Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_10-cv-00341/USCOURTS-cand-3_10-cv-00341-2/pdf.json

Parties Involved:
Michael J. Astrue
Defendant
Nancy R. Lualhati
Plaintiff

Document Text:

United States District Court

For the Northern District of California

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UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

NANCY R. LUALHATI

Plaintiff,

v.

MICHAEL J. ASTRUE,

Defendant.

___________________________________/

No. C-10-0341 EMC

ORDER DENYING PLAINTIFF’S

MOTION FOR SUMMARY

JUDGMENT; DENYING DEFENDANT’S

CROSS-MOTION FOR SUMMARY

JUDGMENT; AND GRANTING

MOTIONS FOR REMAND

(Docket Nos. 16, 19)

In February 2007, Plaintiff Nancy R. Lualhati filed for disability insurance benefits. Ms.

Lualhati has exhausted her administrative remedies with respect to her claim of disability. This

Court has jurisdiction for judicial review pursuant to 42 U.S.C. § 405(g). Ms. Lualhati has moved

for summary judgment or, in the alternative, a remand for additional proceedings. The

Commissioner has cross-moved for summary judgment or a remand. Having considered the parties’

briefs and accompanying submissions, the Court hereby DENIES the parties’ cross-motions for

summary judgment but GRANTS their alternative motions to remand for further proceedings.

I. FACTUAL & PROCEDURAL BACKGROUND

 In February 2007, Ms. Lualhati filed for disability insurance benefits, alleging disability as of

October 15, 2005, based on a heart problem, emphysema, rheumatoid arthritis, and depression. See

AR 92 (application summary); AR 69 (notice of disapproved claims). Ms. Lualhati’s application

was initially denied on June 11, 2007, see AR 69-73 (notice of disapproved claims), and again on

reconsideration on September 28, 2007. See AR 77-81 (notice of reconsideration). Ms. Lualhati

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then sought an administrative hearing before an administrative law judge (“ALJ”). See AR 82

(request for hearing by ALJ). A hearing was held before ALJ Thomas J. Gaye on February 19,

2009. See AR 42 et seq. (ALJ hearing). At the hearing, Ms. Lualhati amended the date of onset

from October 15, 2005, to January 1, 2007, which was “the last day that she actually worked.” AR

46.

On March 16, 2009, the ALJ held that Ms. Lualhati was not disabled under the Social

Security Act. See AR 21-27 (ALJ decision). The ALJ evaluated Ms. Lualhati’s claim of disability

using the five-step sequential evaluation process for disability required under federal regulations. 

See 20 C.F.R. § 404.1520. 

Step one disqualifies claimants who are engaged in substantial gainful

activity from being considered disabled under the regulations. Step

two disqualifies those claimants who do not have one or more severe

impairments that significantly limit their physical or mental ability to

conduct basic work activities. Step three automatically labels as

disabled those claimants whose impairment or impairments meet the

duration requirement and are listed or equal to those listed in a given

appendix. Benefits are awarded at step three if claimants are disabled. 

Step four disqualifies those remaining claimants whose impairments

do not prevent them from doing past relevant work considering the

claimant’s age, education, and work experience together with the

claimant’s residual functional capacity (“RFC”), or what the claimant

can do despite impairments. Step five disqualifies those claimants

whose impairments do not prevent them from doing other work, but at

this last step the burden of proof shifts from the claimant to the

government. Claimants not disqualified by step five are eligible for

benefits.

Celaya v. Halter, 332 F.3d 1177, 1180 (9th Cir. 2003).

At step one, the ALJ found that Ms. Lualhati had not engaged in substantial gainful activity

since January 1, 2007, the alleged onset date. See AR 23 (ALJ decision). At step two, the ALJ

determined that Ms. Lualhati suffered from the following severe impairments: sleep apnea,

degenerative arthritis of the hands and hip joints, history of emphysema, history of atrial fibrillation,

and obesity. See AR 23. The ALJ concluded that Ms. Lualhati did not have an impairment or

combination of impairments that meets or medically equals one of the listed impairments in 20

C.F.R. Part 404, Subpart P, Appendix 1. See AR 24. While the ALJ found that Ms. Lualhati’s

“medically determinable mental impairment[s] of mood disorder and dysthymic disorder” were not

severe, AR 23, he did take into account the functional limitations from these mental impairments at

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step four, when he assessed Ms. Lualhati’s residual functional capacity. See AR 24. As for step

four, the ALJ held that Ms. Lualhati had the residual functional capacity to perform the full range

light work as defined by the regulations. See 20 C.F.R. §§ 404.1567(b). The ALJ noted that an

examining physician as well as state agency consultants had assessed an exertional capacity for

medium work but ultimately he determined that light work was a more appropriate assessment,

giving Ms. Lualhati “the benefit of the doubt regarding the extent of her complaints” regarding

fatigue and difficulty with concentration. See AR 27. Based on this residual functional capacity, the

ALJ concluded, at step five, that Ms. Lualhati was capable of performing her past relevant work as

an accounting clerk, general office clerk, customer service representative, and telephone solicitor. 

See AR 27. In arriving at this conclusion, the ALJ relied largely upon the hearing testimony of a

vocational expert. See AR 27. Accordingly, the ALJ deemed Ms. Lualhati not disabled from the

alleged onset date of January 1, 2007, through the date of his decision (i.e., March 16, 2009). See

AR 27.

Thereafter, Mr. Lualhati sought review of the ALJ decision but her request for review was

denied by the Appeals Council on September 2, 2009. See AR 4-6 (notice of Appeals Council

action). This petition ensued.

II. DISCUSSION

As the Ninth Circuit has explained, a court

may set aside the Commissioner’s denial of benefits when the ALJ’s

findings are based on legal error or are not supported by substantial

evidence in the record as a whole. Substantial evidence means more

than a mere scintilla but less than a preponderance; it is such relevant

evidence as a reasonable mind might accept as adequate to support a

conclusion. A court review[s] the administrative record as a whole to

determine whether substantial evidence supports the ALJ’s decision. .

. . [W]here the evidence is susceptible to more than one rational

interpretation, the ALJ’s decision must be affirmed. 

Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009) (internal quotation marks omitted); see also

Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is the final arbiter with respect to

resolving ambiguities in the medical evidence.” Tommasetti v. Astrue, 533 F.3d 1035, 1041-42 (9th

Cir. 2008).

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In the instant case, Ms. Lualhati argues that the ALJ’s decision was erroneous for the

following reasons: (1) the ALJ improperly concluded, at step two, that she did not have a severe

mental impairment; (2) at step four, the ALJ incorrectly assessed her residual functional capacity

because he failed to take into account the fact that she was diagnosed with fibromyalgia,

incontinence, and Sjogren’s syndrome; (3) the ALJ failed to give clear and convincing reasons for

rejecting her credibility; (4) the ALJ failed to provide specific, cogent reasons for rejecting the

testimony of her lay witnesses; and (5) the ALJ’s conclusion that she could perform her past relevant

work was not supported by substantial evidence. Each of these contentions is addressed below.

A. Mental Impairment

As noted above, at step two of the five-step sequential evaluation process, an ALJ considers

the medical severity of the claimant’s impairments. In the instant case, the ALJ concluded that Ms.

Lualhati had severe physical impairments but not any severe mental impairments. See AR 23 (ALJ

decision). Ms. Lualhati contends that the ALJ erred in making this step two determination.

Title 20 C.F.R. § 404.1520 explains the five-step sequential evaluation process used to

determine whether a claimant is disabled. With respect to step two, the regulation provides that, if a

claimant “do[es] not have a severe medically determinable physical or mental impairment that meets

the duration requirement in § 404.1509, or a combination of impairments that is severe and meets

the duration requirement,” then the claimant is considered not disabled. 20 C.F.R. §

404.1520(a)(4)(ii). 

When a claimant allegedly has a severe mental impairment, an ALJ is required to follow a

special technique at step two. See id. § 404.1520a. “Under the special technique, [the ALJ] must

first evaluate [the claimant’s] pertinent symptoms, signs, and laboratory findings to determine

whether [she has] a medically determinable mental impairment(s).” Id. § 404.1520a(b)(1). If so,

then the ALJ “must then rate the degree of functional limitation resulting from the impairment(s).” 

Id. § 404.1520a(b)(2). There are “four broad functional areas” used to rate the degree of a

claimant’s functional limitation: “Activities of daily living; social functioning; concentration,

persistence, or pace; and episodes of decompensation.” Id. § 404.1520a(c)(3).

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When we rate the degree of limitation in the first three functional areas

(activities of daily living; social functioning; and concentration,

persistence, or pace), we will use the following five-point scale: None,

mild, moderate, marked, and extreme. When we rate the degree of

limitation in the fourth functional area (episodes of decompensation),

we will use the following four-point scale: None, one or two, three,

four or more. 

Id. § 404.1520a(c)(4). 

After rating the degree of functional limitation, an ALJ then determines the severity of the

mental impairment. 

If we rate the degree of your limitation in the first three functional

areas as “none” or “mild” and “none” in the fourth area, we will

generally conclude that your impairment(s) is not severe, unless the

evidence otherwise indicates that there is more than a minimal

limitation in your ability to do basic work activities (see § 404.1521).

Id. § 404.1520a(d)(1) (emphasis added). Under § 404.1521, “[a]n impairment or combination of

impairments is not severe if it does not significantly limit your physical or mental ability to do basic

work activities.” Id. § 404.1521(a).

In the instant case, the ALJ concluded that Ms. Lualhati’s “medically determinable mental

impairment causes no more than ‘mild’ limitation in any of the first three functional areas and ‘no’

episodes of decompensation which have been of extended duration in the fourth area[;] [therefore], it

is nonsevere.” AR 24 (ALJ decision). Implicitly, the ALJ did not find that there was “more than a

minimal limitation in [Ms. Lualhati’s] ability to do basic work activities” as a result of her mental

impairment. Id. § 404.1520a(d)(1). In her papers, Ms. Lualhati challenges the ALJ’s implicit

finding – arguing that the medical evidence shows that her mental impairments were more than “a

slight abnormality that ha[d] ‘no more than a minimal effect on [her] ability to work.’” Smolen v.

Chater, 80 F.3d 1273, 1290 (9th Cir. 1996). Ms. Lualhati emphasizes that “the step-two inquiry is

[simply] a de minimis screening device to dispose of groundless claims.” Id.

For purposes of this opinion, the Court need not make any decision as to whether the ALJ

erred in his step two analysis because any such error was harmless. More specifically, any error was

harmless because, even if the ALJ did not consider any mental impairment of Ms. Lualhati to be

severe for purposes of step two, he still considered the functional limitations arising from the mental

impairment at step four as part of his assessment of Ms. Lualhati’s residual functional capacity. See

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 Although Ms. Lualhati did not expressly make this step four argument in her papers, largely

confining her challenge to step two, the Court addresses the argument to the extent it might be inferred

from the step two argument.

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AR 24 (ALJ decision) (stating that “the following residual functional capacity assessment reflects

the degree of limitation the undersigned has found in the “paragraph B” mental function analysis”). 

The Ninth Circuit has expressly held that an ALJ’s failure to list an impairment at step two is

harmless where the ALJ considers any limitations imposed by the impairment at step four. See

Lewis v. Astrue, 498 F.3d 909, 911 (9th Cir. 2007) (concluding that any failure to list bursitis as

severe at step two was harmless error where ALJ considered functional limitations of bursitis at step

four); Burch, 400 F.3d at 682, 684 (concluding that the ALJ did not commit reversible error in not

considering the claimant’s obesity at step two because the ALJ adequately considered the claimant’s

obesity in his residual functional capacity determination); see also Baldwin v. Astrue, No. ED CV

09-513-PJW, 2010 U.S. Dist. LEXIS 46175 , at *5 (C.D. Cal. May 10, 2010) (stating that, even if

“the ALJ erred at step two, any error was harmless because the ALJ accounted for the symptoms and

limitations allegedly caused by her fibromyalgia in his residual functional capacity determination at

step four”).

In her papers, Ms. Lualhati suggests that the ALJ did not consider any functional limitations

arising from her mental impairment at step four, but this is belied by the ALJ’s written decision. In

the decision, the ALJ explicitly discussed at step four a psychiatric examination of Ms. Lualhati that

was conducted on April 17, 2007. See AR 25 (ALJ decision). In addition, the ALJ expressly

discussed at step four Ms. Lualhati’s complaints of fatigue and trouble with concentration. See AR

26 (ALJ decision). In fact, the ALJ even lowered Ms. Lualhati’s exertional capacity from medium

to light work based on her complaints of, inter alia, fatigue and trouble with concentration. See AR

27. Therefore, Mr. Lualhati’s suggestion has no merit. Similarly, her contention that the ALJ did

not consider at step four the combined effects of her physical and mental impairments has no basis

given the above.

The only issue remaining is whether the ALJ erred at step four in essentially finding the

functional limitations arising from Ms. Lualhati’s mental impairment to be minimal.1

 Here, Ms.

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Lualhati’s basic assertion is that the ALJ improperly rejected the opinion of a nontreating,

examining physician, Ronald F. Johnson. See AR 255-58 (Johnson opinion, dated 4/12/2007). 

Dr. Johnson conducted a psychiatric examination of Ms. Lualhati on April 12, 2007. He

diagnosed Ms. Lualhati as having a mood disorder “with moderate anxiety and depressive features”

as well as a moderate dysthymic disorder. AR 257. Based on these mental impairments, Dr.

Johnson concluded that Ms. Lualhati would have the following functional limitations:

[S]he would have marked difficulties concentrating and focusing on

sustained, productive, timely work tasks in the normal course of a full

8-hour workday or full 40-hour work week. This is based upon the

level of her depression and anxious tension alone, and her medical and

physical conditions would likely add to that assessment. If she were to

interact in a competitive employment setting as she did in this

examination, . . . she would have marked difficulty maintaining pace

and persistence in ordinary work tasks, or in the types of work that she

describes in the past.

. . . [S]he would have moderate difficulty communicating with

others, including the general public, co-workers, and supervisors. . . .

[S]he would have marked difficulties interacting rapidly with others in

coordinated joint work tasks.

. . . [S]he would have mild difficulties maintaining attendance

in locations, based purely upon her psychiatric condition. However,

her medical symptoms and conditions would likely add to that

assessment. She did come to this examination unaccompanied, having

driven a vehicle.

. . . [S]he is capable of managing supportive funds, based upon

her generally adequate performance of simple numerical tasks.

AR 258. 

In his decision, the ALJ expressly acknowledged the opinion of Dr. Johnson but ultimately

gave it “little significance” on the basis that it was “inconsistent with recent progress notes from

Kaiser [i.e., treating medical sources] which document claimant depression is stable on

medications.” AR 25 (ALJ decision). The ALJ referred to the following evidence from Ms.

Lualhati’s treating physicians:

• A diagnosis from her treating physician, Vincent J. Dilella, in January 2007, that her

depression was in remission. The physician’s notes indicate that Ms. Lualhati’s mental

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 In her reply brief, Ms. Lualhati contends that none of her treating sources performed a

“comprehensive psychiatric examination” on her. Reply at 3. While it is not possible to tell how

extensive the mental status examination performed by Dr. Dilella was, the medical record clearly

reflects that he did perform such an examination.

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 Ms. Lualhati does not contend that Dr. Addicott, who appears to have a PhD, is not an

acceptable medical source for purposes of 20 C.F.R. § 404.1513.

4

 Contrary to what Ms. Lualhati argues in her reply brief, see Reply at 3, it does appear that Dr.

Addicott performed a comprehensive mental status examination.

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status examination was normal2

; that no changes to her medication were needed; and that

there were no signs or symptoms of depression. See AR 204 (medical record, dated

1/11/2007).

• A diagnosis from her treating medical source,3 Adrienne Kathleen Addicott, in June 2008,

reaffirming that Ms. Lualhati’s depression was in remission. The medical source’s notes

indicate that Ms. Lualhati’s mental status examination was normal (e.g., attention and

concentration were described as normal, insight and judgment were described as good).4 The

notes also state that Ms. Lualhati’s depression appeared to be stable with medication

(Prozac). See AR 384-86 (medical record, dated 6/11/2008).

• A progress note from her treating physician, Dr. Dilella, in September 2008, noting that Ms.

Lualhati’s depression was improved with medication and assessing Ms. Lualhati’s condition

as stable. See AR 390 (medical record, dated 9/23/2008). The note indicates that Ms.

Lualhati could increase the amount of her depression medication (from 60 mg daily to 80 mg

daily) if her mood were to decline but that she was currently reporting that her “mood has

been OK so far.” AR 390.

• A progress note from her treating physician, Dr. Dilella, in January 2009, stating that Ms.

Lualhati was “[p]sychiatrically stable.” AR 394 (medical record, dated 1/27/2009). The

note indicates that Ms. Lualhati had not been increasing the amount of her depression

medication (i.e., above 60 mg daily) and that Ms. Lualhati was currently reporting her mood

as “OK.” AR 394.

The ALJ’s decision to credit the opinions of Ms. Lualhati’s treating medical sources over the

opinion of Dr. Johnson was not error. “If a treating physician’s opinion is ‘well-supported by

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medically acceptable clinical and laboratory techniques and is not inconsistent with other substantial

evidence in [the] case record, [it will be given] controlling weight.’” Orn v. Astrue, 495 F.3d 625,

631 (9th Cir. 2007) (quoting 20 C.F.R. § 404.1527(d)(2)). Here, Ms. Lualhati does not contend that

the treating sources’ opinions are not well supported by medically acceptable clinical and laboratory

techniques; rather, her only assertion is that the treating sources’ opinions are not consistent with

other substantial evidence, namely, the opinion of Dr. Johnson. Under Ninth Circuit authority, an

examining physician’s opinion can be substantial evidence, in particular when the examining

physician 

provides “independent clinical findings that differ from the findings of

the treating physician” . . . . Independent clinical findings can be either

(1) diagnoses that differ from those offered by another physician and

that are supported by substantial evidence or (2) findings based on

objective medical tests that the treating physician has not herself

considered.

Id. at 632.

But even assuming that, in the instant case, Dr. Johnson’s opinion constitutes substantial

evidence, that simply means that the opinions of the treating sources are not given controlling

weight. See id. “Even when contradicted by an opinion of an examining physician that constitutes

substantial evidence, the treating physician’s opinion is ‘still entitled to deference.’” Id. at 632-33. 

The weight to be accorded the opinion ultimately turns on the factors listed in 20 C.F.R. §

404.1572(d)(2)-(6). See id. at 632. Those factors include the length of the treatment relationship

and the frequency of examination; the nature and extent of the treatment relationship; the

supportability of the treating source’s opinion; the consistency of the treating source’s opinion with

the record as a whole; and the specialization of the treating source.

Taking into account the above factors, the Court concludes that the ALJ did not err in

according the treating sources’ opinions – in particular, Dr. Dilella’s – more weight than Dr.

Johnson’s. Regarding the length of the treatment relationship and the frequency of examination, Ms.

Lualhati’s own statements reflect that she has had a relationship with Dr. Dilella at least since 1998. 

See AR 14 (e-mail, dated 5/18/2009). Also, the medical records reflect that she saw Dr. Dilella or a

member of his office on a fairly frequent basis from November 2006 to January 2009. See AR 201-

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05, 369-77, 382-83, 390-91, 394-95 (medical records). With respect to the nature and extent of the

treatment relationship, the medical records indicate that Ms. Lualhati sought treatment from Dr.

Dilella for her mental impairments specifically and that Dr. Dilella was the primary physician to

treat her mental impairments. Regarding the supportability of Dr. Dilella’s opinion, it appears that

he conducted at least one mental status examination, see AR 204 (medical record, dated 1/11/2007);

moreover, his opinion that Ms. Lualhati’s depression was in remission and/or stable was supported

by her responsiveness to the medication and the lack of any need to alter the dosage. See AR 394

(medical record, dated 1/27/2009). As for the consistency of opinion with the record as a whole, Dr.

Dilella’s opinion was consistent with that of the other treating source, Dr. Addicott, see AR 384-86

(medical record, dated 6/11/2008), as well as that of a nontreating, nonexamining physician. See AR

264-74 (Lucila opinion, dated 4/30/2007). Finally, Ms. Lualhati’s own representations reflect that

Dr. Dilella has a specialty in psychiatry. See AR 14 (e-mail, dated 5/18/2009).

None of the arguments presented by Ms. Lualhati in her papers establishes that Dr. Johnson’s

opinion – based on a one-time examination of Ms. Lualhati – should have been given more weight. 

For example, the fact that one progress note from Dr. Dilella predated Dr. Johnson’s opinion is

insignificant given that there are multiple notes from Dr. Dilella post-dating Dr. Johnson’s opinion. 

Also, the fact that Dr. Johnson is a specialist is a point that should be taken into account, but as

noted above Dr. Dilella appears to be a specialist as well. In her papers, Ms. Lualhati argues still

that, even if her “depression [were] stable on medication, that does not necessarily mean that her

depression is not disabling.” Mot. at 10. The Court notes that there is a difference between

suffering from a mental impairment and being disabled as a result of that impairment. See 20 C.F.R.

§ 404.1505(a) (defining “disability as the inability to do any substantial gainful activity by reason of

any medically determinable physical or mental impairment which can be expected to result in death

or which has lasted or can be expected to last for a continuous period of not less than 12 months”). 

Here, the treating sources’ reports indicated that Ms. Lualhati’s depression was in “remission” and

that her mental status examinations were normal. Hence, it was within the range of the ALJ’s

discretion to afford greater weight to the treatment notes of Ms. Lualhati’s treating sources than to

the report of examining physician, Dr. Johnson, in determining her residual functional capacity. See

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 The Court notes that this diagnosis was made in December 2007, i.e., almost a year after her

alleged onset date. For purposes of this opinion, the Court assumes that the diagnosis was of

impairments existing as of the alleged onset date.

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 The ALJ did refer to myalgia in his written decision, see AR 26 (ALJ decision), but not to

fibromyalgia specifically. The Court notes that, according to the medical records, Ms. Lualhati’s

myalgia was stable. See, e.g., AR 348 (medical record, dated 7/27/2007).

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Tommasetti, 533 F.3d at 1041-42 (noting that ALJ is final arbiter in resolving ambiguities in the

medical evidence).

As a final point, the Court notes that the ALJ’s decision to credit the treating sources over

Dr. Johnson -- i.e., to conclude that she had no real mental limitations -- was consistent with Ms.

Lualhati’s own testimony which reflected that she had no such limitations. Most notably, Ms.

Lualhati indicated, during the hearing before the ALJ , that she had no difficulty with concentration. 

More specifically, Ms. Lualhati testified that she did not have trouble with concentrating while she

reading “if it’s a good book.” AR 59 (ALJ hearing); see also AR 169 (function report) (stating that

she reads for four hours). The ALJ made specific note of this testimony in his decision. See AR 26

(ALJ decision).

B. Additional Physical Impairments

At step four of the five-step sequential evaluation process, an ALJ must determine what the

claimant’s residual functional capacity is – i.e., what the claimant can still do despite her

impairments. In the instant case, Ms. Lualhati contends that the ALJ ignored the fact that she

suffered from fibromyalgia, incontinence, and Sjogren’s syndrome and therefore his assessment of

her residual functional capacity was incorrect.

As Ms. Lualhati maintains, she does appear to have been diagnosed by a treating medical

source with fibromyalgia, incontinence, and Sjogren’s syndrome.5 See AR 425-26 (medical record,

dated 12/10/2007). Moreover, as Ms. Lualhati asserts, the ALJ did not in his decision identify any

of these medical conditions as an impairment from which she suffered.6

 See AR 23 (ALJ decision)

(stating that Ms. Lualhati suffers from “sleep apnea, degenerative arthritis of the hands and hip

joints, history of emphysema, and history of atrial fibrillation (AFIB), and obesity”). On the other

hand, it should be noted that Ms. Lualhati never identified any of the above impairments in her

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original application for benefits. See AR 113 (disability report); AR 69 (notice of disapproved

claims). While Ms. Lualhati seems to have eventually identified incontinence as an impairment – in

conjunction with her request for reconsideration, see AR 77 (notice of reconsideration) – at no point

does she appear to have identified either fibromyalgia or Sjogren’s.

Ms. Lualhati’s failure to identify, at the very least, fibromyalgia or Sjogren’s is problematic,

see, e.g., Seales v. Astrue, No. 1:07-cv-01384-TAG, 2009 U.S. Dist. LEXIS 24578, at *50-51 (E.D.

Cal. Mar. 25, 2009) (concluding that, “[b]ecause Plaintiff has not shown that he raised the issue of

obesity before the ALJ or the Appeals Council, Plaintiff has waived his right to obtain judicial

review of the issue here”), particularly because it is not clear that the record should have alerted the

ALJ to these impairments. For example, fibromyalgia appears to be referenced in only one medical

record, see AR 426 (medical record, dated 12/10/2007), and Sjogren’s in only two. See AR 412

(medical record, dated 10/2/2008); AR 426 (medical record, dated 12/10/2007). Compare Clifford

v. Apfel, 227 F.3d 863, 873 (7th Cir. 2000) (noting that the plaintiff “did not claim obesity as an

impairment when filing her Disability Report” but that “the evidence should have alerted the ALJ”

to this impairment because there were “numerous references in the record to [her] ‘excessive’

weight problem”), with Kitts v. Apfel, 204 F.3d 785, 786 (8th Cir. 2000) (concluding that “ALJ was

not on notice of a need to develop the record further” regarding a mental impairment because the

plaintiff “did not allege a mental impairment in her application or at the hearing, and because the

record shows only a diagnosis of anxiety and prescriptions for anti-anxiety medication from her

family practitioner”); Legrand v. Astrue, No. 4:08CV326 FRB, 2009 U.S. Dist. LEXIS 24952, at

*77-78 (E.D. Mo. Mar. 25, 2009) (noting that “[p]laintiff did not allege a mental impairment in his

application, nor did he testify to a mental impairment at the hearing before the ALJ” and that “a

review of the voluminous treatment record shows only a diagnosis of reactive depression by

plaintiff’s primary care physician, with such diagnosed condition considered by the same physician

to be in remission one month after the initial diagnosis”; this was “scant evidence” insufficient to put

the ALJ on notice).

But even assuming that the ALJ was properly on notice of fibromyalgia and Sjogren’s, not to

mention incontinence, that does not mean that his residual functional capacity assessment was

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necessarily incorrect simply because he did not discuss these impairments in his decision. First,

with respect to Sjogren’s, the medical records do not indicate that Ms. Lualhati had any limitations

as a result of the impairment. Indeed, the treating source characterized the impairment as “mild”

and “basically stable.” AR 412 (medical record, dated 10/2/2008); AR 426 (medical record, dated

12/10/2007). See, e.g., Vincent v. Heckler, 739 F.2d 1393, 1394-95 (9th Cir. 1984) (noting that the

Secretary “need not discuss all evidence presented to her”; instead, “she must explain why

‘significant probative evidence has been rejected’”) (emphasis added). Second, for all three

impairments – fibromyalgia, Sjogren’s, and incontinence – Ms. Lualhati has not identified any

limitations arising from those impairments that the ALJ did not take into account in determining her

residual functional capacity. See Burch, 400 F.3d at 684 (noting that the plaintiff “has not set forth,

and there is no evidence in the record, of any functional limitations as a result of her obesity that the

ALJ failed to consider”). Although Ms. Lualhati has in her reply brief identified common symptoms

of, e.g., fibromyalgia, see Reply at 6, that does not necessarily mean that she exhibited those

symptoms. Moreover, some of those symptoms – for instance, fatigue – were accounted for in the

ALJ’s residual functional capacity assessment. See AR 26 (ALJ decision) (“find[ing] the claimant

credible to have some fatigue and trouble concentrating”). Similarly, some of the symptoms of

Sjogren’s – for instance, arthritis – were taken into consideration by the ALJ by virtue of the fact

that he found Ms. Lualhati to be suffering from degenerative arthritis of the hands and hip joints. 

See AR 23.

Accordingly, in light of the record and Ms. Lualhati’s failure to raise these physical

impairments and more importantly, any material functional limitations therefrom, the Court finds no

ALJ error with respect to his failure to specifically discuss fibromyalgia, Sjogren’s, or incontinence.

C. Credibility

In his decision, the ALJ found that Ms. Lualhati’s testimony about her symptoms arising

from her impairments was only partially credible. See AR 26 (ALJ decision). Ms. Lualhati argues

that this finding was erroneous.

To determine whether a claimant’s testimony regarding

subjective pain or symptoms is credible, an ALJ must engage in a

two-step analysis. First, the ALJ must determine whether the claimant

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 At the hearing before the ALJ, Ms. Lualhati testified that she does not take care of her

grandchildren. See AR 58 (“I don’t take care of them. My grandson is 10. My granddaughter is 13.

So they’re – no. I’m very close with them but I don’t – if the mother goes to therapy and I’m there,

that’s me staying home with them.”). But this testimony was not consistent with previous statements

made by Ms. Lualhati. See AR 120 (function report) (“3 days a week I pick up my grandchildren from

school. Help with homework.”); AR 121 (“I pick up grandchildren from school 3x’s a week. Cook

dinner for them 3x’s a week.”); AR 166 (function report) (“I watch my 2 grandchildren after school and

serve dinner. Ages 9 and 12.”); AR 166 (“My daughter in law lives with me and her and I take care of

her kids.”); AR 172 (“My grandchildren come home around 3pm. Their Mom goes to work around

then. Sit, read, watch TV and help kids with homework until dinner time. Prepare or serve dinner at

6pm. After dinner I play checkers with my grandson and do reading time with him for 45 minutes.”).

Nor was the testimony consistent with the statement of Ms. Lualhati’s daughter-in-law, i.e., the mother

of the children. See AR 158 (function report – third party) (“She watch my kids while I’m at work.”).

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has presented objective medical evidence of an underlying impairment

“which could reasonably be expected to produce the pain or other

symptoms alleged.” The claimant, however, “need not show that her

impairment could reasonably be expected to cause the severity of the

symptom she has alleged; she need only show that it could reasonably

have caused some degree of the symptom.” “Thus, the ALJ may not

reject subjective symptom testimony . . . simply because there is no

showing that the impairment can reasonably produce the degree of

symptom alleged.”

Second, if the claimant meets this first test, and there is no

evidence of malingering, “the ALJ can reject the claimant’s testimony

about the severity of her symptoms only by offering specific, clear and

convincing reasons for doing so.”

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

In the instant case, the ALJ concluded that Ms. Lualhati’s “medically determinable

impairments could reasonably be expected to cause the alleged symptoms.” AR 26 (ALJ decision). 

In other words, Ms. Lualhati had satisfied the first step of the above credibility analysis. But the

ALJ went on to conclude that Ms. Lualhati had not completely satisfied the second step, holding that

her statements about the severity of her symptoms were only partially credible. In arriving at the

conclusion that Ms. Lualhati was only partially credible, the ALJ took note of, inter alia, (1) the

opinion of a nontreating, examining physician, as well as the opinion of a state agency medical

consultant, that Ms. Lualhati was capable of doing medium level work; (2) medical records from her

treating medical sources indicating that her medical conditions were stable; and (3) her daily

activities, which included taking care of her grandchildren,7

 preparing meals, doing household

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chores, driving, grocery shopping, running errands, and reading (without any trouble concentrating

if the book were good). See AR 25-26.

The Court disagrees with Ms. Lualhati’s contention that the ALJ’s credibility findings were

not sufficiently specific. As indicated above, the basis for the ALJ’s credibility findings were clear

– i.e., the medical evidence and Ms. Lualhati’s daily activities. See SSR 96-7p (stating that “[t]he

determination or decision must contain specific reasons for the finding on credibility, supported by

the evidence in the case record”). The ALJ also clearly stated that he did not find Ms. Lualhati

credible to the extent her claims about her symptoms were not consistent with a residual functional

capacity for light work. See AR 26 (ALJ decision). This was enough information to permit the

reviewing agency and the Court to understand “the weight the [ALJ] gave to the individual’s

statements and the reasons for that weight.” Id.; see also Thomas v. Barnhart, 278 F.3d 947, 958

(9th Cir. 2002) (indicating that credibility findings are sufficiently specific so long as they permit a

“court to conclude that the ALJ did not arbitrarily discredit claimant’s testimony”).

The Court also disagrees with Ms. Lualhati’s assertion that, “once an underlying impairment

capable of causing pain is established, [an] ALJ may not discredit testimony because the degree of

pain or limitation is not supported by the medical evidence.” Mot. at 14. “[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. 2007) (emphasis

added); see also 20 C.F.R. § 404.1529(c)(1)-(2) (providing that, “[w]hen the medical signs or

laboratory findings show that you have a medically determinable impairment(s) that could

reasonably be expected to produce your symptoms, such as pain, we must then evaluate the intensity

and persistence of your symptoms” and, “[i]n evaluating the intensity and persistence of your

symptoms, we consider all of the available evidence, including . . . the signs and laboratory findings,

and statements from . . . your treating or nontreating source”). In the instant case, the ALJ did not

conclude that Ms. Lualhati was partially credible based on medical evidence alone.

Finally, the Court disagrees with Ms. Lualhati’s position that the ALJ’s credibility findings

were erroneous because he failed to take into account her obesity, which could exacerbate the effects

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of her other impairments. The ALJ’s written decision clearly reflects that he considered her obesity. 

See AR 26 (ALJ decision).

While, as discussed above, many of Ms. Lualhati’s arguments regarding the issue of

credibility are not well founded, there is, as Ms. Lualhati argues, one significant problem with the

ALJ’s credibility analysis – more specifically, his discussion of her daily activities. The Ninth

Circuit has held that, “daily activities may be grounds for an adverse credibility finding ‘if 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.’” Orn, 496 F.3d at 639; see also Burch,

400 F.3d at 681 (stating that adverse credibility finding based on activities may be proper “if a

claimant engages in numerous daily activities involving skills that could be transferred to the

workplace”). 

In the instant case, the activities in which Ms. Lualhati engaged are arguably transferable to a

work setting. See, e.g., Morgan v. Apfel, 169 F.3d 595, 600 (9th Cir. 1999) (indicating that the

claimant’s ability to fix meals, do laundry, work in the yard, and occasionally care for his friend’s

child was evidence of his ability to work); Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989) (noting

that, “if, despite his claims of pain, a claimant is able to perform household chores and other

activities that involve many of the same physical tasks as a particular type of job, it would not be

farfetched for an ALJ to conclude that the claimant’s pain does not prevent the claimant from

working”). Compare Orn, 496 F.3d at 639 (describing daily activities of the claimant as

“sometimes” reading, watching television, and coloring in coloring books, which failed to establish

that the claimant “has ‘transferable’ skills to be a surveillance system monitor,” a “position that

requires sustained concentration and attention, as well as the ability to act immediately in

emergencies”). 

But it is not clear that Ms. Lualhati was able to engage in such activities for a substantial part

of her day, a point that the ALJ did not address. For example, although Ms. Lualhati did do

household chores and grocery shopping, she did not engage in these activities on a daily basis. 

Indeed, she appears to have done these activities on a limited basis – e.g., laundry every two weeks,

cleaning once or twice a week, grocery shopping once or twice a week, and washing the dishes a

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few times each week. See AR 159-60 (function report – third party); AR 120, 122-23 (function

report); AR 167-68 (function report). Given this circumstance, the Court concludes that the ALJ’s

credibility determination, to the extent it was based on Ms. Lualhati’s daily activities, was

erroneous. The Court finds persuasive the district court’s analysis in Belcher v. Astrue,

1:09cv01234 DLB, 2010 U.S. Dist. LEXIS 65509 (E.D. Cal. June 9, 2010). There, the court noted,

in reasoning applicable here, that, “[t]o the extent the ALJ cites Plaintiff’s ‘physical’ activities, such

as cooking, taking out the trash or doing laundry, those activities are not performed frequently

enough to support a finding that Plaintiff spends a ‘substantial’ portion of his day performing such

activities.” Id. at *43.

Although the Court finds error here, it shall not automatically credit as true Ms. Lualhati’s

claims regarding her symptoms. There is a split in the Ninth Circuit as to whether the credit-as-true

rule is mandatory or discretionary. See Vasquez v. Astrue, 572 F.3d 586, 593 (9th Cir. 2009); see

also Connett v. Barnhart, 340 F.3d 871, 876 (9th Cir. 2003) (stating that “we are not convinced that

the ‘crediting as true’ doctrine is mandatory in the Ninth Circuit” because, “[d]espite the seemingly

compulsory language in [several cases], there are other Ninth Circuit cases in which we have

remanded solely to allow an ALJ to make specific credibility findings”).

Moreover, even if the Court were to credit Ms. Lualhati’s excess pain testimony, it is not

clear that the ALJ would be required to award her benefits. See Varney v. Secretary of Health &

Hum. Servs., 859 F.2d 1396, 1401 (9th Cir. 1988). The ALJ concluded that Ms. Lualhati was

capable of doing light work, and a job is in the category of light work “when it requires a good deal

of walking or standing, or when it involves sitting most of the time with some pushing and pulling

of arm or leg controls.” 20 C.F.R. § 404.1567(b) (emphasis added). Even if Ms. Lualhati’s ability

to walk or stand at length was debatable because she performed household chores and did grocery

shopping on only a limited basis, that would not necessarily preclude her from performing a job

which involved sitting most of the time. The Court acknowledges that Ms. Lualhati claimed to have

limitations in sitting, and not just walking or standing, see, e.g., AR 55 (ALJ hearing) (Ms. Lualhati

testifying that, when she sits, “my butt goes to sleep and my legs start aching and then I have to get

up and, and walk”); AR 127 (function report) (stating that she “become[s] stiff after sitting for 15/30

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minutes”); AR 172 (function report) (indicating that, after sitting for ten minutes, she “get[s] stiff

legs [and has a] spasm in back”); however, that testimony is in conflict with other testimony that she

provided suggesting that she was in fact capable of sitting for extended periods of time. See, e.g.,

AR 169 (function report) (stating that she watches television for about five hours and reads for four

hours). And even if Ms. Lualhati had to take breaks from sitting to relieve any pain, see AR 55

(ALJ hearing) (Ms. Lualhati testifying that, when she sits, “my butt goes to sleep and my legs start

aching and then I have to get up and, and walk”), it is not clear that this limitation would necessarily

preclude her from working. That specific limitation was not considered by the vocational expert. 

Cf. Vasquez, 572 F.3d at 597 (stating that, “’where the testimony of the vocational expert has failed

to address a claimant’s limitations as established by improperly discredited evidence,’ this Circuit

has ‘consistently . . . remanded for further proceedings rather than payment of benefits’”).

D. Lay Witness Testimony

In support of her disability claim, Ms. Lualhati offered written testimony from two lay

witnesses: (1) her sister, Judy Foster, see AR 136-43 (function report – third party), and (2) her

daughter-in-law, Theresa Sespene. See AR 157-64 (function report – third party). Ms. Lualhati

argues that the ALJ erred in concluding that she was not disabled because he did not take into

account the testimony of these relatives.

Ms. Lualhati is correct that the ALJ’s written decision does not make any mention of the

testimony submitted by Ms. Foster. However, an ALJ is not required to “discuss all evidence

presented to [him]”; instead, “[he] must explain why ‘significant probative evidence has been

rejected.’” Vincent, 739 F.2d at 1394-95. Here, the Court cannot conclude that the testimony of Ms.

Foster constitutes “significant probative evidence.” As the Commissioner points out, Ms. Foster

appears to have had limited contact with Ms. Lualhati, seeing her every month or two months. See

AR 136 (stating that “[we] just visit”; “[w]e usually see each other about every 4-8 weeks”). 

Accordingly, she was not in a strong position to be able to comment about Ms. Lualhati’s

limitations, in particular, her daily activities. See Smolen, 80 F.3d at 1289 (stating that “testimony

from lay witnesses who see the claimant every day is of particular value”). Ms. Foster implicitly

acknowledged this fact in her written statement, couching her responses with phrases such as “I

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don’t know” and “I think.” See, e.g., AR 136 (“I don’t know for sure, since I don’t live with her.”);

AR 137 (“I think . . . .”); AR 137 (“Don’t know”); AR 138 (“I am not around Nancy on a daily

basis, so I do not know.”); AR 138 (“I believe . . . .”); AR 139 (“Probably . . . .”).

In contrast to Ms. Foster, Ms. Sespene was in a strong position to be able to comment about

Ms. Lualhati’s limitations because she lives with Ms. Lualhati. See AR 47 (ALJ hearing) (Ms.

Lualhati testifying that she lives with, inter alia, her daughter-in-law). However, the ALJ did

address Ms. Sespene’s testimony in his written decision. See AR 25 (ALJ decision) (discussing Ms.

Sespene’s testimony on Ms. Lualhati’s activities). Ms. Lualhati argues that, even so, the ALJ

ignored critical part of Ms. Sespene’s testimony, most notably, her testimony that Ms. Lualhati had

limitations on standing, walking, and sitting. See AR 158 (function report – third party) (“She was

OK for sitting long time, walking [i.e., prior to disability].”); AR 159 (“She can’t stand too long.”);

AR 162 (“Can’t stand too long or sit too long[,] the back ache occurs. Legs hurt.”); AR 162 (“[She

can walk] 2 blocks, rest for 5 min.”). The Court is troubled by the ALJ’s failure to comment on

these claimed limitations but need not make a definitive ruling as to whether this failure constituted

error as the Court will already be remanding the case for further proceedings based on the ALJ’s

error in assessing Ms. Lualhati’s credibility. The Court notes that, even if it were to credit Ms.

Sespene’s testimony on Ms. Lualhati’s ability to sit, stand, or walk, it is not clear – as discussed

above – that these limitations would necessarily preclude Ms. Lualhati from working, particularly at

the light level. That determination, if necessary based on reconsideration of the testimony, should

be made anew by the ALJ on remand.

E. Remand

For the foregoing reasons, the Court concludes that the ALJ erred in making his credibility

determination and that a remand for further proceedings rather than an award of benefits is

appropriate. The Court notes that, on remand, Ms. Lualhati’s testimony regarding her limitations

and the testimony of Ms. Sespene, in its entirety, should be reconsidered. The other claims of error

are rejected.

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III. CONCLUSION

Accordingly, the parties’ cross-motions for summary judgment are denied but their

alternative motions to remand for further proceedings are granted.

This order disposes of Docket Nos. 16 and 19.

IT IS SO ORDERED.

Dated: July 29, 2010

_________________________ EDWARD M. CHEN

United States Magistrate Judge

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