Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-02444/USCOURTS-cand-3_04-cv-02444-3/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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United States District Court

For the Northern District of California

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United States District Court

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

ANDY L. CIPOLLO,

Plaintiff,

 v.

JO ANNE B. BARNHART, Commissioner of

Social Security,

Defendant.

 /

No. C 04-02444 SI

ORDER GRANTING PLAINTIFF’S

MOTION FOR SUMMARY JUDGMENT,

DENYING DEFENDANT’S MOTION FOR

SUMMARY JUDGMENT, AND

REMANDING CASE

Now before the Court are the parties’ cross motions for summary judgment on plaintiff’s complaint

seeking judicial review of defendant’s denial of plaintiff’s claim for Social Security disability benefits. Having

carefully considered the parties’ arguments, the Court GRANTS plaintiff’s motion for summary judgment,

DENIES defendant’s motion for summary judgment, and REMANDS this case to the Social Security

Administration (“SSA”) for further proceedings.

BACKGROUND

Plaintiffis a 44-year-old manwho livesin Klamath, California. Administrative Record (“AR”) 85-88.

In April 1998, he was injured during an argument with his wife. AR 148-49. From statements in the

administrative record, it appears that plaintiff had been drinking and had kicked out the back window of his

wife’s car. AR 157. He then stood on the hood of her car as she drove away. AR 148-49. Plaintiff fell,

suffering a non-displaced fracture of the right shoulder and a comminuted fracture of the right knee. Id.

Plaintiff subsequently had surgery to address his injuries and started physical therapy. Although initial

reports ofplaintiff’s recovery were promising, he has complained ofpain since the injury. In July 1999, plaintiff

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underwent surgery to address his complaints ofpain in his injured knee. AR 265-66. In August 1999, he again

had surgery to remove “painful hardware” in his knee. AR 264.

Plaintiff filed for disability benefits in July 1998. AR 107-10. In August 1998, his claim was denied

because his condition was not expected to remain severe for twelve months. AR 73. After his request for

reconsiderationwas denied, plaintifffiled a request for a hearing with an administrative law judge (“ALJ”). AR

77-84. After a number of continuances, plaintiff attended a hearing on December 13, 1999. AR 19-20, 34.

At the hearing, plaintiff agreed to attend a consultative examination, whichwas scheduled for February

13, 2000. AR 333, 335. On February 11, 2000, plaintiff phoned in to inform the SSA that he would be

unable to attend the examination. Id. The examination was therefore rescheduled for March 19, 2000. AR

332. Plaintiff did not attend this examination. While no reason for plaintiff’s failure to attend appears in the

administrative record, plaintiff has provided a declaration from his wife to this Court. The declaration states

that plaintiff was incarcerated on March 19, 2000, and that his wife called the SSA to informthemthat plaintiff

would be unable to attend his examination. Pl. Mot. for Summary Judgment, Exh. 1 (Decl. of Diane Cipollo).

On March 31, 2000, the ALJ issued his decision, denying plaintiff’s claim for disability benefits. The

ALJ found that plaintiff had failed to establish his eligibility for disability benefits because he had failed to attend

his consultative examination. In reaching this conclusion, the ALJ rejected the opinions of plaintiff’s doctors

on the ground that they were not supported by “laboratory findings or objective clinical evidence.” AR 21.

Instead, the ALJ relied on x-rays taken fromJanuary and June 1999 that showed that plaintiff’s injuries were

healing. In addition, the ALJ relied on the opinion oftwo non-treating physicians, both of whom opined in the

fall of 1998 that plaintiff’s injuries would be non-severe before April 1999. Based on this review of the

evidence, the ALJ found that “[t]he claimant has failed to meet the burden of establishing the existence of any

‘severe’ physical or mental impariment lasting more than 12 months” and rejected plaintiff’s application for

disability benefits. AR 21.

Plaintiff filed an administrative appeal on December 10, 2001. His appeal was denied on April 24,

2004. AR 5-7. He timely filed this action on June 21, 2004.

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LEGAL STANDARD

This Court may conduct only a limited review of the Secretary’s final decision. It may disturb that

decision “only if it is notsupported by substantialevidence or ifit based on legal error.” Ukolov v. Barnhart,

420 F.3d 1002, 1004 (9th Cir. 2005) . Substantial evidence means “such relevant evidence as a reasonable

mind might accept as adequate to support a conclusion.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir.

2005). Even if substantial evidence supports the ALJ’s factual findings, his decision must be set aside if

improper legal standards were applied in reaching that decision. See Frost v. Barnhart, 314 F.3d 359, 367

(9th Cir. 2002).

The claimant carries the initial burden of proving a disability. Ukolov, 420 F.3d at 1004. In

determining whether a claimant is disabled, the ALJ is required to accept a claimant’s subjective testimony of

pain only if the claimant produces “objective medical evidence of underlying ‘impairment,’ and [shows] that

the impairment, or a combination of impairments, ‘could reasonably be expected to produce pain or other

symptoms.’” Batson v. Commissioner of the Social Security Administration, 359 F.3d 1190, 1196 (9th

Cir. 2004). If this first step is satisfied, “and if the ALJ’s credibility analysis of the claimant’s testimony shows

no malingering, then the ALJ may reject the claimant’s testimony about severity of symptoms with ‘specific

findings stating clear and convincing reasons for doing so.’” Id.

DISCUSSION

Plaintiff challengesthe ALJ’s decision on three grounds: plaintiff’s waiver of counselwas defective;the

ALJ erroneously discounted plaintiff’s credibility; and the ALJ erred by failing to find that plaintiff’simpairment

was severe.

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1. Defective Waiver of Right to Counsel

First, plaintiff argues that the ALJ erred by failing to properly explain to him that he was entitled to

counsel at his hearing. In support of this argument, plaintiff cites Binion v. Shalala, 13 F.3d 243 (7th Cir.

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1994). In Binion, the Seventh Circuit held that, to ensure a valid waiver of counsel, an ALJ must explain to

a pro se claimant: “(1) the manner in which an attorney can aid in the proceedings, (2) the possibility of free

counselor a contingency arrangement, and (3) the limitationon attorney fees to 25 percent ofpast due benefits

and required court approval of the fees.” Id. at 245. 

Even assuming that the Seventh Circuit’s requirements were binding on this Court, it is well established

that in the Ninth Circuit a claimant has to make a showing of prejudice or unfairness resulting from lack of

counsel. Kay v. Heckler, 754 F.2d 1545, 1551 (9th Cir. 1996). Plaintiff has not attempted to make any such

showing. In fact, plaintiff admitted that his case was “a simple case” at his hearing. AR 57. Nor has the Court

uncovered any evidence of prejudice or unfairness from its own review of the transcript. Rather, the record

reveals that the ALJ was very patient with plaintiff. The ALJ offered to keep the record open so plaintiff could

submit additional evidence. AR 67. He sent plaintiff a copy of the record when plaintiff stated that he would

like to review it, and he offered to help plaintiff obtain evidence through his subpoena power. AR 67, 69.

Based on the above, the Court finds that plaintiff was not prejudiced by his lack of counsel.

Accordingly, the Court rejects plaintiff’s argument that his waiver of counsel was deficient.

2. Erroneous Credibility Determination

Plaintiff’s second argument is that the ALJ discounted his credibility based on illegitimate factors. He

argues that the ALJ found his credibility lacking because plaintiff requested that his hearing be continued on

three occasions and because he missed his consultative examination appointment. See AR 20. Plaintiff

contends that both of these are improper bases for an adverse credibility finding.

As an initialmatter, the Court does not agree with plaintiff that the ALJ found his testimony lacking in

credibility. Although the ALJ couched his comments in terms of credibility, the ALJ’s comments reflected his

finding that plaintiff had failed to produce any evidence in support ofhis subjective complaints of pain. See AR

20 (“The claimant’s statements about his impairments and their impact on his ability to work are not found

credible in light ofthe inadequacy of objective evidence to support his assertions.”). As the Ninth Circuit has

stated, an ALJ must conduct a two-step analysis when deciding whether to admit a claimant’s testimony about

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If the Court’s reading of the ALJ’s decision is incorrect, and the ALJ found that plaintiff’s testimony

lacked credibility, the Court agrees with plaintiff that, in this case, three continuances and one missed

appointment do not amount to clear and convincing evidence forrejecting his testimony. See Batson, 359 F.3d

at 1196.

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subjective pain. First, the claimant must “produce objective medical evidence of underlying ‘impairment,’ and

must show that the impairment, or a combination of impairments, ‘could reasonably be expected to produce

pain or other symptoms.’” Batson, 359 F.3d at 1196. Only after the plaintiff satisfies this initial burden must

the ALJ address his subjective claims ofpain. Id. Here, the ALJ found that plaintiff had produced no evidence

of any impairment. See AR 20-21. Thus, the ALJ declined to consider whether plaintiff’s complaints of pain

were actually valid.1

Although the Court does not agree with plaintiff’s argument that the ALJ improperly discounted his

credibility, it finds thatthe ALJ’s decisionmust be reversed for a related reason: the ALJ’s finding that plaintiff

had produced no evidence of an impairment capable of causing him pain was contrary to the evidence in the

record.

The ALJ’s finding that plaintiff had not demonstrated any “medically determinable mental of [sic]

physical impairment,” AR 21, was based upon evaluations from August and October 1998 that predicted

plaintiff’s conditionwould be non-severe before April 1999, and upon x-rays fromJanuary and June 1999 that

showed “significant interval healing.” Id. Although plaintiff’s treating physicians had opined that plaintiff was

suffering frompain, see, e.g., AR 311-26, the ALJ discounted these opinions because theywere notsupported

by “laboratory findings or objective clinical evidence.” AR 21.

The ALJ’s findings, however, ignore significant evidence that plaintiff suffered from an impairment that

was capable of causing pain. Perhaps most significant is the record of plaintiff’s surgeries from July and August

of 1999, which were specifically conducted to address his complaints of pain. AR 264-66. The first surgery

was conducted to correct a possible meniscal tear, and discovered, among other things, a torn posterior

cruciate ligament and a torn lateralcollateralligament. The second surgery was conducted to remove “painful

hardware” from plaintiff’s right tibia. A second significant record of plaintiff’s impairment comes from an

examinationconducted by his doctorin December 1999. This exam found that plaintiff “has very limited range

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2Because the ALJ erred in finding that plaintiff had not produced evidence sufficient to establish the

existence of an impairment capable of causing him pain, the Court will not reach plaintiff’s argument that the

agency erred by finding that any impairment was non-severe. The Court remands to the agency for a

determination ofwhether plaintiff’s impairment can be considered severe. On remand, the Court encourages

the agency to provide plaintiff with another opportunity for a consultative examination.

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of motion of the right shoulder,” and “has difficulty with the extension of the knee at all.” AR 331. Notably,

the doctor’s report states that “I do think the patient has definite disability and limitationin his ability to perform

work due to these injuries.” Id.

The ALJ did not address any ofthis evidence in his decision. Instead, he relied on two x-rays and two

predictions made well in advance ofthe year anniversary of plaintiff’s injury. The Court finds that the reports

above are sufficient to establish that plaintiff suffered from an impairment sufficient to cause significant pain.

Accordingly, the ALJ erred in failing to provide specific, cogent reasons forrejecting plaintiff’stestimony about

his pain.2

CONCLUSION

For the foregoing reasons, the Court GRANTS plaintiff’s motion forsummary judgment (Docket No.

11), DENIES defendant’s motion for summary judgment (Docket No. 18), REVERSES the decision of the

Commissioner of Social Security, and REMANDS this case to the Social Security Administration for further

proceedings consistent with this opinion. 

IT IS SO ORDERED.

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Dated: December 19, 2005 

SUSAN ILLSTON

United States District Judge

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