Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_10-cv-02008/USCOURTS-casd-3_10-cv-02008-0/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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 “Any individual, after any final decision of the Commissioner of Social Security made afer

a hearing to which he was a party . . . may obtain judicial review of such decision by a civil action .

. . brought in the district court of the United States . . . The court shall have the power to enter, upon

the pleadings and transcripts of the record, a judgment affirming, modifying or reversing the decision

of the Commissioner of Social Security, with or without remanding the cause for a rehearing. The

findings of the Commissioner . . . as to any fact, if supported by substantial evidence, shall be

conclusive . . .” 42 U.S.C. § 405(g).

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

TERESA GUARDADO NUNEZ,

Plaintiff,

CASE NO. 10cv2008-AJB (WMc)

REPORT AND

RECOMMENDATION: (1) TO

DENY PLAINTIFF’S MOTION

FOR SUMMARY JUDGMENT

AND (2) TO GRANT

DEFENDANT’S MOTION FOR

SUMMARY JUDGMENT

[ECF Nos. 10, 11]

vs.

MICHAEL J. ASTRUE, Commissioner of

Social Security,

Defendant.

I. 

INTRODUCTION

This matter is before the Court on cross-motions for summary judgment. Plaintiff Teresa

Guardado Nunez brings her motion under § 205(g) of the Social Security Act (“Act”), 42 U.S.C. §

405(g)1, seeking judicial review of the Commissioner of Social Security’s (“Commissioner”) final

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 The Administrative Law Judge’s (“ALJ”) decisions became the final decision of the

Commissioner of Social Security when the Appeals Council denied Plaintiff’s request for review. (AR

1-3).

3

 The AR page numbers cited herein are the numbers located near the bottom right corner of

the page. 

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decision denying his claim for Disability Insurance Benefits (“DIB”) under Title II of the Act.2

Plaintiff asks the Court to grant her motion for summary judgment, reversing the Commissioner’s

decision, which plaintiff argues: (1) fails to assign the proper weight to the opinions of plaintiff’s

treating and examining physicians, and thus (2) is not supported by substantial evidence. The

Commissioner concurrently seeks summary judgment to affirm the ALJ’s decision.

The Court finds the motions appropriate for submission on the papers and without oral

argument pursuant to Local Rule 7.1(d)(1). After careful review of the moving and opposition

papers, the administrative record, the facts, and the law, the Court RECOMMENDS plaintiff’s

motion for summary judgment be DENIED. The Court also RECOMMENDS defendant’s cross

motion to affirm the ALJ decision be GRANTED.

II.

PROCEDURAL HISTORY

On August 21, 2007, Plaintiff applied for Social Security Disability Insurance Benefits

alleging disability. See Administrative Record (“AR”) at 107-14.3 The Commissioner denied

plaintiff’s application initially and also on reconsideration. (AR at 53-54). Plaintiff testified at a

hearing before an Administrative Law Judge (“ALJ”). (AR 26-52). The ALJ found plaintiff

ineligible for disability benefits because she could perform jobs that existed in significant

numbers. (AR 8-25). The Appeals Council declined review of the ALJ’s decision and thus the

ALJ’s decision became the final decision of the Commissioner. (AR 1-3).

On September 29, 2010, plaintiff filed the instant complaint pursuant to §405(g) of the Act

in order to obtain judicial review of a “final decision” from the Commissioner denying her claim

for DIB. Defendant filed an answer to the complaint on December 17, 2010. [ECF Nos. 1, 6].

On February 11, 2011, plaintiff filed a motion for summary judgment. [ECF No. 10].

Defendant filed a cross-motion for summary judgment and opposition to plaintiff’s motion on

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March 10, 2011. [ECF No. 11]. Both motions were found suitable for decision without oral

argument and taken under submission. 

III.

DISCUSSION

1. Legal Standard

A claimant is entitled to disability benefits if, considering her age, education and work

experience, she is unable to perform the work she previously performed and unable “to engage in

any substantial gainful activity by reason of any medically determinable physical or mental

impairment which can be expected to last for a continuous period of not less than 12 months . . .” 

42 U.S.C. § 423(d)(1)(A). The Act further provides that an individual:

shall be determined to be under a disability only if his physical or mental impairment

or impairments are of such severity that he is not only unable to do his previous work

but cannot, considering his age, education, and work experience, engage in any other

kind of substantial gainful work which exists in the national economy, regardless of

whether such work exists in the immediate area in which he lives, or whether a specific

job vacancy exists for him, or whether he would be hired if he applied for work.

42 U.S.C. § 423(d)(2)(A). 

The Secretary of the Social Security Administration has established a five-step sequential

evaluation process for determining whether a person is disabled. 20 C.F.R. §§ 404.1520, 416.920. 

Step one determines whether the claimant is engaged in “substantial gainful activity.” If she is,

disability benefits are denied. 20 C.F.R. §§ 404.1520(b), 416.920(b). If she is not, the decision

maker proceeds to step two, which determines whether the claimant has a medically severe

impairment or combination of impairments. That determination is governed by the “severity

regulation” which provides in relevant part:

If you do not have any impairment or combination of impairments which significantly

limits your physical or mental ability to do basic work activities, we will find that you

do not have a severe impairment and are, therefore, not disabled. We will not consider

your age, education, and work experience. 

20 C.F.R. §§ 404.1520 c), 416.920 c). 

The ability to do basic work activities is defined as “the abilities and aptitudes necessary to

do most jobs.” 20 C.F.R. §§ 404.1521 (b), 416.921 (b). Such abilities and aptitudes include

“[p]hysical functions such as walking, standing, sitting, lifting, pushing, pulling, reaching,

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carrying, or handling”; “[c]apacities for seeing, hearing, and speaking”; “[u]nderstanding, carrying

out, and remembering simple instructions”; [u]se of judgment”; “[r]esponding appropriately to

supervision, co-workers, and usual work situations”; and “[d]ealing with changes in a routine work

setting.” Id. 

If the claimant does not have a severe impairment or combination of impairments, the

disability claim is denied. If the impairment is severe, the evaluation proceeds to the third step,

which determines whether the impairment is equivalent to one of a number of listed impairments

that the Secretary acknowledges are so severe as to preclude substantial gainful activity. 20 C.F.R.

§§ 404.1520 (d), 416.920 (d); 20 C.F.R. Part 404, Appendix 1 to Subpart P. If the impairment

meets or exceeds one of the listed impairments, the claimant is conclusively presumed to be

disabled. If the impairment is not one that is conclusively presumed to be disabling, the evaluation

proceeds to the fourth step, which determines whether the impairment prevents the claimant from

performing work she has performed in the past. If the claimant is able to perform her previous

work, she is not disabled. 20 C.F.R. §§ 404.1520 (e), 416.920 (e). If the claimant cannot perform

her previous work, the fifth and final step of the process determines whether she is able to

perform other work in the national economy in view of her age, education, and work experience. 

The claimant is entitled to disability benefits only if she is not able to perform other work. 20

C.F.R. §§ 404.1520 (f), 416.920 (f). 

Section 405(g) of the Act allows unsuccessful applicants to seek judicial review of a final

agency decision of the Commissioner. 42 U.S.C. § 405(g). The scope of judicial review is

limited. 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 and Human

Servs., 839 F.2d 432, 433 (9th Cir. 1988) (citing Green v. Heckler, 803 F.2d 528, 529 (9th Cir.

1986)). 

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

Sandgathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997) (citation omitted). “[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

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 The ALJ’s specific findings as to each expert’s opinion are discussed below. 

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whole, weighing both the evidence that supports and detracts from the Commissioner’s

conclusions. Desrosiers v. Secretary of Health & Human Servs., 846 F.2d 573, 576 (9th Cir.

1988) (citing Jones v. Heckler, 760 F.2d 993, 995 (9th Cir.1985)). If the evidence supports more

than one rational 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).

Even if the reviewing court finds 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. See 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 Administrator for further proceedings. Id. 

2. The ALJ’s Decision4

After weighing the evidence from the administrative record and listening to the testimony

of plaintiff and the experts, the ALJ made the following findings. Plaintiff had not performed

substantial gainful employment since her application date. (AR 16). She had severe mental and

physical impairments, but her impairments did not meet or equal any of the presumptively

disabling listed impairments. (AR 16-17). Her subjective symptom testimony was not fully

credible. (AR 19-22). Additionally, the ALJ determined: 

Claimant retains the residual functional capacity to perform work at the light exertional

level, lifting and carrying 10 pounds frequently, and 20 pounds occasionally, and

sitting, standing and walking for six hours each per eight-hour workday; with the

following nonexertional limitations: never climbing ladders, ropes or scaffolds;

occasionally climbing ramps and stairs; occasionally stooping and crouching; never

balancing, kneeling or crawling; avoiding concentrated exposure to dangerous moving

machinery, electric shock, radiation and unprotected heights; avoiding concentrated

exposure to extreme heat, cold and vibration; and mentally limited to unskilled work

with no close or frequent interpersonal contact with supervisors, co-workers, or the

public.

(AR 17-18).

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Plaintiff does not contest the ALJ’s findings regarding her physical impairments. See [ECF

Nos. 1, 10]. Plaintiff had no past relevant work, but could perform other jobs that existed in

significant numbers in the national economy. (AR 23-24). Accordingly, the ALJ found plaintiff

not disabled and thus ineligible for disability benefits. (AR 24-25). 

3. Plaintiff’s Argument

Plaintiff contends the ALJ erred in a giving “great weight” to the opinions of Drs. Paxton

and Hurwitz and “less than moderate weight” to the opinions of Drs. Heindenfelder and

Rodriguez-Reimann because Drs. Paxton and Hurwitz were merely reviewing physicians whereas

Drs. Heindenfelder and Rodriguez-Reimann were treating physicians. [ECF No. 10 at 13]. Plaintiff

asserts the opinion of a treating physician is entitled to greater weight than the opinion of a nontreating physician. Id. at 14. Accordingly, plaintiff claims the ALJ’s reliance on non-treating

physician opinions over the opinions of treating physicians was “not only illogical, but illegal.” Id.

at 13.

4. Defendant’s Argument

Defendant contends the ALJ properly relied on the opinions of Drs. Paxton and Hurwitz

and properly discounted the opinions of Drs. Heidenfelder and Rodriguez-Reimann. [ECF No. 11-

1 at 5-7]. Although defendant acknowledges that treating physician opinions are generally given

more weight than non-treating physician opinions, defendant claims an ALJ may properly discount

a treating physician’s opinion where the ALJ finds specific and legitimate evidence in the record in

support of his conclusion. Id.

5. Applicable Law

The opinions of treating physicians are generally given greater weight than those of other

physicians because of the treating physicians' intimate knowledge of the claimant's condition. 

Aukland v. Massanari, 257 F.3d 1033, 1037 (9th Cir. 2001). In order to reject the opinion of a

treating physician, the ALJ is required to show specific and legitimate reasons based on substantial

evidence from the record. Id.; see also Smolen v. Chater, 80 F.3d 1273, 1285 (9th Cir. 1996).

Substantial evidence may be based in part on the testimony of a non-treating, non-examining

medical advisor. Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 602-3 (9th Cir. 1999).

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 The ALJ noted that Dr. Heidenfelder is not board-certified in psychiatry whereas Drs.

Hurwitz and Paxton are board-certified in psychiatry. (AR 22).

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However, substantial evidence may not be based on a reviewing physician’s opinion alone, or on

the reviewing physician’s opinion and the ALJ’s personal observations. Id. Rather, substantial

evidence requires additional evidence, such as inconsistencies between the treating physicians’

reports and the testimony of the claimant. Id. Additionally, an ALJ may properly discount a

treating physician’s opinion where the treating physician relies heavily on the subjective

complaints of the claimant. See Id. However, where the ALJ fails to provide adequate reasons for

rejecting the treating physician's opinion, the court will credit the treating physician's opinion as a

matter of law. Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995).

6. Analysis

As explained above, in order to reject the opinion of a treating physician the ALJ is

required to show specific and legitimate reasons based on substantial evidence from the record. 

a. Dr. Heidenfelder

In his report to the ALJ, Dr. Heidenfelder opined that plaintiff was moderately or markedly

limited in all but one of twenty areas of work functioning. (AR 276-77). Dr. Heidenfelder also

indicated plaintiff had a long history of severe depression with minimal improvement despite two

years of medication and therapy. (AR 278). The ALJ gave “less than moderate weight” to Dr.

Heidenfelder’s opinion based on the following factors: (1) Dr. Heidenfelder’s treatment notes did

not support his conclusion; (2) the reviewing physicians’ opinions credited plaintiff with greater

potential ability than Dr. Heidenfelder;5

 and (3) Dr. Heidenfelder’s opinion was inconsistent with

plaintiff’s daily activities. (AR 22). 

After reviewing the record, this Court concludes that the ALJ identified legitimate and

substantial evidence from the record to discount Dr. Heidenfelder’s opinion. See Morgan, 169 F.3d

at 602-03. This evidence included the expert opinions of the board-certified reviewing physicians,

the discrepancies between Dr. Heidenfelder’s opinion and his treatment notes, the inconsistencies

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 The ALJ noted the discrepancy between Claimant’s global assessment of functioning test

(GAF) score of 60, indicating mild to moderate symptomatology, and Dr. Heidenfelder’s assessment

that Plaintiff has “marked” limitations in multiple functioning areas. (AR 22). 

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between Dr. Heidenfelder’s opinion and his own psychiatric function testing,6 and the

discrepancies between Dr. Heidenfelder’s opinion and plaintiff’s admitted activities. See Id.

The ALJ also cited specific evidence to support his finding of discrepancies in the record.

For example, the ALJ noted “[Dr. Heidenfelder’s] opinion that the claimant has “marked”

limitations in adhering to a schedule is flatly contradicted by her record of treatment with him. In

more than 100 appointments over nearly four years, she did not miss any appointments and was

late only once.” (AR 22). The ALJ also found Dr. Heidenfelder’s assessment of marked functional

limitations was inconsistent with claimant’s admitted daily activities which included caring for her

twin sixteen year-old daughters, driving, shopping, cooking, cleaning, reading, visiting friends,

paying bills and managing a checking account. Id. Finally, the ALJ considered the reviewing

physicians’ opinions regarding the claimant’s functional capacity as well Dr. Heindenfelder’s

treatment notes. (AR 21-22).

Despite this evidence, plaintiff’s argument has some merit. After all, Drs. Heindenfelder

and Rodriguez-Reimann saw plaintiff a combined 260 times whereas Drs. Paxton and Hurwitz

merely reviewed Plaintiff’s medical records. (AR 22). When competing experts disagree, it is

reasonable (indeed required by law) for the ALJ to apply greater weight to the treating physician’s

opinion. Morgan, 169 F.3d at 602. However, this rule is not absolute, and for good reason. See

Morgan, 169 F.3d at 602-3. If the rule were absolute, the ALJ in the instant case would have been

forced to accept Dr. Heindenfelder’s opinion despite conflicting evidence from his own treatment

notes and the admissions of the claimant. Such a rule would subvert the role of the ALJ because

“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).

Based on the evidence identified above, this Court concludes the ALJ cited specific and

legitimate reasons to accord Dr. Heidenfelder’s opinion with “less than moderate weight.” Id.

Further, the Court finds these specific and legitimate reasons were based on more than the

reviewing physician’s opinions and the personal observations of the ALJ. Thus, the ALJ relied on

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substantial evidence in making its determination. See Morgan, 169 F.3d at 602-3.

b. Dr. Rodriguez-Reimann

Dr. Rodriguez-Reimann submitted a letter to the ALJ in which she described her history

with plaintiff and opined that plaintiff was “very responsible” in following up with treatment

appointments and medication recommendations. (AR 293). Also, Dr. Rodriguez-Reimann

submitted a form that indicated plaintiff was moderately or markedly limited in all but one of

twenty areas of work functioning. (AR 294-95). The ALJ gave “less than moderate weight” to Dr.

Rodriguez-Reimann because her opinion was not supported by progress notes, her statement that

Plaintiff was “very responsible” with medication compliance was inconsistent with the record, and

she relied to a large extent on Plaintiff’s subjective statements in forming her opinion. (AR 22-23).

After reviewing the record, this Court concludes the ALJ cited specific reasons to discount

Dr. Rodriguez-Reimann’s opinion. After noting Dr. Rodriguez-Reimann’s pecuniary bias, the ALJ

noted Dr. Rodriguez-Reimann did not submit progress notes, clinic notes, or standardized testing

to substantiate her opinion. (AR 22-23). The ALJ then examined her unsupported opinions and

found her statement that the claimant “was very responsible” with her medication “flatly

contradicted” by the treating notes of the claimant’s other treating physician, Dr. Heidenfelder.

(AR 23). Given the absence of supporting clinical notes or testing and the presence of

contradictory evidence, the ALJ concluded Dr. Rodriguez-Reimann’s opinions relied too heavily

on the claimant’s “self-reporting.” (AR 23). 

The Court finds these specific reasons legitimate because “an ALJ may discredit treating

physicians’ opinions that are conclusory, brief, and unsupported by the record as a whole . . .” See

Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004). Here, Dr. RodriguezReimann’s opinion was not supported by the record because (a) she failed to provide corroborating

clinical evidence, (b) her opinion was undermined by conflicting evidence in Dr. Heidenfelder’s

treatment notes, (c) two board-certified psychiatrists concluded the claimant was not disabled, and

(d) there is no indication Dr. Rodriguez-Reimann relied on any evidence other than claimant’s

subjective statements. Moreover, the ALJ properly discounted Dr. Rodriguez-Reimann’s opinion

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 The ALJ found claimant not credible. Plaintiff does not contest the ALJ’s finding that she

was not credible. 

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because she relied heavily on the claimant’s own statements and the ALJ found the claimant’s

testimony not credible.7

 See Morgan, 169 F.3d at 603.

Accordingly, the ALJ properly discounted Dr. Rodriguez-Reimann’s opinion.

c. Drs. Hurwitz and Paxton

The ALJ gave “great weight” to the opinions of Drs. Hurwitz and Paxton for the following

reasons: (1) both doctors are board-certified psychiatrists and have experience with the Social

Security disability program, (2) their opinions are supported by the record, including the

claimant’s admitted activities of daily life, and (3) both doctors had the benefit of reviewing the

entire medical record. (AR 21). 

Plaintiff does not provide any substantive argument or point to any evidence in the record

to discount Drs. Hurwitz’ and Paxton’s opinions other than their status as reviewing physicians. 

Because “the opinions of non-treating or non-examining physicians may . . . serve as substantial

evidence when the opinions are consistent with independent clinical findings or other evidence in

the record” the Court finds Plaintiff’s argument to the contrary unavailing. See Thomas v.

Barnhart, 278 F.3d 947, 957 (9th Cir. 2002). Indeed, the independent clinic findings of Dr.

Heidenfelder (finding claimant was within normal limits as to judgment, mood, insight, behavior,

speech, attitude, appearance, thought process, thought content, etc. on during numerous clinical

evaluations) and the claimant’s admitted activities (including caring for her twin sixteen year-old

daughters, driving, shopping, cooking, cleaning, reading, visiting friends, paying bills and

managing a checking account) are consistent with Drs. Hurwitz’ and Paxton’s opinions and thus

demonstrate the ALJ made a reasoned decision based on substantial evidence. See Id.

 Accordingly, IT IS RECOMMENDED the Court find the ALJ properly determined the

weight to apply to the relevant expert opinions.

///

///

///

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IV.

CONCLUSION AND RECOMMENDATION

For the reasons explained above, IT IS HEREBY RECOMMENDED the Court DENY

Plaintiff’s motion for summary judgment, GRANT the Commissioner’s cross-motion for summary

judgment.

IT IS ORDERED that no later than February 24, 2012, any party to this action may file

written objections with the Court and serve a copy on all parties. The document should be

captioned “Objections to Report and 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 March 2, 2012. The parties are advised that failure to file

objections within the specified time may result in waiver of the right to raise those objections on

appeal of the Court’s order. See Turner v. Duncan, 158 F.3d 449, 455 (9th Cir. 1998); see also

Martinez v. Ylst, 951 F.2d 1153, 1156 (9th Cir. 1991).

IT IS SO ORDERED.

DATED: February 13, 2012

Hon. William McCurine, Jr.

U.S. Magistrate Judge

United States District Court

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