Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_14-cv-01421/USCOURTS-cand-3_14-cv-01421-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:205 Denial Social Security Benefits

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

MELINDA ANNE LOTT,

Plaintiff,

v.

CAROLYN W. COLVIN,

Defendant.

Case No. 14-cv-01421-JSC 

ORDER DENYING PLAINTIFF’S 

MOTION FOR SUMMARY JUDGMENT 

AND GRANTING DEFENDANT’S 

CROSS MOTION FOR SUMMARY 

JUDGMENT

Re: Dkt. Nos. 16 & 19

Plaintiff Melinda Ann Lott seeks social security disability benefits for a combination of 

impairments including transverse myelitis, back and bilateral hip and leg pain, hand problems, and 

chronic obstructive pulmonary disease. Pursuant to 42 U.S.C. § 405(g), Plaintiff filed this lawsuit 

for judicial review of the final decision by the Commissioner of Social Security (“Commissioner”) 

denying her benefits claim. Now before the Court are Plaintiff’s and Defendant’s Motions for 

Summary Judgment. (Dkt. Nos. 16, 19.) Because the determination of the Administrative Law 

Judge (“ALJ”) that Plaintiff’s pain testimony was not credible is supported by specific clear and 

convincing reasons, Plaintiff’s motion for summary judgment is DENIED and Defendant’s cross 

motion is GRANTED. 

LEGAL STANDARD

A claimant is entitled to disability insurance benefits if she can demonstrate that she is 

unable to engage in substantial gainful activity due to a medically determinable physical or mental 

impairment that can be expected to result in death or last for a continuous period of not less than 

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12 months. 42 U.S.C. § 423(d)(1). The ALJ conducts a five-step sequential inquiry to determine 

whether a claimant is entitled to benefits. 20 C.F.R. § 416.920. At the first step, the ALJ 

considers whether the claimant is currently engaged in substantial gainful activity (i.e., if the 

plaintiff is currently working); if the claimant is not engaged in substantial gainful activity, the 

second step asks if the claimant has a severe impairment or combination of impairments (i.e., an 

impairment that has a significant effect on the claimant’s ability to function); if the claimant has a 

severe impairment, the third step asks if the claimant has a condition which meets or equals the 

conditions outlined in the Listings of Impairments in Appendix 1 of the Regulations (the 

“Listings”); if the claimant does not have such a condition, the fourth step assesses the claimant’s 

residual functional capacity (“RFC”) and determines whether the claimant is still capable of 

performing past relevant work; if the claimant is not capable of performing past relevant work, the 

fifth and final step asks whether the claimant can perform any other work based on the claimant’s 

residual functional capacity, age, education, and work experience. Id.; §§ 404.1520(b)-

404.1520(f)(1).

THE ADMINISTRATIVE RECORD 

Plaintiff was born on January 31, 1958. (AR 203.) She has three grown children, and 

currently lives with her daughter and two grandchildren. (AR 62.) She has been unemployed 

since 2008 when she was laid off from her position as a loan processor with World Savings Bank. 

(AR 64.) Prior to her bank employment, she worked for Carrow’s restaurant for nearly 20 years, 

first as a waitress and then as a manager. (AR 64-65.)

Plaintiff alleges the following severe impairments: transverse myelitis, back and bilateral 

hip and leg pain, hand problems, and chronic obstructive pulmonary disease (“COPD”). The 

alleged onset date of the lower back, hip and leg pain coincides with her lay off as she alleges that 

at the time of her lay off she was in too much pain to find other work. (AR 206.) In November 

2010, Plaintiff filed applications for Disability Insurance Benefits (DIB) and Supplemental 

Security Income (SSI) under Titles II and XVI, respectively. (AR 29.) The applications were 

denied initially, on reconsideration, and after a hearing by an ALJ in April 2013. (Id.) The 

Appeals Council denied review, making the ALJ’s decision final. (AR 5.) Thereafter, Plaintiff 

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commenced this action for judicial review pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). 

I. Medical Evidence

Plaintiff was diagnosed with transverse myelitis, an inflammation of the spinal cord, in the 

early 2000s while a patient at a Kaiser Permanente facility in Union City, California. (AR 209, 

334.) It began as heavy, tingling feeling in her legs, followed by a severe burning pain in her 

back. (AR 209.) She had two MRIs in 2002 and 2006. (Id.) She also had her right hip replaced 

in 2006 or 2007. (AR 249, 334.) Plaintiff received medical care at Kaiser until 2009 when she 

lost her health insurance due to her lay off; thereafter, she occasionally sought treatment for acute 

conditions in the emergency room at Highland Hospital. (AR 66-67.) The record contains some 

treatment records from both Kaiser and Highland hospital, but neither set of records discuss 

Plaintiff’s transverse myelitis or hip replacement except in summarizing her medical history. (AR 

248-330, 438-444, 458-485.) Plaintiff has not submitted medical evidence from a treating source. 

A. Dr. Calvin Pon 

State examining physician Dr. Calvin Pon examined Plaintiff on April 11, 2011. (AR 334.) 

Dr. Pon noted Plaintiff’s chief complaints as “bilateral hand numbness, low back pain with 

associated bilateral lower extremity pain and numbness, and bilateral hip pain.” (Id.) In taking 

her medical history, he noted that Plaintiff had the hand pain for a couple of years and when asked 

about whether she had been told if she had carpal tunnel syndrome, she stated “maybe a little of 

it.” (Id.) Plaintiff also indicated that she had been diagnosed with transverse myelitis 

approximately 8 years ago. (Id.) Plaintiff further indicated that she had a right hip replacement in,

2006 or 2007 and she began experiencing pain in her left hip two years ago and an x-ray of her left 

hip indicated that it was “deteriorating – eventually will need a left hip replacement.” (Id.) 

In his physical examination of Plaintiff, Dr. Pon noted that Plaintiff was 5’4” and weighed 

270 pounds. (AR 335.) She had a stable gait and did not use an ambulatory aid. (Id.) Although 

she was able to get on and off the exam table, her movements were slow. (Id.) Dr. Pon noted that 

Plaintiff had active range of motion in her upper extremities and 5/5 pinch and grip strength. (Id.) 

With respect to her lower extremities, she had normal active range of motion. (Id.) Based on his 

examination, he concluded that she should be able to stand and/or walk for a total of 

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approximately 4 hours during an 8 hour workday. (AR 336.) She should be able to sit for a total 

of 6 hours during an 8 hour workday. (Id.) Stooping, crouching, kneeling and squatting should be 

limited to occasionally, as should climbing stairs, ladders, and crawling. (Id.) He found that she 

should be able to perform bilateral pushing and pulling arm/hand control on a frequent basis 

notwithstanding her complaints of bilateral hand numbness. (Id.) The same was true with respect 

to bilateral lower extremity pushing leg/foot control. He concluded that there was no limit in her 

ability to perform gross and fine manipulative tasks with both hands or reach bilaterally, although 

there might be some symptomatic limitations. (Id.)

B. Dr. Anselmo Mamaril

Dr. Mamaril is a state agency medical consultant whose opinions were generally consistent 

with those of Dr. Pon. He concluded that Plaintiff was capable of 2-4 hours of standing and 

walking out of 8 hours and could sit for 6 hours in an 8 hour workday. (AR 372.) Dr. Mamaril 

noted that Plaintiff had pain from degenerative joint disease (osteoarthritis) of the hips, but found 

that degenerative disc disease and obesity were the restricting factors with respect to any postural 

limitations. (AR 373.) Dr. Mamaril also found Plaintiff’s pain reports only partially credible 

given that she had no significant limitations on her range of motion, no hand or gait dysfunctions, 

no difficult arising from a chair or getting on or off the exam table, and she was able to do light 

household chores, drive, and shop. (AR 376.) With respect to her transverse myelitis he noted 

that “MER from Kaiser Permanente mentioned of pain and back pain and with diagnosis for 

Transverse Myelitis (4/10/08, 9/26/08). Ortho CE report on 4/11/11 mentioned of remote past 

history of Transverse Myelitis about 8 years ago by MRI. Claimant has no evidence of active T. 

Myelitis as per normal neurological findings as reported on the Current CE. T. Myelitis is non 

severe.” (AR 378.) He also found that she did not have a medically determinable impairment 

with respect to either her complaints of hand numbness or poor circulation. (Id.)

C. Dr. Edie Glantz

Dr. Glantz is a state agency examining physician who examined Plaintiff on June 27, 2012. 

Dr. Glantz indicated that Plaintiff’s chief complaints were transverse myelitis, hypertension, 

GERD, and hypercholoesterlemia. (AR 411.) Dr. Glantz noted no issues with Plaintiff’s upper 

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extremities and concluded that Plaintiff had normal range of motion in her lower extremities, 

although she noted that Plaintiff had left hip pain with internal rotation of her left leg. Dr. Glantz

observed that Plaintiff’s gait was “wise-based”—presumably wide-based—and that she did not 

require the use of an assistive device to walk across the examination room, although she brought a 

cane with her. Dr. Glantz concluded that Plaintiff can stand or walk for 6 hours in an 8 hour day 

and that she can sit without functional limitations. (AR 416.) Dr. Glantz found that Plaintiff had 

no limitations with her upper extremities, but had frequently limited push pull in the lower left 

extremity, and occasionally limited in the right lower extremity. (Id.)

D. X-ray reports

Plaintiff had x-rays taken on July 14, 2011 of her hips and lumbar spine. (AR 359-360.) 

The hip x-ray indicates that “there is significant narrowing of intra-articular space of left hip joint 

with mild periarticular osteophytic changes, consistent with moderate to severe osteoarthritis.” 

(AR 359.) With respect to her lumbar spine, the x-ray indicates that she has narrowing of disc 

spaces at L2-3 and L3-4 with subchondral sclerosis and marginal osteophytosis consistent with 

degenerative disc changes. (AR 360.)

II. Plaintiff’s ALJ Hearing Testimony

Plaintiff, appearing pro se, testified that she currently lives with her daughter and two 

granddaughters in Union City. (AR 62.) Her daughter is helping support her financially, and she 

gets money from welfare and food stamps. (AR 63.) She last worked in June of 2008 when she 

was laid off from her job as a loan processor with World Savings Bank. (AR 64.) She has not 

worked since her lay off because she is in pain constantly and the only way she can get anything 

accomplished is on medication. (AR 65.) 

The pain began in 2001 or 2002 and she was diagnosed with transverse myelitis. (Id.) She 

also had a total right hip replacement, which had to be redone a year later because it kept 

dislocating. (AR 67.) During this time Plaintiff was a patient of Dr. Sharma at Kaiser until 2008 

or early 2009 when she lost her health insurance; since then she has not had regular medical care. 

(AR 66.) 

Plaintiff has a variety of ongoing issues. Her left hip is causing her pain and her left leg is 

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“useless.” (AR 66, 72.) The pain in her legs makes it difficult to walk, although she does not like 

to use a cane. (AR 72.) Plaintiff has pain in her feet and has to keep her feet elevated a couple of 

times a month. (AR 68.) She also has significant pain in her lower back and has to “constantly 

sit for a couple of minutes and then go back to what [she] was doing and then sit for a couple of 

minutes.” (AR 69.) She takes Nortriptyline and Viocodin “daily” for the transverse myelitis. She 

takes the Vicodin when she has to do something. (Id.) “If I’m just going to be laying in bed 

watching TV I try not to take it but if I have to, if I know I have to get up and like cook dinner or 

go to the grocery store or something, then I have to take it.” (Id.) She never received any 

treatment for her back because they said there was nothing they could do. (Id.) Plaintiff drinks 

three to four alcoholic drinks a day when she runs out of pain medication. (AR 70.) Because she 

does not have insurance she can only obtain pain medication when she goes to the emergency 

room. (AR 71.) 

Plaintiff performs some chores around the house, including washing dishes and laundry. 

(AR 72.) She helps with the cooking a couple of times a week. (Id.) She generally does not leave 

the house except for big family gatherings and going to the grocery store. (Id.) 

III. Vocational Expert (“VE”) Testimony

Ms. Guillory, the VE, testified that Plaintiff’s past work as a loan processor would have 

been classified as sedentary and her work as a restaurant manager would have qualified as light. 

The ALJ posed three hypotheticals to the VE. First, the ALJ asked whether “an individual of the 

claimant’s age, education and work background limited to light; person can stand and/or walk four 

hours, sit for six hours; occasionally stoop, crouch, kneel, squat, crawl and climb stairs and 

ladders. The individual can frequently bilaterally push and pull with the upper extremities and 

lower extremities. No limitation on reaching.” (AR 75.) The VE testified that such a person 

would be able to perform Plaintiff’s past work as a loan processor. Second, the ALJ asked 

whether an individual limited to medium work who could “frequently push and pull with the lower 

– left lower extremity, occasionally push and pull with the right lower extremity; frequently climb 

stoop, kneel and crouch” could perform any of Plaintiff’s past work. (AR 75.) The VE testified 

that such an individual would be able to perform the past relevant work of loan processor, 

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restaurant manager, or waitress. (AR 75-76.) For the final hypothetical, the ALJ asked whether 

an individual limited to sedentary work who requires a sit/stand option, can stand and/or walk no 

more than two hours, must be able to adjust positions at will, can perform occasional stooping and 

crouching, no climbing, crawling, squatting or kneeling, and occasional use of the lower left 

extremity could perform Plaintiff’s past work. (AR 76.) The VE testified that the individual 

could perform Plaintiff’s past work as a loan processor; however, if the person was “off task 15 

percent of the time” then the individual would be getting to the very high limits of being able to 

perform the job, but likely would be able to do so as long as it did not exceed 15 percent. (Id.)

IV. ALJ’s Findings

In an April 10, 2013 decision, the ALJ found Plaintiff not disabled under sections 223(d) 

and 1614(a)(3)(A) of the Social Security Act using the five-step disability analysis. (AR 29-35.) 

At the first step, the ALJ found that Plaintiff had not engaged in substantial gainful activity since 

her alleged onset date of October 9, 2008. (AR 31.) At the second step, the ALJ found that 

Plaintiff had the following severe impairments: transverse myelitis, status post two right hip 

replacements, osteoarthritis of the left hip, degenerative disc disease of the lumbar spine, 

hyperlipidemia, morbid obesity, and hypertension. (Id.) At the third step, the ALJ found that 

Plaintiff did not have impairments or a combination of impairments that met or equaled the 

severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (AR 32.) 

Between the third and fourth steps, the ALJ found that Plaintiff retained the Residual Functional 

Capacity (“RFC”) to perform light work with the additional limitations of only standing and/or 

walking 4 hours in an 8-hour workday, sitting 6 hours in an 8-hour workday, occasionally 

stooping, crouching, kneeling, squatting, crawling, and climbing stairs and ladders, and frequently 

pushing and pulling with the upper and lower extremities bilaterally, and no limitation on 

reaching. (AR 32.) Thereafter, at the fourth step, the ALJ found that Plaintiff was capable of 

performing her past relevant work as a loan processor. (AR 35). The ALJ therefore concluded that 

Plaintiff was not disabled under the Social Security Act. (Id.)

STANDARD OF REVIEW

Pursuant to 42 U.S.C. section 405(g), the Court has authority to review the ALJ’s decision 

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to deny benefits. When exercising this authority, however, the “Social Security Administration’s 

disability determination should be upheld unless it contains legal error or is not supported by 

substantial evidence.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007); see also Andrews v. 

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); Magallenes v. Bowen, 881 F.2d 747, 750 (9th Cir. 

1989). The Ninth Circuit defines substantial evidence as “such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion;” it is “more than a mere scintilla, but may 

be less than a preponderance.” Molina v. Astrue, 674 F.3d 1104, 1110-11 (9th Cir. 2012) (internal 

citations and quotation marks omitted); Andrews, 53 F.3d at 1039. To determine whether the 

ALJ’s decision is supported by substantial evidence, the reviewing court “must consider the entire 

record as a whole and may not affirm simply by isolating a specific quantum of supporting 

evidence.” Hill v. Astrue, 698 F.3d 1153, 1159 (9th Cir. 2012) (internal citations and quotation 

marks omitted); see also Andrews, 53 F.3d at 1039 (“To determine whether substantial evidence 

supports the ALJ’s decision, we review the administrative record as a whole, weighing both the 

evidence that supports and that which detracts from the ALJ’s conclusion.”). 

Determinations of credibility, resolution of conflicts in medical testimony and all other 

ambiguities are roles reserved for the ALJ. See Andrews, 53 F.3d at 1039; Magallenes, 881 F.2d 

at 750. “The ALJ’s findings will be upheld if supported by inferences reasonably drawn from the 

record.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008) (internal citations and 

quotation marks omitted); see also Batson v. Commissioner, 359 F.3d 1190, 1198 (9th Cir. 2004)

(“When the evidence before the ALJ is subject to more than one rational interpretation, we must 

defer to the ALJ’s conclusion.”). “The court may not engage in second-guessing.” Tommasetti, 

533 F.3d at 1039. “It is immaterial that the evidence would support a finding contrary to that 

reached by the Commissioner; the Commissioner’s determination as to a factual matter will stand 

if supported by substantial evidence because it is the Commissioner’s job, not the Court’s, to 

resolve conflicts in the evidence.” Bertrand v. Astrue, No. 08-CV-00147, 2009 WL 3112321, at 

*4 (E.D. Cal. Sept. 23, 2009).

DISCUSSION

The only issue raised on appeal is whether the ALJ properly rejected Plaintiff’s pain 

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testimony as not credible. “An ALJ engages in a two-step analysis to determine whether a 

claimant’s testimony regarding subjective pain or symptoms is credible.” Garrison, 2014 WL 

3397218, at *15. “First, the ALJ must determine whether the claimant has presented objective 

medical evidence of an underlying impairment which could reasonably be expected to produce the 

pain or other symptoms alleged.” Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007)

(internal citations and quotation marks omitted). “Second, if the claimant meets this first test, and 

there is no evidence of malingering, the ALJ can reject the claimant’s testimony about the severity 

of her symptoms only by offering specific, clear and convincing reasons for doing so.” Id.

(emphasis added) (internal citations and quotation marks omitted). This “clear and convincing” 

standard is not an easy requirement to meet, and “is the most demanding [standard] in Social 

Security cases.” Moore v. Comm’r of Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002). 

“General findings are an insufficient basis to support an adverse credibility determination.” 

Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001). Rather, the ALJ “must state which 

pain testimony is not credible and what evidence suggests the claimant[] [is] not credible.” 

Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993). 

Applying the two-step analysis, the ALJ found that Plaintiff’s “medically determinable 

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

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

entirely credible for the reasons explained in this decision.” (AR 33.) In making this 

determination, the ALJ did not find that Plaintiff was malingering; she thus was required to set 

forth specific, clear and convincing reasons for rejecting Plaintiff’s pain testimony. See 

Lingenfelter, 504 F.3d at 1036. 

Because symptoms regarding pain are difficult to quantify, the SSA regulations list 

relevant factors to assist ALJs in their credibility analysis. These factors include:

(1) The individual’s daily activities;

(2) The location, duration, frequency, and intensity of the 

individual’s pain or other symptoms;

(3) Factors that precipitate and aggravate the symptoms;

(4) The type, dosage, effectiveness, and side effects of any 

medication the individual takes or has taken to alleviate pain or 

other symptoms;

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(5) Treatment, other than medication, the individual receives or has 

received for relief of pain or other symptoms;

(6) Any measures other than treatment the individual uses or has 

used to relieve pain or other symptoms (e.g., lying flat on his or her 

back, standing for 15 to 20 minutes every hour, or sleeping on a 

board); and

(7) Any other factors concerning the individual’s functional 

limitations and restrictions due to pain or other symptoms.

20 C.F.R. § 404.1529(c)(3); see also Light v. Soc. Sec. Admin., 119 F.3d 789, 792 (9th Cir. 1997)

(“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 

activities, his work record, and testimony from physicians and third parties concerning the nature, 

severity, and effect of the symptoms of which he complains.”). These factors are intended to 

“ensure that the determination of disability is not a wholly subjective process, turning solely on 

the identity of the adjudicator.” Bunnel v. Sullivan, 947 F.2d 341, 346 (9th Cir. 1991).

Here, the ALJ based her adverse credibility finding on (1) Plaintiff’s sparse treatment 

records, (2) that the treatment records which do exist involve treatment unrelated to Plaintiff’s 

alleged disabilities, and (3) that the pain testimony is inconsistent with the medical evidence. 

Plaintiff contends that the ALJ erred in relying on her sparse treatment records which involve 

routine care because Ms. Lott has no health insurance and therefore cannot be penalized for failing 

to seek medical care. Plaintiff further contends that she treats her ongoing pain with narcotics 

which is not a form of conservative treatment. The Court addresses each argument in turn.

“[A]n unexplained, or inadequately explained, failure to seek treatment or follow a 

prescribed course of treatment” provides one basis on which an ALJ can discredit an allegation of 

disabling pain. Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989). “While there are any number of 

good reasons for not [seeking treatment], a claimant’s failure to assert one, or a finding by the ALJ 

that the profferred reason is not believable, can cast doubt on the sincerity of the claimant’s pain 

testimony.” Id. (internal citations omitted). Where a claimant suffers from financial hardships, a 

failure to obtain treatment is not a sufficient reason to deny benefits. See Orn v. Astrue, 495 F.3d 

625, 638 (9th Cir. 2007) (“Orn’s failure to receive medical treatment during the period that he had 

no medical insurance cannot support an adverse credibility finding. We have held that an 

unexplained, or inadequately explained, failure to seek treatment may be the basis for an adverse 

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credibility finding unless one of a number of good reasons for not doing so applies. But, disability 

benefits may not be denied because of the claimant’s failure to obtain treatment he cannot obtain 

for lack of funds.”) (internal citations and quotation marks omitted); see also Regennitter v. 

Comm’r of Soc. Sec. Admin., 166 F.3d 1294, 1297 (9th Cir. 1999) (failure to follow treatment plan 

is not a legitimate reason for rejecting a claimant’s pain testimony when the failure is due to lack 

of resources); Gamble v. Chater, 68 F.3d 319, 320–22 (9th Cir. 1995) (“It flies in the face of the 

patent purposes of the Social Security Act to deny benefits to someone because he is too poor to 

obtain medical treatment that may help him.”) (internal citation and quotation marks omitted).

The ALJ here found that Plaintiff’s pain testimony was undermined by the fact that 

“[s]ince the alleged onset date there are sparse treatment records. They primarily relate to routine 

treatment and the non-durational left foot pain.” (AR 33.) Plaintiff contends that her sparse 

treatment records are attributable to her lack of health insurance; this assertion, however, is belied 

by the record as Plaintiff did in fact seek medical treatment during the time she lacked health 

insurance, but did so for routine care or reasons unrelated to her alleged disabilities. In May 2011, 

Plaintiff visited the emergency room after sustaining a crush injury to her shins a week prior—at 

that time she was only taking aspirin for pain relief and rated her pain at 4 out of 10. (AR 407-

408.) The treatment notes do not indicate that she complained of pain due to her transverse 

myelitis or osteoarthritis during this visit. In February and March 2012, Plaintiff had at least two 

visits to the emergency room for left foot pain which was diagnosed as cellulitis. (AR 399-406,

454-473.) The treatment notes for these visits do not indicate that Plaintiff complained of pain 

related to her transverse myelitis or hip pain. At the end of March 2012, she presented with a 

cough and had a chest x-ray which did not show any active chest disease.1

 (AR 454, 478-479.) 

 1 Plaintiff submitted additional medical evidence to the Appeals Council for medical visits in 

March to July 2013. (AR 474-485.) The Appeals Council declined to consider this evidence as it 

found that the records were either duplicates of those previously submitted or post-dated the ALJ’s 

decision. (AR 6.) While some of the records are duplicates, the submission also includes notes 

from an April 2, 2013 visit to the Highland Hospital Clinic wherein Plaintiff complained of 

worsening pain due to her transverse myelitis with hip, bilateral shoulder, and upper and lower 

back pain. (AR 475-477.) Although Plaintiff has not raised a Brewes issue, the Court has 

reviewed the evidence and concludes that it would not have altered the decision here. See Brewes 

v. Commissionar of Social Sec. Admin., 682 F.3d 1157, 1163 (9th Cir.2012) (awarding a claimant 

benefits after finding that additional evidence submitted to the Appeals Council after the ALJ 

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Thus, while Plaintiff was uninsured a significant portion of the time since her alleged disability 

onset, there are nonetheless records of medical treatment for this time period, and these records do 

not indicate that Plaintiff was complaining of severe pain due to her transverse myelitis or 

osteoarthritis. 

Further, Plaintiff’s medical records from 2008-2009—when she did have health 

insurance—do not reflect ongoing treatment for pain related to her transverse myelitis or hip 

osteoarthritis, but rather, treatment for routine medical issues. (AR 250 (4/10/08: treatment for 

“reactive airway disease”), AR 252 (6/30/08: “dry cough with intermittent chest tightness and 

wheezing”), AR 254 (8/12/08: “left ear pain”), AR 256 (9/26/08: bariatric consult), AR 261

(3/10/09: routine gynecological exam), AR 264 (4/1/08: chest tightness).) These records both pre 

and post-date Plaintiff’s October 9, 2008 disability onset date. An ALJ may discount a claimant’s 

symptom testimony where the claimant describes severe and disabling symptoms but has sought 

or received only minimal or conservative treatment for her complaints. See Johnson v. Shalala, 60 

F.3d 1428, 1434 (9th Cir. 1995). Indeed, “the individual’s statements may be less credible if the 

level or frequency of treatment is inconsistent with the level of complaints.” SSR 96–7p. Thus, 

the ALJ’s reliance on the inconsistency between Plaintiff’s complaints and her treatment record 

qualifies as a clear and convincing reason, supported by substantial evidence in the record, for 

rejecting Plaintiff’s subjective symptom testimony here.

Plaintiff’s suggestion that her lack of treatment records can be explained by her selfmedication with narcotics, which is not conservative treatment, is no more availing. As an initial 

matter, Plaintiff’s testimony was inconsistent as to how frequently she takes the Vicodin. On the 

one hand, she testified that she left Kaiser with “a good-sized prescription” that lasted “probably 

about a year or so ago – because I don’t take it every day. I just take it, you know, like I said 

when I need it so it lasts me a while.” (AR 71.) Yet she also testified that she takes Vicodin 

 

rendered his decision would have led to a favorable decision had the evidence been available to 

the ALJ at the claimant’s hearing). Rather, one isolated complaint of pain consistent with her 

allegations of disability right before the ALJ hearing suggests, if anything, that notwithstanding 

Plaintiff’s lack of health insurance she would in fact be willing to visit the doctor for hip and back 

pain.

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“daily” and “when I have to do something.” (AR 69.) But daily Vicodin use is not supported by 

the medical evidence. Plaintiff testified that the only time she obtained more Vicodin after she 

stopped going to Kaiser in 2009 was when she went to the emergency room. (AR 71.) As 

discussed supra, the medical records do reflect a cluster of emergency room visits approximately 

every 12 months or so in 2011 and 2012 wherein Plaintiff received a prescription for Vicodin; 

however, these visits reflect relatively small refills of Plaintiff’s prescription given the passage of 

time between visits. (AR 409 (5/28/11: unknown quantity), AR 408 (6/6/11: 15 tablets), AR 405 

(2/26/12: 30 tablets), AR 462 (3/1/12: 30 tablets), AR 467 (3/19/12: 30 tablets).) 

Even if this evidence was sufficient to show that Plaintiff was self-medicating, this 

treatment is more akin to conservative or routine care given that Plaintiff has not alleged that the 

medication side effects incapacitate her, and instead, indicated that the medication enables her to 

perform tasks such as grocery shop or cook dinner (AR 69). See, e.g., Medel v. Colvin, No. 13-

2052, 2014 WL 6065898, at *8 (C.D. Cal. Nov. 13, 2014) (affirming ALJ’s characterization of the 

plaintiff’s treatment as conservative where his medical records showed that he had been 

“prescribed only Vicodin and Tylenol for his allegedly debilitating low-back pain.”); Stephenson 

v. Colvin, No. CV 13-8303, 2014 WL 4162380, at *9 (C.D. Cal. Aug. 20, 2014) (concluding that 

the ALJ’s discounting of Plaintiff’s credibility was supported by substantial evidence where the 

ALJ characterized Plaintiff’s medical treatment as routine and conservative notwithstanding the

plaintiff’s Vicodin use because the plaintiff “did not allege that Vicodin incapacitates him. Rather, 

after taking Vicodin, he does household chores, gets his son ready for school, takes a walk, 

watches television, sometimes goes to the store, and drives a short distance to pick up his son from 

school”); Morris v. Colvin, No. 13–6236, 2014 WL 2547599, at *4 (C.D. Cal. June 3, 2014) (ALJ 

properly discounted credibility when plaintiff received conservative treatment consisting of 

physical therapy, use of TENS unit, chiropractic treatment, Vicodin, and Tylenol with Vicodin). 

The cases cited by Plaintiff do not suggest otherwise. See, e.g., Tunstell v. Astrue, No. 11-9462, 

2012 WL 3765139, at *4 (C.D. Cal. Aug. 30, 2012) (concluding that the ALJ’s adverse credibility 

finding based on conservative treatment was not justified where the plaintiff testified that Vicodin 

and other narcotic pain medications did not provide pain relief); Nevins v. Astrue, No. 11-0828, 

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2011 WL 6103057, at *5 (C.D. Cal. Dec. 8, 2011) (rejecting ALJ’s adverse credibility finding 

predicated on the plaintiff’s limited and conservative treatment where the plaintiff took numerous 

narcotic pain medications, underwent surgery, had multiple steroid injections and did six months 

of physical therapy).

Moreover, the medical opinion evidence supported the ALJ’s finding that Plaintiff’s 

subjective complaints were not entirely credible. Morgan v. Comm’r of Soc. Sec., 169 F.3d 595, 

600 (9th Cir.1999) (a conflict between subjective complaints and the objective medical evidence 

in the record is a sufficient reason that undermines a claimant’s credibility). Plaintiff has not 

offered any treating source evidence regarding her disability or functional limitations. The ALJ 

thus properly relied on the opinion of Dr. Calvin Pon, the state agency consultative examiner who 

conducted a physical examination and concluded that Plaintiff had the following limitations: (1) 

chronic bilateral hand numbness, (2) history of transverse myelitis approximately 8 years ago, now 

with chronic residual low back pain and associated bilateral lower extremity pain and numbness, 

(3) status-post right hip replacement with chronic residual right hip pain, and (4) chronic left hip 

pain, probably degenerative arthritis. (AR 336.) Given these limitations, Dr. Pon found that 

Plaintiff should be able to stand and/or walk for a total of approximately 4 hours during an 8 hour 

workday and sit for a total of 6 hours during an 8 hour workday with limits on occasional 

stooping, crouching, kneeling, and squatting. 2 (Id.) The ALJ also relied on the residual 

functional capacity assessment of Dr. Mamaril, a state agency consultant, who opined that Plaintiff 

could stand and or walk at least 2 hours in an 8 hour workday and sit for a total of 6 hours during 

an 8 hour workday with unlimited push/pull with her lower extremities and no limits on her upper 

extremities. (AR 371-374.) Dr. Mamaril noted that Plaintiff had severe hip and back 

impairments, but noted only a moderate to slight limitation in her range of motion on each, 

respectively. (AR. 378.) With respect to Plaintiff’s transverse myelitis he noted that she “has no 

evidence of active T. Myelitis as per normal neurological findings as reported on the current CE. 

 2 Dr. Glantz—the other state agency consultative examiner—offered an even less restrictive view 

of Plaintiff’s functional capacity; however, the ALJ assigned little weight to her opinion because 

she did not notice that Plaintiff had surgical scars and provided no consideration of Plaintiff’s hip 

or back issues. (AR 34-35, 411-417.)

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T. Myelitis is non severe.” (Id.) 

The ALJ properly considered this opinion evidence, which showed that Plaintiff was not as 

limited as she claimed. (AR 34.) See Moncada v. Chater, 60 F.3d 521, 524 (9th Cir.1995) (ALJ 

may consider doctor’s belief that claimant can work); Tonapetyan v. Halter, 242 F.3d 1144, 1149 

(9th Cir. 2001) (opinion of examining doctor serves “as substantial evidence supporting the ALJ’s 

findings [regarding] physical impairment”). A lack of objective medical evidence corroborating a 

claimant’s alleged symptoms is an appropriate factor for discounting a claimant’s credibility 

when, as here, the ALJ’s credibility finding is supported by other clear and convincing reasons. 

See Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 2005); see also Carmickle v. Comm’r, Soc. 

Sec. Admin., 533 F.3d 1155, 1161 (9th Cir. 2008) (“Contradiction with the medical record is a 

sufficient basis for rejecting the claimant's subjective testimony”); Lingenfelter v. Astrue, 504 F.3d 

1028, 1040 (9th Cir. 2007) (in assessing credibility, ALJ may consider whether medical evidence 

is consistent with the alleged symptoms).

In sum, the ALJ provided clear and convincing reasons for her adverse credibility finding; 

namely, that Plaintiff’s subjective pain complaints were inconsistent with (1) the sparse treatment 

records which reflected treatment for matters unrelated to her alleged disabilities and (2) the 

objective medical evidence in the record. These reasons provide substantial evidence to support 

the ALJ’s adverse credibility finding. See Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th 

Cir.2008); Lingenfelter, 504 F.3d at 1040.

CONCLUSION

For the reasons stated above, Plaintiff’s motion for summary judgment is DENIED and 

Defendant’s cross motion for summary judgment is GRANTED. Judgment will be entered in 

favor of Defendant and against Plaintiff.

This Order disposes of Docket Nos.16 and 19.

IT IS SO ORDERED.

Dated: April 10, 2015

______________________________________

JACQUELINE SCOTT CORLEY

UNITED STATES MAGISTRATE JUDGE

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