Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_06-cv-04030/USCOURTS-cand-3_06-cv-04030-1/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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United States District Court

For the Northern District of California

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United States District Court

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

JOSE AGUIRRE, JR,

Plaintiff,

 v

MICHAEL J ASTRUE, Commissioner of

Social Security,

Defendant.

 /

No C 06-4030 VRW

 ORDER

Plaintiff Jose M Aguirre, Jr appeals from the

decision of the Social Security Administration (SSA) denying him

social security disability benefits. The court now considers

cross-motions for summary judgment. Doc #9-1; Doc #10. Because

the court concludes that the Administrative Law Judge (ALJ)

committed no legal error and his decision was supported by

substantial evidence, the court DENIES plaintiff’s motion for

summary judgment and GRANTS defendant Michael J Astrue’s motion for

summary judgment.

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I

A

Plaintiff was fifty-nine years old on April 16, 2003, the

date he alleges be became disabled. Administrative Record (AR),

Doc #6 at 70. Plaintiff is a college graduate. AR 99. Plaintiff

has past relevant work experience as a loss prevention agent and as

an accounting clerk. AR 94. Plaintiff reported that as a loss

prevention agent he used his technical skill and knowledge, counted

coins in counting machines, traveled to various locations to check

company employees and lifted weights as heavy as fifty pounds

occasionally and twenty-five pounds frequently. Id. As an

accounting clerk, plaintiff did payroll, light bookkeeping and

basic clerical work. AR 564. Plaintiff has not worked since April

16, 2003. AR 70. 

The administrative record contains many documents

pertaining to plaintiff’s respiratory-system concerns. In 1998,

plaintiff began consulting Dr Toby Levenson, MD, a board certified

allergy and immunology specialist. She noted that plaintiff then

had a long history of asthma and that his symptoms included

“wheezing, dyspnea on exertion, and cough.” AR 175. Dr Levenson

also reported that plaintiff had “a history of snoring, but no

history of apneic episodes or daytime somnolence.” Id. Dr

Levenson’s letter mentioned normal sinuses and recommended

medication for plaintiff’s asthma. AR 176.

On April 19, 1999 Dr Levenson noted that plaintiff’s

cough had completely resolved. AR 169. She also wrote that

plaintiff’s wife reported to her that plaintiff had had nighttime

apneic episodes for two years, during which interval he had gained

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about fifty pounds. Id. Dr Levenson also wrote that “he does have

daytime somnolence and snores at night.” Id. Dr Levenson

recommended that plaintiff obtain a sleep study to rule out sleep

apnea. Id.

On July 19, 1999, Dr Levenson reported that plaintiff’s

full pulmonary function tests revealed only mild obstructive

ventillary defect and that plaintiff was “doing well clinically.” 

AR 165. Dr Levenson stated that plaintiff was “awaiting a sleep

study to rule out sleep apnea as a contributing medical problem.” 

Id. On September 15, 1999 stated that plaintiff was “doing well,”

had “lost 13 lbs,” was “sleeping well” and showed no symptoms of

asthma or snoring. AR 164. 

 One year later, plaintiff visited Dr Levenson again. AR

163. Dr Levenson’s clinical notes from September 25, 2000 include

a cryptic notation indicating symptoms of sleep apnea. Id. Dr

Levenson’s notes from a visit the following month, however, do not

mention sleep apnea or a sleep study. AR 162. Rather, they

indicated that plaintiff was “doing well,” that his asthma was

“under control” and that he had a “rare cough.” Id. 

Plaintiff visited Dr Levenson again in the spring of

2001. Her clinical notes from March 12, 2001 and April 30, 2001,

do not mention sleep apnea or a sleep study. AR 161, 160.

On June 04, 2001, Dr Levenson noted that plaintiff was “doing

well” and was experiencing no problems. AR 159. On December 10,

2001, Dr Levenson recorded that plaintiff’s asthma had subsided and

that plaintiff was “feeling well.” AR 157.

In addition to his respiratory-system ailments, plaintiff

has a history of orthopedic problems. On November 16, 2000,

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plaintiff underwent arthroscopic knee surgery. AR 381. The

procedure demonstrated significant arthritis in the left knee cap

and evidence of significant arthritis in the medial compartment of

the left knee. AR 258. After the arthroscopy, plaintiff required

steroid injection and pain medication. Id. 

On May 16, 2001, orthopaedic surgeon Dr Daniel Morgan, MD

noted that plaintiff had significant degenerative arthritis in the

knee, with exposed bone. AR 373.

The following year, on July 17, 2002, Dr Morgan stated

that plaintiff was experiencing “increasing pain and discomfort in

the medial aspect of the knee.” AR 260. Dr Morgan obtained x-rays

to evaluate the status of plaintiff’s knee. Id. The x-rays

confirmed that plaintiff had “bone against bone in the medial

compartment of the left knee.” Id. Plaintiff’s right knee had

slight narrowing of the medial compartment, not as “severe as that

on the left.” Id. Dr Morgan administered a steroid injection in

the knee. Id. It was plaintiff’s first injection in more than two

years. Id. 

Plaintiff visited Dr Morgan again on October 8, 2002. 

Id. In his notes, Dr Morgan stated that plaintiff was “actually

doing well” and that the injection in his knee had helped. Id. Dr

Morgan stated that plaintiff did not have significant pain in his

knee; however, he did note that plaintiff had some trouble with his

shoulder. Id. Dr Morgan administered a steroid injection to

plaintiff’s shoulder, and noted that plaintiff had “improvement in

his symptoms.” AR 261.

Dr Morgan’s February 18, 2003 notes stated that plaintiff

had “developed pain and discomfort in the shoulder and also in the

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biceps region.” AR 261. Dr Morgan determined that plaintiff had

“gotten gradually more severe,” so that he had “difficulty lifting

his arm up with his elbow flexed and his arm somewhat forward.” 

Id. Dr Morgan injected him with steroids and stated that plaintiff

“had a definite improvement in his symptoms.” Id.

Plaintiff also consulted cardiologist Dr Rohit Sehgal for

heart problems. A March 7, 2003 echocardiogram performed by Dr

Sehgal suggested mild diffuse cardiomypathy (inflamed heart muscle)

and mild thickening of the left ventricle of the heart. AR 202. 

On April 25, 2003, Dr Sehgal performed a left and right

catherization, coronary angiography and ventriculography. AR 191.

Plaintiff engaged in exercise and cardio rehabilitation in 2003 and

2004. See, e g, 512, 515. A January 28, 2004 echocardiography

demonstrated mild to moderate dilated cardiomyopathy. AR 526.

In May 2003, plaintiff at last underwent a sleep study

with neurologist Dr Stephen Brooks, MD of the Stanford Sleep

Disorder Group. AR 145. Dr Brooks’s May 13, 2003 Nocturnal

Polysomnogram (PSG) Report recorded minimal oxygen saturation

levels of 84.8%, consistent with obstructive sleep apnea (OSA). AR

145-46. The oxygen saturation levels improved to 94.1% with

continuous positive airway pressure (CPAP). Dr Brooks diagnosed

OSA, noted that plaintiff improved with CPAP therapy and prescribed

a CPAP device. AR 146. “Nasal CPAP is the treatment of choice for

most patients with subjective sleepiness * * *. CPAP improves

upper airway patency by application of positive pressure to the

collapsible upper airway.” The Merck Manuals Online Medical

Library, “Obstructive Sleep Apnea Syndrome,” <http://www.merck.com/

mmpe/sec05/ch061/ch061b.html> (visited August 16, 2007). On

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September 22, 2003, four months after the CPAP device was

prescribed, Dr Levenson noted that plaintiff slept comfortably with

CPAP therapy. AR 401.

 Meanwhile, a July 31, 2003 magnetic resonance image

(MRI) of plaintiff’s right shoulder, requested by treating

physician Dr Khalid Baig, revealed continued shoulder problems. Dr

Morgan stated that this MRI demonstrated chronic rotator cuff tear

and acromioclavicular arthritis. AR 256. Plaintiff informed Dr

Morgan that cardio rehabilitation “exercises helped his shoulder”

so that he did not feel a need to have any specific aggressive

treatment directed to the shoulder. AR 371. 

On July 8, 2004, Dr Morgan noted that plaintiff’s knees

caused discomfort when he walked long distances and that plaintiff

used a cane in his right hand and a knee brace for support. AR

369. On October 20, 2004, Dr Morgan reviewed x-rays taken of

plaintiff’s left knee. AR 367. Dr Morgan recommended that the

plaintiff be evaluated for total knee replacement. Id. On

December 27, 2004, plaintiff underwent a minimally invasive miniincision total knee arthroplasty for his osteoarthritis. AR 293. 

On February 14, 2005 Dr Morgan noted that plaintiff complained of

increased shoulder pain since using a cane following his total knee

replacement, AR 358, but plaintiff testified soon afterward that

the knee surgery had improved his knee condition. AR 567. 

B

On April 13, 2003, plaintiff filed an application for

Social Security Disability Insurance Benefits. AR 70-72. In the

disability report submitted in support of his initial application,

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plaintiff stated that he was disabled due to his cardiomyopathy,

asthma, knee problems, seizures, sleep apnea and shoulder pain. AR

93. Both initially and on reconsideration, the SSA denied

plaintiff’s request for benefits, finding plaintiff not disabled

within the meaning of the Social Security Act (Act). AR 27, 33. 

On September 3, 2003, Dr B Camille Williams, MD, a nonexamining State agency physician, opined that plaintiff could lift

up to twenty pounds, stand and walk for at least two hours, sit for

six hours and push and pull without limitations. AR 239. 

According to Dr Williams, plaintiff could occasionally climb,

kneel, crouch and crawl. AR 240. Plaintiff was limited to “no

constant” overhead reaching with his right arm. AR 241.

On January 26, 2004, Dr Morgan wrote a letter to the

Department of Social Services in response to a request for

information regarding plaintiff’s medical condition. AR 254. Dr

Morgan opined that plaintiff was basically unable to use the right

upper extremity for any work-related duties at shoulder level or

above and could not lift an object weighing more than four to five

pounds to the shoulder level or above. AR 254. Dr Morgan noted

that the plaintiff’s left knee condition limited his ability to

work in any kind of position requiring squatting, stooping,

kneeling or any heavy lifting over ten to fifteen pounds. Id. Dr

Morgan opined that although the right shoulder and left knee might

require future surgical treatment, it was unlikely that plaintiff

would return to gainful employment requiring him to be “involved in

stooping, squatting, kneeling or nay heavy lifting over ten pounds”

with or without surgical treatment. Id.

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On March 30, 2004, Dr Harmon Michelson, MD, a nonexamining agency physician, completed a residual functional

capacity (RFC) assessment concluding that plaintiff could lift up

to fifty pounds, stand and walk for two hours, sit six hours and

push or pull with limitations in the upper extremities with

postural, manipulative and environmental limitations. AR 264-71.

On April 28, 2004, plaintiff filed a timely request for

an administrative hearing. AR 38. On January 29, 2005 the ALJ

sent plaintiff’s attorney a pre-hearing letter requesting that

plaintiff submit in advance all evidence on which plaintiff would

rely. AR 47. The letter also requested a preliminary statement of

plaintiff’s theory, including plaintiff’s position as to which step

of the sequential evaluation set forth at 20 CFR 404.1520 (see

infra), should be used to decide the case. Id. 

Plaintiff submitted a pre-hearing brief. AR 134. In the

brief, plaintiff asserted that “the combined effect of the

claimant’s exertional and non-exertional impairments have met or

equaled Paragraphs 1.02 (A) and 1.03 of the Listing of

Impairments.” AR 138. In the alternative, plaintiff argued that

the combined effects of plaintiff’s impairments precluded plaintiff

from “performing his past relevant work, as well as any alternative

work.” Id. Plaintiff also argued that “using the MedicalVocational Guidelines (GRIDS) in their framework as a basis for

decisionmaking, Rule 201.06 mandates a finding of ‘disabled.’” Id. 

Plaintiff did not make the argument he now makes on appeal –– that

the severity of his OSA equals Listing 3.09 because the findings of

the PSG test were of equal medical significance to the criteria set

forth in the listing. 

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The administrative hearing took place on April 14, 2005. 

AR 49. At the hearing before the ALJ, plaintiff testified he was

unable to work due to his knee pain, shortness of breath,

cardiomyopathy, sleep apnea and asthma. AR 565. When asked how

long he could stand without a break, plaintiff answered: “I’d say

about 10 minutes or so.” AR 567. Plaintiff testified that his

medication caused headaches two or three times per week, and that

it took him “anywhere from 20 to an hour” to sleep off his

headaches. AR 573. Plaintiff also testified that he did not use

his CPAP machine stating: “when I use it [...] I wake up all of a

sudden with my throat very dry, and I tend to gag. I can’t swallow

right away or I can’t breath.” AR 572.

At the hearing, the ALJ described the plaintiff’s residual

functional capacity (RFC) to the vocational expert (VE) as: 

sedentary work, no work at heights, otherwise

all postural activities, that is crouch,

crawl, kneel, stoop, balance, and use of

ramps and stairs, is at occasional, avoid

concentrated exposure to fumes, dust, gases,

and pollens, avoid all hazards as in

hazardous machinery.

 with the dominant right upper extremity, over

head reaching is limited to occasional, and

no forceful pushing or pulling [and] as

regard to sitting, standing, and walking, an

allowance for a one minute stretch break at

least every 30 minutes, standing to stretch

to briefly stand and walk, and I define

briefly standing and walking is up to a

minute. 

AR 582. The VE opined that a hypothetical individual of plaintiff’s

age, education and work experience and RFC, as set out by the ALJ,

could not work as a loss prevention agent (plaintiff’s prior

employment), but could work as an accounting clerk if he took oneminute stretch breaks every thirty minutes. AR 582-83. The VE

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further opined that if plaintiff could not perform the job of

accounting clerk, his skills would not be readily transferable to

other occupations with the same or lesser degree of skill as his

past relevant employment. AR 583-85. In addition, plaintiff would

not be able to be employed if he had to alternate sitting and

standing every ten minutes and took two to three thirty-minutes naps

per day. AR 586-87. 

On August 17, 2005, the ALJ denied benefits based on the

evidence presented at the hearing, including the testimony of

plaintiff and the VE, the reports of Drs Baig and Morgan and other

medical records. AR 16-23. The ALJ’s decision set forth the fivestep sequential evaluation of disability required by 20 CFR §

404.1520, that is: (1) whether plaintiff was currently engaged in

substantial gainful activity; (2) whether plaintiff had a severe

impairment or combination of impairments; (3) if plaintiff had a

severe impairment, whether plaintiff had a condition that met or

equaled any condition detailed in the Listing of Impairments, 20 CFR

Part 404, Subpart P, App 1; (4) if plaintiff did not have such a

condition, whether plaintiff was capable of performing his past

work; and (5) if not, whether plaintiff had the RFC to do other

available work.

Applying this five-step sequential evaluation to

plaintiff, the ALJ found that plaintiff had medically determinable

impairments that significantly limited his ability to perform basic

work activities, including: cardiomyopathy, osteoarthritis of the

left knee post total knee replacement, asthma, sleep apnea, obesity

and a chronic right shoulder rotator cuff problem; but that he did

not have an impairment that met or equaled any listed impairment. 

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AR 22. He found that plaintiff had the RFC to perform sedentary

work with one-minute stretch breaks and other limitations as noted

at the hearing. Id. At step four, the ALJ found that plaintiff’s

impairments did not —– and never had —– precluded the performance of

his past relevant work as an accounting clerk. Based on this

finding, the ALJ concluded that plaintiff was not disabled at step

four and therefore did not proceed to step five. AR 23. He also

found plaintiff’s subjective statements regarding pain and other

symptoms non-credible. Id.

The ALJ also noted that plaintiff’s own statements to his

treating physicians indicated that his symptoms had improved and/or

stabilized with treatment. AR 21. In his decision, the ALJ noted

that plaintiff reported in July 2003 that he could “walk for 2

miles, could drive for an hour, and could do shopping and yard work

–– activities which are consistent with my residual functioning

capacity finding.” AR 21-22. The ALJ concluded, “taking into

consideration all of the evidence of record, including the

claimant’s allegations of pain and other symptoms, that there has

been no continuous 12 month period during which claimant has been

unable to perform sedentary work with one minute stretch breaks

every 30 minutes, and with the other limitations specified [].” AR

22. 

In reaching this conclusion, the ALJ also discounted the

opinions of treating physicians Dr Baig and Dr Morgan. AR 21. The

ALJ concluded that Dr Baig’s assessment appeared “to be based

largely on claimant’s subjective reports of functioning” and that

“the medical evidence as a whole did not support the restricted

functioning opined by Dr Baig.” Id. 

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While rejecting Dr Morgan’s opinion —– that plaintiff

could not use his upper extremities to work at or above shoulder

level, that he could not lift more than five pounds above shoulder

level and could not engage in repetitive stooping, squatting or

kneeling —– the ALJ pointed out that neither Dr Morgan’s records nor

plaintiff’s records generally established that plaintiff was

“limited for any continuous 12 month period since his alleged

disability onset date.” AR 20. The ALJ specifically pointed to Dr

Morgan’s notes documenting plaintiff’s ability to “walk with no

assistive device within 3 months” of his knee replacement. AR 20-

21. The ALJ also pointed to records demonstrating significant

relief of plaintiff’s shoulder symptoms as a result of steroid

injections. AR 21. 

Plaintiff appealed the ALJ’s decision to the SSA’s Appeals

Council, which denied review. On April 29, 2006, plaintiff timely

filed the instant action for judicial review of the ALJ’s decision.

II

The court’s jurisdiction is limited to reviewing the

administrative record to determine whether the ALJ’s decision is

supported by substantial evidence and whether the SSA complied with

the requirements of the Constitution, the Act and its administrative

regulations in reaching the decision reviewed. 42 USC § 405(g). 

“Substantial evidence” is defined as “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.” 

Andrews v Shalala, 53 F3d 1035 at 1039 (9th Cir 1995).

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The Act provides that certain individuals who are “under a

disability” shall receive disability benefits. 42 USC §

423(a)(1)(D). Disability is the “inability to engage in any

substantial gainful activity by reason of any medically determinable

physical or mental impairment which can be expected to result in

death or which has lasted or can be expected to last for a

continuous period of not less than 12 months.” 42 USC §

423(d)(1)(A). An individual will be found disabled if his

impairments are such “that he is not only unable to do his 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 * * *.” 42 USC § 423(d)(2)(A). 

 

III

Plaintiff makes four major contentions in support of his

motion. First, he contends that the ALJ’s determination that

plaintiff’s OSA (Obstructive Sleep Apnea) did not meet or equal the

criteria set for in the Listing of Impairments contradicted the

clinical studies conducted to determine the presence and degree of

the OSA. Doc #9 at 17. Second, plaintiff contends that the ALJ

improperly rejected the opinion of plaintiff’s treating physician.

Dr Baig. Id at 18. Third, plaintiff contends that the ALJ erred by

discounting plaintiff’s credibility without providing clear and

convincing reasons for doing so. Id at 21. Finally, plaintiff

contends that the ALJ erred by relying on the VE’s answers to

incomplete and inaccurate hypothetical questions. The court

disagrees with each of these contentions.

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A

Plaintiff alleges presumptive disability under Listing

3.10. Listing 3.10 in its entirety states “Sleep related breathing

disorders. Evaluate under 3.09 (chronic cor pulmonae) or 12.02

(organic mental disorders).” Listing 3.09, not much more detailed,

is as follows:

Cor pulmonale secondary to chronic pulmonary 

vascular hypertension. Clinical evidence of

cor pulmonale (documented according to 3.00G)

with: 

A. Mean pulmonary artery pressure greater than

40 mm Hg;

Or 

B. Arterial hypoxemia. Evaluate under the

criteria in 3.02C2; 

Or 

C. Evaluate under the applicable criteria in

4.02.

4.02 concerns chronic heart failure. An impairment is medically

equivalent to a listed impairment if it is at least equal in

severity and duration to the criteria of any listed impairment. 20

CFR § 404.1526. Plaintiff argues that the severity of his OSA

equals the listing because the findings from his May 2003 Nocturnal

Polysomnogram (PSG) test are at least of equal medical significance

to the required criteria contained in Listing 3.09. Doc #11 at 5. 

In determining whether a claimant equals a listing under

Step 3, the ALJ must adequately explain his evaluation of

alternative tests and the combined effects of the impairments. 

Marcia v Sullivan, 900 F2d 172, 176 (9th Cir 1990). 

The ALJ need not state why a claimant failed to satisfy

every different section of the listing of impairments. Gonzalez v

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Sullivan, 914 F2d 1197, 1201 (9th Cir 1990). An examiner's findings

should be as comprehensive and analytical as feasible and, where

appropriate, should include a statement of subordinate factual

foundations on which the ultimate factual conclusions are based, so

that a reviewing court may know the basis for the decision. Id.

Plaintiff argues that the ALJ’s determination improperly

fails to give controlling weight to the results of the PSG test from

the Stanford Sleep Disorders Group. Doc # 9-1 at 17. During the

PSG test, “while breathing unassisted, plaintiff’s minimal oxygen

saturation was 84.8%,” a result consistent with severe OSA. AR

479. Plaintiff asserts in his brief that oxygen saturation levels

below 90% are considered harmful. Doc #9 at 17. According to the

sleep study, with CPAP treatment Plaintiff’s oxygen saturation level

improved to 94.1%. Id. Plaintiff testified, however, that when he

actually started using the CPAP device at home, he had to stop

because of dryness in his throat. AR 572. Plaintiff argues that

the severity of his OSA equals the Listing because the PSG findings

are at least of equal medical significant to the required criteria

contained in Listing 3.09/3.10.

While the ALJ is required to provide foundations for his

equivalency determinations, the ALJ is not required to come up with

every potential equivalency scenario on his own. The onus is on the

claimant to present a theory of equivalency to the ALJ. In this

case, the ALJ requested and received a pre-hearing brief setting

forth plaintiff’s theory under which he believed he was entitled to

benefits. AR 134. Neither in the brief nor at the hearing did

plaintiff argue that plaintiff’s PSG test results should establish

equivalency with Listing 3.10. The ALJ relied on 

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the fact that plaintiff did not undergo the tests required in Parts

A and B of Listing 3.09. AR 20. Having failed to offer the PSG

test as medically equivalent, plaintiff cannot successfully contend

that the ALJ’s decision was not supported by substantial evidence.

Furthermore, even if plaintiff had asked the ALJ to

consider the PSG test results in analyzing equivalency, plaintiff’s

failure to comply with prescribed treatment might well have vitiated

the argument. As previously noted, medical evidence in the record

establishes that plaintiff’s condition improved with the prescribed

CPAP treatment. The social security regulations require that

claimants follow prescribed treatment. 20 CFR 404.1530. The

regulation states in relevant part:

(a) What treatment you must follow. In order

to get benefits, you must follow treatment

prescribed by your physician if this treatment

can restore your ability to work.

(b) When do you not follow prescribed

treatment. If you do not follow the

prescribed treatment without a good reason, we

will not find you disabled * * *.

20 CFR 404.1530. As a result of the Stanford study, Dr Brooks

prescribed plaintiff CPAP therapy going forward. AR 146. The PSG

test with the CPAP therapy showed plaintiff’s oxygen saturation to

be at safe levels. Although plaintiff’s complaints of discomfort

resulting from the CPAP therapy may be valid, plaintiff has not

established that his physician instructed him to discontinue the

therapy or that he even discussed the problem with any doctor. 

Rather, plaintiff glosses over his failure to follow prescribed

treatment. Cf 20 CFR § 404.1530(c). 

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B

The ALJ properly rejected the opinion of treating

physician Dr Baig that plaintiff was unable to perform even

sedentary work. AR 556-57. As a general rule, ALJs give the

opinions of treating physicians more weight than the opinions of

non-treating doctors. Lester v Chater, 81 F3d 821, 830 (9th Cir

1996). Even if the treating doctor’s opinion is contradicted by

another doctor, the ALJ may not reject this opinion without

providing specific and legitimate reasons supported by substantial

evidence in the record for so doing. Id. 

The ALJ accorded Dr Baig’s opinion less than controlling

weight based on conflicting medical and other evidence in the

record. AR 21. The ALJ noted that while Dr Baig attributed

plaintiff’s fatigue and poor concentration to cardiomyopathy,

echocardiograms showed improvement since 2003. He also explained

that: “while Dr Baig suggested in June 2005 that claimant would be

unable to perform even sedentary work on a sustained basis due to

fatigue and poor concentration, he acknowledged that the claimant’s

energy level has improved substantially since he last worked.” Id. 

The ALJ concluded that “the medical evidence as a whole does not

support the restricted functioning opined by Dr Baig over a

sufficient period of time.” AR 21. 

The court notes, moreover, that in his June 2005

declaration Dr Baig seemed not to know that plaintiff had already

stopped using the successful CPAP therapy, as plaintiff testified

two months earlier in April 2005. For example, Dr Baig stated “an

eight-hour work day * * * would be very difficult for him because

his sleep apnea, although helped by the CPAP machine, cannot

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completely take it away [sic], so he continues to have symptoms of

sleep apnea.” AR 554. This discrepancy suggests that Dr Baig based

his opinion on incomplete information regarding plaintiff’s

treatment and condition.

The ALJ also explained that Dr Baig’s assessments appeared

to be based on plaintiff’s non-credible, subjective reports of

functioning. AR 21. See Part III.C, infra. 

In rejecting the opinion of Dr Morgan (plaintiff’s

treating orthopedic surgeon) that plaintiff could not use his upper

extremities to work at or above shoulder level, that he could not

lift more than five pounds above shoulder level and that he could do

no repetitive stooping, squatting or kneeling, the ALJ pointed to Dr

Morgan’s own treatment records. AR 21. Dr Morgan’s notes

documenting plaintiff’s ability to “walk with no assistive device

within 3 months” of his knee replacement support the ALJ’s decision. 

AR 20-21. The ALJ also pointed to records demonstrating significant

relief of plaintiff’s shoulder symptoms as a result of periodic

steroid injections. AR 21. The ALJ stated that “Dr Morgan’s

treatment records indicate that the claimant’s shoulder symptoms

were recurrent but not persistent.” Id. Thus, the ALJ rejected Dr

Morgan’s “opinion as not well-supported by medically acceptable

clinical and laboratory diagnostic techniques, if, in fact, he

intended to find the claimant so limited for a period of at least 12

months.” Id.

 The ALJ committed no error because he provided specific

and legitimate reasons, supported by substantial evidence in the

record, for rejecting the opinions of treating physicians Dr Baig

and Dr Morgan.

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C

Substantial evidence also supports the ALJ’s determination

that plaintiff’s subjective statements regarding disabling symptoms

were not fully credible. Once a disability claimant establishes an

underlying medical impairment reasonably expected to produce some

subjective symptoms, the ALJ may consider various factors in

assessing credibility of the allegedly disabling subjective

symptoms. 20 CFR § 404.1529. Such factors include, inter alia,

type, dosage, effectiveness and adverse side-effects of any

medication; treatment, other than medication; functional

restrictions; daily activities; and ordinary techniques of

credibility evaluation. 20 CFR § 404.1529. If the ALJ’s

credibility finding is supported by substantial evidence, the courts

may not engage in second-guessing. Thomas v Barnhart, 278 F3d 947,

959 (9th Cir 2002). 

Here, the ALJ noted that plaintiff’s own statements to his

treating physicians indicated improvement and/or stabilization of

his symptoms. AR 21-22. The record documents such improvement. 

See AR 186, 340, 395, 401. The ALJ reasoned that plaintiff’s

statements to his doctors contradicted his own claim of impairments

so extreme as to prevent him from doing even sedentary work. AR 22. 

The ALJ also cited plaintiff’s July 2003 Daily Activities

Questionnaire as support for his credibility determination. AR 22. 

There, plaintiff stated that he could walk for two miles, could

drive for an hour, and could do shopping and yard work. AR 108-111.

Plaintiff now argues that the statements were merely aspirational

and did not accurately reflect his abilities. Doc #11 at 9. Yet,

the record supports the ALJ’s conclusion.

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Considering factors including treatment, functional

restrictions, plaintiff’s daily activities and inconsistencies in

plaintiff’s statements, the ALJ properly provided specific, clear

and convincing reasons to reject plaintiff’s allegations of

subjective disabling symptoms. The ALJ’s credibility determination

must be upheld.

D

The VE’s opinions are based on hypothetical assumptions

supported in the record and are therefore valid. Having properly

rejected the opinions of Drs Baig and Morgan, the ALJ did not err by

excluding from the hypothetical question to the VE the functional

limitations contained in those opinions. As discussed above, the

ALJ properly rejected the opinions of plaintiff’s treating

physicians. 

Plaintiff argues that no examining or consulting physician

opined that plaintiff could perform overhead reaching on an

“occasional” basis, as the ALJ represented to the VE. The record

contains the opinion of non-examining state agency physician Dr

Williams, MD. AR 241. Dr Williams stated that based on the review

of the medical evidence, plaintiff was limited to “no constant”

overhead reaching with his right arm. Id. Dr Williams’s opinion

therefore supports the assessment of plaintiff’s functional

limitations presented to the VE. 

The ALJ’s hypothetical question did not incorporate the

opinion of Dr Michelson; however, Dr Michelson’s opinion

contradicted that of Dr Williams. Resolution of such evidentiary

conflicts resides with the ALJ as fact-finder. Sanchez v Secretary

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of Health and Human Services, 812 F2d 509, 511 (9th Cir 1987). 

Having properly rejected the opinions of Drs Baig, Morgan and

Michelson, the ALJ did not err in constructing the hypothetical

question consistent with the opinion of Dr Williams. Thus, the

testimony of the VE constituted substantial evidence supporting the

ALJ’s decision. 

IV

For the reasons stated herein, the court affirms the ALJ’s

decision to deny benefits. Accordingly, the court DENIES

plaintiff’s motion for summary judgment and GRANTS defendant Michael

J Astrue’s motion for summary judgment.

The clerk is directed to enter judgment in favor of

defendant and to close the file. 

IT IS SO ORDERED.

 

VAUGHN R WALKER

United States District Chief Judge

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