Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_10-cv-08225/USCOURTS-azd-3_10-cv-08225-0/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

Sharon Harrington, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV10-08225-PCT-NVW

ORDER

Sharon Harrington seeks review under 42 U.S.C. § 405(g) of the final decision of

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

insurance benefits and supplemental security income under sections 216(i), 223(d), and

1614(a)(3)(A) of the Social Security Act. Because the decision of the Administrative

Law Judge (“ALJ”) is supported by substantial evidence and is not based on legal error,

the Commissioner’s decision will be affirmed.

I. Background

A. Factual Background

Harrington was born on July 3, 1963. She has worked as a home attendant, office

manager, receptionist, records technician, and waitress. Beginning in August 2008,

Harrington cared for her husband for about three months after he suffered a stroke. At the

time of the administrative hearing, Harrington worked approximately 95 hours per month

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as an in-home care provider for her mother and was paid $9.00 per hour by the State of

California. She testified that she set up medications and assisted her mother transferring

from her bed to a chair, and her family did “the rest of it.” 

In 1994, Harrington received an on-the-job injury to her right wrist, for which she

underwent fusion in 1995 and radial nerve surgery . Subsequently, she experienced low

back and neck pain radiating into her right arm. In 2007, she had a spinal stimulator

inserted, which eliminated her right arm pain, but not her back pain. She also has been

diagnosed with sacroiliac joint disorder.

B. Procedural History

On April 29, 2008, Harrington applied for disability insurance benefits and

supplemental security income, alleging disability beginning December 20, 2007, due to

lumbar spine and sacroiliac joint disorders, bilateral carpal tunnel syndrome, gastritis, and

depression. Both applications were denied on initial review and again on reconsideration,

after which Harrington requested that her claim be heard by an ALJ. On March 29, 2010,

an administrative hearing was held in San Bernadino, California, at which Harrington

testified and was represented by counsel. Arthur Lorber, M.D., an impartial medical

expert, and David A. Rinehart, an impartial vocational expert, also appeared and testified

at the administrative hearing.

On May 18, 2010, the ALJ issued his decision that Harrington was not disabled

within the meaning of the Social Security Act. He found that Harrington retained the

capacity to perform a reduced range of light work:

. . . the claimant has the residual functional capacity to perform light work

as defined in 20 CFR 404.1567(b) and 416.967(b) except the claimant can

lift and carry 20 pounds occasionally and 10 pounds frequently. She can

stand and walk for 6 hours out of an 8-hour work day, and she can sit for 6

hours out of an 8-hour work day. She cannot perform power gripping with

the right upper extremity; she can perform occasional overhead reaching

with the right upper extremity. She cannot climb ladders, ropes, or

scaffolds.

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In reliance upon vocational expert testimony, the ALJ found that Harrington is capable of

performing past relevant work as an office manager, receptionist, medical records

technician, and waitress.

On September 21, 2010, the Appeals Council denied Harrington’s request for

review of the ALJ’s unfavorable decision. On September 21, 2010, the Appeals Council

declined to set aside the ALJ’s decision, making that decision the final decision of the

Commissioner. On November 19, 2010, Harrington sought judicial review of this

decision pursuant to § 205(g) of the Social Security Act, 42 U.S.C. § 405(g).

II. Standard of Review

The district court reviews only those issues raised by the party challenging the

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court

may set aside the Commissioner’s disability determination only if the determination is not

supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 625,

630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a

preponderance, and relevant evidence that a reasonable person might accept as adequate

to support a conclusion considering the record as a whole. Id. In determining whether

substantial evidence supports a decision, the court must consider the record as a whole

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id.

As a general rule, “[w]here the evidence is susceptible to more than one rational

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be

upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted).

If the ALJ’s decision is not supported by substantial evidence or suffers from legal

error, the court has discretion to reverse and remand either for an award of benefits or for

further administrative proceedings. Smolen v. Chater, 80 F.3d 1273, 1292 (9th Cir.

1996); Sprague v. Bowen, 812 F.2d 1226, 1232 (9th Cir. 1987). “Remand for further

proceedings is appropriate if enhancement of the record would be useful.” Benecke v.

Barnhart, 379 F.3d 587, 593 (9th Cir. 2004). “Conversely, where the record has been

developed fully and further administrative proceedings would serve no useful purpose,

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the district court should remand for an immediate award of benefits.” Id. (citing Smolen,

80 F.3d at 1292). 

The ALJ is responsible for resolving conflicts in medical testimony, determining

credibility, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir.

1995). In reviewing the ALJ’s reasoning, the court is “not deprived of [its] faculties for

drawing specific and legitimate inferences from the ALJ’s opinion.” Magallanes v.

Bowen, 881 F.2d 747, 755 (9th Cir. 1989). 

III. Five-Step Sequential Evaluation Process

To determine whether a claimant is disabled for purposes of the Social Security

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). If the ALJ determines

that the claimant is disabled or not disabled at any step, the ALJ does not continue to the

next step. The claimant bears the burden of proof on the first four steps, but at step five,

the burden shifts to the Commissioner. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir.

1999).

At the first step, the ALJ determines whether the claimant is engaging in

substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not

disabled and the inquiry ends. Id. At the step two, the ALJ determines whether the

claimant has a “severe” medically determinable physical or mental impairment. 

§ 404.1520(a)(4)(ii). If not, the claimant is not disabled and the inquiry ends. Id. At step

three, the ALJ considers whether the claimant’s impairment or combination of

impairments meet or equal an impairment listed in Appendix 1 to Subpart P of 20 C.F.R.

Pt. 404. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. 

Id. If not, the ALJ proceeds to step four. At step four, the ALJ assesses the claimant’s

residual functional capacity and determines whether the claimant is still capable of

performing past relevant work. § 404.1520(a)(4)(iv). If so, the claimant is not disabled

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

determines whether the claimant can perform any other work based on the claimant’s

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residual functional capacity, age, education, and work experience. § 404.1520(a)(4)(v). 

If so, the claimant is not disabled. Id. If not, the claimant is disabled. Id. 

IV. Analysis

The ALJ found that Harrington meets the insured status requirements of the Social

Security Act through December 31, 2012, and, at step one, she has not engaged in

substantial gainful activity since December 20, 2007. At step two, the ALJ found that

Harrington has the following severe impairments: status post fusion of the right wrist,

degenerative disc disease, and peripheral neuropathy. The ALJ also found that

Harrington’s “medically determinable mental impairments consisting of carpal tunnel

syndrome and depression does not cause more than minimal limitation in the claimant’s

ability to perform basic mental work activities and is therefore nonsevere.” At step three,

the ALJ found that Harrington does not have an impairment or combination of

impairments that meets or medically equals one of the listed impairments in 20 C.F.R.

Part 404, Subpart P, Appendix 1. 

Harrington does not raise any issues related to the ALJ’s determinations at the first

three steps of the five-step sequential evaluation process. Harrington challenges the

ALJ’s weighing of medical source evidence in making his determination of Harrington’s

residual functional capacity at step four.

A. Legal Standard for Weighing Medical Source Evidence

In weighing medical source opinions in Social Security cases, the Ninth Circuit

distinguishes among three types of physicians: (1) treating physicians, who actually treat

the claimant; (2) examining physicians, who examine but do not treat the claimant; and

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

Chater, 81 F.3d 821, 830 (9th Cir. 1995). Generally, more weight should be given to the

opinion of a treating physician than to the opinions of non-treating physicians. Id. A

treating physician’s opinion is afforded great weight because such physicians are

“employed to cure and [have] a greater opportunity to observe and know the patient as an

individual.” Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987). Where a treating

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physician’s opinion is not contradicted by another physician, it may be rejected only for

“clear and convincing” reasons, and where it is contradicted, it may not be rejected

without “specific and legitimate reasons” supported by substantial evidence in the record. 

Lester, 81 F.3d at 830. Moreover, the Commissioner must give weight to the treating

physician’s subjective judgments in addition to his clinical findings and interpretation of

test results. Id. at 832-33.

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

than that of a non-examining physician. Id. at 830. As with a treating physician, there

must be clear and convincing reasons for rejecting the uncontradicted opinion of an

examining physician, and specific and legitimate reasons, supported by substantial

evidence in the record, for rejecting an examining physician’s contradicted opinion. Id. at

830-31. 

The opinion of a non-examining physician is not itself substantial evidence that

justifies the rejection of the opinion of either a treating physician or an examining

physician. Id. at 831. “The opinions of non-treating or non-examining physicians may

also serve as substantial evidence when the opinions are consistent with independent

clinical findings or other evidence in the record.” Thomas, 278 F.3d at 957. Factors that

an ALJ may consider when evaluating any medical opinion include “the amount of

relevant evidence that supports the opinion and the quality of the explanation provided;

the consistency of the medical opinion with the record as a whole; [and] the specialty of

the physician providing the opinion.” Orn, 495 F.3d at 631. 

Moreover, Social Security Rules expressly require a treating source’s opinion on

an issue of a claimant’s impairment be given controlling weight if it is well-supported by

medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent

with the other substantial evidence in the record. 20 C.F.R. § 404.1527(d)(2). If a

treating source’s opinion is not given controlling weight, the weight that it will be given is

determined by length of the treatment relationship, frequency of examination, nature and

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extent of the treatment relationship, relevant evidence supporting the opinion, consistency

with the record as a whole, the source’s specialization, and other factors. Id.

Finding that a treating physician’s opinion is not entitled to controlling weight

does not mean that the opinion should be rejected:

[A] finding that a treating source medical opinion is not wellsupported by medically acceptable clinical and laboratory diagnostic

techniques or is inconsistent with the other substantial evidence in the case

record means only that the opinion is not entitled to “controlling weight,”

not that the opinion should be rejected. Treating source medical opinions

are still entitled to deference and must be weighed using all of the factors

provided in 20 C.F.R. §404.1527. . . . In many cases, a treating source’s

medical opinion will be entitled to the greatest weight and should be

adopted, even if it does not meet the test for controlling weight.

Orn, 495 F.3d at 631-32 (quoting Social Security Ruling 96-2p). Where there is a

conflict between the opinion of a treating physician and an examining physician, the ALJ

may not reject the opinion of the treating physician without setting forth specific,

legitimate reasons supported by substantial evidence in the record. Id. at 632. 

B. The ALJ Did Not Err by Rejecting Examining Physician Dr. Douglas

Larson’s Mental Residual Functional Capacity Assessment.

Harrington contends the ALJ erred by failing to articulate specific and legitimate

reasons for not accepting Dr. Larson’s finding that Harrington’s depressive disorder was

severe. On August 15, 2008, Dr. Larson, a State agency psychological consultant,

examined Harrington. His report states, among other things:

This is a pleasant woman who is suffering from depression and pain and is

not being helped by being on several strong narcotics to control her pain. 

She clearly needs a pain management program and serious counseling to

learn how to cope with her life.

I rated the claimant as 51 on the GAF because she is having moderately

severe symptoms and impairment. She is having difficulty with judgment,

thinking, mood, anxiety and as a result [sic.] is leading to impairment in her

work performance.

Dr. Larson also reported: “The claimant’s psychiatric prognosis is fair with treatment.” 

Based on his examination, Dr. Larson provided the following functional assessment:

1. She is mildly impaired in her ability to understand, remember, and

complete simple commands.

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2. She is moderately impaired in her ability to do [sic.] understand,

remember, and complete complex commands because of her memory

problems and depression.

3. She is moderately impaired in her ability to interact appropriately

with supervisors, co-workers or the public as indicated by her social

withdrawal and avoidance of work.

4. She is mildly impaired in her ability to comply with job rules such as

safety and attendance.

5. She is mildly impaired in her ability to respond to change in the

normal workplace setting.

6. She is mildly impaired in her ability to maintain persistence and pace

in a normal workplace setting.

The ALJ stated:

The undersigned does not accept Dr. Larson’s finding that the claimant’s

depressive disorder is severe. His examination of the claimant was

essentially benign and did not reveal evidence of significant depression. 

While the record reflects that the claimant is taking an anti-depressant, her

treating sources have not referred her to a psychiatrist, and any depressive

or anxiety symptoms have been situational in nature and due primarily to

the claimant[’s] financial problems. 

Even if the ALJ had accepted Dr. Larson’s finding that Harrington’s depressive

disorder was “moderately severe,” Dr. Larson opined that Harrington’s depression caused

her only mild and moderate limitations. “Mild” and “moderate” limitations resulting

from “moderately severe” symptoms of depression do not preclude performing substantial

gainful activity. See Hoopai v. Astrue, 499 F.3d 1071, 1077 (9th Cir. 2007) (“We have

not previously held mild or moderate depression to be a sufficiently severe non-exertional

limitation that significantly limits a claimant’s ability to do work beyond the exertional

limitation.”). Thus, even if the ALJ had accepted Dr. Larson’s opinion fully, doing so

would not have affected the determination of her residual functional capacity.

C. The ALJ Did Not Err by Granting No Weight to Treating Physician

Dr. Arvind Salwan’s Residual Functional Capacity Assessment.

Harrington contends the ALJ erred by granting no weight to the residual functional

capacity assessments of treating physician Dr. Salwan. However, the ALJ did not assign

“no weight” to the 2009 questionnaire in which Dr. Salwan assessed Harrington’s

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residual functional capacity. Rather, he said he did not adopt or agree with Dr. Salwan’s

opinion finding disability, which was expressed in a letter in 2008.

On October 20, 2008, Dr. Salwan submitted a letter stating that Harrington was his

patient, and she had been diagnosed and was receiving treatment for myofascial pain

syndrome, sacral iliac joint arthropathy, and lumbar facet arthropathy. His letter also

stated: “Sharon has been disabled since November 2006.”

In his hearing decision, the ALJ stated:

In a letter dated October 20, 2008, Dr. Salwan reported that the claimant

had diagnoses of myofascial pain syndrome, sacral iliac joint arthropathy,

and lumbar facet arthropathy, which rendered her disabled (Exhibit 12F,

p.2).

The undersigned does not adopt nor agree with Dr. Salwan’s opinion

because it is not supported by his treatment notes or by the other evidence. 

Moreover, a finding of disability is one that is reserved to the

Commissioner (SSR 96-5p), and Dr. Salwan never indicated what the

claimant could do despite her impairments. It is believed that Dr. Salwan

was motivated more out of sympathy for the claimant in writing this letter

as the substantial evidence does not support his opinion.

The ALJ was not required to adopt or agree with Dr. Salwan’s opinion that “Sharon has

been disabled since November 2006.” Whether an individual is “disabled” under the

Social Security Act is an issue reserved to the Commissioner, and “treating source

opinions on issues reserved to the Commissioner are never entitled to controlling weight

or special significance.” Social Security Ruling 96-5p.

Further, the determination of an individual’s residual functional capacity also is an

issue reserved to the Commissioner. Id. Although the ALJ did not specifically reference

Dr. Salwan’s responses to a Multiple Impairment Questionnaire, he was not required to

discuss it or give it controlling weight or special significance, only to consider it. The

ALJ explicitly relied on and cited to Dr. Salwan’s treatment records, including records

dated the same day as the Multiple Impairment Questionnaire, which stated Harrington

had normal range of motion and strength and no joint enlargement or tenderness in each

of her four extremities and she could “undergo exercise testing and/or participate in

exercise program.” 

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Moreover, even if the ALJ were required to articulate how much weight he

assigned to Dr. Salwan’s responses to a Multiple Impairment Questionnaire, the omission

was harmless because Dr. Salwan’s responses to the questionnaire are internally

inconsistent and conflict with Harrington’s testimony and written statements by

Harrington and her husband. On October 7, 2009, Dr. Salwan completed a Multiple

Impairment Questionnaire in which he described Harrington’s pain as severe, located in

her neck and lower back, occurring “all the time,” and precipitated by “moving, lifting,

picking up objects.” He estimated her level of pain as 9 out of 10 and said her pain had

not been completely relieved by medication without unacceptable side effects. Dr.

Salwan opined that Harrington could sit 0-1 hours and stand/walk 0-1 hours in an 8-hour

work day, occasionally lift 0-5 pounds and never more than that, and never carry any

weight at all. He also inconsistently opined that she did not have any significant

limitations in repetitive reaching, handling, fingering, or lifting, but she had moderate

limitations in grasping, turning, twisting objects and using fingers/hands for fine

manipulations and marked limitation using arms for reaching (including overhead). Dr.

Salwan said Harrington’s condition would preclude her from performing full-time work

that required keeping her neck in a constant position (e.g., looking at a computer screen,

looking down at a desk). He also said her pain, fatigue, or other symptoms were severe

enough to constantly interfere with attention and concentration and she would need to

take unscheduled breaks every 15-20 minutes to rest for 15-20 minutes. Dr. Salwan

further opined that Harrington’s impairments were likely to produce “good days” and

“bad days” and she likely would be absent from work more than three times a month. 

Finally, he said that she was limited to no pushing, no pulling, no kneeling, no bending,

and no stooping.

In contrast, Harrington testified that she is able to set up her mother’s medications,

do some housecleaning, go grocery shopping, and lift ten pounds. She said that in an

8-hour day, she could stand for a total of 4 hours with breaks every half hour and sit for a

total of 4 hours with breaks every half hour. Although she alleges disability beginning

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December 20, 2007, she said that for a period of about three months beginning in August

2008 she cared for her husband who had a stroke. In June 2008, she completed a

Function Report in which she said that she gives her mother medications and takes her to

medical appointments, feeds and bathes pets, shares meal preparation duties with her

husband, does light cleaning, shops for groceries and necessary items, regularly attends

church, and can drive by herself unless taking pain medications. Also in June 2008,

Harrington’s husband completed a Function Report in which he said that Harrington feeds

their pets, washes dishes about once a week, goes grocery shopping with her husband for

three hours once a week, watches television two hours per day, and communicates with

others on the computer once a day. He also said she could lift up to 25 pounds.

Harrington contends that the ALJ’s observation that “Dr. Salwan never indicated

what the claimant could do despite her impairments,” is incorrect because Dr. Salwan

estimated “she can sit no more than one hour, stand/walk no more than one hour, and lift

no more than five pounds occasionally. . . .” In fact, Dr. Salwan indicated she could sit

“0-1” hours, stand/walk “0-1” hours, and lift “0-5” pounds, which the ALJ could have

reasonably interpreted as meaning no sitting, no standing or walking, and no lifting.

Thus, the ALJ did not err by not adopting or agreeing with Dr. Salwan’s 2008

opinion finding disability because it was not supported by his treatment notes or by the

other evidence and opined on an issue reserved to the Commissioner. Although the ALJ

did not make an express finding regarding Dr. Salwan’s 2009 functional assessment, he

expressly considered Dr. Salwan’s treatment notes and was not required to assign weight

to Dr. Salwan’s determination of Harrington’s residual functional capacity.

IT IS THEREFORE ORDERED affirming the final decision of the Commissioner

of Social Security denying Sharon Harrington disability benefits.

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IT IS FURTHER ORDERED that the Clerk enter judgment in favor of Defendant

against Plaintiff and that Plaintiff take nothing. The Clerk shall terminate this action.

DATED this 22nd day of August, 2011.

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