Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-4_04-cv-04607/USCOURTS-cand-4_04-cv-04607-0/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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United States District Court

For the Northern District of California

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IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

JANICE D. MCCOY,

Plaintiff,

v.

JO ANNE B. BARNHART,

Commissioner of the Social Security

Administration,

Defendant.

 /

No. C 04-04607 CW

ORDER DENYING

DEFENDANT'S

MOTION FOR

SUMMARY JUDGMENT;

AND GRANTING

PLAINTIFF'S

MOTION TO REMAND 

Plaintiff Janice McCoy has filed a motion for summary judgment

or, in the alternative, remand to the Commissioner of the Social

Security Administration (SSA) for further proceedings. Defendant

Jo Anne Barnhart, in her capacity as Commissioner of the SSA,

opposes this motion and cross moves for summary judgment. Having

considered all of the papers filed by the parties, the Court DENIES

Plaintiff's motion for summary judgment, DENIES Defendant's crossCase 4:04-cv-04607-CW Document 24 Filed 10/27/05 Page 1 of 21
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motion, and GRANTS Plaintiff's motion for remand.

BACKGROUND

I. Procedural History

Plaintiff filed applications for a period of disability,

disability insurance benefits (DIB) and supplemental security

income (SSI) benefits on February 2, 2001. The SSA denied her

benefit applications by notices of initial determination dated

August 3, 2001. No appeal was taken.

On January 26, 2002, Plaintiff re-applied for DIB and SSI

under Titles II and XVI of the Social Security Act, alleging

disability beginning on May 1, 2001, due to neck/upper back and

right ankle pain. Plaintiff's application and request for

reconsideration were denied on the ground that she retained the

ability to do her past work as a warehouse worker. On December 6,

2002, Plaintiff requested a hearing. A hearing was held before an

Administrative Law Judge (ALJ) on January 22, 2004. Plaintiff

appeared and was represented by counsel. A vocational expert also

testified at the hearing. On February 5, 2004, the ALJ issued a

decision finding that Plaintiff was not disabled.

Plaintiff filed a timely request with the Appeals Council for

review of the ALJ's decision, submitting additional evidence and

argument. On August 25, 2004, the ALJ's decision became the

Commissioner's final decision when the Appeals Council denied

Plaintiff's request for review. Thereby, Plaintiff commenced the

instant action for judicial review.

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II. Factual History

A. Plaintiff's Age, Education and Work Experience

Plaintiff was born on September 19, 1956, and was forty-five

years old when she filed her applications for Social Security

disability benefits. She has a high school education and had been

employed as a waitress, warehouse worker, food service worker and

cashier.

Prior to filing her initial application in February, 2002,

Plaintiff began working as a waitress at the Home for Jewish

Living. (Transcript (Tr) 105, 130). She worked from January, 2002,

until March 31, 2003, earning a total of $18,826.31 in 2002, which

qualifies as substantial gainful activity. (Tr 130). Thus, at the

hearing before the ALJ, Plaintiff amended the alleged onset date to

April 1, 2003, the day after she left her job as a waitress. (Id.)

B. Plaintiff's Medical History

On May 19, 1998, Plaintiff was allegedly injured at work when

she had to pull milk cartons and carry food trays up two flights of

stairs for two days because the elevators were not operational. 

(Tr 136, 259). On May 11, 1999, Plaintiff was referred to the

office of John D. Warbritton, M.D. (Tr 134). In a letter dated

August 16, 1999, Dr. Warbritton observed Plaintiff had "a

significant grip strength loss in the right dominant hand . . . a

moderate limitation of neck flexion and right lateral bending and

rotation . . . a moderate cervical paraspinal muscle spasm, and 

. . . a significant spasm and tightness in the muscles about the

right shoulder girdle." (Tr 134-35). Dr. Warbritton concluded

that Plaintiff experienced "permanent residuals referable to her

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neck and upper back which would preclude her from heavy lifting." 

(Tr 135). 

Plaintiff received follow-up pain management with Dr.

Warbritton in December, 1999. (Tr 205). She complained of right

elbow pain from driving and using the keyboard at work. (Id.) In

December, 2000, Plaintiff underwent an open reduction internal

fixation surgery on her right ankle, which was fitted with screws

and a plate. (Tr 147, 160-61). In June, 2002, Dr. Thomas Dorsey

performed a consultation examination at the request of the SSA. 

(Tr 166). Dr. Dorsey observed that Plaintiff's right ankle showed

a "full range of motion" and that she had obtained an "excellent

clinical result" from the ankle surgery. (Tr 168-69). Dr. Dorsey

also concluded that based on his examination, Plaintiff had "no

impairment-related physical limitations." (Tr 169). 

On visits to Alameda County Medical Center, Plaintiff reported

that she continued to experience numbness and pain in her hand,

arm, shoulder and knee during November and December, 2002. (Tr

295-97, 299). In July and August, 2003, Plaintiff complained of

similar symptoms. (Tr 291-94). 

In September, 2003, Plaintiff's right knee was examined by

MRI. (Tr 271). The findings noted "degenerative changes of the

patellar articular surface," a "small cyst," a "complete rupture of

the anterior cruciate ligament," and a "complex tear of the

posterior horn and junction region of the medical meniscus . . .

and . . . lateral meniscus." (Id.). In December, 2003 and March,

2004, Plaintiff sought treatment for right knee and ankle pain. 

(Tr 323, 326).

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1 "a member of the arylacetic acid group of non-steroidal

anti-inflammatory drugs." Physicians' Desk Reference, 59th ed.

(PDR), 2874 (2005). 

2

 "Hydrocodone bitartrate and acetaminophen is supplied in

tablet form for oral administration . . . Hydrocodone is a

semisynthetic narcotic analgesic and antitussive with multiple

actions qualitatively similar to those of codeine. Most of these

involve the central nervous system." PDR at 526.

3 "Cyclobenzaprine HCl relieves skeletal muscle spasm of local

origin without interfering with muscle function. It is ineffective

in muscle spasm due to central nervous system disease." PDR at

1930.

5

From August, 2003 to October, 2003, Plaintiff experienced

numbness in her right hand. (Tr 287, 289, 291, 327). Plaintiff

submitted the following additional evidence to the Appeals Council

concerning her right hand numbness: On February 17, 2004, the

results of an electromyographic examination (EMG) showed moderately

severe right carpal tunnel syndrome and right cubital tunnel

syndrome. (Tr 324-25). In March, 2004, Plaintiff also sought

treatment for right wrist pain. (Tr 323).

Plaintiff reported that she takes the following prescribed

medications: Naprosyn1 (375 mg, twice daily), Vicodin2 (500 mg,

four each day), and Flexeril3 (10 mg, three each day). (Tr 116). 

Plaintiff also takes Prozac for "stress." (Tr 20). 

Plaintiff submits two attachments to her motion which were not

part of the administrative record. The first document is a

"History and Physical Examination," dated September 30, 2004. It

notes the possibility of two surgeries: right wrist carpal tunnel

release surgery and right ankle surgery to remove hardware. Pl.'s

Ex. A. The second document is not dated but Plaintiff asserts that

it was prepared on December 29, 2004. According to this "Operative

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4 The SSA defines RFC as follows: 

Your impairment(s), and any related symptoms, such as pain,

may cause physical and mental limitations that affect what you

can do in a work setting. Your residual functional capacity

is what you can still do despite your limitations. 20 C.F.R.

§ 416.945(a)

5

 Sedentary work involves:

lifting no more than ten pounds at a time, and occasionally

lifting or carrying articles like docket files, ledgers and

small tools. Although a sedentary job is defined as one

which involves sitting, a certain amount of walking and

6

Report," Plaintiff had surgery to remove screws and a plate from

her right ankle. Pl.'s Ex. B. Plaintiff acknowledges that she has

not yet had the planned carpal tunnel release surgery. 

C. ALJ Findings

At step one, the ALJ found Plaintiff has not been engaged in

substantial gainful activity since April 1, 2003. (Tr 21). At

step two, the ALJ concluded that the medical evidence showed

"severe" medically determinable impairments which account for some

degree of right knee and right ankle pain. (Tr 20). The ALJ found

no medically determinable explanation for Plaintiff's complaints of

neck and shoulder pain or numbness in her hand. (Id.). In

addition, the ALJ found the record insufficient to show "severe"

depression or other mental impairments expected to last for twelve

continuous months. (Id.). 

At step three, the ALJ concluded that Plaintiff had no

impairments or combination of impairments meeting or equaling in

severity any Listing-level impairment. (Tr 22). The ALJ also

found that Plaintiff retained the residual functional capacity

(RFC)4 to perform a "full range of 'sedentary' work activities."5

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standing is often necessary in carrying out job duties.

Jobs are sedentary if walking and standing are required

occasionally and other sedentary criteria are met. 20

C.F.R. § 404.1567

7

(Id.). Furthermore, the ALJ did not find Plaintiff's symptom

allegations credible or reliable. At step four, the ALJ accepted

the testimony of the vocational expert Dr. Gerald Belchick that

Plaintiff would be unable to perform any of her past jobs. (Id.). 

Finally, at step five, consulting the Medical Vocational

Guidelines, the ALJ concluded that considering Plaintiff's age,

high school education, work experience and RFC for "sedentary"

work, Plaintiff was not disabled because she could perform other

substantial gainful work. (Id.). 

LEGAL STANDARD

I. Overturning a Denial of Benefits 

A court cannot set aside a denial of benefits unless the ALJ's

findings are based upon legal error or are not supported by

substantial evidence in the record as a whole. 42 U.S.C. § 405(g);

Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989); Martinez v.

Heckler, 807 F.2d 771, 772 (9th Cir. 1986). Substantial evidence

is such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion. Richardson v. Perales, 402 U.S.

389, 401 (1971); Orteza v. Shalala, 50 F.3d 748, 749 (9th Cir.

1995). It is more than a scintilla but less than a preponderance. 

Sorenson v. Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975). 

To determine whether substantial evidence exists to support

the ALJ's decision, a court reviews the record as a whole, not just

the evidence supporting the decision of the ALJ. Walker v.

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Matthews, 546 F.2d 814, 818 (9th Cir. 1976). A court may not

affirm the ALJ's decision simply by isolating a specific quantum of

supporting evidence. Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir.

1989). In short, a court must weigh the evidence that supports the

Commissioner's conclusions and that which does not. Martinez, 807

F.2d at 772. 

If there is substantial evidence to support the decision of

the ALJ, it is well-settled that the decision must be upheld even

when there is evidence on the other side, Hall v. Sec'y of Health,

Educ. & Welfare, 602 F.2d 1372, 1374 (9th Cir. 1979), or when the

evidence is susceptible to more than one rational interpretation,

Gallant v. Heckler, 753 F.2d 1450, 1453 (9th Cir. 1984). If

supported by substantial evidence, the findings of the ALJ as to

any fact will be conclusive. 42 U.S.C. § 405(g); Vidal v. Harris,

637 F.2d 710, 712 (9th Cir. 1981). 

II. Establishing Disability Under the Social Security Act 

Under the Social Security Act, "disability" means: 

 inability to engage in any substantial gainful activity by 

 reason of any medically determinable physical 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 twelve months. 

42 U.S.C. § 423 (d)(1)(A). The impairment must be so severe that

the claimant "is not only unable to do his previous work but cannot 

 . . . engage in any other kind of substantial gainful work." 

42 U.S.C. § 423(d)(2)(A). In addition, the impairment must result

"from anatomical, physiological, or psychological abnormalities

which are demonstrable by medically acceptable clinical and

laboratory techniques." 42 U.S.C. § 423(d)(3). 

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To determine whether a claimant is disabled within the meaning

of the Social Security Act, the Social Security Regulations set out

a five-step sequential process. Reddick v. Chater, 157 F.3d 715,

721 (9th Cir. 1998); Baxter v. Sullivan, 923 F.2d 1391, 1395 (9th

Cir. 1991); 20 C.F.R. § 404.1520 (b)-(f). The burden of proof is

on the claimant in steps one through four. Sanchez v. Sec'y of

Health & Human Servs., 812 F.2d 509, 511 (9th Cir. 1987). In step

one, the claimant must show that she or he is not currently engaged

in substantial gainful activity. 20 C.F.R. § 404.1520(b). In step

two, the claimant must show that he or she has a "medically severe

impairment or combination of impairments" that significantly limits

his or her ability to work. Bowen v. Yuckert, 482 U.S. 137, 140

(1987); Smolen v. Chater, 80 F.3d 1273, 1290 (9th Cir. 1996); 20

C.F.R. § 404.1520(c). If the claimant does not, he or she is not

disabled. Otherwise, the process continues to step three for a

determination of whether the impairment meets or equals a "listed"

impairment which the regulations acknowledge to be so severe as to

preclude substantial gainful activity. Yuckert, 482 U.S. at 141;

20 C.F.R. § 404.1520(d); 20 C.F.R. § 404, Subpt. P, App. 1. If

this requirement is met, the claimant is conclusively presumed

disabled; if not, the evaluation proceeds to step four. At step

four, it must be determined whether the claimant can still perform

"past relevant work." Yuckert, 482 U.S. at 141; 20 C.F.R. 

§ 404.1520(e). If the claimant can perform such work, he or she is

not disabled. If the claimant meets the burden of establishing an

inability to perform prior work, the burden of proof shifts to the

Commissioner for step five. At step five, the Commissioner must

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show that the claimant can perform other substantial gainful work

that exists in the national economy. Yuckert, 482 U.S. at 141; 20

C.F.R. § 1520(f).

DISCUSSION

Plaintiff presents three issues for review. First, she

challenges the ALJ's findings at step two as not supported by

substantial evidence. Second, Plaintiff contends that the ALJ

improperly discounted her credibility. And third, Plaintiff

asserts that the ALJ's reliance on the Medical Vocational

Guidelines was improper. 

I. Step Two Severe Impairment Determination

Plaintiff disputes the ALJ's finding that her neck pain,

shoulder pain, and numbness in her hands were not severe because 

there was no medically determinable explanation for it. Defendant

responds that, although the ALJ acknowledged Plaintiff's subjective

complaints of pain and numbness, there was no medical evidence to

connect these complaints to any severe impairment. Moreover, the

evidence Plaintiff submitted to the Appeals Council would not have

changed the outcome of the case. 

Step two requires that a claimant have one or more "severe

impairments that significantly limit [her] physical or mental

ability to conduct basic work activities." Celaya v. Halter, 332

F.3d 1177, 1180 (9th Cir. 2003). The step two severity

determination is intended to identify those claimants whose

impairments are so slight that they are unlikely to be found

disabled even when the variables of their age, education and

experience are taken into account. Carrao v. Shalala, 20 F.3d 943,

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949 (9th Cir. 1994) (citing Yuckert, 482 U.S. at 153). "The step

two inquiry is a de minimis screening device to dispose of

groundless claims." Smolen, 80 F.3d at 1290. An overly stringent

application of the second stage criteria would violate the statute

because benefits would be denied to claimants who meet the

statutory definition of disabled. Carrao, 20 F.3d at 949. A

finding that the impairment is “not severe” must be “clearly

established by medical evidence;” if it is not clearly established,

the sequential evaluation process must be continued. SSR 85-28.

To determine whether the ALJ's finding is supported by

substantial evidence, the Court considers the record as a whole. 

Walker, 546 F.2d at 818. The Court finds a medically determinable

explanation in the record for Plaintiff's complaints of neck and

shoulder pain and numbness in her hand. In May, 1999, Dr.

Warbritton observed a significant grip strength loss in the right

hand and concluded that there were permanent residuals in

Plaintiff's upper back and neck which would preclude her from heavy

lifting. (Tr 134-35). Notably, the Plaintiff sought treatment on

several occasions for these symptoms in the years following Dr.

Warbritton's diagnosis. (Tr 287, 289, 291-94, 295-97, 299, 323-25,

327). Furthermore, the February 17, 2004 EMG evidence Plaintiff

submitted to the Appeals Council does show moderately severe carpal

tunnel syndrome and right cubital tunnel syndrome. 

Plaintiff also submits new evidence for this Court to review

and requests that, on remand, Defendant be instructed to reconsider

the ALJ's findings in light of this evidence. A federal court may

remand to the Commissioner of SSA "upon a showing that there is new

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evidence which is material and that there is good cause for the

failure to incorporate such evidence into the record in a prior

proceeding. . . ." 42 U.S.C. § 405(g) (citations omitted); see

Allen v. Sec'y of Health and Human Servs., 726 F.2d 1470, 1473 (9th

Cir. 1984). 

Plaintiff introduces two documents prepared by physicians. 

The first document is a "History and Physical Examination" dated

September 30, 2004, proposing surgery to relieve Plaintiff's

symptoms of carpal tunnel syndrome and to remove hardware causing

her pain in her right ankle. The second document is an "Operative

Report" dated December 29, 2004, describing the surgery removing

hardware from Plaintiff's ankle. Because this evidence was

unavailable at the time of the hearing in February, 2004, good

cause is shown. Clem v. Sullivan, 894 F.2d 328, 330 (9th Cir.

1990); Embrey v. Bowen, 849 F.2d 418, 423-24 (9th Cir. 1988). 

 The remaining inquiry is whether this new evidence is

material. New evidence is material if it "bears directly and

substantially on the matter in dispute" and if "there is a

reasonable possibility that the new evidence would have changed the

outcome of the . . . determination.'" Booz v. Sec'y of Health &

Human Servs., 734 F.2d 1378, 1380-81 (9th Cir. 1984) (quoting

Dorsey v. Heckler, 702 F.2d 597, 604-05 (5th Cir. 1983) (internal

quotation marks and citations omitted). 

 The Operative Report describing surgery on Plaintiff's right

ankle is not material. Although the evidence raises the inference

that Plaintiff's condition has not improved, it does not expressly

state or necessarily imply that pain in the right ankle has

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6 "Most unskilled sedentary jobs require good use of both

hands and the fingers; i.e., bilateral manual dexterity . . . . for

repetitive hand-finger actions." Social Security Ruling 96-9p,

Determining Capability to Do Other Work -- Implications of a

Residual Functional Capacity for Less than a Full Range of

Sedentary Work, 61 Fed. Reg. 34,478, 34,482 (July 2, 1996). "Any

significant manipulative limitation of an individual's ability to

handle and work with small objects with both hands will result in a

13

increased. To the contrary, the purpose of the surgery was to

relieve the pain caused by the hardware. Moreover, the ALJ found

Plaintiff had a severe impairment in her right ankle but concluded

nonetheless that she could perform other substantial gainful

activity. Thus, the Operative Report would not have changed the

outcome of the case. 

 The medical evidence proposing surgery to relieve Plaintiff's

symptoms caused by carpal tunnel syndrome, however, bears directly

and substantially on the severity of Plaintiff's pain and numbness

in her right arm and hand, a matter clearly in dispute. Defendant

argues that the EMG evidence was properly rejected by the Appeals

Council because it would not have changed the ALJ's final

determination, i.e., that Plaintiff could perform sedentary work. 

Yet, the ALJ did not consider, nor did Defendant address, the new

evidence of the recommended wrist surgery. Moreover, that evidence

belies the ALJ's reasoning that the impairments were not severe

because Plaintiff was only prescribed conservative treatments; the

evidence suggests that surgery has been prescribed. Finally, given

the state of the record, the new evidence is relevant regarding the

disabling effects of the carpal tunnel syndrome, particularly

whether the condition precludes or diminishes Plaintiff's ability

to perform sedentary work.6 

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significant erosion of the unskilled sedentary occupational base." 

Id.

14

 Therefore, the Court remands to Defendant to consider at step

two the new evidence and any evidence Plaintiff has since acquired

concerning any functional limitations arising from her right carpal

tunnel and right cubital tunnel syndromes. If these impairments

are determined at step two to be severe, Defendant must reconsider

the prior findings at step three through five in that light.

II. Credibility

Plaintiff contends that the ALJ's credibility findings at step

three concerning her knee pain and limited use of her hand were not

sufficiently specific and that he did not provide clear and

convincing reasons for discounting her testimony. Defendant cites

the ALJ's discussion of inconsistencies in the record, Plaintiff's

own self-reported physical abilities and Plaintiff's demeanor at

the hearing to show that the ALJ's findings were specific and

consistent with substantial evidence.

In Cotton v. Bowen, 799 F.2d 1403 (9th Cir. 1986), the Ninth

Circuit developed a threshold test to determine the credibility of

a claimant's subjective symptom testimony. Under Cotton, a

claimant "must produce objective medical evidence of an underlying

impairment 'which could reasonably be expected to produce the pain

or other symptoms alleged.'" Bunnell v. Sullivan, 947 F.2d 341,

344 (9th Cir. 1991) (en banc) (quoting Cotton, 799 F.2d at 1407-

08); see also Smolen, 80 F.3d at 1282. Cotton requires "only that

the causal relationship be a reasonable inference, not a medically

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proven phenomenon." Smolen, 80 F.3d at 1282. Thus, a claimant is

not required to produce objective medical evidence of the pain

itself or its severity. Id. (citing Bunnell, 947 F.2d at 347-48). 

"It is improper as a matter of law for an ALJ to discredit excess

pain testimony solely on the ground that it is not fully

corroborated by objective medical findings." Cotton, 799 F.2d at

1407; Fair v. Bowen, 885 F.2d 597, 601 (9th Cir. 1989). 

 Once a claimant meets the Cotton test, "the Commissioner may

not discredit the claimant's testimony as to subjective symptoms

merely because they are unsupportable by objective evidence. 

Unless there is affirmative evidence showing that the claimant is

malingering, the Commissioner's reason for rejecting the claimant's

testimony must be 'clear and convincing.'" Lester v. Chater, 81

F.3d 821, 834 (9th Cir. 1995) (quoting Swenson v. Sullivan, 876

F.2d 683, 687 (9th Cir. 1989)); Smolen, 80 F.3d at 1281. In

determining whether a plaintiff's testimony concerning the severity

of her symptoms is credible, the ALJ may properly consider: 

(1) ordinary techniques of credibility evaluation, such as the

plaintiff's reputation for lying, prior inconsistent statements

concerning the symptoms, and other testimony by the plaintiff that

appears less than candid; (2) unexplained or inadequately explained

failure to seek treatment or to follow a prescribed course of

treatment; and (3) the plaintiff's daily activities. Smolen, 80

F.3d at 1273.

Defendant argues that the ALJ properly discredited Plaintiff's

knee pain testimony because she reported that she stopped working

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on March 31, 2003 due to pain in her knee and ankle, yet her

reports of severe knee pain did not actually begin until about July

21, 2003, four months after she stopped working. (Tr 21, 293,

335). However, the record reflects that Plaintiff began reporting

pain in her right knee as early as December, 2002. (Tr 296). 

Furthermore, Plaintiff testified at the hearing that, before she

stopped working, her knee pain was so severe that she had to take

many sick days and would hide in the bathroom at work crying

because of the pain. (Tr 334-35, 344).

Defendant also contends that the ALJ's credibility

determination was correct based on the fact that Plaintiff's

physicians only prescribed conservative treatment for the knee

pain. Defendant cites Meanel v. Apfel for the proposition that

subjective pain complaints can be properly discredited where a

claimant receives conservative treatment. 172 F.3d 1111, 1113 (9th

Cir. 1999). Unlike the claimant in Meanel, however, Plaintiff

passes the threshold test articulated in Cotton. Here, the ALJ

found objective medical evidence of a severe impairment, which

could account for some degree of pain in Plaintiff's right knee. 

(Tr 20). Moreover, the ALJ in Meanel rejected the claimant's

testimony because (1) her doctor failed to prescribe, and the

claimant failed to seek, medical treatment; (2) the claimant could

not explain the discrepancy between her pain testimony and the

conservative treatment she had received; and (3) the claimant's

testimony was otherwise inconsistent with her own physician's

findings. 172 F.3d at 1114. The fact that the claimant received

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conservative treatment was a factor in the Meanel court's analysis

but the court did not suggest that this fact alone was dispositive. 

Similarly, Plaintiff's conservative treatments may have been an

appropriate factor in the ALJ's credibility determination but this

factor alone does not provide a clear and convincing reason for

rejecting Plaintiff's testimony. 

Defendant also argues that there is affirmative evidence that

Plaintiff was malingering concerning whether the pain limited her

physical abilities. The ALJ noted that Plaintiff admitted she

could cook, clean, shop with her son, drive to her appointments,

when necessary, and climb a flight of thirty stairs to her

apartment, when necessary. (Tr 339, 346-47). Defendant contends

that these admissions were inconsistent with Plaintiff's assertion

that she could not perform sedentary work and, thus, provided

further support for the ALJ's credibility finding. However,

Plaintiff correctly points out that the ALJ failed to acknowledge

the qualifying statements Plaintiff made regarding these

admissions. Plaintiff testified that she tried to do some

housework and cook "a little bit, with [her son's] help and his

daughter" but that her son "does the majority of work in the

house." (Tr 339). Plaintiff also stated that her son helps her

shop and that she must sit in the car after picking the items out

because she can't stand long in the check-out lines. (Tr 346-47). 

Plaintiff admitted to driving a car but stated that she had to

learn to drive with her left foot and also that her son takes her

to her doctor's appointments the "majority of the time." (Tr 346). 

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Furthermore, Plaintiff testified that she could climb up and down a

flight of stairs but also stated that the stairs act as a deterrent

and the reason she spends a "majority of the time . . . at home." 

(Tr 347). 

Finally, Defendant argues that the ALJ properly discredited

Plaintiff's testimony because of her demeanor at the hearing. The

ALJ described Plaintiff as presenting with "great elaboration of

her aches and pains, with multiple moans and groans." (Tr 21). 

Defendant contends that the ALJ was entitled to rely on his

observations of Plaintiff in finding her not credible over all. 

However, "the ALJ may not rely on his own observations of the

claimant at the hearing as the sole reason for rejecting the

claimant's complaints." Tonapetyan v. Halter, 242 F.3d 1144, 1148

(9th Cir. 2001) (citing Fair, 885 F.2d at 602). Although the ALJ

did not rely solely on observations of Plaintiff's demeanor at the

hearing, the additional fact that Plaintiff only received

conservative treatment for her pain does not suffice to amount to

clear or convincing reasons to discount Plaintiff's credibility. 

Therefore, the Court instructs Defendant on remand to provide

clear and convincing reasons for rejecting Plaintiff's testimony of

her physical limitations arising from pain in her right knee, or to

give her testimony due weight. 

III. Medical Vocational Guildelines

Plaintiff argues that the ALJ's use of the Medical-Vocational

Guildelines (Grids) was improper because Plaintiff has a

significant limitation from a severe non-exertional impairment in

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her right arm and hand. Defendant contends that the ALJ's use of

the Grids was proper because substantial evidence supported a

finding that Plaintiff had the RFC to perform sedentary work.

The Grids are administrative tools that the Commissioner may

use at step five of the disability evaluation. Burkhart v. Bowen,

856 F.2d 1335, 1340 (9th Cir. 1988). Based on age, education, work

experience, and “exertional capacity,” the Grids determine the

employability of claimants with “substantially uniform levels of

impairment.” Id.; see also 20 C.F.R. pt. 404, subpt. P, app. 2. 

However, the ALJ may rely on the Grids only when they “accurately

and completely describe the claimant’s abilities and limitations.” 

Burkhart, 856 F.2d at 1340; see also Tackett v. Apfel, 180 F.3d

1094, 1102 (9th Cir. 1999). If a claimant has an impairment that

limits his or her ability to work without directly affecting his or

her strength, the claimant is said to have non-exertional (not

strength-related) limitations that are not covered by the Grids. 

20 C.F.R., pt. 404, subpt. P., app. 2 § 200.00(d),(e). When a

claimant suffers from non-exertional impairments that are

“sufficiently severe” to limit significantly the range of work

permitted by his or her exertional abilities, the Grids are

inapplicable. Tackett, 180 F.3d at 1102 (citing Desrosiers v.

Sec'y of Health and Human Servs., 846 F.2d 573, 577 (9th Cir.

1988)). In such instances, the ALJ must consider the testimony of

a vocational expert and identify specific jobs that are within the

claimant’s capabilities. Burkhart, 856 F.2d at 1340. Here, the

ALJ accepted the vocational expert's testimony that Plaintiff could

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not perform her past work but did not question him regarding the

range of work or specific jobs Plaintiff could perform within her

abilities. Rather, the ALJ consulted the Grids directly. 

Plaintiff argues that medical and other evidence shows the

existence of a significant impairment in her right arm and hand

causing non-exertional limitations. Given the Court's decision to

remand on whether Plaintiff's right carpal tunnel and cubital

tunnel syndromes constitute a severe impairment, the Court cannot

determine whether the use of the Grids is proper. However, if, on

remand, Defendant finds Plaintiff's carpal tunnel and cubital

tunnel syndromes constitute a severe impairment causing nonexertional limitations "that significantly limit the range of work

permitted by [her] exertional abilities," then use of the Grids

would be improper. Desrosiers, 846 F.2d at 577 (citations

omitted). 

CONCLUSION

For the foregoing reasons, the Court denies Plaintiff's and

Defendant's cross-motions for summary judgment (Docket No. 18 and

21) and grants Plaintiff's motion to remand (Docket No. 18) for

further proceedings as instructed.

IT IS SO ORDERED.

Dated: 10/27/05

___________________________ 

CLAUDIA WILKEN

United States District Judge

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