Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_09-cv-02257/USCOURTS-azd-2_09-cv-02257-0/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

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Steven Bose, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

)

)

)

)

)

)

)

)

)

)

)

)

)

No. CV 09-02257-PHX-MHM

ORDER

 Plaintiff Steven Bose (“Plaintiff”) seeks judicial review and reversal of the final

decision of the Commissioner of Social Security to deny Plaintiff's claim for Social Security

benefits pursuant to 42 U.S.C. § 405(g). After consideration of the arguments set forth in the

parties' briefs, the record in the case, and the applicable law, the Court issues the following

order.

I. BACKGROUND

A. MEDICAL AND PROCEDURAL HISTORY

1. MEDICAL HISTORY BEFORE AUGUST 23, 2006

Plaintiff asserts that as of October 2002, he has been suffering from a series of

medical conditions that cause him severe back and neck pain. (Doc. 19-4 at 5). In

November of 2002, a magnetic resonance imaging (“MRI”) scan of Plaintiff’s spine

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 1 of 16
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 -

“revealed mild diffuse degenerative changes.” Id. The scan also showed “mild broad-based

bulging of the C5-6 and C6-7 disks.” Id. On June 27, 2003, Plaintiff underwent a

neurological evaluation conducted by Dr. John H. Schneider, a board certified neurological

surgeon. Id. Although the evaluation revealed that Plaintiff “had no weakness in his upper

or lower extremities,” it also showed that Plaintiff suffered from “headaches, neck pain, and

cervical spondyolosis.” Id. Dr. Schneider concluded, however, that there was “no structural

abnormality that would prevent the claimant from working, at least in a modified capacity.”

Id. 

In February of 2005, Plaintiff began treatment at the Kingman Regional Medical

Center (“KRMC”). (Doc. 19-9 at 28). At the initial visit, on February 3, 2005, Plaintiff

presented with back and hip pain with onset allegedly occurring three years prior to the visit.

Id. An MRI performed the next day revealed that Plaintiff had “minimal degenerative

changes of the right hip.” Id. at 27. Plaintiff returned to KRMC on March 3, when a

physician determined that Plaintiff was suffering from “cervical spondylosis” and “mild

diffuse degenerative changes.” Id. at 26. On March 31, 2005, another MRI scan of

Plaintiff’s lower back “revealed mild disc desiccation at the L2-3 and L3-4 and degenerative

facet disease from L3-4 and L5-S1.” Id. There was, however, “no evidence of spinal

stenosis or significant findings on MRI scan of the thoracic spine.” Id. One month later,

Plaintiff began seeing Dr. Attiya Salim for pain management. (Doc. 19-8 at 6–12). Between

April 26 and May 24, 2005, Dr. Salim administered three lumbar epidural nerve blocks to

help control Plaintiff’s lower back pain. Id. 

On June 8, 2005, Plaintiff returned to KRMC and was examined by Larry Drumm,

D.O., a family practice resident. (Doc. 19-9 at 17). During that exam, Plaintiff indicated that

the injections he received from Dr. Salim relieved his pain for only a few days. Id.

Following the exam, Dr. Drumm concluded that Plaintiff suffered from: “(1) degenerative

joint disease-lumbar spine; (2) scoliosis-lumbar and thoracic spine–both verified with

radiographic studies; (3) hypertension, controlled without medication; [and] (4) arthritis.”

Id. Dr. Donald Morgan, D.O., reviewed Dr. Drumm’s findings and agreed with them. Id.

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 2 of 16
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 -

On October 10, 2005, Plaintiff returned to the KRMC Family Practice Clinic for additional

treatment. Id. at 15. Plaintiff was seen on this occasion by clinic resident Dr. Saleem

Akhtar, D.O., F.P.. Id. Dr. Akhtar’s findings at this visit were consistent with those of Dr.

Drumm at the June visit, reflecting degenerative joint disease, scoliosis, arthritis, and

hypertension. Id. Immediately following the exam, Dr. Mohammed Subhan reviewed Dr.

Akhtar’s findings and agreed with them. Id. 

In January of 2006, Plaintiff began seeing Dr. Benjamin Venger. (Doc. 19-8 at 31).

Dr. Venger evaluated Plaintiff and concluded that he suffered from chronic neck and back

pain. Id. On February 21, another MRI of Plaintiff’s cervical spine was performed,

revealing “only very mild spinal stenosis at C5-6 and C6-7 with no significant compression

of the spinal cord.” (Doc. 19-4 at 8). The scan also showed that there was “no impingement

upon the existing cervical nerve roots.” Id. On March 16, however, Dr. Venger concluded

that the best course of action was to operate on Plaintiff’s neck. (Doc. 19-8 at 29). Two

months later, Plaintiff underwent surgery to stabilize his spine at the C5-6 vertebrae. Id. at

14. The surgery was performed by Dr. Venger and involved the attachment of a metal plate

to Plaintiff’s spine. Id. According to the post-surgery report, the operation was successful

and was completed without complication. Id. Two months after his surgery, on July 27,

Plaintiff indicated that he was experiencing “a little bit of neck pain” but that, overall, he was

“happy with his surgery.” Id. at 25. 

2. FIRST ALJ DECISION

On January 2, 2004, Plaintiff filed his first Title II application for a period of disability

and disability insurance benefits which alleged disability beginning October 3, 2002. (Doc.

19-4 at 5). Plaintiff’s application was denied initially on June 9, 2004, and upon

reconsideration on August 4, 2004. Id. Plaintiff appealed the decision and a hearing was

held on June 21, 2006 before Administrative Law Judge (“ALJ”) Ronald C. Dickinson. Id.

At that hearing, the ALJ heard testimony from the Plaintiff and from Mark J. Kelman, M.A.,

C.D.M.S., a vocational expert. Id. 

After considering “all of the evidence marked as exhibits in [Plaintiff’s] file, the

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 3 of 16
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 -

testimony at the hearing, and the arguments presented,” the ALJ determined that Plaintiff

suffered from the following series of impairments: “degenerative joint disease and

degenerative disc disease of the cervical spine, degenerative joint disease of the lumbar spine,

chronic lower back pain, neck pain, and right leg pain . . . and headaches.” (Doc. 19-4 at 5,

7). The ALJ further determined, however, that Plaintiff’s testimony was not “fully credible

concerning the severity and extent of his limitations.” Id. at 9. In reaching that conclusion,

the ALJ reasoned that although Plaintiff suffered from a series of ailments, none was

disabling. Id. Instead, it appeared that Plaintiff had been receiving treatment for his

conditions and that those treatments were having at least some positive effect. Id.

Furthermore, the ALJ observed that Plaintiff was able to perform household activities such

as cleaning, doing laundry, and cooking, and that those activities undermined any assertion

of disability. Id. Additionally, the ALJ noted that none of Plaintiff’s treating physicians

“completed a medical source statement on [Plaintiff’s] ability to do work-related physical or

mental activities.” Id. at 10. Finally, the ALJ pointed out that Mr. Kelman, the vocational

expert, had determined that, given all of Plaintiff’s alleged ailments, he was nonetheless able

to “perform the requirements of representative jobs such as production assembler, office

helper, and cashier.” Id. at 11. 

On August 23, 2006, the ALJ rendered his decision and concluded Plaintiff had the

“residual functional capacity to perform the exertional requirements of light, unskilled work

that allows for a sit/stand position.” Id. at 8. The ALJ therefore found that Plaintiff did not

meet the requirements for disability under sections 216(i) and 223(d) of the Social Security

Act and that he was not entitled to benefits. Id. at 12. Plaintiff did not timely appeal the

ALJ’s final determination. 

In sum, as of August 23, 2006, Plaintiff was suffering from the following conditions,

none of which was disabling: degenerative joint disease and degenerative disc disease of the

cervical spine, degenerative joint disease of the lumbar spine, chronic lower back pain, neck

pain, and right leg pain, and headaches. 

3. MEDICAL HISTORY AFTER AUGUST 23, 2006

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 4 of 16
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 -

On January 10, 2007, an MRI of Plaintiff’s cervical spine revealed “no disc herniation

or nerve root impingement at the C2 or C3 disc space levels.” (Doc. 19-8 at 16). The scan

also indicated, inter alia, that there was “no definite nerve root impingement at the C4-5 or

the C6-7 nerve root levels.” Id. Plaintiff’s pain, however, had apparently persisted, as he

began seeing Dr. David Kane, a pain management specialist, on February 23, 2007. Id. at

66. At that visit, Plaintiff filled out a questionnaire and indicated that he was suffering from

sharp pains in his lower back and right shoulder. Id. On March 23, Plaintiff returned to Dr.

Kane’s office and filled out another questionnaire, again indicating that he was suffering

from sharp pains in his lower back and right shoulder. Id. at 64. When filling out the

questionnaire, Plaintiff was to rate his pain at a number between 0 and 10, 0 being “no pain

at all” and 10 being the “worse [sic] pain you can imagine.” Id. Plaintiff indicated that his

pain level on March 23 was a 7 and his average daily pain was between 8 and 9. Id. at 64.

On the same day, Dr. Kane administered the first of a series of injections of pain medication

into Plaintiff’s back to help alleviate his pain. Id. at 56. 

Over the next six months, Plaintiff returned to Dr. Kane on a number of occasions for

follow-up visits and additional injections. Id. Dr. Kane administered injections on April 18,

June 14, and June 27. Id. at 55, 53, 52. On each day that Plaintiff received an injection, he

also filled out a pain questionnaire. Id. at 61–64. On April 18, Plaintiff reported his pain that

day as a 5 and his daily average pain as an 8. Id. at 63. At the June 14 visit, Plaintiff rated

his pain level at 4 to 5, with a daily average pain level of 7. Id. at 62. On June 27, Plaintiff

wrote that his pain was a 4 and his daily average was a 7. Id. at 61. Although it is unclear

whether injections continued after June 27, Plaintiff returned to Dr. Kane’s office on July 19

and September 11. Id. at 59, 60. On July 19 Plaintiff filled out another questionnaire,

indicating that his pain level that day was between 4 and 5, and his daily average pain was

between 6 and 7. Id. at 60. Plaintiff filled out a final questionnaire at Dr. Kane’s office on

September 11, indicating that his pain that day was between 3 and 4, but not indicating a

particular average pain level. Id. at 59. 

Dr. Kane also examined Plaintiff and prepared pain clinic re-evaluations on April 23,

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 5 of 16
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 -

July 19 and September 11, 2007. The April report indicates that while there was tenderness

in Plaintiff’s back, he experienced “significant relief” following treatment. Id. at 54.

Similarly, in the July 19 report, Dr. Kane noted that Plaintiff was “overall doing very well.”

Id. at 70. In the September report, Dr. Kane indicated that Plaintiff’s back was “better,” but

that his neck and headache pain was increasing. Id. at 51.

On November 1, 2007, Plaintiff returned to KRMC for treatment and saw Dr.

Mohammed Subhan for a follow-up visit. (Doc. 19-9 at 6). Over the course of the next

thirteen months, Plaintiff saw Dr. Subhan on seven separate occasions. At these meetings,

Dr. Subhan conducted thorough examinations of Plaintiff and noted his symptoms. At the

November, 2007 visit, Dr. Subhan noted that Plaintiff appeared “well developed, well

nourished,” and “in no acute distress.” Id. at 7. At the same visit, Dr. Subhan also reported

that Plaintiff’s neck exhibited “no decrease in suppleness” and that Plaintiff’s back exhibited

no symptoms. Id. Nonetheless, Dr. Subhan assessed Plaintiff as having degenerative disc

disease and chronic neck and back pain. Id. at 8. On December 4, Plaintiff again saw Dr.

Subhan. Id. at 3. Dr. Subhan’s report following that visit reflects no substantial change in

Plaintiff’s condition. Id. Plaintiff subsequently returned to Dr. Subhan on April 8, May 6,

and July 1, 2008. Id. at 87–92. With the exception of a finding on May 6 that Plaintiff’s

back was tender and experienced muscle spasm, the visits on April 8, May 6, and July 1

yielded no indication that Plaintiff’s condition had changed. Id. Notwithstanding those

findings, Dr. Subhan prepared a “Medical Assessment of Ability to do Work Related

Activities” on July 8, 2008 indicating severe limitations on Plaintiff’s ability to work. Id. at

80–82. The assessment included four important conclusions relating to Plaintiff’s ability to

work: (1) Plaintiff could sit or stand for only fifteen minutes at a time; (2) Plaintiff could sit

for only two hours in an eight-hour work day; (3) Plaintiff could only stand for two hours in

an eight-hour work day; and (4) Plaintiff’s pain severely affected his ability to function. Id.

Plaintiff returned to Dr. Subhan for additional follow-up visits on July 31 and

December 17, 2008. Id. at 73–79. Once again, Dr. Subhan gave no indication that Plaintiff’s

condition had changed or that he was exhibiting any new symptoms. Id. Six months later,

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 6 of 16
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

Ninth Circuit law dictates that, “[i]n order to obtain disability [insurance] benefits,

[a claimant] must demonstrate he was disabled prior to his [or her] last insured date.”

Morgan v. Sullivan, 945 F.2d 1079, 1080 (9th Cir. 1991) (citing 20 C.F.R. § 404.1520).

“The burden of proof on this issue is on the claimant.” Id. Thus, in order for Plaintiff to be

eligible for insurance benefits, he had the burden of proving that he was disabled on or before

December 31, 2007, his date last insured. 

- 7 -

in June of 2009, Dr. Subhan prepared a second assessment of Plaintiff’s ability to work. Id.

at 93–95. Although the report asked for the same information that Dr. Subhan provided on

the July, 2008 report, Dr. Subhan’s answers differed significantly. This time, Dr. Subhan

indicated that Plaintiff could stand for only five minutes at a time, while maintaining the

ability to sit for fifteen minutes at a time. Id. Next, Dr. Subhan indicated that Plaintiff could

now only stand for a total of one hour during an eight-hour work day. Id. Finally, Dr.

Subhan indicated that Plaintiff’s pain affected his ability to function in a moderately severe

manner. Id. 

At the hearing, Plaintiff also submitted a letter written by Dr. Salim discussing

Plaintiff’s alleged impairments. (Doc. 19-9 at 31). The letter is dated December 20, 2007,

and asserts that Plaintiff has been suffering “with Lumbar Disc Disease, Disc Desiccation

seen at L2-3 and at L3-4" and “Degenerative Facet Disease that is seen from L3-4 through

L5-S1.” Id. Dr. Salim also states that she has “tried to relieve [Plaintiff’s] pain level . . .

with a series of lumbar epidural steroid injections and facet injections.” Id. The letter states

that these injections were able to control, but not completely eradicate Plaintiff’s pain. Id.

Finally, Dr. Salim asserts that Plaintiff suffers from pain on a daily basis and that his

impairments “limit his ability to sit or stand for any extended period of time.” Id. Although

there is evidence that Dr. Salim treated Plaintiff in 2005, the letter does not include reference

to any medical records that give context to Dr. Salim’s assertions. 

4. SECOND ALJ DECISION

Plaintiff subsequently filed a second Title II application for a period of disability and

disability insurance benefits and a Title XVI application for supplemental security income

on October 29, 2007.1

 (Doc. 19-3 at 15). Although the application alleged disability

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 7 of 16
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 -

beginning on October 2, 2002, Plaintiff later amended the onset date to August 25, 2006. Id.

at 33–34. On February 20, 2008, Plaintiff’s claims were initially denied. Id. at 15. The

claims were denied again upon reconsideration on May 14, 2008. Id. Plaintiff timely

appealed the decision, and a hearing was held before ALJ M. Kathleen Gavin in Bullhead

City, Arizona on June 2, 2009. Id. 

At the hearing, ALJ Gavin heard testimony from the plaintiff and from Dr. George J.

Bluth, a vocational expert. Id. at 31–54. Plaintiff testified that he suffered from debilitating

neck, back and hip pain, which, in his opinion, precluded him from working. Id. Plaintiff

also testified that the pain was so debilitating as to occasionally confine him to his bed. Id.

at 43. Nonetheless, Plaintiff conceded that he continued to help his mother perform

household tasks, such as peeling potatoes, washing dishes, and shopping for groceries. Id.

at 43–44. Following Plaintiff’s testimony, the ALJ interviewed Dr. Bluth and discussed

Plaintiff’s ability to work. Id. at 49–53. Dr. Bluth testified that, in light of Plaintiff’s alleged

disabilities, “he would be limited to light, unskilled work that offers a sit/stand option, and

there are jobs such as cashier or an assembly worker or a quality control inspector that offer

that sit/stand option.” Id. at 52. After the ALJ read aloud Dr. Subhan’s assessment of

Plaintiff’s ability to work, however, Dr. Bluth, assuming the accuracy of Dr. Subhan’s

assessment, concluded that there would “not be substantial gainful activity” available to

Plaintiff. Id. at 53. 

On July 20, 2009, the ALJ rendered her decision. Relying on Chavez v. Bowen, 844

F.2d 691 (9th Cir. 1988), the ALJ said that ALJ Dickinson’s decision had res judicata effect

and that under Chavez, “in order to overcome the presumption of continuing nondisability

arising from the first administrative law judge’s findings of nondisability,” a claimant “must

prove ‘changed circumstances’ indicating greater disability.” 844 F.2d at 692. Applying

Chavez, the ALJ determined that Plaintiff had not overcome the presumption of continuing

nondisability. Id. at 24. Accordingly, the ALJ concluded that the Plaintiff “was not disabled

under sections 216(i) and 223(d), respectively, of the Social Security Act through December

31, 2007, the date last insured.” Id. at 24. Therefore, the ALJ determined that Plaintiff was

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 8 of 16
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

The federal regulations state that “when [the Social Security Administration]

decide[s] whether [a claimant] is disabled under § 404.1520(g), [it] will consider [the

claimant’s] age in combination with [his or her] residual functional capacity, education and

work experience.” 20 C.F.R. § 404.1563(a). The regulation defines three distinct age

categories: (1) younger person; (2) person closely approaching advanced age; and (3) person

of advanced age. § 404.1563(c)–(e). The regulation further states, “[w]e consider that at

advanced age (age 55 or older), age significantly affects a person’s ability to adjust to other

work.” § 404.1563(e). Accordingly, there are “special rules for persons of advanced age.”

Id. 

- 9 -

not entitled to disability insurance benefits under Title II. Id. 

The ALJ further determined, however, that although Plaintiff had not overcome the

presumption of continuing nondisability, because he was going to enter a new age category

on December 4, 2009, he would qualify as disabled under 20 C.F.R. § 404.1520(g) on that

date and would become eligible for supplemental security income under Title XVI.2

 Id. at

16. Applying the rules “non-mechanically,” the ALJ found “changed circumstances” as of

June 4, 2009. Id. Therefore, the ALJ concluded that, “the claimant has been disabled under

section 1614(a)(3)(A) of the Social Security Act beginning on June 4, 2009.” Id. 

II. STANDARD OF REVIEW

To qualify for disability insurance benefits, an applicant must establish that he is

unable to engage in substantial gainful activity due to a medically determinable physical or

mental impairment that has lasted or can be expected to last for a continuous period of not

less than 12 months. See 42 U.S.C. § 1382c (a)(3)(A). The applicant must also show that

he has a physical or mental impairment of such severity that the applicant is not only unable

to do his previous work, but cannot, considering her age, education, and work experience,

engage in any other kind of substantial gainful work which exists in the national economy.

Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). To determine whether an

applicant is eligible for disability insurance benefits, the ALJ must conduct the following

five-step sequential analysis:

(1) determine whether the applicant is currently employed in substantial

gainful activity;

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 9 of 16
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 -

(2) determine whether the applicant has a medically severe impairment or

combination of impairments;

(3) determine whether any of the applicant’s impairments equals one of a

number of listed impairments that the Commissioner acknowledges as so

severe as to preclude the applicant from engaging in substantial gainful

activity;

(4) if the applicant's impairment does not equal one of the listed impairments,

determine whether the applicant is capable of performing his or her past

relevant work;

(5) if not, determine whether the applicant is able to perform other work that

exists in substantial numbers in the national economy.

20 CFR §§ 404.1520, 416.920; see also Bowen v. Yuckert, 482 U.S. 137, 140-41 (1987).

The Court must affirm an ALJ's findings of fact if they are supported by substantial

evidence and free from reversible legal error. See 42 U.S.C. 405(g); see also Ukolov v.

Barnhart, 420 F.3d 1002, 1004 (9th Cir. 2005). Substantial evidence means “more than a

mere scintilla,” but less than a preponderance, i.e., “such relevant evidence as a reasonable

mind might accept as adequate to support a conclusion.” See, e.g., Sandgathe v. Chater, 108

F.3d 978, 980 (9th Cir. 1997); Clem v. Sullivan, 894 F.2d 328, 330 (9th Cir. 1990).

In determining whether substantial evidence supports a decision, the record as a whole

must be considered, weighing both the evidence that supports and the evidence that detracts

from the ALJ's conclusion. See Richardson v. Perales, 402 U.S. 389, 401 (1971); see also

Tylitzki v. Shalala, 999 F.2d 1411, 1413 (9th Cir. 1993). Nonetheless, “[i]t is for the ALJ,

not the courts, to resolve ambiguities and conflicts in the medical testimony and evidence.”

Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995) (citations and internal quotation

marks omitted). The ALJ may draw inferences logically flowing from the evidence, and

“[w]here evidence is susceptible to more than one rational interpretation, it is the ALJ's

conclusion which must be upheld.” Id. (citation omitted). Regardless, “[i]f the evidence can

support either affirming or reversing the ALJ's conclusion, [then the Court] may not

substitute [its] judgment for that of the ALJ.” Robbins v. Social Sec. Admin., 466 F.3d 880,

882 (9th Cir. 2006).

III. DISCUSSION

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 10 of 16
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 -

Plaintiff contends that ALJ Gavin erred by: (1) rejecting treating physician opinion;

(2) misinterpreting the evidence to the detriment of the Plaintiff; and (3) misapplying Chavez

v. Bowen. (Doc. 20). The Defendant disagrees on all grounds, and argues that the ALJ’s

decision was supported by substantial evidence and should be affirmed. (Doc. 24). To the

extent that the ALJ’s application of Chavez is premised on her conclusion that Dr. Subhan

was unreliable, the Court will address the issues concerning Dr. Mohammed Subhan first.

A. ALJ GAVIN’S REJECTION OF TREATING PHYSICIAN OPINIONS

The Ninth Circuit has held that if an ALJ “wishes to disregard the opinion of the

treating physician he or she must make findings setting forth specific, legitimate reasons for

doing so that are based on substantial evidence in the record.” Murray v. Heckler, 722 F.2d

499, 502 (9th Cir. 1983). Substantial evidence means “more than a mere scintilla,” but less

than a preponderance, i.e., “such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion.” See Sandgathe, 108 F.3d at 980. In determining whether

there is substantial evidence in the record to support the ALJ’s decision, the Court must look

at the record in its entirety. Richardson, 402 U.S. 401. Nonetheless, where there are

ambiguities in the record, and the evidence is subject to multiple interpretations, the Court

may not substitute its judgment for that of the ALJ. Robbins, 466 F.3d 882. 

ALJ Gavin determined that “Dr. Subhan’s recommendations are accorded no weight

due to their inconsistency with his own observations of Mr. Bose’s functioning.” (Doc. 19-3

at 21). The medical evidence of record indicates that although Dr. Subhan’s medical group

treated the Plaintiff for some time, Dr. Subhan himself examined the Plaintiff on only seven

occasions. At each of these exams, Dr. Subhan prepared thorough reports that described

symptoms that the patient exhibited. (Doc. 19-9 at 73–79, 83–92). Although Dr. Subhan

consistently stated that the Plaintiff suffered from degenerative disc disease, chronic back

pain, and chronic neck pain, at all seven of the examinations, he noted that Plaintiff’s neck

“demonstrated no decrease in suppleness.” Id. In addition, at six of the seven exams, Dr.

Subhan noted that Plaintiff’s back was “normal” and indicated no symptoms. Id. On only

one occasion did Dr. Subhan note that Plaintiff’s back experienced “tenderness on

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 11 of 16
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 -

palpitation” and “muscle spasm.” Id. at 88. In fact, Plaintiff concedes that Dr. Subhan’s

“later records are void of discussion of back pain.” (Doc. 20 at 7). After these examinations,

Dr. Subhan prepared two separate reports assessing Plaintiff’s ability to do work. (Doc. 19-9

at 93–95). The most recent of these reports was prepared on June 7, 2009, and essentially

indicated that Plaintiff’s pain conditions completely precluded him from working. Id. 

After independently reviewing the record as a whole, and applying the legal standards

set forth supra, the Court finds that the ALJ’s decision to discredit Dr. Subhan’s reports is

supported by substantial evidence. Dr. Subhan’s medical examination reports do not appear

to comport with his eventual assessments of Plaintiff’s ability to do work related activities.

During the exams, Dr. Subhan certainly noted that Plaintiff suffered from some levels of

pain, but Dr. Subhan never reported any symptoms at all that would substantiate the severe

limitations that they allegedly put on Plaintiff’s ability to work. Rather, Dr. Subhan’s reports

indicate that six of the seven times that he saw the Plaintiff, he was not suffering from any

immediate symptoms. Thus, to the extent that the ALJ was presented with irreconcilable

opinions from Dr. Subhan, her decision to not credit Dr. Subhan’s eventual conclusion about

Plaintiff’s ability to work was supported by substantial evidence. See Robbins, 466 F.3d

882. This is particularly true in light of the medical evidence from Dr. Kane indicating that

Plaintiff’s back pain had actually been improving significantly in late 2007, the same time

that Dr. Subhan performed his initial exams of the Plaintiff. 

Plaintiff also argues that the ALJ erred by not considering the letter written by Dr.

Salim. (Doc. 20 at 7). Specifically, Plaintiff alleges that the ALJ erred because the “opinion

of Dr. Subhan is corroborated” by Dr. Salim’s letter. Id. The fact that the ALJ failed to

address the letter, however, is not outcome determinative. Instead, the “relevant inquiry in

this context is not whether the ALJ would have made a different decision absent any error

. . . it is whether the ALJ’s decision remains legally valid, despite such error.” Carmickle v.

Comm’r Soc. Sec. Admin., 533 F.3d 1155, 1162 (9th Cir. 2008). Thus, so long as “there

remains substantial evidence supporting the ALJ’s conclusions . . . on credibility and the

error does not negate the validity of the ALJ’s ultimate credibility conclusion, such is deemed

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 12 of 16
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

Plaintiff also notes that The ALJ may have misunderstood the alleged onset date.

(Doc. 20 at 9). Plaintiff asserts that a misunderstanding of the onset date “could cloud the

ALJ decision” by allowing the ALJ to consider information outside of the relevant time

frame. Id. There is no evidence in the record, however, that indicates that The ALJ

attempted to reevaluate or reopen any medical evidence that was discussed in the prior ALJ

decision. Accordingly, the fact that The ALJ never explicitly indicated that she would be

using the amended onset date is inconsequential. 

- 13 -

harmless and does not warrant reversal.” Id. (internal quotations and citations omitted). 

Dr. Salim’s letter is dated December 20, 2007 and states that Dr. Salim has been

treating Plaintiff for an undisclosed period of time. (Doc. 19-9 at 31). The letter further

asserts that Plaintiff suffers from pain on a daily basis and the pain limits Plaintiff’s ability

to function. Id. Although the record indicates that Dr. Salim did treat Plaintiff from April

26 to May 24, 2005 (a period already considered by the initial ALJ), no evidence was

provided of treatment during the relevant time period. Thus, to the extent that Dr. Salim’s

letter is based on medical findings outside of the relevant time period, and to the extent that

Dr. Salim fails to provide any relevant medical evidence to support her conclusions, the

Court is not persuaded that the letter undermines the many reasons that the ALJ had for

rejecting Dr. Subhan’s opinions. See Carmickle, 533 F.3d at 1162. Therefore, for the

reasons already discussed, the Court finds that although the ALJ erred by not considering Dr.

Salim’s letter, the ALJ's ultimate conclusion regarding Dr. Subhan’s assessment is supported

by substantial evidence. Accordingly, the ALJ’s decision to reject Dr. Subhan’s opinions

was legally sound and the Court will not disturb it.3

 

B. ALJ GAVIN’S INTERPRETATION OF MEDICAL EVIDENCE

Plaintiff contends that the ALJ misinterpreted medical evidence, specifically Dr.

Subhan’s reports. (Doc. 20). The ultimate conclusions of treating physicians “must be given

substantial weight; they cannot be disregarded unless clear and convincing reasons for doing

so exist and are set forth in proper detail.” Embry v. Bowen, 849 F.2d 418, 422 (9th Cir.

1988). For the reasons set forth above, the Court is satisfied that the ALJ has presented

sufficient evidence to justify the decision to interpret the medical evidence contrary to Dr.

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 13 of 16
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

- 14 -

Subhan’s interpretations. Accordingly, the Court will not disturb the ALJ’s interpretations.

C. APPLICATION OF CHAVEZ V. BOWEN

In Chavez v. Bowen, the Ninth Circuit stated that “the principles of res judicata apply

to administrative decisions, although the doctrine is applied less rigidly to administrative

proceedings than to judicial proceedings.” 844. F.2d at 693. Additionally, the Ninth Circuit

has held that, “in order to overcome the presumption of continuing nondisability arising from

the first administrative law judge’s findings of nondisability, [a claimant] must prove

‘changed circumstances’ indicating greater disability.” Id. (citing Taylor v. Heckler, 765

F.2d 872, 875 (9th Cir. 1985)). An ALJ may not, however, “apply res judicata where the

claimant raises a new issue, such as the existence of an impairment not considered in the

previous application.” Lester v. Chater, 81 F.3d 821, 827 (9th Cir. 1995) (citing Gregory v.

Bowen, 844 F.2d 664 (9th Cir. 1988)). 

Plaintiff alleges that the ALJ incorrectly applied the standards set out in Chavez.

(Doc. 20). Specifically, Plaintiff takes issue with the ALJ’s conclusion that “[t]he new

medical evidence of record does not establish greater impairment than prior to August 23,

2006, and so the threshold for changed circumstances pursuant to Chavez is not met upon a

basis of worsening impairment.” (Doc. 19-3 at 19). Plaintiff asserts that Chavez requires a

showing of both changed circumstances and worsening impairment, and that those showings

are “mutually exclusive.” (Doc. 20). By reading Chavez’s holding in the disjunctive,

however, Plaintiff misunderstands it. Chavez explicitly states that a claimant must prove

“changed circumstances indicating greater disability.” 844 F.2d at 693 (internal quotations

omitted) (emphasis added). Based on the word “indicating,” it is clear that there must be a

causal relationship between the changed circumstances and the greater disability.

Accordingly, while the Plaintiff is correct that he must demonstrate both changed

circumstances and greater disability, Chavez dictates that he must do so in a manner that

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 14 of 16
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

To the extent that Plaintiff appears to misunderstand Chavez, the Court will construe

all of Plaintiff’s arguments regarding any changes in medical conditions as ones pertaining

to the “changed circumstances” element of Chavez. 

- 15 -

shows a causal relationship between the two.4

 

Plaintiff asserts three grounds for changed circumstances: (1) recurrent headaches; (2)

recurrent cervical spine pain; and (3) the “residual functional capacity” assessment completed

by Dr. Subhan. (Doc. 20). These three grounds will be addressed and discussed below.

Plaintiff first alleges that “the recurrent headaches and pain show a worsening

condition than that assessed by the prior ALJ.” (Doc. 20 at 6). Plaintiff fails, however, to

point to any portion of the record indicating that he now suffers from headaches that are more

severe or more frequent than those that the ALJ discussed in the initial decision. Therefore,

to the extent that Plaintiff makes only conclusory assertions of worsening headaches without

reference to any medical evidence of record, the Court is satisfied that the ALJ’s

determination that Plaintiff failed to demonstrate changed circumstances on that point was

substantially justified. 

Next, Plaintiff asserts that he has demonstrated changed circumstances by the

continuing need for epidural injections to control his cervical pain. Once again, Plaintiff fails

to point to any medical evidence of record suggesting that his lumbar pain has worsened.

Instead, it appears that Plaintiff is asserting that his need to continue with a beneficial course

of treatment somehow reflects a greater impairment. The Ninth Circuit has emphasized that

“impairments that can be controlled effectively with medication are not disabling for the

purpose of determining SSI benefits.” Warre v. Comm’r of Soc. Sec., 438 F.3d 1001, 1006

(9th Cir. 2006). That holding is particularly applicable here, where Dr. Kane’s reports

indicate that lumbar injections significantly reduced Plaintiff’s back pain. Accordingly,

Plaintiff’s argument that a continuing ailment, successfully managed by medication, qualifies

as a “changed circumstance,” fails as a matter of law. 

Furthermore, Plaintiff is unable to demonstrate changed circumstances based on Dr.

Salim’s letter. As discussed previously, Dr. Salim’s letter appears to be based on medical

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 15 of 16
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

- 16 -

evidence obtained during a period that was already adjudicated by ALJ Dickinson. And, to

the extent that ALJ Dickinson’s findings must be given a degree of res judicata effect,

Plaintiff cannot attempt to resurrect medical facts that have already been decided simply by

having his doctor refer to those facts at a later time. See Chavez, 844 F.2d at 693. Therefore,

the ALJ’s determination that Plaintiff failed to demonstrate a “changed circumstance” based

on his continued therapy was substantially justified. 

Finally, Plaintiff asserts that the “residual functional capacity” exams performed by

Dr. Subhan demonstrate a “changed circumstance” indicating greater disability. (Doc. 20).

As discussed in Section A, supra, the Court is satisfied that the ALJ’s decision not to credit

Dr. Subhan’s reports regarding Plaintiff’s ability to work was supported by substantial

evidence. In sum, Plaintiff has failed to demonstrate any “changed circumstance” that would

indicate greater disability. Accordingly, the ALJ’s application of Chavez was not erroneous,

and the Court will not displace it. 

IV. CONCLUSION

For the reasons set forth above, the Court finds that the ALJ’s decision to deny

Plaintiff benefits was supported by substantial evidence. 

Accordingly,

IT IS HEREBY ORDERED affirming the Commissioner of Social Security’s

decision to deny Plaintiff’s disability benefits. 

DATED this 31st day of March, 2011.

Case 2:09-cv-02257-MHM Document 25 Filed 03/31/11 Page 16 of 16