Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_11-cv-01634/USCOURTS-caed-2_11-cv-01634-4/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 EASTERN DISTRICT OF CALIFORNIA

JOHN OLIVERI,

Plaintiff, No. 2:11-1634 CKD

vs.

MICHAEL J. ASTRUE, ORDER

Commissioner of Social Security,

Defendant. 

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Plaintiff seeks judicial review of a final decision of the Commissioner of Social

Security (“Commissioner”) denying his application for Disability Income Benefits (“DIB”) under

Title II of the Social Security Act (“Act”). For the reasons discussed below, the court will grant

plaintiff’s motion for summary judgment, deny the Commissioner’s cross-motion for summary

judgment, and remand the case under sentence four of 42 U.S.C. § 405(g) for further

proceedings.

BACKGROUND

Plaintiff, born May 16, 1970, applied for disability income benefits, alleging

disability beginning April 1, 2004. Administrative Transcript (“AT”) 121-124. Plaintiff alleged

he was unable to work due to post traumatic stress disorder (“PTSD”), injuries to the right leg

and foot, and bilateral carpal tunnel syndrome. AT 115, 803. Upon remand from the Appeals

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Council, in a decision dated August 5, 2009, ALJ William C. Thompson, Jr., determined that

plaintiff was not disabled. AT 826-836. The ALJ made the following findings (citations to 20 1

C.F.R. omitted):

1. The claimant meets the insured status requirements of the

Social Security Act through December 31, 2009.

2. The claimant has not engaged in substantial gainful activity

since April 1, 2004, the alleged onset date.

3. The claimant has the following severe impairments: 

continued difficulties following injuries sustained in any

missile attack including an injury to his left leg and

shrapnel wounds; obesity; depression; and posttraumatic

stress disorder.

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 Disability Insurance Benefits are paid to disabled persons who have contributed to the 1

Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income is paid to

disabled persons with low income. 42 U.S.C. § 1382 et seq. Both provisions define disability, in

part, as an “inability to engage in any substantial gainful activity” due to “a medically

determinable physical or mental impairment. . . .” 42 U.S.C. §§ 423(d)(1)(a) & 1382c(a)(3)(A). 

A parallel five-step sequential evaluation governs eligibility for benefits under both programs. 

See 20 C.F.R. §§ 404.1520, 404.1571-76, 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S.

137, 140-142, 107 S. Ct. 2287 (1987). The following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful

activity? If so, the claimant is found not disabled. If not, proceed

to step two. 

Step two: Does the claimant have a “severe” impairment?

If so, proceed to step three. If not, then a finding of not disabled is

appropriate. 

Step three: Does the claimant’s impairment or combination

of impairments meet or equal an impairment listed in 20 C.F.R., Pt.

404, Subpt. P, App.1? If so, the claimant is automatically

determined disabled. If not, proceed to step four. 

Step four: Is the claimant capable of performing his past

work? If so, the claimant is not disabled. If not, proceed to step

five. 

Step five: Does the claimant have the residual functional

capacity to perform any other work? If so, the claimant is not

disabled. If not, the claimant is disabled. 

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 

The claimant bears the burden of proof in the first four steps of the sequential evaluation

process. Bowen, 482 U.S. at 146 n.5, 107 S. Ct. at 2294 n.5. The Commissioner bears the

burden if the sequential evaluation process proceeds to step five. Id.

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4. The claimant does not have an impairment or combination

of impairments that meets or medically equals one of the

listed impairments in 20 CFR Part 404, Subpart P, Appendix 1.

5. After careful consideration of the entire record, I find that

the claimant has the residual functional capacity to perform

a limited range of sedentary work as defined [in the

regulations]. The claimant can lift 10 pounds both

occasionally and frequently. He can stand and walk in

combination for no more than two hours in a day and can

sit for six hours in a day. He can only occasionally operate

left foot controls. The claimant is mentally limited to

simple instructions and relatively restricted contact with the

public.

6. The claimant is unable to perform any past relevant work.

7. The claimant was born on May 16, 1970 and was 33 years

old, which is defined as a younger individual age 18-49, on

the alleged disability onset date.

8. The claimant has at least a high-school education and is

able to communicate in English.

9. Transferability of job skills is not material to the

determination of disability because using the MedicalVocational Rules as a framework supports a finding that the

claimant is “not disabled” whether or not the claimant has

transferable job skills.

10. Considering the claimant’s age, education, work

experience, and residual functional capacity, there are jobs

that exist in significant numbers in the national economy

that the claimant can perform.

11. The claimant has not been under a disability, as defined in

the Social Security Act, from April 1, 2004 through the date

of this decision.

AT 828-836. 

ISSUES PRESENTED

Plaintiff argues that the ALJ committed the following errors in finding plaintiff

not disabled: (1) the ALJ improperly assessed the severity of plaintiff’s impairment due to carpal

tunnel syndrome and the impact of that impairment on plaintiff’s manipulative residual

functional capacity; (2) the ALJ improperly disregarded record medical opinions; and (3) the ALJ

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failed to give great weight to the Veterans Administration (“VA”) 100 percent disability rating

and failed to articulate adequate reasons for not crediting that disability rating. Plaintiff’s third

contention is dispositive and requires remand of this action.2

LEGAL STANDARDS

The court reviews the Commissioner’s decision to determine whether (1) it is

based on proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in

the record as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir.1999). 

Substantial evidence is more than a mere scintilla, but less than a preponderance. Connett v.

Barnhart, 340 F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence

as a reasonable mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d

625, 630 (9th Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The

ALJ is responsible for determining credibility, resolving conflicts in medical testimony, and

resolving ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations

omitted). “The court will uphold the ALJ’s conclusion when the evidence is susceptible to more

than one rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008).

The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th Cir.

1986), and both the evidence that supports and the evidence that detracts from the ALJ’s

conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may

not affirm the ALJ’s decision simply by isolating a specific quantum of supporting evidence. Id.;

 Because this matter will be remanded and a new decision will issue, the court will not 2

address in detail plaintiff’s remaining contentions. The court notes, however, that the ALJ’s

conclusion that plaintiff’s impairment due to carpal tunnel syndrome does not meet the

durational requirement is not supported by the record. On remand, the residual functional

capacity should specifically address any manipulative limitations attributable to this impairment,

whether or not such impairment is characterized as severe at step two of the sequential analysis. 

In addition, if the ALJ on remand rejects record medical opinions, the articulated reasons for

discounting any contradictory opinions must be specific and legitimate and supported by the

record. The ALJ must consider the entirety of a record medical opinion and may not simply

adopt, without explanation, certain portions which support the ALJ’s assessment of plaintiff’s

residual functional capacity. If the ALJ rejects certain record medical opinions as inconsistent,

the ALJ should identify the inconsistencies. 

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see also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports

the administrative findings, or if there is conflicting evidence supporting a finding of either

disability or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d

1226, 1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was

applied in weighing the evidence, see Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988).

ANALYSIS 

Plaintiff contends the ALJ improperly disregarded the 100 percent disability rating

of the Veterans Administration, made on February 9, 1999. In that decision, the VA re-evaluated

some of plaintiff’s impairments and the ratings previously assigned to those impairments for

disability purposes and also determined whether additional alleged impairments should be

considered service connected. As of May 13, 1998, the VA considered plaintiff disabled based

on the following assigned percentages:

1. migraine headaches, 50%;

2. PTSD with major depression and insomnia with resultant

fatigue, 50% (on evaluation, increased from 30% rated from 12/01/91);

3. tender scar, right medial thigh, 10%;

4. shrapnel wound right medial thigh with right knee disability,

30% (on evaluation, continued at same rate from 04/01/92);

5. residuals, fracture, left scapula with shrapnel wound scar,

retained foreign body, 10% (on evaluation, continued at same rate from

08/22/91);

6. shrapnel wound of left lateral foot with retained foreign body,

10% (on evaluation, continued at same rate from 08/22/91);

7. shrapnel wound of the right posterior lateral calf with retained

foreign body, 10 % (on evaluation, continued at same rate from 8/22/91);

8. laceration scar, plantar aspect of right foot with retain [sic]

foreign bodies, 10%. 

AT 735-744. In addition, plaintiff was previously rated as disabled, from August 22, 1991, based

on the following assigned percentages:3

1. chronic lumbosacral pain, 20 %;

2. tinnitus, s/p blast injury, 10 %;

3. chest injury with left pneumothorax, retained foreign 

bodies, 10%.

 These ratings were not re-evaluated in the February 9, 1999 review. 3

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 AT 642. The combined percentages of all of plaintiff’s ratings equal 220%. In a letter dated

June 30, 2005, the VA confirmed that plaintiff had an existing service-connected disability,

specifically itemizing plaintiff’s ratings attributable to depressive disorder, migraine, limitations

of flexion, knee, lumbosacral or cervical strain, tinnitus, and traumatic chest wall defect, with

combined percentages exceeding 100%. AT 734. 

The “ALJ must ordinarily give great weight to a VA determination of disability.” 

McCartey v. Massanari, 298 F.3d 1072, 1076 (9th Cir. 2002). As the McCartey court noted,

there is a “marked similarity” between the VA and Social Security disability programs. Id. 

“Both programs serve the same governmental purpose—providing benefits to those unable to

work because of a serious disability. Both programs evaluate a claimant’s ability to perform

full-time work in the national economy on a sustained and continuing basis; both focus on

analyzing a claimant’s functional limitations; and both require claimants to present extensive

medical documentation in support of their claims. Both programs have a detailed regulatory

scheme that promotes consistency in adjudication of claims. Both are administered by the

federal government, and they share a common incentive to weed out meritless claims. The VA

criteria for evaluating disability are very specific and translate easily into SSA’s disability

framework. Because the VA and SSA criteria for determining disability are not identical,

however, the ALJ may give less weight to a VA disability rating if he gives persuasive, specific,

valid reasons for doing so that are supported by the record.” Id.

In a decision dated April 27, 2007, ALJ Thompson found plaintiff was not

disabled. AT 91. Plaintiff sought review of that decision and the Appeals Council remanded the

matter to the ALJ for further proceedings. AT 24-26. Among other reasons for remanding the

matter, the Appeals Council specifically directed the ALJ to further evaluate the 100 percent

disability rating determined by the Veterans Administration and to indicate what weight was

accorded to that determination. AT 25.

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On remand, the ALJ purportedly considered the Veterans Administration rating

determination but it does not appear that the rating decision was even contained in the

administrative record considered by the ALJ. AT 9 (plaintiff’s July 16, 2010 request for review

of ALJ’s August 5, 2009 decision and attachments thereto made part of administrative record);

730-744 (plaintiff’s July 16, 2010 memorandum and rating decision submitted as attachment

“A”); cf. 27-33 (plaintiff’s request for review of ALJ’s prior April 21, 2007 decision references

VA determination but attachment not included in administrative record); see also AT 830 (only

reference in ALJ’s decision to VA determination cites one line from examining psychiatrist’s

report); AT 264 (examining psychiatrist reported “[t]he claimant apparently has a welldocumented posttraumatic stress disorder and is 100 percent service connected from the military

for having been injured in the Persian Gulf War with a missile explosion”). 

Despite the direction of the Appeals Council to the ALJ to indicate what weight

was accorded the VA determination of disability, the ALJ failed to do so. AT 830-831. In

discussing the determination, the ALJ began by simply repeating the exact same three sentences

that he had set forth in the prior decision, which noted that the VA decision was not binding on

the ALJ. AT 86; cf. AT 830-83. The ALJ then added an additional four sentences to the

paragraph, rejecting the VA’s rating decision on the basis that there was no evidence of

psychiatric hospitalizations or emergency room treatment for mental illness since the alleged

onset date of April 1, 2004 and that there was no evidence that plaintiff has been prescribed

strong, narcotic pain relievers. The articulated reasons for according no weight to the VA ratings

are not persuasive, specific or valid. See McCartey v. Massanari, 298 F.3d at 1076. 

Assuming arguendo that the ALJ’s comments on psychiatric hospitalizations was 4

 There is no requirement that plaintiff be hospitalized or seek emergency room treatment 4

in order to have functional limitations attributable to PTSD, particularly here where the 50%

rating for PTSD was increased from 30% to 50% and was based, in part, on associated fatigue. 

The lack of extreme psychiatric treatment is not a valid reason for discounting the VA’s PTSD

rating.

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directed to the VA’s 50% disability rating attributable to PTSD, there remain eleven other ratings

not discussed by the ALJ, which in combination exceed 100%. For instance, plaintiff had a 50%

rating due to migraine headaches. At the hearing, plaintiff testified about the continued

debilitating effect of his migraine headaches. AT 806-807. There is no discussion anywhere in

the ALJ’s decision of plaintiff’s tinnitus or pneumothorax, both of which were rated by the VA at

10%. Plaintiff also testified that he did not take psychotropic medications as recommended by

his psychiatrist because he had previously tried to commit suicide while so medicated. AT 818. 

He also testified that he had previously taken opiates for his pain but that he tried to reduce their

usage. AT 817-818. Even if the ALJ had properly discredited plaintiff’s explanations as to why

he did not take psychotropic medications or narcotic pain relievers, the ALJ’s failure to set forth 5

sufficient reasons for discounting the other bases for the VA’s disability determination requires

remand of this action. See Berry v. Astrue, 622 F.3d 1228, 1236 (9th Cir. 2010).

CONCLUSION

For the foregoing reasons, this matter will be remanded under sentence four of 42 6

U.S.C. § 405(g) for further findings addressing the deficiencies noted above. 

Accordingly, IT IS HEREBY ORDERED that:

1. Plaintiff’s motion for summary judgment or remand (Dkt. No. 20) is granted.

\\\\\

 The ALJ incorrectly stated that the plaintiff had not been prescribed any pain 5

medication in the last five years. AT 833. Plaintiff testified that he took Piroxicam for pain and

muscle relaxers two or three times a day. AT 810.

 Internal policy of the Social Security Administration provides that on remand from the 6

Appeals Council, including remands generated by the court, the proceedings are held before the

previously assigned ALJ, unless the case previously was assigned to that ALJ on a prior remand

and the ALJ’s decision after remand is the subject of the new remand or the Appeals Council or

court expressly directs the case be assigned to a different ALJ. HALLEX I-2-155(D)(11). The

court recognizes that this provision is a purely internal procedural guidance and is not binding. 

See Moore v. Apfel, 216 F.3d 864 (9th Cir. 2000). However, as this matter was previously

remanded by the Appeals Council and ALJ Thompson has now presided over two hearings on

this disability application, the court deems it appropriate to have another ALJ assigned to this

matter. 

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2. The Commissioner’s cross-motion for summary judgment (Dkt. No. 23) is

denied.

3. This matter is remanded for further proceedings consistent with this order. On

remand, another ALJ shall be assigned.

4. The Clerk of Court enter judgment in favor of plaintiff.

Dated: October 30, 2012

_____________________________________

CAROLYN K. DELANEY

UNITED STATES MAGISTRATE JUDGE

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oliveri1643.ss.rem

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