Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_06-cv-03116/USCOURTS-azd-2_06-cv-03116-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

JEFFREY ADCOCK, 

Plaintiff, 

v.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant. 

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No. CV 06-3116-PHX-MHM

ORDER

Plaintiff Jeffrey Adcock ("Plaintiff") seeks judicial review the Administrative Law

Judge’s decision to deny Plaintiff’s claim for disability insurance benefits pursuant §§ 205(g)

and 1631 of the Social Security Act (“Act”), 42 U.S.C. §§ 405(g), 1383(c)(3). Currently

before the Court are Plaintiff’s motion for summary judgment pursuant to Rule 56(a) of the

Federal Rules of Civil Procedure (“FRCP”) (Dkt. #23) and Defendant Michael Astrue’s

(“Defendant”) cross-motion for summary judgment pursuant to FRCP 56(b) (Dkt. #35).

I. PROCEDURAL HISTORY

Plaintiff filed applications for Disability Insurance and Supplemental Security Income

benefits under Titles II, XVI, and XIX of the Social Security Act, 42 U.S.C. §§ 401 et seq.,

1381 et seq., 1396 et seq., on June 2, 2003. (Administrative Record (“AR”) 59-61, 598-599).

Plaintiff’s applications were denied initially and on reconsideration. (AR 32-36, 39-42, 601-

09). On April 21, 2005, a hearing was held before Administrative Law Judge ("ALJ")

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Michael Cianci, Jr. (AR 648-75). On June 21, 2005, the ALJ denied Plaintiff's application

for a period of disability and disability insurance benefits under section 216(I) and 223 of the

Social Security Act. (AR 16-22). The Appeals Council denied Plaintiff’s request for review

of the ALJ’s decision on November 2, 2006 (AR 7-10), and on December 29, 2006, Plaintiff

initiated the instant action for judicial review of the ALJ’s decision pursuant to 42 U.S.C. §§

405(g), 1383(c)(3).

II. BACKGROUND

A. Plaintiff's Medical History

1. Mental Health

On May 11, 2001, Plaintiff sought emergency treatment for a panic attack and was

diagnosed with “acute anxiety.” (AR 16, 134). On June 1 and 16, 2001, Plaintiff was treated

for “Anxiety/Bipolar Depression,” and on October 9, 2001, Plaintiff was diagnosed with

“Bipolar I Disorder, Most Recent Episode Depressed, Moderate; Cocaine Dependence, in

Full Sustained Remission by self-report” and “Diabetes type II and hypertension, by selfreport.” (AR 172). Plaintiff’s “prognosis for returning to the work force [was] good in terms

of cognitive functions such as attention, concentration and short term memory. However,

his interpersonal skills are somewhat weak, owing chiefly to his lack of medications for his

mental disorder. His ability to perform work-related tasks [was] good in terms of cognitive

functions.” (AR 172).

On October 19, 2001, Plaintiff was treated for anxiety and depression, and was

referred to a psychiatrist. (AR 245). On October 24-25, 2001, Plaintiff began receiving

psychiatric evaluations at Jewish Family and Children’s Services (“JFCS”) and sought

treatment through June 2003 for anxiety, depression, insomnia, and panic attacks with

agoraphobia, usually with social workers and nurses, but also with Dr. Michael Fermo. (AR

303-79). The Court finds it unnecessary to recount here all of Plaintiff’s visits to JFCS as

indicated in the record, suffice to say that the records indicate that Plaintiff’s diagnoses at

JFCS, as well as Plaintiff’s other care providers, remained fairly constant, with diagnoses of

bipolar disorder, depression, panic attacks with agoraphobia, diabetes, high blood pressure,

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A GAF is a numeric scale (0 through 100) used by mental health clinicians and

doctors to rate the social, occupational, and psychological functioning of adults. American

Psychiatric Association, Diagnostic and Statistical Manual of Mental Impairments, 4th text

rev., 2000, p.32 (DSM-IV-TR). A GAF score of 51-60 is indicative of moderate symptoms,

such as flat affect or occasional panic attacks, or any moderate difficulty in social,

occupational, or school functioning. (Id.). A GAF score of 41-50 is indicative of serious

symptoms, and a GAF score of 61-70 is indicative of mild symptoms. (Id.).

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an anxiety disorder, and hypertension. (AR 350, 378). JFCS’s records indicate that

Plaintiff’s mood fluctuated between being “a little bummed” or depressed (AR 311) and

“doing a little better” (AR 306) and “doing great” (AR 312).

Plaintiff’s Global Assessment of Functioning (“GAF”) scores ranged from between

50 (October 25, 2001) and 68 (August 15, 2002).1

 (AR 378, 350). In May and October

2002, January and July 2003, Plaintiff’s treaters at JFCS, including Dr. Fermo, assessed

Plaintiff as only “mildly” mentally ill. (AR 338, 340-42, 345). However, Plaintiff was also

intermittently assessed as “moderately” mentally ill. (AR 313, 344). The assessment of

Plaintiff’s condition ranged from “unchanged” to “[g]ood improvement”; likewise, the

assessment of Plaintiff’s insight, judgment, and concentration ranged from poor to good.

(AR 303, 309, 310, 313, 344, 358, 634). 

On November 20, 2001, Dr. Paul Tangeman, a state agency reviewing psychologist,

reviewed the record and found that Plaintiff had a bipolar disorder, no restriction of activities

of daily living, difficulties in maintaining social functioning that were moderate, difficulties

in maintaining concentration, persistence, or pace that were mild, and one or two episodes

of decompensation of extended durations. (AR 173-186). Dr. Tangeman stated that Plaintiff

was “angry [and] tends to isolate,” but that there was nothing in Plaintiff’s mental status

examinations to “indicate any substantial impairments aside from [Plaintiff’s] social

problems” and that Plaintiff “retains the ability to perform basic work tasks [with] few

socially stressful demands.” (AR 189). In addition, on January 29, 2002, Dr. Ronald

Nathan, another state agency reviewing doctor, reviewed the record and found that Plaintiff

had a bipolar disorder that constituted a severe impairment, but was not expected to last 12

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months. (AR 191, 194). Dr. Nathan also found that Plaintiff’s only degree of limitation was

a mild limitation in maintaining social functioning. (AR 201).

In December 2003, and at various times in 2004, Plaintiff was treated at Southwest

Behavioral Health Services. (AR 458-507). In March 2004, Dr. Raikhelkar noted that

Plaintiff “has done very well since he started to come to this clinic,” and that Plaintiff was

applying for disability benefits. (AR 464). Plaintiff assessment at this time was “[b]ipolar

disorder with manic episodes, in remission now, without psychosis,” “[p]ain syndrome,”

“[s]upport system issues and social issues and economic issues,” and a GAF score of “[a]bout

55.” (AR 464). In addition, in April 2004, Plaintiff began treatment at ValueOptions (AR

550-79), and on January 7, 2005, underwent an “Annual Behavioral Health Update and

Review Summary.” (AR 550). Plaintiff’s status was “normal attention span, memory is

intact, processing is normal and able to problem-solve”; “appropriate affect and mood. . . .

good judgement and [ ] emotionally stable.” (Id.). The assessment stated that Plaintiff lived

alone in an apartment, that Plaintiff “has adequate self-preservation skills,” and that “[o]n a

typical day, [Plaintiff] goes on the internet a lot and enjoys going on E-Bay. He goes with

his aunt shopping everyday. He forces himself to get out of the house and get busy so he

does not get depressed.” The assessment further stated that Plaintiff “expressed working

part-time as a data entry operator again as long as he can still keep his AHCCCS. [Plaintiff]

reports that he can type 70 wpm. He is not able to sit for long period of time.” (AR 552).

2. Physical Health

On February 26, 2002, Plaintiff was treated for neck pain and an upper respiratory

infection by a physician with CIGNA Medical Group. (AR 239, 267). Plaintiff received Xrays of his cervical spine, and on February 26, 2002, Plaintiff’s X-rays were reviewed and

showed “degenerative changes.” (AR 269). On March 11, 2002, Plaintiff was assessed with

acute bronchitis, neck pain with a C-spine X-ray that revealed degenerative joint disease, and

fatigue; Plaintiff’s medications were adjusted. (AR 217). On March 28, Plaintiff began

seeing Dr. John Mahon, for complaints of neck and upper left extremity pain; Dr. Mahon

noted that Plaintiff should try physiotherapy. (AR 391-95). Dr. Mahon noted that Plaintiff

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was on a variety of medications, and that he did not want to add to those, but that he did

speak to Plaintiff about the possibility of epidural steroid injections. (Id.). Plaintiff asked

Dr. Mahon what kind of work he could do and Dr. Mahon opined that “he not have anything

that requires him to gaze upwards. Data entry at a computer is a possibility as long as

[Plaintiff] changes positions frequently and has a monitor placed directly in front of him

rather than to the side.” (Id.). 

On May 9, 2002, Dr. Mahon noted Plaintiff stated that his physiotherapy had “been

very beneficial” and provided him “at least 4 to 6 hours of relief” (AR 393), but on October

30, 2002, Plaintiff reported low back and bilateral leg pain, and Dr. Mahon’s impression was

“bilateral sciatic irritation” and recommended an MRI. (AR 391). Dr. Mahon also noted that

Plaintiff asked for “stronger pain medicine,” but Dr. Mahon did “not want to give him other

medications that [were] going to interfere in any way with his bipolar meds.” (AR 392). On

November 7, 2002, Plaintiff underwent an MRI of his lumbar spine, and the resulting

“impression” was “[m]ultilevel degenerative disc disease of the lumbar spine,” and

“[m]ultilevel ligamentum flavum and facet hypertrophy with multilevel neural foraminal

narrowing and probable neural impingement.” (AR 211-13). After reviewing Plaintiff’s

MRI, Dr. Mahon recommended epidural steroid injections, Valium, a formal physical therapy

program, and a weight reduction program. (AR 386-88). On November 25, 2002, Dr.

Mahon indicated that Plaintiff’s following limitations included “[m]aximum lifting 20

pounds intermittently,” “[a]voidance of bending, stooping, or squatting,” “[r]est periods of

10 minutes every two hours,” and “[m]aximum work day of eight hours with four hours

interrupted by one hour.” (AR 209). From December 2002 to March 2003, Plaintiff received

three epidural injections, and in April 2003, Plaintiff was referred back to pain management.

(AR 222, 260, 262-63).

On April 22, 2003, Dr. Glen Bair, an orthopedic surgeon, examined Plaintiff at the

request of Dr. Mahon, and noted that although Plaintiff’s “range of motion is moderately

decreased,” Plaintiff’s neurologic exam was “not remarkable.” (AR 385). Dr. Bair assessed

Plaintiff with “chronic back pain,” and noted that Plaintiff “apparently is on multiple

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medications for bipolar mood disorder. He smokes a pack of cigarettes a day.” (Id.). Dr.

Bair recommended a lumbar CT scan, which revealed primarily “minimal” disc bulges, the

most pronounced of which was at the L1-L2 level, “which flattents the ventral aspect of the

thecal sac.” (AR 386). The impression was “[l]umbar spine degenerative disc disease

changes.” (AR 387). On May 9, 2003, Plaintiff saw Dr. Bair again, and Dr. Bair noted that

Plaintiff “continues with low back pain”; Dr. Bair recommended that Plaintiff try a back

brace. (AR 382). 

On May 21, 2003, Plaintiff was seen by Dr. William Stevens for spine surgery

consultation on referral by Dr. Drew Peterson, Plaintiff’s treating physician at CIGNA

Medical Group. (AR 214). Plaintiff’s “[p]hysical examination [found] a somewhat

deconditioned male. His affect is appropriate.” (AR 215). Dr. Stevens’s recommended

“[l]umbar physical therapy strengthening and stabilization” and “referral to a pain

management specialist.” Dr. Stevens also “dsicussed the importance of weight loss” and

“advised [Plaintiff] to discontinue tobacco use.” (AR 216).

On October 6, 2003, Dr. Peterson completed a “Medical Assessment of Ability to Do

Work Related Physical Activities” checklist and indicated that Plaintiff had degenerative disc

disease with chronic low back pain, neck pain, and “some difficult [sic] to control

depression.” (AR 420-23). Dr. Peterson checked off that Plaintiff could only sit (due to

back), lift (due to back), stand (due to back), carry, and walk (continuously) for less than one

hour each in an eight-hour workday. (Id.). Dr. Peterson indicated that Plaintiff was limited

by his pain and fatigue, which “moderately severe[ly]” limited Plaintiff’s ability to function.

(AR 422). Dr. Peterson noted that his findings regarding Plaintiff’s limitations were based

on “MRI.” (Id.).

Starting on January 5, 2004, Plaintiff was treated at the Scottsdale Center for

Advanced Pain Management. (AR 510-38). The attending physician noted that Plaintiff was

“an excellent candidate for interventional pain management.” (AR 534-38). Plaintiff stated

his average pain level was “4-5/10" but is sometimes “8/10.” (AR 531). On April 12, 2004,

Plaintiff “seem[ed] to have mostly signs and symptoms of lumbar facet disease,” “his pain

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has improved,” and he “seem[ed] to be doing reasoanbly well.” (AR 526-27). On October

26, 2004, the attending physician noted that Plaintiff “seems to be relatively stable,” but that

he “states that his average pain level with medication is 3-4/10 when he is hanging out

around the house. However, when he is going out to thrift shops and junk shops, which is

his favorite pastime, his pain increases markedly and he cannot spend more than an hour or

two out at a time. . . . Prolonged standing and walking worsens his pain a lot.” (AR 516). 

B. Hearing Testimony

On April 21, 2005, a hearing on Plaintiff’s application for disability benefits was held

before the ALJ. (AR 649-75). Plaintiff and David Janus, a vocational expert, gave testimony

at that hearing. (Id.). Plaintiff, age 43 at the time of the hearing, testified that he had a high

school education and that his past work experience involved clerical data entry (“clerical

jobs, data entry jobs, and temporary jobs. I have been trough a lot of jobs.”). (AR 655-56).

Plaintiff testified that he stopped working in May 2001 due to “[p]anic attacks, and a lot of

stress, mood swings,” and that he had physical problems of degenerative disc disease and

chronic pain. (AR 655-56). Plaintiff stated that he could only stand for thirty to forty-five

minutes before his pain forced him to sit down, and vice versa, he could only sit for that long

before he had to get up or lie down. (AR 656-57). In addition, Plaintiff stated that he could

only walk for “about a half hour” before he had to stop and rest. (AR 657). Further, Plaintiff

stated that he normally took a nap for “several hours” around 1:00 or 2:00 p.m., and that he

had problems sleeping at night and could sometimes “be up for one or two days with no

sleep.” (AR 658). Plaintiff testified that the medication he was taking for his bipolar

disorder “tend[ed] to work.” (AR 664).

The vocational expert was posed several hypotheticals by the ALJ, specifically

whether an individual of Plaintiff’s age, work experience, and educational background, that

could lift no more than 20 pounds occasionally, ten pounds frequently; that could only sit,

stand and/or walk six hours out of an eight hour day; that could not climb ladders, ropes, or

scaffolds, and only occasionally stairs and ramps; that had to avoid bending, crouching,

crawling, kneeling, as well as the cold, vibrations, and hazardous conditions; and that had to

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avoid confrontational roles, which would preclude work that would be of a supervisory

nature, and things like arbitration and negotiation, could perform the past relevant work

either as he or she did, or as performed in the national economy. (AR 668-69). The

vocational expert answered affirmative to both in terms of Plaintiff’s past relevant work

experience as a data entry clerk and receptionist, and as to those jobs as performed in the

national economy. (AR 669). The vocational expert also testified that no work was available

for a hypothetical individual that could only sit, stand, and walk for one hour each for an

eight hour day; he stated that such a limitation would preclude work as a general office clerk

or receptionist, or any similar work, because it would preclude the individual from

maintaining full-time work. (AR 673-74). 

C . ALJ’s Conclusion

On June 21, 2005, the ALJ denied Plaintiff’s claim for disability insurance benefits,

following the requisite five-step sequential evaluation for determining whether an applicant

is disabled under the Social Security Act. See 20 CFR §§ 404.1520 and 416.920. (AR 16-

22). At step one, the ALJ found that the Plaintiff had not engaged in substantial gainful

activity since May 11, 2001. (AR 17). At step two, the ALJ stated that the objective medical

evidence of the record indicated that Plaintiff had a “back disorder, left carpal tunnel

syndrome, stable with recent surgery, hypertension, stable, a history of substance abuse

disorder, reportedly in remission, and an affective disorder resulting in mild restriction of his

activities of daily living, moderate difficulties maintaining social functioning, mild

difficulties maintaining concentration, persistence, and pace, and one or two episodes of

decompensation, each of an extended duration, as a result of his mental impairment.” (Id.).

The ALJ concluded that these impairments were severe; however, at step three, the ALJ

found that these impairments did not meet or equal, either singularly or in combination, the

criteria of any listed impairment pursuant to Appendix 1 of the Regulations, 20 CFR, Part

404, Subpart P, Appendix 1. (Id). 

At step four, the ALJ, considering “all symptoms, including pain, and the extent to

which these symptoms can reasonably be accepted as consistent with the objective medical

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evidence,” concluded that Plaintiff retained the residual functional capacity "for a wide range

of light work activity. He can lift and carry ten pounds frequently and twenty pounds

occasionally, sit, stand and walk for six hours a day each, use the left upper extremity

frequently for handling and constantly use the right upper extremity in that regard,

occasionally bend, crouch, crawl, and kneel, and occasionally climb ramps and stairs. He

cannot climb ladders, ropes, or scaffolds, and he must avoid cold temperatures, vibration, and

hazardous heights and moving machinery. He must also avoid confrontational roles.” (AR

18). 

In making this determination, the ALJ gave “great weight” to the assessment of

Plaintiff’s treating physician, Dr. Mahon, that Plaintiff had the following limitations:

“maximum lifting of 20 pounds intermittently, avoiding bending, stooping, or squatting, rest

periods of 10 minutes every two hours, and maximum work day of eight hours with four

hours interrupted by one hour.” (AR 20). The ALJ stated that “[t]hat opinion was given

probative weight in this decision based on Dr. Mahon’s treating relationship with [Plaintiff],

his respective medical specialty, and his consistency with the greater objective record.” (Id.).

The ALJ also gave probative weight the opinions of the State agency’s reviewing physicians

because of their “consistency with the greater objective record.” (Id.). However, the ALJ

rejected the checklist assessment of Plaintiff’s treating physician, Dr. Peterson, which

“opined that due to back pain, [Plaintiff] could sit, stand and walk for less than 1 hour each

in an 8-hour day . . ." and that Plaintiff was “limited by pain and fatigue to a moderately

severe degree,” because “it [was] inconsistent with the greater objective record, particularly

with respect to the opinion of Dr. Mahon” and appeared to be “motivated by a desire to help

get the claimant benefits.” (Id.). 

In addition, the ALJ rejected Plaintiff’s “allegations that he is severely limited

physically” by his pain because Plaintiff “lives independently in an apartment, drives, shops,

and prepares his own meals. He also does his laundry at his parents’ house. He said that

sometimes he goes to the thrift store every day with his aunt, and that he walks to the mall

for exercise. Although he prefers to say at home, [Plaintiff] makes himself get out and be

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active in order to help control his diabetes. He has a friend that he sees regularly.” (AR 19).

The ALJ concluded that Plaintiff’s subjective complaints were exaggerated and did not

warrant any additional limitations beyond those established in his previously determined

residual functional capacity evaluation. (AR 20-21). Thus, based on the ALJ’s findings

regarding Plaintiff’s residual functional capacity, and the testimony of the vocational expert,

the ALJ concluded that Plaintiff could perform his past relevant work as a receptionist or data

entry clerk. (AR 21). 

III. STANDARD OF REVIEW

The Court must affirm an ALJ’s findings of fact if they are supported by substantial

evidence and free from reversible legal error. See 42 U.S.C. 405(g); see also Marcia v.

Sullivan, 900 F.2d 172, 174 (9th Cir. 1990). Substantial evidence means "more than a mere

scintilla,” but less than a preponderance, i.e., "such relevant evidence as a reasonable mind

might accept as adequate to support a conclusion." See, e.g., Richardson v. Perales, 402 U.S.

389, 401 (1971); Sorenson v. Weinberger, 514 F.2d 1112, 1119, n. 10 (9th Cir. 1975); Clem

v. Sullivan, 894 F.2d 328, 330 (9th Cir. 1990).

In determining whether substantial evidence supports a decision, the record as a whole

must be considered, weighing both the evidence that supports and the evidence that detracts

from the ALJ’s conclusion. See Richardson, 402 U.S. at 401; see also Tylitzki v. Shalala,

999 F.2d 1411, 1413 (9th Cir. 1993). “It is for the ALJ, not the courts, to resolve ambiguities

and conflicts in the medical testimony and evidence.” Andrews v. Shalala, 53 F.3d 1035,

1039 (9th Cir. 1995) (citations and quotations omitted). The ALJ may draw inferences

logically flowing from the evidence, and “[w]here evidence is susceptible to more than one

rational interpretation, it is the ALJ’s conclusion which must be upheld.” Id. (citation

omitted). “If the evidence can support either affirming or reversing the ALJ's conclusion,

[the Court] may not substitute [its] judgment for that of the ALJ.” Robbins v. Social Sec.

Admin., 466 F.3d 880, 882 (9th Cir. 2006).

In order to qualify for disability insurance benefits, a plaintiff must establish that he

is unable to engage in substantial gainful activity due to a medically determinable physical

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or mental impairment that has lasted or can be expected to last for a continuous period of not

less than 12 months. See 42 U.S.C. § 1382c (a)(3)(A). A plaintiff must show that he has a

physical or mental impairment of such severity that he is not only unable to do her previous

work, but cannot, considering his age, education, and work experience, engage in any other

kind of substantial gainful work which exists in the national economy. Quang Van Han v.

Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). To determine whether an applicant is eligible

for disability benefits, the ALJ conducts the following five-step sequential analysis:

(1) determine whether the applicant is currently employed in substantial

gainful activity;

(2) determine whether the applicant has a medically severe impairment or

combination of impairments;

(3) determine whether the applicant’s impairment equals one of a number

of listed impairments that the Commissioner acknowledges as so severe

as to preclude the applicant from engaging in substantial gainful

activity;

(4) if the applicant’s impairment does not equal one of the listed

impairments, determine whether the applicant is capable of performing

his or her past relevant work;

(5) if not, determine whether the applicant is able to perform other work

that exists in substantial numbers in the national economy.

20 CFR §§ 404.1520, 416.920; see also Bowen v. Yuckert, 482 U.S. 137, 140-41 (1987). 

IV. DISCUSSION

Plaintiff contends that the ALJ (1) erred in rejecting the opinion of one of Plaintiff’s

treating physicians, Dr. Peterson; (2) erred in assessing Plaintiff’s credibility as to the

severity of his pain and symptoms; and (3) erred in posing an improper hypothetical to the

vocational expert.

A. The ALJ’s Consideration of Dr. Mahon’s Opinions and Rejection of Dr.

Peterson’s Checklist Assessment

Plaintiff argues that although the ALJ properly gave probative weight to the

November 2002 opinion of Dr. Mahon, one of Plaintiff’s treating physicians, the ALJ’s

residual functional capacity assessment was improper because it did not include the

limitations that Dr. Mahon mentioned, including an avoidance of bending, stooping, or

squatting, rest periods of ten minutes every two hours, and a one hour break after four hours

of work. (Dkt. #25, p.6). In addition, Plaintiff argues that the ALJ improperly rejected the

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October 2003 checklist assessment of Dr. Peterson, another one of Plaintiff’s treating

physicians, that Plaintiff could not perform more than three hours of work in an total eight

hour workday because the ALJ failed to provide the requisite clear and convincing or even

specific and legitimate reasons for rejecting Dr. Peterson’s opinion. Defendant, on the other

hand, contends that the ALJ adequately considered the evidence in the record as a whole and

properly gave probative weight to the opinion of Dr. Mahon while rejecting the controverted

findings of Dr. Peterson.

There are three types of physicians: treating physicians, physicians who examine but

do not treat the claimant ("examining physicians") and those who neither examine nor treat

the claimant ("nonexamining physicians"). Lester v. Chater, 81 F.3d 821, 830 (9th Cir.

1996). “If a treating physician's medical opinion is supported by medically acceptable

diagnostic techniques and is not inconsistent with other substantial evidence in the record,

the treating physician's opinion is given controlling weight.” Holohan v. Massanari, 246

F.3d 1195, 1202 (9th Cir. 2000) (citations omitted). However, a consultative examiner’s

opinion may constitute substantial evidence. See Tonapetyan v. Halter, 242 F.3d 1144, 1149

(9th Cir. 2001).

The ALJ may disregard a treating physician's opinion when his or her opinion is not

supported by the medical record or there is conflicting medical evidence. See, e.g., Flaten

v. Sec'y of Health & Human Servs., 44 F.3d 1453, 1463-1464 (9th Cir. 1995); Magallenes

v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989) (“A lack of supporting clinical findings is a

valid reason for rejecting a treating physician's opinion.”). The ALJ may also disregard a

treating physician's opinion if it is brief and conclusory with little clinical findings to support

its conclusion. See Young v. Heckler, 803 F.2d 963, 968 (9th Cir. 1986). “A check-box

form that does not contain an explanation of the bases for the conclusions made is entitled

to little weight.” Boller v. Astrue, 2008 WL 268970, at *8 (E.D.Cal. 2008) (citing Crane v.

Shalala, 76 F.3d 251, 253 (9th Cir. 1996)). However, “vague, broad, or generalized reasons

are insufficient grounds for the ALJ to reject a treating physician's opinion.” Id. (citing

McAllister v. Sullivan, 888 F.2d 599, 602 (9th Cir. 1989)). If the ALJ is presented with

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conflicting medical opinions, the ALJ must determine credibility and resolve the conflict.

Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992). However, in rejecting a

contradictory treating physician’s opinion, the ALJ must provide "specific and legitimate

reasons" supported by substantial evidence in the record. Id. (quoting Murray v. Heckler,

722 F.2d 499, 502 (9th Cir. 1983)). 

After reviewing the record, the Court finds that the ALJ appropriately credited Dr.

Mahon’s opinion and met his burden in rejecting Dr. Peterson’s October 2003 checklist

assessment that Plaintiff could only sit, lift, stand, carry, and walk for less than one hour each

in an eight-hour workday. First, the ALJ provided specific and legitimate reasons grounded

in the record in rejecting Dr. Peterson’s controverted findings. Most notably, the ALJ

determined that Dr. Peterson’s checklist assessment was “exaggerated” and “inconsistent

with the greater objective record, particularly with respect to the opinion of Dr. Mahon,” and

appeared to be “motivated by a desire to help get the claimant benefits.” (AR 20). In

reviewing the record as a whole, and recognizing the ALJ’s duty to make credibility

determinations, the Court finds that the ALJ’s determination on this point is supported by

substantial evidence.

The findings of Plaintiff’s treating, examining, and nonexamining physicians,

including the findings of Dr. Peterson, are for the most part very similar, finding that Plaintiff

had degenerative disc disease with chronic lower back pain, neck pain, and difficulty in

controlling depression due to Plaintiff’s bipolar and anxiety disorders. Plaintiff’s treating

physician, Dr. Mahon, and the State’s two nonexamining physicians, found that Plaintiff’s

mental and physical impairments did not prevent him from performing basic work tasks as

long as they involved few socially stressful demands and Plaintiff was able to intermittently

rest during an eight-hour workday. It was only Dr. Peterson’s checklist assessment that

differed, finding that Plaintiff was limited to three hours of activity in an eight-hour workday.

Dr. Peterson’s checklist assessment of Plaintiff’s functional ability does not contain an

explanation for the bases of his conclusions, and is thus entitled to little weight in light of the

other physicians opinions and the record as whole. See, e.g., Boller, 2008 WL 268970, at

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Plaintiff cites the Court to the federally mandated minimum lunch period, as well as

the mandated minimum lunch periods in 17 states, which are generally between 30 and 45

minutes, as opposed to a full hour. (Dkt. #43, pp. 1-3). Plaintiff also notes that Arizona does

not have a mandated minimum lunch period. (Id.). However, the Court declines to infer

from that information that Plaintiff would not be afforded an hour lunch break, and thus

given Dr. Mahon's limitation, would not be able to perform his past relevant work to the

degree required under SSR 96-9p.

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*8. In addition, Dr. Peterson’s assessment that Plaintiff was moderately severely limited by

fatigue and pain states that it was based on Plaintiff’s MRI. However, Plaintiff’s MRI was

ordered and originally assessed by Dr. Mahon, and thus Dr. Peterson’s summary conclusion

concerning Plaintiff’s functional limitations on that basis provides sufficient support for the

ALJ to conclude that it does not constitute an independent finding. As such, the Court finds

that the ALJ did not act unreasonably in rejecting Dr. Peterson’s assessment.

Dr. Peterson's limitation of Plaintiff's functional abilities is contradicted by the

objective evidence in the record, including the opinions of Plaintiff’s other treating physician,

Dr. Mahon, and the examining physicians, as well as Plaintiff's stated daily activities. Thus,

the Court finds that the ALJ met his burden in providing specific and legitimate reasons that

are supported by the record in rejecting the significant limitations suggested by Plaintiff's

physician, Dr. Peterson.

In addition, Plaintiff contends that Dr. Mahon’s opinion that Plaintiff needed an hour

break after four hours of work and needed to rest for ten minutes after every two hours of

work does not support the ALJ’s conclusion that Plaintiff could perform his past relevant

sedentary work as a receptionist or date entry clerk because SSR 96-9p states that “[i]n order

to perform a full range of sedentary work, an individual must be able to remain in a seated

position for approximately 6 hours of an 8-hour workday, with a morning break, a lunch

period, and an afternoon break at approximately 2-hour intervals.” Plaintiff states that the

restriction of an hour break after four hours of work precludes Plaintiff from engaging in fulltime work because a normal lunch break does not total one hour.2

 However, there is no

indication that Plaintiff would not be afforded an hour lunch period. SSR 96-9p merely

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states that an individual must be able to sit for approximately 6 hours out of an 8-hour

workday. The ALJ appropriately found that Dr. Mahon’s opinion was consistent with SSR

96-9p and supported the conclusion that Plaintiff could perform his past relevant work

without specific limitations because the limitations specified by Dr. Mahon did not place

additional restrictions on Plaintiff’s past relevant work.

Also, in rejecting Dr. Peterson’s findings, the ALJ afforded weight to the opinion of

the State’s two non-examining physicians, Drs. Tangeman and Nathan, who found no such

significant limitations regarding Plaintiff’s ability to perform basic work tasks. (AR 20). See

Morgan v. Apfel, 169 F.3d 595, 602 (9th Cir.1999) (stating that "rejection of opinion of a

treating or examining physician [may] be based, in part, on the testimony of a nontreating,

nonexamining physician.") (emphasis original). The Court notes that the State’s examining

physicians opinions were primarily based on Plaintiff’s mental impairments, not Plaintiff’s

physical impairments. As such, to the extent that Plaintiff contends the ALJ ignored or

misstated the record with regards to the severity of Plaintiff’s mental impairments and their

impact on Plaintiff’s ability to perform his past relevant work (Dkt. #43, pp. 4-6), the Court

finds that the ALJ appropriately credited the opinions the State agency’s reviewing

physicians with respect to the effect of Plaintiff’s mental impairments. (AR 20). The Court

notes that there were no other specific opinions regarding Plaintiff’s mental impairments and

their effect on Plaintiff’s ability to perform his past relevant work; and although the record

clearly indicates that Plaintiff suffers from bipolar and anxiety disorders, the record indicates

that Plaintiff was predominantly assessed as “mildly” mentally ill, with an average GAF

score that generally ranged between 50 and 68. Further, Plaintiff’s most recent mental health

diagnoses in 2004 indicated that Plaintiff’s mental health appeared to be improving. (AR

464). As such, the Court finds that the record does not establish any basis to overturn the

ALJ’s reliance on the State agency’s reviewing physicians with regards to their analysis of

Plaintiff’s mental health impairments and their relation to Plaintiff’s residual functional

capacity.

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B. Rejection of Plaintiff’s Credibility

Plaintiff contends that the ALJ committed error in rejecting his testimony regarding

the severity of his symptoms, such as his pain level, and its impact on his functional abilities.

However, “[a]n ALJ is not required to believe every allegation of disabling pain or other

non-exertional impairment." Orn v. Astrue, 495 F.3d 625, 635 (9th Cir. 2007) (citation

omitted). Nonetheless, “if there is medical evidence establishing an objective basis for some

degree of pain and related symptoms, and no evidence affirmatively suggesting that the

claimant was malingering, the [ALJ]’s reason for rejecting the [plaintiff’s] testimony must

be clear and convincing and supported by specific findings." Dodrill v. Shalala, 12 F.3d 915,

918 (9th Cir. 1993). General findings are insufficient, rather the ALJ must identify what

evidence is not credible and what evidence undermines the claimant's complaints. Id. In the

instant case, there is no issue with the underlying impairments or the lack of evidence of

Plaintiff’s symptoms or pain, rather the issue centers on whether the ALJ provided the

requisite reasons supported by the evidence to reject Plaintiff's credibility regarding the

severity of his symptoms.

In reviewing the record on this point, the Court finds that the ALJ properly considered

relevant factors in reaching his credibility determination. See Magallenes, 881 F.2d at 750

(stating that "the ALJ is responsible for determining credibility and resolving conflicts in

medical testimony."). For instance, the ALJ cited multiple relevant factors recognized by the

Ninth Circuit in discounting Plaintiff’s testimony as to the severity of his symptoms. See

Bunnell v. Sullivan, 947 F.2d 341, 346-47 (9th Cir. 1991) (noting that relevant factors

include the nature, duration, location, onset, and intensity of pain, functional restrictions and

claimant's daily activities); see also SSR 96-7. The ALJ stated that despite Plaintiff’s

allegations that he could sit and stand for no more than 45 minutes, and could walk for not

more than 30 minutes, the objective medical record indicated otherwise. (AR 19). As noted

above in discussing the opinions of Plaintiff’s physicians, such limitations are simply not

supported by the medical record. In addition, the ALJ cited Plaintiff’s testimony that he lives

independently, drives, shops, and prepares his own meals, does his own laundry at his

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parents’ house, sometimes goes to the thrift store every day with his aunt, and regularly

walks to the mall for exercise. (Id.); see Bunnell v. Sullivan, 947 F.2d 341, 346-47 (9th Cir.

1991) (stating that the ALJ was entitled to contrast Plaintiff's daily activities with her

testimony). While Plaintiff clearly disagrees with the ALJ’s determination, the Court’s

review is limited to whether the ALJ provided the requisite reasons to support his adverse

credibility determination. As such, in reviewing the cited bases for the ALJ’s determination,

the Court finds that the ALJ's credibility analysis was supported by substantial evidence and

free of legal error.

C. The ALJ’s Hypothetical to the Vocational Expert

Plaintiff contends that the hypothetical posed to the vocational expert was improper

in light of the ALJ’s reliance on Dr. Mahon’s opinion that Plaintiff could only work an eighthour day if he had an hour break after four hours of work and ten minute breaks every two

hours. (Dkt. #43, p.8); see Tackett v. Apfel, 180 F.3d 1094, 1101 (9th Cir. 1999) (stating that

the ALJ's depiction of limitations in a posed hypothetical to a vocational expert are required

to be accurate, detailed and supported by medical evidence). Specifically, Plaintiff objects

to the ALJ’s use of a hypothetical individual that “could only sit, stand and/or walk six hours

out of an eight hour day.” (AR 668). 

The Court initially notes, as stated above, that it is not error for the ALJ to rely on a

non-examining physician when his or her findings are supported by independent medical

evidence in the record. In this case, the ALJ relied on the opinions of the State agency’s

reviewing physicians, as well as Dr. Mahon’s opinion and assessed limitations. (AR 20).

The Court finds that the ALJ’s hypothetical appropriately depicted the limitations imposed

by Dr. Mahon and the objective evidence in the record. Dr. Mahon’s statement that Plaintiff

needed an hour break after four hours of work, and that Plaintiff needed ten minute breaks

after every two hours of work, does not run contrary to the hypothetical of an individual who

“could only sit, stand and/or walk six hours out of an eight hour day.” Indeed, Dr. Mahon’s

limitations are consistent with this statement and the other specific limitations referenced by

the hypothetical that the ALJ posed to the vocational expert. Despite Plaintiff’s apparent

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contention, the ALJ did not need to recite Dr. Mahon’s specific words in the hypothetical;

the ALJ appropriately incorporated the limitations on Plaintiff’s functional abilities as

indicated by Dr. Mahon’s opinion and the record as whole. As such, the Court finds no error

based on the hypothetical posed to the vocational expert.

V. SUMMARY

The Court finds that the ALJ did not improperly resolve the conflicts in the medical

testimony and evidence by rejecting Dr. Peterson’s checklist assessment and Plaintiff’s

testimony regarding the severity of his symptoms. The ALJ made the necessary credibility

determinations and provided specific and legitimate reasons that appear to be supported by

substantial evidence in the record. In addition, the Court finds that the hypothetical posed

to the vocational expert was consistent with Dr. Mahon’s opinion. The ALJ properly relied

on the findings of Plaintiff’s treating physician, Dr. Mahon, the State’s reviewing physicians,

and the testimony of the vocational expert, to find that although Plaintiff’s impairments were

severe, Plaintiff’s residual functional capacity did not prevent him from performing his past

relevant work. Thus, based on a review of all the facts and the record presented, the Court

finds that there is substantial evidence to support the ALJ’s decision.

Accordingly,

IT IS HEREBY ORDERED that Plaintiff’s motion for summary judgment is

DENIED. (Dkt. #23).

IT IS FURTHER ORDERED that Defendant’s cross-motion for summary judgment

is GRANTED. (Dkt. #35). 

IT IS FURTHER ORDERED that the Clerk of the Court is directed to enter

judgment accordingly.

DATED this 31st day of March, 2008.

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