Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_05-cv-02251/USCOURTS-casd-3_05-cv-02251-2/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWW)

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- 1 - 05CV2251

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

NOELLA G. SCHNELL,

Plaintiff,

Civil No. 05 CV 2251- BEN (LSP)

ORDER ADOPTING REPORT AND

RECOMMENDATION DENYING

PLAINTIFF’S MOTION FOR

SUMMARY JUDGMENT AND

GRANTING DEFENDANT’S

MOTION FOR SUMMARY

JUDGMENT [Docket Nos. 10-11]

vs.

JO ANNE B. BARNHART,

Commissioner of the Social Security

Administration,

Defendant.

Plaintiff Noella Schnell seeks judicial review of the Commissioner’s decision to deny disability

insurance benefits under Titles II and XVI of the Social Security Act (Act). Cross motions have been

filed. The Honorable Leo S. Papas has issued a Report and Recommendation (Report), recommending

Plaintiff’s motion for summary judgment be DENIED and that Defendant’s cross-motion for summary

judgment be GRANTED. Specifically, Judge Papas found the Commissioner’s decision was

supported by substantial evidence. Timely objections were filed on March 8, 2007, by the Plaintiff.

No reply was filed by the Defendant.

 The Court’s role in reviewing the Report is set forth in 28 U.S.C. § 636(b)(1). Under this

statute, the Court “shall make a de novo determination of those portions of the report . . . to which

objection is made,” and “may accept, reject, or modify, in whole or in part, the findings or

recommendations made by the magistrate [judge].” Id. See also, U.S. v. Reyna-Tapia, 328 F.3d 1114,

Case 3:05-cv-02251-BEN-LSP Document 18 Filed 03/19/07 Page 1 of 18
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1121 (9th Cir. 2003) (“The statute makes it clear that the district judge must review the magistrate

judge’s findings and recommendations de novo if objection is made, but not otherwise. Neither the

Constitution nor the statute requires a district judge to review, de novo, findings and recommendations

that the parties themselves accept as correct.”). Notwithstanding, the Court has made a de novo

review of the entire Report, and agrees with Judge Papas’ reasoning and conclusions as set forth in

the Report. See 28 U.S.C. § 636(b).

I. FACTUAL BACKGROUND AND SUMMARY 

OF ADMINISTRATIVE DECISION

Plaintiff, born on December 21, 1963, was 41 years old at the time of the hearing before the

Administrative Law Judge (ALJ). (R. at 15.) Plaintiff, who is unmarried, has completed

approximately 13 years of education and lives with her parents. (R. at 15, 297, 301.) Plaintiff’s

relevant work experience includes approximately 10 years of secretarial work, approximately one year

of grocery cashier work, and 17 months of parking lot attendant work. (R. at 61-67, 95, 98.)

Plaintiff has also worked as a Salvation Army “bell ringer,” a cosmetologist, and an usher at

the Palomar College theater. Id. The ALJ, however, did not take these three jobs into account as they

were performed for short periods of time and did not qualify as substantial gainful activities (SGA).

See 20 C.F.R. 404.1572-1573 (defining SGA).

Plaintiff was also a student at Palomar College where she was enrolled in theater and

automotive repair courses. (R. at 262-63.) Plaintiff attended Palomar College since at least 2003

where she was able to carry 9 unit class loads. (R. at 273-74.) In addition to her classes, the Plaintiff

also worked as an usher in the college theater for approximately three hours per week. (R. at 262-63.)

A. Plaintiff’s Related Medical History

In 1979, Plaintiff was involved in a skiing accident where she sustained right shoulder injuries

that have never healed properly. (R. at 180-83.) Plaintiff continues to have recurring problems with

periodic right shoulder dislocation and has been diagnosed with “right shoulder instability.” (R. at

180-81, 183, 186.) The Plaintiff’s treating and examining physicians unanimously agree that use of

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1

 A positive ANA test is indicative of various diseases, can be drug-induced, or even appear in normal persons.

Antinuclear antibodies are

[a] group of antibodies that react against normal components of the cell nucleus. These antibodies are

present in a variety of immunological diseases, including systemic lupus erythematosus, progressive

systemic sclorosis, Sjogren’s syndrome, scleroderma, polymyositis, and dermatomyositis, and in some

persons taking hydralazine, procainamide, or isoniazid. In addition, ANA is present in some normal

individuals.

Taber’s Cyclopedic Dictionary 138-39 (19th ed. 2001) (emphasis added).

2

 SLE is “[a] chronic autoimmune inflammatory disease involving multiple organ systems and marked by periodic

acute episodes.” Id. at 1264. One is diagnosed with SLE

if four or more of the following criteria are present, either at one time or sequentially: 1. Butterfly rash;

2. raised, scaly discoid skin lesions; 3. antinuclear antibodies...; 4. immunological disorders including

lupus erythematosus (LE) cells or other autoantibodies; 5. pleuritis or pericaditis; 6. hemolytic anemia,

leukopenia..., lymphopenia..., or thrombocytopenia...; 7. oral or nasopharyngeal ulcers; 8. nonerosive

arthritis; 9. psychosis or convulsions without clear cause; 10. photosensitivity skin rash; 11. proteinuria

. . . . 

Id. 

3

 Voltaren is a “nonsteroidal anti-inflammatory drug” used for “relief of the signs and symptoms of osteoarthritis

. . . . [and] rheumatoid arthritis.” Physicians’ Desk Reference 2307-08 (61st ed. 2007).

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her right shoulder is limited to below the shoulder area. (R. at 110, 186, 192, 198, 253.)

In addition to her shoulder injury, Plaintiff has complained of, inter alia, photosensitivity,

urinary tract infections, generalized body aches, abdominal pain, joint pain, generalized numbness,

fatigue, and rashes. (R. at 128, 119, 146, 168, 183-86, 241.) Plaintiff also has a history of positive and

negative Antinuclear Antibodies (ANA)1 tests that are indicative of several diseases such as systemic

lupus erythematosus (lupus or SLE)2. (R. at 130-31, 133-35, 227, 243.) However, despite Plaintiff’s

complaints and numerous medical evaluations by multiple physicians, Plaintiff has not been positively

diagnosed with any ailment beyond the right shoulder injury.

The medical evidence in the record starts in 1990, when Dr. William Pincus saw Plaintiff on

a referral from Dr. Lawrence Schnell. (R. at 133-35.) Dr. Pincus made a possible diagnosis of

“systemic lupus erythematosis [sic] of a mild variety.” (R. at 135.) However, Dr. Pincus noted that,

while this was the most likely diagnosis, it was not a definitive one. Id. Dr. Pincus also noted that

Plaintiff reacted positively to the medication Voltaren3: “Her response to [Voltaren] was excellent with

almost complete resolution of her discomfort.” Id. After this visit, the record does not contain another

medical visit until 1992. At that time, Dr. Kaplan ordered a blood test that ultimately revealed

negative ANA results. (R. at 130-31.)

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According to the record, Plaintiff did not see another physician until nine years later in 1998,

when Dr. Birchall evaluated Plaintiff for complaints of generalized body aches with fevers and chills

for 3 days. (R. at 128.) Dr. Birchall suspected an unspecified infection and prescribed Cipro. Id.

Plaintiff’s next medical visit was four years later.

The bulk of Plaintiff’s medical records commence in 2002, when at least 7 separate physicians

examined Plaintiff. Plaintiff predominantly complained of urinary tract infections, abdominal pain,

shoulder pain, and general joint pain. (R. at 114, 119, 159, 168, 172, 180.) Although Plaintiff reported

to doctors that she presented and had been diagnosed with lupus, the medical record is dubiously void

of any lupus-related symptoms or ANA tests for 2002. 

During this time, Plaintiff began seeing Dr. Chen, one of her treating physicians. On April 11,

2002, Dr. Chen first evaluated Plaintiff for joint pain; at which time, she declined to complete

Plaintiff’s disability forms. (R. at 172.) On April 22, 2002, Dr. Chen evaluated Plaintiff for similar

complaints and advised Plaintiff to engage in aerobic exercise and moderate activity, to which the

Plaintiff agreed. (R. at 171.) Dr. Chen next evaluated Plaintiff on September 6, 2002. (R. at 150.)

Plaintiff complained of right shoulder pain and explained she was considering becoming an auto

mechanic. Id. Dr. Chen, however, advised Plaintiff to avoid “mechanic work,” and advised Plaintiff

she would have to engage in low impact work if no treatment was available for her shoulder injury.

Id. Plaintiff was then referred to Dr. Paul Milling for an orthopedic consultation. Id.

Dr. Milling found Plaintiff had full range of motion in her right shoulder but noted her right

shoulder was tender and she exhibited signs of apprehension. (R. at 180.) Dr. Milling also advised

Plaintiff to consider additional shoulder surgery but cautioned there would be a decreased chance for

success and likely loss of motion. Id. Dr. Milling offered no diagnosis or opinion regarding Plaintiff’s

work limitations. No further medical consultations or appointments occurred in 2002.

On March 14, 2003, Dr. Thomas Dorsey completed an orthopedic consultation at the request

of the Social Security Administration (SSA). (R. at 183-86.) Dr. Dorsey’s examination revealed

Plaintiff was in general good health with “grossly normal” range of motion in her shoulders, elbows,

wrists, hips, knees, and ankles. (R. at 185.) After full examination, Dr. Dorsey diagnosed Plaintiff

with “right shoulder instability.” (R. at 186.) The examination also revealed two other abnormalities

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28 4

 One’s residual functional capacity is the most work a claimant can still perform despite his or her impairment(s)

and limitations. 20 C.F.R. 404.1545.

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besides Plaintiff’s right shoulder injury: decreased sensation to the fingers of Plaintiff’s right hand as

compared to her left hand and decreased sensation in Plaintiff’s right foot as compared to her left foot.

(R. at 285.) Regarding Plaintiff’s work limitations, Dr. Dorsey’s concluded,

The patient apparently is able to do some type of physical activities since the bilateral

hands show grease on them today. She should be doing no overhead activities. Lifting

and carrying to the level of the waist would be 20 pounds occasionally and 10 pounds

frequently. There are no other limitations.

(R. at 186.) Shortly after Plaintiff’s visit with Dr. Dorsey, the SSA requested that a state agency

medical expert assess Plaintiff’s physical residual functional capacity (RFC) 4.

The state agency medical expert, Dr. James Haaland, completed a consultative report for the

SSA on March 27, 2003. (R. at 189-200.) Dr. Haaland found Plaintiff had the ability to lift or carry

20 pounds occasionally and 10 pounds frequently, stand or walk for about 6 hours in an 8-hour

workday, and sit for 6 hours in an 8-hour workday. (R. at 190.) Dr. Haaland also determined the

Plaintiff could not perform work above the shoulder level with her right arm. (R. at 192.) Dr. Haaland

also noted: “The [claimant] is credible [regarding] the alleged symptomology, but not its severity.”

(R. at 194.)

On July 28, 2003, Plaintiff returned to Dr. Chen, complaining of four months of fatigue,

weakness, and tenderness in all her extremities. (R. at 146.) Dr. Chen noted Plaintiff had a fading rash

on her chest, legs, and arms; and she ordered laboratory tests and prescribed over-the-counter allergy

medication in response. Id. Plaintiff’s test results indicated a positive ANA on August 15, 2003. (R.

at 227.) Plaintiff returned to Dr. Chen on August 29, 2003, where Plaintiff’s positive ANA test and

her “[history] of ‘mild lupus’” were noted. (R. at 147.) Interestingly, however, Dr. Chen did not

diagnose Plaintiff with any specific ailment related to these findings, nor were any additional

medications proscribed. Id. Nonetheless, Dr. Chen completed a “Physical Capacities Evaluation”

form provided by Plaintiff. (R. at 201-02.)

Portions of the opinion Dr. Chen expressed on this form were consistent with those of other

physicians while other portions were inconsistent. See discussion infra part IIIB. Moreover, in

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5

 Diclofenac is a generic version of Voltaren. Physicians’ Desk Reference 2307 (61st ed. 2007).

6

 The exact date of this visit is unclear. It is clear that the visit took place in July 2004, however, the “actual” day

of the month is written illegibly, but appears to be either a 6, 12, or 16. (R. at 241.)

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response to questions on the form, Dr. Chen delivered opinions that no other doctor had expressed.

The form contained fields for “Diagnosis,” “Symptoms,” and “Type of Treatment (i.e., medications).”

(R. at 202.) Based on “generalized pain [and] weakness” symptoms, Dr. Chen diagnosed Plaintiff

with “possible lupus” with a treatment of “diclofenac5.” Id. Also, no mention of any right shoulder

limitations are found in Dr. Chen’s report. Id.

After the August 29, 2003, visit with Dr. Chen, the record contains 10 separate medical visits.

[R. at 143, 214, 210, 209, 207, 204, 218, 235, 240, 241 (in date order).] Plaintiff presented with

various complaints both related and unrelated to the present matter. Most notably, during a June 1,

2004, visit with Dr. Chen, Plaintiff complained of weakness, tiredness when curling her hair, and an

overall feeling of being heavy. (R. at 218.) Dr. Chen recommended gentle stretching and aerobic

exercise. Id. Plaintiff was also prescribed physical therapy 3 times per week for 4 weeks on a later

date. (R. at 235.) During a subsequent visit to Dr. Birchall, Plaintiff was again prescribed Voltaren

for pain. (R. at 241.) Dr. Birchall noted that the etiology of Plaintiff’s pain “remain[ed] elusive” and

opined Plaintiff could “work six to eight hours per day.”6

 Id. Between August 29, 2003, to July 14,

2004, no doctor positively diagnosed Plaintiff with systemic lupus erythematosus (SLE) nor any other

ailment not discussed.

B. Plaintiff’s Administrative Hearing and Subsequent Medical Examination

An administrative hearing was held before Administrative Law Judge Samuel Durso on July

14, 2004. (R. at 260-313.) The Plaintiff testified on her own behalf and was represented by counsel.

A vocational expert, Connie Guillory, also testified at the hearing. (R. at 306-10.) The ALJ

asked Ms. Guillory two hypothetical questions to determine whether Plaintiff could perform her past

relevant work. The first hypothetical question was based on Plaintiff’s residual functional capacity

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7

 The ALJ inquired,

[w]ell now, if I were to find the Claimant can hypothetically handle light work activity as defined by

regulation that would be that she could sit, stand, and/or walk at least – or about six hours each in an

eight-hour workday. She would need to avoid overhead controls, working -- may work above shoulder

level with the right upper extremity; no ladders, ropes and scaffolds, but she could otherwise

occasionally climb, balance, knell, stoop, crouch, crawl on an occasional basis. Environmentally, she

should avoid concentrated exposure to sunlight. If I were to so find the Claimant to have that

hypothetical capacity, in your vocational judgment, would she be able to return to any of her past jobs?

 (R. at 307-08.) 

8

 The ALJ inquired, 

[n]ow, if I were to find that the Claimant could sit six hours, stand and/or walk four hours; she could

occasionally lift up to 25 pounds as well as carry up to 25 pounds. She would be able to use her hands

for simple grasping, pushing and puling and fine manipulation. She could use her feet for repetitive

movements, pushing and pulling. She is able to reach frequently. She would occasionally be able to

bend, squat, crawl, climb. She should not work outdoors. ... She would miss three to four days per

month from work.

(R. at 308-09.)

9

 Ms. Guillory inquired, 

I just have one question and that is, with the first hypothetical which I believe corresponds to Exhibit

5F [Record pages 189-200] -- but nevertheless, would the Claimant or the hypothetical person be able

to perform the Claimant’s past relevant work if her lifting and carrying were limited to the level of the

waist for the 20 pounds occasionally and the level of the waist at 10 pounds frequently, so all her lifting

and carrying would be at the waist level?

(R. at 309.)

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as described by Dr. Dorsey and Dr. Haaland.7 (R. at 307-08.) Ms. Guillory opined that Plaintiff could

return to her previous cashier and secretary jobs but not the parking lot attendant position. (R. at 308.)

The second hypothetical was based solely on Dr. Chen’s August 29, 2003, “Physical Capacities

Evaluation” report.8 (R. at 308-09.) Ms. Guillory responded the Plaintiff would not be able to work

given the information provided in that hypothetical. (R. at 309.) Additional questioning regarding the

first hypothetical was also posed by Plaintiff’s counsel, which yielded consistent answers from Ms.

Guillory.9

 Id.

Before the ALJ concluded the administrative hearing, the ALJ expressed doubts about

Plaintiff’s lupus claims and Dr. Chen’s August 29, 2003, findings. (R. at 310-12.) Accordingly, the

ALJ expressed the desire to further examine the lupus claim and ordered an “internist endocrinologist

examination.” (R. at 311.)

On September 11, 2004, Dr. Henry Lin, an internal medicine specialist, examined Plaintiff.

(R. at 245-54.) Dr. Lin reviewed Plaintiff’s medical records and took notice of her lupus complaint,

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28 10 Dr. Lin’s assessment of the Plaintiff is also consistent with the first hypothetical question posed by the ALJ.

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the history of positive and negative tests, Plaintiff’s history of shoulder injuries, and her complaints

of general pain and weakness. (R. at 245-46.) Dr. Lin’s physical examination revealed that Plaintiff

was in general good health and had full range of motion in most of her extremities. (R. at 247-48.)

Based on this assessment, Dr. Lin opined that Plaintiff did not have lupus and her only limitation was

a right shoulder injury.10 (R. at 232.)

C. The ALJ’s Decision

On January, 13, 2005, the ALJ issued his decision. He determined that the Plaintiff “retain[ed]

the residual functional capacity to perform a range of light work.” (R. at 20.) The ALJ credited

Plaintiff’s right shoulder impairment but discounted her lupus testimony. Id. In doing so, he set forth

Plaintiff’s relevant medical visits and cited a lack of “credible” medical evidence, conservative

treatment, and lack of a definitive lupus diagnosis. (R. at 19-20.) The ALJ also discounted Plaintiff’s

subjective complaints of pain and weakness, citing lack of medical evidence for the pain and

Plaintiff’s continued activities. (R. at 19.)

Additionally, the ALJ discounted Dr. Chen’s August 29, 2003, report because

Dr. Chen’s opinion of work limitations [was] not supported by the evidence of record

considered as a whole, including the records of Dr. Chen. The claimant underwent

intermittent sporadic treatment and had generally unremarkable signs. The claimant’s

major complaint was shoulder dislocation and she did not report signs or symptoms

consistent with the opinion of Dr. Chen as regards any continuous period of not less

than 12 months.

(R. at 18.) Since Ms. Guillory’s opinion that plaintiff could not work (in response to the second

hypothetical) was based on Dr. Chen’s report, the ALJ disregarded her opinion as to that hypothetical

as well. [See R. at 20 (relying on the first hypothetical posed to Ms. Guillory).]

The ALJ also disregarded Dr. Birchall’s July 2004 opinion that Plaintiff could work 6-8 hours

because “[n]o opinion is set forth regarding duration, nor are there longitudinal objective medical

records in support of the opinion rendered.” (R. at 19.) Ultimately the ALJ determined Plaintiff was

able to return to her cashier and secretary positions and found she was not eligible for disability

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benefits.

II. LEGAL BACKDROP AND STANDARD OF REVIEW

A. Legal Requirements as to Disability Benefits

Title II of the Social Security Act (hereinafter, “Act”), as amended, provides for the payment

of insurance benefits to persons who have contributed to the program and who suffer from a physical

or mental disability. 42 U.S.C. § 423(a)(1)(D) (Supp. III 1982). Title XVI of the Act provides for the

payment of disability benefits to indigent persons under the Supplemental Security Income (SSI)

program. § 1382(a). Both titles of the Act define disability as the “inability to engage in any

substantial gainful activity by reason of any medically determinable physical or mental impairment

which can be expected to last for a continuous period of not less than 12 months. . . .” § 416(i)(1)(a).

The Act further provides that an individual

[S]hall be determined to be under a disability only if his physical or mental impairment

or impairments are of such severity that he is not only unable to do his previous work

but cannot, considering his age, education, and work experience, engage in any other

kind of substantial gainful work which exists in the national economy, regardless of

whether such work exists in the immediate area in which he lives, or whether a specific

job vacancy exists for him, or whether he would be hired if he applied for work.

§ 423(d)(2)(a).

The Secretary of the Social Security Administration has established a five-step sequential

evaluation process for determining whether a person is disabled. 20 C.F.R. §§ 404.1520, 416.920

(1986). Step one determines whether the claimant is engaged in “substantial gainful activity.” If (s)he

is, disability benefits are denied. §§ 404.1520(b), 416.920(b). If (s)he is not, the decision maker

proceeds to step two, which determines whether the claimant has a medically severe impairment or

combination of impairments. That determination is governed by the “severity regulation” at issue in

this case. The severity regulation provides in relevant part:

If you do not have any impairment or combination of impairments which significantly

limits your physical or mental ability to do basic work activities, we will find that you

do not have a severe impairment and are, therefore, not disabled. We will not consider

your age, education, and work experience.

§§ 404.1520(c), 416.920(c). 

The ability to do basic work activities is defined as “the abilities and aptitudes necessary to

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do most jobs.” §§ 404.1521(b), 416.921(b). Such abilities and aptitudes include “[p]hysical functions

such as walking, standing, sitting, lifting, pushing, pulling, reaching, carrying, or handling”;

“[c]apacities for seeing, hearing, and speaking”; “[u]nderstanding, carrying out, and remembering

simple instructions”; “[u]se of judgment”; “[r]esponding appropriately to supervision, co-workers, and

usual work situations”; and “[d]ealing with changes in a routine work setting.” Id. 

If the claimant does not have a severe impairment or combination of impairments, the

disability claim is denied. 

If the impairment is severe, the evaluation proceeds to the third step, which determines whether

the impairment is equivalent to one of a number of listed impairments the Secretary acknowledges are

so severe as to preclude substantial gainful activity. §§ 404.1520(d), 416.920(d); 20 C.F.R. pt. 404,

subpt. P, App. 1 (1986). If the impairment meets or equals one of the listed impairments, the claimant

is conclusively presumed to be disabled. If the impairment is not one that is conclusively presumed

to be disabling, the evaluation proceeds to the fourth step, which determines whether the impairment

prevents the claimant from performing work (s)he has performed in the past. If the claimant is able

to perform his/her previous work, (s)he is not disabled. §§ 404.1520(e), 416.920(e). If the claimant

cannot perform his/her previous work, the fifth and final step of the process determines whether (s)he

is able to perform other work in the national economy in view of his/her age, education, and work

experience. The claimant is entitled to disability benefits only if (s)he is not able to perform other

work. §§ 404.1520(f), 416.920(f). 

B. Standard of Review

This Court has jurisdiction pursuant to 42 U.S.C. § 405(g). In a Social Security case, the

Commissioner’s denial of benefits “will be disturbed only if it is not supported by substantial evidence

or is based on legal error.” Brawner v. Sec’y of Health and Human Servs., 839 F.2d 432, 433 (9th Cir.

1988) (citing Green v. Heckler, 803 F.2d 528, 529 (9thCir. 1986)). Substantial evidence means “more

than a mere scintilla” but less than a preponderance. Sandgathe v. Charter, 108 F.3d 978, 980 (9th

Cir. 1997) (citation omitted). “[I]t is such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” Id. (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir.

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1995)). The court must consider the record as a whole, examining both the evidence which supports

the ALJ’s conclusions and that which detracts therefrom. Jones v. Heckler, 760 F.2d 993, 995 (9th

Cir. 1985). “In reaching his findings, the law judge is entitled to draw inferences logically flowing

from the evidence.” Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). If the evidence

supports more than one rational interpretation, the court must uphold the ALJ’s decision. Allen v.

Heckler, 749 F.2d 577, 579 (9th Cir. 1984). Thus when the evidence is inconclusive, “questions of

credibility and resolution of conflicts in the testimony are functions solely of the Secretary.”

Schweiker, 694 F.2d at 642 (internal quotations and citation omitted). 

III. DISCUSSION

A. The Hypothetical(s) Posed to the Vocational Expert.

Plaintiff argues the ALJ posed an incomplete hypothetical question to the vocational expert,

Ms. Guillory, and therefore could not rely on her response. (Pl.’s Obj. to R. & R. 1.) Plaintiff further

objects to the Report’s statements that although the ALJ’s hypothetical question to Ms. Guillory was

unclear, it was cured by the subsequent hypothetical question by Plaintiffs attorney. (Id.; R. & R. 14.)

Plaintiff also unconvincingly argues the ALJ’s hypothetical question was “qualitatively different”

from the hypothetical question submitted by Plaintiff. 

The Plaintiff attempts to isolate a portion of the hypothetical question in which the ALJ stated

Plaintiff “may work above shoulder level with the right upper extremity.” [R. at 308 (emphasis

added).] Plaintiff contends the hypothetical question was incomplete because Plaintiff cannot work

above shoulder level and the subsequent response by Ms. Guillory provides no evidentiary value.

(Pl.’s Obj. to R. & R. 1-2; Pl.’s Mem. Supp. Sum J. 4, 5:22-6:14.) However, Plaintiff’s selective

quotation of the record excludes the first half of the ALJ’s sentence. The full sentence reads: “She

would need to avoid overhead controls, working -- may work above the shoulder level with the right

upper extremity . . . .” (R. at 308.) When read in full context, the ALJ’s sentence is notably

incongruous. In full context, it appears that the ALJ states the Plaintiff is, simultaneously, both able

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11 Defendant has suggested the Court “assume the ALJ said ‘no’ work above the shoulder rather than ‘may’ work

above the shoulder” because the ALJ knew about Plaintiff's impairment and did not suggest Plaintiff could perform

above-shoulder work elsewhere in the record. (Mem. Points Authorities Supp. Def's Cross-Mot. 10:21-26.) While

temptingly simplistic, the Court is ultimately unpersuaded by the Defendant's “transcription error” argument. No evidence

has been provided by either party to support this contention. Accordingly, the Court cannot assume the ALJ meant

anything other than the words that were transcribed. (R. at 308.) 

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and unable to work above shoulder level.11

Had the hearing ended immediately after Ms. Guillory’s response to the ALJ’s first

hypothetical question, there would be sufficient cause to remand this case. However, that was not the

case, the hearing and additional questioning continued. (R. at 308-10.) It would appear that Plaintiff

urges the Court to focus “solely” on the questioning by the ALJ -- in essence ignoring the further

inquiries made by Plaintiff’s counsel and segmenting the testimony into isolated sub-parts. (R. at 309-

10.) That would be nonsensical. 

Plaintiff asked a clarifying question of Ms. Guillory regarding the first hypothetical and was

ultimately able to clear any confusion posed by the ALJ’s initial questioning. Plaintiff’s examination

of Ms. Guillory consisted of one question:

Q I just have one question and that is, with the first hypothetical which I believe

corresponds to Exhibit 5F [Record pages 189-200] -- but nevertheless, would the

Claimant or the hypothetical person be able to perform the Claimant’s past relevant

work if her lifting and carrying were limited to the level of the waist for the 20 pounds

occasionally and the level of the waist at 10 pounds frequently, so all her lifting and

carrying would be at the waist level?

[R. at 309 (emphasis added]. Plaintiff’s restriction to the first hypothetical question limited Plaintiff’s

activity to waist level. As Judge Papas’ correctly pointed out, this limitation is more restrictive than

Plaintiff’s actual abilities since Plaintiff is capable of performing work from the waist to shoulder

area. (R. & R. 16.) Despite the hypothetical’s added restrictiveness, Ms. Guillory opined that the

“erosion [to the Plaintiff’s secretarial abilities] would be so slight, it would be negligible.” (R. at 310.)

Such a condition would not preclude Plaintiff from performing her past secretarial position. Id. Ms.

Guillory further explained that Plaintiff could still perform 65%-80% of cashier jobs comparable to

her past position as “generally performed.” Id. The discounted percentage specifically took into

consideration the proposition that Plaintiff would be unable to “lift anything above the waist.” Id. 

Plaintiff also argues her hypothetical question was “qualitatively different” from that of the

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ALJ. (Pl.’s Obj. to R. & R. 1-3.) Specifically, Plaintiff argues her hypothetical question cited strength

based “exertional limitations,” while the ALJ’s hypothetical question “cited non-exertional,

manipulative limitations which were not part of his final residual functional capacity.” Id. at 2.

Plaintiff further argues her hypothetical question “did not address the myriad of non-exertional

manipulative work functions necessary for work activities such as overhead work, above the shoulder

work, operating overhead controls, reaching, handling, fingering [,] etc.” Id. 

Plaintiff’s argument only has merit if the hearing record is viewed in piecemeal segmentation.

Despite Plaintiff’s contentions that suggest otherwise, it is not necessary for the ALJ to repeat

Counsel’s hypothetical in order to utilize it in his determination. (Pl.’s Mem. Supp. Sum J. 4-6.) It

is unnecessary to segregate the first hypothetical into isolated sub-parts by the respective questioner.

The ALJ was present for Ms. Guillory’s entire testimony and he also listened to Ms. Guillory’s

response to the more restricted hypothetical questioning. The ALJ, therefore, could reasonably rely

on Ms. Guillory’s subsequent answers and opinion in making his final conclusions. 

Furthermore, contrary to Plaintiff’s contention, the ALJ did explore the physical and mental

demands of her past relevant work. Ms. Guillory testified that Plaintiff’s work as a cashier was

performed at a “light exertional level” and was “semi-skilled”; whereas, her job as a secretary was

“sedentary” and “skilled.” (R. at 307.) Limitations are classified as exertional if they affect your

ability to meet the strength demands of jobs. See 20 C.F.R. 416.969a. “The classification of a

limitation as exertional is related to the United States Department of Labor's classification of jobs by

various exertional levels (sedentary, light, medium, heavy, and very heavy) in terms of the strength

demands for sitting, standing, walking, lifting, carrying, pushing, and pulling.” Id. “Limitations or

restrictions which affect your ability to meet the demands of jobs other than the strength demands, that

is, demands other than sitting, standing, walking, lifting, carrying, pushing or pulling, are considered

nonexertional.” Id.

The ALJ may determine the nature of Plaintiff’s past job duties (as actually performed) from

one of two acceptable sources: “a properly completed vocational report, SSR 82-61, and the claimant’s

own testimony, SSR 82-41.” Pinto v. Massanari, 249 F.3d 840, 845 (9th Cir. 2001). Plaintiff

completed a vocational report in which she described her duties as they pertained to her prior positions

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12 Since the record does not adequately indicate whether Plaintiff’s secretarial position involved duties not

generally associated with the position, the Court will instead focus on Plaintiff’s cashier position where no indication lies

in the record that duties, which are not generally associated with the position, are involved. (See generally, R. & R. 28-

30.) 

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of employment. (R. at 61-68). Specifically, Plaintiff testified that she worked as a cashier in 1998.12

(R. at 270.) This corresponds with the position Plaintiff described in her Work History Report. (R.

at 67.) In the vocational report, Plaintiff describes her cashier duties: “Cash register operations

Completing of balance sheet at end of shift.” Id. She further listed the position’s lifting and carrying

requirements: “occasionally it would require stocking inventory + preparing displays, that required

lite [sic] lifting.” Id. 

Having reviewed the “vocational statement of record,” Ms. Guillory testified that “[t]he

position of cashier is classified as light work, semi-skilled, actually and customarily performed are

 consistent.” [R. at 307 (emphasis added)]. In addition, when Plaintiff restrictively clarified the first

hypothetical question, Ms. Guillory responded: “The cashier position, the one she was actually

performing, would be fine, because -- as she described it. It would be fine as actually performed.”

[R. at 310 (emphasis added)]. 

Although the ALJ did not question Plaintiff about her cashier job, the vocational report

provided an independent source upon which the ALJ could rely. The vocational report also provided

Ms. Guillory the necessary information to opine whether Plaintiff could perform her cashier position

as actually performed. Ms. Guillory’s testimony indicates that she indeed considered Plaintiff’s

description of her duties. Id. Therefore, the ALJ fully developed the record with regard to plaintiff’s

cashier job as actually performed. Accordingly, the testimony in the record indicates that Plaintiff can

still perform at least one of her past relevant jobs, thereby demonstrating that the ALJ did not err.

To summarize, the ALJ’s first hypothetical question to Ms. Guillory, while contradictory and

seemingly unclear, was cured by Counsel’s subsequent clarification. The ALJ was present for Ms.

Guillory’s entire testimony and listened to Ms. Guillory’s response to the more restricted hypothetical

questioning. Accordingly, the ALJ could reasonably rely on Ms. Guillory’s subsequent answers and

opinion in making his final conclusions (the administrative hearing must be considered as a whole).

Plaintiff’s “qualitatively different” argument is unconvincing. As Judge Papas’ appropriately

determined, Plaintiff’s clarification to the first hypothetical question provides a sufficient basis in the

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record to convince the Court that Ms. Guillory’s opinion was based on factors that reflected Plaintiff’s

true residual functional capacity. (See R. & R. 16.) 

B. Systemic Lupus Erythematosus (SLE)

Plaintiff also formally objects to the alleged post hoc argument in the Report supporting the

ALJ’s decision that Plaintiff’s SLE was not a severe impairment. [Pl.’s Obj. to R. & R. 3 (referring

to R. & R. 16-19).] Plaintiff cites several cases in opposition to post hoc determinations but fails to

acknowledge the Report’s numerous direct references to the ALJ’s determinations. While the Report

also includes direct citations to the overall record, there are also sufficient references to the ALJ’s

actual decision. 

For example, the Report discussed: 

In positing Plaintiff’s residual functional capacity to Ms. Guillory, the ALJ excluded

Plaintiff’s lupus claim while including her photosensitivity. The ALJ did this because

Dr. Chen notes a diagnosis of possible lupus, but that diagnosis is not

clinically confirmed. In fact, Dr. Pincus, a rheumatologist, specializing

in the treatment of conditions such as lupus, opined that the claimant

had only mild lupus, at most, but did note definitively diagnose the

claimant with that condition. Regardless, Dr. Pincus indicated that the

claimant had [] an excellent response to treatment with her

medications, including Voltaren.

. . . [.]

I also note that the treatment records reflect only intermittent reports of

the claimant’s purported symptomology with sporadic conservative

treatment and inconsistent laboratory findings. No physician of record

has opined . . . [.] that the claimant’s impairments are more limiting

than found by the undersigned [Administrative] Law Judge.

 (R. at 17, 20.) 

(R. & R. 16.)

 In his decision, the ALJ also noted his difficulties with relying on the medical opinion of

Plaintiff’s treating physician, Dr. Chen. (R. at 17.) 

The [ALJ] has considered the opinion and assessment from Dr. Chen , dated August

29, 2003, stating that although the claimant was physically capable of performing a

range of light work, she could not do so in the competitive workplace. In addition, Dr.

Chen opined that the claimant should not work outdoors. In so opining, Dr. Chen

diagnosed possible lupus, with systems of generalized pain and weakness. Dr. Chen

admitted that the length of treatment was unknown, and did not set forth an opinion of

duration. . . . Ordinarily, the opinion of a treating physician is accorded great weight

(Magallenes [sic] v. Bowen, 881 F.2d 751 (9th Cir. 1989)). The [ALJ] is unable to

assign controlling weight to the opinion of Dr. Chen, however, inasmuch as that

opinion is conclusory, is set forth on a checklist form supplied by counsel, and

provides no supporting objective medical data consistent therewith. 

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(R. at 17.) The opinions of treating physicians carry substantial weight in the disability determination.

Magallanes, 881 F.2d at 751. “The treating physician’s opinion is not, however, necessarily

conclusive as to either a physical condition or the ultimate issue of disability.” Id. “The ALJ may

disregard the treating physician’s opinion whether or not that opinion is contradicted.” Id. To ignore

a treating physician’s opinion, the ALJ must provide “specific, legitimate reasons for doing so that

are

based on substantial evidence in the record.” Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983).

Whereas, if the ALJ ignores uncontroverted medical evidence, he must provide clear and convincing

reasons to support his decision. Magallanes, 881 F.2d at 751. If the ALJ ignores controverted

opinions, he must provide specific, legitimate reasons for doing so. Holohan v. Massanari, 246 F.3d

1195, 1203 

(9th Cir. 2001). 

For example, an ALJ may disregard an opinion because it is “brief and conclusionary in form

with little in the way of clinical finding to support [its] conclusion . . . .” Id. (quoting Young v.

Heckler, 803 F.2d 963, 968 (9th Cir. 1986) (alteration in original). See Saelee v. Chater, 94 F.3d 520,

522-523 (9th Cir. 1995), cert. denied, 519 U.S. 1113 (1997) (ALJ may consider the purpose for which

a medical report was obtained); See also Burkhart v. Bowen, 856 F.2d 1335, 1339 (9th Cir. 1988)

(consideration of the fact that a doctor’s report was solicited by claimant’s counsel was a permissible

credibility determination given all of the evidence before the ALJ); Crane v. Shalala, 76 F.3d 251, 253

(9th Cir. 1996) (ALJ permissibly rejected “checkoff” forms that did not contain any explanation for

the limitations shown); Murray, 722 F.2d at 501 (expressing preference for individualized medical

opinions over check-off reports). 

Since the record contains factors that simultaneously support and refute Plaintiff’s lupus claim,

it is solely within the province of the ALJ to resolve the conflict. Sample v. Schweiker, 694 F.2d 639,

642 (9th Cir. 1982). The present case is not one in which the ALJ ignored a conclusive diagnosis.

Ultimately the record contains one opinion that Plaintiff does not have lupus, two cautious opinions

that Plaintiff may have lupus, and no definitive diagnosis that Plaintiff has lupus. (R. at 16-20.) The

ALJ in this case rejected Dr. Chen’s views, as expressed in the Physical Capacity Assessment form,

because: 

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[the] opinion is conclusory, is set forth on a checklist form supplied by counsel, and

provides no supporting objective medical data consistent therewith. For example, Dr.

Chen notes a diagnosis of possible lupus, but that diagnosis is not clinically confirmed.

. . . Further, in April 2002, Dr. Chen opined that the claimant was not disabled and

prescribed aerobic exercise. . . . In sum, Dr. Chen’s opinion of work limitations is not

supported by the evidence [in the] record considered as a whole, including the records

of Dr. Chen.

(R. at 17-18.). Similarly, the ALJ discounted Dr. Birchall’s opinion that Plaintiff could work between

6 and 8 hours because “[n]o opinion is set forth regarding duration, nor are there longitudinal objective

medical records in support of the opinion rendered.” (R. at 19.) It should be noted that nothing in the

record suggests that the ALJ ever doubted Dr. Chen or Dr. Birchall’s designations as treating

physicians. Even under the more stringent “clear and convincing reasons”standard, the reasons stated

within the ALJ’s decision for disregarding Dr. Chen’s and Dr. Birchall’s opinions are sufficient. Both

Dr. Birchall and Dr. Chen issued conclusory opinions that lacked sufficient objective medical support.

The ALJ included both doctors’ findings in his decision before discounting them and explained why

he discounted them. (R. at 16-20.) 

Therefore, based on a review of the record and the preceding analysis, the Court finds the ALJ

did not err in discounting Dr. Chen and Dr. Birchall’s opinions, even with treating physicians’

designations. Furthermore, since Dr. Chen’s opinion was the basis for the ALJ’s second hypothetical

question, the Court also finds the ALJ did not err in ignoring Ms. Guillory’s response to the second

hypothetical question. Finally, Plaintiff’s objection to the post hoc argument, allegedly within Judge

Papas’ Report, supporting the ALJ’s decision that Plaintiff’s SLE was not a severe impairment is

irrelevant because the ALJ has noted sufficient findings regarding the Plaintiff’s lack of disability on

the face of his decision. (Pl.’s Obj. to R. & R. 3; R. & R. 16.) 

Based on a review of the record, the ALJ’s decision to discount Plaintiff’s lupus’ claim is

supported by substantial evidence. Hence, the ALJ did not err by excluding lupus from his disability

determination.

IV. CONCLUSION

After reviewing the administrative record as a whole, weighing both the evidence that supports

and detracts from the ALJ’s conclusion, the Court finds the ALJ provided specific, legitimate reasons

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for his conclusion. Substantial evidence exists to support the ALJ’s findings. Moreover, after

making a de novo review of the entire Report, the Court fully agrees with Judge Papas’ reasoning and

conclusions discussed therein. 

Therefore, Judge Papas’ Report is ADOPTED in full and further SUPPLEMENTED by this

ORDER. For the reasons stated in the Report and cited herein, Plaintiff’s motion for summary

judgment is DENIED and Defendant’s cross-motion for summary judgment is GRANTED.

SO ORDERED.

DATED: March 19, 2007

Hon. Roger T. Benitez

United States District Judge

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