Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_13-cv-01632/USCOURTS-casd-3_13-cv-01632-0/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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UNITED STATES DISTRICT COURT 

SOUTHERN DISTRICT OF CALIFORNIA 

KIMBERL Y KENNEDY, CASE NO. 13cv1632-WQH(KSC) 

Plaintiff, REPORT AND RECOMMENDATION 

vs. DENYING PLAINTIFF'S MOTION 

FOR SUMMARY JUDGMENT AND 

GRANTING DEFENDANT'S CROSS 

MOTION FOR SUMMARY 

CAROLYN W. COLVIN, acting JUDGMENT 

Commissioner ofSocial Security, 
 [Doc. Nos. 16, 23] Defendant. 

Pursuant to Title 42, United States Code, Section 405(g) ofthe Social Security 

Act ("SSA"), plaintiff Kimberly Kennedy ("plaintiff') filed a Complaint on July 12, 

2013 to obtain judicial review of a final decision by the Commissioner of Social 

Security ("defendant") denying her claim for a period ofdisability, disability insurance 

benefits ("DIB"), and supplemental security income ("SSI,,).I This case was referred 

for a Report and Recommendation on the parties' Motions for Summary Judgment. 

[Doc. No.4; See 28 U.S.C. § 636(b)( 1 )(B)] After considering the moving papers [Doc. 

1 Title 42, United States Code, Section 405(g), 12rovides as follows: "Any individual, after any final decision ofthe Commissioner ofSocial Security made after 

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

action ...-brought in the district court ofthe United States .... The court shall have power 

to enter, upon the pleadings and transcri12t of the record a judgment affirming, modifying or reversmg 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 evicfence, shall be conclusive." 

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Nos. 16, 23, 24 (Duplicate), 26], the Administrative Record [Doc. No. 10], and the 

applicable law, the Court RECOMMENDS that plaintiffs Motion for Summary 

Judgment [Doc. No. 16] be DENIED, and that defendant's Cross Motion for Summary 

Judgment [Doc. No. 23] be GRANTED. 

Ie PROCEDURAL HISTORY 

Plaintiff filed applications for a period of disability, DIB, and SSI on June 16, 

2010, alleging disability beginning on November 1, 2008. [Administrative Record 

(AR) at 213-228] After defendant denied plaintiffs applications at both the initial and 

reconsideration levels [AR at 120-27, 130-36], plaintiff appeared with her attorney 

before Administrative Law Judge ("ALJ") Leland Spencer on April 9, 2012 in San 

Diego, California. [AR at 24-71] ALJ Spencer heard testimony from plaintiff, medical 

expert Eric C. Puestow, M.D., and vocational expert John P. Kilcher. Id. Based on the 

testimony and the documentary evidence, on April 17,2012, the ALJ issued his written 

decision, finding that plaintiff was not disabled under sections 216(i) and 223( d) ofthe 

SSA. [AR at 10-18] The ALl's finding that plaintiff was not disabled became 

defendant's final decision on May 17, 2013, when the Appeals Council declined 

plaintiffs request for review. [AR at 1-5] 

II. RELEVANT FACTS 

Ae BacJy:round 

Plaintiffwas born on October 16, 1959. [AR at 296] She completed school up 

through the 11 th grade and is able to communicate in English. [AR at 246-48] 

Plaintiff's past work experience includes the occupations of assistant deli manager, 

bartender, administrative clerk, and truck rental agent. [AR at 248] Her positions of 

assistant deli manager and bar tender required standing, walking, bending, kneeling, 

crawling, reaching, pushing, pulling, lifting up to 50 pounds, squatting, climbing, 

overhead work, and grasping. [AR 256-59] Her positions of administrative clerk and 

truck rental agent required both sitting and standing, walking, climbing, stooping, 

kneeling, crouching, grasping, pushing, pulling, and lifting between 30 and 50 pounds. 

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[AR 260-61] Plaintiff complains of chronic back pain, gastrointestinal issues, kidney 

disease, and bladderlbowel problems. [AR at 247] Plaintiff claims these problems 

caused her difficulty at work, most notably severe back pain from being on her feet at 

her last job of bartender. Id. In an Exertional Daily Activities Questionnaire 

completed by plaintiff on July 7, 2010, she states that she lives with a friend and that 

her average day consists of sleeping, walking, and some chores, but that her constant 

pain hinders all of these activities and her ability to leave the house. [AR at 253-55] 

B. Medical Evidence 

1. Desert Oasis Medical Center (2007 - 2010) 

From 2007 to 2010, plaintiff visited Desert Oasis Medical Center numerous 

times presenting with a myriad ofsymptoms and complaints, most commonly back pain 

and gastrointestinal issues, but also including hemorrhoids and skin irritation on her 

arms and face. [AR 459-88] On August 24,2007, plaintiff presented to this facility 

for the first time complaining of anxiety, bruising to her ribs caused by a recent fall, 

diarrhea, and a lump on the back ofher left leg. [AR at 471] She advised that she was 

in the process of separating from her spouse. Id. Plaintiff admitted to smoking 1 and 

packs of cigarettes per day and drinking alcohol, but denied using illicit drugs. Id. 

The treating physician referred her to a surgeon for the lump, to a gynecologist for an 

annual check-up, and prescribed Lopramide for the diarrhea. [AR at 472] 

On December 27, 2007, plaintiffappeared for a follow-up presenting with amild 

rash, sore throat, and chronic diarrhea. [AR at 469] At that point, plaintiff had still not 

presented to a gynecologist as previously referred. Id. Plaintiff was prescribed 

Benadryl for the rash, a Z-Pack for the sore throat, and given Loperamide for the 

diarrhea. Id. She was again advised to schedule an appointment with a gynecologist 

and referred to a gastroenterologist. Id. 

On July 10,2008, plaintiff again presented with anxiety, and advised that she 

was in the midst ofdivorce proceedings. [AR at 466] Plaintiff stated that Xanaz helped 

with anxiety in the past, and wanted to try it again. Id. Additionally, she complained 

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of a generalized rash, acid reflux, and chronic diarrhea. Id. However, she failed to see 

a gastroenterologist, as referred in December of 2007. Id. She was prescribed Xanax 

for anxiety, Prilosec for acid reflux, and referred to Dr. Singh for the diarrhea. Id. 

On March 25, 2009, plaintiff complained ofanxiety and acid reflux and sought 

refills ofher Xanax and Prilosec, stating that she recently regained insurance coverage. 

[AR at 465] Plaintiff denied any abdominal pain, diarrhea, or urinary complaints. Id. 

She also sought a referral to her gynecologist, Dr. Borchers. Id. The prescriptions 

were filled and the referral was made as requested. Id. 

On April 16, 2009, plaintiff presented as a walk-in patient to the clinic as a 

follow-up to a recent emergency room visit. [AR at 467] Plaintiff had been seen and 

treated in the ER the previous day with kidney stones, hematuria, and abdominal pain. 

Id. After being given three medications in the ER, she woke up the next day with an 

itchy rash. Id. All three medications were discontinued, and replaced with Bactrim, 

Atarax, and an injection to relieve the itching. Id. Plaintiff was referred to Dr. Azher 

for the kidney stones. Id. 

On January 22,2010, plaintiff and "her significant other" appeared in the clinic, 

complaining of itching on her arms and face. [AR at 463] She denied any pain in her 

abdomen, back, or joints. Id. Her alcoholism and tobacco addition were identified as 

contributing factors. [AR at 463-64] Plaintiff presented again on Apri115, 2010 for a 

follow-up. [AR at 461] Due to a fight a couple ofweeks prior, bruising appeared on her 

right breast area. Id. However, she denied any chest pain, abdominal pain, diarrhea, 

or urinary complaints. Id. Plaintiff sought an increase in her Xanax dosage, as the 

current amount prescribed was no longer providing relief. Id. Her Xanax prescription 

was increased, and a referral made for hemorrhoids. [AR at 461-62] 

On June 8, 2010, plaintiff presented with back pain and acid reflux, seeking 

medication for both. [AR at 460] This came shortly after her discharge from the 

hospital on June 4, 2010, to which she was admitted for 10 days for sepsis and anemia 

starting on May 26, 2010. Id. She was advised to continue the medicines proscribed 

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in May, and diagnosed with alcoholic liver disease and anxiety. Id. She was 

prescribed Ultram, Soma, and Zantac for the back pain and ordered to return in one 

month with a completed blood test. Id. 

On July 14, 20 10, plaintiff presented complaining of a burning sensation while 

urinating. [AR at 485] Bactrim was prescribed and plaintiff was again advised to get 

a blood test, something she failed to do following her June 8, 2010 visit. Id. 

The Court notes that on a number of plaintiff s visits in 2010, she denies any 

back or abdominal pain. [AR at 461,463,485] 

2. Western Arizona Re2ional Medical Center (2009 - 2010) 

On April 14, 2009, plaintiff presented to the emergency room chiefly 

complaining ofsevere flank pain, diarrhea, nausea, and vomiting. [AR at 447] Plaintiff 

advised medical staff ofher history ofkidney stones and that she recently experienced 

burning with urination that had since resolved. Id. A CT scan of her abdomen and 

pelvis revealed no acute findings. [AR at 448] Plaintiff was diagnosed with kidney 

stones, but feeling much better one hour into the visit, she was discharged with 

instructions and a variety of prescriptions. [AR at 449] On June 10, 2009, plaintiff 

presented in the emergency room with sudden onset of lesions. [AR at 443] Plaintiff 

was diagnosed with elevated liver enzymes, and instructed not to drink alcohol or take 

Aspirin. Id. 

On May 26, 2010, plaintiffwas taken to the emergency room by ambulance and 

admitted after being found unconscious on the floor of her domicile. [AR 330-440] 

Upon initial physical examination, her vital signs were normal, there was no evidence 

of external trauma, her heart rate and rhythm were normal, and she had normal range 

of motion in her extremities. [AR at 371] Upon regaining consciousness, plaintiff 

explained that she had been experiencing flu-like symptoms and fell and hit her head, 

causing her to lose consciousness. [AR at 357] Plaintiff denied any chest pain, but 

complained of incontinence. Id. CT scans were taken of her head, thoracic spine, 

abdomen, and pelvis, an NIRI was taken ofher brain, and an X-Ray taken ofher chest. 

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[AR at 423-30] While some mild abnonnalities were discovered, nothing acute was 

identified in these scans. More specifically, no "acute intracranial pathology" was 

discovered in her head scans, and "[ n]o evidence of acute or active cardiopulmonary 

disease" presented in the lungs. [AR at 440,435] However, mild cerebral atrophy was 

discovered in her brain, and a mildly enlarged kidney in her abdomen. [AR at 437,432] 

Examination oflung fields were clear and stable, showing only a pattern ofbronchitis. 

[AR at 434] She was diagnosed with septicemia and a urinary tract infection, kept 

under close watch, and treated with a broad spectrum antibiotic. [AR at 340, 357] 

Plaintiff was discharged on June 4, 2010, after 10 days in the hospital. [AR at 330] 

3. Tri-City Medical Center (2010) 

On December 16, 2010, plaintiff presented to the emergency department 

complaining of a sore throat, high fever, cough, chills, ear pain, and general body 

aching. [AR at 519-30] At the time of her admission, she was not experiencing any 

vomiting, nausea, labored breathing, or any other alanning displays. [AR at 519] 

Plaintiff s daughters expressed concern because ofplaintiff s prior admission for sepsis 

on May 26, 2010. [AR at 520-21] "Because [plaintiff] is immune compromised by her 

alcoholism it is felt that she should be treated vigorously with antibiotics to make sure 

that this does not recur .... " [AR at 521] Plaintiff responded well to hydration and 

antibiotics. Id. She was diagnosed with a sore throat and a urinary tract infection and 

discharged the same day. [AR at 525] 

On September 16, 2011, plaintiff arrived at the emergency room with a change 

in mental status and was admitted for further evaluation. [AR at 549] Specifically, 

plaintiff s parents brought her in because plainti ff appeared confused and sleepy. [AR 

at 551] During intake, plaintiff reported that she was an alcoholic and that it had been 

roughly 1 year since she had consumed alcohol, when she was hospitalized for septic 

shock. Id. Plaintiff also complained of head, neck, and back pain. [AR at 560] She 

was diagnosed with a urinary tract infection, hepatic encephalopathy, and cirrhosis of 

liver (alcohol-induced). [AR at 549] All symptoms resolved after treatment with 

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lactulose and antibiotic. Id. Plaintiff was discharged three days later, on September 

19,2011. Id. 

4. Michael Chipman, D.O. - Consultative Examiner (orthopedist) (2010) 

On August 17, 2010, Dr. Chipman examined plaintiff, and reviewed her medical 

records to date in advance ofthe exam, for the purpose ofcompleting a Social Security 

Disability Evaluation. [AR at 499-502] On the date of examination, plaintiff's chief 

complaints were ofback pain and bowellbladder problems. [AR at 499] Plaintiff was 

able to ambulate in the room, get on and offthe table, and take her slip-on shoes on and 

off without assistance or difficulty. [AR at 500] Dr. Chipman conducted a physical 

exam and tested plaintiff's range ofmotion and muscle strength, noting that the x-ray 

of the lumbar spine shows "minimal degenerative changes and no evidence of acute 

pathology." [ARat 500-01] Thus, Dr. Chipman opined that plaintiff's condition would 

not impose a limitation for 12 continuous months. [AR at 501] 

5. Doris Javine, Ph. D. - Consultative Examiner (psychcholo&ist) (2010) 

On August 19,2010, Dr. Javine, a clinical psychologist, conducted a 1 hour and 

15 minute examination ofplaintiff. [ARat 503-07] Dr. Javinenoted that plaintiff drove 

to the interview, arrived on time, was appropriately dressed and with a cooperative and 

pleasant attitude, with sores on her face and leg, and appearing older than her stated 

age of 50 years. [AR at 503] Plaintiff asserted that she is unable to work because she 

cannot stand for "longer than like thirty minutes without [her] kidney[]s hurting .... 

[and she cannot] sit [for] longer than fifty minutes [before] they start bothering [her]." 

Id. Dr. Javine noted that her speech was mildly slurred and that she appears to have 

problems retrieving words, making her mildly difficult to understand. [AR at 504] 

Plaintiff reported managing her own finances, knowing how to use a computer, 

showering every other day, brushing her teeth daily, and dressing without the 

assistance ofothers. Id. Dr. Javine subjected plaintiff to a battery ofscenarios meant 

to test the following categories: orientation, recall, memory, intelligence, calculation, 

abstract thinking, similarities and differences, and judgment. [AR at 505-05] 

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Dr. Javine noted that while plaintiff exhibited difficulty with seriaI3's, she was 

capable of counting backwards from 20 and there were no other cognitive difficulties 

displayed. [AR at 507] More specifically, Dr. Javine found that plaintiff had no 

limitations in the following three areas: (1) ability to understand and remember simple 

instructions, locations, and work-like procedures; (2) social interactions; and, (3) 

responding appropriately to changes in the work setting or in responding to hazards. 

[AR at 508] However, plaintiff was noted as having "mild" impairment in 

concentration and persistence. Id. Dr. Javine concluded by opining that plaintiff "will 

likely be unable to manage awarded benefits responsibly and in her best interest." [AR 

507-08] 

6. Sarah Shepherd, D.O. - Consultative Examiner (orthopedist) (2010) 

After reviewing plaintiff s medical records to date in advance, on February 13, 

2011, Dr. Shepherd examined plaintiff for the purpose ofcompleting a Social Security 

Disability Evaluation. [AR at 533-38] On the date of the examination, plaintiff 

complained ofpain in her right hip, right knee, and generalized pain "body wide." [AR 

at 533] Plaintiff described the hip pain as constant, throbbing, aching, and only relieved 

when she moves her right leg around. [AR at 533] She described the knee pain as being 

triggered by her hip pain, and stated that she has fallen numerous times due to 

unsteadiness on her right leg. Id. In a typical day, plaintiff is able to sleep eight to ten 

hours a day, take her medication, straighten up her room, do stretching exercises, wash 

dishes, do laundry, and do some grocery shopping. [AR at 534] Plaintiff reported 

Soma, Tramadol, Xanax, and Ranitidine as her current medications, and denied 

smoking, but admitted to alcohol use. Id. 

Upon physical examination, plaintiff was pleasant and cooperative, able to sit 

and walk comfortably and without difficulty, but smelled ofalcohol. Id. Dr. Shepherd 

found plaintiff to have good strength and full range of motion in her joints and 

extremities. [AR at 535] As a result of these findings, Dr. Shepherd found that 

plaintiff s complaints of subjective pain in her right hip, right knee, and "body wide" 

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were all without objective clinical correlation. [AR at 536] Thus, Dr. Shepherd opined 

that plaintiffs condition would not impose a limitation for 12 continuous months. Jd. 

7. Cynthia McKinney, M.D. (2011) 

On April 1, 2011, plaintiff presented as a new patient to the Vista Community 

Clinic for the purpose of establishing a plan of care for her chronic back pain and 

abdominal pain. [ARat 603-23] Dr. McKinney received a thorough social and medical 

history from plaintiff. Among other items revealed during intake, plaintiff stated she 

is a recovering alcoholic who, prior to 2010, consumed approximately 4 drinks ofhard 

alcohol per day. [AR at 604] Plaintiff had recently moved from Arizona and sought a 

refill ofher medications. [AR at 603] A physical examination revealed normal findings, 

including plaintiffs back which was described as "non-tender." [AR at 605] In 

addition, a battery of blood tests and labs was ordered. Jd. Plaintiff brought certain 

hospital records, specifically from her emergency room stay in Arizona in May of2010, 

when she was admitted after being found unresponsive at home and diagnosed with 

sepsis triggered by a urinary tract infection. Dr. McKinney instructed plaintiff that her 

most recent medical records needed to be produced and reviewed before most of the 

desired medications could be refilled. Jd. In addition, plaintiff was advised that she 

would be required to sign an "Initial Pain Contract Eval[uation]" before any narcotic 

medications would be prescribed, and only after her prior records were received and 

reviewed and the medications were deemed appropriate. Id. 

On April 13, 2011, plaintiff presented for a follow-up on the labs taken at her 

prior visit. [AR at 600-01] The labs showed evidence ofchronic alcohol abuse, which 

was confirmed in the records received from Arizona. [AR at 600] Dr. McKinney 

discussed scheduling a CT scan of plaintiffs liver to evaluate its function so as to 

determine the next step for treatment ofher liver disease. [AR at 601] 

On April 27, 2011, plaintiff saw Dr. McKinney for the purpose of being 

evaluated for pain medications. [AR at 596-99] Plaintiff continued to complain of 

chronic low back pain, but Dr. McKinney notes that "we still don't have records from 

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her last [primary care physician] in [Arizona] (the medical records release form that 

[plaintiff) filled were for the hospital)." [AR at 596] Dr. McKinney commented that 

plaintiffhad already been told that "no narcotics would be dispensed without previous 

records being available and reviewed." ld. Plaintiff presented as "anxious" and with 

an "irritable affect." [AR at 597] More directly, Dr. McKinney specifically noted that 

"plaintiff became [q]uite [u]pset when she was told (again) that she would not be 

[receiving] narcotics as stated above. She was advised to sign a records release - this 

time for her [primary care provider] in Arizona and she will be referred to Pain 

Management for eval[uation] [and] treatment." ld. 

On May 31, 2011, plaintiff again saw Dr. McKinney. [AR at 586-92] Plaintiff 

was again upset when she did not receive Norco, as she represented she received it 

from her previous medical care provider; however, Dr. McKinney noted that she 

thoroughly read plaintiff s prior records from Arizona and there was no mention ofany 

narcotics being given to plaintiff anywhere. [AR at 586] Plaintiff calmed down after 

Dr. Kinney communicated this, and was content to stay on Tramadol. ld. An NIRI of 

the spine revealed nerve root compression with central canal stenosis. ld. She was 

referred to a pain management specialist to see what, ifanything, could be done for the 

pain. [AR at 585] A physical examination revealed mostly normal findings, with the 

exception of posterior tenderness in the spine, paravertebral muscle spasms, and 

bilateral thoracic and lumbosacral tenderness. [AR at 588] Dr. McKinney noted that 

plaintiff has an "inappropriate affect," is "anxious, exhibits compulsive behavior, is 

paranoid, has poor insight, [and] exhibits poor judgment." ld. Plaintiffwas diagnosed 

with chronic pain, spinal stenosis of lumbar region, alcoholic cirrhosis of the liver, 

anxiety, and an unspecified alcohol dependence. [AR at 588-89] Dr. McKinney 

prescribed Tramadol and Xanax, stated her intent to refer plaintiff to a neurosurgeon, 

and advised plaintiff to keep her appointment with the Pain Clinic. Id. 

On October 5, 2011, plaintiff presented to the emergency department for chronic 

pain. [AR at 580-83] Dr. McKinney noted that plaintiff had been seeing providers 

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"outside of [Vista Community Clinic] [seeking] refills of narcotics according to her 

CURES report. [Plaintiff was] told that she has broken her pain management contract 

and will no longer be able to receive care at VCC due to this (after a month's grace 

period for urgent care needs not including pain meds )." [AR at 581] A prescription for 

Tramadol was refilled for her that day with no further instructions. ld. 

8. William Weissman, M.D. (2011) 

On May 16, 2011, plaintiff presented at Vista Community Clinic as a repeat 

patient with pain management issues. [AR at 593-95] She sought refills of pain 

medications previously prescribed in Arizona, but was having difficult finding old 

medical records. [AR at 593] Specifically, she stated that she had been given a prior 

prescription for Norco, but was unable to provide records ofthe same. ld. A taking 

of her vital signs and physical examination yielded normal findings, with moderate 

pain associated with motion in the cervical spine and lumbar spine. [AR at 594] Dr. 

Weissman refilled plaintiff s prescriptions for Tramadol, Soma, and Xanax, but 

required more information from her if she sought a Norco prescription. ld. Although 

typically seen by Dr. Cynthia McKinney, who also practices at the Vista Community 

Clinic, plaintiff saw Dr. Weissman on this occasion. ld. 

On September 12,2011, Dr. Weissman completed an examination of plaintiff, 

as well as a Physical Medical Source Statement. [AR at 545-48] Leading up to his 

completion ofthe Medical Source Statement, Dr. Weissman indicated that plaintiffhad 

been visiting Dr. McKinney at the Vista Community Clinic monthly for the last nine 

months, presenting with severe and constant neck and back pain, which lead him to 

diagnose her with spinal stenosis, lumbar and cervical pain, muscle spasms, and 

chronic pain. [AR at 545] As to how plaintiffs impairments might impact her ability 

to work, Dr. Weissman asserted that plaintiff may become drowsy, dizzy, or experience 

nausea as a result of her medications. ld. In addition, Dr. Weissman opined that 

plaintiffs impairments have lasted or can be expected to last at least 12 months, and 

that emotional factors contribute to the severity of her symptoms and functional 

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limitations. Id. Specifically, Dr. Weismann identified depression and anxiety as 

contributing psychological conditions. [AR at 546] 

Given all of these impairments, Dr. Weissman estimated plaintiffs functional 

limitations if placed in a competitive work situation as follows: she could sit for no 

more than 30 minutes before needing to get up; could stand for zero minutes before 

needing to sit down or walk around; in an 8-hour workday, could sit and stand for less 

than 2 or those 8 hours; could rarely lift and/or carry 10 pounds, and never lift or carry 

anything more; could never twist, bend, crouch, squat, or climbs stairs or ladders; could 

never use her arms, hands, or fingers to twist, finely manipulate, or reach overhead, but 

could reach in front of her body 20% of the time during an 8-hour workday. [AR at 

546-47] Given these limitations, Dr. Weissman stated that plaintiff needs ajob that 

permits her to shift positions at will from sitting, standing, and walking positions, and 

that plaintiff must be permitted to walk every 90 minutes for at least 1 minute. [AR at 

546] Dr. Weissman also opined that plaintiff will need to take numerous unscheduled 

breaks during a normal workday, estimating at least 20 such breaks per day. Id. 

Dr. Weissman estimated that 25% or more ofplaintiff's average workday would 

be spent "off task," meaning with symptoms severe enough to interfere with the 

attention and concentration needed to perform even simple work. [AR at 548] Given 

all of these issues, Dr. Weissman stated his belief that plaintiff is incapable of 

tolerating even "low stress" work because she is in "constant severe pain" and her 

impairments are likely to produce "all bad days" and no good days. Id. 

9. County of San Die20 Mental Health Services (2011) 

On October 19, 2011, plaintiff was seen for an Initial Screening with the 

following symptoms: depression, crying spells, anxiety, anhedonia, poor appetite, 

trouble sleeping, and paranoia. [AR at 624-40] She was seen by Dr. Paula Proffitt. 

Plaintiff denied any suicidal or homicidal tendencies, and denied any domestic violence 

or current substance abuse. [AR at 626-27] Plaintiff's drug screening, however, was 

positive for benzos, opiates, THe, and another stimulant. [AR at 632] Plaintiff later 

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admitted to occasional THC use and stated that she has some Xanax at home. Id. 

Plaintiff disclosed three previous DUI convictions, spanning from 1983 to 1985. [AR 

at 628] Based on the symptoms discussed and observed at the initial screening, and 

because plaintiff already qualified for the County's Low Income Health Program 

(LIHP), Dr. Proffitt found plaintiff met the medical necessity required for treatment, 

prescribed Celexa, referred plaintiff to NCHC - Encinitas for continued care, provided 

referrals for low cost counseling, and supplied crisis hotline numbers. [AR at 629-31] 

III. ALJ HEARING AND DECISION 

A. Plaintifrs Testimony 

At the April 9 , 2012 hearing before ALI Spencer, plaintiff testified regarding her 

work history, which included a combination of bar tending, convenience store 

management, clerical, and customer service. [AR at 28-31] Based on plaintiffs 

descriptions, almost all ofher occupations, even the ones appearing more sedentary in 

nature by job title, involved lifting, carrying, bending, and other physically strenuous 

demands. Id. Plaintifflast worked in the summer of2008, as a bartender at O'Leary's. 

[AR at 31-32] She stopped working due to a broken right clavicle, suffered when she 

was knocked down a flight ofstairs in her home by three ofher large dogs. [AR at 31­

33] Plaintiff stated she attempted to work after that injury, but was unable to function 

because of "excruciating" and "horrible" pain in her right shoulder. [AR at 32] The 

pain was especially impairing given that she is right handed. Id. As ofthe date ofthe 

hearing, plaintiff stated that chronic pain, stiffness, and numbness in her lower back, 

upper neck, legs, feet, arms, and hands render her unable to sit or stand for prolonged 

periods oftime and thus, unable to work. [AR at 33,43] Plaintiff described the pain 

as daily and usually the same, but sometimes spiking in intensity. [AR at 48] Plaintiff 

stated that her pain is the worst in her lower back and neck. [AR at 48] Her lower back 

pain pre-dated her clavicle injury, something she noticed when engaging in heavy 

lifting (cases ofbeer, kegs, etc.) as a bartender. [AR at 34] When pressed on the issue, 

however, plaintiff was unable to estimate, differentiate, or identify the timing, 

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sequence, or origin of each particular ailment Id. 

As ofthe date ofthe hearing, plaintiff reported to living in a house and asserted 

that she did seek employment after November of 2008. [AR at 35] Specifically, she 

applied online for customer service jobs and other similar jobs that did not involve 

lifting. Id. She estimated that she last looked for work in December of 2011, but 

qualified that she has not seen anything "out there" that would fit with her physical 

limitations. [AR at 41-42] Given her limitations, plaintiff stated she needs a job that 

will allow her to sit or stand at will, and estimated that she can lift no more than 10 

pounds, can sit for no longer than 30 minutes at a time, and can stand on her feet for 

no longer than 25 minutes at a time. [AR at 36] 

She reported that she lives with a friend, and despite having a license, she has 

not driven a vehicle for roughly two years, explaining that she gets "unfocused" 

because the "pain's so bad." [AR at 37-38] Instead, she relies on friends and family 

regularly, and public transportation occasionally. [ARat38] On a typical day, plaintiff 

gets out ofbed, takes a shower, reads, and "piddle paddle[ s] around the house," stating 

"there's really not a whole lot I can do" and describing it as a "struggle." [AR at 39] 

Plaintiff has no pets, is not active with any group or association, and cites walking 

around the house and walking one block to the mailbox every other day as her only 

regular exercise. [AR at 39-40] Plaintiff reports being able to shop, cook, and keep her 

living space clean. [AR at 40] 

Regarding plaintiffs history of alcohol abuse, she stated the last time she had 

a drink was in late May 2010, but that she is not active in any sort of recovering 

alcoholic support organization. [AR at 44-46] Plaintiff reported that she is limited in 

the number and types ofpain medications she can take, because ofthe severe reactions 

she has had to them given her damaged liver. [AR at 47] Further, plaintiff indicated 

that depression and anxiety are daily issues for her, specifically that she is "always 

stressing out and thinking about just how [her] life has changed and how many things 

[she] can't do - - - things [she] used to do." Id. As to her difficulty focusing, plaintiff 

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reports that the intense pain causes her to lose her train of thought easily. [AR at 48] 

Plaintiff testified that the last time she saw a doctor for pain management was 

in 2011, since her liver is unable to process most of the pain medications they 

prescribe. [AR at 49] Plaintiff also testified that she was "thrown out" of a program at 

Vista Community Clinic (a federally funded clinic) because she had seen a doctor 

outside ofthat clinic, but denied that charge and testified to following all clinic rules 

and directions. [AR at 50] 

B. The Written ALJ Decision 

On April 17, 2012, ALl Spencer issued a written decision denying plaintiff's 

claim for DBI and SSI, finding that plaintiffwas not disabled within the meaning ofthe 

SSA. [AR at 10-18] First, he concluded that plaintiff had not engaged in substantial 

gainful activity since the date ofthe alleged onset ofdisability, November 1,2008. [AR 

at 12] At step two, the ALl found plaintiff suffered from the following "severe" 

impairments, as defined in the Regulations: degenerative disc disease and stenosis of 

the lumbar spine. [AR at 12, citing 20 C.F.R. §§ 404.1520(c) and 416.920(c)] Also at 

step two, the ALl found plaintiff suffered from cirrhosis of the liver due to alcohol 

abuse, but found there was no evidence to suggest the disorder would result in more 

than minimal limits and that it therefore did not quality as a severe impairment. [AR 

at 13] At step three, however, plaintiff was found to have no impairment, or 

combination thereof, that met or equaled an impairment listed under 20 C.F.R. §§ 

404. 1520(d), 404.1525, 404.1526, 416.925, 404.920(d), 416.925, and 416.9296. [AR 

at 13] Specifically, the ALl found: "No physician has opined that the [plaintiff's] 

condition meets or equals any listing, and the state agency program physicians opined 

that it does not." Id. 

In assessing plaintiff's residual functional capacity ("RFC") at step four, plaintiff 

was deemed capable of lifting or carrying 1 0 pounds frequently and 20 pounds 

occasionally; needed the opportunity to alternate between sitting and standing every 

30 minutes; sit for no more than a total of4 hours in an 8-hour workday; stand for no 

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more than a total of 4 hours in an 8-hour workday; occasionally bend, stoop, crawl, 

climb, kneel, and balance; and, avoid hazards. [AR at 13, 17] Considering this RFC 

and the testimony from medical expert Eric Puestow, M.D. and vocational expert John 

KUcher, the ALJ found plaintiff incapable of performing any of her past work as a 

bartender, clerk, truck rental agent, and assistant deli manager. [AR at 16] 

Notwithstanding her limitations, considering plaintiffs age, education, work 

experience, and RFC, the ALJ found at step five that jobs exist in significant numbers 

in the national economy that plaintiff is capable of performing, specifically as an 

assembler, packager, and garment sorter. [AR at 17] While the ALJ found that 

plaintiffs above-mentioned impairments could reasonably be expected to cause the 

alleged symptoms, he found plaintiff s "statements concerning the intensi ty, persistence 

and limiting effects ofthese symptoms" not credible to the extent they are inconsistent 

with his RFC assessment. [AR at 20] 

IV. LEGAL STANDARDS 

A. Evaluatin2 SSI and DBI Claims 

To qualify for DBI or SSI benefits under the Social Security Act, an applicant 

must show that he or she is unable to engage in any substantial gainful activity because 

of a medically determinable physical or mental impairment that has lasted or can be 

expected to last at least 12 months or cause death. 42 U.S.C. §§ 423( d), 1382. The 

Social Security Regulations set out a five-step process for determining whether a 

person is disabled within the meaning of the SSA. See 20 C.F.R. §§ 404.1520(a), 

416.920(a); Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999); Batson v. Comm'r 

ofthe Social Security Admin., 359 F.3d 1190, 1194 (9th Cir. 2004). Ifa party is found 

to be "disabled" or "not disabled" at any step in the sequence, there is no need to 

consider subsequent steps. 20 C.F .R. § 416.920. 

First, the ALJ must determine whether the applicant is engaged in substantial 

gainful activity. 20 C.F.R. §§ 404.1520(a)(4)(I), 416.920(a)(4)(I). Ifnot, then the ALJ 

must determine whether the applicant is suffering from a "severe" impairment within 

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the meaning of the Regulations. ld. If the impairment is severe, the ALl must then 

determine whether it meets or equals one of the "Listing of Impairments" in the 

Regulations. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the applicant's 

impairment meets or equals a Listing, the ALJ must then determine whether the 

applicant retains the residual functional capacity ("RFC") to perform his or her past 

relevant work. ld. If the impairment does not meet or equal a Listing, the ALl must 

determine whether the applicant retains the residual functional capacity to perform his 

or her past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). If the applicant cannot 

perform past relevant work, the ALl-at step five-must consider whether the applicant 

can perform any other work that exists in the national economy. 20 C.F.R. §§ 

404.1 520(a)(4)(v), 416.920(a)(4)(v). 

While the applicant carries the burden ofproving eligibility at steps one through 

four, the burden at step five rests on the agency. Celaya v. Halter, 332 F .3d 1177, 1180 

(9th Cir. 2003). Applicants not disqualified at step five are eligible for disability 

benefits. ld. 

1. Substantial Evidence 

The SSA provides for judicial review ofa final agency decision denying a claim 

for DrB or SSI. 42 U.S.C. § 405(g). A reviewing court must affirm the denial of 

benefits if the agency's decision is supported by substantial evidence and applies the 

correct legal standards. ld.; Batson, 359 F.3d at 1193. Substantial evidence means 

"such relevant evidence as a reasonable mind might accept as adequate to support a 

conclusion." Osenbrock v. Apfel, 240 F.3d 1157, 1162 (9th Cir. 2001). When the 

evidence is susceptible to more than one reasonable interpretation, an agency's 

otherwise reasonable decision must be upheld. Batson, 359 F.3d at 1193. Where, as 

here, the Appeals Council denies a request for review, the ALl's decision becomes the 

final agency decision that the court reviews. ld. at 1193 n.l. 

2. Allocating Weight to Medical Opinions 

When presented with conflicting medical opinions, the ALJ must determine 

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credibility and resolve the conflict. Matney v. Sullivan, 981 F .2d 1016, 1019 (9th Cir. 

1992). Greater weight must be given to the opinion oftreating physicians, and in the 

case of conflict, "the ALJ must give specific, legitimate reasons for disregarding the 

opinion of the treating physician." Id. However, this does not mean the treating 

physician's opinion is dispositive. To the contrary, no physician's opinion is binding 

"with respect to the existence ofa claimant's impairment or the ultimate determination 

ofdisability." Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001). Instead, an 

ALJ is to weigh the medical opinion evidence as a whole, considering the entire record. 

20 C.F.R. § 404.1527. Further, an ALJ should not give controlling weight to a treating 

physician's opinion oflimitations unless it is "well-supported" and "not inconsistent" 

with other substantial evidence in the record. Id. at (d)(2). 

3. Credibility of Claimant 

In deciding whether to credit a party's testimony about subjective symptoms or 

limitations, the ALJ must engage in a two-step analysis. Batson, 359 F.3d at 1196; 

Smolen v. Chater, 80 F.3d 1273, 1281 (9th Cir. 1996). First, the party must produce 

objective medical evidence of an underlying impairment that could reasonably be 

expected to produce pain or other symptoms. Batson, 359 F.3d at 1195; Smolen, 80 

F.3d at 1281. If this test is satisfied, and there is no affirmative defense that the party 

is malingering, then the ALJ must determine the credibility of the party's subjective 

complaints. See Robbins v. Social Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006). In 

assessing the credibility ofa party's subjective complaints, the ALJ may consider such 

factors as the party's reputation for truthfulness, daily activities, and any 

inconsistencies in the statements. Light v. Soc. Sec. Admin., 119 F.3d 789, 792 (9th 

Cir. 1997); Smolen, 80 F.3d at 1284. While the ALJ must not disregard a party's 

testimony about the severity ofpain solely due to a lack ofsubstantiation by objective 

medical evidence, Congress expressly prohibits granting disability benefits based 

solely on a party's subjective complaints. See Robbins, 466 F.3d at 883; 42 U.S.C. § 

423(d)(5)(A)("An individual's statement as to pain or other symptoms shall not alone 

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be conclusive evidence ofdisability."). An ALl's credibility finding must be properly 

supported by the record and sufficiently specific to ensure a reviewing court that he or 

she did not "arbitrarily discredit" a party's subjective testimony. Thomas v. Barnhart, 

278 F.3d 947, 958 (9th Cir. 2002). 

v. DISCUSSION 

The ALl's analysis at steps 1 through 4 is not in dispute. The ALl provided 

specific and legitimate reasons for the weight apportioned to the testimony, opinions, 

and medical records presented during and in advance ofthe hearing. Additionally, the 

ALl's discussion of the entire record, including reasons plaintiff states in support of 

her position, reflects that the ALl did consider the record as a whole. See Gallant v. 

Heckler, 753 F.2d 1450, 1455-56 (9th Cir. 1984) (in determining existence of 

substantial evidence a reviewing court must consider both evidence that supports and 

detracts from ALl's conclusion). The ALl methodically evaluated plaintiffs 

testimony, the opinions of the treating physicians, the testimony and opinions of 

medical and vocational experts, and plaintiffs entire medical record in arriving at his 

conclusion regarding plaintiffs RFC. To the extent that the RFC articulated by the 

ALl conflicts with the opinions ofDr. Weissman or plaintiffs subjective complaints, 

the ALJ provided clear and convincing reasons for rejecting both the subjective claims 

and the opinions. Thus, the ALl's findings at steps 1 through 4 are supported by 

substantial evidence and are free of legal error. 

Plaintiff does not challenge the RFC or the ALl's evaluation of the medical 

evidence or her credibility. Rather, she only challenges the ALl's reliance on the 

vocational expert's testimony in finding that plaintiff was still capable ofperforming 

a significant number ofjobs in the national economy. Specifically, plaintiff contends 

that the ALl erred by (1) failing to include all of plaintiffs limitations in his 

hypothetical to the vocational expert; (2) failing to apply a sedentary base grid to 

plaintiff given the significant erosion to the light vocational base; and, (3) relying on 

testimony that is inconsistent with other jobs data noticed by defendant. For the 

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reasons outlined in greater detail below, none of the alleged deficiencies warrant 

reversal ofthe ALI's written decision and findings. 

A. The Hypothetical Posed to the Vocational Expert 

Plaintiff argues that the ALJ erred in relying on the testimony of vocational 

expert John Kilcher because of a discrepancy between plaintiffs limitations as posed 

in a hypothetical scenario by the ALJ to Mr. Kilcher during the hearing, and the actual 

limitations ultimately recognized and established by the ALJ in his written decision. 

[Doc. No. 16-1, p. 10] Specifically, whereas the ALJ ultimately found that plaintiff 

could, inter alia, "sit for no more than a total of 4 hours in an 8-hour workday," the 

hypothetical scenario presented to and assumed by Mr. Kilcher during the hearing was 

one where plaintiff could, inter alia, sit for more than 4 hours per workday. The 

discrepancy regarding plaintiffs ability to stay in a seated position is the only 

difference between the limitations recognized in the ALI's written decision and the 

hypothetical presented to the vocational expert at the hearing. Plaintiff contends that 

this was an incorrect hypothetical scenario, that Mr. Kilcher developed a vocational 

opinion regarding the availability ofjobs fitting plaintiffs limitations based off this 

incorrect assumption, and that the ALJ relied on this vocational opinion in arriving at 

his ultimate conclusion. Based on this Court's reading ofthe administrative record, the 

hearing at issue, the ALI's written decision, and the relevant occupations identified by 

Mr. Kilcher, there is no evidence to suggest that this inconsistency impacted the ALI's 

ultimate determination, let alone prejudiced plaintiff in any way. 

The ALI's hypothetical contained an incorrect clause stating plaintiff was 

capable ofsitting for more than 4 hours in a workday. The hypothetical also contained 

a clause permitting plaintiff to alternate between sitting and standing as regularly as 

every 30 minutes throughout an 8-hour workday (as is assumed and established in the 

written decision as well). The inconsistent sit scenario posed in the hypothetical does 

not impact the analysis for the following two reasons. First, because plaintiff would 

be permitted to alternate between sitting and standing every 30 minutes, she would 

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never be required, as a practical matter, to sit for more than four hours in an 8-hour 

workday. Second, taking the more-than-4-hour sit scenario at face value, the issue is 

moot because none of the three specific occupations identified by vocational expert 

Kilcher require plaintiff to sit for more than 4 hours (even though the ALJ's 

hypothetical question assumed that she could). 

While the sit clause at issue in the hypothetical was, on its own, technically 

inconsistent with the limitations established in the written decision, the plain language 

of the at-will clause allowing plaintiff to alternate between sitting and standing as 

regularly as every 30 minutes cures any deficiency. Further, the transcript from the 

administrative hearing demonstrates that the vocational expert was acutely aware of 

this 30 minute sit/stand requirement in recommending the three occupations presented 

to the ALJ. It is apparent to this Court that the vocational expert did not contemplate 

plaintiff being forced to sit for more than 4 hours in a workday, and clearly accounted 

for the 30 minute sit/stand clause in arriving at his opinions and selecting the three 

occupations as being suitable for plaintiff's needs and limitations. [AR at 62-63,68­

69] Therefore, this Court is satisfied that the 30 minute sit/stand option, which on its 

face conflicts with the more-than-4-hour sit scenario, neutralized and rendered moot 

any facial inconsistency. Because the 30 minute option appears in both scenarios, the 

RFC presented in the hypothetical and the RFC outlined in the final written decision, 

as a practical matter, function as the same. 

In Embrey v. Bowen, the Ninth Circuit held that when a vocational expert 

provides testimony based off a hypothetical scenario, the hypothetical posed must set 

out all of a claimant's limitations and restrictions for the expert's testimony to be 

deemed reliable. Embrey v. Bowen, 849 F .2d 418, 422 (9th Cir. 1988). Applying 

Embrey to the instant action, the alleged error in the hypothetical ALJ Spencer posed 

to vocational expert Kilcher appears harmless. Even though the hypothetical sit 

limitation presented to the vocational expert was, on its own, technically incorrect, 

there is no apparent prejudice to plaintiff as a result, given that the error was sanitized 

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by the plaintiffs consistently-recognized need to alternate between sitting and standing 

(every 30 minutes if necessary) throughout a typical workday. If plaintiff were 

permitted to alternate between sitting and standing every 30 minutes, a controlling 

clause in both the hypothetical and the written decision, an 8-hour workday for plaintiff 

would not entail more than 4 hours of sitting. 

F or all ofthese reasons, the issues raised by plaintiff regarding the hypothetical 

scenario posed to the vocational expert do not want warrant reversal or remand of 

defendant's final decision. Defendant sufficiently carried its burden at step 5 of the 

analysis. If there was any error at all, it was harmless and not the type contemplated 

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incomplete information (Le. entirely without reference to certain ofthe plaintiffs other 

medically determinable and recognized limitations). This is not the case in this action. 

B. The ALJ's Application of the Grids 

Plaintiff alleges that the ALJ erred in his application ofthe medical vocational 

guidelines (the "Grids"). "The Grids are used to determine whether substantial gainful 

work exists for the claimant with respect to substantially uniform levels of 

impairment." Thomas v. Barnhart, 278 F.3d 947, 960 (9th Cir. 2002). Plaintiff 

contends that the ALJ's use ofthe light job base, as opposed to the sedentary job base, 

was an error. [Doc. No. 16-1, pp. 13-14] Plaintiff argues that the vocational expert 

"testified three times that the sedentary job base would be the most appropriate 

exertional base[] due to the limited standing and the sit/stand 30 minute option," and 

that both counsel and the ALJ at the hearing "recognized that the full range of light 

work was significantly reduced [and] that the application ofthe sedentary grid rule was 

an issue critical to the analysis." Id. at 13. Plaintiff takes specific issue with the ALl's 

lack ofinquiry into the "degree oferosion" to the entire light job base, as well as to the 

three specific jobs identified by Mr. Ki1cher. Id. at 14. Plaintiff argues that applying 

a reduced light occupational base (with erosion from the full-range of the light work 

base reflecting plaintiffs additional limitations) instead of a sedentary base is 

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especially significant because plaintiff would have been found disabled under the SSA 

had a sedentary base been applied. Id. 

Defendant contends that the ALJ properly considered plaintiff's additional 

limitations in eroding the occupational base for light work available to plaintiff, and 

that the ALJ reasonably relied upon the testimony of the vocational expert in finding 

that, even after a reduction, there were a significant number of remaining light jobs 

plaintiff could perform. [Doc. No. 23-1, pp. 5-6] When, as here, an individual's 

exertionallimitations fall between the Grids because the Grids do not adequately take 

into account a claimant's full range of abilities and limitations, the occupational base 

lOis impacted, and this impact mayor may not represent a significant number ofjobs in 

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terms ofthe rules directing a conclusion regarding disability. Thomas v. Barnhart, 278 

F .3d at 960; see Social Security Ruling ("SSR") 83-12, available at 1983 WL 31253. 

"Where the extent of erosion ofthe occupational base is not clear, the adjudicator will 

need to consult a vocational resource." SSR 83-12, 1983 WL 31253 at *2. SSR 83-12 

contemplates the exact type of scenario faced by plaintiff, specifically addressing a 

claimant needing to alternate at will between sitting and standing. "Unskilled types of 

jobs are particularly structured so that a person cannot ordinarily sit or stand at will. In 

cases ofunusual limitation ofability to sit or stand, a [vocational specialist] should be 

consulted to clarify the implications for the occupational base." Id. at *4. 

ALJ Spencer therefore did exactly what the Regulations, caselaw, and SSR 83­

12 directed him to do-he consulted a vocational expert. The expert testified that a 

person with plaintiff's profile could perform substantial gainful work in the economy, 

identifying three light level occupations plaintiff could perform, the numbers ofwhich 

were reduced to account for the sit/stand option. [AR at 62-64, 69] Even after 

reduction, and based on the vocational expert's testimony, the ALJ found that a 

significant number ofjobs were available in the three occupations identified. Based 

on this analysis, the ALJ found that plaintiff was not disabled. "SSR 83-12 does not 

mandate a finding of 'disabled.' Instead, it mandates the use ofa [vocational expert], 

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which was exactly the process used in this instance." Moore v. Apfel, 216 F .3d 864, 

871 (9th Cir. 2000). 

Plaintiff asserts that the vocational expert opined that a sedentary job base would 

be the most appropriate exertional base due to plaintiffs need for a 30 minute sit/stand 

option. Thus, plaintiff argues that the ALJ committed error in not following this 

alleged recommendation, or in not giving clear reasons for rejecting it. Plaintiffs 

argument fails, mis-characterizes the nature of vocational expert Kilcher's testimony, 

and misconstrues the role of the vocational expert. Mr. Kilcher qualified that 

application of the sedentary base was his "interpretation" of the Grids alone, since 

plaintiff s condition fell between the light and sedentary base options. [AR at 69-70] 

Vocational expert Kilcher further explained that the Grids provide no further clarity 

beyond the base levels, and if forced to choose between afull range of light base and 

the sedentary options, he would round down to sedentary because plaintiff s limitations 

simply would not fit into the full range of light base as outlined in the Grids. Id. 

Given that vocational experts are routinely called to assist ALJ s in instances 

where a claimant's abilities fall between the Grids, Mr. Kilcher's statements are not at 

all surprising. Thus, plaintiffs "all of nothing" argument is simply not practical, is 

clearly not what was contemplated or intended under the Regulations, and does not 

even appear to be what Mr. Kilcher anticipated. Mr. Kilcher did not testify that the 

light base had been so eroded by plaintiffs limitations that the jobs left available were 

insignificant in number. Taking plaintiffs logic to its natural conclusion, the process 

of"eroding" a base grid would never occur, as all potential erosion scenarios would be, 

as a matter of course, rounded down to the next base option. This approach would 

obviate the need to consult a vocational expert to assess and account for a claimant's 

abilities and limitations which otherwise fall outside ofor between Grids. The caselaw, 

Regulations, and SSRs, however, allow and sometimes mandate that ALJ s consult with 

vocational experts for very the purpose ofanalyzing erosion scenarios and identifying 

the type and number of occupations in existence tailored to a claimant's specific 

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abilities/limitations. 

Furthermore, even assuming it was Mr. Kilcher's "recommendation" that the 

sedentary base be applied, despite the vocational expert's role as testifying expert, the 

ALJ, not the vocational expert, is responsible for weighing the value ofall the evidence 

presented (including the expert testimony), determining the degree of erosion, and 

ultimately selecting the appropriate Grid Rule. While a vocational expert must be 

consulted as part of this process, it does not naturally follow that every 

recommendation made or interpretation advanced by the vocational expert must be 

adopted by the ALJ. Thomas v. Barnhart, 278 F.3d at 960 (" ...when a claimant's 

exertion limitation falls between two grid rules, the ALJ fulfills his obligation to 

determine the claimant's occupational base by consulting a vocational expert regarding 

whether a person with claimant's profile could perform substantial gainful work in the 

economy."). 

F or all of these reasons, this Court finds that defendant sufficiently carried its 

burden at step 5 of the analysis and that the ALJ did not err in his application of the 

Grids. The ALJ was required to consult with a vocational expert. The expert testified 

that plaintiff was capable of performing substantial gainful work in the economy, 

identifYing three light level occupations plaintiff could perform, and providing 

corresponding reduced numbers the ALJ found to be significant. Based on this 

analysis, the ALJ found that plaintiff was not disabled. The ALJ's actions were proper, 

and his findings are substantially supported by the administrative record. Even ifMr. 

Kilcher disagreed with the ALJ's refusal to select the sedentary grid option, as argued 

by plaintiff, this does not undercut or otherwise devalue Mr. Kilcher's other findings, 

namely that three light jobs exist that plaintiff can perform given all ofher limitations, 

including the sit/stand option. Accordingly, the ALJ's application of the Grids does 

not warrant reversal or remand of defendant's decision denying plaintiff disability 

benefits. 

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C. The Jobs Numbers Presented by the Vocational Expert 

Plaintiff contends that the ALJ committed further error by relying on the 

vocational expert's testimony in arriving at the numbers of jobs nationally and 

regionally available for the three occupations identified as being suitable for plaintiff. 

Specifically, plaintiff argues that the numbers2 presented are not supported by the other 

evidence adduced at the hearing, or with other sources of reliable jobs data 

administratively noticed and relied upon by defendant. [Doc. No. 16-1, pp. 14-21] 

Plaintiff asserts that the ALJ improperly considered only national numbers, and attacks 

the accuracy ofthe numbers elicited from vocational expert Kilcher, citing allegedly 

conflicting data from the County Business Patterns, a source published by the Bureau 

of Census. Id. at 15. Specifically, plaintiff claims the vocational expert made an 

aggregation error. Id. at 19. 

Defendant argues that plaintiffs challenge ofthe data is untimely, and that the 

ALJ properly relied on the vocational expert's testimony in both accepting the numbers 

and in finding the numbers to be "significant." Defendant contends that plaintiffs 

counsel raised no objection at the hearing regarding the vocational expert's expertise 

and qualifications, that plaintiff failed to challenge the numbers or submit any 

alternative evidence from other vocational sources during or after the hearing, and 

failed to raise the issue with the Appeals Council on review. [Doc. No. 23-1, 7] For the 

first time before this Court, plaintiff now challenges the numbers provided by the 

vocational expert and adopted by the ALJ because they allegedly conflict with or are 

undercut by other sources of vocational data. Defendant asserts that this type of 

argument was addressed in Gutierrez v. Commissioner ofSocial Security, 740 F.3d 

2 From the ALJ's written opinion: "The vocational expert testified that given all 

of these factors the individua would be able to perform the requirements of 

representative occupations such as: assembler with 400 local jobs and 120,000 

national jobs; packager with 200 local jobs and 100,000 national Jobs; and garment 

sorter, wIth 250 localjohs and 125,000 national jobs. All ofthe numbers ofthese jobs reflect a reduction to the claimant's occupational base for unskilled light work due to 

the nonexertional limits identified in die residual functional capacity." [AR at 17 

(emphasis omitted)] 

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519,527 (9th Cir. 2014), when the Ninth Circuit rejected a plaintiffs after-the-fact 

challenge to the jobs numbers, noting that the claimant failed to challenge the 

vocational expert's expertise and testimony regarding the numbers during the hearing. 

[Doc. No. 23-1, p. 7] 

Plaintiffs arguments are without merit. When the Grids do not match a 

claimant's qualifications, an ALJ can rely on vocational expert testimony to determine 

whether a claimant can still perform jobs in the national economy. Thomas v. 

Barnhart, 278 F.3d at 960; see SSR 83-12, available at 1983 WL 31253. "An ALJ 

may take administrative notice of any reliable job information, including information 

provided by a [vocational expert]. A [vocational expert's] recognized expertise 

provides the necessary foundation for his or her testimony." Bayliss v. Barnhart, 427 

F.3d 1211, 1218 (9th Cir. 2005) (citation omitted). At the time ofthe hearing and on 

appeal, plaintiff failed to challenge the credibility of the expert or the numbers 

provided, despite having cross-examined Mr. Kilcher during the hearing. [AR at 35, 

63-70] Plaintiff fails to identify any actual error in the ALJ's reliance on the vocational 

expert's testimony. Rather, plaintiff offers in its Motion for Summary Judgment 

alternative vocational data evidence. As stated by defendant: "Plaintiff s attorney is 

not a vocational expert; she is merely piecing together statistics from various sources 

and offering her own layperson's interpretation." [Doc. No. 23-2, p. 7] 

In this case, the ALJ took administrative notice of reliable jobs information, 

namely testimony from vocational expert John Kilcher.3 This reliance was proper. 

Bayliss, 427 F.3d at 1218. In response to a hypothetical from the ALJ describing 

plaintiffs limitations, the vocational expert identified three occupations an individual 

with such limitations could perform. He based that determination on his own expertise, 

3 During the hearing, Mr. Kilcher relied on the Dictionary ofOccupational Titles 

("DOT"), a source publiShed by the Department of Labor, in testifying to the three 

occupatIOns at issue. [AR at 63-64] The DOT, the County Business Patterns, and 3 

other publications are recognized and listed in the Regulations as being sources of 

reliabfe job data and information. See SSR 00-4p; 20 C.F.R. §§ 404.1 566(d); 416.966{ d). 

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as well as on the position descriptions in the Dictionary of Occupational Titles 

("DOT,,).4 Because the DOT provides only job descriptions and specifications, and not 

the actual hard numbers regarding the national and regional availability ofthe same, 

vocational experts utilize additional secondary sources to ascertain the numbers of 

positions that exist for each of the DOT codes identified. Brault v. Social Security 

Admin., 683 F.3d 443, 446 (2nd Cir. 2012). These secondary sources typically 

correlate directly with the DOT codes. Id. In this case, vocational expert Kilcher does 

not specifically identify, during the hearing or anywhere in the overall record, which 

secondary source he used to provide the ALJ with the actual reduced numbers plaintiff 

lOis now challenging. 

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To dispute the numbers, plaintiff relies on a non-binding case from the Second 

Circuit, Brault v. Social Security Administration, supra, to argue that a vocational 

expert's testimony can be adversely impacted by the concept of data aggregation -"a 

many-to-one mapping, such as the one the [vocational expert] used to associate DOT 

titles to [a different system ofcodes used by a secondary source], necessarily creat[ing] 

information loss." Id. In Brault, a vocational expert relied upon a secondary source 

for jobs numbers which identified jobs using a different coding system than the DOT. 

The Brault plaintiff argued that the numbers ultimately arrived at by the vocational 

expert were impacted in translation by data aggregation or "inexact matching." Id. at 

445. The Second Circuit recognized the theory as being potentially viable and possibly 

4 "The DOT gives a job type a specific code-for example, '295.467-026 

Automobile Rental Clerk' -and establishes" among other things~ the minimum skill 

level and Qhysical exertion capacity reqUIred to perform that Job. Because of the 

detailed information aJ?p'ended to each DOT code, the codes are useful in determining the type ofwork a disaoility applicant can perform. In facththe DOT is so valued that 

a [vocational expert] whose evidence conflicts with t e DOT must provide a 

'reasonable explanation' to the ALJ for the conflict. The DOT, however, just defines jobs. It does not report how many such jobs are available in the economy.." Brault v. 

Social Security Aamin., 683 F.3(l 443, 446 f2nd Cir. 2012) (emphasis in original). Because the DOT does not provide the actua numbers, vocational experts often turn 

to additional secondary sources for this information, one such acceptable source being the Occupational Emp'loy'ment Quarterly III (the "OEQ"), which is prepared by a 

private organization callea. U.S. PUblishing, "to assess whether positions eXIst for each 

of the [] DOT codes identified." Id. 

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having a real and significant impact on numbers produced by vocational experts. The 

Second Circuit reasoned, however, that the vocational expert's reliance on this 

secondary source did not rise to the level of reversible error because the AtJ sought 

and received a stipulation regarding the expert's qualifications, plaintiffs counsel 

challenged the numbers and raised the issue of data aggregation on its crossexamination of the expert at the hearing, and counsel was even permitted to submit 

supplemental briefing to the ALJ on the same issue after the hearing. "In sum, 

[claimant's] attorney had a full opportunity to explain his objections in significant 

detaiL Nothing more was required." Id. at 451. 

The crux of plaintiff's argument in the present action is that because the DOT 

codes do not always directly correlate with job coding systems utilized by other 

secondary job data sources, data can be lost in translation, leading to unreasonably 

inflated or deflated job numbers. Plaintiff, however, makes this argument without 

knowing which secondary source was utilized by vocational expert Kilcher. Ifplaintiff 

took issue with Mr. Kilcher's qualifications or the source ofhis jobs data, the time to 

raise that issue was during the hearing, shortly thereafter, or on appeal. Based on this 

Court's review ofthe administrative record, the Regulations, and the case law, the ALI 

properly assessed plaintiffs limitations, determined that these limitations impacted her 

ability to perform the full range of light work as defined in the Grids, and obtained 

vocational expert testimony to identify a significant number ofreduced light-level jobs 

she was still capable of performing with her specific limitations. 

Nothing in the administrative record undercuts the ALJ's reliance on the 

vocational expert's testimony, and as argued by defendant, "there is no requirement 

that the Commissioner consult every vocational data source listed under sections 

404.1566 and 416.966, compare them, and then determine whether there is available 

alternative work in the national economy for a claimant." [Doc. No. 23-1] While the 

record fails to reflect the exact secondary source the vocational expert utilized in 

providing the ALJ with the reduced jobs numbers, there is no requirement that the ALJ 

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make such an inquiry, as he was well within his discretion to rely on the expertise and 

testimony of the expert. Bayliss, 427 F.3d at 1218. Further, it is relevant that 

plaintiffs counsel failed to challenge the vocational expert's expertise or testimony 

regarding these numbers, or otherwise further explore the veracity of these figures, 

during the hearing before the ALJ. See Gutierrez, 740 F.3d at 527. 

Accordingly, this Court finds that defendant sufficiently carried its burden at step 

5 of the analysis. No error or unsupported finding in the administrative record or 

written decision has been identified or discovered. Rather, plaintiff seeks to 

collaterally attack the ALl's findings with extraneous vocational data, advancing lay 

theories interpreting the same. This data was available to plaintiff at the time of the 

hearing, and on direct review to the Appeals Council. The ALl's reliance on the 

testimony of vocational expert Kilcher regarding the type and number of jobs in 

existence plaintiffis capable ofperforming was proper. Nothing presented by plaintiff 

in her moving papers [Doc. Nos. 16,26] warrants reversal or remand of defendant's 

decision denying plaintiff disability benefits. 

VI. CONCLUSION 

Consistent with the foregoing, the Court RECOMMENDS that plaintiffs 

Motion for Summary Judgment [Doc. No. 16] be DENIED, and that defendant's Cross 

Motion for Summary Judgment [Doc. No. 23] be GRANTED. 

This Report and Recommendation ("R&R") is submitted to the United States 

District Judge assigned to this case pursuantto 28 U.S.C. § 636(b)(1). Any party may 

file written objections with the Court and serve a copy on all parties within 14 days 

of being served with a copy of this R&R. The document should be captioned 

"Objections to Report and Recommendation." Failure to file objections within the 

specified time may affect the scope ofreview on appeal. Baxter v. Sullivan, 923 F.2d 

1391, 1394 (9th Cir. 1991). 

Date: June "Zr, ,2014 

. CRAWFORD 

United States Magistrate Judge 

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