Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-05379/USCOURTS-cand-3_04-cv-05379-0/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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United States District Court

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IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

 

ESTATE OF RANDY L LOPES,

Plaintiff, 

 No C 04-5379 VRW

v

 ORDER

JO ANNE B BARNHARDT,

Commissioner of Social Security, 

 Defendant. 

_______________________________/

This social security appeal under 42 USC § 405(g) seeks

review of a decision by the Social Security Administration (SSA)

following this court’s remand in case No C-01-0954 VRW, Lopes v

Barnhart. Upon remand, the SSA established for the second time a

disability onset date of December 17, 1996 for claimant Randy L

Lopes (“Lopes”). 

On September 25, 1998, an Administrative Law Judge

(“ALJ”) approved Title XVI supplemental income benefits and denied

Title II disability insurance benefits. Administrative Record

(“AR”) (Doc #8) at 24-25. The denial was based on a finding that

Lopes’s disability had commenced on December 17, 1996, but that his

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insurance had expired some nine months earlier, in March 1996,

making him ineligible for Title II benefits. Following Lopes’s

appeal from that decision, this court remanded the case to the SSA

to redetermine the onset date with help of a medical examiner. AR

at 519:14-16. On remand, the ALJ held a further hearing on

December 2, 2003, and again found Lopes not to have been disabled

before December 17, 1996. Id at 434. By then, Lopes was deceased. 

His estate (the “Estate”) appealed. Doc #1.

The parties have filed cross-motions for summary

judgment. Doc ## 9, 10. For the reasons stated herein, the court

DENIES plaintiff’s motion and GRANTS defendant’s motion.

I

A

The following facts come from the parties’ submissions

and are undisputed. In January 1994, Lopes was released from jail

because he had thrombocytopenia — a condition in which a low blood

platelet count hinders blood clotting – and tested abnormally on a

liver test and positive for hepatitis C. AR at 570:14-571:1. From

January 1994 to July 1994, Lopes received care from Marin Community

Clinic (“MCC”) for chronic active hepatitis B and C, early

cirrhosis, diarrhea and thrombocytopenia. Id at 383-89. On

referral from MCC, doctors at the University of California, San

Francisco Liver Clinic diagnosed Lopes with hepatitis C and

cirrhosis. Id at 290, 405-08. The record contains several sets of

liver test results from 1994. Id at 378, 379-80, 381, 389, 400-01,

398-99, 405, 340. These results are presented in tabular form

below.

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1994 Liver Test Lab Results

 Date 1/5 1/19 1/22 1/31 2/15 3/3, 3/17 4/26 7/18

Source Jail

lab

Jail

lab

Jail

lab

MCC lab MCC

clinic

notes

MCC lab,

clinic

notes 

UCSF

clinic

notes

MCC

clinic

notes

SGOT/

AST

120 191 108 131 131 100 120 124

SGPT/

ALT

155 142 138 125 125 123 160 108

ALK PHOS 269 220 223 236 267 269

Bilirubin

/T-bili

(mg/dl)

1.2 1.3 1.2 1.8 1.6 1.6 2.2

D-bili 0.8 0.8

Albumin/

ALD

(mg/dl)

3.2 2.8 3.1 3.1

Glob/GLLB 3.9 3.3 3.7 3.9

Platelets

/PLT

63 63 73 72 56 63 60

According to the record, Lopes did not visit doctors in

1995, when he was working as a building maintenance worker. But in

February 1996, Lopes resumed liver care at MCC after an emergency

room visit prompted by a sprained foot. AR at 237. Lopes’s three

1996 test results show his bilirubin level more or less steady at

1.7 mg/dl and his albumin level increasing from 3.1 to 3.3 mg/dl. 

Id at 241, 244, 276. In July 1997, Lopes’s bilirubin was 2.8, and

his albumin was 3.1. Id at 261. Although he visited the doctor at

least six times in 1997, the sole set of blood test results was

dated March 1997 and did not include bilirubin or albumin levels. 

Id at 272. 

In response to Lopes’s report of impaired concentration

and memory loss, the SSA ordered psychological evaluations. Id at

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173. Dr Peter Solon, a psychologist, diagnosed Lopes with

adjustment disorder with chronic depressed mood and assigned Lopes

a Global Assessment of Functioning score of 40 in April 1997. AR

at 208. His report stated, “[f]rom a purely psychological point of

view, the overall clinical presentation is a reactive depressive

disorder secondary to the presence of a chronic medical illnss

(Hepatitis A, B and C).” Id. In June 1997, Dr Ida Hilliard, a

psychiatric medical consultant, confirmed the diagnosis of

adjustment disorder with depressed mood. Id at 221, 235. 

The SSA also ordered two residual physical functional

capacity assessments in February and June 1997. Id at 198, 213. 

Both assessments showed that Lopes could do light work. Id. On

the other hand, a medical assessment of ability to do work related

activities, apparently from MCC in late 1997, showed that Lopes

could do only sedentary work. Id at 305-08.

Lopes died on October 30, 1998. Id at 561. According to

the death certificate, Lopes died of cardio-respiratory arrest,

hepatorenal syndrome, liver failure, cirrhosis and hepatocellular

cancer. Id. The death certificate stated that he had suffered

from the latter four conditions for four years. Id. 

B

Lopes submitted two different claims for social security

benefits, in 1994 and 1996. First, on April 22, 1994, Lopes

applied under Title XVI of the Social Security Act, 42 USC

§§ 1381-83(d), for supplemental security income disability benefits

(“1994 claim”). Id at 321-23. After the SSA denied both his

initial application and his reconsideration request, Lopes

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requested a hearing before an ALJ. Id at 345. An ALJ heard

Lopes’s claims and issued a partially favorable decision on August

21, 1995 (“1995 decision”), finding that Lopes had been disabled

for a closed period from November 15, 1993, to November 15, 1994. 

Id at 75-80. The ALJ found that Lopes was not disabled after

November 16, 1994, because the medical evidence showed – and Lopes

conceded – that “his medical condition significantly improved,” so

much so that he began working again as a building maintenance

worker during the last week in November 1994. Id at 78. Lopes did

not appeal the 1995 decision. Lopes stopped working in October

1995 when he was laid off. Id at 443, 566:22-23.

On December 17, 1996, Lopes applied for Title II and

Title XVI social security benefits, alleging that he was disabled

by cirrhosis of the liver and hepatitis A and C as of February 13,

1996 (“1996 claim”). Id at 123, 134. After the SSA denied both

his initial application and his reconsideration request, Lopes

requested a hearing before an ALJ. Id at 93. After the April 20,

1998 hearing (“1998 hearing”), at which Lopes, his attorney and a

vocational expert (“VE”) appeared, the ALJ issued a partially

favorable decision (“1998 decision”), finding Lopes disabled from

December 17, 1996 forward, but not before. Id at 31, 19. The ALJ

also found Lopes not entitled to Title II disability insurance

benefits because his disability onset date of December 17, 1996,

postdated by nine months the March 1996 expiration of his Title II

insurance. Id. The ALJ found that Lopes’s laboratory results did

not meet the criteria established in 20 CFR Pt 404, Subpt P, App 1

(“Listings”) for impairments based on chronic liver disease and

Lopes had the residual functioning capacity (“RFC”) to perform

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sedentary work between February and December 1996. Id at 19-20. 

After December 1996, however, the AlJ found, Lopes’s medical and

mental condition deteriorated so that he no longer could do even

sedentary work. Id at 21-22. Lopes appealed to the Appeals

Council but died shortly thereafter on October 30, 1998. Id at 13-

14, 561. After the Appeals Council declined review and the

decision became final, Lopes’s Estate filed a timely appeal to this

court challenging the December 1996 onset date. Id at 576. 

In that appeal (docket #C 01-0954 VRW), the Estate

contended that either: (1) the 1995 decision was reopened in the

1998 hearing and must be readjudicated or (2) the 1998 decision

must be remanded. AR at 576. In an order dated March 31, 2003,

this court granted the defendant’s motion for summary judgment on

three issues: (1) the ALJ did not controvert Acquiescence Ruling

97-4(9); (2) the ALJ’s 1998 decision did not constitute a de facto

reopening of the 1995 decision; and (3) the court lacked

jurisdiction to reconsider the 1995 decision because Lopes had not

exhausted his administrative remedies. Id at 515:21-23, 518:23-

519:1. This court granted the Estate’s motion for remand on one

issue: that the ALJ did not properly determine Lopes’s disability

onset date under the Social Security Ruling 83-20, which sets forth

how the onset date of disability is to be determined for

disabilities of non-traumatic origin. Id at 517-18; SSR 83-20. 

The court reversed and remanded the case for the ALJ to “review,

pursuant to SSR 83-20, with the assistance of a medical advisor,

whether substantial evidence supports plaintiff’s claimed

disability onset date of February 13, 1996.” Id at 519:15-20:2.

\\ 

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On remand, the ALJ enlisted the help of a medical

examiner. At the hearing on December 2, 2003, plaintiff’s attorney

and a VE appeared in person, while Dr Sergio Bello, a medical

expert (“ME”), appeared by phone. Id at 625. At the request of

plaintiff’s attorney, the ALJ read to the ME three sets of liver

test results from 1994: those from January 22, March 17 and April

26. See table in Part I.A, supra. The ALJ then asked on the

record whether any other medical evidence should be included:

ALJ: I did have a question for you, counsel. And

that was was there any other medical evidence that

you wanted included in the file?

ATTY: No, none. That’s the — the readings that we

just went through are sufficient.

ALJ: All right.

AR at 633. 

The medical evidence of record afforded the ME, to quote

the ALJ, a “very small window of insight,” id at 431: “You know,

it’s a very small window of impression * * * basically a one and a

half, maybe two-year period, it doesn’t give me any indication

about anything was severe at that point [sic]. But it also doesn’t

tell me what happened beyond that.” Id at 635. The ME considered

the 1994 and 1996 test results and concluded that the 1994 results

“would not have been bad enough” to meet any of the Listings for

liver disease and the 1996 results are not “very significant.” Id

at 643. The ME could not determine, based on the available medical

information, whether Lopes had even a severe impairment from

February 13, 1996, to December 17, 1996. Id. Looking at the July

1996 laboratory report showing elevated bilirubin, the ME said that

Lopes would have met the Listings then if he also had ascites or

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esophageal bleeding, but the CT scans and other medical records

showed neither. Id at 638-40. The ME noted that Lopes was

prescribed a medicine for ascites. Id at 640. Because Lopes never

had a biopsy but clearly had chronic liver disease, the ME decided

that Lopes’s condition on July 2, 1997, probably equaled a Listing

with a “ramping up period” of one to six months. Id at 642-44. 

The ME opined that between February and December 1996, Lopes had

the RFC to perform light work. Id at 645. 

The ALJ then posed to the VE two sets of functional

limitations: the ME’s recommended ”light work” RFC and a more

limited sedentary work RFC based on both the 1998 decision and a

doctor’s report from late 1997. Id at 660-61, 432, 305-08. The VE

identified, under each RFC, jobs existing in significant numbers in

the national and regional economies that Lopes could have

performed. Id at 661-62.

The ALJ issued a decision on December 8, 2004 (“2004

decision”) and found that: (1) Lopes “had the severe impairments of

hepatitis A, B and C with early stages of cirrhosis; obesity; and

an adjustment disorder with depression, severe since December 17,

1996”; (2) Lopes’s “impairments did not meet or equal any

impairment in the Listing of Impairments at 20 CFR, Part 404,

Subpart P, Appendix 1”; (3) between February 13, 1996, and December

17, 1996, Lopes could not perform past relevant work, but could

perform sedentary work identified by the VE; (4) Lopes was not

disabled under the Act and Regulations prior to the expiration of

his Title II insured status. Id at 434-35. To determine the

disability onset date, the ALJ relied on the ME’s testimony that

stated Lopes did not meet or equal any Listings from February 13,

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1996, to December 17, 1996, and the VE’s testimony that sedentary

work was available to Lopes. Id at 432-33. The ALJ concluded that

Lopes was therefore not eligible for disability benefits under

Title II. Id at 435.

II

A

The court’s jurisdiction is limited to determining

whether the SSA’s denial of benefits is supported by substantial

evidence in the administrative record. 42 USC § 405(g). 

Substantial evidence is more than a scintilla but less than a

preponderance; it is such relevant evidence as a reasonable mind

might accept as adequate to support a conclusion. Thomas v

Barnhart, 278 F3d 947, 954 (9th Cir 2002). The ALJ's conclusion

must be upheld where it is free of legal error and the evidence is

susceptible to more than one rational interpretation. Id. 

Determinations of credibility, resolution of conflicts in medical

testimony and all other ambiguities are to be resolved by the ALJ. 

Morgan v Commissioner of Social Sec Admin, 169 F3d 595, 599 (9th

Cir 1999); Andrews v Shalala, 53 F3d 1035, 1039 (9th Cir 1995). 

“Disability” means “inability to engage in any

substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected to

result in death or which has lasted or can be expected to last for

a continuous period of not less than 12 months.” 42 USC

§ 423(d)(1)(A). A person with chronic liver disease is disabled if

he has (1) documented esophageal varices; (2) serum bilirubin of

2.5 mg per deciliter or greater, on repeated tests over five

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months; and (3) ascites recurring or persisting for at least five

months associated with persistent hypoalbuminemia of 3.0 gm per

deciliter or less. Listings § 5.05 A, C, D. If the chronic liver

disease is confirmed with a liver biopsy, then the duration

requirements above are reduced to three months. Id, § 5.05 F.

B

By this appeal, the Estate challenges the disability

onset date of December 17, 1996, seeking instead a date at least

ten months earlier that would place the onset date just before the

expiration of Lopes’s Title II insurance status. Lopes Br at 9:6-

8. Specifically, the Estate argues that the ALJ erred by (1)

failing to follow the law of the case; (2) misconstruing and

misapplying the “relevant period” of the case and the law; (3)

failing to consider “all evidence” as required by CFR

§ 404.1520(a)(3); (4) failing to acknowledge and analyze the

combined effect of Lopes’s impairments; and (5) giving an improper

hypothetical to the VE. Lopes Br (Doc #9) at 2:12-14, 5:7-19,

13:20-24, 14:12-14. 

1

The Estate asserts that the ALJ did not abide by the “law

of the case” regarding the 1994 medical evidence. The “law of the

case” doctrine requires the trial court to “follow the appellate

court's resolution of an issue of law in all subsequent proceedings

in the same case; the doctrine does not apply to issues not

addressed by the appellate court.” United States ex rel Lujan v

Hughes Aircraft Co, 243 F3d 1181, 1186 (9th Cir 2001). The Estate

relies on a discovery order in the first appeal, in which this

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court ordered the defendant to produce medical records supporting

the 1995 decision. Docket #C 01-0954 VRW, Doc # 13. This court

stated, “[t]he court is, indeed, convinced that Plaintiff’s medical

records from the transcript supporting ALJ Ball’s decision are

relevant to the instant matter.” Id at 2. The Estate argues that

this statement required the ALJ to review all of the 1994 evidence. 

Lopes Reply (Doc #11) at 6:20-7:8. The court disagrees.

The discovery order addressed whether medical evidence

supporting the 1995 decision was discoverable. The quoted sentence

and its surrounding passages addressed the relevance of the medical

records to that appeal and whether their production would be unduly

burdensome. Because application of the doctrine is limited to the

explicit issue decided, the quoted statement did not require the

ALJ in 1998 to evaluate all of the evidence since November 15,

1993. See Resolution Trust Corp v Massachusetts Mut Life, 200 FRD

183, 187 (WDNY 2001) (applying law of the case doctrine only to the

explicit issue decided in the discovery order). Accordingly,

this court’s discovery order is irrelevant to the merits of the

instant appeal. 

2 

Next, the Estate argues that the ALJ’s determination of

the disability onset date was based on improper relevant periods

because: (1) SSR 83-20 requires the use of the date Lopes stopped

work as the beginning of the relevant period or (2) 42 USC

§ 423(a)(1)(D) and accompanying regulations require the use of the

onset date set from the 1995 decision as the beginning of the

relevant period. Lopes Br at 5-6. Neither argument is persuasive.

\\

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Social Security Ruling 83-20 establishes the framework

for determining the disability onset date. For a disability of

non-traumatic origin, the ALJ starts the analysis with the

claimant’s statement as to when the disability began, then factors

in the date the impairments caused the claimant to stop work and

the dates supported by medical and other evidence. SSR 83-20. In

this case, the October 1995 date when Lopes last worked did not

enter into the analysis because he did not stop work due to the

impairments. Lopes Reply at 5:8-9. The ALJ must then start the

analysis with February 13, 1996, Lopes’s alleged onset date, and

factor in the dates supported by the evidence. The relevant period

of February 13, 1996, based on alleged onset of disability, to

December 17, 1996, the date of the application, was proper because

the medical evidence did not support an earlier date. AR at 643.

Alternatively, the Estate argues that the relevant period

should be framed from the perspective of reinstating the 1994

claim. Lopes Br at 6:15-7:8; Lopes Reply at 5:21-6:20. None of

the authorities it cites supports this argument. 42 USC

§ 423(a)(1)(D) (disability insurance benefits only individual who

applies); 20 CFR §§ 404.250, 404.252 (special computation of

benefits for those entitled to benefits a second time); 20 CFR

§ 404.315(a)(4) (waiting period is waived for those previously

entitled to disability benefits); 20 CFR § 404.1592(d)(2)(ii) (no

trial work period for those who performed work demonstrating the

ability to engage in substantial gainful activity during any

required waiting period). Further, reinstating the 1994 claim

would require reopening that decision, something which this court

has no subject matter jurisdiction to do. AR at 518:26-519:1. 

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3

 The Estate also argues that the ALJ misconstrued and

misapplied 20 CFR § 404.1520, which requires consideration of “all

evidence.” 20 CFR § 404.1520(a)(3) (“We will consider all evidence

in your case record when we make a determination or decision

whether you are disabled”). The Estate argues that the 1994

medical records are part of the evidence and must be considered. 

Lopes Br at 7:9-20. Evidence is anything the claimant submits that

relates to the claim. 20 CFR § 404.1512(b). 

Before it makes a determination that a claimant is not

disabled, the SSA develops the claimant’s “complete medical

history” for at least the twelve months preceding the month of

application or, if applicable, the twelve months before the date

last insured. 20 CFR § 404.1512(d)(2). Using the latter window

for Lopes’s case, the “complete medical history” would include

records back to March 1995. The twelve-month window relates

directly to 42 USC § 423's definition of “disability,” which has a

twelve-month duration component. Given that the Listing for liver

disease requires blood tests establishing certain levels for a

five-month duration up to the disability onset date and that the

1994 data do not establish these levels, the Estate’s argument that

the 1994 records were essential is untenable.

In any case, the ALJ did consider some of the 1994

medical data, those the Estate considered most helpful to its case. 

The ALJ read three of the eight sets of 1994 data to the ME at the

hearing and verified with the Estate’s attorney that the ones she

read were sufficient. AR at 632-33. The ME concluded that Lopes

did not meet the Listings based on the 1994 data. Id at 643. The

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Estate now argues that the excluded 1994 data would have led the ME

to determine an onset date of February 13, 1996, or to corroborate

the four-year duration of illness on the death certificate. Lopes

Br at 9:13-12:9. Given that the three data sets were chosen by

Lopes’s counsel and the omitted test results were not more

favorable to Lopes’s position, the court cannot see how the

inclusion of the other sets could have changed the ME’s conclusion. 

Lopes Br at 12:1-19. The ALJ’s decision to include only a

representative portion of the 1994 data was not legal error and

would not have changed the result. Moreover, this was agreed to by

the Estate’s counsel on the record. The Estate’s request to remand

for the inclusion of more 1994 data is, therefore, denied. 

4

The Estate argues that the ALJ did not consider the

combined effects of Lopes’s impairments, including hypertension,

stab wound, chronic sinusitis and obesity, as required by 20 CFR

§ 404.1520(a). Lopes Br at 14:9-11. Under this section, the ALJ

must “explain adequately his evaluation of alternative tests and

the combined effects of the impairments.” Marcia v Sullivan, 900

F2d 172, 176 (9th Cir 1990). 

In two recent opinions, the Ninth Circuit has explored

the scope of an ALJ’s responsibility for determining the effect of

obesity upon a claimant’s other impairments and on the ability to

work and general health. In Celaya v Halter, 332 F3d 1177, 1182

(9th Cir 2003), the Ninth Circuit found the ALJ’s exclusion of the

plaintiff’s significant obesity from a multiple factor analysis to

be error and remanded to the ALJ. Id at 1182, 84. The court found

especially significant that the obesity was implicit in Celaya’s

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report of symptoms; that the obesity was at least close to the

Listing and could exacerbate the plaintiff’s reported illnesses;

and that the ALJ's observation of Celaya and the information in the

record should have alerted the ALJ to the need to develop the

record, stressing the plaintiff’s pro se status. Id at 1182. In

its more recent opinion in Burch v Barnhart, however, the Ninth

Circuit clarified that the ALJ did not have to discuss the combined

effects of impairments unless the claimant presented evidence that

the combined impairments would equal a Listing. 400 F3d 676, 683

(9th Cir 2005). In Burch, the Ninth Circuit distinguished Celaya

because Burch was represented by counsel and the record did not

indicate that the claimant’s obesity exacerbated other impairments. 

Id at 682. 

In addressing Lopes’s multiple impairments, the ALJ

concluded, “[c]laimant’s impairments considered singly or in

combination did not meet or equal any impairment in the Listing of

Impairments at 20 CFR, Part 404, Subpart P, Appendix 1.” Id at

432. Under Burch, the ALJ did not have to discuss the combined

effects of impairments unless the Estate presented evidence that

the combined impairments would equal a Listing. No such evidence

was presented for hypertension, stab wound, chronic sinusitis and

obesity. 

The Estate relies on Celaya for the proposition that it

is the ALJ, not the plaintiff, who must develop the record as to

the effects of multiple impairments. Unlike the plaintiff in

Celaya, who was illiterate and appeared pro se, the Estate was

represented by counsel who made no reference to the obesity, stab

wound and/or sinusitus. Just as in Burch, in which the Ninth

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Circuit distinguished Celaya, the record is similarly lacking in

evidence that the hypertension, stab wound, chronic sinusitis

and/or obesity either exacerbated the other impairments or nearly

met or equaled a Listing, as did Celaya’s obesity. 

The Estate has, moreover, not pointed to any evidence in

the record of functional limitations imposed by Lopes’s

hypertension or stab wound during the relevant period. Reports of

functional limitations imposed by obesity and chronic sinusitus are

dated in late 1997, well after the relevant period. AR at 280

(letter dated October 10, 1997, from Dr Shapiro re: chronic

sinusitus); id at 305 (undated medical assessment faxed from MCC on

December 5, 1997). The Estate does not address how the existing

evidence would support a multiple factors determination or how it

could change the outcome. Lopes Br at 14:9-11. Without evidence

in the case record that these impairments limited Lopes’s

functioning during the relevant period and would combine to equal a

Listing, the ALJ did not err by not explicitly analyzing these

impairments.

5

Finally, the Estate argues that the hypothetical given to

the VE was improper because the ALJ did not perform the “multiple

factors” determination. Having found a multiple factors

determination unnecessary, the court concludes that the

hypothetical is proper because it refers to a RFC supported by

substantial evidence in the record. In determining RFC, the ALJ

must consider only limitations and restrictions imposed by all of

the impairments, even those that are not severe. SSR 96-8p. 

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Relying on the ME’s testimony, Dr Sommer’s medical

assessment and Dr Shapiro’s letter, the ALJ found that Lopes had

the RFC to lift ten pounds occasionally, stand and walk about two

out of eight hours per day and sit about six out of eight hours per

day. Id at 432, 34. The testimony and reports together included

complete consideration of Lopes’s mental condition, chronic

sinusitus, obesity, and liver diseases. Id at 280, 305, 645. The

ALJ’s RFC determination is supported by substantial evidence. 

III

In conclusion, the court GRANTS defendant’s motion for

summary judgment and DENIES plaintiff’s motion for summary

judgment. The clerk is directed to enter judgment in favor of the

defendant, to close the file and to terminate all pending motions. 

IT IS SO ORDERED.

 

VAUGHN R WALKER

United States District Chief Judge

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