Jolene Moss applied for disability insurance benefits after injuring her right ankle in a car accident. An administrative law judge (“ALJ”) concluded that Moss’s impairment is severe but not disabling. The Social Security Appeals Council declined to review the decision. Moss sought review in the district court, which upheld the Commissioner’s denial of benefits. Moss now appeals to this court. We conclude that the ALJ erred in discounting the opinions of Moss’s treating physician and in assessing Moss’s credibility. We also conclude that the ALJ’s finding that Moss’s impairment does not meet or equal a listed impairment in the Social Security regulations is not supported by substantial evidence. Accordingly, we vacate the judgment and remand for further proceedings.
I. Background
Moss filed her application for benefits in October 2003. She had been working as a gas-station attendant for six years before she fractured and dislocated her right ankle and suffered a severe laceration on her right knee in a car accident. At the time of the accident, she was 43 years old, had a high-school education, and had previously worked as a housekeeper in hotels and nursing homes. After the accident, how *558 ever, Moss was unable to return to her job at the gas station.
Moss underwent immediate surgery to repair her ankle and was released from the hospital three days after the accident. Two months later, the pins that had been used to repair the fracture were removed. Moss’s surgeon, Dr. Asamonja Roy, an orthopedic specialist, thought that Moss was doing well and encouraged her to begin walking and putting weight on her right foot. Moss started physical therapy and by mid-November was walking and able to bear 60 to 70% of her weight on her right foot. By December 2003 she was able to walk at least 600 feet with the use of a cane.
In the months following her accident, Moss also was treated by her family physician, Dr. Steven Norris. A month after the injury, Dr. Norris detected damage to the peripheral nervous system of her ankle as a result of the fracture. In January 2004 he reviewed x-rays of her ankle and observed a bone formation that he suspected was limiting her range of motion, which, he reported, was generally “pretty good.” Dr. Norris also noted that Moss was suffering from “[rjight lower extremity neuro-pathy,” for which he prescribed Neurontin and advised her to continue with physical therapy.
Five months after the accident, in March 2004, Moss was still experiencing difficulties, so she scheduled appointments with a neurologist as well as a second orthopedic specialist. Moss met first with the neurologist, Dr. Rakesh Garg, who was referred to her by Dr. Roy. Following his examination, Dr. Garg concluded that Moss had a “slight limitation” of movement in her right ankle, but he did not detect any nerve damage.
Five days later Moss met with Dr. Steven Kodros, the orthopedic specialist, who, unlike Dr. Garg, described her range of motion as “quite limited.” Dr. Kodros noted that Moss was experiencing pain when she flexed her ankle, and that she had stiffness, tenderness, and diminished sensation in her right foot. He further observed that Moss was walking with a step-page gait pattern and using a cane. Dr. Kodros reviewed an outside CT scan and x-rays of Moss’s ankle and found “some mild residual bony deformity and some early degenerative changes.” He noted that Moss had residual symptoms “consistent with the natural history of her injury itself and more specifically related to residual posttraumatic arthrofibrosis, periar-ticular soft tissue adhesions, and likely the early development of some early posttrau-matic arthritis.” Dr. Kodros ordered a second CT scan and several weeks later followed up with Moss about his findings. The new CT scan confirmed that the fracture itself had healed but not without leaving small bony fragments and debris in the ankle. He noted some early degenerative changes and features that suggested avas-cular necrosis — death of the bone tissue. Based on these findings, Dr. Kodros recommended “conservative management” that would include use of a customized “Arizona ankle-brace” and corticosteroid injections. Should these measures fail, he indicated during this March 2004 consultation, he would recommend surgery.
Moss next saw Dr. Kodros in February 2005. The exam revealed that her condition had not improved. Moss had not obtained the Arizona brace because her insurance would not cover it, so Dr. Kod-ros gave her a temporary brace and repeated his recommendation that she attempt conservative management before resorting to more surgery. Several weeks later, Moss also visited Dr. Norris for a routine check-up. He noted that she was wearing an ankle brace and had a limited *559 range of motion in her right ankle and an altered gait due to pain.
Before her car accident, Moss had received medical treatment for other unrelated ailments. Medical records document treatment in early 2008 for diverticulosis, chronic constipation, hyperthyroidism, sinusitis, and fatigue. And before that, in 2000, Moss was diagnosed as suffering from migraine headaches.
The Social Security Administration denied Moss’s application a month after it was filed. A month after that, the agency also denied reconsideration. Moss requested further review, and in January 2006 an ALJ heard testimony from Moss and a vocational expert.
Moss testified that she experiences “chronic pain 24/7,” as well as stiffness, tightness, and swelling in her right ankle. She stated that she is unable to sit or stand for extended periods of time and cannot walk with full weight on her right foot, resulting in back and hip pain. The pain, she said, interferes with her sleep, requiring her to take sleeping pills. She continues to take Neurontin to alleviate the burning feeling and “pins and needles” sensation in her ankle. She also takes Tylenol Arthritis and Motrin, which provide only minimal relief but do not cause the drowsiness and constipation she experienced with the prescription pain medications she had been taking.
In describing her daily activities, Moss stated that she is able to dress herself and bathe using a stool. She tries to do housework but can no longer squat or bend; she is able to make light meals and wash dishes, though standing is painful. She no longer drives or does any yard work, laundry, or grocery shopping. Moss testified that during her husband’s frequent business travels, her adult daughter, who lives with them, helps with the laundry and shopping. For exercise, Moss said, she uses her cane to take occasional walks around the block and up and down the driveway.
The ALJ asked a vocational expert (“YE”) whether there are entry-level jobs available to a 46-year-old high-school graduate who is limited to unskilled, sedentary work that requires no climbing and only minimal standing and walking. The YE responded that although Moss cannot perform her past relevant work and has no transferrable skills, he found three positions that exist in significant numbers in the national economy-cafeteria cashier, ampule sealer, and surveillance system monitor-that Moss could perform given the limitations described.
The ALJ concluded that Moss is not disabled because she can perform some sedentary jobs that exist in significant numbers in the national economy. The ALJ applied the sequential five-step analysis, see 20 C.F.R. § 404.1520, and at step one found that Moss had not been engaged in substantial gainful activity and at step two that her ankle injury constitutes a severe impairment. The ALJ acknowledged that Moss also suffers from back and abdominal pain, sinusitis, fatigue, and headaches. At step three, however, the ALJ found that Moss’s ankle injury does not meet or equal a listed impairment. Moving to step four, the ALJ found that Moss cannot perform her past relevant work as a cashier or housekeeper but even with all of her ailments still retains the residual functional capacity to perform some sedentary jobs.
. In making these determinations, the ALJ declined' to fully credit Moss’s complaints of pain because, the ALJ said, there had been no medical finding that she needs a cane or that she is unable to effectively ambulate. The ALJ further stated that the medical evidence and *560 Moss’s own account of her daily activities do not corroborate her testimony concerning the intensity, duration, and limiting effects of her symptoms. The ALJ additionally discounted the medical opinions of Dr. Kodros, the orthopedic specialist. The ALJ characterized Dr. Kodros’s opinions as inconclusive and inconsistent with Dr. Garg’s findings, and surmised that some of Dr. Kodros’s medical opinions “may have been made to help the claimant in a pending legal matter since the doctor was reporting directly to her attorney.” Therefore, at step five the ALJ concluded that a significant number of sedentary jobs exist in the national economy that Moss can perform despite her limitations.
II. Analysis
Because the Appeals Council declined to review the ALJ’s decision, the ALJ’s ruling is the final decision of the Commissioner of Social Security.
Getch v. Astrue,
Moss raises a number of arguments, primarily that the ALJ failed to give appropriate weight to the medical opinions of Dr. Kodros which in turn contributed to a flawed assessment of her credibility. She also argues that at step three the ALJ failed to conduct a legally sufficient, analysis of the listings of impairments. We agree with Moss about Dr. Kodros and about the ALJ’s adverse credibility determination, and further conclude that the ALJ’s determination that Moss’s impairment does not meet or equal a listed impairment is not supported by substantial evidence.
Moss is correct that the ALJ failed to appropriately consider the medical opinions of Dr. Kodros, one of her treating physicians. A treating physician’s opinion about the nature and severity of the claimant’s impairment is normally given controlling weight so long as it is “well-supported by medically acceptable clinical and laboratory diagnostic techniques” and is consistent with substantial evidence in the record. 20 C.F.R. § 404.1527(d)(2);
Bauer v. Astrue,
The ALJ, however, discounted the opinions of Dr. Kodros based on speculation that Moss was referred to him by her attorney and that his findings “may have been made to help the claimant in a pending legal matter since the doctor was reporting directly to her attorney.” And the ALJ altogether failed to address whether Dr. Kodros’s medical opinions are supported by medically acceptable clinical and laboratory diagnostic techniques.
See Bauer,
Additionally, the ALJ failed to determine the weight to be accorded Dr. Kod-ros’s opinion in accordance with Social Security Administration regulations.
See
20 C.F.R. § 404.1527(d)(2). If an ALJ does not give a treating physician’s opinion controlling weight, the regulations require the ALJ to consider the length, nature, and extent of the treatment relationship, frequency of examination, the physician’s specialty, the types of tests performed, and the consistency and supportability of the physician’s opinion.
Id.-, Bauer,
Moss is also correct that the ALJ’s failure to give appropriate weight to Dr. Kodros’s testimony resulted in a flawed determination that her complaints of pain are not credible. We will uphold an ALJ’s credibility determination if the ALJ gave specific reasons for the finding that are supported by substantial evidence.
Arnold v. Barnhart,
*562
There are two other troubling features about the ALJ’s assessment of Moss’s credibility. First, the ALJ’s recitation of the administrative record is misleading or inaccurate on several significant points. With respect to Moss’s treatment history, the ALJ represents that her doctors had not recommended further surgery and that she had gone a relatively long period of time without seeing her family doctor. In fact, however, Dr. Kodros said that another surgery was a real possibility if Moss did not respond to his recommended course of conservative treatment. And while infrequent treatment or failure to follow a treatment plan can support an adverse credibility finding, we have emphasized that “the ALJ ‘must not draw any inferences’ about a claimant’s condition from this failure unless the ALJ has explored the claimant’s explanations as to the lack of medical care.”
Craft v. Astrue,
The second aspect that gives us pause about the ALJ’s credibility assessment is the undue weight placed on Moss’s household activities in assessing her ability to work outside the home. An ALJ cannot disregard a claimant’s limitations in performing household activities.
See Craft,
Finally, the ALJ’s determination that Moss’s impairment does not meet a listed impairment is not supported by substantial evidence. In evaluating Listing 1.03, the ALJ found that Moss had failed to establish an inability to ambulate effectively, one of the necessary elements of that listing. The regulations state that “ineffective ambulation” is “defined generally” as requiring the use of a hand-held assistive device that limits the functioning of both upper extremities. See 20 C.F.R. pt. 404P, app. 1, § 1.00(B)(2)(a). But the regulations further provide a nonexhaustive list of examples of ineffective ambulation, such as the inability to walk without the use of a walker or two crutches or two canes; the inability to walk a block at a reasonable pace on rough or uneven surfaces; the inability to carry out routine ambulatory activities, like shopping and banking; and the inability to climb a few steps at a reasonable pace with the use of a single handrail. Id.
Here, the ALJ concluded that Moss had failed to establish her inability to effectively ambulate because Moss uses just one cane and because according to the ALJ, the medical evidence does not point to ineffective ambulation and Moss herself testified that she is “able to live indepen *563 dently” and occasionally walks around the block. As previously noted, however, the ALJ’s determinations regarding the medical evidence and Moss’s credibility are not supported by substantial evidence. Consequently, the ALJ failed to adequately consider whether Moss in fact meets the listing based on the provided examples such as an inability to walk a block at a reasonable pace on rough or uneven surfaces, or the inability to carry out routine activities, like shopping and banking. See 20 C.F.R. pt. 404P, app. 1, § 1.00(B)(2)(a).
III. Conclusion
Accordingly, we VACATE the judgment of the district court and Remand with instructions to remand the case to the agency for further proceedings.