Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_13-cv-08051/USCOURTS-azd-3_13-cv-08051-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Susan M. Schreffler, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security 

Defendant. 

No. CV-13-08051-PCT-NVW

ORDER 

Plaintiff Susan M. Schreffler seeks review under 42 U.S.C. § 405(g) of the final 

decision of the Commissioner of Social Security (“the Commissioner”), which denied her 

disability insurance benefits and supplemental security income under sections 216(i), 

223(d), and 1614(a)(3)(A) of the Social Security Act. Because the decision of the 

Administrative Law Judge (“ALJ”) is supported by substantial evidence and is not based 

on legal error, the Commissioner’s decision will be affirmed. 

I. BACKGROUND 

A. Factual Background 

Schreffler was born in November 1962 and was thirty-five years old on the alleged 

disability onset date. She has at least a high school education and is able to communicate 

in English. She previously worked as a laborer and utility worker at a coal-fired power 

plant. She alleges both psychological and physical medical problems, including 

schizoaffective disorder, hypertension, diabetes, heart murmur, osteoporosis, sleep apnea, 

osteoarthritis, peripheral neuropathy, and a disc protrusion at lumbar level L5-S1. 

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Schreffler has had years of psychological treatment for substance abuse issues, which 

include use of alcohol and methamphetamine. 

B. Procedural History 

Schreffler applied for disability insurance benefits on February 27, 2008, and for 

supplemental security income on February 29, 2008, alleging disability beginning May 6, 

1998. On June 7, 2011, she appeared with her attorney and testified at a hearing before 

the ALJ. 

On July 19, 2011, the ALJ issued a decision that Schreffler was not disabled 

within the meaning of the Social Security Act. The Appeals Council denied Schreffler’s 

request for review of the hearing decision, making the ALJ’s decision the 

Commissioner’s final decision. On March 13, 2013, Schreffler sought review by this 

Court. 

II. STANDARD OF REVIEW 

The district court reviews only those issues raised by the party challenging the 

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court 

may set aside the Commissioner’s disability determination only if the determination is 

not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 

625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. In determining whether 

substantial evidence supports a decision, the court must consider the record as a whole 

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. 

As a general rule, “[w]here the evidence is susceptible to more than one rational 

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be 

upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted). 

III. FIVE-STEP SEQUENTIAL EVALUATION PROCESS 

To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears 

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the burden of proof on the first four steps, but at step five, the burden shifts to the 

Commissioner. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

At the first step, the ALJ determines whether the claimant is engaging in 

substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not 

disabled and the inquiry ends. Id. At step two, the ALJ determines whether the claimant 

has a “severe” medically determinable physical or mental impairment. 

§ 404.1520(a)(4)(ii). If not, the claimant is not disabled and the inquiry ends. Id. At step 

three, the ALJ considers whether the claimant’s impairment or combination of 

impairments meets or medically equals an impairment listed in Appendix 1 to Subpart P 

of 20 C.F.R. Pt. 404. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to 

be disabled. Id. If not, the ALJ proceeds to step four. At step four, the ALJ assesses the 

claimant’s residual functional capacity and determines whether the claimant is still 

capable of performing past relevant work. § 404.1520(a)(4)(iv). If so, the claimant is not 

disabled and the inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, 

where he determines whether the claimant can perform any other work based on the 

claimant’s residual functional capacity, age, education, and work experience. 

§ 404.1520(a)(4)(v). If so, the claimant is not disabled. Id. If not, the claimant is 

disabled. Id. 

At step one, the ALJ found that Schreffler meets the insured status requirements of 

the Social Security Act through December 31, 2004, and that she has not engaged in 

substantial gainful activity since May 6, 1998. To obtain disability insurance benefits, 

Schreffler must prove disability before December 31, 2004. To obtain supplemental 

security income, she must prove disability from February 2008 through July 19, 2011. 

At step two, the ALJ found that Schreffler has the following severe combination of 

impairments: polysubstance dependence, anxiety disorder not otherwise specified, and 

mood disorder not otherwise specified. At step three, the ALJ determined that Schreffler 

does not have an impairment or combination of impairments that meets or medically 

equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404. 

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At step four, the ALJ found that, based on all of her impairments, including the 

substance abuse disorders, Schreffler: 

has the residual functional capacity to perform light work as 

defined in 20 CFR 404.1567(b) and 416.967(b) with the 

following limitations/restrictions: 

 The claimant is limited to simple and repetitive tasks 

 The claimant must avoid work related hazards 

 The claimant must avoid jobs requiring frequent 

interacting with the public, supervisors, and coworkers 

 The claimant would miss more than four days [of] 

work each month due to substance abuse 

The ALJ further found that Schreffler is unable to perform past relevant work. At step 

five, the ALJ concluded that, considering Schreffler’s age, education, work experience, 

and residual functional capacity based on all of the impairments, including the substance 

use disorders, there are no jobs that exist in significant numbers in the national economy 

that Schreffler can perform. 

The ALJ made additional findings regarding whether Schreffler would be found 

disabled if she stopped substance use. He found that, if Schreffler stopped the substance 

use, the remaining limitations (anxiety and mood disorders) would cause more than a 

minimal impact on the claimant’s ability to perform basic work activities; therefore, she 

would continue to have a severe impairment or combination of impairments. If she 

stopped the substance use, she would not have an impairment or combination of 

impairments that meets or medically equals any of the impairments listed in 20 C.F.R. 

Part 404, Subpart P, Appendix 1. If she stopped the substance use, she would have the 

residual functional capacity to perform light work as defined in 20 C.F.R. §§ 404.1567(b) 

and 416.967(b) except limited to simple and repetitive tasks and only occasional 

interaction with supervisors, co-workers, and the public. With that residual functional 

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capacity, there would be jobs that exist in significant numbers in the national economy 

that Schreffler could perform. 

The ALJ concluded that because Schreffler would not be disabled if she stopped 

the substance use, her substance use disorder is a contributing factor material to the 

determination of disability, and therefore she has not been disabled within the meaning of 

the Social Security Act at any time from the alleged onset date through the date of his 

decision. 

IV. ANALYSIS 

Schreffler does not dispute the ALJ’s assessment that alcohol materially 

contributes to her psychological issues of record for most of the period in question. The 

only issue Schreffler raises on appeal is whether the ALJ committed legal error by failing 

to consider her physical impairments. The ALJ’s hearing decision shows that he fully 

considered her alleged physical impairments and sufficiently explained why he did not 

find them to be severe. 

Under Social Security Rules, 

No symptom or combination of symptoms can be the basis for a finding of disability, no matter how genuine the individual’s complaints may appear to be, unless there are medical signs and laboratory findings demonstrating the existence of a medically determinable physical or mental impairment. 

SSR 96-4p; SSR 96-7p. In evaluating the credibility of a claimant’s testimony regarding 

subjective pain or other symptoms, the ALJ is required to engage in a two-step analysis: 

(1) determine whether the claimant presented objective medical evidence of an 

impairment that could reasonably be expected to produce some degree of the pain or 

other symptoms alleged; and, if so with no evidence of malingering, (2) reject the 

claimant’s testimony about the severity of the symptoms only by giving specific, clear, 

and convincing reasons for the rejection. Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 

2009). 

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Schreffler contends that she has the following documented physical problems: 

hypertension, coronary artery disease, irritable bowel syndrome, peripheral neuropathy, 

osteoarthritis, obstructive sleep apnea, and lumbar spondylosis with radiculopathy 

(lumbar disc protrusion). She asserts that the ALJ “misinterpreted the physical problems 

of the claimant because he has apparently not reviewed and not cited the objective 

findings of peripheral neuropathy or lumbar disc protrusion.” In support of that assertion, 

she cites a March 2, 2010 report stating that an electrodiagnostic study reveals evidence 

of peripheral neuropathy in bilateral lower extremities and recommending follow-up with 

the referring physician. She does not cite the September 13, 2010 treatment notes that 

state that she had not started on gabapentin even though it was ordered in February 2010 

to treat pain related to peripheral neuropathy. Schreffler also cites an April 8, 2010 report 

stating that a CT scan shows “small central subligamentous disc protrusion L5-S1.” She 

does not cite any evidence of physical impairment before December 31, 2004, to support 

her claim for disability insurance benefits. 

The ALJ was not required to refer specifically to each of Schreffler’s medical 

records. He stated that Schreffler had sought “very intermittent treatment” for physical 

impairments, “especially knee pain, back pain, and neck pain.” The ALJ identified 

specific medical evidence supporting his finding that Schreffler’s physical impairments 

are not medically determinable or are not severe: 

 February 19, 2008: X-ray of Schreffler’s left knee was normal. 

 May 30, 2008: Schreffler reported back, neck, and hand pain, and 

worsening of back pain the past two years, but reported the last time she 

had imaging of her back was fifteen years prior. The physical examination 

was normal. 

 June 30, 2008, and July 9, 2008: During treatment for injury to her toe, 

right hand, and left ear, Schreffler did not report any back or other 

musculoskeletal pain. 

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 January 31, 2009: Schreffler sought treatment at the emergency room for 

chest pain, headaches, and panic attacks. She did not report any 

musculoskeletal complaints, multiple diagnostic tests revealed mild to no 

abnormal results, and the physician noted a completely normal exam. 

 February 5, 2009: Schreffler sought treatment for chest pain, shortness of 

breath, and general malaise. She did not report any musculoskeletal 

complaints, and the physician noted a completely normal exam. The 

physician also wrote: “She claims that she had stopped using 

methamphetamine and alcohol for a long time and then she had used heavy 

alcohol for 2 days as well as she also used methamphetamine.” 

 Continued intermittent treatment through March 12, 2009: Schreffler 

complained of chest pain, dizziness, headaches, alcohol-induced injuries, 

numbness, and burning sensation while urinating. Physical examinations 

were “mostly normal.” 

 March 2009: Colonoscopy revealed severe sigmoid diverticulitis. June 

2010 CT revealed diverticulosis without diverticulitis. 

 April 11, 2009: Schreffler ambulated without difficulty and was able to get 

on and off the examination table without difficulty. The “mostly normal” 

objective examination did not corroborate her subjective complaints except 

for slight difficulty tandem walking and slightly decreased grip strength 

bilaterally. 

 April 8, 2010: An MRI of the brain revealed normal results. 

 August 10, 2010: Schreffler sought treatment for chest pain, shortness of 

breath, and other symptoms that she thought was a heart attack. She denied 

back pain, joint pain, joint swelling, muscle cramps, muscle weakness, 

stiffness, or arthritis. 

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 January 1, 2011: Schreffler sought treatment at the emergency room for 

substance abuse. She did not report any physical complaints, and the 

physician noted a completely normal physical examination. 

The ALJ noted Schreffler “testified at the hearing that she suffers from severe and 

debilitating back pain, headaches, trouble breathing, and sleep apnea” and “has very 

limited ability to sit, stand, and walk.” Although the ALJ concluded that Schreffler had 

not presented objective medical evidence of a physical impairment that could reasonably 

be expected to produce some degree of the pain or other symptoms alleged, he provided 

specific, clear, and convincing reasons for finding Schreffler’s statements concerning the 

intensity, persistence, and limiting effects of her symptoms not credible to the extent they 

are inconsistent with the residual functional capacity assessment. He expressly 

considered the following: 

the claimant’s own lack of subjective complaints; the absence of medically determinable impairments which can reasonably be expected to produce her symptoms; the absence of longitudinal records showing regular contact with physicians; the claimant’s receipt of only routine and conservative 

treatment without reasonable or credible explanation; the claimant’s lack of attempts to obtain relief from pain and other symptoms; the claimant’s failure to try even prescribed treatment modalities for relief; the lack of consistency of claimant’s subjective complaints throughout the medical record; the claimant’s inconsistent work history and earnings record even prior to the alleged onset of disability; and the presence of acknowledged daily activities at a level 

fundamentally inconsistent with allegations of disabling 

symptoms. 

These are specific, clear, and convincing reasons for finding Schreffler’s testimony about 

the severity of her symptoms not entirely credible. 

IT IS THEREFORE ORDERED that the final decision of the Commissioner of 

Social Security is affirmed. The Clerk shall enter judgment accordingly and shall 

terminate this case. 

Dated this 17th day of January, 2014 

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