Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_13-cv-02616/USCOURTS-azd-2_13-cv-02616-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
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 

Armentha Hooker, 

Plaintiff, 

v. 

Carolyn W. Colvin, 

Defendant.

No. CV-13-02616-PHX-JAT

ORDER 

 Plaintiff Armentha Hooker, mother of minor claimant Z.H., appeals a denial of 

benefits by the Acting Commissioner of Social Security (“Commissioner”). The Court 

now rules on this appeal. 

I. BACKGROUND 

 A. Procedural History 

 Plaintiff filed an application for disability insurance benefits on May 28, 2009 on 

behalf of her minor daughter, Z.H., alleging Z.H.’s disability beginning May 26, 2009. 

The claim was denied on September 15, 2009, and again upon reconsideration on January 

13, 2010. Plaintiff requested a hearing, which was conducted by an Administrative Law 

Judge (“ALJ”) on April 17, 2012 in Phoenix, Arizona. 

 B. Factual Background 

 Z.H. began seeing mental health professionals in 2007 at the age of five due to 

behavioral problems at home and school. Specifically, Plaintiff reported to a 

psychologist, Herb Brenden, Ed.D, L.P., that Z.H. had trouble focusing and following 

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directions and became violent with peers and teachers. Dr. Brenden referred Z.H. to a 

psychiatrist, Dexter D. Whittemore, M.D., and Z.H. was diagnosed with attention deficit 

hyperactivity disorder (“ADHD”) and oppositional defiant disorder (“ODD”). 

Dr. Whittemore prescribed Daytrana 15 mg and noted improvements in focus, 

organization, and impulsivity. At one point during Z.H.’s treatment with Dr. Whittemore, 

Z.H.’s father reported that she was doing “generally well” with the treatment plan, but 

Z.H.’s teachers, continued to report behavioral problems. 

 In 2009, when she was seven years old, Z.H. qualified for special education 

services in her school district in Minnesota, which included intermittent attendance in 

special education classes and a behavioral intervention plan. Between 2009 and 2010, 

Z.H.’s parents and teachers reported periods of improvement and periods of increased 

violent, disruptive, and impulsive behavior. Dr. Whittemore eventually added Ritalin to 

Z.H.’s treatment plan. 

 Plaintiff and Z.H. moved to Arizona in 2010 and saw a psychiatrist, Edwin A. 

Perez, M.D., in October 2010, seven months after Z.H.’s last appointment with Dr. 

Whittemore. Z.H.’s new school district in Arizona placed Z.H. on an “individual 

education plan,” under which Z.H.’s teacher reported steady improvements. 

 Dr. Perez completed an assessment of Z.H.’s limitations on June 30, 2011, in 

which he concluded that Z.H. had marked limitations in motor functioning, social 

functioning, and concentration, persistence, or pace. Z.H.’s fourth grade teacher in 

Arizona, Ms. Linda Foster, filled out a similar assessment, concluding that Z.H. had 

marked limitations in cognitive/communicative functioning and concentration, 

persistence, or pace as well as an extreme limitation in social functioning. At the hearing, 

a non-examining medical expert, Raymond E. Moore, Ph.D, testified that Z.H. did not 

have any marked or extreme limitations. Plaintiff also testified at the hearing, stating that 

Z.H. inflicts physical harm on others and herself, takes abnormally long to do her 

homework, has trouble focusing, and is generally defiant toward adults. 

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II. DISABILITY 

 A. Three-Step Evaluation Process 

 The ALJ follows a three-step process to evaluate whether a child is disabled. First, 

the ALJ determines whether the child is engaged in substantial gainful activity. 20 C.F.R. 

§ 416.924(a), (b). If the child is engaged in substantial gainful activity, then she is not 

disabled. 20 C.F.R. § 416.924(b). Second, the ALJ determines whether the child has a 

“medically determinable impairment(s) that is severe.” 20 C.F.R. § 416.924(c). For 

purposes of this step, “a slight abnormality or a combination of slight abnormalities that 

causes no more than minimal functional limitations” does not constitute a severe 

impairment. 20 C.F.R. § 416.924(c). If the child has no severe, medically determinable 

impairment, the she is not disabled. 20 C.F.R. § 416.924(c). Finally, the ALJ must 

determine whether the child’s impairment “meet[s], medically equal[s], or functionally 

equal[s] the listings.” 20 C.F.R. § 416.924(d). The impairment medically equals a listed 

impairment if “it is at least equal in severity and duration to the criteria of any listed 

impairment.” 20 C.F.R. § 416.926(a); Howard ex rel. Wolff v. Barnhart, 341 F.3d 1006, 

1012 (9th Cir. 2003). The impairment is functionally equivalent to a listed impairment if 

the child has a “marked” limitation in two areas or an “extreme” limitation in one area. 

20 C.F.R. § 416.926a (a); Howard, 341 F.3d at 1012. 

 In making disability determinations, the ALJ must “develop the record and 

interpret the medical evidence.” Howard, 341 F.3d at 1012 (citing Crane v. Shalala, 76 

F.3d 251, 255 (9th Cir. 1996)). In doing do, however, “the ALJ does not need to ‘discuss 

every piece of evidence.’” Id. (citing Black v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998) 

and Vincent v. Heckler, 739 F.2d 1393, 1394–95 (9th Cir.1984)). 

B. The ALJ’s Decision 

 At step one, the ALJ determined that Z.H. is not engaged in gainful employment. 

At step two, the ALJ determined that Z.H. has two medically determinable, severe 

impairments: ADHD and ODD. At step three, the ALJ found that Z.H. does not have an 

impairment or combination of impairments that meets, medically equals, or functionally 

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equals the listings. Accordingly, the ALJ concluded that Z.H. is not disabled and 

therefore Plaintiff is not entitled to benefits. 

 C. Standard of Review 

 A district 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. Substantial evidence means more than a mere scintilla 

but less than a preponderance. Substantial evidence is 

relevant evidence, which considering the record as a whole, a reasonable person might accept as adequate to support a 

conclusion. Where the evidence is susceptible to more than one rational interpretation, one of which supports the ALJ’s decision, the ALJ’s decision must be upheld. 

Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (internal citation and quotation 

marks omitted). This is because “[t]he trier of fact and not the reviewing court must 

resolve conflicts in the evidence, and if the evidence can support either outcome, the 

court may not substitute its judgment for that of the ALJ.” Matney v. Sullivan, 981 F.2d 

1016, 1019 (9th Cir. 1992). Under this standard, the Court will uphold the ALJ’s findings 

if supported by inferences reasonably drawn from the record. Batson v. Comm’r of the 

Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). However, the Court must consider 

the entire record as a whole and cannot affirm simply by isolating a “specific quantum of 

supporting evidence.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (internal 

quotation omitted). 

III. Discussion 

 Plaintiff’s main objections to the ALJ’s decision center on the way the ALJ 

assigned weight to the various sources of evidence. Specifically, Plaintiff argues that the 

ALJ erred by assigning “little weight” to Dr. Perez’s assessment, ignoring Ms. Foster’s 

assessment, and relying on Dr. Moore’s opinion. As these sources differ in nature, the 

Court will address them each separately. 

 A. Dr. Perez 

 Plaintiff’s first and largest argument is that the ALJ erroneously assigned “little 

weight” to Dr. Perez’s assessment of Z.H. The ALJ explained that she diminished the 

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weight given to Dr. Perez’s assessment because Dr. Perez was “not seeing [Z.H.] 

consistently or regularly” when he completed the assessment and because the assessment 

was inconsistent with Z.H.’s medical1

 and school records. 

 ALJs are entitled to give less weight to physicians that do not regularly treat a 

claimant or who are not procured for the purpose of treatment. The regulations provide 

in-depth guidance in this regard: 

Treating source means your own physician, psychologist, or other acceptable medical source who provides you, or has provided you, with medical treatment or evaluation and who has, or has had, an ongoing treatment relationship with you. Generally, we will consider that you have an ongoing treatment relationship with an acceptable medical source when the medical evidence establishes that you see, or have seen, the source with a frequency consistent with accepted medical practice for the type of 

treatment and/or evaluation required for your medical condition(s). We may consider an acceptable medical source who has treated or evaluated you only a few times or only after long intervals (e.g., twice a year) to be your treating source if the nature and frequency of the treatment or evaluation is 

typical for your condition(s). We will not consider an acceptable medical source to be your treating source if your relationship with the source is not based on your medical need for treatment or evaluation, but solely on your need to obtain a report in support of your claim for disability. In such a case, we will consider the acceptable medical source to be a nontreating 

source. 

20 C.F.R. § 416.902. 

 The Ninth Circuit has elaborated upon this guidance, holding that “[t]he key issue 

in determining whether [a physician] was claimant’s treating physician is whether his 

examinations of her were prompted by her need for treatment.” Benton ex rel. Benton v. 

Barnhart, 331 F.3d 1030, 1038 (9th Cir. 2003) (quoting Bowman v. Commr, Soc. Sec. 

Admin., 2001 WL 215790 (Feb. 23, 2001)). Additionally, the Ninth Circuit has explained 

that “[i]t is not necessary, or even practical, to draw a bright line distinguishing a treating 

physician from a non-treating physician. Rather, the relationship is better viewed as a 

series of points on a continuum reflecting the duration of the treatment relationship and 

the frequency and nature of the contact.” Id. (quoting Ratto v. Sec’y, Dep’t of Health & 

 

1

 The Court acknowledges that the notes cited by the ALJ as “Dr. Perez’s own treatment notes” were actually written by Dr. Whittemore and other mental health 

professionals. This error, however, is insubstantial, as the contents of the notes, not the 

author’s identity, is at issue. 

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Human Servs., 839 F. Supp. 1415, 1425 (D. Or. 1993)). 

 Applying these standards, the Court concludes that the ALJ did not commit 

reversible error by assigning “little weight” to Dr. Perez’s assessment. After a careful 

review of the record, the Court could locate documentary evidence of only three visits 

Z.H. had with Dr. Perez: one on October 25, 2010 (Tr. 871–77), another on October 12, 

2011 (Tr. 831–33), and another on January 11, 2012 (Tr. 985–86). Only one of these 

visits occurred before Dr. Perez completed his assessment in June of 2011. There are no 

treatment notes on the record for the June 15, 2011 visit Dr. Perez claims he had with 

Z.H. Even if Dr. Perez did, in fact, see Z.H. in June 2011, that would only be his second 

recorded visit with Z.H. before completing the assessment and the first recorded visit in 

eight months. The other records cited by Plaintiff consist of notes taken by other health 

care professionals, informed consent forms, and Dr. Perez’s assessment itself. The only 

other evidence that indicates Dr. Perez may have seen Z.H. more than twice before 

making his assessment is Plaintiff’s testimony that Z.H. visits Dr. Perez “from once a 

month to once every three months.” The fact remains, however, that there is no 

documentary evidence of any such regular visits. Additionally, Plaintiff was testifying in 

April of 2012 about Z.H.’s current schedule with Dr. Perez, so the testimony does not 

necessitate the conclusion that Z.H. had a regular schedule with Dr. Perez before Dr. 

Perez completed his assessment. In short, there is little record evidence that Dr. Perez had 

an “ongoing treatment relationship” with Z.H. when he completed the assessment; to the 

contrary, the record strongly indicates that Dr. Perez saw Z.H. a few times, at most, 

before completing the assessment. 

 The ALJ’s assignment of “little weight” to the Dr. Perez’s assessment is further 

buttressed by her reasonable findings that Dr. Perez’s assessment was inconsistent with 

the medical record and Z.H.’s school records. In particular, the ALJ cited progress reports 

within Z.H.’s school records that note Z.H.’s improvement in behavior, (Tr. at 776, 780), 

and a “45-day screening report” that shows only a few areas of behavioral and functional 

inadequacies, (Tr. 778). The ALJ also cites treatment notes that indicate Z.H. was a 

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mainstream student (as opposed to a special education student), (Tr. 663) and was “doing 

generally well” with her focus and impulsivity, (Tr. 664). These school and medical 

records showing Z.H.’s functionality, combined with the evidence showing the limited 

nature of Dr. Perez’s treating relationship with Z.H., constitute substantial evidence 

supporting the ALJ’s decision to assign Dr. Perez’s assessment diminished weight. 

Therefore, the ALJ did not err by assigning “little weight” to Dr. Perez’s assessment. 

B. Ms. Foster 

 Plaintiff argues that the ALJ erred by ignoring an assessment completed by Ms. 

Foster, which corroborates Dr. Perez’s conclusions that Z.H. had disabling limitations. 

The Commissioner argues that any error in ignoring Ms. Foster’s assessment was 

harmless because Ms. Foster did not base her opinion on scientific or medical testing. 

Finally, the Commissioner argues that because the ALJ properly rejected Dr. Perez’s 

conclusion that Z.H. has marked limitations, the ALJ need not address every piece of lay 

testimony which reaches the same conclusions. 

 Both parties cite Molina v. Astrue, 674 F.3d 1122 (9th Cir. 2012) in support of 

their positions. In that case, the Ninth Circuit affirmed their well-established precedent 

that “lay witness testimony cannot be disregarded without comment,” but held that the 

ALJ’s failure to comment on lay testimony was harmless “[b]ecause the ALJ had validly 

rejected all the limitations described by the lay witnesses.” Molina, 674 F.3d at 1114, 

1122 (9th Cir. 2012) (quoting Nguyen v. Chater, 100 F.3d 1462, 1467 (9th Cir. 1996) 

(internal quotations marks omitted)). Specifically, the court held that because the ALJ 

had validly found that the claimant’s purported limitations were not supported by the 

record, “the ALJ’s failure to give specific witness-by-witness reasons for rejecting the lay 

testimony did not alter the ultimate nondisability determination.” Id. at 1122. 

Molina’s holding is directly applicable here. First, the Court notes that it was 

unable to locate any mention of Ms. Foster’s assessment in the ALJ’s decision; the 

portions of the ALJ’s decisions the Commissioner claims cited Ms. Foster’s assessment 

actually cite a treatment note by Dr. Whittemore. Thus, the ALJ erred by disregarding lay 

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testimony without comment. Molina, 674 F.3d at 1114. As noted above, however, the 

ALJ in this case properly rejected the limitations described by Dr. Perez because they 

were not supported by the record. Therefore, because Mr. Foster reached essentially the 

same conclusions Dr. Perez reached regarding Z.H.’s limitations, the ALJ’s error was 

harmless. 

C. Dr. Moore 

 Plaintiff argues that Dr. Moore’s opinion does not constitute substantial evidence 

to support the ALJ’s finding of nondisability. Plaintiff notes that Dr. Moore did not take 

into account the records of Z.H.’s treatment before the alleged onset date or the records 

of her treatment after December 2011, all of which Plaintiff argues indicate major 

limitations. Plaintiff further argues that Dr. Moore erroneously concluded that Z.H.’s 

limitations were a result of non-compliance with medication. Finally, Plaintiff argues that 

Dr. Moore placed too much emphasis on the school records indicating improvement in 

Z.H.’s behavior, since those records did not identify how improvement was measured and 

because those records “pertained to a discrete period of time” and thus “were not an 

accurate representations of Z.H.’s functioning over time.” 

 ALJs give weight to a nonexamining source based on factors laid out by the 

regulations. The following factors are applicable here: 

Supportability. The more a medical source presents relevant evidence to support an opinion, particularly medical signs and laboratory findings, the more weight we will give that opinion. The better an explanation a source provides for an opinion, the more weight we will give that opinion. Furthermore, because nonexamining sources have no examining or treating relationship with you, the weight we will give their opinions will depend on the degree to which they provide supporting explanations for their opinions. We will evaluate the degree to which these opinions consider all of the pertinent evidence in your claim, including opinions of treating and other examining sources. 

Consistency. Generally, the more consistent an opinion is with the record as a whole, the more weight we will give to that opinion. 

20 C.F.R. § 416.927(c)(3)–(4); see also Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 

2002) (“The opinions of non-treating or non-examining physicians may also serve as 

substantial evidence when the opinions are consistent with independent clinical findings 

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or other evidence in the record. “). 

 The Court is troubled that Dr. Moore formed his opinion without reviewing the 

records that predate the alleged onset date or postdate December 2011. Nevertheless, 

even without reviewing those records, Dr .Moore reviewed nearly two years’ worth of 

treatment notes and school records, so it cannot be said that his opinion is without basis. 

The Court also recognizes that, as Plaintiff points out, the record contains evidence of 

behavior that is consistent with the limitations claimed by Plaintiff and Dr. Perez. But the 

record also contains evidence of behavior that indicates Z.H. has no marked or severe 

limitations. For example, as Dr. Moore explained in his testimony, Z.H. is a mainstream 

student, receives normal grades, and has shown consistent improvement in her behavior 

at school. The medical records also indicate multiple times when Plaintiff reported Z.H.’s 

medications as being helpful. This evidence shows that Dr. Moore’s opinion is consistent 

with substantial record evidence, even if other record evidence contradicts his opinion. It 

is the ALJ’s duty to resolve these types of conflict in the evidence. See Parra v. Astrue, 

481 F.3d 742, 750 (9th Cir. 2007) (“Generally, questions of credibility and resolution of 

conflicts in the testimony are functions solely for the agency.”) (quoting Sample v. 

Schweiker, 694 F.2d 639, 642 (9th Cir. 1982) (internal quotations marks omitted)). 

Accordingly, although this is a close case, the Court must defer to the ALJ’s decision to 

give significant weight to Dr. Moore’s opinion. 

D. Plaintiff’s Testimony 

 The ALJ cited three primary reasons for discrediting Plaintiff’s testimony2

: gaps in 

treatment, noncompliance with treatment, and inconsistency with the educational record 

which shows that Z.H. was a mainstream student. (Tr. 21–22). Plaintiff argues that the 

record contains evidence that Z.H. received “extensive psychiatric care from about 

age 5.” Plaintiff also points out record evidence that Z.H. was, in fact, medication-

 

2

 Plaintiff’s brief seems to suggest that Z.H. herself testified or otherwise made 

claims of disability, (Doc. 13 at 23–25, 23 n.5) but she was not present at the hearing, (Tr. 16, 38, 96), and no other statements by Z.H. could be located by the Court. The Court therefore considers the arguments made by Plaintiff to pertain to the testimony of Plaintiff, Z.H.’s mother and the official claimant at the agency proceedings. 

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compliant. Additionally, Plaintiff argues that the ALJ should not have put much weight 

on the fact that Z.H. was a mainstream student because there is great variability among 

school districts on these matters and because Z.H. received some special education 

services. 

 The Social Security Administration has promulgated a ruling outlining how an 

ALJ should determine a claimant’s credibility. S.S.R. 96–7p (Cum. Ed.1996), available at 

61 Fed.Reg. 34,483–01 (July 2, 1996) (“[T]he individual’s statements may be less 

credible if the level or frequency of treatment is inconsistent with the level of complaints, 

or if the medical reports or records show that the individual is not following the treatment 

as prescribed and there are no good reasons for this failure.”). The Ninth Circuit has 

upheld this ruling: 

Social Security Administration rulings specify the proper bases for rejection of a claimant's testimony. See S.S.R. 02–1p (Cum. Ed.2002), available at Policy Interpretation Ruling Titles II and XVI: Evaluation of 

Obesity, 67 Fed.Reg. 57,859–02 (Sept. 12, 2002); S.S.R. 96–7p (Cum. Ed.1996), available at 61 Fed.Reg. 34,483–01 (July 2, 1996). An ALJ’s decision to reject a claimant's testimony cannot be supported by reasons that do not comport with the agency’s rules. See 67 Fed.Reg. at 57860 (“Although Social Security Rulings do not have the same force and effect 

as the statute or regulations, they are binding on all components of the Social Security Administration, ... and are to be relied upon as precedents in adjudicating cases.”); see Daniels v. Apfel, 154 F.3d 1129, 1131 (10th 

Cir.1998) (concluding that ALJ's decision at step three of the disability determination was contrary to agency regulations and rulings and therefore warranted remand). Factors that an ALJ may consider in weighing a claimant's credibility include reputation for truthfulness, inconsistencies in 

testimony or between testimony and conduct, daily activities, and “unexplained, or inadequately explained, failure to seek treatment or follow a prescribed course of treatment.” Fair, 885 F.2d at 603; see also Thomas,

278 F.3d at 958–59. 

Orn v. Astrue, 495 F.3d 625, 635–36 (9th Cir. 2007). 

 The ALJ’s decision here uses the precise criteria outlined by the Social Security 

Administration and the Ninth Circuit, and is supported by substantial evidence. The ALJ 

dedicates five paragraphs to describing instances in the record where Z.H. missed followup visits, (Tr. 663, 708), responded well to medication, (Tr. 669, 680, 871), went seven 

months without seeking treatment, (Tr. 708, 825, 845), and had had periods where she 

was not taking medications, (Tr. 691). (Tr. 21–22). As the Social Security Administration 

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and the Ninth Circuit have recognized, these instances properly impeach the credibility of 

Plaintiff’s reports of Z.H.’s limitations. Indeed, Plaintiff does not argue that these 

instances did not occur, but that the ALJ should have instead emphasized Z.H.’s instances 

of compliance and history of getting psychiatric treatment for seven years. It is 

quintessentially the province of the ALJ to resolve conflicts of evidence and to make 

credibility determinations, and a reviewing court may only rarely overturn those findings. 

See Parra, 481 F.3d at 750. Because the ALJ cited substantial record evidence to support 

her findings regarding Plaintiff’s credibility, the Court will uphold the ALJ’s decision to 

disregard Z.H.’s testimony as not credible.3

IV. CONCLUSION 

 For the foregoing reasons, 

IT IS ORDERED that the decision of the Administrative Law Judge is affirmed. 

IT IS FURTHER ORDERED that the Clerk of the Court shall enter judgment 

accordingly. The judgment will serve as the mandate of this Court. 

 Dated this 3rd day of February, 2015. 

 

3

 The Court notes that the ALJ did not discuss Z.H.’s status as a mainstream 

student in much detail. Specifically, while the ALJ noted that Z.H. is a “mainstream 

student who has continually been elevated from one grade to the next,” she did not address that Z.H. had attended special educations classes intermittently and had behavioral problems. See 20 C.F.R. § 416.924a(b)(7)(iv). The Court need not reach this 

issue, however, because it holds that the other reasons the ALJ gave for discrediting Z.H.’s testimony were independently sufficient to withstand scrutiny. 

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