Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_14-cv-02637/USCOURTS-azd-2_14-cv-02637-0/pdf.json

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

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Sylvia P. Velazquez, 

Plaintiff, 

v. 

Carolyn W. Colvin, 

Defendant.

No. CV-14-02637-PHX-DLR

ORDER 

 Plaintiff Sylvia Velazquez seeks review of the final decision of the Commissioner 

of Social Security (“the Commissioner”), which denied her disability insurance benefits 

and supplemental security income (“SSI”). For the following reasons, the 

Commissioner’s decision is remanded for further proceedings. 

BACKGROUND

 On May 26, 2011, Velazquez applied for disability insurance benefits and SSI, 

alleging disability beginning on April 1, 2010. (A.R. 193.) She appeared with her 

attorney and testified before an Administrative Law Judge (“ALJ”) on February 25, 2013. 

(Id. at 36-71.) A vocational expert also testified. (Id.) The ALJ found that Velazquez 

was not disabled within the meaning of the Social Security Act. (Id. at 15-35.) The 

Appeals Council denied Velazquez’s request for review, making the ALJ’s decision the 

Commissioner’s final decision. (Id. at 1-7, 11-14.) Thereafter, Velazquez appealed to 

this Court. (Doc. 1.) 

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LEGAL STANDARD 

The district court reviews only those issues raised by the party challenging the 

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court 

may set aside the Commissioner’s disability determination only if the determination is 

not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 

625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. As a general rule, 

“[w]here the evidence is susceptible to more than one rational interpretation, one of 

which supports the ALJ’s decision, the ALJ’s conclusion must be upheld.” Thomas v. 

Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted). 

DISCUSSION 

To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears 

the burden of proof on the first four steps, but at step five, the burden shifts to the 

Commissioner. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). At the first step, 

the ALJ determines whether the claimant is engaging in substantial gainful activity. 20 

C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not disabled and the inquiry ends. Id. 

At step two, the ALJ determines whether the claimant has a “severe” medically 

determinable physical or mental impairment. § 404.1520(a)(4)(ii). If not, the claimant is 

not disabled and the inquiry ends. Id. At step three, the ALJ considers whether the 

claimant’s impairment or combination of impairments meets or medically equals an 

impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404. § 404.1520(a)(4)(iii). 

If so, the claimant is automatically found to be disabled. Id. If not, the ALJ proceeds to 

step four. At step four, the ALJ assesses the claimant’s residual functional capacity 

(“RFC”) and determines whether the claimant is still capable of performing past relevant 

work. § 404.1520(a)(4)(iv). If so, the claimant is not disabled and the inquiry ends. Id. 

If not, the ALJ proceeds to the fifth and final step, where he determines whether the 

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claimant can perform any other work based on the claimant’s RFC, age, education, and 

work experience. § 404.1520(a)(4)(v). If so, the claimant is not disabled. Id. If not, the 

claimant is disabled. Id. 

 At step one, the ALJ found that Velazquez meets the insured status requirements 

of the Social Security Act through December 31, 2013, and that she has not engaged in 

substantial gainful activity since April 1, 2010. (A.R. 20.) At step two, the ALJ found 

that Velazquez has the following severe impairments: fibromyalgia, asthma, diffuse 

myofascial pain, morbid obesity, suspected arthritis of the knees, bipolar disorder, 

posttraumatic stress disorder (“PTSD”), dysthymia, anxiety disorder with depressive 

features, and polysubstance dependence, which is in remission. (Id.) At step three, the 

ALJ determined that Velazquez does not have an impairment or combination of 

impairments that meets or medically equals an impairment listed in Appendix 1 to 

Subpart P of 20 C.F.R. Pt. 404. (Id. at 21.) At step four, the ALJ found that Velazquez 

has the RFC to perform: 

light work as defined in 20 [C.F.R.] 404.1567(b) and 416.967(b) except [Velazquez] can lift and/or carry 50 pounds occasionally and 10 pounds frequently; [she] has no limitations in her ability to sit, stand, and/or walk; 

[she] can occasionally climb stairs and ramps, but can never climb ladders, ropes, or scaffolds; [she] can occasionally stop and crouch, but can never kneel or crawl; [she] must avoid unprotected heights; and, due to mental health and pain medication side effects, [she] can only perform unskilled routine work in a socially limited and stable environment. 

(Id. at 22.) Based on this RFC, the ALJ found that Velazquez is unable to perform any of 

her past relevant work. (Id. at 30.) However, at step five the ALJ concluded that jobs 

exist in significant numbers in the national economy that Velazquez could perform, 

considering her age, education, work experience, and RFC. (Id.) 

 Velazquez argues that the RFC assessed by the ALJ is inconsistent with the 

limitations imposed by her impairments. Specifically, she contends that the ALJ 

improperly discounted: (1) medical opinions that assessed limitations inconsistent with 

sustained work, (2) Velazquez’s symptom testimony, and (3) the third-party report of her 

daughter. (Doc. 15 at 9-24.) 

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I. Medical Opinion Evidence 

The ALJ is responsible for resolving conflicts in medical testimony. Andrews v. 

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). Generally, more weight should be given to 

the opinion of a treating physician than to the opinions of non-treating physicians. Lester 

v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). Where a treating physician’s opinion is not 

contradicted by another physician, it may be rejected only for “clear and convincing” 

reasons, and where it is contradicted, it may not be rejected without “specific and 

legitimate reasons” supported by substantial evidence in the record. Id. Likewise, an 

examining physician’s opinion generally must be given greater weight than that of a nonexamining physician. Id. at 830. As with a treating physician, there must be clear and 

convincing reasons for rejecting the uncontradicted opinion of an examining physician, 

and specific and legitimate reasons, supported by substantial evidence in the record, for 

rejecting an examining physician’s contradicted opinion. Id. at 830-31. 

A. Physiological Opinion Evidence 

The ALJ was presented with conflicting medical opinions on the limiting effects 

of Velazquez’s physical impairments. Dr. Cifuentes, Velazquez’s treating physician, 

opined that Velazquez would be unable to work for 8 hours per day, 5 days per week on a 

consistent basis. (A.R. at 534-35, 930-31.) He opined that, in an 8 hour work day, she 

would be able to sit, stand, and walk for less than 2 hours, and would be able to lift and 

carry less than 10 pounds. (Id.) He indicated that Velazquez could use her hands and 

feet occasionally, but could bend, reach, and stoop less than occasionally. (Id.) 

Additionally, he opined that Velazquez’s conditions would cause her to miss 4-5 days per 

month, and that the side effects of her medications would severely limit her ability to 

work. (Id.) These opinions, if credited, would limit Velazquez to a less than sedentary 

exertional capacity. (Id. at 26, 66-68.) 

 However, consultative physician Dr. Cunningham examined Velazquez and 

assessed functional limitations consistent with a light exertional capacity. (Id. at 26, 63, 

516-21.) Specifically, he opined that, despite her impairments, Velazquez: (1) could 

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occasionally lift 50 pounds and frequently lift 10 pounds; (2) has no sitting, standing, or 

walking limitations; (3) can occasionally climb ramps and stairs, but can never use 

ladders, ropes, or scaffolds; (4) can occasionally stoop and crouch, never kneel or crawl, 

and has no limitations on reaching, handling, fingering, and feeling; and (5) should avoid 

working around heights. (Id. at 517-20.) 

 The ALJ resolved this conflict by giving little weight to Dr. Cifuentes’ opinions 

and great weight to Dr. Cunningham’s. (A.R. 26.) The ALJ concluded that Dr. 

Cifuentes’ opinion was less reliable because “the objective treatment records do not 

support such a debilitating residual functional capacity,” and because Velazquez’s 

impairments could be managed conservatively with medication. (Id.) Inconsistency with 

objective medical records and conservative treatment are specific and legitimate reasons 

for discrediting medical testimony. See Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th 

Cir. 2008); Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001). However, the ALJ 

did not adequately support her reasons with evidence from the record. 

 Regarding the objective treatment records, the ALJ states that x-rays “showed only 

mild-thoracic dextrocurvature” and “no abnormal findings” for Velazquez’s lumbar 

spine. (Id.) Velazquez argues, and the Court agrees, that the ALJ’s rationale reflects a 

misunderstanding of her conditions. After concluding that Velazquez suffers from 

fibromyalgia, the ALJ determined that Dr. Cifuentes’ opinion as to the limiting effects of 

the condition was less reliable because x-rays did not reveal spinal abnormalities. Social 

Security regulations define fibromyalgia as “a complex medical condition characterized 

primarily by widespread pain in the joints, muscles, tendons, or nearby soft tissues that 

has persisted for at least 3 months.” See SSR 12-2p, 2012 WL 3104869, at *2. To 

establish the existence of fibromyalgia a claimant generally must supply evidence that 

other disorders that could cause these symptoms have been excluded. Id. at *3. That 

Velazquez’s fibromyalgia did not result in abnormal x-rays does not suggest its effects 

are less limiting that Dr. Cifuentes opined, especially when the condition is defined, in 

part, by the absence of such objective indicia. See Benecke v. Barnhart, 379 F.3d 587, 

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594 (9th Cir. 2004) (noting that fibromyalgia typically eludes objective measurement); 

see also Green-Younger v. Barnhart, 335 F.3d 99, 109 (2d Cir. 2003) (explaining that 

“negative findings simply confirm a diagnosis of fibromyalgia” by eliminating other 

medical condition that might manifest similar symptoms). 

 Regarding conservative pain management, the ALJ cites May 18, 2011 and 

September 27, 2012 treatment notes from Dr. Galindo and Physician’s Assistant 

Burzinksi. (A.R. 26.) But these records do not support the ALJ’s conclusion. Although 

the May 18, 2011 treatment note indicates that Percocet was prescribed for Velazquez’s 

lumbago, the note also states that Velazquez “does not have the money to see [a] 

specialist at this point,” and, consequently, referral to pain management and 

rheumatology would be deferred. (Id. at 340.) Rather than indicating Velazquez’s 

conditions could be managed conservatively, this treatment note suggests that 

Velazquez’s course of treatment was the result of her inability to afford more specialized 

care. Moreover, the September 27, 2012 treatment note states that Velazquez “is on 

[P]ercocet which is no longer relieving pain.” (Id. at 914.) 

 Although the ALJ articulated legitimate reasons for assigning little weight to Dr. 

Cifuentes’ opinion, she erred by not supporting these reasons with substantial evidence in 

the record. 

B. Psychological Opinion Evidence 

 The ALJ was presented with conflicting medical opinions on the limiting effects 

of Velazquez’s mental impairments. Dr. Agosto, Velazquez’s treating psychiatrist, 

opined that her mental impairments severely limit her ability to respond appropriately to 

supervision, coworkers, and customary work pressures. (Id. at 932.) He opined that 

Velazquez has moderately severe limitations in understanding, carrying out, and 

remembering instructions, and in performing simple tasks. (Id.) Ultimately, he 

concluded that Velazquez’s psychiatric symptoms would severely limit the sustainability 

of her work pace and severely restrict her ability to perform daily work-related activities. 

(Id. at 932-33.) 

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Three consultative psychologists also examined Velazquez. Dr. Steingard opined 

that Velazquez becomes easily frustrated and confused, even with simple directions, is 

easily distractible, and that her socialization and ability to adapt to the competitive 

marketplace are limited. (Id. at 526-27.) Dr. Rabara examined Velazquez and concluded 

that she could not adequately be assessed because of her poor effort and exaggeration. 

(Id. at 532.) He questioned Velazquez’s claims of depression and anxiety, and opined 

that her low test scores, including a Full Scale IQ score of 55, were implausible. (Id.) 

Finally, Dr. Bowen examined Velazquez and was unable to assess her level of 

functioning “because of her exaggeration . . . .” (Id. at 793.) Like Dr. Rabara, Dr. 

Bowen opined that Velazquez “is clearly embellishing and exaggerating,” and also noted 

that she “has consistently been inconsistent – across all of the records she reports 

different symptoms, patterns of substance abuse, and accounts of abuse. She has also 

consistently put forth very little effort . . . .” (Id.) 

 The ALJ resolved this conflict by assigning little weight to Dr. Agosto’s opinion, 

partial weight to Dr. Steingard’s opinion, and some weight to the opinions of Drs. Rabara 

and Bowen. The ALJ gave Velazquez “the benefit of the doubt,” and found that she “is 

limited to simple tasks with some social limitations.” (Id. at 30.) 

 The ALJ supplied sufficient and adequately supported reasons for weighing the 

psychological opinion evidence as she did. She explained that Dr. Agosto’s opinion was 

undercut by evidence that Velazquez’s depression stabilized with medication, and that 

independent examination findings from the consultative psychologists indicated that 

Velazquez exaggerated her symptoms, put forward little effort during examinations, and 

gave conflicting reports of past trauma and substance abuse. (Id. at 28-30.) The ALJ did 

not arbitrarily weigh the psychological opinion evidence.1

 

1

 Velazquez suggests that the ALJ erred in assigning little weight to the Global Assessment of Functioning (“GAF”) scores throughout the record. (Doc. 15 at 17.) The 

Court disagrees. The ALJ reasonably concluded that, comparatively, the GAF scores were a less reliable indicator of Velazquez’s functional capacity than the more detailed medical notes and reports in the record. (A.R. at 27.) 

Velazquez also contends that the ALJ erred by failing to address a letter submitted 

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II. Velazquez’s Symptom Testimony 

 Velazquez argues that the ALJ improperly discredited her symptom testimony. In 

evaluating the credibility of a claimant’s symptom testimony, the ALJ is required to 

engage in a two-step analysis: (1) determine whether the claimant presented objective 

medical evidence of an impairment that could reasonably be expected to produce some 

degree of the pain or other symptoms alleged; and, if so with no evidence of malingering, 

(2) reject the claimant’s testimony about the severity of the symptoms only by giving 

specific, clear, and convincing reasons for the rejection. Vasquez v. Astrue, 572 F.3d 

586, 591 (9th Cir. 2009). The ALJ found that Velazquez’s impairments could reasonably 

be expected to cause her alleged symptoms, but that her “statements concerning the 

intensity, persistence and limiting effects of these symptoms are not entirely credible for 

the reasons explained in this decision.”2

 (A.R. at 24.) 

 Although the ALJ, over the course of several pages, summarizes the symptom 

testimony and medical evidence, the ALJ does not identify which statements she finds 

credible and which she does not. Nor does the ALJ “link that testimony to the particular 

parts of the record supporting her non-credibility determination.” Brown-Hunter v. 

Colvin, 806 F.3d 487, 494 (9th Cir. 2015.) Instead, “she simply state[s] her noncredibility conclusion and then summarize[s] the medical evidence supporting her RFC 

determination.” Id. As the Ninth Circuit recently reiterated in Brown-Hunter, “[t]his is 

 with her medical records, which found her eligible for Seriously Mentally Ill (“SMI”) benefits through the State of Arizona. (A.R. at 679-80.) Although the findings of other agencies can be probative of disability when the criteria and evaluation processes are similar to those utilized in Social Security disability cases, see McCartney v. Massanari, 298 F.23d 1072, 1075-76 (9th Cir. 2002), there is no evidence in the record regarding the basis for the SMI determination. Velazquez bears the burden of proving that she is disabled, and the ALJ did not err by not discussing a letter which, without some context 

and explanation, has little probative value. 2

 Notably, although Drs. Rabara and Bowen thought Velazquez was exaggerating her symptoms and observed that she provided inconsistent information about her past trauma and substance abuse, the ALJ did not make a malingering finding when discussing the credibility of Velazquez’s symptoms testimony. (A.R. 22-24.) A reviewing court is “constrained to review the reasons the ALJ asserts,” Connet v. 

Barnhart, 340 F.3d 871, 874 (9th Cir. 2003), and may not “affirm the agency [decision] on a ground not invoked by the ALJ,” Marsh v. Colvin, 792 F.3d 1170, 1172 (9th Cir. 

2015). 

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not the sort of explanation or the kind of ‘specific reasons’ [the Court] must have in order 

to review the ALJ’s decision meaningfully . . . .” Id. 

III. Third-Party Report 

 Finally, Velazquez argues that the ALJ improperly discredited the third-party 

report of her daughter. The ALJ must take lay testimony regarding a claimant’s 

symptoms into account unless the ALJ “expressly determines to disregard such testimony 

and gives reasons germane to each witness for doing so.” Lewis v. Apfel, 236 F.3d 503, 

511 (9th Cir. 2001). Here, the ALJ concluded that the statements of Velazquez’s 

daughter were only partially credible, given that certain of Velazquez’s daily activities 

were inconsistent with the severity of symptoms reported by her daughter. Additionally, 

the ALJ found that Velazquez’s daughter is not unbiased because she has a familial 

motivation and financial interest in seeing Velazquez receive benefits, considering the 

two lived together. (A.R. at 24.) The ALJ offered germane reasons for only partially 

crediting the third-party report of Velazquez’s daughter. The Court finds no error.3

CONCLUSION 

 For the foregoing reasons, the Court finds that the ALJ erred in weighing the 

medical opinion evidence concerning the limiting effects of Velazquez’s physical 

impairments and in discrediting Velazquez’s symptom testimony. However, given the 

conflicts in the medical testimony, the Court finds that remanding for computation of 

benefits is inappropriate. See Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 

1105-07 (9th Cir. 2014). Instead, the Court remands this case for further proceedings. 

On remand, the ALJ shall reassess and resolve the conflicting medical opinion evidence, 

as well as Velazquez’s symptom testimony, consistent with Brown-Hunter. 

// 

// 

 

3

 Velazquez relies on Brown-Hunter to argue that the ALJ’s rationale for discrediting the third-party report of her daughter is inadequate. However, Brown-Hunter

addressed the “specific reasons” standard applicable to claimant symptom testimony, not the “germane reasons” standard applicable to third-party reports. 806 F.3d at 494. 

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IT IS ORDERED that the final decision of the Commissioner of Social Security 

is REMANDED for proceedings consistent with this order. The Clerk shall enter 

judgment accordingly and shall terminate this case. 

 Dated this 10th day of February, 2016. 

Douglas L. Rayes 

United States District Judge

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