The opinion of the court was delivered by: Craig M. Kellison United States Magistrate Judge
MEMORANDUM OPINION AND ORDER
Plaintiff, who is proceeding with retained counsel, brings this action for judicial review of a final decision of the Commissioner of Social Security under 42 U.S.C. § 405(g). Pursuant to the written consent of all parties, this case is before the undersigned as the presiding judge for all purposes, including entry of final judgment. See 28 U.S.C. § 636(c). Pending before the court are plaintiff's motion for summary judgment (Doc. 15) and defendant's cross-motion for summary judgment (Doc. 18).
Plaintiff applied for social security benefits protectively on April 28, 2006. In the application, plaintiff claims that her disability began on October 1, 2003. Plaintiff claims that her disability is caused by a combination of back pain, chest pain, severe obesity (BMI of 57), varicose veins, high blood pressure, left hand pain, and leg pain. Plaintiff's claim was initially denied. Following denial of reconsideration, plaintiff requested an administrative hearing, which was held on May 2, 2008, before Administrative Law Judge ("ALJ") Mark C. Ramsey. In a June 10, 2008, decision, the ALJ concluded that plaintiff is not disabled based on the following findings:
1. The claimant has not engaged in substantial gainful activity since April 28, 2006, the application date (20 CFR 416.920(b) and 404.971 et seq.).
2. The claimant has the following severe impairment: Varicose veins in the lower extremities, and morbid obesity (20 CFR 416.920(c)).
3. The claimant does not have an impairment or combination of impairments that meets or medically equals one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 416.925 and 416.926).
4. After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform the full range of light work as defined in 20 CFR 416.967(b). Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this category when it requires a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered capable of performing a full or wide range of light work, an individual must have the ability to do substantially all of these activities. If someone can do light work, we determine that he can also do sedentary work, unless there are additional limiting factors such as loss of fine dexterity or inability to sit for long periods.
5. The claimant is capable of performing her past relevant work as a Bookkeeper. This work does not require the performance of work-related activities precluded by the claimant's residual functional capacity (20 CFR 416.965).
6. The claimant has not been under a disability, as defined in the Social Security Act, since April 28, 2006 (20 CFR 416.920(f)), the date the application was filed.
After the Appeals Council declined review on March 25, 2009, this appeal followed.
II. SUMMARY OF THE EVIDENCE
The certified administrative record ("CAR") contains the following evidence, summarized below:
Plaintiff had a California Refugee Health Assessment completed on December 6, 2005, about one month after her arrival in the United States as a refugee. The assessment noted Plaintiff was severely obese, with a BMI of 57. She had swelling and redness in her right lower extremity, and follow up was needed to rule out DVT (deep venous thrombosis) following the long flight from Russia. Her blood pressure was 144/82.
On February 1, 2006, Plaintiff had an echocardiogram due to hypertensive heart disease and chest pain. The findings indicate that the study was technically very limited, including limited echo penetration of cardiac structures due to massive obesity. The conclusions from this limited study revealed grossly preserved LV systolic chamber size and function, and no obvious ventricular hypertrophy.
Plaintiff was seen several times in 2006 at Manzanita Medical Clinic, but the hand written notes are mostly illegible. In 2006, she was seen on February 14, February 28, April 28, and June 6. At each of these visits, Plaintiff's obesity and varicose veins were noted. The doctor also identified trace edema in April 2006, and mentions edema again in June 2006. He discussed diet and the possibility of bariatric surgery.
On April 20, 2007, Plaintiff was seen for a cough. It was noted Plaintiff has hypertension, morbid obesity, and venous insufficiency. She was seen again on August 13, 2007, for what appears to be a regular evaluation, perhaps reporting chest pain.
Plaintiff was seen on September 27, 2007, apparently for pain in her knees and back. She was referred for an x-ray of her lumbar spine and right knee, which were performed the same day. The notes continue to indicate morbid obesity, noting her BMI at 61. In addition, it appears that the notes indicate no edema, but it is unclear. The lumbar spine x-ray showed:
Bilateral pars defects of L5 posterior elements are noted without significant anterolisthesis. Normal alignment of the spinal column. Incidentally noted are triangular shaped bone fragments adjacent to the anterosuperior end plates of L4 and T12, which could represent limbus vertebra versus anterior Schmorl's nodes. They appear well corticated. Acute etiology is unlikely.
There is no evidence of scoliosis on the frontal view. Vertebral body heights are preserved. Disc spaces are normal as well. The spinal canal appears patent throughout. No evidence of significant posterior element or neural foraminal degenerative changes. No transverse process fractures.
1. Bilateral L5 pars defects.
2. Limbus vertebrae versus anterior Schmorl's nodes within the anterosuperior end plates of L4 and T12, likely chronic.
3. Normal alignment of the spinal column. No evidence of vertebral body compression fractures or significant degenerative changes.
The knee x-ray showed: There is sharpening of the tibial spines, as well as mild joint line spurring medially and laterally ...