Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_13-cv-08085/USCOURTS-azd-3_13-cv-08085-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Robert Hughes, 

Plaintiff, 

v. 

Social Security Administration 

Commissioner, 

Defendant.

No. CV-13-08085-PCT-DGC

ORDER 

 Plaintiff filed an application for disability insurance benefits on June 10, 2010, 

alleging disability beginning on November 12, 2009. The claim was denied on 

September 23, 2010, and upon reconsideration on December 17, 2010. Plaintiff was 

granted a hearing in which he appeared with counsel before Administrative Law Judge 

(“ALJ”) Thomas Cheffins on April 27, 2012. The ALJ determined that Plaintiff was not 

disabled under the relevant portions of the Social Security Act. Tr. at 81. The Appeals 

Council denied review on March 4, 2013 (Tr. at 1), and Plaintiff filed this action seeking 

reversal of the denial and remand (Doc. 13). Defendant has filed a memorandum in 

opposition (Doc. 14), and Plaintiff has filed a reply (Doc. 15). Neither party has 

requested oral argument. For the reasons that follow, the decision will be vacated and the 

matter remanded for further administrative proceedings. 

I. Standard of Review. 

 Defendant’s decision to deny benefits will be vacated “only if it is not supported 

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by substantial evidence or is based on legal error.” Robbins v. Soc. Sec. Admin., 466 F.3d 

880, 882 (9th Cir. 2006). “‘Substantial evidence’ means more than a mere scintilla, but 

less than a preponderance, i.e., such relevant evidence as a reasonable mind might accept 

as adequate to support a conclusion.” Id. In determining whether the decision is 

supported by substantial evidence, the Court must consider the record as a whole, 

weighing both the evidence that supports the decision and the evidence that detracts from 

it. Reddick v. Charter, 157 F.3d 715, 720 (9th Cir. 1998). If there is sufficient evidence 

to support the Commissioner’s determination, the Court cannot substitute its own 

determination. See Young v. Sullivan, 911 F.2d 180, 184 (9th Cir. 1990). 

 For purposes of Social Security benefits determinations, a disability is 

the inability to do 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. 

20 C.F.R. § 404.1505. 

 Determining whether a claimant is disabled involves a sequential five-step 

evaluation. The claimant must show that (1) he is not currently engaged in substantial 

gainful employment, (2) he has a severe physical or mental impairment, and (3) the 

impairment meets or equals a listed impairment or (4) his residual functional capacity 

(“RFC”) precludes him from performing his past work.1

 If at any step the Commissioner 

determines that a claimant is or is not disabled, the analysis ends; otherwise, it proceeds. 

If the claimant establishes his burden through step four, the Commissioner must find the 

claimant disabled unless he finds that the claimant can make an adjustment to other work. 

The Commissioner bears the burden at step five of showing that the claimant has the RFC 

to perform other work that exists in substantial numbers in the national economy. See 20 

C.F.R. § 404.1520(a)(4)(i)-(v). 

 

1

 RFC is the most a claimant can do with the limitations caused by his impairments. See Rodriguez v. Bowen, 876 F.2d 759, 762 (9th Cir. 1989); 20 C.F.R. 

§ 416.945(a); SSR 96-8p, 1996 WL 374184 (July 2, 1996). 

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II. Analysis. 

 The ALJ found at step one that Plaintiff had not worked since November 12, 2009. 

Tr. at 75. At step two, the ALJ found that Plaintiff suffered from the following severe 

impairments: obesity, chronic obstructive pulmonary disease, sleep apnea (CPAP), and 

diabetes mellitus. Id. The ALJ found at step three that none of the impairments or 

combination thereof met or medically equaled one of the listed impairments. Id. at 76. 

The ALJ found that Plaintiff had the RFC to perform sedentary work, with limited 

exceptions, including occasional ability to climb ramps or stairs, but never ladders, ropes, 

or scaffolds, ability to occasionally stoop, crouch, balance, kneel or crawl, but that he 

could never be exposed to irritants, chemicals, or unprotected heights, nor could he use 

moving machinery. Id. at 77. The ALJ found at step four that Plaintiff was therefore 

unable to perform any of his past relevant work as a ranch hand, landscaper, construction 

worker, or fabricator. Id. at 80. At step five, however, the ALJ found that there were 

jobs that existed in significant numbers in the national economy that Plaintiff could 

perform. Id. The ALJ therefore concluded that Plaintiff was not disabled. Id. at 20. 

 Plaintiff argues that the ALJ’s determination was based on legal error because 

(1) in the ALJ’s hypothetical posed to the vocational expert, the ALJ failed to include the 

fact that Plaintiff relies on an oxygen tank, and (2) the ALJ failed to accord adequate 

weight to the opinion of Plaintiff’s treating physician and inappropriately afforded more 

weight to the opinions of stage agency consultants. Doc. 13 at 4. 

 A. Incomplete Hypothetical. 

 Plaintiff argues that he requires access to an oxygen tank upon even mild exertion, 

and that the ALJ failed to include this limitation in the hypothetical he posed to the 

vocational expert. Doc. 13 at 8. Because the vocational expert concluded that very few 

if any employers would be willing to accommodate the limitation of an oxygen tank, 

Plaintiff argues that the ALJ’s failure to include this limitation in the hypothetical 

resulted in an inaccurate RFC determination. Id. Defendant argues that the record does 

not support Plaintiff’s assertion that he needs full-time use of an oxygen tank, that even if 

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he did, the limitation did not continue for long enough to be included in the hypothetical, 

and that any error in not including the limitation was harmless because sedentary work 

does not involve substantial exertion and Plaintiff only needs oxygen during exertion. 

Doc. 14 at 9-11. 

 Plaintiff’s treatment notes, which he cites as evidence that he must use an oxygen 

tank full-time, indicate that he was using oxygen for treating “nighttime hypoxemia” in 

December 2009 and January 2010 (Tr. at 256, 262), and for treating “obstructive sleep 

apnea” in May and August 2011 (Tr. at 301-02). It was not until January 2012 that the 

notes indicate that he was “using oxygen on exertion.” Tr. at 299. Defendant argues that 

the notes are evidence that Plaintiff used oxygen only at night until January 2012, and 

that even if he used oxygen for exertion from 2012 on, he did not do so for a sufficient 

amount of time to constitute a disability. Doc. 14 at 9-10. Plaintiff testified at his 

hearing that he used the oxygen during the day (Tr. at 26), and that he started on the 

oxygen in 2010 (Tr. at 28), but the ALJ discounted Plaintiff’s testimony as not credible. 

Plaintiff does not dispute this finding. 

 Under well-established law, “[i]f the hypothetical [posed to the vocational expert] 

does not reflect all the claimant’s limitations . . . the expert’s testimony has no 

evidentiary value to support a finding that the claimant can perform jobs in the national 

economy.” DeLorme v. Sullivan, 924 F.2d 841, 850 (9th Cir. 1991) (citing Embrey v. 

Bowen, 849 F.2d 418, 423 (9th Cir. 1988); Gallant v. Heckler, 753 F.2d 1450, 1457 (9th 

Cir. 1984)). Nevertheless, an ALJ does not err in not including a Plaintiff’s limitation in 

a hypothetical if the weight of other evidence refutes the existence of that limitation. 

Matthews v. Shalala, 10 F.3d 678, 681 (9th Cir. 1993) (finding no error where ALJ did 

not include a “staying in one position limitation” where ALJ found limitation not 

significant and not credible). 

 Plaintiff does not cite clear evidence that he needed a full-time oxygen tank, as the 

treatment notes primarily indicate the use of oxygen for nighttime disorders and upon 

exertion. The ALJ found Plaintiff’s subjective complaints about the severity of his 

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breathing problems to be less than fully credible, and cited numerous legitimate reasons 

for doing so. Tr. at 78-79 (including Plaintiff’s failure to follow treatment 

recommendations, vague testimony, leaving his last job for non-medical reasons, and 

receipt of unemployment compensation, among others). 

In short, the evidence does not establish that Plaintiff had a limitation that should have 

been included in the hypothetical posed to the vocational expert. 

 B. Medical Opinions. 

 Plaintiff next argues that the ALJ erred when he gave no weight to treating 

physican Dr. El-Harakeh’s opinion, in which the doctor opined that Plaintiff could not 

perform even sedentary work. Doc. 13 at 11. 

 “The ALJ must consider all medical opinion evidence.” Tommasetti v. Astrue, 

533 F.3d 1035, 1041 (9th Cir. 2008); see 20 C.F.R. § 404.1527(c); SSR 96-5p, 1996 WL 

374183, at *2 (July 2, 1996). In weighing medical source opinions in Social Security 

cases, the Ninth Circuit distinguishes among three types of physicians: (1) treating 

physicians, who actually treat the claimant; (2) examining physicians, who examine but 

do not treat the claimant; and (3) non-examining physicians, who neither treat nor 

examine the claimant. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). Generally, 

more weight should be given to the opinion of a treating physician than to the opinions of 

non-treating physicians. Id. 

 The ALJ may reject the contradicted opinion of a treating or examining physician 

by “setting forth specific and legitimate reasons for doing so that are based on substantial 

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

and quotation omitted). “The ALJ can ‘meet this burden by setting out a detailed and 

thorough summary of the facts and conflicting clinical evidence, stating his interpretation 

thereof, and making findings.” 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.” Id. Where a treating 

physician’s opinion is not contradicted by another physician, it may be rejected only for 

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“clear and convincing” reasons. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). 

Further, “[t]he ALJ need not accept the opinion of any physician, including a treating 

physician, if that opinion is brief, conclusory, and inadequately supported by clinical 

findings.” Id.

 The ALJ stated that he gave no weight to Dr. El-Harakeh’s opinion because it is 

not consistent with medical evidence in the record and is based on Plaintiff’s subjective 

complaints. Tr. at 79. The ALJ’s opinion, however, references Dr. El-Harakeh’s opinion 

as “Ex. 9F,” which is not, in fact, an opinion by Dr. El-Harakeh but rather an opinion by 

Dr. Brecheisen. Tr. at 79.2

 The ALJ then goes on to say that Dr. El-Harakeh’s opinion is 

contradicted by his own medical findings, citing records showing that “claimant’s 

breathing was improved on medication,” he had no hemoptysis, he had only mild 

obstructive pulmonary disease, and he denied problems and was doing fairly well. Id. 

But the only evidence cited by the ALJ that is, in fact, a medical record by Dr. ElHarakeh is Ex. 5F. Tr. at 252-257. The ALJ states that this opinion shows that the 

“claimant’s breathing was improved on medication and that he had 90% saturation,” but 

the ALJ does not explain how this contradicts any other opinion by Dr. El-Harakeh. Tr. 

at 79. The other medical records cited by the ALJ are not medical records from Dr. ElHarakeh. See Tr. at 269-75, 294-95. 

 The ALJ also discounted Dr. El-Harakeh’s opinion because it is “contradicted by 

the opinions of other examining experts, DDS, and treating physician Dr. Bradshaw.” 

Tr. at 79. In support, the ALJ cites generally to two state agency consulting physician 

reports, (Tr. at 44-56, 58-69), without noting what, if any, portions of those opinions 

contradict Dr. El-Harakeh’s opinion. He also cites generally to Dr. Bradshaw’s treatment 

notes from June and November 2011 (Tr. at 294-98) without noting what portion, if any, 

contradicts Dr. El-Harakeh’s opinion. 

 

2

 The ALJ likely meant to refer to Dr. El-Harakeh’s opinion report at Ex. 14F. Tr. 289-293. Because the ALJ never discusses any specific content of Dr. El-Harakeh’s opinion, and treatment notes from Dr. El-Harakeh are scattered throughout the record, the Court cannot presume to know which opinion by Dr. El-Harakeh the ALJ rejected. 

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 The ALJ has not set forth specific and legitimate reasons for rejecting Dr. ElHarakeh’s opinion, Barnhart, 278 F.3d at 957, and in fact has not even noted which 

opinion he rejects. Because this was legal error, the ALJ’s decision will be vacated. 

IV. Remedy. 

 The decision to remand for further development of the record or for an award of 

benefits is within the discretion of the Court. 42 U.S.C. ' 405(g); see Harman v. Apfel, 

211 F.3d 1172, 1173-74 (9th Cir. 2000). An action will be remanded for an award of 

benefits only where three conditions are met: (1) the ALJ has failed to provide legally 

sufficient reasons for rejecting evidence, (2) no outstanding issue remains that must be 

resolved before a determination of disability can be made, and (3) it is clear from the 

record that the ALJ would be required to find the claimant disabled were the rejected 

evidence credited as true. 

 The ALJ has failed to provide legally sufficient reasons for rejecting the opinion 

of Dr. El-Harakeh. Where the Court finds that the ALJ failed to give legally-sufficient 

reasons for not crediting testimony, the evidence must be credited as true under Ninth 

Circuit law. See Varney v. Secretary of Health and Human Services, 859 F.2d 1396 (9th 

Cir. 1988) (“if grounds for [discrediting a claimant’s testimony] exist, it is both 

reasonable and desirable to require the ALJ to articulate them in the original decision.”); 

Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995) (“Where the Commissioner fails to 

provide adequate reasons for rejecting the opinion of a treating or examining physician, 

we credit that opinion ‘as a matter of law.’ ” (citing Hammock v. Bowen, 879 F.2d 498, 

502 (9th Cir.1989); Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir.2000) (same); 

Benecke v. Barnhart, 379 F.3d 587 (9th Cir.2007); (“Because the ALJ failed to provide 

legally sufficient reasons for rejecting Benecke's testimony and her treating physicians’ 

opinions, we credit the evidence as true.”). 

 In this case, however, outstanding issues remain that must be resolved before a 

determination of disability can be made. Specifically, the ALJ failed to explain which 

opinion of Dr. El-Harakeh he rejected. The record includes many pages of treatment 

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notes by Dr. El-Harakeh between 2009 and 2012, Tr. at 252-65, 299-317, but the ALJ’s 

only citation to Dr. El-Harakeh’s opinion erroneously cites treatment notes from a 

different doctor. Tr. 294-98. Therefore, remand for development of the record consistent 

with this opinion is in order. 

 Plaintiff argues that, upon remand, this matter must be assigned to a different ALJ 

because Judge Cheffins revealed a serious prejudice against Plaintiff at the hearing. Doc. 

13 at 16. Plaintiff cites no specific act or show of prejudice that would entitle him to an 

exception to the agency’s policy of reassigning the case to the same ALJ. 

 IT IS THEREFORE ORDERED remanding this matter for further 

administrative action consistent with this decision. Plaintiff’s request for a new ALJ is 

denied. 

 Dated this 6th day of May, 2014. 

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