Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_06-cv-02666/USCOURTS-azd-2_06-cv-02666-0/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

Anett Pierce, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV-06-2666-PHX-NVW

ORDER

The court has before it Plaintiff Anett Pierce’s (“Pierce’s”) Motion for Summary

Judgment (Doc. #17). Pierce’s motion will be denied for the reasons set forth below, and

judgment will be entered for Defendant..

I. Background

Pierce is a 53-year-old individual with a high school education who has previously

worked as a bank teller and a customer service associate. (Tr. 26, 538.) She alleges that she

has been disabled and out of work since September 12, 2001, at which time she was 46 years

old. (Tr. 20.) Pierce’s primary complaint is of chronic pain afflicting her right shoulder,

right knee, elbow, wrists, neck, and back. She also suffers from diabetes, depression, and

anxiety disorder with panic attacks. (Tr. 21.) Pierce states that her knee, shoulder, neck, and

back problems began after an automobile accident that occurred in 1998. (Tr. 542.) In

November of 2000 she had surgery on her right knee for a torn medial meniscus and

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chondromalacia patella. (Tr. 536.) The following month she had surgery on her right

shoulder for a glenoid labrum tear, impingement syndrome, and degenerative

acromioclavicular joint. (Tr. 526.) In May of 2002 she had a second shoulder operation

resulting in a diagnosis of adhesive capsulitis. (Tr. 516–18.) Pierce was diagnosed with

moderate right and mild left carpal tunnel syndrome in December of 2001 and subsequently

underwent surgical releases in 2003. (Tr. 165, 386, 400.)

In addition to these surgical procedures, for many years Pierce has been under the

general care of her family physician, Dr. Kevin Turner, and under the care of Dr. Richard

Emerson for her orthopedic maladies. She has received Hyalgen shots for persistent knee

pain, physical therapy following her surgeries, and has undergone a number of diagnostic xray and MRI scans to pinpoint the causes of her pain. Based upon their experience with

Pierce, her treating physicians concluded that she has an extremely limited residual

functional capacity of less than sedentary work and is “disabled.” (Tr. 112, 121–22, 123–25,

134–44, 475–477, 489–91, 497–500.) 

Pierce underwent an independent consultative examination by Dr. Richard Collins in

2001. Dr. Collins stated that Pierce’s subjective symptoms outweigh the objective evidence

of impairment. (Tr. 172.) In December 2003, Dr. Atul Patel performed a consultative

physical examination on Pierce on behalf of the State. He reported finding only mild

degenerative changes in the medial joint compartment of her right knee, that she had a

normal based and not antalgic gait, that she had full range of motion with no warmth,

swelling or discoloration, and that there was no ligament instability. With respect to her right

shoulder, he reported discomfort only with range of motion in the extremes and slightly

limited abduction. His report showed mild lateral elbow tenderness over the epicondyle,

mild discomfort with forceful provocations, reasonably maintained grip, and negative

Phalen’s and Tinel’s testing for carpal tunnel syndrome. X-rays of her cervical spine show

only mild degenerative disc disease at C5-C6 and C6-C7. Based upon this examination, Dr.

Patel concluded that Pierce can lift ten pounds occasionally and less than ten pounds

frequently. He also concluded that she can walk or stand two hours and, with occasional

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changes in position, can sit six hours in an eight hour work day. (Tr. 415–20.) In 2004,

subsequent non-examining physicians agreed with Dr. Patel’s and disagreed with the treating

physicians’ conclusions regarding Pierce’s residual functional capacity. (Tr. 421–28,

444–51.) 

II. Procedural History 

On June 30, 2003, Plaintiff protectively filed an application for disability insurance

benefits, alleging a September 12, 2001 disability onset. (Tr. 20.) The application was

denied initially and on reconsideration. (Tr. 29–42.) On March 1, 2006, Plaintiff appeared

with counsel and testified before an administrative law judge (ALJ). (Tr. 533–58.) In a

decision dated May 22, 2006, the ALJ found that Plaintiff was not disabled. (Tr. 18–28.) 

The ALJ determined that Pierce has a “severe impairment” due to the combination of her

knee, shoulder, elbow, back, and neck problems, but that none of her impairments meet the

criteria for any listed impairments under 20 C.F.R. § 404, Subpart P, Appendix 1. Based

upon his review of the objective evidence, the ALJ determined that Pierce’s allegations

concerning the severity of her pain were not fully credible. He also disagreed with the

conclusions of Pierce’s treating, examining, and non-examining physicians on the subject of

her residual functional capacity. 

The ALJ assessed a residual functional capacity to perform light exertion work with

the following restrictions: lifting more than twenty pounds frequently and twenty pounds

occasionally; working with a “sit/stand option”; no climbing, crawling, crouching, squatting,

kneeling, using her lower extremities for pushing or pulling, or using her upper extremities

for work above the shoulder level. (Tr. 21.) Based upon this residual functional capacity,

the ALJ concluded that Pierce could not return to her past work because it was skilled and

did not allow for a sit/stand option. (Tr. 26.) A vocational expert testified that some of the

skills Pierce obtained while working as a bank teller and customer service associate would

transfer to certain semi-skilled sedentary jobs. (Tr. 553). In particular, with the assistance

of the vocational expert, the ALJ concluded that Pierce is able to perform the sedentary jobs

of billing clerk, payroll clerk, calculating machine operator, and customer service

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representative, and the light exertion jobs of office helper, unarmed gate guard, and

receptionist. Because a significant number of these jobs exist in the economy, the ALJ

concluded that Pierce is not disabled within the meaning of the Social Security Act. (Tr.

26–27.) The Appeals Council denied Pierce’s request for review of the ALJ’s decision (Tr.

8–10), and Pierce commenced this action for judicial review pursuant to 42 U.S.C. § 405(g).

III. Standard of Review

The 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). In its review, the court

“may set aside a denial of disability benefits only if it is not supported by substantial

evidence or if it is based on legal error.” Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir.

1997) (citations omitted); see Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996).

“Substantial evidence is relevant evidence which, considering the record as a whole, a

reasonable person might accept as adequate to support a conclusion.” Flaten v. Sec’y of

Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995) (citations omitted). Such

evidence is “more than a scintilla” but “less than a preponderance.” Smolen, 80 F.3d at 1279

(citations omitted). “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 v. Barnhart, 278 F.3d 947, 957 (9th Cir.

2002). 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.” Id. at 954 (citations omitted). 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).

IV. Analysis

Pierce alleges that the ALJ’s decision was deficient because 1) her impairments do

equal the severity requirements for listed orthopedic impairments under the statute; 2) the

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ALJ’s residual functional capacity assessment is inconsistent with his conclusion that she

requires a sit/stand option and with the job descriptions contained in the Dictionary of

Occupational Titles; 3) the ALJ failed to credit her subjective complaint and pain testimony;

and 4) the ALJ improperly rejected the opinions of the treating, examining, and nonexamining physicians. 

A. The ALJ did not err in concluding that Pierce’s impairments fall

short of the severity requirements for the listed impairments.

Pierce argues that her impairments meet the severity requirements of the orthopedic

impairments listed under 20 C.F.R. § 404, Subpart P, Appendix 1. Specifically, she contends

that her impairments meet the requirements for major dysfunction of 1) a weight-bearing

joint resulting in inability to ambulate effectively, §1.02A; and 2) one major peripheral joint

in each upper extremity resulting in inability to perform fine and gross movements

effectively, §1.02B. With respect to major dysfunction of a weight-bearing joint, she claims

she has demonstrated an inability to ambulate effectively solely because every physician has

agreed that she “cannot stand on her feet for a sustained period of time and, in total, cannot

stand more than 6 hours.” Pierce overlooks that the definition of “ambulate effectively” in

the statute requires her to show that she cannot “sustain[] a reasonable walking pace over a

sufficient distance to be able to carry out activities of daily living . . . such as shopping.” 20

C.F.R. § 404, Subpart P, Appendix 1 §1.00.B.2.b.(2). She has not made any such showing

and, moreover, the ALJ pointed out that Pierce goes grocery shopping with her husband. 

The listing for upper extremities would require Pierce to show some evidence that she

cannot carry out “activities of daily living,” such as evidence of an “inability to prepare a

simple meal and feed oneself, the inability to take care of personal hygiene, [and] the

inability to sort and handle papers.” §1.00.B.2.c. Pierce does not make any such showing.

Instead, she states conclusorily that she is unable to perform fine and gross movements

effectively. The ALJ’s findings that Pierce undertakes activities of daily living, such as

feeding herself, going grocery shopping, and doing her own banking, amply support his

conclusion that Pierce’s condition does not meet the requirements for this or any listing.

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B. The ALJ’s residual functional capacity assessment is not inconsistent

internally or with the Dictionary of Occupational Titles.

Pierce next challenges the ALJ’s finding that she is able to work as a billing clerk,

payroll clerk, calculating machine operator, customer service representative, office helper,

unarmed gate guard, or receptionist. The ALJ decided that Pierce cannot perform her past

jobs of bank teller or customer service associate because these jobs do not have sit/stand

options. Pierce points out that the vocational consultant also testified that a billing clerk,

payroll clerk, calculating machine operator, and customer service representative do “not

[have] a sit/stand option but certainly if you need to stand for a moment or two and then get

down you could.” She contends that because the ALJ concluded that she cannot perform her

past work because of the lack of a sit/stand option, she also cannot perform the other work

identified by the ALJ either. 

The term “sit/stand option” appears nowhere in the Social Security Act, the

regulations, or the Dictionary of Occupational Titles (DOT). Pierce has not furnished a

definition of “sit/stand option,” nor has she directed the court to any relevant case that could

clarify the ambiguous term. The court is left to guess the meaning and importance of a

sit/stand option. Whatever the term means, it is clear from the vocational consultant’s

testimony that bank tellers and customer service associates are primarily standing positions,

and therefore inappropriate for Pierce’s knee condition. (Tr. 552–53.) On the other hand,

the occupations identified by the ALJ are primarily sedentary jobs that would allow Pierce

to stand and change position occasionally, which is consistent with the residual functional

capacity propounded by the ALJ and by Dr. Patel. The ALJ therefore had substantial

evidence to conclude that Pierce could no longer perform her previous standing intensive

jobs because she needs the option to sit, but could perform the identified sedentary jobs so

long as she had some opportunity to stand occasionally.

Pierce also alleges a discrepancy between the vocational consultant’s testimony and

the DOT descriptions of office helper, unarmed gate guard, and receptionist. However, as

pointed out by Defendant, Pierce never states the nature of the alleged discrepancy. The

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court need not delve into the DOT and the hearing transcript to make Pierce’s argument for

her. Even so, based upon a reading of the DOT and the trial transcript, the court perceives

no discrepancy between the DOT and the vocational consultant that the ALJ should have

explained.

C. The ALJ gave clear and convincing reasons based upon substantial

evidence for discounting Pierce’s subjective complaint and pain

testimony.

Plaintiff next argues that the ALJ erred in rejecting his pain testimony. Pain of

sufficient severity caused by a medically diagnosed “anatomical, physiological, or

psychological abnormalit[y]” may provide the basis for determining that a claimant is

disabled. 42 U.S.C. § 423(d)(5)(A); see Bunnell v. Sullivan, 947 F.2d 341, 344–45 (9th Cir.

1991) (en banc). If a claimant “has presented objective evidence that he suffers from an

impairment that could cause pain, he need not present medical evidence to support the

severity of the pain.” Chavez v. Sec’y of Health & Human Servs., 103 F.3d 849, 853 (9th

Cir. 1996). Thus, “the court may not as a matter of law discount the claimant’s testimony

about his pain solely because it is not corroborated by medical findings.” Id. (citing Bunnell,

947 F.2d at 346). 

“Unless there is affirmative evidence showing that the claimant is malingering, the

Commissioner’s reasons for rejecting the claimant’s testimony must be ‘clear and

convincing.’” Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995). “General findings are

insufficient; rather, the ALJ must identify what testimony is not credible and what evidence

undermines the claimant’s complaints.” Id. He may consider various factors, including the

claimant’s daily activities, effectiveness of pain medication, and relevant character evidence.

Bunnell, 947 F.2d at 346; see also 20 C.F.R. §§ 404.1529(c)(3), 416.929(c)(3) (listing similar

factors considered by the ALJ in assessing a claimant's credibility). “Although lack of

medical evidence cannot form the sole basis for discounting pain testimony, it is a factor that

the ALJ can consider in his credibility analysis.” Burch v. Barnhart, 400 F.3d 676, 681 (9th

Cir. 2005). In addition, the ALJ may consider the claimant’s work record, observations of

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treating or examining physicians and other third parties, precipitating and aggravating

factors, and functional restrictions caused by the symptoms. Smolen, 80 F.3d at 1284. 

Pierce has presented objective medical evidence that she suffers from impairments

that could cause pain. The ALJ did not entirely reject Pierce’s claimed pain, but rather did

not “fully credit” her allegations. The ALJ somewhat credited her pain testimony by placing

restrictions on her ability to perform light exertion work, and by finding that she requires a

sit/stand option. 

In coming to this conclusion, the ALJ sequentially and thoroughly compared

Plaintiff’s complaints regarding pain in her knee, shoulder, wrists, neck, and back with the

objective clinical evidence of impairment produced by her treating and examining

physicians. In each case, the ALJ found that the evidence did not support her allegations of

disabling pain because the degree of underlying impairment was inconsistent with the

claimed degree of pain. Furthermore, the ALJ found numerous other inconsistencies with

her claimed degree of pain, including her failure to seek further treatment for her knee and

shoulder complaints, the conservative nature of the treatment she was prescribed for her neck

and back, and her ability to engage in daily activities, such as driving, cooking, ironing,

doing laundry, and shopping for groceries. Such reasons taken together constitute clear and

convincing reasons for discrediting Pierce’s pain testimony. Burch, 400 F.3d at 681.

D. The ALJ provided specific, legitimate reasons for rejecting the treating,

examining, and non-examining physician’s conclusions.

This is a case of conflicting medical opinions. Whereas Pierce’s treating physicians

believe that she is disabled and has a residual functional capacity of less than sedentary work,

the examining consulting physician Dr. Patel and the non-examining reviewing physicians

concluded that she has a residual functional capacity consistent with sedentary work.

Additionally, Pierce’s treating physicians’ opinions conflict with the finding of the

independent consultative examiner, Dr. Collins, that Pierce’s subjective symptoms outweigh

the objective and clinical evidence. 

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When presented with such a case, “the ALJ must determine credibility and resolve the

conflict.” Batson v. Comm’r of the Social Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004)

(citation omitted). Greater weight is typically afforded to the opinion of a treating physician

because he “is employed to cure and has a greater opportunity to observe and know the

patient as an individual.” Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987) (citations

omitted). However, the treating physician’s opinion “is not binding on an ALJ.” Tonapetyan

v. Halter, 242 F.3d 1144, 1148 (9th Cir. 2001). Where there is a conflict between the

opinion of a treating physician and an examining physician, as here, “the ALJ must give

specific, legitimate reasons for disregarding the opinion of the treating physician.” Batson,

359 F.3d at 1195 (citation omitted). “The ALJ can meet this burden by setting out a detailed

and thorough summary of the facts and conflicting clinical evidence, stating his interpretation

thereof, and making findings.” Magallanes, 881 F.2d at 751 (citing Cotton v. Bowen, 799

F.2d 1403, 1408 (9th Cir. 1986)). The ALJ must explain his departure from the opinion of

a treating physician even as to “ultimate conclusions,” such as residual functional capacity

or legal disability, which are purportedly reserved to the Commissioner. See, e.g., Morgan

v. Apfel, 169 F.3d 595, 601 (9th Cir. 1999); Lester v. Chater, 81 F.3d 821, 830 (9th Cir.

1995); Roberts v. Shalala, 66 F.3d 179, 183–84 (9th Cir. 1995); Embrey v. Bowen, 849 F.2d

418, 421–22 (9th Cir. 1988) (noting that the “subjective judgments of treating physicians are

important, and properly play a part in their medical evaluations”); Cotton, 799 F.2d at 1408.

The ALJ made a detailed summary of the objective medical findings and compared

them to each doctor’s ultimate conclusions on residual functional capacity. After

summarizing the objective medical evidence available for each of Pierce’s impairments, he

noted that Dr. Emmerson’s and Dr. Turner’s opinions were either entirely unsupported by

any objective evidence, were inconsistent with their own clinical findings, or conflicted with

the findings of the consulting physicians and Dr. Collins. Because the treating physician’s

opinions were unsupported by the medical evidence, the ALJ stated that they were likely

based upon their acceptance of Pierce’s subjective complaints, which the ALJ had already

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properly discounted. These are specific, legitimate reasons for rejecting the treating

physicians’ opinions on Pierce’s residual functional capacity. Batson, 359 F.3d at 1194–95;

Morgan v. Comm’r of Soc. Sec., 169 F.3d 595, 602 (9th Cir. 1999). 

The ALJ also rejected Dr. Patel’s and the non-examining consulting physicians’

conclusions that Pierce can only stand for two hours out of an eight hour day and can only

lift ten pounds occasionally. He did so based upon Dr. Patel’s physical evaluation, which

showed that Pierce had mild symptoms in her upper extremities, a normal gate, full ranges

of motion and no warmth, swelling, discoloration, or instability in the knees, and normal

neurological evaluations. Again, an ALJ “may discredit [even] treating physicians’ opinions

that are . . . unsupported by the record as a whole or by objective medical findings.” Batson,

359 F.3d at 1195 (citing Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001)). It

therefore follows that the ALJ can reject the examining and non-examining consulting

physicians’ opinions for the same reasons.

The residual functional capacity assessment of the examining and non-examining

consulting physicians placed Pierce at a sedentary level of work, while the ALJ concluded

that Pierce could perform light work with limitations. Contrary to Pierce’s claim, even if the

ALJ had accepted that she could only perform sedentary work, the Medical-Vocational Grids

would not have conclusively deemed her disabled. Rather, the vocational expert testified that

skills Pierce acquired during her previous work would transfer to other semi-skilled

sedentary jobs, such as billing clerk, payroll clerk, calculating machine operator, and

customer service representative. According to Medical-Vocational Rule 201.15, an

individual closely approaching advanced age with a high school education, transferrable

skills, and a residual functional capacity for sedentary work is not deemed disabled. 20

C.F.R. § 404, Sub. P, App. 2 § 201.15. The ALJ did not err in assessing a residual

functional capacity different than the examining consulting physician, but even if he did, that

error was inconsequential to the ultimate nondisability determination because even at a

sedentary work level she would not be deemed disabled. There is therefore no need to

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disturb the ALJ’s decision on this ground. See Stout v. Comm’r of Soc. Sec., 454 F.3d 1050,

1054–56 (9th Cir. 2006). 

IT IS THEREFORE ORDERED that Plaintiff Anett Pierce’s Motion for summary

Judgment (Doc. #17) is denied.

IT IS FURTHER ORDERED that the clerk enter judgment for the Defendant and

terminate the case.

DATED this 26th day of October, 2007.

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