Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-02352/USCOURTS-azd-2_12-cv-02352-0/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 (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Joni Ellen Payton, 

Plaintiff, 

vs. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant.

No. CV-12-02352-PHX-NVW

ORDER 

Plaintiff Joni Ellen Payton seeks review under 42 U.S.C. § 405(g) of the final 

decision of the Commissioner of Social Security (“the Commissioner”), which denied her 

supplemental security income under section 1614(a)(3)(A) of the Social Security Act. 

Because the decision of the Administrative Law Judge (“ALJ”) is supported by 

substantial evidence and is not based on legal error, the Commissioner’s decision will be 

affirmed. 

I. BACKGROUND 

A. Factual Background 

Payton was born in December 1965. She has a limited education and has no past 

relevant work. She has been diagnosed with hepatitis C, human immunodeficiency virus 

(HIV), mild sleep apnea, headaches, cervical and lumbar degenerative disc disease, and 

obesity. She is generally able to drive, shop for groceries, go to medical appointments, 

work in the garden, cook, and do light household chores. She helps her teenaged son 

with homework and can play board games. 

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B. Procedural History 

On October 1, 2010, Payton applied for supplemental security income, alleging 

disability beginning January 15, 2003. On April 10, 2012, she appeared with her attorney 

and testified at a hearing before the ALJ. A vocational expert also testified. 

On April 19, 2012, the ALJ issued a decision that Payton was not disabled within 

the meaning of the Social Security Act. The Appeals Council denied Payton’s request for 

review of the hearing decision, making the ALJ’s decision the Commissioner’s final 

decision. On November 2, 2012, Payton sought review by this Court. 

II. STANDARD OF REVIEW 

The district court reviews only those issues raised by the party challenging the 

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court 

may set aside the Commissioner’s disability determination only if the determination is 

not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 

625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. In determining whether 

substantial evidence supports a decision, the court must consider the record as a whole 

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. 

As a general rule, “[w]here the evidence is susceptible to more than one rational 

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be 

upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted). 

The ALJ is responsible for resolving conflicts in medical testimony, determining 

credibility, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 

1995). In reviewing the ALJ’s reasoning, the court is “not deprived of [its] faculties for 

drawing specific and legitimate inferences from the ALJ’s opinion.” Magallanes v. 

Bowen, 881 F.2d 747, 755 (9th Cir. 1989). 

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III. FIVE-STEP SEQUENTIAL EVALUATION PROCESS 

To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 416.920(a). The claimant bears the 

burden of proof on the first four steps, but at step five, the burden shifts to the 

Commissioner. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

At the first step, the ALJ determines whether the claimant is engaging in 

substantial gainful activity. 20 C.F.R. § 416.920(b). If so, the claimant is not disabled 

and the inquiry ends. Id. At step two, the ALJ determines whether the claimant has a 

“severe” medically determinable physical or mental impairment. § 416.920(c). If not, 

the claimant is not disabled and the inquiry ends. Id. At step three, the ALJ considers 

whether the claimant’s impairment or combination of impairments meets or medically 

equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404. 

§ 416.920(d). If so, the claimant is automatically found to be disabled. Id. If not, the 

ALJ proceeds to step four. At step four, the ALJ assesses the claimant’s residual 

functional capacity and determines whether the claimant is still capable of performing 

past relevant work. § 416.920(f). If so, the claimant is not disabled and the inquiry ends. 

Id. If not, the ALJ proceeds to the fifth and final step, where he determines whether the 

claimant can perform any other work based on the claimant’s residual functional 

capacity, age, education, and work experience. § 416.920(g). If so, the claimant is not 

disabled. Id. If not, the claimant is disabled. Id. 

At step one, the ALJ found that Payton has not engaged in substantial gainful 

activity since October 1, 2010. At step two, the ALJ found that Payton has the following 

severe impairments: hepatitis C, human immunodeficiency virus (HIV), mild sleep 

apnea, headaches, cervical and lumbar degenerative disc disease, and obesity. At step 

three, the ALJ determined that Payton does not have an impairment or combination of 

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impairments that meets or medically equals an impairment listed in Appendix 1 to 

Subpart P of 20 C.F.R. Pt. 404. 

At step four, the ALJ found that Payton: 

has the residual functional capacity to perform sedentary 

work as defined in 20 CFR 416.967(a) except the claimant 

should never climb ladders, ropes, and scaffolds. She is able 

to occasionally climb ramps and stairs, balance, stoop, 

crouch, kneel, and crawl. In addition, the claimant should 

avoid concentrated exposure to extreme heat, irritants such as 

fumes, odors, dusts, and gases, chemicals, moving machinery, 

and unprotected heights. 

The ALJ further found that Payton is unable to perform any of her past relevant work. At 

step five, the ALJ concluded that, considering Payton’s age, education, work experience, 

and residual functional capacity, there are jobs that exist in significant numbers in the 

national economy that Payton could perform. 

IV. ANALYSIS 

A. The ALJ Did Not Err in Evaluating Payton’s Credibility. 

In evaluating the credibility of a claimant’s testimony regarding subjective pain or 

other symptoms, the ALJ is required to engage in a two-step analysis: (1) determine 

whether the claimant presented objective medical evidence of an impairment that could 

reasonably be expected to produce some degree of the pain or other symptoms alleged; 

and, if so with no evidence of malingering, (2) reject the claimant’s testimony about the 

severity of the symptoms only by giving specific, clear, and convincing reasons for the 

rejection. Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009). 

First, the ALJ found that Payton’s medically determinable impairments could 

reasonably be expected to cause the alleged symptoms. Second, the ALJ found Payton’s 

statements regarding the intensity, persistence, and limiting effects of the symptoms not 

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credible to the extent they are inconsistent with the ALJ’s residual functional capacity 

assessment. 

The ALJ provided the following specific, clear, and convincing reasons for finding 

Payton’s statements regarding the intensity, persistence, and limiting effects of the 

symptoms not entirely credible. First, the record showed that Payton’s HIV condition has 

been kept under good control with antiretroviral therapy, and she was successfully treated 

for hepatitis C in 2004. The ALJ concluded: “Generally asymptomatic conditions are 

not indicative of debilitating limitations. This lessens the claimant’s credibility.” 

Second, regarding Payton’s respiratory complaints, the record showed that Payton 

reported improvement following use of a CPAP machine, but despite numerous 

recommendations to quit smoking, she had not. The ALJ concluded: 

Continued cigarette usage, despite recommendations to quit, 

undermines the claimant’s allegations of disabling symptoms 

and limitations, and suggests her respiratory symptoms were 

not as severe as alleged. Her credibility is damaged. 

Third, Payton has complained of headaches, but neurological examinations were 

consistently within normal limits. Treatment consisted of only occasional medication 

prescribed by Payton’s primary care physician. The ALJ reasoned that such conservative 

treatment is not consistent with debilitating symptoms and limitations and concluded that 

Payton’s “credibility is effectively lessened.” 

Fourth, regarding Payton’s neck and back pain, the record showed appropriate 

treatment with a pain specialist and improvement with medication, mild exercise, and 

injections. Payton reported doing well with pain medication. Thus, the ALJ concluded: 

“Symptoms effectively controlled with medication and radiofrequency ablation is not 

consistent with the claimant’s allegations.” 

Fifth, the ALJ found that Payton had not been entirely compliant in taking 

prescribed medications, despite agreeing to take only medication prescribed by the pain 

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specialist. The ALJ concluded: “Not adhering to the contract signed with her treating 

specialist further diminishes the claimant’s credibility as to her allegations.” 

Sixth, the ALJ found that treating physicians consistently observed that Payton did 

not appear to be ill or in acute distress, and physical examinations were typically within 

normal limits. Records indicated she was able to sit, stand, and walk with no difficulty. 

Payton reported no deficits with regard to activities of daily living to her treating 

physicians. Rather, on October 26, 2010, she reported that she had been “very active 

over the last few months” and had “actually taken up hiking.” In 2011, Payton reported 

engaging in aerobics and exercising three times per week. The ALJ found these reports 

to be inconsistent with Payton’s allegations of disability. 

Finally, Payton described daily living activities that were not limited to the extent 

one would expect, given her complaints of disabling symptoms and limitations. The ALJ 

found that Payton’s activities of daily living lent additional support to his conclusions. 

The ALJ did not reject Payton’s subjective symptom testimony entirely, but rather 

considered it along with “the combined effect of her conditions, including obesity, and 

the probable side effects of medication” to “find she is capable of performing a range of 

sedentary exertion.” 

Therefore, the ALJ did not err by finding Payton’s statements regarding the 

intensity, persistence, and limiting effects of the symptoms not entirely credible because 

he provided specific, clear, and convincing reasons, supported by substantial evidence in 

the record, for doing so. 

B. The ALJ Did Not Err in Weighing Medical Source Evidence. 

1. Legal Standard 

In weighing medical source opinions in Social Security cases, the Ninth Circuit 

distinguishes among three types of physicians: (1) treating physicians, who actually treat 

the claimant; (2) examining physicians, who examine but do not treat the claimant; and 

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(3) non-examining physicians, who neither treat nor examine the claimant. Lester v. 

Chater, 81 F.3d 821, 830 (9th Cir. 1995). Generally, more weight should be given to the 

opinion of a treating physician than to the opinions of non-treating physicians. Id. 

Where a treating physician’s opinion is not contradicted by another physician, it may be 

rejected only for “clear and convincing” reasons, and where it is contradicted, it may not 

be rejected without “specific and legitimate reasons” supported by substantial evidence in 

the record. Id. Moreover, the Commissioner must give weight to the treating physician’s 

subjective judgments in addition to his clinical findings and interpretation of test results. 

Id. at 832-33. 

Further, an examining physician’s opinion generally must be given greater weight 

than that of a non-examining physician. Id. at 830. As with a treating physician, there 

must be clear and convincing reasons for rejecting the uncontradicted opinion of an 

examining physician, and specific and legitimate reasons, supported by substantial 

evidence in the record, for rejecting an examining physician’s contradicted opinion. Id.

at 830-31. 

The opinion of a non-examining physician is not itself substantial evidence that 

justifies the rejection of the opinion of either a treating physician or an examining 

physician. Id. at 831. “The opinions of non-treating or non-examining physicians may 

also serve as substantial evidence when the opinions are consistent with independent 

clinical findings or other evidence in the record.” Thomas, 278 F.3d at 957. 

Moreover, Social Security Rules expressly require a treating source’s opinion on 

an issue of a claimant’s impairment be given controlling weight if it is well-supported by 

medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent 

with the other substantial evidence in the record. 20 C.F.R. § 404.1527(d)(2). If a 

treating source’s opinion is not given controlling weight, the weight that it will be given 

is determined by length of the treatment relationship, frequency of examination, nature 

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and extent of the treatment relationship, relevant evidence supporting the opinion, 

consistency with the record as a whole, the source’s specialization, and other factors. Id. 

Factors that an ALJ may consider when evaluating any medical opinion include 

“the amount of relevant evidence that supports the opinion and the quality of the 

explanation provided; the consistency of the medical opinion with the record as a whole; 

[and] the specialty of the physician providing the opinion.” Orn, 495 F.3d at 631. 

2. Treating Physicians Jayashree Raju, D.O., and Roberto Alvarez, 

M.D. 

The Commissioner is responsible for determining whether a claimant meets the 

statutory definition of disability and does not give significance to a statement by a 

medical source that the claimant is “disabled” or “unable to work.” 20 C.F.R. 

§ 416.927(d). The ALJ correctly stated that Dr. Raju’s and Dr. Alvarez’s opinions that 

Payton was “totally disabled” and “unable to gain or sustain employment” would not be 

given any weight because these are issues reserved to the Commissioner. 

In addition, the ALJ provided the following clear, convincing, specific, and 

legitimate reasons supported by substantial evidence in the record for doing so: (1) the 

opinions contained no functional analysis, (2) they were unsupported by the medical 

evidence of record, and (3) they were not consistent with these physicians’ own treatment 

notes. The ALJ did not err in determining that “these mere statements that the claimant is 

disabled are afforded no weight.” 

3. Treating Pain Management Specialist Brian Page, D.O. 

The ALJ correctly declined to give controlling weight to Dr. Page’s opinion that 

Payton has been unable to gain employment due to her medical conditions because this is 

an issue reserved to the Commissioner. The ALJ also provided the following reasons for 

affording Dr. Page’s opinion little weight: (1) the opinion did not include any functional 

limitations; (2) it was conclusory, providing no evidence relied upon in forming the 

opinion; (3) it was not consistent with the evidence of record or his own treatment notes; 

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and (4) it relied in part on an assessment of impairments for which Dr. Page rendered no 

treatment. Moreover, the ALJ concluded that Dr. Page relied quite heavily on Payton’s 

subjective report of symptoms, which the ALJ found to be unreliable. 

Dr. Page’s September 28, 2010 opinion consists of one paragraph. It states: 

Joni Payton has been a long-term chronic pain patient of 

mine. We have been treating her for pain related to HIV as 

well as Hepatitis C, severe lumbar degenerative disc disease 

and disc bulging of the cervical spine. She is on high doses 

of pain medication. We have been performing injections and 

physical therapy on her for quite some time. She has severe 

low back pain, headaches and upper back pain as well as 

other medical conditions. She has been unable to gain 

employment due to all of these medical conditions as well as 

some sedation related to the high doses of pain medication 

she is currently taking. 

This opinion plainly does not include any functional limitations and does not include or 

refer to any assessments of Payton’s pain severity. Dr. Page’s conclusion that Payton 

“has been unable to gain employment due to all of these medical conditions” is beyond 

his actual knowledge. Although Dr. Page’s opinion states that he has treated Payton for 

“pain related to HIV as well as Hepatitis C,” his treatment records refer only to neck and 

back pain, which supports the ALJ’s conclusion that “Dr. Page only treated the claimant 

for her neck and back pain.” Thus, the ALJ has provided clear, convincing, specific, and 

legitimate reasons supported by substantial evidence in the record for giving Dr. Page’s 

opinion little weight. 

Therefore, the ALJ did not err in giving little weight to Dr. Page’s opinion. 

4. Treating Pulmonologist Stephen Anthony, M.D. 

The ALJ gave little weight to Dr. Anthony’s opinion that Payton had been unable 

to gain employment because of her medical conditions as well as some sedation related to 

the high doses of pain medication she is taking. The ALJ provided the following clear, 

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convincing, specific, and legitimate reasons supported by substantial evidence in the 

record for affording Dr. Anthony’s opinion little weight: (1) the opinion was based on 

assessments of some conditions for which Payton had received no treatment from Dr. 

Anthony, (2) it was not supported by the greater objective medical evidence of record, 

and (3) because the opinion departed substantially from the rest of the evidence of record 

and was prompted by Payton’s request, it was likely that Dr. Anthony was motivated to 

assist Payton in obtaining benefits. 

Therefore, the ALJ did not err in giving little weight to Dr. Anthony’s opinion. 

5. State Agency Reviewing Physicians 

The ALJ gave the opinions of the state agency reviewing physicians “great weight 

in this case based on their consistency with the greater objective medical evidence of 

record, particularly regarding the assessment that the claimant could perform a range of 

sedentary exertion.” However, the ALJ afforded their opinions only partial weight 

because “the assertions that the claimant could perform a range of light exertion remains 

unsupported by the evidence of record,” “[i]t does not appear these physicians adequately 

considered the claimant’s subjective complaints,” and “additional evidence, which 

supports the residual functional capacity reached herein, was submitted at the hearings 

level.” Therefore, the ALJ did not err by giving the opinions of the state agency 

reviewing physicians partial weight to the extent they were supported by the evidence of 

record. 

C. The ALJ Did Not Err by Rejecting the Third Party Report from 

Payton’s Roommate, Louis Rizzatti. 

In additional to medical sources, the ALJ may consider evidence from spouses, 

parents, friends, and others regarding the severity of a claimant’s impairment and how it 

affects her ability to work. 20 C.F.R. §§ 404.1513(d)(4), 416.913(d)(4). “In considering 

evidence from ‘non-medical sources’ who have not seen the individual in a professional 

capacity in connection with their impairments, such as spouses, parents, friends, and 

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neighbors, it would be appropriate to consider such factors as the nature and extent of the 

relationship, whether the evidence is consistent with other evidence, and any other factors 

that tend to support or refute the evidence.” SSR 06-3p, 2006 WL 2329939 at *5. Lay 

witness evidence is competent evidence and cannot be disregarded without providing 

specific reasons germane to each witness. Bruce v. Astrue, 557 F.3d 1113, 1115 (9th Cir. 

2009). The ALJ may not discredit lay testimony as not supported by medical evidence in 

the record. Id. at 1116 (citing Smolen v. Chater, 80 F.3d 1273, 1292 (9th Cir. 1996)). 

The ALJ stated: 

The third party statements of the claimant’s 

boyfriend/roommate do not establish that the claimant is 

disabled []. Since this individual makes no reference to being 

trained to make exacting observations as to dates, 

frequencies, types and degrees of medical signs and 

symptoms, or of the frequency or intensity of unusual moods 

or mannerisms, the accuracy of the third party statements is 

questionable. Moreover, by virtue of the relationship as a 

friend and roommate of the claimant, he cannot be considered 

a disinterested third party whose statement would not tend to 

be colored by affection for the claimant and a natural 

tendency to agree with the symptoms and limitations the 

claimant alleges. Most importantly, significant weight cannot 

be given to the third party’s statements because they, like the 

claimant’s, are simply not consistent with the preponderance 

of the opinions and observations by medical doctors in this 

case. 

Thus, the ALJ provided two specific reasons germane to Payton’s roommate, Louis 

Rizzatti: lack of qualifications to make exacting observations regarding Payton’s medical 

symptoms and the nature of the relationship. Even though the ALJ could not discredit the 

lay witness opinion solely because it was not supported by medical evidence, it was not 

error to consider the opinion’s consistency with other evidence along with other factors. 

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Moreover, even if the ALJ had given the lay witness opinion significant weight, 

the opinion did not establish that Payton was unable to perform sedentary work with the 

limitations identified in the residual functional capacity assessment. Rizzatti stated that 

Payton had good days and bad days, but on good days, she shopped, cleaned, worked in 

the garden, and did housework. He said that on some days, she can do nothing, but he 

did not say how frequently she could do nothing. He stated that she prepared food or 

meals once or twice daily. He said that her ability to perform household chores was 

inconsistent, but he did not say how frequently she was not able to do light housework. 

He also stated that she went to medical appointments frequently, she drives a car, and she 

can go out alone. 

Therefore, the ALJ did not err by concluding that significant weight could not be 

given to Rizzatti’s third party statement. 

IT IS THEREFORE ORDERED that the final decision of the Commissioner of 

Social Security is affirmed. The Clerk shall enter judgment accordingly and shall 

terminate this case. 

Dated this 11th day of July, 2013. 

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