Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-00186/USCOURTS-azd-2_12-cv-00186-0/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 

Teresa Wade, 

Plaintiff, 

v. 

Michael J. Astrue, Commissioner of Social 

Security, 

Defendant. 

No. CV-12-0186-PHX-DGC

ORDER 

 Plaintiff Teresa Wade applied for disability insurance benefits and supplemental 

security income in August 2007 (Tr. 197-206), claiming to have been disabled since 

November 5, 2003 (id. at 207). The applications were denied initially on February 1, 

2008, (Tr. 138-139, 142-49), and upon reconsideration on September 18, 2008 (Tr. 140-

141, 151-57). A hearing before an Administrative Law Judge (“ALJ”) was held on 

June 21, 2010. Tr. 78. The ALJ issued a written decision on October 8, 2010, finding 

that Plaintiff was not disabled within the meaning of the Social Security Act. Tr. 43-67. 

The ALJ’s decision became Defendant’s final decision when the Appeals Council denied 

review. Tr. 1-12. Plaintiff then commenced this action for judicial review pursuant to 42 

U.S.C. § 405(g). Doc. 1. The Parties have not requested oral argument. For reasons that 

follow, the Court will affirm Defendant’s decision. 

I. Standard of Review.

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

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

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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). The Court cannot affirm the 

decision “simply by isolating a specific quantum of supporting evidence.” Day v. 

Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975); see Robbins, 466 F.3d at 882. 

II. Analysis. 

 Whether a claimant is disabled is determined using a five-step sequential 

evaluation process. The claimant bears the burden in steps one through four. To 

establish disability the claimant must show (1) she is not currently working, (2) she has a 

severe medically determinable physical or mental impairment, and (3) the impairment 

meets or equals a listed impairment or (4) her residual functional capacity (“RFC”) 

precludes him from performing her past work.1

 At step five, the Commissioner bears the 

burden of showing that the claimant has the RFC to perform other work that exists in 

substantial numbers in the national economy. 20 C.F.R. § 416.920(a)(4)(i)-(iv); see 20 

C.F.R. pt. 404, subpt. P, app. 1 (Listing of Impairments). “The Commissioner can meet 

this burden through the testimony of a vocational expert or by reference to the Medical 

Vocational Guidelines[.]” Thomas v. Barnhart, 278 F.3d 947, 955 (9th Cir. 2002) (citing 

Tackett v. Apfel, 180 F.3d 1094, 1099 (9th Cir. 1999)). 

 Plaintiff has not worked since the alleged onset date of disability. Tr. 80-81. The 

ALJ found that Plaintiff has the following severe combination of impairments: 

degenerative disc disease, fibromyalgia, chronic pain disorder, obesity, and affective 

disorder. Tr. 48-53. The ALJ determined that these impairments are not severe enough 

 

1

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

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

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to meet or equal a listed impairment. Tr. 53-54. The ALJ concluded that while Plaintiff 

is not able to perform her past work (Tr. 60-62), she is not disabled because she has the 

RFC to perform sedentary work (Tr. 54) which works exists in substantial numbers in the 

national economy (Tr. 60-62). 

 Plaintiff argues that the ALJ erred by discounting Plaintiff’s testimony (Doc. 17 at 

9-17), by failing to properly weigh medical source opinion evidence (id. at 17-23), by 

discounting third party evidence (id. at 23-24), and by relying upon inaccurate and 

unreliable vocational expert testimony (id. at 24-26). Defendant contends the decision is 

supported by substantial evidence and free from legal error. Doc. 18 at 9. 

A. Plaintiff’s Testimony.

 Plaintiff testified that on November 5, 2003, her alleged onset date, she suffered 

from back pain, seasonal depression, and aches and pains of her entire body. Tr. 80-82. 

Plaintiff stated that on November 5, 2003, she could walk for approximately 30 minutes, 

stand for approximately 45-60 minutes, and sit for approximately 60-90 minutes before 

pain or fatigue would force her to stop. Tr. 83-84. She stated that 20 pounds was the 

most she could lift and carry with her right or left arm. Tr. 84. 

 Plaintiff testified that her health, and specifically her back pain and depression, has 

worsened from her alleged onset date. Tr. 88. Plaintiff stated that she has been informed 

by doctors that she is not a candidate for back surgery because her pain is not severe 

enough. Tr. 88-89. Since 2009, Plaintiff stated that she has seen physicians’ assistant 

(“P.A.”) Robert S. Dawson about twice a month for a Teradol pain shot injection in her 

back. Tr. 90. As of the date of the hearing, Plaintiff testified that she could walk for 

approximately 20 minutes, stand for approximately 20-25 minutes, and sit for 

approximately 15-45 minutes before she would have to stop. Tr. 84-86. Plaintiff stated 

that she could carry 5-10 pounds with both arms, but that she could not bend and lift any 

weight off the ground, although she could lift a 5-10 pound object from table height. 

Tr. 86-87. 

 Plaintiff testified that she last worked in security for a county courthouse. Tr. 97. 

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She stated that she was fired because she would cry at work due to her depression and ask 

to leave early in order to lie down due to her back pain. Tr. 97-100. Plaintiff stated that 

at the time she was fired in November 2003, she would need to lie down for 

approximately 90 minutes. Tr. 100. Plaintiff testified that she still needs to lie down 

during the day because of her back pain. Tr. 100. Plaintiff stated that on average she 

needs to lie down five times a day for approximately 20-30 minutes. Tr. 101. 

 Plaintiff testified that she has lost approximately 17 pounds because of changes 

made to her diet. Tr. 102. Plaintiff testified that she does not exercise and has not done 

any regular exercise since her alleged onset date. Id. 

 Plaintiff testified that she last saw Dr. Monica Taylor-Desir, a psychiatrist, in 

November 2005, and that she then began seeing Lezlie Duckett, a registered nurse 

practitioner (“R.N.P.”). Tr. 93-94. Plaintiff testified that the last time she saw Duckett 

was in September or October of 2009 and that she has not seen a doctor or nurse since 

then. Tr. 95. 

 The ALJ found that Plaintiff’s statements concerning the intensity, persistence, 

and limiting effects of her symptoms were not credible to the extent they are inconsistent 

with the RFC assessment. In reaching this conclusion, the ALJ evaluated Plaintiff’s 

testimony using the two-step analysis established by the Ninth Circuit. See Smolen v. 

Chater, 80 F.3d 1273, 1281 (9th Cir. 1996). Applying the test of Cotton v. Bowen, 799 

F.2d 1403 (9th Cir. 1986), the ALJ first determined that Plaintiff’s impairments could 

reasonably produce the symptoms alleged. Tr. 56. Given this conclusion, and because 

there is no evidence of malingering,2

 the ALJ was required to present “specific, clear and 

convincing reasons” for finding Plaintiff not entirely credible. Smolen, 80 F.3d at 1281. 

This clear and convincing standard “is the most demanding required in Social Security 

cases.” Moore v. Comm’r Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002). 

 

2

 The Commissioner contends that the “clear and convincing” standard should not apply in part because there was evidence of malingering. Doc. 18 at 11, n. 11. While the 

record may have supported the ALJ making such a finding, the ALJ did not. 

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 “Pain of sufficient severity caused by a medically diagnosed ‘anatomical, 

physiological, or psychological abnormality’ may provide the basis for determining that a 

claimant is disabled.” Light v. SSA, 119 F.3d 789, 792 (9th Cir. 1997) (citing 42 U.S.C. 

§ 423(d)(5)(A)); Bunnell v. Sullivan, 947 F.2d 341, 344-45 (9th Cir. 1991)). “Once a 

claimant produces objective medical evidence of an underlying impairment, an ALJ may 

not reject a claimant’s subjective complaints based solely on lack of objective medical 

evidence to fully corroborate the alleged severity of pain.” Moisa v. Barnhart, 367 F.3d 

882, 885 (9th Cir. 2004) (citation and alterations omitted); see 20 C.F.R. 

§ 404.1529(c)(2); SSR 96-7p, 1996 WL 374186, at *1 (July 2, 1996). 

 Additionally, although “[a]n ALJ’s finding that a claimant generally lacked 

credibility is a permissible basis to reject excess pain testimony, . . . a finding that the 

claimant lacks credibility cannot be premised wholly on a lack of medical support for the 

severity of the pain.” Light, 119 F.3d at 792 (citations omitted). General assertions that 

the claimant's testimony is not credible are insufficient. See Parra v. Astrue, 481 F.3d 

742, 750 (9th Cir.2007). The ALJ must identify “what testimony is not credible and what 

evidence undermines the claimant’s complaints.” Id. (quoting Lester, 81 F.3d at 834). In 

weighing a claimant’s credibility, the ALJ may consider some of the following factors: 

claimant’s reputation for truthfulness, inconsistencies either in claimant’s testimony or 

between her testimony and her conduct, unexplained or inadequately explained failure to 

seek treatment or to follow a prescribed course of treatment, claimant’s daily activities, 

claimant’s work record, and the compatibility of claimant’s testimony with the medical 

evidence. Thomas, 278 F.3d at 958-59. 

 In this case, the ALJ rejected Plaintiff’s testimony on four grounds. First, the ALJ 

found that Plaintiff’s pain and other symptom allegations “exceed the limitations 

reasonably expected from the medical findings,” (Tr. 56), and noted the following 

objective evidence as support for his finding: (1) spinal imaging and clinical findings are 

generally described as “mild,” “minimal,” and “small”; (2) a February 2006 MRI of the 

thoracic spine showed mild disc degeneration in the lower thoracic spine with no 

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evidence of disc herniation; (3) a MRI of the lumbar spine showed disc space narrowing 

and disc degeneration at the L2-3, L4-5 and L5-S1 levels; (4) mild central narrowing was 

seen at L2-3; (4) no neural foraminal compromise was identified; (5) small central disc 

herniation was seen at L5-S1 causing no significant central stenosis or neural foraminal 

compromise; (6) facet degenerative changes at L4-5 and L5-S1 bilaterally; and (7) 

Physician’s Assistant Robert S. Dawson noted in February 2010 that x-rays of the spine 

showed “mild degenerative changes throughout.” Tr. 56. 

 Second, the ALJ noted that the objective evidence did not show that Plaintiff 

suffered two common side effects of prolonged and/or chronic pervasive pain: weight 

loss and diffuse atrophy or muscle-wasting. Tr. 56. The record did show that Plaintiff 

lost about 17 pounds from her alleged onset date, but the ALJ found that this was not a 

significant amount of weight loss, particularly given Plaintiff’s statement that this weight 

loss was due to diet changes. Id.; Tr. 102. The ALJ noted that there was no evidence in 

the record regarding diffuse atrophy or muscle-wasting. T.R. 56. From this the ALJ 

inferred that “although [Plaintiff] undoubtedly experiences some degree of pain, that pain 

has apparently not altered the use of muscles and joints to the extent that it has resulted in 

diffuse atrophy or muscle-wasting.” Id.

 Third, the ALJ noted Plaintiff’s testimony that she is able to handle daily activities 

that are inconsistent with her complaints of disabling symptoms and limitations. Tr. 56. 

These activities include handling her personal care, preparing simple meals, taking care 

of others and pets, handling personal finances, shopping in stores and by computer, 

driving, visiting with friends, watching television, walking, reading, participating in yoga 

sessions, and attending school for approximately four months. Tr. 56-57. The ALJ 

further noted that “the physical and mental requirements of these household tasks and 

social interaction are consistent with a significant degree of overall functioning.” Tr. 57. 

 Fourth, the ALJ found that Plaintiff was non-compliant with a prescribed course of 

treatment. Tr. 57. The ALJ noted that in March 2005, Melanie Dunham, family nurse 

practitioner (“F.N.P.”), addressed Plaintiff’s fibromyalgia diagnosis by suggesting that 

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exercise and activities of daily living were strongly encouraged but needed to start slowly 

and gradually increase with time. Id. The ALJ found, however, that Plaintiff had not 

undertaken regular exercise from her alleged onset date to the date of the hearing. Id. 

The ALJ concluded that Plaintiff was “less than credible with respect to the extent to 

which her impairments preclude the performance of work-related activities, especially 

when she has failed to follow the [] recommendations.” Id.

 Plaintiff argues that the ALJ improperly rejected her subjective symptom 

testimony due to a lack of supporting evidence. Doc. 17 at 7. Plaintiff notes that 

“fibromyalgia is not expected to result in the abnormal objective data sought by the ALJ 

herein” and cites to SSR 12-2P, 2012 WL 3104869 (July 25, 2010), Preston v. Secretary 

of Health and Human Services, 854 F.2d 815, 817-19 (6th Cir. 1988) (referring to 

fibromyalgia as “fibrositis”), and Sarchet v. Chater, 78 F.3d 305, 307 (7th Cir. 1996) 

(ALJ misunderstood fibromyalgia and the disease’s symptoms) for support. Doc. 17 at 7-

8. Moreover Plaintiff contends that fibromyalgia pain cannot be objectively quantified 

and that she need not do so to establish disability. Id. at 11. 

 SSR 12-2P provides that once a person is determined to have fibromyalgia her 

statements about symptoms and functional limitations are to be evaluated according to 

the two-step process set forth in SSR 96-7P. These policies provide that “[i]f objective 

medical evidence does not substantiate the person’s statements about the intensity, 

persistence, and functionally limiting effects of symptoms, we consider all other evidence 

in the case record.” SSR 12-2P, 2012 WL 3104869 at *5. Here, the ALJ’s finding was 

based in part on a lack of objective medical evidence – that Plaintiff had mild, minimal, 

or small disc degeneration, narrowing, or herniation in her back. Tr. 56; see Carmickle v. 

Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1161 (9th Cir.2008) (“Contradiction with the 

medical record is a sufficient basis for rejecting the claimant’s subjective testimony.”) 

(citation omitted); Batson v. Comm’r Soc. Sec. Admin., 359 F.3d 1190, 1197 (9th 

Cir.2004) (lack of objective medical evidence supporting claimant’s allegations 

supported ALJ’s finding that claimant was not credible). But the ALJ did not stop there. 

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As noted above, he also found that Plaintiff’s daily activities were not consistent with her 

alleged level of symptoms, that she did not show the weight loss and muscle compromise 

associated with the levels of pain she alleged, and that she did not comply with exercise 

recommendations made for treatment of her fibromyalgia. The Court concludes that the 

ALJ’s conclusion is consistent with SSR 12-2P and SSR 96-7P and was not erroneous. 

 Plaintiff also raises specific objections to the ALJ’s credibility determinations 

based on Plaintiff’s daily activities and alleged non-compliance with medical 

recommendations. Doc. 17 at 12-15. As to Plaintiff’s daily activities, the Court finds 

that the ALJ “properly considered Plaintiff’s daily activities in finding [her] testimony 

incredible.” Curry v. Astrue, No. 09-CV-2580-PHX-GMS, 2010 WL 3789535, at *6 (D. 

Ariz. Sept. 22, 2010); see Thomas, 278 F.3d at 958-59 (the ALJ did not err in rejecting 

the claimant’s pain testimony where the claimant “was able to perform various household 

chores such as cooking, laundry, washing dishes, and shopping”). “Although evidence of 

[the claimant’s] daily activities may also admit of an interpretation more favorable to [the 

claimant], the ALJ’s interpretation was rational, and we must uphold the ALJ’s decision 

where the evidence is susceptible to more than one rational interpretation.” Burch v. 

Barnhart, 400 F.3d 676, 680-81 (9th Cir. 2005) (quotation marks and citations omitted) 

(ALJ found claimant “able to care for her own personal needs, cook, clean and ship” and 

concluded that these activities “suggest she is quote functional.”). 

 Plaintiff argues that the ALJ erred in discrediting her testimony due to her noncompliance with medical advice. Doc. 17 at 13. Plaintiff contends that she followed 

“doctor advice to exercise, but same was no longer beneficial and therefore she did not 

continue to exercise ‘regularly.’” Id. Plaintiff points to evidence in the record that she 

followed advice to exercise during her alleged disability period, but when asked at the 

hearing if she had “done any regular exercise whatsoever” between November of 2003 

and the present, she testified she does not do regular exercise. Tr. 102. Given this direct 

evidence, the ALJ did not err in discrediting Plaintiff’s testimony due to her failure to 

follow a course of treatment prescribed in 2005. 

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 The Court concludes that substantial evidence supports the ALJ’s credibility 

determination, and that the ALJ provided clear and convincing reasons for discounting 

Plaintiff’s credibility. 

B. Medical Source Opinions. 

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

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

374183, at *2 (July 2, 1996). The Ninth Circuit distinguishes between the opinions of 

treating physicians, examining physicians, and non-examining physicians. See Lester v. 

Chater, 81 F.3d 821, 830 (9th Cir. 1996). Generally, an ALJ should give greatest weight 

to a treating physician’s opinion and more weight to the opinion of an examining 

physician than a non-examining physician. See Andrews v. Shalala, 53 F.3d 1035, 1040-

41 (9th Cir. 1995); 20 C.F.R. § 416.927(d)(1), (2). A treating physician’s opinion is not 

necessarily conclusive of a physical impairment or the ultimate issue of disability, 

however, and an ALJ need not accept such an opinion if it is brief, conclusory, and 

unsupported by clinical findings. See Thomas, 278 F.3d at 956-57 (citing Matney v. 

Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992)). 

 Where the treating physician’s opinion is credible and uncontroverted, the ALJ 

must provide clear and convincing reasons for rejecting it. Id.; Regennitter v. Comm’r 

Soc. Sec. Admin., 166 F.3d 1294, 1298-99 (9th Cir. 1999). Even if a treating physician’s 

opinion is controverted by a non-treating physician’s opinion, the ALJ must make 

findings setting forth “‘specific, legitimate reasons’ supported by substantial evidence in 

the record” for rejecting it. Lester, 81 F.3d at 830 (quoting Murray v. Heckler, 722 F.2d 

499, 502 (9th Cir. 1983)); see Thomas, 278 F.3d at 957. “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.’” Thomas, 278 F.3d at 

957 (quoting Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)). One specific, 

legitimate reason is where the treating physician’s opinion is premised on the claimant’s 

subjective complaints, which the ALJ had already properly discounted. See Fair v. 

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Bowen, 885 F.2d 597, 605 (9th Cir. 1989). Where the treating physician’s opinion is 

controverted by a non-treating physician’s opinion based on independent clinical 

findings, the non-treating physician’s opinion itself may be substantial evidence. See 

Thomas, 278 F.3d at 957 (citing Morgan v. Comm’r Soc. Sec. Admin., 169 F.3d 595, 600 

(9th Cir. 1999)). “‘When there is conflicting medical evidence, the [ALJ] must determine 

credibility and resolve the conflict.’” Id. (quoting Matney, 981 F.2d at 1019); see also

Andrews, 53 F.3d at 1041 (citing Magallanes, 881 F.2d at 751). 

 Opinions of examining or consulting physicians alone may constitute substantial 

evidence supporting the ALJ’s decision when they are consistent with other evidence in 

the record. See Magallanes, 881 F.2d at 752 (“[T]he reports of consultative physicians . . 

. may serve as substantial evidence.”); Thomas, 278 F.3d at 957 (“The opinions of nontreating or non-examining physicians may . . . serve as substantial evidence when the 

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

record.”); see also 20 C.F.R. § 404.1527(e) (stating that the opinions of non-examining 

physicians constitute medical evidence). 

 Physicians’ assistants and nurse practitioners are considered “other sources,” 

20 C.F.R. § 404.1513(d)(1), and although not “acceptable medical sources,” 20 C.F.R. 

§ 404.1513(a), an ALJ must take into account other source opinion evidence unless he or 

she expressly determines to disregard it and provides germane reasons for doing so. Cole 

v. Astrue, 395 Fed. Appx. 387, 389 (9th Cir. 2010); see also Turner v. Comm’r Soc. Sec.,

613 F.3d 1217, 1224 (9th Cir. 2010); Lewis v. Apfel, 236 F.3d 503, 511 (9th Cir. 2001). 

 1. Melanie Dunham, F.N.P.

 Melanie Dunham, F.N.P., stated in a letter dated March 7, 2005, that “exercise and 

activities of daily living were strongly encouraged, but need to start slowly and gradually 

increase such activities with time.” Tr. 487. At the time, Dunham also indicated that 

Plaintiff “may need to start working gradually, less than 12 hours per work,” but that 

“[a]fter a period of time hopefully this number can increase.” Id. In a letter dated 

May 16, 2006, Dunham noted that Plaintiff experienced chronic pain and extreme 

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fatigue, and opined that “an ideal work setting for [Plaintiff] would be one that is flexible 

and not at all strenuous. A part time job with no expectations of lifting anything greater 

than 5-10 pounds would be a reasonable employment arrangement.” Tr. 466. In a letter 

dated July 12, 2006, Dunham again noted that Plaintiff “has a chronic condition that 

limits her ability to work at full capacity or forty hours a week.” Tr. 461. At that time, 

Dunham indicated that “[a] part-time, flexible position would be more appropriate [for 

Plaintiff].” Id. The ALJ gave these opinions limited weight because “they are 

conclusory and are not adequately supported by clinical signs and laboratory findings in 

the contemporaneous treatment notes.” Tr. 58. The ALJ also noted that as a nurse 

practitioner, Dunham was not an “acceptable medical source,” and that she had opined 

that Plaintiff was capable of working, albeit with restrictions. Id. Plaintiff does not 

appear to object to the weight the ALJ afforded Dunham’s opinion. 

 2. Robert S. Dawson, P.A.

 Robert S. Dawson, P.A., saw Plaintiff six times from January through May 2010. 

Tr. 776-94. During this treatment period, Dawson noted impairments and diagnoses of 

nausea, vomiting, inability to take medications, possible upper gastrointestinal 

dysmotility which significantly worsens fibromyalgia, depression, hypothyroidism, 

irritable bowel syndrome, and non-inflammatory gastroesophageal reflux disease. Id. On 

February 4, 2010, Dawson noted that x-rays of Plaintiff’s spine showed “[m]ild 

[d]egenerative changes throughout.” Tr. 778. On March 30, 2010, Dawson opined that 

Plaintiff was unable to work eight hours a day, five days a week on a regular and 

consistent basis. Tr. 872. Specifically, Dawson opined that Plaintiff would be limited to 

less than two hours per day of sitting, standing or walking, and that she could not lift or 

carry more than 15 pounds. Id. His assessment noted that at the time Plaintiff was “not 

able to take medications,” which “significantly worsens [her diagnoses].” Id. The ALJ 

gave Dawson’s opinion “limited weight” because it is inconsistent with the “sparse 

contemporaneous treatment records, which provided very limited clinical findings and 

basically list [Plaintiff]’s subjective complaints and past medical assessments.” Tr. 58. 

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The ALJ also noted that Dawson, a physician’s assistant, is not an “acceptable medical 

source.” Id.

 Plaintiff argues that the ALJ erred in not considering the factors set forth in SSR 

06-03p for evaluating the opinion of a non-acceptable medical source. Doc. 17 at 22. 

Plaintiff also submits that limiting the weight afforded Dawson’s opinion because of the 

“limited clinical findings” is an improper rational regarding the effect of fibromyalgia 

pain. Id. Defendant responds that the ALJ reasonably discounted Dawson’s opinions 

because Dawson treated Plaintiff at a time when her symptoms were at their very worst, 

and thus Dawson could not provide a “detailed, longitudinal picture” of Plaintiff’s 

impairments pursuant to 20 C.F.R. § 404.1527(c)(2). Doc. 18 at 17. 

 As noted above, an ALJ need only provide germane reasons for discounting “other 

source” opinion evidence. The Court concludes that the ALJ’s weighing of Dawson’s 

opinion, in which he identified sparse treatment records, limited clinical findings, and 

reliance on Plaintiff’s subjective complaints as problematic (Tr. 58), satisfies this modest 

standard. 

 3. Dr. Robert Barker.

 On January 29, 2008, Dr. Robert Barker, state agency medical examiner, 

examined Plaintiff. Tr. 51518-24. He concluded that Plaintiff “has a normal physical 

examination except for being overweight” (Tr. 520), and opined that Plaintiff’s obesity 

diagnosis did not constitute a condition that would impose any limitations on Plaintiff for 

12 continuous months (Tr. 521). 

 The ALJ gave this opinion “limited weight as previous examinations have 

demonstrated limitations of back range or motion and tender points.” Tr. 58. Plaintiff 

argues the ALJ found some limitations in Plaintiff’s RFC (Tr. 54) and thus the ALJ 

actually rejected Dr. Barker’s opinion (Doc. 17 at 22-23). The Court concludes that any 

error in how the ALJ weighed Dr. Barker’s opinion is harmless because the ALJ imposed 

more limitations in Plaintiff’s RFC than Dr. Barker recommended, and these additional 

limitations benefit Plaintiff. Tommasetti, 533 F.3d at 1038 (“the court will not reverse an 

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ALJ’s decision for harmless error, which exists when it is clear from the record that the 

ALJ’s error was inconsequential to the ultimate nondisability determination.” (quotation 

marks and citations omitted)). 

 4. Dr. Ernest Griffith.

 Dr. Ernest Griffith, a state agency medical consultant, opined that Plaintiff could 

stand, walk, or sit for six hours in an eight-hour workday and lift and carry 5-10 pounds. 

Tr. 525-32. The ALJ gave this opinion significant weight because it was consistent with 

the evidence overall. Tr. 58. Plaintiff objects to the weight afforded this opinion, 

arguing that Dr. Griffith’s assessment does not reflect an examination or review of actual 

treatment notes and rather relies on reports rejected by the ALJ. Doc. 17 at 23. 

 Although the ALJ gave “substantial” weight to the opinion of Dr. Griffith (Tr. 58), 

this constitutes legal error only if his opinion is not consistent with independent clinical 

findings or other evidence in the record. See Thomas, 278 F.3d at 957. Dr. Griffith’s 

opinion is consistent with other evidence in the record (Tr. 56-59), but it is also at odds 

with the other source treating opinion of Dawson (Tr. 872). The Court found previously 

that the ALJ stated germane reasons for discounting Dawson’s opinion, and thus the ALJ 

did not err in giving substantial weight to Dr. Griffith’s opinion when other evidence in 

the record supported it. See Morgan, 169 F.3d at 600 (“Opinions of nonexamining, 

testifying medical advisor may serve as substantial evidence when they are supported by 

other evidence in the record and are consistent with it.”). Further, any error in the ALJ’s 

weighing of Dr. Griffith’s opinion is harmless because the ALJ imposed a sedentary RFC 

and thus imposed greater limitations on Plaintiff’s RFC than recommended by Dr. 

Griffith. See Tommasetti, 533 F.3d at 1038. 

 5. Lezlie Duckett, R.N.P. 

Lezlie Duckett opined in November 2008 that Plaintiff had several psychiatric 

limitations and restrictions, including that she was severely limited in her ability to relate 

to other people; to understand, carry out and remember instructions; to respond 

appropriately to supervisors, co-workers and customary work pressures; to perform 

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complex tasks; and to perform varied tasks. Tr. 734-35. Duckett indicated that the level 

of severity existed as of August 2003. Tr. 735. The ALJ gave this assessment “limited 

weight” because “although [Duckett] acknowledges and has considered [Plaintiff]’s 

treatment history[,] . . . the contemporaneous treatment notes do not support such a 

restrictive assessment.” Tr. 58-59. The ALJ noted Plaintiff’s long treatment history, but 

concluded that Plaintiff’s depression and anxiety “appeared to be well controlled by 

medication for significant periods of time.” Tr. 59. The ALJ supported this conclusion 

by Dr. Taylor Desir’s August 2007 notes indicating that Plaintiff had limited medication 

adjustments (Tr. 638), from which the ALJ concluded that Plaintiff’s treatment was 

effective (Tr. 59). 

 Plaintiff argues that the ALJ erred in limiting the weight afforded to Duckett’s 

opinion and submits that the treatment notes are actually consistent with disability. 

Doc. 17 at 20-22. Defendant argues the ALJ did not err in limiting the weight given to 

Duckett’s opinion because the more recent records showed the symptoms as moderate 

(Tr. 769-72), which is inconsistent with Duckett’s opinion (Doc. 18 at 19). The Court 

will not consider Defendant’s “post hoc rationalizations that attempt to intuit what the 

ALJ may have been thinking,” Bray v. Comm’r Soc. Sec. Admin., 554 F.3d 1219, 1225 

(9th Cir. 2009), but the Court nonetheless finds that the ALJ stated germane reasons for 

discrediting Duckett’s “other source” opinion. 

 6. Dr. Patricia Rose, Ed.D. 

Dr. Patricia Rose, doctor of education (“Ed.D”), a board certified state 

consultative psychological examiner, opined that Plaintiff has the understanding and 

intellect to work because she did so in the past. Tr. 493, 496. Dr. Rose further opined 

that Plaintiff would have difficulty completing work tasks. Tr. 493, 498. Dr. Rose 

concluded that Plaintiff would need work adjustment assistance before being able to 

maintain work (Tr. 498), and that Plaintiff could possibly work on a part-time basis 

(Tr. 497). The ALJ gave Dr. Rose’s opinion “some weight” because he found it “based 

on a thorough examination and . . . consistent with the objective evidence.” Tr. 59. 

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 Plaintiff argues that the ALJ did not afford Dr. Rose’s opinion any weight, and in 

fact disregarded the opinion, because Dr. Rose’s opinion supports a finding of disability 

since under SSR 96-8p, 1996 WL 374184, at *2 (July 2, 1996), the inability to complete a 

full time work schedule constitutes a disability. Doc. 17 at 18. Defendant argues that the 

ALJ gave Dr. Rose’s opinion some weight because he did not accept Dr. Rose’s 

recommendation that Plaintiff return to work initially on a part-time basis (Doc. 18 at 20), 

and that this conclusion was reasonable and supported by substantial evidence (id.). The 

ALJ did not “pick and choose” from Dr. Rose’s opinion as Plaintiff claims. Rather, the 

ALJ gave the state consultant’s opinion weight where it was “consistent with the 

objective evidence.” Tr. 59. This does not constitute legal error. 

 7. Dr. David Yandell, Ph.D.

 Dr. David Yandell, a state agency psychological consultant, reviewed Plaintiff’s 

medical records and completed a mental RFC assessment in January 2008. Tr. 500-517. 

Dr. Yandell opined that Plaintiff “retains the capacity to perform simple and probably 

some detailed job tasks on a sustained basis.” Tr. 502. The ALJ gave “substantial 

weight” to this opinion because “it is consistent with the overall evidence.” Tr. 58. 

 Plaintiff argues Dr. Yandell’s opinion is entitled to the least amount of weight 

(Doc. 17 at 19), and that it is unclear why his opinion is given more weight than Dr. 

Rose’s opinions, especially when Dr. Yandell appears to have relied only on the report of 

Dr. Rose (Tr. 502, 516). Defendant argues that the medical opinion of Dr. Yandell is still 

entitled to great weight even though it is not based on an independent examination 

(Doc. 18 at 18), and that any error in the weight given the opinion is harmless because the 

ALJ imposed more limitations on Plaintiff’s RFC than recommended by Dr. Yandell 

(id.). The Court agrees with Defendant. See Tommasetti, 533 F.3d at 1038. 

 8. Dr. Steven Patrick, Ph.D. 

 Dr. Steven Patrick, consultative psychological examiner, examined Plaintiff in 

August 2008 (Tr. 710) and opined that Plaintiff’s “current mental health [is] unlikely to 

prevent [her] from sustaining gainful employment for the next 12 + months” (Tr. 713, 

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715). Dr. Patrick opined that Plaintiff “exhibits no impairment in cognitive and memory 

functioning” (Tr. 715), that she “appears to get along adequately with others” (id.), and 

that she “is able to communicate” (id.). Dr. Patrick also opined that Plaintiff’s “attention 

is evaluated as fair and her concentration is poor to fair.” Tr. 713. 

 The ALJ noted that he gave some weight to Dr. Patrick’s opinion “to the extent it 

is consistent with the residual capacity assessment.” Tr. 59. Plaintiff contends that this 

statement is meaningless (Doc. 17 at 18-19), and that the ALJ rejected Dr. Patrick’s 

assessment in finding that Plaintiff has “moderate difficulties” with concentration and 

that she has difficulty in interacting with people (Tr. 54). On the other hand, Plaintiff 

also argues the ALJ failed to explain why he rejected most of Dr. Patrick’s opinions when 

he found Plaintiff to be more restricted than Dr. Patrick opined (Doc. 17 at 19), and that 

the ALJ failed to explain why Dr. Patrick’s opinion is entitled to “some weight” when he 

is not a treating physician (id.). Defendant argues that any error in how the ALJ 

evaluated Dr. Patrick’s opinion is harmless because the ALJ concluded that Plaintiff’s 

RFC was more limited than Dr. Patrick’s assessment. Doc. 18 at 21. The Court agrees 

and finds that the ALJ’s weighing of Dr. Patrick’s opinion does not constitute legal error. 

C. Lay Witness Testimony.

 Plaintiff argues that the ALJ failed to consider the report of Christina Barton, 

Plaintiff’s cousin-in-law. Tr. 17 at 23. The ALJ found that Ms. Barton’s report 

“basically corroborated” Plaintiff’s symptoms and daily activities. Tr. 55. Plaintiff 

contends that the ALJ implicitly discredited Ms. Barton’s report without having provided 

germane reasons for doing so. Doc. 17 at 34. Defendant argues that the ALJ’s error in 

not giving individualized reasons for rejecting Ms. Barton’s report constitutes harmless 

error. Doc. 18 at 15 (citing Molina v. Astrue, 674 F.3d 1104, 1117 (9th Cir. 2012) 

(“Where lay witness testimony does not describe any limitations not already described by 

the claimant, and the ALJ’s well-supported reasons for rejecting the claimant’s testimony 

apply equally well to the lay witness testimony, it would be inconsistent with our prior 

harmless error precedent to deem the ALJ’s failure to discuss the lay witness testimony to 

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be prejudicial per se.”)). 

 To discount competent lay witness testimony, “the ALJ must give reasons that are 

germane to each witness.” Molina, 674 F.3d at 1114 (quotation marks and citations 

omitted). But if the ALJ “gives germane reasons for rejecting testimony by one witness, 

the ALJ need only point to those reasons when rejecting similar testimony by a different 

witness.” Id. Having found that the ALJ did not err in discrediting Plaintiff’s testimony, 

the Court finds that the ALJ’s discounting of Ms. Barton’s report – that “basically 

corroborated” Plaintiff’s testimony – does not constitute legal error. Id. at 1117. 

D. Vocational Expert Testimony. 

 At step five, the Commissioner has the burden of demonstrating that the claimant 

can perform some work that exists in “significant numbers” in the national or regional 

economy, taking into account the claimant’s RFC, age, education, and work experience. 

Tackett, 180 F.3d at 1100; 42 U.S.C. § 423(d)(2)(A); 20 C.F.R. § 404.1560(c). The 

Commissioner may satisfy that burden either through the testimony of a vocational expert 

or by reference to the Medical-Vocational Guidelines appearing in 20 C.F.R. Part 404, 

Subpart P, Appendix 2. Tackett, 180 F.3d at 1100-01; see also Hill v. Astrue, 638 F.3d 

1144, 1152 (9th Cir. 2012) (“The ALJ may meet his burden at step five by asking a 

vocational expert a hypothetical question based on medical assumptions supported by 

substantial evidence in the record and reflecting all the claimant's limitations, both 

physical and mental, supported by the record.”). “If a vocational expert’s hypothetical 

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

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

economy.” Matthews v. Shalala, 10 F.3d 678, 681 (9th Cir. 1993). 

At the hearing, the ALJ asked vocational expert Tracy Young whether jobs exist in 

the national economy for an individual with Plaintiff’s age, education, work experience, 

and RFC. Tr. 104-07. The vocational expert responded that that there are jobs that exist 

in the national economy for such a hypothetical person, and gave examples of hand 

packager, job number 559.687-014 in the Dictionary of Occupational Titles (“DOT”); 

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production worker, job number 713.687-018 in the DOT; and inspector, job number 

716.687-030 in the DOT. Tr. 108-09. The vocational expert further testified that 21,640 

hand packer jobs exist in the national economy and approximately 340 in the Arizona 

economy, that 28,290 production worker jobs exist in the national economy and 275 in 

the Arizona economy, and that 13,200 inspector jobs exist in the national economy and 

220 in the Arizona economy. Id. The Occupational Employment Quarterly (“OEQ”), the 

source relied on by the vocational expert to provide the numbers of jobs that exist in the 

national and regional economies, aggregates jobs with similar limitations to show the 

numbers that exist in the respective economies. Tr. 124-29. The ALJ accepted the 

vocational expert’s testimony and determined that “[Plaintiff] is capable of making a 

successful adjustment to other work that exits in significant numbers in the national 

economy.” Tr. 62. 

 Plaintiff argues that the vocational expert’s testimony regarding job numbers was 

unreliable because the OEQ’s job groupings include jobs that exceed Plaintiff’s 

limitations. Doc. 17 at 25. Plaintiff raised similar arguments before the ALJ, but the ALJ 

determined that the OEQ was a reliable source and accepted the vocational expert’s 

testimony. Tr. 61-62. The ALJ determined that “the vocational expert’s testimony is 

consistent with the information contained in the Dictionary of Occupational Titles.” T.R. 

61. Because the vocational expert’s testimony comports with the DOT, the Court cannot 

find that the ALJ’s acceptance of the vocational expert’s testimony constitutes legal error. 

Massachi v. Astrue, 486 F.3d 1149, 1153 (9th Cir. 2007) (holding that where a conflict 

exists between DOT and vocational expert testimony, “the ALJ must then determine 

whether the vocational expert’s explanation for the conflict is reasonable and whether a 

basis exists for relying on the expert rather than the Dictionary of Occupational Titles.”). 

 Plaintiff also argues that the vocational expert did not provide numbers for a 

region of Arizona, and instead provided numbers for the entire State. Doc. 17 at 26. The 

Court finds, however, that even if the numbers provided by the vocational expert for the 

Arizona economy do not demonstrate that a significant number of jobs were available in 

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the regional economy, the numbers provided for the national economy do indicate the 

existence of a significant number of jobs. Beltran v. Astrue, 700 F.3d 386, 390 (9th Cir. 

2012) (“If we find either of the two numbers [for jobs available in the national economy 

or in the regional economy] “significant,” then we must uphold the ALJ’s decision.” 

(emphasis in original)). The ALJ’s decision at step five is supported by substantial 

evidence and his reliance on the vocational expert’s testimony does not constitute legal 

error. 

 IT IS ORDERED: 

 1. Defendant’s administrative decision is affirmed. 

 2. The Clerk is directed to enter judgment accordingly and terminate this 

matter. 

 Dated this 25th day of January, 2013. 

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