Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_05-cv-02152/USCOURTS-azd-3_05-cv-02152-0/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)

---

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

1

 (Tr. at 27; however, the transcript at 494 of the hearing indicates that the ALJ and

Plaintiff's counsel believed the protective filing date was December 12, 2002.)("Tr." stands

for the transcript filed by the Commissioner as part of her Answer. Title 42 U.S.C. § 405(g)).

2

 Guadamuz v. Bowen, 859 F.2d 762, 763 (9th Cir. 1988)and Corrao v. Shalala, 20 F.3d

943, 948 n.3 (9th Cir. 1994) compare the two benefit programs. The parallel five-step

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Donald S. Roth, 

Plaintiff, 

vs.

JoAnne Barnhart, Commissioner of the

Social Security Administration, 

Defendant. 

)

)

)

)

)

)

)

)

)

)

)

)

)

No. CV-05-2152-PCT-LOA

ORDER

Plaintiff Donald S. Roth ("Plaintiff") seeks judicial review of the Administrative

Law Judge's decision denying his disability insurance benefits. All parties have previously

consented in writing to magistrate judge jurisdiction pursuant to 28 U.S.C. § 636(c)(1).

(docket # 6)

I. PROCEDURAL HISTORY

On November 26, 2002,1 Plaintiff protectively filed an application under Title II and

Title XVI for Disability Insurance Benefits and Supplemental Security Income payments under

the Social Security Act (the “Act”), 42 U.S.C. § 401 et seq and § 1382 et seq.

2

, respectively.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 1 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

sequential evaluation, however, governs eligibility for benefits under both programs. See 20

C.F.R. §§ 404.1520, 404.1571-76, 416.920 & 416.971-76. 

3

 Tr. at 28.

4

 Specifically, the ALJ found that Plaintiff's "chronic obstructive pulmonary disease,

asthma, sleep apnea, obesity, cervical and lumbar degenerative disc disease, bipolar disorder,

a learning disorder and polysubstance dependence allegedly in remission" are severe

impairments within the meaning of the Regulations 20 CFR §§ 404.1520(c) and 416.920(b).

(Tr. at 37, ¶ 3) 

5

 Tr. at 37, ¶ 2.

6

 Tr. at 37, ¶ 7.

7

 The Commissioner classifies physical exertional requirements of work as "sedentary,"

"light," "medium," "heavy," and "very heavy" work. 20 C.F.R. § 404.1567. (Plaintiff's

Statement of Facts ["PSOF"], p. 3)

"Light work" is defined as work that requires lifting no more than 20 pounds at a time

with frequent lifting or carrying of objects weighing up to 10 pounds. 20 C.F.R. §

- 2 -

Plaintiff alleged disability starting March 1, 20023 due to bipolar disorder, attention deficit

hyperactivity disorder, hypertension, hearing loss, memory loss, back pain and chronic

respiratory problems. (Tr. at 28) Several earlier applications for benefits were filed and denied

for reasons not relevant to this appeal as Plaintiff did not request their reopening. (Id.) 

Upon Plaintiff’s October 30, 2003 request (Tr. at 63), Administrative Law Judge

("ALJ") Joan G. Knight conducted a hearing on Plaintiff’s application on October 18, 2004. (Tr.

at 27) In a November 24, 2004 written decision, the ALJ determined that although Plaintiff has

severe impairments4

, has not engaged in substantial gainful activity since the alleged onset of

disability5

 and is unable to perform any of his past relevant work6, the ALJ concluded that

Plaintiff is, nevertheless, able to perform "light work", as defined in the Regulations, found in

significant numbers in the national economy as identified by the testifying vocational expert,

George J. Bluth, Ph.D. (Tr. at 37, ¶ 3.) The ALJ denied Plaintiff's claims for benefits finding

that Plaintiff was not under a "disability" as defined in the Act at any time through the date of

her decision. Specifically, the ALJ determined that Plaintiff is capable of performing "light

work"7

 and "retains the ability to perform simple repetitive tasks . . . [and] is limited to a work

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 2 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

404.1567(b). To perform the full range of light work, a person must be able to stand or walk,

off and on, for a total of approximately six hours out of an eight-hour day. Social Security

Ruling 83-10; Plaintiff's Statement of Facts, p. 3.

- 3 -

environment which requires minimal interpersonal contact and demand." (Tr. at 37, ¶ 11 and ¶

6, respectively) The ALJ's decision became the final decision of the Commissioner on June 1,

2005 when the Social Security Appeals Council denied Plaintiff’s January 20, 2005 request for

review. (Tr. at 7, 20) 

Having exhausted the administrative review process, Plaintiff timely appealed the

Commissioner’s final determination to this federal court pursuant to 42 U.S.C. § 405(g) by filing

his Complaint on July 1, 2005. (Docket # 1) On January 11, 2006, Plaintiff moved for summary

judgment. (Docket ## 14-16) On February 13, 2006, the Commissioner filed her response in

opposition to Plaintiff's summary judgment motion and Cross-motion for Summary Judgment

(Docket ## 20-23) to which Plaintiff responded on February 28, 2006 (docket # 24). The

Commissioner has not filed a reply. Oral argument has not been requested. The matter is now

ripe for ruling.

II. STANDARD OF REVIEW

The district court must affirm the Commissioner's findings if they are supported by

substantial evidence and are free from reversible legal error. Smolen v. Chater, 80 F.3d 1273,

1279 (9th Cir. 1996); Marcia v. Sullivan, 900 F.2d 172, 174 (9th Cir. 1990). Substantial evidence

means more than a mere scintilla, but less than a preponderance; it is “such relevant evidence

as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales,

402 U.S. 389, 401 (1971); Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1998). In determining

whether substantial evidence supports a decision, the district court considers the record as a

whole, weighing both the evidence that supports and that which detracts from the ALJ’s

conclusions. Reddick, 157 F.3d at 720; Tylitzki v. Shalala, 999 F.2d 1411, 1413 (9th Cir. 1993).

The ALJ is responsible for resolving conflicts, determining credibility, and resolving

ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); Magallanes v. Bowen, 881

F.2d 747, 750 (9th Cir. 1989). The ALJ is also required to "scrupulously and conscientiously

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 3 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

- 4 -

probe into, inquire of, and explore for all the relevant facts," being especially diligent to ensure

favorable as well as unfavorable facts are elicited. Higbee v. Sullivan, 975 F.2d 558, 561 (9th

Cir.1992). If sufficient evidence supports the ALJ’s determination, the district court cannot

substitute its own determination. Young v. Sullivan, 911 F.2d 180, 184 (9th Cir. 1990).

Therefore, if on the whole record before the district court, substantial evidence supports the

ALJ’s decision, the district court must affirm it. Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir.

1989); 42 U.S.C.A. § 405(g). 

Under the Social Security Act, a “disability” is defined as an “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 U.S.C. § 423(d)(1)(A). An

individual is determined to be under a disability if “his physical or mental impairment or

impairments are of such severity 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 U.S.C. § 423(d)(2)(A). A claimant

bears the initial burden of proving that he or she is disabled. 42 U.S.C. § 423 (d)(5); Ukolov v.

Barnhart, 420 F.3d 1002, 1104 (9th Cir. 2005); Reddick, 157 F.3d at 721. If a claimant shows

that he or she was unable to perform past relevant work, the burden shifts to the Commissioner

to show that the claimant “can perform other substantial gainful work that exists in the national

economy.” Reddick, 157 F.3d at 721; Swenson v. Sullivan, 876 F.2d 683, 687 (9th Cir.1989);

Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 2004).

In order to determine whether a claimant is disabled within the meaning of the Act,

a five-step evaluation must be performed by the ALJ:

(1) if the claimant is performing substantial gainful work, s/he is not disabled.

(2) if the claimant is not performing substantial gainful work, his impairment(s)

must be "severe" before s/he can be found to be disabled

(3) If the claimant is not performing substantial gainful work and has a "severe"

impairment(s) that has lasted or is expected to last for a continuous period of at

least twelve months, and his/her impairment(s) meets or medically equals a listed

impairment contained in Appendix 1, Subpart P, Regulation No. 4, the claimant

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 4 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

8

 Dr. Easley's medical record for October 5, 2004, the closest record of Plaintiff's

weight to the October 18, 2004 hearing, indicates Plaintiff weighed 274 pounds. This record

does not indicate whether this is the weight reported by Plaintiff or determined from a scale

by the doctor's staff.

9

 A medical record prepared by Judy L. Finney, M.D. indicated Plaintiff has "morbid

obesity" and that he "is consistent in having no interest at all in exercise or weight loss." (Tr.

- 5 -

is presumed disabled without further inquiry.

(4) if the claimant's impairment(s) does not prevent him/her from doing claimant's

past relevant work, s/he is not disabled.

(5) if the claimant's impairment(s) prevents him/her from performing his/her past

relevant work, if other work exits in significant numbers in the national economy

that accommodates his/her residual functional capacity and vocational factors,

s/he is not disabled.

(Tr. at 28 - 29)

20 C.F.R. §§ 404.1520 and 416.920; Bowen v. Yuckert, 482 U.S. 137, 140 - 41 (1987)

(citing 20 C.F.R. §§ 404.1520(b)-(f)); Reddick, 157 F.3d at 721. The burden of proof is

on the claimant as to steps one through four. Tackett v. Apfel, 180, F.3d 1094, 1098 (9th

Cir. 1999). Here, the ALJ found that Plaintiff satisfied steps one, two, and four but not

step three. (Tr. at 29 - 30) If a claimant's impairments do not meet or equal the criteria

for an impairment in the Listing at step three but do satisfy the fourth step, the evaluation

moves to the fifth step. 20 C.F.R. § 404.1520(e). At the fifth step, the burden of proof

shifts to the Commissioner as the ALJ acknowledged in her report. (Tr. at 35) Penny v.

Sullivan, 2 F.3d 953, 956 (9th Cir. 1993). Thus, the critical issue here is step five: whether

Plaintiff retains the residual functional capacity to perform substantial gainful work

existing in significant numbers in the national economy in view of his age, education, and

work experience. 

III. THE COMMISSIONER’S FINDINGS

Plaintiff was born on July 5, 1960, and was forty-four (44) years old on

October 18, 2004, the date of the subject hearing. (Tr. at 28, 35) Plaintiff is 6 feet tall

(Tr. at 225) and weighed, according to the ALJ, approximately 300 pounds8

 on the date

of the subject hearing. (Tr. at 32) The ALJ described Plaintiff as morbidly obese.9

 (Tr.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 5 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28 at 159; Exh. 5f, p. 3)

- 6 -

at 32) Plaintiff obtained a high school equivalent education and has one year of college

education. (Tr. at 28) Plaintiff last worked on March 1, 2002. His past work experience

includes employment as an auto brake mechanic, a grocery store stocker, a cook and taxi

driver. (Tr. at 28, 499 - 501) Although she referenced a record that indicated claimant

stopped working for reasons unrelated to his impairments ("business related lay off"),

the ALJ concluded that Plaintiff is unable to perform any of his past relevant work. (Tr.

at 34, 37) 

Plaintiff testified at the hearing that he is unable to work because of his

back pain, his breathing difficulties and his mental problems. (Tr. at 502) Plaintiff

described his back problem as his "number one problem" with "radiating pain down low."

(Id.) He indicated that the pain was getting worse and he needs "to sleep sitting up"

which causes more pain and pressure on his hip. (Id.) He testified that although his back

pain is in the low, mid and upper back, the worst pain is the "real sharp" "constant" pain

in his lower back located "right about his pant['s] line." (Tr. at 503) Plaintiff described

the severity of the pain as a constant 8 or 9 on a scale of 1 to 10 with 10 being the worst.

(Id.) Plaintiff further testified that he could sit for only about 35 to 40 minutes before he

feels the need to lay down or move around due to the pain. (Id.) He testified that he

typically can not stand longer than 45 to 60 minutes before he needs to lean against

something or sit down. (Tr. at 504) In an eight-hour day, Plaintiff testified that he needs

to lay down for about 3 hours due to his back pain if he is not having any breathing

problems. (Id.) Plaintiff acknowledged that Dr. Easley, a treating family physician,

prescribes Duragesic skin patches and morphine sulfate pills twice a day for his pain. (Tr.

at 504 - 505) The record reflects he was takes other medications as well.

Plaintiff's understanding of his breathing problem, which he testified

requires frequent emergency room visits, is that he's "getting plugs that block up the

passageways so [he] can't get air passed [his] throat into [his] lung and [he] end[s] up

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 6 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

10 See, www.valuoptions.com/news/releases/release03022006.htm

11 It is common knowledge that the adverse oral effects of methamphetamine use

("meth mouth") can be devastating. This footnote is not intended to imply that Plaintiff's

dental problems were caused, in whole or in part, by methamphetamine use.

- 7 -

choking." (Tr. at 505 - 506) In the four months immediately prior to the October 18,

2004 hearing, he testified that he coughs up "plugs" ( phlegm) daily which have caused

him to be taken to the hospital by paramedics four times prior to the hearing because he

could not breath. (Id.) Plaintiff's testimony indicated he takes physician-prescribed

medicine (Prednisone and Albuterol sulfate) and uses a breathing machine two to four

times daily) and handheld inhalers. (Tr. at 507) Each machine treatment takes ten

minutes or so.

Plaintiff admitted in the hearing to taking Zyprexa for his schizophrenia

and bipolar disorder and Bupropion for his depression, all prescribed by Dr. Gillcrest

through "Valley (sic) Options." (Tr. at 507) ValueOptions (Nova) is a well-known

behavioral health organization with 22 clinics in the Phoenix metro community.10

Plaintiff candidly admitted to using methamphetamine earlier in month of the hearing.

(Tr. at 509) He testified he "very rarely" uses this speed-like illicit drug but when he

does, it is because of his fear of dying in his sleep due to his breathing difficulties with

phlegm. He claims the methamphetamine helps him stay awake and breathe. (Id.) Upon

cross-examination by the ALJ, Plaintiff could not estimate how often he used illicit drugs

since March 2002 when he stopped working but denies using them when he did work.

(Tr. at 514) He testified that the Prednisone has caused him to lose eight teeth11 in the

two years before the hearing; he feels alone and is worried about losing his son to his exwife. 

At the hearing, Plaintiff testified that he lives with his 10-year old son

whom he described as "very independent [who] mostly tak[es] care of me." (Tr. at 512)

They live off welfare and money from his sisters. Plaintiff averred that his son does the

laundry, takes out the trash, and makes his bed before he goes to school. (Id.) Plaintiff

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 7 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

12 This testimony is of questionable credibility if Plaintiff was correctly quoted in the

September 20, 2004 Scottsdale Healthcare hospital record ("Patient is a smoker,

approximately one pack a day.") (Tr. at 399)

- 8 -

acknowledged making his son something to eat, like a bagel or bowl of cereal, before he

goes to school and thereafter Plaintiff will usually sit around the apartment all day and

watch TV until his son comes home from school. Plaintiff testified that he can not walk

very far. (Tr. at 520) When he goes to the grocery store, Plaintiff testified he can walk

from the handicapped parking area to the store's motorized shopping carts which he uses

to drive around inside the store while shopping. He claimed he can only lift objects up

to 20 pounds because, depending upon how many medications he has taken that day,

before he would lose his balance. (Tr. at 520 - 521)

Upon cross-examination by the ALJ, Plaintiff testified he stopped smoking

five or six weeks before the hearing12 and that he stopped taking the physician-prescribed

Depakote because he was taking up to 22 pills a day and he felt the Depakote was not

doing anything for him. Besides, he testified that he did not feel he needed to take

Depakote because when he took it he "felt like a cabbage or a plant on the side of the

road just sitting all the time." (Tr. at 514)

The ALJ found that Plaintiff was unable to perform his past relevant work.

(Tr. at 37, ¶ 7) Thus, the burden of proof shifted to the Commissioner to prove that other

work exists in significant numbers in the national economy that would accommodate

Plaintiff's residual functional capacity and vocational factors. If Plaintiff's residual

functional capacity and vocational factors do not enable him to work, Plaintiff is disabled

within the meaning of the Act; otherwise, he is not disabled and not entitled to benefits.

Only two witnesses were called to testify at the October 2004

administrative hearing: Plaintiff and a vocational expert, Dr. George J. Bluth. Upon

questioning by the ALJ, Dr. Bluth testified that an individual of Plaintiff's age, education

and vocational background, with the physical and mental limitations set forth in Exhibits

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 8 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

13 Exhibit 12F is a mental Residual Functional Capacity Assessment completed by nonexamining physician, Jack A. Marks, M.D., with Disability Determination Service ("DDS"),

Arizona Department of Economic Security, on June 20, 2003. (Tr. at 246 - 249)

14 Exhibit 23F is a Physical Residual Functional Capacity Assessment completed by

DDS non-examining physician, James F. Stagg, M..D., on October 18, 2003. (Tr. at 346 - 353)

Since the ALJ's report does not indicate that she relied on Dr. Stagg's finding, it will not be

discussed herein.

15 Exhibit 16F is a Physical Residual Functional Capacity Assessment completed by

DDS non-examining physician, Jerry L. Dodson, M..D., on July, 2003. (Tr. at 277 - 284)

16 Exhibit 30F is the Medical Assessment of Ability to do Work-Related (Physical)

completed by treating physician Foster Easley, D.O., on October 15, 2004. (Tr. 423 - 424)

17 Exhibit 31F is the Pain Functional Capacity Questionnaire prepared by Foster Easley,

D.O. on October 5, 2004. (Tr. at 425 - 426)

18 Exhibit 14F is the Medical Assessment of Ability to do Work-Related (Mental)

completed by treating physician W.R. Womack, M.D. on July 2, 2003. (Tr. at 264 - 265)

- 9 -

12F13, 23F14 and 16F15 prepared by three state agency non-examining physicians, would

be able to perform both sedentary and light exertional work available in significant

numbers in the national economy. (Tr. at 518) Considering this same hypothetical

person with the same limitations but adding the limitations set forth in Exhibit 30F16

prepared by a treating physician, Dr. Bluth concluded that no work would be available

to such a person. When Plaintiff's counsel asked Dr. Bluth to assume the information

contained in the pain questionnaire17 completed by the same treating physician as well

as the other limitations contained in the ALJ's hypothetical questions, Dr. Bluth testified

that such a person would not be able to sustain any kind of work. (Tr. at 521 - 522)

Finally, when Plaintiff's counsel asked Dr. Bluth to assume the information contained in

a different treating physician's mental medical source statement18 and to assume this same

individual was suffering from the cumulative effects of the limitations found by this same

physician, Dr. Bluth opined that such a person would not be able to sustain work related

activities on a regular and continuing basis (eight hours a day, five days a week or an

equivalent work schedule). (Tr. at 522). The ALJ also conceded at the hearing that a

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 9 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

19 Specifically , the ALJ's report indicates that she considered Listing 3.03 B for asthma

attacks and found that Plaintiff did not experience the frequency or severity of asthma attacks

to meet the criteria of the listing. (Tr. at 30) 

20 The term "residual functional capacity" is defined in the Regulations as the most an

individual can still do after considering the effects of physical and/or mental limitations that

affect the ability to perform work related tasks (20 C.F.R. §§ 404.1545 and 416.945 and Social

Security Ruling 96-8p). (Tr. at 30)

- 10 -

person with the limitations consistent with Plaintiff's hearing testimony, i.e., he needs to

lay down three to four hours a day, "would not be able to sustain any full-time work."

(Tr. at 521)

The ALJ found that Plaintiff's chronic obstructive pulmonary disease,

asthma, sleep apnea, obesity, cervical and lumbar degenerative disc disease, bipolar

disorder, a learning disorder and polysubstance dependence allegedly in remission are

severe impairments within the meaning of the Regulations 20 CFR §§ 404.1520(c) and

416.920(b). (Tr. at 29) The ALJ did not, however, find that Plaintiff's impairments are

severe enough to meet or medically equal, either singly or in combination, one of the

impairments listed in Appendix 1, subpart P, Regulations No. 419 "because no treating or

examining physician has mentioned findings equivalent in severity to the criteria of any

listed impairment." (Tr. at 29 - 30) The ALJ acknowledged that Plaintiff's impairments

"may be expected to result in some pain and functional limitations" but found that

Plaintiff’s allegations concerning his symptoms and limitations were "lacking in

credibility" and that Plaintiff's "medical history and other evidence in the record do not

entirely substantiate the intensity of pain and degree of limitation the claimant has

reported." (Id.) The ALJ determined that Plaintiff had sufficient "residual functional

capacity"20 ("RFC") to perform "a significant range of light work as defined in 20 CFR

§§ 404.1567 and 416.967." (Tr. at 36) The ALJ concluded that Plaintiff's RFC permits

him to perform light work existing in significant numbers in the national economy. (Id.)

Therefore, the ALJ found that Plaintiff "is not under a 'disability' as defined in the Social

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 10 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

- 11 -

Security Act, at any time through the date of the decision (20 CFR §§ 404.1520(g) and

416.920(g)).” (Tr. at 37)

IV. DISCUSSION

In his Motion for Summary Judgment, Plaintiff alleges that the ALJ's

decision is not supported by substantial evidence and is founded on multiple errors.

Specifically, Plaintiff claims that (1) the ALJ erred by rejecting opinions of Plaintiff's

treating physicians, Dr. Womack and Dr. Easley, (2) the ALJ erred by relying on

opinions of non-testifying, non-examining state agency physicians, Jack A. Marks, M.D.

and Jerry L. Dodson, M.D., who did not review all of the evidence and gave little

explanations for their opinions, (3) the ALJ erred in evaluating Plaintiff's mental

impairments because the ALJ relied upon a one-time GAF score and determined a global

mental RFC assessment instead of the function-by-function assessment required by

Social Security Ruling 96-8p, and (4) the ALJ erred by discounting the severity of

Plaintiff's impairments without providing clear and convincing reasons and by failing to

specify what portion of Plaintiff's testimony was not credible and what evidence

undermined that testimony. Plaintiff requests that the Court remand for an award of

benefits because the record is fully developed and, considering the improperly discredited

evidence, a finding of disability is clearly required. Alternatively, Plaintiff should remand

for further proceedings with specific instructions to address Plaintiff's assignments of

error.

In response to Plaintiff's motion, the Commissioner contends that the ALJ's

decision that Plaintiff was not disabled within the meaning of the Act is supported by

substantial evidence and is free of reversible legal error. The Commissioner frames the

issues as (1) whether the ALJ properly weighed the opinions of treating physicians Dr.

Womack and Dr. Easley; (2) whether the ALJ properly relied upon the opinions of the

State Agency physicians; (3) whether the ALJ properly evaluated Plaintiff's mental

impairments, and (4) whether the ALJ properly evaluated Plaintiff's allegations of the

severity of his symptoms and limitations.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 11 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

- 12 -

Because treating physicians have a greater opportunity to know and

observe their patients, a treating physician's opinions are generally given more weight

than the opinion of a non-treating source. Magallanes, 881 F.2d at 751. Under the

Regulations, if a treating physician's medical opinion is supported by medically

acceptable diagnostic techniques and is not inconsistent with other substantial evidence

in the record, the treating physician's opinion is given controlling weight. 20 C.F.R. §

404.1527(d)(2); Social Security Ruling (SSR) 96-2p; Holohan v. Massanari, 246 F.3d

1195, 1202 (9th Cir. 2001). If the treating physician's medical opinion is inconsistent with

other substantial evidence in the record, "[t]reating source medical opinions are still

entitled to deference and must be weighted using all the factors provided in 20 CFR [§]

404.1527." SSR 96-2p; Holohan, 246 F.3d at 1202 ("Adjudicators must remember that

a finding that a treating source medical opinion is . . . inconsistent with the other

substantial evidence in the case record means only that the opinion is not entitled to

'controlling weight,' not that the opinion should be rejected. . . . In many cases, a treating

source's medical opinion will be entitled to the greatest weight and should be adopted,

even if it does not meet the test for controlling weight."). Id. An ALJ may rely on the

medical opinion of a non-treating doctor instead of the contrary opinion of a treating

doctor only if she or he provides "specific and legitimate" reasons supported by

substantial evidence in the record. Lester, 81 F.3d at 830. (internal quotation marks and

citation omitted). If the treating physician's opinion on the issue of disability is

controverted, the ALJ must still provide "specific and legitimate" reasons in order to

reject the treating physician's opinion. Id.

Mindful of these controlling rules in Social Security cases in the Ninth

Circuit, the Court concludes that the ALJ erred by rejecting the opinions of both

Plaintiff's treating physicians, Dr. Womack and Dr. Easley, and by not adopting the

unrebutted testimony of the vocational expert, Dr. Bluth, that a person with the

limitations found by Dr. Womack and/or Dr. Easley would not be able to sustain any kind

of work. 

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 12 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

21 Exhibits 10F, 19F and 24F. (PSOF, p. 5, fn. 11) 

22 It is unclear what the ALJ means by a "mental status examination" because the ALJ

acknowledged in the same paragraph that Dr. Womack completed a Medical Source Statement

of Ability to do Work-Related Activities (mental)(Exhibit 14F). (Tr. at 34)

- 13 -

In a lengthy, hopscotch written decision that belies the simplicity of this

outcome-determinative issue, the ALJ rejected the opinions of Plaintiff's two treating

physicians and, in a fair comparison with her own, adopted the opinions of Drs. Marks

and Dodson, each of which was rendered, at least, 15 months before the October 2004

hearing. The ALJ wrote that she did not assign controlling weight to Plaintiff's treating

physicians (Drs. Womack and Easley) for "several reasons" yet the ALJ did not set forth

the "specific and legitimate reasons" "supported by substantial evidence in the record"

to explain her rationale for not giving deference the opinions of the treating physicians

and accepting the non-examining physicians' opinions and assessments in the

hypothetical questions posed to the vocational expert. Andrews, 53 F.3d at 1043;

Benecke v. Barnhart, 379 F.3d 587, 592 (9th Cir. 2004)(finding that "[t]he opinions of

these non-examining doctors are entitled to less weight than doctors who treated or

examined Benecke."); Penny, 2 F.3d at 958 ("Without a personal medical evaluation it

is almost impossible to assess the residual functional capacity of any individual.") 

The expressed reason that the ALJ rejected Dr. Womack's opinion,

Plaintiff's primary care physician who had professionally seen and treated Plaintiff at

least 16 times over a 15 month period21 before the October 18, 2004 hearing, was

because he is a family practitioner, there was no evidence that Dr. Womack conducted

a "mental status examination"22 and "[Dr. Womack's] opinion appears to rest in part on

an assessment of impairments [psychiatric limitations] outside the doctor's area of

expertise." (Tr. at 34) While she claimed to fully consider non-cited Ninth Circuit case

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 13 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

23 Tr. at 31.

24 Plaintiff's Memorandum in Support of Motion for Summary Judgment (docket # 16),

p. 7 - 8; PSOF ¶¶ 12 -13.

25 See footnote 10 supra.

- 14 -

law in her report23, the ALJ's reasons for rejecting Dr. Womack's opinions directly

conflict with binding Ninth Circuit precedent: 

Finally, the ALJ argues that Dr. Kho's [treating physician and pain

specialist] opinion as to [claimant's] mental functioning may be

disregarded because he is not a mental health specialist.. . . His opinion

constitutes "competent psychiatric evidence" and may not be discredited

on the ground that he is not a board certified psychiatrist. (citation

omitted) Indeed, the treating physician's opinion as to the combined

impact of the claimant's limitations--both physical and mental--is entitled

to special weight. As the Commissioner's own regulations recognize,

treating physicians like Dr. Kho bring a "unique perspective to the medical

evidence." 20 C.F.R. § 404.1527(d)(2). An integral part of the treating

physician's role is to take into account all the available information

regarding all of his patient's impairments--including the findings and

opinions of other experts. The treating physician's continuing relationship

with the claimant makes him especially qualified to evaluate reports from

examining doctors, to integrate the medical information they provide, and

to form an overall conclusion as to functional capacities and limitations,

as well as to prescribe or approve the overall course of treatment. This is

particularly true in cases like Lester's, where the parts of the functional

restrictions arising from the claimant's physical impairments cannot be

separated from the parts arising from his mental impairments.

Lester, 81 F.3d at 833.

The Lester precedent is especially compelling here for two different reasons. First, not

one of the two non-treating, non-examining state agency physicians testified at the

hearing and, therefore, their opinions were not subjected to the rigors of cross

examination under penalty of perjury by knowledgeable counsel experienced with

medical issues and social security cases. Andrews, 53 F.3d at 1041 (9th Cir. 1995).

Secondly, none of the two non-examining physicians "review[ed] a massive amount of

medical evidence added to the file after their opinions were rendered and gave almost no

explanation for those opinions."24 Dr. Marks' opinion was rendered in June, 200325; Dr.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 14 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

26 See footnote 12 supra.

27 Chief complaint: shortness of breath. (Tr. at 285 - 291)

28 Sleeping difficulties due to "severe obstructive sleep apnea." (Tr. at 383 - 390)

29 Emergency room records, dated March 30, 2004, with "chief complaint: shortness

of breath" (Tr. at 398 - 400); emergency room records, dated February 17, 2004, with "chief

complaint: back pain and chronic sinus drainage" (Tr. at 401 - 402); emergency room records,

dated February 2, 2004, with "chief complaint: hip and back pain" (Tr. at 403 - 404);

emergency room record, dated July 20, 2003, with "chief complaint: difficulty breathing."

Note: the ER physician's impression was (1) acute asthma and (2) methamphetamine abuse

(Tr. at 401 - 402)

30 Emergency room records, dated July 8, 2004, with "Reason for Consultation:

Bronchial asthma, intubated in field." and "Clinical assessment: Chronic obstructive

pulmonary disease" (Tr. at 444 - 480)

31 Dr. Easley assumed Plaintiff's care, treated and professionally saw Plaintiff at least

nine times from April 15, 2004 through October 5, 2004. These records are significant because

they demonstrate that very strong (narcotic) drugs were prescribed for Plaintiff's chronic pain.

(PSOF ¶ 6)

32 The October 7, 2004 Nova evaluation makes a diagnosis of bipolar disorder,

psychosis and depression. (Tr. at 391 - 394)

- 15 -

Dodson's on July, 200326 and, therefore, they could not have considered Plaintiff's

medical records generated thereafter, such as, the emergency room or other hospital

records from Yavapai Regional Medical Center (Exh 17F27), John C. Lincoln Hospital

(27F28), Scottsdale Healthcare Osborn (Exh. 29F29), Phoenix Baptist Medical Center

(33F30) and all of Dr. Easley's records31, the last couple of office visits with Dr. Womack

and Nova's Psychiatric Evaluation.32 One may not reasonably argue that these medical

records were not relevant and material for the non-examining physicians to read and

consider to fairly evaluate Plaintiff's claims and treatment for his combined back,

breathing, mental problems and his pain, all of which Plaintiff argues prevent him from

working because they directly support those claims.

The Commissioner argues conclusions for affirmation of the ALJ's

decision. Specifically, the Commissioner writes that the ALJ set forth specific, legitimate

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 15 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

33 Commissioner's Response (docket # 22), p. 3, ll 6 - 10.

34 Id. at ll 21 - 22.

35 Id. at ll 8 - 9.

36 Exhibit 32F. (Tr. 427 - 443)

- 16 -

reasons for not assigning controlling weight to the opinions of Plaintiff's treating

physicians and that substantial evidence supports the ALJ's rulings33 but she gives little

discussion and analysis to why the ALJ rejected Dr. Womack's and Dr. Easley's opinions.

The Commissioner argues that Dr. Womack's opinion was "not supported by medical

evidence."34 The Commissioner then repeats her reliance on Dr. Womack's status as a

family physician and properly notes that, in general, more weight is assigned to

specialists' opinions in their area of specialty, citing 20 C.F.R. § 404.1527(d)(5). In the

Ninth Circuit, however, specialization alone of a non-treating physician does not trump

a treating physician's opinions: "[T]he primacy of [a treating physician's] opinion derives

from his superior vantage compared to a non-treating physician, even apart from any

superior credentials." Benton v. Barnhart, 331 F.3d 1030, 1036, fn. 1 (9th Cir. 2003)

(Emphasis in original). Moreover, the Commissioner does not fairly explain why "the

ALJ accorded far greater weight to the opinions of non-examining physicians"35 rather

than giving Plaintiff's treating physicians' opinions more deference or greater weight as

required by the Ninth Circuit even if the ALJ found they did not meet the test for

controlling weight. Holohan, 246 F.3d at 1202. This error alone warrants reversal.

By the same token, the ALJ did not assign controlling, deferential or

greater weight to the opinions of Dr. Easley, another treating physician who treated and

saw Plaintiff nine (9) times professionally from April 4, 2004 to October 5, 2004,36 over

those opinions of the non-examining physicians who, again, only considered a portion

of Plaintiff's medical records and medical history over a year before the subject hearing.

Plaintiff argues that a material contradiction exists in the ALJ's narrative report and,

among other claims of error, the ALJ engaged in inappropriate speculation in discounting

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 16 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

37 Commissioner's Memorandum in Support of Defendant's Cross-Motion Summary

Judgment (dkt # 22), at 4, l 15.

38 On October 5, 2004, Dr. Easley opined that Plaintiff's pain or degree of pain "seriously

affects ability to function"; can "reasonably be expected to result from clinical or diagnostic

findings" that is documented, and is sufficiently severe to "frequently" interfere with Plaintiff's

attention and concentration. Exhibit 31F (Tr at 425 - 426)

- 17 -

Dr. Easley's opinions. The Commissioner, however, argues that specific and legitimate

reasons and substantial evidence (Dr. Marks' and Dr. Dodson's opinions and "little

objective evidence of a significant medical problem"37) existed for the ALJ to not give

either controlling, deferential or greater weight to Dr. Easley's opinions. Moreover, the

Commissioner argues, the ALJ found that Plaintiff's "allegations of subjectively disabling

complaints" were not credible and Dr. Easley's opinions were based upon these noncredible subjective complaints, citing Sandgathe v. Chater, 108 F.3d 978, 980 (9th Cir.

1997). The Court disagrees.

When the ALJ wrote that Plaintiff's "treating physician [Dr. Easley]

provided restrictions significantly consistent with those reached in this decision[]" and

then she cited Dr. Easley's pain assessment38 as support, one can only assume that the

ALJ is referring to Plaintiff's issues of pain even though the ALJ does not specify the

restrictions to which she is referring. (Tr. at 32) Later in her report the ALJ

acknowledges that she "has not assigned controlling weight to [Dr. Easley's] statements

[regarding Plaintiff's pain assessment] because his treatment notes do not corroborate the

severity of pain that the claimant has alleged and the doctor has reported." (Tr. at 34 - 35)

The written basis for her conclusion and criticism of Dr. Easley's opinions is because it

"appears" that Dr. Easley "relied quite heavily" on Plaintiff's subjective report of

symptoms and limitations and "seemed to uncritically accept as true" what Plaintiff

reported. This is sheer conjecture on the part of the ALJ as there is no evidence in the

record, much less substantial evidence, to warrant this conclusion and criticism of the

foundation of Dr. Easley's opinions. Conjecture and speculation do not meet the

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 17 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

- 18 -

definition of substantial evidence. Quan v. Gonzales, 428 F.3d 883, 887 (9th Cir.2005)

("Conjecture and speculation can never replace substantial evidence as the basis for an

adverse credibility finding.") (citing immigration case Guo v. Ashcroft, 361 F.3d 1194,

1199 (9th Cir.2004)); Green-Younger v. Barnhart, 335 F.3d. 99, 108 (2nd Cir. 2003) (ALJ

and district court reversed for failing to accord controlling weight to treating physician's

opinion that applicant could not work because of severe pain: stating that the treating

physician "relied on Green-Younger's subjective complaints hardly undermines his

opinion as to her functional limitations, as '[a] patient's report of complaints, or history,

is an essential diagnostic tool.'" (citation omitted)). 

Contrary to the ALJ's speculation, Dr. Easley's opinion as to Plaintiff's

degree of pain set forth in his pain assessment (Exh 31F, ¶ 3; Tr. at 425) indicates that

it is based upon objective, documented clinical or diagnostic findings. The form does not

ask the physician to identify those findings but the May 4, 2004 radiographic evidence

shows (1) "mild degenerative change at the anterior and lateral aspect of the vertebral

bodies" and "mild facetal arthrosis" of the lumbosacral spine, and (2) mild degenerative

changes of the cervical spine with "an ossific density measuring approximately 8 x 6

lying anterior to the C5-6 intervertebral disk space consistent with a degenerative

calcification." (Tr. at 436 and 437) Albeit "mild" in the radiologist's interpretation, it is,

nevertheless, an "acceptable diagnostic technique" that supports Dr. Easley's opinion.

Holohan, 246 at 1202. Additionally, the Commissioner has cited no evidence in the

record that mild degenerative changes in the spine can not cause back pain. Sufficient

objective evidence exists to credit Dr. Easley's opinions.

While the Court recognizes that oftentimes an ALJ must make difficult

decisions regarding credibility, the law of the Ninth Circuit provides that once a claimant

produces medical evidence of an underlying impairment (here the ALJ found 8 different

severe impairments), the Commissioner may not discredit the claimant's testimony as to

the severity of symptoms merely because they are unsupported by objective medical

evidence. Bunnell v. Sullivan 947 F.2d 341, 343 (9th Cir.1991) (en banc); Moisa v.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 18 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

39 Exhibits 3F (erroneously labeled as 3E in the report; Tr. at 98 - 101) and 4F

(erroneously labeled as 4E in the report; Tr. at 102 - 110) are statements provided by Plaintiff's

roommate, Amanda Hensley, in June, 2003 and a friend, Donald Freestone, who saw Plaintiff

frequently in May - June, 2003.

40 The ALJ wrote that these reasons are "explained elsewhere in this decision" but the

Court and the parties are left to guess at what she is referring in this 11-page report.

- 19 -

Barnhart, 367 F.3d 882 (9th Cir. 2004). Here, the ALJ found that Plaintiff's multiple

impairments were not only severe, they precluded him from doing his previous work.

Moreover, there was no affirmative evidence presented at the hearing that Plaintiff was

malingering. Additionally, the ALJ conceded that Plaintiff's impairments "may be

expected to result in some pain and limitations" and that he "does experience a degree of

limitation." (Tr. at 30) Notwithstanding these findings and the ALJ had "no reason to

dispute the veracity" (Id.) of the two witness statements which corroborated Plaintiff's

testimony on his limitations and lifestyle39, the ALJ found Plaintiff's "allegations

concerning his symptoms and non-exertional limitations lacking in credibility"; that his

"statements concerning his impairments and the impact upon his ability to work are not

entirely credible" and "there exist good reasons for questioning the reliability of the

claimant's subjective complaints"40 (Tr. at 30, 35)

The law in the Ninth Circuit is clear. "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.'" Reddick, 157 F.3d at 722; Lester

v. Chater, 81 F.3d 821, 834 (9th Cir.1995); Swenson v. Sullivan, 876 F.2d 683, 687 (9th

Cir. 1989). Like the error made in Holohan, the ALJ selectively relied on some entries

in claimant's medical records and ignored many others that supported Plaintiff's claims

of pain and difficulties in breathing, standing and inability to work. Holohan, 246 F.3d

at 1206. The examples which the ALJ cited do not constitute clear and convincing

reasons for rejecting Plaintiff's sworn testimony. For example, the ALJ finds that there

have been significant gaps in Plaintiff's treatment but she doesn't identify those gaps and

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 19 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

41 See citations to authority at Plaintiff's Memorandum (dkt # 16), at 6, fn. 17.

42 With regard to the claimant's daily activities, Plaintiff testified that he watched

television most of every day, which is supported by the witness statements (Exh. 3F and 4F),

and that he prepared easy morning meals for his adolescent son and went grocery shopping.

- 20 -

the significance of these gaps, if they do exist; that Plaintiff's treatment "has been

essentially routine and/or conservative in nature"; and that except for narcotic pain

medication, Plaintiff "has not been under treatment for a chronic pain syndrome" by

undergoing transcutaneous electrical nerve stimulator, acupuncture, physical therapy,

biofeedback or other treatment or therapy. (Tr. at 31) This Court is unaware of any case

law or regulation, and the Commissioner has cited none, that one's disabling pain is not

real and genuine unless one's treating physician has prescribed, and the claimant has

undergone whether he can afford it or not, such pain treatment. Also, there is no evidence

that had Plaintiff's treating physician recommended and Plaintiff underwent such

treatment, Plaintiff's pain would have been eliminated or reduced to a degree that would

permit Plaintiff to work. The ALJ's expertise is in the area Social Security law, not

medicine, and she improperly substituted her opinion in this regard for that of Dr.

Easley's regarding Plaintiff's degree of pain and pain management. Medical treatment and

pain management are beyond the ALJ's area of expertise.41

Finally, Plaintiff's activities of daily living42 that the ALJ cited to support

her conclusions on credibility and his disputed ability to engage in substantial gainful

employment are either an inaccurate characterization of the evidence or provide little, if

any, lawful support for rejecting Plaintiff's claim that he is unable to work. The ALJ

wrote that Plaintiff's "limited daily activities cannot be objectively verified with any

degree of certainty" totally ignores the corroborating witness statements found in Exhibits

3F and 4F. (Tr. at 32) The Ninth Circuit "has repeatedly asserted that the mere fact that

a plaintiff has carried on certain daily activities . . . does not in any way detract from [the

Plaintiff's] credibility as to [his] overall disability. One does not need to be 'utterly

incapacitated' in order to be disabled.'" Benecke, 379 F.3d at 593; Vertigan v. Halter, 260

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 20 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28 43 There was evidence that Plaintiff cared for only one child, aged 10, at time of hearing.

- 21 -

F.3d 1044, 1050 (9th Cir.2001) (quoting Fair v. Bowen, 885 F.2d 597, 603 (9th

Cir.1989)). The ALJ also found that Plaintiff's "caring for young children43 can be quite

demanding both physically and emotionally, which further suggests the claimant is not

as limited as he has alleged." (Tr. at 34) As a general statement, most parents will agree

that caring for very young children is, among others, physically and emotionally

demanding. This generalization, however, is contradicted by the record that Plaintiff's

son essentially cares for himself except for grocery shopping, constitutes inappropriate

speculation upon which legal decisions should not be based, and does not meet the Ninth

Circuit's "clear and convincing" standard for rejecting Plaintiff's testimony. Reddick, 157

F.3d at 722. This is clear error.

V. REMAND FOR BENEFITS OR ADDITIONAL EVIDENCE

In light of the ALJ's errors, the Court must determine whether it should

remand for benefits or remand for additional evidence. The Court has discretion to

remand for either purpose. Smolen v. Chater, 80 F.3d 1273, 1292 (9th Cir. 1996);

McCartey v. Massanari, 298 F.3d 1072, 1076 (9th Cir., 2002). Remand for further

administrative proceedings is appropriate if enhancement of the record would be useful.

Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir.2000); Moisa v. Barnhart, 367 F.3d 882,

886-87 (9th Cir.2004) (stating, in a Social Security disability case, that remand is

appropriate in most circumstances). Remand for further proceedings, however, is

unnecessary if the record is fully developed and further administrative proceedings would

serve no useful purpose. Smolen, 80 F.3d at 1293. Such a circumstance arises when: (1)

the ALJ has failed to provide legally sufficient reasons for rejecting the claimant's

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. Harman, 211 F.3d

at 1178; McCartey, 298 F.3d at 1076. The Court concludes that the ALJ should have

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 21 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

44 Federal law also provides that if a person receiving certain Social Security benefits

is convicted of a felony where an element of the offense is the possession, use or distribution

of a controlled substance, as defined in 21 U.S.C. § 802(6), such person is immediately

ineligible certain types of social security and other governmental benefits. See, 21 U.S.C. §

862a; United States v. Littlejohn, 224 F.3d 960 (9th Cir. 2000). 

- 22 -

credited Dr. Cunningham's assessment through the hypothetical question posed to the

vocational expert which likely would have resulted in an answer that Plaintiff's physical

limitations preclude Plaintiff from further gainful employment. Had the ALJ properly

considered Plaintiff's evidence and properly followed existing law on the opinions of

examining physicians vis a vis the non-treating, non-examining state agency physicians,

the ALJ would have found Plaintiff disabled within the meaning of the Act and eligible

for benefits, assuming, of course, that Plaintiff's illicit drug usage is not a contributing

factor material to the determination of disability. 

VI. DRUG USAGE

Although the Court finds that the ALJ erred in determining that Plaintiff

was not disabled within the meaning of the Act and that Plaintiff is, indeed, disabled

under the Act, this finding does not automatically entitle Plaintiff to disability

benefits. 

On March 28, 1996, Congress enacted Section 105 of the Contract with

American Advancement Act ("CAAA"), Pub. L. No. 104-121, § 105(a)(1)(C),

including a subsection entitled "Denial of Disability Benefits to Drug Addicts and

Alcoholics, 42 U.S.C. § 423(d)(2)(C). This statute provides that "[a]n individual shall

not be considered to be disabled for purposes of this title if alcoholism or drug

addiction would (but for this subparagraph) be a contributing factor material to the

Commissioner's determination that the individual is disabled." 42 U.S.C. §

423(d)(2)(C).44 The implementing regulations specify that: "If we find that you are

disabled and have medical evidence of your drug addiction or alcoholism, we must

determine whether your drug addiction or alcoholism is a contributing factor material

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 22 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

45 Methamphetamine is classified as a "dangerous drug" under Arizona law. A.R.S. §

13-3401. Simple possession of methamphetamine is a Class 4 felony and carries a

presumptive prison sentence of 2.5 years subject to the Arizona constitutional limitations of

Proposition 200. A.R.S. § 13-3407; § 13- 701(C)(3); § 13-901.01(A) and (D).

Methamphetamine is classified as a Schedule III "controlled substance" under federal law. 21

U.S.C. § 802(6) and § 812(c). Simple possession of methamphetamine is a Class A

misdemeanor for a first conviction under federal law and carries a maximum prison sentence

of 12 months; a Class E felony if convicted with a similar prior conviction. 21 U.S.C. §

844(a).

46 There is no evidence cited in the record by the ALJ that Plaintiff had an alcohol

problem at any time in his life.

- 23 -

to the determination of disability." 20 C.F.R. §§ 404.1535(a), 416.935(a); Bustamante

v. Massanari, 262 F.3d 949 (9th Cir. 2001); Ball v. Massanari, 254 F.3d 817 (9th Cir.

2001). 

Where the claimant is found to be disabled and there is medical

evidence of the claimant's drug addiction or alcoholism, the ALJ should proceed

under 20 C.F.R. §§ 404.1535 or 416.935 to determine if the claimant "would still [be

found] disabled if [he or she] stopped using alcohol or drugs." 20 C.F.R. §§

404.1535. 416.935; Bustamante, 262 F.3d at 955. 

In this case, Plaintiff is disabled but there is medical evidence of his

significant long-term usage of methamphetamine.45 The ALJ mentioned or discussed

Plaintiff's methamphetamine usage 11 times in her report and concluded that she

"need not make a determination regarding whether drug/alcoholism46 [was] a

contributing factor material in determining disability because the claimant [had] not

been found disabled." (Tr. at 37) In light of the Court's finding that Plaintiff is

disabled within the meaning of the Act, the Court will remand this matter for a

determination of whether Plaintiff's illicit drug usage or addiction, if any, "is a

contributing factor material to the determination of disability." 42 U.S.C. §

423(d)(2)(C). The key and sole inquiry in making this determination on remand is

whether the ALJ would still find Plaintiff disabled if he stopped using illicit drugs.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 23 of 24
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

- 24 -

20 C.F.R. § 404.1535. If the ALJ finds that Plaintiff's unlawful drug use was/is a

contributing factor material to the determination of his disability, benefits should be

denied. 42 U.S.C. § 423(d)(2)(C). On the other hand, if the ALJ finds that Plaintiff's

illegal drug use was/is not such a factor, the ALJ should award benefits in accordance

with the undersigned's findings in this Order. 

Accordingly,

IT IS HEREBY ORDERED that Plaintiff’s Motion For Summary

Judgment (document # 14) is GRANTED. 

IT IS FURTHER ORDERED that Defendant’s Cross-motion For

Summary Judgment (doc. # 21) is DENIED.

IT IS FURTHER ORDERED that this matter is reversed and remanded

for a hearing consistent with this order.

DATED this 24th day of April, 2006.

Case 3:05-cv-02152-LOA Document 25 Filed 04/24/06 Page 24 of 24