(SS) Matajcich v. Commissioner of Social Security

1 \ [7] 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA [10] 11 SANTRA F. MATAJCICH , No. 2:21-cv-00911 CKD (SS) 12 Plaintiff, 13 v. ORDER 14 Commissioner of Social Security, 15 Defendant. [17] 18 Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 19 (“Commissioner”) denying an application for Supplemental Security Income (“SSI”) under Title 20 XVI of the Social Security Act (“Act”). The parties have consented to Magistrate Judge 21 jurisdiction to conduct all proceedings in the case, including the entry of final judgment. For the 22 reasons discussed below, the court will deny plaintiff’s motion for summary judgment and grant 23 the Commissioner’s cross-motion for summary judgment. 24 BACKGROUND 25 Plaintiff, born in 1980, applied on September 10, 2018 for SSI, alleging disability 26 beginning August 1, 2017. Administrative Transcript (“AT”) 16, 33. Plaintiff alleged she was 27 unable to work due to pulmonary hypertension, sleep apnea, asthma, COPD, thyroid issues, 28 cirrhosis, lumbar stenosis, depression, PTSD, and anxiety. AT 78. In a decision dated October 1 22, 2020, the ALJ determined that plaintiff was not disabled.1 AT 16-24. The ALJ made the 2 following findings (citations to 20 C.F.R. omitted): 3 1. The claimant has not engaged in substantial gainful activity since September 20, 2018, the application date. [4] 2. The claimant has the following severe impairments: asthma with 5 allergic rhinitis; cervical degenerative disc disease; lumbar degenerative disc disease; hepatic steatosis; obesity; metabolic 6 syndrome; obstructive sleep apnea; gastroesophageal reflux disease with hiatal hernia; fibromyalgia; tremor; incontinence; post7 traumatic stress disorder; major depressive disorder; and anxiety. 8 3. The claimant does not have an impairment or combination of impairments that meets or medically equals one of the listed 9 impairments in 20 CFR Part 404, Subpart P, Appendix 1. [10] 1 Disability Insurance Benefits are paid to disabled persons who have contributed to the [11] Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income is paid to 12 disabled persons with low income. 42 U.S.C. § 1382 et seq. Both provisions define disability, in part, as an “inability to engage in any substantial gainful activity” due to “a medically 13 determinable physical or mental impairment. . . .” 42 U.S.C. §§ 423 (d)(1)(a) & 1382c(a)(3)(A). A parallel five-step sequential evaluation governs eligibility for benefits under both programs. 14 See 20 C.F.R. §§ 404.1520 , 404.1571-76, 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-142 , 107 S. Ct. 2287 (1987). The following summarizes the sequential evaluation: [15] Step one: Is the claimant engaging in substantial gainful [16] activity? If so, the claimant is found not disabled. If not, proceed to step two. [17] Step two: Does the claimant have a “severe” impairment? If [18] so, proceed to step three. If not, then a finding of not disabled is appropriate. [19] Step three: Does the claimant’s impairment or combination [20] of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P, App.1? If so, the claimant is automatically determined [21] disabled. If not, proceed to step four. [22] Step four: Is the claimant capable of performing his past work? If so, the claimant is not disabled. If not, proceed to step five. [23] Step five: Does the claimant have the residual functional [24] capacity to perform any other work? If so, the claimant is not disabled. If not, the claimant is disabled. [25] Lester v. Chater, 81 F.3d 821 , 828 n.5 (9th Cir. 1995). [26] 27 The claimant bears the burden of proof in the first four steps of the sequential evaluation process. Bowen, 482 U.S. at 146 n.5, 107 S. Ct. at 2294 n.5. The Commissioner bears the 28 burden if the sequential evaluation process proceeds to step five. Id. 1 4. After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform 2 light work, except the claimant can lift and carry 20 pounds occasionally and 10 pounds frequently, and can stand and/or walk for 3 approximately 6 hours and sit for approximately 6 hours, in an 8hour workday, with normal breaks. The claimant cannot climb 4 ladders, ropes and scaffolds and can occasionally climb stairs and ramps. The claimant can occasionally balance, stoop, kneel, crouch 5 and crawl. She can occasionally reach overhead with the bilateral upper extremities. She can frequently handle and finger, bilaterally. 6 The claimant should have only occasional exposure to wetness, humidity and atmospheric conditions and no exposure to extreme 7 cold and extreme heat[.] The claimant can understand, remember and carry out simple, routine and repetitive instructions and tasks. 8 The claimant should perform only low stress work, which is defined as requiring only occasional changes in work setting, occasional 9 changes in work duties, occasional simple, work-related decisionmaking and no work on a moving conveyor belt. The claimant can 10 have no public contact and occasional coworker and supervisor interaction. She must be permitted to wear discreet incontinence 11 undergarments while at work. 12 5. The claimant is unable to perform any past relevant work.2 13 6. The claimant was born on XX/XX/1980, which is defined as a younger individual age 18-49, on the date the application was filed. [14] 7. The claimant has at least a high-school education. [15] 8. Transferability of job skills is not an issue in this case because the 16 claimant’s past relevant work is unskilled. 17 9. Considering the claimant’s age, education, work experience, and residual functional capacity, there are jobs that exist in significant 18 numbers in the national economy that the claimant can perform.3 19 10. The claimant has not been under a disability, as defined in the Social Security Act, since September 10, 2018, the date the 20 application was filed. 21 AT 18-34. 22 //// 23 //// 24 //// [25] 2 The ALJ noted that plaintiff had past relevant work as a medical biller, food server, dental [26] assistant, and caregiver. AT 32. [27] 3 Relying on vocational expert testimony, the ALJ found that plaintiff could perform 28 representative occupations such as routing clerk, merchandise worker, and mail clerk. AT 33-34. 1 ISSUES PRESENTED 2 Plaintiff argues that the ALJ committed the following errors in finding plaintiff not 3 disabled: (1) the ALJ erred by failing to account for work-related limitations caused by plaintiff’s 4 incontinence; and (2) the ALJ erred by failing to account for work-related impairments caused by 5 plaintiff’s headaches. 6 LEGAL STANDARDS 7 The court reviews the Commissioner’s decision to determine whether (1) it is based on 8 proper legal standards pursuant to 42 U.S.C. § 405 (g), and (2) substantial evidence in the record 9 as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial 10 evidence is more than a mere scintilla, but less than a preponderance. Connett v. Barnhart, 340 11 F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence as a reasonable 12 mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d 625, 630 (9th 13 Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is 14 responsible for determining credibility, resolving conflicts in medical testimony, and resolving 15 ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations omitted). 16 “The court will uphold the ALJ’s conclusion when the evidence is susceptible to more than one 17 rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 18 The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th 19 Cir. 1986), and both the evidence that supports and the evidence that detracts from the ALJ’s 20 conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not 21 affirm the ALJ’s decision simply by isolating a specific quantum of supporting evidence. Id.; see 22 also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports the 23 administrative findings, or if there is conflicting evidence supporting a finding of either disability 24 or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d 1226 , 25 1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was applied in 26 weighing the evidence. See Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). 27 //// 28 //// 1 ANALYSIS 2 A. Incontinence 3 At the August 26, 2020 hearing, plaintiff testified that she had worked as a medical biller, 4 waitress, dental assistant, and home health aide. AT 60-61. In 2016, she was working as a track 5 coach when she stopped working in order to care for her infant niece. AT 61, 64. She testified 6 that she “started getting sick” around that time; her alleged disability onset date was August 1, 7 2017. AT 61. Plaintiff testified that, among other health problems, she had chronic bladder and 8 bowel incontinence that “affects me every day.” AT 66. Plaintiff stated that “[i]t’s gotten so 9 severe that I literally poop myself two, three, four times a day. And I have problems with 10 diarrhea.” AT 66. Plaintiff testified that, while the cause of her chronic incontinence was 11 unknown, it was exacerbated by stress or anxiety, and she had to wear adult diapers. AT 66-67. 12 The ALJ asked plaintiff whether the diapers worked to absorb the waste products, and plaintiff 13 testified that they worked “sometimes”; other times, “there’s so much at one time that it still runs 14 down my leg.” AT 68-69. The ALJ summarized this testimony in her decision. AT 23, 25. 15 In her first claim, plaintiff asserts that the ALJ failed to account for work-related 16 impairments caused by plaintiff’s incontinence. The ALJ’s residual functional capacity (RFC) 17 provided that she could perform light work with physical, mental, and social limitations, and that 18 she “must be permitted to wear discreet incontinence undergarments while at work.” Plaintiff 19 argues that 20 such a narrow limitation . . . fails to account for all the practical ramifications of her incontinence, or, for that matter, of the 21 undergarment itself. While an incontinence undergarment protects the worker’s clothing and the employer’s property (chairs, etc.) . . . 22 the upshot of her RFC is that Plaintiff is required to sit in her own waste until her next scheduled break. . . . This ignores a variety of 23 obvious realities related to sitting in human waste, both for Plaintiff and those around her: Plaintiff’s emotional distress; her increased 24 risk of skin rash and irritation; her increased risk of a bladder infection from exposure to bacteria; the smell of adult feces and urine 25 in a working environment; the potential hazards related to accidents on the floor; damage to property, such as chairs; and how all of these 26 might impact working relationships in a competitive employment setting. [27] 28 (ECF No. 16-2 at 7; emphasis in original). 1 Social Security Ruling 96-8p sets forth the policy interpretation of the Commissioner for 2 assessing residual functional capacity. SSR 96-8p. Residual functional capacity is what a person 3 “can still do despite [the individual’s] limitations.” 20 C.F.R. §§ 404.1545 (a), 416.945(a) (2003); 4 see also Valencia v. Heckler, 751 F.2d 1082, 1085 (9th Cir. 1985) (residual functional capacity 5 reflects current “physical and mental capabilities”). RFC is assessed based on the relevant 6 evidence in the case record, including the medical history, medical source statements, and 7 subjective descriptions and observations made by the claimant, family, neighbors, friends, or 8 other persons. 20 C.F.R. §§ 404.1545 (a)(1), 404.1545(a)(3). When assessing RFC, the ALJ must 9 consider the claimant’s “ability to meet the physical, mental, sensory, and other requirements of 10 work[.]” 20 C.F.R. §§ 404.1545 (a)(4). 11 Here, the ALJ found incontinence to be one of several severe impairments which 12 “significantly limit the ability to perform basic work activities[.]” AT 19. However, the ALJ 13 determined that plaintiff’s “symptoms were not as debilitating as she claimed” and that her 14 “testimony appeared to be marked by exaggeration regarding the severity of her symptoms.” AT 15 24. Plaintiff does not challenge this adverse credibility finding (which applied to several aspects 16 of her testimony) in a separate claim; rather, she argues that the ALJ erred in discounting her 17 testimony about her chronic incontinence. (ECF No. 16-2 at 7-8.) Plaintiff asserts that record 18 evidence supports her testimony about the nature and severity of this problem. (Id.) 19 The ALJ discussed the credibility of plaintiff’s testimony about her incontinence-related 20 symptoms, writing: “Although the medical evidence of record documents the claimant’s work-up 21 for incontinence, treatment records do not document the extreme degree of symptomatology as 22 alleged by the claimant at the hearing.4 The persuasiveness of the claimant’s subjective 23 complaints are diminished in light of her apparent exaggeration.” AT 25. 24 The ALJ summarized the relevant evidence as follows: 25 • “In January 2017, the claimant began complaining of abdominal pain to primary care 26 providers. . . . The claimant reported she had regular bowel movements daily in the [27] 28 4 Citing AT 511-524, 584-802, 803-823 (treatment records from 2017, 2018, and 2019). 1 morning, and she denied any difficulty.” AT 26, citing AT 440. 2 • “In September 2018, the claimant complained of urinary frequency and urinary 3 incontinence. However, she admitted that [these symptoms] were normal for ‘her 4 whole life’ since she was sexually molested and had ‘nerve issues’ as it related to the 5 pelvic area.” AT 28, citing AT 673 (September 2018 treatment record where plaintiff 6 presented for back pain and headache). 7 • “The claimant established care with Shasta Orthopedics in September 2018 due to 8 complaints of lumbar pain and incontinence.” AT 28, citing AT 803-821. 9 • “In February 2019, the claimant was advised that her spine was relatively unlikely to 10 be causing the fecal incontinence that was the cause for her referral.” AT 28, citing 11 AT 109. 12 • “On January 31, 2019, the claimant was seen in the UC Davis Spinal Clinic due to 13 worsening fecal incontinence in the setting of presumed lumbar stenosis. The 14 claimant indicated it occurred primarily when changing position from sitting to 15 standing when she realized she soiled herself. The claimant described her urinary 16 incontinence as a sensation of urinary urgency that became more frequent since being 17 on Lasix. . . . It was determined that the claimant’s fecal incontinence and urinary 18 urgency were unlikely related to the lumbar spine.” AT 28, citing AT 809. 19 • “In September 2019, the claimant was seen for metabolic syndrome. . . . The claimant 20 detailed one instance she thought she was done stooling, but upon getting up she had 21 some bowel ‘leakage.’ . . . Work-up was ordered to help determine the etiology of the 22 claimant’s diarrhea.” AT 30, citing AT 1052, 1041. 23 In sum, the ALJ reviewed the medical evidence pertaining to incontinence and found that 24 “treatment records do not document the extreme degree of symptomatology” plaintiff testified to 25 at the hearing. AT 25. Moreover, the ALJ made the following findings about plaintiff’s 26 credibility in general: 27 • “[T]he claimant’s son detailed [her] daily activities to include the following: took her 28 children to and from school; cared for a pet dog; cooked and prepared food daily; 1 performed housework (laundry, vacuuming, dusting, dishes), although some days she 2 needed help; could drive ‘perfectly fine’; went shopping once or twice a week . . . ; 3 enjoyed walking and going to the dog park often; went out to the movies, coffee, and 4 lunches, and went to church regularly. These written statements were inconsistent 5 with the claimant’s testimony and subjective complaints[.]” AT 24, citing AT 2476 254 (April 2019 third-party function report). ] 7 • “The record includes statements by the claimant’s own provider suggesting the 8 claimant was engaging in possible misrepresentation. . . . The persuasiveness of the 9 claimant’s subjective complaints are diminished in light of this apparent 10 inconsistency.” AT 25, citing AT 467-468 (November 2017 physical therapy note 11 stating that “[t]he fact that plaintiff is a housekeeper and works full-time is 12 inconsistent with her complaints of hip, neck, and shoulder pain.”). 13 • “[E]vidence suggests that the claimant had a history of being paid cash or otherwise 14 for work that was not reported to the Social Security Administration or on tax returns. 15 . . . This evidence . . . indicates that the claimant’s daily activities have, at least at 16 times, been significantly greater than the claimant has generally reported. The 17 claimant’s apparent ability to work during the period of adjudication is inconsistent 18 with her allegations of disabling functional limitations.” AT 25-26, citing AT 789 19 (June 2017 treatment note stating that plaintiff “cleans houses for a living and spends 20 most of the day on her feet”); AT 469 (November 2017 treatment note stating: “The 21 fact that she is a housekeeper and works full-time is inconsistent with her complaints 22 of hip, neck, and shoulder pain.”); AT 475 (December 2018 treatment note stating that 23 plaintiff “cleans houses for a living”); AT 496 (December 2018 treatment note 24 referring to plaintiff’s job cleaning houses). 25 • “Despite the claimant’s subjective complaints of incapacitating limitations, the 26 claimant’s activities of daily living have at times been greater than the claimant 27 generally reported, including working full-time as a housekeeper and caring for 28 multiple children in the home[.]” AT 31. 1 Based on the foregoing, the ALJ found plaintiff to be exaggerating her symptoms, and the 2 court finds no reason not to defer to the ALJ’s credibility analysis. See Saelee v. Chater, 94 F.3d 3 520, 522 (9th Cir. 1995) (the ALJ determines whether a disability applicant is credible, and the 4 court defers to the ALJ’s discretion if the ALJ used the proper process and provided proper 5 reasons). The ALJ concluded that evidence that plaintiff worked full-time as a housekeeper and 6 was able to perform a normal range of daily activities was inconsistent with her claims of 7 debilitating incontinence; however, the ALJ credited plaintiff’s testimony that she needed to wear 8 an adult diaper, and this was reflected in the RFC. The ALJ also credited the opinions of two 9 medical consultants, Dr. L. Pancho and Dr. Kim Rowlands, both of whom reviewed the 10 longitudinal record and opined that plaintiff could perform light work with some limitations; 11 neither opined as to any limitations related to incontinence. AT 31, citing AT 85-86, 102-104. In 12 light of the above, the RFC regarding incontinence was adequately explained and grounded in 13 substantial evidence. 14 B. Headaches 15 Plaintiff next claims that the ALJ erred by failing to account for work-related impairments 16 caused by plaintiff’s headaches. 17 At the August 2020 hearing, plaintiff testified that her main impairments were PTSD and 18 edema. AT 62. She also testified to chronic incontinence and sleepiness requiring her to nap 19 multiple times a day. AT 65-68. Plaintiff did not testify about headaches or any functional 20 limitations due to headaches. See AT 23 (summary of testimony as to physical symptoms). 21 The ALJ did not find plaintiff’s headaches a severe impairment; rather, she found that 22 plaintiff’s headache symptoms “have been accounted for as symptoms of cervical degenerative 23 disc disease, lumbar degenerative disc disease, and fibromyalgia.” AT 29. The RFC does not 24 include any limitations related to headaches or light sensitivity. 25 Plaintiff asserts that the RFC does not incorporate the “numerous references to 26 photophobia in the record” or evidence that plaintiff’s headaches are related to neck movement. 27 (ECF No. 16-2 at 10.) Plaintiff cites an April 2019 doctor’s visit in which she presented for 28 headaches, describing them as severe and aggravated by bright lights and noise. AT 584. 1 || Plaintiff stated that these symptoms were relieved by over-the-counter medication.” AT 584. 2 | Plaintiff argues that her headaches should have “result[ed] in limitations such as needing to rest in 3 || the dark.” (ECF No. 16-2 at 11.) 4 In reviewing the medical record, the ALJ noted that plaintiff “complained of headaches, 5 || which appeared to be related to her neck pain. . . . The claimant reported relief of symptoms with 6 || over-the-counter pain medications, rest, manipulation, and gabapentin. The claimant reported 7 || chiropractic treatment was helping with her back pain and headaches.” AT 27. The ALJ also 8 || considered a March 2020 MRI of the cervical spine, which showed mild findings. AT 29. As 9 || noted above, the ALJ credited the opinions of the two consulting physicians, who found that 10 | plaintiff could perform light work; neither opined that there were any limitations related to 11 || headaches or photophobia. AT 31, citing AT 85-86, 102-104. 12 Plaintiff has not shown reversible error as to the ALJ’s failure to incorporate headache-related 13 || limitations in the RFC. As above, the court finds that the RFC was adequately explained and 14 || grounded in substantial evidence. 15 | CONCLUSION 16 For the reasons stated herein, IT IS HEREBY ORDERED that: 17 1. Plaintiffs motion for summary judgment (ECF No. 16) is denied; 18 2. The Commissioner’s cross-motion for summary judgment (ECF No. 18) is granted; 19 | and 20 3. Judgment is entered for the Commissioner. 21 || Dated: November 7, 2022 / a8 } if | / p , Si 22 CAROLYNK. DELANEY 23 UNITED STATES MAGISTRATE JUDGE 24 || 2/matajcich911.ssi.ckd [25] 26 5 Plaintiff asserts in her brief that headaches “prevent her from driving”; however, this contradicts 27 || evidence that plaintiff took her children to and from school daily and went to doctor’s appointments, the grocery store, and other places. In his third-party function report, her adult son 28 || stated: “She can drive perfectly fine.” AT 250.