Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-4_09-cv-02440/USCOURTS-cand-4_09-cv-02440-0/pdf.json

Parties Involved:
Michael J. Astrue
Defendant
Maybelline Munguia
Plaintiff

Document Text:

United States District Court

For the Northern District of California

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United States District Court

For the Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

MAYBELLINE MUNGUIA,

Plaintiff, No. C 09-02440 PJH

v. ORDER AFFIRMING THE

ADMINISTRATIVE LAW JUDGE’S

MICHAEL J. ASTRUE, DECISION DENYING SOCIAL SECURITY

Commissioner of BENEFITS

Social Security

Defendant.

_______________________________/

INTRODUCTION

Plaintiff Maybelline Munguia (“Munguia”) seeks judicial review of the Commissioner

of Social Security’s (“the Commissioner’s”) decision denying her claim for disability benefits

pursuant to 42 U.S.C. § 405(g). This action is before the court on the parties’ crossmotions for summary judgment. Munguia failed to file a reply to the government’s

opposition brief. Having read the parties’ papers and administrative record, and having

carefully considered their arguments and relevant legal authority, the court GRANTS the

Commissioner’s cross-motion for summary judgment, DENIES Munguia’s cross-motion for

summary judgment, and AFFIRMS the Commissioner’s final decision.

BACKGROUND

Munguia filed an application for Supplemental Security Income (“SSI”) on September

19, 2006, alleging disability beginning January 1, 1995 due to diabetes, sickle cell anemia,

anemia, heart failure, obesity, and right arm pain. (A.R. 59, 67, 104-106.) Munguia’s SSI

applications were denied initially on March 21, 2007, (A.R. 59-63), and upon

reconsideration on June 1, 2007. (A.R. 67-71.) Munguia filed a request for an

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administrative hearing on June 12, 2007. (A.R. 73.) The hearing before Administrative

Law Judge Robert P. Wenten (“the ALJ”) took place on May 21, 2008. (A.R. 15.) At the

hearing, Munguia was represented by her current attorney and testified on her own behalf. 

(A.R. 15-56.) A vocational expert was present via telephone but did not testify to any

substantive matter because the ALJ determined at the hearing that the disability

determination would be based on subjective factors. (A.R. 55-56.) 

On February 18, 2009, the ALJ issued a decision and found Munguia not disabled

under the terms of the Social Security Act. (A.R. 8-13.) The Appeals Council denied

Munguia’s request for review of the ALJ’s decision, (A.R. 1-4), and the ALJ’s decision

became final. (A.R. 1.) Munguia then commenced this action for judicial review of the

ALJ’s decision pursuant to 42 U.S.C. § 405(g).

STATUTORY AND REGULATORY FRAMEWORK

The Social Security Act (“the Act”) provides for the payment of disability insurance

benefits to people who have contributed to the Social Security system and who suffer from

a physical or mental disability. See 42 U.S.C. § 423(a)(1). To evaluate whether a claimant

is disabled within the meaning of the Act, the ALJ is required to use a five-step analysis. 20

C.F.R. § 404.1520. The ALJ may terminate the analysis at any stage where a decision can

be made that the claimant is or is not disabled. See Pitzer v. Sullivan, 908 F.2d 502, 504

(9th Cir. 1990).

At step one, the ALJ determines whether the claimant is engaged in any “substantial

gainful activity,” which would automatically preclude the claimant from receiving disability

benefits. See 20 C.F.R. § 404.1520(a)(4)(I). If the claimant is not engaged in substantial

gainful activity, at the second step, the ALJ must consider whether the claimant suffers

from a severe impairment which “significantly limits [the claimant’s] physical or mental

ability to do basic work activities.” See 20 C.F.R. § 404.1520(a)(4)(ii). The third step

requires the ALJ to compare the claimant’s impairment to a listing of impairments in the

regulations. If the claimant’s impairment or combination of impairments meets or equals

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the severity of any medical condition contained in the listing, the claimant is presumed

disabled and is awarded benefits. See C.F.R. § 404.1520(a)(4)(iii).

If the claimant’s condition does not meet or equal a listing, the ALJ must proceed to

the fourth step to consider whether the claimant has sufficient “residual functional capacity”

(“RFC”) to perform his past work despite the limitations caused by the impairment. See 20

C.F.R. § 404.1520(a)(4)(iv). If the claimant cannot perform his past work, the

Commissioner is required to show, at step five, that the claimant can perform other work

that exists in significant numbers in the national economy, taking into consideration the

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

See C.F.R. § 404.1520(a)(4)(v). 

Overall, in steps one through four, the claimant has the burden to demonstrate a

severe impairment and an inability to engage in his previous occupation. Andrews v.

Shalala, 53 F.3d 1035, 1040 (9th Cir. 1995). If the analysis proceeds to step five, the

burden shifts to the Commissioner to demonstrate that the claimant can perform other

work. Id.

ALJ’s FINDINGS

The ALJ determined that Munguia was not disabled at step five of the disability

evaluation. (A.R. 12.)

At step one, the ALJ noted that Munguia’s earnings in 1983, 1985, and 1986 were

minimal, and her limited work record and minimal earnings indicated that she had never

engaged in any substantial gainful activity. (A.R. 9.) Therefore, the ALJ proceeded to step

two of the disability determination. (A.R. 9.)

The ALJ found at step two that Munguia suffers from the medically determinable

impairments of anemia, uterine fibroid tumors, right upper extremity phlebitis, diabetes

mellitus, and obesity. (A.R. 9.) Because these impairments significantly limited Munguia’s

ability to perform basic work activities, the ALJ found these impairments to be “severe.” 

(A.R. 9.) However, the ALJ did not find Mugnuia’s other claimed impairments, including a

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1

 Thrombocytopenia is “[a] condition in which an abnormally small number of platelets

is present in the circulating blood.” STEDMAN’S MEDICAL DICTIONARY, 1984 (28th ed.

2006). 

2

 Hematocrit is the “[p]ercentage of the volume of a blood sample occupied by cells.”

STEDMAN’S MEDICAL DICTIONARY at 862. 

3

 Pancytopenia is a “[p]ronounced reduction in the number of erythrocytes all types of

leukocytes, and the blood platelets in the circulating blood.” STEDMAN’S MEDICAL

DICTIONARY at 1411. 

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heart condition and sickle cell disease, to be severe because they were not corroborated by

medical evidence. (A.R. 9.)

At step three of the disability determination, the ALJ found that none of Munguia’s

impairments or combination of impairments met or equaled the impairments listed in the

regulations. In so finding, the ALJ noted that Munguia’s medical records did not describe

the frequency of transfusions or persistently elevated hematocrit count required for listing

level chronic anemia. (A.R. 9.) Similarly, the ALJ found that Munguia’s medical records

failed to adequately support listing level diabetes mellitus. (A.R. 9.) The ALJ noted that

while obesity is no longer a listed impairment, the cumulative effects of Munguia’s obesity

are not medically equivalent to any listed impairment. (A.R. 9.) Finally, the ALJ determined

that none of the medical findings in the record were equal in severity and duration to any of

the listed impairments. (A.R. 10.)

The ALJ then considered Munguia’s residual functional capacity and found that she

had a residual functional capacity for light work. In making this determination, the ALJ

reviewed the pertinent medical evidence, including records indicating that Munguia had

been hospitalized in January 2006 based on complaints of fatigue, shortness of breath,

lower extremity edema, and a history of heavy periods. (A.R. 10.) During that

hospitalization, Munguia was diagnosed with severe anemia and possible reactive

thrombocytopenia1

 with a decreased hematocrit2 level and pancytopenia,3 diabetes

mellitus, and obesity. (A.R. 10.) An ultrasound also revealed a large uterine fibroid. (A.R.

10.) During this hospitalization, Munguia improved following a blood transfusion. (A.R. 10.)

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 The record is unclear regarding the significance of these numbers. However, it

appears that a diagnosis of diabetes mellitus “is confirmed when any two measurements of

plasma glucose performed on different days yield levels at or above . . . 200 mg/dL” when

tested at random. STEDMAN’S MEDICAL DICTIONARY at 529. 

5

 The record is unclear about the significance of the “reactive” test for hepatitis B.

However, hepatitis B was not one of the impairments alleged by Munguia, and it is only briefly

addressed in the medical record. Without more information, the court will not consider this test

as an instrumental factor in reviewing the ALJ’s decision. 

5

Several months later, in July 2006, Munguia reentered the hospital on complaints of

weakness and shortness of breath. (A.R. 10.) Munguia was again diagnosed with acute

and chronic anemia which improved after a blood transfusion. (A.R. 10.) Munguia

received an additional diagnosis of borderline diabetes with a blood glucose of 225 mg/dL.4

(A.R. 10.)

The ALJ then noted that medical records from a December 2006 visit to the Tiburcio

Vasquez Health Center indicated that Munguia’s hematocrit level was within normal limits

after she reported that she had been taking iron as described. (A.R. 10.) Additionally,

those medical records indicated that Munguia’s diabetes was under control with a glucose

level of 115 mg/dL. (A.R. 10.)

Subsequently, in 2007 and 2008, Munguia was seen several times at the Alameda

County Medical Center (“Center”). (A.R. 10-11.) In July 2007, Munguia visited the Center

on complaints of right arm pain due to a transfusion in July 2006 having missed her vein. 

(A.R. 10.) During an October 2007 visit to the Center, Munguia reported a headache only,

and her glucose level was 199 mg/dL. (A.R. 10.) Although the Center called Munguia in

the beginning of November to make a same-day appointment, she did not return for

treatment until December 2007. (A.R. 10.) At the December 2007 visit, Munguia’s glucose

level was 279 mg/dL and a hepatitis B testing was reactive.5

 (A.R. 10.) During a March

2008 visit to the Center for complaints of arm and back pain, Munguia’s anemia was

described as probably due to her menses as well as due to noncompliance with her iron

therapy. (A.R. 11.) The Center’s medical records also indicated that Munguia missed two

appointments for follow-up care in April 2008, (A.R. 273, 274), and the ALJ noted that there

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is no evidence that Munguia sought or received any subsequent treatment for any

condition. (A.R. 11.)

Based on these objective medical findings, the ALJ determined that Munguia had

been able to perform light work at all relevant times. (A.R. 11.) Then, the ALJ cited a

February 2007 consultative examination performed by Dr. Sharma. (A.R. 10.) This

examination was done at the request of the Department of Social Services to determine

Munguia’s residual functional capacity. (A.R. 253.) The ALJ noted that Dr. Sharma

diagnosed Munguia with diabetes mellitus, uterine fibroids, anemia, and moderate obesity. 

(A.R. 10.) Dr. Sharma further concluded that Munguia could perform light work: lifting 10

pounds frequently and 20 pounds occasionally and standing and walking for six hours per

day with normal breaks. (A.R. 10.) 

As noted, based on the medical evidence, the ALJ agreed with Dr. Sharma that

Munguia was able to perform light work. (A.R. 10) This was in spite of Munguia’s

assertions to the contrary.

In rejecting Munguia’s claim that she was unable to perform any work, the ALJ first

noted that Munguia’s medical records after her 2006 hospitalizations described “sparse”

treatment, missed appointments, and noncompliance with prescribed treatment. (A.R. 11.) 

The ALJ also pointed to discrepancies between Munguia’s testimony about her elevated

glucose levels and the objective medical record. (A.R. 11.) He noted that Munguia’s

testimony about her inability to reach comfortably with her right arm was uncorroborated by

medical examination. (A.R. 11.) According to the ALJ, Munguia’s testimony about her

ongoing fatigue and shortness of breath was not reflected in the medical records. (A.R.

11.) Finally, the ALJ noted that Munguia was raising six children by herself without any

other adult assistance. (A.R. 11.) The ALJ inferred that the substantial energy expended

by raising her children would be undoubtedly more than the energy required from many

sedentary or light jobs. (A.R. 11.)

Because Munguia had never performed any substantial gainful activity, the ALJ

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could not determine whether she had sufficient residual functional capacity to perform her

past work at step four of the sequential disability determination. (A.R. 11-12.) Therefore,

the ALJ proceeded to step five and found that there were jobs existing in significant

numbers in the national economy which Munguia could perform given her residual

functional capacity for light work, age, education, and work experience. (A.R. 12.)

STANDARD OF REVIEW

This court has jurisdiction to review final decisions of the Commissioner pursuant to

42 U.S.C. § 405(g). The ALJ’s decision must be affirmed if the ALJ’s findings are

“supported by substantial evidence and if the [ALJ] applied the correct legal standards.” 

Holohan v. Massanari, 246 F.3d 1195 (9th Cir. 2001) (citation omitted). “Substantial

evidence” means more than a scintilla, but less than a preponderance, or evidence which a

reasonable person might accept as adequate to support a conclusion. Thomas v. Barnhart,

278 F.3d 947, 954 (9th Cir. 2002). The court is required to review the administrative record

as a whole, weighing both the evidence that supports and detracts from the ALJ’s

conclusion. McAllister v. Sullivan, 888 F.2d 599, 602 (9th Cir. 1989). Where the evidence

is susceptible to more than one rational interpretation, the court must uphold the ALJ’s

decision. Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989).

ISSUE

Munguia raises only one claim on appeal. She seeks reversal of the

Commissioner’s denial of disability insurance benefits, arguing that the Commissioner’s

decision to reject her subjective testimony was not supported by specific, clear, and

convincing reasons.

DISCUSSION

The ALJ did not err when he rejected Munguia’s subjective testimony that she was

unable to perform any work.

The ALJ is responsible for determining the credibility of witnesses, including the

claimant, that testify before him or her. Magallanes, 881 F.2d at 750. To determine the

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credibility of the claimant’s testimony about subjective pain or symptoms, an ALJ must

utilize a two-step analysis. Lingenfelter v. Astrue, 504 F.3d 1028, 1035-36 (9th Cir. 2007). 

In the first step, “the ALJ must determine whether the claimant has presented objective

medical evidence of an underlying impairment ‘which could reasonably be expected to

produce the pain or other symptoms alleged.’” Id. at 1036 (citing Bunnell v. Sullivan, 947

F.2d 341, 344 (9th Cir. 1991)). However, the claimant does not have to demonstrate that

the underlying impairment could reasonably cause the subjective severity of the claimant’s

pain or symptoms; “she need only show that it could reasonably have caused some degree

of the symptom.” Id. (quoting Smolen v. Chater, 80 F.3d 1273, 1282 (9th Cir. 1996)). If the

claimant has presented objective medical evidence of an underlying impairment in the first

step and there is no evidence of malingering, the ALJ must move to the second step. Id.

In the second step, “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.” Id. (quoting

Smolen, 80 F.3d at 1281)). The ALJ may engage in ordinary techniques of credibility

evaluation, such as considering claimant’s reputation for truthfulness and inconsistencies in

claimant’s testimony. See Burch v. Barnhart, 400 F.3d 676, 680 (9th Cir. 2005) (citing

Tonapetyan v. Halter, 242 F.3d 1144, 1148 (9th Cir. 2001)).

As noted, in step two of the five-step sequential disability determination analysis, the

ALJ determined that Munguia suffered from several medically determinable impairments,

including anemia, uterine fibroid tumors, right upper extremity phlebitis, diabetes mellitus,

and obesity. Although the ALJ later determined that these did not meet or equal the listings

at step three, the ALJ’s impairment finding at step two of the analysis indicates that

Munguia presented objective medical evidence of an underlying impairment that could

reasonably cause some degree of the alleged symptoms. See Bunnell, 947 F.2d at 344. 

Because Munguia presented objective medical evidence of an underlying impairment and

there was no evidence of malingering, the ALJ effectively proceeded to the second step of

the Lingenfelter credibility test. See Lingenfelter, 504 F.3d at 1036.

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Although Munguia correctly points out that the ALJ utilized an improper legal

standard for rejecting her subjective testimony at the second stage of the Lingenfelter test,

noting that the ALJ gave “specific and legitimate” reasons for rejecting Munguia’s subjective

testimony rather than the legally correct “specific, clear and convincing” standard, see

Lingenfelter, 504 F.3d at 1036, any such error was harmless because the ALJ proffered

five putatively “specific, clear, and convincing” reasons, as required, for rejecting Munguia’s

subjective testimony. Those reasons are as follows:

(1) Munguia’s medical records describe “sparse treatment,” missed 

appointments, and noncompliance with treatment regimens since her 

2006 hospitalizations;

(2) Munguia’s testimony about her elevated glucose levels is not 

corroborated by the objective medical record; 

(3) Munguia’s alleged right arm pain and inability to reach with her right arm are

unsupported by the medical evidence;

(4) Munguia’s testimony about her continuing fatigue and shortness of breath 

is not reflected in complaints registered in the medical record; and

(5) Munguia is raising six children by herself, and the energy necessary for 

this endeavor is “undoubtedly more” than that required from many 

sedentary or light jobs.

1. Sparse Treatment, Missed Appointments, and Noncompliance with Treatment

Regimens

The ALJ correctly rejected Munguia’s subjective testimony based in part on multiple

missed appointments, noncompliance with prescribed treatment, and sparsity of treatment.

An ALJ is not required to believe every allegation of disabling pain or other

symptoms. Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989). Rather, the ALJ is

specifically tasked with determining the credibility of all witnesses in a disability proceeding.

See Magallanes, 881 F.2d at 750. To find a pain or symptom allegation incredible, an ALJ

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may rely on evidence establishing (1) an “unexplained . . . failure to seek treatment or

follow a prescribed course of treatment;” Fair, 885 F.2d at 603; (2) “conservative treatment”

inconsistent with the alleged symptoms; Parra v. Astrue, 481 F.3d 742, 751 (9th Cir 2007);

or (3) daily activities inconsistent with the alleged symptoms. Fair, 885 F.2d at 603.

In this case, the ALJ cited two unexplained missed appointments in April 2008, a

documented failure to comply with treatment regimens in March 2008, and a lack of followup treatment for any condition as one of the grounds for rejecting Munguia’s subjective

testimony. Munguia argues that the record must clearly show why she missed

appointments and failed to follow prescribed medical therapy before the ALJ can draw a

negative inference from these facts. However, this is clearly contrary to the law; in steps

one through four of the five-step disability determination, the claimant has the burden of

proving disability. Andrews, 53 F.3d at 1040. The ALJ rejected Munguia’s subjective

testimony while determining her residual functional capacity before step four. Therefore,

Munguia had the burden of justifying her missed appointments and noncompliance with

prescribed treatment. See Fair, 885 F.2d at 603 (“While there are any number of good

reasons for [failing to seek treatment or follow a prescribed course of treatment], a

claimant’s failure to assert [a good reason] can cast doubt on the sincerity of the claimant’s

. . . testimony.”). Munguia never offered an explanation for the missed appointments and

the therapy noncompliance, so the ALJ rightfully considered this evidence to cast doubt on

the validity of her subjective testimony. 

Furthermore, the ALJ found that Munguia had undergone “sparse treatment” for her

alleged impairments. Ninth Circuit precedent establishes that “conservative treatment”

alone is sufficient to cast doubt on a claimant’s subjective testimony. See Parra, 481 F.3d

at 751. The ALJ reasonably interpreted the medical record as establishing that Munguia

underwent “sparse treatment” for her impairments since her 2006 hospitalizations. 

Munguia missed multiple appointments and the record documented a failure to comply with

prescribed medical treatment. 

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2. Elevated Glucose Testimony Not Corroborated by the Medical Record

Munguia testified that she checks her glucose levels occasionally and the readings

go “up past three and four’s [sic].” Munguia’s medical record documents at least fourteen

glucose tests since January 2006. Of these, only one surpassed 300 mg/dL, and three

surpassed 200 mg/dL. The ALJ correctly identified discrepancies between Munguia’s

testimony and the objective medical record. Then, the ALJ used these discrepancies to

question the credibility of Munguia’s subjective testimony. 

Preliminarily, before discussing the ALJ’s subjective credibility determination, it is

important to address the ALJ’s finding that Munguia did not suffer from listing level diabetes

mellitus. At step two of the disability determination process, the ALJ found that Munguia

suffered from “severe” diabetes mellitus, a finding that is supported by the record. 

However, this is not inconsistent with the ALJ’s determination at step three that Munguia’s

diabetes mellitus did not meet listing level requirements. 

The ALJ correctly determined that Munguia did not suffer from listing level diabetes

mellitus. Although the medical record does show that Munguia suffers from diabetes

mellitus, see STEDMAN’S MEDICAL DICTIONARY at 529, the disparity in the step three

determination is possible because, according to the listings, diabetes mellitus is not a listing

level disability until the medical record shows neuropathy, acidosis, or retinitis proliferans.

See 20 C.F.R. § 404, Subpt. P, App. 1, § 9.08. Because the medical evidence in this case

does not establish the necessary symptoms or test results for a listing level impairment, the

ALJ correctly determined that Munguia did not suffer from listing level diabetes mellitus.

Although Munguia did not establish that she suffered from listing level diabetes

mellitus, the ALJ nonetheless was required to weigh her subjective testimony about her

diabetes in the residual functional capacity calculus. Ninth Circuit precedent allows ALJs to

make adverse credibility inferences based on contradictions between the claimant’s

testimony and the relevant medical evidence. Johnson v. Shalala, 60 F.3d 1428, 1434 (9th

Cir. 1995). Furthermore, reviewing courts may not “reverse credibility determinations of an

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 The ALJ’s decision states that Munguia went to the Alameda County Medical Center

with complaints of right arm pain in July 2007. (A.R. 10.) There is no evidence in the

administrative record of a July 2007 visit to the Alameda County Medical Center. It appears

that the ALJ simply confused the July 2006 hospitalization with the September 2007 visit to the

Center.

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ALJ based on contradictory or ambiguous evidence.” Id. “Where the evidence is

susceptible to more than one rational interpretation,” a reviewing court must defer to the

ALJ’s decision. Burch, 400 F.3d at 680-81 (quoting Magallanes, 881 F.2d at 750). Here,

the ALJ’s determination that the inconsistencies between Munguia’s testimony and the

objective medical record tarnished the credibility of Munguia’s testimony was a rational

interpretation of the facts and was soundly based in the law. See Johnson, 60 F.3d at

1434.

3. Medical Evidence of Right Arm Pain and Reduced Right Arm Mobility

The ALJ found that “no significant positive objective findings with respect to

[Munguia’s] right upper extremity have been reported on examinations.” Because the

objective medical record did not reflect a significant underlying medical ailment, the ALJ

refused to credit Munguia’s subjective testimony of right arm reduced mobility and pain. 

Even though there are other rational interpretations, the court finds the ALJ’s interpretation

reasonable. 

Munguia alleged right arm pain and reduced mobility stemming from a missed vein

blood transfusion in July 2006. The medical evidence, however, did not reflect any

complaints of right arm pain or reduced mobility until September 20076 during a visit to the

Center. During this appointment, the examining physician diagnosed Munguia with right

upper arm phlebitis and noted that Munguia’s vein was distended. On a March 2008 visit to

the Center, Munguia’s arm pain was diagnosed as myalgia.

On February 20, 2007, before the 2007 and 2008 visits to the Center on complaints

of arm pain but after the alleged 2006 faulty blood transfusion, the Sunnybrook Medical

Group performed an internal medicine consultation on Munguia at the request of the

Department of Social Security Services. During this consultative examination, Munguia did

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not report a faulty blood transfusion nor did she allege reduced arm movement or pain. 

Instead, the medical records from this examination indicate that Munguia’s shoulder

abduction was to 180 degrees bilaterally. Finally, in a March 2007 case analysis, Munguia

reported no manipulative limitations.7

It is questionable whether Munguia has proven “significant positive objective findings

with respect to her upper extremity pain and reduced mobility.” As stated above, Munguia

was diagnosed in September 2007 with right upper extremity phlebitis and a distended vein

and in March 2008 with myalgia. Therefore, Munguia presented the ALJ with medical

evidence that something was wrong with her arm. However, the conflicting nature of these

diagnoses is problematic; there was no medical consensus between the two examining

doctors about the cause of Munguia’s arm pain. The ALJ reasonably rejected the scant

medical evidence about Munguia’s arm pain and reduced mobility. 

Even assuming that Munguia has given objective medical proof of an underlying

illness, see Lingenfelter, 504 F.3d at 1036, the ALJ reasonably rejected her subjective

testimony. If Munguia had presented clear objective evidence of an underlying illness, the

ALJ could reject her subjective testimony about the severity of Munguia’s symptoms only

by stating specific, clear, and convincing reasons for doing so. See Lingenfelter, 504 F.3d

at 1036. The ALJ has done that in this case. 

Although the ALJ did not explicitly point to the other stated grounds for rejecting

Munguia’s subjective testimony when he discounted her allegations of arm pain and

reduced mobility, these other factors convincingly militate against crediting Munguia’s arm

pain testimony. After she was diagnosed with phlebitis or myalgia, Munguia missed two

appointments at the Center and did not provide an explanation for these missed visits. 

Furthermore, Munguia testified that she does household chores – laundry, cooking, and

grocery shopping – that are not reasonably consistent with her subjective testimony of

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 The record is unclear whether the March 2007 report of fatigue and shortness of

breath was the result of an examination or if it was simply part of an administrative summary

of previous medical records.

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disabling pain. An unexplained failure to seek treatment and an ability to do daily activities

inconsistent with the alleged symptoms are both grounds for rejecting the subjective

testimony of a claimant. See Fair, 885 F.2d at 603.

The ALJ’s interpretation of the facts was rational, and he reasonably rejected

Munguia’s subjective testimony about right arm pain and reduced mobility.

4. Ongoing Fatigue and Shortness of Breath in the Medical Record

The ALJ refused to credit Munguia’s testimony about her ongoing fatigue and

shortness of breath because “her medical records fail to document such complaints.” 

Munguia challenges this finding contending that “[t]he ALJ’s depiction of the record is

inaccurate.”

Munguia’s medical records reflect four complaints of fatigue or shortness of breath:

during her two hospital stays in 2006, at a February 2007 Social Security disability

evaluation, and at a March 2007 case analysis.8

 During the twenty-seven-month period for

which Munguia provided medical records, she was examined at least eight times. 

Therefore, while the objective medical record shows somewhat sporadic complaints of

fatigue and shortness of breath, it does display a pattern of complaints lasting longer than

twelve months from January 2006 to February 2007. However, there is no recorded

complaint of fatigue or shortness of breath after the February 2007 Social Security disability

evaluation.

Taken as a whole, though, the ALJ’s decision to discount Munguia’s testimony

based on the discrepancies between her testimony and the objective medical record is

reasonable. The medical evidence records a fourteen-month period during which Munguia

made no complaint of fatigue or shortness of breath. This is not an excessive pain case

where the objective medical record does not reflect the subjective severity of the claimant’s

symptoms. See, e.g., Bunnell, 947 F.2d 341. Rather, the objective medical evidence in this

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case simply does not record the alleged symptoms of fatigue and shortness of breath for a

majority of the time period for which Munguia provided medical records. Cf. Parra, 481

F.3d at 750 (finding that the claimant’s testimony was not credible after citing medical

records that conflicted with the claimant’s testimony). Here, the discrepancy between the

testimony and the medical record goes even further than in Parra; there are no medically

documented complaints of fatigue and shortness of breath between February 2007 and

April 2008.

The ALJ’s determination that the discrepancies between Munguia’s subjective

testimony and her medical record were adequate grounds to question the credibility of

Munguia’s testimony was a rational interpretation of the facts. 

5. Raising Six Children 

Finally, the ALJ pointed to Munguia’s home life as evidence of an ability to maintain

a work burden exceeding that of “many sedentary or light jobs.” Since Munguia’s husband

was deported, Munguia has been the sole adult caretaker of her six children. The ALJ

specifically pointed to Munguia’s testimony about her laundry and grocery shopping

activities to support his finding that raising six children alone is inconsistent with a claim of

chronic fatigue impairing Munguia’s ability to do light or sedentary work.

Testimony about a claimant’s daily activities which is inconsistent with the alleged

symptoms is a reasonable basis for casting doubt on the credibility of a claimant’s

subjective testimony. Lingenfelter, 504 F.3d at 1040. However, “many home activities are

not easily transferable to what may be the more grueling environment of the workplace . . .

.” Fair, 885 F.2d at 603. 

Munguia argues that her children are no longer babies – her children range in age

from nine years-old to eighteen years-old – and, therefore, the children are often in school

which gives Munguia “significant down time and rest periods.” Additionally, Munguia

testified that her oldest son does a significant amount of the basic household work. 

While Munguia consistently asserts that her oldest son helps her with the household

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tasks, Munguia’s testimony indicates that she does many tasks such as laundry, grocery

shopping, and cooking. The record clearly establishes that Munguia does extensive

laundry work including carrying the laundry one block from her apartment to the apartment

complex-supplied washing machines, waiting in the laundry room while the machines are

running, placing the wet clothes back in the hamper, and hanging the clothes to dry. 

Munguia’s testimony about her grocery shopping and cooking activities is not as extensive

as her testimony about her laundry duties, but the record shows that Munguia goes grocery

shopping and cooks, at least occasionally. (See A.R. 28.) (stating that “[w]hen I do go

[shopping] it’s only when I feel better”); (A.R. 39) (stating that “sometime [sic] I won’t even

cook;” thereby establishing that not cooking is the exception rather than the rule).

Munguia’s household duties are not as extensive as those of the claimants in other

Ninth Circuit cases whose claims were denied in part due to inconsistencies between daily

activities and alleged symptoms. See Fair, 885 F.2d at 604 (stating that the claimant

“remains capable of caring for all his own personal needs, the performance of his own

routine household maintenance and shopping chores, riding public transportation, and

driving his own automobile”); Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 600

(9th Cir. 1999) (noting that the ALJ’s determination that the claimant’s “ability to fix meals,

do laundry, work in the yard, and occasionally care for his friend’s child served as evidence

of [claimant’s] ability to do work”); Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001)

(finding that claimant’s “daily activities, such as attending to the needs of her two young

children, cooking, housekeeping, laundry, shopping, attending therapy and various other

meetings every week” undermined her claim of totally disabling pain). However, the ALJ’s

determination that Munguia’s ability to do laundry, shop, and care for her six children was

inconsistent with her alleged chronic fatigue symptoms was a rational interpretation of the

facts. While it is true that common household duties often cannot be transferred to the

workplace, see Fair, 885 F.2d at 603, the ALJ’s finding that raising six children would

involve an amount of work comparable to many sedentary or light jobs is reasonable.

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CONCLUSION

For the foregoing reasons, the court GRANTS the Commissioner’s cross-motion for

summary judgment, DENIES Munguia’s cross-motion for summary judgment, and

AFFIRMS the Commissioner’s final decision. The court finds that the ALJ gave clear,

specific, and convincing reasons for rejecting Munguia’s subjective testimony.

This order fully adjudicates the motions listed at numbers fourteen and fifteen of the

clerk’s docket for this case. The clerk shall close the file.

IT IS SO ORDERED.

Dated: March 4, 2010

______________________________

PHYLLIS J. HAMILTON

United States District Judge

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