The opinion
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8 UNITED STATES DISTRICT COURT
9 FOR THE EASTERN DISTRICT OF CALIFORNIA
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11 Dena Lee Anderson, No. 1:24-cv-01076-GSA
12 Plaintiff, OPINION & ORDER DIRECTING ENTRY
OF JUDGMENT IN FAVOR OF
13 v. DEFENDANT COMMISSION OF SOCIAL
SECURITY AND AGAINST PLAINTIFF
14 Commissioner of Social Security,
(ECF No. 14, 16)
15 Defendants.
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I. Introduction
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Plaintiff Dena Lee Anderson seeks judicial review of a final decision of the Commissioner
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of Social Security denying her application for disability benefits under Titles II and XVI the
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Social Security Act.1
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II. Factual and Procedural Background
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The ALJ held a hearing on July 15, 2024. AR 817-839. On July 22, 2024, the ALJ issued
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an unfavorable decision. AR 797–810. The Appeals Council denied review and this appeal
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followed.
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III. The Disability Standard
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Pursuant to 42 U.S.C. §405(g), this court has the authority to review a decision by the
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Commissioner denying a claimant disability benefits. “This court may set aside the
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28 1 The parties consented to the jurisdiction of a United States Magistrate Judge. Docs. 4, 5.
1 Commissioner’s denial of disability insurance benefits when the ALJ’s findings are based on
2 legal error or are not supported by substantial evidence in the record as a whole.” Tackett v.
3 Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999) (citations omitted). Substantial evidence is evidence
4 within the record that could lead a reasonable mind to accept a conclusion regarding disability
5 status. See Richardson v. Perales, 402 U.S. 389, 401 (1971). It is more than a scintilla, but less
6 than a preponderance. See Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1996) (internal citation
7 omitted).
8 When performing this analysis, the court must “consider the entire record as a whole and
9 may not affirm simply by isolating a specific quantum of supporting evidence.” Robbins v. Social
10 Security Admin., 466 F.3d 880, 882 (9th Cir. 2006) (citations and quotations omitted). If the
11 evidence could reasonably support two conclusions, the court “may not substitute its judgment for
12 that of the Commissioner” and must affirm the decision. Jamerson v. Chater, 112 F.3d 1064,
13 1066 (9th Cir. 1997) (citation omitted). “[T]he court will not reverse an ALJ’s decision for
14 harmless error, which exists when it is clear from the record that the ALJ’s error was
15 inconsequential to the ultimate nondisability determination.” Tommasetti v. Astrue, 533 F.3d
16 1035, 1038 (9th Cir. 2008).
17 To qualify for benefits under the Social Security Act, a plaintiff must establish that he or
18 she is unable to engage in substantial gainful activity due to a medically determinable physical or
19 mental impairment that has lasted or can be expected to last for a continuous period of not less
20 than twelve months. 42 U.S.C. § 1382c(a)(3)(A). An individual shall be considered to have a
21 disability only if . . . his physical or mental impairment or impairments are of such severity that
22 he is not only unable to do his previous work, but cannot, considering his age, education, and
23 work experience, engage in any other kind of substantial gainful work which exists in the national
24 economy, regardless of whether such work exists in the immediate area in which he lives, or
25 whether a specific job vacancy exists for him, or whether he would be hired if he applied for
26 work. 42 U.S.C. §1382c(a)(3)(B).
27 To achieve uniformity in the decision-making process, the Commissioner has established
28 a sequential five-step process for evaluating a claimant’s alleged disability. 20 C.F.R. §§
1 416.920(a)-(f). The ALJ proceeds through the steps and stops upon reaching a dispositive finding
2 that the claimant is or is not disabled. 20 C.F.R. §§ 416.927, 416.929.
3 Specifically, the ALJ is required to determine: 1- whether a claimant engaged in
4 substantial gainful activity during the period of alleged disability; 2- whether the claimant had
5 medically determinable “severe impairments”; 3- whether these impairments meet or are
6 medically equivalent to one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P,
7 Appendix 1; 4- whether the claimant retained the residual functional capacity (“RFC”) to perform
8 past relevant work; and 5- whether the claimant had the ability to perform other jobs existing in
9 significant numbers at the national and regional level. 20 C.F.R. § 416.920(a)-(f). While the
10 Plaintiff bears the burden of proof at steps one through four, the burden shifts to the
11 commissioner at step five to prove that Plaintiff can perform other work in the national economy
12 given her RFC, age, education and work experience. Garrison v. Colvin, 759 F.3d 995, 1011 (9th
13 Cir. 2014).
14 IV. The ALJ’s Decision
15 At step one, the ALJ found that Plaintiff did not engage in substantial gainful activity
16 since from the alleged onset date to the date last insured. AR 802.
17 At step two, the ALJ found that Plaintiff had the following severe impairments:
18 degenerative disc disease and degenerative joint disease of the lumbar spine and history of
19 fracture of the left proximal humerus. AR 802. At step three, the ALJ found that Plaintiff did not
20 have an impairment or combination thereof that met or medically equaled the severity of one of
21 the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. AR 803.
22 Prior to step four, the ALJ evaluated Plaintiff’s residual functional capacity (RFC) and
23 concluded that Plaintiff had the RFC to perform light work as defined in 20 C.F.R. 404.1567(b)
24 but with the following additional limitations:
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frequent overhead reaching with the left (nondominant) upper extremity, frequent
26 pushing and pulling with the feet, frequent climbing stairs and ramps, balancing,
and kneeling, occasional climbing ladders and scaffolds, stooping, crouching, and
27 crawling, and occasional exposure to heights and heavy machinery. AR 803.
28 At step four, the ALJ found that Plaintiff could not perform her past relevant work as a
1 mail carrier. AR 808. At step five, relying on the VE’s testimony, the ALJ found that
2 considering Plaintiff’s age, education, work experience and RFC Plaintiff could perform the
3 following jobs existing in significant numbers in the national economy: cleaner (DOT 323.687-
4 014), which is light, unskilled work (SVP level 2) existing in significant numbers (177,000 jobs
5 in the national economy); inspector (DOT 559.687- 074), which is light, unskilled work (SVP
6 level 2) existing in significant numbers (6,000 jobs nationally); and, assembler (DOT 706.684-
7 022), which is light, unskilled work (SVP level 2) existing in significant numbers (16,000 jobs
8 nationally). AR 809.
9 Accordingly, the ALJ concluded that Plaintiff was not disabled from December 18, 2014,
10 the alleged onset date, through December 31, 2019, the date last insured. AR 810.
11 V. Issues Presented
12 Plaintiff asserts four claims of error: 1- The ALJ did not address the combination of
13 impairments in the RFC; 2- The ALJ failed to address Adult Listing 14.09, psoriatic arthritis; 3-
14 The ALJ failed to consider Ms. Anderson’s spinal limitations; and 4- The ALJ did not provide
15 hypotheticals which reflected the combination of impairments.
16 A. Combination of Impairments; RFC Generally
17 1. Applicable Law
18 Before proceeding to steps four and five, the ALJ determines the claimant’s residual
19 functional capacity (RFC) which is “the most [one] can still do despite [his or her] limitations”
20 and represents an assessment “based on all the relevant evidence.” 20 C.F.R. § 416.945(a)(1).
21 The RFC must consider all of the claimant’s impairments, severe or not. 20 C.F.R. §§
22 416.920(e), 416.945(a)(2). “The ALJ can meet this burden by setting out a detailed and thorough
23 summary of the facts and conflicting evidence, stating his interpretation thereof, and making
24 findings.” Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989).
25 2. Analysis
26 Plaintiff explains that pursuant to SSR 85-28, 20 CFR, 404.1523 and 416.923, the ALJ
27 must consider the impact of the combination of a person’s impairments on that person's ability to
28 function, rather than consider separately the contribution of each impairment alone. Id.
1 Similarly, Plaintiff emphasizes the regulatory requirement that the ALJ consider the
2 combination of severe and non-severe impairments. Plaintiff contends the ALJ failed to explain
3 how she considered the combined effects.
4 As to this argument, these citations do not require the ALJ to articulate specifically how
5 the combination of impairments are considered.2
6 Further, to the extent Plaintiff is suggesting that her non-severe impairment of psoriatic
7 arthritis should have been considered in formulating the RFC, the ALJ did address Plaintiff’s
8 psoriatic arthritis, and it is clear why no corresponding restrictions were included in the RFC:
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Between and 2018 and 2019, the claimant complained to her treatment
10 providers of gouty and psoriatic arthritis. On examination, the claimant’s treatment
providers observed psoriatic plaques at the arms, legs, trunk, and axilla, as well as
11 tenderness and swelling at the left ankle, but did not observe evidence of any
significant complication(s) of the claimant’s conditions, such as inflammation,
12 stiffness, or swelling at the joints or issues with other body parts (e.g., mouth,
eyes, etc.). The claimant’s treatment providers prescribed medication to treat the
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claimant’s conditions. The claimant told her treatment providers she did not
14 always take her medication as prescribed, but indicated the medication was at least
somewhat helpful. Further, the claimant did not pursue a referral to a
15 rheumatologist (Ex. 14F/26-34, 38-43, 51, 59-61, 70-72; Ex. 16F/23).
Accordingly, in light of the lack of evidence of significant functional limitations
16 attributable to the claimant’s psoriatic arthritis, the undersigned finds this
impairment was not severe through the date last insured.
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AR 803
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These observations by the ALJ, which Plaintiff neither acknowledges nor disputes, cast
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significant doubt on an argument that Plaintiff’s psoriatic arthritis, individually or in combination
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with her severe impairments, limited her ability to perform work activities.
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2 This differs from the regulations applicable to medical opinions. Specifically, 20 C.F.R. §
23 404.1520c(c) provides that “We will articulate how we considered the medical opinions and prior
administrative medical findings.” (emphasis added). By contrast, the regulations Plaintiff cites
24 concerning combined effects of severe and non-severe impairments states only that “we will
consider the combined effect of all your impairments. 20 CFR, 404.1523. The requirement that
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the agency “Articulate how we considered” is different than “we will consider.” This suggest that
the articulation requirement only applies to the ALJ’s assessment of medical opinions, and not the
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combined effects of severe and non-severe impairments. There is no dispute here that the ALJ
27 did address severe and non-severe impairments. There is no additional requirement to explain the
combined effects, nor does Plaintiff explain how the ALJ could meet that burden, even if it
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1 B. Listing 14.09 (Psoriatic Arthritis)
2 Plaintiff contends the ALJ did not address this listing. However, in the discussion that
3 ensues, Plaintiff addresses neither the listing’s requirements nor the ALJ’s findings about her
4 psoriatic arthritis as quoted above (benign physical examinations, medication was helpful when
5 taken as prescribed, was not always taken as prescribed, and she did not pursue a rheumatology
6 referral).
7 Listing 14.09 has 4 alternative categories to meet the listing with each category containing
8 multiple subsidiary categories, and each of those subsidiary categories containing their own
9 required elements. For example:
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A. Persistent inflammation or persistent deformity of
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1. One or more major peripheral joints in a lower extremity (see 14.00C8) and
12 medical documentation of at least one of the following:
a. A documented medical need (see 14.00C6) for a walker, bilateral
13 canes, or bilateral crutches (see 1.00C6d) or a wheeled and seated
mobility device involving the use of both hands (see 1.00C6e(i)); or
14 b. An inability to use one upper extremity to independently initiate,
sustain, and complete work-related activities involving fine and gross
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movements (see 14.00C7), and a documented medical need
16 (see 14.00C6) for a one-handed, hand-held assistive device
(see 1.00C6d) that requires the use of the other upper extremity or a
17 wheeled and seated mobility device involving the use of one hand
(see 1.00C6e(ii)); or
18 2. One or more major peripheral joints in each upper extremity (see 14.00C8) and
medical documentation of an inability to use both upper extremities to the
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extent that neither can be used to independently initiate, sustain, and complete
20 work-related activities involving fine and gross movements (see 14.00C7).
And subcategory B, C, and D are equally dense.
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To support the argument that Listing 14.09 applies, Plaintiff explains:
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23 Ms. Anderson has psoriatic arthritis and explained at the hearing “It’s hard
to hold things because my hands are hurting and it’s hard to grip. It’s kind of hard
24 to explain, but yes, my, my (sic) hands don’t function fully when they’re hurting
like that” (AR 54). Psoriatic arthritis is addressed under Adult Listing 14.09.
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MSJ at 0.
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To begin, it is worth noting that there is no contention that Plaintiff did not have psoriatic
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arthritis, nor that at times it could be difficult for Plaintiff to hold things. However, to establish
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1 an impairment of listing level severity, and the corresponding presumption of disability that goes
2 along with it, much more is required. This is clearly demonstrated in the required elements set
3 forth above in listing 14.09.
4 On this point of psoriatic arthritis Plaintiff explains:
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Dr. Hisham Abukamleh, MD reports Ms. Anderson’s condition emerged at
6 age of 14, and was seen by multiple dermatologists was given her topical steroids.
Dr. Lawrence Cosner, MD diagnoses severe psoriatic arthritis (AR 636,668). Dr.
7 Hisham Abukamleh, notes the infections result in lesions in her toes which fill
with pus. Ms. Anderson has been seen by a rheumatologist who started her on
8 methotrexate and folic acid in addition to a DEXA scan ordered by the
rheumatologist because of her history 3.2 of a fracture. (AR 1064). Dr. Hisham
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Abukamleh reports she has had difficulty walking. (AR 535, 636, 639, 713).
10 MSJ at 9.
11 However, this one-paragraph discussion does not actually demonstrate the point Plaintiff
12 is attempting to assert as Dr. Lawrence Cosner did not diagnose “severe” psoriatic arthritis, rather
13 the term “severe” was a characterization which appeared under the “HPI” (History of Present
14 Illness) that contained subjective information that importantly was obtained from the patient.3
15 AR 636. Plaintiff also cites page 668 of the administrative record for the same proposition,
16 severe psoriatic arthritis, but that page merely states “other psoriasis.”
17 But importantly and notwithstanding, use of the word “severe” in isolation would not
18 satisfy listing 14.09’s exacting requirements.
19 As to Dr. Hisham Abukamleh’s note that “the infections result in lesions in her toes which
20 fill with pus,” as quoted above, it is not at all clear how this note arguably fits into Plaintiff’s
21 claim(s). Moreover, Plaintiff references “The infections” without explaining what that refers to.
22 Plaintiff provides no citation as to where Dr. Abukamleh made such a statement and further
23 provides no explanation as to how these alleged infections are applicable to listing 14.09.
24 As for the referral to rheumatology and the prescription for methotrexate, these establish
25 little more than Plaintiff’s condition was serious enough to result in her being seen by a specialist
26 and prescribed medication, but it is not explained how this condition meets the requirements of
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28 3 See https://health.maryland.gov/bacc/Documents/soap.pdf (explaining that HPI is subjective)
1 listing 14.09.
2 As to Dr. Hisham Abukamleh’s statement that she has had difficulty walking, this point is
3 equally unpersuasive. Plaintiff cites AR 535, but that was a physical therapy visit with Dr.
4 J’arshid Farajzadehfor for a shoulder (humeral head) fracture, shoulder impingement syndrome,
5 and cervical spine strain, which appear to have little to do with walking.
6 Plaintiff also cites AR 636 and 639, which contain no reference to walking difficulty,
7 although other surrounding records do reflect difficulty walking or legs giving out. These
8 surrounding records however are part of Plaintiff’s own subjective HPI (history of present illness)
9 and importantly not findings observed by a provider.
10 Similarly, Plaintiff cites AR 713, which reflects under HPI the subjective contention of
11 walking difficulty. But the same page notes discharge instructions of “You may walk and bear
12 weight as tolerated.”
13 In sum, the ALJ committed no error in declining to recite the requirements of Listing
14 14.09 (Psoriatic Arthritis) and articulate their applicability, or lack thereof, where nothing in the
15 record other than the diagnoses suggest that Listing 14.09 was met.
16 C. Spinal Limitations
17 Plaintiff contends the ALJ failed to address her spinal limitations arguing that the ALJ
18 disregarded Ms. Anderson’s limitations at the Step Two finding. The ALJ explained as follows:
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Listing 1.15 contemplates a disorder of the skeletal spine resulting in
20 compromise of a nerve root(s). In this case, the claimant’s spinal
impairment does not satisfy the requirements of Listing 1.15 because
21 there is insufficient evidence of any of the following conditions: A
documented medical need for a walker, bilateral canes, or bilateral
22 crutches or a wheeled and seated mobility device involving the use of
both hands; an inability to use one upper extremity to independently
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initiate, sustain, and complete work-related activities involving fine and
24 gross movements, and a documented medical need for a one-handed,
hand-held assistive device that requires the use of the other upper
25 extremity or a wheeled and seated mobility device involving the use of
one hand; and/or an inability to use both upper extremities to the extent
26 that neither can be used to independently initiate, sustain, and complete
work-related activities involving fine and gross movements (AR 803).
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AR 803.
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1 Plaintiff asserts that “the record shows on going spinal damage with compression on her
2 discs which require a cane. The record as discussed above shows objective evidence of spinal
3 impingement.” Plaintiff further asserts that “Dr. Moradian prescribes a cane for safety and not
4 weight bearing in 2015 (AR 420). In Emergency she is noted as ambulating with a cane. At the
5 hearing in 2024 Ms. Anderson states she continues to need her cane (AR 834).” MSJ at 11.
6 As quoted above, listing 1.15 requires the need for bilateral canes, not just one cane.
7 D. Whether the ALJ’s hypotheticals Reflected Her Combination of
8 Impairments
9 Plaintiff explains that “Given the inadequate RFC the rest of the sequential steps are
10 unsupported.” However, this argument is entirely derivative of the argument concerning the
11 deficiency of the RFC which, as discussed above, is not meritorious. Thus, this claim of error
12 fails for the same reasons as stated above.
13 E. Step Five
14 Here, Plaintiff contends that the ALJ did not meet the burden of proof at Step Five
15 because the identified jobs in the National economy are in conflict with the RFC.
16 Despite Plaintiff’s contention that the jobs provided “conflict with the RFC,” Plaintiff is
17 continuing to argue that the RFC is deficient. Specifically, Plaintiff is arguing that the identified
18 step five jobs conflict with what the RFC should be, not with what the RFC is.
19 Plaintiff does not attempt to argue how the identified jobs at step five---cleaner, inspector
20 assembler---conflict with the actual RFC for light work with postural and manipulative
21 limitations. Nor does Plaintiff attempt to articulate a basis to question the VE’s testimony that an
22 individual with Plaintiff’s limitations could perform those 3 jobs.
23 In sum, the argument does not demonstrate that the RFC deficient.
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F. Subjective Testimony
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26 Plaintiff’s final argument begins with a header labelled “The ALJ failed to provide clear
27 and convincing reasons to discount Ms. Anderson’s statements.” MSJ at 12. The ensuing
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1 discussion however does not address the Plaintiff’s statements, rather Plaintiff again references
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listing 14.09, briefly quotes applicable caselaw, and ultimately questions whether the ALJ
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properly incorporated the opinion of Dr. Levine, whose opinion the ALJ found persuasive.
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Here, Plaintiff quotes Dr. Levine’s opinion:
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I felt she should be able to sit six out of eight hours, but not longer than 45 minutes
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at a time without, as an example, standing and/or walking around a desk for a one
7 to two-minute period, although could stay on task if the job allowed. And I felt she
should be able to stand two out of eight hours, but not longer than 30 minutes at a
8 time without the ability of sitting fer two to three minutes, and felt she could walk
two out of eight hours, but not longer than 20 minutes at a time without the ability
9 of sitting for two to three minutes (AR44).
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Plaintiff explains that “The ALJ finds Medical Expert Orthopedist Dr. Levine persuasive.
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Dr. Levine as discussed above finds damage to Anderson’s back, legs, and feet. He finds she is
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limited in her ability to ambulate. The ALJ did not resolve the conflict.” MSJ at 15,
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Importantly though, the ALJ did include those limitations in a hypothetical to the VE, who
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15 testified that such an individual could perform jobs existing in significant numbers in the national
16 economy. The applicable testimony follows:
17 Q: Okay. So if we have a hypothetical individual this ladies age, education and
past work history, capable of light work, but she could only stand 30 minutes at a
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time, up to two hours. Walk 20 minutes of the time, up to two hours for a total of
19 standing and walking of four hours. She can also sit 45 minutes at a time, up to six
hours. No overhead reaching with the left upper extremity.
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. . .
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A: That is correct.
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. . .
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Q Okay. And would there be some jobs available within this
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A: Yes. We're looking at jobs in the light category. And a sample of jobs would
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include office helper . . .
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This testimony demonstrates that the ALJ did pose a hypothetical to the VE containing
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precisely the same limitations Dr. Levine opined and which spoke to whether Dr. Levine’s
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1 opinion would be work preclusive, namely: sit 6 of 8 hours and no longer than 45 consecutive
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minutes; stand 2 of 8 hours but no longer than 30 consecutive minutes; and walk 2 of 8 hours but
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no longer than 20 consecutive minutes. Importantly, the VE testified that these limitations would
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not preclude a hypothetical claimant from performing jobs existing in significant numbers in the
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national economy. Thus, any error in constructing the RFC would be harmless.
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7 VI. Order
8 The ALJ’s decision that Plaintiff was not disabled is supported by substantial
9 evidence and applicable law.
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Accordingly, it is ordered that:
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1. Plaintiff’s motion for summary judgment (Doc. 14) is DENIED.
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2. Defendant’s cross motion (Doc. 16) is GRANTED.
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3. The Clerk of Court is directed to enter judgment in favor of Defendant
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Commissioner of Social Security, and against Plaintiff.
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IT IS SO ORDERED.
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Dated: February 19, 2026 /s/ Gary S. Austin
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UNITED STATES MAGISTRATE JUDGE
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