Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-5_05-cv-04035/USCOURTS-cand-5_05-cv-04035-3/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 (DIWW)

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United States District Court

For the Northern District of California

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1 Pursuant to 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73, all parties have

expressly consented that all proceedings in this matter may be heard and finally adjudicated

by the undersigned.

 *E-filed 2/28/07*

NOT FOR CITATION

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

SAN JOSE DIVISION

ROSANA J. GIORDANO,

Plaintiff,

 v.

LINDA S. McMAHON, Acting Commissioner

of Social Security,

Defendant. /

No. C05-04035 HRL

ORDER (1) DENYING PLAINTIFF’S

MOTION FOR SUMMARY JUDGMENT;

AND (2) GRANTING DEFENDANT’S

CROSS-MOTION FOR SUMMARY

JUDGMENT

[Re: Docket Nos. 13, 16]

In this Social Security action, plaintiff Rosana J. Giordano appeals a final decision by

the Commissioner denying her application for disability insurance benefits. Presently before

the court are plaintiff’s motion for summary judgment and defendant’s cross-motion for

summary judgment.1

 Plaintiff filed a reply brief, and the matter was submitted without oral

argument. Having considered the papers submitted by the parties, and for the reasons set forth

below, the court denies plaintiff’s motion and grants defendant’s motion.

I. BACKGROUND

Plaintiff is a 38-year-old woman with a 12th grade education and a history of back

problems. (AR 36.) Her medical situation is complicated by obesity, depression, memory

problems, and side effects from medication. (AR 49, 50, 56.) Plaintiff’s main work experience

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has been as a bank teller. (AR 84.) Plaintiff underwent a lumbar diskectomy in 2000 and

experienced sporadically increasing back pain until she stopped working in September 2002 due

to the pain. (AR 37.) Her back pain has been treated with medicine and physical therapy, but a

contemplated lumbar fusion procedure has not been performed because plaintiff has not

managed to lose the weight necessary to allow the surgery. (AR 47-50.)

Plaintiff applied for disability insurance benefits in February 2003, contending that she

was disabled due to a herniated disc, bone spur, and degenerative disc disorder with detachment

and scar tissue beginning September 18, 2002. (AR 83.) The claim was initially denied on

May 13, 2003. (AR 61.) Plaintiff filed a request for reconsideration, adding a claim of mental

disability, but the claim was denied at the reconsideration level on August 12, 2003. (AR 65-

69.) Plaintiff appeared for a hearing before an Administrative Law Judge (ALJ) on March 4,

2004, represented by counsel. The ALJ issued his order finding plaintiff not disabled on April

4, 2004. (AR 15-24.) He found that plaintiff’s degenerative disc disease was a “severe”

impairment under 20 C.F.R. § 404.1520(c). (AR 24.) However, he concluded that this

impairment did not meet or medically equal one of the listed impairments in Appendix 1,

Subpart P, Regulation No. 4. (AR 24.) The ALJ further found that plaintiff has the residual

functional capacity (“RFC”) to perform at least a significant range of light work activity, and

that plaintiff’s impairment does not prevent her from performing her past relevant work. (AR

24.) On February 15, 2005, the Appeals Council denied plaintiff’s request for review, despite

her submission of additional evidence concerning her alleged mental disorders, and the ALJ’s

decision became the final decision of the Commissioner. (AR 8-11.) Plaintiff now seeks

judicial review of that decision. 

II. LEGAL STANDARD

Pursuant to 42 U.S.C. § 405(g), this court has the authority to review the

Commissioner’s decision denying benefits. The Commissioner’s decision will be disturbed

only if it is not supported by substantial evidence or if it is based upon the application of

improper legal standards. Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595, 599 (9th

Cir. 1999); Moncada v. Chater, 60 F.3d 521, 523 (9th Cir. 1995). In this context, the term

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“substantial evidence” means “more than a mere scintilla but less than a preponderance – it is

such relevant evidence that a reasonable mind might accept as adequate to support the

conclusion.” Moncada, 60 F.3d at 523. When determining whether substantial evidence exists

to support the Commissioner’s decision, the court examines the administrative record as a

whole, considering adverse as well as supporting evidence. Drouin v. Sullivan, 966 F.2d 1255,

1257 (9th Cir. 1992). The Commissioner’s decision must be affirmed if the record can

reasonably support either affirming or reversing the decision. Moncada, 60 F.3d at 523.

III. DISCUSSION

Plaintiff contends that the ALJ erred in (1) rejecting the opinion of plaintiff’s treating

physician; (2) concluding that plaintiff’s alleged mental impairment was not severe; (3)

determining that plaintiff is capable of returning to her past work; and (4) discounting plaintiff’s

subjective testimony pursuant to a finding that plaintiff is “not totally credible.” Defendant

asserts that the ALJ’s decision is supported by substantial evidence and free of legal error. 

A. Treating Physician Opinion

Plaintiff argues that the ALJ improperly rejected the opinion of plaintiff’s treating 

neurologist, Dr. Saadi. There are several reports from Dr. Saadi in the record, most notably a

March 8, 2004 Medical Source Statement in which Dr. Saadi diagnosed plaintiff with “failed

back syndrome with intractable radiculitis.” (AR 290.) Dr. Saadi checked a box stating that

plaintiff would be “incapable of even ‘low stress’ jobs” and found extreme limitations on

plaintiff’s physical activity, including (1) sit only 20 minutes at a time and only 2 hours total

during an 8-hour day; (2) stand only 20 minutes at a time; (3) stand or walk only 2 hours total

during an 8-hour day; (4) walk around for 10 minutes every 30 minutes; (5) need to alternate

positions at will; (6) need to take unscheduled breaks to lie down; (7) rarely lift 10 pounds; and

(8) never twist or stoop. (AR 290-95.) Dr. Saadi checked the box indicating that plaintiff’s

symptoms would “constantly” interfere with the attention and concentration needed to perform

even simple work tasks. (AR 292.)

In contrast, the ALJ found that plaintiff retains the residual functional capacity to

perform at least a significant range of light work activity, standing, walking, and sitting up to 6

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hours each with the usual breaks and lifting and carrying up to 20 pounds occasionally and 10

pounds frequently. (AR 21.) The ALJ based this on medical records and opinions provided by

Dr. Saadi as well as other treating physicians Dr. Bui, Dr. Abaci, and Dr. Nchekwbe, in addition

to State Agency physicians. The State Agency physicians provided the minor limitations

eventually adopted by the ALJ. (AR 21.)

The ALJ noted that the sole medical opinion in the record that the plaintiff would be

limited to less than light work activity was the March 8 assessment of Dr. Saadi. (AR 21.) The

ALJ then explained: 

“The undersigned is unable to document sufficient objective signs

and laboratory findings to justify such extreme limitations for the

claimant, and in fact, finds them to be significantly contradicted by

the relatively minor medical examinations near that date. For

example, on October 20, 2003, Dr. Abaci had found the claimant’s

gait to be relatively normal, she had no scoliosis, normal lodosis,

her range of motion was “okay,” but she was obese and

deconditioned....October MRI’s had documented a normal cervical

spine and fairly minor objective findings in her lumbar spine... 

January 31, 2003 straight leg raising tests had been normal, as

observed by this same Dr. Saadi...and there was no evidence of

neurological or sensory deficits....Based on these objective medical

findings, the undersigned rejects the March 8, 2004 assessments

submitted by Dr. Saadi, including his disability onset date of April

2002 (or 5 months prior to when he actually first saw the claimant),

as being perhaps disproportionately more influenced by the

claimant’s subjective complaints than by actual objective medical

signs and laboratory findings. The undersigned therefore accords

more weight to the State Agency physicians’ medical opinions

detailed above.” (AR 22.)

Treating and examining physicians, such as Dr. Saadi, have a special role in the

adjudication of Social Security cases. "The opinion of an examining doctor, even if

contradicted by another doctor, can only be rejected for specific and legitimate reasons that are

supported by substantial evidence in the record." Widmark v. Barnhart, 454 F.3d 1063, 1066 

(9th Cir. 2006) (citing Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1995). That is the

standard applicable to this case, because Dr. Saadi's opinion is contradicted by those of the State 

Agency physicians. See Widmark, 454 F.3d at 1066-67 (even a brief, conclusory opinion of a

state agency reviewing physician suffices to establish a conflict among medical opinions). 

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28 2 The ALJ presumably intended to refer to the November 2003 MRI, because

there are no MRI results from October 2003 in the record.

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The court concludes that the ALJ gave specific, legitimate reasons for discounting Dr.

Saadi’s opinion that are based on substantial evidence in the record. First, the ALJ pointed to

specific pieces of objective evidence in the record, such as Dr. Abaci's finding that the plaintiff's

gait was relatively normal and Dr. Saadi's observation of normal straight leg raising tests, that

support the ALJ's specific, legitimate conclusion that the objective evidence does not justify

extreme limitations. (AR 22.) Plaintiff contends that there is ample objective evidence to

support Dr. Saadi’s functional assessment. Plaintiff cites Dr. Saadi’s review of a November

2003 MRI where Dr. Saadi concluded that the “disk space is majorly collapsed, with foraminal

stenosis,” and argues that the ALJ’s conclusion that the MRI produced only “minor” findings is

baseless.2 (AR 22, 242.) However, the radiologist explaining the scans did not use the term

“majorly collapsed.” Instead, the radiologist found minimal problems with the cervical spine

and, as for the lumbar spine, found “postoperative change L5-S1 with some marrow edema

within the vertebral bodies and probable postop fibrosis at the L5-S1 dorsal nerve rootlet level

on the left.” (AR 244.) A lumbosacral x-ray conducted at the same time found “narrowed L5-

S1 interspace” but “no abnormal motion with lateral flexion and extension.” (AR 245.) The

ALJ is entitled to review the MRI results himself rather than accepting Dr. Saadi’s description

of the MRI findings.

Next, the ALJ concluded that Dr. Saadi's opinion may have been overly influenced by

plaintiff's subjective complaints. (AR 22.) Plaintiff asserts that there is no evidence that this

was so. As discussed more fully below, the court concludes that the ALJ properly discounted

plaintiff’s credibility as to her subjective complaints. And, although the ALJ does not quote

any part of the record to show that Dr. Saadi was overly influenced by subjective complaints,

the ALJ is entitled to extrapolate from the character of Dr. Saadi's numerous reports that this

was so. "The ALJ is responsible for determining credibility, resolving conflicts in medical

testimony, and resolving ambiguities." Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir.1995).

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Finally, the ALJ decided to accord more weight to the State Agency physicians' opinions

which concluded that plaintiff retains the residual functional capacity to perform at least a

significant range of light work activity. (AR 22.) Plaintiff argues that the ALJ erred in relying

on the State Agency physician opinion, because that opinion was produced in May 2003 and

therefore did not incorporate the findings of the November 2003 MRI. Defendant responds that

the ALJ was entitled to conclude that there were few important changes between the September

2002 and November 2003 MRIs, because in November 2003 Dr. Saadi described plaintiff as

“continu[ing] to have the same symptoms as before.” (AR 242.) The ALJ was within his

discretion to conclude that the May 2003 government physician opinion remained relevant

evidence. 

It would have been reasonable for the ALJ to conclude that there is sufficient objective

evidence in the record to support Dr. Saadi’s restrictive assessment, but it is not this court’s role

to re-decide the case. Because the ALJ gave specific and legitimate reasons for rejecting the

March 8, 2004 statement, this court defers to the ALJ’s decision to do so. Accordingly,

plaintiff’s motion as to this issue is denied and defendant’s motion as to this issue is granted.

B. Severity of Mental Impairment

Plaintiff argues that the ALJ erred in concluding that plaintiff's depression was "nonsevere." A severe impairment is one that significantly limits the claimant's ability to do basic

work activities. 20 C.F.R. § 404.1520(c), 404.1521. The ALJ gave the following written

analysis about plaintiff's mental impairments:

The undersigned finds that on November 25, 2003, her treating

primary physician Dr. Saadi recommended a psychological

evaluation and prescribed Zoloft, without evidence of significant

objective signs and laboratory findings of mental problems

thereafter. Although Dr. Saadi later opined that the claimant would

be incapable of even low-stress jobs partially due to "reactive

depression," the undersigned finds no objective evidence of ongoing

symptomatology of a longitudinal nature to support that medical

opinion. On May 3, 2003, the State Agency physicians concluded

that based on the objective medical evidence through that date,

"there is no evidence of any psychiatric impairment".... The

undersigned further notes that the claimant's treating psychologist

from December 2003 through February 2004, Sema Bayla, Ph.D.,

did not submit any residual functional capacity/medical source

statement in support of the claiman'ts disability. For all these

reasons, the undersigned finds that any allegation of a severe mental

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impairment will be considered "non-severe" for the purposes of this

decision." (AR 19.)

When plaintiff appealed the ALJ's decision to the Appeals Council, she submitted an additional

report, from David Devine, Ph.D. Dr. Devine's report and attached Psychiatric Review

Technique described plaintiff as suffering from "major depressive disorder, recurrent,

severe...generalized anxiety disorder...and chronic pain disorder." (AR 313.) Dr. Devine

opined that these problems would cause "significant functional limitations." (AR 314.) In

denying plaintiff's request for review, the Appeals Council stated: 

...[T]he Council does not accord this opinion controlling or

significant weight. It is unclear as to whether Dr. Devine is a

treating source. He did not indicate when he first saw you or

whether you continued to be seen. Also there is no showing that Dr.

Devine performed a mental status evaluation or that psychological

testing was undertaken.

Additionally, while Dr. Devine opined that you met a listing, that

listing was not identified. Moreover, the moderate limitations noted

by Dr. Devine are inconsistent with a finding that a listing was met. 

Furthermore, the assessment was for a month. Thus, even if these

limitations were accorded controlling weight, there is no showing

that the limitations last a period of 12 continuous months. (AR 9.)

Plaintiff now argues that (1) the ALJ committed legal error in failing to perform the

requisite functional assessment prescribed by 20 C.F.R. § 404.1520a, and (2) the ALJ did not

base his decision on substantial evidence. As for the first point, the special technique described

in § 404.1520a is only required if the claimant has a "medically determinable mental

impairment." The State Agency physicians found "no medically determinable psych

impairment." (AR 169.) They noted her allegations about her mental symptoms, but 20 C.F.R.

§ 404.1508 states that a "physical or mental impairment must be established by medical

evidence consisting of signs, symptoms, and laboratory findings, not only by your statement of

symptoms." Thus, the ALJ was not required to perform any further functional assessment.

The next issue is whether the ALJ's and Appeals Council's decisions about the nonseverity of plaintiff's alleged mental impairment were based on substantial evidence. Plaintiff

points to a variety of statements by her treating and examining physicians that she was suffering

from depression derivative of her physical pain. However, the fact that there is some evidence

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pointing in one direction does not mean that there is not also substantial evidence pointing in

the other direction. Both the ALJ and the Appeal Council appear to have based their decisions

about plaintiff's depression on substantial evidence in the record. For example, the ALJ notes

that plaintiff's treating psychologist did not submit a statement in support of plaintiff's alleged

mental disability. (AR 19.) Moreover, the government physicians found no objective evidence

of a mental impairment. (AR 19.) Thus, the ALJ cited sufficient evidence to support his

conclusion that plaintiff did not carry her burden of proof at this stage of the disability

determination. The Appeals Council based its dismissal of Dr. Devine's report on substantial

evidence that Dr. Devine was not plaintiff's treating psychologist and had not engaged in

thorough, independent psychological testing of plaintiff. (AR 9.) Plaintiff does not dispute the

existence of any of the pieces of evidence relied on by the ALJ and the Appeals Council. 

Accordingly, plaintiff’s motion as to this issue is denied and defendant’s motion as to this issue

is granted.

C. Finding that Plaintiff Can Return to Past Work

Plaintiff argues that the record does not support the ALJ's "facile conclusion" that she

can return to her past work. Plaintiff asserts that such a finding is "implausible given the severe

pain, which is aggravated with prolonged sitting and standing; her need to alternate positions;

the sedative effects of medication; and her onset of depression which prohibits her from

performing complex tasks and working at a consistent pace." Defendant responds that the ALJ

considered, when assessing plaintiff's RFC, all of the limitations that were shown to exist, and

thus he did not err in omitting plaintiff's other alleged limitations, which she had not carried her

burden of proving. The ALJ properly established plaintiff's RFC to perform at least a

significant range of light work, and then found that the evidence established that she could

return to her past relevant work as customer service agent, retail cashier, accountant, and bank

teller. (AR 23.) The ALJ found that she could return to that work both as it is generally

performed in the national economy and as she actually performed it. (AR 23.) Plaintiff's

assertion that the ALJ's conclusions are "implausible" ignores the fact that the ALJ is

responsible for determining RFC and is also responsible for "resolving ambiguities." See 20

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C.F.R. § 404.1546(c) and Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir.1995). Accordingly,

plaintiff’s motion as to this issue is denied and defendant’s motion as to this issue is granted.

D. Plaintiff’s Subjective Testimony

Plaintiff argues that the ALJ erred in discounting plaintiff's subjective testimony as "less

than fully credible when compared to the record as a whole." (AR 23.) Plaintiff presented

evidence of an underlying impairment that could reasonably be expected to produce pain and

other symptoms. Thus, absent affirmative evidence of malingering, the ALJ could only reject

the claimant's testimony about the severity of her symptoms by giving "clear and convincing

reasons" for doing so. Batson v. Commissioner, 359 F.3d 1190, 1196 (9th Cir. 2004). "The fact

that a claimant's testimony is not fully corroborated by the objective medical findings, in and of

itself, is not a clear and convincing reason for rejecting it." Vertigan v. Halter, 260 F.3d 1044,

1049 (9th Cir. 2001). 

The ALJ made clear and convincing findings to support his determination that plaintiff's

complaints were not fully credible. In addition to citing objective medical findings that

undermine plaintiff's subjective testimony, the ALJ noted that "there is evidence that the

claimant has been less than fully compliant with recommended medical treatment." (AR 23.) 

As examples, he cited plaintiff's continued weight gain in the face of recommendations to lose

weight, plaintiff's failure to follow-up on Dr. Saadi's advice that she seek physical therapy, 

and (after plaintiff did begin physical therapy) a therapist's note that "patient has apparently

self-limited their therapy care." (AR 23.)

Plaintiff now argues that it was wrong for the ALJ to cite her failure to lose weight. 

Social Security Ruling 02-1p states that the Social Security Administration will "rarely use

'failure to follow prescribed treatment' for obesity to deny or cease benefits," and only when

certain strict conditions are met. "Failure to follow prescribed treatment" can result in a denial

of benefits under 20 C.F.R. § 404.1530. However, the ALJ in this case did not rely on 20

C.F.R. § 404.1530 to deny benefits to the claimant. The ALJ cited the plaintiff's failure to

follow recommended treatment for her obesity as just one example among many of times that

plaintiff was less than fully compliant with recommended medical treatment. The strict

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conditions described in S.S.R. 02-1p were therefore not binding on the ALJ in this case. The

ALJ's statement of specific reasons for discrediting plaintiff's testimony is sufficient.

Accordingly, plaintiff’s motion as to this issue is denied and defendant’s motion as to this issue

is granted.

IV. ORDER

Based on the foregoing, plaintiff’s motion for summary judgment or remand is

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

Dated: 2/28/07

 

HOWARD R. LLOYD

UNITED STATES MAGISTRATE JUDGE

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Notice will be sent to:

Mary Patricia Parnow mary.parnow@ssa.gov 

Harvey Peter Sackett hps@hpspc.com, lucyc@sackettlaw.com; julie@sackettlaw.com;

juanita@sackettlaw.com 

Sara Winslow sara.winslow@usdoj.gov, kathy.terry@usdoj.gov; claire.muller@usdoj.gov 

Counsel are responsible for distributing copies of this document to co-counsel who have not

registered for e-filing under the court’s CM/ECF program.

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