Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_09-cv-02400/USCOURTS-casd-3_09-cv-02400-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:206 Social Security Benefits

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 42 U.S.C. § 405(g) provides: 1

Any individual, after any final decision of the Commissioner of Social Security made after a

hearing to which he was a party . . . may obtain a review of such decision by a civil action . . .

brought in the district court of the United States. . . . The court shall have power to enter, upon

the pleadings and transcript of the record, a judgment affirming, modifying or reversing the

decision of the Commissioner of Social Security, with or without remanding the cause for a

rehearing. The findings of the Commissioner . . . as to any fact, if supported by substantial

evidence, shall be conclusive.

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

JAVIER SAN RAMON, Civil No. 09cv2400-BEN (CAB)

Plaintiff,

REPORT AND RECOMMENDATION

TO DENY PLAINTIFF’S MOTION FOR

SUMMARY JUDGMENT AND GRANT

DEFENDANT’S MOTION FOR

SUMMARY JUDGMENT

[Doc. Nos. 16 & 17]

v.

MICHAEL J. ASTRUE, Commissioner of

Social Security Administration,

Defendant.

I. Introduction

Plaintiff Javier San Ramon brings this action pursuant to 405(g) , to obtain judicial review of 1

a final decision of the Commissioner of Social Security (“Commissioner”) denying his application

for Social Security Disability Insurance Benefits (“SSDI”) under Title II of the Social Security Act

(“Act”), 42 U.S.C. §§ 401, et seq. Plaintiff has filed a motion for summary judgment. [Doc. No.

16.] In that motion, Plaintiff argues he should have been found “disabled” under the Act and that the

Appeals Council’s decision adopting Administrative Law Judge (“ALJ”) David L. Wurzel’s decision

Case 3:09-cv-02400-BEN-CAB Document 18 Filed 12/30/10 Page 1 of 17
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 To be entitled to disability insurance benefits, Plaintiff “must establish that [his] disability 2

existed on or before” the date his insured status expired. Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir.

1998); see also Flaten v. Sec’y of Health & Human Servs., 44 F.3d 1453, 1460 (9th Cir. 1995) (social

security statutory scheme requires disability to be continuously disabling from time of onset during

insured status to time of application for benefits, if individual applies for benefits for current disability

after expiration of insured status). In this case, Plaintiff’s date last insured was June 30, 2000. (AR at

246.)

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of April 1, 2008, denying him benefits should be reversed because the ALJ’s decision is not

supported by substantial evidence and is based on legal error. The Commissioner has filed a crossmotion for summary judgment. [Doc. No. 17.] In that motion, the Commissioner argues the ALJ’s

decision is supported by substantial evidence and is not based on legal error.

Pursuant to Southern District of California Local Civil Rule 7.1(d)(1), the Court finds these

motions may be decided on the papers and that no oral argument is necessary. After careful

consideration of the papers, the administrative record, and the applicable law, this Court

recommends the ALJ’s decision be AFFIRMED, Plaintiff’s motion for summary judgment be

DENIED, and the Commissioner’s cross-motion for summary judgment be GRANTED.

II. Procedural History

Plaintiff applied for SSDI benefits on January 17, 2006. (Administrative Record (“AR”) at

234-44.) Plaintiff alleged disability as of July 4, 1999 due to mold injury, chemical sensitivity and

chronic fatigue, dizziness, cloudy thinking, insomnia, nervous system pain, joint pain, various

allergic reactions, and chronic asthma. (AR at 252.) On June 20, 2006, the Social Security

Administration (“Administration”) determined Plaintiff was not disabled from the period of July 4,

1999 to June 30, 2000, his date last insured (“DLI”), and denied him benefits. (AR at 178-82.) 2

Plaintiff requested reconsideration of his application, and the Administration denied benefits again

after reconsideration. (AR at 183-88.) On February 28, 2007, Plaintiff requested an administrative

hearing before an ALJ. (AR at 189.)

On March 19, 2008, the ALJ conducted a hearing to consider the merits of Plaintiff’s

application. (AR at 152-59.) This hearing resulted in his application being denied by the ALJ in a

written decision dated April 1, 2008. (AR at 162-77.) Plaintiff disagreed with the ALJ’s decision,

and on May 2, 2008, he requested an Appeals Council Review of the decision. (AR at 150-51.) On

August 27, 2009, the Appeals Council found there was no basis for granting Plaintiff’s request for

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review and affirmed the ALJ’s decision, which became the final decision of the Commissioner. (AR

at 1-3.)

On October 27, 2009, after having exhausted all administrative remedies, Plaintiff initiated

this action challenging the proceedings in connection with the Commissioner adopting the ALJ’s

decision. [Doc. No. 1.] On December 14, 2009, the Commissioner filed an answer to Plaintiff’s

complaint. [Doc. No. 3.] On December 28, 2009, District Judge Roger T. Benitez referred all

matters in this action to Magistrate Judge Cathy Ann Bencivengo for a report and recommendation. 

[Doc. No. 8.] On June 25, 2010, Plaintiff filed his motion for summary judgment, requesting that

the Court reverse the ALJ’s decision and remand for payment of benefits. [Doc. No. 16.] On July

16, 2010, Defendant filed his cross-motion for summary judgment, requesting that the ALJ’s

decision be affirmed. [Doc. No. 17.]

III. Factual Background

A. The Requests for Continuance

The case was originally set for an administrative hearing before the ALJ on December 20,

2007. (AR at 198.) Plaintiff requested a continuance, claiming that he was having surgery on his

jaw in Tijuana, Mexico. (AR at 207-09.) He also claimed he was seeking legal representation and

needed records from Dr. G. Heuser. (AR at 209.) The ALJ granted the continuance, but also

informed Plaintiff that he would not grant any further continuances “without a very good reason.” 

(AR at 210.) The hearing was rescheduled for March 19, 2008. (AR at 213.) On March 12, 2008,

Michael J. Walkup, Plaintiff’s attorney, wrote to the ALJ requesting another continuance. He

claimed he needed more time to obtain medical records. (AR at 229.) He also requested that he and

Plaintiff appear at the administrative hearing by telephone, because they were both disabled. (Id.) 

The ALJ denied the request for a continuance and denied the request for telephonic appearance. (AR

at 310.)

B. Administrative Hearing

The administrative hearing scheduled for March 19, 2008 went forward, and Plaintiff

personally appeared at the hearing without his attorney. (AR at 154-59.) Mr. Walkup, Plaintiff’s

attorney, had advised him not to answer questions. (AR at 155.) Therefore, the ALJ had no

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testimony from Plaintiff. The ALJ indicated that Plaintiff had submitted no work history, but it was

his understanding that Plaintiff had worked as an engineer at some point. (AR at 156.)

Mary Jesko testified at the administrative hearing as a vocational expert. (AR at 156.) The

ALJ presented a hypothetical of a person with the following limitations: a 51-year-old person with a

high school and four-year college degree; able to lift and carry up to 10 pounds, sit for six hours and

stand alone for two hours in an eight hour day, i.e., a sedentary exertional level; occasionally

climbing ramps and stairs; occasionally stooping; moderate exposure to chemicals, dust, mold,

perfume and cologne; and no close or frequent personal contact with supervisors or co-workers. (AR

at 157.) Ms. Jesko said she could not answer whether Plaintiff could return to his past work, but

based on the limitations the ALJ set out, she concluded that there were jobs that existed for Plaintiff

to do. Examples of the jobs included optical lens assembler, final assembler, and bench hand. (AR

at 158.)

C. Medical Evidence in the Record

1. Steven R. Nusinow, M.D.

Treatment notes from Dr. Nusinow indicate that Plaintiff first saw him on November 3, 2000. 

(AR at 382-88.) At the first visit, Plaintiff complained of a mild cough and sore throat. (AR at 382.) 

Plaintiff also reported extreme fatigue for the last one and a half years, for which he was seeing a

toxicologist. An examination revealed “minimal pale swelling nose with clear drainage, throat and

ears clear.” Plaintiff visited Dr. Nusinow again on February 5, 2001, after he had been rear ended. 

He complained of pain in his back, neck and buttocks. Dr. Nusinow found “whiplash injury with

acute cervical, thoracic and lumbar strain.” (Id.) Plaintiff continued to see Dr. Nusinow several

times throughout the year 2002, and a few times in 2003, 2006 and 2007. In 2002, he complained of

fatigue, gastrointestinal problems, and pain in his knees. (AR at 383-85.) In 2003, he complained of

chemical sensitivities. (AR at 385.) When he returned in 2006, he again complained of chemical

sensitivities. It appears Dr. Nusinow spent some time with him reviewing his medical record and

discussing his issues. He did not have any acute complaints. (AR at 386-87.) In 2007, Plaintiff also

complained of chemical sensitivities. (AR at 387.) Plaintiff reported to Dr. Nusinow that he was

going to have two of his teeth removed to minimize the effects of mercury toxicity. (Id.)

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2. Jonathan Wasserberger, M.D.

Dr. Wasserberger submitted an interval update dated May 10, 2001. (AR at 313-15.) He

indicated he is a medical toxicologist and had been seeing Plaintiff for toxigenic mold exposure. He

moved out of the apartment in July 2000, but he became sick again when he reentered the apartment

to pick up his belongings. He experienced memory dysfunction and fatigue. In addition, Plaintiff

experienced multiple chemical sensitivity. He tried to move into a new apartment, but he became

dizzy and fatigued due to the chemicals in the apartment. Dr. Wasserberger reported that Plaintiff

used a charcoal filter mask in public. (AR at 313.) Plaintiff informed Dr. Wasserberger that it did

help his fatigue, but it caused him to feel social isolation, because people thought he had HIV or

tuberculosis. Dr. Wasserberger reported that Plaintiff’s lab tests showed he was positive for

“immune suppression” and for the “toxigenic mold Stachybotrys.” (AR at 314.) All other lab tests

were normal.

Dr. Wasserberger’s assessment was that:

[T]he patient has a mycotoxicosis that has resulted in chronic fatigue

immunosuppression syndrome and memory dysfunction. He has sinusitis, proven by

MRI. He also has onychomycosis which is most annoying to him at this time and

changing his life most dramatically at this time; this is a manifestation of multiple

chemical sensitivities.

(Id.) Dr. Wasserberger believed Plaintiff could not go to work. (AR at 313.)

On May 23, 2002, Dr. Wasserberger saw Plaintiff for a medical toxicology follow-up visit. 

Dr. Wasserberger documented that Plaintiff’s symptoms of fatigue, tremors, memory loss and sinus

problems had improved. Although the doctor noted that Plaintiff still had multiple chemical

sensitivities, he also noted that Plaintiff was feeling better since being out of the toxic environment

and was now living in a “clean home.” (AR at 344.)

3. William James Rea, M.D.

Dr. Rea submitted a letter dated January 22, 2002. (AR at 342-43.) In the letter, he stated

that Plaintiff first consulted with him on June 19, 2001 with complaints of chronic fatigue, chemical

sensitivity and allergies. (AR at 342.) At that time, Plaintiff reported that he had been well until

1999, when he started to feel tired constantly. He started to see Dr. Wasserberger on October 12,

2000, and Dr. Wasserberger suspected Plaintiff had a mold exposure at home. Dr. Rea diagnosed

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Plaintiff as having immune deregulation, allergic rhinitis, food sensitivity, mold sensitivity, pollen

sensitivity, chemical sensitivity, chronic fatigue and fibromyalgia. (Id.) Dr. Rea’s treatment for

Plaintiff involved “an internal environment conducive for healing.” (AR at 343.) In Dr. Rea’s

opinion, “a working environment is unable to comply with the prescribed treatment plan. . . . This

patient must rigidly avoid public buildings or any physical environment where exposure would

occur.” Dr. Rea believed Plaintiff was disabled and unable to engage in any type of work. (Id.)

4. State Agency Medical Consultants

Dr. Rose reviewed the medical records to perform a Psychiatric Review Technique but

indicated there was insufficient evidence to make a determination on disability. (AR at 360.) Dr.

Spellman also reviewed the medical records on December 26, 2006 and found insufficient evidence

to make a disability determination for the period July 4, 1999 to June 30, 2000. (AR at 375.)

5. Gunnar Heuser, M.D.

In a letter dated May 26, 2009, Dr. Heuser reported that Plaintiff had been his patient since

April 2000 and had seen him at intervals over the years, last on March 2, 2009. (AR at 23.) Dr.

Heuser reported that Plaintiff’s complaints included impairment of brain, lung and immune functions

due to mold exposure. (Id.) Dr. Heuser believed Plaintiff to be totally disabled, because he reacts

strongly to everyday chemicals in his environment. (AR at 24.) No treatment notes accompanied

Dr. Heuser’s letter.

D. ALJ’s findings

After a discussion of the evidence in the record, the ALJ determined that Plaintiff was not

entitled to SSDI benefits during the insured period of July 4, 1999 to June 30, 2000. (AR at 170-77.) 

In making his determination, the ALJ found that Plaintiff had the following medically determinable

impairments: sensitivity to chemicals and fumes; onychomycosis, right foot; allergic rhinitis; and

sinusitis. (AR at 171.) Despite these impairments, the ALJ found that Plaintiff had:

the residual functional capacity to perform work activity at the sedentary exertional

level, lifting and carrying up to ten pounds, sitting for six hours per eight-hour

workday, and standing and walking for two hours per eight-hour workday; with the

following nonexertional limitations: never climbing ladders, ropes or scaffolds; never

balancing, kneeling or crawling; occasionally climbing ramps and stairs; occasionally

stooping and crouching; avoiding even moderate exposure to chemicals, dust, fumes,

gases, molds, perfumes and colognes; and limited to unskilled work with no close or

frequent interpersonal contact with supervisors, co-workers, or the public.

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(Id.)

The ALJ found that there was no evidence that Plaintiff sought medical treatment until

October 2000, four months after his DLI. The ALJ also found Plaintiff’s self-reporting inconsistent

and unreliable. (AR at 172.) He had reported to Dr. Wasserberger that he had started feeling ill in

June 2000, but he reported to Dr. Nusinow that he started having “extreme fatigue” in May 1999. 

The ALJ also noted that Plaintiff was well enough to drive and be out in public, because in March

2000 and February 2001, he had been driving and was rear-ended. He was also well enough in

March 2002 to go to Tijuana for dental treatments. (Id.) The ALJ gave little weight to the functional

assessments of Plaintiff’s two treating physicians, Dr. Rea and Dr. Wasserberger, because he found

they were not very credible. The ALJ, however, did give Plaintiff the benefit of the doubt and found

Plaintiff was “limited” as Dr. Wasserberger believed him to be. (AR at 175.) Finally, the ALJ gave

moderate weight to the opinion of Dr. Spellman, the state agency medical consultant, who found

there was insufficient evidence to establish a medically determinable impairment. (Id.)

Giving the Plaintiff the “maximum reasonable benefit of the doubt,” the ALJ found that

Plaintiff did have medically determinable impairments prior to June 30, 2000. (AR at 175.) Because

Plaintiff did not submit a work history report and did not testify at the administrative hearing, the

ALJ assumed that Plaintiff was unable to perform his past relevant work. (AR at 176.) The ALJ

then concluded, based on the testimony of the vocational expert, that Plaintiff could perform work

existing in significant numbers in the national economy. (AR at 177.) Therefore, a finding of “not

disabled” was appropriate under the Act. (Id.)

IV. Discussion

A. Legal Standard

The Social Security Act authorizes payment of SSDI benefits to individuals who have an

“inability to engage in any substantial gainful activity by reason of any medically determinable

physical or mental impairment which can be expected to result in death or which has lasted or can be

expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). The

disabling impairment must be so severe that the claimant is not only unable to do his previous work,

but, considering age, education, and work experience, cannot engage in any kind of substantial

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gainful work that exists in the national economy. 42 U.S.C. § 423(d)(2)(A).

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

determines whether a claimant is engaged in “substantial gainful activity.” If so, the claimant is not

disabled. 20 C.F.R. § 404.1520(b). Second, the Commissioner determines whether the claimant has

a “severe impairment or combination of impairments” that significantly limits the claimant’s

physical or mental ability to do basic work activities. If not, the claimant is not disabled. 20 C.F.R.

§ 404.1520(c). Third, the medical evidence of the claimant’s impairment is compared to a list of

impairments that are presumed severe enough to preclude work; if the claimant’s impairment meets

or equals one of the listed impairments, benefits are awarded. 20 C.F.R. § 404.1520(d). Fourth, if

the impairment meets or equals one of the listed impairments, the Commissioner determines whether

the claimant can do his past relevant work. If the claimant can do his past work, benefits are denied. 

20 C.F.R. § 404.1520(e). If the claimant cannot perform his past relevant work, the burden shifts to

the Commissioner. In step five, the Commissioner must establish that the claimant can perform

other work. 20 C.F.R. § 404.1520(f). If the Commissioner meets this burden and proves that the

claimant is able to perform other work that exists in the national economy, then benefits are denied.

Sections 405(g) and 421(d) of the Social Security Act allow unsuccessful applicants to seek

judicial review of a final agency decision of the Commissioner. 42 U.S.C. §§ 405(g), 421(d). 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.

Sec’y of Health & Human Servs., 839 F.2d 432, 433 (9th Cir. 1988) (citing 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. Sec’y of Health & Human Servs., 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.

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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 that substantial evidence supports the ALJ’s conclusions,

the court must set aside the decision if the ALJ failed to apply the proper legal standards in weighing

the evidence and reaching his or her 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 Commissioner for further proceedings. Id.

B. Plaintiff’s Claims

Plaintiff asserts three grounds for reversal of the ALJ’s decision. First, he asserts that the

Appeals Council failed to give clear and convincing reasons for rejecting the opinion of Dr. Heuser. 

Second, he argues that it was legal error for the ALJ to go forward with the administrative hearing

without Plaintiff’s attorney. Third, he argues that the ALJ did not give clear and convincing reasons

for rejecting the opinions of Drs. Rea and Wasserberger. Based upon these grounds, Plaintiff

contends that the Court can now find him disabled and award benefits. The Court considers each of

Plaintiff’s arguments below.

1. ALJ’s rejection of Drs. Rea’s and Wasserberger’s opinions

Plaintiff argues that the ALJ did not give clear and convincing reasons for rejecting the

opinions of Dr. Rea and Dr. Wasserberger. (Pl.’s Mem. 8.) Plaintiff claims the ALJ “attacked” Drs.

Rea and Wasserberger and argues that because their opinions are uncontradicted, the ALJ erred in

not accepting their opinions.

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

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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 (nonexamining

physicians). Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). The ALJ must give the medical

opinion of a treating physician “special weight,” because a treating physician “is employed to cure

and has a greater opportunity to know and observe the patient as an individual.” Andrews, 53 F.3d at

1041 (citation omitted); Rodriguez v. Bowen, 876 F.2d 759, 761 (9th Cir.1989). However, the

treating physician’s opinion on the ultimate issue of disability is not necessarily conclusive. Matney

v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992). The ALJ may disregard the treating physician’s

opinion if the ALJ sets forth “specific, legitimate reasons . . . based on substantial evidence.”

Rodriguez, 876 F.2d at 762. The ALJ can meet this burden of substantial evidence by “providing a

detailed summary of the facts and conflicting clinical evidence, along with a reasoned interpretation

thereof.” Id. Finally, the ALJ need not accept an opinion of a treating physician if it is

“conclusionary and brief and unsupported by clinical findings.” Matney, 981 F.2d at 1019.

Dr. Rea submitted a letter dated January 22, 2002. (AR at 342-43.) In the letter, he stated

that Plaintiff first consulted with him on June 19, 2001 with complaints of chronic fatigue, chemical

sensitivity and allergies. (AR at 342.) At that time, Plaintiff reported that he had been well until

1999, when he started to feel tired constantly. Dr. Rea diagnosed Plaintiff as having immune

deregulation, allergic rhinitis, food sensitivity, molds sensitivity, pollen sensitivity, chemical

sensitivity, chronic fatigue and fibromyalgia. (Id.) In Dr. Rea’s opinion, “This patient must rigidly

avoid public buildings or any physical environment where exposure would occur.” (AR at 343.) Dr.

Rea believed Plaintiff was disabled and unable to engage in any type of work. (Id.)

In his written opinion, the ALJ noted that Plaintiff began seeing Dr. Rea, one year after the

DLI. (AR at 173.) Dr. Rea reported that Plaintiff began seeing Dr. Wasserberger on October 12,

2000, four months after the DLI. (Id.) The ALJ’s assessment of Dr. Rea’s credibility was as

follows:

I give little weight to the opinions of Dr. Rea. If he sounds like a charlatan, the Texas

Medical Board thinks so too. On August 24, 2007, the Texas Medical Board filed a

formal complaint against Dr. Rea, charging him with conducting diagnostic tests such

as “pupillography” for which there is “absolutely no basis in scientific literature,”

checking for “abnormal” conditions having “no clinical relevance,” and using skin

testing for which there is “no scientific basis” to diagnose such disorders as “allergy

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 The rest of Dr. Rea’s letter, then, is irrelevant, because it does not speak to Plaintiff’s condition 3

during the period for which he seeks benefits. Nevertheless, the Court examines the ALJ’s other reasons

for rejecting Dr. Rea’s opinions as well.

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to neurotransmitters” when “in fact, there is no such diagnosis” [(AR at 291-92)]. 

The Texas Medical Board further charges that Dr. Rea “demonstrates a substandard

knowledge of basic immunology,” that he “repeatedly fails to appropriately apply the

results of his testing,” and that his “unscientific tests mislead patients into believing

they have either an autoimmune or immunological basis for their complaints, when in

fact, they do not” [(AR at 293)]. The Texas Medical Board further charges that Dr.

Rea’s “diagnoses are not supported by accurate interpretation of valid tests,”

including “diagnoses of deficiencies in immune function when the tests themselves

show that this is not the case,” and that Dr. Rea’s treatments are “nonsensical and can

be harmful,” such as “heat depuration therapy” which “is simply a sauna” and “has no

known therapeutic indication of the diseases [Dr. Rea] purports to treat” and

“injections of neurotransmitters” and “other chemicals which can be a dangerous

practice.” (Id.) The Texas Medical Board further charges that Dr. Rea’s “training

and certification do not qualify him to perform his clinical practice” as he is “neither

board-certified nor trained as an allergist,” since his “training in the 1970’s was in the

field of thoracic surgery,” and “he claims to have board-certification in the field of

environmental medicine, which is not recognized by the American Board of Internal

Medicine.” (Id.)

. . .

Dr. Rea’s claim that the claimant’s “strachybotrys exposure profile” was “positive for

the IgG antibody” is [at] best misleading, as serology reports on blood samples

collected on October 18, 2000, and September 4, 2001, were both well within the

normal range [(AR at 330)].

Dr. Rea’s diagnosis of “fibromyalgia” is completely unsupported. Fibromyalgia is an

impairment with well-defined diagnostic criteria published by the American College

of Rheumatologists in 1990. Those diagnostic criteria require two clinical findings,

one subjective, the other objective: First, subjective complaint of widespread pain on

both sides of the body, both above and below waist level, persisting for at least three

months; and second, “positive” clinical findings on digital palpation of at least 11 of

18 precisely defined anatomical tender points. The diagnostic term, “positive,” is

defined with specificity and precision as a “painful” not merely a “tender” response to

digital palpation at a prescribed force of about four kilograms (about 10 pounds). The

record contains no findings on physical examination that would even begin to meet

the diagnostic criteria for fibromyalgia.

(AR at 173-74.)

Despite Plaintiff’s claim that the ALJ erred in rejecting Dr. Rea’s opinion, the ALJ gave a

number of “specific, legitimate reasons . . . based on substantial evidence.” Rodriguez, 876 F.2d at

762. The first was that Dr. Rea’s letter indicates that Plaintiff saw both Dr. Rea and Dr.

Wasserberger after his DLI. The ALJ also cited a complaint against Dr. Rea from the Texas 3

Medical Board. Dr. Rea had diagnosed Plaintiff with “immune deregulation,” and according to the

charges by the Texas Medical Board, Dr. Rea had diagnosed patients with “deficiencies in immune

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4

forced to resign from the board. (Pl.’s Mem. 8.) As evidence of this claim, Plaintiff cites to some typed

up notes from Dan O. Harper, M.D. (AR at 6-8.) It is unclear who Dan O. Harper is and what authority

he has to report on the disposition of the Texas Medical Board case.

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function when the tests themselves show that this is not the case.” (AR at 293.) Therefore, the

charges by the Texas Medical Board called into question Dr. Rea’s diagnosis of “chemical

sensitivity” and his assessment that Plaintiff was disabled. The charges by the Texas Medical Board

were a legitimate, specific reason for the ALJ to question Dr. Rea’s credibility. The ALJ also cited 4

inconsistencies between Dr. Rea’s diagnoses and the lab reports in the record. Taken together, the

ALJ provided specific, legitimate reasons supported by substantial evidence for rejecting Dr. Rea’s

opinion.

As it relates to Dr. Wasserberger, Dr. Wasserberger submitted an interval update dated May

10, 2001, and a medical toxicology follow-up visit report dated May 23, 2002. (AR at 313-15, 344.)

He reported that Plaintiff was exposed to toxigenic mold in his apartment. His assessment was that

Plaintiff could not go to work, because of “multiple chemical sensitivities and chronic fatigue and

memory dysfunctions.” (AR at 313.) Dr. Wasserberger diagnosed Plaintiff with “a mycotoxicosis

that has resulted in chronic fatigue immunosuppression syndrome and memory dysfunction,”

“sinusitis, proven by MRI,” and onychomycosis. (AR at 314.) In May 2002, Dr. Wasserberger

reported that Plaintiff’s symptoms of fatigue, tremors, memory loss and sinus problems had

improved since being out of the toxic environment. (AR at 344.)

The ALJ analyzed Dr. Wasserberger’s opinion as follows:

Like Dr. Rea, he also states that the claimant’s strachybotrys serology was “positive”

when it was well within the normal range [(AR 330, 335)].

[The] diagnosis of mycotoxicosis is not supported by MRI of the brain done in

November 2000 on suspicion of mycotoxicosis. In fact, the MRI was perfectly

normal except for evidence of sinusitis [(AR at 354)].

Although I am not impressed with Dr. Wasserberger’s opinions, I have found that the

claimant is “limited” as he opined. I note that Dr. Wasserberger himself noted that

May 23, 2002, the claimant had realized “marked improvement” and was no longer

wearing a mask [(AR at 345)].

There is no record of complaint or treatment for any toxicological or allergic

impairment prior to October 2000, which is four months after DLI in June 2000. I am

giving the claimant maximum reasonable benefit of the doubt in finding that he did

have medically determinable impairments prior to DLI.

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The statute states, in pertinent part, “The Commissioner of Social Security shall notify each

5

claimant in writing, together with the notice to such claimant of an adverse determination, of the options

for obtaining attorneys to represent individuals in presenting their cases before the Commissioner of

Social Security. Such notification shall also advise the claimant of the availability to qualifying claims

of legal services organizations which provide legal services free of charge.” 42 U.S.C. § 406(c).

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(AR at 175.)

Plaintiff takes issue with the ALJ’s “attack” on Dr. Wasserberger’s claim that he was board

certified in toxicology. Plaintiff claims, “ALJ Wurzel is wrong, as the American Board of

Toxicology would attest.” (Pl.’s Mem. 8.) Plaintiff then cites a website for the American Board of

Toxicology, which provides no information about Dr. Wasserberger’s board certification. Plaintiff

provides nothing further to support his argument that the ALJ erred in rejecting Dr. Wasserberger’s

opinion. In fact, the ALJ gave Plaintiff the “maximum benefit” of the doubt and did credit some of

Dr. Wasserberger’s opinion regarding Plaintiff’s disability. The ALJ, however, did cite reasons that

put Dr. Wasserberger’s opinion into doubt. For one, Dr. Wasserberger’s opinion was incongruous

with the lab reports. And more importantly, Dr. Wasserberger provided no record of treatment or

examination for the period at issue, between July 4, 1999 and June 30, 2000. The Court finds these

are specific, legitimate reasons, based on substantial evidence, to reject Dr. Wasserberger’s opinion.

2. ALJ’s decision to go forward without Plaintiff’s attorney

Plaintiff also argues that it was legal error for the ALJ to go forward with the administrative

hearing without Plaintiff’s attorney. (Pl.’s Mem. 6-7.) Plaintiff contends that his attorney could not

travel, and the ALJ refused to allow Mr. Walkup to appear by telephone, even though he was “ready,

willing, and able” to appear by telephone. (Id. at 7.) Plaintiff argues that he “has a statutory right to

be represented by an attorney of his choice.” (Id.)

A Social Security claimant has a statutory right to be represented by counsel at an

administrative hearing. 42 U.S.C. § 406 ; 20 C.F.R. §§ 404.1700, 416.1500. Although the absence 5

of counsel, standing alone, does not deprive a claimant of a fair hearing, the Commissioner has a

duty to inform the claimant of the right to counsel, so that the claimant may decide knowingly

whether he or she wishes to waive this right. Edwards v. Sullivan, 937 F.2d 580, 585 (11th Cir.

1991); Thompson v. Sullivan, 933 F.2d 581, 584 (7th Cir. 1991); Clark v. Schweiker, 652 F.2d 399,

403 (5th Cir. 1981). A claimant must be informed not only of his or her right to counsel, but of the

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importance of having an attorney, of the availability of free legal services to represent indigent

claimants, and the limits on fees to private counsel to twenty-five percent of retroactive benefits. 

Binion v. Shalala, 13 F.3d 243, 245 (7th Cir. 1994); Smith v. Schweiker, 677 F.2d 826, 829 (11th

Cir. 1982); Clark, 652 F.2d at 403; see also Blom v. Barnhart, No. 04-C-0912, 363 F. Supp. 2d

1041, 1046 (E.D. Wis. Mar. 26, 2005) (finding uninformed waiver invalid even though claimant was

an attorney).

Here, Plaintiff’s attorney, Michael J. Walkup, had requested that he and Plaintiff appear

telephonically at the administrative hearing, because they were both disabled. (AR at 229.) The ALJ

denied the request. (AR at 310.) The ALJ addressed this issue in his written opinion:

I know nothing about attorney Walkup beyond what he alleges in his letters of March

12th and 14th, 2008. His allegations about the claimant’s ability to attend did not

make any sense. In the aforementioned letter of March 14, 2008, he alleged that he

too suffered from “similar problems” as the claimant rendering him unable to travel

or to attend hearings in person, although he allegedly had appeared by telephone for

“several years” in hearings “all over the country.” He said he did not appear in person

at hearings even in his own area of Chicago, as he develops “asthmatic reactions to

paper product” and would “likely have a problem sitting in your waiting room in

proximity to the copier.” He would not be able, he said, to “review a paper file,” and

[“]may also have difficulty around people who wear scented products or with any

recent office redecorating or construction.” He said he was “receiving disability

benefits” himself.

With his claimed hypersensitivity to paper products, one fairly wonders how attorney

Walkup reviewed files prior to the recent adoption of electronic files. One also

wonders how he is able to receive disability benefits while working for years as an

attorney under the standard fee agreement in cases all over the country. Taking

together, attorney Walkup’s allegations do not make sense.

In any event, I did instruct my clerk to advise attorney Walkup that we would

accommodate his alleged disability. This is an “electronic file” case not requiring

review of paper products. We have four client conference rooms off our waiting

room that are private rooms not containing copiers or any other paper products. I do

not wear “scent” of any kind, and I specifically asked the court reporter and

vocational expert appearing at the claimant’s hearing not to wear any either. On the

morning of the hearing, I confirmed that they did receive my request and that they had

complied with it. I believe that these were reasonable accommodations.

(AR at 168.)

The ALJ had reviewed Mr. Walkup’s request to appear telephonically and made

accommodations for Mr. Walkup’s “paper intolerance” but, in his discretion, decided that it was not

necessary for him to appear telephonically. While Plaintiff argues that he has a right to be

represented by an attorney of his choice, he does not cite to any authority that requires the ALJ to

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permit that attorney to appear telephonically. It is not uncommon for attorneys to travel from out of

town to appear at hearings, so Plaintiff’ argument that he chose “an attorney from out of town” is

unconvincing. When Plaintiff appeared at the administrative hearing, he informed the ALJ that his

attorney had advised him not to answer any questions. (AR at 154-55.) He actually indicated,

“Well, frankly, I’d much rather prefer answer questions, but the attorney--” (AR at 155.) But when

the ALJ asked him to give a “clear yes or no” whether he was going to answer questions, he said no. 

(Id.) Even if the ALJ had erred by not allowing Mr. Walkup to appear telephonically, Plaintiff fails

to establish that he was prejudiced.

Although a Social Security claimant has the right to be represented by counsel at an

administrative hearing, the “[l]ack of counsel does not affect the validity of the hearing unless the

[claimant] can demonstrate prejudice or unfairness in the administrative proceedings.” Key v.

Heckler, 754 F.2d 1545, 1551 (9th Cir. 1985) (citing Vidal v. Harris, 637 F.2d 710, 713 (9th Cir.

1981)). Thus, the critical issue is whether the administrative proceeding was fair, not whether the

claimant properly waived his right to counsel. Vidal, 637 F.2d at 714 (“[T]he issue is not whether

the right to representation was knowingly waived, rather, it is whether, in the absence of

representation, the administrative law judge met the heavy burden imposed by [Cox v. Califano, 587

F.2d 988 (9th Cir. 1978)]”); see also Higbee v. Sullivan, 975 F.2d 558, 561-62 (9th Cir. 1992) (per

curiam).

Where a claimant is unrepresented by counsel, it is “incumbent upon the ALJ to

conscientiously and scrupulously probe into, inquire of, and explore all the relevant facts” at the

hearing so as to protect the claimant’s interests. Cox, 587 F.2d at 991; see also Higbee, 975 F.2d at

561; Key, 754 F.2d at 1551; Vidal, 637 F.2d at 713-14. When the “heavy burden imposed by Cox” is

not met in this context, and the unrepresented claimant may have been prejudiced, “the interests of

justice demand that the case be remanded.” Vidal, 637 F.2d at 714-15.

Plaintiff has not argued that the ALJ failed to fully and fairly develop the record in this case. 

It appears Plaintiff’s counsel was submitting documents before and after the administrative hearing

and even after the ALJ had issued his decision. Despite this fact, there are practically no records that

document treatment during the specific period for which Plaintiff seeks disability benefits, the period

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from July 4, 1999 to June 30, 2000. Plaintiff has failed to show that he was prejudiced by the ALJ

denying Mr. Walkup’s request to appear telephonically.

3. Appeals Council’s rejection of Dr. Heuser’s opinion

Plaintiff argues that the Appeals Council failed to provide clear and convincing reasons for

rejecting the opinion of Dr. Gunnar Heuser, who he claims is his treating physician. (Pl.’s Mem. 6.) 

Plaintiff argues that Dr. Heuser found him disabled since April 2000. (Id.) A letter dated May 26,

2009 from Dr. Heuser was submitted after the ALJ issued his decision, but was considered, and

rejected, by the Appeals Council on reconsideration. (AR at 1.)

In Dr. Heuser’s May 26, 2009 letter, he indicated that he initially saw Plaintiff on April 4,

2000 and “then at intervals over the years.” (AR at 23.) Dr. Heuser reported in his letter that he

reviewed the records from numerous doctors, including Dr. Rea, Dr. Wasserberger and others. After

reviewing these records, the doctor concluded, “The patient reacts strongly to everyday chemicals in

his environment and is therefore in my opinion, totally disabled and has been since his initial

consultation.” (AR at 24.) Dr. Heuser’s letter was submitted after the ALJ had issued his decision

on April 1, 2008. The Appeals Council rejected the letter, because it was dated May 26, 2009, which

was after Plaintiff’s DLI. (AR at 1.) The Appeals Council concluded, “Therefore, it does not affect

the decision about whether you were disabled at the time you were last insured for disability

benefits.” (AR at 2.)

The Appeals Council properly rejected Dr. Heuser’s opinion. Social Security regulations

provide that where new and material evidence is submitted to the Appeals Council with the request

for review, the entire record will be evaluated and review of the ALJ’s decision will be granted

where the Appeals Council finds that the ALJ’s action, findings, or conclusion is contrary to the

weight of the evidence currently of record. 20 C.F.R. § 404.970. Because the post-decision

evidence was considered by the Appeals Council, it is part of the record on review by this Court. 

Ramirez v. Shalala, 8 F.3d 1449, 1452 (9th Cir. 1993); Gomez v. Chater, 74 F.3d 967, 971 (9th Cir.

1996). The court may remand a case in light of new evidence when the new evidence is material to

the disability determination and the claimant has shown good cause for failing to present the

information earlier. Mayes v. Massanari, 276 F.3d 453, 462 (9th Cir. 2001). To be material, the

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new evidence must bear “directly and substantially on the matter in dispute.” Id. Material evidence

should relate to the period on or before the date of the ALJ’s decision. See 20 C.F.R. § 404.970. 

The claimant must also demonstrate a “reasonable possibility” that the new evidence would have

changed the disability determination. Mayes, 276 F.3d at 462.

While Dr. Heuser’s letter relates to a period before the ALJ’s decision, Plaintiff has failed to

show that the “new evidence” would have changed the disability determination. As previously

discussed, the weight of the evidence supports the ALJ’s finding of not disabled. While Plaintiff

claims Dr. Heuser was a “treating physician,” no treatment notes accompany Dr. Heuser’s letter. 

The ALJ need not accept an opinion of a treating physician if it is “conclusionary and brief and

unsupported by clinical findings.” Matney, 981 F.2d at 1019. Finally, Plaintiff has failed to show

good cause for failing to present the letter earlier. This Court concludes that the Appeals Council did

not err in rejecting Dr. Heuser’s opinion and denying the request for review.

V. Conclusion

After a thorough review of the record and the papers submitted and based on the reasons

discussed above, this Court finds the ALJ’s decision that Plaintiff could sustain jobs that constitute

substantial gainful activity and that exist in significant numbers in the regional and national

economies was supported by substantial evidence in the record and was not based on legal error. 

Accordingly, this Court recommends Plaintiff’s motion for summary judgment be DENIED and the

Commissioner’s cross-motion for summary judgment be GRANTED.

This Report and Recommendation is submitted to the United States District Judge assigned

to this case pursuant to 28 U.S.C. § 636(b)(1). Any party may file written objections with the Court

and serve a copy on all parties on or before January 13, 2011. The document should be captioned

“Objections to Report and Recommendation.” Any reply to the objections shall be filed and served

no later than 10 days after being served with the Objections.

IT IS SO ORDERED.

DATED: December 30, 2010

CATHY ANN BENCIVENGO

United States Magistrate Judge

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