Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_08-cv-00954/USCOURTS-casd-3_08-cv-00954-0/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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1

 42 U.S.C. § 1383(c)(3) provides:

The final determination of the Commissioner of Social Security after a hearing [to determine eligibility or amount

of benefits] shall be subject to judicial review as provided in section 405(g) of this title...

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

BEVERLY HADRICK,

Plaintiff,

CASE NO. 08cv954-BEN (WMc)

REPORT AND

RECOMMENDATION DENYING

PLAINTIFF’S MOTION FOR

SUMMARY JUDGMENT AND

GRANTING DEFENDANT’S CROSS

MOTION FOR SUMMARY

JUDGMENT

vs.

MICHAEL ASTRUE, Commissioner of

Social Security,

Defendant.

INTRODUCTION

Plaintiff Beverly Hadrick (hereinafter Plaintiff) brings this action pursuant to section

405(g) of the Social Security Act, 42 U.S.C. § 1383 (c)(3)1 to obtain judicial review of a final

decision of the Commissioner of Social Security (“Commissioner”) denying her claim for Social

Security Disability Insurance Benefits (“SSDI”) under Title II and Title XVI of the Social Security

Act (“Act”), 42 U.S.C §§ 1381, et seq. Plaintiff has filed a motion for summary judgment. In that

motion, Plaintiff argues she should have been found “disabled” under the Act and the Appeals

Council’s decision adopting the Administrative Law Judge’s (“ALJ”) decision of July 28, 2005

denying her benefits should be reversed because the ALJ’s decision is not supported by substantial

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evidence and is based on legal error. The Commissioner filed a cross-motion for summary

judgment. In the motion, the Commissioner argues the ALJ’s decision is supported by substantial

evidence and is not based on legal error.

PROCEDURAL HISTORY

Plaintiff filed an application for supplemental security income payments on April 29, 2003.

(A.R. at 758.) The claim was denied initially and then again on reconsideration. Plaintiff filed a

request for a hearing and her claim was denied by decision on July 28, 2005. Plaintiff

subsequently filed an additional application for supplemental security income payments on

December 28, 2005. (Id.) Plaintiff is alleging disability since January 17, 2001, on both

applications. Plaintiff filed a request for review of the decision that was denied by the Appeals

Council on March 17, 2006. Plaintiff subsequently filed an appeal with the United States District

Court Southern District of California. On September 5, 2007, Plaintiff’s appeal was granted and

the decision was remanded for further consideration. (Id.)

 On remand and after two more hearings the ALJ issued a decision on March 26, 2008. 

The ALJ found Plaintiff was disabled from December 1, 2003 through March 1, 2005. (A.R. at

762.) October 21, 2008, the appeals counsel declined to assume jurisdiction. On November 30,

2009, Plaintiff filed a Motion for Summary Judgment. (Doc. No. 20.) On January 4, 2010,

Defendant filed a Cross Motion for Summary Judgment and Response in Opposition to Plaintiff’s

Motion for Summary Judgment. (Doc. No. 21.) 

FACTUAL BACKGROUND

Plaintiff was born July 30, 1960; at the alleged onset of her disability Plaintiff was fortytwo years old. (A.R. at 754.) Plaintiff has a twelfth grade education and is able to read and

communicate in English. (A.R. at 755.) Plaintiff has no transferable job skills due to a lack of

past relevant work experience. (Id.) 

At the August 2007 hearing Plaintiff testified she cannot work due to (a) joint disease of

the knee, (b) back pain, (c) asthma and (d) carpal tunnel syndrome. (A.R.at 835.) Plaintiff states

she receives Workers Compensation (Id.)

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2 There are nine diagnostic categories that the Act considers to be medically determinable mental impairment(s):

Organic mental disorders (12.02); schizophrenic, paranoid, and other psychotic disorders (12.03); affective disorders

(12.04); mental retardation (12.05); anxiety related disorders (12.06); somatoform disorders (12.07); personality disorders

(12.08); substance addiction disorders (12.09); and autistic disorder and other pervasive developmental disorders (12.10).

20 C.F.R.Pt. 404, Subpt. P, App. 1 § 12.00.A.

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LEGAL STANDARD

The supplemental security income program established by Title XVI of the Act provides

benefits to disabled persons without substantial resources and little income. 42 U.S.C. § 1383. To

qualify, a claimant must establish an inability to engage in “substantial gainful activity” because of

a “medically determinable physical or mental impairment” that “has lasted or can be expected to

last for a continuous period of not less than 12 months.” 42 U.S.C. § 1382c(a)(3)(A). The

disabling impairment must be so severe that, considering age, education, and work experience, the

claimant cannot engage in any kind of substantial gainful work that exists in the national economy. 

42 U.S.C. § 1382(a)(3)(B).

The Commissioner makes this assessment by a five-step analysis. First, the claimant must

currently not be working. 20 C.F.R. § 416.920(b). Second, the claimant must have a “severe”

impairment. 20 C.F.R. § 416.920(c). Third, the medical evidence of the claimant’s impairment is

compared to a list of impairments presumed severe enough to preclude work. 20 C.F.R. §

416.920(d). If the claimant’s impairment meets or equals one of the listed impairments, benefits

are awarded. 20 C.F.R. § 416.920(d). Fourth, if the claimant can do his past work, benefits are

denied. 20 C.F.R. § 416.920(e). Fifth, if the claimant cannot do his past work and, considering the

claimant’s age, education, work experience, and residual functional capacity, cannot do other work

that exists in the national economy, benefits are awarded. 20 C.F.R. § 416.920(f). The last two

steps of the analysis are required by statute. 42 U.S.C. § 1382(a)(3)(B).

In addition, when evaluating the severity of a claimant’s alleged mental impairments, the

Commissioner uses a “special technique” at each level of the review process. 20 C.F.R. §

416.1520a. In order to be considered disabled under the Act, the claimant must have: (1) a

medically determinable mental impairment(s), 20 C.F.R. § 416.1520a(b)(1)2

, and (2) exhibit

specified functional limitations as a result of that impairment(s) which prohibit the claimant from

engaging in any gainful activity. 20 C.F.R. § 416.1520a(b)(2). If the claimant has a medically

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determinable mental impairment but does not exhibit the requisite functional limitations, the

claimant may nevertheless still be considered disabled if the claimant exhibits clusters of

symptoms or a syndrome indicating an inability to engage in gainful activity. 20 C.F.R. §

404.1520a(d); 20 C.F.R. Pt. 404, Subpt. P, App. 1 § 12.00.A. (impairment(s) must either pose

functional limitations or cause symptoms or a syndrome to support a finding of disabled). 

 Sections 405(g) through 1383(c)(3) of the Act, allow unsuccessful applicants to seek

judicial review of a final agency decision of the Commissioner. 42 U.S.C. §§ 1383(c)(3), 405(g). 

The scope of judicial review is limited, however, and the Commissioner’s denial of benefits “will

be disturbed only if it is not supported by substantial evidence or is based on legal error.” Brawner

v. Secretary of Health and Human Services, 839 F.2d 432, 433(9th Cir. 1988) (quoting Green v.

Heckler, 803 F.2d 528, 529 (9th Cir. 1986)).

Substantial evidence means “more than a mere scintilla” but less than a preponderance. 

Sandqathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997). “[I]t is such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion.” Id. (quoting Andrews v.

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). The court must consider the record as a whole,

weighing both the evidence that supports and detracts from the Commissioner’s conclusions.

Desrosiers v. Secretary of Health & Human Services, 846 F.2d 573, 576, (9th Cir. 1988). If the

evidence supports more than one rational interpretation, the court must uphold the ALJ’s decision. 

Allen v. Heckler, 749 F.2d 577, 579 (9th Cir. 1984). When the evidence is inconclusive, “questions

of credibility and resolution of conflicts in the testimony are functions solely of the Secretary.”

Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). 

The ALJ has a special duty in social security cases to fully and fairly develop the record in

order to make an informed decision on a claimant’s entitlement to disability benefits. DeLorme v.

Sullivan, 924 F.2d 841, 849 (9th Cir. 1991). Because disability hearings are not adversarial in

nature, the ALJ must “inform himself about the facts relevant to his decision,” even if the claimant

is represented by counsel. Id. (quoting Heckler v. Campbell, 461 U.S. 458, 471 n.1 (1983)).

Even if the reviewing court finds substantial evidence supports the ALJ’s conclusions, the

court must set aside the decision if the ALJ failed to apply the proper legal standard(s) in weighing

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the evidence and reaching a decision. Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978). 

Section 405(g) permits a court to enter a judgment affirming, modifying or reversing the

Commissioner’s decision. 42 U.S.C. § 405(g). The reviewing court may also remand the matter to

the Social Security Administrator for further proceedings. Id.

DISCUSSION

Medical Evidence Presented

In order to understand Plaintiff’s alleged medical problems a review of her relevant

medical history is presented here. 

Dr. Thomas Harris, M.D. (orthopedic surgeon)-Treating physician (2001-2005)

 -March 7, 2001: Plaintiff began seeing Dr. Harris for a swollen left knee . (A.R. at 752.) 

At that time, Plaintiff complained of a swollen left knee. (A.R. at 752 .) She reported having

undergone three prior surgeries on her left knee before she had another knee injury in January

2001. She reported she had no work restrictions related to her knee as a result of those surgeries. 

Dr. Harris diagnosed a sprain/strain of the left knee, referred Plaintiff for an MRI, prescribed

Tylenol with Codeine #3 and placed Plaintiff on temporary total disability status. (A.R. at 752 .) 

-April 18, 2001: Dr. Harris performed arthroscopic surgery on Plaintiff’s left knee. (A.R. at 

373.) 

-September 2001: Plaintiff reported her right knee was starting to bother her because she

was having to compensate for her left knee. (A.R. at 755.)

-November 27, 2001: Dr. Harris prepared a “Treating Physician Permanent and Stationary

Report.” He stated Plaintiff would require future medical care, including anti-inflammatory pain

medications, physical therapy, Synvisc injections and, additional arthroscopic chondroplasties and

eventually a total knee arthroplasty due to significant chondral damage in Plaintiff’s left knee.

(A.R. at 755 ).

-April 2002: Dr. Harris reported Plaintiff continued to have ongoing symptoms. He

recommended a series of Synvisc injections for Plaintiff’s left knee. (A.R. at 375.) 

-June 2002: Plaintiff reported having increased back and hip pain, with pain radiating into

both legs with numbness and tingling. (A.R. at 373.) 

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3

 RSD is a chronic neurological syndrome resulting from an injury to a nerve or soft tissue that does not follow

the normal healing path, and in which the sympathetic nervous system seems to assume an abnormal function after an

injury. See Oldham v. Astrue, 509 F.3d 1254, 1255 fn.1 (10th Cir. 2007).

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-October 2002: Plaintiff reported having another fall in October 2002 due to her left leg

“giving out” on her. (A.R. at 375 .) Dr. Harris prescribed physical therapy and crutches. 

-November 2002: Plaintiff sustains another fall due to her knee. Dr. Harris advises her to

remain on crutches to keep from falling. (A.R. at 375.)

-January 2003: Dr. Harris prescribed Lortab for Plaintiff’s ongoing pain. (A.R. at 375 .)

-February 2003: Plaintiff reported having significant pain in her low back radiating into her

left leg, as well as trouble getting around and sitting. (A.R. at 756.) Plaintiff’s primary case

physician refers her to a neurologist who diagnoses carpal tunnel in the right hand. (A.R. at 375 .)

Plaintiff ‘s gait is found by Dr. Harris to still be antalgic and very irregular. She is also found to

have back spasms and flattening of the lumbar spine. (A.R. at 756.)

-April 2003: A lumber MRI is performed showing degenerative disc disease at L5-S1 and a 

small central focal protrusion without spinal stenosis or neural foraminal narrowing. (A.R. at 756.)

-June 2003: Plaintiff complains of chronic lumbrosacral spine pain with burning into the

left lower extremity, as well as burning in her right wrist. (A.R. at 190.) Plaintiff used Valium to

control her muscle spasms.

-July 2003: Dr. Harris refers Plaintiff to Dr. David Kupfer M.D. (hand surgeon) for her

upper extremity discomfort and to Dr. Denise Rubino, M.D. for possible epidural steroid injections

to relieve Plaintiff’s lower back discomfort. (A.R. at 759.)

-October 2003: Plaintiff reported her left knee had given out and she had fallen down

again, landing on her right wrist and injuring her right leg. (A.R. at 543 .) 

-November 2003: Dr. Harris gives Plaintiff a series of three Synvisc injections in her left

knee.

-December 2003: Dr. Kupfer performs carpal tunnel surgery. (A.R. at 535.)

-January 2004: Dr. Harris observes Plaintiff was possibly developing Reflex Sympathy

Dystrophy (“RSD”) 3

 of the right upper extremity. (A.R. at 532 .) Dr. Harris reports Plaintiff had

been unable to work since 2001 due to the injuries she sustained in January 2001. 

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-April 2004: Dr. Harris recommends Plaintiff see a pain management specialist. Dr Harris

recommends an MRI and possible arthroscopy on Plaintiff’s right knee. (A.R. at 394.) However,

her workman’s compensation carrier denies the request on the basis her right knee problems are

unrelated to her work related injury. (A.R. at 513-515 .)

-June 2004: Dr. Harris notes Plaintiff continues to have symptoms of RSD in her right

upper extremity, burning left knee pain, and back pain. (A.R. at 511.) Dr. Harris also notes

concern Plaintiff is having reactive depression secondary to her medical condition. He suggests

Plaintiff be seen by a psychiatrist. (A.R. at 511.)

-July 2004: Dr. Harris notes none of his recommendations for further treatments have been

approved by Plaintiff’s compensation carrier. He asserts her treatment is being compromised by

her inability to receive treatment for both her left and right knees. 

-August 2004: Dr. Harris continues Plaintiff on her pain management regimen. (A.R. at

503.) Dr. Harris states Plaintiff is not capable of performing sustained sedentary work on a regular

and continuing basis. (A.R. at 506.) 

-May 2005: Dr. Harris notee Plaintiff still had ongoing multiple orthopedic complaints

involving her knees and upper extremities. 

-August 2004 and May 2005 : Dr. Harris finds Plaintiff cannot lift any weight at all due to

her bilateral carpal tunnel syndrome and ulnar neuropathy. He states Plaintiff can stand and/or

walk for less than 2 hours in an 8 hour workday, and could sit for 6 hours out of an 8 hour

workday, but would need to alternate sitting and walking/standing every 15-20 minutes due to

bilateral knee meniscus tears and chondromalacia, as well as chronic lumbar sprain with

degeneration. He also states Plaintiff’s ability to push and pull is limited, and that she can never

climb, balance, kneel, crouch, crawl, or stoop. Finally he states Plaintiff’s manipulative functions

are impaired, such that she should never engage in reaching, handling, or fingering, and can

engage in feeling only on an occasional basis. (A.R. at 394-401.)

David M. Kupfer, M.D. (hand surgeon) – Treating physician (2003–2004)

-December 2003: Dr. Kupfer performs carpal tunnel release surgery on Plaintiff’s right

wrist. (A.R. at 499.)

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-January 2004: Plaintiff complains of increased frequent numbness and tingling in both

hands. (A.R. at 499.) 

-March 2004: Dr. Kupfer confirms RSD diagnosis and refers Plaintiff to Dr. Zimmer for

ganglion blocks. 

-May 2004: Dr. Kupfer notes Plaintiff’s right hand and finger symptoms are significantly

better following treatment with Dr. Zimmer. (A.R. at 513-515.)

-June 2004: Dr. Kupfer recommends Plaintiff receive a cervical MRI due to postsympathetic block radiculitis. (A.R. at 492.)

-September 2004: Plaintiff reports substantial improvement in her right hand and the postsurgical RSD has improved. (A.R. at 501.) Dr. Kupfer indicats Plaintiff is temporarily totally

disabled pending surgery on her left arm. 

-June 2005: Dr. Kupfer opines Plaintiff is not capable of performing sustained sedentary

work on a regular and continuing basis. (A.R. at .) 

2005 - Present: According to Plaintiff’s attorney, Plaintiff “has not seen Dr. Harris since

2005, but he continues to prescribe her medications because of her pain.” (A.R. at 835 citing the

Supplemental Security Income Benefits Hearing August 27, 2007. )

Denise Rubino, M.D.–Treating physician (2003)

-October 2003: Plaintiff received lumbar epidural steroid injections by Dr. Rubino. Dr.

Rubino opined Plaintiff can sit, stand, and walk for only one hour each per day, and can not lift or

carry any weight over five pounds. (A.R.at 362.) She qualifies her opinion, however, by stating

Plaintiff can be reassessed after treatment has been concluded. (A.R.at 365.)

Eric Zimmer, M.D. – (pain management specialist) Treating physician (2004)

-May 2004: Dr. Zimmer reports Plaintiff is suffering from a severe aggressive RSD in the

right upper extremity, and should receive another series of ganglion blocks. (A.R.at 423-427.)

Richard Greenfield, M.D.-- Examining Orthopedic Surgeon (2002–2003)

-February/March 2002: Dr. Greenfield opines Plaintiff has achieved maximum medical

benefit from active medical care with respect to her left knee. 

-February 2003: Dr. Greenfield reevaluates Plaintiff’s knee, hip, pelvis, and back

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complaints. He finds no further disability or restrictions in the left knee. However, Plaintiff

requires ongoing conservative care, and the care provided by Dr. Harris was appropriate. (A.R. at

284.) He also finds Plaintiff’s injury to her left knee had causes her right knee, back and hip

problems. 

-November 2003: A third evaluation of Plaintiff was done for her hand complaints. Dr. 

Greenfield finds it is possible her hand symptoms had been caused by using her crutches. He

advises Plaintiff has a temporary partial disability due to her hands, and she can not do any

repetitive tasks such as typing, keying, fingering, grasping, lifting, carrying, pushing, or pulling. 

He recommends nerve conduction studies in order to further evaluate Plaintiff’s condition. (A.R.

at 392.)

Byron King, M.D. -Examining Orthopedic Surgeon (2003)

-May 2003: On review of Dr. Harris’ April 2001 report, Dr. King finds advanced

degenerative changes in Plaintiff’s left knee. He also finds Plaintiff requires appropriate treatment

for her hands, wrists, lower back, and right knee. He does not believe Plaintiff’s factors of

disability can be accurately rated without Plaintiff first reaching maximum medical improvement.

(A.R. at 370.)

Steven Gerson, D.O.– Examining Internist (2002)

-July 2003: Dr. Gerson performs an internal medicine evaluation of Plaintiff. He notes

Plaintiff’s chief complaints at that time are left knee pain and asthma. Dr. Gerson opines Plaintiff

can lift up to 10 pounds frequently and 20 pounds occasionally, and can sit, stand, and walk for 6

hours in an 8 hour workday. (A.R. at 313.)

Thomas Sabourin, M.D. – Examining Orthopedic Surgeon (2004)

-November 2004: After performing an orthopedic consultation, Dr. Saboruin finds : 1)

degenerative arthritis of the left knee, status post multiple knee surgeries; 2) bilateral carpal tunnel

syndrome, status post right carpal release; 3) reflex sympathetic dystrophy of the right upper

extremity, now improved; 4) cervical spine degenerative arthritis; and 5) lumbar spine

degenerative disc disease. (A.R. at 436.) 

Dr. Sabourin finds: “[H]er complaints are somewhat disproportionate to the determinable

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condition....her complaints are much more vociferous than the actual physical examination.” (A.R.

at 440.)

Vocational Evidence Presented

Vocational expert (“VE”), Gloria Lasoff , testified at the August 2007 hearing. Based upon

the vocational profile, residual functional capacity assessment and hypotheticals provided by the

ALJ at that time, VE Lasoff, testified no former work is available to Plaintiff. However, based

upon her RFC and the hypotheticals presented she could perform eighty-five percent of the

unskilled sedentary jobs available in the national economy. (AR at 859.) Specifically, VE Lasoff

testified Plaintiff could perform jobs classified as assembler, production inspector, and cuff folder.

(A.R. at 860.) 

VE Mark Remas testified at the February 2008 hearing. Based upon the vocational profile

and hypotheticals provided by the ALJ at that time, VE Remas testified no former work was

available to Plaintiff. (A.R. at 885.) Similar to VE Lasoff’s testimony, VE Remas testified

Plaintiff could perform fifty percent of the unskilled sedentary work available in the national

economy. Specifically, VE Remas testified Plaintiff could perform jobs classified as lens inserter,

final assembler, and cuff folder. (A.R. at 886.)

Both vocational experts testified; if Dr. Harris’ opinion regarding Plaintiff’s work

restrictions were accepted, Plaintiff would be precluded from performing any work. (A.R. at 864,

886.)

ALJ’s Medical Evidence Evaluation

After a lengthy discussion of the medical evidence presented and a presentation of

Plaintiff’s testimony, the ALJ determined Plaintiff was not entitled to disability insurance benefits

under the Act (A.R. at 749.) based upon the following findings:

1. From January 17, 2001 through the date of his decision, Plaintiff did not engage in

substantial gainful activity. (A.R. at 752.)

2. Plaintiff’s cervical and lumbar degenerative disc disease, degenerative joint disease of

the knees status post multiple surgeries, asthma, bilateral carpal tunnel syndrome status post

surgical release, somatoform pain disorder, alcohol abuse, and polysubstance abuse are considered

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“severe” based on the requirements in the Regulations [citation omitted]. (Id.)

3. These medically determinable impairments do not meet or medically equal one of the

listed impairments in [the Social Security Regulations.] (Id.)

4. The ALJ finds that, from January 1, 2001 through October 1, 2001, the Plaintiff had the

residual functional capacity to perform less than sedentary work. The undersigned gives the

Plaintiff the benefit of the doubt that she was only capable of performing limited range of less than

sedentary work. (A.R. at 754.) The Plaintiff was unable to perform any of her past relevant work

during this time. (Id.)

5. Medical improvement occurred as of October 2, 2001. (A.R. at 755.) The undersigned

finds Plaintiff’s functional capacity for basic work activities has increased. (A.R. at 761.) 

6. Beginning on October 2, 2001 through November 31, 2003, Plaintiff has not had an

impairment or combination of impairments that meets or medically equals on of the impairments.

(A.R. at 756.) 

7. The ALJ finds the Plaintiff’s allegations regarding her limitations during the period from

October 2, 2001 through November 31, 2003, are not totally credible for the reasons set forth in

the body of the decision. 

8. From October 2, 2001 through November 31, 2003, Plaintiff had the residual functional

capacity to perform sedentary work except she was able to lift and carry ten pounds occasionally

and less than ten pounds frequently; stand for 3-4 hours and sit for six hours in an eight hour day;

occasionally climb stairs and ramps, balance, and stoop, but never climb ropes, ladders or

scaffolds and no frequent kneeling, crawling, or squatting; frequently but not continuously or

repetively finger and feel; unrestricted in reaching; occasionally keyboard and type; and had to

avoid concentrated exposure to pollutants. She was limited to simple, low stress activities in

supportive environment. 

9. The ALJ finds that, beginning on December 1, 2003, through March 1, 2005, Plaintiff

had the residual functional capacity to perform less than sedentary work. The ALJ finds that

beginning December 1, 2003 through March 1, 2005, Plaintiff’s allegations regarding her

symptoms and limitations are generally credible. (A.R. at 762.)

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10. Beginning on December 1, 2003, through March 1, 2005, Plaintiff was unable to

perform past relevant work. (A.R. at 765.)

 11. From December 1, 2003, through March 1, 2005, there were no jobs that existed in

significant numbers in the national economy Plaintiff could have performed. 

12. Plaintiff was under a disability from December 1, 2003 through March 1, 2005. 

13. Medical improvement occurred as of March 1, 2005, the date Plaintiff’s disability

ended. 

14. Beginning on March 1, 2005, Plaintiff has not had an impairment or combination of

impairments that meets or medically equals one of the impairments listed in [the Social Security

Regulations].

15. The ALJ finds that beginning on March 1, 2005, Plaintiff has had the residual

functional capacity to perform sedentary work ... she is able to lift and carry ten pounds

occasionally and less than ten pounds frequently; stand for 3-4 hours at 1.5 hours at a time and sit

for six hours in an eight hour day; occasionally climb stairs and ramps, balance, and stoop, but

never climb ropes, ladders or scaffolds; cannot frequently kneel. crawl, or squat; can frequently but

not continuously or highly repetitive finger and feel; is unrestricted in reaching; occasionally

keyboard and type; and must avoid concentrated exposure to cold, pollutants, industrial vibration,

and hazards. She is limited to simple, low stress activities in a supportive environment. (A.R. at

768.) 

16. Beginning March 1, 2005, considering Plaintiff’s age, education, work experience, and

residual functional capacity, the claimant has been able to perform a significant number of jobs in

the national economy. (A.R. at 773.) Plaintiff’s disability ended on March 1, 2005. [citation

omitted.] 

Plaintiff’s Claim on Appeal

Plaintiff asserts four claims: 1) The ALJ failed to address substantial evidence establishing

Plaintiff’s obesity ; 2) The ALJ’s decision failed to adequately reject the opinions of Plaintiff’s

treating physicians; 3) The ALJ failed to establish medical improvement; 4) The ALJ failed to

resolve conflicts in the testimony of the vocation expert; 5) The ALJ failed to establish Plaintiff

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was able to perform work from October 2, 2001 to November 30, 2003. 

1) Plaintiff’s Obesity

Plaintiff contends the ALJ failed to consider the impact of her obesity with her other

multiple impairments on her ability to work. (Pl. MSJ at 4.) Specifically Plaintiff contends “[t]he

ALJ ignored substantial evidence that Plaintiff’s obesity was a severe impairment that imposed

functional limitations.” (P’s MSJ at 4.) 

Defendant contends Plaintiff failed to present obesity related limitations in her argument

claiming disability. (Def’s MSJ at 5.) Specifically, Defendant asserts Plaintiff did not present any

evidence or argument at the hearing to support her claim that her obesity in conjunction with her

other serious medical impairments renders her disabled and entitled to benefits. 

The Ninth Circuit has held “[t]he ALJ in a social security case has an independent ‘duty to

fully and fairly develop the record and to assure that the claimant’s interests are considered.’”

Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir. 2001). Obesity is a complicated, chronic and

often misunderstood disease which the Commissioner must scrutinize carefully pursuant to SSR

02-01p.” Phillips v. Barnhart, 421 F.Supp. 2d 272, 282 (D.Mass 2006). Social Security Ruling

02-1P, 2000 WL 628049 (S.S.A.) states in pertinent part:

Because there is no listing for obesity, we will find...that a listing is met

if there is an impairment that, in combination with obesity, meets the

requirements of a listing. For example, obesity may increase the severity of

coexisting or related impairments to the extent that the combination of

impairments meets the requirements of a listing. This is especially true of

musculoskeletal, respiratory, and cardiovascular impairments. ...

Obesity in combination with another impairment may or may not

increase the severity or functional limitations of the other impairment. We will

evaluate each case based on the information in the case record. 

SSR 02-1p.

Well on point here is Celaya v. Halter, 332 F.3d 1177 (9th Cir. 2003). The Court held “the ALJ

was responsible for determining the effect of Celaya’s obesity upon her other impairments, and its

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effect on her ability to work and general health, given the presence of those impairments.” Id. at

1182. After Celya, the Ninth Circuit again addressed the issue of whether the ALJ adequately

considered plaintiff’s obesity in Burch v. Barnhart, 400 F 3d 676, 681 (9th Cir. 2004). While the

record revealed the claimant was obese, the Ninth Circuit in Burch held an “ALJ is not required to

discuss the combined effects of a claimant’s impairments or compare them to any listing in an

equivalency determination, unless the claimant presents evidence in an effort to establish

equivalence.” Id. at 683. 

In this case, several factors weigh against finding the ALJ erred. First, with the exception

of Dr. Weilepp’s testimony the medical record is silent about her weight and whether and to what

degree Plaintiff’s weight affects her condition. Second, obesity is not raised in Plaintiff’s report of

symptoms. Third, it does not appear from the evidence in the record that Plaintiff is at the

“extreme” end of obesity. Indeed, Dr. Weilepp testified that after March 2005, Plaintiff was only

“moderately” overweight. Finally, and most importantly, at the August 2007 hearing Plaintiff’s

counsel spent significant time questioning the medical expert about Plaintiff’s ability for gross

manipulations. (A.R. at 851-856.) In contrast, Plaintiff’s counsel appears never to have addressed

Plaintiff’s alleged work restrictions based upon her weight. Even at the February 2008 hearing

Plaintiff’s counsel failed to raise the issue of Plaintiff’s weight as a factor in her disability. (A.R. at

881.) Thus, Plaintiff simply fails to direct the Court’s attention to any evidence in the record to

support a finding that Plaintiff was disabled on account of her alleged obesity in combination with

any other impairment. 

Furthermore, the Court finds the ALJ’s failure to specifically include obesity in

combination with Plaintiff’s other impairments is harmless error. The Ninth Circuit has held,

“[w]e recognize harmless error applies in the Social Security context. Stout v. Commissioner Soc.

Sec. Admin., 454 F.3d 1050, 1054 (9th Cir. 2006). A finding of harmless error has been upheld

“where the mistake was nonprejudicial to the claimant or irrelevant to the ALJ’s ultimate disability

conclusion.” Id. That the ALJ incorporated Dr. Weilepp’s opinions (including his opinion

regarding her weight) into his own formulation of Plaintiff’s RFC shows Plaintiff was not

prejudiced by the ALJ’s lack of specificity regarding her weight. Similarly, the ALJ’s ultimate

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determination that Plaintiff had the residual functional capacity to perform only sedentary work

demonstrates any specific reference to obesity was irrelevant to the ALJ’s disability conclusion. 

For example, sedentary jobs are defined, in part, when “walking and standing are required only

occasionally and all other sedentary criteria are met.” DICOT 713.687-026. This aspect of

Plaintiff’s RFC fits well within Plaintiff’s physical limitations as evidenced by the information

presented in the record, including the testimony of Dr. Weilepp. 

For these reasons, it is recommended Plaintiff’s motion for summary judgment on her

claim that the ALJ committed error for failure to specifically address her obesity be DENIED. 

2) Non-treating vs. Treating physicians

Plaintiff contends the “ALJ failed to properly reject the treating physicians’s opinion of

Plaintiff’s limitations with specific and legitimate reasons based upon substantial evidence in the

record.” (P’s MSJ at 8.) Specifically, Plaintiff argues “[t]he ALJ failed in his duty to provide

specific and legitimate reasons to reject the opinions of Drs. Harris and Rubino.” (Id.) Plaintiff

cites the Ninth Circuit case of Lester v. Chater, 81 F. 3d 821, 830-31 (9th Cir 1995) for the

proposition the opinion of an examining physician can only be rejected for specific and legitimate

reasons supported by substantial evidence in the record, even if contradicted by a non-examining

doctor. Id. 

Defendant argues it was not error for the ALJ to discount Drs. Harris and Rubino’s

opinions because they were inconsistent with the record as a whole. Defendants also contend the

ALJ provided numerous reasons supported by substantial evidence in the record. (Def. at 6.) As

noted by Defendant “[t]he ALJ noted that the opinions that Plaintiff was always incapable of even

sedentary work was inconsistent with other evidence in the record.” (Id.) Moreover, Defendant

points out “[t]he ALJ referred to other medical sources who did not find Plaintiff to be totally

disabled including Steven E. Gerson, D.O., S.C. Swan, M.D., George C. Spellman, M.D., and

Thomas Sabourin, M.D.” (Id. at 7.) 

The Ninth Circuit distinguishes among the opinions of three types of physicians: (1) those

who treat the claimant (“treating physicians”); (2) those who examine but do not treat the claimant

(“examining physicians”); and (3) those who neither examine nor treat the claimant

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(“nonexamining physicians”). Lester v. Chater, 81 F3d 821, 830 (9th Cir. 1996). As a general

rule, more weight is given to the opinion of a treating source than to that of a nontreating

physician. Id. (citing Winans v. Bowen, 853 F2d 643, 647 (9th Cir. 1987)). Likewise, the opinion

of an examining physician is typically entitled to greater weight than that of a nonexamining

physician. Pitzer v. Sullivan, 908 F.2d 502, 506 (9th Cir. 1990). 

The Ninth Circuit examined the weight to be given a treating source opinion in Orn v.

Astrue, 495 F.3d 625 (9th Cir. 2007) The Ninth Circuit held “[i]f a treating physician’s opinion is

not given ‘controlling weight’ because it is not ‘well-supported’ or because it is inconsistent with

other substantial evidence in the record, the Administration considers specific factors in

determining the weight it will be given. Those factors include the ‘length of the treatment

relationship and the frequency of examination’ by the treating physician; and the ‘nature and

extent of the treatment relationship’ between the patient and the treating physician. Generally, the

opinions of examining physicians are afforded more weight than those of non-examining

physicians, and the opinions of examining non-treating physicians are afforded less weight than

those of treating physicians.” Id. at 631. 

 Where a non-treating, non-examining physician’s opinion contradicts the treating

physician’s opinion, the ALJ may only reject the treating physician’s opinion “if the ALJ gives

specific, legitimate reasons for doing so that are based upon substantial evidence in the record.”

Jamerson v. Chater, 112 F.3d. 1064, 1066 (9th Cir. 1997) (quoting Andrew v. Shalala, 53 F3d

1035, 1041 (9th Cir. 1995)). “The ALJ may 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.” Morgan v. Apfel, 169 F.3d 595, 600-601 (9th Cir. 1999) (citing Magallanes,

supra, 881 F.2d at 751)). Additionally, “[r]eports of consultative physicians called in by the

Secretary may serve as substantial evidence.” Andrews, supra, 53 F.3d at 1041. Where medical

reports are inconclusive, “questions of credibility and resolution of conflicts in the testimony are

functions solely of the Secretary.’” Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982)

(quoting Waters v. Gardner, 452 F.2d 855, 858 n.7 (9th Cir. 1971)).

An noted herein, the ALJ in this case initially set forth his reasons why he did not fully

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credit Dr.Harris’ and Dr. Rubino’s opinions as treating physicians. In his analysis the ALJ cited to

substantial evidence in the record to support his reasons not to give controlling weight to the

opinions of Drs. Harris and Rubino regarding Plaintiff’s ability to sustain employment. In Orn,

supra, the ALJ’s reasons for rejecting the treating physician’s opinion were actually contradicted

by the record in that case. Orn v. Astrue, 495 F.3d at 634. In contrast, the ALJ here specifically

cited to inconsistencies between the opinions of Drs. Harris and Rubino and other evidence

presented in the record, including “substantial evidence of record , documenting less severe

limitations.” (A.R. at 760.) “The doctor failed to cite any medical testing results or objective

observations to support his conclusions as to the claimant’s residual functional capacity.” (Id.; see

also A.R. at 771.) 

The ALJ next set forth the evidence presented in the record he used to determine Plaintiff

has not been under a disability. As presented herein, the ALJ relied on the opinions of virtually all

the physicians (treating and non-treating, examining and non-examining) to support his conclusion

Plaintiff is not disabled. Specifically, the record indicates none of the non-treating or nonexamining physician’s opinions contradicted the treating physician’s opinions with the exception

of Drs. Harris and Rubino’s statements that Plaintiff is unable to function in the competitive job

market. (A.R. at 760-761, 768-773.) Overall, the great majority of physicians in this case who

either treated, examined or reviewed Plaintiff’s medical condition made findings consistent with

the ALJ’s residual functional determination. Accordingly, the Court finds the ALJ’s finding is

supported by substantial evidence and free of legal error and recommends Plaintiff’s motion on

this ground be DENIED.

3) The ALJ failed to establish medical improvement

Plaintiff also contends “[t]he ALJ’s discussion failed to provide evidence that Plaintiff was

no longer disabled as of October 2, 2001 due to improvements in Plaintiff’s residual functional

capacity.” (P’s MSJ at 13.) Plaintiff relies on various reports of treating physician Dr. Harris. For

example, Plaintiff cites Dr. Harris’ report of October 29, 2001 referring to “numerous ongoing

medical impairments and limitations.” (Id.) 

Defendant contends ‘[t]he ALJ ... provided substantial evidence of medical improvement

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28 4

 The Court may cite unpublished Ninth Circuit opinions issued on or after 01/01/07. U.S. Ct. App. 9th Cir. Rule

36-3(b).

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and his conclusion should be upheld regardless of Plaintiff’s disagreement .” (Def. MSJ at 8.) For

example, Defendant points out the ALJ’s citation to the reports of Dr. Harris (A.R. at 226, 775.),

Dr. Greenfield (A.R. at 293-295) and Dr. Gerson (A.R. at 316-317.) According to the ALJ these

physicians all noted improvements in Plaintiff’s physical condition. The ALJ pointed to evidence

in the record Plaintiff exhibited only slight knee pain (A.R. at 227.) Plaintiff’s knee was stable

(A.R. at 227). Plaintiff’s MRI showed normal menisci without tears (A.R. at 299.) Plaintiff has

full range of motion in her knee and a stable gait (A.R. at 316) and almost normal strength in her

knee with no atrophy. (A.R. at 756, 184.) 

There is substantial evidence in the record supporting the ALJ’s finding of medical

improvement after October 2001. Despite Plaintiff’s protestations and her own citations to the

record in support of her claim; “[w]here the evidence is susceptible to more than one rational

interpretation, we must uphold the ALJ’s conclusions.” Tommasetti v. Astrue, 533 F.3d 1035,

1038 (9th Cir. 2008). “Thus, even if the weight of the evidence is against the ALJ’s conclusion, so

long as there is substantial evidence to support the conclusion, we must affirm.” Pearson v. Astrue,

2010 WL 76446 (9th Cir. 2010).4 It is recommended Plaintiff’s motion for summary judgment on

this claim be DENIED. 

4) Error regarding the Vocational Expert

Plaintiff argues the ALJ failed to resolve conflicts in the testimony of the Vocational

Expert (“VE”). Specifically, she contends the physical demands of the jobs identified by the VE,

and adopted by the ALJ, as other work Plaintiff can perform (e.g. lens inserter, final assembler and

cuff folder) exceed Plaintiff’s limitations. (P.’s MSJ at 18.) In response, Defendant contends

“there is no conflict between the vocational expert’s testimony and the DOT.” (Def. MSJ at 8.)

 From October 2, 2001 through November 31, 2003 the ALJ found Plaintiff’s residual

functional capacity (“RFC”) was as follows: 

[A]ble to lift and carry ten pounds occasionally and less than ten

pounds frequently; stand for 3-4 hours and sit for six hours in an eight hour

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day; occasionally climb stairs and ramps, balance, and stoop, but never climb

ropes, ladders or scaffolds and no frequent kneeling, crawling, or squatting;

frequently but not continuously or repetitively finger and feel; unrestricted in

reaching; occasionally keyboard and type; and had to avoid concentrated

exposure to pollutants. ... limited to simple, low stress activities in supportive

environment. (A.R.at 757.)

Further, March 1, 2005 the ALJ found Plaintiff’s RFC was as follows:

[A]ble to lift and carry ten pounds occasionally and less than ten

pounds frequently; stand for 3-4 hours at 1.5 hour intervals at a time and sit

for six hours in an eight hour day; occasionally climb stairs and ramps,

balance, and stoop, but never climb ropes, ladders or scaffolds, cannot

frequently kneel, crawl, or squat; can frequently but not continuously or

highly repetitively finger and feel; is unrestricted in reaching; occasionally

keyboard and type; and must avoid concentrated exposure to cold, pollutants,

industrial vibration, and hazards. She is limited to simple, low stress activities

in a supportive environment. (A.R. at 768.) 

A review of the exertional requirements for the three occupations cited by the VE all fall

within Plaintiff’s exertional limitations. For example, none require climbing, balancing, stooping,

kneeling, crouching, or crawling. See DICOT 713.687-026, 713.687-018, 685.687-014. Further,

only frequent reaching, handling and fingering is present in each occupation. Id. Lastly, all are

categorized as sedentary work. Id. Here, Plaintiff has failed to adequately demonstrate the

existence of ambiguities in the record between Plaintiff’s RFC and the occupations cited by the VE

as suitable for Plaintiff. Therefore, it is recommended Plaintiff’s claim for summary judgment on

this ground be DENIED. 

5) ALJ erred in finding Plaintiff able to work from October 2, 2001 through

November 30, 2003

Plaintiff contends the ALJ “failed to identify any job positions for the time period from

October 2, 2001, to November 31 (sp) 2003.” (P’s MSJ at 20.) Specifically, Plaintiff asserts the

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28 5 The transcript indicates “ME” to designate the testimony of vocational expert Mr. Remas. A thorough review

of the transcripts indicates that the “ME” designation for Mr. Remas is a typographical error.

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ALJ’s decision did not identify any positions Plaintiff could perform with her functional

limitations from during the time period from October 2001 through November 2003. The record

transcript shows the ALJ expressly asked the VE5

 about the period from October 2001 through

November 2003 what jobs would be available given Plaintiff’s RFC :

VE: That would rule out past relevant work, Your Honor, because this would be

essentially at a sedentary work level. Past work was light or medium. So that would rule it

all out. Within this hypothetical, there would be other work available. 

ALJ: Of the 200 sedentary, unskilled, how many would available?

VE: 50 percent, Your Honor.

ALJ: And the illustrations of those would be what?

VE: Lens inserter, 713 –

ALJ: Next job title?

VE: Final assembler.

ALJ: All right. The third one?

VE: A cuff folder. (A.R.at 883-886.)

The testimony of vocational expert Mark Remas is clear. He specifically identifies the

three occupations cited herein as available to Plaintiff from October 2, 2001 to November 31,

2003. Additionally, within the section of his decision addressing Plaintiff’s RFC between October

2001 and November 2003, the ALJ noted the vocational expert testified “given all of these factors

the individual would be able to perform the requirements of representative occupations such as the

following ...lens inserter, final assembler, cuff folder.” (A.R. at 762..)

Thus, substantial evidence supports the ALJ’s conclusion jobs within Plaintiff’s

capabilities exist in the national market. For these reasons, Plaintiff’s allegation of error on this

ground is unsupported by the record in this case. According, it is recommended Plaintiff’s motion

for summary judgment be DENIED on this ground. 

 ///

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CONCLUSION

Accordingly, it is recommended that Plaintiff’s Motion for Summary Judgment be

DENIED and that Defendant’s Cross-Motion for Summary Judgment be GRANTED.

This Report and Recommendation of the undersigned Magistrate Judge is submitted to the

United States District Judge assigned to the this case, pursuant to the provisions of 28 U.S.C. §

636(b)(1).

 IT IS HEREBY ORDERED that any written objections to this Report must be filed with

the Court and served on all parties no later than February 22, 2010. The document should be

captioned “Objections to Report and Recommendation.”

IT IS FURTHER ORDERED that any reply to the objections shall be filed with the Court

and served on all parties no later than March 1, 2010. The parties are advised that failure to file

objections within the specified time may waive the right to raise those objections on appeal of the

Court’s order. Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991). 

IT IS SO ORDERED.

DATED: February 8, 2010

Hon. William McCurine, Jr.

U.S. Magistrate Judge

United States District Court

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