Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-00713/USCOURTS-azd-2_12-cv-00713-0/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 

Eva L. Green, 

Plaintiff, 

v. 

Michael J. Astrue, 

Commissioner of Social Security, 

Defendant.

No. CV-12-00713-PHX-DGC

ORDER 

 Pursuant to 42 U.S.C. § 405(g), Plaintiff Eva L. Green (“Plaintiff” or “the 

claimant”) seeks judicial review of the Commissioner’s decision finding her not disabled 

within the meaning of the Social Security Act. For the reasons that follow, the Court will 

vacate the Commissioner’s decision and remand for an award of benefits. 

I. Background.

 Plaintiff filed for disability insurance benefits and supplemental security income in 

August 2009 alleging a disability onset date of November 1, 2007. Her applications were 

twice denied by state agencies and again by an Administrative Law Judge (“ALJ”) that 

found Plaintiff not disabled within the meaning of the Social Security Act in an opinion 

dated April 8, 2011. Tr. at 16-25. The Social Security Administration Appeals Council 

denied a request for review. Tr. at 1-5. 

II. Legal Standard.

 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 

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

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

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

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

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

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

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

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

III. Analysis. 

 For purposes of Social Security benefits determinations, a disability is 

the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted 

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

20 C.F.R. § 404.1505. 

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

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

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

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

(“RFC”) precludes her from performing her past work. If at any step the Commissioner 

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

step five. If the claimant meets her burden through step four, the Commissioner bears the 

burden at step five of showing that the claimant has the RFC to perform other work that 

exists in substantial numbers in the national economy. See 20 C.F.R. § 404.1520(a)(4)(i)-

(v). 

 The ALJ found that Plaintiff had not engaged in substantial gainful activity from 

her alleged disability onset date through the date of his decision. Tr. at 18. At step two, 

the ALJ found that Plaintiff suffered from degenerative disc disease of the lumbar spine 

with radiculopathy and cervical spondylosis that the ALJ categorized as a severe 

impairment. Tr. at 19. At step three, the ALJ found that the combination of impairments 

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did not meet or equal one of the listed impairments. Tr. at 20; see C.F.R. pt. 404, subpt. 

P. app. 1. The ALJ then found that Plaintiff had the RFC to perform the full range of 

sedentary work. Tr. at 20; see 20 C.F.R. 404.1567(a) & 416.967(a). With that RFC, the 

ALJ determined that Plaintiff was capable of performing her past relevant work as a 

receptionist and an appointment clerk. Tr. at 24. Because he found that Plaintiff could 

perform past relevant work, the ALJ concluded that Plaintiff was not disabled within the 

meaning of the Social Security Act. Tr. at 24. 

 Plaintiff alleges that the ALJ erred by rejecting the opinion of a treating physician 

without adequate support, by rejecting Plaintiff’s subjective complaints without adequate 

foundation, and by relying on the opinion of an examining physician whose license had 

been suspended in another state. The Court will address each argument in turn. 

 A. Opinion of Dr. Jatin Daas. 

 Dr. Jatin Daas is Plaintiff’s treating physician. While the “ALJ must consider all 

medical opinion evidence,” Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008), 

“[t]he medical opinion of a claimant’s treating physician is entitled to ‘special weight,’” 

Rodriquez v. Bowen, 876 F.2d 759, 762 (9th Cir. 1989) (quoting Embrey v. Bowen, 849 

F.2d 418, 421 (9th Cir. 1988)). The ALJ may reject the opinion of a treating or 

examining physician by making “‘findings setting forth specific legitimate reasons for 

doing so that are based on substantial evidence in the record.’” Thomas v. Barnhart, 278 

F.3d 947, 957 (9th Cir. 2002) (citation omitted). “The ALJ can meet this burden by 

setting out a detailed and thorough summary of the facts and conflicting clinical 

evidence, stating his interpretation thereof, and making findings.” Id. (internal citation 

omitted). Furthermore, where the treating physician’s opinion is not contradicted by 

another physician, the ALJ’s reasons for rejecting the opinion must be “clear and 

convincing.” Rodriguez v. Bowen, 876 F.2d 759, 762 (9th Cir. 1989); see Lewis v. Apfel, 

236 F.3d 503, 517 (9th Cir. 2001) (“[A]n ALJ may reject a treating doctor’s medical 

opinion, if no other doctor has contradicted it, only for ‘clear and convincing’ reasons 

supported by substantial evidence.”) (citing Reddick, 157 F.3d at 725). 

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 Dr. Daas opined that Plaintiff’s pain was severe and the pain would constantly 

interfere with her attention and concentration. Tr. at 22. He concluded that as a result of 

her ailments, Plaintiff was capable of less than the full range of sedentary work because 

she could not lift or carry anything, could stand or walk for less than fifteen minutes 

during an eight hour workday, and could sit for two to three hours of an eight hour 

workday. Tr. at 22. The ALJ discounted that opinion, reasoning that it was “not 

consistent with the greater objective medical evidence of record or Dr. Daas’ own 

treatment notes.” Tr. at 22. He also noted that Dr. Daas’ assessment was inconsistent 

with Plaintiff’s activities of daily living and that Dr. Daas “uncritically accepted as true” 

most of Plaintiff’s subjective complaints. Tr. at 22.

 While the ALJ did survey the objective medical data (Tr. at 21-22), he did not 

point out how that evidence contradicts Dr. Daas’ assessment. For instance, the ALJ 

cited a November 2009 MRI of the lumbar spine that revealed “mild to moderate 

dextroscoliosis, degenerative disc at L4-5 with mild disc bulge and posterior midline 

annular tear, and degenerative disc at L5-S1 level with mild disc bulge and facet 

hypertrophy with mild foraminal stenosis.” Tr. at 21 (citing Tr. at 694-701). He also 

cited an MRI of the cervical spine in July 2010 that revealed “mild foraminal stenosis at 

C5-6 and normal alignment of the vertebral bodies with no evidence of subluxation or 

disc space narrowing,” and an MRI of the lumbar spine performed at the same time that 

“showed degenerative disc bulge and facet hypertrophy at L4-5 and K5-S1 levels with 

bilateral foraminal stenosis at L5-S1 level.” Tr. at 21 (citing Tr. at 810-24). While the 

MRI results do provide objective medical evidence, the ALJ provided no explanation as 

to why this evidence contradicts Dr. Daas’ statements. Some portions of the MRIs 

describe conditions as “mild,” but others show “annular tears,” “degenerative discs,” and 

“disc bulge.” Without more explanation, this evidence does not refute Dr. Daas’ 

assessment and may in fact support it. 

 The ALJ also stated that “[i]n general, physical examinations reveal no apparent 

acute or chronic distress as she has been described as ‘sitting comfortably,’ exhibiting 

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normal gait and station, and not observed using an assistive device.” Tr. at 22. The ALJ 

did not provide specific citations to the record, and so it is unclear to which examinations 

he was referring. Because the ALJ did not provide sufficient detail, the Court cannot 

evaluate the extent to which these physical examinations undermine Dr. Daas’ opinion. 

The ALJ’s bald recitation of test results – without explanation or citation – is not 

sufficient to discount the opinion of a treating physician. It does not satisfy the Ninth 

Circuit’s requirement that the ALJ provide “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. 

 Dr. Daas opined that Plaintiff’s pain would constantly interfere with her attention 

and concentration. Tr. at 1020. The ALJ found this opinion less than credible because, 

he said, Dr. Daas’ treatment notes contain no mention of concentration, attention, or 

memory problems. Tr. at 22. This appears to be an inaccurate reflection of both Dr. 

Dass’ opinion and his treatment notes. The report from Dr. Daas responds to this 

question about the severity of Plaintiff’s pain: “How often is your patient’s experience 

with pain sufficiently severe to interfere with attention and concentration?” Tr. at 1020 

(emphasis added). The question calls for the physician to evaluate the severity of the 

patient’s pain, not to evaluate the patient’s overall attention and concentration powers. 

The treatment notes clearly show that Dr. Daas treated Plaintiff for pain. Tr. at 1014-

1019. The Court therefore cannot conclude that the treatment notes are inconsistent with 

the opinion provided by Dr. Daas. 

 In the response brief, the Commissioner cites to other portions of Dr. Daas’ 

treatment notes that he believes contradict the finding that Plaintiff was incapable of 

lifting (Doc. 14 at 17), but the Court must review only the reasoning and factual findings 

offered by the ALJ, not “post hoc rationalizations.” Bray v. Comm’r of Soc. Sec. Admin., 

554 F.3d 1219, 1225. The ALJ did not provide this basis for rejecting Dr. Daas’ opinion. 

 The ALJ also purported to discount Dr. Daas’ opinion because his assessment 

conflicted with the Plaintiff’s activities of daily living. Tr. at 22. The ALJ does not 

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specify, however, what activities conflict with the Doctor’s assessment, and his citations 

refer to over 100 pages in the record (Tr. at 521-536, 602-669, 829-884), making it 

impossible to discern his specific rationale. In an earlier portion of the decision, the ALJ 

mentioned that Plaintiff was able to “prepare simple meals, drive a vehicle, pay bills, 

handle a savings account, count change, and use a checkbook.” Tr. at 21. The ALJ also 

noted that Plaintiff said she could lift up to two pounds, walk one eighth of a mile, and sit 

for five to ten minutes at a time. Tr. at 21. Dr. Daas opined that claimant could not carry 

anything, that she could stand or walk for under fifteen minutes during an eight hour 

workday, and that she could sit for two to three hours during a workday. While Dr. Daas’ 

limitations are somewhat different than Plaintiff’s self-reported limitations, both reports 

show significant limitations in carrying, standing, walking, and sitting. The differences 

are not so significant as to warrant the rejection of Dr. Dass’ opinion. 

 Finally, the ALJ claims to have discounted Dr. Daas’ opinion because he 

uncritically relied on Plaintiff’s subjective complaints. Tr. at 20. Citing 42 U.S.C. 

§ 423(d)(5)(A), Plaintiff maintains that once evidence of the underlying impairments are 

established, the regulations do not require the claimant to show additional evidence of the 

severity of the symptoms. The Ninth Circuit has held that “[o]nce the claimant produces 

medical evidence of an underlying impairment, the Commissioner may not discredit the 

claimant’s testimony as to subjective symptoms merely because they are unsupported by 

objective evidence.” Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1996). 

 The Commissioner responds that Plaintiff has conflated the standards for 

“evaluating a claimant’s subjective statements with the standard for evaluating medical 

source opinions.” Doc. 14 at 20. He argues that in the case of medical source opinions 

the ALJ must consider whether there is objective medical evidence to support the 

opinion. Id. The Ninth Circuit has held, however, that “an ALJ does not provide clear 

and convincing reasons for rejecting an examining physician’s opinion by questioning the 

credibility of the patient’s complaints where the doctor does not discredit those 

complaints and supports his ultimate opinion with his own observations.” Ryan v. 

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Comm’r of Soc. Sec., 528 F.3d 1194, 1199-1200 (9th Cir. 2008) (citing Edlund v. 

Massanari, 253 F.3d 1152, 1159 (9th Cir. 2001)). As in Ryan, there is nothing to indicate 

that Dr. Daas discredited Plaintiff’s subjective complaints, nor is there evidence that Dr. 

Daas relied more heavily on the subjective complaints than on his own clinical 

observations. Additionally, some of the objective medical evidence – particularly the 

MRI results mentioned above – could be read as supporting Dr. Daas’ conclusions. 

In summary, the Court concludes that the ALJ failed to provide sufficient reasons 

for discounting the opinion of Plaintiff’s treating physician. 

 B. Plaintiff’s Subjective Testimony. 

 Plaintiff claims that the ALJ erred by discounting her subjective testimony. 

Doc. 13 at 18. The ALJ must engage in a two-step analysis to evaluate the credibility of 

a claimant’s testimony. “First, the ALJ must determine whether the claimant has 

presented objective medical evidence of an underlying impairment ‘which could 

reasonably be expected to produce the pain or other symptoms alleged.’” Lingenfelter v. 

Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (quoting Bunnell v. Sullivan, 947 F.2d 341, 

344 (9th Cir. 1991) (en banc)). If the claimant meets this first test, and there is no 

evidence of malingering, the ALJ “can reject the claimant’s testimony about the severity 

of her symptoms only by offering specific, clear and convincing reasons for doing so.” 

Smolen v. Chater, 80 F.3d 1273, 1282 (9th Cir. 1996). The ALJ may consider at least the 

following factors when weighing the claimant’s credibility: the claimant’s reputation for 

truthfulness, inconsistencies either in the claimant’s testimony or between her testimony 

and her conduct, the claimant’s daily activities, her work record, and testimony from 

physicians and third parties concerning the nature, severity, and effect of the symptoms 

of which claimant complains. Thomas, 278 F.3d at 958-59 (citing Light v. Soc. Sec. 

Admin., 119 F.3d 789,792 (9th Cir. 1997)). 

 The ALJ noted that the course of treatment is not what “one would expect for a 

totally disabled individual.” Tr. at 21. After noting the MRI results and discussing the 

effectiveness of treatment that included “medial branch blocks in the cervical spine and 

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steroid epidural injections in the lumbar spine,” the ALJ concluded that the “medical 

evidence of record diminishes the claimant’s credibility as it shows of relatively 

conservative treatment.” The ALJ does not explain why cervical blocks and lumbar 

steroid injections are too conservative for the physical symptoms Plaintiff alleges. 

 The ALJ also noted that Plaintiff attempted to work after the alleged onset date 

and that the work stopped because of a business-related layoff rather than the alleged 

disability. Tr. at 23. This led the ALJ to infer that Plaintiff’s symptoms were not as bad 

as she claimed. The ALJ also cited to treatment records where Plaintiff reported 

limitations that are not as severe as those she reported to the ALJ. Tr. at 23. The ALJ 

also believed Plaintiff’s activities of personal care and a normal social life undermined 

her claims about the severity of her condition, and that her relatively low earnings prior to 

her disability “suggests a lack of motivation and undermines the claimant’s credibility.” 

Tr. at 23. 

 Plaintiff’s attempt to work after her disability onset date, the fact that her 

employment ended because she was laid off, her prior earnings history, and the 

disparities between her limitations as described in the record and presented to the ALJ, all 

constitute specific evidence on which the ALJ could rely in assessing her credibility. 

This evidence provides clear and convincing reasons for the ALJ to discount Plaintiff’s 

subjective testimony. Thus, while not all of the ALJ’s proffered reasons are correct, the 

Court concludes that the ALJ did not err in discounting Plaintiff’s subjective testimony. 

 C. Medical Opinion of Dr. Prieve. 

The Commissioner concedes that Dr. Prieve’s license was suspended in the State 

of Massachusetts when he examined Plaintiff and that the ALJ’s reliance on his 

testimony was therefore barred by 20 C.F.R. § 404.1503a (“We will not use in our 

program any individual or entity . . . whose license to provide health care services is 

currently revoked or suspended by any State licensing authority[.]”). The Commissioner 

contends that Dr. Prieve’s opinion was harmless because the ALJ found it only “partially 

persuasive.” Doc. 14 at 22 (citing Tr. at 22). 

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 While the ALJ did not wholly credit his conclusions, Dr. Prieve was the only 

examining physician in the case and his opinion directly contradicted the opinion of the 

treating physician. Tr. at 22. Without that contradiction, more weight may have been 

afforded to the opinion of the treating physician. Furthermore, the Commissioner 

concedes that Dr. Prieve’s report made up part of the record that was considered by Dr. 

Handal and Dr. Susman when forming their opinions regarding Plaintiff’s condition. 

Doc. 14 at 22. The Court concludes that consideration of Dr. Prieve’s opinion was not 

harmless error. 

D. Remedy. 

 Having decided to vacate Defendant’s decision, the Court has the discretion to 

remand the case for further development of the record or for an award benefits. See 

Reddick v. Chater, 157 F.3d 715, 728 (9th Cir. 1998). In Smolen v. Chater, the Ninth 

Circuit held that evidence should be credited and an action remanded for an immediate 

award of benefits when the following three factors are satisfied: (1) the ALJ has failed to 

provide legally sufficient reasons for rejecting evidence, (2) there are no outstanding 

issues that must be resolved before a determination of disability can be made, and (3) it is 

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

such evidence credited. 80 F.3d 1273, 1292 (9th Cir. 1996); see Varney v. Sec. of Health 

& Human Servs., 859 F.2d 1396, 1400 (9th Cir. 1988) (Varney II) (“In cases where there 

are no outstanding issues that must be resolved before a proper determination can be 

made, and where it is clear from the record that the ALJ would be required to award 

benefits if the claimant’s excess pain testimony were credited, we will not remand solely 

to allow the ALJ to make specific findings regarding that testimony.”); Swenson v. 

Sullivan, 876 F.2d 683, 689 (9th Cir. 1989) (same); Rodriguez v. Bowen, 876 F.2d 759, 

763 (9th Cir. 1989) (“In a recent case where the ALJ failed to provide clear and 

convincing reasons for discounting the opinion of claimant’s treating physician, we 

accepted the physician’s uncontradicted testimony as true and awarded benefits.”) (citing 

Winans v. Bowen, 853 F.2d 643, 647 (9th Cir. 1988)); Hammock v. Bowen, 879 F.2d 498, 

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503 (9th Cir. 1989) (extending Varney II’s “credit as true” rule to a case with outstanding 

issues where the claimant already had experienced a long delay and a treating doctor 

supported the claimant’s testimony). 

 Since Varney was decided, the overwhelming authority in this Circuit makes clear 

that the “credit as true” doctrine is mandatory. See Lester v. Chater, 81 F.3d 821, 834 

(9th Cir. 1995); Smolen v. Chater, 80 F.3d 1273, 1292 (9th Cir. 1996); Reddick v. Chater, 

157 F.3d 715, 729 (9th Cir. 1998); Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir. 2000); 

Moore v. Comm’r of Soc. Sec., 278 F.3d 920, 926 (9th Cir. 2002); McCartey v. 

Massanari, 298 F.3d 1072, 1076-77 (9th Cir. 2002); Moisa v. Barnhart, 367 F.3d 882, 

887 (9th Cir. 2004); Benecke v. Barnhart, 379 F.3d 587, 593-95 (9th Cir. 2004); Orn v. 

Astrue, 495 F.3d 625, 640 (9th Cir. 2007); Lingenfelter v. Astrue, 504 F.3d. 1028, 1041 

(9th Cir. 2007).1

 In this case, the ALJ has proffered legally sufficient reasons for discounting 

Plaintiff’s subjective complaints, but failed to advance legally sufficient reasons for 

rejecting the opinion of the Plaintiff’s treating physician. In Stevens v. Astrue, No. CV 

11-1978-PHX-DGC, 2012 WL 2017947 (D. Ariz. June 5, 2012), this Court noted a 

similar anomaly and held that, despite the fact that the treating physician’s statement was 

based at least in part on Plaintiff’s subjective complaints, under Ninth Circuit law the 

doctor’s statement still must be credited as true and the case remanded for an award of 

benefits. The vocational expert in this case testified that if Plaintiff suffered from the 

limitations in Dr. Daas’ report, she would be incapable of all work. Tr. at 56. Crediting 

Dr. Daas’ opinion as true will therefore be dispositive in this case. 

 

 

1

 This Court disagrees with the Ninth Circuit’s credit as true doctrine. The Court 

is bound, nonetheless, to follow Ninth Circuit precedent. 

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IT IS ORDERED that the Commissioner’s decision is vacated and the case is 

remanded for an award of benefits. 

 Dated this 17th day of December, 2012. 

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