Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_14-cv-01530/USCOURTS-caed-1_14-cv-01530-1/pdf.json

Parties Involved:
Teresa Marie Berkebile
Plaintiff
Commissioner of Social Security
Defendant

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

INTRODUCTION

Plaintiff Teresa Marie Berkebile (“Plaintiff”) seeks judicial review of a final decision of the 

Commissioner of Social Security (“Commissioner”) denying her application for disability insurance 

benefits (“DIB”) under Title II of the Social Security Act. The matter is currently before the Court on 

the parties’ briefs, which were submitted, without oral argument, to Magistrate Judge Barbara A. 

McAuliffe. 

The Court finds the decision of the Administrative Law Judge (“ALJ”) to be supported by 

substantial evidence in the record as a whole and based upon proper legal standards. Accordingly, this 

Court affirms the agency’s determination to deny benefits.

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TERESA MARIE BERKEBILE,

 Plaintiff,

v.

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security,

Defendant.

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Case No.: 1:14-cv-01530-BAM

ORDER REGARDING PLAINTIFF’S

SOCIAL SECURITY COMPLAINT

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FACTS AND PRIOR PROCEEDINGS

On April 4, 2011, Plaintiff filed an application for disability insurance benefits. AR 165-68.

1

 

Plaintiff alleged that she became disabled on March 15, 2011, due to sleep apnea and bipolar disorder. 

AR 107, 165. Plaintiff’s applications were denied initially and on reconsideration. AR 107-111, 114-

118. Subsequently, Plaintiff requested a hearing before an Administrative Law Judge (“ALJ”). ALJ 

Danny Pittman held a hearing on January 22, 2013, and issued an order denying benefits on May 17, 

2013. AR 23-37. Plaintiff sought review of the ALJ’s decision, which the Appeals Council denied, 

making the ALJ’s decision the Commissioner’s final decision. AR 1-3, 17-18. This appeal followed.

Hearing Testimony

The ALJ held a hearing on December 19, 2012, in Fresno, California. AR 42-89. Plaintiff 

appeared and testified. She was not represented by counsel. AR 44. Impartial Vocational Expert 

(“VE”) Thomas Dachelet also testified. AR 44, 83.

At the outset of the hearing, the ALJ confirmed that Plaintiff was prepared to proceed with the 

hearing without a representative. The ALJ then informed Plaintiff of her right to representation, which 

she waived. AR 45-46. The ALJ also informed Plaintiff that the issue in the case was whether or not 

she was disabled and provided her the standards for a disability finding. AR 47-48. 

In response to questions from the ALJ, Plaintiff testified that she was born in 1963, was 5’3,” 

and weighed 180. She was single and lived alone, but had a 31-year old child. With regard to income, 

Plaintiff indicated that she was a veteran and received disability from the VA. She also was receiving 

worker’s comp payments because she was injured at her job. She was not receiving a disability 

retirement from the state, but she had applied for it. AR 48-49.

Plaintiff reported that she had a driver’s license and, on average, drove once or twice a week. 

Plaintiff also reported that she had a bachelor’s degree in economics, with a minor in business. AR 

50. With regard to her military experience, Plaintiff testified that she was in the Army, where she 

worked as a radio and teletype operator. She received an honorable discharge in 1988. 

 

1 References to the Administrative Record will be designated as “AR,” followed by the appropriate page number.

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Plaintiff testified that she had not done any work since her alleged onset date of March 15, 

2011. Based on her alleged onset date, the ALJ asked Plaintiff about her official earnings record, 

which showed earnings of over $17,000 in the first quarter of 2012. Plaintiff explained that people 

with lower seniority were offered a lay-off package of that amount. Plaintiff took the package, but did 

not work after 2011. Plaintiff also confirmed that she received unemployment in the first and second 

quarters of 2012 and that she was still receiving unemployment. AR 51-52. When questioned about 

whether she was actively looking for work, Plaintiff indicated that she had been trying to find work 

that did not require above-the shoulder, lifting or computer work. AR 52-53.

When asked if she would have taken a job if offered, Plaintiff explained that she has been good 

at finding and interviewing for jobs. She also has been hired for jobs she is not emotionally or 

mentally able to do. Although she has not had any requests for interviews, if there was something that 

she could do, then she would probably try it. AR 53. The ALJ then explained that if Plaintiff told the 

state that she was physically able to work, but now she was saying she could not work, then there was 

an inconsistency. Plaintiff understood. AR 54. 

In response to questions about her work history, Plaintiff testified that she worked for 

Northwest Administrators as a field representative for the teamster’s pension fund. Her duties 

included travel to various union sites and meetings with members regarding their retirement. Plaintiff 

then worked for American Century as an investor relations specialist for 3 1⁄2 or 4 years. In 2005, 

Plaintiff then went to work for Kelly Services at State Fund doing miscellaneous projects. It started as 

a temp job, but then she was hired permanently. Plaintiff clarified that she was initially hired as a 

claims adjuster and was demoted to a program tech. She worked as a claims adjuster for eight months, 

which was mostly training, and never became proficient in that job. She primarily worked as a 

program tech for State Fund, which was her last job. AR 54-57.

When asked what prevented her from working, Plaintiff testified that her main issue was 

obstructive sleep apnea, which prevented her from a good night’s sleep. Plaintiff indicated that she 

has several days throughout the week when she cannot function and sometimes has to stay in bed 

because she is not getting sleep. Plaintiff testified that she cannot predict those days and cannot 

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schedule herself for a job. Plaintiff thought the most she could do was a part-time position. AR 57-

58.

Plaintiff confirmed that she was receiving worker’s comp for a neck injury, her shoulders, 

hands, wrists and elbows. The case was still in process. AR 58-59. Plaintiff indicated that she was 

receiving medical treatment at the VA. AR 59.

Plaintiff provided additional information regarding her sleep apnea. She explained that she 

was waiting for a third surgery, but the apnea made her depressed because she has no energy. 

Although she has goals, her body and mental state will not allow her to do it. Plaintiff reported that 

she had been working on her sleep apnea since 2004. She has tried CPAP machines, BiPAP machines, 

and different masks without resolution. AR 59.

When questioned about her medications, Plaintiff testified that the medications for depression 

help control her symptoms. She also testified that the medications for cholesterol were controlling her 

cholesterol. Plaintiff additionally confirmed that she was taking medication for the obstructive sleep 

apnea. Plaintiff reported that Dr. Howsepian, her psychiatrist, said that modafinil could help with 

energy, but it only helped a little. Plaintiff did not have any noticeable side effects from her 

medications. AR 60-61. 

In response to questions about her obstructive sleep apnea, Plaintiff testified that she already 

had two surgeries. Her third surgery was not yet scheduled due to allergies. Plaintiff indicated that 

she had slight improvement with the prior surgeries. AR 61.

In response to questions about her neck, Plaintiff testified that surgery had not yet been 

recommended. She also did not have injections, physical therapy or a neck brace. AR 61-62. 

Plaintiff reported that she has pain in her neck on a daily basis, especially if she drives. The pain 

radiates into her arms from her shoulders to her fingers. She gets numbness on both sides. When 

asked to describe the pain, Plaintiff testified that if she turns the wrong way it is a stabbing pain. 

Regularly, her neck is stiff and feels strange. It makes her nervous about doing anything. She takes 

Ibuprofen for pain, which does help, but she cannot take it all the time. Plaintiff reported that driving, 

typing, writing, lifting, and reaching above her shoulder make her pain worse. AR 63-65 

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When asked about her mental health, Plaintiff testified that she had been hospitalized in 1996 

and 1997 for depression. She was in the hospital for two weeks the first time and one week a second 

time. She had herself admitted. Since 2000, she has been receiving mental health treatment with the 

VA. She attends individual therapy. AR 62-63. 

In response to questions about her restrictions, Plaintiff testified that she did not have any 

issues with sitting and could stand about 30 minutes at a time. Walking and standing bother her 

shoulders and neck. Plaintiff testified that she can walk about half a block. She thought she could lift 

and carry 10 pounds, which is what her doctor suggested. She could lift a case of soda, but would 

have pain. She could lift a 5-pound bag of potatoes, but not a 20-pound bag. Plaintiff also testified 

that it would bother her to use a keyboard on a continuous basis. Generally, she can use a keyboard, a 

pen and do buttons and zippers for a short time. She does not drop things, but has come close. If she 

does drop something, she is able to bend over and pick it up. However, it bothers her to reach 

overhead, so she tries to avoid it. AR 66-68.

When asked about memory problems, Plaintiff testified that she has had them since birth from 

the obstructive sleep apnea. She is forgetful and has both short and long-term memory problems. She 

also has trouble concentrating because she gets distracted. Plaintiff thought she could follow two and 

three-step instructions. She also testified that she has issues getting along with people because she is 

not patient and is irritable. She has not been arrested or fired for physical or verbal altercations, but 

she has created some bad work environments. Plaintiff additionally reported that she has intermittent 

crying spells at least weekly. AR 68-70.

When asked to describe a typical day, Plaintiff testified that she wakes up and feeds and waters 

her animals. She has two cats and two dogs. If she has energy, she tries to do some work around the 

house, like load the dishwasher. She will have weeks where she cannot do anything but watch TV 

because she does not have energy. She will go without grocery shopping. AR 70-71. She sleeps 10 

to 12 hours every night and takes naps once or twice a week for two to five hours. AR 71. When she 

is depressed, she is not able to bathe, dress or feed herself. She sometimes prepares her own meals. 

When she has energy, she does her own laundry. She sometimes vacuums, sweeps or mops the floors. 

She has heavy allergies, so she oftentimes does not dust. She very infrequently does any yard work or 

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gardening and has someone mow her lawn. She pays her bills and goes grocery shopping by herself. 

She does not go to church, clubs or movies, but she does go to restaurants. She sometimes visits with 

friends or family. She no longer does any outside activities. She does not go to athletic events or the 

mall. She likes to do variety puzzle books. AR 71-73.

Following questioning and statements by the Plaintiff, the VE described his qualifications. 

Plaintiff did not have any objections to him testifying. AR 80-81. The VE characterized Plaintiff’s 

past work as general clerk, union field rep and customer service rep. AR 83-85. 

For the first hypothetical, the ALJ asked the VE to assume an individual of Plaintiff’s age and 

education with the same past jobs limited to lifting and carrying up to 50 pounds occasionally and up 

to 25 frequently, standing and/or walking up to six hours and sitting up to six hours in an eight-hour 

day with normal breaks, limited to frequent balancing, stooping, kneeling, crouching, crawling and 

climbing ramps and stairs, no climbing ladders, rope or scaffolds, needing to avoid all exposure to 

hazards and limited to simple routine tasks with no more than incidental contact with the general 

public. The VE testified that this individual would not be able to perform any of Plaintiff’s past jobs, 

but there would be other work available, such as hand packager, machine packager, and laundry 

checker. AR 85-86.

For the second hypothetical, the ALJ asked the VE to add an additional limitation to the first 

hypothetical that the individual would be limited to no production rate or pace work. The VE testified 

that this would eliminate all jobs and there would be no work available. AR 86.

For the third hypothetical, the ALJ asked the VE to assume the same hypothetical individual 

precluded from repetitive motions of the neck and upper extremities, no work at or above should level, 

no repetitive motions of the hand or fine manipulation, no lifting more than 10 pounds and limited to 

standing, walking, and sitting up to six hours each in an eight-hour day. The VE testified that there 

would not be any work for this individual. AR 86-87.

For the fourth hypothetical, the ALJ asked the VE to add an additional limitation that the 

individual would be precluded from any task that required either ongoing interpersonal social contact 

or ongoing detailed instructions and required the ability to adapt to changing workplace situations, 

pressure to keep up and to attend the details or be scrutinized in the workplace. The ALJ clarified that 

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this person would not be able to work in a job where there was ongoing interpersonal or social contact. 

This person would be able to perform the simple unskilled, but was precluded from any job that 

required the ability to adapt to changes in the workplace. The VE testified that there would be no 

work for this person. AR 87-88. 

Medical Record

The entire medical record was reviewed by the Court. AR 285-809. The relevant medical 

evidence, summarized here, will be referenced below as necessary to this Court’s decision. 

On March 10, 2011, Plaintiff sought treatment for continuing neck and shoulder pain. A letter 

was provided for Plaintiff’s employer requesting that Plaintiff be given easy/modified duty for 2 

weeks until March 25 and that avoidance of repetitive movements (essentially scanning) was 

recommended. AR 356-57. 

On March 14, 2011, Plaintiff met with Dr. Avek Howsepian, a clinical psychiatrist at the 

Veteran’s Administration (“VA”), and requested augmentation of her medication or some other 

change to cope with the downturn in her mood. Plaintiff was opting to return to work full-time with 

accommodations. AR 352-53. Dr. Howsepian wrote a letter to the medical director at the State 

Compensation Insurance Fund. After reviewing a copy of Plaintiff’s job description, Dr. Howsepian 

opined that, from a psychiatric standpoint, Plaintiff was able to resume full-time work beginning 

March 31, 2011. However, he recommended that her work days begin later, at 0700, as an 

accommodation to her difficulties managing stress early in the day. AR 352. 

On March 21, 2011, Dr. Howsepian spoke with Plaintiff, who reported that she had not been to 

work, except for 2 days in the past 2 weeks. Plaintiff explained she had trouble getting to work, was 

in a destructive mode, her house and car were a mess, she had been thinking about her Army disability 

claim, had gone gambling once, and smoked cigarettes for a couple days and was smoking pot. Dr. 

Howsepian discussed his misgivings about Plaintiff’s work pattern and avoidance of work. Plaintiff 

felt trapped between medical leave option and full-time work. Dr. Howsepian strongly urged Plaintiff 

not to take medical leave option and not pursue a career in the direction of permanent disability. AR 

349. 

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On March 29, 2011, Plaintiff met with Dr. Howsepian and reported that she was considering 

tracheostomy following failed surgical intervention and continuing symptoms. Dr. Howsepian noted 

that he discussed in detail his concerns about Plaintiff heading in the direction of disability, 

“emphasizing [he] did not believe this is in her best interest.” AR 346. Dr. Howsepian also discussed 

how the goal of treatment leading to well-being and the goal of disability were diametrically opposed. 

AR 346. On mental status, Plaintiff was dysphoric and stated she was depressed. She was anxious 

and clearly apprehensive about the meeting. AR 346.

On April 6, 2011, Dr. Peter Baylor, a pulmonary staff physician, advised Plaintiff that the only 

option for her severe obstructive sleep apnea was an elective tracheostomy. Dr. Baylor offered nighttime oxygen, modafanil and a consult with Dr. Cheng regarding a possible tracheostomy. AR 343-44.

On April 18, 2011, Plaintiff met with Dr. Howsepian. Plaintiff reported that she was on 

medical retirement from work for 3 months and was applying for SSD. Plaintiff planned to resume 

psychotherapy with Dr. Richardson. Dr. Howsepian noted Plaintiff continued to attribute a substantial 

majority of difficulties to obstructive sleep apnea. AR 332-33.

On April 27, 2011, Plaintiff saw Dr. Pong Ping Cheng, an otolaryngologist, for a surgical 

opinion. Dr. Cheng indicated it was difficult to communicate with Plaintiff because of her bipolar 

disorder. Dr. Cheng noted that nasal CPAP therapy and palate surgery had both failed. Plaintiff did 

not like laryngoscopy and the examination was suboptimal. Dr. Cheng discussed a tracheostomy, but 

Plaintiff was resistant. She also had further studies pending at Stanford. Although many surgical 

options were discussed, Dr. Cheng reported that the discussion became acrimonious because of 

communication problems, and Plaintiff walked out in the middle of the visit. Dr. Cheng opined that 

Plaintiff should continue to be treated at Stanford. AR 324-25.

On May 11, 2011, Plaintiff reported receiving a neck roll/pillow, wedge pillow and heating pad 

from her VA physical therapist. Plaintiff also reported that her symptoms were improved with the use 

of a cervical roll and exercises. Plaintiff planned to continue physical therapy through Kaiser and the 

worker’s comp program. Plaintiff cancelled her last scheduled appointment, stating she felt good and 

the weather was nice, so she was going to do something fun. The therapist intended to discontinue 

Plaintiff’s VA physical therapy. AR 320. 

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On July 26, 2011, Dr. Steven Stoltz, a Board Certified Internist, completed a consultative 

evaluation. On physical examination, Plaintiff was in no obvious distress and was alert and oriented 

times four. Her grip strength was 60-65-60 in her right and 70-70-65 in her left. The range of motion 

in her neck and back were within normal limits. Straight leg raising was negative at 90 degrees and 

Laseque’s sign was negative. The range of motion in Plaintiff’s shoulders, elbows and wrists was 

within normal limits. Her strength was 5/5 in all extremities. Dr. Stoltz identified Plaintiff’s 

diagnoses as obstructive sleep apnea, hyperlipidemia, and psychiatric. Dr. Stoltz indicated that 

Plaintiff was seen “mainly for her obstructive sleep apnea” and Plaintiff had a very long history with 

multiple interventions, including surgery. AR 383-84. Dr. Stoltz opined that Plaintiff’s limitations 

would be mainly in relationship to the consequences from her obstructive sleep apnea, such as daytime 

sleepiness and naps. Dr. Stoltz stated that he would limit Plaintiff from working at unprotected 

heights or around moving mechanical parts. As Plaintiff had a driver’s license, Dr. Stoltz did not feel 

that any limitations were necessary for operating a motor vehicle. Dr. Stoltz further opined that other 

activities, such as lifting, carrying, sitting, standing, walking and postural activities were without 

limits. AR 379-384.

On August 20, 2011, Dr. Ekram Michiel, a Board Certified Psychiatrist, completed a 

consultative psychiatric evaluation. Plaintiff complained of depression, bipolar, severe sleep apnea, 

chronic fatigue and anxiety. When identifying her habits, Plaintiff stated that she smoked a couple 

joints of marijuana a day. Plaintiff reported that she was able to take care of her personal hygiene and 

was able to shop, cook and do household chores sometimes. On mental status examination, Plaintiff’s 

mood was depressed. Her affect was intense, sad and tearful. Her thought process was goal-directed 

and her thought content was not delusional. She was oriented to person, place and date. Her attention 

and concentration were fairly intact, as was her immediate recall. Her short-term memory was slightly 

impaired and her long-term memory was fair. Plaintiff was diagnosed with depressive disorder NOS, 

anxiety disorder NOS and cannabis dependence. Dr. Michiel assigned Plaintiff a Global Assessment 

of Functioning (“GAF”) of 50-55. Based upon the evaluation, Dr. Michiel believed Plaintiff was able 

to maintain attention and concentration to carry out simple repetitive job instructions. She was able to 

relate and interact with coworkers, supervisors and the general public while performing simple job 

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instructions, but was unable to carry out an extensive variety of technical or complex instructions. Dr. 

Michiel also opined that Plaintiff was unable to handle her own funds because of her dependence on 

marijuana. AR 388-391.

On August 9, 2011, Plaintiff reported to Dr. Colleen Richardson, a clinical psychologist at the 

VA, that a friend stayed with her for about a week, helping her around the house and helping her get 

motivated to start cleaning, washing her car, mopping the floors and tending her lawn. AR 502. 

On August 30, 2011, Dr. Baylor reviewed Plaintiff’s sleep study results and indicated that 

Plaintiff’s sleep efficiency was reduced at 78% (normal is greater than 85%). Dr. Baylor opined that 

Plaintiff had moderate to severe obstructive sleep apnea. AR 500. 

On August 31, 2011, Plaintiff reported to Dr. Richardson that she continued to do well and was 

very positive about the direction of her life. She was losing weight, working in her yard, fixing up her 

house and taking care of things in her life. AR 497.

On September 21, 2011, Dr. Richardson noted that Plaintiff continued to do well, maintaining 

her current level of elevated mood and doing things around her house. AR 497.

On October 13, 2011, Alvin Smith, Ph.D., completed a Psychiatric Review Technique form. 

Dr. Smith opined that Plaintiff had mild restriction in the activities of daily living, mild difficulties in 

maintaining social functioning and moderate difficulties in maintaining concentration, persistence or 

pace. She had no repeated episodes of decompensation. AR 392-402.

Dr. Smith also completed a Mental Residual Functional Capacity Assessment form. Dr. Smith 

opined that Plaintiff was moderately limited in the ability to understand and remember detailed 

instructions, in the ability to carry out detailed instructions, and in the ability to maintain attention and 

concentration for extended periods. She also was moderately limited in the ability to work in 

coordination or proximity to others without being distracted by them, in the ability to interact 

appropriately with the general public and in the ability to get along with coworkers or peers without 

districting them or exhibiting behavioral extremes. Dr. Smith concluded that Plaintiff retained the 

capacity to understand, remember, and carry out non-complex instructions, attend and concentrate for 

extended periods without significant interruptions, exercise reasonable judgment in a workplace 

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setting and complete a routine workday that involved no more than incidental contact with the general 

public. AR 403-05.

On October 18, 2011, Dr. Craig Billinghurst completed a Physical Residual Functional 

Capacity Assessment form. Dr. Billinghurst opined that Plaintiff could lift and/or carry 50 pounds 

occasionally and 25 pounds frequently, could stand and/or walk about 6 hours in an 8-hour workday, 

could sit about 6 hours in an 8-hour workday and could push and/or pull without limitation. She could 

frequently climb ramps and stairs, balance, stoop, kneel, crouch and crawl, but could never climb 

ladders, ropes or scaffolds. She had no manipulative, visual or communicative limitations, but must 

avoid all exposure to hazards (machinery, heights, etc.). AR 406-412.

On October 26, 2011, Dr. Richardson noted Plaintiff continued to do well, maintaining her 

current level of elevated mood and doing things around her house. Plaintiff reported that she went on 

a vacation to Cambria for several days. AR 484. 

On December, 1, 2011, Plaintiff reported to Dr. Richardson that she was still doing very well. 

Plaintiff had cooked Thanksgiving dinner for 5 friends, making a 24.5 pound turkey, a ham and all the 

fixings. AR 471.

A December 1, 2011 x-ray of Plaintiff’s right hand showed minimal degenerative changes. A 

subsequent x-ray on December 13, 2011 showed no significant change from December 1. AR 424-25.

On December 16, 2011, Plaintiff began a physical fitness program with the VA. AR 450. 

On December 22, 2011, Dr. Richardson indicated that Plaintiff continued to do well outside of 

therapy. AR 451.

On December 29, 2011, Plaintiff reviewed with Dr. Richardson a list of pros and cons of either 

leaving or staying with her job at the state. Dr. Richardson observed that Plaintiff’s memory and 

concentration were adequate, she was oriented to person, place, time and situation and her thought 

processes were linear, logical and goal directed. AR 449. 

On January 5, 2012, Plaintiff reported to Dr. Howsepian that she was doing extremely well, 

which she largely attributed to no longer being shackled to her old job. Plaintiff also reported that she 

was looking into an ATM franchise, participating in a seminar, thinking about transporting cars from 

out the area for sale and thinking about law school. Plaintiff also informed Dr. Howsepian that she 

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had Thanksgiving at her home with guests. On mental status, Plaintiff’s mood was significantly 

elevated and she reported much more fluid thoughts. Dr. Howsepian indicated that her assessment 

was suspicious for hypomania. AR 445.

On February 10, 2012, Plaintiff reported to Dr. Richardson that her parents were in town and 

she was enjoying spending some time with them. Plaintiff’s mood was euthymic with mood 

congruent affect. Her memory and concentration were adequate and she was oriented to person, place, 

time and situation. Her thought processes were linear, logical, and goal directed. Her judgment and 

insight were intact. AR 442. 

On March 12, 2012, Dr. Blaine Johnson, an orthopaedic surgeon, completed a Qualified 

Medical Evaluation. Following a review of records and examination, Dr. Johnson diagnosed Plaintiff 

with multilevel degenerative disk and degenerative joint disease, greatest seen at C6-7, with associated 

cervical spine sprain/strain and muscle spasm, including paracervical muscles and trapezii, bilateral 

bicipital tendinitis, bilateral acromioclavicular joint degenerative joint disease, right shoulder 

impingement, bilateral carpal tunnel syndrome, worse on the right than on the left, and flexor carpi 

radialis longus tendinitis bilaterally. With regard to work restrictions, Dr. Johnson opined that 

Plaintiff was precluded from repetitive motions of her neck and upper extremities, no work at or above 

the shoulder level, no repetitive motions of hands or fine manipulation and no lifting of more than 10 

pounds. AR 504-24.

On May 10, 2012, Dr. Howsepian indicated that Plaintiff continued to do very well, which she 

attributed to no longer working at her previous place of employment. AR 790.

On July 19, 2012, Plaintiff reported to Dr. Richardson that she had taken a trip to see her 

parents in Idaho. Plaintiff also reported that she “had never felt so good in her life.” AR 787. Dr. 

Richardson indicated that they would like have one or two more sessions before terminating. AR 787.

On September 20, 2012, Dr. Howsepian noted that Plaintiff was doing better than he had seen 

her. Plaintiff planned to open her own business on her land. Plaintiff asked which medication they 

might discontinue in light of how well she was doing. However, Plaintiff was to continue with her 

current medications. AR 768-69.

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On October 15, 2012, Dr. Howsepian prepared a Physician’ Report on Disability form. 

Plaintiff’s diagnoses were identified as Bipolar Disorder, Type II, and social anxiety disorder. Dr. 

Howsepian opined that Plaintiff was substantially incapacitated from performance of the usual duties 

of the position for her current employer. Dr. Howsepian indicated that although Plaintiff was 

currently stable on multiple psychiatric medications, any tasks that required either interpersonal/social 

contact or detailed instructions and required the ability to adapt to changing workplace situations, 

pressure to keep up to attend deal and be scrutinized in the workplace was highly likely to result in 

emotional decompensation. AR 637-38.

Evidence Submitted to Appeals Council

On May 19, 2013, Dr. Baylor completed a questionnaire and opined that Plaintiff’s medical 

problems precluded her from performing any full-time work at any exertional level, including the 

sedentary level. Dr. Baylor identified Plaintiff’s primary impairment as severe obstructive sleep

apnea. He further opined that Plaintiff could sit, stand or walk for several hours at one time, but she 

could fall asleep easily by day. He also indicated that she could sit, stand and walk several hours in an 

8-hour period, but could fall asleep at inappropriate times by day. Dr. Baylor indicated that when 

daytime somnolence is severe, Plaintiff may need to lie down and she was unable to stay fully awake 

by day like a normal person. AR 809. 

On May 21, 2013, Dr. Howsepian completed a Medical Source Statement, Psychiatric form. 

Dr. Howsepian opined that Plaintiff had marked limitations in the ability to relate and interact with 

supervisors and co-workers, maintain concentration and attention for at least two hour increments, and 

withstand the stress and pressure associated with an eight-hour work day and day-to-day work. 

Plaintiff also had moderate limitations in the ability to understand, remember, and carry out an 

extensive variety of technical and/or complex job instructions and deal with the public. Dr. 

Howsepian indicated that Plaintiff had been depressed since childhood and had a very difficult time 

with anxiety and dealing with stress. AR 808. 

The ALJ’s Decision

Using the Social Security Administration’s five-step sequential evaluation process, the ALJ 

determined that Plaintiff did not meet the disability standard. AR 26-37. More particularly, the ALJ 

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found that Plaintiff had not engaged in any substantial gainful activity since March 15, 2011, her 

alleged onset date. AR 28. Further, the ALJ identified obstructive sleep apnea, cervical degenerative 

disc disease, depressive disorder, anxiety disorder, obesity, tendonitis and osteoarthritis as severe 

impairments. AR 28. Nonetheless, the ALJ determined that the severity of Plaintiff’s impairments 

did not meet or equal any of the listed impairments. AR 28-30. Based on his review of the entire 

record, the ALJ determined that Plaintiff retained the residual functional capacity (“RFC”) to perform 

a limited range of medium work. She could occasionally lift and carry up to 50 pounds and frequently 

25 pounds, stand and/or walk for 6 hours and sit for 6 hours in an 8-hour workday with normal breaks. 

She also had postural limitations to include frequent balancing, stooping, kneeling, crouching, 

crawling and climbing ramps and stairs, but no climbing ladders, ropes and scaffolds. She must avoid 

all exposure to hazards and was limited to simple, routine tasks with no more than incidental contact 

with the general public. AR 30-36. The ALJ found that Plaintiff could not perform any of her past 

relevant work, but there were other jobs existing in significant numbers in the national economy that 

Plaintiff could perform. AR 36-37. The ALJ therefore concluded that Plaintiff was not disabled under 

the Social Security Act. AR 37. 

SCOPE OF REVIEW

Congress has provided a limited scope of judicial review of the Commissioner’s decision to 

deny benefits under the Act. In reviewing findings of fact with respect to such determinations, this 

Court must determine whether the decision of the Commissioner is supported by substantial evidence. 

42 U.S.C. § 405(g). Substantial evidence means “more than a mere scintilla,” Richardson v. Perales, 

402 U.S. 389, 402 (1971), but less than a preponderance. Sorenson v. Weinberger, 514 F.2d 1112, 

1119, n. 10 (9th Cir. 1975). It is “such relevant evidence as a reasonable mind might accept as 

adequate to support a conclusion.” Richardson, 402 U.S. at 401. The record as a whole must be 

considered, weighing both the evidence that supports and the evidence that detracts from the 

Commissioner’s conclusion. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). In weighing the 

evidence and making findings, the Commissioner must apply the proper legal standards. E.g., 

Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). This Court must uphold the Commissioner’s 

determination that the claimant is not disabled if the Commissioner applied the proper legal standards, 

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and if the Commissioner’s findings are supported by substantial evidence. See Sanchez v. Sec’y of 

Health and Human Servs., 812 F.2d 509, 510 (9th Cir. 1987).

REVIEW

In order to qualify for benefits, a claimant must establish that he or she is unable to engage in 

substantial gainful activity due to a medically determinable physical or mental impairment which has 

lasted or can be expected to last for a continuous period of not less than twelve months. 42 U.S.C. § 

1382c(a)(3)(A). A claimant must show that he or she has a physical or mental impairment of such 

severity that he or she is not only unable to do his or her previous work, but cannot, considering his or 

her age, education, and work experience, engage in any other kind of substantial gainful work which 

exists in the national economy. Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). The 

burden is on the claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 

1990).

Here, Plaintiff argues that the Commissioner’s decision should be reversed because (1) the 

ALJ’s RFC finding is based on insubstantial evidence and legal error; (2) the ALJ gave legally 

insufficient reasons for rejecting Dr. Howsepian’s opinion; (3) the Appeals Council failed to address 

Dr. Baylor’s opinion; (4) the ALJ’s reasons for discrediting Plaintiff are not clear and convincing; and 

(5) the ALJ did not fully and fairly develop the record. 

DISCUSSION2

I. Substantial Evidence Supports the ALJ’s Physical RFC Assessment

Plaintiff first argues that the ALJ’s physical RFC erroneously rejected the opinion of Dr. 

Johnson, Plaintiff’s qualified medical examiner, in favor of the opinion of Dr. Billinghurst, a nontreating state agency physician. (Doc. 15 at 15). The Commissioner contends, however, that the ALJ 

considered all evidence in the record, including the opinions of Drs. Johnson and Billinghurst, and 

properly assessed Plaintiff’s physical RFC based on substantial evidence. (Doc. 16 at 13-15).

///

 

2

The parties are advised that this Court has carefully reviewed and considered all of the briefs, including 

arguments, points and authorities, declarations, and/or exhibits. Any omission of a reference to any specific argument or 

brief is not to be construed that the Court did not consider the argument or brief.

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A. Legal Standard

Cases in this circuit distinguish among the opinions of three types of physicians: (1) those who 

treat the claimant (treating physicians), (2) those who examine but do not treat the claimant 

(examining physicians), and (3) those who neither examine nor treat the claimant (non-examining 

physicians). As a general rule, a treating physician’s opinion carries more weight than an examining 

physician’s, and an examining physician’s opinion carries more weight than a reviewing physician’s. 

Holohan v. Massanari, 246 F.3d 1195, 1202 (9th Cir. 2001); Orn v. Astrue, 495 F.3d 625 (9th Cir.

2007). The Commissioner may not reject the opinion of either an examining physician or a treating 

physician, even if contradicted, without specific and legitimate reasons that are supported by 

substantial evidence in the record. Lester v. Chater, 81 F.3d 821, 831 (9th Cir. 1996). Further, the 

opinion of a non-examining physician cannot, by itself, constitute substantial evidence that justifies 

the rejection of the opinion of either an examining physician or a treating physician. Pitzer v. Sullivan, 

908 F.2d 502, 506 n. 4 (9th Cir. 1990); Gallant v. Heckler, 753 F.2d 1456 (9th Cir. 1984).

Notwithstanding the above discussion, an ALJ is not required to accept an opinion of a 

physician if it is conclusory and not supported by clinical findings. Matney v. Sullivan, 981 F.2d 1016, 

1019 (9th Cir. 1992). Additionally, an ALJ is not bound to a medical source’s opinion concerning a 

claimant’s limitations on the ultimate issue of disability. Magallanes v. Bowen, 881 F.2d 747, 751 (9th 

Cir. 1989). If the record as a whole does not support the medical source’s opinion, the ALJ may reject 

that opinion. Batson v. Comm' r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004). Items in the 

record that may not support the physician’s opinion include clinical findings from examinations, 

conflicting medical opinions, conflicting physician’s treatment notes, and the claimant’s daily 

activities. Id.; Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005); Connett v. Barnhart, 340 F.3d 

871, 874–75 (9th Cir. 2003); Morgan v. Comm' r of Soc. Sec. Admin., 169 F.3d 595, 600–601 (9th Cir.

1999).

B. The ALJ Correctly Weighed the Medical Evidence

Plaintiff argues that the ALJ improperly rejected the opinion of Dr. Johnson, an examining 

physician, and improperly assigned greater weight to the opinion of Dr. Billinghurst, a non-examining 

state agency physician. (Doc. 15 at 15-18). The Court disagrees. The ALJ reviewed the entire 

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medical record and, in the absence of a treating physician’s opinion, reasonably gave the greatest 

weight to Dr. Billinghurst’s opinion in determining Plaintiff’s physical RFC. AR 35. The ALJ 

assigned Dr. Johnson’s opinion limited weight based upon, among other things, Plaintiff’s routine 

activities, along with her reports in the medical record regarding a higher level of functioning. AR 36. 

1. Dr. Billinghurst 

On October 18, 2011, Dr. Billinghurst reviewed the medical record and provided a physical 

RFC assessment. AR 406-412. Dr. Billinghurst found Plaintiff could lift and/or carry 50 pounds 

occasionally and 25 pounds frequently, could stand and/or walk about 6 hours in an 8-hour workday 

and sit about 6 hours in an 8-hour workday. AR 407. He also found that Plaintiff could frequently 

balance, stoop, kneel, crouch and crawl, but could never climb ladders, ropes or scaffold and must 

avoid hazards, such as machinery and heights. AR 409-10. 

2. Dr. Johnson

On March 12, 2012, Dr. Johnson completed a Qualified Medical Examination for worker’s 

compensation, reviewed medical records and provided an assessment of Plaintiff’s work restrictions. 

AR 504-524. Dr. Johnson found that Plaintiff had work preclusions from repetitive motions of her 

neck, repetitive motions of her upper extremities, no work at or above the level of the shoulders, no 

repetitive motions of her hands or fine manipulation and no lifting of more than 10 pounds. AR 523. 

3. Analysis

As noted above, the ALJ found that Plaintiff retained the physical RFC for a limited range of 

medium work. She could lift and carry up to 50 pounds occasionally and 25 pounds frequently, could 

stand and/or walk for 6 hours and could sit for 6 hours in an 8-hour workday. However, she could not 

climb ladders, ropes and scaffolds and must also avoid all exposure to hazards. AR 30-36. In so 

finding, the ALJ gave “limited weight” to Dr. Johnson’s opinion and “great weight” to Dr. 

Billinghurst’s assessment. AR 34.

With respect to Dr. Johnson, the ALJ gave limited weight to the examining physician’s opinion 

that Plaintiff was precluded from repetitive motions of her neck, repetitive motions of her upper 

extremities, no work at or above the level of the shoulders, no repetitive motions of her hand or find 

manipulation, and no lifting of more than 10 pounds because Plaintiff’s routine activities and her 

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reports in the medical record established a greater level of functioning. AR 34-35. An ALJ properly 

may discount a physician’s opinion based on conflicting evidence in the record regarding claimant’s 

daily activities. See Morgan, 169 F.3d at 600–602. In this instance, the ALJ cited Plaintiff’s August 

2011 report in the medical records that she was doing well, working in her yard and fixing up her

house. AR 35, 502. The ALJ also cited Plaintiff’s report in October 2011 that she travelled on 

vacation for several days, Plaintiff’s report in December 2011 that she cooked Thanksgiving dinner for 

five of her friends, making a 24.5 pound turkey, a ham and all the fixings, and Plaintiff’s reported 

participation in a physical fitness program. AR 35, 450, 471, 484. Additionally, the ALJ relied on 

Plaintiff’s testimony that she does all of her household chores except yard work, does puzzles and 

independently cares for two cats and two dogs. AR 35, 70-73. Although the evidence may be subject 

to an alternate interpretation, the ALJ’s interpretation is rational and entitled to deference. Molina v. 

Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (“Even when the evidence is susceptible to more than one 

rational interpretation, we must uphold the ALJ’s findings if they are supported by inferences 

reasonably drawn from the record.”). 

Contrary to Plaintiff’s argument, substantial evidence supports the ALJ’s decision to give 

greater weight to Dr. Billinghurst’s opinion because it was consistent with the objective evidence of 

record. AR 34. “[W]hen it is an examining physician’s opinion that the ALJ has rejected in reliance 

on the testimony of a nonexamining advisor, reports of the nonexamining advisor need not be 

discounted and may serve as substantial evidence when they are supported by other evidence in the 

record and are consistent with it.” Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995) (emphasis 

in original). In addition to the foregoing support from Plaintiff’s reported activities in the medical 

evidence, other evidence in the record supported the ALJ’s determination to assign greater weight to 

the opinion of Dr. Billinghurst. This included the opinion of another examining physician, Dr. Stoltz. 

AR 30, 31. Following a physical examination, which included range of motion and grip strength 

testing, Dr. Stoltz identified an essentially normal exam with limitations only from working at 

unprotected heights or around moving mechanical parts based on Plaintiff’s history of sleep apnea. 

AR 30, 379-84. Reports of consultative physicians may serve as substantial evidence. Andrews, 53 

F.3d at 1041. The Court finds the ALJ’s treatment of Dr. Billinghurst’s opinion is not erroneous, is 

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supported by the record, and therefore must be affirmed. See Thomas v. Barnhart, 278 F.3d 947, 954

(9th Cir. 2002). Accordingly, the Court will not reverse or remand the ALJ’s decision on this ground.

II. The ALJ Properly Evaluated Dr. Howsepian’s Opinion

Plaintiff argues that the ALJ failed to give specific and legitimate reasons for rejecting the 

opinion of Dr. Howsepian, her treating psychiatrist. (Doc. 15 at 19). The Commissioner counters that 

the ALJ properly discounted Dr. Howsepian’s opinion because it was inconsistent with his assessment, 

treatment records and other opinions in the record. (Doc. 16 at 18-19).

1. Dr. Howsepian

On October 15, 2012, Dr. Howsepian provided a Physician’ Report form, which identified 

Plaintiff’s diagnoses as Bipolar Disorder, Type II, and social anxiety disorder. Dr. Howsepian opined

that although Plaintiff was currently stable on multiple psychiatric medications, any tasks that required 

either interpersonal/social contact or detailed instructions and required the ability to adapt to changing 

workplace situations, pressure to keep up to attend deal and be scrutinized in the workplace were

highly likely to result in emotional decompensation. AR 637-38.

2. Drs. Michiel and Smith

On August 20, 2011, Dr. Michiel, a consultative examiner, diagnosed Plaintiff with depressive 

disorder NOS, anxiety disorder NOS and cannabis dependence. Based upon his evaluation, Dr. 

Michiel believed Plaintiff was able to maintain attention and concentration to carry out simple 

repetitive job instructions. She was able to relate and interact with coworkers, supervisors and the 

general public while performing simple job instructions, but was unable to carry out an extensive 

variety of technical or complex instructions. AR 388-391.

On October 13, 2011, Dr. Smith, a state agency consultant, completed both a Psychiatric 

Review Technique form and a Mental Residual Functional Capacity Assessment form. Dr. Smith 

concluded that Plaintiff retained the capacity to understand, remember, and carry out non-complex 

instructions, attend and concentrate for extended periods without significant interruptions, exercise 

reasonable judgment in workplace setting and complete a routine workday that involved no more than 

incidental contact with the general public. AR 403-05.

///

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3. Analysis

In this case, the ALJ provided specific and legitimate reasons for rejecting the limitations 

found by Plaintiff’s treating physician in favor of the consultative examiner. The ALJ gave “very little 

weight” to Dr. Howsepian’s assessment because it was inconsistent with his own opinion as well as 

other opinions in the record. 

First, the ALJ discounted Dr. Howsepian’s opinion because it was inconsistent with his own 

opinions and internally inconsistent. See, e.g., Bayliss, 427 F.3d at 1216 (discrepancies between 

doctor’s opinion and doctor’s other recorded observations and opinions is a clear and convincing 

reason for not relying on the doctor’s opinion); Batson, 359 F.3d at 1195 n.3 (ALJ may reject a 

treating physician’s opinion that is not supported by his or her treatment notes); Thomas, 278 F.3d at

957 (ALJ may reject treating physician opinion inconsistent with own records and prior opinions). 

Here, the ALJ properly contrasted Dr. Howsepian’s opinion that Plaintiff’s difficulty with mood and 

anxiety symptoms had been present since childhood and work related stressors incapacitated her with 

record evidence that she had these symptoms for a longitudinal period but was able to work and obtain

a college degree. AR 35. Additionally, the ALJ cited to the internal inconsistency in Dr. Howsepian’s 

opinion regarding Plaintiff’s limitations with his statement that Plaintiff’s symptoms were “currently 

stable.” AR 34, 637-38. Further, the ALJ referenced Plaintiff’s mental health treatment notes, which 

conflicted with Dr. Howsepian’s own opinion. For example, the ALJ identified treatment records 

from September 2011 noting Plaintiff was doing well, along with treatment notes from October 2011 

noting that Plaintiff continued to do well, was doing things around her house and enjoyed a vacation to 

Cambria for several days with a new group of friends, and Dr. Howsepian’s treatment notes from 

January 2012 noting Plaintiff to be “doing extremely well” and looking into franchise businesses and 

law school. AR 32, 445, 484, 497. 

Second, the ALJ accorded “significant weight” to the opinion of Dr. Michiel, the consultative 

examiner. Dr. Michiel’s opinion constitutes substantial evidence, because it rests on his own 

independent examination of Plaintiff. See Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001). 

Consistent with the ALJ’s mental RFC finding, Dr. Michiel found that Plaintiff could carry out simple 

repetitive job instructions. AR 388-391.

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Third, the ALJ credited the opinion of Dr. Smith, the state agency consultant, because it was 

consistent with the objective record of evidence. AR 34. Dr. Smith acknowledged Plaintiff’s 

treatment records with the VA, which indicated fairly normal mental status presentations. AR 402. 

Further, Dr. Smith credited the findings from Dr. Michiel’s examination, which included activities of 

daily living indicating that she could independently manage her basic needs, take care of her affairs, 

travel and socialize on a limited basis. AR 402. An opinion of a state agency consultant also 

constitutes substantial evidence supporting the ALJ’s decision if is consistent with the examining 

psychologist’s opinions, underlying independent examinations and treatment records. See Tonapetyan, 

242 F.3d at 1149 (opinions of nontreating or nonexamining doctors may serve as substantial evidence 

when consistent with independent clinical findings or other evidence in the record); Andrews, 53 F.3d 

at 1041 (“reports of the nonexamining advisor need not be discounted and may serve as substantial 

evidence when they are supported by other evidence in the record and are consistent with it”). 

Contrary to Plaintiff’s argument, the subsequent evidence submitted to the Appeals Council

does not undermine the ALJ’s decision to discount Dr. Howsepian’s opinion. The ALJ considered the 

entirety of the medical record, which included the contrary opinions of consultative examiners and 

state agency consultants and Dr. Howsepian’s own treatment records, in discounting Dr. Howsepian’s 

opinions and developing a mental RFC. An additional opinion from Dr. Howsepian does not 

undermine the ALJ’s findings. The Court therefore finds that the ALJ gave specific and legitimate 

reasons for discounting Dr. Howsepian’s opinion. 

III. The Appeals Council Properly Addressed Later Submitted Evidence

Plaintiff submitted the opinion of Dr. Baylor to the Appeals Council in conjunction with her 

request for review of the ALJ’s hearing decision. The Appeals Council received this evidence and 

made it part of the record. AR 5. Plaintiff now contends the Appeals Council’s failure to mention the 

opinion of Dr. Baylor in its analysis was legal error. (Doc. 15 at 23).

Contrary to Plaintiff’s argument, the Appeals Council expressly addressed the later submitted 

evidence, which included Dr. Baylor’s opinion. AR 1, 5. The Appeals Council concluded that the 

information did not provide a basis for changing the ALJ’s decision. AR 2. 

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As the Appeals Council accepted and considered this later submitted evidence, the Court also 

must consider such evidence in its review. “[W]hen the Appeals Council considers new evidence in 

deciding whether to review a decision of the ALJ, that evidence becomes part of the administrative 

record, which the district court must consider when reviewing the Commissioner’s final decision for 

substantial evidence.” Brewes v. Comm’r of Soc. Sec. Admin., 682 F.3d 1157, 1163 (9th Cir. 2012). 

The Court therefore turns to the opinion of Dr. Baylor submitted to the Appeal Council. 

In his opinion, Dr. Baylor identified Plaintiff’s primary impairment as severe obstructive

apnea. Although he opined that Plaintiff could sit, stand and walk several hours in an 8-hour period, 

he indicated that she could fall asleep at inappropriate times. He also indicated that when her daytime 

somnolence was severe, she may need to lie down. Dr. Baylor stated that Plaintiff was unable to stay 

fully awake by day like a normal person. AR 809. 

The Court finds that Plaintiff has not established that there is a reasonable possibility that this 

evidence from Dr. Baylor would have changed the ALJ’s decision. See Mayes v. Massanari, 276 F.3d 

453, 462 (9th Cir. 2001) (to warrant a remand, claimant must show “reasonable possibility” that new 

evidence would have changed outcome of administrative hearing). This is particularly true given that 

the medical opinion evidence of record considered by the ALJ accounted for Plaintiff’s daytime 

somnolence. For instance, Dr. Stoltz, the consultative examiner, opined that Plaintiff’s limitations 

were mainly in relationship to the consequences from her obstructive sleep apnea, such as daytime 

sleepiness and naps. Dr. Stoltz therefore assessed limitations on working at unprotected heights or 

around moving mechanical parts. AR 379-384. Further, Dr. Billinghurst, the state agency consultant, 

similarly limited Plaintiff from climbing ladders, ropes and scaffolds and working around hazards, 

such as machinery and heights. AR 407-10. In reaching this determination, Dr. Billinghurst 

considered Dr. Stoltz’s opinion, which showed an essentially normal exam “with limitations related to 

sleepiness.” AR 407. As discussed above, the ALJ’s decision to afford great weight to the opinion of 

Dr. Billinghurst was supported by substantial evidence and not in error. 

IV. The ALJ Properly Evaluated Plaintiff’s Credibility

Plaintiff next argues that the ALJ’s reasons for discrediting her were not clear and convincing. 

(Doc. 15 at 24). The Commissioner counters that the ALJ articulated sufficient reasons for finding 

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Plaintiff’s subjective complaints not fully credible. The Court finds that the ALJ properly assessed 

Plaintiff’s credibility. 

In deciding whether to admit a claimant’s subjective complaints of pain, the ALJ must engage 

in a two-step analysis. Batson, 359 F.3d at 1196. First, the claimant must produce objective medical 

evidence of his impairment that could reasonably be expected to produce some degree of the symptom 

or pain alleged. Id. If the claimant satisfies the first step and there is no evidence of malingering, the 

ALJ may reject the claimant’s testimony regarding the severity of his symptoms only if he makes 

specific findings and provides clear and convincing reasons for doing so. Id. The ALJ must “state 

which testimony is not credible and what evidence suggests the complaints are not credible.” Mersman 

v. Halter, 161 F.Supp.2d 1078, 1086 (N.D. Cal. 2001) (“The lack of specific, clear, and convincing 

reasons why Plaintiff’s testimony is not credible renders it impossible for [the] Court to determine 

whether the ALJ’s conclusion is supported by substantial evidence.”). Factors an ALJ may consider 

include: (1) the applicant’s reputation for truthfulness, prior inconsistent statements or other 

inconsistent testimony; (2) unexplained or inadequately explained failure to seek treatment or to 

follow a prescribed course of treatment; and (3) the applicant’s daily activities. Smolen v. Chater, 80 

F.3d 1273, 1284 (9th Cir. 1996).

At the first step of the analysis, the ALJ found that Plaintiff’s “medically determinable 

impairments could reasonably be expected to cause the alleged symptoms.” AR 34. At the second 

step of the analysis, however, the ALJ found Plaintiff’s statements concerning the intensity, 

persistence, and limiting effects of her symptoms were not entirely credible. AR 34. In so doing, the 

ALJ provided several clear and convincing reasons for finding her “not fully credible.” AR 35. 

First, the ALJ found that Plaintiff’s allegations were not supported by the objective evidence. 

AR 34. An ALJ is entitled to consider whether there is a lack of medical evidence to corroborate a 

claimant’s alleged symptoms so long as it is not the only reason for discounting a claimant’s 

credibility. Burch v. Barnhart, 400 F.3d 676, 680–81 (9th Cir. 2005); Batson, 359 F.3d at 1196-97 

(ALJ properly relied on objective medical evidence and medical opinions in determining credibility). 

With regard to her physical limitations, the ALJ considered record evidence that Plaintiff continued to 

be able to walk and move in a satisfactory manner, along with evidence that showed no significant 

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muscle weakness or any loss of control or muscle wasting in her arms and legs. AR 34, 379-84. The 

ALJ also considered radiology studies that showed minimal degenerative changes in her hands, feet 

and ankles. AR 34, 424-25. With regard to her mental limitations, the ALJ considered not only 

medical evidence of her ability to think and communicate, but also multiple reports in 2011 and 2012 

that she was doing well. AR 34, 445, 449, 451, 471, 484, 497, 768-69, 787, 790. 

Second, the ALJ discounted Plaintiff’s credibility based on her reported activities. AR 34-35. 

An ALJ may properly consider a plaintiff's daily activities when discounting a plaintiff's subjective 

testimony. Valentine v. Comm'r Soc. Sec. Admin., 574 F.3d 685, 693 (9th Cir. 2009) (evidence that 

plaintiff “exercised and undertook several projects after he retired” suggested that his “later claims 

about the severity of his limitations were exaggerated”); Mulligan v. Colvin, No. 1:14-cv-1023-BAM, 

2015 WL 5687661, at * 5 (E.D. Cal. Sept. 25, 2015) (discounting credibility where plaintiff 

maintained his own personal hygiene, prepared meals, performed light household chores and yard 

work once or twice a week, and shopped a couple times a month). “Even where those activities 

suggest some difficulty functioning, they may be grounds for discrediting the claimant’s testimony to 

the extent that they contradict claims of a totally debilitating impairment.” Molina, 674 F.3d at 1113. 

Here, the ALJ found that Plaintiff does all the household chores, except for yard work, independently 

cares for her pets, worked in her yard, fixed up her house, socialized, travelled on vacation, cooked 

Thanksgiving dinner, and started a program for physical fitness. AR 34, 70-73, 450, 471, 484, 497.

Third, the ALJ also considered that Plaintiff collected unemployment benefits during her 

purported period of disability and she testified that she would have accepted work if it had been 

offered. AR 35, 51-54. Receipt of unemployment benefits, coupled with record evidence that the 

claimant held herself out as available for work, can undermine a claimant’s alleged inability to work 

full time. Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1161-1162 (9th Cir. 2008) (“receipt 

of unemployment benefits can undermine a claimant’s alleged inability to work fulltime”). 

The ALJ provided clear and convincing reasons for finding Plaintiff not fully credible. 

V. The ALJ Fully and Fairly Developed the Record

As a final argument, Plaintiff alleges that the ALJ failed to fully and fairly develop the record, 

a duty that was enhanced because Plaintiff was not represented by legal counsel at the hearing. (Doc. 

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15 at 27-29). In particular, Plaintiff faults the ALJ for failing to obtain Plaintiff’s treatment records 

from Kaiser or any other records upon which Dr. Johnson based his opinion. (Doc. 15 at 28).

An ALJ’s duty to develop the record is triggered if there is ambiguous evidence or the record is 

inadequate for proper evaluation of evidence. When such a duty is triggered, an ALJ can develop the 

record by (1) making a reasonable attempt to obtain medical evidence from the claimant’s treating 

sources; (2) ordering a consultative examination when the medical evidence is incomplete or unclear 

and undermines the ability to resolve the disability issue; (3) subpoenaing or submitting questions to 

the claimant’s physicians; (4) continuing the hearing; or (5) keeping the record open for more 

supplementation. Tonapetyan, 242 F.3d at 1150; 20 C.F.R. § 404.1517.

Here, there is no indication that the record was ambiguous or inadequate for proper evaluation 

of Plaintiff’s physical capabilities, including the limitations identified by Dr. Johnson, a worker’s 

compensation evaluator. Dr. Johnson precluded Plaintiff from repetitive motions of her neck and 

upper extremities, work at or above the shoulder level, repetitive motions of hands or fine 

manipulation and lifting of more than 10 pounds. Dr. Johnson’s report contained a summary of 

Plaintiff’s medical records related to her neck, shoulders and arms. AR 504-524. Moreover, 

Plaintiff’s application for disability insurance benefits was not premised on issues related to her neck, 

arms or hands. AR 107, 165. Further, and more critically, the record contained independent 

evaluations of Plaintiff’s physical abilities, including examination by Dr. Stoltz, along with 

assessments by state agency consultants versed in Social Security standards. AR 379-384, 406-412, 

525-30. 

CONCLUSION

Based on the foregoing, the Court finds that the ALJ’s decision is supported by substantial 

evidence in the record as a whole and is based on proper legal standards. 

Accordingly, this Court DENIES Plaintiff’s appeal from the administrative decision of the 

Commissioner of Social Security. 

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The Clerk of this Court is DIRECTED to enter judgment in favor of Defendant Carolyn W. Colvin, 

Acting Commissioner of Social Security, and against Plaintiff Teresa Marie Berkebile.

IT IS SO ORDERED.

Dated: March 7, 2016 /s/ Barbara A. McAuliffe _

UNITED STATES MAGISTRATE JUDGE

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