Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_06-cv-01060/USCOURTS-azd-2_06-cv-01060-0/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 (DIWC)

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Francisco Duran, 

Plaintiff, 

vs.

Jo Anne Barnhart, 

Commissioner of Social Security, 

Defendant. 

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No. CV 06-1060-PHX-JAT

ORDER

Pending before the Court are Plaintiff's Motion for Summary Judgment (Doc. #10)

and Defendant's Cross Motion for Summary Judgment (Doc. #14). The Court now rules on

the Motions.

I. Procedural and Factual Background

Plaintiff Francisco Duran filed concurrent applications for Disability Insurance

Benefits (DIB) and Supplemental Security Income (SIS) on January 7, 2004, alleging

inability to work as of January 1, 2004. These applications were denied initially and on

reconsideration. An Administrative Law Judge (ALJ) held a hearing on September 9, 2005.

The ALJ issued a decision on December 29, 2005 denying Mr. Duran's claims, finding that

Mr. Duran was not disabled within the meaning of the Social Security Act (the "Act"). The

ALJ's decision became the final decision of Defendant Social Security Commissioner (the

"Commissioner") on March 9, 2006, when the Appeals Council found no basis to change the

ALJ's decision and denied Mr. Duran's Request for Review. Mr. Duran filed this action on

April 13, 2006, pursuant to 42 U.S.C. §405(g).

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Plaintiff is 59 years old, and was 57 years old on his alleged disability onset date.

Plaintiff claims he is unable to work because of back pain with any activity, lower

extremities pain, and residuals from diabetes, including fatigue. Plaintiff has a sixth-grade

education and is not literate in the English language. Plaintiff's past relevant work

experience includes: car lot driver, hand packager, fruit picker, loader, general laborer, and

warehouse quality controller.

Medical Evidence

Dr. Eduardo Alcantar, treated Mr. Duran from December 22, 2003 to September 12,

2005. In April of 2004, the doctor diagnosed hypertension, hyperlipidemia, and diabetes. 

Dr. Malcom McPhee, a consultive examiner, examined Mr. Duran on April 7, 2004.

The physical exam was essentially normal. Mr. Duran could squat seventy-five percent of

a full squat, hop, and kneel; and he had normal strength in all four extremities. He did have

some mild tenderness in his lower lumbar region, bilaterally, but he had normal range of

motion in his neck, shoulders, elbows, hands wrists, hips, knees, ankles, and feet. The

straight leg raise test was normal and sensation was intact to touch and pinprick in all four

limbs. Dr. McPhee diagnosed low back aches with mild facet arthritis at L5-D1 seen on xray report, diabetes mellitus, and hypertension.

Dr. McPhee completed a medical assessment form on April 17, 2004 regarding Mr.

Duran's ability to perform work activity. The doctor assessed that, in an eight-hour day, Mr.

Duran could occasionally lift fifty pounds, frequently lift twenty-five pounds, stand, walk,

or sit about six hours, occasionally climb, balance, crouch or stoop, frequently kneel and

crawl, and had an unlimited ability to reach, handle, finger, feel, see, hear, and speak. Dr.

McPhee assessed no further limitations.

On April 22, 2004, Dr. James Hopkins, a reviewing State agency physician, performed

a medical functional assessment of plaintiff's ability to perform work activity. In an eighthour work day, the doctor assessed that Mr. Duran could occasionally lift fifty pounds,

frequently lift twenty-five pounds, stand, walk, or sit for about six hours, and had an

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unlimited ability to push, pull, or use hand or foot controls. Dr. Hopkins assessed no further

limitations.

On June 3, 2004, Dr. W.O. Day, another reviewing State agency physician, performed

a medical functional assessment of Mr. Duran's ability to perform work activity. Dr. Day

assessed that Mr. Duran could occasionally lift fifty pounds, frequently lift twenty-five

pounds, and stand, walk, or sit about six hours in an eight- hour work day. Mr. Duran had

an unlimited ability to push, pull, or use hand or foot controls. He could occasionally climb,

balance, and stoop, and frequently could stoop, kneel, crouch, and crawl. Dr. Day assessed

no further limitations.

Mr. Duran had a MRI on October 10, 2004. The MRI revealed an approximately 25%

vertical height loss of the T12 vertebra, hermangiomas within T10 and L1, disc bulge with

facet hypertrophy at L4-5, and, at L5-S1, a disc bulge with facet degeneration and seven

millimeter subchondral cyst within the right pars

Dr. Huston, an orthopedic surgeon, treated Mr. Duran from November of 2004 to

June of 2005 on referral by Dr. Alcantar. In November 2004, Dr. Huston indicated that

physical therapy had not helped Mr. Duran and recommended injection therapy. Physical

examination was essentially normal, except for a slight reduction in strength and some giveway throughout the upper and lower extremities. On December 21, 2004, Dr. Huston

indicated that Mr. Duran was not a candidate for surgery. In June 2005, Dr. Huston

discharged Mr. Duran with a diagnosis of low back pain and lumbar disc disease. Dr. Huston

declined to assess Mr. Duran's functional ability to work and released him from care with a

recommendation that he continue an independent exercise program that he learned in

physical therapy.

In December of 2004, a nurse practitioner in Dr. Alcantar's clinic, S. Ponce, completed

a medical assessment of ability to work form and assessed that plaintiff retained the ability

to lift or carry up to ten pounds occasionally, sit for three hours, stand for one hour, and walk

for three hours, for a total of three hours on his feet, in an eight-hour day. Nurse Practitioner

Ponce determined that Mr. Duran could sit, stand, and walk only intermittently and

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alternatively in an eight-hour work day. And that Mr. Duran could not use his hands for fine

or continuous manipulative tasks, could bend and squat occasionally, but could not crawl,

climb, or reach. S. Ponce further assessed that Mr. Duran was moderately limited from

working around unprotected heights, mildly limited from being around moving machinery,

driving automobile equipment, exposure to marked changes in temperature or humidity, and

had no limitations from exposure to dust, fumes, or gases. Overall, Nurse Practitioner Ponce

found that Mr. Duran's activities would be limited due to moderate to severe pain and fatigue.

II. Analysis and Conclusion

Standard

The Court will overturn the Commissioner's decision to deny benefits "only if it is not

supported by substantial evidence or is based on legal error." Magallanes v. Bowen, 881

F.2d 747, 750 (9th Cir. 1989). Substantial evidence is more than a mere scintilla, but less than

a preponderance. Reddick v. Charter, 157 F.3d 715, 720 (9th Cir. 1998). In determining

whether substantial evidence exists to support a decision, this Court considers the record as

a whole, weighing both the evidence that supports the ALJ's conclusions and the evidence

that detracts from the ALJ's conclusions. Id. If sufficient evidence exists to support the

Commissioner's decision, the Court cannot substitute its own determination. Young v.

Sullivan, 911 F.2d 180, 184 (9th Cir. 1990). And the ALJ is responsible for resolving

conflicts in medical testimony and ambiguities and for determining credibility. Andrews v.

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995).

Mr. Duran raises two issues on appeal from the Commissioner's decision. First, he

argues that the ALJ erred in rejecting the nurse practitioner's opinion without giving specific,

legitimate reasons. Second, he claims the ALJ erred in finding Mr. Duran's testimony not

fully credible. 

Nurse Practitioner's Opinion

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A nurse practitioner is not an "acceptable medical source" under the social security

disability regulations. 20 C.F.R. §416.913(a) & (d)(1); Gomez v. Chater, 74 F.3d 967, 971

(9th Cir. 1996). Mr. Duran nonetheless argues that, pursuant to Gomez, Nurse Practitioner

Ponce should be considered an acceptable medical source and Ponce's disability assessment

should be afforded the same weight as a treating physician's. The ALJ therefore could not

reject Ponce's determination without listing legitimate and specific reasons.

In holding, under the circumstances of that case, that the nurse practitioner's opinion

should carry the same weight as the treating physician's, the Gomez court relied on factors

not present here. The Gomez court found that the plaintiff's chart notes indicated that

although the treating physician did not personally examine the plaintiff after a certain point,

the nurse practitioner did consult with the physician numerous times regarding the plaintiff's

treatment. 74 F.3d at 971. The Gomez court held that because the nurse practitioner in that

case worked so closely under the supervision of the treating physician, she actually acted as

the physician's agent with regard to the plaintiff's treatment. Id. And the ALJ therefore

properly gave the nurse practitioner's opinion the same weight as a treating physician's. 

The current case is distinguishable from Gomez. Nurse Practitioner Ponce's progress

notes do not indicate that Ponce consulted with or worked closely under the supervision of

Dr. Alcantar, the treating physician. In his reply brief, Mr. Duran states, "The doctor,

however, is the overseer of the nurse practitioner and supports the function and opinion of

his employee. In this case the nurse practitioner completed assessment forms under the

supervision of Dr. Alcantar." But Mr. Duran does not cite to any portion of the record or any

other authority to support this statement. A bald statement regarding supervision is

insufficient to bring this case within the ambit of Gomez. 

Mr. Duran argues that the ALJ did not give legitimate and specific reasons supported

by substantial evidence in the record for rejecting Nurse Practitioner Ponce's opinion as

required by Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983). Because Nurse

Practitioner Ponce does not qualify as an acceptable medical source under the Gomez agency

theory, however, the ALJ did not have to list specific, legitimate reasons for rejecting Ponce's

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opinion as she would have for a treating physician's opinion. The Court further finds that the

ALJ's opinion is supported by substantial evidence from the record. The opinion of Dr.

McPhee, the examining physician, the observations of Dr. Huston, and the opinions of the

State Agency consulting doctors all agree that Mr. Duran is capable of performing past

relevant work experience. It is the ALJ's function to resolve conflicts in medical evidence.

Andrews, 53 F.3d at 1039. The Court finds that substantial evidence exists in the record to

support the ALJ's resolution of the medical evidence. 

Mr. Duran's Credibility

In his second point, Mr. Duran argues that the ALJ improperly rejected his credibility.

When, as here, objective medical findings establish the existence of medical impairment, if

a claimant testifies that he or she experiences pain at a higher level, the Commissioner may

disbelieve that testimony. Greger v. Barnhart, 464 F.3d 968, 972 (9th Cir. 2006);

Magallanes, 881 at 755. But the Commissioner must make a specific and justifiable finding

that the claimant's testimony is not credible. Id. The ALJ found Mr. Duran's testimony

regarding the extent of his pain and inability to work not fully credible because: the medical

evidence did not support Mr. Duran's claims regarding the level of his pain; Mr. Duran

claimed he had learned virtually no English, but answered some questions in English at the

hearing; and, despite claims of pain while driving, at the time of the hearing, Mr. Duran had

been driving as part of his job at a car auction for eight months. The Court finds that the ALJ

provided clear and cogent reasons for partially rejecting the credibility of Mr. Duran and will

not reverse the ruling.

The Court holds that substantial record evidence supports the ALJ's resolution of the

conflicting medical testimony and her credibility determinations. The ALJ's decision is

therefore affirmed.

Accordingly,

IT IS ORDERED GRANTING Defendant's Cross Motion for Summary Judgment

(Doc. #14).

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IT IS FURTHER ORDERED DENYING Plaintiff's Motion for Summary Judgment

(Doc. #10).

DATED this 25th day of January, 2007.

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