Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_10-cv-00306/USCOURTS-azd-2_10-cv-00306-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:205 Denial Social Security Benefits

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Vivian Martinez, 

Plaintiff, 

vs.

Commissioner of Social Security, 

Defendant. 

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No. CV-10-00306-PHX-NVW

ORDER

Vivian Martinez seeks review under 42 U.S.C. § 405(g) of the decision of the

Commissioner of Social Security (“the Commissioner”) denying disability benefits. 

Because the decision of the Administrative Law Judge (“ALJ”) is supported by

substantial evidence and is not based on legal error, the Commissioner’s decision will be

affirmed.

I. Background

A. Procedural History

Martinez is alleging disability since June 1, 2003. She was insured through June

30, 2005, and must establish disability on or before that date to be entitled to a period of

disability and disability insurance benefits. 

On November 19, 2003, Martinez protectively filed applications for disability

insurance benefits (DIB) and supplemental security income (SSI) under Titles II and XVI

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1

All references to the regulations refer to the 2010 edition. Subsequent citations refer

to part 404, which addresses Title II of the Act, and have parallel citations in part 416, which

addresses Title XVI.

2

Diabetes insipidus is a condition characterized by excessive thirst and urination

without elevated blood glucose.

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of the Social Security Act, 42 U.S.C. §§ 401-433, 1381-1383c. On September 14, 2004,

Martinez reapplied for DIB and SSI, and those claims appear to have been consolidated

with the 2003 claims. On September 22, 2006, a hearing was held to determine whether

Martinez was disabled within the meaning of the Social Security Act. On November 21,

2006, the ALJ issued an unfavorable hearing decision. On September 19, 2008, the

Appeals Council vacated the November 21, 2006 hearing decision and remanded the case

for further proceedings. 

On February 25, 2009, the ALJ conducted a second hearing. On August 5, 2009,

the ALJ issued a second decision denying Martinez benefits. On December 16, 2009, the

Appeals Council denied Martinez’s request for review, making the ALJ’s second decision

(the “Decision”) the final decision of the Commissioner pursuant to 20 C.F.R.

§§ 404.981, 416.1481 (2010).1

 Martinez brought the current action for review of the

Decision under 42 U.S.C. § 405(g). 

B. Factual Background

Martinez is a 38-year-old high school graduate who suffers from morbid obesity,

residual effects of a ganglion cyst of the right wrist, low back pain, and situational

depression. She alleges that she became disabled on June 1, 2003, due to a back injury,

pinched nerve of the left leg, pituitary tumor, and diabetes insipidus.2

In January 2001, Martinez was hit in the head, and a subsequent CT scan indicated

that she had a pituitary tumor. In February 2001, Martinez had surgery to remove the

tumor, but it grew back over time. In 2005, Martinez had a second surgery to remove the

tumor again. She does not presently need a third surgery. She reports some memory loss

and difficulty concentrating, but displays average intelligence and cognitive functioning.

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In 2001, Martinez also fell off of the stairs at her house and injured her back. She

reports continued pain in her lower back and running down her left leg. 

In 2003 and 2005, Martinez had surgery to remove a volar ganglion cyst in her 

right wrist. As a result, she has some continuing weakness in her right hand, but does not

require any further surgery. 

II. Standard of Review

The district court reviews only those issues raised by the party challenging the

ALJ's decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The district

court may set aside the Social Securities Administration’s disability determination only if

the determination is unsupported by substantial evidence or is based on legal error. Orn

v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla,

less than a preponderance, and relevant evidence that a reasonable person might accept as

adequate to support a conclusion considering the record as a whole. Id. In determining

whether substantial evidence supports a decision, the court must consider the record as a

whole and may not affirm simply by isolating a “specific quantum of supporting

evidence.” Id. 

“The opinions of non-treating or non-examining physicians may also serve as

substantial evidence when the opinions are consistent with independent clinical findings

or other evidence in the record.” Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002). 

As a general rule, “[w]here the evidence is susceptible to more than one rational

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be

upheld.” Id. at 954 (citations omitted). 

The ALJ is responsible for resolving conflicts in medical testimony, determining

credibility, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir.

1995). In reviewing the ALJ’s reasoning, the court is “not deprived of [its] faculties for

drawing specific and legitimate inferences from the ALJ’s opinion.” Magallanes v.

Bowen, 881 F.2d 747, 755 (9th Cir. 1989).

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III. Analysis

To determine whether a claimant is disabled for purposes of the Social Security

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). In this case, the ALJ

denied benefits under step three of the process, which required the ALJ to determine

whether Martinez had an impairment that meets or equals one of the listed impairments in

20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§ 404.1525, 404.1526, 416.925,

and 416.926), and step five, which required the ALJ to assess Martinez’s residual

functional capacity, age, education, and work experience and to determine whether

Martinez could make an adjustment to work other than her past relevant work. 

A. The ALJ Complied with the Appeals Council’s Remand Order.

 On remand, the ALJ “shall take any action that is ordered by the Appeals Council

and may take any additional action that is not inconsistent with the Appeals Council’s

remand order.” 20 C.F.R. § 404.977(b). Martinez contends that the ALJ failed to comply

with the Appeals Council’s remand order in several respects. On September 19, 2008, the

Appeals Council granted Martinez’s request for review, vacated the ALJ’s November 21,

2006 hearing decision, and remanded the case to the ALJ to:

• Obtain any additional medical evidence concerning the claimant’s mental

and physical impairments in order to complete the administrative record in

accordance with the regulatory standards regarding consultative

examinations and existing medical evidence (20 CFR 404.1512-1513 and

416.912-913). . . . 

• Further evaluate the claimant’s mental impairment in accordance with the

special technique described in 20 CFR 404.1520a and 416.920a,

documenting application of the technique in the decision by providing

specific findings and appropriate rationale for each of the functional areas

described in 20 CFR 404.1520a(c) and 416.920a.

• Give further consideration to the claimant’s maximum residual functional

capacity and provide appropriate rationale with specific references to

evidence of record in support of the assessed limitations (20 CFR 404.1545

and 416.945 and Social Security Ruling 96-8p).

• Obtain evidence from a vocational expert to clarify the effect of the

assessed limitations on the claimant’s occupational base (Social Security

Ruling 83-14). The hypothetical questions should reflect the specific

capacity/limitations established by the record as a whole. . . .

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1. The ALJ Obtained “Any Additional Medical Evidence” Concerning the

Martinez’s Mental and Physical Evidence to Complete the

Administrative Record.

The Social Security claimant bears responsibility for furnishing medical and other

evidence to prove disability. 20 C.F.R. § 404.1512. The Appeals Council did not shift

this responsibility to the ALJ, but rather directed the ALJ to ensure that “any additional

evidence” was considered by the ALJ and included in the administrative record. The ALJ

considered not only the prior evidence, but also additional treatment records from Dr.

Ring and Dr. Barranco and additional testimony from Plaintiff and a vocational expert. 

The additional evidence was included in the administrative record.

2. The ALJ Further Evaluated Martinez’s Mental Impairment and

Provided Specific Findings and Appropriate Rationale for Each of the

Functional Areas.

The Appeals Council found that the medical evidence showed Martinez has a

severe mental impairment, but the initial hearing decision did not contain an adequate

evaluation of this impairment pursuant to 20 §§ C.F.R. 404.1520a and 416.920a. Under

20 C.F.R. §§ 404.1520a and 416.920a, the ALJ was required to rate the degree of

Martinez’s functional limitation in four broad functional areas: daily living activities;

social functioning; concentration, persistence, or pace; and episodes of decompensation. 

The initial hearing decision states that because Martinez had no history of mental health

treatment, the ALJ adopted the mental residual functional capacity suggested by the

Disability Determination Service examiner. Based on a diagnosis of major depressive

disorder, the examiner opined that Martinez had moderate mental limitations and retained

the capacity to perform simple repetitive tasks. However, the initial hearing decision did

not address mental impairment in its determination of the types of work Martinez is

capable of performing.

In contrast, the Decision discussed Martinez’s mental limitations and found

Martinez has moderate restriction in activities of daily living; mild difficulties in social

functioning; mild to moderate difficulties in concentration, persistence, or pace; and no

episodes of decompensation for an extended duration. The ALJ specifically found that

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Martinez “can understand, remember and carry out simple and detailed job instructions;

relate and interact with the public, supervisors and co-workers; maintain concentration

and attention for simple repetitive work; and tolerate job-related stress.” 

3. The ALJ Gave Further Consideration to Martinez’s Maximum

Residual Functional Capacity and Provided Appropriate Rationale

with Specific References to Evidence of Record in Support of the

Assessed Limitations.

In the initial hearing decision, the ALJ found that Martinez “can perform sedentary

work, or work involving lifting and/or carrying up to 20 pounds occasionally and 10

pounds frequently, standing/walking up to three or four hours per day, and sitting up to

six hours per day.” The ALJ also found “she must alternate between sitting and standing,

can no more occasionally perform postural changes, and must avoid exposure to hazards.” 

The initial hearing decision found “no evidence that [Martinez’s] obesity requires any

accommodation beyond the ability to alternate between sitting and standing, and limiting

her overall standing time to no more than three or four hours per day.” The Appeals

Council noted that the initial hearing decision did not specify the sit/stand option in the

function-by-function assessment of Martinez’s ability to do work-related physical

activities. 

On remand, the ALJ found Martinez “has the residual functional capacity to

perform the full range of sedentary work, or work which is generally performed while

sitting, . . ., occasionally lift and carry 20 pounds and frequently lift and carry 10 pounds,”

and “stand and walk at least 2 hours each in an 8-hour workday.” The ALJ further found

that Martinez “can occasionally climb, balance, stoop, kneel, crouch and crawl,” but

“should avoid working at unprotected heights and around hazardous machinery due to

obesity.” 

The ALJ found that Martinez did not require a sit/stand option, “based on the lack

of objective evidence to support severity of back pain,” and therefore did not specify the

sit/stand option in the function-by-function assessment of Martinez’s ability to do workrelated physical activities. The Decision implies that Martinez’s obesity does not require

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a sit/stand option, and substantial evidence in the record supports the ALJ’s finding that a

sit/stand option is not required, whether because of severe back pain or because of

obesity. See Orn, 495 F.3d at 630 (ALJ’s determination may not be set aside if it is

supported by substantial evidence). Further, the ALJ provided specific references to

record evidence in support of the assessed limitations. 

On March 1, 2004, State agency physician Dr. J. Hayden considered Martinez

capable of sedentary-level functioning due to her low back problems and obesity and did

not find that Martinez must periodically alternate sitting and standing to relieve pain or

discomfort. On May 27, 2004, State agency physician Dr. James Hopkins considered

Martinez capable of sedentary-level functioning due to her back problems and did not

find that Martinez must periodically alternate sitting and standing to relieve pain or

discomfort. 

On March 10, 2005, medical consultant Dr. Brent Layton examined Martinez and

concluded she was capable of sedentary-level functioning, but needed to alternate

standing and sitting due to low back problems and obesity. In dictation made on March

23, 2005, medical consultant Dr. Brent Layton opined that Martinez would have problems

with standing and no problems with sitting, and did not mention any need to alternate

sitting and standing. On August 30, 2005, Dr. O’Brien, a consultative examining

physician, concluded Martinez needed to alternate between sitting and standing every

quarter hour and the change needs to last for ten minutes, due to severe obesity and range

of motion. On September 22, 2005, State agency physician Dr. Ernest Griffith considered

Martinez capable of sitting (with normal breaks) about 6 hours in an 8-hour workday,

standing and/or walking at least 2 hours in an 8-hour workday, and standing/walking 3

hours with a 2 to 4 minute break after 1 hour. Dr. Griffith also opined that Martinez must

periodically alternate sitting and standing to relieve pain or discomfort.

In a written statement dated December 22, 2003, Martinez acknowledged she was

able to bathe, groom, watch television, clean, sweep, mop, dust, vacuum, wash dishes,

cook, wash clothes, and run errands. On May 14, 2004, Martinez wrote that on an

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average day she cooks, cleans, washes clothes, showers, and runs errands. She said she

was able to dust, sweep, mop, vacuum, wash clothes and dishes, and talk on the

telephone. She also said she was able to shop for groceries and personal items for 45

minutes to an hour. On November 19, 2004, Martinez wrote that she cooked, cleaned the

house, showered, did laundry, and shopping. She also stated she “swam 1 time this

summer and only for 1 hr -vs- could normally handle 5 hrs.” 

During the first hearing in 2006, Martinez testified that she was 5’3” tall and

weighed 320 pounds. She also testified that she could stand without sitting for fifteen

minutes and sit without standing for fifteen minutes. 

During the second hearing in 2009, Martinez testified that she weighed 308

pounds. When asked how long she can sit in a chair without discomfort, she testified that

she has lower back discomfort all of the time, which she treats with the prescription

medications tramadol and Vicodin. When asked whether the medications control her

pain, Martinez testified that they do not completely take away the pain, but do help her

sleep. When asked how long she can stand in one place without needing to sit down or

lean against a table, she responded, “Not very long at all.” The ALJ found Martinez’s

statements concerning the intensity, persistence, and limiting effects of her alleged

symptoms not credible to the extent they were inconsistent with the residual functional

capacity assessment.

Thus, the ALJ plainly gave further consideration to Martinez’s maximum residual

functional capacity and provided appropriate rationale with specific references to

evidence of record. Substantial evidence supports the ALJ’s determination that Martinez

does not require a sit/stand option, which made it unnecessary to specify the sit/stand

option in the function-by-function assessment of Martinez’s ability to do work-related

physical activities. The ALJ’s conclusions, however, rest on her assignment of weight to

the medical evidence and her findings regarding Martinez’s credibility. As discussed

below, the ALJ did not err in assigning weight to the medical evidence or in finding

portions of Martinez’s testimony lacking credibility.

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4. The ALJ Obtained Evidence from a Vocational Expert to Clarify the

Effect of the Assessed Limitations on Martinez’s Occupational Base.

During the second hearing, the ALJ obtained testimony from a vocational expert as

directed by the Appeals Council. The remand order stated, “The hypothetical questions

should reflect the specific capacity/limitations established by the record as a whole.” 

Martinez contends the ALJ erred in basing the Decision on a hypothetical question that

did not match her residual functional capacity conclusion. As stated before, the ALJ’s

residual functional capacity conclusion was that Martinez can perform the full range of

sedentary work, or work which is generally performed while sitting, occasionally lift and

carry 20 pounds and frequently lift and carry 10 pounds, and stand and walk at least 2

hours each in an 8-hour workday, without alternating between sitting and standing.

The ALJ posed questions to the vocational expert regarding a hypothetical

individual with the following characteristics: same age, education, and vocational

background as Martinez; can lift and/or carry up to 20 pounds occasionally, 10 pounds

frequently; stand and/or walk up to 3 or 4 hours per day; sit up to 6 hours per day; must

alternate between sitting and standing; must limit postural changes, such as bending and

stooping, to occasional; and must avoid exposure to hazards. The vocational expert

opined that the hypothetical individual could perform receptionist and telephone

solicitor/customer service jobs. In response to a subsequent question, the vocational

expert explained that unskilled assembly type work would not permit a sit/stand option

because that would decrease production. At that point, the ALJ asked how eliminating

the sit/stand option would affect the analysis and asked several more questions. Thus, the

ALJ solicited the vocational expert’s opinion based on the residual functional capacity

she would ultimately adopt and, in addition, the vocational expert’s opinion based on a

residual functional capacity further limited by a sit/stand option.

Moreover, the Decision identifies receptionist and telephone solicitor jobs as

representative occupations that Martinez could perform, and both of those jobs were

identified by the vocational expert as ones that could accommodate a sit/stand option

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limitation. Not only did the ALJ not err in her questioning of the vocational expert, any

such error would have been to Martinez’s favor. 

B. The ALJ Did Not Err in Assigning Weight to Medical Opinions and

Third Party Statements.

1. Treating Physician Rodney S. Iancovici, M.D.

A treating source’s opinion on the issue(s) of a claimant’s impairment(s) will be

given controlling weight if it is well-supported by medically acceptable clinical and

laboratory diagnostic techniques and is not inconsistent with the other substantial

evidence in the record. 20 C.F.R. § 404.1527(d)(2). If a treating source’s opinion is not

given controlling weight, the weight that it will be given is determined by length of the

treatment relationship, frequency of examination, nature and extent of the treatment

relationship, relevant evidence supporting the opinion, consistency with the record as a

whole, the source’s specialization, and other factors. Id. 

Dr. Iancovici was Martinez’s primary care physician beginning July 26, 2005. On

December 19, 2005, Dr. Iancovici completed a medical assessment of Martinez’s ability

to do work-related activities and opined that she could sit for one hour at a time, the total

time she could sit during an eight-hour work day was one hour, and she could spend no

time standing or walking. On September 12, 2006, Dr. Iancovici again completed a

medical assessment of Martinez’s ability to do work-related activities and opined again

that she could sit for one hour at a time, the total time she could sit during an eight-hour

work day was one hour, and she could spend no time standing or walking. 

Martinez contends the ALJ erred in failing to provide Dr. Iancovici’s opinion

controlling weight or the deference it deserves. The Decision states:

The undersigned has also considered Dr. Iancovici’s opinion that the

claimant cannot work (Exhibit 24F/20 and 25F) and gives it no controlling

weight. The opinion is too restrictive based on objective evidence which

does not support the existence of impairment so severe as to preclude all

work activity. Moreover, the claimant visits Dr. Iancovici infrequently.

. . . .

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In September 2006, Dr. Iancovici completed a medical assessment of [Martinez’s] 

ability to do work related activities and opined that the claimant had a more 

restrictive RFC – less than sedentary-level functioning (Exhibit 25F/1-3). The 

undersigned has considered the opinion of Dr. Iancovici and gives it no controlling

weight as it is without substantial support from the other evidence of record, 

specifically the normal radiological and objective findings in the case record. 

Moreover, the claimant visits the doctor infrequently.

(Tr. 34.) 

The Commissioner concedes that the ALJ erred to the extent she discounted Dr.

Iancovici’s opinions because Martinez saw him infrequently. Such error is harmless and

does not warrant reversal where, as here, the ALJ’s remaining reasoning is adequately

supported by substantial evidence in the record. See Carmickle v. Comm’r, Soc. Sec.

Admin., 533 F.3d 1155, 1162 (9th Cir. 2008). The ALJ expressly based her determination

of weight assigned to Dr. Iancovici’s opinion on the lack of record evidence supporting

his opinion, “specifically the normal radiological and objective findings in the case

record.”

On January 8, 2004, treating neurologist Dr. F. David Barranco examined

Martinez and an MRI scan obtained in May 2003. He found no clear evidence of lumbar

radiculopathy despite L4 symptomatology. He concluded “that her MRI scan does not

show any type of pathology on the left side that would account for any of the leg

symptoms.” Dr. Barranco asked Martinez to return to orthopedic specialist Dr. Jody

Daggett to determine whether the pain source was her hip. On January 29, 2004, Dr.

Daggett observed that Martinez did “not appear to have intrinsic hip pathology by history,

physical examination or by radiographic studies.” The January 29, 2004 X-ray showed

no acute fracture or dislocation of the left hip, only early degenerative changes. Dr.

Daggett noted that Martinez’s response to epidural steroid injections was “profoundly

positive though her relief was transient.” Dr. Daggett recommended that Martinez be

evaluated by a neurosurgeon for left lumbar radiculopathy. On June 8, 2004, Martinez

had a lumbar spine MRI, which showed normal results except for a small right paracentral

disk extrusion at L4-5, contained within the ventral epidural fat and which does not

significantly distort the thecal sac or abut the adjacent nerve roots. On July 15, 2004,

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after reviewing Martinez’s new MRI scan, Dr. Barranco concluded Martinez had no

structural abnormality that accounts for her back and left leg pain, but probably had

“some kind of irritative radiculitis.” On August 9, 2006, further radiographic studies

found no abnormalities and no evidence of destructive changes. 

 Thus, the ALJ did not err by not giving Dr. Iancovici’s opinion controlling

weight because his opinion is inconsistent with other substantial evidence in the record

and is not supported by relevant evidence. 

2. Consultative Evaluating Physician Steven C. Hirdes, Ed.D., State

Agency Reviewing Physician David Yandell, Ph.D., and the

Vocational Expert 

The Decision states:

On August 10, 2005, medical consultant Steve C. Hirdes, Ed.D., opined that

the claimant was restricted to simple repetitive tasks due to major

depressive disorder with anxious and agitated features (Exhibit 14F). The

undersigned has considered the opinion of Dr. Hirdes and gives it no

controlling weight as the opinion appears to rely in part on an assessment of

an impairment[] for which the claimant received no treatment from that

doctor (20 CFR 404.1527(e) and 416.927 (e)) (Social Security Ruling

96-5p).

(Tr. 33-34.) Martinez misstates the Decision as giving Dr. Hirdes’ opinion no weight

when it actually gives his opinion no controlling weight. Dr. Hirdes’ evaluation identifies

a diagnosis of “major depressive disorder, single episode, moderate to severe with

agitation and anxiety,” but there is no evidence in the record that Martinez was ever

treated for any mental health condition. 

Dr. Hirdes evaluated Martinez on twenty mental abilities. He found no evidence

of limitation or no evidence of significant limitation on seventeen of the twenty abilities. 

He found Martinez to be moderately limited, but not precluded, regarding (1) the ability

to perform activities within a schedule, maintain regular attendance, and be punctual

within customary tolerances; (2) the ability to work in coordination with or proximity to

others without being distracted by them; and (3) the ability to accept instructions and

respond appropriately to criticism from supervisors. Although the evaluation form asked

for findings upon which he based his conclusions, Dr. Hirdes did not identify any. Dr.

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Hirdes observed average intellectual functioning and mild concentration problems. The

ALJ did not err by not giving Dr. Hirdes’ opinion controlling weight when he did not

identify findings upon which he based his conclusions.

Martinez also contends that the ALJ failed to acknowledge the vocational expert’s

testimony regarding the limitations identified by Dr. Yandell and erroneously concluded

that the opinion supported a finding that the claimant can perform simple repetitive work. 

On August 25, 2005, based upon Dr. Hirdes’ evaluation, state agency reviewing physician

Dr. Yandell opined:

While [Martinez] may have moderate difficulty performing activities within

a schedule with regular attendance and punctuality, her previous work

history demonstrates she has been capable of this on an ongoing basis. She

may show some difficulty working with others without being distracted by

them [] but has demonstrated an ability to function occupationally in such

conditions. She may also have moderate difficulty accepting instructions

and responding appropriately []. Overall, she receives good ratings and is

capable of performing at least simple unskilled job skills on an ongoing

basis.

(Tr. 494.) When the vocational expert was asked whether Martinez would be precluded

from receptionist or telephone solicitor jobs by the three identified areas of moderate

limitation, the vocational expert said she did not believe Martinez could do either of those

jobs because they would involve dealing with the public and Martinez would have

difficulty working with others without being distracted by them. The ALJ explained that

she understood speaking to others on the telephone to be different from working in close

proximity to others who may be distracting. Apparently not understanding the distinction

between public contact and proximity, the vocational expert then opined that since

Martinez has difficulty working with others without being distracted, she would not be

able to do either job because they both involve dealing with the public. The ALJ did not

err by disregarding this part of the vocational expert’s testimony because the vocational

expert was supposed to be opining based on limitations found by Dr.Yandell, and Dr.

Yandell expressly found that, regardless of Martinez’s moderate limitation in working

with others, she had “demonstrated an ability to function occupationally in such

conditions.” 

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3. Consultative Evaluating Physician George M. O’Brien, D.O.

On August 30, 2005, Dr. O’Brien, a consultative examining physician, observed

that Martinez was unable to fully extend her left knee and had a prominent limp. He

noted that Martinez did not use a crutch, but she reported that she occasionally does. (Id.) 

He found Martinez “with considerable functional limitations primarily due to her morbid

obesity and past injury of her left leg and knee” and that she “would have difficulty in

holding employment.” On the Medical Source Statement of Ability to Do Work-Related

Activities (Physical), following the statement “If your patient suffers from severe fatigue

and cannot complete an 8 hour day or 40 hour workweek, please comment on what

findings you have based this conclusion,” Dr. O’Brien wrote, “morbid obesity.” Dr.

O’Brien did not explain why he concluded Martinez would not be able to hold

employment or complete an eight-hour workday or forty-hour workweek when he also

opined that she could stand or walk at least two hours but less than six hours in an eighthour day and sit five hours in an eight-hour day. Because Dr. O’Brien provided no basis

for his conclusions, the ALJ did not err by finding that Dr. O’Brien’s residual functional

capacity assessment “too speculative [] as there is no reason why the claimant cannot hold

an unskilled sedentary job.”

4. Ms. Verdugo

In addition to evidence from acceptable medical sources identified in 20 C.F.R.

§ 404.1513(a), the ALJ was permitted to consider evidence from other sources, including

medical sources not listed in § 404.1513(a), such as nurse-practitioners, physicians’

assistants, naturopaths, chiropractors, audiologists, and therapists. 20 C.F.R.

§ 404.1513(d)(1). Martinez contends the ALJ erred in giving Lisa Verdugo’s medical

source statement of ability to do work-related activities no controlling weight. Martinez

has offered no evidence that Ms. Verdugo should be considered a medical source or that

she has any medical training whatsoever, only that she works in Dr. Iancovici’s office. 

Even with the increased involvement of nurse-practitioners, physicians’ assistants, and

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others in medical treatment and evaluation, merely being employed by a physician does

not qualify an individual as a medical source under §§ 404.1513(a) or 404.1513(d)(1). 

5. Ms. Martinson

Evidence from non-medical sources may be used to show the severity of a

claimant’s impairment and how it affects her ability to work. 20 C.F.R. § 404.1513(d)(4). 

Martinez contends the ALJ erroneously rejected the third-party statement of long-time

friend Carrie Martinson based on misstatements of fact. However, the ALJ did not reject

Ms. Martinson’s statement and expressly relied on much of it. The Decision accurately

states:

In a third party questionnaire dated December 23, 2003, Carrie L.

Martinson (claimant’s friend) reported that the claimant performed a broadrange of daily activities including bathing, cooking, cleaning, cooking [sic.],

doing laundry, vacuuming, washing dishes, driving a car, shopping,

watching television, spending time with others, talking on the telephone,

and using the computer.

(Tr. 38, 188-196.) The ALJ also accurately stated that Ms. Martinson reported that

Martinez claimant performed a broad range of daily activities. 

The ALJ did not mention that Ms. Martinson reported that Martinez cannot put her

left shoe or sock on without assistance and cannot bend to shave her legs. Contrary to

Ms. Martinson’s statement (and Martinez’s testimony), but without attributing it to Ms.

Martinson, the ALJ concluded that Martinez “requires no assistance in dressing or in

personal grooming.” (Tr. 39.) It is not clear from the record whether the ALJ found a

portion of Ms. Martinson’s statement lacking credibility, merely overlooked this portion

of Ms. Martinson’s statement, or meant to say “little or no” instead of “no” assistance. 

Regardless, Martinez does not contend that this alleged oversight is reversible error. 

Substantial evidence in the record supports finding that Martinez is able to independently

bathe, care for her hair, and dress, requiring only assistance with putting on her left sock

and shoe and shaving her legs, and no evidence suggests that she is unable to work

because she cannot put on her left sock and shoe or shave her legs independently.

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Martinez also contends that the ALJ’s conclusion that Martinez has normal daily

activities and interactions is a misstatement of fact and contrary to Ms. Martinson’s

statement. In fact, the Decision draws an inference from both Martinez’s testimony and

Ms. Martinson’s statement:

It thus can be inferred that the claimant has maintained a somewhat normal

level of daily activity and interaction. It should be noted that the physical

and mental requirements of these household tasks and social interactions are

consistent with a significant degree of overall functioning.

(Tr. 39.) Ms. Martinson’s statement that Martinez does household chores, cooks every

day, goes outside two or three times weekly, is able to go out alone, drives a car, shops

twice a month, and every day talks on the telephone and emails on a computer provides

substantial evidence to support the ALJ’s inference that Martinez “has maintained a

somewhat normal level of activity and interaction.”

C. The ALJ Did Not Err in Comparing Medical Findings with Listed

Impairment 1.04A.

At step three of the five-step sequential evaluation process, the ALJ considered the

medical severity of Martinez’s impairments. If the ALJ had found that Martinez has a

medical impairment that meets or equals one of the Social Security listings in 20 C.F.R.

§§ 404.1525, 404.1526, 416.925, or 416.926, the ALJ would have found Martinez

disabled without need for further evaluation at steps four and five. However, the ALJ

found that Martinez does not have an impairment or combination of impairments that

meets or medically equals one of the listed impairments. 

Although Martinez’s attorney had argued in her hearing brief that Martinez’s

impairments meet or equal in severity a listing, the brief did not identify which listing

applied. When questioned by the ALJ, Martinez’s attorney admitted there was no listing

that Martinez “squarely meets.” (Tr. 733.) Notwithstanding this clear waiver of any

challenge to the ALJ’s step three analysis, Martinez argued in her opening brief on appeal

that the ALJ erred by making a summary conclusion without comparing the medical

findings with the criteria from Listing 1.04A. Listing 1.04A describes disorders of the

spine resulting in compromise of a nerve root or the spinal cord considered to be severe

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enough to prevent an individual from doing any gainful activity. In her reply brief,

Martinez did not respond to the Commissioner’s detailed comparison of the medical

evidence of record regarding Martinez’s spine with Listing 1.04A, which demonstrates

that Martinez has not shown that her low back impairment met or equaled all the criteria

of Listing 1.04A for any twelve-month period.

Therefore, the ALJ did not err in her step three analysis regarding whether

Martinez has a medical impairment that meets or equals a Social Security listing.

D. The ALJ Did Not Err in Evaluating Martinez’s Credibility.

In evaluating the credibility of Martinez’s testimony regarding subjective pain or

other symptoms, the ALJ was required to engage in a two-step analysis: (1) determine

whether Martinez had presented objective medical evidence of an impairment that could

reasonably be expected to produce some degree of the pain or other symptoms alleged;

and, if so with no evidence of malingering, (2) reject Martinez’s testimony about the

severity of the symptoms only by giving specific, clear, and convincing reasons for the

rejection. See Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009). 

First, the ALJ found that Martinez’s medically determinable impairments could

reasonably be expected to cause the alleged symptoms. The ALJ did not make a finding

of malingering. Second, the ALJ found Martinez’s statements regarding the intensity,

persistence, and limiting effects of the symptoms not credible to the extent they are

inconsistent with the ALJ’s residual functional capacity assessment. In other words, the

ALJ found Martinez’s statements not credible to the extent she claims she is unable to

perform sedentary work. As shown below, the ALJ provided specific, clear, and

convincing reasons for rejecting those statements.

1. Martinez’s Testimony Regarding the Limiting Effects of the

Symptoms of Her Impairments

When her attorney asked Martinez why she cannot work, Martinez responded that

she has memory loss and she is unable to pick up anything or lift anything. In response to

questioning by the ALJ, Martinez testified she has lower back discomfort all of the time

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for which she takes the prescription medications tramadol and Vicodin. She testified that

the medications do not take the pain completely away, but they do help her sleep. 

Martinez also testified that she has headaches four or five times a week, and each

headache usually lasts two to three hours, but may last all day. To treat the headaches,

Martinez takes only over-the-counter aspirin. She testified that she also has problems

with her right hand, including numbness and weakness. She testified that she also has

severe nonstop pain in her legs, mainly in her left inner thigh. 

Martinez further testified that she feels she has a depressive disorder, but has not

been seen by a mental health professional. She said that her doctor does not think she

needs mental health care even though she suffers from depression all the time. 

2. The ALJ’s Reasons for Rejecting Some of Martinez’s Testimony

Regarding the Limiting Effects of the Symptoms of Her

Impairments

The ALJ found that Martinez had been capable of the exertional requirements of

sedentary work since her alleged onset date, June 1, 2003, through the date last insured,

June 30, 2005, and Martinez’s alleged symptoms and limitations are not corroborated by

the objective medical evidence. The Decision provides numerous specific, clear, and

convincing reasons for rejecting portions of Martinez’s testimony regarding the limiting

effects of the symptoms of her impairments. 

The ALJ noted that treating neurologist Dr. F. David Barranco’s notes state that

Martinez reported that she was “feeling fine” and not having headaches. The ALJ further

noted that Martinez takes no medication for headaches and had seen Dr. Barranco only

twice in 2007 and not since. The ALJ also identified Martinez’s self-described daily

activities that indicate Martinez is able to perform at least sedentary work:

She acknowledges, in her written statements and oral testimony, that she is

able to bathe and groom, drive during the day, watch television, clean,

sweep, mop, dust vacuum, wash dishes, cook, listen to music, do laundry,

shop, spend time with others, and manage her financial matters (see

Exhibits 4E, 8E, 9E, and testimony.

(Tr. 39.) This evidence contradicts Martinez’s allegation that she cannot perform

sedentary work and her testimony that she has headaches all of the time. Moreover,

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Martinez’s testimony that she has chronic lower back and left leg discomfort and

numbness in her right hand is not inconsistent with finding that she is capable of

performing sedentary work. Her ability to perform sedentary work is further supported

by Ms. Martinson’s statement that Martinez communicates with her daily by telephone

and computer e-mail.

To the extent the ALJ improperly relied on Martinez’s failure to lose weight and

misstated that Martinez had not seen specialists, the Commissioner concedes those errors. 

Such errors are harmless, however, because the ALJ provided other valid reasons for

rejecting portions of Martinez’s testimony and the ALJ’s remaining reasoning is

adequately supported by substantial evidence in the record. See Carmickle, 533 F.3d at

1162. 

Therefore, the ALJ did not err in rejecting as not credible portions of Martinez’s

testimony to the extent she claims the limiting effects of the symptoms of her impairments

prevent her from performing sedentary work. 

IT IS THEREFORE ORDERED affirming the final decision of the Commissioner

of Social Security denying Vivian Martinez disability benefits.

IT IS FURTHER ORDERED that the Clerk enter judgment in favor of Defendants

against Plaintiff and that Plaintiff take nothing. The Clerk shall terminate this action.

DATED this 1st day of September, 2010.

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