Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_05-cv-03379/USCOURTS-cand-3_05-cv-03379-1/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

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

DENISE A. SCHANZ,

Plaintiff,

 v.

JO ANNE B. BARNHART, Commissioner of

Social Security,

Defendant /

No. 05-03379 MMC

ORDER GRANTING IN PART

PLAINTIFF’S MOTION FOR SUMMARY

JUDGMENT; DENYING DEFENDANT’S

CROSS-MOTION FOR SUMMARY

JUDGMENT

(Docket Nos. 13, 15)

Plaintiff Denise A. Schanz (“Schanz”) brings this action pursuant to 42 U.S.C.

§ 405(g) to obtain judicial review of a final decision of the Commissioner of the Social

Security Administration (“Commissioner”) that Schanz was not disabled, and thus not

entitled to disability benefits, during the period for which she seeks benefits under Title II of

the Social Security Act. Before the Court are Schanz’s motion for summary judgment or, in

the alternative, remand, filed December 12, 2005, and the Commissioner’s cross-motion for

summary judgment, filed December 30, 2005. Pursuant to Civil Local Rule 16-5, the

motions have been submitted on the papers without oral argument. The Court, having

considered the papers in support of and in opposition to the motions, hereby rules as

follows.

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 “The Commissioner follows a five-step sequential evaluation process in assessing

whether a claimant is disabled.

Step one: Is the claimant engaging in substantial gainful activity? If so, the claimant

is found not disabled. If not, proceed to step two.

Step two: Does the claimant have a “severe” impairment? If so, proceed to step

three. If not, then a finding of not disabled is appropriate.

Step three: Does the claimant’s impairment or combination of impairments meet or

equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P, App.1? If so, the claimant is

automatically determined disabled. If not, proceed to step four.

Step four: Is the claimant capable of performing his past work? If so, the claimant is

not disabled. If not, proceed to step five.

Step five: Does the claimant have the residual functional capacity to perform any

other work? If so, the claimant is not disabled. If not, the claimant is disabled.” McCartey

v. Massanari, 298 F.3d 1072, 1074 n.6 (9th Cir. 2002) (citing 20 C.F.R. § 404.1520).

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BACKGROUND

On November 25, 2002, Schanz, who was then 45 years old, filed an application for

disability benefits. (See Certified Transcript of Administrative Proceedings (“Tr.”) at 60-63.)

Schanz alleged disability as a result of “5 protruding discs & pinched nerve in neck causing

numbness & pain in neck, right arm & hand.” (See Tr. at 87.) After Schanz’s application

was denied initially by the Social Security Administration (“SSA”), she sought

reconsideration, asserting high blood pressure and depression as additional bases of

disability. (See Tr. at 33.) After her claim was denied on reconsideration, (see id.), Schanz

requested a hearing before an Administrative Law Judge (“ALJ”). (See Tr. at 41.)

On May 19, 2004, the ALJ conducted a hearing, and took testimony from Schanz,

Schanz’s husband Leon Schanz, and a vocational expert. (See Tr. at 314-85.) Following

the hearing, the ALJ rendered a decision unfavorable to Schanz. (See Tr. at 15-24.)

In that decision, filed September 24, 2004, the ALJ analyzed Schanz’s application

under the five-step sequential evaluation process set forth in the Code of Federal

Regulations (“C.F.R.”).1

 At step one, the ALJ found Schanz had not engaged in substantial

gainful activity since February 16, 2002. (See Tr. at 22.) At step two, the ALJ found

Schanz “has cervical disc degeneration with radiculopathy into the upper right extremity,

obesity, hypertension controlled on medication and depressive disorder . . . .” (See Tr. at

22.) Although the ALJ never expressly found the above-referenced impairments to be

severe, he impliedly did so, as he continued to step three in the evaluation process. (See

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 The ALJ found Schanz “is mildly-moderately limited in social functioning, ADLs

[activities of daily living], and in concentration, persistence, or pace due to the combined

effects of her secondary depression, pain, and medication.” (See Tr. at 22.)

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Tr. at 22); see also 20 C.F.R. § 404.1520(a)(4) (“If we cannot find that you are disabled or

not disabled at a step, we go on to the next step.”). At step three, the ALJ found Schanz

did not have an impairment or combination of impairments that met or equaled a listed

impairment. (See Tr. at 22-23.) At step four, the ALJ found Schanz could not perform her

past relevant work as a teacher’s aide, a customer service representative, a cashier and

assistant manager for a gas station, or a seamstress. (See Tr. at 20-21, 23.) 

At step five, the ALJ found Schanz had the residual functional capacity to “lift and

carry up to 10 lbs frequently; sit for 6 hours in an 8-hour day; stand/walk for 6 hours in an 8-

hour day”; “use ramps/stairs”; “crouch, crawl, climb, balance, stoop and kneel occasionally.” 

(See Tr. at 22.) The ALJ further found that “with her dominant right upper extremity she

can reach, handle, finger and feel occasionally.” (See id.) Additionally, the ALJ found

Schanz is “precluded from heights” but “is capable of working at an average pace.” (See

id.) The ALJ found Schanz’s asserted inability to perform any work was “not entirely

credible,” and that Schanz is capable of performing a “wide range of light work,” although

her “nonexertional limitations do not allow her to perform the full range of light work.”2 (See

Tr. at 23.) Based on the Medical-Vocational Guidelines and the vocational expert’s

testimony, the ALJ found there were a significant number of jobs in the national and local

economy that Schanz could perform and, accordingly, concluded Schanz was not disabled. 

(See Tr. at 22-23.)

On October 11, 2004, Schanz filed a request for review of the ALJ’s decision. (See

Tr. at 12-14.) On July 12, 2005, the Appeals Council denied her request for review. (See

Tr. at 5-9.) On August 19, 2005, Schanz filed the instant action for judicial review pursuant

to 42 U.S.C. § 405(g). 

STANDARD OF REVIEW

The Commissioner’s determination to deny disability benefits will not be disturbed if

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it is supported by substantial evidence and based on the application of correct legal

standards. See Mayes v. Massanari, 276 F.3d 453, 459 (9th Cir. 2001). Substantial

evidence has been defined as “more than a mere scintilla, but less than a preponderance; it

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

conclusion.” See De la Fuente v. F.D.I.C., 332 F.3d 1208, 1220 (9th Cir. 2003) (internal

quotation and citation omitted). The reviewing court must consider the administrative

record as a whole and weigh the evidence both supporting and detracting from the ALJ’s

decision. See Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1998). If the evidence is

susceptible to more than one rational interpretation, the reviewing court will uphold the

decision of the ALJ. See Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002).

DISCUSSION

In her motion for summary judgment, Schanz argues that the ALJ’s decision should

be reversed and benefits awarded, or in the alternative, that the action be remanded for

further proceedings. Specifically, Schanz asserts, the ALJ erred by: (1) failing to discuss all

impairments of record; (2) rejecting the opinions of Schanz’s treating and examining

physicians; (3) discounting Schanz’s subjective pain testimony and the corroborating

testimony of Schanz’s husband; and (4) failing to adequately demonstrate that Schanz has

the residual functional capacity to perform a wide range of light work.

A. ALJ’s Review of Claimant’s Impairments

Schanz argues that the ALJ failed to find several impairments at step two of the

evaluation process, and that the ALJ failed to take all of her impairments into consideration

when making his equivalence evaluation at step three. In particular, Schanz argues that

the ALJ did not address the following asserted impairments: “post right wrist carpal release

surgery”; “post right tennis elbow surgery”; degenerative disc disease of the lower back;

high cholesterol and triglycerides; asthma and allergic rhinitis; gastroesophageal reflux

disease (“GERD”); and the effect of an abusive relationship with her father and husband on

her depression. (See Plaintiff’s Motion at 12.)

At step two of the evaluation process, a “severe impairment” is one that significantly

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GERD is an acronym for gastroesophageal reflux disease.

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limits the claimant’s physical or mental ability to perform basic work activities. See

20 C.F.R. § 404.1520(c). “In Social Security cases the ALJ has a duty to fully and fairly

develop the record and to assure that the claimant’s interests are considered.” Brown v.

Heckler, 713 F.2d 441, 443 (9th Cir. 1983). The burden, however, is on the claimant to

show that an impairment is severe. See Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir.

1999). 

In the instant case, Schanz makes no attempt to explain how the impairments she

asserts the ALJ failed to discuss significantly limit her ability to perform basic work

activities. Nor is there any evidence in the medical record to suggest these impairments

placed any significant limitation on her ability to perform basic work activities.

Although the ALJ did not discuss the effects of Schanz’s right wrist carpal tunnel

surgery, right tennis elbow surgery, asthma, allergic rhinitis, or GERD,3

 neither did any of

the physicians who opined as to Schanz’s work-related abilities. (See, e.g., Tr. at 179-193,

221-223, 233-244.) It is not enough for Schanz simply to name impairments and fault the

ALJ for not considering them; it is her burden to adduce evidence as to why these

impairments significantly limit her ability to perform work-related activities. See Tackett v.

Apfel, 180 F.3d at 1098.

As noted, the ALJ specifically found Schanz to have several impairments. (See Tr.

At 22) (“The medical evidence establishes the claimant has cervical disc degeneration with

radiculopathy into the upper right extremity, obesity, hypertension controlled on medication,

and depressive disorder . . . .”) Although, as Schanz points out, the ALJ did not expressly

find any of these impairments to be severe, such finding is implicit in his proceeding to the

next step in the evaluation process. Further, the ALJ’s finding that Schanz’s “additional

nonexertional limitations do not allow her to perform the full range of light work,” reflects his

consideration of the effect of Schanz’s obesity and depression on her ability to perform

work-related activities. (See Tr. at 23.) 

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 In light of the above ruling, the Court does not address plaintiff’s argument that the

ALJ’s errors at step two led to an improper evaluation at step three. The Court finds no

evidence in the record, nor does plaintiff point to any, that the ALJ erred in determining that

plaintiff had no impairment or combination of impairments listed in or equivalent to those

listed in 20 C.F.R., Pt. 404, Subpt. P, App. 1.

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Accordingly, Schanz has not demonstrated the ALJ erred in his determination of

Schanz’s severe impairments at step two of the evaluation process.4

B. Opinions of Treating and Examining Physicians

Schanz argues the ALJ erred by rejecting the opinions of her treating physician Julie

Winter, M.D. (“Dr. Winter”) in favor of the opinions of Joey English, M.D. (“Dr. English”), an

examining physician, and Mark Tambellini, M.D. (“Dr. Tambellini”), a non-treating, nonexamining physician, in determining the severity of Schanz’s impairments. Schanz further

argues the ALJ erred by crediting the opinion of Dr. Tambellini over that of Dr. English with

respect to Schanz’s ability to walk and stand during the course of an eight-hour workday.

1. Dr. Winter

Dr. Winter has been Schanz’s treating physician since January 2000. (See Tr. at

89.) From October 2001 to December 2003, Dr. Winter saw Schanz at least eight times. 

(See Tr. at 195-207, 209-10, 241-44.) Dr. Winter assessed Schanz as having chronic neck

pain and radiculopathy. (See Tr. at 198, 203, 207, 210.) 

On December 8, 2003, Dr. Winter prepared a medical assessment of Schanz’s

ability to perform work-related activities. (See Tr. at 241.) Dr. Winter concluded that

Schanz was not able to lift or carry more than five pounds on an occasional basis. (See Tr.

at 241.) Dr. Winter further concluded that Schanz could not sit for more than two hours in

an eight-hour day because her arm and neck would start throbbing; that she tilted her head

to the side most of the time, which affected her ability to stand and walk; and that she was

in pain all of the time. (See Tr. at 242, 244.) Dr. Winter found Schanz could not kneel,

crouch, bend at the waist or crawl for any significant length of time, and that Schanz’s

ability to reach, handle, feel, and push/pull were all affected by her impairment because

they caused increased neck pain. (See Tr. at 242-43.) Dr. Winter stated that Schanz could

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 The medical assessment form used by Dr. Winter requested that she fill in a blank

indicating the percentage of an eight-hour workday the claimant could use her right and left

hands, fingers and arms. (See Tr. at 243.) Dr. Winter wrote “max 2/” for the right hand,

fingers and arm and “max 4/” for the left hand, fingers and arm, (see id.), which the parties

interpret to mean two percent and four percent, respectively. The Court notes, however,

that Dr. Winter has used the (/) symbol in other documents to refer to hours, not

percentages. (See Tr. at 197 (“[Claimant] not sleeping due to pain, sleeps 2/ then up.”))

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 The record does not indicate whether Dr. English was retained by Schanz or by the

SSA.

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only use her right hand, fingers and arms for a maximum of two hours per working day and

her left hand, fingers and arm for four hours per working day.5

 (See Tr. at 243.) When

asked to indicate the medical findings that supported these assessments, Dr. Winter

repeatedly stated, “see MRI report.” (See Tr. at 242-44.) The MRI to which Dr. Winter

referred was taken on November 11, 2001 and was read by N. Yeung, M.D. (“Dr. Yeung”)

to reveal a “right C5-6 lateral HNP [herniated nucleus pulposus] with secondary right-sided

neural foraminal stenosis.” (See Tr. at 217.)

2. Dr. English

On March 7, 2003, Schanz received a comprehensive neurological examination from

Dr. English.6 (See Tr. at 179.) After performing a series of range of motion tests,

Dr. English diagnosed Schanz with “chronic right C6 radiculopathy.” (See Tr. at 182-183.) 

Dr. English stated that “[o]bjectively on examination, [Schanz] has normal range of motion

of the cervical spine, but with a clear increase in her pain with both passive and active

range of motion testing.” (See Tr. at 184.) Based upon these findings, Dr. English opined

that Schanz should be able to stand for approximately two hours and sit for approximately

six hours in an eight hour day. (See Tr. at 184.) Dr. English further opined that “it would be

reasonable to limit” Schanz to lifting and/or carrying 20 pounds occasionally and 10 pounds

frequently, “given her difficulty with neck extension and her convincing radicular pain.” 

(See Tr. at 184.) Dr. English also stated that Schanz should be limited to only occasional

bending, stooping, crouching, kneeling, crawling, reaching, or feeling. (See Tr. at 184.)

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 The ALJ refers to Dr. Tambellini as a “state agency medical consultant.” (See Tr.

at 19.)

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3. Dr. Tambellini

On March 20, 2003, Dr. Tambellini completed a “Physical Residual Functional

Capacity Assessment” of Schanz, based on his review of the medical record.7

 (See Tr. at

185.) Dr. Tambellini concluded that Schanz could lift 20 pounds occasionally and 10

pounds frequently, and that she was capable of walking and standing six hours in an eighthour day. (See Tr. at 191.) Dr. Tambellini limited Schanz’s use of her right arm to

occasional reaching, handling, fingering and feeling, but placed no restrictions on use of

her left arm. (See Tr. at 188.)

4. Application of Treating Physician Rule

 As discussed above, the opinion of Dr. Winter conflicts with those of Drs. English

and Tambellini with respect to Schanz’s ability to perform work-related functions. The ALJ

explicitly rejected the opinion of Dr. Winter while implicitly adopting the opinions of Drs.

English and Tambellini. (See Tr. at 19-20, 22.)

 Generally, the opinion of a treating physician is given greater weight than opinions of

non-treating physicians because a treating physician has a greater opportunity to know and

observe the patient. See Smolen v. Chater, 80 F.3d 1273, 1285 (9th Cir. 1996). Where

the treating physician’s opinion contradicts the opinion of an examining or consulting

physician, the ALJ must provide “‘specific and legitimate reasons’ supported by substantial

evidence in the record” for rejecting the treating physician’s opinion. See Lester v. Chater,

81 F.3d 821, 830 (9th Cir. 1996) (quoting Murray v. Heckler, 722 F.2d 499, 502 (9th Cir.

1983).) When the nontreating physician’s opinion rests on “independent clinical findings

that differ from the findings of the treating physician,” however, the rule established by

Murray is inapplicable, because such opinion itself constitutes substantial evidence. See

Magallanes, 881 F.2d at 751; see also Tonapetyan, 242 F.3d 1144, 1149 (9th Cir. 2001)

(holding non-treating physician’s opinion “alone constitute[d] substantial evidence, because

it rest[ed] on his own independent examination” of claimant). Under such circumstances,

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the ALJ is required only to resolve the conflict between the treating and nontreating

physicians and give good reasons for the weight given to the treating physician’s opinion. 

See Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995); see also 20 C.F.R.

§ 404.1527(d)(2).

In the instant case, the opinion of Dr. English, an examining physician, constitutes

substantial evidence because it was based on range-of-motion testing and independent

clinical findings derived therefrom. (See Tr. at 182.) There is no evidence that Dr. Winter

performed or relied on similar tests in her assessment of Schanz’s work-related abilities. 

(See Tr. at 241-244.) An ALJ is entitled to weigh conflicting medical evidence and to credit

the opinion of one doctor over another, provided his decision is supported by substantial

evidence. See Andrews v. Shalala, 53 F.3d at 1041. Here, however, the ALJ’s decision

does not indicate the ALJ in fact weighed the opinion of Dr. English against the opinion of

Dr. Winter.

 The ALJ’s discussion of Dr. Winter’s findings consists of the following paragraph:

In December, 2003 the claimant was evaluated by Dr. Winter. He 

opined the claimant could not lift or carry more than 5 pounds and could 

not sit longer than 2 hours in an 8-hour workday. He precluded her from 

kneeling, crouching, bending at the waist and crawling. He restricted her 

to very little climbing or stooping. He opined she had very limited ability to

manipulate her hands for grasping, torquing, twisting and fine finger 

manipulation. He placed restrictions on both the left and right upper 

extremities despite the fact the claimant complained only of pain and 

numbness in the right hand and arm. Dr. Winter’s findings are rejected. 

They are not supported by the objective medical evidence and are far more

restrictive than necessary. He did not discuss objective findings that support 

his conclusions and the conclusions appear based on the claimant’s 

subjective complaints. He placed limitations on the use of the left upper 

extremity but the claimant did not allege any impairment of the left upper 

extremity.

(See Tr. at 19-20 (internal citations omitted).)

Further, although the ALJ stated Dr. Winter’s findings are “not supported by the

objective medical evidence” and “appear based on the claimant’s subjective complaints,”

(see Tr. at 20), Dr. Winter’s opinion was expressly based in part on the results of an MRI,

which, as noted, revealed that Schanz had a right C5-6 lateral herniated nucleus pulposus 

with secondary right-sided neural foraminal stenosis. (See Tr. at 242-244.) The ALJ found

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Schanz was impaired due to cervical disc degeneration with radiculopathy in the right upper

extremity. (See Tr. at 21.) The ALJ does not explain why Dr. Winter’s reliance on the

above-referenced MRI does not constitute objective evidence in support of Dr. Winter’s

findings; he does not state, for example, that the condition shown in the MRI is unlikely to

cause the claimed level of impairment, and, in rejecting Dr. Winter’s opinion, does not even

mention, much less rely upon, the range of motion tests conducted by Dr. English.

Accordingly, the Court finds the ALJ did not meet his burden of weighing the

conflicting evidence and providing sufficient reasons for rejecting the opinion of Dr. Winter.

5. Application of Examining Physician Rule

As discussed above, the opinions of Dr. English and Dr. Tambellini are in conflict. 

Dr. English, after performing a comprehensive neurological examination, opined that

Schanz should be able to stand for approximately two hours in an eight-hour workday. 

(See Tr. at 184.) Based solely upon a review of Schanz’s medical records, Dr. Tambellini

opined that Schanz was capable of walking and standing for six hours in an eight-hour day. 

(See Tr. at 191.) The ALJ, without expressly crediting the opinion of Dr. Tambellini or

rejecting the opinion of Dr. English, found Schanz was capable of standing and walking for

six hours in an eight-hour workday. (See Tr. at 22.) 

“The opinion of an examining physician is . . . entitled to greater weight than the

opinion of a nonexamining physician.” Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). 

If the opinion of an examining physician conflicts with that of a nonexamining physician, the

ALJ may reject the examining physician’s opinion only for specific and legitimate reasons

that are supported by substantial evidence in the record. See id. at 830-31; see also

Andrews, 53 F.3d at 1043 (finding ALJ “met his burden of giving specific, legitimate

reasons based on substantial evidence for rejecting the examining physician’s opinion . . .

in favor of the nonexamining expert’s opinion”). 

Here, the ALJ’s entire discussion of Dr. Tambellini’s findings consists of the following

sentence: “In a March 2003 residual functional capacity assessment the state agency

medical consultant [Dr. Tambellini] also concluded that the claimant was capable of

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performing light work despite complaints of chronic neck and right arm pain.” (See Tr. at

19.) The ALJ did not mention Dr. Tambellini’s findings as to Schanz’s ability to stand and

walk, although the ALJ apparently credited those findings when assessing Schanz’s

functional capacity. The ALJ gave no reason for crediting the opinion of Dr. Tambellini over

that of Dr. English. 

Accordingly, the Court finds the ALJ did not meet his burden of providing specific

and legitimate reasons for crediting the opinion of the non-examining physician, Dr.

Tambellini, over that of the examining physician, Dr. English.

6. Other Treating Physicians

Schanz argues the ALJ erred by failing to properly evaluate the opinions of Schanz’s

other treating physicians. 

Other than Dr. Winter, the only treating physician who opined as to Schanz’s ability

to perform work-related activities was Harinder S. Auluck, M.D. (“Dr. Auluck”), who

performed a psychiatric evaluation of Schanz. (See Tr. at 221.) Dr. Auluck found Schanz’s

concentration to be “fair to patchy” and that “she is likely to experience some difficulty

maintaining persistence and pace at times.” (See Tr. at 223.) Dr. Auluck further found

Schanz is able to remember and carry out only simple instructions and that her ability to

interact effectively with coworkers, supervisors and members of the public is “minimally

compromised.” (See id.) Dr. Auluck opined, however, that, from a psychiatric point of

view, “there is no reason why [Schanz] should not be able to maintain an eight hour

workday or a forty hour work week (sic).” (See id.) The ALJ discussed Dr. Auluck’s

findings at length, and Dr. Auluck’s opinion is not contradicted by any other evidence in the

medical records. (See Tr. at 20.)

Accordingly, Schanz has not demonstrated the ALJ erred in evaluating the opinions

of Schanz’s other treating physicians.

C. Credibility of Schanz’s Subjective Complaints of Pain

Schanz argues the ALJ erred by finding Schanz’s testimony was not credible to the

extent she claimed pain prevented her from working. The ALJ found Schanz’s allegations

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“appear overstated” and that the “treatment records and the consultative examination do

not reflect the severe symptoms claimed.” (See Tr. at 22.) The ALJ further found Schanz’s

testimony “not entirely credible to the extent she alleged an inability to perform any work.” 

(See Tr. at 23.)

Schanz testified before the ALJ that since January 2000, she gets pain in her neck

and arm “all the time” and that her pain prevents her from working. (See Tr. at 333.) 

Schanz also testified she has trouble picking up objects because she doesn’t have feeling

in her right hand. (See Tr. at 338.) Schanz testified she cannot sleep for more than two

and a half hours at a time, due to discomfort, and, consequently, has to take naps in the

morning and afternoon. (See Tr. at 343.) Schanz further testified she no longer is able to

vacuum, wash, or scrub the floors; she cannot pull wet clothes out of the laundry because

“it’s just too much pull”; and she can “[w]ash a few dishes,” but cannot prepare a meal from

start to finish because she “cannot stand at the stove that long to do it.” (See Tr. at 354.) 

After Schanz received two cervical epidural injections, she reported they failed to

provide any relief for her pain. (See Tr. 157, 161, 165.) At the hearing before the ALJ,

Schanz testified she uses an icepack on the back of her neck and takes Flexoral, Vicodin,

and Motrin for pain relief. (See Tr. at 340.) She testified she went to physical therapy for

three months, but stopped going after the physical therapist determined the therapy was

not providing any relief. (See Tr. at 341.) Schanz further testified she wears a neck brace

at least twice a day for thirty minutes at a time to help relieve the pressure on her neck. 

(See Tr. at 349.)

Schanz’s medical records reveal that on at least sixteen separate occasions

between January 2000 and July 2004, she complained of pain in her neck and arm to

seven different physicians. (See Tr. at 156, 159, 165-66, 179, 195, 197, 202, 204, 206,

208-09, 213, 221, 241, 301.) 

A claimant who alleges disability based on subjective symptoms, such as pain, must

meet two requirements: “(1) she must produce objective medical evidence of an

impairment or impairments; and (2) she must show that the impairment or combination of

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impairments could reasonably be expected to (not that it did in fact) produce some degree

of symptom.” See Smolen v. Chater, 80 F.3d 1273, 1281-82 (9th Cir. 1996) (emphasis in

original); see also Cotton v. Bowen, 799 F.3d 1403 (9th Cir. 1986). “The claimant need not

produce objective medical evidence of the pain or fatigue itself, or the severity thereof.” 

See Smolen, 80 F.3d at 1282. Additionally, “the claimant need not show that her

impairment could reasonably be expected to cause the severity of the symptom she has

alleged”; as noted, she need only show it could reasonably have caused “some degree” of

the symptom. See id. “This approach reflects the highly subjective and idiosyncratic

nature of pain and other such symptoms.” Id.

If the claimant meets the above-referenced requirements, and there is no evidence

of malingering, the ALJ can reject the claimant’s testimony as to the severity of her

symptoms only by offering specific, clear and convincing reasons for doing so. See

Smolen, 80 F.3d at 1281. In assessing the claimant’s credibility, the ALJ “may consider,”

among other things, an unexplained or inadequately explained failure to seek treatment or

to follow a prescribed course of treatment. See id. at 1284. The ALJ “must . . . consider”

the credibility factors set out in SSR 88-13, which include the claimant’s work record as well

as observations by treating and examining physicians and other third parties regarding: (1)

the nature, onset, duration, and frequency of the claimant’s symptom; (2) precipitating and

aggravating factors; (3) the type, dosage, effectiveness, and adverse side effects of any

pain medication; (4) treatment, other than medication, for pain relief; (5) functional

restrictions caused by the symptoms; and (6) the claimant’s daily activities. See id.; SSR

88-13.

In the instant case, the ALJ found “the medical evidence established [Schanz] has

cervical disc degeneration with radiculopathy into the upper right extremity,” (see Tr. at 22),

and acknowledged that Schanz has been treated for pain associated with that condition,

(see Tr. at 18-20.) Because the ALJ did not find Schanz is malingering, and there is no

evidence in the record demonstrating she is malingering, the burden shifted to the ALJ to

provide specific, clear, and convincing reasons for rejecting Schanz’s testimony as to the

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extent of her pain. See Smolen, 80 F.3d at 1281. 

The ALJ’s discussion of Schanz’s complaints of pain consists of the following:

The extent of her allegations at the hearing was not supported by medical

evidence. She alleged an inability to perform any work. However, orthopedic

and neurological findings were minimal throughout the record. Most

physicians found her capable of performing a wide range of light work. The

testimony of her husband was consistent with her testimony but also appears

exaggerated in light of the objective findings. The claimant has not

undergone significant medical treatment. She has not attended a pain clinic

and has not undergone other treatment to relive pain such as chiropractic

manipulation. She has not sought significant mental health treatment. The

allegations of the claimant appear overstated. The treatment records and the

consultative evaluations do not reflect the severe symptoms claimed.

(See Tr. at 21-22.) In essence, the ALJ based his assessment of Schanz’s credibility on a

determination that: (1) the objective medical records did not support Schanz’s testimony as

to the degree of her pain and (2) Schanz’s pursuit of conservative medical treatment

indicated her pain was not as severe as she claimed. 

Schanz was examined by seven different physicians over a period of four years; all

of the physicians noted that Schanz suffered pain in her neck and/or right arm. (See Tr. at

156, 159, 165-66, 179, 195, 197, 202, 204, 206, 208-09, 213, 221, 241, 301.) Dr. English,

the only examining physician who opined that Schanz was physically capable of performing

light work, stated “the claimant has a normal range of motion of the cervical spine, but with

a clear increase in her pain with both passive and active range of motion testing.” (See Tr.

at 184.) Dr. English described Schanz’s “radicular pain” as “convincing.” (See id.) In Dr.

Winter’s opinion, the MRI was consistent with Schanz’s complaint that her pain is

sufficiently severe to “constantly” interfere with attention and concentration. (See Tr. at

244.) Although one doctor, Kamran Sahrakar, M.D. (“Dr. Sahrakar”), told Schanz “her pain

is not typical for C5-6 pain,” he also told Schanz “her disc herniation . . . may be

responsible for some of her tingling and pain in the right upper extremity.” (See id. at 208.) 

No physician who examined Schanz disputed that her impairment might cause pain, and no

physician questioned that Schanz was suffering the amount of pain she reported.

As noted, the ALJ further found Schanz’s testimony as to her pain lacked credibility

because Schanz “has undergone only conservative medical treatment.” (See Tr. at 21.) 

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Vicodin, or hydrocodone, is an opioid and Schedule II controlled substance under

the Controlled Substance Act.

15

As discussed above, however, no physician questioned Schanz’s reported amount of pain. 

Additionally, despite his acknowledgment that Schanz received two cervical epidural

injections and takes Vicodin for pain relief,8

 (see Tr. at 21), the ALJ nonetheless found

Schanz had not received “significant” medical treatment,” (see id.). Moreover, the record

reflects that Dr. Sahrakar discussed with Schanz the possibility of disc fusion surgery, but

told her “there are implications with respect to fusing a joint in the neck causing future

difficulties and long-term implications of the operation as well as short-term difficulties,

especially in light of her weight.” (See Tr. at 208.) 

Accordingly, the Court finds the ALJ has not set forth sufficient reasons for rejecting

Schanz’s testimony as to the extent of her pain.

The ALJ found “the testimony of [Schanz’s] husband was consistent with her

testimony but also appeared exaggerated in light of the objective findings.” (See Tr. at 21.) 

Lay witness testimony can be an important source of information about a claimant’s

impairments, and an ALJ can reject it “only by giving specific reasons germane to each

witness.” See Regennitter v. Commissioner, 166 F.3d 1294, 1298 (9th Cir. 1999). As

noted above, the ALJ failed to set forth clear and convincing reasons for rejecting Schanz’s

testimony. The ALJ provided no additional reasons for rejecting the corroborating

testimony of Schanz’s husband.

Accordingly, the ALJ has not set forth sufficient reasons for rejecting the testimony of

Schanz’s husband.

D. Schanz’s Residual Functional Capacity

Schanz argues the ALJ erred in determining that Schanz can perform jobs that exist

in significant numbers in the national economy. 

“Once a claimant has established that he or she suffers from a severe impairment

that prevents the claimant from doing any work he or she has done in the past, the claimant

has made a prima facie showing of disability . . . [and] the burden shifts to the

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Commissioner to show that the claimant can perform some other work that exists in

‘significant numbers’ in the national economy, taking into consideration the claimant’s

residual functional capacity, age, education, and work experience.” Tackett v. Apfel,

180 F.3d at 1100; 20 C.F.R. § 404.1560(b)(3). The Commissioner may meet this burden in

either of two ways: (1) by the testimony of a vocational expert or (2) by reference to the

Medical-Vocational Guidelines (“the grids”). See Tackett, 180 F.3d at 1101; 20 C.F.R. Pt.

404, Subpt. P, App. 2.

The Commissioner may use the grids alone only “where they completely and

accurately represent a claimant’s limitations,” in other words, where a claimant is “able to

perform the full range of jobs in a given category, i.e., sedentary work, light work, or

medium work.” See id. (emphasis in original). Where the grids do not completely and

accurately describe a claimant’s limitations, the ALJ also must hear testimony from a

vocational expert. See Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001). 

Moreover, because the grids are based solely on “strength factors,” they are “sufficient only

when a claimant suffers only from exertional limitations.” See id.

In the instant case, the ALJ concluded that Schanz was able to perform a “wide

range of light work,” with limitations of occasional crouching, climbing, balancing, stooping

and kneeling. (See Tr. at 22-23.) The ALJ further found Schanz is “mildly-moderately

limited in social functioning, ADLs, and in concentration, persistence, or pace due to the

combined effects of her secondary depression, pain, and medication,” (see id. at 22), and

that such “nonexertional limitations do not allow her to perform the full range of light work,”

(see id. at 23); see also SSR 96-9p, 1996WL 374186 at *5. 

Because the Grids do not completely and accurately describe Schanz’s limitations,

the ALJ turned to the testimony of a vocational expert to determine whether jobs exist in the

national economy for an individual of Schanz’s age, education, past relevant work

experience and residual functional capacity. (See Tr. at 22-23.) The hypothetical posed by

the ALJ asked the vocational expert to “assume a capacity with a lifting and carrying

maximum of 10 pounds at any time, . . . sitting accumulative (sic) total of 6 hours out of an

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8-hour day, standing and walking accumulatively, 6 out of 8, no heights.” (See Tr. at 367-

68.) The ALJ further asked the vocational expert to assume Schanz was capable of only

occasional “reaching, handling, fingering, and feeling” with her right arm, and that she has

“no greater than average production pace.” (See Tr. at 368.) After considering the

testimony of the vocational expert, the ALJ found Schanz could work as a gate guard, a

counter clerk, or as a children’s attendant. (See Tr. at 22.)

Contrary to the hypothetical posed to the vocational expert, Dr. Winter concluded

Schanz is limited to carrying a maximum of five pounds and to sitting a maximum of two

hours in an eight-hour day. (See Tr. at 241-242.) Dr. English concluded Schanz was

limited to standing no more than two hours out of an eight-hour day. (See Tr. at 184.) 

Schanz testified that constant pain in her neck and arm prevent her from working and force

her to take frequent naps during the day. (See Tr. at 333, 344.) As discussed above, the

Court has found the ALJ failed to adequately explain his reasons for rejecting the opinions

of Dr. Winter and Dr. English on these issues, as well as Schanz’s subjective pain

complaints.

Accordingly, the Court finds the hypothetical posed to the vocational expert does not

provide adequate support for the ALJ’s determination that Schanz can perform work that

exists in significant numbers in the national economy. 

E. Form of Relief

Where the ALJ has improperly rejected relevant evidence, the Ninth Circuit has, on

occasion, declined to “remand solely to allow the ALJ to make specific findings” regarding

that evidence, and instead has credited the improperly rejected evidence as true and

remanded solely for an award of benefits. See Lester, 81 F.3d at 834 (internal quotation

and citation omitted); see also Smolen, 80 F.3d at 1292 (holding court may remand for

award of benefits “where the record has been fully developed and where further

administrative proceedings would serve no useful purpose”). In other such instances,

however, the Ninth Circuit has remanded for further proceedings rather than for an award

of benefits. See Connett v. Barnhart, 340 F.3d 871, 876 (9th Cir. 2003) (stating: “We are

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not convinced that the ‘crediting as true’ doctrine is mandatory in the Ninth Circuit”;

discussing cases; remanding for reconsideration of claimant’s pain testimony); see also

Bunnell v. Barnhart, 336 F.3d 1112, 1115-16 (9th Cir. 2003) (remanding for reconsideration

where, inter alia, ALJ “failed to provide adequate reasons for rejecting the opinion of the

treating physicians” and “did not properly reject [the claimant’s] subjective complaints”). In

particular, those courts have remanded for further proceedings when “outstanding issues

must be resolved before a proper determination can be made.” See id. at 1115. 

Here, “outstanding issues” remain to be resolved. In particular, issues remain as to

whether sufficient reasons exist for the ALJ’s rejection of the opinions of Dr. Winter and

Dr. English and Schanz’s subjective pain testimony. Development of these issues will

affect the ALJ’s determination as to whether Schanz can perform jobs existing in significant

numbers in the national economy. 

Accordingly, the Court cannot find that “the record has been fully developed” or that

“further administrative proceedings would serve no useful purpose.” See Smolen, 80 F.3d

at 1292. Consequently, the Court will remand the action for further administrative

proceedings.

CONCLUSION

For the reasons set forth above, Schanz’s motion for summary judgment is hereby

GRANTED in part, defendant’s cross-motion for summary judgment is DENIED, and the

matter is REMANDED for further proceedings consistent with this decision.

The Clerk shall close the file.

IT IS SO ORDERED.

Dated: June 15, 2006 

MAXINE M. CHESNEY

United States District Judge

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