Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_05-cv-00381/USCOURTS-azd-4_05-cv-00381-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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1

 In 1994, an ALJ found Plaintiff disabled from February, 1993; that disability ceased

in October, 1999. (Tr. 16.)

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Rodney A. Jacobs, 

Plaintiff, 

vs.

Jo Anne B. Barnhart, Commissioner of

Social Security,

Defendant. 

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CV 05-00381-TUC-CKJ (JCG)

REPORT AND 

RECOMMENDATION

Plaintiff Rodney A. Jacobs filed this action for review of the final decision of the

Commissioner for Social Security pursuant to 42 U.S.C. §§ 405(g). The case has been referred

to the United States Magistrate Judge pursuant to the Rules of Practice of this Court. 

Pending before the court is a motion for summary judgment filed by Plaintiff on

September 19, 2005 (Doc. No. 9), and a cross-motion for summary judgment filed by Defendant

Jo Anne B. Barnhart on November 18, 2005. (Doc. No. 14.)

The Magistrate Judge recommends the District Court, after its independent review of the

record, enter an order denying Plaintiff's motion for summary judgment and granting

Defendant's cross-motion for summary judgment. 

PROCEDURAL BACKGROUND

On the protective filing date of February 11, 2003, Plaintiff filed an application for

disability insurance benefits,1

 claiming back and knee pains that prevent him from working.

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2

 Citation to the Administrative Record (Doc. No. 5) is abbreviated herein as "TR."

3

 Citations to the record are abbreviated as follows: Plaintiff's Motion for Summary

Judgment (PMSJ); Defendant's Motion for Summary Judgment (DMSJ); Plaintiff's Response

to Defendant's Motion for Summary Judgment (PR); Plaintiff's Statement of Facts (PSOF); and

Defendant's Statement of Facts (DSOF.) 

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(Tr. 16, 87.)2

 Plaintiff stopped working in May 2002 (Tr. 87), and is currently receiving

workers' compensation. (Tr. 65.)

In his application, Plaintiff claimed disability onset of October 2, 2001. (Tr. 65.) The

claim was denied both initially (May 2003) and on reconsideration (September 2003). (Tr. 36,

46.) Both times, the disability examiners' primary diagnosis of Plaintiff was "disorders of back

(discogenic and degenerative.)" (Tr. 31, 33.) A request for a hearing was timely filed. (Tr. 16.)

On June 9, 2004, a hearing was conducted before the Honorable Administrative Law

Judge Mary M. Kunz. (Tr. 347.) Plaintiff appeared with counsel; also appearing were a neutral

medical expert and a neutral vocational expert. (Tr. 16.) The ALJ issued a decision denying

Plaintiff's claim on December 1, 2004. (Tr. 13.) On December 4, Plaintiff filed a timely request

for review. (Tr. 11.) The Appeals Council denied review and upheld the ALJ's decision on

April 5, 2005. (Tr. 7.)

On June 9, 2005, Plaintiff timely filed a complaint in this Court pursuant to 42 U.S.C.

§ 405(g) (Doc. No. 1), to which Defendant filed an answer on July 26, 2005. (Doc. No. 4.) On

September 19, 2005, Plaintiff filed a Motion for Summary Judgment (Doc. No. 9), which was

followed by Defendant's Cross-Motion for Summary Judgment on November 18, 2005.3

 (Doc.

No. 14.) Plaintiff filed a Response and Opposition brief on December 30, 2005. (Doc. No. 20.)

RECORD ON APPEAL

I. Plaintiff's Work History, Condition, and Treatment

Plaintiff Rodney Jacobs was born on April 2, 1960, graduated high school, and had

almost two years of technical school training. (PSOF p. 1; DSOF 1, citing Tr. 95.) His past

employment has included work as a brisket cutter at a packing plant, press operator, equipment

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operator, lot attendant, delivery driver, (PSOF p. 1, citing Tr. 112-20), laborer, machine

operator, and material manager. (DSOF 1, citing Tr. 90.) 

Plaintiff has had surgery on each knee four times (PSOF p. 1, citing Tr. 141-42, 168,

181), and he wears bilateral braces on both. (PSOF p. 2, citing Tr. 245.) He uses intermittently

a wheelchair, crutches, a cane, or two Kenny sticks. (PSOF p. 2, citing Tr. 245, 208, 322, 343.)

He has pursued total knee replacements but was told he was too young. (PSOF p. 2, Tr. 314.)

Plaintiff underwent lumbar fusion in 1994 (PSOF p. 1, citing Tr. 181), and cervical surgery in

2005. (PSOF p. 1, citing Ex. 3.) Plaintiff testified that he is not being treated for his neck and

shoulder problems. (Tr. 357.) He also testified that, although a cervical discogram in the

mid-1990s revealed herniated discs and a pinched sciatic nerve, no one performed the

recommended surgery on his neck. (Tr. 358.) 

According to his testimony, Plaintiff's knee, back, and neck pain, along with impairment

from medications, prevent him from working. (Tr. 354.) Plaintiff said his knee pain is "pretty

much constant," worsening when he walks. (Tr. 354.) He is able to walk about twenty-five feet

before he tires and his knee and back pain increases; he is able to stand for ten minutes and sit

for ten to fifteen minutes before his back, knee, and neck pains increase. (Tr. 355-56.) Plaintiff

also testified that his arms fatigue easily (Tr. 357), and that he has trouble raising them over his

head. (Tr. 358.) 

II. Expert Testimony

a. Medical Expert

Dr. Andrew Steiner reviewed Plaintiff's medical records and testified at the hearing. (Tr.

366.) He concluded that there was little to no objective evidence in the record to support

Plaintiff's complaints of severe back, neck, and knee pain, nor his complaints of whole-body

fatigue. Specifically, he rejected the findings of Dr. D.M. Van Nostrand and Dr. Carol Ness; the

former diagnosed Plaintiff with severe spinal disease and the latter diagnosed him with knee

instability. (Tr. 370-71, 375.) Dr. Steiner also rejected Dr. Van Nostrand's April 2003 finding

of laxity in the knee, accepting instead a January 2004 orthopedic exam that did not find such.

(Tr. 373.)

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Dr. Steiner said Plaintiff's back and knees had a good range of motion. (Tr. 367-68.) 

He noted that imaging studies showed mild bilateral knee osteoarthritis, but concluded that

Plaintiff's ongoing pain reports could not be explained. (Tr. 368.) He acknowledged there were

reports of neck pain, but that "we don't really have much information on the etiology of that. .

. ." (Tr. 367.) He said that although Plaintiff had a history of problems with his knees, there

had been surgeries, and the record did not show any current problems. (Tr. 376.) 

Dr. Steiner's opinion was that Plaintiff's medical condition did not meet or equal the

Listings (Tr. 368), but that the record did show someone who should be sedentary, with only

very occasional kneeling, crouching, bending, twisting, stooping, crawling, climbing, and lifting

or reaching above shoulder level. (Tr. 369.) He found nothing in the record to support a finding

that Plaintiff could not sit for more than fifteen minutes at a time, or to indicate loss of muscle

strength or atrophy. (Tr. 371, 380.) 

b. Vocational Expert

Wayne Onken, vocational expert, was given this hypothetical by the ALJ: 

[A]ssume for the purpose of these questions that we have an

individual who is presently 44, and so is a younger individual.

This individual has a high school education and work experience

as described in your report. He's impaired by a number of

conditions, including some lumbar condition that resulted in a

fusion. There was some treatment of neck pain. He was diagnosed

with obesity and has had multiple surgeries on the knees on both

sides. He takes medications which may result in side effects of

fatigue and drowsiness and grogginess. So in the first question, I

want you to assume that because of the pain and possible side

effects of medication, I would limit him, first of all, to unskilled

work. Exertionally, he would be limited to sedentary work

involving lifting up to ten pounds occasionally, six hours of sitting

and two hours of standing in an eight-hour workday. However,

this work should not involved [sic] more than occasional use of any

foot pedals, should not involve more than occasional kneeling,

crouching, crawling, climbing, bending, twisting, or stopping, no

more than occasional reaching or lifting above shoulder level.

Should not involve exposure to hazards and should not involve

walking more than 100 yards at one time. 

Onken replied that a claimant in Plaintiff's position could not perform any of the jobs he

has performed in the past because they were all beyond the sedentary level. (Tr. 382.) Onken

also testified, however, that there were unskilled, sedentary jobs in the national economy that

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the Plaintiff could perform, such as lens inserter, final assembler, and hand packer jobs (Tr. 383)

and that Plaintiff could still do those jobs even if limited to sitting no more than an hour and

standing for no more than ten minutes. (Tr. 383.) However, if Plaintiff were only able to sit

for up to fifteen minutes, he could only do the hand packer job. (Tr. 384.) 

III. Medical Evidence

The medical records contained in the administrative file are as follows: Minneapolis

VAMC hospital records from September through October 1991 (Tr. 141-54), and July 2002 (Tr.

155-77); medical records from Minneapolis VAMC from March 2003 through July 2003 (Tr.

185-242) and August 2003 through May 2004 (Tr. 325-45) ; and medical records from St. Cloud

VAMC from January 2001 through July 2003 and October 2003 through January 2004. (Tr.

243-324.) Also included in the record is a consultative review from March 26, 2003 (Tr. 178),

a consultative exam from Dr. Van Nostrand from April 2003 (Tr. 180), and a residual functional

capacity assessment from September 2003. (Tr. 299.) 

According to the medical records, around October 2001, when Plaintiff claims his

disability began, he sought medical care for a persistent cough; he did not have any orthopedic

complaints at that time. (DSOF 5, citing Tr. 282.) In January 2002, at a wellness exam,

Plaintiff said the pain in his knees was "controlled pretty well" by Tylenol, and he denied

fatigue. (DSOF 6, citing Tr. 279.) Plaintiff had physical therapy on his knees in August and

September 2002. (DSOF 6, citing Tr. 273-78.) In December 2002, Plaintiff reported continuing

significant knee pain, but he said he had not experienced significant back problems since back

surgery in 1993; he denied orthopedic impairments in his extremities and reported that he

stopped doing physical therapy at the VA and was working sporadically with a personal trainer

at Gold's Gym. (DSOF 7, citing Tr. 271.) In May 2003, before a right knee arthroscopy,

Plaintiff denied any systemic complaints other than knee pain; afterwards he complained of low

back pain, neck pain, and headaches. (DSOF 8, citing Tr. 252, 258.) 

On April 23, 2003, Dr. Van Nostrand examined Plaintiff and endorsed his complaints

that he could lift no more than 10 pounds, that he could walk less than 150 feet, and that his

primary pain was in his back and knees. (DSOF 9, citing Tr. 180-84.) The doctor reported a

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4

 Defendant and the ALJ both stated that this exam took place in October, 2003

(DSOF 12), but the record indicates that it took place in July, 2003, with a repeat dictation

taking place in October, 2003. (Tr. 317.)

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"palpable spasm in the trapezius muscles and paracervical musculature, [and that c]ervical

distraction and compression [we]re unremarkable"; he noted that cervical fusion had been

contemplated in the past and observed that Plaintiff wore braces but was able to ambulate

without them. He also reported "valgus and varus laxity especially involving the left knee."

(Tr. 182-83.) Ultimately, the doctor concluded that Plaintiff had "severe spinal disease

involving . . . his cervical lumbar spine," and that Plaintiff "is unable to do any sitting for more

then [sic] one hour at a time with much discomfort [and] can only stand for 10 minutes at a

time." (Tr. 183.) 

On July 1, 2003,4

 Dr. Ness examined Plaintiff, who complained of knee and low back

pain. (DSOF 12.) Dr. Ness did not find any limitations during her examination of Plaintiff's

neck and arms. (Tr. 320.) She noted normal knee extension, no atrophy, and limited flexion.

(Tr. 320.) She noted that Plaintiff appeared in no acute distress, except for when ambulating,

and that his gait was wide-based and very slow and measured. (Tr. 319.) She conducted a

"limited examination" for knee instability, but was unable to do a full exam because of

Plaintiff's discomfort. (Tr. 321.) Dr. Ness considered Plaintiff probably unemployable because

of his limited ability to walk and sit. (Tr. 322.)

That same month, Nurse Ellen Ellickson examined Plaintiff and noted that he had normal

arm strength, diminished leg strength, and full range of motion of his neck; she observed that

Plaintiff had braces on both knees and walked with two Kenny sticks, and similar to Dr. Ness,

described his gait as labored. (Tr. 245.) Nurse Ellickson considered Plaintiff unemployable

because of his weakness, fatiguability, and poor endurance. (DSOF 10, citing Tr. 246-48.)

Also in July 2003, two physicians at the Minneapolis VAMC determined Plaintiff could only

perform sedentary work with minimal walking. (DSOF 11, citing Tr. 187.)

In February 2004, the VA concluded that Plaintiff was entitled to individual

unemployability due to pain, fatigue, and knee weakness. (DSOF 13, citing Tr. 129-30.) 

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5 Residual functional capacity is defined as that which an individual can still do

despite her limitations. 20 C.F.R. § 404.1545.

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CLAIM EVALUATION

I. Legal Standard

Social Security Administration (SSA) regulations require that disability claims be

evaluated pursuant to a five-step sequential process. 20 C.F.R. §§ 404.1520; Baxter v. Sullivan,

923 F.2d 1391, 1395 (9th Cir.1991). The first step requires a determination of whether the

claimant is engaged in substantial gainful activity. 20 C.F.R. §§ 404.1520(b). If so, then the

claimant is not disabled and benefits are denied. Id. 

If the claimant is not engaged in substantial gainful activity, the ALJ proceeds to step

two, which requires a determination of whether the claimant has a "medically severe impairment

or combination of impairments." 20 C.F.R. §§ 404.1520(c). In making a determination at step

two, the ALJ uses medical evidence to consider whether the claimant's impairment more than

minimally limits or restricts his or her "physical or mental ability to do basic work activities."

Id. If the ALJ concludes the impairment is not severe, the claim is denied. Id. 

Upon a finding of severity, the ALJ proceeds to step three, which requires a

determination of whether the impairment meets or equals one of several listed impairments that

the Commissioner acknowledges are so severe as to preclude substantial gainful activity. 20

C.F.R. §§ 404.1520(d); 20 C.F.R. Pt. 404, Subpt. P, App.1. If the claimant's impairment meets

or equals one of the listed impairments, then the claimant is presumed to be disabled, and no

further inquiry is necessary. Ramirez v Shalala, 8 F.3d 1449, 1452 (9th Cir.1993). If the

claimant's impairment does not meet or equal a listed impairment, evaluation proceeds to the

next step. 

The fourth step requires the ALJ to consider whether the claimant has sufficient residual

functional capacity5

 (RFC) to perform past work. 20 C.F.R. §§ 404.1520(e). If the ALJ

concludes the claimant has sufficient RFC, then the claim is denied. Id. 

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If the claimant cannot perform any past work due to a severe impairment, then the ALJ

must move to the fifth step which requires consideration of the claimant's RFC to perform other

substantial gainful work in the national economy in view of claimant's age, education, and work

experience. 20 C.F.R. §§ 404.1520(f). 

II. The ALJ's Findings

The ALJ made the following findings:

1. Plaintiff met the nondisability requirements for a period of disability and disability

insurance benefits set forth in Section 216(i) of the Social Security Act on October 2, 2001, his

alleged onset date of disability, and is insured for benefits through the date of this decision;

2. Plaintiff has not engaged in substantial gainful activity since October 2, 2001;

3. Plaintiff's status post lumbar fusion in 1993, status post multiple bilateral knee

surgeries for ligament and meniscus repair, mild bilateral osteoarthritis, and obesity are

considered "severe" based on the requirements in the Regulations 20 C.F.R. §404.1520(c);

4. These medically determinable impairments do not meet or medically equal one

of the listed impairments in Appendix 1, Subpart P, Regulation No. 4;

5. Plaintiff's allegations regarding his limitations were not totally credible;

6. Plaintiff has the following residual functional capacity: unskilled work, lifting and

carrying no more than ten pounds at a time, walking or standing two hours out of an eight-hour

day, sitting six hours out of an eight-hour day, with no more than occasional foot pedals, and

occasional kneeling, crouching, crawling, climbing, bending, twisting, stooping, reaching, or

lifting above shoulder level, no walking more than 100 yards without a rest, and no work around

hazards;

7. Plaintiff is unable to perform his past relevant work as a meat boner, tree trimmer,

collator operator, heavy truck driver, industrial truck operator, automobile detailer, material

handler, or welding-machine tender (20 CFR § 404.1565);

8. Plaintiff is a younger individual (20 CFR § 404.1563);

9. Plaintiff has a high school education plus three years of college (20 CFR §

404.1564);

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10. Plaintiff has a semi-skilled and unskilled background with no transferable skills

within his residual functional capacity (20 CFR § 404.1568);

11. Considering Plaintiff's residual functional capacity, age, education, and relevant

work history, he is able to make a vocational adjustment to work that exists in significant

numbers in the national economy, examples of which are: lens inserter, final assembler, and

hand packager; and

12. Plaintiff was not under a "disability," as defined in the Social Security Act, at any

time through the date of this decision (20 CFR § 404.1520(g)).

Based on these findings, the ALJ concluded that Plaintiff was not entitled to a period of

disability or to disability insurance benefits with respect to the application filed on February 11,

2003. (Tr. 27-28.) The ALJ's determination was made at step five of the inquiry process: the

ALJ concluded that Plaintiff retained the residual functional capacity to perform other work that

exists in significant numbers in the national economy.

ANALYSIS

I. Standard of Review

An individual is entitled to SSI disability benefits if he or she demonstrates, through

medically acceptable clinical or laboratory standards, an inability to engage in substantial

gainful activity due to a physical or mental impairment that can be expected to last for a

continuous period of at least twelve months. 42 U.S.C. § 1382c(a)(3)(A). "[A] claimant will

be found disabled only if the impairment is so severe that, considering age, education, and work

experience, that person cannot engage in any other kind of substantial gainful work which exists

in the national economy." Penny v. Sullivan, 2 F.3d 953, 956 (9th Cir. 1993) (quoting Marcia

v. Sullivan, 900 F.2d 172, 174 (9th Cir. 1990)).

To establish a prima facie case of disability, the claimant must demonstrate an inability

to perform his or her former work. Gallant v. Heckler, 753 F.2d 1450, 1452 (9th Cir. 1984).

Once the claimant meets that burden, the Commissioner must come forward with substantial

evidence establishing the claimant is not disabled. Fife v. Heckler, 767 F.2d 1427, 1429 (9th

Cir. 1985).

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6

 The term "physician" includes psychologists and other health professionals who are

not medical doctors. Lester v. Chater, 81 F.3d 821, 830 n.7 (9th Cir.1995). 

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The findings of the Commissioner are meant to be conclusive. 42 U.S.C. §§ 405(g),

1383(c)(3). The Court may overturn the decision to deny benefits "only if it is not supported

by substantial evidence or it is based on legal error." Matney v. Sullivan, 981 F.2d 1016, 1019

(9th Cir. 1992) (citations omitted). The Commissioner's determination that a claimant is not

disabled must be upheld if the Commissioner applied the proper legal standards and the record

as a whole contains substantial evidence to support the decision. Clem v. Sullivan, 894 F.2d

328, 330 (9th Cir. 1990) (citing Desrosiers v. Secretary, 846 F.2d 573, 575-76 (9th Cir.1988);

Delgado v. Heckler, 722 F.2d 570, 572 (9th Cir. 1983)). Substantial evidence is defined as "such

relevant evidence as a reasonable mind might accept as adequate to support a conclusion."

Richardson v. Perales, 402 U.S. 389, 401 (1971) (citation omitted); Winans v. Bowen, 853 F.2d

643, 644 (9th Cir.1987). The standard is less than a "preponderance of the evidence" standard.

Matney, 981 F.2d at 1019. 

"[I]f the evidence can support either outcome, the court may not substitute its judgment

for that of the ALJ." Matney, 981 F.2d at 1019 (citing Richardson, 402 U.S. at 400). When

applying the substantial evidence standard, however, the court should not mechanically accept

the Commissioner's findings but should review the record critically and thoroughly. Day v.

Weinberger, 522 F.2d 1154 (9th Cir.1975). Reviewing courts must consider the evidence that

supports as well as detracts from the Commissioner's conclusion. Id. at 1156. A denial of

benefits will be set aside if the Commissioner fails to apply proper legal standards in weighing

the evidence even though the findings may be supported by substantial evidence. Frost v.

Barnhart, 314 F.3d 359, 367 (9th Cir. 2002); Benitez v. Califano, 573 F.2d 653, 655 (9th

Cir.1978).

In evaluating evidence to determine whether a claimant is disabled, the opinion of a

treating physician6

 is entitled to great weight. Ramirez v. Shalala, 8 F.3d 1449, 1453-54 (9th

Cir.1993). The Commissioner may reject a treating physician's uncontradicted opinion only if

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she sets forth clear and convincing reasons for doing so. Lester v. Chater, 81 F.3d 821, 830 (9th

Cir.1995); Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989). If the treating physician's

opinion is contradicted by another doctor, the Commissioner may reject that opinion only if she

provides specific and legitimate reasons supported by substantial evidence in the record. Lester,

81 F.3d at 830. No distinction is drawn "between a medical opinion as to a physical condition

and a medical opinion on the ultimate issue of disability." Rodriguez v. Bowen, 876 F.2d 759,

761 n.7 (9th Cir.1989). 

When medical reports are inconclusive, questions of credibility and resolution of

conflicts in the testimony are functions solely of the Commissioner. Magallanes, 881 F.2d at

751 (citations omitted). The Commissioner's finding that a claimant is less than credible,

however, must have some support in the record. See Light v. Social Security Administration,

119 F.3d 789 (9th Cir.1997).

The ALJ need not accept the claimant's subjective testimony of disability, but if he

decides to reject it, "[he] must provide specific, cogent reasons for the disbelief." Lester, 81

F.3d at 834. "Unless there is affirmative evidence showing that the claimant is malingering, the

Commissioner's reasons for rejecting the claimant's testimony must be clear and convincing."

Id. "General findings are insufficient; rather, the ALJ must identify what testimony is not

credible and what evidence undermines the claimant's complaints." Id.

II. Discussion

Plaintiff presents three challenges to the ALJ's findings: (1) the ALJ lacked substantial

evidence for finding Plaintiff did not have a severe neck impairment; (2) the ALJ did not

consider a VA determination that Plaintiff was disabled, as required by law; and (3) the ALJ

improperly discounted the opinions of two examining physicians in favor of the non-examining,

testifying expert. The Magistrate Judge recommends finding in favor of the Defendant on all

three challenges.

a. Substantial evidence supported the ALJ's finding that Plaintiff did not have severe

neck pain. 

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7

 Although she found the neck pain to be non-severe, the ALJ considered Plaintiff's

testimony regarding difficulty reaching above his head due to neck pain in consideration in

reducing Plaintiff's residual functional capacity to occasional reaching, or lifting above shoulder

level. (Tr. 25.) 

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Plaintiff argues that the ALJ improperly dismissed the severity of Plaintiff's neck

condition, and that the Court should reverse and grant benefits. (PMSJ 8-9.) Alternatively,

Plaintiff asks the Court to remand for consideration of material new evidence, specifically: (1)

a recent MRI that documents a neck condition, and (2) the fact of a post-hearing cervical

surgery. 

The ALJ found that Plaintiff's neck pain was not a severe impairment7

. (Tr. 19.) Her

finding was supported by substantial evidence. She noted that Plaintiff's complaints of neck

pain were occasional, that no diagnoses had been made regarding neck pain and that Plaintiff

had not been prescribed medications or treatment for neck pain. (Tr. 18.) The ALJ noted that

Plaintiff's range of motion of his cervical spine was determined to be adequate in January 2001

and that his neck examination in January 2002 was unremarkable. (Id.) She also found that

Plaintiff had not reported neck pain during examinations in January 2001, January 2002, or in

more recent examinations, including visits in January and December 2002 (Tr. 18), and

Plaintiff's July 2003 exam by the VA to determine disability. (Tr. 244, 317-18.) Plaintiff also

testified that he had not been treated for neck problems since 1998 or 1999. (Id.) The neutral

medical expert found no information on ideology or ongoing treatment associated with

Plaintiff's reports of neck pain. (Tr. 19.) 

Plaintiff argues that the ALJ's finding overlooks the following evidence that Plaintiff's

neck pain was severe: (1) during a January 2001 exam, Plaintiff said he had an EMG in

December 2000 because of neck pains (PMSJ p. 8, citing Tr. 288); (2) in February 2001,

Plaintiff visited the VA because of neck pain and reported increased and constant neck pain

(PMSJ p. 8, citing Tr. 232); (3) in July 2002, Plaintiff mentioned neck problems in a preanesthesia report prior to knee surgery (PMSJ p. 8, citing Tr. 159); (4) in April 2003, Plaintiff

told a doctor that "cervical fusion had been contemplated in the past" (PMSJ p. 8, citing Tr.

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8

 The ALJ need not accept the claimant's subjective testimony of disability, but if he

decides to reject it, "[he] must provide specific, cogent reasons for the disbelief." Lester, 81

F.3d at 834. The ALJ discounted Plaintiff's credibility in this case because Plaintiff had

demonstrated an unwillingness to follow prescribed medical treatment and likely had an

economic disincentive to go back to work due to receipt of a sizable monthly VA pension. (Tr.

26.) 

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182); and (5) in June 2003, Plaintiff reported neck, lower back, and right knee pain. (PMSJ p.

8, citing Tr. 251; DSOF 8, citing Tr. 252.) This evidence of neck pain is intermittent, however,

and based primarily on the Plaintiff's own subjective complaints, which the ALJ found not

totally credible.8

 The ALJ's decision must be upheld if the evidence is reasonably susceptible

to more than one rational interpretation. Allen, 726 F.2d at 1473. Because the ALJ was

confronted with a series of subjective complaints by Plaintiff about his neck (complaints that

were not consistently voiced during medical examinations) and a lack of objective evidence

supporting a finding of neck impairment, this Court concludes that the ALJ's finding was

reasonable and supported by substantial evidence.

Plaintiff has argued, in the alternative, that the Court should remand in light of new

evidence demonstrating a severe neck impairment. The new evidence in question is an MRI

taken seven months after the hearing, which showed a "severe narrowing and mild to moderate

stenosis," and a cervical surgery "to 'take the pressure off the spinal cord and to remove pressure

from the various nerve roots" after the Appeals Council issued its decision. (PMSJ p. 9.)

Plaintiff argues that this new evidence demonstrates that Plaintiff had an ongoing cervical

condition in existence at the time of the ALJ hearing, and claims that the ALJ's opinion would

have been different if this evidence had been considered. 

Under § 405(g), the Court may "at any time order additional evidence to be taken before

the Commissioner of Social Security, but only upon a showing that there is new evidence which

is material and that there is good cause for the failure to incorporate such evidence into the

record in a prior proceeding." 42 U.S.C. § 405(g) (2000); see also Wainwright v. Sec'y of

Health & Human Servs., 939 F.2d 680, 682 (9th Cir. 1991). "New evidence is material if it

'bear[s] directly and substantially on the matter in dispute,' and if there is a 'reasonable

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possibility that the new evidence would have changed the outcome of the determination.'"

Bruton v. Massanari, 268 F.3d 824, 827 (9th Cir. 2001) (quoting Booz v. Sec'y of Health &

Human Servs., 734 F.2d 1378, 1380 (9th Cir. 1984)). 

The new evidence presented by Plaintiff is arguably material, as it bears directly on the

issue of whether Plaintiff had a severe neck impairment. The ALJ's finding that Plaintiff did

not have severe neck pain was based primarily on the lack of objective support for such a

finding. If such objective evidence had been before her, there is a reasonable possibility her

decision on this issue would have been different. Plaintiff is not entitled to relief on this ground,

however, because Plaintiff has failed to demonstrate good cause for not submitting the evidence

during the original hearings. 

The good cause requirement is liberally applied if it does not appear the Secretary will

be prejudiced. Burton v. Heckler, 724 F.2d 1415, 1417-18 (9th Cir. 1984). To demonstrate

good cause, the claimant must demonstrate that the new evidence was unavailable earlier. Key

v. Heckler, 754 F.2d 1545, 1551 (9th Cir. 1985) ("If new information surfaces after the

Secretary's final decision and the claimant could not have obtained that evidence at the time of

the administrative proceeding, the good cause requirement is satisfied."). But the liberal

application can only be pushed so far. "A claimant does not meet the good cause requirement

by merely obtaining a more favorable report once his or her claim has been denied." Mayes v.

Massanari, 276 F.3d 453, 462-63 (9th Cir. 2001) (finding lack of good cause to remand for

evidence showing herniated discs where claimant had noted "spinal problems" on her initial

application for disability benefits, but had said only that her back hurt at the ALJ hearing,

instead complaining mostly of other medical problems). Plaintiff does not show that the

objective evidence of his neck problems was unavailable at the time he applied for benefits or

even at the time of his hearing in June, 2004. Plaintiff's only justification for failing to obtain

the MRI or the surgery prior to filing his claim is that he tried to obtain a cervical consultation

eight months before his disability onset date (PSOF p. 2, citing Tr. 232), but that his condition

was not adequately assessed until he moved to Tucson. (PSOF p. 2, citing Exs. 1 & 2.)

Presumably, Plaintiff's argument is that he could not get objective evidence on his neck despite

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trying; thus, because the evidence did not exist before the hearing and he could not get it before

the hearing, he had good cause for not submitting it. However, the Court notes that Plaintiff's

initial attempt to obtain a cervical consultation took place in February, 2001, and that more than

three years passed before the ALJ hearing took place in June, 2004. Plaintiff does not explain

whether he made (or if not, why he did not make) additional attempts to have his neck examined

or treated in the more than three years before the hearing. Moreover, during this same time

period, Plaintiff failed to complain about his neck in a number of medical consultations. This

would suggest that the Plaintiff only felt a need to pursue his neck ailments after being denied

disability benefits – which is not good cause under Mayes. Plaintiff does have the remedy of

re-applying for benefits if he believes he is currently disabled by his neck impairment. 

Because Plaintiff has failed to plead good cause for failing to bring forth this evidence,

and because the Court does find such in the record, there is no reason to remand for further

proceedings.

b. The ALJ Properly Considered the VA Disability Rating in Accordance with

Eighth Circuit Law.

Plaintiff next argues that the ALJ did not consider a Veteran's Administration rating

finding Plaintiff unemployable in accordance with governing law. Plaintiff argues that the

Ninth Circuit requires an ALJ to give "great weight" to a VA determination of disability, or

must give "persuasive, specific, valid reasons" for failing to do so. (PSOF pgs. 10-11, citing

McCartney v. Massanari, 298 F.3d 1072, 1076 (9th Cir. 2002)). Although Plaintiff correctly

recites the Ninth Circuit legal standard, the hearing before the ALJ took place in St. Cloud,

Minnesota – in the Eighth Circuit. (Tr. 16.) This Court may only overturn the decision of the

ALJ if it is based on legal error. Matney, 981 F.2d at 1019. An ALJ sitting in the Eighth

Circuit cannot be said to have committed legal error for failing to apply the laws of a sister

circuit. See 20 C.F.R. § 404.985 (stating that Social Security Administration ALJs, to the extent

that they apply the holdings of United States Court of Appeals decisions during the

administrative review process, look to the law of the circuit in which they are located).

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9

 This Court concludes that even if the Ninth Circuit standard set forth in McCartney

was applied, the ALJ's holding should be upheld as the ALJ provided specific, valid reason for

rejecting the VA's conclusion. See also 20 C.F.R. § 404. 1504 (205) (determinations by other

agencies are not binding on the Social Security Administration).

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Accordingly, this Court will review the ALJ's treatment of the VA's findings pursuant to Eight

Circuit law. 

Eighth Circuit law requires the ALJ to consider the VA's finding of disability, but the

ALJ is not bound by the disability rating of another agency when he is evaluating whether the

claimant is disabled for purposes of social security benefits. See Pelkey v. Barnhart, 433 F.3d

575, 579 (8th Cir. 2006) (citations omitted). An ALJ is regarded as having properly considered

the VA's findings if it fully considers the evidence underlying the VA's final conclusion. Id. 

In this case, the ALJ acknowledged that the VA had found Plaintiff unemployable: she

noted that Dr. Ness examined Plaintiff for purposes of VA employability, that Dr. Ness

concluded that Plaintiff was probably not employable, and that Plaintiff was receiving a VA

"pension" which, according to the record, is actually a VA unemployment benefit. (Tr. 24, 79.)

Although the ALJ did not expressly state that she was required to consider the VA's finding, she

fully considered the evidence underlying the VA's final conclusion: the opinion of Dr. Ness.

(Tr. 24.) The ALJ stated that Dr. Ness's opinion was not entitled to significant weight because

it was based in part on Plaintiff's subjective complaints, the examination was conducted

specifically for the purpose of determining employability, the examination was limited, and the

examination was in conflict with other medical evidence in the record. (Tr. 22-23, 24.)

Accordingly, the ALJ properly considered the evidence underlying the VA's final conclusion,

in compliance with Eighth Circuit law.9

c. The ALJ properly discounted the opinions of two examining physicians in favor

of the non-examining, testifying expert

Plaintiff contends that the ALJ improperly adopted the opinion of the medical advisor,

Dr. Steiner, in place of the medical advisors who actually examined Plaintiff – Dr. Carol Ness

and Nurse Ellen Ellickson. The ALJ concluded that Nurse Ellickson's opinion was not entitled

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to significant weight, because it was not supported by the record. The ALJ also concluded that

Dr. Ness's opinion was not entitled to significant weight, because it was based in part on

Plaintiff's subjective complaints, which the ALJ did not find credible. In addition, the ALJ

found that Dr. Ness's examination was limited and conducted for the purpose of determining

employability. 

The ALJ is not bound by an expert's opinions. However, the uncontroverted opinions

of claimant's physicians may only be rejected if the ALJ gives clear and convincing reasons for

doing so. Reddick, 157 F.3d at 725 (quoting Matthews v. Shalala, 10 F.3d 678, 680 (9th Cir.

1993)). The opinion of a non-examining medical expert is not alone substantial evidence

sufficient to justify rejecting examining or treating physician's opinions. Morgan, 169 F.3d at

602. However, it can comprise part of the basis on which such opinions can be rejected. Id.

Medical opinion may be discounted if it is inconsistent-either internally, with other medical

reports, or with the claimant's testimony. Id. at 603. Also, it may be discounted if it is

"'premised to a large extent'" on the claimant's properly discounted complaints. Id. (citing Fair

v. Bowen, 885 F.2d 597, 605 (9th Cir. 1989)). 

The opinions of Dr. Ness and Nurse Ellickson were not uncontroverted. Rather, their

opinions were contradicted by the opinions of (1) Dr. Steiner, who specializes in physical

medicine and rehabilitation and who reviewed all of the testimony and medical evidence

presented at the hearing, (2) Dr. Santos, an orthopedic specialist who examined Plaintiff in

October, 2003, and opined that the magnitude of Plaintiff's pain did not correlate with objective

evidence, (3) Dr. Esteberg, an orthopedic specialist who reviewed Plaintiff's medical records

and opined that there were no clear objective findings consistent with Plaintiff's pain pattern,

(4) Dr. Grierson, an orthopedic specialist who opined that Plaintiff could work at a sedentary

job that required minimal walking and bending and no heavy lifting, and (5) Drs. Kawjecki and

Phipps, who reviewed Plaintiff's medical records and whose opinions were consistent with the

medical evidence. (Tr. 20-24.) Thus, the ALJ was not obliged to accept the opinions of Dr.

Ness and Nurse Ellickson; she had clear and convincing reasons for doing so. 

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The ALJ's decision to discount the opinions of Dr. Ness and Nurse Ellickson was wellsupported by the record. First, Dr. Ness' and Nurse Ellickson's opinions were inconsistent with

the medical evidence presented. Dr. Ness opined that Plaintiff was not employable because of

knee and back pain, but his medical records showed few to no complaints of back pain during

examinations, and his orthopedic examinations showed that Plaintiff had good range of motion,

little instability and no atrophy in his knees. (Tr. 24.) Nurse Ellickson concluded that Plaintiff

suffered from fatigue, weakness and pain, but Dr. Steiner testified that Plaintiff did not suffer

from any medical conditions that would account for fatigability, and that the muscle conditions

around Plaintiff's knees did not indicate fatigability. Dr. Steiner found no evidence that Plaintiff

had lost muscle strength. In addition, Plaintiff's orthopedist had opined that radiographic

pictures did not correlate well with the magnitude of Plaintiff's symptoms. (Tr. 24.)

Second, Dr. Ness' and Nurse Ellickson's opinions were premised to a large extent on

Plaintiff's complaints, which the ALJ found not credible. Dr. Ness stated that she based her

opinion in part on Plaintiff's complaints. In addition, she ultimately concluded Plaintiff could

not work because of back and neck pain, but her examination of Plaintiff's knees was limited

due to Plaintiff's reports of discomfort, and her finding of back pain appears to have been based

entirely on Plaintiff's reports. Thus, Dr. Ness' reasons for finding Plaintiff unable to work

stemmed directly from Plaintiff's complaints. Nurse Ellickson's stated reasons for finding

Plaintiff unemployable were his weakness, fatigability, and poor endurance. While her opinion

was not based entirely on subjective complaints – she did perform a limited examination – the

ALJ concluded Nurse Ellickson 's opinion also relied heavily on subjective complaints. 

The ALJ cited specific and proper reasons for discounting the opinions of Dr. Carol Ness

and Nurse Ellen Ellickson, both of which found Plaintiff unemployable. Dr. Ness's and Nurse

Ellickson's opinions were properly rejected because they were inconsistent with the other

medical records and the testifying medical expert's opinion, and because substantial evidence

supported the finding they were premised to a large extent on Plaintiff's subjective complaints.

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RECOMMENDATION

For the foregoing reasons, the Magistrate Judge recommends that the District Court, after

its independent review, enter an Order denying Plaintiff's Motion for Summary Judgment.

(Doc. No. 9) and granting Defendant's Cross-Motion for Summary Judgment (Doc. No. 14).

Pursuant to 28 U.S.C. § 636(b), any party may file and serve written objections within

10 days after being served with a copy of this Report and Recommendation. If objections are

not timely filed, the party's right to de novo review may be waived. See United States v. ReynaTapia, 328 F.3d 1114, 1121 (9th Cir. 2003) (en banc), cert. denied, 540 U.S. 900 (2003). If

objections are filed, the parties should direct them to the District Court by using the following

case number: CV 05-381-TUC-CKJ.

The Clerk of the Court is directed to send a copy of this Report and Recommendation

to all parties.

DATED this 2nd day of November, 2006.

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