Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_08-cv-02037/USCOURTS-azd-2_08-cv-02037-0/pdf.json

Nature of Suit Code: 865
Nature of Suit: Social Security - RSI (405(g))
Cause of Action: 42:405 Review of HHS Decision (SSID)

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NOT FOR PUBLICATION

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Martin Hires, 

Plaintiff, 

vs.

Commissioner of Social Security

Administration, 

Defendant. 

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No. CV-08-2037-PHX-FJM

ORDER

The court has before it plaintiff’s opening brief (doc. 8), defendant’s response (doc.

10), and plaintiff’s reply (doc. 11). We also have before us plaintiff’s motion for admission

of newly acquired evidence (doc. 9). 

Plaintiff filed an application for disability insurance benefits on December 29, 2004,

alleging a disability onset date of August 1, 2003, due to severe bilateral foraminal stenosis

and disc herniation, bilateral degenerative joint disease of his knees, hypertension and heart

disease. Following a hearing, the administrative law judge (“ALJ”) issued a decision

concluding that plaintiff can perform his past relevant work as an aerospace manufacturing

engineer and therefore is not disabled. The ALJ’s decision became the final decision of the

Commissioner when the Appeals Council denied plaintiff’s request for review. Plaintiff then

filed this action for judicial review pursuant to 42 U.S.C. § 405(g).

Case 2:08-cv-02037-FJM Document 12 Filed 12/29/09 Page 1 of 5
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A district court may set aside a denial of benefits “only if it is not supported by

substantial evidence or if it is based on legal error.” Thomas v. Barnhart, 278 F.3d 947, 954

(9th Cir. 2002). Substantial evidence is “relevant evidence which, considering the record as

a whole, a reasonable person might accept as adequate to support a conclusion. Where the

evidence is susceptible to more than one rational interpretation, one of which supports the

ALJ’s decision, the ALJ’s conclusion must be upheld.” Id. (citation omitted). 

Plaintiff contends that the ALJ erred in concluding that he does not meet or equal

Listed Impairment 1.04A for spinal disorders. See 20 C.F.R. Part 404, Subpart P, App. 1,

§ 1.04A. If a claimant has an impairment or combination of impairments that meets or equals

the criteria outlined in the “Listing of Impairments,” then the claimant is presumed disabled

at step three of the five-step sequential evaluation process. 20 C.F.R. § 404.1520(d). Listed

Impairment 1.04A is met or equaled if there is a “disorder of the spine . . . resulting in

compromise of a nerve root . . . with [e]vidence of nerve root compression characterized by

neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss . . .

accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive

straight-leg raising test.” 20 C.F.R. Part 404, Subpart P, App. 1, § 1.04A. The diagnosis of

a listed impairment is insufficient to support a disability determination. Instead, “objective

medical and other findings” are needed to satisfy the criteria of a specific listing. Id. §

404.1525(c)(3). 

Here, the ALJ concluded without explanation that the “claimant does not have an

impairment or combination of impairments that meets or medically equals one of the listed

impairments.” Tr. 20. The ALJ did not address evidence in the record that would arguably

support a conclusion that plaintiff’s back impairment meets or equals Listing 104.A. For

example, the record contains MRI findings of “disk space narrowing at L4-5" and “[l]eft

paracentral disc herniation , L3-4 with superior migration posterior to the L3 vertebral body

. . . with involvement of the left L3 nerve root.” Tr. 109. Plaintiff was diagnosed with

sciatica, Tr. 381, and with “lumbar nerve root compression and disc degeneration.” Tr. 496.

Because there was some evidence of nerve root involvement, the ALJ was required to

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If a claimant cannot perform work on a “regular and continuing basis” (i.e., 8 hours

a day, 5 days a week, or some equivalent schedule), he is disabled. SSR 96-8p. 

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address whether plaintiff’s back impairment fits within the definition of Listing 1.04A. “An

ALJ must evaluate the relevant evidence before concluding that a claimant’s impairments do

not meet or equal a listed impairment. A boilerplate finding is insufficient to support a

conclusion that a claimant’s impairment does not do so.” Lewis v. Apfel, 236 F.3d 503, 512

(9th Cir. 2001). The ALJ’s failure to explain his conclusion that the evidence of record does

not meet or equal Listing 1.04A warrants remand. 

The ALJ also failed to recognize the opinions of three physicians who opined that

plaintiff’s limitations render him unable to work. The medical opinion of a treating physician

is entitled to special weight and can be rejected only if the ALJ provides “specific and

legitimate reasons supported by substantial evidence in the record for so doing.” Lester v.

Chater, 81 F.3d 821, 830 (9th Cir. 1995) (quotation omitted). 

Here, Dr. Flitman, whom plaintiff characterizes as a treating physician, opined that

plaintiff cannot work full-time because his sitting, standing, and walking are limited to less

than 8 hours a day.1

 Tr. 490-92. Dr. Majhail, also characterized as a treating physician,

diagnosed sciatica, disc degeneration, severe back pain and concluded that plaintiff’s

limitations prevent him from working full-time. Tr. 379-81. Dr. Bambakidis opined that

plaintiff can sit/stand/walk for no more than three hours in an eight-hour day. Tr. 494. The

Commissioner incorrectly characterizes Drs. Flitman, Majhail, and Bambakidis’ opinions as

concluding that plaintiff can perform sedentary work. Response at 5. But these opinions

state that plaintiff does not have the residual functional capacity to perform full-time work

at any exertional level. Tr. 379, 490, 494; see also Vertigan v. Halter, 260 F.3d 1044, 1049

n.3 (9th Cir. 2001) (citing SSR 83-10 which defines sedentary work as requiring the ability

to sit for six hours a day).

The ALJ ignored each of these opinions, instead relying on the opinion of state agency

consulting physician, Keith Cunningham, who opined that plaintiff can perform light work.

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Tr. 22-23. A state agency physician’s controverting opinion does not itself constitute

substantial evidence to support the rejection of plaintiff’s treating physicians. Although the

ALJ suggests that treating physician Murli Raman, M.D.’s opinion supports the conclusion

that plaintiff can perform light work, he fails to recognize that Dr. Raman opined that

plaintiff cannot sit, stand, or walk for more than one hour in an eight-hour day and thus

cannot perform full-time work. Tr. 180. The ALJ failed to provide adequate reasons for

rejecting the opinions of plaintiff’s treating physicians. This omission also warrants remand.

The ALJ also failed to give the appropriate weight to the Veteran’s Administration’s

conclusion that plaintiff is disabled and entitled to benefits. “Great weight” should be given

to the VA’s disability determination. McCartey v. Massanari, 298 F.3d 1072, 1076 (9th Cir.

2002). An “ALJ may give less weight to a VA disability rating if he gives persuasive,

specific, valid reasons for doing so that are supported by the record.” Id. Here, the ALJ

concluded that the VA’s decision was not persuasive because “it did not consider the

claimant’s ability to work within the confines of the adopted RFC.” Tr. 22. This presumes

the “adopted RFC” is correct, yet this is the very issue under consideration here. The ALJ’s

explanation for disregarding the VA’s disability determination is neither persuasive, specific,

nor valid. 

Finally, the ALJ rejected plaintiff’s subjective complaints of disabling pain concluding

that the complaints are not supported by either his activities of daily living or the objective

medical evidence. But the ALJ does not discuss how plaintiff’s daily activities are

incompatible with plaintiff’s subjective complaints. Moreover, the absence of supporting

medical evidence is insufficient in itself to reject a claimant’s subjective complaints of pain.

Lester, 81 F.3d at 834. “Unless there is affirmative evidence showing the claimant is

malingering, the Commissioner’s reasons for rejecting the claimant’s testimony must be

“clear and convincing.’” Id. The ALJ’s failure to support the rejection of plaintiff’s

subjective symptoms also warrants remand. 

For all of these reasons, we remand this case to the Social Security Commissioner

with instructions for an immediate payment of benefits. “Where the Commissioner fails to

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provide adequate reasons for rejecting the opinion of a treating or examining physician, we

credit that opinion ‘as a matter of law.’” Id. (citations omitted). “Similarly, where the ALJ

improperly rejects the claimant’s testimony regarding his limitations, and the claimant would

be disabled if his testimony were credited, . . . that testimony is also credited as a matter of

law.” Id. The defendant does not point to any evidence of record (nor do we find any) that

would otherwise provide the evidence needed to reject the treating physicians’ opinions or

plaintiff’s testimony. It is clear from the record that the ALJ would be required to find that

the plaintiff is disabled were such evidence credited. There are no further issues or evidence

to consider on remand. 

Therefore, IT IS ORDERED REVERSING the Commissioner’s denial of benefits

and REMANDING this case pursuant to the fourth sentence of 42 U.S.C. § 405(g) for an

immediate award of benefits (doc. 8). 

IT IS FURTHER ORDERED DENYING plaintiff’s motion for admission of newly

discovered evidence as moot (doc. 9).

The clerk shall enter final judgment. 

DATED this 29th day of December, 2009.

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