Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-02096/USCOURTS-azd-2_12-cv-02096-0/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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IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Kim Houston, 

Plaintiff, 

v. 

Carolyn W. Colvin, Commissioner of 

Social Security, 

Defendant. 

No. CV-12-02096-PHX-BSB

ORDER 

 Kim Houston (Plaintiff) seeks judicial review of the final decision of the 

Commissioner of Social Security (the Commissioner), denying his application for 

disability insurance benefits and supplemental security income benefits under the Social 

Security Act. The parties have consented to proceed before a United States Magistrate 

Judge pursuant to 28 U.S.C. § 636(b) and have filed briefs in accordance with Local Rule 

of Civil Procedure 16.1. For the following reasons, the Court affirms the 

Commissioner’s decision. 

I. Procedural Background 

 In June 2009, Plaintiff applied for disability insurance benefits, 42 U.S.C. § 401-

34, and supplemental security income, 42 U.S.C. § 1381-83c, under Titles II and XVI of 

the Social Security Act (the Act). (Tr. 129-39.)1

 Plaintiff alleged that he had been 

disabled since June 2009, due to lower back pain, diabetes, and a heart attack. (Tr. 144.) 

 

1

 Citations to “Tr.” are to the certified administrative transcript of record located at docket 12. 

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After the Social Security Administration (SSA) denied Plaintiff’s initial application and 

his request for reconsideration, he requested a hearing before an administrative law judge 

(ALJ). (Tr. 63-74, 90-91.) After conducting a hearing, the ALJ issued a decision finding 

Plaintiff not disabled under the Act. (Tr. 15-25.) This decision became the final decision 

of the Commissioner when the Social Security Administration Appeals Council denied 

Plaintiff’s request for review. (Tr. 1-3); see 20 C.F.R. § 404.981 (explaining the effect of 

a disposition by the Appeals Council.) Plaintiff now seeks judicial review of this 

decision pursuant to 42 U.S.C. § 405(g). 

II. Medical Record 

 The record before the Court establishes the following history of diagnosis and 

treatment. 

A. Enrique Cifuentes, M.D.

 Plaintiff received regular treatment from Dr. Cifuentes at Gila Internal Medicine 

Office (Gila) from January 2009 through 2011. (Tr. 220-38, 287-293, 308-23.) Although 

the signatures on most of the treatment notes are illegible, the parties do not dispute that 

Dr. Cifuentes provided the treatment described in the Gila records. The record reflects 

that Dr. Cifuentes treated Plaintiff for various complaints, including hypertension, lower 

back pain, and diabetes. (Tr. 221-38, 308-21.) Plaintiff was prescribed various 

medications including Oxycodone (Tr. 227, 228, 232, 234), Flexeril (Tr. 230), and 

Percocet. (Tr. 224, 226, 271, 375, 377, 387, 394, 430.) Examinations generally showed 

that Plaintiff had normal reflexes, normal gait, and no edema, but that he also had some 

numbness and parethesias. (Tr. 221-38, 308-21.) Dr. Cifuentes consistently 

recommended “diet” and “exercise.” (Tr. 222, 224, 232, 234, 236, 309, 311, 313.) 

 In January 2010, Dr. Cifuentes completed a physical capacities assessment and a 

residual functional capacity (RFC) assessment. (Tr. 277-79, 280-81.) He opined that 

Plaintiff could not perform even sedentary work. (Tr. 277-79.) Dr. Cifuentes opined that 

Plaintiff could lift less than ten pounds, could stand or walk less than two hours in an 

eight-hour workday, and could sit two hours in an eight-hour workday. (Tr. 277.) He 

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also opined that Plaintiff could never climb, stoop, kneel, or crouch, and could only 

occasionally reach. (Tr. 279.) 

 Dr. Cifuentes explained that these limitations were a result of “lumbalgia [low 

back pain], lumbosacral neuritis, lumbosacral spondylosis, [and] annular bulges [at] L4-5 

and L5-S1.” (Tr. 277.) Dr. Cifuentes found that Plaintiff suffered from “chronic back 

pain [with] radiculopathy, arthralgias, decreased range of motion, [and] vertigal dizziness 

due to medications.” (Tr. 279.) In addition, Dr. Cifuentes assessed severe pain, defined 

as “[e]xtremely impaired due to pain which precludes ability to function” (Tr. 280), that 

frequently interfered with attention and concentration, and lead to the failure to complete 

tasks in a timely manner. (Tr. 281.) 

 In January 2011, Dr. Cifuentes completed another physical capacities assessment 

and RFC assessment. (Tr. 372-74, 370-71.) Dr. Cifuntes indicated that Plaintiff had 

severe pain. (Tr. 370.) He found that Plaintiff could occasionally carry ten pounds, 

frequently carry less than ten pounds, stand less than two hours in an eight-hour workday, 

and sit for six hours in an eight-hour work day. (Tr. 372.) He further found that Plaintiff 

could never climb, balance, stoop, kneel, crouch, or crawl. (Tr. 373.) He opined that 

Plaintiff could not perform fine manipulation or “feel,” but could occasionally handle and 

reach. (Tr. 373.) 

B. Minesh Zaveri, M.D. 

 On referral from Dr. Cifuentes, Dr. Zaveri treated Plaintiff at Sonoran Pain 

Management. (Tr. 224, 253-73, 375-437.) Examinations documented that Plaintiff had 

some positive straight leg raising tests, tenderness in the lumbar spine, antalgic gait, and 

normal strength, reflexes, and senses. (Tr. 257, 263, 270, 329, 376, 386, 393, 409, 417, 

423, 434.) Plaintiff had several epidural steroid injections beginning in October 2009. 

(Tr. 254-72, 375-436.) He also had lumbar facet injections (Tr. 272), lumbar medical 

nerve branch blocks (Tr. 436, 431), and lumbar nerve radiofrequency ablation. (Tr. 381, 

419, 425, 438.) He initially reported some resolution of his low back pain. (Tr. 256, 

262.) Plaintiff subsequently reported more significant resolution of his pain. (Tr. 375, 

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385, 416, 422, 428, 433.) Later examinations reflected that Plaintiff no longer had 

positive straight leg raising tests. (Tr. 376, 378, 386, 393, 400, 409.) On Dr. Zaveri’s 

recommendation, Plaintiff attended physical therapy from January through March 2010. 

(Tr. 324-63.) At discharge, Plaintiff’s therapist opined that his progress had “plateaued” 

and that his prognosis was fair. (Tr. 324.) 

C. Elizabeth Ottney, D.O. 

 In September 2009, the state agency referred Plaintiff to Dr. Ottney for a 

consultative examination. (Tr. 214-16.) Although Dr. Ottney ordered an x-ray as part of 

the consultative examination, she conducted the examination without the films because 

they were not available on the date of Plaintiff’s appointment. (Tr. 215 (noting that the 

lumbosacral spine films [are] unavailable for my review today”).) 

 During that examination, Plaintiff reported that he had low back pain that had 

started one year earlier with no precipitating injury. (Tr. 214.) Plaintiff stated that an 

MRI showed that he had two bulging disk in his back. (Id.) Plaintiff reported that his 

back pain was “better” with medication. (Id.) During the examination, Plaintiff reported 

fatigue, dizziness, shortness of breath, and a racing heart. (Tr. 215.) On examination, 

Dr. Ottney found that Plaintiff had no edema, normal strength in his upper and lower 

extremities, normal balance, normal coordination, the ability to walk without a cane, and 

normal straight leg raising tests. (Tr. 215.) Plaintiff could heel and toe walk, tandem 

walk, and squat. (Id.) Plaintiff’s range of motion in his joints was normal except his 

lumbar flexion was limited to thirty degrees. (Id). Dr. Ottney opined that Plaintiff was 

not limited in his ability to “sit, hear, see, speak, finger, grasp or reach.” (Tr. 215.) She 

found that Plaintiff did not appear limited in his ability to stoop or crouch, but “may have 

difficulty with repetitively climbing ladders and scaffolding as well as crawling 

secondary to a small knee effusion.” (Tr. 216.) She also opined that Plaintiff could lift 

ten pounds frequently and twenty pounds occasionally. (Tr. 216.) 

/ / / 

/ / / 

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D. Christopher Maloney, M.D. 

 On November 4, 2009, Dr. Maloney, a state agency physician, completed a 

physical RFC assessment based on his review of the medical record. (Tr. 239-46.) 

Dr. Maloney found that Plaintiff could occasionally lift/carry twenty pounds and could 

frequently lift/carry ten pounds. (Tr. 240.) He also found that Plaintiff could stand/walk 

and sit for about six hours in an eight-hour workday. (Id.) He further found that Plaintiff 

could frequently balance, stoop, kneel, and crouch, and could occasionally climb 

ramps/stairs and crawl. (Tr. 241.) He found that Plaintiff had no “manipulative 

limitations.” (Tr. 242.) 

E. James Green, M.D 

 In March 2010, Dr. Green, a state agency physician, reviewed the medical record, 

including the opinions of Dr. Ottney and Dr. Cifuentes, and assessed Plaintiff’s physical 

RFC. (Tr. 294-301.) Dr. Green found that Dr. Cifuentes’s opinion that Plaintiff had a 

“less-than-sedentary” RFC and was nearly “bedridden” was not supported by the 

objective medical evidence or the functional data in the file and was not projected to last 

twelve months. (Tr. 300.) Dr. Green found that Plaintiff could occasionally lift/carry 

twenty pounds and could frequently lift/carry ten pounds. (Tr. 295.) He found that 

Plaintiff could stand/walk and sit six hours in an eight-hour workday. (Id.) He further 

found that Plaintiff could occasionally climb ramps and stairs, balance, stoop, kneel, 

crouch, and crawl. (Tr. 296.) He found that Plaintiff had no “manipulative limitations.” 

(Tr. 297.) In support of his findings, Dr. Green stated that, although Plaintiff complained 

of pain, he had “excellent progress” from local injections and was “projected to light 

work.” (Tr. 295.) He also noted that Plaintiff was able to drive, shop, and take his kids 

to school. (Tr. 299.) 

III. Administrative Hearing Testimony 

 Plaintiff was in his forties at the time of the administrative hearing. (Tr. 23, 37.) 

He had an eleventh grade education and a general equivalency diploma. (Tr. 39.) 

Plaintiff’s past relevant work included heavy truck driver. (Tr. 51, 145.) Plaintiff 

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testified at the administrative hearing that he was unable to work because of ongoing low 

back pain due to “three bulging discs.” (Tr. 42.) He stated that interventions such as 

injections and radiofrequency ablation helped relieved his pain for a few days, and “then 

it’s back to where it was.” (Tr. 44.) Plaintiff testified that during a typical eight-hour day 

he spent six hours lying in bed sleeping or watching television. (Tr. 44-45, 49.) Plaintiff 

testified that he could stand for one hour and sit for forty minutes. (Tr. 44.) He also 

testified that he experienced numbness and weakness in his hands. (Tr. 47.) 

 Vocational expert Nathan Dean, M.Ed. also testified at the administrative hearing. 

He classified Plaintiff’s past work as semi-skilled and skilled work performed at the 

medium exertional level. (Tr. 51.) The vocational expert responded to a hypothetical 

question from ALJ. The ALJ asked the vocational expert to assume: 

[S]o if we had someone ... able to do light exertional level work ... [a]nd the job would be unskilled. There’d be postural restrictions, so there’d be no crawling or crouching or climbing or squatting or kneeling. And lower extremity 

limitations, so there’d be no use of the legs or feet for pushing or pulling foot or leg controls.2

 (Tr. 51-52.) 

 The vocational expert responded that a person with those limitations could 

perform work as a small product assembler, photocopy machine operator, and packing 

line worker. (Tr. 52, 24.) The vocational expert further testified that a person with the 

limitations that Dr. Cifuentes assessed would be unable to sustain any work. (Tr. 53-54.) 

The vocational expert also testified that the limitations to which Plaintiff testified would 

preclude any sustained work. (Tr. 53.) 

IV. The ALJ’s Decision 

 A claimant is considered disabled under the Social Security Act if he is unable “to 

engage in any substantial gainful activity by reason of any medically determinable 

 

2

 Plaintiff asserts that the ALJ, Ronald C. Dickinson, has used “substantially similar hypothetical questions” in other cases when he has issued an unfavorable 

decision. (Doc. 17 at 14, Appendix.) Because the hypothetical reflected limitations that were supported by the record, see Section VI(D) infra, the similarity between the hypothetical in this case and those used in other cases does not impact the Court’s resolution of any issues in this case. 

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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); see also 42 U.S.C. § 1382c(a)(3)(A) (nearly identical standard for 

supplemental security income disability insurance benefits). To determine whether a 

claimant is disabled, the ALJ uses a five-step sequential evaluation process. See 20 

C.F.R. §§ 404.1520, 416.920. 

 In the first two steps, a claimant seeking disability benefits must initially 

demonstrate (1) that he is not presently engaged in a substantial gainful activity, and 

(2) that his disability is severe. 20 C.F.R. § 404.1520(a) (c). If a claimant meets steps 

one and two, he may be found disabled in two ways at steps three and four. At step three, 

he may prove that his impairment or combination of impairments meets or equals an 

impairment in the Listing of Impairments found in Appendix 1 to Subpart P of 20 C.F.R. 

pt. 404. 20 C.F.R. § 404.1520(a)(4)(iii). If so, the claimant is presumptively disabled. If 

not, the ALJ proceeds to step four. At step four, a claimant must prove that his RFC 

precludes him from performing his past work. 20 C.F.R. § 404.1520(a)(4)(iv). If the 

claimant establishes this prima facie case, the burden shifts to the government at step five 

to establish that the claimant can perform other jobs that exist in significant number in the 

national economy, considering the claimant’s RFC, age, work experience, and education. 

If the government does not meet this burden, then the claimant is considered disabled 

within the meaning of the Act. 

 Applying the five-step sequential evaluation process, the ALJ found that Plaintiff 

had not engaged in substantial gainful activity during the relevant period. (Tr. 17.) At 

step two, the ALJ found that Plaintiff had the following severe impairments, 

“degenerative disc disease of the lumbar spine, radiculopathy in the lower extremities 

bilaterally, neuritis, spondylosis, peripheral neuropathy in the upper extremities 

bilaterally, bilateral carpal tunnel syndrome, [and] diabetes mellitus type II.” (Id.) The 

ALJ also listed coronary artery disease and past heart attacks (before the disability onset 

date) among Plaintiff’s severe impairments. (Tr. 18.) At the third step, the ALJ found 

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that the severity of Plaintiff’s impairments did not meet or medically equal the criteria of 

an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Id.) At step four, 

the ALJ concluded that Plaintiff retained “the residual functional capacity to perform 

light, unskilled work with no crawling, climbing, squatting, kneeling, and no use of the 

lower extremities for pushing or pulling.” (Id.) 

 The ALJ concluded that Plaintiff could not perform his past relevant work 

(Tr. 23.) At step five, the ALJ found that considering Plaintiff’s age, education, work 

experience, and RFC, he could perform other “jobs that exist in significant numbers in 

the national economy.” (Id) The ALJ concluded that Plaintiff was not disabled within 

the meaning of the Act. (Tr. 24.) 

V. Standard of Review 

 The district court has the “power to enter, upon the pleadings and transcript of 

record, a judgment affirming, modifying, or reversing the decision of the Commissioner, 

with or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). The district 

court reviews the Commissioner’s final decision under the substantial evidence standard 

and must affirm the Commissioner’s decision if it is supported by substantial evidence 

and it is free from legal error. Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996); 

Ryan v. Comm’r of Soc. Sec. Admin., 528 F.3d 1194, 1198 (9th Cir. 2008). 

 Even if the ALJ erred, however, “[a] decision of the ALJ will not be reversed for 

errors that are harmless.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). 

Substantial evidence means more than a mere scintilla, but less than a preponderance; it 

is “such relevant evidence as a reasonable mind might accept as adequate to support a 

conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (citations omitted); see 

also Webb v Barnhart, 433 F.3d 683, 686 (9th Cir. 2005). In determining whether 

substantial evidence supports a decision, the court considers the record as a whole and 

“may not affirm simply by isolating a specific quantum of supporting evidence.” Orn v.

Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (internal quotation and citation omitted). 

 The ALJ is responsible for resolving conflicts in testimony, determining 

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

Cir. 1995). “When the evidence before the ALJ is subject to more than one rational 

interpretation, [the court] must defer to the ALJ’s conclusion.” Batson v. Comm’r of Soc. 

Sec. Admin., 359 F.3d 1190, 1198 (9th Cir. 2004) (citing Andrews, 53 F.3d at 1041). 

VI. Discussion of Plaintiff’s Claims 

 Plaintiff asserts that the ALJ erred by (1) rejecting the assessment of treating 

physician Enrique Cifuentes, M.D., (2) relying on the opinions of state agency examining 

physician Elizabeth Ottney, D.O. and the state agency reviewing physicians, 

(3) “determining [Plaintiff’s] work capacities without support by substantial evidence in 

the record,” and (4) rejecting Plaintiff’s symptom testimony without providing clear and 

convincing reasons for doing so. (Doc. 15 at 1-2.) Plaintiff asks the Court to remand his 

case for a determination of disability benefits. (Id.) In response, the Commissioner 

argues that the ALJ’s decision is free from legal error and is supported by substantial 

evidence in the record. (Doc. 18.) 

A. Weight Assigned to Medical Source Opinions

 In weighing medical source evidence, the Ninth Circuit distinguishes between 

three types of physicians: (1) treating physicians, who 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 is given to a treating physician’s opinion. Id. The ALJ 

must provide clear and convincing reasons supported by substantial evidence for 

rejecting a treating or an examining physician’s uncontradicted opinion. Id.; Reddick v.

Chater, 157 F.3d 715, 725 (9th Cir. 1998). An ALJ may reject the controverted opinion 

of a treating or an examining physician by providing specific and legitimate reasons that 

are supported by substantial evidence in the record. Bayliss v. Barnhart, 427 F.3d 1211, 

1216 (9th Cir. 2005); Reddick, 157 F.3d at 725. 

 Opinions from non-examining medical sources are entitled to less weight than 

treating or examining physicians. Lester, 81 F.3d at 831. Although an ALJ generally 

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gives more weight to an examining physician’s opinion than to a non-examining 

physician’s opinion, a non-examining physician’s opinion may nonetheless constitute 

substantial evidence if it is consistent with other independent evidence in the record. 

Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002). When evaluating medical 

opinion evidence, the ALJ may consider “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 v. Astrue, 495 F.3d 625, 631 (9th Cir. 2007). 

B. Weight Assigned Dr. Cifuentes’s Assessment 

 The ALJ assigned “no evidentiary weight” to Dr. Cifuentes’s January 27, 2010 

assessment and his determination that Plaintiff had a “less than a sedentary residual 

functional capacity.” (Tr. 21-22.) The ALJ explained that “Dr. Cifuentes’s own clinical 

records do not support his own conclusions or his assessment nor are his conclusions 

supported by any credible treating or examining physician.” (Tr. 21.) The ALJ also 

stated that Dr. Cifuentes’s “less-than-sedentary” assessment appeared to be “based on his 

adoption of [Plaintiff’s] subjective allegations.” (Tr. 22.) Plaintiff contends that these 

reasons for rejecting Dr. Cifuentes’s assessments are legally insufficient because they do 

not constitute either “clear and convincing” or “specific and legitimate” reasons for 

discounting the treating physician’s opinions. (Doc. 15 at 21.) 

 As an initial matter, as noted by the ALJ, the medical record contains the 

following evidence that contradicts Dr. Cifuentes’s assessment that Plaintiff had a less 

than sedentary RFC: (1) Dr. Ottney’s examination report finding Plaintiff unlimited in his 

ability to sit, hear, see, speak, finger, grasp, reach, stoop or crouch, and finding that 

Plaintiff could lift ten pounds frequently and twenty pounds occasionally (Tr. 214-217); 

(2) Dr. Zaveri’s treatment notes consistently report that Plaintiff had normal lumber 

flexion and extension (Tr. 257, 263, 269-70, 376, 386, 393, 416, 429), stable lower 

extremities with full strength and full range of motion (Tr. 257, 263, 27, 376, 386, 392, 

416, 429), and a stable gain and station (Tr. 257, 263, 376, 386, 392, 416, 429); 

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(3) neurologist Gregory Hunter performed and reviewed EMG and NCV 

electrodiagnostic tests to evaluate Plaintiff’s median and ulnar motor and sensory nerves 

and did not impose any limitations on Plaintiff’s RFC (Tr. 365-69); (4) state agency 

reviewing physician Maloney’s assessment that Plaintiff could carry ten pounds 

frequently and twenty pounds occasionally, could sit or stand for about six hours in an 

eight hour day, was not limited in his ability to push or pull, and could frequently 

balance, stoop, kneel and crouch (Tr. 239-246); and (5) state agency reviewing 

physician Green’s assessment that Plaintiff could occasionally carry twenty pounds and 

could frequently carry ten pounds, could sit or stand for about six hours in an eight-hour 

day, was unlimited in his ability to push or pull, and could occasionally climb 

ramp/stairs, balance, stoop, kneel, crouch, and crawl. Because the record contained 

conflicting evidence, the ALJ had to provide specific and legitimate reasons supported by 

substantial evidence in the record to discount Dr. Cifuentes’s assessments. See Bayliss, 

427 F.3d at 1216; Reddick, 157 F.3d at 725. 

 1. Boilerplate Rationale/ALJ Interpreted the Medical Record 

 Plaintiff argues that the ALJ’s first reason for rejecting Dr. Cifuentes’s assessment 

— that Dr. Cifuentes’s opinion was not supported by his clinical records — fails for lack 

of specificity because the ALJ did not describe what was lacking from the clinical records 

and thus, this reason is boilerplate rationale. (Doc. 15 at 21.) Plaintiff further argues that 

the ALJ improperly interpreted the medical evidence when he found that Dr. Cifuentes’s 

treatment notes did not support his assessments of Plaintiff. (Doc. 15 at 22.) 

 When there is a conflict between the opinions of a treating physician and an 

examining physician, or between the opinion of a treating physician and objective 

evidence in the record as a whole, the ALJ may disregard the opinion of the treating 

physician if he sets forth “‘specific and legitimate reasons supported by substantial 

evidence in the record for doing so.’” Tonapetyan v. Halter, 242 F.3d 1144, 1148 (9th 

Cir.2001) (quoting Lester v. Chater, 81 F.3d 821, 830 (9th Cir.1995)); see Batson v. 

Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004) (stating that an ALJ 

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“need not accept the opinion of any physician, including a treating physician, if that 

opinion is brief, conclusory, and inadequately supported by clinical findings”). Although 

the ALJ found that Dr. Cifuentes’s treatment notes did not support his conclusions or 

assessments, the ALJ did not identify which of Dr. Cifuentes’s clinical records were 

inconsistent with his assessments. (Tr. 21.) However, any error in the ALJ’s failure to 

identify such records was harmless because, as discussed below, the ALJ provided other 

legally sufficient reasons for rejecting Dr. Cifuentes’s assessments and specifically 

discussed the other record evidence that was inconsistent with Dr. Cifuente’s 

assessments. (Tr. 21-22.) 

 In rejecting Dr. Cifuentes’s January 27, 2010 assessment, the ALJ noted that it 

was inconsistent with the opinions of Dr. Ottney and the state agency reviewing 

physicians Maloney and Green. (Tr. 19-22.) The ALJ specifically discussed those 

opinions and identified the inconsistencies, which the Court discussed above in Section 

VI(B). (Tr. 19-22.) The ALJ also relied on Dr. Green’s finding that Dr. Cifuentes’s first 

assessment in January 2010 was inconsistent with the medical record and with 

Dr. Cifuentes’s treatment notes. (Tr. 22, 300.) Finally, the ALJ relied on the treatment 

notes of Dr. Zaveri who oversaw Plaintiff’s facet injections and epidural steroid 

injections. (Tr. 21.) Dr. Zaveri found that the Plaintiff made “excellent progress after the 

facet injections.” (Tr. 257.) 

 2. Medical Opinion Based on Subjective Complaints 

 Plaintiff further argues that the ALJ erred in discounting Dr. Cifuentes’s 

assessment because it appeared to be based mainly on Plaintiff’s subjective complaints. 

(Doc. 15 at 23, Tr. 22.) Because the ALJ properly discredited Plaintiff’s subjective 

complaints as discussed in Section VI(E)(2) below, the ALJ did not err in this regard. 

See Bray, 554 F.3d at 1228 (9th Cir. 2009) (ALJ properly discounts a physician’s opinion 

that is based solely upon claimant’s self-reporting if ALJ concludes that claimant’s selfreporting is not credible); see also Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002) 

(rejecting physician’s opinion in part because it was based on claimant’s subjective 

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complaints, not on new objective findings); Tonapetyan, 242 F.3d at 1149 (medical 

opinion premised on subjective complaints may be disregarded where record supports 

ALJ in discounting claimant’s credibility). 

 In summary, the ALJ did not err in discounting Dr. Cifuentes’s assessments of 

Plaintiff’s pain and RFC and, as discussed below, the ALJ’s determination is supported 

by substantial evidence in the record. See Richardson, 402 U.S. at 401 (substantial 

evidence is “such relevant evidence as a reasonable mind might accept as adequate to 

support a conclusion.”). 

C. ALJ’s Reliance on Examining and Reviewing Physicians’ Opinions 

 Plaintiff also argues that the ALJ erred in relying on the opinions of examining 

physician Ottney and reviewing state agency physicians Maloney and Green as 

substantial evidence in support of his RFC and disability determinations. (Doc. 15 at 25.) 

 The ALJ accorded significant weight to the opinions of Dr. Ottney and the state 

agency reviewing physicians. These opinions were consistent with the record evidence 

and constituted substantial evidence upon which the ALJ could rely. See Tonapetyan, 

242 F.3d at 1149 (examining physician’s “opinion alone constitutes substantial evidence, 

because it rests on his own independent examination of” the claimant.); Thomas, 278 at 

957 (“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.”). 

 Plaintiff specifically complains that the ALJ erred in relying on Dr. Ottney’s 

opinion because she did not review Plaintiff’s MRI or an x-ray of Plaintiff’s 

“lumbrosacral spine,” which was ordered but unavailable at the time of Plaintiff’s 

appointment. (Doc. 15 at 26.) The ALJ did not err in this regard. Dr. Ottney took a 

history from Plaintiff and examined him. Based on that history and examination, she 

found that Plaintiff had low back impairments. (Tr. 214-15.) Because Dr. Ottney 

apparently did not need the results of diagnostic tests to confirm Plaintiff’s low back 

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impairments, the ALJ did not err in relying on her opinion even though it did not include 

a discussion of diagnostic tests. 

 Plaintiff also asserts that Dr. Ottney failed to discuss Plaintiff’s background 

medical information or explain the “rated capacities.” (Doc. 15 at 26.) Contrary to 

Plaintiff’s assertion, Dr. Ottney’s report discusses the history of Plaintiff’s “present 

illness,” including low back pain and a history of Type II diabetes. (Tr. 214.) 

Dr. Ottney’s report also details Plaintiff’s past medical history and treatment. (Tr. 214-

15.) 

 Dr. Ottney’s notes regarding her physical examination of Plaintiff support her 

“rated capacities.” (Tr. 215.) She noted that Plaintiff’s muscle strength in both the upper 

and lower extremities and his grip was “5/5 bilaterally.” (Id.) She also found that his 

balance and coordination were normal, and that he was able to “move on and off the 

exam table with ease.” (Tr. 215.) Upon examination of Plaintiff’s back, Dr. Ottney 

found that Plaintiff had a normal straight leg test in the supine and sitting positions, and 

that his lower extremities revealed no signs of “crepitus, joint instability, atrophy, or 

deformity.” (Id.) She reported a small left knee effusion and found that it could cause 

Plaintiff “difficulty with repetitive climbing ladders and scaffolding as well as crawling.” 

(Tr. 215-16.) In addition, Dr. Ottney reported that Plaintiff could heel to toe and tandem 

walk, could squat without difficulty, could shift his weight to each individual foot, but 

did not perform a hop. (Tr. 15.) Finally, she reported that Plaintiff had normal range of 

motion in all of his major joints, except his lumbar flexion was limited to thirty degrees. 

(Id.) Thus, Dr. Ottney discussed Plaintiff’s history and provided sufficient explanation of 

her “rated capacities.” The ALJ did not err in relying on this report as substantial 

evidence in support of his RFC and disability determination. 

D. Determination of Plaintiff’s Work Capacities 

 Plaintiff also argues that the ALJ’s assessment of Plaintiff’s postural limitations 

included in his RFC is not supported by substantial evidence in the record. (Doc. 15 at 

25, 27.) Residual functional capacity is what a person “can still do despite [the 

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individual’s] limitations.” 20 C.F.R. §§ 404.1545(a), 416.945(a); see also Valencia v. 

Heckler, 751 F.2d 1082, 1085 (9th Cir.1985) (RFC reflects current “physical and mental 

capabilities”). 

 Plaintiff argues that the ALJ found that Plaintiff had more postural limitations than 

the record evidence indicates. The ALJ found that Plaintiff was precluded from crawling, 

crouching, climbing, squatting, kneeling and using his lower extremities for pushing and 

pulling. (Doc. 15 at 16 comparing ALJ’s functional assessments with those completed by 

Dr. Ottney and state agency reviewing physicians; Tr. 18.) In contrast, Dr. Ottney and 

the state agency reviewing physicians found that Plaintiff could occasionally or 

frequently crawl, crouch, climb ramps and stairs, and kneel and that he was unlimited in 

his ability to push or pull with his lower extremities. (Id.) 

 Although the ALJ’s assessment of Plaintiff’s postural limitations was more 

restrictive than those assessed by Dr. Ottney and the state agency reviewing physicians, 

with the exception of pushing and pulling on which Dr. Cifuentes gave no opinion, the 

ALJ found the same postural limitations that Dr. Cifuentes assessed in 2011. (Tr. 373 

(finding Plaintiff precluded from climbing, balancing, stooping, kneeling, crouching, and 

crawling).) Thus, with the exception of the ALJ’s finding that Plaintiff was precluded 

from pushing and pulling with his lower extremities, substantial evidence supports the 

ALJ’s assessment of Plaintiff’s postural limitations. 

 Even if the ALJ erred in assessing Plaintiff’s postural limitations by finding him 

more limited in his ability to push and pull with his lower extremities than the record 

indicated, any error is harmless because it was in Plaintiff’s favor. Moreover, had the 

ALJ adopted the less-restrictive postural limitations suggested by the examining and nonexamining physicians, the vocational expert likely would have found Plaintiff capable of 

performing at least the same jobs that he cited. (Tr. 52.) Thus, any error would not 

change the outcome in this case and remand is not warranted. 

 Plaintiff further argues that the ALJ erred in finding Plaintiff limited to “unskilled 

work,” even though the record did not include any evidence that would justify such a 

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limitation. (Doc. 15 at 28.) Again, any error in this regard was in Plaintiff’s favor and 

does not warrant remand. 

E. Credibility of Plaintiff’s Reported Pain and Symptoms 

 1. The Two-Step Analysis 

 An ALJ engages in a two-step analysis to determine whether a claimant’s 

testimony regarding subjective pain or symptoms is credible. Lingenfelter v. Astrue, 504 

F.3d 1028, 1035B36 (9th Cir. 2007). “First, the ALJ must determine whether the 

claimant has presented objective medical evidence of an underlying impairment ‘which 

could reasonably be expected to produce the pain or other symptoms alleged.’” Id. at 

1036 (quoting Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir. 1991) (en banc)). The 

claimant is not required to show objective medical evidence of the pain itself or of a 

causal relationship between the impairment and the symptom. Smolen, 80 F.3d at 1282. 

Instead, the claimant must only show that an objectively verifiable impairment “could 

reasonably be expected” to produce his pain. Lingenfelter, 504 F.3d at 1036 (quoting 

Smolen, 80 F.3d at 1282); see also Carmickle v. Comm’r of Soc. Sec., 533 F.3d at 1160-

61 (9th Cir. 2008) (“requiring that the medical impairment could reasonably be expected 

to produce pain or another symptom . . . requires only that the causal relationship be a 

reasonable inference, not a medically proven phenomenon”). 

 If a claimant shows that he suffers from an underlying medical impairment that 

could reasonably be expected to produce his pain or other symptoms, the ALJ must 

“evaluate the intensity and persistence of [the] symptoms” to determine how the 

symptoms, including pain, limit the claimant’s ability to work. See 20 

C.F.R. § 404.1529(c)(1). In making this evaluation, the ALJ may consider the objective 

medical evidence, the claimant’s daily activities, the location, duration, frequency, and 

intensity of the claimant’s pain or other symptoms, precipitating and aggravating factors, 

medication taken, and treatments for relief of pain or other symptoms. See 20 

C.F.R. § 404.1529(c); Bunnell, 947 F.2d at 346. 

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 At this second evaluative step, the ALJ may reject a claimant’s testimony 

regarding the severity of his symptoms only if the ALJ “makes a finding of malingering 

based on affirmative evidence,” Lingenfelter, 504 F.3d at 1036 (quoting Robbins v. Soc.

Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006)), or if the ALJ offers “clear and 

convincing reasons” for finding the claimant not credible. Carmickle, 533 F.3d at 1160 

(quoting Lingenfelter, 504 F.3d at 1036). Ordinary credibility factors, such as prior 

inconsistent statements concerning symptoms, other testimony that appears less than 

candid, the claimant’s reputation for lying, inadequately explained failure to follow a 

prescribed course of treatment, and the claimant’s daily activities, are reasons to find the 

testimony about the severity of the symptoms not credible, even when there is medical 

evidence establishing a basis for some degree of the symptomology. Smolen v. Chater, 

80 F.3d 1273, 1284 (9th Cir. 1996). 

 Relying on the Ninth Circuit decision in Bunnell, the Commissioner initially 

argues that an ALJ need not provide “clear and convincing” reasons for discrediting a 

claimant’s testimony regarding subjective symptoms, and instead must make findings 

that are “‘supported by the record’ and ‘sufficiently specific to allow a reviewing court to 

conclude the adjudicator rejected the claimant’s testimony on permissible grounds.’” 

(Doc. 18 at 9 (citing Bunnell, 947 F.2d at 345-46).) In Bunnell, the court did not apply 

the “clear and convincing” standard, and the Commissioner argues that because no 

subsequent en banc court has overturned Bunnell, its standard remains the law of the 

Ninth Circuit. (Doc. 18 at 8-9.) Although the Ninth Circuit has not overturned Bunnell, 

subsequent cases have elaborated on its holding and have accepted the clear and 

convincing standard. See Taylor v. Comm’r of Soc. Sec. Admin., 659 F.3d 1228, 1234 

(9th Cir. 2011); Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009); Lingenfelter, 504 

F.3d at 1036; Reddick, 157 F.3d at 722; Swenson v. Sullivan, 876 F.2d 683, 687 (9th Cir. 

1989). Accordingly, the Court will determine whether the ALJ provided clear and 

convincing reasons for discounting Plaintiff’s credibility. 

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 2. Plaintiff’s Pain and Symptom Testimony 

 At the beginning of his discussion of Plaintiff’s RFC, the ALJ rejected Plaintiff’s 

statement that he was “unable to work due to his impairments, limitations, and 

symptoms,” explaining that “the medical evidence does not support his allegation, which 

diminishes his credibility.” (Tr. 18.) The ALJ specifically rejected Plaintiff’s testimony 

that he “had to lay down for about 6 hours in an 8-hour workday,” “that he can stand 1 

hour in an 8-hour workday,” and that he “can sit 40 minutes” in an eight hour workday. 

(Tr. 18.) At the conclusion of the section of the ALJ’s decision discussing Plaintiff’s 

RFC, the ALJ stated that Plaintiff’s “medically determinable impairments could 

reasonably be expected to cause only some of the symptoms alleged,” and he further 

stated that Plaintiff’s “statements concerning the intensity, persistence and limiting 

effects of [his] symptoms are not credible to the extent that they are inconsistent with the 

residual functional capacity assessment determined by the undersigned.”3

 (Tr. 23.) 

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

symptom testimony. 

 a. Circular Reasoning 

 Plaintiff first argues that the ALJ’s conclusion that Plaintiff’s testimony was not 

credible to the extent that it was inconsistent with the ALJ’s RFC assessment is improper 

circular reasoning because the ALJ was supposed to take into account the limiting effects 

of Plaintiff’s symptoms in formulating his RFC, not determine Plaintiff’s RFC and then 

reject any symptom testimony that was not consistent with that RFC. See Leitheiser v. 

Astrue, 2012 WL 967647 at *9 (D. Or. Mar. 16, 2012) (“Dismissing a claimant’s 

credibility because it is inconsistent with a conclusion that must itself address the 

claimant’s credibility is circular reasoning and is not sustained by this court”); Hale v. 

Astrue, 2011WL 6965856, at *4 (D. Or. Nov. 30, 2011) (“Dismissing a claimant’s 

 

3

 Although these two statements appear in different parts of the ALJ’s discussion, both statements are part of the ALJ’s credibility determination. 

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credibility because it is inconsistent with a conclusion that must itself address the 

claimant’s credibility is improper circular reasoning”). 

 Although the statement at the conclusion of the ALJ’s RFC discussion contains 

what could be considered improper circular reasoning if that statement were considered 

in isolation, the record reflects that before the ALJ made that statement, he identified the 

portions of Plaintiff’s testimony that he deemed not credible. Cf Spiva v. Astrue, 628 

F.3d 346, 348 (7th Cir. 2010) (denouncing the way in which ALJ’s “routinely state (with 

some variations in wording) that . . . ‘the claimant’s statements concerning the intensity, 

persistence and limiting effects of these symptoms are not entirely credible,’ yet fail to 

indicate which statements are not credible and what exactly ‘not entirely’ is meant to 

signify[.]”) (citing Parker v. Astrue, 597 F.3d 920 (7th Cir. 2010)). Specifically, the ALJ 

rejected Plaintiff’s testimony that he needed to lay down six hours out of the day and that 

he had limited ability to stand and sit. In other words, the ALJ considered the limiting 

effects of Plaintiff’s symptoms before formulating Plaintiff’s RFC, and the ALJ identified 

Plaintiff’s statements that he discredited. The ALJ’s challenged statement appears to be a 

summary rather than an unsupported conclusion. Moreover, even if the ALJ erred in 

relying on circular reasoning to discredit Plaintiff’s credibility, any error was harmless 

because, as discussed below, he provided other clear and convincing reason for 

discrediting Plaintiff’s symptom testimony. 

 b. Other Grounds for Discrediting Plaintiff’s Testimony 

 The ALJ gave the following additional reasons for finding Plaintiff not entirely 

credible: (1) Plaintiff’s testimony about his need to lay down most of the day and his 

limited ability to sit and stand was inconsistent with Dr. Cifuentes’s 2011 assessment; 

(2) Plaintiff’s complaints were inconsistent with Dr. Ottney’s assessment; and 

(3) Plaintiff’s complaints were inconsistent with his reports of significant pain relief with 

epidural injections. (Tr. 18-19, 21-22.) 

 As part of the overall disability analysis, the ALJ must consider whether there are 

any inconsistencies in the evidence. See 20 C.F.R. § 404.1529(c)(4) (stating that an ALJ 

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must consider “whether there are any inconsistencies in the evidence.”) “Contradiction 

with the medical record is a sufficient basis for rejecting [a] claimant’s subjective 

testimony.” Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1161 (9th Cir. 

2008) (citation omitted) (finding that ALJ properly rejected claimant’s testimony that he 

could only lift ten pounds occasionally in favor of doctor’s contradictory opinion that he 

could lift up the ten pounds frequently). 

 Plaintiff testified that he had to lie down for six hours in an eight hour day, that he 

could stand for one hour in an eight-hour day, and that he could sit for forty minutes in an 

eight-hour day. This testimony was contradictory to the January 3, 2011 assessment of 

Plaintiff’s treating physician Dr. Cifuentes who found that Plaintiff could sit for “about 6 

hours in an 8 hour work day” and that he need to alternated sitting and standing every 

hour. (Tr. 372-73.) This testimony was also contradictory to Dr. Ottney’s findings that 

Plaintiff’s medical history would not limit his ability to sit. (Tr. 215.) Furthermore, this 

testimony was inconsistent with Plaintiff’s reports of significant pain relief with epidural 

injections. (Tr. 376, 386, 393, 400, 409.) 

 The ALJ properly considered inconsistencies between Plaintiff’s statements and 

the medical record when assessing his credibility. See Bray v. Comm’r Soc. Sec. Admin., 

554 F.3d 1219, 1227 (9th Cir. 2009) (upholding credibility determination where ALJ 

noted that claimant’s statements at the hearing were inconsistent with the objective 

evidence in the medical record). The ALJ gave clear and convincing reasons for 

rejecting Plaintiff’s symptom testimony that are supported by substantial evidence in the 

record. 

VII. Conclusion 

The ALJ did not commit legal error in discounting Plaintiff’s testimony regarding 

the severity of his symptoms, assigning weight to the opinions of Dr. Cifuentes 

Dr. Ottney, and the state agency examining physicians, or in assessing Plaintiff’s RFC. 

Additionally, the record contains substantial evidence in support of the ALJ’s 

determination that Plaintiff was not disabled. 

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Accordingly, 

IT IS ORDERED that the Commissioner’s decision denying Plaintiff benefits 

in this case is AFFIRMED. The Clerk of Court is directed to enter judgment in favor of 

the Commissioner and against Plaintiff and to terminate this action. 

 Dated this 4th day of December, 2013. 

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