Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_12-cv-08179/USCOURTS-azd-3_12-cv-08179-0/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 (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Janette Bell, 

Plaintiff, 

vs. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant.

No. CV-12-08179-PCT-NVW

ORDER 

Plaintiff Janette Bell seeks review under 42 U.S.C. § 405(g) of the final decision 

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

supplemental security income under section 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 

Bell was born in January 1964. She completed high school and is able to 

communicate in English. She has worked as a housecleaner, grocery clerk, server, 

personnel clerk, and pharmacy clerk. She has been diagnosed with chronic obstructive 

pulmonary disease (“COPD”), fibromyalgia, migraine headaches, and possible seizure 

disorder. She had right hip surgery after a motor vehicle accident in 1994. In her 

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Opening Brief, Bell states that her “most compelling problem is respiratory in nature” 

and that her medical problems “include COPD, fibromyalgia, and migraine headaches.” 

B. Procedural History 

On October 1, 2007, Bell protectively applied for supplemental security income, 

alleging disability beginning July 10, 2007. On July 16, 2010, she appeared with her 

attorney and testified at a hearing before the ALJ. A vocational expert also testified. 

On November 18, 2010, the ALJ issued a decision that Bell was not disabled 

within the meaning of the Social Security Act. The Appeals Council denied Bell’s 

request for review of the hearing decision, making the ALJ’s decision the 

Commissioner’s final decision. On September 6, 2012, Bell sought review by this Court. 

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). 

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 

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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. § 416.920(a). 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. § 416.920(a)(4)(i). If so, the claimant is not 

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

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

§ 416.920(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 meets or equals an impairment listed in Appendix 1 to Subpart P of 20 

C.F.R. Pt. 404. § 416.920(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. § 416.920(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 residual functional capacity, age, education, and work experience. 

§ 416.920(a)(4)(v). If so, the claimant is not disabled. Id. If not, the claimant is 

disabled. Id. 

IV. ANALYSIS 

The ALJ found that Bell has not engaged in substantial gainful activity since 

October 1, 2007. At step two, the ALJ found that Bell “has the following severe 

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impairments: chronic obstructive pulmonary disease (COPD), fibromyalgia, a history of 

right hip fracture, carpal tunnel syndrome, questionable history of stroke, seizure, 

migraines, a history of polysubstance abuse and an adjustment disorder with depressed 

mood.” At step three, the ALJ determined that Bell 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. At step four, the ALJ found that Bell: 

has the residual functional capacity to perform sedentary 

work as defined in 20 CFR 416.967(a) except the claimant 

cannot be exposed to hazards or to extremes of heat or cold. 

She must avoid fumes. She can perform the simple and 

repetitive tasks characteristic of unskilled work. She must 

avoid ladders, ropes or scaffolds, but she can perform other 

postural activities occasionally. 

The ALJ concluded that Bell is unable to perform any past relevant work. At step five, 

the ALJ found that, considering Bell’s age, education, work experience, and residual 

functional capacity, there are jobs that exist in significant numbers in the national 

economy that she can perform. 

A. The ALJ Did Not Err in Weighing Medical Source Evidence. 

1. Legal Standard 

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. 

Where a treating 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 

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the record. Id. 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 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. 

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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. Orn, 

495 F.3d at 632. 

2. Treating Neurologist Ronald Bennett, M.D. 

On August 4, 2008, Bell began seeing Dr. Bennett, a neurologist, with complaints 

of headaches and seizures. During the initial consultation, Bell reported that she also 

suffered from fibromyalgia, chronic depression, and alcoholism. She reported being 

sober for the past year and a former smoker. Dr. Bennett’s initial consultation report lists 

recommendations, including adding a tricyclic antidepressant to Bell’s regimen because it 

has more effect on headaches than a serotonin reuptake inhibitor such as Paxil. 

Bell returned to see Dr. Bennett four more times during August 2008. An 

abnormal EEG study on August 11, 2008, indicated a probable source for a clinical 

seizure disorder. On August 14, 2008, Dr. Bennett conducted a visual evoked potential 

study and an auditory evoked potential study, both of which were normal. On October 3, 

2008, a chart note states that Bell wanted Dr. Bennett to write a prescription for an 

antidepressant other than Paxil because he had told her Paxil was not “headache 

friendly.” 

On July 15, 2010, Dr. Bennett reported that Bell had requested that he fill out her 

Ability to Work Activity Form in support of her disability application. He said that he 

had not seen her since April 2010 when she saw him for headaches, but the record does 

not include treatment notes from April 2010. Dr. Bennett stated that Bell’s “problem is 

migraine,” but she also has severe anxiety and depression. He also stated that, because of 

her limp and problems with her right leg, he would like to do an electromyography test to 

determine whether she has nerve damage from her motor vehicle accident and surgery 

sixteen years earlier. The electromyography and nerve conduction tests performed on 

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July 15, 2010, showed “evidence for a polyneuropathy bilaterally, both motor and 

sensory.” On July 15, 2010, Dr. Bennett partially completed a Medical Assessment of 

Ability to Do Work Related Activities form, on which he indicated that Bell “can not 

stand or walk for a long duration” and in an 8-hour work day can stand or walk 0 hours. 

He opined that Bell can never bend, squat, crawl, climb, or reach. He did not complete 

the questions regarding her ability to sit, lift, carry, or use her hands. He indicated that 

pain or fatigue (he did not indicate which) moderately affect Bell’s ability to function. 

Bell contends the ALJ erred by giving Dr. Bennett’s July 15, 2010 opinion “less 

weight.” The ALJ provided the following clear, convincing, specific, and legitimate 

reasons for doing so: 

Dr. Bennett’s opinion was entitled to less weight for several 

reasons. First, although the claimant may have a “problem” 

with her right leg, the evidentiary record does not support 

total preclusion from standing or walking throughout the day. 

Dr. Bennett’s treatment notes indicate an antalgic gait with a 

tendency to limp, but he describes her coordination as good 

[]. In an initial examination, he described headaches and 

seizures but he did not express concern about leg pain, or 

describe limitations in walking or standing []. The underlying 

treatment notes are sparse, documenting about two months of 

treatment from August of 2008 to October of 2008 []. Dr. 

Bennett states that he saw the claimant in April of 2010 (for 

headaches) but the evidentiary record contains little or no 

evidence from this time. There is little evidence in the record 

to support a total preclusion from postural activities. Finally, 

Dr. Bennett did not cite to any objective and clinical 

evidence, and the lack of explanation reduced the 

persuasiveness of his opinion. 

Bell concedes that Dr. Bennett did not cite any clinical or objective evidence in making 

his assessment, but argues that the electromyography and nerve conduction tests study 

finding peripheral neuropathy is sufficient support for Dr. Bennett’s opinion that she can 

stand or walk 0 hours in an 8-hour work day. Without further explanation, the ALJ was 

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not required to assume that a diagnosis of peripheral neuropathy precluded any walking 

or standing. Moreover, the ALJ’s residual functional capacity assessment does not 

require Bell to walk or stand. 

The ALJ complied with Social Security Rules by weighing Dr. Bennett’s opinion 

in accord with the length of the treatment relationship, frequency of examination, nature 

and examination of the treatment relationship, relevant evidence supporting the opinion, 

and consistency with the record as a whole. Bell alleged disability beginning in July 

2007. Dr. Bennett began treating Bell in August 2008 for headaches and seizures and 

noted her antalgic gait then, but did not attempt to diagnose her right leg problem (which 

began in 1994) until July 2010 when she asked him to complete the disability assessment. 

The record does not show that he ever treated Bell for peripheral neuropathy. 

Further, Bell incorrectly contends “the ALJ accepts the opinion of the nonexamining state agency physician who relegated the claimant to light to sedentary work.” 

In fact, the ALJ stated that she gave weight to the state agency consultants’ opinions, but 

extended Bell “some benefit of the doubt” in consideration of her “partially credible 

subjective complaints, the effects of pain or fatigue and any aggravating factors,” and 

reduced the residual functional capacity assessment to the sedentary level. 

Thus, the ALJ did not err by giving less weight to Dr. Bennett’s opinion. 

B. The ALJ Did Not Err in Evaluating Bell’s Credibility. 

In evaluating the credibility of a claimant’s testimony regarding subjective pain or 

other symptoms, the ALJ is required to engage in a two-step analysis: (1) determine 

whether the claimant presented objective medical evidence of an impairment that could 

reasonably be expected to produce some degree of the pain or other symptoms alleged; 

and, if so with no evidence of malingering, (2) reject the claimant’s testimony about the 

severity of the symptoms only by giving specific, clear, and convincing reasons for the 

rejection. Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009). 

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First, the ALJ found that Bell’s medically determinable impairments could 

reasonably be expected to cause the alleged symptoms. Second, the ALJ found Bell’s 

statements regarding the intensity, persistence, and limiting effects of the symptoms not 

credible to the extent they are inconsistent with the ALJ’s residual functional capacity 

assessment. In other words, the ALJ found Bell’s statements not credible to the extent 

she claims she is unable to perform sedentary work with simple and repetitive tasks. The 

ALJ did not find evidence of malingering. 

The ALJ gave the following specific, clear, and convincing reasons, supported by 

substantial evidence, for finding Bell’s subjective symptom testimony only partially 

credible: 

The claimant’s testimony regarding her symptoms and her 

complete inability to engage in work activity was not fully 

persuasive, and she has admitted to the ability to perform a 

variety of daily activities, inconsistent with her disability 

allegations. In a function report, the claimant reported that 

she spent most of her time sitting in a chair watching TV, and 

she attended to most personal needs without difficulty. The 

claimant admitted that she cooks simple meals, does ceramics 

and reads (a couple of times a week) []. The third party 

described spending 5-6 hours with the claimant, watching 

television or reading. He noted that the claimant had no 

problems caring for her personal needs, with the exception of 

getting out of the tub; she could cook simple meals and do 

household chores such as laundry and dishes []. Such 

activities are consistent with the range of sedentary exertional 

activity described herein. 

Bell does not dispute that she can perform sedentary activities, but rather contends 

that this evidence does not show that she is able to perform full-time sedentary work and 

the ALJ was required to cite reasons unrelated to the subjective testimony for partially 

discounting Bell’s credibility. In fact, the ALJ stated multiple objective reasons for doing 

so: the treatment course was not consistent with Bell’s allegations of incapacity, some of 

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the conditions existed while Bell was working, some showed significant improvement 

with medication and routine medical treatment, adverse side effects of medication were 

not documented in the record, and Bell admitted she stopped working for reasons other 

than her medical conditions. 

Moreover, the ALJ expressly gave Bell’s subjective symptom allegations “the 

benefit of the doubt” by limiting her residual functional capacity to sedentary work. 

Therefore, the ALJ did not err by finding Bell’s subjective symptom testimony partially 

credible. 

C. At Step Four, the ALJ Did Not Err by Failing to Properly Consider the 

“Listings” at 20 C.F.R. § 404, Subpart P, Appendix I. 

Bell contends the ALJ erred by failing to properly consider whether her COPD 

condition satisfied Listing 3.02(A). As explained above, at step three, the ALJ was 

required to consider whether the claimant’s impairment or combination of impairments 

meets or equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404, 

and Bell bore the burden of proof at step three. The ALJ considered the Listings and, 

regarding Bell’s COPD, stated: “Her spirometry results were abnormal, but they did not 

establish disability via the requirements of listing 3.02 (Chronic pulmonary 

insufficiency).” 

Listing 3.02A sets the standard for finding chronic pulmonary insufficiency based 

on a person’s height and pulmonary function testing. Listing 3.00E provides detailed 

instructions for pulmonary testing. It defines FEV1 as the reported forced expiratory 

volume. Listing 3.00E also requires that the FEV1 be the largest of at least three 

satisfactory forced expiratory maneuvers and that two of the satisfactory spirograms must 

be reproducible for both pre-bronchodilator and post-bronchodilator tests. To be 

reproducible, a value must not differ from the largest value by more than 5 percent or 0.1 

L, whichever is greater. 

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Listing 3.00E directs that spirometry should be repeated after administration of an 

aerosolized bronchodilator if the pre-bronchodilator FEV1 value is less than 70 percent of 

the predicted normal value. It states, “The effect of the administered bronchodilator in 

relieving bronchospasm and improving ventilatory function is assessed by spirometry,” 

and the values used in Listing 3.02A “must only be used as criteria for the level of 

ventilatory impairment that exists during the individual’s most stable state of health.” 

Listing 3.02A defines chronic pulmonary insufficiency for a person 67 inches tall 

as having an FEV1 value equal to or less than 1.35 and for a person 68 inches tall as 

having an FEV1 value equal to or less than 1.45. Three FEV1 tests were performed in 

connection with Bell’s disability application: May 5, 2008; August 5, 2008; and 

September 25, 2008. The May test results had a variance too great to be considered 

reproducible, and the examiner noted the variance was due to poor effort. The August 

test reported Bell’s height as 67 inches, her pre-bronchodilator FEV1 as 1.39, and her 

post-bronchodilator FEV1 as 1.97. The September test reported her height as 68 inches, 

her pre-bronchodilator FEV1 as 1.37, and her post-bronchodilator FEV1 as 1.73. 

Regardless of whether Bell is 67 or 68 inches tall and whether the pre-bronchodilator 

FEV1 should be considered, none of the values were equal to or less than 1.35. 

Therefore, the ALJ did not err by finding that Bell’s spirometry results did not meet 

Listing 3.02A. 

IT IS THEREFORE ORDERED that the final decision of the Commissioner of 

Social Security is affirmed. The Clerk shall enter judgment accordingly and shall 

terminate this case. 

Dated this 8th day of April, 2013. 

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