Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_16-cv-01823/USCOURTS-casd-3_16-cv-01823-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:0405id Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

JANICE BARBARA HAMILTON,

Plaintiff, 

v.

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security,

Defendant. 

Case No.: 16-cv-01823-W-MDD

REPORT AND 

RECOMMENDATION ON 

CROSS MOTIONS FOR 

SUMMARY JUDGMENT

[ECF NOS. 14, 15]

Plaintiff Janice Barbara Hamilton (“Plaintiff”) filed this action 

pursuant to 42 U.S.C. § 405(g) for judicial review of the decision of the 

Commissioner of the Social Security Administration (“Commissioner”) 

denying Plaintiff’s application for a period of disability and disability 

insurance benefits under Title II of the Social Security Act. Plaintiff moves 

the Court for summary judgment reversing the Commissioner and ordering 

an award of benefits, or in the alternative, to remand the case for further 

administrative proceedings. (ECF No. 14). Defendant has moved for 

summary judgment affirming the denial of benefits. (ECF No. 15).

For the reasons expressed herein, the Court recommends that Plaintiff’s 

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motion be DENIED and Defendant’s motion be GRANTED.

I. BACKGROUND

A. Factual Background

Plaintiff alleges that she became disabled on July 1, 2013 due to back 

and knee pain. (A.R. 74, 24-25).1 Plaintiff’s date of birth, December 6, 1965, 

categorize her as a younger individual at the time of filing. She has since 

changed her age category to that of an individual closely approaching 

advanced age. 20 C.F.R. §§ 404.1563, 416.963; (A.R. 42).

B. Procedural History

On February 10, 2014, Plaintiff filed an application for disability 

insurance benefits under Title II of the Social Security Act (“Act”). (A.R. 21). 

Plaintiff’s claim was denied initially on March 14, 2014, and denied upon 

reconsideration on June 28, 2014. (A.R. 21). A hearing was held on October 

7, 2015, before Administrative Law Judge (“ALJ”) Donald P. Cole. (A.R. 36-

72). Plaintiff appeared and was represented by counsel. (A.R. 36). Plaintiff 

and Vocational Expert (“VE”) Erin Welsh testified at the hearing. (A.R. 62-

70).

On November 25, 2015, the ALJ issued a written decision finding 

Plaintiff not disabled. (A.R. 21-31). Plaintiff appealed and submitted 

additional information to the Appeals Council. (A.R. 1, 6). After considering 

the additional information, the Appeals Council denied Plaintiff’s request to 

review the ALJ’s decision. (A.R. 1-3). Consequently, the ALJ’s decision 

became the final decision of the Commissioner. (A.R. 1).

On July 15, 2016, Plaintiff filed a Complaint with this Court seeking 

 

1 “A.R.” refers to the Administrative Record filed on August 4, 2016 and is 

located at ECF No. 12.

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judicial review of the Commissioner’s decision. (ECF No. 1). On October 27, 

2016, Defendant answered and lodged the administrative record with the 

Court. (ECF Nos. 11, 12). On December 2, 2016, Plaintiff moved for 

summary judgment. (ECF No. 14). On January 6, 2017, the Commissioner 

cross-moved for summary judgment and responded in opposition to Plaintiff’s 

motion. (ECF Nos. 15, 16). On January 25, 2017, Plaintiff responded in 

opposition to the Commissioner’s motion. (ECF No. 17).

II. DISCUSSION

A. Legal Standard

The supplemental security income program provides benefits to 

disabled persons without substantial resources and little income. 42 U.S.C. § 

1382. To qualify, a claimant must establish an inability to engage in 

“substantial gainful activity” because of a “medically determinable physical 

or mental impairment” that “has lasted or can be expected to last for a 

continuous period of not less than 12 months.” 42 U.S.C. § 1382c(a)(3)(A). 

The disabling impairment must be so severe that, considering age, education 

and work experience, the claimant cannot engage in any kind of substantial 

gainful work that exists in the national economy. 42 U.S.C. § 1382c(a)(3)(B).

The Commissioner makes this assessment through a process of up to 

five steps. First, the claimant must not be engaged in substantial, gainful

activity. 20 C.F.R. § 416.920(b). Second, the claimant must have a “severe” 

impairment. 20 C.F.R. § 416.920(c). Third, the medical evidence of the 

claimant’s impairment is compared to a list of impairments that are 

presumed severe enough to preclude work. 20 C.F.R. § 416.920(d). If the 

claimant’s impairment meets or is equivalent to the requirements for one of 

the listed impairments, benefits are awarded. Id. If the claimant’s 

impairment does not meet or is not equivalent to the requirements of a listed 

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impairment, the analysis continues to a fourth and possibly fifth step and 

considers the claimant’s residual functional capacity. 20 C.F.R. § 416.920(e). 

At the fourth step, the claimant’s relevant work history is considered along 

with the claimant’s residual functional capacity. Id. If the claimant can 

perform the claimant’s past relevant work, benefits are denied. 20 C.F.R. § 

416.920(f). At the fifth step, if the claimant is found not able to perform the 

claimant’s past relevant work, the issue is whether claimant can perform any 

other work that exists in the national economy, considering the claimant’s 

age, education, work experience and residual functional capacity. 20 C.F.R. 

§ 416.920(g). If the claimant cannot do other work that exists in the national 

economy, benefits are awarded. Id.

Sections 405(g) and 1383(c)(3) of the Social Security Act allow

unsuccessful applicants to seek judicial review of a final agency decision of

the Commissioner. 42 U.S.C. § 405(g), 42 U.S.C. § 1383(c)(3). The scope of 

judicial review is limited, and the Commissioner’s denial of benefits “will be 

disturbed only if it is not supported by substantial evidence or is based on 

legal error.” Brawner v. Secretary of Health & Human Services, 839 F.2d 

432, 433 (9th Cir. 1988) (quoting Green v. Heckler, 803 F.2d 528, 529 (9th Cir. 

1986)).

Substantial evidence means “more than a mere scintilla” but less than a 

preponderance. Sandqathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997). “[I]t 

is such relevant evidence as a reasonable mind might accept as adequate to 

support a conclusion.” Id. (quoting Andrews v. Shalala 53 F.3d 1035, 1039 

(9th Cir. 1995)). The court must consider the record as a whole, weighing 

both the evidence that supports and detracts from the Commissioner’s 

conclusions. Desrosiers v. Secretary of Health & Human Services, 846 F.2d 

573, 576 (9th Cir. 1988). If the evidence supports more than one rational 

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interpretation, the court must uphold the ALJ’s decision. Allen v. Heckler, 

749 F.2d 577, 579 (9th Cir. 1984). When the evidence is inconclusive, 

“questions of credibility and resolution of conflicts in the testimony are 

functions solely of the Secretary.” Sample v. Schweiker, 694 F.2d 639, 642 

(9th Cir. 1982).

The ALJ has a special duty in social security cases to fully and fairly 

develop the record in order to make an informed decision on a claimant’s 

entitlement to disability benefits. DeLorme v. Sullivan, 924 F.2d 841, 849 

(9th Cir. 1991). Because disability hearings are not adversarial in nature, 

the ALJ must “inform himself about the facts relevant to his decision,” even if 

the claimant is represented by counsel. Id. (quoting Heckler v. Campbell, 461 

U.S. 458, 471 n.1 (1983)).

Even if a reviewing court finds that substantial evidence supports the 

ALJ’s conclusions, the court must set aside the decision if the ALJ failed to 

apply the proper legal standards in weighing the evidence and reaching his or 

her decision. Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978). Section 

405(g) permits a court to enter a judgment affirming, modifying or reversing 

the Commissioner’s decision. 42 U.S.C. § 405(g). The reviewing court may 

also remand the matter to the Social Security Administration for further 

proceedings. Id.

B. The ALJ’s Decision

The ALJ concluded Plaintiff was not disabled, as defined in the Social 

Security Act, from July 1, 2013, through the date of the ALJ’s decision, 

November 25, 2015. (A.R. 21).

The ALJ found that Plaintiff has the following severe impairments: 

degenerative disc disease and knee sprain/strain. (A.R. 23). The ALJ 

determined that Plaintiff did not have an impairment or combination thereof 

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that meets or is medically equivalent to the severity of one of the listed 

impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§ 

404.1520(d), 404.1525 and 404.1526) because no physician has opined that 

the severity of Plaintiff’s conditions equate to any listed impairment, and no 

medical evidence in the record supports a finding thereof. (Id.).

The ALJ also found that Plaintiff has the residual functional capacity (“RFC”) 

to “perform light work as defined in 20 CFR [§] 404.1567(b) except frequently 

balancing and crouching; occasionally climbing stairs and ramps, but no 

climbing ladders, ropes, or scaffolds; occasionally stooping, kneeling, and 

crawling; avoiding concentrated exposure to extreme cold, vibrations, and 

hazards such as moving machinery and unprotected heights.” (A.R. 23-24). 

In making this finding, the ALJ noted that Plaintiff’s statements regarding 

the intensity, persistence and limiting effects of her symptoms “are not fully 

credible” because Plaintiff’s daily activities and objective medical evidence 

did not support her alleged symptoms. (A.R. 26). Based on VE Welsh’s 

testimony, the ALJ found that Plaintiff is capable of performing past relevant 

work as a dental assistant and office manager because her RFC permits her 

to perform these jobs as they are actually and generally performed. (A.R. 30). 

The ALJ specifically noted the following to be of particular relevance:

1. Plaintiff’s Testimony 

The ALJ noted that Plaintiff alleged back problems including disc 

degeneration requiring disc removal, spinal fusions, metal cages, rods, screws 

and hardware implementation, a torn disc in February 2014, repeated disc 

tearing, L2 and L3 retrolisthesis and broad-based posterior endplate 

osteophyte L2 and L3 3 mm causing pressure of the thecal sac, as well as 

knee problems requiring surgical intervention. (A.R. 24). She claimed that 

her impairments cause pain and limit her ability to perform exertional, 

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non-exertional, postural, environmental, daily and personal care activities. 

(Id.). Plaintiff further claimed that she experienced ten days of paralysis 

after her February 2014 disc tear and similar paralysis after subsequent disc 

tears. (Id.). She stated that she is able to sit in a car for half an hour and 

alleged that her impairments made it difficult to care for herself, work, sleep, 

put shoes on and go outdoors with family and friends. (Id.). Plaintiff also 

alleged that she was prescribed Flexeril, Prevacid, Xanax, Lansoprazole, 

Alprazolam, allergy eye drops, probiotics, Salonpas and Vicoprofen. (Id.). 

Plaintiff maintained the only medication that helps with her pain is “ice 

every two hours, followed with using a tens unit.” (Id.). The ALJ specifically 

noted that Plaintiff claimed that her medications caused sleepiness and 

inability to function, but admitted that the lowest dose of Vicoprofen works. 

(A.R. 24). Plaintiff also alleged that she wore a back brace when experiencing 

unbearable pain and that cold/damp weather exacerbates her pain. (A.R. 25).

The ALJ specified that in Plaintiff’s March 6, 2014 questionnaire, she 

admitted that she can perform activities for two to three hours after taking a 

pain pill, and would be “good” for another two to three hours after laying 

down for an hour. (A.R. 24-25). Plaintiff alleged disc tears happen often, and 

they keep her in bed for three to four days. (A.R. 25). The ALJ mentioned 

that Plaintiff attempted to walk daily, perform errands and keeps house in 

two to three hour intervals. (Id.). Plaintiff acknowledged that she lived in a

two-story home, and that as long as she has no torn discs and paralysis, she 

can climb twelve stairs, lift five pounds and carry two pounds. (Id.). She 

further admitted she was capable of grocery shopping once a week, house 

cleaning in small areas each day, driving and gardening once a week for 

enjoyment. (Id.). Plaintiff also performed yard work, which involved using a 

blower and cleaning windows every few months. (Id.). The ALJ found 

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Plaintiff’s alleged impairments inconsistent with her daily activity and social 

interaction. (Id.). 

The ALJ additionally mentioned Plaintiff’s March 1, 2015 letter and 

found the assertions therein not fully credible. (A.R. 25). The ALJ noted that 

in her letter, Plaintiff alleged that she was unable to stand or sit for more 

than an hour, the pain kept her from sleeping through the night and bilateral 

leg nerve pain would numb her leg and render her unable to walk for days. 

(Id.). Plaintiff also asserted that a surgical solution is required because 

another disc was collapsing and some of her implanted metal was separating 

from bone. (Id.). The ALJ noted that Plaintiff’s allegations were inconsistent 

with the diagnostic imaging provided, and treatment notes did not support 

the need for surgical intervention. (Id.). 

In addition, the ALJ described that during the hearing, Plaintiff 

testified about her surgery in 2009 or 2010, which “did more harm than 

good”. (A.R. 25). The ALJ noted that this surgery occurred prior to Plaintiff’s 

alleged onset of disability. (Id.). Plaintiff also testified that she took pain 

pills every two to three hours and that her pain medications were not 

working. (Id.). She also admitted to delaying additional back surgery and 

refusing a prescription for morphine because she fears that she will “lose 

[her] soul.” (Id.). Plaintiff further expressed that she feared repeated disc 

tears, which allegedly cause electric shock, collapsing, paralysis and loss of 

bowel function. (A.R. 25, 26). She stated that disc tear recovery required 

three to seven days of lying on her back with ice or heat. (A.R. 26). Plaintiff 

further testified that she experienced left knee swelling and pain and that 

her right knee stiffens with cold weather. (Id.). 

The ALJ found that Plaintiff’s description of the severity of her pain is 

inconsistent with her testimony that she resisted going to the emergency 

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room three times a week for treatment because of time constraints, 

embarrassment and her ability to obtain stronger medication from her 

treating physician. (A.R. 25-26).

2. Third Party Opinions

The ALJ considered Plaintiff’s third party correspondence dated 

between August and November 2014 from Plaintiff’s spouse, mother, former 

aunt-in-law, friends and acquaintances. (A.R. 26). The ALJ found the third 

parties’ statements credible only with respect to Plaintiff’s ability to do light 

work. (Id.). More specifically, the ALJ noted that third party lay opinion 

regarding diagnosis and the severity of Plaintiff’s symptoms or side effects of 

medications in relation to Plaintiff’s ability to work is less persuasive than 

professional medical opinion on the same issues. (Id.). Here, the ALJ found 

that the third parties’ opinions were not impartial because they have familial 

and/or relationship motivations to help the Plaintiff, further, their 

statements were not supported by medical evidence in the record. (Id.).

3. Treatment Records

The ALJ reviewed Plaintiff’s treatment records dated from December 

1999 through September 2015 and noted the 2013 and 2014 treatment notes

as particularly relevant to Plaintiff’s alleged disability beginning on July 1, 

2013. (A.R. 26). The ALJ also pointed out that Plaintiff submitted sporadic 

treatment notes since the alleged onset date and no treatment notes since 

March 2014, other than two disability statements in May and September 

2015. (A.R. 26-27).

a. 2013 Treatment Notes

Plaintiff’s August 14, 2013 treatment note reported that Plaintiff took 

/ / /

/ / /

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Vicoprofen six times each day,2 which reduced her pain and allowed her to 

function. (A.R. 27). Plaintiff’s November 6, 2013 treatment note reported 

that her condition improved by fifty percent, and she was able to perform 

more physical activity due to decreased pain. (Id.). Plaintiff had also 

decreased her Vicoprofen intake to four to five tablets each day. (Id.). 

Plaintiff claimed that her pain increased during cold weather. (Id.). In 

addition, the ALJ mentioned that the treatment notes describe Plaintiff to be 

in mild to moderate discomfort and not overmedicated. (Id.). The ALJ also 

noted that other than mild to moderate lumbar paraspinal tenderness to 

palpation with moderate spasm, limited range of motion in the lumbar spine 

and a positive straight left leg raise test, her physical examinations were 

generally unremarkable. (Id.).

b. 2014 Treatment Notes

Plaintiff’s January 29, 2014 progress note indicated that in December 

2013, she developed knee swelling. (A.R. 27). It also reported that Plaintiff 

began to walk on a regular basis and started to walk three miles daily. (Id.). 

Additionally, the treatment note reported that Plaintiff appeared to be in 

mild to moderate discomfort and was not overmedicated. (Id.). The ALJ 

noted that Plaintiff’s physical examination findings were similar to those in 

her previous exam, except for a moderate tenderness to palpation to the 

medial joint line and above the left knee patella. (Id.). Otherwise, the 

findings were generally unremarkable, and Plaintiff exhibited normal gait, 

strength, sensation and reflexes in the lower extremities. (Id.).

 

2 The ALJ mistyped the number of times Plaintiff was taking Vicoprofen; the 

record reflects that number to be six, not eight. (Compare A.R. 27, with A.R. 

259).

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The ALJ additionally mentioned that Plaintiff’s March 27, 2014 MRI 

revealed status post laminectomy of L4 and partial laminectomy of L3 with 

fusions of L3, L4, L5 and S1 bodies by pedicle screws, cages placed at L4-L5 

disc space, combination of retrolisthesis of L2 in relation to L3 and 

broad-based posterior endplate osteophyte formation at L2-L3 level, which 

measured about 3 mm and caused pressure over the anterior aspect of the 

thecal sac. (Id.). The ALJ noted that Plaintiff declined bilateral knee x-rays 

and MRI to evaluate her worsening knee pain on January 29, 2014. (A.R. 

27). The ALJ found that this demonstrates a potential unwillingness to 

improve her condition and indicates that her symptoms were not as severe as 

she described. (Id.). The ALJ further found that Plaintiff’s failure to follow 

prescribed treatment without a good reason is a basis for finding that 

Plaintiff is not disabled. (Id.).

4. Michael Moon, M.D.

On May 6, 2014, treating physician, Michael Moon, M.D. opined that 

Plaintiff cannot physically perform the customary duties of a dental 

hygienist, cannot compete in the labor market and is permanently disabled. 

(A.R. 28). Dr. Moon reported that Plaintiff required daily round-the-clock 

medication to control her pain and experienced frequent lower back pain that 

caused her to be bedbound for days at a time. (Id.). Dr. Moon attributed 

Plaintiff’s pain to segment instability at L2-3 and stated that surgery in this 

region may be an option. (Id.). Dr. Moon also noted that Plaintiff was 

reluctant to consider surgery and managed her pain by restricting physical 

activity and ingesting pain medication. (Id.).

On September 16, 2015, Dr. Moon opined that Plaintiff’s pain and/or 

pain disorder, depression, anxiety and side effects from prescribed medication 

limited her ability to work. (A.R. 28). The ALJ found that Dr. Moon’s 

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treatment notes do not support these conditions. (Id.). Dr. Moon also 

claimed that Plaintiff completed quarterly visits for fourteen years, but the 

ALJ noted that there were no treatment notes in the record since March 

2014. (Id.). Dr. Moon reported Plaintiff’s capacity as limited to the following: 

lifting and/or carrying 20 pounds rarely, 10 pounds occasionally and less than 

10 pounds frequently, sitting for approximately two hours during a workday, 

standing and/or walking for less than two hours in a workday, requiring 

alternating positions from sitting, standing or walking, rarely bending, 

stooping, climbing, kneeling or crawling, being absent from work more than 

four days each month due to her condition and requiring unscheduled breaks 

and to lie down during the workday. (Id.).

The ALJ afforded little weight to Dr. Moon’s disability statements. 

(A.R. 27, 28). The ALJ found Dr. Moon’s opinions inconsistent with the entire 

evidence of record. (A.R. 28). Specifically, the ALJ found that Dr. Moon’s 

statements were contrary to Plaintiff’s treatment notes, which demonstrate 

that Plaintiff’s symptoms improved over time. (Id.). For example, from 

August 2013 to November 2013, Plaintiff’s pain and medication intake 

decreased, and in January 2014, she began to walk daily. (Id.). The ALJ also 

found that Dr. Moon’s disability statements were inconsistent with Plaintiff’s 

refusal to undergo x-ray and MRI examinations for her knee in January 

2014, continued performance of daily living activities, personal care and 

social interaction, driving, resisting emergency room treatment and lack of 

records showing repeated disc tearing. (Id.).

5. State Agency Medical Consultants

The State Agency Medical Consultants opined that Plaintiff can 

perform light work including lifting and/or carrying 20 pounds occasionally 

and 10 pounds frequently, sitting, standing and/or walking for about six 

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hours during a workday, climbing ramps and stairs, frequently to 

occasionally, climbing ladders, ropes or scaffolds, stooping, kneeling and 

crawling, frequently balancing and crouching and avoiding concentrated 

exposure to extreme cold, vibration and hazards. (A.R. 29). The ALJ 

accorded significant weight to the State Agency Medical Consultants’ 

determinations. (Id.). The ALJ adopted an RFC similar to the State Agency 

Medical Consultants’, with increased climbing limitations. (Id.). In support, 

the ALJ cited to Plaintiff’s treatment notes showing medical improvement 

over time, refusal to undergo evaluations for knee pain and to go to the 

emergency room, continued performance of daily activities and lack of 

medical evidence supporting her allegations of disabling pain, The ALJ 

specifically noted that his RFC finding is supported by the evidence as a 

whole because Plaintiff’s less-than-fully-credible complaints and the objective 

medical evidence do not support the severity of Plaintiff’s alleged symptoms. 

(Id.).

6. Vocational Expert

At Plaintiff’s October 7, 2015 hearing, VE Erin Welsh testified that 

Plaintiff’s past work as a dental assistant is classified as skilled light work 

and her work as an office manager is classified as skilled sedentary work. 

(A.R. 30, 64). In light of the VE’s testimony and Plaintiff’s RFC, age, 

education and work experience, the ALJ found that Plaintiff is able to 

perform the physical and mental demands associated with these past 

relevant composite jobs as they are actually and generally performed. 

(A.R. 30).

The ALJ additionally found that, based on the VE’s testimony, Plaintiff 

is able to perform other unskilled light work such as mailroom clerk and 

office helper and unskilled sedentary work such as callout operator and 

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escort vehicle driver, all of which exist in significant numbers in the national 

economy. (A.R. 30-31).

C. Appeals Council Decision

 On August 1, 2016, the Appeals Council set aside its decision denying 

Plaintiff’s request for review of the ALJ’s decision because Plaintiff submitted 

new medical evidence3 to the Council not previously presented to the ALJ. 

(A.R. 1). The Appeals Council subsequently considered the Administrative 

Record, Plaintiff’s new evidence and Plaintiff’s reasons for challenging the 

ALJ’s decision. (Id.). The Appeals Council also reviewed evidence from Dr. 

Moon, dated May 6, 2014 and September 6, 2015, but determined these 

records were not new “because they are copies of exhibits 3F and 8F [of the 

Administrative Record].” (Id.). The Appeals Council ultimately determined 

that Plaintiff’s new evidence “does not provide a basis for changing the 

[ALJ’s] decision.” (Id.). 

D. Whether Substantial Evidence Supports the ALJ’s Decision

Plaintiff contends that the ALJ’s non-disability determination is not 

supported by substantial evidence and is not free of legal error. (ECF No. 14-

1 at 3). Specifically, Plaintiff argues that in light of Dr. Kim’s report—which 

was additional evidence submitted to and considered by the Appeals 

Council—the ALJ’s RFC assessment is not supported by substantial 

evidence. (Id. at 6, 8). Plaintiff maintains that reversal is warranted because 

Dr. Kim is a specialist who examined Plaintiff, presented medical evidence, 

 

3 Plaintiff submitted new medical evidence from Dr. Paul Kim, M.D. Dr. Kim 

examined Plaintiff on January 7, 2016 and concluded that she “has some 

inability at L2-3 with adjacent segment disease with degeneration.” Dr. Kim 

opined that “Plaintiff is unable to work” and “is quite disabled.” (A.R. 422).

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reviewed Plaintiff’s imaging reports and rendered an opinion consistent with 

the opinion of treating physician, Dr. Moon. (Id. at 7-8).

Defendant responds that because Dr. Kim’s report lacks a thorough 

functional assessment and Plaintiff’s lack of credibility is unchallenged, the 

substantial evidence that supported the ALJ’s decision is unaffected. (ECF 

No. 15-1 at 5, 6). Defendant further asserts that Plaintiff is not entitled to a 

remand based on her new medical report because it does not a have a 

reasonable possibility of changing the outcome of the ALJ’s determination. 

Defendant cites to Burton v. Heckler, 724 F.2d 1415, 1417 (9th Cir. 1984) in 

support. (Id. at 6). Plaintiff replies that Burton is inapplicable because it 

interprets Sentence Six of 42 U.S.C. § 405(g), and she “is requesting review 

under Sentence Four.”4 (ECF No. 17 at 4).

 1. Legal Standard

When, as here, “the Appeals Council considers new evidence in deciding 

whether to review a decision of the ALJ, that evidence becomes part of the 

administrative record, which the district court must consider when reviewing 

the Commissioner's final decision for substantial evidence.” Brewes v. 

Comm'r of Soc. Sec. Admin., 682 F.3d 1157, 1163 (9th Cir. 2012); see also 

Burrell v. Colvin, 775 F.3d 1133, 1136 (9th Cir. 2014).

The Ninth Circuit distinguishes among the opinions of three types of 

 

4 The Court acknowledges that it is unclear whether the materiality and good 

cause standard in Sentence Six of 42 U.S.C. § 405(g) is required to justify 

remand in light of additional evidence not before the ALJ. Compare Brewes, 

682 F.3d at 1164 (declining to apply the materiality standard), with Mayes v. 

Massanari, 276 F.3d 453, 462 (9th Cir. 2001) (requiring a showing of 

materiality and good cause). However, as more fully explained below, the 

ALJ’s decision is supported by substantial evidence, and therefore, the Court 

need not reach this issue.

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physicians: (1) those who treat the Plaintiff (“treating physicians”); (2) those 

who examine but do not treat the Plaintiff (“examining physicians”); and (3) 

those who neither examine nor treat the Plaintiff (“non-examining 

physicians”). Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1996). As a general 

rule, more weight is given to the opinions of a treating source than to that of 

a non-treating physician. Id. (citing Winans v. Bowen, 853 F.2d 643, 647 (9th 

Cir. 1987)). Likewise, the opinion of an examining physician is typically 

entitled to greater weight than that of a non-examining physician. Pitzer v. 

Sullivan, 908 F.2d 502, 506 (9th Cir. 1990).

In Orn v. Astrue, 495 F.3d 625 (9th Cir. 2007), the Ninth Circuit held:

If a treating physician's opinion is not given ‘controlling weight’ 

because it is not ‘well-supported’ or because it is inconsistent with 

other substantial evidence in the record, the Administration 

considers specified factors in determining the weight it will be 

given. Those factors include the ‘length of the treatment 

relationship and the frequency of examination’ by the treating 

physician; and the ‘nature and extent of the treatment 

relationship’ between the patient and the treating physician. 

Generally, the opinions of examining physicians are afforded more 

weight than those of non-examining physicians, and the opinions 

of examining non-treating physicians are afforded less weight 

than those of treating physicians.

Id. at 631 (internal citations omitted).

Where a non-treating, non-examining physician’s opinion contradicts 

the treating physician’s opinion, the ALJ may only reject the treating 

physician’s opinion “if the ALJ gives specific, legitimate reasons for doing so 

that are based on substantial evidence in the record.” Jamerson v. Chater, 

112 F.3d 1064, 1066 (9th Cir. 1997) (quoting Andrews v. Shalala, 53 F.3d 

1035, 1041 (9th Cir. 1995)). “The ALJ may meet this burden by setting out a 

detailed and thorough summary of the facts and conflicting evidence, stating 

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his interpretation thereof, and making findings.” Morgan v. Apfel, 169 F.3d 

595, 600-601 (9th Cir. 1999) (citing Magallanes v. Bowen, 881 F.2d 747, 750 

(9th Cir.1989)).

2. Analysis

The Court will conduct a two-step analysis regarding Plaintiff’s claim 

that Dr. Kim’s new evidence and Dr. Moon’s opinion evidence together 

outweigh the opinions of the State Medical Consultants. First, the Court will 

determine whether the ALJ properly afforded little weight to Dr. Moon. 

Second, the Court will determine whether Dr. Kim’s post hearing opinion 

would alter the ALJ’s decision. 

Here, the ALJ afforded little weight to treating physician Dr. Moon’s 

findings because he found them to be “inconsistent with the entire evidence of 

record.” (A.R. 28). The ALJ explained that Dr. Moon’s description of Plaintiff 

as “essentially permanently disabled” is unsupported by his own treatment 

records, which indicate Plaintiff’s improvement over time. (A.R. 212, 261, 

263). For example, Dr. Moon’s treatment notes describe Plaintiff as 

appearing to be only in “mild to moderate discomfort.” (A.R. 259, 261, 263). 

The treatment notes also report that Plaintiff’s pain decreased from 2013 to 

2014, as evidenced by Plaintiff reducing her Vicoprofen intake from six 

tablets a day to four and beginning to walk on a regular basis. (A.R. 259, 

261, 263). Additionally, Dr. Moon’s claim that Plaintiff’s psychological 

conditions include depression and anxiety is inconsistent with his earlier 

treatment notes, which reported that Plaintiff was “alert and oriented,” had a 

“stable” mood and denied suicidal ideation. (A.R. 263). 

Although Dr. Moon alleged that Plaintiff completed quarterly visits for 

14 years, the ALJ’s record contained no treatment records since March 2014, 

despite the ALJ’s request for updated records. (A.R. 312, 39-40, 72). 

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Plaintiff’s counsel admitted during the hearing that he requested updated 

medical records from Dr. Moon, but that they were “basically just more of the 

same.” (A.R. 39). Notably, Plaintiff admitted that she had not received any 

other treatment besides medication since she stopped working. (A.R. 53).

At the hearing, Plaintiff testified she experienced severe disc tears 

approximately three to four times a month. (A.R. 58-59). However, there are 

no treatment notes or diagnostic reports to support Plaintiff’s claim of

debilitating and repeated disc tears. Plaintiff was reluctant to consider 

surgery, resisted emergency room treatment, declined x-rays and MRI 

evaluations for her knee pain and instead chose to manage her pain by 

restricting her physical activity and taking pain pills. (A.R. 277, 56, 264). 

The Court notes that Plaintiff’s counsel asked Plaintiff very few questions 

about her back and knee during his direct examination at the hearing. (See

A.R. 59-62). The Court further notes that Plaintiff’s alleged symptoms are 

inconsistent with statements in her Exertion Questionnaire about her ability 

to perform daily activities such as driving, walking daily, running errands, 

housekeeping and gardening in two to three hour intervals. (A.R. 183-85).

Based on this record, the Court finds that the ALJ gave specific and 

legitimate reasons for affording little weight to Dr. Moon’s opinions and 

relying substantially on the non-treating, non-examining State Agency 

Medical Consultants’ opinions. See Jamerson, 112 F.3d at 1066. Plaintiff’s 

attempt to discredit the State Agency Medical Consultants’ expertise is 

unpersuasive because both consultants are familiar with Social Security 

rules, regulations and requirements, and their respective opinions are 

consistent with each other and the evidence in the record. 20 C.F.R. §§ 

404.1527(c)(4), (6). 

The Court further finds that Dr. Kim’s medical opinion does not affect 

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the ALJ’s decision because it does not add material information that would 

undermine the substantial evidence relied upon by the ALJ. In addition to a 

physical examination, Dr. Kim reviewed and relied on the December 2015 

radiographic and diagnostic studies provided by Plaintiff. (A.R. 420). Dr. 

Kim’s findings are consistent with the findings made by the doctors who 

conducted or interpreted those studies. (A.R. 420). 

Dr. Kim’s physical exam produced no findings contrary to the other 

record evidence. For example, a 14-point patient evaluation showed

Plaintiff’s neck had full range of motion, and her lumbar spine had limited 

flexion/extension with normal stability, normal lordosis, and a well healed 

incision posteriorly. (A.R. 420). Dr. Kim noted that Plaintiff was unable to 

walk on her heels and toes bilaterally, but the totality of Dr. Kim’s findings of 

Plaintiff’s lower extremities were consistent with the record medical 

evidence. (Id.). For instance, Dr. Kim opined that she had full range of 

motion in her hips, knees and ankles, no atrophy of the quadriceps or 

gastrocnemius-soleus, smooth and symmetric swing phase coordination and a 

negative straight leg raise. (Id.). Dr. Kim’s interpretation of Plaintiff’s 

radiographic images of the lumber spine revealed no hardware loosening, 

solid fusion at L4-5 and posterolateral fusion at L3-4, retrolisthesis at L2-3, 

some degeneration at L2-3 and minimal central stenosis. (Id.). Ultimately, 

Dr. Kim’s recommended treatment was for “facet blocks and see how she 

responds.” (A.R. 420). 

Accordingly, the Court does not find Dr. Kim’s report persuasive on the 

issue of Plaintiff’s disability. (A.R. 421). Dr. Kim’s opinion was obtained after

the ALJ’s adverse determination. See Weetman v. Sullivan, 877 F.2d 20, 23 

(9th Circ. 1989); Macri v. Chater, 93 F.3d 540, 544 (9th Cir. 1996). The Court 

finds that even taking into account Dr. Kim’s report, the ALJ’s RFC finding 

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and non-disability determination is supported by substantial evidence in the 

record. Brewes, 682 F.3d at 1163; see Sandgathe, 108 F.3d at 980 (defining 

substantial evidence as “relevant evidence as a reasonable mind might accept 

as adequate to support a conclusion.”); Brawner, 839 F.2d at 433 (denial of 

benefits “will be disturbed only if it is not supported by substantial evidence 

or is based on legal error.”).

The ALJ’s findings are consistent with the record as a whole. Section 

416.920b of Title 20 in the Code of Federal Regulations states that after 

reviewing all of the evidence relevant to a claimant’s claim, the ALJ makes 

findings about what the evidence shows. The ALJ is also “responsible for 

making the determination or decision about whether [a claimant] meet[s] the 

statutory definition of disability.” 20 C.F.R. § 416.927(d)(1). The Court’s 

review of the administrative record revealed no ambiguity or error indicating 

that the ALJ’s decision was based on less than substantial evidence. 42 

U.S.C. § 405(g).

Accordingly, the Court finds the ALJ’s findings of fact and conclusions 

of law, including Plaintiff’s RFC, is supported by substantial evidence and 

free of legal error.

III. CONCLUSION

The Court RECOMMENDS that Plaintiff’s Motion be DENIED and 

that Defendant’s Motion be GRANTED. This Report and Recommendation 

of the undersigned Magistrate Judge is submitted to the United States 

District Judge assigned to this case, pursuant to the provisions of 28 U.S.C. § 

636(b)(1).

IT IS HEREBY ORDERED that any written objections to this report 

must be filed with the court and served on all parties no later than August 

16, 2017. The document should be captioned “Objections to Report and 

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Recommendation.” 

IT IS FURTHER ORDERED that any reply to the objections shall be 

filed with the court and served on all parties no later than August 23, 2017. 

The parties are advised that failure to file objections within the specific time 

may waive the right to raise those objections on appeal of the Court’s order. 

Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991).

Dated: August 2, 2017

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