Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_14-cv-02478/USCOURTS-azd-2_14-cv-02478-0/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 

Ronda Lee Laier, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant. 

No. CV-14-02478-PHX-NVW 

ORDER 

Plaintiff Ronda Lee Laier seeks review under 42 U.S.C. § 405(g) of the final 

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

disability insurance benefits and supplemental security income under sections 216(i), 

223(d), and 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 

Plaintiff was born in October 1958, has a limited education, and is able to 

communicate in English. She worked as a dietary manager for a nursing home in Utah 

for many years before moving to Arizona to care for her ill father. In Arizona she 

worked as a security guard and was promoted to a supervisor position. Her employment 

ended in 2010. At the time of the November 2012 hearing, Plaintiff was living in a twostory house in El Mirage, Arizona, with her husband, her 12-year-old daughter, and 

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Plaintiff’s father. Plaintiff’s husband is disabled due to short-term memory loss caused 

by brain injury. Together, Plaintiff and her husband care for Plaintiff’s father and 

daughter. 

In May 2011, Plaintiff applied for disability insurance benefits and supplemental 

security income. Her amended alleged onset date of disability is September 1, 2010. On 

November 2, 2012, she appeared with her attorney and testified at a hearing before the 

ALJ in Phoenix, Arizona. A vocational expert also testified. Plaintiff’s attorney 

explained to the ALJ that Plaintiff has moderate degenerative disc disease, which causes 

her some problems, but her mental impairments (i.e., depression, anxiety, panic disorder) 

are more severe. 

On February 22, 2013, the ALJ issued a decision that Plaintiff was not disabled 

within the meaning of the Social Security Act. The Appeals Council denied Plaintiff’s 

request for review of the hearing decision, making the ALJ’s decision the 

Commissioner’s final decision. On November 7, 2014, Plaintiff 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); 

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accord Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (“Even when the evidence 

is susceptible to more than one rational interpretation, we must uphold the ALJ’s findings 

if they are supported by inferences reasonably drawn from the record.”). 

Harmless error principles apply in the Social Security Act context. Molina v. 

Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012). An error is harmless if there remains 

substantial evidence supporting the ALJ’s decision and the error does not affect the 

ultimate nondisability determination. Id. The claimant usually bears the burden of 

showing that an error is harmful. Id. at 1111. 

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. § 404.1520(a). The claimant bears 

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

step five. 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. § 404.1520(a)(4)(i). 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. 

§ 404.1520(a)(4)(ii). 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. § 404.1520(a)(4)(iii). 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. § 404.1520(a)(4)(iv). If so, the claimant is not 

disabled and the inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, 

where she determines whether the claimant can perform any other work based on the 

claimant’s residual functional capacity, age, education, and work experience. 

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§ 404.1520(a)(4)(v). If so, the claimant is not disabled. Id. If not, the claimant is 

disabled. Id. 

At step one, the ALJ found that Plaintiff meets the insured status requirements of 

the Social Security Act through December 31, 2015, and that she has not engaged in 

substantial gainful activity since September 1, 2010, the amended onset date. At step 

two, the ALJ found that Plaintiff has the following severe impairments: multilevel 

lumbar and thoracic degenerative disc disease, hip bursitis, a dysthymic disorder, a 

generalized anxiety disorder, and cannabis abuse. At step three, the ALJ determined that 

Plaintiff does not have an impairment or combination of impairments that meets or 

medically equals the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, 

Appendix 1. 

At step four, the ALJ found that Plaintiff: 

has the residual functional capacity to perform a full range of work at all 

exertional levels but with the following nonexertional limitations: needs to 

work in a job where contact with the general public or co-workers is 

occasional. 

The ALJ further found that Plaintiff is unable to perform any past relevant work. At step 

five, the ALJ concluded that, considering Plaintiff’s age, education, work experience, and 

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

economy that Plaintiff can perform. 

IV. ANALYSIS 

A. The ALJ Did Not Err in Evaluating Plaintiff’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 

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

determination, an ALJ “may not reject a claimant’s subjective complaints based solely on 

a lack of objective medical evidence to fully corroborate the claimant’s allegations.” 

Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1227 (9th Cir. 2009) (internal 

quotation marks and citation omitted). But “an ALJ may weigh inconsistencies between 

the claimant’s testimony and his or her conduct, daily activities, and work record, among 

other factors.” Id. The ALJ must make findings “sufficiently specific to permit the court 

to conclude that the ALJ did not arbitrarily discredit claimant’s testimony.” Thomas v. 

Barnhart, 278 F.3d 947, 958 (9th Cir. 2002); accord Tommasetti v. Astrue, 533 F.3d 

1035, 1039 (9th Cir. 2008). 

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

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

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

symptoms not credible to the extent they are inconsistent with the ALJ’s residual 

functional capacity assessment. 

At the ALJ hearing, Plaintiff’s attorney stated that Plaintiff’s mental impairments 

are more severe than her degenerative disc disease, which he described as moderate. The 

attorney said Plaintiff suffers from dysthymic disorder, major depressive disorder, 

generalized anxiety disorder, and the panic disorder of agoraphobia. Plaintiff has not 

received treatment from a mental health professional. The only mental health treatment 

Plaintiff has received is medication prescribed by her primary care physician, which 

consists of alprazolam (generic Xanax) for anxiety.1

 

 1

 Plaintiff’s primary care physician’s notes for her first office visit on December 

22, 2010, indicate that Plaintiff said Xanax had helped her chronic anxiety in the past. 

The physician’s notes for January 7, 2011, state that Plaintiff explained her positive urine 

drug screen was caused by taking Xanax prescribed for her husband and that she had not 

been prescribed it previously. 

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Plaintiff testified that she is overwhelmed with anxiety for two to three hours 

almost every day, but her prescription medication helps. When asked about problems 

other than anxiety that prevent her from working, she said she feels she cannot “process 

quick enough,” she “falls apart” when told she is not doing what she should be doing, and 

she gets agitated by loud noises and not understanding her daughter’s homework. 

Plaintiff testified that being around other people makes her feel that she is being judged 

and causes her to panic. 

Plaintiff said she left her last job in July or August 2010 because she was passing 

out and getting sharp pains that would radiate through her back, and she was passing out 

about twice a week. She also testified that when she began having pain she thought she 

was having a gallbladder attack, but an endoscopy and a colonoscopy did not reveal 

anything. When she returned to work, she was terminated because her supervisor felt she 

could not do the tasks she was given. She looked for other similar work, but no one was 

hiring at the time. 

Plaintiff said she quit physical therapy after two times because the pain in her back 

was overwhelming. She testified that she does not drive because she is afraid of blacking 

out, which had happened three or four times a month since 2010. She said that she was 

scheduled for an appointment with a neurologist on November 8, 2012, to address her 

blacking out. 

Plaintiff testified that the longest she can walk without stopping is 20 minutes 

because she gets tired. She said she can sit only 15-20 minutes before shifting positions. 

She said she can stand only ten minutes because standing causes her feet to swell. She 

also said her feet swell every day for most of the day so she must elevate her feet. She 

also testified that she was referred to a neurologist to determine what is causing her feet 

to swell. 

The ALJ found that Plaintiff’s credibility is diminished by the following: (1) 

Plaintiff has engaged in a somewhat normal level of daily activity and interaction; (2) her 

limited range of activities does not appear to be caused by any established impairment; 

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(3) Plaintiff’s allegations regarding the severity of her symptoms and limitations are 

greater than expected in light of the objective medical record and conservative treatment; 

and (4) Plaintiff’s hearing testimony was vague and inconsistent. The ALJ noted that 

Plaintiff refused mental health treatment recommended by her primary care physician and 

did not report her feet swelling until October 2012. The ALJ also noted that there are no 

medical records corroborating her alleged episodes of fainting. 

Thus, the ALJ provided specific, clear, and convincing reasons supported by 

substantial evidence for discrediting Plaintiff’s subjective symptom testimony. 

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

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

Chater, 81 F.3d 821, 830 (9th Cir. 1995). 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. 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. at 830; Orn v. 

Astrue, 495 F.3d 625, 632 (9th Cir. 2007) (where there is a conflict between the opinion 

of a treating physician and an examining physician, the ALJ may not reject the opinion of 

the treating physician without setting forth specific, legitimate reasons supported by 

substantial evidence in the record). 

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

than that of a non-examining physician. Lester, 81 F.3d 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 

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substantial evidence in the record, for rejecting an examining physician’s contradicted 

opinion. Id. at 830-31. 

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. In 

deciding weight to give any medical opinion, the ALJ considers not only whether the 

source has a treating or examining relationship with the claimant, but also whether the 

treatment or examination is related to the alleged disability, the length of the relationship, 

frequency of examination, supporting evidence provided by the source, and medical 

specialization of the source. 20 C.F.R. § 404.1527(c). Generally, more weight is given 

to the opinion of a specialist about medical issues related to his area of specialty than to 

the opinion of a source who is not a specialist. 20 C.F.R. § 404.1527(c)(5). The ALJ 

may discount a physician’s opinion that is based only the claimant’s subjective 

complaints without objective evidence. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 

1190, 1195 (9th Cir. 2004). The opinion of any physician, including that of a treating 

physician, need not be accepted “if that opinion is brief, conclusory, and inadequately 

supported by clinical findings.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 

1228 (9th Cir. 2009). 

2. Treating Primary Care Physician Mason J. Roy, M.D. 

Plaintiff alleges onset of disability on September 1, 2010. Dr. Roy began treating 

Plaintiff on December 22, 2010, for chronic arthritis pain in her knees and hips and for 

chronic anxiety. He prescribed alprazolam (generic Xanax) for anxiety and nothing for 

pain. On January 7, 2011, Plaintiff reported pain on the right side of her lower rib cage. 

On January 25, 2011, Dr. Roy referred Plaintiff to a surgeon for assessment of her 

continued right upper abdominal pain and renewed her prescription for alprazolam. On 

March 7, 2011, Dr. Roy referred Plaintiff to physical therapy for lumbago (lower back 

pain), hip pain, and thoracic back pain, ordered hip and thoracic spine x-rays, and 

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prescribed carisoprodol instead of alprazolam, which Plaintiff reported was of “no help.” 

On March 23, 2011, Dr. Roy prescribed alprazolam for anxiety and did not prescribe 

carisoprodol. On April 11, 2011, Dr. Roy noted that Plaintiff’s anxiety was better, but 

she requested an increase in the number of tablets of alprazolam per day, and also that 

she was getting pain medications from “geriatric md but is running out of meds.” Dr. 

Roy prescribed alprazolam for anxiety and lumbago and hydrocodone-acetaminophen for 

anxiety and lumbago. He also ordered blood tests and noted that Plaintiff was to have her 

first physical therapy session the next day. On May 9, 2011, Dr. Roy noted that Plaintiff 

was “feeling a little better with meds and PT.”2

 He also noted that Plaintiff was applying 

for Social Security disability, he had completed the physical evaluation for her, and he 

would complete the mental evaluation next visit. He ordered refills of alprazolam and 

hydrocodone-acetaminophen and gave Plaintiff information regarding mental health selfreferral. On June 7, 2011, Dr. Roy noted Plaintiff was “doing reasonably well on current 

regimen,” she requested her alprazolam prescription be increased, and she decided not to 

go to behavioral health “due to trust issues.” He ordered refills of alprazolam and 

hydrocodone-acetaminophen for anxiety and lumbago. 

After slightly less than six months of treating Plaintiff as her primary care 

physician, Dr. Roy completed a Residual Functional Capacity Questionnaire and a 

Mental Capacity Assessment, both dated June 7, 2011. He identified Plaintiff’s diagnosis 

as anxiety, depression, back pain, and hip pain, and her prognosis as fair. He identified 

Plaintiff’s symptoms as neck pain, thoracic back pain, low back pain, and anxiety. Dr. 

Roy opined that Plaintiff’s symptoms are severe enough to constantly interfere with the 

attention and concentration required to perform simple work-related tasks. He also 

opined that the maximum distance Plaintiff can walk is 50 feet, the maximum time 

Plaintiff can sit at one time is 10 minutes, and the maximum time Plaintiff can stand/walk 

 2

 Vibrant Care Rehabilitation records show that Plaintiff was assessed for physical 

therapy on April 26, 2011, was treated on April 27, 2011, and did not return after April 

27, 2011. 

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at one time is 5 minutes. Dr. Roy further opined that in an 8-hour work day, the total 

amount of time Plaintiff can sit is one hour and the total amount of time she can 

stand/walk is one hour. He opined that Plaintiff will need to take unscheduled 15-minute 

breaks every 20-30 minutes. He opined that she can occasionally lift and carry less than 

10 pounds, but never more, and she can do repetitive reaching, handling, or fingering 

20-25% of an 8-hour workday. He further opined that Plaintiff is likely to be absent 

more than four times a month as a result of her impairments. 

On the Mental Capacity Assessment, Dr. Roy found slight or moderate limitations 

in all but three areas. He opined that Plaintiff has marked limitation in her ability to 

maintain attention and concentration for extended periods, her ability to complete a 

normal workweek without interruptions from psychologically based symptoms, and her 

ability to set realistic goals or make plans independently of others. He also opined that 

Plaintiff would likely have more than four absences in an average month. For 

medical/clinical findings that support this assessment, Dr. Roy wrote, “Extensive medical 

history.” Dr. Roy could not have been referring to his six-month treatment relationship 

with Plaintiff, but his treatment notes do not indicate that he had any knowledge of 

Plaintiff’s past mental health history. 

After June 7, 2011, Dr. Roy continued to treat Plaintiff through October 2012, 

primarily for lumbago, anxiety, and insomnia. On September 7, 2011, Plaintiff reported 

that her anxiety had improved with the increased amount of alprazolam, and she 

continued home exercises and physical therapy,3

 but it was not helping. Dr. Roy referred 

Plaintiff to an orthopedic specialist and prescribed hydrocodone-acetaminophen, 

alprazolam, and amitriptyline. On October 7, 2011, Dr. Roy noted that physical therapy 

was ongoing, and the appointment with the orthopedic specialist was scheduled for 

 3

 The record does not show Plaintiff received physical therapy after April 27, 

2011. On November 28, 2011, when Plaintiff was first seen at the CORE Institute, she 

reported having recently completed 8 sessions of physical therapy with minimal 

improvement. 

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November 28, 2011. He renewed her prescription for hydrocodone-acetaminophen with 

refills to last for three months. On January 11, 2012, Dr. Roy noted that Plaintiff’s 

anxiety and insomnia were worse recently due to family issues, she had an MRI 

completed, and she would call to schedule a follow-up appointment with the orthopedic 

specialist. He prescribed alprazolam, Ambien, and hydrocodone-acetaminophen with 

refills to last for three months.4

 On February 10, 2012, Dr. Roy saw Plaintiff again and 

noted that she was stable on her current medication regime and had no current 

complaints. On March 12, 2012, Dr. Roy noted that Plaintiff requested increased anxiety 

medication and she reported the orthopedic physician assistant recommended a possible 

ablation procedure. Plaintiff continued to see Dr. Roy monthly through October 2012 

and received prescription medications for anxiety and low back pain. 

3. Treating Pain Management Physician Eric Feldman, M.D. 

On February 14 and 24, 2012, Dr. Feldman, of the CORE Institute, performed 

bilateral L4-5 transforaminal epidural steroid injections on Plaintiff. Plaintiff was seen 

by a physician assistant at the CORE Institute on November 28, 2011, January 23, 2012, 

March 1, 2012, and April 19, 2012. It does not appear that Dr. Feldman actually 

examined Plaintiff before August 22, 2012. 

On August 22, 2012, Dr. Feldman saw Plaintiff, ordered physical therapy, and 

completed a Residual Functional Capacity Questionnaire. He identified Plaintiff’s 

diagnosis as chronic low back pain and her prognosis as fair. He identified her symptoms 

as low back and leg pain and fatigue. Dr. Feldman opined that Plaintiff’s symptoms are 

severe enough to constantly interfere with the attention and concentration required to 

perform simple work-related tasks. He also opined that the maximum distance Plaintiff 

can walk is 1-2 city blocks, the maximum time Plaintiff can sit at one time is 30 minutes, 

and the maximum time Plaintiff can stand/walk at one time is 5-10 minutes. Dr. Feldman 

 4

 Medical records from the CORE Institute show that on January 23, 2012, March 

1, 2012, and April 19, 2012, Plaintiff was prescribed oxycodone-acetaminophen by a 

physician assistant in addition to the medications prescribed by Dr. Roy. 

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further opined that in an 8-hour work day, the total amount of time Plaintiff can sit is 2-3 

hours and the total amount of time she can stand/walk is 0-1 hour. He opined that 

Plaintiff will need to take unscheduled breaks of 1-2 minutes every 15 minutes. He 

opined that she can occasionally lift and carry up to 10 pounds, but never more, and she 

has no limitations in doing repetitive reaching, handling, or fingering. He further opined 

that Plaintiff is likely to be absent more than four times a month as a result of her 

impairments. 

The ALJ found that the medical source statements from Drs. Roy and Feldman 

were not supported by their own progress notes and appeared to be based on Plaintiff’s 

subjective statements. These are legitimate, clear, and convincing reasons, supported by 

substantial evidence in the record, for giving the medical source statements of Drs. Roy 

and Feldman little or no weight. Although the ALJ did not explicitly state that she had 

considered Dr. Roy’s mental assessment as well as his physical assessment, she cited the 

exhibit numbers of both assessments, and therefore it can be assumed that she considered 

both exhibits that she cited. The ALJ did not explicitly state the degree of weight she 

gave the opinions of these treating physicians, but it is plain from the context that the 

ALJ gave them little or no weight. 

C. The ALJ Did Not Err in Her Examination of the Vocational Expert. 

An ALJ may rely on a vocational expert’s testimony that is based on a 

hypothetical that contains all of the limitations the ALJ found credible and supported by 

substantial evidence in the record. Ghanim v. Colvin, 763 F.3d 1154, 1166 (9th Cir. 

2014). “However, if an ALJ’s hypothetical is based on a residual functional capacity 

assessment that does not include some of the claimant’s limitations, the vocational 

expert’s testimony has no evidentiary value.” Id. (internal quotation marks and citation 

omitted). 

For reasons previously stated, the ALJ did not err by finding Plaintiff’s testimony 

regarding the severity of her symptoms and limitations less than fully credible or by 

giving little weight to the opinions of Drs. Roy and Feldman. The ALJ gave “some 

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weight” to the opinion of consultative examiner Ilyssa Swartout, Psy.D., regarding social 

functioning, and limited Plaintiff to occasional contact with the public. The ALJ was not 

required to pose a hypothetical to the vocational expert with limitations she did not find 

credible and supported by substantial evidence in the record. Giving “some weight” to 

Dr. Swartout’s opinion did not require the ALJ to rely on a hypothetical posed to the 

vocational expert by Plaintiff’s counsel that included Dr. Swartout’s opinion of 

“moderate to marked” limitation in social functioning, especially when neither the 

opinion nor the hypothetical distinguished “moderate” from “marked” limitation. 

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 12th day of June, 2015. 

Neil V. Wake

United States District Judge

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