Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-01701/USCOURTS-cand-3_04-cv-01701-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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United States District Court

For the Northern District of California

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1 Although the complaint and all other filings in the instant appeal

spell plaintiff’s last name “Rombalch,” nearly all documents in the

administrative record spell her name “Rombakh.” Where record documents are

quoted in this order, the original spelling will be used. 

United States District Court

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

VALENTINA A ROMBALCH,

Plaintiff,

 v

JO ANNE B BARNHART, Commissioner

of Social Security

Defendant.

 

No C 04-01701 VRW

 ORDER

Plaintiff Valentina A Rombalch1

 appeals from a decision

of the Social Security Administration (SSA) denying her application

for Social Security Income (SSI) benefits under Title XVI of the

Social Security Act (“the Act”). The parties have filed cross

motions for summary judgment. Pl Mot (Doc # 6); Def Mot (Doc #10). 

Based upon careful review of the administrative record and the

applicable law, the court DENIES plaintiff’s motion and GRANTS

defendant’s motion. 

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I

A

Plaintiff was born in Russia on June 23, 1948, and was

fifty-four years old on November 12, 2002, the date of application

for benefits at issue on this appeal. Administrative Record (AR)

(Doc #5) at 96 146-55. She completed her education in Russia,

including high school and four years of college studying “lathe

production technology and glassworks technology,” then worked in

Russia for twenty-nine years as an instructor at a technical school

AR 17, 34-35, 129, 243. 

On October 17, 1997, plaintiff was admitted to the United

States, together with her husband, as a refugee under section 207

of the Immigration and Nationality Act, 8 USC § 1157, AR 99,

apparently because her husband is Jewish. AR 235. According to

plaintiff, she has never held employment in any capacity in the

United States. AR 39. In her November 13, 2002 SSI application,

plaintiff stated that her household in Santa Clara consisted of

herself, her husband and her two sons and that the house was owned

or in the process of being bought by one of her sons, Oleg Rombakh. 

AR 100. At the December 2003 hearing, however, plaintiff testified

that she lived only with her husband, whom she described as a “very

sick person.” AR 49-50. In her daily activities questionnaire,

plaintiff wrote that on an average day she studied English, cooked,

cleaned, read the newspaper and books, walked and rested. AR 123. 

Evidence regarding the exertional requirements of

plaintiff’s job in Russia appears in various places in the

administrative record. In plaintiff’s December 28, 2002, Work

History Report (WHR), she described her teaching job in Russia as a

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 The administrative law judge’s decision incorrectly stated that

plaintiff’s first application gave a disability onset date of January

1, 1993. AR 16. It is possible that the ALJ confused this

application with that submitted on the same date by plaintiff's

husband, Gennadiy Nisunovich Rombakh, that was also included in the

record, apparently by mistake. See AR 93-95. The discrepancy is not

material to any issue before the court on this appeal. 

3

“turner instructor,” AR 161, and represented that her job

responsibilities included: writing “reports for each lesson,”

conducting lessons in which she taught students how to operate

“turner machines” and overseeing students as they worked. AR 35-

36, 161. She described the job as requiring four hours per day

walking, three hours per day standing and one hour per day sitting,

frequent lifting of fifteen pounds and occasional lifting of at

most twenty pounds. AR 161, 129-30. Her statements in a March 22,

2001 WHR filed in connection with her first SSI claim were

generally consistent, but noted frequent lifting of ten, not

fifteen, pounds. AR 129-30. In later testimony, however,

plaintiff described the job as requiring much more exertion;

specifically, that it required her to lift almost thirty pounds and

to spend the majority of her day on her feet. AR 44. 

On March 6, 2001, plaintiff applied for SSI benefits

contending a disability onset date of January 1, 1979.2

 

Plaintiff’s husband applied for SSI benefits at the same time. AR

115. AR 103-12. Her application was denied initially and on

reconsideration, and she did not request a hearing on the 2001

claim. AR 16. 

On November 13, 2002, plaintiff applied for SSI benefits

for a second time, AR 99-102, claiming to be disabled based on

various health conditions including “high blood pressure,

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arthritis, vericose veins [sic], bleeding uterus; depression” which

made her get tired easily, feel weak and suffer from headaches. AR

103-12. This time, she alleged an onset date of December 1, 1996. 

AR 99. Plaintiff’s application was again denied initially and on

reconsideration. AR 78, 82, 83. Plaintiff requested a hearing

before an ALJ, AR 87, and secured appointed counsel to represent

her. AR 90. Because the administrative law judge (ALJ) declined

to re-open plaintiff’s earlier claim, AR 16, and plaintiff did not

appeal that aspect of the ALJ’s ruling, only the November 2002

application is the subject of this appeal. The administrative

record, however, contains nearly all the documents and medical

records pertaining to both the 2001 and the 2002 applications. 

B

Apart from the medical reports ordered by the SSA in

connection with plaintiff’s claim for benefits, discussed below,

medical records in the administrative record consist of extensive

clinic notes from plaintiff’s treating physician at the Santa Clara

Valley Medical Center’s Refugee Clinic. AR 270-329; 351-85. 

Noteworthy from these records was an August 23, 2001 visit with Dr

Susan Wong in which plaintiff brought up depression: “Never feels

suicidal. But once she feels angry enough she wants to bite

herself. Pt doesn’t want to be referred to mental health. She

just wants to try meds.” AR 272. Dr Wong prescribed Zoloft, an

antidepressant, id, and refilled this prescription at least twice,

AR 270, 372. Plaintiff presumably took Zoloft until February 4,

2002, when Dr Wong noted “pt felt a lot better. She wants to stop

taking zoloft after finish her current Rx.” AR 370. On September

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4, 2002, however, plaintiff asked to restart Zoloft because “she

sort of feels ‘down’ again lately.” AR 362. The notes reflect at

least two refills of Zoloft after that date. AR 399, 406. 

Regarding the evaluation of plaintiff’s asserted physical

impairments, the record contains reports from two agency-ordered

comprehensive internal medicine examinations and attendant internal

agency medical evaluations by non-examining physicians. 

On May 31, 2001 plaintiff saw Paul D Levin, MD for a

comprehensive internal medicine evaluation. AR 222-25. Dr Levin’s

report made note of plaintiff’s reported medical history, including

past chest wall pain, high blood pressure, headaches with eye

twitches, arthritis pain in her hands and knees, post-bunionectomy

pain in both feet and unexplained pain in her left hip, AR 222. He

noted her height to be 63 inches and her weight to be 259 pounds;

he described her as “very overweight.” AR 223. Dr Levin noted the

range of motion in plaintiff’s spine and hips to be “normal.” AR

224. He diagnosed plaintiff with high blood pressure “under fair

control,” “mild to moderate” osteoarthritis of the hands, mild

osteoarthritis of the knees, and “probably degenerative disc

disease of her lumbar spine, significant.” AR 225. Dr Levin also

diagnosed “chronic mild discomfort” in her feet due to previous

surgery for bunions. AR 222, 225. Dr Levin suspected plaintiff

had active disc disease because of the “absence of a left ankle

jerk” and radiating pain down her leg. AR 225. He concluded that

she could lift ten pounds easily, twenty pounds occasionally, walk

for a total of thirty minutes in an eight-hour day, sit for eight

hours in an eight-hour day, bend, stoop and crouch, and had no

limitation in fine or gross touch, reaching, handling, grasping or

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manipulating; he stated that she should avoid crawling, climbing,

balancing or reaching. Id. In his report, he found that she was

able to stand for ten to fifteen minutes at a time. Id. 

Following receipt of Dr Levin’s report, agency physician

Harmon Michelson, MD reviewed the case records and completed a

Physical Residual Functional Capacity Assessment dated July 2,

2001. AR 226-32. His primary diagnosis was morbid obesity, with a

secondary diagnosis of hypertension. AR 226. He checked boxes

showing plaintiff able to lift twenty pounds occasionally and ten

pounds frequently, stand/walk six hours per day and sit six hours

per day, with unlimited pushing/pulling (upper extremity) capacity. 

AR 227. He found her stooping, kneeling, crouching, crawling and

climbing abilities limited because “claimant is morbidly obese and

would not be able to get in and out of these postures except on an

occasional basis, slowly, and with considerable exertion.” AR 228. 

He found no manipulative, visual, communicative or environmental

limitations. AR 229-30. He found plaintiff’s alleged onset date

of 1979 “not credible” given her stated work history through 1997

and “activities enumerated to psychologist by claimant herself

which include up to full days of attendance at school” and

expressed skepticism about plaintiff’s claim of disability:

claimant’s credibility is tainted by symptom

amplification, at the very least. Note

especially, that except for the [consulting

examiner], no one spontaneously observes any

impairments at all. Note that her gait and

ability to get around in various * * * offices is

unimpaired. There is no justification for further

x-rays or [work-up] at department’s expense,

because no matter what they show, the longitudinal

MEOR and the current function speak for

themselves, and the claimant is not even near

allowance level impairment. 

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AR 231. Dr Michelson’s evaluation expressed disagreement with Dr

Levin’s suggested restrictions, commenting that they “are backed up

by neither his own exam nor the longitudinal HX. Just about all

the findings are normal.” AR 232. These conclusions were reviewed

and affirmed by Samuel McFadden, MD. AR 233. 

On February 20, 2003, in connection with plaintiff’s

March 2002 application for benefits, Dr Dean Chiang, a boardcertified internal medicine specialist, conducted a second physical

examination of plaintiff. AR 332-35. He noted her height as 64

inches and her weight as 256 pounds and described her as an “alert,

oriented, obese white female who was friendly and cooperative.” AR

333. Regarding plaintiff’s “chief complaint” of joint pain, he

concluded that she suffered from joint pain that was “likely

secondary to osteoarthritis,” but found her “freely ambulatory at

least with short distances inside the clinic,” but stated it would

not be surprising to find out “her mobility is somewhat limited for

long distances.” AR 335. 

Dr Chiang determined that plaintiff could stand and walk

for between four to six hours in an eight-hour day and would be

able to lift and carry, as well as push and pull, thirty pounds

occasionally and ten to fifteen pounds frequently. Id. Dr Chiang

found “no manipulative limitations and no other relevant workplace

environmental limitations.” Id. 

Following submission of Dr Chiang’s report, agency

physician Neyvin Gordon, MD completed a further RFC Assessment on

April 1, 2003 that agreed in all significant respects with that

completed in July 2001 (AR 226-32). AR 341-48.

\\

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Plaintiff also underwent three agency-ordered mental

health examinations in connection with her applications for SSI

benefits; these formed the basis for agency physicians’ assessments

of her claim. 

On June 7, 2001, psychiatrist Rafael H Gutierrez, MD

examined plaintiff without the help of an interpreter. His report

noted “I need to say that this lady spoke very little English and

had a hard time communicating with me in which I tried my very best

throughout the interview to understand her. * * * [T]his was en

extremely difficult case for me since there was not a translator

provided * * *. [T]here needs to be a psychiatric evaluation at the

county medical clinic with a translator.” AR 234-35, 237. With

those caveats, he diagnosed plaintiff with dysthymic disorder with

adjustment disorder, “depressed mode,” and a Global Assessment of

Functioning (GAF) of 55. Id at 237. The report mentioned

plaintiff’s obesity and her tearfulness several times and observed

“I feel that this lady is depressed.” AR 236. But Dr Gutierrez

also found her oriented and cooperative with “good contact with

reality.” Id at 236. 

On August 13, 2001, a consultative neuropsychologist,

Faith Tobias, PhD, evaluated plaintiff with the assistance of a

translator. AR 242-45. Dr Tobias gave a simple Axis I diagnosis

of “major depressive disorder” and deferred Axis II and III

diagnoses. AR 244. Of eleven work-related abilities listed in her

report, Dr Tobias found no impairment in nine of the areas

including following simple instructions, following complex/detailed

instructions, maintaining pace or persistence to perform both

simple and complex tasks, maintaining adequate

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attention/concentration and adapting to changes in job routine. AR

245. Dr Tobias found that plaintiff displayed “marked impairment”

in the ability to “[w]ithstand the stress of a routine work day” as

well as the ability to “[m]aintain emotional stability [and]

predictability.” Id. She also noted that “[d]uring today’s

evaluation the claimant was able to read and write simple sentences

in English. However, her spoken English is more limited.”

On September 15, 2001, agency physician George Norbeck,

MD completed a Psychiatric Review Technique form indicating that

plaintiff suffered from affective disorders that were “severe,” but

“not expected to last twelve months.” AR 251. The review

indicated no restriction in activities of daily living, social

functioning or maintaining concentration, persistence or pace, and

indicated “insufficient evidence” regarding repeated episodes of

decompensation. AR 261. On September 15, 2001, agency physician

Craig A Smith MD affirmed these findings. AR 251. Dr Norbeck also

completed a Mental Residual Functional Capacity Assessment dated

September 14, 2001 that identified “moderate” limitations in

working in proximity to others without distraction and “marked”

limitations in “the ability to complete a normal workday and

workweek without interruptions from psychologically based symptoms

and to perform at a consistent pace without an unreasonable number

and length of rest periods.” AR 248. 

On March 5, 2003, plaintiff saw consultative psychologist

Ubaldo Sanchez, PhD, for a comprehensive evaluation. AR 336-40. 

Dr Sanchez’s report did not mention an interpreter. It noted

further that plaintiff “speaks English with an accent” and “did not

have any difficulty with complex instructions and repetition and

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emphasis were not needed.” AR 336. It also noted that plaintiff

“did not demonstrate any physical impairment, and no distinguishing

motor characteristics were noted” and, regarding plaintiff’s report

of “feeling depressed,” it quoted plaintiff as saying the medicine

for depression prescribed by her doctor had made her feel “much

better.” It also noted “She does not see a mental health

professional. ‘It’s a Russian thing. We never go to a

psychologist.’” AR 338. 

Dr Sanchez conducted several tests: the Bender Visual

Motor Gestalt Test, Reyes 15 Items Memory Test, Wechsler Adult

Intelligence Scale – III and Wechsler Memory Scale – III. 

Plaintiff obtained a full-scale IQ score of 80, placing her at the

“lower limits of the low average range of measured intelligence.” 

AR 338. The report noted, however, that “[h]er verbal scores [from

her measured intelligence tests] must be viewed with caution given

the cultural bias of the test.” AR 340. On the memory sub-tests,

plaintiff scored in the lowest one percentile in auditory,

immediate and working memory, and in the lowest fifth percentile in

visual memory, indicating “a decline in memory skills.” Id. Dr

Sanchez diagnosed plaintiff with major depressive disorder and a

GAF of 53. AR 339. He listed “unemployed” among “psycho-social

stressors.” Id. Dr Sanchez concluded that plaintiff would benefit

from mental health treatment and that she “is not limited to daily

activities such as dressing, bathing and eating, * * * would not

have any difficulty being socially appropriate, * * * [is] able to

perform mildly complex tasks [and] * * * to handle funds,” but

would have “mild to moderate difficulty concentrating, focusing and

keeping up with the pace of a working environment.” AR 340. 

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On the basis of Dr Sanchez’s report, agency physician

Craig A Smith, MD completed a Psychiatric Review Technique form in

April 2003 marking only the boxes for “affective disorders” and

“impairments not severe.” AR 387. On June 23, 2003, agency

physician George P Norbeck, MD affirmed this conclusion. Id. 

 

C

On April 11, 2003, the SSA denied plaintiff’s second

application for SSI benefits. AR 78. After her request for 

reconsideration proved fruitless, AR 83, plaintiff requested a

hearing before an ALJ. AR 87. She also secured counsel to

represent her. AR 90. On October 30, 2003, plaintiff’s attorney,

Mr Terry LaPorte, sent a letter to the ALJ amending plaintiff’s

alleged disability onset date to the date of her initial

application —— March 6, 2001. AR 176. In this letter, plaintiff

requested the reopening of her March 6, 2001 application pursuant

to the provisions of 20 CFR § 1588-89. Id. 

The ALJ opened the hearing on December 18, 2003. AR 33-

63. Plaintiff, her attorney and Vocational Expert (VE) Ron Morrell

were present. Plaintiff testified that she was disabled due to

“strong pain” in her hands, leg, and back, and that she had

problems with her knee and hip and with depression. AR 40-48. 

While at the hearing, plaintiff wore a brace on her left wrist. AR

20, 54. When the ALJ asked her about it, plaintiff testified that

three months before the hearing her doctor had recommended the

brace to ease the “strong pain” she suffered in her left wrist. AR

54-55. Plaintiff stated that she could stand for about ten to

fifteen minutes at a time and that she could not walk further than

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across the street without taking a break to rest. AR 43. 

Plaintiff further testified that she began taking classes to learn

English in 1997, and that for the three years preceding her 2003

hearing, she attended English classes three days a week for about

three hours, AR 38, and that her progress in learning English was

hindered by her medical impairments, especially by her memory

problems. AR 49. 

The VE testified that based on the exhibit file,

plaintiff’s past job in Russia fell into the light exertional

category, but that plaintiff’s inconsistent testimony at the

hearing that her job had required lifting as much as thirty pounds

suggested a medium exertional level. AR 58. The VE opined that

there would be “no transferable skills to sedentary employment

[but] [t]here would be transferable skills to light exertionally.” 

AR 59. Plaintiff’s attorney then questioned the VE about various

hypothetical non-exertional (i e, mental health) restrictions drawn

from various mental health evaluations in the reports, such as

“mild to moderate difficulties in concentrating, focusing and

keeping up with the pace of a working environment,” “marked

restriction in the ability to withstand the stress of a routine

workday” and “marked restriction in the ability to maintain

emotional stability * * * caused by depression.” AR 60-62. The VE

testified that with only “mild” non-exertional restrictions,

plaintiff could transfer her skills to other light work, but that

“moderate” restrictions would hamper her ability to maintain

employment. AR 60-62. 

On February 14, 2003, the ALJ issued a decision finding

that plaintiff did not meet the criteria for disability. The ALJ

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began by denying the request to re-open plaintiff’s 2001

application, stating that, because more than one year had elapsed

following the initial determination of the prior claim, “that claim

does not require reopening for ‘any reason,’” AR 16, and no good

cause to reopen the prior determination existed. Id.

To determine whether plaintiff was entitled to benefits,

the ALJ conducted the five-step sequential evaluation of

plaintiff's claim of disability as set forth at 20 CFR §

404.1520(b)-(f), which considered: (1) whether plaintiff was

currently engaged in “substantial gainful activity”; (2) whether

plaintiff had a “severe” impairment or combination of impairments;

(3) if plaintiff had a severe impairment, whether plaintiff had a

condition which met or equaled the conditions outlined in the

Listing of Impairments, 20 CFR Pt 404, Subpt P, App 1 as well as

the duration requirement; (4) if plaintiff did not have such a

condition, whether plaintiff was capable of performing her past

work; and if not, (5) whether plaintiff had the residual functional

capacity to perform any other work which existed in substantial

numbers in the national economy. 

At the first step, the ALJ found that the claimant had

not engaged in substantial gainful activity since the amended

alleged onset of disability. AR 21. 

At the second step, he found that plaintiff had two

medically determinable impairments —— a mild adjustment disorder

and mild arthritis —— and that these qualified as “severe.” AR 21. 

Concerning plaintiff’s reported depression, the ALJ adopted the

specific findings of consultative psychologist Dr Sanchez that

plaintiff “would not have significant limitations in her activities

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of daily living or social functioning, and would have only ‘mild to

moderate’ limitations in her ability to maintain concentration and

keep up with the pace of a working environment.” AR 19. “Because

there is no evidence that the claimant ever felt the necessity to

pursue psychiatric or psychological care of any kind, and because

this medical opinion is significantly more restrictive than others

in the file,” the ALJ accorded less weight to the opinion of Dr

Tobias who opined, in 2001, that plaintiff “would have ‘marked’

limitations in withstanding the stress of a routine workday and in

maintaining emotional stability and predictability.” Id. 

At step three, the ALJ found that while the medical evidence

supported a finding that plaintiff had mild arthritis, this

impairment did not singly or in combination with plaintiff’s nonexertional limitations, “meet or medically equal * * * one of the

impairments listed in Appendix 1, Subpart P Regulations [No] 4.” 

AR 18, 22. Because there was no evidence that plaintiff received

or was then receiving any more than basic medical treatment, the

ALJ based his conclusions on the consultative evaluations and state

agency physicians who had previously reviewed the complete,

objective medical evidence. AR 19. Regarding the asserted mental

health restrictions, the ALJ wrote:

Neither consultative mental health evaluator in

the record opined that the claimant would be

incapable of returning to her past relevant work

due to her alleged mental health impairments. In

fact, as emphasized previously, the claimant has

pursued no mental health treatment or even

referrals, other than those required by the State

Agency, secondary to her SSI claims. 

AR 20. The ALJ rejected Dr Tobias’s opinion that plaintiff would

have “marked” limitations in managing work stress and emotional

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stability as “inconsistent with the medical records” and with the

opinions of the other evaluators and because plaintiff had not

pursued mental health treatment. Id. 

The ALJ also discounted plaintiff’s subjective complaints

as “not fully credible when compared to the record as whole,”

noting specifically plaintiff’s admitted capacity to spend her days

cooking, cleaning, studying English and “helping out around the

house,” the uncontradicted evidence that her depression was

effectively controlled with Zoloft and her failure to pursue mental

health treatment. AR 22. The ALJ commented on the conflicting

dates alleged for onset of disability, including one that alleged

severe pain and depression during a period when she also claimed to

be involved in an intensive English study program. AR 20. 

At step four, the ALJ concluded that “the claimant’s past

relevant work as a sheet metal instructor did not require the

performance of work-related activities precluded by her residual

functional capacity (20 CFR § 416.965),” and that her “medically

determinable mild adjustment disorder and mild arthritis [did] not

prevent [her] from performing her past relevant work.” AR 22. 

This conclusion was based on the ALJ’s finding, based on the

reports in the record, that plaintiff could lift and carry up to

twenty pounds occasionally and ten pounds frequently, sit up to six

hours and stand and walk for up to six hours in an eight-hour

workday. Id. Accordingly, he found that she could “perform a

significant range of light work.” AR 18, 22. Here, the ALJ also

noted that, according to the VE, claimant could return to her past

relevant work as a sheet metal instructor “as it is customarily

performed in the United States general economy.” AR 21. Having

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reached this conclusion at step four, the ALJ did not proceed to

step five. 

In conclusion, the ALJ held that the claimant was “not

under a ‘disability’ as defined in the Social Security Act, at any

time through the date of the decision (20 CFR § 416.920(e))” and

was therefore ineligible for SSI payments under Sections 1602 and

1614(a)(3)(A) of the Act. AR 22.

Plaintiff appealed to the SSA’s Appeals Council, which

denied review, rendering the ALJ’s decision final. AR 7-11. On

April 30, 2004, plaintiff timely filed the instant action seeking

judicial review. 

II 

Under 42 USC § 405(g), a decision to deny benefits may be

overturned if the decision is not supported by substantial evidence

or if the decision is based on legal error. Thomas v Barnhart, 278

F3d 947, 954 (9th Cir 2002). Substantial evidence means more than

a scintilla but less than a preponderance. Id. Substantial

evidence is relevant evidence which, considering the record as a

whole, a reasonable person might accept as adequate to support a

conclusion. Id. Where the evidence is susceptible to more than

one interpretation, one of which supports the ALJ’s decision, the

ALJ’s conclusion must be upheld. Id.

III

 A 

“Disabled” is defined as “unable to do any substantial

gainful activity by reason of any medically determinable physical

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or mental impairment which can be expected to result in death or

which has lasted or can be expected to last for a continuous period

of not less than 12 months.” 20 CFR § 416.927. 

Conditions meeting the criteria set forth in the “Listing

of Impairments” are presumed disabling, without any specific

finding as to the claimant’s ability to perform his past relevant

work or any other jobs. Lester v Chater, 81 F3d 821, 828 (9th Cir

1995); 20 CFR § 416.920(d). A claimant is deemed disabled if her

condition either “meets” or “equals” a listed impairment. Id. To

“meet” any of the listed mental impairments, the SSA must find that

diagnostic criteria in paragraph A of the impairment definition

(for example emotional lability and impairment in impulse control

or medically documented persistence of a short term memory

impairment) are met, as well as that a specified number of

functional restrictions in paragraph B (for example, marked

restriction of activities of daily living and marked difficulties

in maintaining concentration, persistence or pace) are met. Id. 

The purpose of the functional criteria in paragraph B is to measure

the severity of the claimant’s impairment. 20 CFR Part 404,

subpart P, App 1 § 12.00(C). 

Even if a claimant’s mental impairment does not meet the

criteria specified in the listings, however, she must be found

disabled if “the combination of [her] impairments is medically

equal to any listed impairment.” Lester, 81 F3d at 829; 20 CFR §

416.926(a). As relevant here, the claimant’s illnesses “must be

considered in combination and must not be fragmentized in

evaluating their effects.” Lester, 81 F3d at 829, citing Beecher v

Heckler, 756 F2d 693, 694-95 (9th Cir 1985). In addition, where a

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claimant alleges mental impairments, the ALJ is required to use the

“special technique” set forth in 20 CFR § 416.920a(a) for

evaluating the severity of mental impairments. 

The court may set aside the ALJ's final decision when

that decision is based on legal error or where the findings of fact

are not supported by substantial evidence in the record taken as a

whole. Tackett v Apfel, 180 F3d 1094, 1097-98 (9th Cir 1999). 

Even if substantial evidence supports the ALJ's factual findings,

the decision must be set aside if improper legal standards were

applied in weighing the evidence and reaching the decision. See

Benitez v Califano, 573 F2d 653, 655 (9th Cir 1978). 

B

In her appeal, plaintiff alleges that she is disabled and

unable to work due to osteoarthritis and a history of major

depression. AR 407. Plaintiff makes two challenges to the

decision: (1) she asserts that he failed to consider her

exertional and non-exertional limitations in combination and (2)

she contends that he improperly failed to account for plaintiff’s

lack of facility in English. Pl Mot (Doc #6) at 5. 

1

First, the court addresses plaintiff’s assertion that the

ALJ improperly failed to consider the combination of plaintiff’s

exertional and non-exertional limitations. The ALJ found that

plaintiff “has a mild adjustment disorder and mild arthritis,

impairments that are ‘severe’ within the meaning of the Regulations

but not ‘severe’ enough to meet or medically equal, either singly

or in combination to one of the impairments listed in Appendix 1,

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Subpart P, Regulations No 4.” AR 18. 

The ALJ properly relied on Dr Chiang’s report finding

plaintiff free of significant physical limitations as on the

unequivocal conclusions of agency physicians that plaintiff was not

disabled by her arthritis. 

Similarly, the three SSA-ordered mental health

evaluations were reviewed and considered by the state agency

physicians who concluded that plaintiff was able to perform light

work. AR 391. The ALJ, relying on these reports, addressed the

degree of limitation in each of the four functional areas specified

in § 404.1520a. AR 19-20. The ALJ gave cogent reasons for

according less weight to Dr Tobias’s more restrictive findings,

which he found to be at odds with the other medical evidence and

with plaintiff’s failure to seek treatment. Id. 

Plaintiff also contends that the ALJ should not have

discredited her alleged mental impairments based on her failure to

pursue mental health treatment given the asserted scarcity of

mental health services for primarily Russian-speaking individuals

without health insurance in the Santa Clara County area. AR 408. 

It was reasonable, however, for the ALJ to give weight to the fact

that “the claimant has pursued no mental health treatment or even

referrals, other than those required by the State Agency, secondary

to her SSI claims,” AR 20, and that plaintiff’s depression had

been so completely controlled by Zoloft that she discontinued this

medication for six months. AR 21. 

The ALJ’s finding that plaintiff’s impairments did not,

in combination, meet or equal a listed impairment is supported by

substantial evidence in the record and must therefore be upheld. 

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2

Plaintiff’s second claim —— that the ALJ improperly

failed at step four of the sequential analysis to consider

plaintiff’s inability to speak English in evaluating her ability to

perform her past relevant work —— is also without merit. Plaintiff

contends that her inability to communicate in English made her

unable to perform her past relevant work and therefore amounts to a

disability. Id at 6. 

The governing section of the Act is 42 USC §

1382c(a)(3)(B), which provides: 

an individual shall 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.

In Social Security Ruling 82-40, the SSA set forth guidance as to

how to approach the fourth step to determine “whether the individual

can do his or her previous work, whether in the United States or in

a foreign economy,” when the prior work experience is in a foreign

economy:

The relevance of past work in a foreign economy for

purposes of regulations sections 404.1520(e) and

416.920(e) is no different from the relevance of

past work in the United States economy with respect

to the physical and mental demands of the

particular past job. If a claimant can meet the

sitting, standing, walking, lifting, manipulative,

intellectual, emotional and other physical and

mental requirements of a past job, he or she is

still functionally capable of performing that job

regardless of the fact that the individual no

longer resides in the country where the past work

was performed. It is only after a claimant proves

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that he or she is not able to do his or her

previous work that the burden shifts to the

Secretary to show that there is work available in

the United States national economy which the

claimant can do (the fifth and last step of the

sequential evaluation process).

The stated purpose of SSR 82-40 was to address problems arising from

the view that “past work performed in a foreign economy” was only

relevant to the fourth step if substantially similar work was found

in the United States economy by making clear that vocational factors

such as education, should not be considered at the fourth step of

the sequential analysis. See 20 CFR §§ 404.1560(b), 416.960(b). 

Instead, whether similar work can be found in the United States

economy is an inquiry properly reserved for the fifth step of the

sequential analysis. 

The Ninth Circuit has specifically upheld SSR 82-40 as

consistent with the Social Security Act and its implementing

regulation(s). Quang Van Han v Bowen, 882 F2d 1453, 1457 (9th Cir

1989). In Quang, a claimant whose occupational history consisted

solely of working in an herbal medicine store in Vietnam challenged

SSR 82-40 as inconsistent with 42 USC § 1382c(a)(3)(B), which

defines “disability” in part as the inability to “engage in any

other kind of substantial gainful work which exists in the national

economy.” The court held that the Secretary’s interpretation of §

1382c(a)(3)(B) —— that “although the Act requires ‘other’ work to

exist in the United States, it places no such limitation on

‘previous’ work” —— was one of at least two reasonable

interpretations of the statute and not inconsistent with the Act or

its implementing regulations. Id at 1457. The court explained the

justification for SSR 82-40 thusly: 

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Each of the steps asks the ultimate question, whether

the claimant is healthy enough to be employable, in

terms that approximate the statute with increasing

precision. If the claimant is in sufficient physical

and mental condition to perform [her] previous work,

[her] impairment is clearly not so severe as to

preclude employment. This should hold true no matter

where [her] previous work took place * * *. 

Id.

While Quang did not directly address plaintiff’s central

contention in this appeal —— the ability to speak English as a

factor in determining disability —— its holding, when combined with

other relevant sources of law, plainly bars consideration of a

claimant’s inability to communicate in English when evaluating

claimant’s ability to perform previous relevant work. In Garcia v

Secretary of Health & Human Servs, 46 F3d 552 (6th Cir 1995), the

Sixth Circuit rejected a claimant’s challenge to the SSA’s

determination that he retained the RFC to perform his past relevant

work despite his “virtual inability to communicate in English.” 

The court analyzed the text of the statute and found that Congress

intended to exclude vocational factors from step four of the

sequential analysis: 

This intent is borne out by the structure of the

disability definition. The phrase “considering his

age, education, and work experience” interrupts and

therefore exclusively modifies the phrase “but cannot

* * * engage in any other kind of substantial gainful

work which exists in the national economy.”

Accordingly, the phrase “considering his age,

education, and work experience” does not modify the

phrase “not only unable to do his previous work.” 

The inevitable reading is that Congress intended a

claimant’s ability to perform previous work to be

assessed apart from the considerations of age,

education, and work experience.”

Id at 555-56 (citations omitted). In Garcia, the Sixth Circuit

expressed accord with the Ninth Circuit’s opinion in Quang,

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explaining that “Congress manifested the intention [to distinguish

sharply between unemployment compensation and the disability

benefits provided by the Act] by defining ‘disability’ under the

Act as a predominantly medical determination, as opposed to a

vocational one.” Id at 558-59. Accord Bussi v Barnhart, 87 Soc Sec

Rep Serv 605, 2003 US Dist LEXIS 9278 at *20, 2003 WL 21283448

(SDNY 2003) (claimant’s inability to speak English held irrelevant

to determination of whether she can perform her past relevant

work); Martinez v Bowen, 685 F Supp 70, 71 (SDNY 1988) (remand for

consideration of impact of plaintiff's inability to speak English

on his ability to perform past relevant work held inappropriate,

citing Social Security Ruling 82-40). 

The ability to communicate in English is considered as

part of the rule governing education as a vocational factor, 20 CFR

§ 416.964(b)(5). The regulation acknowledges that the inability to

speak English is a handicap: 

Because English is the dominant language of the

country, it may be difficult for someone who doesn’t

speak and understand English to do a job, regardless

of the amount of education the person may have in

another language. Therefore, we consider a person’s

ability to communicate in English when we evaluate

what work, if any, he or she can do.

 Id. If, however, the SSA determines at step four that the claimant

can still perform her past relevant work, “we will find that you

are not disabled,” and will not proceed to step five, at which

vocational factors are considered. 20 CFR § 416.920(a)(4)(iv). 

If, and only if, the ALJ had reached the fifth step under the

sequential analysis would it have been appropriate to evaluate

educational factors such as plaintiff’s ability to speak English,

but his analysis concluded at step four. 

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The ALJ’s mention that plaintiff was able to perform her

past relevant work as it is “customarily performed in the United

States general economy,” AR 21, while helpful, was not necessary to

find plaintiff not disabled at step four. 

IV

For the reasons stated herein, plaintiff’s motion is

DENIED and defendant’s motion is GRANTED. The clerk shall enter

judgment in favor of defendant and against plaintiff. 

The clerk is directed to terminate all pending motions

and to close the file. 

IT IS SO ORDERED.

 

VAUGHN R WALKER

United States District Chief Judge

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