Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_12-cv-01744/USCOURTS-casd-3_12-cv-01744-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

ESTRELLA ESTILLER ALEDIA,

Plaintiff,

v.

CAROLYN W. COLVIN, Commissioner

of Social Security,

Defendant. 

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Civil No. 12cv01744 WQH(RBB)

REPORT AND RECOMMENDATION

DENYING PLAINTIFF'S MOTION FOR

SUMMARY JUDGMENT [ECF NO. 18]

AND GRANTING DEFENDANT'S

CROSS-MOTION FOR SUMMARY

JUDGMENT [ECF NO. 19] 

On July 16, 2012, Plaintiff Estrella Estiller Aledia filed a

Complaint against Defendant Michael J. Astrue, the thenCommissioner of Social Security [ECF No. 1]. Plaintiff challenges

the denial of her claim for disability insurance benefits. (Compl.

2-3, ECF No. 1.) Defendant filed an Answer on October 12, 2012,

along with the Administrative Record [ECF Nos. 10, 11]. On

February 26, 2013, Aledia's Motion for Summary Judgment was filed

[ECF No. 18].1 

1

 Because Plaintiff's Motion for Summary Judgment is not

consecutively paginated, the Court will cite to it using the page

numbers assigned by the electronic case filing system.

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Since the initiation of this lawsuit, Carolyn W. Colvin has

replaced Astrue as the Acting Commissioner of Social Security. 

Colvin is therefore substituted for her predecessor pursuant to

Federal Rule of Civil Procedure 25(d). Defendant filed a CrossMotion for Summary Judgment and Opposition to Plaintiff's Motion

for Summary Judgment on March 28, 2013, along with a Memorandum of

Points and Authorities [ECF No. 19]. Colvin refiled the same

Cross-Motion for Summary Judgment and Opposition to Plaintiff's

Motion for Summary Judgment, along with the same Memorandum of

Points and Authorities; however, it was docketed as a "Response in

Opposition re 18 [Plaintiff's] Motion for Summary Judgment" [ECF

No. 20].

The Court finds this matter is suitable for decision without

oral argument. See S.D. Cal. Civ. R. 7.1(d)(1). For the reasons

set forth below, the Court recommends that the district court DENY

Aledia's Motion for Summary Judgment [ECF No. 18] and GRANT

Defendant's Cross-Motion for Summary Judgment [ECF No. 19].

I. MEDICAL EVIDENCE

Plaintiff is a fifty-eight year old woman with one year of

college education. (Admin. R. Attach. #2, 45-46, 63, ECF No. 11.) 

Aledia was evaluated for myeloma and lymphoma in 2007 and 2009; all

tests came back negative. (Id. Attach. #8, 477.) In February of

2008, Plaintiff was diagnosed with fatty liver disease, but by June

of 2010 her liver condition was "stable." (Id. Attach. #7, 420;

id. Attach. #8, 482.) 

Aledia was admitted to Grossmont Hospital on November 11,

2009, because she felt dizzy and weak, and had pain in her right

shoulder. (Id. Attach. #7, 216.) A chest x-ray performed by Dr.

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Tere Trout showed no significant abnormality. (Id. at 222.) Dr.

Craig Norris ordered a CT scan, which revealed that Plaintiff had

no bone lesions in her chest, pelvic area, or abdomen. (Id.

Attach. #8, 519-20.) Medical doctor Kumara Prathipati conducted a

physical examination on December 14, 2009, which yielded normal

findings. (Id. Attach. #7, 329.) A bone marrow biopsy was also

performed that month, which showed "no evidence of involvement by a

lymphoproliferative disorder." (Id. at 339.) The following month,

Aledia again complained of dizziness, weakness, headaches, and foot

pain. (Id. at 330.) Dr. Prathipati examined her and found no

abnormalities. (Id. at 331-32.) In April of 2010, Plaintiff saw

Dr. Prathipati because of her dizziness, leg weakness, and pain in

her ribs and right foot. (Id. at 334.) Her doctor was unable to

determine the etiology of her dizziness, but noted that Aledia was

undergoing therapy for vertigo. (Id.)

On July 1, 2010, Aledia returned to Dr. Prathipati and claimed

that her fatigue was getting worse and that she was experiencing

head and body aches, nausea, and dizziness. (Id. at 391.) Again,

the doctor was unable to determine what was causing the chronic

dizziness and fatigue. (Id. at 393.) The doctor diagnosed

Plaintiff with monoclonal gammopathy. (Id.) The following month,

Dr. Prathipati was still unable to determine the cause of Aledia's

"extreme fatigue," but expressed that an upcoming bone marrow exam

and consultation with an oncologist would likely help determine the

etiology of Aledia's symptoms. (Id. at 413.) 

II. THE ADMINISTRATIVE HEARING

On March 4, 2011, an administrative hearing was held before

Administrative Law Judge ("ALJ") Treblin. (Id. Attach. #2, 42.) 

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Plaintiff and her former attorney, Todd Greenwold, were present. 

(Id.) 

Aledia testified that she worked as an electronic technician

from 1997 until her resignation in 2009. (Id. at 47, 55-56.) She

also previously worked in real estate. (Id. at 48.) Plaintiff

claimed that she had monoclonal gammopathy, which caused pain in

her bones and muscles as well as constant fatigue. (Id. at 48-49.) 

Additionally, she stated that she suffered from liver problems,

high blood pressure, and swelling in her feet and legs. (Id. at

49.) Aledia took no medication for her monoclonal gammopathy, but

she took an unspecified high blood pressure medication, as well as

Prilosec, Naproxen (for swelling), Cotryline (for gout), meclizine,

and Prozac. (Id. at 49-50, 58-59.) She submitted that she did not

experience any side effects from these medications. (Id. at 51.) 

Plaintiff maintained that she could lift up to ten pounds, but

experienced "problem[s]" with both hands. (Id. at 51-52.) She

could sit, stand, or walk for one hour at a time, but felt dizzy

when bending down and getting back up. (Id. at 52.) On good days,

Aledia was able to clean her home for short periods of time. (Id.

at 54.) She claimed that she spent approximately four days a week

in bed all day. (Id. at 54-55.) 

Plaintiff testified that during her last three years as an

electronic technician, she was "really, really sick and [her] feet

[were] always swelling . . . ." (Id. at 57.) She stated that near

the end of her employment, her medical condition often caused her

miss work or leave early. (Id.) Even though her job did not

require her to stand, she expressed that sitting became too much to

tolerate because she frequently felt dizzy and weak. (Id.) 

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Plaintiff explained that she was awaiting test results for a

possible cancer diagnosis and felt that her medical condition was

deteriorating. (Id. at 57-58.) 

Aledia's attorney asserted that Plaintiff had a good work

history and recently developed pre-myeloma lymphoma, which was

"consistent with a Cancer [sic]." (Id. at 60.) The attorney

indicated that Aledia resigned from her job due to her worsening

medical condition. (Id.) 

The ALJ found that Plaintiff suffered from severe impairments:

monoclonal gammopathy, fatty liver, and hypertension. (Id. at 28.) 

But she did not have an impairment or combination of impairments

that met or equaled a listed impairment that would make her

eligible for benefits. (See id.) Furthermore, Judge Treblin found

that Aledia "has the residual functional capacity to perform the

full range of sedentary work as defined in 20 CFR 404.1567(a)." 

(Id.) 

III. APPLICABLE LEGAL STANDARDS

A. Generally

To qualify for disability benefits under the Social Security

Act, an applicant must show two things: (1) He or she suffers from

a medically determinable impairment that can be expected to last

for a continuous period of twelve months or more, or would result

in death; and (2) the impairment renders the applicant incapable of

performing the work that he or she previously performed or any

other substantially gainful employment that exists in the national

economy. See 42 U.S.C.A. §§ 423(d)(1)(A), (2)(A) (West 2011). An

applicant must meet both requirements to be classified as

"disabled." Id.

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Sections 205(g) and 1631(c)(3) of the Social Security Act

allow applicants whose claims have been denied by the Social

Security Administration to seek judicial review of the

Commissioner's final agency decision. Id. §§ 405(g), 1383(c)(3). 

The district court may affirm, modify, or reverse the

Commissioner's decision. Id. § 405(g). The court should affirm

the decision unless "it is based upon legal error or is not

supported by substantial evidence." Bayliss v. Barnhart, 427 F.3d

1211, 1214 n.1 (9th Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d

599, 601 (9th Cir. 1998)). The district court may also remand the

matter to the Social Security Administration for further

proceedings. 42 U.S.C.A. § 405(g).

B. Remand for Further Proceedings

A district court may remand a Social Security disability

matter to the Commissioner of Social Security under sentence four

of 42 U.S.C. § 405(g). Hoa Hong Van v. Barnhart, 483 F.3d 600, 605

(9th Cir. 2007). That provision states, "The court shall have

power to enter, upon the pleadings and transcript of the record, a

judgment affirming, modifying, or reversing the decision of the

Commissioner of Social Security, with or without remanding the

cause for a rehearing." 42 U.S.C.A. § 405(g). "A sentence-four

remand is essentially a determination that the Commissioner erred

in denying benefits." Havrylovich v. Astrue, No. 09-1113-HA, 2011

U.S. Dist. LEXIS 7187, at *19 (D. Or. Jan. 25, 2011) (citing Hoa

Hong Van, 483 F.3d at 605). If a case is remanded for a rehearing,

the Commissioner may modify or affirm the original findings of fact

or the decision. See 42 U.S.C.A. § 405(g).

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A remand to the Commissioner for further proceedings or to

award benefits is within the court's discretion. McAllister v.

Sullivan, 888 F.2d 599, 603 (9th Cir. 1989). "'If additional

proceedings can remedy defects in the original administrative

proceedings, a social security case should be remanded. Where,

however, a rehearing would simply delay receipt of benefits,

reversal [and an award of benefits] is appropriate.'" Id. (quoting

Lewin v. Schweiker, 654 F.2d 631, 635 (9th Cir. 1981)). "[T]he

proper course, except in rare circumstances, is to remand to [an

administrative] agency for additional investigation or

explanation." INS v. Ventura, 537 U.S. 12, 16 (2002) (internal

quotation marks and citation omitted) (discussing remand to Board

of Immigration Appeals).

IV. DISCUSSION

At the time of ALJ Treblin's decision, Aledia had not been

diagnosed with cancer. (Admin. R. Attach. #2, 31, ECF No. 11.)2

The ALJ determined that Plaintiff had monoclonal gammopathy, fatty

liver disease, and hypertension, but was not disabled and was able

to perform a full range of sedentary work. (Id. at 28, 32.) He

based his findings, in part, on his conclusion that Aledia was not

credible. (Id. at 31.) Plaintiff contends that the ALJ provided

insufficient reasons for rejecting medical evidence and her

testimony. (Mot. Summ. J. Attach. #1 Mem. P. & A. 6, ECF No. 18.)3

2 There is also no evidence that she has been diagnosed with

cancer subsequent to the ALJ's decision. 

3

 Aledia's argument heading reads, "The ALJ failed to provide

legally sufficient reasons to reject the medical evidence and

testimony of Estrella Aledia which was consistent with the medical

records." (Id.) Yet, Plaintiff does not offer any support for her

contention that the ALJ improperly rejected medical evidence. She

does not cite to or provide a summary of the evidence, or explain

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Commissioner Colvin asserts that substantial evidence supported ALJ

Treblin's determination that Aledia's statements were not fully

credible. (See Cross-Mot. Summ. J. & Opp'n Attach. #1 Mem. P. & A.

2, ECF No. 19.) 

"Administrative law judges are responsible for reviewing the

evidence and making findings of fact and conclusions of law." 20

C.F.R. § 404.1527(e)(2) (2012). Conflicts in the evidence should

be resolved by the Commissioner, not the courts. See Laffoon v.

Califano, 558 F.2d 253, 254 (5th Cir. 1977); see also Sprague v.

Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987). The ALJ is the final

arbiter of ambiguities in the medical evidence. Tommasetti v.

Astrue, 533 F.3d 1035, 1041-42 (9th Cir. 2008). The Commissioner's

decision must be upheld when the evidence would support more than

one rational interpretation. Havrylovich, 2011 U.S. Dist. LEXIS

7187, at *4 (citing Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir.

2002)).

Plaintiff requests that her matter be remanded for the payment

of benefits or, in the alternative, remanded to the Commissioner

"for the correction of the legal errors." (Mot. Summ. J. Attach.

#1 Mem. P. & A. 17, ECF No. 18.) The Ninth Circuit has articulated

the standard district courts must apply when deciding whether to

remand a matter for further proceedings:

Remand for further administrative proceedings is

appropriate if enhancement of the record would be useful. 

Conversely, where the record has been developed fully and

how the ALJ's alleged rejection was improper. Rather, it appears

that Aledia's reference to the medical evidence is only offered in

support of her single claim that the ALJ erred in rejecting her

testimony. (See id. at 14.) For these reasons, the Court

construes Aledia's reference to the medical evidence to be in

support of this claim, rather than a separate basis for challenging

ALJ Treblin's decision. 

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further administrative proceedings would serve no useful

purpose, the district court should remand for an

immediate award of benefits. More specifically, the

district court should credit evidence that was rejected

during the administrative process and remand for an

immediate award of benefits if (1) the ALJ failed to

provide legally sufficient reasons for rejecting the

evidence; (2) there are no outstanding issues that must

be resolved before a determination of disability can be

made; and (3) it is clear from the record that the ALJ

would be required to find the claimant disabled were such

evidence credited.

Benecke v. Barnhart, 379 F.3d 587, 593 (9th Cir. 2004) (citations

omitted); see Strauss v. Comm'r of the Soc. Sec. Admin., 635 F.3d

1135, 1138 (9th Cir. 2011) (applying the standard outlined in

Benecke). "A claimant is not entitled to benefits under the

statute unless the claimant is, in fact, disabled, no matter how

egregious the ALJ's errors may be." Strauss, 635 F.3d at 1138. 

Aledia insists that her testimony shows that she is incapable

of "maintaining substantial gainful work." (Mot. Summ. J. Attach.

#1 Mem. P. & A. 6, ECF No. 18.) She argues that in order for the

ALJ to reject her testimony, he needed to provide clear and

convincing reasons for doing so. (Id. at 7.) According to

Plaintiff, however, ALJ Treblin provided legally insufficient and

conclusory reasons for his adverse credibility determination. (Id.

at 8, 10.) 

She concludes that the administrative law judge rejected her

testimony because it was not supported by objective medical

evidence. (Id. at 10.) She insists that an ALJ may not reject

subjective pain testimony solely on the basis of objective medical

evidence. (Id.) Plaintiff claims that the ALJ's findings are

inconsistent because he made note of her "'vigilance' in seeking

medical treatment" and impressive work history, the latter

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"'lend[ing] credibility to her statements.'" (Id. at 11.) 

Plaintiff continues, "Consequently, in evaluating Ms. Aledia's

testimony the ALJ is trying to have it both ways: finding Ms.

Aledia credible and not credible at the same time." (Id. at 12.) 

Next, Plaintiff asserts that the Judge Treblin improperly

rejected her testimony based on her daily activities. (Id. at 13-

14.) "Evidence that a claimant can participate in basic human

function 'is not determinative of disability.'" (Id. at 13.) 

Aledia urges that the ALJ failed to explain how her "meager

activities relate to the ability to perform gainful work activity

over a 40 hour, five day work week." (Id. at 14.) This failure,

according to Plaintiff, constituted reversible error. (Id.) 

The claimant further notes that her treating physician's

reports were consistent with her testimony, which supports her

credibility. (Id.) Moreover, there was no evidence that Aledia

was malingering. (Id. at 15.) Based on the above, Plaintiff

requests that the Court reverse and remand this case for the

payment of benefits. (Id. at 17.) 

In contrast, Colvin alleges that substantial evidence

supported the ALJ's findings that Aledia's statements were not

fully credible. (Cross-Mot. Summ. J. & Opp'n Attach. #1 Mem. P. &

A. 2, EFC No. 19.) Defendant contends that ALJ Treblin properly

weighed the evidence that supported and detracted from Aledia's

credibility. (Id. at 4.) "Weighing in favor of Plaintiff's

credibility, the ALJ properly considered the vigilance required by

Plaintiff in following up with medical providers, as well as her

good work history." (Id. at 5.)

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The administrative law judge concluded that "the medical

evidence did not support Aledia's alleged severity or degree of

functional limitation as to her reports of pain, weakness,

dizziness, and fatigue[,]" and this weighed against Plaintiff's

credibility. (Id. (citing Admin. R. Attach. #2, 31, ECF No. 11).) 

Colvin asserts that the ALJ properly determined that Plaintiff's

"symptoms were of undetermined significance or had no clear

etiology." (Id.) Defendant cites to medical evidence showing that

Aledia's doctors struggled to determine the cause of her

complaints. (Id. at 5-6 (citing Admin. R. Attach. #7, 222, 334,

393, 413, ECF No. 11).) "[T]he ALJ properly considered that not

only did the medical evidence not support the extent of Plaintiff's

subjective complaints, but demonstrated that her symptoms were of

undetermined significance . . . i.e., that the evidence did not

clearly support the existence of some of her alleged symptoms." 

(Id. at 6.) 

Further, Colvin insists that objective evidence did not

support the severity of Aledia's alleged symptoms. (Id.) 

Defendant contends that Plaintiff's diagnostic exams were

"essentially negative" and that her physical exams revealed that

she had "normal joints, was neurologically intact, and had no leg

edema and no calf tenderness." (Id. at 6-7 (citing Admin. R.

Attach. #2, 31, ECF No. 11).) According to Colvin, numerous

medical exams and reports showed normal findings. (Id. at 7

(citing Admin. R. Attach. #2, 48-49, 51-52, ECF No. 11; id. Attach.

#7, 222, 292-93, 331, 334; id. Attach. #8, 464, 501, 520).) Aledia

was also found to be "generally healthy." (Id.) 

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Next, the Defendant asserts that the ALJ properly determined

that Plaintiff's medication history was inconsistent with the

alleged severity of her symptoms and functional limitations. (Id.

at 7-8.) Colvin notes that Aledia did not take medication for her

fatty liver disease or monoclonal gammopathy; she did take Prilosec

for gastroesophageal reflux disease, Naproxen for pain, and took

other medications, all without side effects. (Id. at 8.) Based on

ALJ Treblin's findings, Defendant urges that "[t]he effectiveness

of such conservative treatment, along with the lack of side

effects, undermined Plaintiff's allegations that her pain and other

symptoms disabled her." (Id.) Accordingly, Colvin requests that

the Court affirm the Commissioner's decision. (Id. at 10.) 

"In order for the ALJ to find [claimant's] testimony

unreliable, the ALJ must make 'a credibility determination with

findings sufficiently specific to permit the court to conclude that

the ALJ did not arbitrarily discredit claimant's testimony.'"

Turner v. Comm'r of Soc. Sec. Admin., 613 F.3d 1217, 1224 n.3 (9th

Cir. 2010) (quoting Thomas, 278 F.3d at 958). In evaluating the

credibility of a plaintiff's testimony regarding subjective pain,

the adjudicator must engage in a two-step analysis. Vasquez v.

Astrue, 572 F.3d 586, 591 (9th Cir. 2009) (citing Lingenfelter v.

Astrue, 504 F.3d 1028, 1035-36 (9th Cir. 2007)); see Batson v.

Comm'r of the Soc. Sec. Admin., 359 F.3d 1190, 1196 (9th Cir.

2004). "'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.'" Vasquez, 572 F.3d at 591 (quoting

Lingenfelter, 504 F.3d at 1036). Second, if the claimant satisfies

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

reject the claimant's testimony about the severity of the symptoms

if he gives "'specific, clear and convincing reasons'" for doing

so. Id. (quoting Lingenfelter, 504 F.3d at 1036); Smolen v.

Chater, 80 F.3d 1273, 1283-84 (9th Cir. 1996).

Here, Judge Treblin initially determined that Aledia's

impairments "could reasonably be expected to cause the alleged

symptoms . . . ." (Admin. R. Attach. #2, 30, ECF No. 11.) Neither

the Plaintiff nor the Defendant challenges this conclusion. The

first prong of the ALJ's inquiry regarding Aledia's credibility is

therefore satisfied. See Vasquez, 572 F.3d at 591. The issue,

then, is whether Judge Treblin provided clear reasons for the

adverse credibility finding that are supported by the evidence in

the record. 

The Commissioner's reasons for rejecting a claimant's

testimony must be "clear and convincing." Reddick v. Charter, 157

F.3d 715, 722 (9th Cir. 1998) (quoting Lester v. Chater, 81 F.3d

821, 834 (9th Cir. 1995)). To support a finding that the plaintiff

was not credible, the ALJ must "'point to specific facts in the

record which demonstrate that [the plaintiff] is in less pain than

she claims.'" Vasquez, 572 F.3d at 592 (quoting Dodrill v.

Shalala, 12 F.3d 915, 918 (9th Cir. 1993)). The ALJ must make

specific findings "stat[ing] which pain testimony is not credible

and what evidence suggests the complaints are not credible." 

Dodrill, 12 F.3d at 918. A reviewing court should not be forced to

speculate as to the grounds for an administrative law judge's

rejection of a plaintiff's allegations of disabling pain. Bunnell

v. Sullivan, 947 F.2d 341, 346 (9th Cir. 1991) (citing Murray v.

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Heckler, 722 F.2d 499, 502 (9th Cir. 1983)); see also Steele v.

Barnhart, 290 F.3d 936, 941 (7th Cir. 2002) (explaining that the

ALJ must build an accurate and logical connection between the

evidence and the decision).

In general, questions of credibility are for the ALJ to

resolve. Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). 

Courts should not "second-guess" an ALJ's credibility

determinations. Allen v. Heckler, 749 F.2d 577, 580 (9th Cir.

1984). If the evidence is conflicting and could be rationally

interpreted more than one way, the court must uphold the ALJ's

decision. Id. at 579. 

Social Security Ruling 96-7p provides the relevant standard: 

4. In determining the credibility of the individual's

statements, the adjudicator must consider the entire case

record, including the objective medical evidence, the

individual's own statements about symptoms, statements

and other information provided by treating or examining

physicians or psychologists and other persons about the

symptoms and how they affect the individual, and any

other relevant evidence in the case record. An

individual's statements about the intensity and

persistence of pain or other symptoms or about the effect

the symptoms have on his or her ability to work may not

be disregarded solely because they are not substantiated

by objective medical evidence.

5. It is not sufficient for the adjudicator to make a

single, conclusory statement that 'the individual's

allegations have been considered' or that 'the

allegations are (or are not) credible.' It is also not

enough for the adjudicator simply to recite the factors

that are described in the regulations for evaluating

symptoms. The determination or decision must contain

specific reasons for the finding on credibility,

supported by the evidence in the case record, and must be

sufficiently specific to make clear to the individual and

to any subsequent reviewers the weight the adjudicator

gave to the individual's statements and the reasons for

that weight.

Soc. Sec. Ruling 96-7p, 1996 SSR LEXIS 4, at **2-4 (July 2, 1996). 

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The Ninth Circuit has articulated the grounds on which an ALJ

may properly discredit a claimant's testimony: 

In weighing a claimant's credibility, the ALJ may

consider [claimant's] 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.

Light v. Soc. Sec. Admin., 119 F.3d 789, 792 (9th Cir. 1997)

(citations omitted). Where the ALJ's credibility assessment is

supported by substantial evidence, it will not be disturbed even

where some of the reasons for discrediting a claimant's testimony

were improper. Tonapetyan v. Halter, 242 F.3d 1144, 1147-48 (9th

Cir. 2001); see Carmickle v. Comm'r, Soc. Sec. Admin., 533 F.3d

1155, 1163 (9th Cir. 2008). 

Here, Judge Treblin provided the following reasons for finding

that Plaintiff was not fully credible: 

The undersigned finds that the claimant's reports of

pain, weakness, dizziness and fatigue are only partially

credible because the medical evidence does not support

her alleged severity and degree of functional limitation. 

Fortunately, the claimant has not been diagnosed with

cancer and has not had to undergo cancer treatment. The

claimant's medication history is also inconsistent with

her alleged symptom severity and functional limitation. 

Specifically, the claimant is not taking any medications

for her fatty liver or monoclocal gammopathy, and she

reported no side effects from the medications she is

taking. The undersigned appreciates the vigilance

required in following up with medical providers and

tracking the progress of the claimant's monoclonal

gammopathy; however, the record shows that follow up

appointments have been about 1 time per month and thus

also would not interfere with the claimant's ability to

sustain work activity. The undersigned commends the

claimant for her good work history and that too lends

credibility to her statements; however, the objective

physical exams and diagnostic findings of record do not

support the severity of her alleged symptoms. 

Specifically, diagnostic exams have been essentially

negative and physical exams have showed no leg edema, no

calf tenderness, all of her joints were normal, and she

was neurologically intact (Exhibits 3F/22; 7F/13, 21;

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15F/5-6; 17F/3; 18F/21-22, 34, 66, 71, 90). Indeed, many

of her reported symptoms are of underdetermined

significance or have no clear etiology (Exhibits 7F/16,

15F/6, 17F/3, 18F/34). Accordingly, giving the claimant

the benefit of the doubt, the undersigned has limited her

to sedentary exertion work. 

(Admin. R. Attach. #2, 31, ECF No. 11.) 

A. Medication History

ALJ Treblin found that Plaintiff had three severe impairments: 

monoclonal gammopathy, fatty liver, and hypertension. (Id. at 28.) 

In November of 2010, Aledia's treating physician diagnosed

Plaintiff with monoclonal gammopathy of undetermined significance,

describing Aledia's lab results as "fairly stable." (Id. at 30.) 

A 2008 liver biopsy showed "fatty liver," but "in June 2010 there

was no evidence of advancing fibrosis and the claimant's provider

suspected that [Aledia's] fatty liver condition was stable." (Id.)

The ALJ noted that Aledia was not taking any medication for her

fatty liver disease or monoclonal gammopathy, and her hypertension

was "well controlled" with medication. (Id.) Plaintiff did take

Prilosec, high blood pressure medication, Naproxen, Cotryline,

meclizine, and Prozac to treat various other conditions. (Id. at

49-50, 58-59.) 

In assessing credibility, an ALJ may consider "[t]he type,

dosage, effectiveness, and side effects of any medication." 20

C.F.R. § 404.1529(c)(3)(iv) (2012). "[E]vidence of 'conservative

treatment' is sufficient to discount a claimant's testimony

regarding severity of an impairment." Parra v. Astrue, 481 F.3d

742, 751 (9th Cir. 2007) (noting that claimant was treated with an

over-the-counter pain medication); see Soc. Sec. Ruling 96-7p, 1996

SSR LEXIS 4, at *21 ("[T]he individual's statements may be less

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credible if the level or frequency of treatment is inconsistent

with the level of complaints . . . ."). The fact that Plaintiff

did not require medication for her fatty liver disease or

monoclonal gammopathy was a valid consideration as part of ALJ

Treblin's credibility determination. See Morris v. Astrue, No.

CV–11–13–JPH, 2012 WL 3548040, at *4 (C.D. Cal. Oct. 18, 2012)

("Plaintiff's allegation he suffers from disabling pain is

undermined by his failure to consistently seek treatment, to use

any medication, and by solely conservative treatment . . . ."). 

Moreover, Aledia failed to provide a good reason for not taking

medication to treat other conditions. See Smolen, 80 F.3d at 1284

(citations omitted) (stating that an ALJ may not reject symptom

testimony where the claimant provides a good reason for not taking

medication).

The administrative law judge also discredited Aledia's

testimony because she did not suffer any side effects from her

medications. (Id. at 31.) This, too, is a permissible reason for

discounting a plaintiff's credibility. See 20 C.F.R. §

404.1529(c)(3)(iv); Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir.

1995) (stating that an ALJ may rely on the lack of evidence of side

effects from prescribed medications to support adverse credibility

determination); Tway v. Astrue, No. 12cv1093–WQH–WVG, 2013 WL

1316719, at *5 (S.D. Cal. Mar. 27, 2013) (holding that the absence

of adverse side effects from medication was a legitimate reason to

discredit a claimant's testimony). The medications taken by Aledia

controlled many symptoms and conditions, and they did not result in

adverse side effects. These are clear and convincing reasons for

the ALJ to discount Plaintiff's testimony. 

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B. Lack of Objective Evidence

Next, Judge Treblin rejected Aledia's testimony because the

objective evidence did not support the severity of her alleged

symptoms. (Admin. R. Attach. #2, 31, ECF No. 11.) The ALJ noted

that Plaintiff had not been diagnosed with cancer and had symptoms

of undetermined etiology. (Id.) The ALJ wrote that "[b]y August

2010, Dr. Prathipati was still unable to identify an etiology for

[Aledia's] reported fatigue." (Id. at 29 (citing id. Attach. #7,

413).) Similarly, the doctor had been unable to identify the cause

of her dizziness. (Id. (citing id. Attach. #7, 334).) Aledia's

complaints of chronic fatigue were described in the medical records

as "vague." (Id. at 30 (citing id. Attach. #7, 464).) He also

stated that the medical evidence showed no abnormal findings. (Id.

at 31.) 

"[T]he adjudicator may not discredit a claimant's testimony of

pain and deny disability benefits solely because the degree of pain

alleged by the claimant is not supported by objective medical

evidence." Bunnell, 947 F.2d at 346-47 (emphasis added). 

Nonetheless, "[w]hile subjective pain testimony cannot be rejected

on the sole ground that it is not fully corroborated by objective

medical evidence, the medical evidence is still a relevant factor

in determining the severity of the claimant's pain and its

disabling effects." Rollins v. Massanari, 261 F.3d 853, 857 (9th

Cir. 2001). As discussed, the ALJ provided other specific,

convincing reasons for discrediting Aledia's testimony about her

subjective symptoms. His credibility determination was therefore

not based solely on inconsistencies between Plaintiff's testimony

and the objective medical evidence. ALJ Treblin properly

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articulated what testimony he found not to be credible and how the

evidence undermined those complaints. See Holohan, 246 F.3d at

1208; Dodrill, 12 F.3d at 918. 

Plaintiff argues that her "treating physician has described

Ms. Aledia's impairments as interfering with her ability to

maintain work activity on a consistent basis in that she will be

absent more than 4 days per month as a result of her severe

impairments." (Mot. Summ. J. Attach. #1 Mem. P. & A. 11, ECF No.

18.) This overstates the evidence. First, the conclusion

Plaintiff identifies is contained in the Physical Residual

Functional Capacity Questionnaire signed by a physician's

assistant. (See Admin. R. Attach. #8, 547, ECF No. 11.) Next,

"[a] physician's assistant is not a 'treating physician' and is not

listed in the CFR as a medical source that can provide evidence to

establish impairment." Armijo v. Colvin, No. 2:12-cv-330 BCW, 2013

U.S. Dist. LEXIS 63759, at *10 (D. Utah May 3, 2013). "Thus, the

treating physician rule does not apply to the physician's

assistant's opinion." Id. at *11. Finally, at best, a physician

assistant may be a medical source who is not an "acceptable medical

source." Schnovell-Miller v. Colvin, No. 2:12-cv-321 EFB, 2013

U.S. Dist. LEXIS 46206, at *9 n.3 (E.D. Cal. Mar. 29, 2013). 

C. Activities of Daily Living

Plaintiff asserts that Judge Treblin relied on Aledia's daily

activities in rejecting her subjective testimony. (See Mot. Summ.

J. Attach. #1 Mem. P. & A. 12-13, ECF No. 18.) That is incorrect. 

The ALJ only briefly alluded to Plaintiff's household chores when

recounting her testimony, and he did not state that he was relying

on her activities of daily living as a basis for discrediting her

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testimony. (See Admin. R. Attach. #2, 30-31, ECF No. 11.) Judge

Treblin wrote:

The claimant reported that she has chronic weakness,

dizziness, fatigue, swelling in her feet and legs, and

whole body pain that limit her ability to sit, stand,

walk, lift, carry and perform postural movements. She

explained that she has good days and bad days but is

bedridden approximately four days per week due to her

symptoms. She further explained that she tries to

perform household chores but tires. She stated that she

takes medication for her hypertension and pain but takes

none for her monoclonal gammopathy and fatty liver. She

further stated that her medications do not cause side

effects. She reported that she is worried about her

health and has concentration problems but no problems

with memory or social interaction. Finally, she reported

that she stopped working because of her medical problems. 

(Id. (quoting Admin. R. Attach. #2, 30, ECF No. 11).) 

(Id. at 30.)

Courts may not engage in "post hoc rationalizations that

attempt to intuit what the [ALJ] might have been thinking[.]" Bray

v. Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1226 (9th Cir. 2009);

see SEC v. Chenery Corp., 332 U.S. 194, 196 (1947) (noting that a

reviewing court must limit its analysis to the grounds invoked by

the administrative agency); Connett v. Barnhart, 340 F.3d 871, 874

(9th Cir. 2003). The inquiry is whether the reasons articulated by

the ALJ in making the credibility determination were clear and

supported by substantial evidence. The error complained of by

Aledia is not one that was made here. 

D Partial Credibility Finding

 Because the conflicting evidence of record both supported and

detracted from Aledia's credibility, the ALJ determined that she

was "partially credible." (Admin. R. Attach. #2, 31, ECF No. 11.) 

The Plaintiff objects that ALJ Treblin is "trying to have it both

ways." (Mot. Summ. J. Attach. #1 Mem. P. & A. 12, ECF No. 18.) 

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There may be instances where a finding that the claimant was

truthful about certain matters would weigh against finding the

claimant untruthful about related items. See Carradine v.

Barnhart, 360 F.3d 751, 754 (7th Cir. 2004) ("And if [the claimant]

was testifying truthfully and against her interest about her daily

activities, why did the administrative law judge think she was

lying about her pain.") Even so, as a general matter, an ALJ may

determine that a claimant is partially credible. See Parra, 481

F.3d at 750-51 (upholding determination that claimant and thirdparty witness were partially credible). 

In making a credibility determination the ALJ "must

specifically identify what testimony is credible and what testimony

undermines the [plaintiff's] complaints." Morgan v. Comm'r of Soc.

Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999). As noted, the

Court must give deference to the ALJ's credibility determination

and cannot re-weigh the evidence on review. 42 U.S.C. § 405(g)

(stating that the findings of the Commissioner as to any fact, if

supported by substantial evidence, shall be conclusive); Allen, 749

F.2d at 580; Waters v. Gardner, 452 F.2d 855, 858 n. 7 (9th Cir.

1971). Here, the ALJ discussed the conflicting evidence and made

his ultimate determination that "the claimant's reports of pain,

weakness, dizziness and fatigue are only partially 

credible . . . ." (Admin. R. Attach. #2, 31, ECF No. 11.) This

finding is supported by substantial evidence and should not be

disturbed. See Hill v. Astrue, No. 03:11–CV–01014–HU, 2013 WL

1294650, at *43 (D. Or. Feb. 4, 2013) (upholding ALJ's credibility

determination where evidence was conflicting). 

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Judge Treblin did not discredit Aledia's testimony solely on

the basis that it was unsupported by objective medical evidence. 

On the whole, the administrative law judge provided specific,

detailed bases for his credibility assessment, which is supported

by the evidence in the record. See Turner v. Comm'r of Soc. Sec.

Admin., 613 F.3d at 1224 n.3; see also Belmontes v. Astrue, No.

1:10–cv–02378 JLT, 2012 WL 947300, at *7-8 (E.D. Cal. Mar. 20,

2012) (finding that the lack of treatment and insufficient

objective evidence were sufficient reasons for rejecting claimant's

testimony). Accordingly, reversal or remand is not warranted.

V. CONCLUSION AND RECOMMENDATION

"The decision of the Commissioner must be upheld if it is

supported by substantial evidence and if the Commissioner

applied the correct legal standards." Howard ex rel. Wolff v.

Barnhart, 341 F.3d 1006, 1011 (9th Cir. 2003) (citing Pagter

v. Massanari, 250 F.3d 1255, 1258 (9th Cir. 2001)). If the

AlJ's decision is not supported by substantial evidence,

remand or reversal is appropriate. Gallant v. Heckler, 753

F.2d 1450, 1457 (9th Cir. 1984). For the reasons stated

above, Plaintiff's Motion for Summary Judgment [ECF No. 18]

should be DENIED, and Defendant's Cross-Motion for Summary

Judgment [ECF No. 19] should be GRANTED. The Court recommends

affirming the decision of the administrative law judge. 

This Report and Recommendation will be submitted to the

United States District Court Judge assigned to this case,

pursuant to the provisions of 28 U.S.C. § 636(b)(1). Any

party may file written objections with the Court and serve a

copy on all parties on or before July 24, 2013. The document

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should be captioned "Objections to Report and Recommendation." 

Any reply to the objections shall be served and filed on or

before August 7, 2013. The parties are advised that failure

to file objections within the specified time may waive the

right to appeal the district court's order. Martinez v. Ylst,

951 F.2d 1153 (9th Cir. 1991).

Dated: July 2, 2013 

RUBEN B. BROOKS

United States Magistrate Judge

cc: Judge Hayes

 All Parties of Record

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