Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_14-cv-00712/USCOURTS-caed-1_14-cv-00712-1/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:206 Social Security Benefits

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

Plaintiff Jeff J. Coats, Sr. asserts he is entitled to disability insurance benefits under Title II of 

the Social Security Act. Plaintiff argues the administrative law judge erred in evaluating the record. 

Because the Court finds the ALJ identified legally sufficient reasons for rejecting Plaintiff’s credibility 

and properly evaluated the medical evidence, the administrative decision is AFFIRMED.

BACKGROUND

The Social Security Administration denied Plaintiff’s application for benefits at the initial level 

and upon reconsideration. (Doc. 7-3 at 25; Doc. 8-5 at 13-18) Plaintiff requested a hearing, and 

testified before an ALJ on May 23, 2012. (Doc. 7-3 at 25, 51) The ALJ determined Plaintiff was not 

disabled under the Social Security Act, and issued an order denying benefits on June 15, 2012. (Id. at 

25-42) The Appeals Council denied Plaintiff’s request for review. (Id. at 2-4) Therefore, the ALJ’s 

determination became the final decision of the Commissioner of Social Security.

JEFF J. COATS, SR., 

 Plaintiff,

v.

CAROLYN W. COLVIN,

Acting Commissioner of Social Security,

 Defendant.

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Case No.: 1:14-cv-00712 - JLT

ORDER DIRECTING ENTRY OF JUDGMENT IN 

FAVOR OF DEFENDANT, CAROLYN W. COLVIN, 

ACTING COMMISSIONER OF SOCIAL SECURITY, 

AND AGAINST PLAINTIFF, JEFF J. COATS, SR.

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STANDARD OF REVIEW

District courts have a limited scope of judicial review for disability claims after a decision by 

the Commissioner to deny benefits under the Social Security Act. When reviewing findings of fact, 

such as whether a claimant was disabled, the Court must determine whether the Commissioner’s 

decision is supported by substantial evidence or is based on legal error. 42 U.S.C. § 405(g). The ALJ’s 

determination that the claimant is not disabled must be upheld by the Court if the proper legal standards 

were applied and the findings are supported by substantial evidence. See Sanchez v. Sec’y of Health & 

Human Serv., 812 F.2d 509, 510 (9th Cir. 1987).

Substantial evidence is “more than a mere scintilla. It means such relevant evidence as a 

reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 

389, 401 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197 (1938)). The record as a whole 

must be considered, because “[t]he court must consider both evidence that supports and evidence that 

detracts from the ALJ’s conclusion.” Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). 

DISABILITY BENEFITS

To qualify for benefits under the Social Security Act, Plaintiff must establish 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. 42 U.S.C. 

§ 1382c(a)(3)(A). An individual shall be considered to have a disability only if:

his physical or mental impairment or impairments are of such severity that he is not 

only unable to do his previous work, but cannot, considering his age, education, and 

work experience, engage in any other kind of substantial gainful work which exists in 

the national economy, regardless of whether such work exists in the immediate area in 

which he lives, or whether a specific job vacancy exists for him, or whether he would 

be hired if he applied for work. 

42 U.S.C. § 1382c(a)(3)(B). The burden of proof is on a claimant to establish disability. Terry v. 

Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990). If a claimant establishes a prima facie case of disability, 

the burden shifts to the Commissioner to prove the claimant is able to engage in other substantial 

gainful employment. Maounis v. Heckler, 738 F.2d 1032, 1034 (9th Cir. 1984).

ADMINISTRATIVE DETERMINATION

To achieve uniform decisions, the Commissioner established a sequential five-step process for 

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evaluating a claimant’s alleged disability. 20 C.F.R. §§ 404.1520, 416.920(a)-(f). The process requires 

the ALJ to determine whether Plaintiff (1) engaged in substantial gainful activity during the period of 

alleged disability, (2) had medically determinable severe impairments (3) that met or equaled one of the 

listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1; and whether Plaintiff (4) had 

the residual functional capacity to perform to past relevant work or (5) the ability to perform other work 

existing in significant numbers at the state and national level. Id. The ALJ must consider testimonial 

and objective medical evidence. 20 C.F.R. §§ 404.1527, 416.927.

A. Relevant Medical Evidence

Plaintiff reported his last day of work was on April 23, 2009, after which he “went on 

unemployment for a few days.” (Doc. 7-9 at 38) On April 29, Plaintiff reported he “had the gradual 

onset of pain in his right hip while walking his dog,” which “became incredibly severe.” (Id.) Plaintiff 

visited the emergency room, where “[p]lain films were negative for a fracture.” (Id.)

Dr. Warren Borgquist first treated Plaintiff on May 7, 2009, “at which time [Plaintiff] was in 

tears from the severity of the pain.” (Doc. 7-9 at 38) Dr. Borgquist ordered a CT scan, which was 

negative and showed “absolutely no signs of a fracture.” (Id.; see also Doc. 7-9 at 81-82) On May 8, 

Dr. Borgquist noted Plaintiff was “a little less miserable” but had “exquisite pain” with internal rotation 

of his hip. (Id. at 38) Dr. Borgquist prescribed prednisone and hydrocodone to Plaintiff. (Id.) At a 

follow-up appointment on May 14, Dr. Borgquist observed that Plaintiff moved “very cautiously” 

because “slight rotation of the hip hurts him.” (Id.) Upon examination, Dr. Borgquist found Plaintiff 

had tenderness “over the femoral triangle anteriorly and . . . posteriorly under the gluteal cleft.” (Id.) 

Also, when Plaintiff was on his back, he was “unable to raise his leg up at all because of the severity of 

the pain.” (Id.)

On May 27, 2009, Plaintiff continued to report pain in his hip, as well as his low back, 

shoulders, and knee. (Doc. 7-9 at 37) Plaintiff also reported he had “a history of mood disturbances,” 

which Dr. Borgquist believed was “probably related to alcoholism.” (Id.) In addition, Dr. Borgquist 

noted Plaintiff had “depression, but it is related to situations rather than underlying depression.” (Id.) 

Dr. Borgquist observed that Plaintiff was able to “move from the chair to the exam table much easier 

than a month ago.” (Id.) According to Dr. Borgquist, Plaintiff exhibited “[m]ild pain to palpation” in 

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his lumbar spine and his “hip remain[ed] exquisitely tender to internal rotation when he [was] sitting on 

the exam table.” (Id.) 

In August 2009, Plaintiff reported he still had “severe hip pain,” and “could barely get his bone 

scan . . . because lying in that position just killed his right hip.” (Doc. 7-9 at 34) Dr. Borgquist noted 

the bone scan was negative, and the “etiology [was] undetermined” for the pain, which Plaintiff 

reported was a 5/10 and “10/10 when he stands.” (Id.) Plaintiff’s prescription for hydromorphone was 

increased. (Id.) 

On September 9, 2009, Dr. Borgquist noted Plaintiff said he had not had alcohol since his last 

check-up, “but he [was] freaking out,” “extremely anxious,” and tearful. (Doc. 7-9 at 33) Dr. Borgquist 

again found Plaintiff’s right hip was “[t]ender to internal and external rotation with him sitting.” (Id.) 

Plaintiff reported the “pain level [was] 5/10.” (Id.) 

In October 2009, Plaintiff had an MRI of his right hip, which Dr. John Bokelman found showed 

no fractures, “[n]o significant arthritic changes of the right hip or evidence of acetabular labral tear,” 

and “[n]o evidence of iliopsoas bursitis or pelvic abscess.” (Doc. 7-9 at 79) Dr. Bokelman determined 

the findings were “suggestive of mild gluteus medius muscle strain bilaterally,” although Dr. Borgquist 

said he could not find this on the MRI scan. (Id. at 28, 79) 

Dr. Borgquist gave Plaintiff a shot of Depo-Meldol to treat the pain on October 27, 2009. (Doc. 

7-9 at 28) Plaintiff reported he was “having trouble with his alcoholism and pain management issues,” 

but was attending Alcoholics Anonymous meetings. (Id. at 25, 28) Dr. Borgquist noted Plaintiff 

needed to go to a rehab facility, but there were “no resources for that in [the] county.” (Id. at 28) In 

November and December 2009, Plaintiff continued to report having pain in his right hip and low back, 

which he said was a “7 out of 10.” (Id. at 25) Dr. Borgquist observed that Plaintiff was “tearful and 

crying . . . in the office and agitated much of the time, and then he [had] an incredible temper.” (Id.) 

He diagnosed Plaintiff with bipolar mood disorder. (Id.)

Dr. W. Jackson completed a physical residual functional capacity and case assessment on 

December 31, 2009. (Doc. 7-8 at 2-13) Dr. Jackson noted Plaintiff alleged “his hip is out of socket,” 

but found the medical evidence “does not support his allegation.” (Id. at 12) According to Dr. Jackson, 

Plaintiff received “treatment for significant hip pain but imagining shows only gleuteal strain.” (Id.) 

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Further, Dr. Jackson observed that Plaintiff’s “bone scan, CT and labs [were] not indicative of severe 

impairment.” (Id. at 3) Dr. Jackson opined Plaintiff was able to lift and carry 10 pounds occasionally 

and less than 10 pounds frequently, stand and/or walk at least two hours in an eight-hour workday, sit 

about six hours in an eight-hour day. (Id.) Also, Dr. Jackson found Plaintiff was only occasionally able 

to climb ramps and stairs, balance, stoop, kneel, crouch, and crawl; and never climb ladders, ropes, or 

scaffolds. (Id. at 5) Dr. Jackson concluded Plaintiff was limited with his ability to push and pull in the 

lower extremities. (Id. at 3) Dr. Jackson believed Plaintiff was required to avoid concentrated exposure 

to extreme cold and heat. (Id. at 6) Dr. Jackson explained that Plaintiff was “only partially credible,”

because the medical record did not support his allegations of his hip being out of place, or the severity 

of his alleged limitations. (Id. at 12) Dr. Jackson believed Plaintiff’s condition would “likely improve 

within 12 months, but [it was] difficult to be sure.” (Id. at 13)

In January 2010, Plaintiff had an evaluation with Dr. Ariana DeMers, an orthopedist. (Doc. 7-

10 at 22-23) Dr. DeMers observed Plaintiff was “tearful and extremely anxious.” (Id. at 22) She 

found Plaintiff was “tender to palpation all over,” and exhibited “significant pain” with internal rotation 

of his hips. (Id.) Dr. DeMers recommended Plaintiff take physical therapy, which caused Plaintiff to 

be “tearful.” (Id. at 23) In addition, around the same time, Dr. Borgquist told Plaintiff to “stop 

smoking pot.” (Id. at 24)

Dr. Les Kalman conducted a psychiatric evaluation on January 26, 2010. (Doc. 7-8 at 14) He 

observed that Plaintiff’s “posture was normal but his gait was antalgic,” and Plaintiff ambulated with 

the assistance of a cane. (Id.) Plaintiff reported he would “get[] emotional, running hot and cold, and 

[had] mood swings.” (Id.) He explained: “It doesn’t take much to set me off. No patience, no 

tolerance. I’m in pain a lot.” (Id.) Also, Plaintiff “admitted to feelings of hopelessness, helplessness, 

and worthlessness and significantly diminished energy levels.” (Id.) Plaintiff told Dr. Kalman he “had 

been using alcohol to deal with his moods,” and had been sober for 90 days. (Id.) He admitted “he was 

in jail once in 2002 for [a] lewd act with minor,” but felt the “charges were not justified.” (Id. at 15) 

Plaintiff the fact that he was registered sex offender “has a significant impact on his ability to get 

housing.” (Id. at 15) Plaintiff denied having suicidal or homicidal thoughts. (Id.) Dr. Kalman found

Plaintiff “exhibited an impaired memory” because “[h]e recalled none out of 3 objects at 5 minutes.” 

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(Id.) Dr. Kalman observed: “Mr. Coats present[ed] with a fluctuating mood, predominately anger and 

depression. He was tearful, crying intermittently throughout the interview alternating with anger 

related to his current situation. Also, he is despondent over his physical condition with chronic hip and 

back pain.” (Id. at 16) Dr. Kalman diagnosed Plaintiff with an intermittent explosive disorder, 

“Adjustment disorder depressed secondary to medical condition,” “R/O Bipolar disorder not otherwise 

specified.” (Id.) Dr. Kalman concluded:

I He is able to relate with supervisors and co-workers;

II He is able to deal with the public;

III He is able to understand and carry out simple one or two step job instructions;

IV He has a decreased ability to maintain attention and concentration; [and]

V He is psychiatrically able to withstand stress and pressures associated with daily 

work activities.

(Id.) Dr. Kalman believed Plaintiff’s mental condition was “not expected to improve significantly in 

the next 12 months” and gave him a GAF score of 50.1 (Id.)

Dr. Robert Paxton completed a mental residual functional capacity assessment and psychiatric 

review technique form on February 10, 2010. (Doc. 7-8 at 17-30) Dr. Paxton opined Plaintiff was “not 

significantly limited” with his ability to understand, remember, and carry out very short and simple 

instructions; but was “moderately limited” with the ability to understand, remember, and carry out 

detailed instructions. (Id. at 17) Also, Dr. Paxton believed Plaintiff was “moderately limited” with his 

ability to “maintain attention and concentration for extended periods.” (Id.) He indicated Plaintiff was

“not significantly limited” with the ability to maintain attendance and complete a normal workday 

without interruptions from psychologically-based symptoms, and was “not significantly limited” with 

the ability to respond appropriately to changes in the work setting. (Id. at 17-18) Dr. Paxton opined 

Plaintiff had mild restriction in his activities of daily living; moderate difficulties in maintaining social 

functioning; and moderate difficulties in maintaining concentration, persistence, and pace. (Id. at 28) 

Accordingly, Dr. Paxton concluded Plaintiff was “[a]ble to understand and remember work locations 

 

1

GAF scores range from 1-100, and in calculating a GAF score, the doctor considers “psychological, social, and 

occupational functioning on a hypothetical continuum of mental health-illness.” American Psychiatric Association, 

Diagnostic and Statistical Manual of Mental Disorders, 34 (4th ed.) (“DSM-IV). A GAF score between 41-50 indicates 

“[s]erious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairments 

in social, occupational, or school functioning (e.g., no friends, unable to keep a job).” Id.

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and procedures of a simple, routine nature involving 1-2 step job tasks and instructions.” (Id. at 19)

Further, Dr. Paxton opined Plaintiff “[w]ould be able to remain socially appropriate with co-workers 

without being distracted by them but would require limited public contact.” (Id.)

Plaintiff began physical therapy, which he reported was “helping a little bit.” (Doc. 7-9 at 17) 

In March 2010, Plaintiff still limped and reported it was “hard for him to walk.” (Id.) Plaintiff said he 

was “able to walk on the flat surfaces . . . a little better but the pain [was] so severe he require[d] large 

doses of opiate pain medication even to walk around normally.” (Id.) Plaintiff reported “his depression 

and mood swings [were] horrible” and he “had anger and rage behavior.” (Id.) Dr. Borgquist concluded 

that Plaintiff’s “mood disorder plus his sleep disturbance and his pain ... make him unemployable.” 

(Id. at 14)

In April 2010, Plaintiff reported he still could not walk “and any movement at all hurt[] him 

terribly.” (Doc. 7-9 at 13; Doc. 7-11 at 77) He was taking morphine “3 times a day for pain 

management and [was] still miserable.” (Id.) Dr. Borgquist opined Plaintiff was “clearly going to be 

disabled for at least a year, and perhaps the rest of his life.” (Id.) Again, Dr. Borgquist concluded

Plaintiff’s mood “disorder plus his hip pain in combination make him unemployable.” (Id.)

On June 1, 2010, Plaintiff reported he continued to have right hip pain, which he stated was a 

“5/10.” (Doc. 7-9 at 12) Dr. Borgquist observed that Plaintiff limped “pathetically,” and found he had 

tenderness “to palpation posteriorly, anteriorly, and with hip rotation.” (Id.) Also, Dr. Borgquist noted 

Plaintiff had “gained 20 pounds” while taking Abilify, and said Plaintiff was “going to have to go off of 

it.” (Id.) On June 10, Plaintiff received a steroid injection in his right hip. (Doc. 7-8 at 35)

On July 8, 2010, Plaintiff had an MRI on his lumbar spine. (Doc. 7-8 at 33-34; Doc. 7-9 at 75-

76) Dr. Sangeeta Gambihir determined Plaintiff had “[m]ild right anterior cord impingement at T12-L1 

due to a right paracentral disk bulge with associated osteophytic ridging;” “[m]ild to moderate L4-5, 

mild L3-4 and mild L5-S1 acquired central canal stenosis;” and “[m]ultilevel neural foraminal stenosis, 

greatest on the right at L5-S1 (mild to moderate).” (Id.)

On July 20, 2010, Plaintiff told Dr. Borgquist that his mood was worse, and he stopped taking 

Lamictal because he was still gaining weight. (Doc. 7-9 at 10) Dr. Borgquist opined Plaintiff’s weight 

gain unrelated to the medicine, and because Plaintiff stopped taking his medication, his “[pr]obable 

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bipolar mood disorder” was going untreated. (Id.) Also, Dr. Borgquist noted Plaintiff had received “a 

therapeutic injection into his right hip,” which gave him “marked pain relief for about a week.” (Id.) 

However, Plaintiff reported the pain had returned, and he “continued to limp.” (Id.) Dr. Borgquist 

treated Plaintiff’s pain in his left wrist with an injection of neutralized lidocaine, noting that “carpal 

tunnel injections are not curative and he should be evaluated for carpal tunnel surgery.” (Id. at 11)

In October 2010, Dr. Meador examined Plaintiff, who visited “for a routine med refill regarding 

a diagnosis of chronic low back pain.” (Doc. 7-8 at 32) Plaintiff told Dr. Meador that his pain was 

“controlled” with Kadian. (Id.) Dr. Meador found Plaintiff had “[n]o tenderness with palpation of the 

lumbar vertebrae,” and “good range of motion to the back.” (Id.) In addition, Dr. Robert Pollard 

treated Plaintiff “for left hand pain.” (Doc. 7-9 at 9) Plaintiff told Dr. Pollard that for the past year, he 

“had progressive pain and numbness in his left hand, and his second through fifth fingers are numb 

with increased pain to his wrist at night.” (Id.) He said the pain was “5/10 and worse at night.” (Id.) 

Dr. Pollard ordered an EMG to determine whether Plaintiff had carpal tunnel syndrome in his left hand. 

(Id.) In addition, due to Plaintiff’s “excessive weight gain,” Dr. Pollard “recommended that he stop the 

marijuana and increase his activity.” (Id.) 

Dr. Sara Richey treated Plaintiff for the first time on November 17, 2010, following the death of 

Dr. Borgquist. (Doc. 7-9 at 5, 83) She observed that Plaintiff was “a very complex gentleman with 

chronic pain, depression, history of alcoholism, active carpal tunnel syndrome, and unexplained hip 

pain.” (Id. at 5) Dr. Richey noted that Plaintiff was “listed as bipolar,” but because he was unable to 

“describe any high points, only low points,” Dr. Richey did not believe he suffered from the disorder. 

(Id.) Rather, she believed he “ha[d] a depression with mood disorder and alcoholism.” (Id.) Further, 

Dr. Richey observed that he was “sad and tearful” and complained of “ongoing right hip pain,” despite 

“normal MRI of the right hip.” (Id. at 5-6) According to Dr. Richey, Plaintiff “was advised to go ... to 

physical therapy twice a week for 12 weeks, but . . . was discharged because he kept no showing.” (Id.) 

Plaintiff reported he was miserable on the pain medication, and “his pain [was] not controlled at all.” 

(Id. at 6) He told Dr. Richey that he was “using medical marijuana, but trying to quit.” (Id.) Dr. 

Richey found Plaintiff showed “some tenderness in the lower lumbar segments with exaggerated 

reaction to light touch,” as well as “tenderness over the trochanter of the right hip and tenderness with 

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range of motion for both abduction and adduction.” (Id.) Further, Plaintiff’s gait was “slightly 

antalgic.” (Id.)

On December 17, 2010, Plaintiff had a follow-up appointment with Dr. Richey. (Doc. 7-11 at 

67) Dr. Richey noted Plaintiff’s urinalysis “showed some hydrocodone,” which was “inconsistent with 

his prescription.” (Id.) In addition, Plaintiff was “supposed to be on Cymbalta 30 mg b.i.d., but he 

[had] not been taking it.” (Id. at 68) Dr. Richey observed that Plaintiff was “mildly impaired and less 

whiny,” although he continued to show “some tenderness in the lower lumbar segments with 

exaggerated reaction to light touch.” (Id.) Plaintiff also exhibited “tenderness over the trochanter of 

the right hip,” and had a “slightly antalgic” gait. (Id.) Dr. Richey believed the “negative hip imaging, 

negative bone scan,” and MRI scans “cannot be completely correlated with his hip pain.” (Id.) Dr. 

Richey expressed concerns about Plaintiff’s uncontrolled use of opiates and noted, “he must start 

making progress in order to keep getting pain medicine here. . . The patient must not use any Vicodin 

or any other prescribed opiates or unprescribed opiates whatsoever while he is getting pain medications 

from me. He is to take his morphine only. He can take ibuprofen. He may not take any other opiate. 

This was spelled out clearly and he verified understanding. He will be allowed no other aberrant urine 

drug screens.” (Id.)

On January 7, 2011, Dr. Savage gave Plaintiff an intake assessment at Forest Road Health and 

Wellness Center. (Doc. 7-10 at 52) Plaintiff reported he was “an emotional mess. . . all the time.” (Id.) 

Plaintiff believed he was “not even employable because [he was] such a freaking mess.” (Id.) Plaintiff 

said that on an average day, he would “just sit and watch TV,” and eat because marijuana made him 

hungry. (Id.) Plaintiff said he had Cymbalta, which he believed “would help if he took it consistently” 

and remembered to take it. (Id. at 53) Dr. Savage observed that Plaintiff was “ponderously depressed, 

tearful and crying throughout the session,” as well as “dysphoric, and somewhat impulsive, irritable at 

times in flashes of anger/ frustration.” (Id.) Dr. Savage diagnosed Plaintiff with “Major Depression, 

Recurrent, moderate;” chronic pain disorder; alcoholism, in sustained remission; and cannabis 

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dependence. (Id. at 54) Dr. Savage gave Plaintiff a GAF score of 40.2 (Id.)

Dr. Paul Martin conducted a psychological evaluation on January 17, 2011. (Doc. 7-10 at 55) 

Plaintiff reported he was “in extreme pain, described as 8/10.” (Id.) Plaintiff also said he was depressed 

and had “problems with concentration and memory.” (Id. at 55-56) Dr. Martin observed that Plaintiff 

“endorsed numerous symptoms of depression including low energy[,] poor motivation, social 

withdrawal, crying spells, anhedonia, and a sense of hopelessness.” (Id. at 55) In addition, he noted 

Plaintiff “became tearful,” was “distressed and easily overwhelmed.” (Id. at 56) Dr. Martin found 

Plaintiff’s attention, concentration, and “[m]emory for recently learned information was adequate” 

because he “recited 3 out of 3 words after a brief delay.” (Id.) Dr. Martin opined Plaintiff’s “insight 

and judgement appeared to be fair but affected by chronic pain.” (Id.) Dr. Martin concluded:

The claimant had no difficulty understanding, remembering, and carrying out simple 

instructions. He had no difficulty with detailed and complex instructions. He had 

moderate difficulty maintaining attention and concentration for the duration of the 

evaluation. His pace was severely decreased. He demonstrated severe difficulty with 

pace and persistence. He had severe difficulty enduring the stress of the interview. He is 

likely to have severe difficulty adapting to changes in routine work-related settings. 

Based upon observations of current behavior and reported psychiatric history, the 

claimant’s ability to interact with the public, supervisors, and coworkers there appears to 

be moderate impairment. 

(Id. at 57) Further, he opined Plaintiff “would have difficulty sustaining his attention and concentration 

and cognitive effort secondary to his depression and chronic pain.” (Id.) Dr. Martin gave Plaintiff a 

GAF score of 55, and noted his prognosis was guarded.3 (Id. at 56)

Dr. Fariba Vesali conducted a comprehensive orthopedic evaluation on January 25, 2011. (Doc. 

7-10 at 58) Plaintiff’s primary complaint was “[l]ow back pain,” which he described as “constant, 

sharp, with occasional radiation to right ankle.” (Id.) Dr. Vesali observed that Plaintiff was “not in 

acute distress,” “did not have any difficulties to get on and off the examination table,” and “did not 

have any difficulties to take off his shoes and put them on.” (Id. at 59) In addition, Dr. Vesali noted 

Plaintiff walked “slowly with no particularly abnormal gait,” although “[h]e deferred walking on toes 

 

2

A GAF score of 31-40 indicates “[s]ome impairment in reality testing or communication (e.g., speech is at times 

illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, 

thinking or mood (e.g., depressed man avoids friends, neglects family, and is unable to work . . .).” DSM-IV at 34.

3

A GAF score of 51-60 indicates “moderate symptoms ... OR moderate difficulty in social, occupational, or 

school functioning (e.g., few friends, conflict with peers or co-workers).” DSM-IV at 34.

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and heels because of low back pain.” (Id.) Dr. Vesali determined Plaintiff’s motor strength was “5/5 in 

bilateral upper and lower extremities including grip strength,” but had “[d]ecreased light touch and 

pinprick sensation” in his right leg. (Id. at 60) Based upon the examination, Dr. Vesali indicated she 

did “not feel the condition will impose any limitations 12 continuous months.” (Id. at 61) Dr. Vesali 

concluded Plaintiff “should be able to walk, stand, and sit six hours in an eight-hour day with normal 

breaks,” and “lift/carry 50 pounds occasionally and 25 pounds frequently.” (Id.) Further, she opined 

Plaintiff did not have postural, manipulative, or workplace environmental limitations. (Id.)

At a follow-up appointment in late January 2011, Dr. Savage observed that Plaintiff was 

“tearful, doleful” and “constantly negative.” (Doc. 7-11 at 112) Dr. Savage determined Plaintiff’s 

memory was intact, but his “[a]ttention and concentration [were] slightly impaired.” (Id.)

In February 2011, Dr. Richey noted Plaintiff exhibited a “significant chronic pain disorder” and 

had “chronic right hip pain with negative imaging and negative bone scanning,” as well as “lumbar 

spinal stenosis with some cord changes at T12-L1.” (Doc. 7-11 at 62) Plaintiff reported his pain level 

was “6 in his low back.” (Id. at 63) Plaintiff also reported he had “severe right hip area pain,” which 

Dr. Richey believed was “out of proportion to findings on multiple types of imaging of the area.” (Id.) 

On March 1, 2011, Dr. Barbara Bammann conducted a consultative examination after a referral 

from Dr. Richey. (Doc. 7-11 at 115) Plaintiff reported he had “a sharp pain midline in the low back,” 

which was aggravated by “everything or any movement.” (Id.) Dr. Bammann observed that he “was 

obviously distraught and had an antalgic gait on the right.” (Id.) Plaintiff had a positive straight leg 

raise test on the right leg, but negative on the left. (Id.) In addition, he “was diffusely tender 

throughout the low lumbar spine, but no one specific area of focal tenderness.” (Id.) Dr. Bammann 

opined: “He has a very limited ability to sit, stand or walk for any period of time. He cannot do any 

lifting or carrying and he certainly cannot do any bending.” (Id. at 116) Dr. Bammann concluded 

Plaintiff had “a very legitimate disability from any kind of employment.” (Id.)

Dr. Greg Ikawa reviewed the record and completed a mental residual assessment and psychiatric 

review technique form on March 1, 2011. (Doc. 7-11 at 117- 27; Doc. 7-12 at 2-4) Dr. Ikawa opined 

Plaintiff was “not significantly limited” with his ability to understand, remember, and carry out very 

short and simple instructions; and Plaintiff was “moderately limited” with the ability to understand, 

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remember, and carry out detailed instructions. (Doc. 7-12 at 2) Dr. Ikawa believed Plaintiff was “not 

significantly limited” with all other aspects of concentration, persistence, social interaction, and 

adaptation. (Id. at 2-3) Further, Dr. Ikawa opined Plaintiff had moderate restrictions in his activities of 

daily living; mild difficulties in maintaining social functioning; and moderate difficulties in maintaining 

concentration, persistence, and pace. (Doc. 7-11 at 125) Dr. Ikawa concluded Plaintiff was “[a]ble to 

sustain simple and repetitive tasks” and was “[a]ble to relate and adapt.”4 (Doc. 7-12 at 4)

In March 2011, Dr. Richey observed that Plaintiff was “moderately somatoform, but not 

tearful.” (Doc. 7-13 at 18) Dr. Richey found Plaintiff had decreased testosterone, which was “related 

to his chronic opiate usage,” and she sought approval of a testosterone gel. (Id.) She also noted 

Plaintiff was referred for a TENS unit trial, which Plaintiff said was “helping a lot.” (Id.) However, 

Plaintiff did not comply with the request to “repeat serum protein electrophoresis with urine 

immunophoresis studies” or “to get an ultrasound of his abdomen to rule out liver disease.” (Id.) Due 

to Plaintiff’s continued report of “low back and right lower extremity sciatica pain,” Dr. Richey 

referred Plaintiff to an orthopedist, Dr. Suneeta Chhugani. (Id. at 17; Doc. 7-12 at 55)

Plaintiff reported Dr. Chhugani that his pain level was “4/10,” and said his “current medication 

regimen [gave] him good pain relief.” (Id. at 57) Upon examination, Dr. Chhugani found Plaintiff 

exhibited “mild tenderness” throughout his body: 

Patient has mild tenderness to extremes of range of motion at his shoulders bilaterally, 

right greater than left. Flexion and abduction are worse than extension. He has mild 

tenderness to extremes of range of motion at his ankle on the right side, as well as at his 

subtalar joint on the right side. ... Remainder of the joints in the upper and lower 

extremities does not reveal any swelling, tenderness, limitation of range of motion, or 

deformity. ... There is minimal tenderness in the region of his sacroiliac joints bilaterally; 

11 out of 18 tender points of fibromyalgia are positive.

(Id. at 56) In addition, Dr. Chhugani observed that Plaintiff “ambulate[d] with a normal gait without 

any ambulatory assistant device.” (Id.) Dr. Chhugani diagnosed Plaintiff with fibromyalgia and 

osteoarthritis of the hands. (Id. at 52)

Dr. Roger Fast completed a physical residual functional capacity assessment on April 22, 2011. 

(Doc. 7-12 at 32-37) Dr. Fast observed Plaintiff suffered from morbid obesity, lumbar degenerative 

 

4 Dr. Peter Bradley reviewed the medical record on September 15, 2011 and adopted “as written” the conclusion 

that Plaintiff “could sustain work effort at unskilled tasks.” (Doc. 7-13 at 74)

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disc disease with stenosis, right gluteal tendonitis, alcoholism in remission, and asthma. (Id. at 33) He 

opined Plaintiff was able to lift and carry 20 pounds occasionally and 10 pounds frequently, stand 

and/or walk at four hours in an eight-hour day, and sit about six hours in an eight-hour day. (Id. at 33, 

36) Dr. Fast found Plaintiff was able to “occasionally” engage in all postural activities including 

climbing, stooping, balancing, kneeling, crouching, and crawling. (Id. at 34) Dr. Fast noted Plaintiff 

had “developed increasing back pain and exams show[ed] some improvement in his hip.” (Id. at 36) 

Dr. Fast gave more weight should be given to the opinion of Dr. Bammann because she “had the 

benefit of the lumbar imaging study showing DDD and stenosis.” (Id.) Therefore, Dr. Fast believed 

the “medium RFC by Dr. Vesali is not restrictive enough.” (Id.)

At a follow-up examination on April 27, 2011, Dr. Chhugani reviewed x-rays of Plaintiff’s right 

hip, shoulder, and ankle and found Plaintiff did “not have any evidence of inflammatory arthritis.” 

(Doc. 7-12 at 52) Plaintiff reported his pain was “6 out of 10, and that he “occasionally” suffered from 

depression. (Id. at 54) According to Dr. Chhugani, Plaintiff ambulated “with a mildly antalgic gait” 

and continued to have “mild tenderness” throughout his body. (Id.) 

In May 2011, Dr. Richey opined Plaintiff’s chronic pain, which he described as a “5” out of ten,

was “out of proportion to any actual x-ray findings.” (Doc. 7-13 at 11) Dr. Richey noted Plaintiff was 

taking “a much higher dose of morphine than [she] would like to give,” but Dr. Richey did not feel the 

prescription could be changed because they were “working up so many issues.” (Id. at 12) In addition, 

Dr. Richey observed that Plaintiff was “pretty devastated,” “tearful and upset” because his house had 

recently burned down. (Id. at 11) Dr. Richey noted Plaintiff weighed 331 pounds, and was a candidate 

for bariatric surgery. (Id. at 11-12) Plaintiff began a pre-bariatric diet in June 2011, and continued to 

report pain that Dr. Richey believed was “out of proportion to any actual radiological findings.” (Doc. 

7-14 at 57)

On June 23, 2011, Dr. Richey referred Plaintiff to the emergency department because he felt 

weak and “like passing out,” and was sweaty. (Doc. 7-14 at 112) Upon examination, Plaintiff did not 

exhibit any tenderness in his neck or back, and he had a “normal range of motion” in his back. (Id. at 

113) Plaintiff had an EKG, which was “unremarkable.” (Id. at 115) Similarly, Plaintiff’s lab results 

were “unremarkable with the exception of some abnormalities on his thyroid function.” (Id.)

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Dr. Ernest Wong reviewed the record and completed a case analysis on September 1, 2011. 

(Doc. 7-13 at 73) Dr. Wong noted Plaintiff’s activities included “daily walks, meal preparation, 

domestic [activities of daily living] w/o assistance, socializing, [and] animal care.” (Id.) He observed 

that Plaintiff had negative hip imaging, including a negative bone scan, and that Dr. Richey believed 

the pain reports were “out of proportion to findings on multiple imaging of the area.” (Id.) Based upon 

his review of the record, Dr. Wong affirmed the RFC offered by Dr. Fast. (Id.)

In October 2011, Plaintiff requested that Dr. Richey complete paperwork from his attorney for 

Plaintiff “to get Disability.” (Doc. 7-14 at 47) Dr. Richey informed Plaintiff that she would not fill out 

the forms, but believed her records were “sufficient.” (Id.) Dr. Richey believed most of Plaintiff’s 

disability was psychological and an evaluation should be obtained from a psychiatrist or psychologist. 

(Id.)

In November 2011, Plaintiff “had a Roux-en-y gastric bypass surgery,” during which the 

physicians noticed “his liver looked abnormal.” (Doc. 7-14 at 12) A biopsy of the liver showed 

Plaintiff had “stage 4 cirrhosis.” (Id.at 12, 85) Dr. Hope Ewing explained the lab results indicated

Plaintiff had “biochemically stable liver disease without evidence of other liver disease,” but he was at 

risk for hepatocellular carcinoma and needed to begin routine cancer screening every six months. (Id.

at 12) She began treating Plaintiff for “Alcoholic Cirrhosis” on January 4, 2012. (Id. at 14)

In December 2011, Dr. Richey noted Plaintiff was “no longer seeing Dr. Savage because she 

felt that his behavior was threatening and she became very uncomfortable treating him after a while.” 

(Doc. 7-14 at 43) Dr. Richey opined that Plaintiff was in an “[e]xtremely labile emotional state, 

although [he] seem[ed] to have improved slightly.” (Id. at 44) Also, Plaintiff reported his pain level 

was “7 to 8” in his back and right hip. (Id.) Dr. Richey noted Plaintiff “used up his pain medications 

too early,” and that he “must take his medication exactly as prescribed and not more often.” (Id. at 45) 

Plaintiff again requested that Dr. Richey complete some paperwork “to certify his disability.” (Id.) 

However, Dr. Richey explained she “really [did] not want to sign.” (Id.) She noted: “It is my opinion 

that all of his disability is psychological and he really needs a psychologist to be managing his issues 

but [he] has estranged Dr. Savage.” (Id.)

In January 2012, Plaintiff reported he was “using his TENS unit all of the time,” which was not 

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ordered by Dr. Richey though she said she would be “happy to sign” a new order for one. (Doc. 7-14 at 

39) Plaintiff reported his depression was “a little better.” (Id.) Dr. Richey noted it was the first time 

she saw Plaintiff “when he did not dissolve into tears halfway through the visit.” (Id.) She speculated it 

may be because his son was doing better and was in a recovery program, or because Plaintiff’s 

girlfriend was at the office with him. (Id.) Dr. Richey explained Plaintiff appeared “mildly needy 

rather than completely pathetic as it ha[d] always been in the past.” (Id. at 40) In addition, she noted 

Plaintiff had lost “well over 50 pounds” after his surgery, and he did not have any significant 

tenderness in his lumbar spine. (Id.) However, Plaintiff reported he was “not getting very good pain 

control any longer.” (Id.) Dr. Richey noted his dosage had been decreased because she was “not 

continuing him on high-dose schedule 2 medications,” and Plaintiff would “have to go somewhere 

else” if he wanted such medication. (Id. at 40-41)

Dr. Ewing noted on February 13, 2012, that Plaintiff had “a MELD score of 9 which is actually 

quite good” because “over 15 one might consider consultation for a liver transplant.” (Doc. 7-14 at 12) 

She observed that Plaintiff reported “some typical symptoms with fatigue, insomnia, edema and 

depression.” (Id.) In addition, Dr. Ewing noted Plaintiff had constant pain in his back and abdomen, 

which was aggravated with movement or being in a prolonged position.” (Id. at 16) Dr. Ewing opined 

Plaintiff was able to sit for “0-1” hour and stand/walk “0-1” hour in an eight-hour day, and he needed to 

move around “every hour” for 5 minutes before he needed to sit again. (Id. at 16-17) Dr. Ewing 

indicated Plaintiff was able to lift and carry 0-10 pounds frequently and 10-20 pounds occasionally. 

(Id. at 17) She believed Plaintiff had “minimal” limitations with grasping, turning, and twisting objects; 

using his fingers and hands for fine manipulations; and using his arms for reaching, including overhead. 

(Id. at 17-18) Dr. Ewing opined also that Plaintiff was “unable to cope with life stressors, depression” 

and was likely to be absent from work more than three times a month due to his impairments. (Id. at 

19-20) Although Plaintiff’s “liver function [was] preserved,” Dr. Ewing believed Plaintiff would “have 

difficulty in a competitive work environment as his symptoms will continue to be progressive and 

clearly his disability will be expected to last for the rest of his life.” (Id. at 12-13)

On February 16, 2012, Plaintiff reported he was “having nightmares of killing babies,” and 

wanted to “go back to Dr. Savage.” (Doc. 7-14 at 36) Dr. Richey observed that the visit took “an 

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inordinate amount of [her] time” because Plaintiff was “crying almost the entire visit.” (Id. at 38) Dr. 

Richey noted she talked to Dr. Savage who indicated she was potentially willing to see him again.” 

(Id.at 36) Plaintiff reported his pain was a “5,” and he showed “tenderness just at the lumbar region.” 

(Id. at 37) Plaintiff’s gait was “unremarkable,” and he had “[n]o gross motor or sensory deficits.” (Id.)

Dr. Bammann completed a “multiple impairment questionnaire” on February 22, 2012. (Doc. 

7-14 at 3-10) Dr. Bammann noted she treated Plaintiff “annually,” and he was diagnosed with (1) 

lumbar spinal stenosis, (2) psoriasis, (3) carpal tunnel syndrome in his left hand, (4) sleep apnea, and 

(5) stage 4 cirrhosis. (Id. at 3) She explained these diagnoses were supported by an MRI of Plaintiff’s 

lumbar spine showing “multilevel stenosis” and “liver panel abnormalities.” (Id.) Dr. Bammann noted 

Plaintiff reported having low back and right leg pain and numbness, fatigue, hot flashes, and left hand 

paresthesia. (Id.) She noted Plaintiff described his pain as 7 out of 10, or “moderately severe.” (Id. at 

5) Dr. Bammann opined Plaintiff was able to sit for “0-1” hour and stand/walk “0-1” hour in an eighthour day. (Id.) She believed Plaintiff needed to “constantly” move around, and should not sit or stand 

continuously in a work setting. (Id. at 5-6) She indicated Plaintiff could occasionally lift 10-20 

pounds, but never lift more than 20 pounds. (Id.) Dr. Bammann opined Plaintiff had “marked” 

limitations with using his arms for reaching (including overhead), and “moderate” limitations with 

using his fingers/hands for fine manipulations, grasping, turning, and twisting. (Id. at 6-7) According 

to Dr. Bammann, Plaintiff was precluded from pushing, pulling, kneeling, bending, and stooping. (Id.

at 9) Also, she noted Plaintiff suffered from depression and impaired concentration, and was incapable 

of even “low stress.” (Id. at 8) She concluded Plaintiff was permanently disabled. (Id. at 3)

In March 2012, Plaintiff told Dr. Richey he was in an accident while riding a moped in Las 

Vegas “and took a header when he ran into [a] traffic block-up of some sort.” (Doc. 7-14 at 33) 

Plaintiff reported that “he went over the handlebars,” and he broke two toes. (Id.) Dr. Richey found 

Plaintiff was “[s]lightly tender to compression in the lumbar spine with exaggerated response,” and he 

had “no gross motor or sensor deficit.” (Id. at 34) Dr. Richey noted Plaintiff had a “[c]hronic opiate 

tolerance with rather excessive dosages for his documented deficits,” and he seemed “to be doing a 

little bit better on [a] fentanyl patch.” (Id.) She observed also that Plaintiff had “used a fair amount of 

Percocet since the injury,” and declined to give him more than was required for a few days because 

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Plaintiff did “not need to medicate every ache and pain that happens to him.” (Id. at 35) Dr. Richey 

noted he was “back in therapy,” and was expected to work on “pain self-management.” (Id.)

On March 14, 2012, Plaintiff had another MRI on his lumbar spine. (Doc. 7-14 at 23-24) Dr. 

Juanito Villanueva compared the MRI to the one taken in July 2010, and found “[m]oderate 

spondylosis with mild areas of progression,” including “progressive right foraminal narrowing at l4-5, 

progressive discogenic reaction deep to the endplates at l2-3 and l4-5, and progressive right facet 

hypertrophy at L4-5. (Id. at 24) Dr. Villanueva opined “the discogenic signal changes . . . look[ed] like 

they [were] typical in reaction to degenerative discopathy, and “the canal at L4-5 [was] low normal 

about the same as before.” (Id.)

Dr. Savage agreed to resume treating Plaintiff, and completed a “Psychiatric/ Psychological 

Impairment Questionnaire” on April 3, 2012.5(Doc. 7-14 at 118-19) She opined that Plaintiff was 

“Cannabis Dependent;” and he suffered from morbid obesity, chronic pain disorder, a personality 

disorder not otherwise specified. (Id. at 118) Dr. Savage believed Plaintiff was likely to be absent 

from work as a result of the impairments or treatment more than three times a month. (Id.) Dr. Savage 

noted: “[Plaintiff] states his depression is due to being morbidly obese, in chronic pain & as a result

unable to get a job.” (Id., emphasis in original) She believed Plaintiff’s prognosis was “Good to Fair,” 

and gave him a GAF score of 60. (Id. at 118)

In October 2012—after the ALJ issued his decision— Dr. Richey faxed a letter to Plaintiff’s 

counsel in which she wrote: “Mr. Coats has recently been diagnosed with liver cirrhosis which appears 

to be moderately advanced. It is likely that the complications of this condition disable him from 

pursuing full time work.” (Doc. 7-14 at 121)

B. Administrative Hearing Testimony

Plaintiff appeared at a hearing before the ALJ on May 23, 2012, at which time he was 

 

5

Plaintiff asserts, “Dr. Savage completed an eight-page Psychiatric/Psychological Impairment Questionnaire on 

April 3, 2012, of which only two pages appear in the record.” (Doc. 11 at 17) Presumably, Plaintiff believes the report was 

eight pages long because the numbers of the questions jumps from question number 4 to 21, and the last page indicates it is 

8/8. (See Doc. 7-14 at 118-19) However, there is no indication that Dr. Savage completed the remaining numbers, or that 

the “missing” pages were provided to the ALJ by Plaintiff’s counsel when he mailed the question form. To the extent 

Plaintiff now suggests the record was incomplete, he has failed to show the ALJ had a duty to further develop the record. 

See Mayes v. Massanari, 276 F.3d 453, 459-60 (9th Cir. 2001) (The duty to develop the record is “triggered only when there 

is ambiguous evidence or when the record is inadequate to allow for proper evaluation of the evidence”). Moreover, as 

discussed below, Plaintiff explicitly waived his assertion that he suffered from disabling mental impairments.

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represented by counsel, Raymond Ugarte. (Doc. 7-3 at 51) Plaintiff testified that he had a twelfthgrade education, and he was able to read, write, and do simple math. (Id. at 55-56) He reported that he 

last worked in 2008 as a labor driver for a construction excavation company. (Id. at 56) Plaintiff said 

he had problems with his liver, right hip, back, right shoulder, right ankle, and possible carpal tunnel in 

his left hand. (Id. at 56, 60)

He reported he had carpel tunnel surgery on his right hand in 2000, and bicep tendon surgery in 

2001. (Doc. 7-3 at 57) Also, Plaintiff had a gastric bypass, which he said “has helped.” (Id. at 62) 

Plaintiff said that on a scale of one to ten, with “[t]en being that the pain is so excruciating that you 

have to go to the emergency room in an ambulance,” and “[e]ight being that you have to go to the 

emergency room, but you can drive yourself,” his shoulder pain was a “five” on average and “seven” at 

the worst. (Id.) He reported the pain in his left hand was “a two,” but got up to a “seven;” and his back 

pain was “six when it’s bad,” although he went to the hospital for the pain. (Id. at 63)

Plaintiff testified he was “extremely active with Alcoholics Anonymous,” and answered a 

hotline at his house Monday through Friday, from 1:00 to 4:00 p.m. (Doc. 7-3 at 63) He explained that 

he was a sponsor, and the 1-800 phone hotline was directed to his house for those three hours a day. 

(Id. at 63-64) Plaintiff believed talking to others helped him maintain his sobriety. (Id. at 64) He said 

he spent the remainder of each day watching television and attending AA meetings. (Id. at 65)

He said he was able to bathe and dress himself, although he had difficulty putting on socks 

sometimes. (Doc. 7-3 at 64) In addition, Plaintiff stated he had difficulty with grasping and holding 

items, such as a gallon of milk. (Id. at 65-66) He explained he had “no lateral strength in [his] 

shoulder whatsoever because of the Rotator Cuff.” (Id. at 66) He estimated he was able to “sit in the 

same place without moving at all” for about twenty minutes in a straight-back chair. (Id. at 70) 

Plaintiff explained he elevated his legs every day by sitting on a recliner or placing a pillow under his 

knees. (Id. at 67) He estimated he had twenty “bad days” per month, when he was not “able to move.” 

(Id. at 68) Also, Plaintiff said he suffered from nausea caused by “liver issues.” (Id. at 69)

Plaintiff testified he was a candidate for both back surgery and shoulder surgery. (Doc. 7-3 at 

69) He also reported he was “in line for a [liver] transplant.” (Id. at 71-72) Plaintiff then clarified that 

he was not on a transplant list yet because “[his] liver hasn’t gotten bad enough; it hasn’t shrunken 

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small enough yet.” (Id. at 72) He believed he was going to be placed on the transplant list about six 

months after the hearing. (Id.)

Vocational expert Christopher Salvo (“VE”) testified after Plaintiff at the hearing. (Doc. 7-3 at 

74) The VE classified Plaintiff’s past relevant work as a construction laborer, DOT 869.684-014.6 (Id.)

The VE explained that it was “a semi-skilled occupation... and heavy in regard to the physical 

demands.” (Id. at 74-75) However, the VE determined Plaintiff performed the work “as very heavy.” 

(Id. at 75) In addition, the VE noted Plaintiff had past work as an operating engineer, DOT 859.683-

010, which as a “skilled occupation . . . and medium in nature.” (Id.)

The ALJ asked the VE to consider a hypothetical individual “of the claimant’s age, education, 

and work experience [who] was able to do light work, with no climbing of ladders, ropes or scaffolds, 

occasional climbing of ramps or stairs, occasional stooping, crouching, kneeling and crawling.” (Doc. 

7-3 at 75-76) Also, the individual was required to “avoid [the] use of hazardous machinery, and all 

exposure to unprotected heights.” (Id. at 76) The ALJ limited the individual to simple and repetitive 

tasks, “as defined in the DOT as SVP levels one and two,”7that had “no strict production quota, with an 

emphasis on a per shift, rather than a per hour basis.” (Id.) The VE opined such a person was not able 

to perform Plaintiff’s past relevant work, but was able to perform other work in the local region or 

national economy, including small products assembler, DOT 706.684-022; production assembler, DOT

706.687-010; and barker, DOT 342-657-010. (Id. at 76-77)

Next, the ALJ added the limitation to “frequent handing and fingering with the upper left 

extremity.” (Doc. 7-3 at 77) The VE opined the “hypothetical person could perform those duties of the 

... jobs that [he] mentioned.” (Id.) However, if the person was limited “to occasional fingering, 

handling with the left upper extremity,” the VE opined both of the assembly jobs would be eliminated 

because they required “using both hands on more than an occasional basis.” (Id.) However, the person 

could still work as a barker, and there were “at least 3,000 positions in California, and at least 16,000 

 

6

The Dictionary of Occupational Titles (“DOT”) by the United States Dept. of Labor, Employment & Training 

Admin., may be relied upon to evaluate “whether the claimant is able to perform work in the national economy.” Terry v. 

Sullivan, 903 F.2d 1273, 1276 (9th Cir. 1990), and may be a primary source of information for the ALJ. 20 C.F.R. § 

404.1566(d)(1).

7

“SVP,” or specific vocational preparation, is defined as the amount of lapsed time required by a typical worker to 

learn techniques and acquire information needed for average performance in a specific job position. DOT, page 1009.

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throughout the United States.” (Id.)

Third, Plaintiff’s counsel asked the VE to consider the limitations given initially, and that “the 

hypothetical individual needs to get up and move around every hour for five minutes away from the 

work station, or the work area.” (Doc. 7-3 at 79) The VE opined such a limitation would preclude the 

person from Plaintiff’s past relevant work. (Id.) 

The VE agreed that if Plaintiff was restricted to the sedentary level of work, “he would grid out, 

given his age at the current time.” (Doc. 7-3 at 78)

C. The ALJ’s Findings

Pursuant to the five-step process, the ALJ determined Plaintiff did not engage in substantial 

activity after the alleged onset date of May 10, 2009. (Doc. 7-3 at 27) Second, the ALJ found Plaintiff 

“has the following severe impairments: disorder of the back; degenerative joint disease of the right 

shoulder; degenerative joint disease of the right ankle; alcoholic cirrhosis; history of alcohol abuse; and 

major depressive disorder.” (Id.) These impairments did not meet or medically equal a listed 

impairment. (Id. at 19) Next, the ALJ determined:

[Plaintiff] has the residual functional capacity to perform a range of light work as 

defined in 20 CFR 404.1567(b) and SSR 83-10 specifically as follows: the claimant can 

lift and/or carry 20 pounds occasionally and 10 pounds frequently; he can stand and/or 

walk for six hours out of an eight-hour workday with regular breaks; he can sit for six 

hours out of an eight-hour workday with regular breaks; he is precluded from climbing 

ladders, ropes and scaffolds[;] he can occasionally climb ramps or stairs; he can 

occasionally stoop, crouch, kneel, and crawl; he is precluded from using hazardous 

machinery; he is precluded from all exposure to unprotected heights; due to pain and 

side effects of medication[;]the claimant is limited to performing simple, as defined in 

the DOT as SVP levels 1 and 2, routine, repetitive tasks at jobs; he is precluded from 

performing work that has strict production quotas, with an emphasis on a per shift 

rather than a per hour basis; and he can frequently perform handling and fingering with 

the left upper extremity.

(Id. at 29) With this residual functional capacity (“RFC”), the ALJ found Plaintiff was able to perform 

“jobs that exist in significant numbers in the national economy,” including small products assembler, 

production assembler, and barker. (Id. at 41) Thus, the ALJ concluded Plaintiff was not disabled as 

defined by the Social Security Act. (Id. at 41-42)

DISCUSSION AND ANALYSIS

Plaintiff argues that the ALJ erred in assessing the mental function assessments of Drs. Savage 

and Martin, and by giving “little or no weight” to the physical function assessments of his treating 

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physicians, Drs. Bammann and Ewing.” (Doc. 11 at 20, 24, emphasis omitted) In addition, Plaintiff 

asserts the ALJ failed to properly evaluate the credibility of his subjective complaints. (Id. at 26-29) 

On the other hand, Defendant contends the ALJ’s decision was “supported by substantial evidence, 

free from legal error, and should be affirmed.” (Doc. 14 at 29)

A. The ALJ’s Credibility Determination 

When evaluating a claimant’s credibility, an ALJ must determine first whether objective 

medical evidence shows an underlying impairment “which could reasonably be expected to produce the 

pain or other symptoms alleged.” Lingenfelter v. Astrue, 504 F.3d 1028, 1035-36 (9th Cir. 2007) 

(quoting Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir. 1991)). Next, if there is no evidence of 

malingering, the ALJ must make specific findings as to the claimant’s credibility. Id. at 1036. In this 

case, the ALJ determined Plaintiff’s “medically determinable impairments could reasonably be 

expected to cause some of the alleged symptoms.” (Doc. 7-3 at 32) However, the ALJ found his 

“allegations concerning the intensity, persistence and limiting effects of his symptoms are less than 

fully credible.” (Id. at 31) 

An adverse credibility determination must be based on clear and convincing evidence where 

there is no affirmative evidence of a claimant’s malingering and “the record includes objective medical 

evidence establishing that the claimant suffers from an impairment that could reasonably produce the 

symptoms of which he complains.” Carmickle v. Comm’r of Soc. Sec. Admin., 533 F.3d 1155, 1160 

(9th Cir. 2008). Factors that may be considered include, but are not limited to: (1) the claimant’s 

reputation for truthfulness, (2) inconsistencies in testimony or between testimony and conduct; (3) the 

claimant’s daily activities, (4) an unexplained, or inadequately explained, failure to seek treatment or 

follow a prescribed course of treatment and (5) testimony from physicians concerning the nature, 

severity, and effect of the symptoms of which the claimant complains. Fair v. Bowen, 885 F.2d 597, 

603 (9th Cir. 1989); see also Thomas v. Barnhart, 278 F.3d 947, 958-59 (9th Cir. 2002). To support a 

credibility determination, the ALJ “must identify what testimony is not credible and what evidence 

undermines the claimant’s complaints.” Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1996). 

Here, the ALJ considered Plaintiff’s daily activities, his failure to comply with treatment, the 

objective evidence, Plaintiff’s criminal history, and his ability to take a vacation. (Doc. 7-3 at 30-31) 

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The Ninth Circuit has determined these are relevant factors in assessing the credibility of a claimant. 

See, e.g., Fair, 885 F.2d at 603; Thomas, 278 F.3d at 958-59. However, Plaintiff argues the ALJ’s 

credibility analysis was flawed, and that the reasons articulated by the ALJ do not “truly undermine[] 

his veracity.” (Doc. 11 at 27) 

1. Plaintiff’s activities

When a claimant spends a substantial part of the day “engaged in pursuits involving the 

performance of physical functions that are transferable to a work setting, a specific finding as to this 

fact may be sufficient to discredit a claimant’s allegations.” Morgan v. Comm’r of the Soc. Sec. 

Admin., 169 F.3d 595, 600 (9th Cir. 1999) (citing Fair, 885 F.2d at 603). For example, a claimant’s

ability to cook, clean, do laundry and manage finances may be sufficient to support an adverse 

credibility determination. See Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1175 (9th Cir. 2008). 

Similarly, an ALJ may conclude “the severity of . . . limitations were exaggerated” when a claimant 

exercises, gardens, and participates in community activities. Valentine v. Comm’r of Soc. Sec. Admin., 

574 F.3d 685, 693 (9th Cir. 2009). 

In Burch v. Barnhart, the ALJ explained the claimant’s daily activities “suggest that she is quite 

functional. She is able to care for her own personal needs, cook, clean and shop.” Id., 400 F.3d 676, 680 

(9th Cir. 2005). Likewise, here, the ALJ noted that Plaintiff testified he lived alone was able to attend 

his personal care and was “able to drive, prepare food, perform household chores, walk, shop, care for a 

dog, and attend Alcoholics Anonymous meetings.” (Doc. 7-3 at 29, 30) In addition, Plaintiff reported 

he was “a sponsor for Alcoholics Anonymous,” and talked on the telephone daily. (Id. at 30) The ALJ 

found these activities showed that, “despite his impairment, [Plaintiff] has engaged in a somewhat 

normal level of daily activity and interaction.” (Id. at 31) Further, the ALJ observed, “The physical 

and mental capabilities requisite to performing many of the tasks described above as well as the social 

interactions replicate those necessary for obtaining and maintaining employment.” (Id.) As the Ninth 

Circuit explained in Burch, “Although the evidence of [the plaintiff’s] daily activities may also admit of 

an interpretation more favorable to [him], the ALJ’s interpretation was rational, and [the court] ‘must 

uphold the ALJ’s decision where the evidence is susceptible to more than one rational interpretation.’” 

Burch, 400 F.3d at 680 (quoting Magallanes, 881 F.2d at 750). Thus, Plaintiff’s daily activities support 

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the adverse credibility determination.

2. Failure to comply with treatment

The Regulations caution claimants that “[i]n order to get benefits, you must follow treatment 

prescribed by your physician if this treatment can restore your ability to work.” 20 C.F.R. §§ 

404.1530(a), 416.930(a). If a claimant fails to follow the prescribed treatment without an acceptable 

reason, the Commissioner “will not find [the claimant] disabled.” 20 C.F.R. §§ 404.1530(b), 

416.930(b). Accordingly, the Ninth Circuit determined, “[A]n unexplained, or inadequately explained, 

failure to . . . follow a prescribed course of treatment . . . can cast doubt on the sincerity of the 

claimant’s pain testimony. Fair, 885 F.2d at 603. Therefore, noncompliance with a prescribed course 

of treatment is clear and convincing reason for finding a plaintiff's subjective complaints lack 

credibility. Id.; see also Bunnell, 947 F.2d at 346. 

Here, the ALJ found there was “evidence that the claimant has not been entirely compliant in 

taking prescribed medications.” (Doc. 7-3 at 31) For example, the ALJ noted Plaintiff “admitted he 

forgot to take his psychiatric medications and he admitted that his condition would likely improve if 

he took his medications as prescribed.” (Id., citing Doc. 7-10 at 53) The ALJ found, “The claimant’s 

noncompliance with his psychiatric medications suggests that the symptoms may not have been as 

limiting as the claimant has alleged in connection with this application.” (Id.) Further, the ALJ found 

Plaintiff’s failure to comply with treatment “demonstrates a possible unwillingness to do that which is 

necessary to improve his condition.” (Id.)

Plaintiff contends the ALJ erred in considering his failure to comply with treatment because 

“the very notes he cited reflect not an unwillingness to take his medication but a mere forgetting to do 

so.” (Doc. 11 at 28) However, the Regulations identify the “[a]cceptable reasons for failure to follow 

prescribed treatment,” including:

 (1) The specific medical treatment is contrary to the established teaching and tenets of 

your religion.

 (2) The prescribed treatment would be cataract surgery for one eye when there is an 

impairment of the other eye resulting in a severe loss of vision and is not subject to 

improvement through treatment.

(3) Surgery was previously performed with unsuccessful results and the same surgery 

is again being recommended for the same impairment.

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(4) The treatment because of its enormity (e.g. open heart surgery), unusual nature 

(e.g., organ transplant), or other reason is very risky for you; or

(5) The treatment involves amputation of an extremity, or a major part of an 

extremity.

20 C.F.R. §§ 404.1530(c), 416.930(c). Thus, that a claimant forgets to take his medication is not an 

accepted reason excusing the failure to follow prescribed treatment. See id.

Accordingly, this Court determined that the fact that a claimant “forgot” to take his medication 

is not sufficient to counter an adverse credibility determination that is based in part upon the failure to 

comply with treatment. See Craven v. Comm’r of Soc. Sec., 2015 WL 4620551 at*8 (E.D. Cal. July 31, 

2015). In Craven, the claimant admitted “he did not always use his insulin medication as prescribed 

because he ‘forgets to take his afternoon dose...” Id. The Court found the ALJ did not err in finding 

Craven failed to follow his prescribed treatment, because the fact that he forgot to take his medication 

was “insufficient” to invalidate the ALJ’s conclusion that Craven was not complying with his 

treatment. Id. Similarly, here, the fact that Plaintiff did not take his medication—because he forgot—is 

a proper basis to support the ALJ’s reasoning.8 Thus, the ALJ’s conclusion that Plaintiff had a history 

of not complying with treatment was supported by the medical record, and a clear and convincing 

reason for rejecting Plaintiff's testimony.

3. Inconsistencies with the medical record

In general, “conflicts between a [claimant’s] testimony of subjective complaints and the 

objective medical evidence in the record” can constitute “specific and substantial reasons that 

undermine . . . credibility.” Morgan v. Comm’r of Social Sec. Admin., 169 F.3d 595, 600 (9th Cir. 

1999). The Ninth Circuit explained, “While subjective pain testimony cannot be rejected on the sole 

ground that it is not fully corroborated by objective medical evidence, the medical evidence is still a 

 

8

Notably, Craven the Court found “the record contains a number of other treating records indicating [the] 

plaintiff’s non-compliance with his prescribed treatments beyond those the ALJ cited in support” of his conclusion that the 

plaintiff “failed to fully comply with the treatments his treating physicians prescribed.” Craven, 2015 WL 4620551 at *8. 

Likewise, here, there are several indications in the record that Plaintiff was not complying with the recommendations of his 

physicians and his treatment plan. For example, although Drs. Borgquist and Pollard told Plaintiff to stop smoking 

marijuana (see Doc. 7-9 at 9; Doc. 10 at 24), Plaintiff continued using marijuana (see Doc. 7-10 at 52; Doc. 7-14 at 118). In 

addition, in March 2011, Plaintiff failed to have testing done that was ordered by Dr. Richey, including a “serum protein 

electrophoresis with urine immunophoresis studies” and “an ultrasound of his abdomen to rule out liver disease.” (Doc. 7-

13 at 18)

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relevant factor in determining the severity of the claimant’s pain and its disabling effects.” Rollins, 261 

F.3d at 857; see also Burch, 400 F.3d at 681 (“Although lack of medical evidence cannot form the sole 

basis for discounting pain testimony, it is a factor that the ALJ can consider in his credibility analysis”). 

Because the ALJ did not base the decision solely on the fact that the medical record did not support the 

degree of symptoms alleged by Plaintiff, the objective medical evidence was a relevant factor in 

determining Plaintiff’s credibility. 

However, if an ALJ cites the medical evidence as part of a credibility determination, it is not 

sufficient for the ALJ to make a simple statement that the testimony is contradicted by the record. 

Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001) (“general findings are an insufficient basis 

to support an adverse credibility determination”). Rather, an ALJ must “specifically identify what 

testimony is credible and what evidence undermines the claimant’s complaints.” Greger v. Barnhart, 

464 F.3d 968, 972 (9th Cir. 2006); see also Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993) (an 

ALJ “must state which . . . testimony is not credible and what evidence suggests the complaints are not 

credible”). Here, the ALJ found the medical record conflicted with Plaintiff’s testimony “concerning 

his symptoms and limitations was exaggerated and inconsistent with the totality of the objective 

evidence.” (Doc. 7-3 at 31) The ALJ observed that “on numerous occasions in the record, the 

claimant’s physicians reported the claimant’s description of his symptoms and allegations of pain were 

unusual and inconsistent with the objective medical evidence.” (Id.)

Specifically, the ALJ observed that “at the claimant’s most recent appointment in March 2012, 

his primary care physician noted that the claimant’s chronic subjective low back pain and right hip pain 

was without significant underlying documented pathology.” (Doc. 7-3 at 31, citing Doc. 7-14 at 34) 

The ALJ noted Dr. Richey opined also that “none of [Plaintiff’s] impairments . . . were significant 

enough to cause the extreme pain complaints the claimant has asserted.” (Id.) Specifically, in the 

treatment records cited by the ALJ, Dr. Richey found:

Chronic subjective low back and right hip pain without significant underlying 

documented pathology. He had minimal L5-S1 neural foraminal stenosis and minimal 

T12 to L1, L4-5, L3-4 and L5-S1 acquired central canal stenosis on MRI done in 2010. 

There was no evidence of focal disk protrusion. There was no definite core impingement 

except possibly a little bit at T12-L1. None of this was felt to be significant enough to 

cause his extreme pain complaints. He also has a history of a gluteus medius muscle 

strain bilaterally without any arthritic changes of the right hip or any acetabular labral 

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tear and no evidence of iliopsoas bursitis or pelvic abscess. His complaint of hip pain has 

been unexplained.

(Doc. 7-14 at 34) Accordingly, the ALJ concluded “the discrepancy between the claimant’s testimony 

and the objective medical evidence diminishes the persuasiveness of the claimant’s subjective 

complaints and the alleged functional limitations.” (Doc. 7-3 at 31)

The fact that the objective medical record did not support Plaintiff’s subjective complaints was 

a valid consideration by the ALJ. As the Ninth Circuit explained, an ALJ may consider “contradictions 

between claimant’s testimony and the relevant medical evidence.” Johnson v. Shalala, 60 F.3d 1428, 

1434 (9th Cir. 1995) Because the ALJ sufficiently identified medical evidence—including findings of 

Plaintiff’s treating physician—that undermined the credibility of Plaintiff’s complaints, the objective 

medical record supports the adverse credibility determination. See Greger, 464 F.3d at 972; Dodrill, 12 

F.3d at 918. 

4. Plaintiff’s criminal history

The ALJ noted Plaintiff had been “convicted and incarcerated for committing a crime of moral 

turpitude, lewd acts on a minor.” (Doc. 7-3 at 31) Plaintiff does not dispute that this was a crime of 

moral turpitude, but argues the ALJ erred in considering this as part of the credibility determination 

because: “[w]hile any crime against a minor is undoubtedly reprehensible, it does not necessarily 

follow that it involves dishonesty.” (Doc. 11 at 29) Plaintiff contends he was “quite forthright in 

admitting that difficult fact to his psychologist, and the record contains no evidence of inconsistent 

statements or other forms of dishonesty.”9 (Id.) 

Significantly, however, an ALJ may rely upon a claimant’s convictions for crimes of moral 

turpitude as part of a credibility determination. Albidrez v. Astrue, 504 F.Supp.2d 814, 822 (C.D. Cal 

2007) (“convictions involving moral turpitude . . . are a proper basis for an adverse credibility 

determination”); see also Hardisty v. Astrue, 592 F.3d 1072, 1080 (9th Cir. 2010) (in ruling on an 

Equal Access to Justice Act request, the Court determined the ALJ’s credibility determination was 

substantially justified when it was based, among other factors, on the claimant’s prior criminal 

 

9

Notably, though Plaintiff admitted he paid two minor to perform a sex act at a party, he also told Dr. Kalman 

that the “charges were not justified.” (Doc. 7-8 at 15) 

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convictions); see also Richey v. Colvin, 2013 WL 5228185 at *20 (N.D. Cal. Sept. 17, 2013) (“[i]n 

finding a claimant's testimony not credible, an ALJ may rely on convictions for crimes of moral 

turpitude”); Farmer v. Colvin, 2014 WL 3818510 at *16 (D.Ariz. Aug. 4, 2014) (“[c]onsideration of 

evidence of prior incarceration, particularly for a crime of moral turpitude, is not error, and may 

constitute clear and convincing reasons for discounting a social security claimant’s testimony”). 

Therefore, the ALJ did not err in finding Plaintiff’s criminal history made his “credibility highly 

suspect,” and this factor supports the adverse credibility determination.

5. Plaintiff’s ability to take a vacation

The ALJ observed, “Although a vacation and a disability are not necessarily mutually exclusive, 

the claimant’s decision to go on a vacation [to Las Vegas, Nevada] and ride on a moped while on 

vacation tends to suggest that the alleged symptoms and limitations may have been overstated.” (Doc. 

7-3 at 31) Plaintiff contends the ALJ erred in considering Plaintiff’s ability to take a vacation or ride a 

moped as part of the credibility determination, because “[t] The ALJ never specifically set forth how he 

believes that moped ride contradicts Mr. Coats’ claim of being unable to perform the prolonged sitting, 

standing, walking, lifting, or carrying entailed in full-time work.” (Doc. 11 at 29)

On the other hand, Plaintiff’s ability to travel to Las Vegas for a vacation does undermine his 

testimony that he was only “able to sit for up to 20 minutes.” (See Doc. 7-3 at 30, 31) For example, 

this Court found an ALJ properly considered a claimant’s ability to take a vacation as part of the 

credibility determination where the claimant claimed “she could not sit for an hour-and-a-half,” yet 

“she flew for five-and-a-half hours to go on vacation in Jamaica.” Leon v. Astrue, 830 F. Supp. 2d 844, 

846 (E.D. Cal. 2011) (citing Tommasetti, 533 F.3d at 1040 (holding the ALJ properly inferred from the 

claimant’s ability to travel to Venezuela that he was not as physically limited as he alleged)).

However, even if the ALJ erred by not specifically explaining how the ability to vacation is 

inconsistent with Plaintiff’s allegations, as Plaintiff argues, such error was harmless. The ALJ met his 

burden to identify several clear and convincing reasons supporting the adverse credibility 

determination, which were “sufficiently specific to allow a reviewing court to conclude the ALJ 

rejected the claimant’s testimony on permissible grounds.” Moisa v. Barnhart, 367 F.3d 882, 885 (9th 

Cir. 2004); see also Thomas, 278 F.3d at 958. As such, the reliance upon one invalid reason is a 

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harmless, because the error “does not negate the validity of the ALJ’s ultimate credibility conclusion.” 

Carmickle , 533 F.3d at 1160 (quoting Batson v. Comm’r of Soc. Sec. Admin, 359 F.3d 1190, 1197 (9th 

Cir. 2004).

B. The ALJ’s Evaluation of the Medical Record

In this circuit, the courts distinguish the opinions of three categories of physicians: (1) treating 

physicians; (2) examining physicians, who examine but do not treat the claimant; and (3) nonexamining physicians, who neither examine nor treat the claimant. Lester v. Chater, 81 F.3d 821, 830 

(9th Cir. 1996). In general, the opinion of a treating physician is afforded the greatest weight but it is 

not binding on the ultimate issue of a disability. Id.; see also 20 C.F.R. § 404.1527(d)(2); Magallanes 

v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989). Further, an examining physician’s opinion is given more 

weight than the opinion of non-examining physician. Pitzer v. Sullivan, 908 F.2d 502, 506 (9th Cir. 

1990); 20 C.F.R. §§ 404.1527(d)(2), 416.927(d)(2). 

A physician’s opinion is not binding upon the ALJ, and may be discounted whether another 

physician contradicts the opinion. Magallanes, 881 F.2d at 751. An ALJ may reject an uncontradicted

opinion of a treating or examining medical professional only by identifying “clear and convincing” 

reasons. Lester, 81 F.3d at 831. In contrast, a contradicted opinion of a treating or examining 

professional may be rejected for “specific and legitimate reasons that are supported by substantial 

evidence in the record.” Lester, 81 F.3d at 830. When there is conflicting medical evidence, “it is the 

ALJ’s role to determine credibility and to resolve the conflict.” Allen v. Heckler, 749 F.2d 577, 579 

(9th Cir. 1984). The ALJ’s resolution of the conflict must be upheld by the Court when there is “more 

than one rational interpretation of the evidence.” Id.; see also Matney v. Sullivan, 981 F.2d 1016, 1019 

(9th Cir. 1992) (“The trier of fact and not the reviewing court must resolve conflicts in the evidence, 

and if the evidence can support either outcome, the court may not substitute its judgment for that of the 

ALJ”). 

1. Plaintiff’s mental limitations

As an initial matter, Plaintiff asserts the ALJ erred in evaluating the medical record related to 

his mental impairments. However, at the administrative hearing, Plaintiff’s counsel, Mr. Ugarte, told 

the ALJ that Plaintiff was “seeking to waive the psychological aspect of his case,” and his “focus [was] 

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strictly on physical [impairments].” (Doc. 7-3 at 56) Mr. Ugarte explained: “There is a problem with 

his treating physician, his psychological treating physician. ... There’s a problem with his treating 

doctor’s opinion, and he’s seeking alternative psychiatric treatment. And as a result, he is going to –

he’s going to waive the psychological aspect and simply focus on the physical matter. (Id. at 56-57) 

Thus, the Court finds Plaintiff explicitly waived any argument that he suffered from disabling mental 

impairments at the administrative hearing. See Meanel v. Apfel, 172 F.3d 1111, 1115 (9th Cir. 1999) 

(holding that “at least when claimants are represented by counsel, they must raise all issues and 

evidence at their administrative hearings in order to preserve them on appeal”). Nevertheless, even if 

Plaintiff had not waived his alleged mental limitations, the ALJ supported his decision related to the 

weight given to the opinions of Drs. Martin and Savage. 

a. Opinion of Dr. Savage

The ALJ rejected the opinion of Plaintiff’s treating physician, Dr. Galyn Savage. (Doc. 7-3 at 

37) The ALJ found the opinion “appears to rely quite heavily upon the claimant’s subjective 

allegations.” (Id.) In addition, the ALJ found Dr. Savage’s opinion was “not supported by the doctor’s 

clinical and diagnostic findings.” (Id.) Further, the ALJ observed that Plaintiff was “able to engage in 

numerous activities of daily living, despite his psychological impairments, which shows he has greater 

abilities than those assessed by Dr. Savage.” (Id.) 

The Ninth Circuit has determined the opinion of a treating physician may be rejected for each of 

the reasons articulated by the ALJ. See, e.g., Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 

2008) (an ALJ may reject an opinion predicated upon “a claimant’s self-reports that have been properly 

discounted as not credible”); Young v. Heckler, 803 F.2d 963, 968 (9th Cir. 1986) (a physician’s 

opinion may be rejected “if brief and conclusory in form with little in the way of clinical findings to 

support [its] conclusion”); Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001) (holding an ALJ 

may reject an opinion when the physician sets forth restrictions that “appear to be inconsistent with the 

level of activity that [the claimant] engaged in”).

As the ALJ noted, Dr. Savage indicated Plaintiff was likely to be absent from work more than 

three times a month, but did not identify any “clinical and diagnostic findings” to support the opinion. 

(Doc. 7-3 at 38; see also Doc. 7-14 at 119) Rather, Dr. Savage noted only: “Plaintiff states his 

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depression is due to being morbidly obese, in chronic pain & as a result unable to get a job.” (Doc. 7-

14 at 119, emphasis added) Thus, it appears that Dr. Savage relied upon Plaintiff’s subjective 

complaints when concluding Plaintiff would miss work more than three days a month. As discussed 

above, the ALJ set forth clear and convincing reasons to find Plaintiff lacked credibility concerning the 

extent of his subjective complaints. Consequently, these were specific and legitimate reasons for 

rejecting the opinion of Dr. Savage.

Further, the ALJ found Plaintiff’s daily activities were “numerous,” and conflicted with the 

opinion that Plaintiff would miss work more than three times each month. (Doc. 7-3 at 37) Although 

Plaintiff asserts “the ALJ does not identify [his] ‘activities of daily living’” (Doc. 11 at 24), the ALJ 

discussed Plaintiff’s activities extensively. The ALJ noted Plaintiff was “able to drive, prepare food, 

perform household chores, walk, shop, care for a dog, and attend Alcoholics Anonymous meetings.” 

(Doc. 7-3 at 29) The ALJ observed also that Plaintiff talked on the telephone daily as a sponsor for 

Alcoholics Anonymous. (Id. at 29, 30) Indeed, Plaintiff testified he managed an Alcoholics 

Anonymous hotline number for three hours each weekday, and he tried to attend “a meeting every day, 

they have a meeting.” (See id. at 63-65) This level of activity suggests Plaintiff is able to maintain a 

schedule and, as the ALJ found, is inconsistent with Dr. Savage’s opinion that Plaintiff’s mental 

impairments could preclude him from work more than three times a month. Accordingly, the ALJ set 

forth legally sufficient reasons for rejecting the opinion of Dr. Savage. See Rollins, 261 F.3d at 856; 

see also Fisher v. Astrue, 429 Fed. App’x 649, 652 (9th Cir. 2011) (the ALJ set forth specific and 

legitimate reasons for rejecting a physician’s opinion where the assessment was based upon the 

claimant’s subjective complaints, and limitations identified by the doctor conflicted with the claimant’s 

daily activities).

b. Opinion of Dr. Martin

The ALJ found the opinion of examining physician Dr. Martin was “generally consistent with 

the objective evidence of record including treatment notes from the claimant’s treating practitioners.” 

(Doc. 7-3 at 39) Specifically, the ALJ observed:

Dr. Martin opined the claimant would have moderate difficulty sustaining his attention 

and concentration, and cognitive effort due to pain and depression. [Citation] Dr. Martin 

also stated the claimant had no difficulty understanding, remembering, and carrying out 

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simple, detailed or complex instructions [Citation]. Dr. Martin stated the claimant had 

severe difficulty with pace and persistence; and he opined the claimant would have 

severe difficulty adapting to changes in routine work-related settings [Citation]. Finally, 

Dr. Martin opined the claimant had moderate impairment in his ability to interact with the 

public, supervisors and coworkers [Citation]. 

(Id. at 38-39) The ALJ explained he gave “significant weight” to the opinion of Dr. Martin in limiting 

Plaintiff “to performing simple repetitive tasks, due to pain, medication side effects, and concentration 

problems.” (Id. at 39) In addition, the ALJ noted he “included a limitation that precluded the claimant 

from performing work that required fast-paced production or quotas” “in light of Dr. Martin’s findings 

from the mental status examination that the claimant did not respond well to stress and ... had difficulty 

maintaining a constant pace.” (Id.)

Plaintiff asserts the ALJ “ultimately credited only a selected aspect of Dr. Martin’s overall 

assessment,” and failed to address Dr. Martin’s opinions that Plaintiff “would have difficulty sustaining 

attention, concentration, and cognitive effort generally; severe difficulty with pace and persistence; 

severe difficulty enduring stress even of the clinical interview; severe difficulty adapting to changes in 

routine work-related settings; and moderate impairments in his ability ‘to interact with the public, 

supervisors, and coworkers.’” (Doc. 11 at 21) Plaintiff argues:

Several courts have held that moderate limitations in attention and concentration are not 

necessarily accommodated by unskilled work. See, e.g., Newton v. Chater, 92 F.3d 688 

(8th Cir. 1996) (“unskilled sedentary work” is insufficient to describe and accommodate 

concentration deficiencies); McGuire v. Apfel, 1999 WL 426035, at *15 (D. Ore. 1999) 

(same); Keyser v. Barnhart, No. 03-60078 (E.D. Mich. 2004) (unpublished) (“unskilled 

jobs with a low stress level” not alone sufficient to accommodate a claimant with 

“moderate limitations with respect to concentration, persistence or pace”); Edwards v. 

Barnhart, 2005 WL 2038210 *9 (E.D. Mich. 2005) (same). Likewise, an inhibited ability 

to handle the stresses of the workplace is not presumptively accommodated by simple 

work. See, e.g., Kusilek v. Barnhart, 2005 WL 567816 *5 (W.D. Wis. 2005) (“I agree 

with the magistrate judge that “low stress routine work” is not exactly the same as 

“unskilled or simple, semiskilled work”). Additionally, the inability to deal with routine 

changes in the work setting and an inability to interact appropriately with others are 

similarly unaddressed by the limitation to simple work with no strict production quotas.

(Doc. 11 at 22) Therefore, Plaintiff concludes the opinion of Dr. Martin was “given very little weight 

at all, and with no rationale for the division.” (Id.)

As an initial matter, Plaintiff mischaracterizes the assessment of Dr. Martin, who did not opine 

Plaintiff would have difficulty with difficulty with pace and persistence, but rather observed that during 

the evaluation, Plaintiff “demonstrated difficulty with pace and persistence” and “had severe difficulty 

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enduring the stress of the interview.” (Doc. 7-10 at 57) In fact, Dr. Martin offered very few findings 

regarding Plaintiff’s limitations and abilities to work, although he concluded that Plaintiff “would have 

difficulty sustaining his attention and concentration and cognitive effort secondary to his depression 

and chronic pain.” (Id.) However, Dr. Martin gave Plaintiff a GAF score of 55 (id. at 56), thereby 

indicating Plaintiff had “moderate symptoms (e.g., flat affect and circumstantial speech, occasional 

panic attacks) OR moderate difficulty in social, occupational, or school functioning.” (DSM-IV at 34, 

emphasis added) Drs. Ikawa and Bradley reviewed the record—including Dr. Martin’s findings from 

the consultative examination—and determined that, despite moderate difficulties with concentration, 

pace, and persistence, Plaintiff was “[a]ble to sustain simple and repetitive tasks” and “sustain work 

effort at unskilled tasks.” (Doc. 7-12 at 4; Doc. 7-13 at 74) Similarly, Dr. Paxon reviewed the record 

and found Plaintiff had no more than moderate mental limitations, and was able to “respond 

appropriately to change” in the work setting.10 (Doc. 7-8 at 17-18)

Moreover, the Ninth Circuit has determined the limitation to unskilled work adequately 

encompasses a claimant’s “moderate mental residual functional capacity limitations” and “marked 

limitation in [an] ability to maintain concentration over extended periods. See, e.g., Thomas v. 

Barnhart, 278 F.3d 947, 953, 955 (9th Cir. 2002). Similarly, the Court concluded the limitation to

“simple, routine, repetitive” accommodated the examining and reviewing physicians’ findings that the 

claimant had a “slow pace” and “several moderate limitations in other mental areas.” Stubbs-Danielson 

v. Astrue, 539 F.3d 1169 (9th Cir. 2008); see also Sabin v. Astrue, 337 Fed. App’x. 617, 620-21 (9th 

Cir. 2009) (finding the ALJ properly assessed medical evidence when finding that—despite moderate 

difficulties as to concentration, persistence, or pace—the claimant could perform simple and repetitive 

tasks on a consistent basis). 

Courts within the Ninth Circuit have also concluded that a claimant’s low tolerance of stress is 

encompassed in a limitation “to simple, repetitive tasks” and work “that does not require meeting fast-

 

10 Significantly, as explained by the Ninth Circuit, the opinions of non-examining physicians “may constitute 

substantial evidence when it is consistent with other independent evidence in the record.” Tonapetyan v. Halter, 242 F.3d 

1144, 1149 (9th Cir. 2001). Because their opinions are consistent with the opinion of Dr. Kalman that Plaintiff was 

“psychiatrically able to withstand stress and pressures associated with daily work activities” (Doc. 7-8 at 16), the opinions 

of Drs. Ikawa, Bradley, and Paxton, are substantial evidence supporting the residual functional capacity assessment.

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paced quotas.” See, e.g., Keller v. Colvin, 2014 WL 130493 at *3 (E.D. Cal. Jan. 13, 2014) (finding the 

ALJ “appropriately captured” a physician’s opinion that the plaintiff required “low stress settings” by 

“limiting [the] plaintiff to simple, repetitive tasks equating to unskilled work); Suiter v. Colvin, 2014 

WL 1659279 at *19 (C.D. Cal. Apr. 25, 2014) (finding the limitation to “work of a repetitive (i.e., 

simple) nature that does not require meeting fast-paced quotas (i.e. low-stress)” reflected the doctor’s 

opinion that the claimant’s anxiety and depression “could interfere with his ability to deal with ordinary 

work stresses); see also Vezina v. Barnhart, 70 Fed. App’x. 932 (9th Cir. 2003) (in response to a 

hypothetical restricting the claimant to low-stress work, the vocational expert listed jobs involving 

“simple, repetitive, relatively unskilled tasks”). 

Finally, the ALJ rejected Dr. Martin’s conclusion that Plaintiff had a “moderate impairment in 

his ability to interact with the public, supervisors and coworkers” and “severe difficulty adapting to 

changes in routine work-related settings,” finding instead Plaintiff was not as limited as the physician 

concluded. (See Doc. 7-3 at 39) The ALJ observed that another consultative examiner, Dr. Kalman, 

“opined the claimant was able to relate to supervisors and coworkers [and] he is able to deal with the 

public.” (Id.) In addition, Dr. Kalman found Plaintiff was “psychiatrically able to withstand stress and 

pressures associated with daily work activities.”11 (Id.; see also Doc. 7-9 at 16) Further, ALJ noted the 

“longitudinal evidence” showed Plaintiff’s mental impairment and mood improved with treatment, and 

Plaintiff “continued to engage in numerous activities of daily living despite his impairment.” (Id.) 

Consequently, the ALJ met his burden to identify specific and legitimate reasons to find Plaintiff’s 

limitations with adaptation were not severe, as opined by Dr. Martin. See Rollins, 261 F.3d at 856; 

Mendoza v. Astrue, 371 Fed. Appx. 829, 831-32 (9th Cir. 2010) (explaining the opinion of a physician 

may be rejected where it is “unsupported by the record as a whole”).12 

 

11 Significantly, under the Regulations, basic work activities include “[r]esponding appropriately to supervision, 

co-workers and usual work situations;” and “[d]ealing with changes in a routine work setting.” 20 C.F.R. §§ 404.1521(a), 

416.921(a). 

12 To the extent Plaintiff even had “moderate” difficulties with difficulties with social functioning and adaptation, 

the limitation to simple, repetitive and routine tasks incorporated these limitations. See, e.g., Koehler v. Astrue, 283 Fed. 

Appx. 443, 445 (9th Cir. 2008) (ALJ’s finding that claimant lacked a “severe” mental impairment was proper even though 

claimant had “moderate” limitation in the “ability to respond to changes in the workplace setting”); Diakogiannis v. Astrue, 

975 F. Supp. 2d 299, 312 (W.D.N.Y. 2013) (finding the ALJ adequate accounted for “significantly delayed adaptive 

behavior . . . in finding that [the claimant] could perform ‘simple, routine, and repetitive tasks’”). As one district court

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c. Conclusion

For the foregoing reasons, the Court finds Plaintiff waived his assertion that he suffered from a 

disabling mental impairment at the hearing. See Meanel, 172 F.3d at 1115; Andrade v. Comm’r of Soc. 

Sec., 2011 U.S. Dist. LEXIS 29120 (E.D. Cal. (finding that where the claimant was represented by 

counsel and failed to raise an issue at the administrative hearing, it was not preserved for appeal); 

Howard v. Colvin, 2013 U.S. Dist. LEXIS 56072 at *12 (E.D. Wash. Apr. 18, 2013) (where the 

claimant “explicitly waived the issue [of his physical impairments] at the administrative hearing,” he 

was unable challenge the ALJ’s findings related to his physical impairments on appeal). 

However, even if the issue was not waived, the ALJ set forth legally sufficient reasons for 

rejecting the opinion of Dr. Savage, and the residual functional capacity assessment incorporates the 

moderate mental limitations that the ALJ found supported in Dr. Martin’s opinion. Thus, the ALJ did 

not err in finding Plaintiff has the mental ability to perform “simple, as defined in the DOT as SVP 

levels 1 and 2, routine, repetitive tasks at jobs” that did not have “strict production quotas, with an 

emphasis on a per shift rather than a per hour basis.” (See Doc. 7-3 at 29)

2. Plaintiff’s physical limitations

Plaintiff contends, “The ALJ committed harmful legal error in granting little or no weight to the 

physical function assessments of treating physicians Bammann and Ewing13.” (Doc. 11 at 24, emphasis 

omitted) According to Plaintiff, “In finding that Mr. Coats’ musculoskeletal impairments of his back, 

right shoulder, and right ankle as well as his liver cirrhosis only limit him to the performance of a 

reduced range of light work, the ALJ rejected the more restrictive assessments of treating physiatrist 

Bammann and family practitioner Ewing.” (Id.) Plaintiff argues, “All of the ALJ’s criticisms of the 

physical function assessments of both Dr. Bammann and Dr. Ewing—which he leveled jointly at both 

doctors’ assessments—take the form of general, almost boilerplate language that one must strain to 

 

explained, such limitations with adaptation are not per se disabling, nor do they preclude the performance of jobs that 

involve simple, repetitive tasks.” McLain v. Astrue, 2011 WL 2174895 at *6 (C.D. Cal. June 3, 2011).

13 Dr. Bammann and Dr. Ewing also offered findings related to Plaintiff’s mental limitations. However, Plaintiff 

does not challenge these findings, and addresses only portions of the opinion related to his physical limitations. 

Accordingly, the Court finds any challenge to the remainder of the assessments of Dr. Bammann and Dr. Ewing is waived. 

See Indep. Towers of Wash. v. Washington, 350 F.3d 925, 929 (9th Cir. 2003) (the Court will “review only issues with are 

argued specifically and distinctly,” and when a claim of error is not raised, the argument is waived).

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apply to the facts at hand.”14 (Doc. 11 at 24-25) On the other hand, Defendant contends, “The ALJ 

properly considered the medical opinion evidence regarding physical impairment and gave less weight 

to the opinions from Drs. Ewing and Bammann.” (Doc. 14 at 19, emphasis omitted)

Importantly, the opinions of Drs. Bammann and Ewing were contradicted by the opinions of 

Plaintiff’s treating physician Dr. Richey—who believed “all of his disability is psychological” (Doc. 7-

14 at 43)—as well as an examining physician (Dr. Vesali) and non-examining physicians (Drs. Fast, 

and Wong). Accordingly, the ALJ was required to articulate “specific and legitimate reasons” to reject 

the opinions, supported by substantial evidence in the record. Lester, 81 F.3d at 830.

a. Opinions of Dr. Bammann

The ALJ indicated he gave “little weight” to the assessments offered by Dr. Bammann. (Doc. 

7-3 at 37) The ALJ observed that Dr. Bammann opined on two occasions that Plaintiff “was disabled 

from any employment.” (Id. at 36) However, the ALJ found it was “not clear that the doctor was 

familiar with the definition of ‘disability’ contained in the Social Security Act and Regulations,” and it 

was “possible that the doctor was referring solely to an inability to perform the claimant’s past work...” 

(Id.) Although the ultimate legal determination as to whether a claimant is disabled under the Social 

Security Act is to the Commissioner, the ALJ is still required to give legally sufficient reasons for 

rejecting a physician’s opinions about the claimant’s ability to work. See Reddick v. Chater, 157 F.3d 

715, 725 (explaining that a physician may render “medical, clinical opinions” or “opinions on the 

ultimate issue of disability,” and that the reasons required to reject an opinion on the ultimate issue of 

disability are comparable to those required for rejecting a medical opinion); see also Nyman v. Heckler, 

779 F.2d 528, 531 (9th Cir. 1985) (“[c]onclusory opinions by medical experts regarding the ultimate 

question of disability are not binding on the ALJ”). 

Here, the ALJ found Dr. Bammann’s opinion was “quite conclusory, providing very little 

explanation of the evidence relied on in forming that opinion.” (Doc. 7-3 at 36) Furthermore, the ALJ 

found the opinions offered by Dr. Bammann were “not well-supported by the totality of the objective 

 

14 As discussed below, the ALJ addressed the opinions offered by each physician separately. (See Doc. 7-3 at 35-

36) Thus, the Court rejects Plaintiff’s assertion that the ALJ only “jointly” addressed the opinions of Drs. Bammann and 

Ewing.

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evidence in the record,” and contradicted Plaintiff’s activities of daily living. (Id.) Finally, the ALJ 

determined that it appeared the opinion of Dr. Bammann was based “quite heavily upon the claimant’s 

subjective complaints.” (Id. at 37) The Ninth Circuit has determined each of these reasons may support 

the decision to give less than controlling weight to the opinion of a treating physician. See Young, 803 

F.2d at 968; Rollins, 261 F.3d at 856; Mendoza, 371 Fed. App’x. at 831-32.

i. Lack of explanation regarding the limitations

The Ninth Circuit has determined an ALJ may reject reports of physicians “that did not contain 

any explanation of the bases of their conclusion.” Crane v. Shalala, 76 F.3d 251, 253 (9th Cir. 1996).

In the opinion dated March 1, 2011, Dr. Bammann conducted an examination of Plaintiff and noted an 

MRI showed Plaintiff had an MRI that showed “[m]ultilevel lumbar central stenosis and right L5-S1 

foraminal stenosis.” (See Doc. 7-11 at 115-16) Similarly, in the opinion dated February 22, 2012, Dr. 

Bammann noted she had conducted another exam, and that Plaintiff had an MRI showing “multilevel 

stenosis,” carpal tunnel syndrome in his left hand, and “liver panel abnormalities.” (See Doc. 7-14 at 3) 

Thus, Dr. Bammann identified clinical findings to support her diagnoses of Plaintiff’s impairments. 

However, as the ALJ found, Dr. Bammann’s opinions were “quite conclusory,” and did not explain her 

conclusion that these impairments caused the extreme limitations identified. The lack of explanation 

from Dr. Bammann supports the ALJ’s decision to give “little weight” to the opinion of Dr. Bammann. 

See Crane, 76 F.3d at 253; see also Holohan v. Massanari, 246 F.3d 1195, 1202 (9th Cir. 2001) (“the 

regulations give more weight to opinions that are explained than to those that are not”). 

ii. Totality of the evidence 

An ALJ may reject an opinion when it is “unsupported by the record as a whole.” Batson v. 

Comm’r of the Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2003); see also Morgan v. Comm’r of 

the Soc. Sec. Admin, 169 F.3d 595, 602-03 (9th Cir. 1999) (a medical opinion’s inconsistency with the 

overall record constitutes a legitimate reason for discounting the opinion). However, to reject an 

opinion as inconsistent with the medical record, the “ALJ must do more than offer his conclusions.” 

Embrey v. Bowen, 849 F.2d 418, 421 (9th Cir. 1988). The Ninth Circuit explained: “To say that 

medical opinions are not supported by sufficient objective findings or are contrary to the preponderant 

conclusions mandated by the objective findings does not achieve the level of specificity our prior cases 

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have required.” Embrey, 849 F.2d at 421-22.

Here, the ALJ found the limitations set forth by Dr. Bammann “contrast[ed] sharply with the 

other evidence of record, including the claimant’s activities of daily living15, which renders it less 

persuasive.” (Doc. 7-3 at 36) In addition, the ALJ found the “clinical notes, diagnostic test results, and 

laboratory findings do not support the functional limitations assessed.” (Id. at 37) For example, the 

ALJ noted Dr. Vesali performed a consultative examination where she observed that Plaintiff was “able 

to get on and off the examination without difficulty; he could put on and take off his shoes without 

difficulties; and his gait was slow but not particularly abnormal.” (Id. at 33, Doc. 7-10 at 59) In 

addition, the ALJ observed that Dr. Vesali found Plaintiff “was able to ambulate without an assistive 

device,” and he “had full motor strength and muscle bulk and tone in his upper and lower extremities.” 

(Id., citing Doc.7-10 at 61) Therefore, the ALJ carried his burden to identify conflicting evidence and 

made findings to resolve the conflict. See Cotton v. Bowen, 799 F.2d at 1403, 1408 (9th Cir. 1986).

iii. Reliance upon Plaintiff’s subjective complaints

The Ninth Circuit has determined that an ALJ may reject an opinion predicated upon “a 

claimant’s self-reports that have been properly discounted as not credible.” Tommasetti, 533 F.3d at 

1041; see also Fair v. Bowen, 885 F.2d 597, 605 (9th Cir. 1989) (“The ALJ thus disregarded [the 

physician’s] opinion because it was premised on Fair’s own subjective complaints, which the ALJ had 

already properly discounted. This constitutes a specific, legitimate reason for rejecting the opinion of a 

treating physician.”) For example, in Tommassetti, the Court reviewed the physician’s records, and 

found “they largely reflect[ed] Tommasetti’s reports of pain, with little independent analysis or 

diagnosis.” Id., 533 F.3d at 1041. Because the ALJ found the claimant’s subjective complaints lacked 

credibility, the Court concluded that “the ALJ’s adverse credibility determination supports the limited 

rejection of [the physician’s] opinion because it was primarily based on Tommasetti's subjective 

comments concerning his condition.” Id.

Here, the ALJ noted Dr. Bammann opined Plaintiff “was unable to sit, stand, and/or walk for 

more than 1 hour of an eight-hour workday; and he would not be able to sit continuously in a work 

 

15 As discussed above, an ALJ may also reject a physician’s opinion when the restrictions “appear to be 

inconsistent with the level of activity that [the claimant] engaged in.” Rollins, 261 F.3d at 856.

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setting.” (Doc. 7-3 at 36, citing Doc. 7-14 at 5) Also, the ALJ observed that Dr. Bammann “opined the 

claimant could lift and/or carry up to 20 pound[s] occasionally and he has limitations in his ability to 

perform repetitive reaching, handling, fingering, and lifting;” “moderate limitations in his ability to 

grasp, turn, and twist objects ...[and] in the ability to use his fingers for fine manipulations; and marked 

limitation in his ability to use his arms for reaching.” (Id., citing Doc. 7-14 at 6-7) However, as the 

ALJ determined, Dr. Bammann did not identify any clinical testing for these limitations in her 

questionnaire. Rather, Dr. Bammann noted Plaintiff complained he had a “constant” pain level of “7” 

on a scale of 0-10, and reported the pain was aggravated by “[a]ny movement, standing [and] walking.” 

(Doc. 7-14 at 4-5) Because the ALJ properly rejected the credibility of Plaintiff’s subjective 

complaints, it was proper for the ALJ to give less weight to the opinions of Dr. Bammann because she 

relied upon Plaintiff’s reports of pain. See Tommasetti, 533 F.3d at 1041.

b. Opinions of Dr. Ewing

The ALJ indicated he did not adopt all portions of the assessment offered by Dr. Hope Ewing, 

who treated Plaintiff for cirrhosis. (Doc. 7-3 at 37) The ALJ noted Dr. Ewing opined Plaintiff was able 

to “lift 20 pound[s] occasionally and 10 pounds frequently,” and adopted these limitations in the 

residual functional capacity assessment. (See id. at 29, 37) However, the ALJ gave “little weight” to 

the remainder of the opining, including the limitations concerning Plaintiff’s ability to sit, stand, walk, 

and perform postural activities. (Id. at 37) The ALJ found Dr. Ewing’s opinion appeared “to rely quite 

heavily on the claimant’s subjective complaints.” (Id.) The ALJ found also that “the clinical notes, 

diagnostic test results, and laboratory findings do not support the functional limits assessed.” (Id.) 

Furthermore, the ALJ concluded Dr. Ewing’s limitations were “not consistent with the claimant’s 

numerous activities of daily living...” (Id.) As discussed above, the Ninth Circuit has determined each 

of these reasons may constitute a specific and legitimate reason for giving less weight to the opinion 

offered by a physician. See Young, 803 F.2d at 968; Rollins, 261 F.3d at 856; Mendoza, 371 Fed. 

Appx. at 831-32.

i. Objective evidence

Dr. Ewing noted Plaintiff had “mild coagulopathy with an INR of 1.2,” which supported her 

diagnosis that Plaintiff had “Alcoholic Cirrhosis.” (Doc. 7-14 at 12, 15) However, Dr. Ewing did not 

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explain her conclusion that Plaintiff’s cirrhosis caused the limitations identified related to his ability to 

sit, stand, or walk. Indeed, review of the questionnaire form completed by Dr. Ewing does not identify 

any clinical testing or objective findings by Dr. Ewing related to Plaintiff’s ability to sit, stand, and 

walk. (See Doc. 7-14 at 14-21) The lack of explanation from Dr. Bammann and the failure to identify 

objective evidence supports the ALJ’s decision to give “little weight” to the opinion of Dr. Ewing. See 

Crane, 76 F.3d at 253; Holohan, 246 F.3d at 1202. 

ii. Reliance upon Plaintiff’s subjective complaints

As the ALJ noted, Dr. Ewing concluded Plaintiff “could sit, stand, and/or walk, for less than one 

hour out of an eight-hour workday; and he needs to move around every hour.” (Doc. 7-3 at 37, citing 

Doc. 7-14 at 16-17) However, Dr. Ewing did not identify any objective evidence to support these 

conclusions in the records cited by the ALJ. On the other hand, she indicated that Plaintiff reported that 

on a scale of 0-10, his pain level was a “7” and his fatigue was a “7.” (Doc. 7-14 at 16) In addition, 

she said Plaintiff described his pain as “daily, constant,” said it was aggravated by “movement, 

prolonged position.” (Id. at 16-17) Given the lack of objective evidence identified by Dr. Ewing in 

support of her opinions, it appears she relied upon Plaintiff’s subjective reports of pain and fatigue in 

formulating her opinions. See Tommasetti, 533 F.3d at 1041. Because the ALJ properly rejected the 

credibility of Plaintiff’s subjective complaints, this was a specific and legitimate reason for the ALJ to 

give less weight to the opinions of Dr. Ewing.

c. Substantial evidence supports the RFC determination

When an ALJ rejects contradicted opinions of physicians, the ALJ must not only identify 

specific and legitimate reasons for rejecting those opinions, but the decision must also be “supported by 

substantial evidence in the record.” Lester, 81 F.3d at 830. Accordingly, because the ALJ articulated 

specific and legitimate reasons for rejecting the opinion of Dr. Bammann and portions of the opinion of 

Dr. Ewing, the decision must be supported by substantial evidence in the record.

The term “substantial evidence” “describes a quality of evidence ... intended to indicate that the 

evidence that is inconsistent with the opinion need not prove by a preponderance that the opinion is 

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wrong.” SSR 96-2p, 1996 SSR LEXIS 9 at *816. “It need only be such relevant evidence as a 

reasonable mind would accept as adequate to support a conclusion that is contrary to the conclusion 

expressed in the medical opinion.” Id. Here, the RFC determination that Plaintiff is able to perform a 

light work (including the ability to “lift and/or carry 20 pounds occasionally and 10 pounds frequently,” 

“stand and/or walk for six hours out of an eight-hour workday” and “sit for six hours out of an eighthour workday with regular breaks”) with postural limitations is supported by opinions of Dr. Ewing, 

examining physician Dr. Vesali.

As the ALJ noted, Dr. Ewing concluded Plaintiff could “lift and/or carry up to 20 pounds 

occasionally and up to 10 pounds frequently.” (Doc. 7-3 at 37) Similarly, Dr. Vesali believed Plaintiff 

retained this ability—finding after the examination that Plaintiff was able to “lift and carry up to 50 

pounds occasionally and 25 pounds frequently. (Doc. 7-10 at 58) In addition, Dr. Vesali concluded 

that Plaintiff “should be able to walk, stand, and sit six hours in an eight-hour day with normal breaks.” 

(Id. at 61) Dr. Vesali did not believe Plaintiff had postural, manipulative or environmental limitations. 

(Id.) Significantly, the opinion of an examining physician may be substantial evidence in support of the 

Commissioner’s decision when the opinion is based upon independent clinical findings. Orn v. Astrue, 

495 F.3d 625, 632 (9th Cir. 2007); Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001). 

Because Dr. Vesali conducted an examination of Plaintiff, including testing his motor strength and 

range of motion, her conclusions were based upon independent clinical findings. Thus, the opinion is 

substantial evidence in support of the RFC. 

Dr. Roger Fast, a non-examining physician, concluded also that Plaintiff was able to lift and 

carry 20 pounds occasionally and 10 pounds frequently. (Doc. 7-12 at 33) Because the opinion of Dr. 

Fast was “consistent with other independent evidence in the record”—including the opinions of Drs. 

Ewing and Vesali—it also was substantial evidence supporting the lifting and carrying limitations 

articulated by the ALJ. Tonapetyan, 242 F.3d at 1149. 

 

16 Social Security Rulings (SSR) are “final opinions and orders and statements of policy and interpretations” 

issued by the Commissioner. 20 C.F.R. § 402.35(b)(1). Although they do not have the force of law, the Ninth Circuit gives 

the Rulings deference “unless they are plainly erroneous or inconsistent with the Act or regulations.” Han v. Bowen, 882 

F.2d 1453, 1457 (9th Cir. 1989); see also Avenetti v. Barnhart, 456 F.3d 1122, 1124 (9th Cir. 2006) ("SSRs reflect the 

official interpretation of the [SSA] and are entitled to 'some deference' as long as they are consistent with the Social 

Security Act and regulations").

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Moreover, it appears the ALJ gave Plaintiff the benefit of the doubt by setting forth postural 

limitations in the RFC, although none were identified by Dr. Vesali. The ALJ explained that “in light 

of the claimant’s subjective allegations of low back pain and right ankle pain,” he “precluded the 

claimant from climbing ladders, ropes, and scaffolds; and limited to no more than occasional stooping, 

crouching, kneeling, and crawling, or climbing ramps and stairs.” (Doc. 7-3 at 38) Given that the RFC 

was more restrictive than the limitations assessed by Dr. Vesali, the findings are supported by 

substantial evidence because, at a minimum, Plaintiff retains the ability to perform the tasks identified 

by the ALJ in the RFC. See, e.g. Ivory v. Colvin, 2013 WL 6182573 at *8 (E.D. Cal. Nov. 25, 2013) 

(finding the ALJ did not err in evaluating the medical record where the ALJ found the claimant lacked 

credibility, but “assessed a more restrictive RFC” than the limitations identified by the consultative 

examiner, “giving [the] plaintiff some benefit of the doubt”); Cortez v. Colvin, 2014 U.S. Dist. LEXIS 

61022 at *15-16 (CD. Cal. Apr. 30, 2014) (finding the ALJ did not err where the ALJ found the 

claimant was “less than fully credible” but nevertheless gave the claimant “the benefit of the doubt 

[and] found a more restrictive RFC” than those offered by consultative examiners). 

Accordingly, the Court finds the RFC set forth by the ALJ is supported by substantial evidence 

in the record.

VI. Conclusion and Order

For the reasons set for above, the Court finds the ALJ identified clear and convincing reasons to 

find Plaintiff’s subjective complaints lacked credibility that were “sufficiently specific to permit the 

court to conclude the ALJ did not arbitrarily discredit [the] claimant’s testimony.” Thomas, 278 F.3d at 

958. In addition, the ALJ identified legally sufficient reasons for giving little weight to the opinions of 

Drs. Bammann and Ewing. See Tommasetti, 533 F.3d at 1041; Bayliss, 427 F.3d at 1216. Because the 

ALJ applied the proper legal standards and the residual functional capacity is supported by substantial 

evidence, the ALJ’s determination that Plaintiff is not disabled must be upheld by the Court. Sanchez, 

812 F.2d at 510.

Accordingly, IT IS HEREBY ORDERED:

1. The decision of the Commissioner of Social Security is AFFIRMED; and

2. The Clerk of Court IS DIRECTED to enter judgment in favor of Defendant 

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Carolyn W. Colvin, Acting Commissioner of Social Security, and against Plaintiff 

Jeff J. Coats, Sr.

IT IS SO ORDERED.

Dated: September 30, 2015 /s/ Jennifer L. Thurston 

UNITED STATES MAGISTRATE JUDGE

Case 1:14-cv-00712-JLT Document 17 Filed 09/30/15 Page 42 of 42