Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_15-cv-01500/USCOURTS-casd-3_15-cv-01500-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:0405id Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

CHRISTOPHER L. FRISBIE, Civil

No. 15-cv-1500 BAS (BGS)

Plaintiff,

REPORT AND

RECOMMENDATION: DENYING

PLAINTIFF’S MOTION FOR

SUMMARY JUDGMENT AND

GRANTING DEFENDANT’S

CROSS-MOTION FOR SUMMARY

JUDGMENT

 (ECF Nos. 17 and 18.)

v.

CAROLYN W. COLVIN, 

Acting Commissioner of Social Security,

Defendant.

I. INTRODUCTION

On July 7, 2015, Christopher L. Frisbie (“Frisbie”) filed a complaint pursuant to

the Social Security Act (“Act”), 42 U.S.C. § 405(g), challenging the Commissioner of the

Social Security Administration’s (“Commissioner”) denial of disability benefits. (ECF

No. 1.) On October 16, 2015, the Commissioner filed an answer. (ECF No. 12.) On

December 7, 2015, Frisbie filed a motion for summary judgment, requesting reversal of

the Administrative Law Judge’s (“ALJ”) final decision. (ECF No. 17.) Specifically,

Frisbie seeks reversal of the ALJ’s denial or, in the alternative, remand for further

administrative proceedings on the basis that the ALJ failed to: (1) consider obesity as a

severe impairment; (2) consider post traumatic stress disorder, obsessive compulsive

disorder and major depressive disorders when determining residual functional capacity

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and (3) articulate legally sufficient reasons for rejecting Plaintiff’s pain and limitation

testimony. (Id.) 

On January 8, 2016, the Commissioner filed a cross-motion for summary judgment

and a response in opposition to Frisbie’s motion. (ECF. Nos. 18 and 19.) The

Commissioner argues that the ALJ’s decision was supported by substantial evidence, is

free from legal error, and should be affirmed. Id. On January 22, 2016, Frisbie filed a

reply in support of his motion for summary judgment and in opposition to Respondent’s

cross-motion for summary judgment. [ECF No. 20.]

Pursuant to Civ. L.R. 7.1(d)(1), the Court finds the parties’ cross-motions suitable

for decision on the papers and without oral argument. After careful consideration of the

administrative record and the applicable law, the Court recommends that Frisbie’s motion

for summary judgment be DENIED and that Commissioner’s cross-motion for summary

judgment be GRANTED.

II. BACKGROUND

Frisbie filed an application for supplemental security income on July 12, 2012,

alleging disability beginning June 30, 2006. (AR 223-228.) The Social Security

Administration (“SSA”) denied Frisbie’s application on August 21, 2012. (AR 124-139.) 

On October 4, 2012, Frisbie requested reconsideration of his application. (AR 166-168.) 

The SSA denied reconsideration on November 19, 2012. (AR 140-154.) Subsequently,

on January 2, 2013, Frisbie requested a hearing before an ALJ. (AR 175.) On October 1,

2013, the ALJ, William K. Mueller held a hearing. (AR 34.) Frisbie appeared,

represented by Attorney Jackie Slosser. (AR 36.) Mary Jesko, an impartial vocational

expert (“VE”), also appeared and testified. (AR 36.)

A. Adult Function Report

In his Adult Function report, Frisbie stated: “I have a fear of germs. I wash my

hands 30-35 times a day. I have a huge fear of police. I can’t even be near one without

feeling unprotected like I need to defend myself. It makes me violent, especially if I get

stopped when I’m riding in a vehicle and one approaches me with their hand on their gun. 

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It makes me want to punch them in defense of not getting hurt or killed by one. They are

a huge cause of my nightmares because of the accident.” (AR 292)

B. Hearing Testimony 

At the October 1, 2013 hearing, Frisbie testified that he had not worked in the 10

years since his car accident. He is a home-schooled high school graduate who can read

and write. Before being home-schooled, Frisbie was placed in special education classes

in elementary and junior high school. Frisbie testified that he had obtained and renewed

his driver’s license, although he does not drive because he is afraid of cars. His girlfriend

drives him if he needs to leave the house. Frisbie told the ALJ at the hearing that he

spends his day watching television and movies and sleeping. Frisbie’s girlfriend and her

daughter clean, cook and do laundry for Frisbie, although he testified that he knows how

to use the microwave and knows how to do his laundry. He also knows how to feed,

shower and dress himself, although Frisbie testified that: “it can be hard at times [to take

a shower]. I’ve almost fallen a few times.” (AR 46.) Frisbie told the ALJ at the hearing

that his legs give out sometimes and guessed that this happens up to three or four times in

a month. (AR 46.) Nevertheless, Frisbie testified he is responsible for personal grooming,

putting on clean clothes, brushing his hair and using mouthwash. (AR 55.) 

Frisbie testified that he sees a psychologist once a month and had recently been

prescribed Latuda, which he had been taking for 2 weeks at the time of the hearing before

the ALJ. Frisbie testified that he has obsessive compulsive disorder which causes him to

sanitize his hands because he does not like touching anything. (AR 48.) He also stated

that has “voices in my head, like thoughts....just weird crazy thoughts.” (AR 50.) Frisbie

could not remember when or for how long he began hearing voices, nor could he recall

which doctor he told about the voices. (AR 56.)

When the ALJ asked Frisbie about his physical pain and symptoms, Frisbie stated

his left knee is worse than the right knee. He testified that he needs a cane all the time. 

He takes ibuprofen for his knee pain. He also ices and elevates his left knee. Frisbie

testified he also experiences pain in the middle of his back and shoulder area. (AR 57-

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59.) Although he had not received injections in his knees by the time of the hearing,

Frisbie testified that he was seeking a referral for the procedure and had been told that he

would need knee surgery in the future. (AR 61.) Frisbie stated that he could only sit for

15 to 20 minutes before having to stand up due to knee pain. (AR 62.)

The ALJ also called the Vocational Expert (“VE”), Mary Jesko, to testify. (AR

63.) The VE testified that Frisbie was unable to return to his past work as a fast food

cook. (AR 64-65.) In response to the ALJ’s question of whether there was work “an

individual similar to Mr. Frisbie in age, education and work experience that was limited

to sedentary work and was further limited to nonpublic, simple, routine tasks with only

occasional contact with coworkers and supervisors” could perform, the VE testified that

there were jobs available. The specific jobs listed by the VE were: (1) final assembler;

(2) lens inserter; and (3) bench hand. (AR 65.) 

C. Medical Records Cited By the ALJ

1. Lilian Nguyen PA - Neighborhood Healthcare

On February 9, 2012, Frisbie attended a medical appointment to follow up on xrays

of his knees, spine and wrists. The Physician’s Assistant noted: “Xrays show

osteoarthrosis of bilat knees with joint effusions. Pt ambulates with cane. Lspine and

Tspine shows minimal degenerative changes. PT c/o of low back pain but does not take

his meds as directed. Last refill was over 4 months ago.” (AR 332.) 

The Physician’s Assistant also noted: “Pt has hx of OCD which includes excessive

handwashings to point of severe dryness and cracking of skin. Pt also has hx of

depression but w/o any suicidal or homocidal ideation. Pt reports oversleeping, feeling

fatigue, not enjoying pleasurable things. However, pt is noncompliant on meds.” (AR

332.)

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2. Gregory M. Nicholson, M.D. - Seagate Medical Group - Psychiatric 

Consultative Examination

On August 13, 2012, Frisbie underwent a comprehensive psychiatric evaluation by

Dr. Gregory Nicholson, a board certified psychiatrist. (AR 361.) Dr. Nicholson

summarized Frisbie’s history of illness as follows: 

“The claimant stated in 2004 he was getting a ride somewhere and something

happened that caused police officers to start shooting at the vehicle; the claimant

ended up getting into a car accident and sustained gunshots [sic] wounds to the

back and left leg and he required surgery on the leg. He is bothered by nightmares

and memories of these traumatic experiences and avoids watching violent TV or

movies and he feels hyper-vigilant around police officers. He stated he has

attention deficit hyperactivity disorder and endorsed trouble concentrating, he is

often forgetful and loses and misplaces things easily, and he often feels

hyperactive. He stated he has obsessive compulsive disorder and said ‘If I touch

something that’s not mine I have to wash my hands or use hand-sanitizer. I have to

wash my hands about 200 times a day. It takes me only 2 days to go through a

bottle of hand-sanitizer. I feel compelled to count things repeatedly, for example,

when I’m washing my face or my neck I have to wash three times’....He is

bothered by auditory hallucinations and hears voices that ‘say bad things, like they

tell me that I’m going to burn my house down or that I’m going to hurt my dog.’ 

He also feels paranoid and feels afraid that someone will hurt him. He endorsed

depressed mood, insomnia, decreased energy, irritability, and decreased interest in

normal activities. He denied any history of suicidality. He denied any history of

symptoms related to mania.”

(AR 362.)

As for the evaluation, Dr. Nicholson noted that Frisbie presented for the

examination neatly and casually groomed. Frisbie used a cane to walk and carried a

bottle of hand sanitizer in his pocket. (AR 363.) Dr. Nicholson stated Frisbie was

cooperative, made good eye contact and had no psycho motor agitation or retardation. 

His speech was normal. He was alert to time, place, person and purpose and appeared to

Dr. Nicholson to be of average intelligence. Mr. Frisbie’s thought processes were

assessed by Dr. Nicholson as coherent and organized. Dr. Nicholson noted Frisbie’s

mood was depressed with a dysphoric affect and gave Frisbie a GAF score of 45. (AR

363-365.) Based on his examination, Dr. Nicholson opined that: “(1) The claimant is

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able to understand, remember, and carry out simple one or two-step job instructions;

(2)The claimant is able to do detailed and complex instruction; (3) The claimant’s ability

to relate and interact with coworkers and the public is moderately limited; (4) The

claimant’s ability to maintain concentration and attention, persistence and pace is

moderately limited; (5) The claimant’s ability to accept instructions from supervisor’s is

mildly limited; (6) The claimant’s ability to maintain regular attendance in the work place

and perform work activities on a consistent basis is mildly limited; and (7) The claimant’s

ability to perform work activities without special or additional supervision is moderately

limited.” (AR 365-366.)

3. William C. Eves, M.D., Inc. - Orthopaedic Evaluation

Frisbie presented on October 9, 2012, for an evaluation of his knees. Dr. Eves

noted: “The knee problem is located in the left and right knee. The onset was sudden

following a specific injury in a car accident in 2003. The patient was shot in the knee by

a police officer, followed by a car accident.” (AR 371.) 

At the conclusion of the orthopaedic evaluation, Dr. Eve opined: “The patient has

evidence of bilateral osteoarthritis of the knees, based on their history, physical exam, CT

scans and radiographs that were reviewed in the office today. They [sic] are having

significant pain in the knees that affects their daily activities. We discussed treatment

options with the patient, including activity modification, a formal physical therapy

program, nonsteroidal anti-inflammatory drugs (NSAIDS), pain medications, an

ultrasound guided intra-articular cortisone injection, an ultrasound guided hyaluronic acid

(Supartz) series of injections, and surgical options for the knee arthritis. The patient

wanted to proceed with the formal physical therapy program and with the ultrasound

guided intra-articular cortisone injection to each knee. We will obtain authorization for

the physical therapy program, and the intra-articular knee cortisone injection.” (AR 373.)

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4. Diane Carillo PT - Sharp Grossmont Rehabilitation Services

On February 12, 2013, Frisbie was issued a Home Exercise Program (“HEP”) and

discharged from physical therapy with the note that: “He feels he is able to perform his

HEP and has a supportive caregiver to assist. Therefore we will discharge his [sic] to his

HEP.” (AR 422.)

5. Enzo Arya - Licensed Clinical Social Worker - Neighborhood 

Healthcare

On July 30, 2013, Frisbie presented for a followup appointment to discuss his

PTSD and depression. (AR 454-55.) Frisbie’s results on the Mental Status Exam were: 

“APPEARANCE: appropriate. 

BEHAVIOR: cooperative, agitation.

SPEECH: regular rate and rhythm.

AFFECT: guarded and frustrated. 

THOUGH PROCESSES: linear, coherent.

THOUGHT CONTENT: No SI (“Suicidal Ideation”)/No HI (“Homicidal

 Ideation”), No Hallucinations.

SUICIDAL IDEATION: none.

ORIENTATION: alert/oriented.” 

(AR 454-55.) 

At the conclusion of the appointment, the licensed clinical social worker referred

Frisbie to “psychiatric support and more intensive therapy”. (AR 455.)

D. ALJ’s Findings

1. Legal Standard for Determination of Disability

In order to qualify for disability benefits, an applicant must show that: (1) he or 

she suffers from a medically determinable physical or mental impairment that can be

expected to result in death, or that has lasted or can be expected to last for a continuous

period of not less than twelve months; and (2) the impairment renders the applicant

incapable of performing the work that he or she previously performed or any other

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substantially gainful employment that exists in the national economy. See 42 U.S.C. §

423(d)(1)(A), (2)(A). An applicant must meet both requirements to be “disabled.” Id. 

The applicant has the burden to establish disability. Terry v. Sullivan, 903 F.2d 1273,

1275 (9th Cir. 1990). 

The Secretary of the Social Security Administration set forth a five-step sequential

evaluation process for determining whether a person has established his or her eligibility

for disability benefits. See 20 C.F.R. §§ 404.1520, 416.920. The five steps in the process

are as follows: 

1. Is the 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 or more of the specific

impairments described in 20 C.F.R. Pt. 404, Subpt. P, App. 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).

In steps one through four, the claimant bears the burden of proof to establish that

he is disabled. Smolen v. Chater, 80 F.3d 1273, 1289 (9th Cir. 1996); see Parra v.

Astrue, 481 F.3d 742, 746 (9th Cir. 2007) (finding that the claimant bears the burden “to

establish [his] entitlement to disability insurance benefits” at all times). At step five, the

Commissioner bears the burden of proof to demonstrate that the claimant is not disabled. 

See Valentine v. Comm’r of Soc. Sec. Admin., 574 F.3d 685, 689 (9th Cir. 2009) (stating

that the burden shifts to the Commissioner at step five to show that claimant can do other

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kinds of work). The Commissioner must show that the claimant can perform other work

that exists in significant numbers in the national economy by “taking into consideration

the claimant’s residual functional capacity, age, education, and work experience.” 

Tackett v. Apfel, 180 F.3d 1094, 1100 (9th Cir. 1999); see also 20 C.F.R. § 404.1566

(describing “work which exists in the national economy”). If the Commissioner meets

this burden, then the claimant is not disabled. Bustamante, 262 F.3d at 954. However, if

the Commissioner fails to meet this burden, then the claimant is disabled. Id.

2. The ALJ’s Decision

On December 4, 2013, the ALJ issued his decision denying Frisbie’s application

for supplemental social security income. (AR at 29.) In arriving at his decision, the ALJ

applied the Commissioner’s five-step sequential disability determination process set forth

in 20 C.F.R. § 416.920(a). At step one, the ALJ found that Frisbie had not engaged in

substantial gainful activity during the relevant period. Accordingly, the ALJ found that

Frisbie satisfied step one. (AR 22.) 

At step two, the ALJ found that Frisbie suffered from the following severe

impairments: (1) arthritis of the knees; and (2) a learning disorder. Thus, with regard to

Frisbie’s listed severe impairments, the ALJ found that Frisbie satisfied step two. (AR

22.)

At step three, the ALJ found that Frisbie did not have an impairment or

combination of impairments that met or medically equaled one of the listed impairments

under medical listing 12.04.1

 (AR 22-23.) Specifically, the ALJ found “based on the

treatment records, the report of the psychiatric consultative examiner, and the claimant’s

statements, ... the claimant’s mental impairments caused mild restriction of activities of

daily living, moderate difficulties in maintaining social functioning, moderate difficulties

in maintaining concentration, persistence or pace, and no episode of decompensation of

1

 Listing 12.04 provides: “Affective disorders: Characterized by a disturbance of mood,

accompanied by a full or partial manic or depressive syndrome. Mood refers to a prolonged emotion that

colors the whole psychic life; it generally involves either depression or elation. The required level of

severity for these disorders is met when the requirements in both A and B are satisfied, or when the

requirements in C are satisfied. See 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.04.” 

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extended duration.” (AR23.) The ALJ, therefore, proceeded to step four. (Id.)

The fourth and fifth steps require the ALJ to determine how the claimant’s

impairments affect the claimant’s ability to perform work. To make this determination,

the ALJ formulates the claimant’s Residual Functional Capacity assessment (“RFC”). 

The RFC “is used at step four of the sequential evaluation process to determine whether

an individual is able to do past relevant work,” See 20 C.F.R. § 404.1545(a)(1) (defining

an RFC as “the most [a claimant] can still do despite [his or her] limitations.”) An RFC

is used “at step five to determine whether an individual is able to do other work,

considering his or her age, education, and work experience.” Social Security Ruling

(“SSR”) 96-8p. Here, the ALJ found Frisbie had the RFC to perform “sedentary work as

defined in 20 CFR 416.967(a)2

 except the claimant is limited to non-public, simple

routine tasks; he can have occasional contact with co-workers and supervisors.” (AR 23.) 

The ALJ noted that “in making this finding, the undersigned has considered all symptoms

and the extent to which these symptoms can be reasonably accepted as consistent with the

objective medical evidence and other evidence.” (AR 23.)

In developing the RFC, the ALJ found Frisbie was “less than fully credible” with

respect to the intensity, persistence and limiting effects of his allegedly disabling

impairments. (AR 24.) The ALJ explained in his decision:

 “The claimant stated he lives in a mobile home with his girlfriend and roommates,

and could do the following activities of daily living: maintain his personal care,

feed the dog, retrieve mail, let the dogs out, ride in a car, and watch television. The

claimant admitted to the consultative examiner that he had no difficult with

dressing, bathing, or hygiene. He also could manage his finances. He could go out

on his own....The claimant has described daily activities that are not limited to the

extent one would expect given the complaint of disabling symptoms and

limitations. Some of the physical and mental abilities and social interactions

required in order to perform these activities are the same as those necessary for

obtaining and maintaining employment. The undersigned finds the claimant’s

2

 20 CFR § 416.967(a) provides: “Sedentary work. Sedentary work involves lifting no more than

10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools.

Although a sedentary job is defined as one which involves sitting, a certain amount of walking and

standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are

required occasionally and other sedentary criteria are met.”

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ability to participate in such activities diminishes the credibility of the claimant’s

allegations of functional limitations.” 

(AR 25.)

The ALJ also considered Frisbie’s noncompliance with medications as a factor in

discounting his credibility. (AR 26.) Specifically, the ALJ explained:

“The medical records indicate the claimant has been diagnosed with obsessivecompulsive disorder (“OCD”) ... The claimant also has a history of depression

without any suicidal or homicidal ideation. However, the claimant was not

compliant with his medications. This demonstrates a possible unwillingness to do

what is necessary to improve his conditions. It may also be an indication that the

claimant’s symptoms were not as severe as the claimant purported. The claimant’s

mental status examinations were normal. A medical report dated July 30, 2013,

revealed the claimant was diagnosed with posttraumatic stress disorder, major

depressive disorder and learning disorder. The claimant was conservatively treated

with medications. 

A medical report, dated February 9, 2012, revealed the claimant’s x-rays [sic]

image of his knees showed he had osteoarthritis in his bilateral knees with joint

effusions. The claimant used a cane for ambulation. The claimant’s diagnostic

tests regarding the claimant’s lumbar spine and thoracic spine showed minimal

degenerative changes. It was noted that the claimant complained of low back pain

but does not take his medications as directed.

This evidence of noncompliance of medications undermines the credibility of

claimant’s subjective complaints and alleged disability. Although the failure to

follow prescribed treatment without a good reason can be the basis for a finding

that the claimant is not disabled, the undersigned considered it as a credibility

factor in this case and does not base the ultimate decision in this case on this factor

alone.”

(AR 26.)

Additionally, the ALJ found that objective medical evidence did not support

Frisbie’s claims of disabling limitations to the degree he alleged. Specifically, the ALJ

noted a course of conservative treatment that included medication and physical therapy.

(AR 26-27.) 

Finally, in developing Frisbie’s RFC, the ALJ considered opinion evidence from

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the state agency physicians’ report3 and the consultative examiner’s report of Dr. Gregory

Nicholson. The ALJ assigned significant weight to these reports explaining: 

“The opinions of all of these physicians are generally consistent in that they assess

the claimant is able to perform a range of work at the light or less than light

exertional level with some differences in the degree of specific function-byfunction limitations.”

(AR 26-27.)

As to Dr. Nicholson’s report in particular, the ALJ stated: 

“Dr. Nicholson opined the claimant to have mild to moderate mental limitations. 

The undersigned finds Dr. Nicholson’s opinion to be consistent with the findings

and the medical records as a whole and incorporated some of the limitations in the

residual functional capacity.”

(AR 27.)

Next, the ALJ considered the VE’s testimony to determine that while Frisbie is not

able to perform past relevant work as a fast food cook, he is capable of performing the

unskilled sedentary occupations such as Final Assembler, Lens Inserter and Bench Hand. 

(AR 29.)

III. SCOPE OF REVIEW

Section 205(g) of the Social Security Act allows unsuccessful applicants to seek

judicial review of a final agency decision. 42 U.S.C. § 405(g). The scope of judicial

review is limited. See id. This Court has jurisdiction to enter a judgment affirming,

modifying, or reversing the Commissioner’s decision. See id.; 20 C.F.R. § 404.900(a)(5). 

The matter may also be remanded to the Social Security Administration for further

proceedings. 42 U.S.C. § 405(g).

3

The State Agency Physician Report of H. Amado, M.D., dated August 21, 2012, opined:

“‘Your condition results in some limitations in your ability to perform work related activities. 

While you are not capable of performing work you have done in the past, you are able to perform

work that is less demanding. We have determined that your condition is not severe enough to

keep you from working. We considered the medical and other information, your age, education,

training, and work experience in determining how your condition affects your ability to work.”

(AR 137-38.) See also State Agency Physician Report of Pamela Hawkins, Ph.D., on

reconsideration dated November 19, 2012 finding no disability and the capability to do other

work. (AR 140-153.)

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The Commissioner’s decision must be affirmed upon review if it is: (1) supported

by “substantial evidence” and (2) based on proper legal standards. Uklov v. Barnhart,

420 F.3d 1002, 1004 (9th Cir. 2005). If the Court, however, determines that the ALJ’s

findings are not supported by substantial evidence or are based on legal error, the Court

may reject the findings and set aside the decision to deny benefits. Aukland v.

Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001). 

Substantial evidence is more than a scintilla but less than a preponderance. 

Connett v. Barnhart, 340 F.3d 871, 873 (9th Cir. 2003). It is “relevant evidence that,

considering the entire record, a reasonable person might accept as adequate to support a

conclusion.” Id.; see also Howard ex rel. Wolff v. Barnhart, 341 F.3d 1006, 1012 (9th

Cir. 2003) (finding substantial evidence in the record despite the ALJ’s failure to discuss

every piece of evidence). Moreover, “where evidence is susceptible to more than one

rational interpretation,” the ALJ’s conclusion must be upheld. Burch v. Barnhart, 400

F.3d 676, 679 (9th Cir. 2005). This includes deferring to the ALJ’s credibility

determinations and resolutions of evidentiary conflicts. See Lewis v. Apfel, 236 F.3d 503,

509 (9th Cir. 2001). Nevertheless, the Court “must consider the entire record as a whole

and may not affirm simply by isolating a specific quantum of supporting evidence.” 

Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006). 

IV. DISCUSSION 

In the instant motion, Frisbie argues: 

(1) the ALJ erred in failing to consider obesity as a severe impairment in the

sequential disability analysis and in failing to consider the effect that obesity, in

combination with his other impairments, would have on his ability to work [ECF No. 17,

pp. 5-7]; 

(2) the ALJ failed to consider his post-traumatic stress disorder (“PTSD”),

obsessive compulsive disorder (“OCD”) and major depressive disorder in the RFC

assessment [ECF No. 17, pp. 7-10]; and 

(3) the ALJ erred in failing to articulate clear and convincing reasons for

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discounting his credibility. [ECF No. 17 at pp. 11-14.] 

Frisbie asks the Court to reverse the ALJ’s decision and award him benefits. (Id. at

14.) In the alternative, Frisbie requests the case be remanded to the ALJ for further

administrative proceedings. Id.

As to Frisbie’s obesity argument, Defendant contends the record did not support a

finding of functional limitation due to obesity, therefore if the ALJ’s failure to explicitly

discuss Plaintiff’s weight was error, it is harmless. [ECF No. 18-1 at pp. 3-4.] Similarly,

as to Frisbie’s mental RFC, Defendant argues Plaintiff’s treatment records did not

support a disabling mental impairment. Defendant also contends the ALJ did consider all

of Frisbie’s mental impairments regardless of their severity. [ECF No. 18-1 at pp.4-6.] 

Finally, with respect to the ALJ’s determination that Frisbie’s subjective pain allegations

were not fully credible, Defendant argues the ALJ properly found Frisbie less than

credible based on Plaintiff’s inconsistent statements, conservative treatment and

noncompliance. [ECF No. 18-1 at pp. 7-9.]

A. There Is No Evidence In The Record To Demonstrate Obesity Is An

Impairment

1. Relevant Law

Social Security Rules provide that obesity is considered a “severe” impairment

“when[,] alone or in combination with another medically determinable physical or mental

impairment(s), it significantly limits an individual’s physical or mental ability to do basic

work activities.” Titles II and XVI: Evaluation of Obesity, SSR 02-1p (S.S.A), 2002 WL

34686281. The ruling states: “There is no specific level of weight or BMI that equates

with a ‘severe’ or a ‘not severe’ impairment.... [the SSA] will do an individualized

assessment of the impact of obesity on an individual’s functioning when deciding

whether the impairment is severe.” Id.

In Celaya v. Halter, 332 F.3d 1177 (9th Cir.2003), the Ninth Circuit held that an 

ALJ should consider the effect of the claimant's obesity in combination with other

impairments on the claimant's ability to work even if the claimant does not raise obesity

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as a limitation. Id. at 1182. However, the Ninth Circuit’s decision in Celaya was

premised on the fact that: (1) obesity was implicitly raised in the plaintiff’s report of

symptoms; (2) the record showed plaintiff's obesity was close to the listing criterion and

was a condition that could exacerbate reported illnesses; and (3) the ALJ's personal

observation of the claimant and information in the record should have alerted him to the

need to develop the record on behalf of the plaintiff who was pro se. Burch, 400 F.3d at

682 (citing Celaya, 332 F.3d at 1182). 

Two years later, in Burch v. Barnhart, 400 F.3d 676 (9th Cir. 2005), the Ninth

Circuit distinguished Celaya by ruling an ALJ’s failure to consider obesity at various

steps of the sequential evaluation process was not error because: (1) the record did not

indicate claimant’s obesity exacerbated other impairments; (2) the claimant was

represented by counsel; (3) the claimant did not specify the listing she believed she met

or equaled; and (4) the claimant failed to provide evidence to support a diagnosis of a

listed impairment or evidence of functional limitations due to obesity. Id. at 682-83.

2. Analysis

While it is true the ALJ did not discuss obesity in his decision denying disability

benefits, it has also been admitted by Frisbie in his reply brief that he did not list obesity

in his application as one of the conditions he believed limited his ability to work. (AR

244; ECF No. 20 at 7-8.) Further, neither Frisbie, nor his counsel raised obesity at the

hearing before the ALJ. There are notations in Frisbie’s medical records that document

his weight and Body Mass Index (“BMI”)4

, however there is no diagnosis of obesity in

Frisbie’s medical records that stem from that information. Similarly, a need to lose or

maintain a certain weight is nowhere addressed in Frisbie’s physical therapy treatment

notes. (AR 422-426.) 

Given that Frisbie: (1) was and is represented by counsel; (2) failed on several

occasions to allege obesity as a disabling impairment; and (3) has provided no medical

4

See October 9, 2012 Orthopaedic Evaluation report of Dr. William Eves at AR 372

listing Frisbie’s height as 6 ft., 9 in., weight at 321 lb. and BMI of 34.4.

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evidence diagnosing any functional limitations arising from obesity, IT IS

RECOMMENDED that the Court find the ALJ's failure to address obesity or otherwise

categorize obesity as a severe impairment in his decision was not error. There are neither

allegations, nor evidence in Frisbie’s record demonstrating his weight is an impairment

that significantly limited his physical or mental ability to do basic work activities. See

Burch, 400 F.3d 682–83 (ALJ did not commit reversible error by failing to consider

obesity where claimant was represented by counsel and failed to present evidence

indicating obesity exacerbated impairments or resulted in functional limitations); Aguilar

v. Colvin, 2014 WL 1653109, at *7 (S.D. Cal. Apr.22, 2014) (ALJ did not err by failing

to discuss obesity when claimant was represented by counsel, did not list obesity as a

limitation on the disability application, did not present evidence that obesity impaired her

ability to work and did not present evidence showing obesity caused functional

limitations).

B. The ALJ Did Consider Frisbie’s PTSD, OCD and Depression in Determining

the RFC

1. Relevant Law

Social Security Ruling 96-8p states: “In assessing RFC, the adjudicator must 

consider limitations and restrictions imposed by all of an individual's impairments, even

those that are not ‘severe.’” Titles II and XVI: Assessing Residual Functional Capacity

in Initial Claims: SSR 96-8p (S.S.A), 1996 WL 374184. 

2. Analysis

a) Severity 

At step three of the sequential evaluation process, the ALJ found Frisbie did not

have a mental impairment or combination of impairments that met or medically equaled

the severity of a listed impairment. (AR 22.) As to Frisbie’s mental impairments, the

ALJ determined listing 12.045

 was not met. The ALJ explained his reasoning as to why

5

12.04 Affective disorders: Characterized by a disturbance of mood, accompanied by a full or partial manic

or depressive syndrome. Mood refers to a prolonged emotion that colors the whole psychic life; it generally involves

either depression or elation. The required level of severity for these disorders is met when the requirements in both A

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Frisbie did not meet the “B” and “C” criteria of listed impairment 12.04 for depression. 

Specifically, the ALJ found Frisbie did not satisfy “paragraph B” criteria because he only

has mild restrictions in activities of daily living; moderate difficulties in maintaining

social functioning; moderate difficulties maintaining concentration, persistence, or pace;

and no episodes of decompensation of extended duration. (AR 23.) At least two

“marked” limitations or one “marked” limitation and “repeated” episodes of

decompensation of an extended duration are required to satisfy “B” criteria. (Id.)

Similarly, the ALJ found Frisbie did not meet the listing’s “C” criteria because

evidence in the record did not support a finding of: repeated episodes of extended

decompensation; a residual disease process that has resulted in such marginal adjustment

that even a minimal increase in mental demands or change in environment would cause

decompensation; or current history of one-or-more years of inability to function outside

of a highly supportive living arrangement. (AR 23.) 

Frisbie argues his mental impairments of PTSD, OCD and depression should have

been found to be severe based on his low Global Assessment of Functioning (“GAF”)

scores, which were listed as 38 by Dr. Olga Caplin (AR481) and 45 by Dr. Gregory

Nicholson. (AR 365). However, the ALJ explained in his decision that “the GAF score

(as a method of evaluating the severity of impairments) has been specifically rejected by

the SSA.” (AR 27.) Accordingly, the SSA provides in its Revised Medical Criteria for

Evaluating Mental Disorders and Traumatic Brain Injury that:

“The GAF scale ... is the scale used in the multiaxial evaluation system endorsed

by the American Psychiatric Association. It does not have a direct correlation to

the severity requirements in our mental disorders listings.” 

65 Fed. Reg. 50746-01, 2001 WL 117632, (Aug. 21, 2000).

In addition, the ALJ’s rejection of the GAF scores and finding of non-severity

were further supported by the treatment notes of Dr. Caplin and Dr. Nicholson. See e.g.

Valentine v. Comm’r of Soc. Sec. Admin. 574 F.3d 685, 692-93 (9th Cir. 2009) (explaining

and B are satisfied, or when the requirements in C are satisfied. See 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.04.

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that a conflict with treatment notes is a specific and legitimate reason to reject a treater’s

opinion.) Specifically, in contrast to Frisbie’s low GAF score, Dr. Caplin’s mental status

exam notes indicated: an alert level of consciousness; all normal orientation; good

hygiene, cooperative behavior age/appropriate judgment; fair insight and no visual, tactile

or olfactory hallucinations and no delusions. (AR 479-480.) 

 Similarly, Dr. Nicholson’s treatment notes found Frisbie was: neatly and casually

groomed with good eye contact and good interpersonal contact, generally cooperative

with no psychomotor agitation or retardation. Dr. Nicholson further opined that Frisbie’s

thought processes were coherent and organized, his speech was normal, he was alert and

oriented to time, place, person and purpose and appeared to be of average intelligence

with insight and judgment grossly intact. (AR 363-365.) The ALJ is responsible for

determining credibility, resolving conflicts in medical testimony, and for resolving

ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir.1995). If the evidence is

subject to more than one rational interpretation, the ALJ's conclusion must be upheld.

Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). Accordingly, IT IS

RECOMMENDED the Court find there was substantial evidence in the record to

support the ALJ’s determination that Frisbie’s mental impairments of PTSD, OCD and

depression did not meet or equal the severity of a listed impairment.

b.) Consideration of All Impairments

Even though the ALJ did not find Frisbie’s mental impairments severe, he

explicitly stated that he would nevertheless consider all impairments in his RFC

assessment. The ALJ’s decision makes clear: 

“the limitations identified in the ‘paragraph B’ criteria are not a residual functional

capacity assessment but are used to rate the severity of mental impairments ... The

mental residual functional capacity assessment ... requires a more detailed

assessment by itemizing various functions contained in the broad categories found

in paragraph B of the adult mental disorders listings in 12.00 of the Listing of

Impairments (SSR 96-8p). 

(AR 23.) 

Contrary to Frisbie’s assertions, the ALJ does address Frisbie’s OCD (AR 25),

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history of depression (AR 25) and post traumatic stress disorder (AR 26) in the RFC

analysis section of his decision and determines Frisbie has the Residual Functional

Capacity to “perform sedentary work as defined in 20 CFR 416.967(a) except the

claimant is limited to non-public, simple routine tasks; he can have occasional contact

with co-workers and supervisors.” (AR 23.) In preparing the RFC, the ALJ also noted:

“the undersigned took into consideration the claimant’s subjective complaints and

provided a more restrictive residual functional capacity than assessed by the State

agency physicians.” (AR 27.) (emphasis added.) IT IS THEREFORE

RECOMMENDED that the Court find the ALJ did not err because he did consider the

limitations imposed by all of Frisbie’s mental impairments, including his PTSD, OCD

and depression, in the RFC even though those conditions were properly found not to be

severe.

C. The ALJ’ Credibility Determination of Frisbie Was Properly Supported

1. Relevant Law

The ALJ has a “well-settled role as the judge of credibility.” Matthews v. Shalala,

10 F.3d 678, 680 (9th Cir. 1993) (quoting Sample v. Schweiker, 694 F.2d 639, 642 (9th

Cir. 1982)). Accordingly, the ALJ’s assessment of a claimant’s credibility and pain

severity should be given “great weight.” Dominguez v. Colvin, 927 F. Supp. 2d 846, 865

(9th Cir. 2003) (citing Nyman v. Heckler, 779 F.2d 528, 531 (9th Cir. 1986)). The ALJ is

not “required to believe every allegation of disabling pain, or else disability benefits

would be available for the asking, a result plainly contrary to 42 U.S.C. § 423(d)(5)(A).” 

Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012) (quoting Fair v. Bowen, 885 F.2d

597, 603 (9th Cir. 1989)). 

The Ninth Circuit has established a two-step analysis for the ALJ to evaluate the

credibility of a claimant’s testimony regarding subjective pain and impairments. Vasquez

v. Astrue, 572 F.3d 586, 591 (9th Cir. 2008) (citing Lingenfelter v. Astrue, 504 F.3d 1028,

1035-36 (9th Cir. 2007)). First, the ALJ must determine whether the claimant presented

objective medical evidence of an impairment or impairments that could reasonably be

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expected to produce the pain or other alleged symptoms. Id. Second, if the claimant

satisfies the first step and there is no affirmative evidence of malingering, the ALJ may

reject the claimant’s testimony only if he provides “specific, clear and convincing

reasons” for doing so. Id.; see also Parra v. Astrue, 481 F.3d 742, 750 (9th Cir. 2007)

(citing Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995)). These reasons must be

“sufficiently specific to permit the court to conclude that the ALJ did not arbitrarily

discredit the claimant’s testimony.” Turner v. Comm’r of Soc. Sec., 613 F.3d 1217, 1224

n. 3 (9th Cir. 2010) (quoting Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996)). 

In weighing the credibility of the claimant’s testimony, the ALJ may use “ordinary

techniques of credibility determination.” Id. The ALJ may consider the “inconsistencies

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

work records, 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). 

2. Analysis

Frisbie satisfied the first step of the two-step credibility analysis because the ALJ

determined that Frisbie presented objective medical evidence of medically determinable

impairments that could reasonably be expected to cause his alleged symptoms. (AR 25.) 

The ALJ made no finding that Frisbie was malingering, nor did any of the presented

evidence suggest that he was malingering. Nonetheless, the ALJ found that Frisbie’ s

statements “concerning the intensity, persistence and limiting effects of these symptoms

are not entirely credible”. (AR 25.) Therefore, the only remaining issue is whether the

ALJ provided “specific, clear and convincing reasons” for discounting Frisbie’s

subjective pain testimony. See Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir.

2008).

The Court recommends a finding that the ALJ’s decision properly set forth

“specific, clear and convincing reasons” supported by substantial evidence in the record

for rejecting Frisbie’s subjective pain testimony to the extent it was inconsistent with the

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RFC assessment. (AR 24.) The ALJ stated the following reasons for finding Frisbie’s

testimony was not credible: (1) the limitations alleged in Frisbie’s testimony were

inconsistent with his daily activities (AR 25); (2) Plaintiff had a history of noncompliance

and conservative treatment (AR 26); and (3) objective medical evidence did not support

the intensity, persistence, and limiting effects of Frisbie’s symptoms. (AR 27.) The

Court will consider the validity of the ALJ’s stated reasons below.

i. Daily Activities

One basis for the ALJ’s credibility determination was the inconsistency between

Frisbie’s alleged limitations and his daily activities, which is sufficient to support a

finding that Frisbie was not entirely credible. See Lingenfelter, 504 F.3d at 1040 (in

determining credibility, an ALJ may consider “whether claimant engages in daily

activities inconsistent with alleged symptoms”). Specifically, daily activities may be

grounds for discrediting a claimant’s testimony when 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.” Fair, 885 F.2d at 603. Even when such

activities suggest some difficulty functioning, the ALJ may discredit a claimant’s

testimony to the extent that they contradict claims of a totally debilitating impairment. 

See Turner, 613 F.3d at 1225; Valentine v. Comm’r Social Sec. Admin., 574 F.3d 685,

693 (9th Cir. 2009). 

In this case, the ALJ noted Frisbie alleged he had difficulty lifting, squatting,

bending, standing, reaching, walking, sitting, kneeling, talking, climbing stairs,

remembering, completing tasks, concentrating, understanding, following instructions, and

getting along with others. (AR 25.) However, the ALJ found Frisbie’s daily activities of:

“maintain[ing] his personal care, feed[ing] the dog, retriev[ing] the mail, let[ting] the

dogs out, rid[ing] in a car, and watch[ing] television”, in addition to “admitt[ing] to the

consultative examiner that he had no difficulty with dressing, bathing or hygiene. He

also could manage his finances [and] He could go out on his own” were inconsistent with

the wide-ranging limitations alleged in Frisbie’s testimony. (AR 25.)

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Therefore, IT IS RECOMMENDED that the Court find it was proper for the ALJ

to consider daily activities and conclude that “[s]ome of the physical and mental abilities

for social interactions required in order to perform these activities are the same as those

necessary for obtaining and maintaining employment .... [thus] the claimant’s ability to

participate in such activities diminishes the credibility of the claimant’s allegations of

functional limitations.” (AR 25; see Curry v. Sullivan, 925 F.2d 1127, 1130 (9th Cir.

1991) (holding that an indication that a claimant is able to take care of personal needs,

prepare meals, do easy housework, and shop for groceries can be seen as inconsistent

with a condition that precludes all work activity); see also Burch v. Barnhart, 400 F.3d

676, 681 (2005) (stating that the ALJ may discredit claimant's testimony if a he engages

in daily activities involving skills that could be transferred to the workplace).

ii. Noncompliance and Conservative Treatment 

Other grounds cited by the ALJ in discounting Frisbie’s credibility included

Frisbie’s noncompliance with medication and conservative treatment with physical

therapy and medication. (AR 26.) Where, as here, the medical record evidences an

impairment that can be reasonably expected to produce pain, an ALJ may properly

consider the nature of the symptoms, medication, treatment and functional restrictions. 

Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir. 1991). 

As to medication prescribed, an ALJ may evaluate the credibility of subjective

complaints by considering unexplained, or inadequately explained, failure to seek

treatment or to follow a prescribed course of treatment. Smolen v. Chater, 80 F.3d 1273,

1284 (9th Cir.1996). The ALJ did so in this case and in his decision further explained

this reasoning and how it applied to Frisbie, specifically citing Frisbie’s February 9,

2012, medical report from Neighborhood Healthcare:

 “The medical records indicate the claimant has been diagnosed with obsessivecompulsive disorder (“OCD”) A medical report, dated February 9, 2012, indicated

the claimant has a history of OCD ... The claimant also has a history of depression

without any suicidal or homicidal ideation. However the claimant was not

compliant with his medications. This demonstrates a possible unwillingness to do

what is necessary to improve his conditions. It may also be an indication that the

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claimant’s symptoms were not as severe as the claimant purported. The claimant’s

mental status examinations were normal.”

(AR25-26, AR 332.)

As to treatment, the Ninth Circuit has held that the conservative nature of plaintiff's

treatment provides a clear and convincing reason for rejecting plaintiff's statements

concerning the severity of her impairments. See Parra v. Astrue, 481 F.3d 742, 751 (9th

Cir.2007) (“[E]vidence of ‘conservative treatment’ is sufficient to discount a claimant's

testimony regarding severity of an impairment.”). In his decision, the ALJ cited multiple

medical reports documenting Plaintiff’s diagnosis of mild to moderate osteoarthritis in

the right knee and moderate osteoarthritis in the left knee and subsequent conservative 

treatments with physical therapy, a home exercise program, pain medication and supartz

injections. (AR 26, Exhs. C2F, C5F, C8E, C9F, C10F.) The ALJ made it clear that

“[a]lthough the failure to follow prescribed treatment without a good reason can be a

basis for finding that the claimant is not disabled, the undersigned considered it as a

credibility factor in this case and does not base the ultimate decision in this case on this

factor alone.” (AR 26.) Thus, IT IS RECOMMENDED that the Court find the ALJ

properly considered Frisbie’s noncompliance and conservative treatment as factors in his

credibility assessment.

iii. Medical Evidence

Another basis for the ALJ’s credibility determination was that the medical records

did not support the alleged intensity, persistence, and limiting effects of Frisbie’s

symptoms. (AR 27.) When the ALJ finds that medically determinable impairments

could reasonably be expected to cause a claimant’s alleged symptoms, the ALJ may not

reject a claimant’s testimony solely based on inconsistent medical evidence. See Reddick,

157 F.3d at 722 (finding that an ALJ cannot reject a claimant's testimony simply because

it is unsupported by objective medical evidence). However, when assessing a claimant’s

credibility, the ALJ may consider inconsistent medical evidence as a factor in his

credibility analysis. See Lingenfelter, 504 F.3d at 1040 (in determining credibility, the

ALJ may consider “whether the alleged symptoms are consistent with the medical

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evidence”). 

The ALJ found that the medical evidence did not support the alleged severity of

Frisbie’s symptoms. (AR 27.) In coming to this conclusion, the ALJ analyzed all the

medical records submitted “including medical records dated prior to the relevant time

period and subsequent to the hearing. (Exhs. C1F-C12F).” (AR 25.) The ALJ noted that

the opinions of the State agency medical and psychological consultants all assessed

claimant as able to perform a range of work at the light or less than light exertional level. 

(AR 27.) The ALJ also noted that the opinion of psychiatric consultative examiner, Dr.

Nicholson, found Frisbie’s mental limitations as mild to moderate. (AR 27.) The ALJ

added:

“The claimant’s subjective complaints are less than fully credible and the objective

medical evidence does not support the alleged severity of symptoms. ... the

claimant [w]as not credible when asked to describe his limitations; the claimant

alleged it was painful to even sit for 15 minutes. His allegation was not supported

by medical evidence. The claimant alleged he could not stand independent of his

cane or his leg might give out; however, the claimant could no specify any

particular time this has occurred.”

(AR 27.)

Accordingly, the ALJ properly considered inconsistencies between Frisbie’s

subjective allegations and medical records as one of several factors in his credibility

assessment. IT IS RECOMMENDED that the Court find there was a sufficient basis for

the ALJ to discount Frisbie’s subjective pain testimony. IT IS FURTHER

RECOMMENDED that the Court find the ALJ’s credibility determination properly set

forth three “specific, clear and convincing” reasons supported by substantial evidence in

the record.

V. CONCLUSION

Having reviewed the matter, the undersigned Magistrate Judge recommends that

Frisbie’s motion for summary judgment be DENIED and that Commissioner’s

cross-motion for summary judgment be GRANTED. This Report and Recommendation

of the undersigned Magistrate Judge is submitted to the United States District Judge

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assigned to this case, pursuant to 28 U.S.C. § 636(b)(1).

IT IS ORDERED that no later than April 13, 2016, any party to this action may

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

should be captioned “Objections to Report and Recommendation.”

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

the Court and served on all parties no later than April 27, 2016.

DATED: March 29, 2016

Hon. Bernard G. Skomal

U.S. Magistrate Judge

United States District Court

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Case 3:15-cv-01500-BAS-BGS Document 21 Filed 03/29/16 Page 25 of 25