Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-01523/USCOURTS-azd-2_12-cv-01523-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Cynthia Wendte, 

Plaintiff, 

vs. 

Carolyn W. Colvin,1

 Acting Commissioner 

of the Social Security Administration, 

Defendant. 

No. CV-12-1523-PHX-GMS

ORDER 

 Pending before the Court is the appeal of Plaintiff Cynthia Wendte, which 

challenges the Social Security Administration’s decision to deny benefits. (Doc. 1.) For 

the reasons set forth below, the Court vacates that decision and remands for further 

proceedings. 

BACKGROUND 

 Wendte claims that she has been disabled since September 30, 1999. (R. at 15.) 

She is currently 35 years old and completed ninth grade. (Id. at 1311–12.) Wendte does 

not appear to have relevant employment prior to the onset of her alleged disability. (Id. at 

21.) Wendte submitted a Title II application for disability and disability benefits on April 

4, 2008, and a Title XVI application on April 15, 2005. (Id. at 40.) The Social Security 

 

1

 Carolyn W. Colvin became the Acting Commissioner of the Social Security Administration on February 14, 2013. Pursuant to Rule 25(d) of the Federal Rules of 

Civil Procedure and 42 U.S.C. § 405(g), Carolyn W. Colvin is substituted for Michael J. 

Astrue as the Defendant in this suit. 

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Administration (“SSA”) denied her claims on August 21, 2008, and again on December 

31, 2008. (Id.) Wendte subsequently requested a hearing, which was held on April 20, 

2010 in Phoenix, Arizona. (Id.) On November 18, 2009, the Administrative Law Judge 

(“ALJ”) issued a decision finding that Wendte was not disabled under sections 216(i) and 

223(d) of the Social Security Act. (Id. at 13.) That decision was reversed by the Appeals 

Council and the case was remanded back to the ALJ with instructions to re-consider 

several pieces of evidence. (Id.) The ALJ held another hearing and issued a second 

decision on December 22, 2011, again finding that Wendte was not disabled within the 

meaning of the Act. (Id. at 22.) 

 To determine whether Wendte was disabled, the ALJ undertook the five-step 

analysis detailed at 20 C.F.R. §§ 404.1520(a) and 416.920(a).2

 (R. at 14.) He determined 

at the first step that Wendte had not engaged in substantial gainful activity since 

September 30, 1999, the alleged onset date. (Id. at 15.) The ALJ then found that Wendte 

had the following impairments that are severe in combination: congenital heart block, 

cardiomyopathy, chronic heart failure, status-post defibrillator and pacemaker 

implantation, and depression secondary to her general medical condition. (Id. at 16.) At 

 

2

 Under the test: 

A claimant must be found disabled if she proves: (1) that she 

is not presently engaged in a substantial gainful activity[,] (2) that her disability is severe, and (3) that her impairment meets or equals one of the specific impairments described in the regulations. If the impairment does not meet or equal one of the specific impairments described in the regulations, the 

claimant can still establish a prima facie case of disability by 

proving at step four that in addition to the first two 

requirements, she is not able to perform any work that she has done in the past. Once the claimant establishes a prima facie case, the burden of proof shifts to the agency at step five to demonstrate that the claimant can perform a significant 

number of other jobs in the national economy. This step-five determination is made on the basis of four factors: the 

claimant’s residual functional capacity, age, work experience and education. 

Hoopai v. Astrue, 499 F.3d 1071, 1074-75 (9th Cir. 2007) (internal citations 

and quotations omitted). 

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step three, the ALJ determined that none of these impairments, either alone or in 

combination, met or equaled any of the SSA’s listed impairments. (Id. at 17–18.) 

 At that point, the ALJ made a determination of Wendte’s residual functional 

capacity (“RFC”),3

 concluding that she could perform sedentary unskilled work as 

defined in 20 C.F.R. §§ 404.1567(a) and 416.967(a) with the following restrictions: she 

cannot crawl, crouch, climb, squat or kneel, and she should not be exposed to extremes of 

temperature or humidity or unusual dust, gases, or fumes. (R. at 18.) Still at step four, the 

ALJ concluded that Wendte did not have any past relevant work. (Id. at 21.) The ALJ 

therefore reached step five and found (with the assistance of a vocational expert (“VE”)) 

that Wendte was not disabled because there are jobs that exist in significant numbers in 

the national economy that she could perform. (Id. at 21–22.) The Appeals Council 

declined to review the decision. (Id. at 4–6.) 

Wendte filed the Complaint in this action on July 16, 2012, seeking the Court’s 

review of the ALJ’s denial of benefits. (Doc. 1.) The matter became fully briefed on 

January 17, 2013. (Docs. 15, 19, 20.) 

DISCUSSION 

I. LEGAL STANDARD 

 A reviewing federal court will address only the issues raised by the claimant in the 

appeal from the ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 

2001). A federal court may set aside a denial of disability benefits when that denial is 

either unsupported by substantial evidence or based on legal error. Thomas v. Barnhart, 

278 F.3d 947, 954 (9th Cir. 2002). Substantial evidence is “more than a scintilla but less 

 

3

 In greater detail, a residual functional capacity (“RFC”) is “an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work 

setting on a regular and continuing basis.” SSR 96–8p. In particular, the RFC assessment 

must describe the maximum amount of each work-related activity the individual can perform based on the evidence available in the case record. Id. The RFC determination 

may be based on a wide variety of evidence in the record–the claimant’s medical history, laboratory findings, the effects of treatment, reports of daily activities, lay evidence, recorded observations, medical source statements, effects of symptoms that are reasonably attributable to a medically determinable impairment, evidence from attempts to work, the need for a structured living environment, and work evaluations. Id

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than a preponderance.” Id. (quotation omitted). It “is relevant evidence which, 

considering the record as a whole, a reasonable person might accept as adequate to 

support a conclusion.” Id. (quotation omitted). 

 Subject to the Ninth Circuit’s standards in particular cases, the ALJ is responsible 

for resolving conflicts in testimony, determining 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, we must defer to the ALJ’s 

conclusion.” Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1198 (9th Cir. 2004). 

This is so because “[t]he [ALJ] and not the reviewing court must resolve conflicts in 

evidence, and if the evidence can support either outcome, the court may not substitute its 

judgment for that of the ALJ.” Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992) 

(citations omitted). 

II. ANALYSIS 

 Wendte argues that the ALJ erred by: (A) improperly discounting the opinions of 

her treating cardiologist and other doctors, (B) relying on the VE’s opinion at Step Five 

when that opinion was offered in response to incomplete information about Wendte’s 

symptoms, (C) improperly discounting Wendte’s own testimony regarding the severity of 

her symptoms, and (D) improperly rejecting all third party witness statements. 

A. Improper Discount of Wendte’s Treating Cardiologist 

Wendte claimed that the ALJ improperly discounted the opinions of her treating 

cardiologist on the effect of her symptoms. The regulations craft a hierarchy for medical 

opinions offered by licensed doctors. The opinion of a treating physician is given more 

weight than non-treating and non-examining medical sources. See Orn v. Astrue, 495 

F.3d 625, 631 (9th Cir. 2007); Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995); 20 

C.F.R. § 404.1527. When the treating doctor’s opinion is uncontradicted, the ALJ can 

reject those conclusions only for “‘clear and convincing’ reasons.” Lester, 81 F.3d at 830 

(quoting Baxter v. Sullivan, 923 F.2d 1391, 1396 (9th Cir. 1991)). Even when another 

doctor disagrees with the treating doctor’s opinion, the ALJ can reject the treating 

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doctor’s conclusions only when he provides “‘specific and legitimate reasons’ supported 

by substantial evidence in the record for so doing.” Id. (quoting Murray v. Heckler, 722 

F.2d 499, 502 (9th Cir. 1983)).4

 In the words of the Commissioner, “[t]he regulations 

provide progressively more rigorous tests for weighing opinions as the ties between the 

source of the opinion and the individual become weaker.” SSR 96-6p.5

 And so “the 

opinions of physicians or psychologists who do not have a treatment relationship with the 

individual are weighed by stricter standards, based to a greater degree on medical 

evidence, qualifications, and explanations for the opinions, than are required of treating 

sources.” Id.

 Opinions on the ultimate issue of disability, however, are not considered medical 

opinions, and do not receive the same level of deference according to the SSA 

regulations. 20 C.F.R. § 404.1527(d). That issue is reserved for the ALJ. Id. Although the 

ALJ is not “bound” by a controverted opinion of the treating physician on disability, he 

can reject that opinion only by citing “specific and legitimate reasons supported by 

substantial evidence in the record.” Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998); 

Lester, 81 F.3d at 830. In reality, then, the “reasons for rejecting a treating doctor’s 

credible opinion on disability are comparable to those required for rejecting a treating 

doctor’s medical opinion.” Reddick, 157 F.3d at 725. 

 The ALJ specifically addressed the opinion offered by Wendte’s treating 

cardiologist, Dr. Andy Tran. (R. at 20.) He gave limited weight to the opinions of Dr. 

Tran that were found in the medical source statements because he found those 

 

4

 Some of the factors an ALJ can consider when deciding whether to reject the opinion of a treating doctor are the “‘[l]ength of the treatment relationship and the frequency of examination’ by the treating physician; and the ‘nature and extent of the 

treatment relationship’ between the patient and the treating physician.” Orn, 495 F.3d at 

631 (quoting 20 C.F.R. § 404.1527(c)(2)(i)-(ii)). 

5

 Social Security Rulings (SSRs) “do not carry the ‘force of law,’ but they are binding on ALJs nonetheless.” Bray v. Comm'r Soc. Sec. Admin., 554 F.3d 1219, 1224 

(9th Cir. 2009). They “‘reflect the official interpretation of the [SSA] and are entitled to 

some deference as long as they are consistent with the Social Security Act and regulations.’” Id. (alteration in original) (quoting Avenetti v. Barnhart, 456 F.3d 1122, 

1124 (9th Cir. 2006)). 

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conclusions (namely, that Wendte could not work) inconsistent with Dr. Tran’s other 

observations that appeared in the record and “the great weight of the other evidence of 

record.” (Id.) Since the ALJ has not pointed to opinions from any other doctor that 

directly contradict Dr. Tran’s conclusions, either on the general medical question or on 

the question of disability, he must articulate clear and convincing reasons, supported by 

substantial evidence in the record, for discounting Dr. Tran’s opinion. 

 Wendte has had a pacemaker since she was nine years old. (Id. at 16.) 

Malfunctions over the years have required replacement of the pacemaker. (Id.) Wendte 

began seeing Dr. Tran in 2006. (Id.) He performed heart surgery on her in October 2007 

that was only partially successful. (Id. at 518.) Dr. Tran consistently reported that Wendte 

regularly experienced dizziness, palpitations, and lightheadedness that sometimes 

resulted in emergency room visits. (Id. at 462, 489, 904–63.) There was some variation in 

the reporting of symptoms of lightheadedness or palpitations over that period, but the 

symptoms of shortness of breath appeared to worsen in 2011. (Id. at 904–63.) Dr. Tran 

had instructed Wendte that she was to sit or lie down when she experiences these 

symptoms. (Id. at 510, 957, 963.) 

 Dr. Tran filled out a Physical Residual Functional Capacity Questionnaire in 

September of 2011. (Id. at 288–92.) He diagnosed Wendte with complete heart block, 

junctional tachycardia, cardiomyopathy, and CHF. While he pronounced her prognosis as 

“good”, he observed present symptoms of fatigue, palpitations, and syncope. (Id.) He 

opined that her symptoms would frequently interfere with her ability to perform work 

tasks, and that Wendte would need unscheduled hourly breaks of 10-15 minutes. (Id.) In 

addition, he determined that she would likely miss around three full days of work each 

month. (Id.) Those observations and opinions were consistent with those he made on 

similar questionnaires in July 2011 and February 2010. (Id. at 643–47, 649–53.) He 

completed other questionnaires in June and December 2007, in which he opined that she 

would not be able to work due to her heart problems. (Id. at 391–96, 635.) 

 In affording limited weight to Dr. Tran’s disability opinion, the ALJ cited 

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inconsistency between Dr. Tran’s opinions on Wendte’s residual functional capacity and 

his treatment notes. Inconsistency can be a clear and convincing reason for rejecting 

opinion evidence from a treating physician. See, e.g., Morgan v. Comm’r of Social Sec. 

Admin., 169 F.3d 595, 602 (9th Cir. 1999). For example, Dr. Tran’s notes reflect a 

change in prognosis from “guarded” to “good” from 2007 to 2011, while he was opining 

over the same period that Wendte was unable to work. (Id. at 20.) In addition, Dr. Tran 

classified Wendte’s heart condition as a class II-III under the New York Heart 

Association’s criteria in June 2007, but changed that classification to class I-II in 

December 2008, which indicates more mild symptoms. (Id.) The ALJ could properly find 

that both of these changes undermined Dr. Tran’s specific opinion about Wendte’s ability 

to work. A change in prognosis is likely to be based on the physician’s observation of the 

patient’s symptoms and the effect on those symptoms of the current treatment regime. 

Moreover, the change in classification is a direct reflection of improved symptoms. In 

contrast to these observations, Dr. Tran continually opined that Wendte would be unable 

to work. The ALJ could therefore appropriately find that these statements were 

inconsistent, and that the inconsistency was a substantial reason to give Dr. Tran’s 

opinion less weight. 

The ALJ also cited an October 2007 report that Wendte was no longer exhibiting 

severe tachycardiac symptoms or palpitations as evidence that Wendte’s symptoms were 

not as serious as Dr. Tran claimed in his questionnaire. (Id.) Although the ALJ here 

references only the October 2007 report, he previously discussed another report from 

December 2008 where Wendte reported no palpitations or chest pains. (Id. at 17.) It is 

true those symptoms reappear in numerous subsequent reports. (See, e.g., id. at 288–92.) 

Yet there is also evidence that the symptoms improved from time to time. Wendte 

contends that the opinions that would have strongest bearing on the question of disability 

were consistent: the daily effect of Wendte’s symptoms, amount of time expected to 

miss, need for unscheduled hourly breaks, and diagnoses. Nevertheless, it is not the role 

of this Court to reevaluate and reweigh the evidence. There is substantial evidence to 

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support the ALJ’s determination that Dr. Tran’s opinions on Wendte’s ability to work 

were inconsistent with other observations on the severity of her symptoms. 

 Nevertheless, the Court notes that a state examiner, Dr. Stanley Levin, evaluated 

Wendte for the Arizona Department of Economic Security in August of 2006. He 

pronounced her unable to work, with a poor prognosis for recovery. (Id. at 371–74, 641.) 

While Dr. Levin deferred to Dr. Tran on the severity of Wendte’s heart problems, an 

opinion of an examining physician that Wendte was unable to work is favorable evidence 

that should have been addressed by the ALJ. Generally, errors are harmless where they 

are “inconsequential to the ultimate nondisability determination.” Molina, 674 F.3d at 

1115 (quoting Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1162 (9th Cir. 

2008)). Thus, for example, errors are harmless if the record shows that “the ALJ would 

have reached the same result absent the error” or “it was clear [the errors] did not alter 

the ALJ’s decision.” Id. Although Dr. Levin specifically examined Wendte and 

determined that she was unable to work, the main basis for his conclusion was Wendte’s 

heart problems and he deferred to the determinations of Dr. Tran in that regard. Dr. 

Levin’s conclusions therefore would not have affected the ALJ’s ultimate nondisability 

determination. Since the Court has concluded that the ALJ did not impermissibly 

discount Dr. Tran’s opinion, and the ALJ would apply that same reasoning to the 

conclusions of Dr. Levin (which are derivative of Dr. Tran’s opinions), then any error in 

not considering Dr. Levin’s opinion was harmless. 

B. The ALJ’s Reliance on Allegedly Incomplete Testimony from the VE 

 Wendte claims that the ALJ erred at step five. Once the ALJ reaches the fifth step 

of the sequential analysis, the regulations require the ALJ to consider the claimant’s RFC 

and relevant vocational factors (age, education, and work experience) to determine 

whether the claimant can “make an adjustment to other work.” 20 C.F.R. § 416.920(g). In 

other words, the burden shifts from the claimant to the ALJ at the fifth step. Now the 

Commissioner “must demonstrate that the claimant is not disabled and can engage in 

work that exists in significant numbers in the national economy.” Hill v. Astrue, 698 F.3d 

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1153, 1161 (9th Cir. 2012). One way the ALJ can carry his burden is to “ask[ ] a 

vocational expert a hypothetical question based on medical assumptions supported by 

substantial evidence in the record and reflecting all the claimant’s limitations, both 

physical and mental, supported by the record.” Id. (emphasis added). “If a vocational 

expert’s hypothetical does not reflect all the claimant’s limitations, then the expert’s 

testimony has no evidentiary value to support a finding that the claimant can perform jobs 

in the national economy.” Matthews v. Shalala, 10 F.3d 678, 681 (9th Cir. 1993) (internal 

quotation marks and citation omitted); see also Hill, 698 F.3d at 1162 (holding that 

vocational expert’s opinion could not constitute substantial evidence because the ALJ’s 

hypothetical did not taken into account certain mental limitations). 

 Two hearings took place before the ALJ in this case due to the remand from the 

Appeals Council. At the first, the ALJ asked about the availability of jobs for a person 

with the following limitations: limited education, able to do sedentary, exertional, 

unskilled work, with no crawling, crouching, climbing, squatting, or kneeling, no 

exposure to extremes of temperature, humidity or unusual dust, and nothing more than 

simple reading, writing, and math. (R. at 1297–98.) The vocational expert opined that 

there were jobs in the state and national economy that such a person could do, and gave 

one example—a food and beverage order clerk. (Id. at 1298.) At the second, the question 

included the same exertional and environmental limitations described above, but the ALJ 

did not include the limitation to simple reading, writing, and math. (Id. at 1324.) The 

expert responded that there were jobs, and those included a food and beverage order 

clerk, printed circuit layout taper, and type copy examiner. (Id. at 1325.) 

 Wendte alleges three errors in the hypothetical posed by the ALJ to the vocational 

expert at the hearing. First, she claims that the ALJ’s hypothetical failed to include the 

impairment of status post implantation of a defibrillator and pacemaker, with its 

accompanying environmental limitations. Wendte testified that she is unable to work 

around microwaves, generators, magnets, power tools, CB radios, or security detectors 

because of the electromagnetic interference those devices cause with her pacemaker. (Id.

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at 1331–32.) For example, Wendte acknowledged that she has a special card to be taken 

aside at airport screening detectors. (Id. at 1332.)6

 When those limitations were presented 

to the vocational expert, she opined that those additional environmental restrictions 

would “most likely eliminate the three jobs I gave you, assuming that testimony.” (Id. at 

1333.) 

 The ALJ did not address this testimony. It was error for the ALJ not to discuss 

Wendte’s impairment of status post implantation of a defibrillator and pacemaker—an 

impairment the ALJ specifically found to be a severe. (Id. at 16.) Those devices would 

have a separate impact on Wendte’s ability to perform work. The law is clear that the 

hypothetical posed to the VE must include all limitations or else it loses its evidentiary 

value. See Matthews, 10 F.3d at 681. Wendte provided uncontradicted testimony on the 

environmental limitations that accompany her devices. The Court could find nothing in 

the record that would undermine Wendte’s claim that her constant reliance on her 

pacemaker and defibrillator to live precludes her from consistent and sustained exposure 

to many devices that appear in common workplaces. The ALJ did not provide any reason 

for discrediting this testimony about Wendte’s environmental restrictions. His decision 

not to discuss the pacemaker with the VE, and subsequent reliance on her answer to an 

incomplete hypothetical was in error. 

 Wendte also claims the ALJ erred by failing to include a moderate limitation in 

concentration, persistence, and pace in his hypothetical. The ALJ determined that Wendte 

had “fatigue that sometimes makes it difficult for her to concentrate and stay focused on 

tasks. Accordingly, she is limited to unskilled work.” (R. at 18.) Wendte objects to the 

ALJ’s equating difficulties with concentration, pace, and persistence with an ability to 

perform unskilled work. Indeed, the Commissioner describes unskilled work as merely 

 

6

 Wendte cites a report from InTech on pacemakers to support her testimony at the hearing about the potential of electromagnetic interference. (Doc. 15 at 7 n.4.) While the 

information contained therein may substantiate Wendte’s testimony, review of the ALJ’s decision in the district courts is limited the record before the ALJ. Therefore, the Court 

did not consider the InTech report. Wendte has not cited any other evidence of the 

electromagnetic issues caused by her pacemaker besides her testimony. 

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“work which needs little or no judgment to do simple duties that can be learned on the 

job in a short period of time.” 20 C.F.R. § 416.968(a). The Commissioner’s definition of 

“concentration, persistence, or pace” is the “ability to sustain focused attention and 

concentration sufficiently long to permit the timely and appropriate completion of tasks 

commonly found in work settings.” Id. § 404, App. 1 to Subpart P, 12.00(c)(3). The 

ALJ’s assumption that difficulties with concentration, persistence, or pace are solved by 

limiting the claimant to unskilled work was in error. 

 The SSA has explained that, “[b]ecause response to the demands of work is highly 

individualized, the skill level of a position is not necessarily related to the difficulty an 

individual will have in meeting the demands of the job. A claimant’s [mental] condition 

may make performance of an unskilled job as difficult as an objectively more demanding 

job.” SSR 85-15. As the Seventh Circuit has put it, the ALJ needed to construct an 

“accurate and logical bridge” between the mental medical evidence and the decision to 

account for those mental impairments by limiting the claimant to unskilled work. Craft v. 

Astrue, 539 F.3d 668, 677–78 (7th Cir. 2008). 

Here, however, the ALJ did not include any limitations in concentration, 

persistence, and pace in Wendte’s RFC. That error resulted in the insufficiency of the 

hypothetical posed to the vocational expert. The Ninth Circuit requires vocational expert 

testimony to incorporate any “concentration, persistence, and pace” deficiencies. See 

Thomas v. Barnhart, 278 F.3d 947, 956 (9th Cir. 2002) (requiring the vocational expert to 

consider such limitations, although the ALJ need not state them directly); Newton v. 

Chater, 92 F.3d 688, 695 (9th Cir. 1996) (same). Wendte’s difficulties with 

concentration, persistence, and pace have support in the medical evidence provided by 

Dr. Tran and Wendte’s own testimony, discussed below. Both noted that Wendte had to 

frequently lie down during the day and that her severe heart problems would likely cause 

her to miss several days of work a month. (R. at 288–92, 643–47, 649–53, 1272–76, 

1319–22.) The ALJ himself found that Wendte had “fatigue that sometimes makes it 

difficult for her to concentrate and stay focused on tasks.” (Id. at 18.) The vocational 

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expert testified that no work would be available for a person with such limitations. (Id. at 

1326.) While the ALJ rejected the conclusions of Dr. Tran with regard to his disability 

opinion, the ALJ did not discount Dr. Trans’ evaluations of Wendte’s limitations in 

concentration, persistence, and pace. The ALJ therefore erred by failing to include the 

limitations in concentration, persistence, and pace in his RFC and the hypothetical 

presented to the VE. 

Wendte’s final claim of error at step five was that the ALJ failed to specify in his 

hypothetical that Wendte was limited to simple math and reading. The ALJ informed the 

vocational expert that Wendte had a “limited” education. (Id. at 1324.) The 

Commissioner defines limited education as having “ability in reasoning, arithmetic, and 

language skills, but not enough to allow a person with these educational qualifications to 

do most of the more complex job duties needed in semi-skilled or skilled jobs.” 20 C.F.R. 

§ 416.964(b)(3). As a rough proxy, the Commissioner “generally consider[s] that a 7th 

grade through the 11th grade level of formal education is a limited education.” Id. In 

contrast, a “marginal” education “means ability in reasoning, arithmetic, and language 

skills which are needed to do simple, unskilled types of jobs” and the school grade 

approximation is “formal schooling at a 6th grade level or less.” Id. § 416.964(b)(2). 

Wendte completed the 9th grade, which would qualify as a limited education 

under the applicable regulation. (R. at 1311–12.) The uncontroverted evidence, however, 

is that her actual abilities were much lower—Wendte could do math at a third grade level 

and read at a sixth grade level. (Id. at 385–90.) The ALJ therefore erred in classifying 

Wendte’s educational abilities as “limited.” That error, however, was harmless. At the 

first hearing, the ALJ asked the vocational expert a hypothetical where an individual 

could do “nothing more than simple reading, writing, and math.” (Id. at 1297-98.) The 

vocational expert opined that the food and beverage order clerk position would be 

available, even with those limitations. Therefore, the ALJ’s failure to accurately depict 

Wendte’s education was harmless; jobs were still available at Wendte’s education level. 

It would not have had an effect on the ultimate conclusion of no disability. 

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Nevertheless, the ALJ made material errors at step five by failing to include in his 

hypothetical to the VE limitations that stemmed from Wendte’s pacemaker and 

defibrillator, and her difficulties with concentration, persistence, and pace. As is evident 

from the discussion above, those errors were not harmless because the VE testified that 

those limitations would preclude all employment. 

C. Wendte’s Testimony

Wendte claims the ALJ improperly discounted her testimony regarding the 

severity and impact of her symptoms. Wendte testified at both hearings and submitted 

several reports on the severity of her symptoms. She testified about numerous operations 

that have occurred on her heart since childhood. (Id. at 1276–81.) She described the same 

symptoms observed by Dr. Tran—namely, that she experiences dizziness and fatigue 

while sitting or standing that often causes her to pass out if she does not rest for a period 

of time. (Id. at 1281–83.) These episodes occur around six to seven times each day. (Id. at 

1317.) She also testified as to her depression. (Id. at 1286.) 

The standard governing claimant testimony is well-established. If the ALJ has 

determined (as he has here) that there is “objective medical evidence of an underlying 

impairment which could reasonably be expected to produce the pain or other symptoms 

alleged”, and there is no evidence of claimant malingering, “then the ALJ must give 

‘specific clear and convincing reasons’ in order to reject the claimant’s testimony about 

the severity of the symptoms.” Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012) 

(quoting Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009)); see also, e.g., 

Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007). 

ALJ did not find Wendte’s testimony regarding the extent and severity of her 

symptoms credible because it was not “supported by the medical evidence of record.” (R. 

at 19.) The ALJ did not cite any specific contradictions at that point in his discussion. 

“[O]nce a claimant produces objective medical evidence of an underlying impairment, an 

[ALJ] may not reject a claimant's subjective complaints based solely on a lack of 

objective medical evidence to fully corroborate the alleged severity of pain.” Bunnell v. 

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Sullivan, 947 F.2d 341, 345 (9th Cir. 1991) (en banc). The ALJ is required to state 

specific reasons demonstrating inconsistency and cannot make a general finding that the 

claimant’s testimony lacks objective corroboration. See Rollins v. Massanari, 261 F.3d 

853, 856 (9th Cir. 2001). 

The ALJ cited one inconsistency that led to his determination that Wendte was 

“not fully credible”: “the record shows that claimant always has recovered well following 

these procedures”, meaning her heart surgeries. (R. at 19.) That she has recovered well 

from surgery does not contradict or undermine either the medical evidence or Wendte’s 

own testimony regarding the severity of her regular symptoms. To the extent the ALJ’s 

reference to successful recovery had in mind Wendte’s recovery from pacemaker 

implantation at age 7 in 1987 or her pacemaker replacement at age 12 in November 1992, 

the Court does not find that reason clear and convincing. Wendte’s response to a 

procedure 26 years ago bears little on the question of whether her current symptoms 

make her disabled. Nor does her recovery from other operations relate to her ongoing 

symptoms. 

Although the ALJ discusses only this purported inconsistency in the section of his 

opinion dealing with Wendte’s credibility, he later noted Dr. Tran’s observations 

regarding the severity of Wendte’s symptoms. Specifically, the ALJ cited the 

improvement in prognosis and the downgrade in the classification of Wendte’s heart 

symptoms as evidence her symptoms are not as severe. (Id. at 20.) Moreover, as 

discussed above with Dr. Tran, the ALJ cited instances where Wendte reported an 

absence of disabling symptoms. (Id. at 16–17, 20.) While Wendte argues that those were 

isolated reports, that is a question of evidentiary weight that the regulations leave to the 

ALJ. This Court determines evidentiary sufficiency, and the reports cited above qualify 

as substantial evidence to support the ALJ’s adverse credibility determination. The ALJ 

therefore did not commit error when he found Wendte’s testimony “not fully credible.” 

D. Third-party Statements 

A number of third-parties submitted statements or testified at Wendte’s hearing. 

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Wendte’s mother, Cindy Newby, testified at the hearing. (Id. at 1290–96.) Wendte has 

been living with her mother since 1999. (Id. at 1291.) She testified that Wendte has 

difficulties doing “everyday thing[s]” and that she experiences dizziness and fatigue daily 

that requires her to stop what she is doing. (Id. at 1292–96.) She testified that Wendte 

was fired at previous jobs because her illness necessitated frequent breaks. (Id. at 1294.) 

Newby also submitted a third party function report. (Id. at 175–83.) In that report, she 

states that Wendte tires easily, needs lots of naps, cannot stand for significant periods of 

time, and cannot drive. (Id.) Other friends and family submitted statements that contained 

similar observations. (Id. at 250–64, 295–305.) The ALJ gave “limited evidentiary 

weight” to the testimony and statement of Newby and the other family members and 

friends because “none of these partial witnesses is either a medical or vocational expert.” 

(Id. at 20.) He also lumped together Wendte’s testimony with her mother’s and deemed it 

inconsistent with the medical record. (Id. at 19.) 

Lay testimony as to a claimant’s symptoms or how an impairment affects the 

claimant’s ability to work is competent evidence that the ALJ must take into account. 

Nguyen v. Chater, 100 F.3d 1462, 1467 (9th Cir. 1996); Dodrill v. Shalala, 12 F.3d 915, 

919 (9th Cir. 1993). The Ninth Circuit has held that competent lay witness testimony 

“cannot be disregarded without comment,” Nguyen, 100 F.3d at 1467, and that in order to 

discount competent lay witness testimony, the ALJ “must give reasons that are germane 

to each witness,” Dodrill, 12 F.3d at 919. The Commissioner’s regulations specifically 

call for the kind of third-party testimony Wendte submitted. See 20 C.F.R. § 

404.1545(a)(3).7

There is substantial evidence to support the ALJ’s decision to discount the 

testimony of Wendte’s mother, Newby. The ALJ stated that her third party statements 

 

7

 “We will consider any statements about what you can still do that have been provided by medical sources, whether or not they are based on formal medical examinations. . . . We will also consider descriptions and observations of your limitations from your impairment(s), including limitations that result from your symptoms, such as pain, provided by you, your family, neighbors, friends, or other persons.” 

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were not supported by the medical evidence of record. (R. at 19.) As discussed above, the 

ALJ cited substantial evidence to support that determination in his decision. 

Likewise, the ALJ’s reason for assigning little weight to the of the other friends 

and families—that the third parties are not medical or vocational experts—is a germane 

reason. The ALJ stated that he gave this statements their due consideration but that they 

did not weigh heavily in the disability determination because the third-party statements 

did not come from experts. That the Commissioner’s regulations expressly call for thirdparty non-expert testimony does not preclude the ALJ from considering that testimony, 

but giving it less weight due to its non-expert source. It was therefore not error for the 

ALJ to discount the opinions of these third parties. 

E. Remedy 

The ALJ erred by providing incomplete hypotheticals to the VE at step five. That 

error prejudiced Wendte’s case. The Court must therefore vacate the ALJ’s conclusions 

at step five. 

 Having decided to vacate the ALJ’s decision, the Court has the discretion to 

remand the case either for further proceedings or for an award of benefits. See Reddick, 

157 F.3d at 728. The rule in this Circuit is that the Court should: 

credit[] evidence and remand[] for an award of benefits where (1) the ALJ 

has failed to provide legally sufficient reasons for rejecting [certain] 

evidence, (2) there are no outstanding issues that must be resolved before a 

determination of disability can be made, and (3) it is clear from the record 

that the ALJ would be required to find the claimant disabled were such 

evidence credited. 

Smolen, 80 F.3d at 1292. 

 Because the Court has concluded that the ALJ’s errors were a failure to discuss 

certain evidence in his decision or present certain evidence to the VE, the appropriate 

resolution is to remand this case for further proceedings. The ALJ is in the best position 

to appropriately factor the environmental limitations attendant to a pacemaker and 

Wendte’s difficulties with concentration, persistence, and pace into the step five analysis. 

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CONCLUSION

 The ALJ made material error in his decision. Remand for reconsideration in light 

of this opinion is appropriate. 

 IT IS THEREFORE ORDERED that the ALJ’s decision is VACATED and this 

case is REMANDED for further proceedings. 

 Dated this 30th day of May, 2013. 

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