Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_06-cv-03053/USCOURTS-azd-2_06-cv-03053-0/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)

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NOT FOR PUBLICATION

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Anne M. McDowell, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner Social

Security Administration, 

Defendant. 

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No. CV-06-3053-PHX-FJM

ORDER

Plaintiff applied for Social Security disability benefits in May 2003. The Social

Security Administration denied the application initially and on reconsideration. After a

review hearing, an administrative law judge (“ALJ”) issued a decision on July 28, 2006,

agreeing that plaintiff is not disabled. Finding no reason to revisit that decision, the appeals

council denied a request for review. Plaintiff filed this action pursuant to 42 U.S.C. § 405(g)

for judicial review of the ALJ’s decision.

The court has before it plaintiff’s motion for summary judgment (doc. 14), statement

of facts (doc. 15), and supporting memorandum (doc. 19). The court also has before it

defendant’s cross-motion for summary judgment (doc. 21), statement of facts (doc. 22),

supporting memorandum (doc. 23), and plaintiff’s response (doc. 26). For the reasons below,

we deny both parties’ motions and remand to the Commissioner for further consideration.

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I

Plaintiff is 60 years old and has worked most recently in education, as a teacher,

administrator, writing coach, tutor, and scoring supervisor. Plaintiff alleges disability

beginning May 2, 2003. She suffers from various medical conditions including fibromyalgia

and, most significant to her claimed disability, migraine headaches. According to plaintiff,

she first experienced migraine headaches after undergoing a mastectomy in 1983, Tr. 538,

but they have occurred with greater strength and frequency in recent years, possibly in

connection with leaking silicone breast implants, which were removed in 2004, Tr. 529. 

Plaintiff alleges that in 2003 she was suffering migraines almost daily. Id. By the

time of her administrative review hearing, medication, diet, and exercise had reduced the

number of migraines to 12 to 15 a month. Tr. 529–30. Plaintiff alleges that the headaches

are accompanied by nausea, loss of balance, and sensitivity to light and noise. She often lies

down in the dark to get relief from the migraines, which can last several hours. Tr. 529.

Plaintiff also alleges that she experiences lack of concentration and memory loss, perhaps

from the combination of her headaches and the medications to treat them. Tr. 531, 534. 

II

In this action, plaintiff specifically challenges the ALJ’s determination that chronic

headaches do not render her disabled. We may set aside the ALJ’s decision only if it is based

on legal error or is not supported by substantial evidence in the record. Verduzco v. Apfel,

188 F.3d 1087, 1089 (9th Cir. 1999). The ALJ conducted the five-step sequential evaluation

set out in 20 C.F.R. § 404.1520. If at any step in the process the claimant is found to be

disabled, the inquiry ends. Plaintiff contends that the ALJ erred at steps two, four, and five.

At step two, the ALJ determines whether the claimant has a medical impairment that

is “severe” under the Regulations. Plaintiff contends that the ALJ erred at step two by stating

that plaintiff has “a history of migraine headaches” rather than “ongoing migraine

headaches.” Plaintiff’s Memorandum at 3. Even if the word choice was inapt, it was not

error, because the ALJ at the same step classified the migraines, along with plaintiff’s other

impairments, as severe and continued with the evaluation. There also was no error at step

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five for the simple reason that the ALJ did not reach it; the ALJ determined at step four that

plaintiff is not disabled, which ended the inquiry. Therefore, we confine our analysis to step

four.

III

At step four, the ALJ assessed plaintiff’s “residual functional capacity” (“RFC”).

This assessment considers the functional limitations that result from an individual’s

“medically determinable impairments.” S.S.R. 96-8p. RFC depicts a claimant’s ability to

carry out sustained work-related activity, 8 hours a day, 5 days a week. S.S.R. 96-8p. Here,

the ALJ determined that plaintiff has a medically determinable condition that could account

for her symptoms, Tr. 19, and proceeded to assess her limitations.

The Social Security regulations distinguish between “exertional” and “non-exertional”

limitations. See S.S.R. 96-4p. Exertional limitations are those affecting the strength

demands of work, such as the ability to lift objects. Non-exertional limitations include

mental limitations and all physical limitations that are not related to strength demands, such

as the ability to concentrate. Pain can result in both exertional and non-exertional limitations,

or a combination of both. Id. The ALJ concluded that plaintiff has an RFC without

exertional limitations and only with “environmental” non-exertional limitations, such as a

need to avoid “concentrated exposure to noise, vibration, dust, chemicals, and fumes.” Tr.

18. Thus, the ALJ concluded that plaintiff’s migraines do not result in any exertional or nonexertional limitations beyond environmental restrictions. 

Two of plaintiff’s treating physician’s completed medical assessment forms. Id.

On August 7, 2004, Dr. Stuart Hetrick reported that plaintiff has frequent headaches, back

pain, and cognitive problems and rated her degree of restriction as “moderate.” Tr. 435–436.

On March 3, 2006, Dr. David Gannon also completed an assessment, characterizing

plaintiff’s frequent headaches as a “severe” impairment that would limit her ability to

perform work related activities. Tr. 437–438. The ALJ accorded the treating physicians’

assessments “little weight” 

 Assessments by treating physicians are accorded special weight. Rodriguez v.

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Bowen, 876 F.2d 759, 761 (9th Cir. 1989). One that is well-supported by medically accepted

diagnostic techniques and is not inconsistent with other substantial evidence should be given

controlling weight. S.S.R. 96-2p. Even if a treating physician’s assessment is not given

controlling weight, it is still entitled to deference. Id. An ALJ may reject such an

assessment, but only by providing “specific, legitimate reasons for doing so, and this decision

must itself be based on substantial evidence.” Id. at 762. 

Citing exhibits 24F and 25F, the ALJ stated that plaintiff’s headaches have “clearly

improved” and therefore concluded that the treating physicians’ assessments were “not

supported by the weight of the evidence in the record.” Tr. 19. Exhibit 24F comprises

medical records from February 2004 to July 2005, which do not express any clear indication

of an improving condition. Tr. 346–386. Exhibit 25F comprises the treatment notes of

Dr. Carol Foster from August to September, 2005. Tr. 387-390. Dr. Foster noted several

times in late 2005 and early 2006 that plaintiff’s condition was improving, Tr. 387, 443, 448,

but it clearly persisted. In one of the most recent records, a treatment note dated March 27,

2006, Dr. Foster characterized plaintiff’s condition as “chronic daily headache [with] gradual

improvement.” A few references to improvement in a claimant’s condition is not a legitimate

reason to discount the opinions of treating physicians whose conclusions are backed by

extensive treatment records. See Rhodes v. Schweiker, 660 F.2d 722, 723 (9th Cir. 1981).

Plaintiff’s medical records over the past several years detail a great number of complaints

and a battery of medications and therapies used to treat migraines and pain. 

The ALJ relied on evidence of plaintiff’s “fairly active lifestyle” to discount the

treating physicians’ assessments. Tr. 19. The ALJ noted that plaintiff is able to exercise,

attend church regularly, clean her home, and prepare meals, among other things. The ALJ

concluded that such “daily activities and behaviors are not consistent with the claimant’s

allegation of disability.” Id. Daily routine can be evidence relevant to a claimant’s capacity

for work. 20 C.F.R. § 404.1529(c)(3). If plaintiff were alleging a different impairment, one

that constantly inhibited activity, we might agree with the ALJ’s use of this evidence.

However, plaintiff alleges that her abilities vary greatly depending on whether she has a

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headache and its severity. Tr. 119–120. Given the intermittent nature of plaintiff’s alleged

disability, we find that a “fairly active lifestyle” is not sufficient to contradict the treating

physicians’ assessments. Cf. Thomas v. Sullivan, 876 F.2d 666, 669 (8th Cir. 1989) (noting

that the ability to do some routine tasks is not the same as the ability to perform substantial

gainful activity). 

In lieu of the treating physicians, the ALJ relied on the assessments of two nonexamining state agency physicians, Tr. 20. One found only mild psychological limitations,

Tr. 244–256, and the other found no exertional limitations, Tr. 273–280. It appears that these

sources did not consider the intermittent effects of plaintiff’s migraines. Furthermore, the

conclusion of a non-examining physician is entitled to less weight than that of an examining

one, and much less than that of a treating physician. Lester v. Chater, 81 F.3d 821, 830 (9th

Cir. 1995). The conclusions of a non-examining physician, without more, is not evidence

sufficient to reject the opinion of a treating physician. Pitzer v. Sullivan, 908 F.2d 502, 506

n.4 (9th Cir. 1990).

Finally, we note the ALJ gave limited weight to the “function report” completed

by plaintiff’s husband, Tr. 105–113, on the basis that “Mr. McDowell is neither a medical

expert nor a vocational expert.” Tr. 19. But that is the very definition of third-party opinion

evidence, and the regulations make such evidence relevant to the evaluation of subjective

symptoms such as pain. 20 C.F.R. § 404.1529(c)(3).

In sum, the ALJ concluded that plaintiff was without any limitations, save minor

environmental ones, and relied on that conclusion in posing hypothetical questions to the

vocational expert, Tr. 542–543, which led to a finding of no disability at step four. In

reaching a conclusion on the extent of plaintiff’s limitations, the ALJ erroneously discounted

the opinions of treating physicians and plaintiff’s husband. We therefore remand for further

proceedings and take no position on the ultimate issue of disability.

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IV 

Accordingly, IT IS ORDERED DENYING plaintiff’s motion for summary

judgment (doc. 14), DENYING defendant’s cross-motion for summary judgment (doc. 21),

and REMANDING the case to the Commissioner under sentence four of 42 U.S.C. § 405(g)

for further consideration in accordance with this order. The clerk is instructed to enter final

judgment in this action.

DATED this 17th day of December, 2007.

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