Kanika Revels v. Nancy Berryhill , 874 F.3d 648 ( 2017 )


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  •                      FOR PUBLICATION
    UNITED STATES COURT OF APPEALS
    FOR THE NINTH CIRCUIT
    KANIKA SHAVON REVELS,                             No. 15-16477
    Plaintiff-Appellant,
    D.C. No.
    v.                           2:14-cv-01623-
    SRB
    NANCY A. BERRYHILL, Acting
    Commissioner Social Security,
    Defendant-Appellee.                    OPINION
    Appeal from the United States District Court
    for the District of Arizona
    Susan R. Bolton, District Judge, Presiding
    Argued and Submitted May 19, 2017
    San Francisco, California
    Filed October 26, 2017
    Before: Andrew J. Kleinfeld and Kim McLane Wardlaw,
    Circuit Judges, and Cathy Ann Bencivengo,* District Judge.
    Opinion by Judge Wardlaw;
    Dissent by Judge Kleinfeld
    *
    The Honorable Cathy Ann Bencivengo, United States District Judge
    for the Southern District of California, sitting by designation.
    2                      REVELS V. BERRYHILL
    SUMMARY**
    Social Security
    The panel reversed the district court’s order affirming the
    denial of supplemental security income and disability
    insurance benefits by the Commissioner of the Social
    Security Administration, and remanded with instructions to
    remand the case to the agency for the calculation and award
    of benefits.
    The administrative law judge (“ALJ”) found that claimant
    had three severe medical impairments – arthritis, obesity, and
    fibromyalgia – but determined that claimant could perform
    her past relevant work, and denied benefits.
    In July 2012, the Social Security Administration issued
    Social Security Ruling (“SSR”) 12-2P, a ruling that
    established that fibromyalgia may be a severe medical
    impairment for purposes of determining disability.
    The panel held that in determining the intensity,
    persistence, and limiting effects of claimant’s symptoms, the
    ALJ failed to provide legally sufficient reasons for rejecting
    the opinions of rheumatologist Dr. Nolan, physical therapist
    Richard Randall, and nurse practitioner Mager. The panel
    also held that the ALJ erred in rejecting claimant’s symptom
    testimony and the lay opinions of her mother and father. The
    panel concluded that these errors arose from a fundamental
    misunderstanding of fibromyalgia. The panel further held
    **
    This summary constitutes no part of the opinion of the court. It has
    been prepared by court staff for the convenience of the reader.
    REVELS V. BERRYHILL                       3
    that the ALJ failed to properly analyze claimant’s
    fibromyalgia-related symptoms pursuant to SSR 12-2P, and
    the court’s opinion in Benecke v. Barnhart, 
    379 F.3d 587
     (9th
    Cir. 2004).
    Specifically, the panel held that the ALJ erred in giving
    Dr. Nolan’s opinion no weight, and instead should have
    found it to be controlling as to the intensity, persistence, and
    limiting effects of claimant’s fibromyalgia. The panel
    concluded that because the vocational expert testified that a
    claimant with the physical limitations outlined in Dr. Nolan’s
    medical opinion would be unable to do any full-time work,
    Dr. Nolan’s opinion by itself established that claimant was
    entitled to benefits.
    The panel concluded that each of the “credit-as-true”
    factors, outlined in Garrison v. Colvin, 
    759 F.3d 995
    , 1020
    (9th Cir. 2014), were satisfied, and that remand for the
    calculation and award of benefits was warranted.
    Judge Kleinfeld dissented. Judge Kleinfeld would hold
    that the ALJ properly found that claimant was not wholly
    credible, and properly dismissed medical testimony
    supporting claimant’s position. Judge Kleinfeld would
    conclude that claimant did not establish that the ALJ’s
    conclusions were unsupported by substantial evidence, and he
    would affirm the ALJ’s decision to deny benefits.
    4                  REVELS V. BERRYHILL
    COUNSEL
    Eric G. Slepian (argued), Phoenix, Arizona, for Plaintiff-
    Appellant.
    Lars J. Nelson (argued), Special Assistant United States
    Attorney; David Morado, Regional Chief Counsel, Region X;
    Office of the General Counsel, Social Security
    Administration, Seattle, Washington;     for Defendant-
    Appellee.
    OPINION
    WARDLAW, Circuit Judge:
    Kanika Revels (“Revels”), a now forty-one-year-old
    woman who suffers from fibromyalgia, and who last worked
    as a phlebotomist, appeals the district court’s order affirming
    the denial of supplemental security income and disability
    insurance benefits by the Commissioner of the Social
    Security Administration (“SSA”). In July 2012, the SSA
    issued Social Security Ruling (“SSR”) 12-2P, a ruling that
    establishes that fibromyalgia may be a severe medical
    impairment for purposes of determining disability. In
    addition, the SSA provided guidelines for the proper
    evaluation of the disease, echoing many of our statements
    about fibromyalgia in Benecke v. Barnhart, 
    379 F.3d 587
     (9th
    Cir. 2004). The administrative law judge (“ALJ”), the SSA
    Appeals Council, and the district court failed to heed the
    instructions of those rulings, and instead analyzed her
    symptoms and rejected Revels’ claim without considering the
    unique characteristics of fibromyalgia, the principal source of
    her disability. We reverse the judgment below and instruct
    REVELS V. BERRYHILL                  5
    the district court to remand the case to the agency for the
    calculation and award of benefits.
    I.
    Revels applied for supplemental security income and
    disability insurance benefits on February 2, 2011, claiming a
    disability onset date of January 20, 2011. On February 9,
    2011, the agency denied Revels’ application for supplemental
    security income because her income rendered her ineligible.
    Finding her not disabled, the agency denied her application
    for disability insurance benefits on June 29, 2011. On
    reconsideration on November 23, 2011, the agency again
    rejected both claims, relying only on the finding that Revels
    was not disabled. Revels requested a hearing before an ALJ,
    which was held on October 1, 2012. At the hearing, Revels
    provided updated medical records to support her claimed
    impairments. In addition, both Revels and a vocational
    expert testified.
    On October 26, 2012, the ALJ concluded that Revels was
    not disabled and denied her claims. The ALJ followed the
    five-step sequential evaluation process for determining
    whether an individual is disabled. At step one, he found that
    Revels had not engaged in “substantial gainful activity” since
    January 20, 2011, her alleged disability onset date. At step
    two, he determined that she had the following severe
    impairments: arthritis, obesity, and fibromyalgia. He
    determined that her depression was nonsevere.1 At step three,
    the ALJ determined that Revels did not have an impairment
    or combination of impairments that met or medically equaled
    1
    Revels does not challenge this finding on appeal.
    6                   REVELS V. BERRYHILL
    one of the listed impairments in 20 C.F.R. Part 404, Subpart
    P, Appendix 1.
    Before reaching step four, the ALJ determined Revels’
    residual functional capacity (“RFC”). He determined that she
    was mostly able to perform light work as defined in 
    20 C.F.R. § 404.1567
    (b). Light work entails lifting up to twenty pounds
    at a time, with frequent lifting or carrying of objects up to ten
    pounds. 
    20 C.F.R. § 404.1567
    (b). It also may include “a
    good deal of walking or standing,” or “sitting most of the
    time with some pushing and pulling of arm or leg controls.”
    
    Id.
     The ALJ found that Revels had slight limitations on her
    ability to do light work. He found that she could only
    occasionally climb ladders, ropes, scaffolds, ramps, and
    stairs, and only occasionally stoop, crouch, kneel, and crawl.
    He determined that she could frequently balance and reach
    overhead bilaterally, and was capable of frequent handling,
    fingering, and feeling. He also found that she should avoid
    irritants such as fumes, odors, dust, and gases, and should
    avoid unprotected heights and the use of moving machinery,
    except motor vehicles.
    In determining Revels’ RFC, the ALJ found that Revels’
    impairments could reasonably be expected to cause the
    symptoms she alleged, but that her statements about the
    intensity, persistence, and limiting effects of her conditions
    were “not entirely credible to the extent they [we]re
    inconsistent with the . . . residual functional capacity
    assessment.” He found her testimony to be inconsistent with
    the medical treatment notes and her descriptions of her daily
    activities. The ALJ also discredited Revels’ testimony
    because of Revels’ “inconsistent reporting of marijuana
    usage,” and inconsistent descriptions of the effectiveness of
    her treatments. The ALJ assigned no weight to the opinions
    REVELS V. BERRYHILL                      7
    of Revels’ treating rheumatologist, Dr. Joseph Nolan, or her
    physical therapist, Richard Randall. He gave “some weight”
    to the opinion of the state agency consultative examiner, Dr.
    Keith Cunningham, and assigned significant weight to the
    opinions of the two state agency nonexamining physicians,
    Dr. Alicia Blando and Dr. Debra Rowse. He also assigned
    significant weight to Revels’ hand doctor, Dr. Sebastian
    Ruggeri.
    At step four, the ALJ determined that Revels’ RFC
    allowed her to perform her past relevant work as a medical
    assistant and phlebotomist. Accordingly, he denied benefits.
    The Appeals Council denied Revels’ request for review
    on May 20, 2014. It considered additional evidence
    submitted by Revels’ primary care provider, Jacqueline
    Mager, but determined that the evidence did not provide a
    basis for overturning the ALJ’s decision. Revels then filed a
    complaint in the United States District Court for the District
    of Arizona, seeking review of the agency’s decision. The
    district court affirmed the ALJ’s decision on June 10, 2015.
    Revels timely appealed.
    II.
    A. Standard of Review.
    We review de novo a district court’s order affirming a
    denial of Social Security benefits by the Commissioner.
    Brown-Hunter v. Colvin, 
    806 F.3d 487
    , 492 (9th Cir. 2015).
    We set aside a denial of Social Security benefits only when
    the ALJ decision is “based on legal error or not supported by
    substantial evidence in the record.” Benton ex rel. Benton v.
    Barnhart, 
    331 F.3d 1030
    , 1035 (9th Cir. 2003). “Substantial
    8                  REVELS V. BERRYHILL
    evidence means more than a mere scintilla, but less than a
    preponderance. It means such relevant evidence as a
    reasonable mind might accept as adequate to support a
    conclusion.” Desrosiers v. Sec’y of Health & Human Servs.,
    
    846 F.2d 573
    , 576 (9th Cir. 1988) (citations omitted) (internal
    quotation marks omitted). “Where evidence is susceptible to
    more than one rational interpretation, the ALJ’s decision
    should be upheld.” Orn v. Astrue, 
    495 F.3d 625
    , 630 (9th Cir.
    2007) (internal quotation marks omitted). Yet we “must
    consider the entire record as a whole, weighing both the
    evidence that supports and the evidence that detracts from the
    Commissioner’s conclusion, and may not affirm simply by
    isolating a specific quantum of supporting evidence.”
    Garrison v. Colvin, 
    759 F.3d 995
    , 1009 (9th Cir. 2014)
    (quoting Lingenfelter v. Astrue, 
    504 F.3d 1028
    , 1035 (9th Cir.
    2007)). “We review only the reasons provided by the ALJ in
    the disability determination and may not affirm the ALJ on a
    ground upon which he did not rely.” Id. at 1010; see also
    SEC v. Chenery Corp., 
    318 U.S. 80
    , 87 (1943) (“The grounds
    upon which an administrative order must be judged are those
    upon which the record discloses that its action was based.”).
    B. Evaluation of Medical Source Opinions.
    The medical opinion of a claimant’s treating doctor is
    given “controlling weight” so long as it “is well-supported by
    medically acceptable clinical and laboratory diagnostic
    techniques and is not inconsistent with the other substantial
    evidence in [the claimant’s] case record.” 
    20 C.F.R. § 404.1527
    (c)(2). When a treating doctor’s opinion is not
    controlling, it is weighted according to factors such as the
    length of the treatment relationship and the frequency of
    examination, the nature and extent of the treatment
    relationship, supportability, and consistency with the record.
    REVELS V. BERRYHILL                       9
    
    Id.
     § 404.1527(c)(2)–(6). Greater weight is also given to the
    “opinion of a specialist about medical issues related to his or
    her area of specialty.” 
    20 C.F.R. § 404.1527
    (c)(5). A
    doctor’s specialty is especially relevant with respect to
    diseases that are “poorly understood” within the rest of the
    medical community. Benecke, 
    379 F.3d at
    594 n.4.
    “To reject [the] uncontradicted opinion of a treating or
    examining doctor, an ALJ must state clear and convincing
    reasons that are supported by substantial evidence.” Ryan v.
    Comm’r of Soc. Sec., 
    528 F.3d 1194
    , 1198 (9th Cir. 2008)
    (alteration in original) (quoting Bayliss v. Barnhart, 
    427 F.3d 1211
    , 1216 (9th Cir. 2005)). “If a treating or examining
    doctor’s opinion is contradicted by another doctor’s opinion,
    an ALJ may only reject it by providing specific and legitimate
    reasons that are supported by substantial evidence.” 
    Id.
    (quoting Bayliss, 
    427 F.3d at 1216
    ); see also Reddick v.
    Chater, 
    157 F.3d 715
    , 725 (9th Cir. 1998) (“[The] reasons for
    rejecting a treating doctor’s credible opinion on disability are
    comparable to those required for rejecting a treating doctor’s
    medical opinion.”). “The ALJ can meet this burden by
    setting out a detailed and thorough summary of the facts and
    conflicting clinical evidence, stating his interpretation
    thereof, and making findings.” Magallanes v. Bowen,
    
    881 F.2d 747
    , 751 (9th Cir. 1989) (quoting Cotton v. Bowen,
    
    799 F.2d 1403
    , 1408 (9th Cir. 1986)). “When an examining
    physician relies on the same clinical findings as a treating
    physician, but differs only in his or her conclusions, the
    conclusions of the examining physician are not ‘substantial
    evidence.’” Orn, 
    495 F.3d at 632
    . Additionally, “[t]he
    opinion of a nonexamining physician cannot by itself
    constitute substantial evidence that justifies the rejection of
    the opinion of either an examining physician or a treating
    10                 REVELS V. BERRYHILL
    physician.” Lester v. Chater, 
    81 F.3d 821
    , 831 (9th Cir.
    1995) (emphasis in original).
    In addition to considering the medical opinions of
    doctors, an ALJ must consider the opinions of medical
    providers who are not within the definition of “acceptable
    medical sources.” See 
    20 C.F.R. § 404.1527
    (b), (f); SSR 06-
    3P. While those providers’ opinions are not entitled to the
    same deference, an ALJ may give less deference to “other
    sources” only if the ALJ gives reasons germane to each
    witness for doing so. Molina v. Astrue, 
    674 F.3d 1104
    , 1111
    (9th Cir. 2012). The same factors used to evaluate the
    opinions of medical providers who are acceptable medical
    sources are used to evaluate the opinions of those who are
    not. 
    Id.
     § 404.1527(f); SSR 06-3P. Those factors include the
    length of the treatment relationship and the frequency of
    examination, the nature and extent of the treatment
    relationship, supportability, consistency with the record, and
    specialization of the doctor. Id. § 404.1527(c)(2)–(6). Under
    certain circumstances, the opinion of a treating provider who
    is not an acceptable medical source may be given greater
    weight than the opinion of a treating provider who is—for
    example, when the provider “has seen the individual more
    often than the treating source, has provided better supporting
    evidence and a better explanation for the opinion, and the
    opinion is more consistent with the evidence as a whole.” Id.
    § 404.1527(f)(1).
    C. Evaluation of a Claimant’s Testimony and Third-Party
    Reports.
    We have established a two-step analysis for determining
    the extent to which a claimant’s report of her symptoms must
    be credited:
    REVELS V. BERRYHILL                    11
    First, 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. In this
    analysis, the claimant is not required to show
    that her impairment could reasonably be
    expected to cause the severity of the symptom
    she has alleged; she need only show that it
    could reasonably have caused some degree of
    the symptom. Nor must a claimant produce
    objective medical evidence of the pain or
    fatigue itself, or the severity thereof.
    If the claimant satisfies the first step of this
    analysis, and there is no evidence of
    malingering, the ALJ can reject the claimant’s
    testimony about the severity of her symptoms
    only by offering specific, clear and
    convincing reasons for doing so. This is not
    an easy requirement to meet: The clear and
    convincing standard is the most demanding
    required in Social Security cases.
    Garrison, 759 F.3d at 1014–15 (citations omitted) (internal
    quotation marks omitted). To reject third-party reports of a
    claimant’s impairments, the standard is much lower: an ALJ
    need only “give reasons that are germane to each witness.”
    Molina, 
    674 F.3d at 1114
     (quoting Dodrill v. Shalala, 
    12 F.3d 915
    , 919 (9th Cir. 1993)); see also 
    20 C.F.R. § 404.1529
    (c)(3).
    12                  REVELS V. BERRYHILL
    III.
    The ALJ found that Revels had three severe medical
    impairments: arthritis, obesity, and fibromyalgia. However,
    the medical records largely pertain to Revels’ fibromyalgia,
    as do the assessments concerning her limited functional
    ability. Because this case turns on whether the ALJ properly
    found Revels not disabled based on his conclusions about her
    fibromyalgia-related limitations, it is helpful to understand
    what fibromyalgia is, how it is properly diagnosed, and what
    its symptoms are.
    Fibromyalgia is “a rheumatic disease that causes
    inflammation of the fibrous connective tissue components of
    muscles, tendons, ligaments, and other tissue.” Benecke,
    
    379 F.3d at 589
    . Typical symptoms include “chronic pain
    throughout the body, multiple tender points, fatigue, stiffness,
    and a pattern of sleep disturbance that can exacerbate the
    cycle of pain and fatigue.” 
    Id. at 590
    . What is unusual about
    the disease is that those suffering from it have “muscle
    strength, sensory functions, and reflexes [that] are normal.”
    Rollins v. Massanari, 
    261 F.3d 853
    , 863 (9th Cir. 2001)
    (Ferguson, J., dissenting) (quoting Muhammad B. Yunus,
    Fibromyalgia Syndrome: Blueprint for a Reliable Diagnosis,
    Consultant, June 1996, at 1260). “Their joints appear normal,
    and further musculoskeletal examination indicates no
    objective joint swelling.” 
    Id.
     (quoting Yunus, supra, at
    1260). Indeed, “[t]here is an absence of symptoms that a lay
    person may ordinarily associate with joint and muscle pain.”
    Id. The condition is diagnosed “entirely on the basis of the
    patients’ reports of pain and other symptoms.” Benecke,
    
    379 F.3d at 590
    . “[T]here are no laboratory tests to confirm
    the diagnosis.” 
    Id.
    REVELS V. BERRYHILL                              13
    For a long time, fibromyalgia was “poorly understood
    within much of the medical community.” 
    Id.
     Indeed,
    “[t]here used to be considerable skepticism that fibromyalgia
    was a real disease.” Kennedy v. Lilly Extended Disability
    Plan, 
    856 F.3d 1136
    , 1137 (7th Cir. 2017). In previous
    decisions, we were reluctant to recognize fibromyalgia as an
    impairment that could render one disabled for Social Security
    purposes. See Rollins, 
    261 F.3d at 857
     (“Assuming, without
    deciding, that fibromyalgia does constitute a qualifying
    ‘severe impairment’ under the Act . . . .”).
    A sea-change occurred in 2012, when the SSA issued a
    ruling recognizing fibromyalgia as a valid “basis for a finding
    of disability.”2 Social Security Ruling (“SSR”) 12-2P, at *2.
    The ruling provides two sets of criteria for diagnosing the
    condition, based on the 1990 American College of
    Rheumatology Criteria for the Classification of Fibromyalgia
    and the 2010 American College of Rheumatology
    Preliminary Diagnostic Criteria. 
    Id.
     Pursuant to the first set
    of criteria, a person suffers from fibromyalgia if: (1) she has
    widespread pain that has lasted at least three months
    (although the pain may “fluctuate in intensity and may not
    always be present”); (2) she has tenderness in at least eleven
    of eighteen specified points on her body; and (3) there is
    evidence that other disorders are not accounting for the pain.
    
    Id.
     at *2–3. Pursuant to the second set of criteria, a person
    suffers from fibromyalgia if: (1) she has widespread pain that
    2
    Though Social Security Rulings do not have the force of law, they
    “constitute Social Security Administration interpretations of the statute it
    administers and of its own regulations.” Quang Van Han v. Bowen,
    
    882 F.2d 1453
    , 1457 (9th Cir. 1989). Therefore, “we defer to Social
    Security Rulings unless they are plainly erroneous or inconsistent with the
    [Social Security] Act or regulations.” 
    Id.
    14                 REVELS V. BERRYHILL
    has lasted at least three months (although the pain may
    “fluctuate in intensity and may not always be present”);
    (2) she has experienced repeated manifestations of six or
    more fibromyalgia symptoms, signs, or co-occurring
    conditions, “especially manifestations of fatigue, cognitive or
    memory problems (“fibro fog”), waking unrefreshed,
    depression, anxiety disorder, or irritable bowel syndrome”;
    and (3) there is evidence that other disorders are not
    accounting for the pain. Id. at *3.
    Therefore, diagnosis of fibromyalgia does not rely on X-
    rays or MRIs. Further, SSR 12-2P recognizes that the
    symptoms of fibromyalgia “wax and wane,” and that a person
    may have “bad days and good days.” SSR 12-2P, at *6. In
    light of this, the ruling warns that after a claimant has
    established a diagnosis of fibromyalgia, an analysis of her
    RFC should consider “a longitudinal record whenever
    possible.” Id.
    IV.
    A. Personal and Medical Records.
    The administrative record provides a comprehensive
    account of Revels’ impairments and functional limitations.
    Starting around 2000, Revels began to develop neck and
    upper back pain. Because of her pain, as well as her asthma,
    she obtained a disability placard in 2003. Around 2010, the
    pain in her neck and back increased markedly, and she also
    began to experience pain in her hands and feet. Revels
    visited the emergency room for pain twice in 2010, and three
    times in 2011. At least one of the visits was prompted by a
    fall caused by the pain and medication. Revels also
    REVELS V. BERRYHILL                            15
    underwent treatment with a variety of doctors because of the
    pain she suffered.
    1. Treating providers.
    Revels’ primary care provider, nurse practitioner
    Jacqueline Mager,3 saw her for at least ten appointments
    between 2010 and 2012 . During nine of those appointments,
    Revels sought treatment for chronic pain she was
    experiencing in her neck, back, feet, and hands. Mager
    referred Revels to several specialists: Dr. Doust, a pain-
    management specialist; Dr. Nolan, a rheumatologist; and Dr.
    Ruggeri, a hand specialist. In addition to her own evaluations
    of Revels, Mager received reports from the other doctors. On
    March 6, 2012, Mager completed a check-the-box assessment
    of Revels’ ability to perform work-related physical activities.
    Mager indicated that, in an eight-hour workday, Revels could
    sit less than two hours, stand or walk less than two hours, lift
    less than twenty pounds, and carry less than fifteen pounds.
    She also opined that Revels could only occasionally use her
    hands and feet, and could only occasionally bend, crawl,
    climb, reach, stoop, balance, crouch, or kneel. The form was
    co-signed by a doctor in Mager’s clinic, Dr. Richard Wolfson.
    Dr. Doust, a pain-management specialist, first saw Revels
    on June 17, 2010. He treated her for the pain she was
    experiencing throughout her body, and saw her at least ten
    3
    We may consider as part of the record on review the medical records
    from Mager that were submitted to the Appeals Council. See Brewes v.
    Comm’r of Soc. Sec. Admin., 
    682 F.3d 1157
    , 1163 (9th Cir. 2012) (“[W]e
    have routinely considered evidence submitted for the first time to the
    Appeals Council to determine whether, in light of the record as a whole,
    the ALJ’s decision was supported by substantial evidence.”).
    16                 REVELS V. BERRYHILL
    times in 2010 and 2011. During her visits with Dr. Doust,
    Revels consistently described her pain as moderate or severe,
    ranging from seven to ten on a ten-point scale, and repeatedly
    explained that her pain significantly interfered with her daily
    activities. Dr. Doust ordered MRIs of Revels’ spine, which
    revealed a bulging disc in her back and degenerative facets in
    her neck. On multiple visits, he also noted that she had a
    positive straight-leg raise test, which indicates a lower-back
    issue such as a herniated disc. Dr. Doust diagnosed Revels
    with fibromyalgia, cervical and lumbosacral degeneration,
    unspecified muscle pain and inflammation, cervical and
    lumbar nerve compression, and nerve inflammation. To
    alleviate her pain, he prescribed various pain relievers and
    muscle relaxants: Valium, Flector, Soma, Vicodin, and
    Percocet. In addition, he administered facet injections into
    her neck and epidural steroid injections into her back.
    Dr. Nolan, a rheumatologist, began treating Revels for
    chronic pain on September 23, 2010. He saw her at least
    twelve times between 2010 and 2012. Dr. Nolan found that
    Revels’ joints were normal with no synovitis, and that there
    were no limitations in her range of motion. However, during
    the first appointment, he noted that Revels’ “history is quite
    characteristic of fibromyalgia,” and throughout his treatment,
    he consistently found that she had “tenderness to palpation in
    the typical fibromyalgic tender points.”          Dr. Nolan
    administered eight tender-point examinations of Revels
    during his treatment. During five of the eight examinations,
    she had more than eleven out of eighteen tender points.
    Based on those results, Dr. Nolan concluded that Revels met
    the American College of Rheumatology’s 1990 diagnostic
    criteria for fibromyalgia. To treat this condition, Dr. Nolan
    prescribed Neurontin, Robaxin, Trazodone, Lyrica, Soma,
    and Vicodin. To treat fibromyalgia flare-ups in Revels’
    REVELS V. BERRYHILL                      17
    hands and wrists, Dr. Nolan administered several steroid
    injections. He concluded that her pain would not respond to
    surgical treatment.
    On September 27, 2011, Dr. Nolan completed a check-
    the-box assessment of Revels’ functional capacity. He
    reported the following: Revels could sit for forty minutes at
    a time, for a total of three hours per day; stand for one hour
    at a time, for a total of three hours per day; and walk for
    twenty minutes at a time, for a total of two hours per day. He
    also indicated that she needed to recline for at least one hour
    per day and alternate between sitting and standing positions
    every forty minutes, and also required a ten-minute break
    every sixty minutes. He reported that she could very
    seldomly lift and carry up to ten pounds or climb stairs, bend,
    stoop, crouch, kneel, or crawl. He noted that she could not
    repetitively grasp, push, pull, or do fine manipulations with
    her hands. If Revels was employed, Dr. Nolan estimated she
    would miss work at least seventy-five percent of the time. On
    September 10, 2012, he filled out another report with similar
    findings. Dr. Nolan also completed five insurance forms in
    2011 and 2012 certifying that Revels could not work.
    Dr. Ruggeri, a hand specialist, began treating Revels on
    February 8, 2011, after she experienced increased pain and
    weakness in her hands and wrists. Dr. Ruggeri saw Revels
    five times over a five-month period in 2011. In addition to
    visually examining her hands, Dr. Ruggeri ordered X-rays, a
    nerve conduction and velocity study, and an ultrasound. In
    his treatment notes, he wrote that she had “normal appearing
    hands” and “normal bony anatomy,” and he concluded that
    she had “bilateral median neuritis.” To treat the condition, he
    recommended vitamin B6, warm soaks and stretching, and
    physical therapy. He also prescribed methylprednisone to
    18                 REVELS V. BERRYHILL
    reduce inflammation and “encouraged [her] to go back to
    some gainful work.” Though he noted that she was being
    treated for fibromyalgia, he did not offer an opinion on
    whether her hand pain was related to the condition.
    Revels saw a number of other providers on a more limited
    basis. Dr. William Stevens, a specialist in spinal issues,
    examined her in August and September of 2011. Reviewing
    MRIs and X-rays of Revels’ spine, he determined that she
    had disc protrusion, stenosis, and radiculopathy. He
    recommended physical therapy but did not believe that
    surgery would resolve her pain. Dr. Glen Bair, an
    orthopedist, treated Revels twice in 2011 for pain in her left
    foot following an incident where she “stepped down wrong.”
    He determined that X-rays of her feet appeared normal and
    recommended stretching. Revels also went to physical
    therapy.
    2. Examining providers.
    Dr. Keith Cunningham examined Revels once, on March
    9, 2011, for the Arizona Department of Economic Security.
    In his report, he recorded Revels’ complaints of spinal pain.
    He wrote that, during the examination, Revels could “squat
    and stand,” and could “walk, turn, and face [him] with a
    normal gait.” He also recorded that she could “stand on each
    leg independently.” He did not state whether she could do
    these activities once or multiple times, or whether she could
    do them for any prolonged period of time. However, he did
    note that she walked “to and from the exam room slowly.”
    He found that both her coordination and range of motion were
    “normal,” and that a straight-leg raise test was negative.
    Based on these findings, he concluded that she had “[c]hronic
    back pain with preserved range of motion” and
    REVELS V. BERRYHILL                      19
    “[f]ibromyalgia without typical trigger points on today’s
    exam.” On a four-page form entitled “Medical Source
    Statement of Ability to Do Work-Related Activities,” Dr.
    Cunningham responded only to the first question, indicating
    that Revels was not disabled. He did not respond to any of
    the follow-up questions, such as what her lifting, carrying,
    standing, and walking restrictions were.
    Richard Randall, a physical therapist, examined Revels on
    August 18, 2011, to evaluate her ability to perform work-
    related physical activities. He prepared an eight-page report
    after conducting a three-and-a-half-hour examination and
    reviewing her medical records. He found that “she was
    unable to perform sitting position manipulative activities” for
    more than twenty-five minutes, and that she had “20 minutes
    of maximum standing tolerance.” He also determined that
    she “would not be able to exert up to 10 lbs. of force
    occasionally and/or exert a negligible amount of force
    frequently to lift, carry, push, pull, or otherwise move objects
    including the human body.” He concluded that these
    limitations rendered her unable to “maintain any sustained
    functional work position in order to function at a rate
    conducive to gainful employment.” Randall also conducted
    various validity tests to determine whether the results were
    reliable, and found that Revels’ reports of pain were accurate
    and that she was providing “full physical effort” during the
    exam.
    3. Nonexamining physicians.
    State agency physicians reviewed Revels’ medical records
    at both the initial and reconsideration levels. At the initial
    level, Dr. Alicia Blando reviewed Revels’ medical records.
    In her report, she relied on Dr. Cunningham’s assessment that
    20                 REVELS V. BERRYHILL
    Revels had fibromyalgia but did not show typical trigger
    points on the day of his exam, and also on the nerve
    conduction and velocity study ordered by Dr. Ruggeri that did
    not reveal abnormalities. She noted that Revels’ complaints
    of hand pain were contradicted by her ability to write by
    hand, “at times, [in] small script,” on one of her Social
    Security forms. She further noted that the medical records
    showed no atrophy, and that Revels was able to take care of
    five children and their daily needs. Dr. Blando assessed
    Revels’ RFC: Revels could occasionally lift and/or carry
    twenty pounds, and frequently lift and/or carry ten pounds;
    she could stand and/or walk (with normal breaks) for six
    hours in an eight-hour workday; and she could sit (with
    normal breaks) for more than six hours in an eight-hour
    workday. She also found that there was no limit to Revels’
    ability to push and pull and that she could occasionally climb
    ramps and stairs, stoop, kneel, crouch, and crawl, but could
    never climb ladders, ropes, or scaffolds. She found that
    Revels had no reaching, handling, fingering, or feeling
    limitations.
    At the reconsideration level, Dr. Debra Rowse reviewed
    Revels’ medical records and largely agreed with Dr. Blando’s
    RFC assessment. She found that there was “no medical
    diagnosis for [Revels’] complaints of ‘pain everywhere.’”
    She gave little weight to Dr. Nolan’s opinion because his
    “exams do not meet the American College of
    Rheumatology’s or SSA’s diagnostic criteria for
    fibromyalgia.” Though her RFC assessment mostly matched
    Dr. Blando’s, Dr. Rowse found that Revels could frequently
    climb ramps and stairs and occasionally climb ladders, ropes,
    and scaffolds.
    REVELS V. BERRYHILL                      21
    4. Self-reporting and third-party evidence.
    In a function report dated March 14, 2011, Revels
    described her daily activities. In response to the prompt
    “Describe what you do from the time you wake up until going
    to bed,” she listed an array of activities: using the bathroom,
    brushing her teeth, washing her face, taking her children to
    school, washing dishes, doing laundry, sweeping, mopping,
    vacuuming, going to a doctor’s appointment for herself or for
    one of her children, visiting her mother and father, cooking,
    shopping, getting gas, and feeding her dogs. She repeated
    several times, however, that her ability to do those activities
    depended on how she felt and “what [her] health permit[ted].”
    She explained that she would do as much as possible “until
    [she couldn’t] do it anymore.” She “didn’t finish” many of
    the tasks she started, and often had to “take a break.” As she
    put it, “I just do what I can in a day’s work before I get tired
    and give up.”
    Throughout the function report, Revels reiterated the
    limitations on her daily activities. She stated that she had
    difficulty dressing, bathing, caring for her hair, shaving,
    feeding herself, and using the toilet. When she would prepare
    a complete meal, it took “all day” because she needed to take
    breaks. She was sometimes forced to split up grocery
    shopping into two trips. She had limited ability to squat,
    bend, stand, reach, kneel, sit, walk, or climb stairs, and also
    had difficulty holding things. To assist with her pain, she
    wore a back brace daily, a leg brace two to three times a
    week, and a splint every night for her hands. She stated that
    it took her four days to fill out the report.
    Revels completed a second function report on September
    28, 2011, in which she provided similar information. In
    22                 REVELS V. BERRYHILL
    addition to the above, she stated that she could not walk more
    than fifteen to twenty minutes without rest, and that her pain
    interfered with her ability to sleep. She also described a
    problem with burning herself while cooking because she
    would drop pots and pans. Revels’ mother and father filled
    out function reports describing many of the same issues.
    Revels’ father reported that he often went over to Revels’
    home to assist her with household chores.
    B. Revels’ Testimony Before the ALJ.
    At the hearing before the ALJ, Revels testified that she
    had stopped working as a phlebotomist on January 21, 2011,
    because she was in “extreme pain.” She had difficulty
    kneeling down to assist her patients and had to use the
    countertop to stabilize herself. She was concerned for her
    patients’ safety. When asked where she experiences pain,
    Revels responded, “All over.” She described her pain as
    “aching pains, sharp pains in [her] back, sharp pains in [her]
    wrist.” She also described numbness in her leg. In addition,
    she explained that she had issues with her hands “clos[ing]
    up” and “lock[ing]” on her. She testified that she no longer
    had problems with her left foot, although it did get swollen at
    times. She rated her pain, on average, as a seven out of ten,
    noting that it could become worse at times. She stated that
    her pain felt like “somebody[] [was] driving . . . a
    screwdriver” into her.
    Revels testified that she lived in a single-story home with
    her grandparents, three daughters (ages 13, 16, and 19), and
    three grandchildren (all younger than two years old). She
    explained that her pain was always present and limited her
    ability to do daily chores. She took her kids to school in the
    morning but then had difficulty completing tasks at home,
    REVELS V. BERRYHILL                    23
    such as laundry, mopping, and vacuuming. When asked how
    long she could vacuum, she answered, “Maybe 10,
    15 minutes tops.” She testified that she could do chores for
    only twenty to thirty minutes before she needed to take a
    break, and that she needed to lie down every day, usually for
    about an hour on average. Though she previously had dogs,
    she had to give them up six months before the hearing. She
    also explained that she had problems driving and using her
    cell phone because of her hand pain. She could not assist
    with taking care of her grandchildren because she was not
    able to hold them. She testified that she could stand for
    twenty to thirty minutes and sit for thirty to forty-five
    minutes, and also testified that she could walk no more than
    one block and lift no more than ten pounds.
    Revels explained that the hand injections she received
    from Dr. Nolan “t[ook] the edge off” and provided limited
    relief for a week. She relied on medication, however,
    because she could “only get so many shots.” She explained
    that the medications do not completely take away the pain
    and that she was experiencing side effects, including
    sleepiness and dizziness. She sometimes fell, and once had
    to go to the emergency room after falling in the shower. She
    explained that physical therapy had made her symptoms
    worse, as did facet and epidural injections. She felt better
    when sleeping, although she constantly had to change
    positions.
    C. Vocational Expert’s Testimony Before the ALJ.
    The vocational expert (“VE”) testified about the work
    capabilities of several hypothetical claimants. The ALJ first
    asked about a claimant who could do light exertional work
    with the following limitations: she could occasionally climb
    24                 REVELS V. BERRYHILL
    ladders, ropes, and scaffolds; occasionally stoop, crouch,
    kneel, and crawl; frequently balance and climb ramps or
    stairs; and needed to avoid irritants such as fumes, odors,
    dusts, and gases. The VE testified that such a claimant could
    do Revels’ past relevant work as a medical assistant and
    phlebotomist. The second hypothetical involved a claimant
    who was identical to the first but had bilateral manipulative
    limitations allowing her to frequently do activities such as
    reaching overhead, handling, fingering, and feeling. The VE
    testified that the hypothetical claimant could also work as a
    medical assistant and phlebotomist. The third hypothetical
    involved a claimant identical to the second, although the
    manipulative limitations were greater, allowing her to only
    occasionally do the highlighted activities. The VE testified
    that the claimant would not be able to do Revels’ past
    relevant work of medical assistant and phlebotomist.
    However, this person could work as a case aid, furniture
    rental clerk, and dressing room or tanning salon attendant. As
    a final hypothetical, the ALJ asked about a claimant with the
    same capabilities as in the second hypothetical, but who could
    only do sedentary, rather than light, work. The VE testified
    that the claimant could work as a receptionist.
    Revels’ attorney also presented several hypotheticals. He
    first presented a hypothetical based on Revels’ restrictions as
    described by treating rheumatologist Dr. Nolan. The VE
    testified that those limitations would preclude a claimant
    from doing any full-time work. Her attorney also asked about
    a claimant who needed to lie down for an average of one hour
    during a workday. The VE testified that this would likely
    preclude competitive employment because, though a typical
    employee is allowed an hour of break time, that time is
    broken up into two fifteen-minute breaks and one thirty-
    minute break. Finally, Revels’ attorney asked about Revels’
    REVELS V. BERRYHILL                     25
    limitations as described by physical therapist Richard
    Randall. The VE testified that those limitations would
    preclude Revels’ past work and any other work.
    V.
    We conclude that in determining the intensity,
    persistence, and limiting effects of Revels’ symptoms, the
    ALJ failed to provide legally sufficient reasons for rejecting
    the opinions of Dr. Nolan, physical therapist Richard Randall,
    and Nurse Practitioner Mager. He also erred in rejecting
    Revels’ symptom testimony and the reports from her mother
    and father. These errors arose from an apparent fundamental
    misunderstanding of fibromyalgia. The ALJ failed to
    properly analyze Revels’ fibromyalgia-related symptoms
    pursuant to SSR 12-2P, issued in 2012, and our court’s 2004
    opinion in Benecke v. Barnhart. This appears to be a
    recurrent problem. See Weiskopf v. Berryhill, No. 15-16008,
    
    2017 WL 2533445
    , at *2 (9th Cir. June 12, 2017) (“[T]he
    ALJ did not properly analyze Weiskopf’s evidence of
    fibromyalgia.”); Hamilton-Carneal v. Colvin, 670 F. App’x
    613, 613 (9th Cir. 2016) (“The ALJ therefore erred by
    discounting Hamilton-Carneal’s ‘subjective complaints and
    limitations’ [resulting from fibromyalgia] as ‘simply out of
    proportion to and not corroborated by the objective medical
    evidence.’”); Payan v. Colvin, 672 F. App’x 732, 732 (9th
    Cir. 2016) (“The ALJ failed to properly assess Payan’s
    residual functional capacity (“RFC”) in light of Social
    Security Ruling 12-2p.”); Benecke, 
    379 F.3d at 594
     (“[T]he
    ALJ erred in discounting the opinions of Benecke’s treating
    physicians, relying on his disbelief of Benecke’s symptom
    testimony as well as his misunderstanding of fibromyalgia.”).
    In evaluating whether a claimant’s residual functional
    capacity renders them disabled because of fibromyalgia, the
    26                 REVELS V. BERRYHILL
    medical evidence must be construed in light of fibromyalgia’s
    unique symptoms and diagnostic methods, as described in
    SSR 12-2P and Benecke. The failure to do so is error, as is
    true here.
    A. The ALJ Erred by Giving The Medical Opinion of
    Treating Physician Dr. Nolan “No Weight.”
    Dr. Nolan treated Revels at least twelve times between
    2010 and 2012, and was thus one of Revels’ treating
    physicians. See 
    20 C.F.R. § 404.1527
    (a)(2). In determining
    Revels’ RFC, the ALJ gave “[n]o weight” to Dr. Nolan’s
    medical opinion of her symptoms and her functional
    limitations.
    Dr. Nolan’s opinion of Revels’ functional limitations was
    contradicted by the findings of Dr. Rowse and Dr. Blando,
    the nonexamining doctors from the state agency, and, to some
    extent, the opinion of Dr. Ruggeri, the hand specialist.
    Therefore, in rejecting Dr. Nolan’s opinion, the ALJ was
    required to provide specific and legitimate reasons supported
    by substantial evidence. He failed to do so.
    The ALJ first stated that Dr. Nolan’s opinion was
    “conclusory, with little explanation in how he determined the
    claimant’s functional limitations.” However, the record
    demonstrates that after each of his appointments with Revels,
    Dr. Nolan provided a detailed account of the visit, including
    Revels’ complaints of pain, the effectiveness of the
    prescribed medication or injections, and his findings on the
    current state of her fibromyalgia. Moreover, along with his
    assessment of Revels’ functional limitations, he included a
    two-page, single-spaced letter describing the basis for his
    findings. He explained Revels’ medical history, her repeated
    REVELS V. BERRYHILL                     27
    complaints of pain, the medical evidence of fibromyalgia, her
    response to prescribed medications, and his analysis of other
    doctors’ findings. Therefore, the ALJ’s dismissal of Dr.
    Nolan’s opinion as conclusory is not supported by the record.
    The ALJ next found that Dr. Nolan’s opinion was
    “inconsistent with . . . [his] own treatment notes.” He stated
    that Dr. Nolan could not have determined that Revels was
    restricted in sitting, standing, or walking because his
    treatment notes were “invariably focused on [Revels’]
    experience of hand pain.” However, Dr. Nolan’s notes
    consistently discuss Revels’ neck and back pain. Moreover,
    Dr. Nolan was treating Revels for fibromyalgia, a condition
    that involves “chronic pain throughout the body.” Benecke
    
    379 F.3d at 590
    .
    The ALJ further erred by relying on four visits during
    which Dr. Nolan found that parts of Revels’ body were
    “nontender” and that she had a “normal range of motion.”
    Lacking certain tender points does not rule out fibromyalgia-
    related symptoms, since a doctor need only find eleven out of
    eighteen tender points to diagnose the condition. Moreover,
    a person with fibromyalgia may have “muscle strength,
    sensory functions, and reflexes [that] are normal.” Rollins,
    
    261 F.3d at 863
     (Ferguson, J., dissenting) (quoting Yunus,
    supra, at 1260).
    In addition, the ALJ rejected Dr. Nolan’s opinion because
    it was supposedly not “supported by objective medical
    evidence.” The ALJ pointed to several tests that yielded
    normal results: a nerve conduction and velocity study of
    Revels’ hands by Dr. Ruggeri, as well as wrist X-rays and
    spine MRIs. He took issue with Dr. Nolan’s tender-point
    examinations because they were “solely based on subjective
    28                     REVELS V. BERRYHILL
    pain complaints,” and he also noted that, at multiple
    appointments, Revels showed less than eleven out of eighteen
    tender points. This analysis demonstrates a fundamental lack
    of knowledge about fibromyalgia. Fibromyalgia is diagnosed
    “entirely on the basis of patients’ reports of pain and other
    symptoms,” and “there are no laboratory tests to confirm the
    diagnosis.” Benecke, 
    379 F.3d at 590
    . Pursuant to SSR 12-
    2P, tender-point examinations themselves constitute
    “objective medical evidence” of fibromyalgia. 
    Id.
     at *2–3.
    Moreover, the symptoms of fibromyalgia “wax and wane,”
    and a person may have “bad days and good days.” Id. at *6.
    That is why the Social Security Administration recommends
    looking at longitudinal records, see id., as Dr. Nolan did. At
    five out of eight appointments, Revels had eleven or more
    tender points, the cutoff for a diagnosis of fibromyalgia under
    SSR 12-2P’s first set of criteria.4
    Finally, the ALJ stated that Dr. Nolan’s findings were
    inconsistent with Revels’ “own assertions and testimony.”
    He pointed to Revels’ remark to Dr. Ruggeri that “she was
    independent in daily activities,” as well as Revels’ testimony
    that she did various household tasks. However, the ALJ
    omitted highly relevant qualifications to this statement. For
    example, when Revels described to Dr. Ruggeri that she was
    independent, she also added that she “requires a longer time
    to complete tasks,” and that her goal was to “return to normal
    activities.” The record actually demonstrates that Dr. Nolan’s
    4
    The dissent defends the ALJ’s finding that Revels was only partially
    credible and the ALJ’s dismissal of the opinions of Dr. Nolan, Randall,
    Dr. Wolfson, and Nurse Practitioner Mager on the basis of contradictory
    objective tests. In so doing, like the ALJ, the dissent fails to evaluate
    Revels’ testimony and her medical record in light of fibromyalgia’s unique
    symptoms and diagnostic methods, as described in SSR12-2P and
    Benecke.
    REVELS V. BERRYHILL                             29
    findings were consistent with Revels’ descriptions of her
    daily activities. Revels repeatedly stated—to her doctors and
    physical therapists, in her function reports, and at her
    hearing—that she struggled to complete household tasks
    because she needed to take numerous breaks. Revels’ ability
    to complete some household tasks was perfectly consistent
    with Dr. Nolan’s opinion of Revels’ limited functional
    capacity. Dr. Nolan did not find that Revels was bedridden.
    He found that she needed significant breaks when sitting or
    standing, and needed to recline for at least an hour each day.
    The only remaining reason the ALJ gave for rejecting Dr.
    Nolan’s opinion was the contradictory opinions of the state
    doctors.5 Both doctors found that Revels’ functional
    limitations were significantly less than those found by Dr.
    Nolan. However, the opinions of nonexamining doctors
    “cannot by [themselves] constitute substantial evidence that
    justifies the rejection of the opinion of either an examining
    physician or a treating physician.” Lester, 81 F.3d at 831
    (emphasis in original).
    Even if the ALJ had pointed to substantial evidence
    supporting the decision not to give Dr. Nolan’s opinion
    controlling weight, he failed to explain why Dr. Nolan’s
    opinion deserved “no weight” at all. When a treating
    provider’s opinion is not entitled to “controlling weight”
    because of substantial contradictory evidence, that opinion is
    5
    The ALJ also stated that Dr. Nolan’s opinion was contradicted by
    Dr. Cunningham and “other treating doctors,” but he did not explain what
    he meant. Dr. Cunningham did not provide a functional capacity
    evaluation, so it is unclear what discrepancy the ALJ might have been
    referring to. And it is similarly unclear what “other treating doctors” the
    ALJ was referring to.
    30                 REVELS V. BERRYHILL
    still “entitled to deference” based on factors such as the
    length and nature of the treatment relationship. Orn,
    
    495 F.3d at
    632–33; see also 
    20 C.F.R. § 404.1527
    (c). Here,
    there were strong reasons to defer to Dr. Nolan’s opinion. Dr.
    Nolan had the most extensive treatment relationship with
    Revels. Moreover, a rheumatologist’s specialized knowledge
    is “particularly important with respect to a disease such as
    fibromyalgia that is poorly understood within much of the
    medical community.” Benecke, 
    379 F.3d at
    594 n.4. As a
    result, we have previously given a rheumatologist’s opinion
    of a claimant’s fibromyalgia “greater weight than those of the
    other physicians because it is an opinion of a specialist about
    medical issues related to his or her area of specialty.” 
    Id.
    (internal quotation marks omitted).
    The ALJ did not provide “specific and legitimate reasons”
    to reject Dr. Nolan’s opinion, and he failed to follow the
    appropriate methodology for weighting a treating physician’s
    medical opinion. Accordingly, we conclude that the ALJ
    erred in giving Dr. Nolan’s opinion no weight. The ALJ
    should have instead found it to be controlling as to the
    intensity, persistence, and limiting effects of Revels’
    fibromyalgia. Because the VE testified that a claimant with
    the physical limitations outlined in Dr. Nolan’s medical
    opinion would be unable to do any full-time work, Dr.
    Nolan’s opinion “alone establishes that [Revels] is entitled to
    benefits.” Lingenfelter, 
    504 F.3d at
    1041 n.12 (emphasis in
    original).
    B. The Agency Erred by Failing to Credit the Opinion of
    Nurse Practitioner Mager.
    Mager is a nurse practitioner who saw Revels at least ten
    times between 2010 and 2012. She assisted in treating
    REVELS V. BERRYHILL                    31
    Revels’ chronic pain and referred her to pain-management
    specialist Dr. Doust, rheumatologist Dr. Nolan, and hand
    specialist Dr. Ruggeri. She consistently saw Revels during
    her pain treatment and received reports from the specialists.
    She filled out a check-the-box assessment of Revels’
    functional limitations which, like Dr. Nolan’s assessment,
    indicated severe restrictions on Revels’ abilities. That form
    was not submitted until after the ALJ’s decision, but the
    Appeals Council considered it and made it part of the record.
    Though Mager’s opinion was submitted after the ALJ’s
    decision, we may consider it in determining whether the
    ALJ’s decision was supported by substantial evidence. See
    Brewes, 682 F.3d at 1163. Also, though Mager is not an
    “acceptable medical source,” she is an “other source” and
    there are strong reasons to assign weight to her opinion.
    Mager was a treating source who examined Revels at least ten
    times over two years. See 
    20 C.F.R. § 404.1527
    (c)(1)–(2), (f)
    (explaining that an opinion from a source who has examined
    the claimant and had a longer treatment relationship should
    generally be given greater weight). Moreover, Mager was in
    a unique position as a primary care provider, as she received
    reports from specialists and had an overview of Revels’
    conditions. See 
    id.
     § 404.1527(c)(2)(ii) (in determining the
    weight that should be given to an opinion, the ALJ should
    look at “the treatment the source has provided and . . . the
    kinds and extent of examinations and testing the source has
    performed or ordered from specialists”). Moreover, her
    check-the-box assessment was co-signed by an acceptable
    medical source in her clinic, Dr. Richard Wolfson. Mager’s
    opinion thus provides additional support to our conclusion
    that the ALJ’s rejection of Dr. Nolan’s opinion was not
    supported by substantial evidence.
    32                 REVELS V. BERRYHILL
    C. The ALJ Erred by Failing to State Germane Reasons
    for Rejecting Physical Therapist Randall’s Functional
    Capacity Evaluation.
    Randall is a physical therapist who saw Revels once at the
    request of her attorney. He conducted a functional capacity
    evaluation and afterward prepared a nine-page report on his
    findings. He found that Revels had limitations similar to
    those found by Dr. Nolan and Mager. Even though Randall’s
    opinion is not entitled to the same deference as “acceptable
    medical sources,” the ALJ erroneously afforded his opinion
    no weight by failing to provide germane reasons for its
    rejection. Molina, 
    674 F.3d 1111
    .
    First, the ALJ stated that Randall’s opinion of Revels’
    limitations was “far beyond what is supported by objective
    testing.” Again, this reasoning was based on a flawed
    understanding of fibromyalgia, which cannot be diagnosed by
    what the ALJ considered to be “objective testing.” Second,
    the ALJ stated that Randall’s opinion was inconsistent with
    those of Dr. Cunningham, Dr. Rowse, Dr. Blando, and Dr.
    Ruggeri. However, Dr. Cunningham never provided an
    evaluation of Revels’ functional capacity, and though Dr.
    Ruggeri “encouraged” Revels to go back to work, he never
    opined on her specific functional limitations. While the ALJ
    is correct that Randall’s opinion was inconsistent with the
    opinions of Dr. Rowse and Dr. Blando—neither of whom
    examined Revels—he failed to note that it was consistent
    with that of her treating rheumatologist, Dr. Nolan.
    Moreover, though Randall only examined Revels once, he
    examined her for three-and-a-half hours and extensively
    reviewed the medical records from other doctors, ultimately
    producing a nine-page report.
    REVELS V. BERRYHILL                      33
    D. The ALJ Did Not Provide Clear and Convincing Reasons
    to Reject Revels’ Testimony.
    Revels testified at length about her symptoms and her
    functional limitations. She also completed two written
    function reports and submitted third-party function reports
    from her mother and father. The ALJ found that Revels’
    “medically determinable impairments could reasonably be
    expected to cause the alleged symptoms,” and he did not
    make a finding of malingering. Nevertheless, he concluded
    that her symptom testimony was “not entirely credible to the
    extent [it was] inconsistent with the . . . residual functional
    capacity assessment.” He also assigned little weight to the
    third-party reports from Revels’ mother and father.
    The ALJ took a backward approach to determining
    Revels’ credibility. He found that Revels’ testimony was not
    credible “to the extent [it was] inconsistent with the . . .
    [RFC].” However, an ALJ must take into account a
    claimant’s symptom testimony when determining the RFC.
    Laborin v. Berryhill, 
    867 F.3d 1151
    , 1154 (9th Cir. 2017);
    Trevizo v. Berryhill, 
    862 F.3d 987
    , 1000 n.6 (9th Cir. 2017).
    To determine the RFC first and then assess the claimant’s
    testimony is to “put[] the cart before the horse.” Laborin,
    867 F.3d at 1154. The ALJ’s approach is “inconsistent with
    the Social Security Act and should not be used in disability
    decisions.” Id. at 1153; see also Trevizo, 862 F.3d at 1000
    n.6. Though this may not itself be reversible error, when
    taken together with the ALJ’s failure to provide “clear and
    convincing” reasons for rejecting Revels’ testimony, we
    cannot conclude anything other than that the ALJ’s failure to
    credit Revels’ testimony was error. Like his rejection of the
    opinions of Dr. Nolan and physical therapist Randall, the ALJ
    34                 REVELS V. BERRYHILL
    did not consider Revels’ testimony in light of her
    fibromyalgia diagnosis.
    The ALJ stated that Revels’ testimony was undercut by
    the lack of “objective findings” supporting her claims of
    severe pain. He highlighted several examinations that had
    mostly normal results, such as an X-ray and MRIs of Revels’
    neck and back, as well as the nerve conduction and velocity
    study of her hands. He also cited medical records showing
    that, at several doctor’s appointments, Revels exhibited
    normal muscle strength, tone, and stability, as well as a
    normal range of motion. This reasoning was similar to his
    reasoning for rejecting Dr. Nolan’s opinion, and was similarly
    erroneous. As described above, the examination results cited
    by the ALJ are perfectly consistent with debilitating
    fibromyalgia. The condition is diagnosed “entirely on the
    basis of patients’ reports of pain and other symptoms,” and
    “there are no laboratory tests to confirm the diagnosis.”
    Benecke, 
    379 F.3d at 590
    . Indeed, fibromyalgia is diagnosed,
    in part, by evidence showing that another condition does not
    account for a patient’s symptoms. SSR 12-2P, at *3.
    The ALJ also noted that Dr. Ruggeri had encouraged
    Revels “to go back to some gainful work,” and that Dr. Bair
    had asserted that Revels’ feet were “fine.” Neither doctor’s
    opinion provided a legitimate reason for rejecting Revels’
    testimony. Dr. Ruggeri’s offhand recommendation that
    Revels go back to work was based on his examination of her
    hands, and Dr. Bair’s evaluation only pertained to her feet.
    Neither evaluated Revels’ fibromyalgia. Therefore, their
    opinions merited much less weight than Dr. Nolan’s, who
    specifically treated Revels for fibromyalgia, and whose
    medical opinion matched Revels’ testimony. See 
    20 C.F.R. § 404.1527
    (c)(2)(ii) (“For example, if your ophthalmologist
    REVELS V. BERRYHILL                              35
    notices that you have complained of neck pain during your
    eye examinations, we will consider his or her medical opinion
    with respect to your neck pain, but we will give it less weight
    than that of another physician who has treated you for the
    neck pain.”).
    The ALJ also erred in rejecting Revels’ testimony on
    account of the supposedly “conservative” treatment she
    received. Any evaluation of the aggressiveness of a treatment
    regimen must take into account the condition being treated.
    Revels received facet and epidural injections in her neck and
    back, as well as steroid injections in her hands. She was
    prescribed a variety of medications for her pain, including
    Valium, Vlector, Soma, Vicodin, Percocet, Neurontin,
    Robaxin, Trazodone, and Lyrica. The ALJ provided no
    explanation why he deemed this treatment “conservative” for
    fibromyalgia. We have previously “doubt[ed] that epidural
    steroid shots to the neck and lower back qualify as
    ‘conservative’ medical treatment.” Garrison, 759 F.3d at
    1015 n.20. Further, Revels’ treatment was significantly more
    aggressive than the type of fibromyalgia treatment we found
    to be conservative in Rollins v. Massanari.6
    6
    In Rollins, we found the treatment conservative only after noting that
    the doctor had primarily recommended that the petitioner “avoid strenuous
    activities.” 
    261 F.3d at 856
    . Moreover, Rollins’ analytical approach to
    fibromyalgia disability claims is now questionable. We decided that case
    eleven years before SSR 12-2P, when it was still unclear whether
    fibromyalgia could “constitute a qualifying ‘severe impairment’ under the
    Act.” 
    Id. at 857
    . We only assumed, for the purposes of the opinion, that
    it was. In light of SSR 12-2P and our opinion in Benecke, 
    379 F.3d 587
    ,
    fibromyalgia is now unquestionably a qualifying impairment.
    Additionally, we did not acknowledge in Rollins that fibromyalgia
    symptoms wax and wane, and that a person suffering from the disease
    may not display symptoms ordinarily associated with joint and muscle
    pain. Our failure to do so was contrary to the more-developed, later
    36                    REVELS V. BERRYHILL
    Finally, the ALJ erred in finding that there was “wide
    disparity” between Revels’ symptom testimony and her
    reports of her daily activities. Though inconsistent daily
    activities may provide a justification for rejecting symptom
    testimony, “the mere fact that a plaintiff has carried on certain
    daily activities . . . does not in any way detract from her
    credibility as to her overall disability.” Benecke, 
    379 F.3d at 594
     (alteration in original) (quoting Vertigan v. Halter,
    
    260 F.3d 1044
    , 1050 (9th Cir. 2001)). A claimant “does not
    need to be utterly incapacitated in order to be disabled.” 
    Id.
    (quoting Vertigan, 
    260 F.3d at 1050
    ). The ALJ relied on
    Revels’ function report in which she listed a number of
    activities she might do in a day: using the bathroom, brushing
    her teeth, washing her face, taking her children to school,
    washing dishes, doing laundry, sweeping, mopping,
    vacuuming, going to a doctor’s appointment for her or for one
    of her children, visiting her mother and father, cooking,
    shopping, getting gas, and feeding her dogs. He failed to
    acknowledge that, over and over in the same report, Revels
    explained that she could complete only some of the tasks in
    a single day and regularly needed to take breaks—which was
    consistent with her symptom testimony. Further, Revels’
    description of her daily activities differed in large measure
    from the petitioner’s in Rollins. There, we rejected the
    petitioner’s testimony regarding her fibromyalgia-related
    symptoms because she “was equivocal about how regularly
    she was able to keep up with all of [her] activities.” 
    261 F.3d at 857
    . Revels, however, repeatedly and consistently
    knowledge about fibromyalgia set forth in SSR 12-2P and Benecke, both
    of which recognize that an ALJ must evaluate the record in light of the
    unique characteristics of fibromyalgia.
    REVELS V. BERRYHILL                          37
    described the severe limitations on her ability to complete
    daily activities.7
    Consequently, the ALJ failed to meet the high bar for
    rejecting a claimant’s symptom testimony. For similar
    reasons, he erred in assigning little weight to the reports
    submitted by Revels’ mother and father. He found that their
    reports were inconsistent with objective medical evidence and
    with Revels’ description of her daily activities. As described
    above, that reasoning was erroneous, and not only does it not
    constitute “clear and convincing” evidence for rejecting
    Revels’ testimony, it does not constitute “germane” reasons
    for rejecting the third-party function reports of Revels’
    mother and father.
    VI.
    “The decision whether to remand a case for additional
    evidence, or simply to award benefits[,] is within the
    discretion of the court.” Sprague v. Bowen, 
    812 F.2d 1226
    ,
    1232 (9th Cir. 1987) (remanding for determination of benefits
    where the panel was “convinced that substantial evidence
    does not support the Secretary’s decision, and because no
    legitimate reasons were advanced to justify disregard of the
    treating physician’s opinion”). “[I]f additional proceedings
    can remedy defects in the original administrative proceeding,
    a social security case should be remanded” for further
    proceedings. Garrison, 759 F.3d at 1019 (quoting Lewin v.
    7
    The ALJ also stated that Revels was not credible because she
    inconsistently reported her marijuana usage and her pain levels. On
    appeal, the Commissioner does not defend either as a valid ground for
    rejecting Revels’ symptom testimony, and thus we do not address them
    here.
    38                      REVELS V. BERRYHILL
    Schweiker, 
    654 F.2d 631
    , 635 (9th Cir. 1981)). Generally,
    however, where “(1) the record has been fully developed and
    further administrative proceedings would serve no useful
    purpose; (2) the ALJ has failed to provide legally sufficient
    reasons for rejecting evidence, whether claimant testimony or
    medical opinion; and (3) if the improperly discredited
    evidence were credited as true, the ALJ would be required to
    find the claimant disabled on remand,” id. at 1020, we
    remand for an award of benefits.8
    We find that each of these credit-as-true factors is
    satisfied and that remand for the calculation and award of
    benefits is warranted. First, the record has been fully
    developed. It includes treatment notes from over fifty
    medical visits from 2010 to 2012, as well as additional
    medical records stretching back to 2002. It contains
    functional capacity assessments from two treating providers
    and two nonexamining doctors. It also includes Revels’
    testimony about the severity of her symptoms, two function
    reports filled out by Revels, and function reports filled out by
    her mother and her father. Most importantly, the VE was
    asked hypotheticals about the ability of an individual with
    Revels’ physical limitations as described by Dr. Nolan, and
    testified that those limitations were inconsistent “with the
    performance of [Revels’] past work or any other full-time
    work.”
    The other two credit-as-true factors are also satisfied. The
    ALJ failed to provide legally sufficient reasons for rejecting
    8
    In rare instances, though each of the credit-as-true factors is met, the
    record as a whole leaves serious doubt as to whether the claimant is
    actually disabled, see Garrison, 759 F.3d at 1021, in which case we
    remand for further development of the record.
    REVELS V. BERRYHILL                             39
    the medical opinion of Revels’ treating rheumatologist and
    for rejecting Revels’ testimony about her symptoms. He also
    erred in rejecting the medical opinion of Revels’ physical
    therapist and in rejecting the lay opinions of Revels’ mother
    and father. If credited as true, Dr. Nolan’s opinion
    establishes that Revels is disabled, because the VE testified
    that someone with the limitations established by Dr. Nolan
    could not work. Further, there is no “serious doubt” that,
    based on “the record as a whole,” Revels is in fact disabled.
    Her impairment of fibromyalgia has been repeatedly
    substantiated by tender-point examinations, which SSR 12-2P
    establishes as proper evidence of the condition. Moreover,
    Revels’ testimony, her function reports, and the treatment
    notes from her doctors consistently show that she was
    suffering from severe pain.9
    We therefore reverse the judgment of the district court
    with instructions to remand to the ALJ for the calculation and
    award of benefits.
    REVERSED; REMANDED WITH INSTRUCTIONS.
    9
    Because we find that the record on appeal establishes Revels’
    disability and functional limitations, we need not reach Revels’ contention
    that the Appeals Council erred in failing to include additional evidence in
    the administrative record.
    40                       REVELS V. BERRYHILL
    KLEINFELD, Senior Circuit Judge, dissenting:
    I respectfully dissent.      The ALJ’s credibility
    determination was adequately supported.1 Even if we might
    disagree with his finding that Revels could perform light
    work, it was nevertheless supported by “substantial
    evidence.”2
    I.
    This case does not turn on whether Revels has
    fibromyalgia. Instead, the issue is Revels’ “residual
    functional capacity.” Based on the evidence in the record, the
    ALJ found that Revels could perform light work. In so doing,
    he found that Revels’ “statements concerning the intensity,
    persistence and limiting effects” of her fibromyalgia were
    “not entirely credible” because they were inconsistent with
    medical evidence and her own testimony.
    According to the majority, this was incorrect because
    Social Security Ruling 12-2p3 says that fibromyalgia is
    actually characterized by inconsistent symptoms. But the
    1
    See Morgan v. Comm’r of Soc. Sec. Admin., 
    169 F.3d 595
    , 599 (9th
    Cir. 1999); see also Turner v. Comm’r of Soc. Sec., 
    613 F.3d 1217
    , 1225
    (9th Cir. 2010) (upholding a partial credibility finding because of
    discrepancies in the claimant’s testimony).
    2
    See Young v. Sullivan, 
    911 F.2d 180
    , 183 (9th Cir. 1990)
    (“Substantial evidence means more than a mere scintilla, but less than a
    preponderance.”) (citations and quotation marks omitted).
    3
    
    77 Fed. Reg. 43,640
     (July 25, 2012).
    REVELS V. BERRYHILL                 41
    majority errs because it reads Ruling 12-2p too broadly and
    because it gives short shrift to Rollins v. Massanari.4
    A. Ruling 12-2p provides extensive guidance about what
    constitutes a fibromyalgia diagnosis.5          It notes that
    fibromyalgia symptoms often come and go. But when it
    comes to the residual functional capacity of a person with
    fibromyalgia, this is what Ruling 12-2p says: “For a person
    with [fibromyalgia], we will consider a longitudinal record
    whenever possible because the symptoms of [fibromyalgia]
    can wax and wane so that a person may have ‘bad days and
    good days.’”6 And when it comes to evaluating “the intensity
    and persistence” of a person’s symptoms, Ruling 12-2p says
    that the ALJ considers “all of the evidence in the case record”
    if the claimant’s testimony is not backed up by “objective
    medical evidence.”7
    The ALJ’s determination that Revels can perform light
    work is consistent with Ruling 12-2p. The record spans a
    thousand pages and describes multiple doctors treating and
    examining Revels between 2010 and 2012. That counts as
    a “longitudinal record.” Based on that record, the ALJ
    found Revels to be only partially credible because
    objective tests—like Dr. Ruggeri’s analysis of her hand
    functioning—contradicted Revels’ own function reports.
    That is not the same as saying that Revels is only partially
    4
    
    261 F.3d 853
     (9th Cir. 2001).
    5
    See 77 Fed. Reg. at 43,641–43.
    6
    Id. at 43,644.
    7
    Id. at 43,643.
    42                          REVELS V. BERRYHILL
    credible because her symptoms were inconsistent over time.
    Revels’ symptoms may “wax and wane,” but having good
    days and bad days does not contradict the ALJ’s findings that
    she had enough capacity to perform light work.
    B. Not only is the ALJ’s credibility determination
    consistent with Ruling 12-2p, but it is also supported by
    precedent.
    In Rollins v. Massanari, we assumed without deciding
    that Rollins had a severe impairment of fibromyalgia.8 We
    then held that when determining functional capacity, Rollins’
    subjective pain testimony could be discounted by her
    “testimony about her 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, and so forth.”9 This was despite the
    fact that Rollins was “somewhat equivocal about how
    regularly she was able to keep up with all of these
    activities.”10
    Rollins controls here. Revels believes that her pain and
    need for breaks during daily activities means that she lacks
    the capacity for light work. But even though she may have to
    take breaks in her chores, it was permissible for the ALJ to
    find that Revels’ activity level is inconsistent with the severe
    pain that she describes. Revels describes her pain as being a
    constant 7 out of 10, sometimes increasing to 8, 9, or even
    8
    
    261 F.3d at 857
    .
    9
    
    Id.
    10
    
    Id.
    REVELS V. BERRYHILL                          43
    “greater than 10.” To a doctor, that means that Revels
    experienced constant “severe” pain, sometimes increasing to
    the “worst pain imaginable.”11 It was reasonable to infer that
    someone in that much pain cannot clean a house or take care
    of infants, even with breaks. This inference is supported by
    Dr. Rowse’s statement that Revels’ claims were inconsistent
    with her activities.        The ALJ discussed Revels’
    inconsistencies in his decision, thus giving compelling
    reasons for partially discounting her testimony.
    Despite the majority’s statement to the contrary, Rollins’s
    approach is not “questionable.” It is irrelevant that Rollins
    was decided before Ruling 12-2p was issued. Even if Ruling
    12-2p had been in effect, Rollins would have been decided
    the same way: Rollins would have met the requirements for
    a fibromyalgia diagnosis, but her residual functional capacity
    would have shown that she could still perform some work.
    II.
    Just as the ALJ properly found that Revels was not wholly
    credible, he also permissibly dismissed medical testimony
    supporting Revels’ position.
    Revels’ examining physician, Dr. Nolan, provided only
    conclusory reasons for his findings, and almost all of his
    opinions were check-box forms. His description of Revels’
    medical issues was also contradicted by objective medical
    11
    Harald Breivik et al., Assessment of pain, 101 BRIT. J. OF
    ANAESTHESIA 17, 18 (2008); see CHRIS PASERO & MARGO MCCAFFERY,
    PAIN ASSESSMENT AND PHARMACOLOGIC MANAGEMENT 56 (2011);
    Amelia Williamson & Barbara Hoggart, Pain: a review of three commonly
    used pain rating scales, 14 J. CLINICAL NURSING 798, 799–800 (2005).
    44                       REVELS V. BERRYHILL
    evidence and Revels’ own activity levels. And “when
    evaluating conflicting medical opinions, an ALJ need not
    accept the opinion of a doctor if that opinion is brief,
    conclusory, and inadequately supported by clinical
    findings.”12
    The findings of Revels’ physical trainer, Richard Randall,
    were not supported by objective medical tests, and they were
    contradicted by Dr. Ruggeri’s opinion. Also, Randall is not
    an “acceptable medical source” under the Social Security
    regulations,13 so he is not entitled to the same deference that
    a physician receives.14
    The questionnaire signed by Dr. Wolfson and Nurse
    Practitioner Jacqueline Mager was a check-box form that is
    contradicted by objective medical evidence and Revels’
    ability to perform tasks like cleaning and caring for her
    grandchildren. Because Ms. Mager is a nurse practitioner,
    her opinion also receives less deference than a physician’s (at
    least to the extent she did not work under Dr. Wolfson’s
    “close supervision”).15
    12
    Bayliss v. Barnhart, 
    427 F.3d 1211
    , 1216 (9th Cir. 2005); see also
    Crane v. Shalala, 
    76 F.3d 251
    , 253 (9th Cir. 1996) (holding that an ALJ
    “permissibly rejected” three psychological evaluations “because they were
    check-off reports that did not contain any explanation of the bases of their
    conclusions”).
    13
    
    71 Fed. Reg. 45,593
    , 45,594 (Aug. 9, 2006); see also 
    82 Fed. Reg. 5,844
    , 5,846–47 (Jan. 18, 2017).
    14
    Molina v. Astrue, 
    674 F.3d 1104
    , 1111 (9th Cir. 2012).
    15
    Id.; 71 Fed. Reg. at 45,594. The new rule defining nurse
    practitioners as “acceptable” sources had not yet taken effect. See 82 Fed.
    Reg. at 5,844, 5,846.
    REVELS V. BERRYHILL                    45
    The ALJ therefore gave each of these testimonies its due.
    III.
    Revels evidently has fibromyalgia. She doubtless feels
    pain or discomfort much of the time. Whether its severity
    prevents her from working is a question different from
    whether she has the disease. Medical conditions affect
    different people differently, and just because someone says
    they feel excruciating pain does not make it so. In this
    appeal, Revels does not establish that the ALJ’s conclusions
    were unsupported by substantial evidence. We should have
    affirmed the ALJ’s decision.
    Therefore, I respectfully dissent.
    

Document Info

Docket Number: 15-16477

Citation Numbers: 874 F.3d 648

Filed Date: 10/26/2017

Precedential Status: Precedential

Modified Date: 1/12/2023

Authorities (22)

Orn v. Astrue , 495 F.3d 625 ( 2007 )

58-socsecrepser-332-unemplinsrep-cch-p-16105b-98-cal-daily-op , 157 F.3d 715 ( 1998 )

Lingenfelter v. Astrue , 504 F.3d 1028 ( 2007 )

Jana M. Bayliss v. Jo Anne B. Barnhart, Commissioner, ... , 427 F.3d 1211 ( 2005 )

Coreen L. SPRAGUE, Plaintiff-Appellant, v. Otis R. BOWEN, ... , 812 F.2d 1226 ( 1987 )

James T. YOUNG, Plaintiff-Appellee, v. Louis W. SULLIVAN, M.... , 911 F.2d 180 ( 1990 )

Helen Lewin v. Richard S. Schwieker, Secretary of Health ... , 654 F.2d 631 ( 1981 )

Molina v. Astrue , 674 F.3d 1104 ( 2012 )

Ryan v. Commissioner of Social Security , 528 F.3d 1194 ( 2008 )

Betty J. DODRILL, Plaintiff-Appellant, v. Donna SHALALA, ... , 12 F.3d 915 ( 1993 )

Kathryn C. Rollins v. Larry G. Massanari, Acting ... , 261 F.3d 853 ( 2001 )

Turner v. Commissioner of Social Security , 613 F.3d 1217 ( 2010 )

60-socsecrepser-541-unemplinsrep-cch-p-16155b-1999-daily-journal , 169 F.3d 595 ( 1999 )

50-socsecrepser-134-unemplinsrep-cch-p-15093b-96-cal-daily-op , 76 F.3d 251 ( 1996 )

Robert H. DESROSIERS, Plaintiff-Appellant, v. SECRETARY OF ... , 846 F.2d 573 ( 1988 )

Clementine COTTON, Plaintiff-Appellant, v. Otis BOWEN, ... , 799 F.2d 1403 ( 1986 )

Mary M. MAGALLANES, Plaintiff-Appellant, v. Otis R. BOWEN, ... , 881 F.2d 747 ( 1989 )

Shirley J. Vertigan v. William A. Halter, Acting ... , 260 F.3d 1044 ( 2001 )

Kathryn L. Benecke v. Jo Anne B. Barnhart, Commissioner of ... , 379 F.3d 587 ( 2004 )

QUANG VAN HAN, Plaintiff-Appellant, v. Otis R. BOWEN, ... , 882 F.2d 1453 ( 1989 )

View All Authorities »