Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_09-cv-01730/USCOURTS-azd-2_09-cv-01730-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Florence E. Stone, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV 09-01730-PHX-EHC

ORDER

This is an action for judicial review of a denial of disability benefits under the Social

Security Act, 42 U.S.C. § 405(g). The matter is fully briefed (Doc. 31 & 33). Plaintiff did

not file a reply brief.

Plaintiff applied for disability benefits on January 13, 2006 (Administrative Record

[Tr.] ) at approximately 50 years of age, alleging an onset of disability beginning October 1,

2002 (Tr. 12, 66). Plaintiff alleged impairments due to depression; bipolar disorder; anxiety;

fibromyalgia; hypertension; osteoarthritis in both knees; back pain; poor eye sight;

degenerative disc disease in her back and hips; plantar fasciitis; hand, ankle, and shoulder

pain; chronic pain syndrome; and memory and concentration problems (Tr. 78, 93-96, 164).

Plaintiff is insured for benefits through March 31, 2012 (Tr. 12). The Administrative Law

Judge (“ALJ”) listed Plaintiff’s medically determinable impairments as back disorder

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Spondylosis refers to “ankylosis” (stiffening or fixation) of the vertebra, often applied

non-specifically to any lesion of the spine of a degenerative nature. Stedman’s Medical

Dictionary, at 90, 1678 (27th ed. 2000); Crawford v. Astrue, 633 F. Supp. 2d 618, 627 n.2

(N.D. Ill. 2009). 

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(spondylosis of the lumbar spine);1

 arthritis (osteoarthritis of the knees); mental depression;

and generalized anxiety disorder (Tr. 16). Plaintiff’s past relevant work was listed as

assembler, daycare provider, and home health aid (Tr. 24-25, 90-91, 113, 376). Plaintiff has

a high school general equivalency degree (GED) (Tr. 355). 

Plaintiff’s application was denied initially and upon reconsideration (Tr. 12, 49-52, 57-

61). Plaintiff timely requested a hearing before an ALJ (Tr. 12, 44, 347-386). During the

hearing, Plaintiff, through counsel, amended her alleged disability onset date to January 1,

2006 (Tr. 12, 78, 349-350). The ALJ denied Plaintiff’s application (Tr. 12-25). The Social

Security Appeals Council denied Plaintiff’s request for review (Tr. 2-4), which was a final

decision. Plaintiff filed her Complaint in this Court on August 20, 2009 (Doc. 1). Defendant

filed an Answer on February 4, 2010 (Doc. 10). 

I.

Standard of Review

A person is “disabled” for purposes of receiving social security benefits if he or she

is unable to engage in any substantial gainful activity due to a medically determinable

physical or mental impairment which can be expected to result in death or which has lasted

or can be expected to last for a continuous period of at least twelve months. Drouin v.

Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992). Social Security disability cases are evaluated

using a five-step sequential evaluation process pursuant to 20 C.F.R. §§ 404.1520 and

416.920 to determine whether the claimant is disabled. The claimant has the burden of

demonstrating the first four steps. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

In the first step, the ALJ must determine whether the claimant currently is engaged in

substantial gainful activity; if so, the claimant is not disabled and the claim is denied.

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If the claimant is not currently engaged in substantial gainful activity, the second step

requires the ALJ to determine whether the claimant has a “severe” impairment or combination

of impairments which significantly limits the claimant’s ability to do basic work activities;

if not, a finding of “not disabled” is made and the claim is denied.

If the claimant has a “severe” impairment or combination of impairments, the third step

requires the ALJ to determine whether the impairment or combination of impairments meets

or equals an impairment listed in the regulations; if so, disability is conclusively presumed and

benefits are awarded. 

If the impairment or impairments do not meet or equal a listed impairment, the ALJ

will make a finding regarding the claimant’s “residual functional capacity” based on all the

relevant medical and other evidence in the record. A claimant’s residual functional capacity

(“RFC”) is what he or she can still do despite existing physical, mental, nonexertional and

other limitations. Cooper v. Sullivan, 880 F.2d 1152, 1155 n.5 (9th Cir. 1989). 

At step four, the ALJ determines whether, despite the impairments, the claimant can

still perform “past relevant work”; if so, the claimant is not disabled and the claim is denied.

The claimant has the burden of proving that he or she is unable to perform past relevant work.

If the claimant meets this burden, a prima facie case of disability is established. 

The Commissioner bears the burden as to the fifth and final step in the analysis of

establishing that the claimant can perform other substantial gainful work. The Commissioner

may meet this burden based on the testimony of a vocational expert or by reference to the

Medical-Vocational Guidelines. Tackett, 180 F.3d at 1099. 

The Court has the “power to enter, upon the pleadings and transcript of record, a

judgment affirming, modifying, or reversing the decision of the Commissioner of Social

Security, with or without remanding the cause for rehearing.” 42 U.S.C. § 405(g). The

decision to deny benefits should be upheld unless it is based on legal error or is not supported

by substantial evidence. Ryan v. Commissioner of Social Security, 528 F.3d 1194, 1198 (9th

Cir. 2008). Substantial evidence means “such relevant evidence as a reasonable mind might

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Dyslipidemia refers to a condition marked by abnormal concentrations of lipids or

lipoproteins in the blood. See Rivera v. Commissioner of Social Sec., 728 F. Supp. 2d 297,

307 n.9 (S.D.N.Y. 2010).

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accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401, 91

S.Ct. 1420, 1427 (1971). “Substantial evidence is more than a mere scintilla but less than a

preponderance.” Bayliss v. Barnhart, 427 F.3d 1211, 1214 n. 1 (9th Cir. 2005) (internal

quotation marks and citation omitted). The Court must consider the record in its entirety and

weigh both the evidence that supports and the evidence that detracts from the Commissioner’s

conclusion. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir.1985).

II.

Background Facts

(A) Plaintiff’s 2006 Medical Records - Drs. Weldon and Blatny

In February 2006, Plaintiff was examined by Donald C. Weldon, M.D., regarding

arthritis, back pain, arm and shoulder pain, hypertension, dyslipidemia,2

 depression, and

cataracts (Tr. 272-274). Plaintiff reported living with her husband and two step-children,

working for Health and Human Services as a community assistant 17.5 hours a week, and

moving from Arizona to Nebraska in 2002 (Tr. 272). Dr. Weldon’s assessment of Plaintiff

included: smoker, hypertension (noncompliant with treatment), dyslipidemia (noncompliant

with treatment), bilateral cataracts with visual impairment, gastroesophogeal reflux disease

(GERD), irritable bowel syndrome, anxiety/depression, menometrorrhagia (excessive uterine

bleeding) (suspect perimenopausal), left ulnar (forearm) neuropathy symptoms, chronic pain,

and history of workplace injury (Tr. 276). X-rays of Plaintiff’s spine in February 2006,

revealed “mild spondylosis deformans. No acute osseous [bony] abnormalities” (Tr. 278). 

In March, May and June 2006, Richard Blatny, Jr., M.D., assessed Plaintiff with HTN

(hypertension), hyperlipidemia, anxiety and foot pain (Tr. 290, 291, 203). Dr. Blatny initially

assessed foot pain more likely related to Plaintiff’s shoes and walking surfaces. At the June

exam, Plaintiff also complained of swelling and fatigue and Dr. Blatny observed “noticeable

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Fibromyalgia is a rheumatic disease that causes inflammation of the fibrous

connective tissue components of muscles, tendons, ligaments and other tissue. Common

symptoms include chronic body pain, multiple tender points, fatigue, stiffness, and a pattern

of sleep disturbance that can exacerbate pain and fatigue. Benecke v. Barnhart, 379 F.3d 587,

589 (9th Cir. 2004). 

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edema from her knees down bilaterally, and this is new” (Tr. 203). Dr. Blatny assessed

weight gain and fatigue and prescribed a diuretic drug (Tr. 203). On August 28, 2006, Plaintiff

told Dr. Blatny she was doing okay but was convinced she had fibromyalgia,3

 listing several

symptoms (Tr. 203). Plaintiff said she was not able to do activity due to pain from

fibromyalgia. Dr. Blatny assessed fatigue, multiple chronic pain syndrome consistent with

osteoarthritis and likely fibromyalgia (Tr. 202). 

On October 2, 2006, Dr. Blatny, at Plaintiff’s request (Tr. 202), wrote a letter to

Plaintiff’s attorney (Tr. 191), stating that Plaintiff had been a patient for several years and had

experienced progressive pain. Dr. Blatny described the pain as widespread, throughout

Plaintiff’s head, neck, shoulders, back and legs, mostly in muscle areas, but there was some

joint involvement consistent with arthritis. An extensive past work-up was essentially

negative. Dr. Blatny opined that Plaintiff met the criteria for the diagnosis of fibromyalgia,

which was the cause for most of her pain, and that Plaintiff was under a lot of emotional

stress. Dr. Blatny opined: “[c]ertainly, from my standpoint, she would meet the diagnostic

criteria for this disease syndrome. There is no concrete testing that can be done for the

diagnosis. Rather this is a diagnosis of exclusion by history” (Tr. 191).

In November 2006, Plaintiff reported to Dr. Blatny that overall she was doing okay

except for her usual aches and pains, fibromyalgia and arthritis (Tr. 202). Plaintiff’s lab work

looked “very good.” Dr. Blatny assessed chronic pain syndrome secondary to fibromyalgia

and arthritis, hyperlipidemia, and fatigue, and continued Plaintiff’s medications (Tr. 202).

In December 2006, Dr. Blatny treated Plaintiff for left knee pain, noting pain with full

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extension, marked crepitance in the knee and tenderness along both joint lines, assessed

osteoarthritis of the left knee, and administered an injection for the pain (Tr. 201).

(B) Plaintiff’s Psychological Evaluation - February 2006

On February 27, 2006, Allen Meyer, Ph.D., performed a psychological evaluation of

Plaintiff (Tr. 281-285). Plaintiff’s results on the Wechsler Memory Scale III (WMS-III)

placed her within the average range of ability. Dr. Meyer diagnosed generalized anxiety

disorder and rated Plaintiff’s global assessment of functioning (GAF) at 55, which is

indicative of an individual with moderate difficulty in social, occupational, or school

functioning (Tr. 284; Doc. 33 at 15). Dr. Meyer found that Plaintiff would have no restrictions

in her activities of daily living, would have some difficulties in social functioning due to being

nervous around new people or unfamiliar places, and would be able to sustain concentration

and attention needed for task completion. Plaintiff could remember and understand short

simple instructions under ordinary supervision, would have difficulty relating appropriately

to co-workers and when she had to meet new people or go to new places, and no difficulty

adapting to changes in her environment (Tr. 286).

(C) State Agency Non-Examining Medical Opinions - 2006

On March 22, 2006, Linda Schmechel, Ph.D., a State Agency psychologist, reviewed

the medical evidence and opined that Plaintiff had generalized anxiety disorder which resulted

in moderate limitations in her ability to maintain social functioning (Tr. 246-262 [Tr. 246,

251, 256]). Dr. Schmechel’s mental residual functional capacity assessment indicated that

Plaintiff would be moderately limited in her ability to perform activities within a schedule,

maintain attendance, work in coordination with or proximity to others without being distracted

by them, interact appropriately with the public, accept instructions, and complete a normal

workday and workweek without psychological interruptions (Tr. 260-261). On July 24, 2006,

Dr. Schmechel’s assessment was affirmed by Rebecca K. Braymen-Lawyer, Ph.D., who

reviewed the updated medical records (Tr. 245). Also on July 24, 2006, P.E. Horley, M.D.,

reviewed the medical records and noted that Plaintiff’s daily living activities showed she did

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chores, had some difficulty with close up work and was still driving (Tr. 167). Dr. Horley

affirmed a March 22, 2006 residual functional capacity assessment that Plaintiff would be able

to perform a modified range of light work (Tr. 167, 236-244). 

(D) Plaintiff’s 2007-2008 Medical Records - Drs. Blatny and Weldon

In July 2007, Plaintiff complained to Dr. Blatny of stress, depression at times and being

easily angered (Tr. 200). Dr. Blatny assessed fatigue, depression, and “palpitations, question

stress related” and recommended Cymbalta (Tr. 200), which is used to treat major depressive

disorders, generalized anxiety disorders, diabetic peripheral neuropathic pain, and

fibromyalgia (Doc. 33 at 12 n. 3). In August 2007, Plaintiff appeared “upbeat” and responsive

to Cymbalta. Dr. Blatny assessed depression with interval improvement and prescribed

Cymbalta daily (Tr. 200). However, in October 2007, Plaintiff complained to Dr. Blatny of

depressive type symptoms and said she had ceased taking Cymbalta because she could not

tolerate it and was taking an herbal treatment (Tr. 199). Plaintiff complained of pain in her

knees and said she had been “really busy” with daycare. Dr. Blatny assessed HTN stable,

hyperlipidemia stable, and “severe arthritis, diffuse”. Plaintiff declined Dr. Blatny’s offer of

an orthopedic referral and hormone therapy for suspected perimenopausal symptoms. Dr.

Blatny recommended smoking cessation and continued her prescribed medications (Tr. 199).

On April 9, 2008, Plaintiff complained to Dr. Blatny about depression, mentioning a

break up with her husband, chronic bilateral knee pain and chronic back pain (Tr. 199). Dr.

Blatny recommended Sertraline therapy, a generic version of Zoloft an antidepressant

medication (Tr. 199; Doc. 33 at 13 n. 4). Dr. Blatny recommended weight loss and exercise

to relieve the pain and noted his previous Darvocet prescription appeared helpful (Tr. 199).

Dr. Blatny diagnosed obesity and diffuse osteoarthritis and continued Plaintiff’s current

medications (Tr. 198). 

 On May 1, 2008, Plaintiff was examined by Dr. Weldon following Dr. Blatny’s

referral (Tr.184). Dr. Weldon noted “handicap sticker, occasional cane”. Plaintiff had not

seen an orthopedist following Dr. Blatny’s recommendation for a bilateral total knee

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Bipolar disorder refers to manic depressive illness and is a brain disorder that causes

unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

United States v. Kilkeary, 2011 WL 339460 *4 n.2 (3d Cir. 2011). 

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arthroplasty (TKA). Dr. Weldon’s assessment included osteoarthritis knees, chronic pain,

fibromyalgia by history and anxiety (Tr.184). On June 13, 2008, Plaintiff asked Dr. Weldon

about Amrix to treat fibromyalgia. Plaintiff reported anxiety and mentioned a pending

deposition of her mother (Tr. 183). Dr. Weldon’s assessment included fibromyalgia and

anxiety and he provided samples of Pristiq for anxiety. A June 16, 2008 note showed a

prescription for cyclobenzaprine instead of Amrix (Tr. 183). On June 26, 2008, Plaintiff saw

Dr. Weldon regarding her anxiety and anger (Tr. 183). Dr. Weldon noted Plaintiff’s family

members with bipolar disorder and that Plaintiff reported seeing a psychologist. Dr. Weldon

assessed fibromyalgia Amrix 30 responsive, bipolar,4

 and HTN. Dr. Weldon offered

authorization for Amrix, provided samples of Symbyax, and recommended a psychiatrist

referral (Tr. 183). 

On July 11, 2008, Plaintiff reported to Dr. Weldon for follow-up regarding her bipolar

disorder and intolerance of Symbyax. Plaintiff said several relatives were taking Depakote.

Dr. Weldon diagnosed bipolar disorder and prescribed Depakote (Tr. 182). On July 21, 2008,

Dr. Weldon observed that Plaintiff appeared responsive to Depakote and noted her pleasant

mood. Dr. Weldon assessed bipolar disorder Depakote responsive, and fibromyalgia (Tr. 182).

 On August 18, 2008, Plaintiff reported to Dr. Weldon that she had forgotten to take her

Depakote and her husband and mother noted hostility (Tr. 182). Dr. Weldon observed no

mood or thought disorder and opined that Plaintiff conveyed a “sense of chronic functional

insufficiency”. Dr. Weldon diagnosed “bipolar/chronic musculoskeletal pain” and continued

Plaintiff’s current medications (Tr. 182). 

(E) Plaintiff’s Eye Surgery 2005-2008

An October 2005 eye examination noted a decrease in Plaintiff’s vision due to

development of cataracts in both eyes (Tr. 270-271). Cataract surgery and lens implants were

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performed in Plaintiff’s eyes in February and March 2007 (Tr. 219, 224, 226, 229, 232). On

June 6, 2008, Dr. Gordon Stelting treated Plaintiff post- surgery. Plaintiff’s vision in her right

eye was 20/20 and 20/50 in her left eye (Tr. 194). 

III.

The Hearing Before the ALJ: October 21, 2008

Plaintiff, represented by counsel, and the Vocational Expert (“VE”) Steven Kuhn

testified at the hearing. Plaintiff amended her onset date to January 1, 2006 (Tr. 349-350,

355). Plaintiff testified she was 52 years of age, 5'10" tall, and weighed about 258 pounds

(Tr. 355). Plaintiff tried to do children’s daycare in her home from October 2007 to January

2008 but could not pick up the children, stand or cook, or do the job (Tr. 356). Plaintiff

described her sister as “mentally handicapped” and said she took care of her about three and

one-half hours per day (Tr. 357, 370). Plaintiff’s past care of her mother was about 3 hours

per week. She presently cares for her mother, who lives with her, about 10 hours and 55

minutes a week (Tr. 357). 

Plaintiff said her pain is constant, is located in her back, arms, hands and knees, and

interferes with her daily living (Tr. 358). Plaintiff can stand and do dishes but after a few

minutes she has to sit down and take a 15 to 30 minute break (Tr. 358-359). Her ability to

stand is sometimes for a shorter period depending on the pain (Tr. 359). She has days when

she cannot do anything around the house and sits in a recliner or lies down (Tr. 359). She has

5 out of 7 “bad days” (Tr. 359) and this has gotten “worse” since January 2006 (Tr. 359-360).

Plaintiff said she does not sleep well due to pain constantly, she tires easily, and she takes a

nap for 2 to 3 hours (Tr. 360). This occurs 6 out of 7 days (Tr. 360).

Plaintiff said she has problems interacting with people and that during her past

employment she had to leave the workplace if a lot of people were going to be in the same

area (Tr. 360-361). Due to her anxiety, Plaintiff tries not to go out much to places where there

are a lot of people (Tr. 361). Her anxiety “flares up” when she has to go some place new (Tr.

362). She also has panic attacks (Tr. 362). The medications prescribed by Drs. Weldon and

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Blatny have not helped her anxiety (Tr. 362-363). Plaintiff has not seen a counselor for her

anxiety and bipolar disorder due to lack of money and health insurance coverage (Tr. 363).

Plaintiff said that extreme foot pain, which feels like bruising, limits her standing and

walking (Tr. 363). Plaintiff said on “bad days” it is a “chore” to walk from the house to the

mailbox, and on “other days” she can walk halfway around the block (Tr. 364). Plaintiff

experiences pain in her leg and back when sitting, stating she can sit for an hour to an hourand-a-half (Tr. 364). Plaintiff said she cannot get through an 8-hour day by alternating sitting,

standing and walking because when she is in severe pain she props her leg up (Tr. 365). She

also has to take a nap (Tr. 365). Plaintiff said she forgets things very easily (Tr. 365).

When questioned by the ALJ, Plaintiff testified she is paid $7.22 an hour for caring for

her mother (Tr. 367). Plaintiff has been caring for her mother since 2004 and said she helps

her mother wash her hair, takes her to the doctor, and cooks the evening meal but no lifting

(Tr. 368-369). Plaintiff cared for her sister between 2003 and July/August 2007 and was paid

$6.50 per hour (Tr. 369). Plaintiff said she helped teach her sister how to grocery shop (Tr.

370). Plaintiff described her past work as custom cable assembly for electronics for two years

(Tr. 372-373). She stopped because she could not read the blueprints (Tr. 373). Plaintiff said

she had cataract surgery in both eyes in 2007 but could not see any better (Tr. 373-374).

Plaintiff has a driver’s license with no restriction or endorsement for glasses (Tr. 374).

Plaintiff has difficulty seeing “small stuff” and claimed her vision is not correctable (Tr. 375).

The VE testified that work as an assembler is light, unskilled; that work as a daycare

provider is light semi-skilled; and that work as a home health aid (such as caring for Plaintiff’s

mother and sister) is light (Tr. 376, 381). Based on a hypothetical question that included

moderate limitations in dealing with the general public and large numbers of co-workers, the

VE testified that Plaintiff could perform her past relevant work as an assembler, home health

aid, and daycare provider (Tr. 377-378). When questioned by Plaintiff’s counsel, the VE

testified that all work would be precluded given Plaintiff’s testimony regarding the limitations

on standing, walking and lifting (Tr. 383-385). 

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IV.

The ALJ’s Findings

The ALJ found that Plaintiff had not engaged in substantial gainful activity since the

amended onset date of January 1, 2006 (Tr. 15), and that Plaintiff’s medically determinable

impairments were a back disorder (spondylosis of the lumbar spine), arthritis (osteoarthritis

of the knees), mental depression and generalized anxiety disorder (Tr. 16). Plaintiff did not

have an impairment or combination of impairments that met the listing criteria under the

regulations (Tr. 23).

The ALJ gave little weight to Plaintiff’s testimony and statements based on a finding

that Plaintiff had not been fully credible (Tr. 24). The ALJ found that Plaintiff had overstated

the degree of her impairments based on the following: the medical evidence does not show

that Plaintiff has any type of impairment that could be expected to cause such major

limitations as Plaintiff described; Plaintiff is not taking any prescription pain medications;

Plaintiff testified that her vision had not improved after her cataract surgery when the medical

evidence showed otherwise; Plaintiff testified that she takes a nap everyday when no

physician of record indicated a need for sleep 2-3 hours during the day; medical records

showed treatment on a sporadic basis regarding her physical symptoms; the lack of treating

history regarding her mental symptoms; and, Plaintiff’s daily activities, including caring for

her mother, suggest she is functioning at a fairly high level (Tr. 22-23). The ALJ included as

relevant to the credibility finding that Plaintiff had engaged in substantial gainful activity after

the alleged onset date from a previous application dated August 19, 1994 and after her original

alleged onset date of October 1, 2002 from her current application (Tr. 15). 

The ALJ found that although the evidence showed a diagnosis of fibromyalgia, the file

showed minimal medical findings to justify the diagnosis (Tr. 24). The medical evidence also

showed that Plaintiff’s hypertension was well-controlled with medication (Tr. 24). 

The ALJ found that Plaintiff’s determinable mental impairments of mental depression

and generalized anxiety disorder were “severe” (Tr. 23). After discussing that the case

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showed that Plaintiff had moderate limitations on social functioning due to her depression and

anxiety, the ALJ found that the medical records showed her depressive symptoms had

improved on psychotropic medications such as Cymbalta and Depakote (Tr. 24).

The ALJ found that Plaintiff has the residual functional capacity for light work with

additional non-exertional limitations (Tr. 23). The ALJ concurred with the DDS opinion that

Plaintiff has moderate limitations in her social interaction, but no other significant mental

limitations, and that she is moderately limited in dealing with the general public, with coworkers and supervisors. The ALJ found Plaintiff capable of performing her past work as

assembler, daycare provider and home health aid, and that she is not disabled (Tr. 24-25). 

V.

Discussion

Plaintiff contends that the ALJ erred in finding that Plaintiff was not credible and in

failing to afford adequate weight to the opinion of her treating physician Dr. Blatny. Plaintiff

argues in favor of reversal for an award of disability benefits or, in the alternative, remand for

a new hearing before a different ALJ. Defendant argues that the ALJ’s decision should be

affirmed. 

The Court first considers the ALJ’s consideration of Dr. Blatny’s opinion. Defendant

has responded to Plaintiff’s argument by noting that Plaintiff’s objection is that the ALJ did

not consider fibromyalgia as one of her severe impairments (Doc. 33 at 29). 

“By rule, the Social Security Administration favors the opinion of a treating physician

over non-treating physicians.” See Orn v. Astrue, 495 F.3d 625, 631 (9th Cir. 2007) (citing

20 C.F.R. § 404.1527). Where a treating doctor’s opinion is uncontradicted, an ALJ may

reject it only for “clear and convincing” reasons; however, a contradicted opinion of a treating

or examining physician may be rejected for “specific and legitimate” reasons supported by

substantial evidence in the record. See Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1995).

The record shows that Dr. Weldon included in Plaintiff’s assessments chronic pain in

February 2006 (Tr. 276) and fibromyalgia, anxiety, chronic musculoskeletal pain and bipolar

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disorder in June, July and August 2008 (Tr. 183, 182). Dr. Blatny assessed fatigue, multiple

chronic pain syndrome consistent with osteoarthritis and fibromyalgia regarding Plaintiff’s

examinations in August and November 2006 (Tr. 200, 202). In his October 2, 2006 letter, Dr.

Blatny said Plaintiff had been his patient for several years and described Plaintiff’s pain as

widespread throughout her head, neck, shoulders, back and legs, in muscle areas and joints

consistent with arthritis (Tr. 191). Dr. Blatny opined that Plaintiff met the criteria for a

fibromyalgia diagnosis and referenced the diagnosis as “exclusion by history” (Tr.191).

Plaintiff testified regarding constant pain in her back, arms, hands and knees, that she has to

take breaks, the pain interferes with her sleep, and she tires easily (Tr. 358-360). 

Fibromyalgia is a disease that eludes objective evidence. Benecke v. Barnhart, 379

F.3d 587, 590, 594 (9th Cir. 2004)(“[f]ibromyalgia’s cause is unknown, there is no cure, and

it is poorly-understood within much of the medical community”). “The process of diagnosing

fibromyalgia includes (1) the testing of a series of focal points for tenderness and (2) the

ruling out of other possible conditions through objective medical and clinical trials.” Rogers

v. Commissioner of Social Security, 486 F.3d 234, 244 (6th Cir. 2007). In Benecke, the ALJ

erred in requiring objective evidence for a disease such as fibromyalgia that “is diagnosed

entirely on the basis of patients’ reports of pain and other symptoms”. Benecke, 379 F.3d at

590, 594. 

“An ALJ may reject a treating physician’s opinion if it is based ‘to a large extent’ on

a claimant’s self-reports that have been properly discounted as incredible.” Tommasetti v.

Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008). In this case, however, the ALJ found that the

record showed minimal medical findings regarding the fibromyalgia diagnosis (Tr. 24),

describing the record as showing benign examinations regarding physical impairments, such

as x-rays of the lumbar spine showing mild spondylosis and range of motion in both knees

(Tr. 24). However, this “benign” evidence seems consistent with Dr. Blatny’s reference to 

the fibromyalgia diagnosis “of exclusion by history.” Fibromyalgia patients may “present no

objectively alarming signs” and may “manifest normal muscle strength and neurological

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reactions and have a full range of motion.” Rogers, 486 F.3d at 243-244(noting that objective

tests are of little relevance in determining the existence or severity of fibromyalgia).

Moreover, Dr. Weldon included fibromyalgia in Plaintiff’s assessments. 

As for the ALJ’s concern that minimal medical findings supported the fibromyalgia

diagnosis (noting lack of trigger points on examination), the ALJ should have attempted to

develop the record further by contacting the treating physician to determine whether required

information is available. See 20 C.F.R. § 404.1512(e). The ALJ could have obtained an

explanation from Dr. Blatny regarding his August 2006 report that Plaintiff listed several

fibromyalgia symptoms and his October 2006 letter stating that Plaintiff met the criteria for

a fibromyalgia diagnosis. An ALJ’s duty to develop the record is triggered when there is

ambiguous evidence or when the record is inadequate to allow for proper evaluation of the

evidence. Mayes v. Massanari, 276 F.3d 453, 459-460 (9th Cir. 2001). “The ALJ in a social

security case has an independent duty to fully and fairly develop the record and to assure that

the claimant’s interests are considered.” Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir.

2001)(internal quotation marks and citations omitted). This duty applies even where the

claimant is represented by counsel. Celaya v. Halter, 332 F.3d 1177, 1183 (9th Cir. 2003).

Remand for further proceedings is appropriate in this case because outstanding issues remain

that must be resolved before a determination of disability can be made. Varney v. Sec’y of

HHS, 859 F.2d 1396, 1400 (9th Cir. 1988). 

Upon remand, a more complete report from Dr. Blatny regarding his findings that

support the fibromyalgia diagnosis should be obtained. Dr. Weldon also diagnosed Plaintiff

with fibromyalgia and a more complete report should be obtained from this physician as well.

It further may be helpful to obtain residual functional capacity reports from these physicians.

After such reports are obtained, Defendant will be better able to make a well-reasoned

decision as to the weight to be given the opinions of Plaintiff’s treating physicians. 

Additional issues should be clarified upon further development of the record. “Social

Security proceedings are inquisitorial rather than adversarial. It is the ALJ’s duty to

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investigate the facts and develop the arguments both for and against granting benefits.” Sims

v. Apfel, 530 U.S. 103, 110-111 (2000)(citing Richardson v. Perales, 402 U.S. 389, 400-401

(1971)).

Plaintiff’s medical records show depression and anxiety diagnosed by Dr. Weldon and

Dr. Blatny between 2006 and 2008 (Tr. 276, 291, 200, 199, 184, 183). In February 2006, Dr.

Meyer diagnosed generalized anxiety disorder and discussed Plaintiff’s difficulties in social

functioning, relating to co-workers, meeting new people and in going to new places. Dr.

Meyer noted Plaintiff’s report of difficulty falling asleep because of her mind racing, recurring

episodes of deterioration whenever she had to meet new people, and increasing problems with

anxiety over the years ((Tr. 281-285). Dr. Schmechel, a State Agency psychologist, noted

Plaintiff’s generalized anxiety disorder as of March 2006 (Tr. 246-262). Dr. Schmechel

reported moderate limitations in Plaintiff’s ability to perform activities within a schedule,

maintain attendance, work in coordination with or in proximity to others, interact

appropriately with the public, accept instructions, and complete a normal workday and

workweek without psychological interruptions (Tr. 260-261). Other State Agency reviewing

assessments occurred in July 2006 (Tr. 245, 167).

Plaintiff’s care-giving activities for her sister and mother have been part-time. Plaintiff

testified she could not do the job of operating a child daycare in her home between October

2007 and January 2008 (Tr. 356). Plaintiff testified she has problems interacting with people

causing her in the past to leave the workplace (Tr. 360-361). She reported increased anxiety

when going someplace new (Tr. 362). Plaintiff’s testimony on these issues seems consistent

with Dr. Meyer’s and Dr. Schmechel’s findings regarding Plaintiff’s limitations.

In June, July and August, 2008, Dr. Weldon diagnosed Plaintiff with bipolar disorder

(Tr. 183, 182). In June 2008, Plaintiff reported seeing a psychologist (Tr. 183). However, the

record does not contain any psychological evaluations or residual functional capacity

assessments dated after July 2006 that take into account Plaintiff’s depression, generalized

anxiety disorder and bipolar disorder. This issue should be clarified on remand.

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 Plaintiff’s claims of error regarding the ALJ’s credibility determination warrant some

discussion for purposes of remand. Credibility determinations bear on evaluations of medical

evidence when an ALJ is presented with conflicting medical opinions or inconsistency

between a claimant’s subjective complaints and diagnosed condition. See Webb v. Barnhart,

433 F.3d 683, 688 (9th Cir. 2005). 

Regarding Plaintiff’s argument that the ALJ erred in finding she was not taking

prescription pain medications, Defendant concedes this error but argues it was harmless (Doc.

33 at 25-26). Medical records show that Plaintiff was prescribed various pain medications,

e.g., (Tr. 184, 199 (Darvocet); Tr. 200 & Doc. 33 at 12 n.3 (Cymbalta); Tr. 183 (Amrix)).

 The ALJ found that Plaintiff’s testimony that her vision had not improved following

her cataract surgery was inconsistent with Dr. Stelting’s post-surgery report showing vision

improvement (Tr. 194). It may be appropriate for Plaintiff to clarify this issue on remand

since she now claims that she misstated this point at the hearing (Doc. 31 at 25).

Plaintiff argues error in the ALJ’s credibility finding that no physician prescribed

Plaintiff’s 2 to 3-hour daily naps. A claimant’s limitation which is self-imposed rather than

a medical necessity is a basis on which an ALJ may discredit a claimant’s alleged limitation.

See Blakeman v. Astrue, 509 F.3d 878, 882 (8th Cir. 2007). Medical records show Plaintiff’s

reports of fatigue and pain (Tr. 272-276, 203, 202, 201, 200,199, 191, 184, 182). Plaintiff

testified that pain interferes with her sleep (Tr. 360). The relevant issue is whether Plaintiff’s

condition compels her to nap as she claims and the effect on her residual functional capacity.

Plaintiff argues error in the ALJ’s credibility finding that she obtained sporadic

treatment (no emergency room visits or hospitalization) for her physical symptoms and in not

considering Plaintiff’s explanation that she could not afford certain treatment.

Noncompliance with medical care or unexplained or inadequately explained reasons for

failing to seek medical treatment may cast doubt on a claimant’s subjective complaints. Fair

v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989). However, “disability benefits may not be

denied because of the claimant’s failure to obtain treatment he cannot obtain for lack of

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funds.” Gamble v. Chater, 68 F.3d 319, 321 (9th Cir. 1995). The record should be further

developed to clarify the available medical resources in light of Plaintiff’s financial

circumstances. 

Plaintiff argues that the ALJ erred in finding that Plaintiff’s allegations of physical and

mental limitations were belied by her daily activities and in not considering information

provided by third parties. The ALJ must make specific findings relating to a claimant’s daily

activities and their transferability to a work setting to conclude that a claimant’s daily

activities warrant an adverse credibility determination. Orn, 495 F.3d at 639. In any event,

these and the other issues relevant to credibility should be reconsidered or clarified as

appropriate upon remand based on a re-examination of the medical evidence, including

additional medical reports and residual functional capacity information.

Plaintiff requests that the matter be given to a different ALJ on remand. Although

courts have ordered or recommended that the Commissioner assign a case to a different ALJ

on remand, e.g., Miles v. Chater, 84 F.3d 1397, 1401 (11th Cir. 1996), the selection of a new

ALJ on remand has been considered to be within the discretion of the Commissioner. Hartnett

v. Apfel, 21 F. Supp. 2d 217, 222 (E.D.N.Y. 1998). The Court will deny Plaintiff’s request

without prejudice but will recommend that the matter be assigned to a different ALJ and that

a decision in the case be expedited. 

 Accordingly, 

IT IS ORDERED that the decision of the Commissioner denying Plaintiff’s claim for

benefits is vacated and the case is remanded for further proceedings consistent with this

Order. The Court recommends that the matter be assigned to a different ALJ on remand and

that a decision in the case be expedited.

//

//

//

//

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IT IS FURTHER ORDERED that the Clerk of Court shall enter Judgment

accordingly.

DATED this 29th day of March, 2011.

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