Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_05-cv-03163/USCOURTS-cand-3_05-cv-03163-0/pdf.json

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

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UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

ANITA HERNOKO,

Plaintiff,

v.

JOANNE B. BARNHART,

Commissioner of Social

Security

Defendant.

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No. 05-3163 BZ

ORDER GRANTING PLAINTIFF’S

MOTION FOR SUMMARY JUDGMENT

AND DENYING DEFENDANT’S

CROSS-MOTION FOR SUMMARY

JUDGMENT

Plaintiff Anita Hernoko timely appeals from a final

decision by the Commissioner of Social Security (the

“Commissioner”) under 42 U.S.C. § 405(g) denying review of the

Administrative Law Judge’s (“ALJ”) decision. In her motion

for summary judgment, she asks that the case be remanded with

instructions to award disability benefits. Defendant has made

a cross-motion for summary judgment. Because the Appeals

Council denied review, the decision of the ALJ becomes the

decision of the Commissioner for purposes of review. The ALJ

found that since plaintiff was capable of performing light

work with certain restrictions, she was not disabled and

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therefore not eligible for disability benefits. Tr. at 20.

The Commissioner’s decision to deny benefits will be

disturbed only if it is not supported by substantial evidence

or is based on legal error. 42 U.S.C. § 405(g); Batson v.

Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir.

2004); Lewis v. Apfel, 236 F.3d 503, 509 (9th Cir. 2001). 

The alleged onset of plaintiff’s disability was September

13, 2001, when she was dismissed after three years from her

job as an administrative assistant. This job involved lifting

packages, filing and sitting at her desk for several hours. 

Plaintiff’s disability, back and neck pain, resulted from her

fall when her office chair broke on March 30, 2000. Plaintiff

returned to work but her pain worsened, and she had to miss

work often because of her back pain and doctors’ appointments. 

Plaintiff claims her employer discharged her because of this. 

On June 6, 2003, plaintiff applied for disability benefits. 

After denials initially and upon reconsideration, plaintiff

filed a timely request for an administrative hearing, which

occurred on January 5, 2005. The ALJ denied plaintiff’s

application on March 23, 2005, and the Appeals Council

subsequently denied plaintiff’s request for review. 

Following the standard five step process for evaluating

plaintiff’s claim, see 20 C.F.R. § 404.1520, the ALJ found at

step one that she had not engaged in substantial gainful

activity since September 13, 2001. Tr. at 13. At step two,

the ALJ accepted that a combination of plaintiff’s

impairments, including obesity, abdominal pain,

osteoarthritis, myofascial pain syndrome and depression,

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interfered with her ability to perform basic work. Id. At

step three, the ALJ found that none of her impairments, or a

combination, met the severity for any of the Listed

Impairments in Appendix 1 to Subpart P of Social Security

Regulations No. 4. Id. At step four, the ALJ found that

plaintiff could not perform her past work. Tr. at 18. Once a

claimant establishes that she cannot perform past work, the

burden shifts to the Commissioner to determine if there is a

significant number of other jobs that she can perform. At

step five, the ALJ found that plaintiff could perform two

types of jobs: Small Products Assembler and Cashier II. Id.

Plaintiff contends that the ALJ committed legal error

because he improperly rejected the opinion of plaintiff’s

treating physician and the subjective testimony of plaintiff

and her husband; and the ALJ posed an incomplete hypothetical

question to the vocational expert at the hearing. Because at

least one of these contentions has merit, the ALJ’s decision

contains legal error, and the case must be remanded. 

Because a treating doctor is familiar with the patient’s

history, her opinion deserves greater weight than the opinions

of other physicians. Rodriguez v. Bowen, 876 F.2d 759, 761-62

(9th Cir. 1989). In order to reject an uncontroverted

treating doctor’s ultimate conclusions, the ALJ must provide

“clear and convincing” reasons. Lester v. Chater, 81 F.3d

821, 830 (9th Cir. 1995)(quoting Embrey v. Bowen, 849 F.2d

418, 422 (9th Cir. 1988)); Rodriguez, 876 F.2d at 762. Even

if another doctor’s opinion contradicts that of the treating

physician, the ALJ must provide “‘specific and legitimate

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reasons’ supported by substantial evidence” to reject the

opinion of the treating physician. Lester, 81 F.3d at 830

(quoting Murray v. Heckler, 722 F.2d 499, 502 (9th Cir.

1983)); Embrey, 849 F.2d at 421. To say only that the

objective findings do not support the treating physician’s

conclusions is inadequate. Embrey, 849 F.2d at 421. 

Furthermore, the subjective elements of a treating physician’s

opinion are also important and should be given substantial

weight. The ALJ may disregard them only with clear and

convincing reasons. Id.

Plaintiff’s treating doctor, Dr. Jonathan Francis, is a

pain management specialist who has been seeing plaintiff since

September 2001. On September 14, 2001, Dr. Francis

recommended plaintiff refrain from working and instead seek

additional treatment. Tr. at 297-98. On March 30, 2004,

based on three years of treatment, Dr. Francis felt that

plaintiff was still not able to return to work because of pain

and, possibly, depression. Tr. at 230. The objective

findings to support his conclusion were limited mobility and

function of the lumbar and cervical spinal areas. Plaintiff’s

MRI showed reduced foramina and osteoarthritic changes in

areas of her cervical spine, as well as exaggerated lumbar

lordosis of the lumbar spine. Tr. at 229. Dr. Francis

further found that plaintiff’s claims of pain were credible

and that she was unable to walk for more than one to two hours

per day. He stated that she could sit for only an hour at a

time with a fifteen minute break, for a total of three hours

per day. Dr. Francis opined that plaintiff would not be able

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to appear at a job consistently, and she would be unable to

work at all one to two times per week. Id. He corroborated

plaintiff’s complaints of increasing pain, explaining that

“[i]n some patients, the fascial inflammation can take some

time to resolve after the injury.” Id. 

The ALJ discredited Dr. Francis’ opinion because he

characterized it as “based primarily on claimant’s subjective

complaints” and because it was contradicted by a non-treating

physician, Dr. William A. Jackson Ross, Sr. Dr. Ross is an

orthopaedic surgeon who saw plaintiff once in 2001, in

connection with plaintiff’s worker’s compensation claim. Tr.

at 17. The ALJ found Dr. Ross’ report to be the most

credible. The reports of the other doctors fell between Dr.

Ross’ findings and Dr. Francis’ recommendations, with Dr. Mark

Chan, her previous treating physician, recommending vocational

modifications and Dr. Stephen Dell, a neurosurgeon, remarking

on “the persistence of [plaintiff’s] symptoms so many months

after injury.” Tr. at 150. Similar to the other doctors, Dr.

Robert Fox, a neurologist, concurred in the diagnosis of back

strain and myofascial pain syndrome. Tr. at 213. He did not

address plaintiff’s ability to work. 

State agency medical consultants did consider plaintiff’s

ability to work in August 2003 and December 2003, finding a

residual functional capacity (“RFC”) for medium work and

recommending plaintiff return to her prior work with limits on

bilateral reaching and heavy lifting. Tr. at 200, 223. The

ALJ disagreed, deeming plaintiff’s RFC was for light work but

“the limit to only occasional reaching [was] not warranted by

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the medical evidence.” Tr. at 17. During the administrative

hearing, the ALJ asked the vocational expert if there were any

jobs at the light or sedentary levels that fit a hypothetical

of no reaching or lifting at or above the shoulder level

repetitively. When the vocational expert responded that there

were no such jobs, the ALJ suggested bench assembly. Tr. at

436. After further clarification, the vocational expert

agreed that bench assembly would involve repetitive use of the

hands at desk level but not anything at or above shoulder

level. 

The ALJ accorded Dr. Francis’ opinion less weight because

he concluded that the doctor “recognizes that the objective

findings do not support [plaintiff’s] reported level of pain,

suggests psychological factors, but then opines rather extreme

limitations.” Id. Not only did this analysis fail to list

with specificity and clarity the reasons for rejecting Dr.

Francis’ opinion, it mischaracterized it and improperly

purported to rely on some portions of it while ignoring

others. 

Dr. Francis did not state that his objective findings did

not support the level of pain reported, as the ALJ concluded. 

Tr. at 15. Dr. Francis actually stated that while the

findings for plaintiff’s “pain symptoms are not terribly

severe,” and “there may be some contribution from

psychological factors, likely some depression, . . . I do not

feel that [plaintiff] is able to return to work.” Tr. at 230. 

Dr. Francis also stated that he had “no reason at all to feel

that [plaintiff was] exaggerating her symptoms.” Id.

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The ALJ likewise misinterpreted Dr. Francis’ statement

that he was “hopeful that [plaintiff’s] symptoms would

diminish within the next one to two years,” Tr. at 230, to

mean that plaintiff’s “symptoms should diminish in the next

one to two years,” Tr. at 15, undermining plaintiff’s claims

of worsening pain. Tr. at 17. Throughout his analysis of the

report of the treating physician, instead of according it the

weight to which it was entitled, the ALJ improperly singled

out certain statements, which he mischaracterized, while

ignoring the bulk of Dr. Francis’ conclusions, which supported

plaintiff. See Bergfield v. Barnhart, 361 F.Supp.2d 1102,

1113 (D. Ariz. 2005)(ALJ improperly relied on doctor’s

conclusion that condition was stable while ignoring conclusion

that condition was disabling); Switzer v. Heckler, 742 F.2d

382, 385-86 (7th Cir. 1984). 

The ALJ also erred in failing to articulate specific,

legitimate reasons for disregarding the treating physician’s

opinion. Embrey, 849 F.2d at 421. He did not explain why he

thought his interpretation of the evidence was correct, and

did not give proper weight to Dr. Francis’ interpretation of

the subjective complaints of his patient. Id.

Additionally, the ALJ improperly dismissed subjective

testimony by plaintiff and her husband. While the ALJ’s

credibility determinations are entitled to deference, once a

claimant produces objective evidence of an impairment that

could cause pain, the ALJ may not discredit the claimant’s

allegations of pain, even when there is insufficient evidence

to fully corroborate the severity of the pain, without making

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1 Defendant argues that Dodrill and its progeny relied

on an earlier version of 20 C.F.R. § 404.1513(d), which was

superseded in 2000. Even so, Dodrill appears to remain good

law. In 2001, the Ninth Circuit cited it for the proposition

that an ALJ should take into account lay witness testimony

unless the ALJ expressly determines to disregard such

testimony. Lewis, 236 F.3d at 511. Lewis also cited Vincent

v. Heckler, 739 F.2d 1393 (9th Cir. 1984), which defendant

cites for the proposition that the ALJ need not expressly give

reasons for disregarding lay witness testimony. In Vincent, however, the lay witness testimony conflicted with the medical

evidence; that is not the case here. 

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specific findings. Bunnell v. Sullivan, 947 F.2d 341, 345

(9th Cir. 1991); Nguyen v. Chater, 100 F.3d 1462, 1467 (9th

Cir. 1996)(citing Dodrill v. Shalala, 12 F.3d 915, 919 (9th

Cir. 1993))1; see also Lester, 81 F.3d at 834 (“Unless there

is affirmative evidence showing that the claimant is

malingering, the Commissioner’s reasons for rejecting the

claimant’s testimony must be clear and convincing.”)(internal

quotation marks omitted). 

Plaintiff testified that because of her pain, she could

not concentrate and had to adjust her position every hour,

massaging her back and treating it with hot packs. She

testified that she must spend two to three hours everyday

lying down because of the pain. Tr. at 425-26. The ALJ’s

reasons for dismissing her testimony are not clear and

convincing. The ALJ did not find plaintiff credible because

her treating physician had only recommended conservative

treatment and plaintiff consistently declined stronger pain

medications. Tr. at 17. But plaintiff’s treating physician

explained that her “extreme[] reluctance to take medication”

curtailed his willingness to prescribe more serious pain

medication. Tr. at 229. At the administrative hearing,

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plaintiff attributed her reluctance to take strong medications

to her fear that they could cause heart attacks or strokes and

exacerbate her other health conditions for which she was

already taking medications. Tr. at 428. She also stated that

many medications upset her stomach, heartburn or ulcer. Id.

In light of her belief that “medicine is not going to help”

and make her gain weight, when her doctors had already

diagnosed her as obese, plaintiff’s desire to eschew strong

medications is understandable. Tr. at 429. “Where a claimant

provides evidence of a good reason for not taking medication

for her symptoms, her symptom testimony cannot be rejected for

not doing so.” Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir.

1996). Plaintiff also testified that alternative treatments,

such as physical therapy and massage, seemed to work better

than medications. Tr. at 427.

Second, the ALJ cited plaintiff’s “extensive travel” as a

reason to discount her pain testimony. Tr. at 16. He

remarked that travel over long distances would likely be

painful for someone in plaintiff’s condition. Id. The

“extensive travel” consisted primarily of a trip to Indonesia

in 2001 to attend her father’s funeral and a trip to Indonesia

a year later to visit her mother; trips which do not suggest

travel for pleasure. And airplane travel is different from

work. During airplane travel, plaintiff would presumably not

have to concentrate as she would during a job. She generally

would be able to move, stand and change positions as needed. 

“The Social Security Act does not require that claimants be

utterly incapacitated to be eligible for benefits.” 

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Bergfield, 361 F.Supp.2d at 1112. See also Gallant v.

Heckler, 753 F.2d 1450, 1453-54 (9th Cir. 1984)(reversing and

remanding for benefits in a similar case, where the claimant

suffered back pain but could take care of himself, cook, swim

and walk). 

The ALJ also should have articulated his reasons for

discounting plaintiff’s husband’s testimony, identifying the

medical evidence on which he was relying. “[T]estimony from

lay witnesses who see the claimant every day is of particular

value.” Smolen, 80 F.3d at 1289. Plaintiff’s husband

observes his wife every day and can explain or discuss her

daily behavior. He testified that his wife’s condition has

deteriorated. She suffers from “constant back pain, shoulder

pain, to the point where she just has to lay in the bed.” Tr.

at 419. She cannot walk very far, and she cannot bend to pick

up items on the floor. Tr. at 420-21. He has taken on most

of the household chores because plaintiff’s pain precludes her

from doing laundry, taking out the garbage or lugging

groceries. He must give her frequent massages to ease her

pain. Because her insurance and workers’ compensation have

stopped covering her, plaintiff and her husband pay for her

weekly or biweekly massage treatments out of their own

pockets. Tr. at 420. In summarizing but not addressing this

testimony, the ALJ committed legal error. 

Finally, the ALJ erred in his hypotheticals to the

vocational expert during the administrative hearing. The

ALJ’s hypothetical assumed no repetitive use at or above the

shoulder level for the upper extremities. Tr. at 435-36. 

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After some prodding from the ALJ, the expert testified that

there were two types of jobs that plaintiff could perform: 

Small Products Assembler and Cashier II. Tr. at 438-39. 

However, the ALJ’s hypothetical did not include the “moderate

limitation in her ability to maintain concentration,

persistence, and pace,” which the ALJ found to be present. 

Tr. at 17. Furthermore, the ALJ assumed that plaintiff had no

limitations on the number of hours she could stand per day. 

Although Dr. Francis, plaintiff’s treating physician, did not

discuss this specific limitation, it is unreasonable to assume

that plaintiff could stand for five hours to complete a full

eight-hour workday, when she would not be able to sit for more

than three hours every day and walk for more than one to two

hours per day. Tr. at 230. When plaintiff’s attorney asked

the vocational expert the number of jobs available for a

person who could sit for only three hours per day, the

vocational expert replied that there were no such jobs because

that precluded working a full eight-hour day. Tr. at 442. 

The ALJ asked the vocational expert to assume that plaintiff

could stand for five hours, and the vocational examiner then

agreed plaintiff could perform the assembler and cashier jobs. 

The ALJ further clarified there was no need for plaintiff’s

attorney to ask about “[a]ny combination of factors that

reduces the sit/stand/walk below eight hours a day” because

“by definition they can’t work,” which was the point of the

attorney’s hypothetical. Tr. at 443. Because plaintiff

cannot sit and/or stand for eight hours, there are no jobs

available for her. Without these additional limitations, the

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hypotheticals provide no valuable evidence. Gallant, 753 F.2d

at 1456 (hypotheticals are useful only if they are supported

by medical evidence and include all of the claimant’s

impairments).

Additionally, the ALJ failed to address the vocational

expert’s answer to questions posed by claimant’s attorney,

that there were no jobs available for a person who would

likely miss at least four days of work a month, as Dr. Francis

thought likely, because employers typically tolerate only one

unscheduled absence per month. Tr. at 440-1. The ALJ also

did not address his stipulation, in response to a question,

that most, perhaps all, employers do not permit lying down on

the job. Tr. at 443. Had the ALJ considered these answers,

the ALJ would have had to decide at step five that there were

no jobs plaintiff could perform, and she was thus disabled and

entitled to benefits. 

In cases where the record is fully developed and further

administrative proceedings would serve no purpose and merely

delay the award of benefits, the court has the discretion to

remand for an award of benefits. Lewis, 236 F.3d at 518;

Rodriguez, 876 F.2d at 763; Gallant, 753 F.2d at 1453-54

(reversing and remanding for benefits because a person who

cannot walk, sit or stand for over an hour without pain does

not have the capacity to do most jobs in the economy). 

Because the ALJ improperly discredited Dr. Francis’ opinion

that plaintiff should not work, the subjective testimony of

plaintiff and her husband and the hypotheticals establishing

the absence of jobs for plaintiff, he committed legal error. 

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There are no outstanding issues to be resolved before a

determination of disability can be made, and it is clear from

the record that the Commissioner would be required to find

plaintiff disabled were the legal errors remedied and the

evidence credited. Smolen, 80 F.3d at 1292. Accordingly, IT

IS HEREBY ORDERED that plaintiff’s motion for summary

judgment is GRANTED and defendant’s cross-motion for summary

judgment is DENIED. The case is remanded to the

Commissioner, with instructions to calculate and pay

plaintiff disability benefits. Defendant shall submit an

appropriate form of judgment forthwith.

DATED: June 15, 2006 

 Bernard Zimmerman

United States Magistrate Judge

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