibility of a claimant’s testimony regarding subjective symptoms is

analyzed in two steps. Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009). First, the

ALJ must determine whether the claimant has presented objective evidence of an

impairment or impairments that could reasonably be expected to produce the pain or other

symptoms alleged. Id. Second, if the claimant meets the first step, and there is no

affirmative evidence of malingering, the ALJ may reject the claimant’s testimony only

if she provides “specific, clear and convincing reasons” for doing so. Id. “In order for

the ALJ to find [a claimant’s] testimony unreliable, the ALJ must make ‘a credibility

determination with findings sufficiently specific to permit the court to conclude that the

ALJ did not arbitrarily discredit claimant’s testimony.’” Turner v. Comm’r of Soc. Sec.,

613 F.3d 1217, 1224 n.3 (9th Cir. 2010) (quoting Thomas v. Barnhart, 278 F.3d 947, 958

(9th Cir. 2002)). It is “not sufficient for the ALJ to make only general findings; he must

state which . . . testimony is not credible and what evidence suggests the complaints are

not credible.” Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993) (citing Varney v. Sec’y

of Health & Human Servs., 846 F.2d 581, 584 (9th Cir. 1988)). “In weighing a

claimant’s credibility, the ALJ may consider his reputation for truthfulness,

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

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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. Soc.

Sec. Admin., 119 F.3d 789, 792 (9th Cir. 1997) (citing Smolen v. Chater, 80 F.3d 1273,

1284 (9th Cir. 1996); Moncada v. Chater, 60 F.3d 521, 524 (9th Cir. 1995); 20 C.F.R. §

404.1529(c)); see also Orn, 495 F.3d at 636 (noting factors an ALJ may consider in

making credibility assessment include claimant’s “reputation for truthfulness,

inconsistencies in the testimony or between testimony and conduct, daily activities, and

‘unexplained, or inadequately explained, failure to seek treatment or follow a prescribed

course of treatment.’”) (quoting Fair, 885 F.2d at 603); Fair, 885 F.2d at 604 n.5 (an ALJ

is permitted to use “ordinary techniques of credibility evaluation”). Even if one or more

reasons listed by the ALJ are invalid, so long as the ALJ provides some valid reasons, the

ALJ’s credibility determination will be upheld. Bray v. Comm’r of Soc. Sec. Admin., 554

F.3d 1219, 1227 (9th Cir. 2009); Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155,

1162-63 (9th Cir. 2008); Batson, 359 F.3d at 1195-97. 

3. Analysis

Here, the ALJ found that “medically determinable impairments could reasonably

be expected to cause the alleged symptoms.” (A.R. 37.) However, the ALJ concluded

that Plaintiff’s “statements concerning the intensity, persistence and limiting effects of

these symptoms are not credible to the extent they are inconsistent with the above

residual functional capacity assessment.” (A.R. 37.) Because the ALJ found Plaintiff

met the first step of the test, and there is no evidence of malingering, the Court must

determine whether the ALJ provided “specific, clear and convincing reasons” for his

adverse credibility finding. Vasquez, 572 F.3d at 591. The Court finds that he did.

First, the ALJ discussed how Plaintiff’s activities of daily living undermine her

credibility. The ALJ indicated that Plaintiff “goes regularly to the gym despite her

debilitating pain and allegations that she has difficulty leaving the house and dealing with

people.” (A.R. 38.) Plaintiff’s motion for summary judgment counters that Plaintiff goes

to the gym “as therapy for her medical impairments.” (ECF No. 11-1 at 18:1-2). 

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Although a social security claimant may engage in exercise for therapeutic reasons

despite pain, Vertigan v. Halter, 260 F.3d 1044, 1050 (9th Cir. 2001), the record does not

support Plaintiff’s post hoc justification that her daily gym visits were therapeutic. 

Rather, Plaintiff’s physician’s notes simply state that she was going to the gym daily. 

(A.R. 407, 751.) Moreover, irrespective of the physical pain that might result from

Plaintiff’s daily gym visits, Plaintiff’s daily gym visits are at odds with her testimony that

she has difficulty leaving the house and being surrounded by other people. (A.R. 55, 57.) 

Accordingly, the Court finds that Plaintiff’s daily gym visits, despite her alleged

disability, is a specific, clear and convincing reasons supporting the ALJ’s decision to

discount Plaintiff’s credibility. 

The ALJ also reasoned that due to her husband’s deployment, Plaintiff “is fully

responsible for the care of her young child” and “she is able to provide adequate care for

[him] by herself with minimal assistance.” (A.R. 38.) As Plaintiff’s motion correctly

argues, the “mere fact that a plaintiff has carried on certain daily activities, such as

grocery shopping, driving a car, or limited walking for exercise, does not in any way

detract from her credibility as to her overall disability.” Vertigan, 260 F.3d at 1050.

However, the Court finds that Plaintiff’s ability to take care of her child, despite her

alleged disability, is a specific, clear and convincing reason supporting the ALJ’s decision

to discount Plaintiff’s credibility. See Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir.

2001) (finding that the ALJ properly rejected a claimant’s testimony regarding her pain

from fibromyalgia where that testimony “was undermined by her own testimony about

her daily activities, such as attending to the needs of her two young children, cooking,

housekeeping, laundry, shopping, attending therapy and various other meetings every

week.”); Morgan, 169 F.3d at 600 (noting that a claimant’s “ability to fix meals, do

laundry, work in the yard, and occasionally care for his friend’s child served as evidence

of [his] ability to work. If a claimant is able to spend a substantial part of his day

engaged in pursuits involving the performance of physical functions that are transferable

to a work setting, a specific finding as to this fact may be sufficient to discredit a

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claimant’s allegations.”) (citing Fair, 885 F.2d at 603).6 The ALJ additionally noted that

both Dr. Jensen and Dr. Englehorn opined that Plaintiff “has only a mild restriction in her

activities of daily living.” (A.R. 38-39.) This finding by the ALJ further supports the

Court’s conclusion that the ALJ identified specific, clear and convincing reasons for

discounting Plaintiff’s credibility.

Second, the ALJ discounted the credibility of Plaintiff’s testimony because “she

refuses most methods of help offered to her.” (A.R. 38.) In support of this conclusion,

the ALJ cites a medical record completed by Dr. Englehorn, where he opined that with

regard to Plaintiff’s psychiatric health, Plaintiff “repeats same list of problems every visitbut denies most methods of help.” (A.R. 652.) The Court finds this a clear and

convincing reason to support the ALJ’s decision to discredit Plaintiff’s testimony. See

Montalvo v. Astrue, 237 F. App’x 259, 262 (9th Cir. 2007) (upholding an ALJ’s rejection

of a claimant’s subjective testimony of pain where the claimant “failed to comply with

certain aspects of her recommended treatment--she did not return for a follow-up visit,

[and] did not follow a treating physician’s recommendation[s].”); Bunnell v. Sullivan, 947

F.2d 341, 346 (9th Cir. 1991) (recognizing that a relevant factor in determining a

claimant’s credibility “may be ‘unexplained, or inadequately explained, failure to seek

treatment or follow a prescribed course of treatment.’”) (quoting Fair, 885 F.2d 597 at

n.5). This finding by the ALJ further supports the Court’s conclusion that the ALJ

identified specific, clear and convincing reasons for discounting Plaintiff’s credibility.

Third, the ALJ discounted the credibility of Plaintiff’s testimony because Plaintiff

“has been prescribed conservative therapies” for her treatment of pain, such as physical

therapy, electrical nerve stimulation, and Tylenol. (A.R. 38.) “[E]vidence of

‘conservative treatment’ is sufficient to discount a claimant’s testimony regarding

severity of an impairment.” Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 2007), cert.

6 Plaintiff’s reliance on Gentle v. Barnhart, 430 F.3d 865, 867-68 (7th Cir. 2005), is unpersuasive. Although that Seventh Circuit decision provides some support for Plaintiff’s argument, it is not in harmony with the Ninth Circuit decisions cited above. 

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denied, 552 U.S. 1141 (2008) (quoting Johnson v. Shalala, 60 F.3d 1428, 1434 (9th Cir.

1995)). Accordingly, the ALJ identified a specific, clear and convincing reason for

discounting Plaintiff’s credibility.

Finally, the ALJ discounted the credibility of Plaintiff’s testimony because she has

consistently been released by her physicians without limitations after her visits to the

Naval Medical Center. (A.R. 38). The administrative record supports this assertion. 

(A.R. 248, 265, 270, 275, 279, 284, 290, 295, 300, 332, 339, 344, 363, 381, 386, 396,

408, 418, 437, 442, 455, 459, 465, 470, 579, 582, 587, 600, 609, 628, 646, 653, 658, 663,

682, 707, 718, 724, 729, 735, 741, 746, 752, 767, 775, 785, 817, 823, 827, 831, 842, 848,

867, 873.) The ALJ also noted that both Dr. Ramirez and Dr. Englehorn reported that

Plaintiff was in good health, and that Dr. Pendragon opined that Plaintiff’s “primary

problem might be a Somatoform disorder related to her focus on pain.” (A.R. 38). The

ALJ additionally noted that while Plaintiff “has an impressive list of complaints that she

repeats at every office visit . . . her exams consistently show very little in the way of

objective medical findings.” (A.R. 38.) Here, Plaintiff argues that “a rejection of a

claimant’s testimony based on a lack of objective evidence is always legally insufficient.” 

(ECF No. 11-1 at 14:26-15:1.) However, as discussed above, the ALJ did not solely rely

on a lack of objective medical evidence in discounting Plaintiff’s testimony. Thus, the

ALJ’s finding of a lack of medical evidence to support Plaintiff’s testimony is specific,

clear and convincing reason justifying the ALJ’s decision to discount Plaintiff’s

credibility. See Burch, 400 F.3d at 681 (“Although the lack of medical evidence cannot

form the sole basis for discounting pain testimony, it is a factor that the ALJ can consider

in his credibility analysis.”); accord Bunnell v. Sullivan, 947 F.2d 341, 346-47 (9th Cir.

1991) (en banc) (holding that an ALJ “may not discredit a claimant’s testimony of pain

and deny disability benefits solely because the degree of pain alleged by the claimant is

not supported by objective medical evidence.”). 

In sum, the Court finds that the ALJ set forth “findings sufficiently specific to

permit the reviewing court to conclude that the ALJ did not arbitrarily discredit the

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claimant’s testimony.” Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir. 1995) (per curiam)

(citing Bunnell, 947 F.2d at 345-46). Accordingly, the Court must defer to the ALJ’s

credibility analysis. See Fair, 885 F.2d at 603 (“Where, as here, the ALJ has made

specific findings justifying a decision to disbelieve an allegation . . . and those findings

are supported by substantial evidence in the record, our role is not to second-guess that

decision.”).7

C. Remand For Further Proceedings Is Appropriate

In social security cases, the Court has discretion to remand a case either for

additional evidence and findings, or to award benefits. McAllister v. Sullivan, 888 F.2d

599, 603 (9th Cir. 1989) (citing Winans, 853 F.2d at 647). “If additional proceedings can

remedy defects in the original administrative proceedings, a social security case should

be remanded. When, however, a rehearing would simply delay receipt of benefits,

reversal [and an award of benefits] is appropriate.” Lewin v. Schweiker, 654 F.2d 631,

635 (9th Cir. 1981) (citations omitted).

Here, as indicated above, the ALJ committed legal error by rejecting Dr. Jensen’s

medical opinion. Therefore, remand for further proceedings is appropriate. On remand, 

the ALJ cannot reject Dr. Jensen’s opinion without providing “specific and legitimate

reasons . . . supported by substantial evidence in the record.” Lester, 81 F.3d at 830

(citing Andrews, 53 F.3d at 1043). If the ALJ determines that Dr. Jensen’s opinion

should not be given controlling weight, the ALJ must address the weight to accord her

opinion using all of the factors provided in 20 C.F.R. § 404.1527(c)(2). 

/ / /

/ / /

7 The Court’s conclusion is not altered by the possibility that the ALJ may have noted additional reasons for discrediting Plaintiff’s testimony that may not have been

supported by specific, clear and convincing reasons. Even if one or more reasons listed

by the ALJ are invalid, so long as the ALJ provides some valid reasons, the ALJ’s credibility determination will be upheld. Bray, 554 F.3d at 1227; Carmickle, 533 F.3d

at 1162-63; Batson, 359 F.3d at 1195-97.

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VI. CONCLUSION

After a thorough review of the record in this matter and based on the foregoing

analysis, this Court RECOMMENDS Plaintiff’s motion for summary judgment be

GRANTED and Defendant’s cross-motion for summary judgment be DENIED, and the

case be REMANDED for further proceedings.

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) and Civil Local Rule 72.1(d). 

IT IS HEREBY ORDERED that no later than January 6, 2014, any party may

file and serve written objections with the Court and serve a copy on all parties. The

documents should be captioned “Objections to Report and Recommendation.” 

IT IS FURTHER ORDERED that any reply to the objections shall be filed and

served no later than ten days after being served with the objections. 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, 1156-57

(9th Cir. 1991).

IT IS SO ORDERED.

DATED: December 5, 2013

DAVID H. BARTICK

United States Magistrate Judge

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