Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_04-cv-02872/USCOURTS-azd-2_04-cv-02872-2/pdf.json

Nature of Suit Code: 865
Nature of Suit: Social Security - RSI (405(g))
Cause of Action: 42:416 Denial of Social Security Benefits

---

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

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

CHARLES D. DUNHAM, )

)

Plaintiff, ) 

) No. CIV 04-2872 PHX RCB

vs. ) 

) O R D E R

JO ANNE B. BARNHART, )

Commissioner of Social )

Security )

)

Defendant. ) )

On December 13, 2004, Plaintiff Charles D. Dunham filed the

above-entitled action pursuant to 42 U.S.C. § 405(g) for judicial

review of a final decision of the Commissioner of Social Security

(the "Commissioner") denying his application for disability

insurance benefits under Title II of the Social Security Act (the

"Act"). Compl. (doc. # 1). Currently pending before the Court are

Plaintiff's motion for summary judgment (doc. # 10) and Defendant's

cross-motion for summary judgment (doc. # 15). On April 10, 2006,

Defendant filed a response in opposition to Plaintiff's motion. 

Resp. (doc. # 14). By order entered September 1, 2006, the Court 

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 1 of 13
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

- 2 -

extended the time for Plaintiff to respond to Defendant's motion

until September 8, 2006. Order (doc. # 20). The Court has not

received a response from Plaintiff to date. Under Local Rule of

Civil Procedure 7.2(i), the Court may deem a party's lack of

opposition-- or untimely opposition-- as consent to the granting of

a motion, and may grant the motion summarily if it is facially

meritorious. LRCiv 7.2(i); Henry v. Gill Indus., Inc., 983 F.2d

943, 950 (9th Cir. 1993). The Court finds the matter suitable for

decision without oral argument. See LRCiv 7.2(f), 56.1(b). Having

carefully considered the arguments raised, the Court now rules.

I. BACKGROUND

On August 31, 1993, Plaintiff filed an application for

disability insurance benefits under Title II of the Act,

complaining of chronic fatigue syndrome with an onset date of June

10, 1992. See Admin. R. (doc. ## 3A, 3B) (collectively "Admin.

R.") at 113-16. On January 12, 1996, administrative law judge

("ALJ") Philip E. Moulaison issued a decision finding Plaintiff

disabled from June 10, 1992 through August 31, 1994. Id. at 423-

26. On remand from the Appeals Council, ALJ Moulaison issued a

second decision on April 29, 1999 finding Plaintiff disabled from

June 10, 1992 through October 7, 1994. Id. at 482-84. On July 26,

2002, the Appeals Council again vacated the ALJ's decision and

remanded for further proceedings. Id. at 492-94. 

On December 6, 2002, a hearing was held before ALJ Michael D.

Tucevich where Dr. Clifford Harris, a non-examining physician

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 2 of 13
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

 As with his previous hearings, Plaintiff knowingly waived his

right to representation at the hearing. See Admin. R. at 69-70.

2

 At the hearing before ALJ Tucevich, Dr. Harris characterized

Plaintiff's treating physicians as "alternative medical-type people,"

and expressed his view that he "do[es] not think [homeopathy] has any

good scientific background." Admin. R. at 95.

- 3 -

testified as a medical expert.1 Id. at 67-111. Thereafter, on

December 26, 2002, ALJ Tucevich issued a decision finding that

Plaintiff was not disabled within the meaning of the Act for any

period of time, and denying his application for benefits. Id. at

27-35. That decision does not discuss any of the medical opinion

evidence from Plaintiff's treating physician, Alan Ketover, M.D.,

which had been cited at the end of ALJ Moulaison's previous

decisions that were partially favorable to Plaintiff. See id. at

27-35, 213-14, 217-91, 428, 486-87. Instead, ALJ Tucevich's

decision indicates that the file "contains reports from 'Other

sources' such as . . . homeopaths," on which he accorded little

weight on the basis that homeopaths are not "acceptable medical

sources." Admin. R. at 32. Although no names are mentioned, it is

apparent that these statements were made in reference to Dr.

Ketover, a licensed physician who subscribes to the medical

philosophy of homeopathy.2

 See id. at 242.

On October 13, 2004, the Appeals Council of the Social

Security Administration (the "SSA") issued a decision adopting ALJ

Tucevich's findings, except that the Council found Plaintiff

capable of performing his past relevant work through December 26,

2002. Id. at 11-13. At that point, the decision of the Appeals

Council became the final decision of the Commissioner. See 20

C.F.R. § 404.981; Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir.

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 3 of 13
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 -

1999). In accordance with 42 U.S.C. § 405(g), Plaintiff sought

review in this Court.

II. STANDARD OF REVIEW

A. Fed. R. Civ. P. 56

Summary judgment is appropriate "when there is no genuine

issue of material fact" such that "the moving party is entitled to

judgment as a matter of law." Fed. R. Civ. P. 56. In determining

whether to grant summary judgment, a district court must view the

underlying facts and the inferences to be drawn from those facts in

the light most favorable to the nonmoving party. See Matsushita

Elec. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986).

If a party will bear the burden of proof at trial as to an

element essential to its claim, and fails to adduce evidence

establishing a genuine issue of material fact with respect to the

existence of that element, then summary judgment is appropriate. 

See Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). Not

every factual dispute is capable of defeating a properly supported

motion for summary judgment. Rather, the party opposing the motion

must show that there is a genuine issue of material fact. See

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986). A

factual dispute is genuine if the evidence is such that a rational

trier of fact could resolve the dispute in favor of the nonmoving

party. Id. at 248. A fact is material if determination of the

issue might affect the outcome of the case under the governing

substantive law. Id. Thus, a party opposing a motion for summary

judgment cannot rest upon bare allegations or denials in the

pleadings, but must set forth specific facts demonstrating a

genuine issue for trial. See id. at 250. If the nonmoving party's

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 4 of 13
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

- 5 -

evidence is merely colorable or not significantly probative, a

court may grant summary judgment. See id. at 249; see also Cal.

Architectural Build. Prods., Inc. v. Franciscan Ceramics, 818 F.2d

1466, 1468 (9th Cir. 1987).

Finally, the fact that both parties have moved for summary

judgment does not alter these standards. "It is well settled that

a court's duty to ascertain whether facts remain in contention is

not obviated by cross motions for summary judgment." Eby v. Reb

Realty, Inc., 495 F.2d 646, 649 (9th Cir. 1974).

B. 42 U.S.C. § 405(g)

The Commissioner's denial of benefits is subject to judicial

review pursuant to 42 U.S.C. § 405(g). The decision of the

Commissioner must be affirmed if it is supported by

substantial evidence and the Commissioner applied the correct legal

standards. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir.

2005); Benton v. Barnhart, 331 F.3d 1030, 1035 (9th Cir. 2003);

Tackett, 180 F.3d at 1097; Reddick v. Chater, 157 F.3d 715, 720

(9th Cir. 1998). Factual determinations by the Commissioner,

acting through an ALJ, must be affirmed if supported by substantial

evidence. See Celaya v. Halter, 332 F.3d 1177, 1180 (9th Cir.

2003); Saelee v. Chater, 94 F.3d 520, 521 (9th Cir. 1996).

Substantial evidence 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). It is more than a

"mere scintilla," but less than a preponderance. Richardson, 402

U.S. at 401 (1971) (internal quotations omitted); Connett v.

Barnhart, 340 F.3d 871, 873 (9th Cir. 2003); Tackett, 180 F.3d at

1098; Reddick, 157 F.3d at 720; Sorenson v. Weinberger, 514 F.2d

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 5 of 13
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

- 6 -

1112, 1119 n.10 (9th Cir. 1975).

 In reviewing the Commissioner's decision, the district court

must "consider the evidence as a whole, weighing both the evidence

that supports and the evidence that detracts from the

Commissioner's conclusion." Smolen v. Chater, 80 F.3d 1273, 1279

(9th Cir. 1996). If the evidence can reasonably support either

affirming or reversing the Commissioner’s conclusion, the district

court may not substitute its judgment for that of the Commissioner

and must affirm. See McCartey v. Massanari, 298 F.3d 1072, 1075

(9th Cir. 2002); Tackett, 180 F.3d at 1098; Reddick, 157 F.3d at

720; Andrews v. Shalala, 53 F.3d 1035, 1039-40 (9th Cir. 1995). 

Finally, "[a] decision of the ALJ will not be reversed for

errors that are harmless." Stout v. Comm'r, SSA, 454 F.3d 1050,

1054 (9th Cir. 2006) (citation omitted); accord Burch v. Barnhart,

400 F.3d 676, 679 (9th Cir. 2005); Curry v. Sullivan, 925 F.2d

1127, 1131 (9th Cir. 1991). Thus, errors that are inconsequential

to the ALJ's ultimate determination as to disability are not

reversible. Stout, 454 F.3d at 1055. However, the error of

silently disregarding testimony about how an impairment limits a

claimant's ability to work has never been held harmless. See id.

at 1055-56. 

III. DISCUSSION

A person is considered disabled under the Act when he or she

becomes unable "to engage in any substantial gainful activity by

reason of any medically determinable physical or mental impairment

. . . which has lasted or can be expected to last for a continuous

period of not less than twelve months." 42 U.S.C. § 423(d)(1)(A). 

In an administrative proceeding to determine eligibility for

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 6 of 13
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

- 7 -

disability insurance benefits, the Commissioner conducts a

five-step sequential evaluation process to determine whether a

claimant is disabled within the meaning of the Act. See 20 C.F.R.

§ 404.1520(b)-(f). If at any of those five steps the Commissioner

can find the claimant disabled or not, the inquiry ends. 20 C.F.R.

§ 404.1520(a).

In this case, Plaintiff was found "not disabled" at the fourth

stage of the sequential evaluation process when the Appeals Council

determined that Plaintiff retains the residual functional capacity

to engage in sedentary work and his past relevant work as a CPA. 

Admin. R. at 11-13, 30-35; 20 C.F.R. § 404.1520(e). Plaintiff

argues that the Appeals Council erred by (1) deciding his case

differently than did the previous ALJ decisions of January 12, 1996

and April 29, 1999, (2) not giving any consideration to medical

opinion evidence from his treating physician, Dr. Ketover, and (3)

inadequately developing the record by failing to admit additional

records from, or ordering a consultative examination by, Dr.

Ketover. Mot. (doc. # 10) at 7-11. The Court considers each

argument in turn.

A. Nonconformance with Previous ALJ Decisions

Plaintiff argues that the Commissioner's most recent decision

is not supported by substantial evidence, because it is

contradicted by the previous ALJ decisions of January 12, 1996 and

April 29, 1999 in which he was found disabled for the period from

June 10, 1992 to October 7, 1994. Mot. (doc. # 10) at 8. The

Commissioner aptly points out that those decisions are no longer

binding, as they have been vacated by the Appeals Council. See

Mem. in Supp. (doc. # 17) at 4; see also Admin. R. at 492-94; 20

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 7 of 13
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 -

C.F.R. §§ 404.955(c), 404.987(b). The Court agrees, and will begin

its analysis by reviewing the Appeal Council's decision of October

13, 2004 on its own merits, as that decision now reflects the final

decision of the Commissioner in this matter. See 20 C.F.R. §

404.981; Tackett, 180 F.3d at 1097.

B. Treating Physician's Medical Opinion

Under the Social Security Regulations (the "Regulations"),

evidence of a claimant's impairment may be provided by either an

"acceptable medical source" or "other source." 20 C.F.R. §§

404.1513(a), 404.1513(d). Only an acceptable medical source can

provide medical opinion evidence. 20 C.F.R. § 404.1527(a)(2). As

a general rule, an uncontradicted medical opinion from a claimant's

treating source must be accorded controlling weight. 20 C.F.R. §

404.1527(d)(2). The uncontradicted opinion and ultimate

conclusions of a treating source may not be rejected unless the ALJ

provides clear and convincing reasons supported by substantial

evidence in the record for doing so. Baxter v. Sullivan, 923 F.2d

1391, 1396 (9th Cir. 1991); Embrey v. Bowen, 849 F.2d 418, 422 (9th

Cir. 1988). If controverted by other medical evidence, the ALJ may

disregard the opinion only by setting forth "specific and

legitimate reasons" supported by substantial evidence in the record

for doing so. See 20 C.F.R. § 416.927(f)(2)(ii); Andrews, 53 F.3d

at 1043. 

As evidence of his impairments in the case at hand, Plaintiff

provided the Commission with medical records from his treating

physician, Alan Ketover, M.D.. Admin. R. at 213-14, 217-91. As a

licensed physician, Dr. Ketover is an acceptable medical source. 

See 20 C.F.R. § 404.1513(a)(1). Plaintiff thus argues that the

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 8 of 13
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

3

 Under the Regulations, licensed physicians are "acceptable

medical sources." See 20 C.F.R. § 404.1513(a)(1). Even

"naturopaths" are regarded as "acceptable medical sources" so long as

they are also licensed physicians. See 20 C.F.R. § 404.1513(d)(1).

In any event, the Regulations are silent with respect to

"homeopathy," which is the medical philosophy to which Dr. Ketover

subscribes. Because Dr. Ketover is a licensed physician, it seems

inescapable that he is an "acceptable medical source." See id. §

404.1513(a)(1).

- 9 -

Appeals Council should have either given Dr. Ketover's opinion

controlling weight or explained in the decision its reasons for not

doing so. Mot. (doc. # 10) at 8-11. Plaintiff's point is well

taken. Although ALJ Moulaison had apparently considered Dr.

Ketover's opinion in reaching the decisions of January 12, 1996 and

April 29, 1999 that were partially favorable to Plaintiff, see

Admin. R. at 428, 486-87, the subsequent decision of ALJ Tucevich,

on which the Appeals Council relied, made no reference to Dr.

Ketover, see id. at 11, 27-35. Indeed, for all that appears, ALJ

Tucevich erroneously treated Dr. Ketover as an "other source,"

rather than an "acceptable medical source," on the basis that he

practices homeopathic medicine.3

 See Admin. R. at 32.

Defendant claims that (1) the Appeals Council properly

disregarded Dr. Ketover's opinion by relying on the opinion of Dr.

Harris, a non-treating source who testified as a medical expert at

the December 6, 2002 hearing before ALJ Tucevich, and (2) "the

Appeals Council gave additional reasons for favoring Dr. Harris'

opinion over that of Dr. Ketover." Mem. in Supp. (doc. # 17) at 5

(citing Admin. R. at 95, 100, 217-91). These arguments fail for

the following reasons.

First, the fact that Dr. Harris' hearing testimony indirectly

referred to records, which counsel was later able to identify as

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 9 of 13
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 -

"correlat[ing] to the evidence received from Dr. Ketover," see id.,

is no substitute for the ALJ's discussion of the relevant evidence

in his final decision. Similarly, Dr. Harris' opinion that

homeopathic medicine, as practiced by Dr. Ketover, does not have

"any good scientific background," Admin. R. at 95, or that

Plaintiff's complaints "were not associated with a properly

diagnosed medical condition," Mem. in Supp. (doc. # 17) at 5,

cannot be assumed to reflect the ALJ's view in the absence of

actual findings to that effect. It is ALJ's responsibility to

discuss the relevant evidence, and provide sufficient reasons

explaining the weight accorded to that evidence in reaching his

final decision on disability. Neither has happened here, and the

Court will not supplant Dr. Harris' hearing testimony and opinions

as post hoc rationalizations for the ill-explained decisions of the

ALJ and Appeals Council.

Second, the Appeals Council did not provide any explanation

for the total lack of discussion of Dr. Ketover's findings. 

Rather, the Council merely offered their view as to why Dr. Ketover

did not need to be contacted again to provide an updated opinion

relating to Plaintiff's functional capacity. Admin. R. at 12. 

Moreover, the Council adopted all of the ALJ's findings. Id. For

the reasons explained above, those findings are inadequate and

quite possibly premised on the erroneous characterization of Dr.

Ketover as an "other source."

As a licensed physician and a treating source, Dr. Ketover was

an "acceptable medical source" whose opinion should have been

accorded controlling weight. Neither the ALJ nor the Appeals

Council set forth "specific and legitimate reasons" supported by

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 10 of 13
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 -

substantial evidence in the record, let alone clear and convincing

reasons, for the failure to discuss Dr. Ketover's opinion. 

Moreover, in light of ALJ Moulaison's reliance on Dr. Ketover's

findings in the previous decisions that were partially favorable to

Plaintiff, see Admin. R. at 428, 486-87, the Court cannot find that

these errors were harmless. See Stout, 454 F.3d at 1055. The

error of silently disregarding lay testimony about how an

impairment limits a claimant's ability to work has never been held

harmless. See id. at 1055-56. The same should hold true for the

error of silently disregarding the medical opinion of a treating

source, particularly where previous decisions relying on that

opinion reached conclusions favorable to the claimant.

The Court is circumspect in its consideration of the relief to

be awarded, and observes that Dr. Ketover had at one time indicated

that Plaintiff could return to work as of November 22, 1993--

almost eighteen months after his claimed onset date. See Admin. R.

at 217. Accordingly, the Court will remand the case for further

findings. The ALJ should consider Dr. Ketover's opinion as

"acceptable medical source" evidence from a treating source, and

explain his reasons for the weight accorded to that evidence in

reaching his final decision. See Baxter, 923 F.2d at 1396; Embrey,

849 at 422; see also Andrews, 53 F.3d at 1043; 20 C.F.R. §

416.927(f)(2)(ii).

C. Development of the Record

Plaintiff argues that he was deprived of the right to a full

and fair hearing by the ALJ's failure to develop the record. Mot.

(doc. # 10) at 8-10. Plaintiff claims that the ALJ should have

developed the record by ordering a consultative examination by Dr.

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 11 of 13
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 -

Ketover, rather than Dr. Harris, and allowing Plaintiff to submit

additional medical records from Dr. Ketover, including invoices,

notations, and lab reports. Id. at 9-10.

The Ninth Circuit has often repeated its admonishment that

"the ALJ has a special duty to fully and fairly develop the record

and to assure that a claimant's interests are considered," even

when the claimant is represented by counsel. Webb v. Barnhart, 433

F.3d 683, 687 (9th Cir. 2003); Tonapetyan v. Halter, 242 F.3d 1144,

1150 (9th Cir. 2001); Smolen, 80 F.3d at 1288; Brown v. Heckler,

713 F.2d 441, 443 (9th Cir. 1983) (citing Thompson v. Schweiker,

665 F.2d 936, 941 (9th Cir. 1982)). Plaintiff in this case was

unrepresented. Under the Regulations, a consultative examination

is normally required when "[t]here is an indication of a change in

[the claimant's] condition that is likely to affect [the

claimant's] ability to work, but the current severity of [the

claimant's] impairment is not established." See 20 C.F.R. §§

404.1519a(b)(5), 416.919a(b)(5). In addition, Plaintiff correctly

notes that a claimant's treating source is ordinarily the preferred

source for a consultative examination. See Mot. (doc. # 10) at 9

(citing 20 C.F.R. § 404.1519h).

On remand, the ALJ must consider any medical evidence from Dr.

Ketover regarding Plaintiff's physical limitations that was

previously excluded. However, without knowing how the record will

develop on remand, the Court cannot say with certainty whether the

ALJ will be required to order a consultative examination from Dr.

Ketover. In any event, if an examination is deemed necessary, the

Court would expect the ALJ's decision to fully explain the

rationale for the selection of the source for the examination,

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 12 of 13
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 -

consistent with the provisions of 20 C.F.R. §§ 404.1503a, 404.1519,

and 404.1519g through 404.1519j.

IV. CONCLUSION

In light of the foregoing analysis,

IT IS ORDERED that Plaintiff's motion for summary judgment

(doc. # 10) is GRANTED.

IT IS FURTHER ORDERED that Defendant's cross-motion for

summary judgment (doc. # 15) is DENIED.

IT IS FURTHER ORDERED remanding to the Commission for further

administrative action pursuant to sentence 4 of 42 U.S.C. § 405(g). 

On remand the Commission shall reevaluate Plaintiff's claim for

disability insurance benefits in accordance with this decision and

the applicable Ninth Circuit law.

IT IS FINALLY ORDERED directing the Clerk of the Court to

enter judgment in favor of Plaintiff and terminate this case.

DATED this 13th day of September, 2006.

Copies to counsel of record and Plaintiff pro se

Case 2:04-cv-02872-RCB Document 21 Filed 09/14/06 Page 13 of 13