Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_08-cv-02665/USCOURTS-caed-2_08-cv-02665-1/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 (DIWC)

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

JOHN E. OWENS, 

Plaintiff, No. CIV S-08-2665 MCE EFB

vs.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant. FINDINGS AND RECOMMENDATIONS

 /

Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security

(“Commissioner”) denying his application for Social Security Disability Insurance Benefits

(“DIB”) and Supplemental Security Income (“SSI”) under Titles II and XVI of the Social

Security Act. For the reasons discussed below, the court recommends that defendant’s motion

be granted and plaintiff’s motion be denied.

I. BACKGROUND

Plaintiff, born September 9, 1957, formally applied for DIB and SSI on February 17,

2006. Administrative Record (“AR”) 10. His application alleged that he had been disabled

since April 30, 2004. Id. at 8. The application was denied initially and upon reconsideration,

and plaintiff requested an administrative hearing. Id. at 16. On January 8, 2008, a hearing was

held before administrative law judge (“ALJ”) Sandra K. Rogers. Id. at 17-40. Plaintiff was

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 Disability Insurance Benefits are paid to disabled persons who have contributed to the

Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income is paid to

disabled persons with low income. 42 U.S.C. § 1382 et seq. Both provisions define disability,

in part, as an “inability to engage in any substantial gainful activity” due to “a medically

determinable physical or mental impairment. . . .” 42 U.S.C. § 1382c(a)(3)(A). A five-step

sequential evaluation governs eligibility for benefits under both programs. See 20 C.F.R. §§

404.1520, 404.1571-76, 416.920 and 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-42

(1987). The following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful activity? If so,

the claimant is found not disabled. If not, proceed to step two. 

Step two: Does the claimant have a “severe” impairment? If so, proceed

to step three. If not, then a finding of not disabled is appropriate. 

Step three: Does the claimant’s impairment or combination of

impairments meet or equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P,

App.1? If so, the claimant is automatically determined disabled. If not, proceed

to step four.

Step four: Is the claimant capable of performing his past work? If so, the

claimant is not disabled. If not, proceed to step five. 

Step five: Does the claimant have the residual functional capacity to

perform any other work? If so, the claimant is not disabled. If not, the claimant

is disabled. 

Lester v. Chater, 81 F.3d 821, 828, n.5 (9th Cir. 1995). 

The claimant bears the burden of proof in the first four steps of the sequential evaluation

process. Bowen, 482 U.S. at 146 n.5. The Commissioner bears the burden if the sequential

evaluation process proceeds to step five. Id.

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represented by counsel and testified at the hearing. Also testifying was vocational expert

Stephen B. Schmidt. Id. 

The ALJ issued a decision on April 24, 2008, finding that plaintiff was not disabled.1

 Id.

at 8-16. The ALJ made the following specific findings:

1. The claimant meets the insured status requirements of the

Social Security Act through June 30, 2008.

2. The claimant has not engaged in substantial gainful activity at

any time relevant to this decision (20 CFR 404.1520(b) and

416.920(b)).

3. The claimant has the following severe impairment: Chronic

Obstructive Pulmonary Disease (COPD) (20 CFR 4-4.1520(c) and

416.920(c)).

***

4. The claimant does not have an impairment or combination of

impairments that meets or medically equals one of the listed

impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR

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404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and

416.926).

***

5. The claimant has the residual functional capacity to perform a

limited range of light work. He can sit or stand/walk 6 hours in an

8 hour workday; lift/carry 20 lb. occasionally and 10 lb.

frequently; occasionally climb, balance, stoop, kneel, crouch, and

crawl; and should avoid concentrated exposure to fumes, odors,

dusts, gases, poor ventilation, etc.

***

6. The claimant is unable to perform any past relevant work (20

CFR 404.1565 and 416.965).

***

7. The claimant was born on September 9, 1957 and was 46 years

old on the alleged disability onset date, which is defined as a

younger individual age 45-49 (20 CFR 404.1563 and 416.963).

8. The claimant has a high school education and is able to

communicate in English (20 CFR 404.1564 and 416.964).

9. Transferability of job skills is not an issue in this case because

the claimant’s past relevant work is unskilled (20 CFR 404.1568

and 416.968).

***

10. Considering the claimant’s age, education, work experience,

and residual functional capacity, there are jobs that exist in

significant number in the national economy that the claimant can

perform (20 CFR 404.1560(c), 404.1566, 416.960(c) and 416.966).

***

11. The claimant has not been under a “disability,” as defined in

the Social Security Act, from April 30, 2004 through the date of

this decision (20 CFR 404.1520(g) and 416.920(g)).

Id. at 8-16.

Plaintiff requested that the Appeals Council review the ALJ’s decision. However, on

September 6, 2008, the Appeals Council denied review, leaving the ALJ’s decision as the “final

decision of the Commissioner of Social Security.” Id. at 1-4.

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II. MEDICAL EVIDENCE

A. Chronic Obstructive Pulmonary Disease (COPD)

In May 2004, plaintiff was admitted to San Joaquin General Hospital for shortness of

breath, fever, and a cough. AR 193-95, 197-200, 202-207, 252-57. Pulmonary function tests

revealed findings consistent with mild to moderate chronic obstructive pulmonary disease

(COPD). On discharge, he was diagnosed with bilateral pneumonia, COPD, and hyperthyroidism

and was prescribed Atrovent, Albuterol, Azmacort, Allegra, Doxycycline and Prednisone staring

with a taper dose. Id. Follow-up pulmonary function testing on May 26, 2004 revealed mild

obstructive airway disease with air trapping and normal diffusion capacity. AR 196.

In June 2004, plaintiff was diagnosed with chronic bronchitis, COPD, hyperthyroidism,

and anemia, and was referred for further testing. AR 190-91. A chest x-ray in July 2004

revealed bullous emphysema. AR 188. A CT scan in September 2004 showed right upper lobe

apical blebs, AR 187, and another chest x-ray in September 2004 showed COPD with probable

mild associated CHF, question of minimal right infrahilar pneumonia or atelectasis. AR 183. 

On November 4, 2004, a chest x-ray confirmed a decrease in right lower lobe infiltrate and

atelectasis and no change in prominent bullous disease. AR 181. 

On November 18, 2004, plaintiff was seen at San Joaquin General Hospital. AR 180. 

Plaintiff reported shortness of breath and a cough, and stated that he had smoked for 15 years

and had used “rock cocaine” for 13 months. Id. The examination revealed emphysema, and

plaintiff was referred to a pulmonologist. Id.

On December 7, 2004, a chest x-ray showed “some middle lobe atelectasis, perhaps

slightly better than on the last examination,” and “extensive emphysematous changes in the

upper lobes, particularly on the right.” AR 179. A CT scan on December 23, 2004 showed

prominent bullous disease of both lungs not significantly changed since September 7, 2004

except for a new small bleb in the periphery of the right middle lobe. AR 178.

////

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On January 13, 2005, plaintiff was seen at San Joaquin General Hospital’s Family

Practice for a cough and pain associated with the coughing. AR 176. It was opined that plaintiff

was in need of a bronchoscopy with a pulmonologist, was prescribed Prednisone and Tylenol

#310, and was referred for further treatment. Id.

On February 10, 2005, plaintiff was examined by his physician, Dr. Ahmed Mahmoud, at

San Joaquin General Hospital. AR 175. Plaintiff was diagnosed with COPD, asthma, chronic

bronchitis, poor pulmonary function tests, and intermittent steroid therapy. Id.

On February 22, 2005, plaintiff was treated at San Joaquin General Hospital’s Family

Practice for cough and difficulty breathing. AR 174. He was diagnosed with severe COPD with

emphysema, allergic rhinitis, and chronic low back pain secondary to degenerative joint disease. 

Id. He was prescribed Albuterol and a nebulizer machine, Atrovent and Vicodin. Id. 

On May 25, 2005, pulmonary function testing showed that plaintiff had mild obstruction,

premedication, and mild restriction, postmedication. AR 170-72. 

On November 6, 2005, plaintiff was seen at San Joaquin General Hospital and described

a productive cough for the past three days, worsening shortness of breath, headache, chest pain

and fever. AR 232. Plaintiff was admitted after having a positive chest x-ray that showed right

middle and lower lobe pneumonia. Id. On November 9, 2005, he was discharged in fair

condition and was diagnosed with pneumonia, COPD, hyperthyroidism, and polysubstance

abuse. Id. 

In January 2006, an examination of plaintiff revealed bilateral wheezing in the lungs, and

plaintiff was diagnosed with an exacerbation of COPD. AR 332. In February 2006, plaintiff

was seen regarding his worsening cough and worsening back aches. AR 331. On March 21,

2006, plaintiff underwent another CT scan of the chest that showed apical bullous

emphysematous changes, considerably greater on the right, and the 4.5 cm bulla or bleb was seen

at the right base anterolaterally. AR 230. As of May 2006, plaintiff continued to report

shortness of breath and a cough, and was diagnosed with bullous emphysema. AR 330.

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On June 4, 2006, plaintiff received treatment at San Joaquin General Hospital for back

pain. AR 326-28. On June 5, 2006, plaintiff underwent pulmonary function testing (PFT). AR

266-80. The PFT showed moderate obstructive airway disease based on low FVC (66%

predicted), low FEV1 (58% predicted) and low flow rate. Id. Significant improvement in FVC

and FEV1 was noted on bronchodilator use and variable reproducibility was noted on

post-bronchodilator test. AR 266.

On June 20, 2006, P.A. Bianchi, M.D., completed a physical residual functional capacity

assessment of plaintiff, and opined that plaintiff was capable of performing light work consisting

of frequently carrying 10 pounds and occasionally carrying 20, sitting, standing and walking for

6 hours, occasionally climbing, balancing, stooping, kneeling, crouching, and crawling, and

avoiding concentrated exposure to fumes, odors, dusts, gas, and poor ventilation. AR 281-88. 

On June 29, 2006, he was seen at San Joaquin General Hospital’s Family Practice for COPD and

lower back pain. AR 324.

In December 2006, plaintiff was seen at San Joaquin General Hospital for shortness of

breath and a cough. AR 320-23; 334-37. An examination of plaintiff revealed wheezing and

rales in his chest and he was diagnosed with COPD. Id. From January 2007 to October 2007,

plaintiff was also treated for his COPD and lower back pain. AR 333; 365-67; 370-73.

B. Mental Diagnoses/Conditions

In 1993, plaintiff complained of insomnia, paranoia, nightmares, decreased memory, poor

concentration, intrusive thoughts, and stress. AR 217-27. He was diagnosed with Cocaine

Delusional Disorder and Depressive Disorder NOS. Id. He was in a cocaine/drug treatment

program at the time. Id.

In January 2006, plaintiff was treated at San Joaquin Mental Health Services. AR 214,

360-63. He reported hearing voices, depression, and feelings of isolation because he was afraid

to be hurt. AR 214; 362-63. He stated his girlfriend had lost their baby in a car wreck and he

heard the baby calling “daddy.” AR 214; 360. He also reported that his friend died recently and

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that he continued to see, hear and talk to him. AR 213; 359. Examinations revealed crying,

sadness, and hopelessness, a depressed mood, and a reported loss of sleep and appetite. AR 214;

359-61. He was diagnosed with psychotic disorder and was referred for further treatment. AR

363.

On February 14, 2006, Dr. Graff, of San Joaquin Mental Health Services, stated that

plaintiff was “dramatic, thrashing about, speaking forcefully, whining, crying w/o tears”; that

plaintiff “reports visual hallucinations and is unable to answer orientation questions despite

excellent memory for recent event”; and that plaintiff was “endorsing questions of malingering.” 

AR 213. He opined that plaintiff was malingering, had a personality disorder, and was engaged

in drug abuse. Id.

On May 9, 2006, plaintiff was evaluated by consultative psychologist David C.

Richwerger, Ed.D. AR 258-64. Dr. Richwerger reported that plaintiff stated he had a history of

outpatient psychiatric treatment due to hearing voices, and has difficulty with his memory, hears

ongoing voices, sees people on the walls, has troubling thoughts, often feels anxious and

depressed, and had suicidal ideations about two weeks prior. AR 259. Plaintiff stated that he

was taking Seroquel. Id. Plaintiff states that he did not sleep well because he heard voices and

thought someone was trying to kill him, was dependent on others for daily activities and

financial issues, and did not like to be around people. Id.

Dr. Richwerger’s examination revealed that plaintiff made ongoing jaw flicking motions

and a growling sound and did not make eye contact. AR 261. He was oriented to person and

place, did not know the date (but knew the year), and did not know the purpose of his evaluation. 

Id. His verbal responses were often mumbled and very difficult to understand, his thought

processes were tangential, he often looked around the room, and he insisted that the blinds be

closed and the door open, then he closed the door and opened it again. Id. He had difficulty

with simple tasks and was not able to respond to complete tasks, and was agitated, irritable and

paranoid. Id. Dr. Richwerger’s memory testing revealed that plaintiff was in the 0.2 percentile

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 The GAF Scale “[c]onsider[s] psychological, social, and occupational functioning on a

hypothetical continuum of mental health-illness.” The American Psychiatric Association’s

Multiaxial Assessment, set forth in the Diagnostic and Statistical Manual of Psychiatric

Disorders, (“DSM-IV”) (4th Ed. 2005), at 34. A GAF of 31 to 40 denotes “some impairment in

reality testing or communication” (e.g., speech is at times illogical, obscure, or irrelevant) OR

“major impairment in several areas, such as work or school, family relations, judgment, thinking

or mood.” Id.

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on verbal memory tasks and was in less than the 0.1 percentile on concentration and attention

tasks. Id. He was only able to remember two digits forward and zero digits backward. Id. He

did not respond to abstraction or to judgment tasks and his reality contact appeared impaired. Id. 

Dr. Richwerger attempted to conduct a memory malingering test, but the test could not be

completed because plaintiff did not appear capable of focusing on the test stimulus cards. Id.

Plaintiff could not focus on many of the tests Dr. Richwerger attempted to conduct and

became agitated. AR 262. His verbal IQ was 56 and his performance and full scale IQ could not

be determined. Id. Dr. Richwerger opined that plaintiff “appeared to be affected by the presence

of a psychotic process,” and diagnosed plaintiff with schizophrenia, paranoid type, and a Global

Assessment of Functioning (GAF) score of 40.2

 AR 262-63. Dr. Richwerger recommended that

plaintiff return to his treating psychiatrist and opined that plaintiff would have extreme

impairment in his ability to perform detailed and complex tasks, simple and repetitive tasks and

had great difficulty with any task presented to him; to perform work activities on a consistent

basis; to perform work activities without special supervision; to complete a normal workday or

workweek without interruption from a psychiatric condition; to understand and accept

instructions from supervisors; to interact with co-workers and the public; to maintain regular

attendance in the workplace; to deal with the usual stressors encountered in competitive work;

and to manage his own funds. AR 263-64.

On May 17 and 23, 2006, Charles Wood, LCSW, at the San Joaquin Mental Health

Services examined plaintiff and noted that although plaintiff stated that he continued to hear

voices and have insomnia, and felt that someone was out to get him, plaintiff did not appear to be

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responding to internal stimuli and did not appear sleep deprived. AR 356.

On August 16, 2006, State Agency psychiatrist A.R. Schrift, M.D., concluded that

plaintiff did not suffer from a mental impairment. AR 289. He noted that all of the medical

record of evidence regarding plaintiff’s COPD described him as intact, oriented, not psychotic,

and able to give a coherent history. AR 309. Dr. Schrift stated that plaintiff’s “allegations are

just not credible. His descriptions of AH & HV, plus not knowing the year are very suspicious. 

In fact as discharge in 11/05 he had a benign MSE. [Plaintiff] most likely malingering or at the

very least exaggerating his [symptoms].” Id. Dr. Schrift also noted that although plaintiff

claimed to be sober for years, his urine screens were positive for cocaine and cannabis when he

was admitted for three days for his COPD. Id. R. Tashijian, M.D., reviewed Dr. Schrift’s

assessment and affirmed it in February of 2007. AR 348.

On November 14, 2007, consultative psychologist Dr. Les Kalman, examined plaintiff. 

AR 382-90. Plaintiff reported difficulty sleeping and voices telling him not to go to sleep, and

stated that he did not like to be around people. AR 382. Dr. Kalman’s examination revealed

that plaintiff was dressed and groomed, had normal posture and gait, and had some shaking of

the upper extremities. Id. Plaintiff was slumped to the side of his chair, kept his eyes closed

through most of the interview, and responded to questions rather laconically with brief, terse

responses. Id. He reported being laid off for not showing up to work. Id.

The examination further revealed that plaintiff was not very cooperative and appeared

lethargic and disinterested. AR 383. His responses were delayed; he appeared lethargic but was

oriented to person, place and time; he recalled two of three objects at five minutes; he was able

to do four digits forward, three digits backward; he could do serial 3’s with three errors; he could

add, subtract, and multiply; his abstracts were intact; he did not know any proverbs; and insight

into his mental illness and judgment were poor. Id. His mood was irritable, apathetic and sad; 

his affect was flat; and he denied any suicidal or homicidal thoughts. AR 384. His thought

process was significant for vague, poverty of ideas, and there were no loose associations, mood

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 A GAF of 41 to 50 denotes “[s]erious symptoms (e.g., suicidal ideation, severe

obsessional rituals, frequent shoplifiting) OR any serious impairment in social, occupational, or

school functioning (e.g., no friends, unable to keep a job).” 

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swings or emotional liability. Id. Plaintiff reported delusions of a prosecutory nature, feeling

people were after him, with ideas of reference that the television was talking about him. Id. He

was capable of caring for his own personal hygiene but did not perform any other daily

activities, did not have any friends, and did not like to be around people. Id. He was

uncooperative with the interview, giving minimal responses, at times seeming to listen and other

times not. Id. He was diagnosed with polysubstance dependence in remission, psychosis, and

emphysema and was assigned a GAF of 50.3

 Id. His condition was not expected to improve

significantly in the next twelve months and he was not competent to manage his own funds. AR

385.

After examining plaintiff, Dr. Kalman completed a mental impairment statement opining

that plaintiff was not significantly limited in his ability to understand and remember very short

and simple repetitive instructions; was mildly limited in his ability to remember locations and

work-like procedures, to carry out short and simple instructions or tasks, to maintain attention

and concentration for extended periods, to perform activities within a schedule, to sustain an

ordinary routine without special supervision, to make simple work-related decisions, to ask

simple questions or request assistance, to maintain socially appropriate behaviors, to respond

appropriately to expected or unexpected changes, to be aware of hazards and take precautions, to

travel in unfamiliar places, and to set realistic goals; and he was moderately limited in his ability

to understand and remember detailed instructions or tasks, to carry out detailed instructions, to

work in coordination with or proximity to others without being unduly distracted by them, to

complete a normal workday and workweek without interruption from psychologically based

symptoms, to perform at a consistent pace without an unreasonable number and length of rest

periods, to interact appropriately with the general public or customers, to accept instructions and

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to respond appropriately to criticism from supervisors, and to get along with co-workers or peers

without unduly distracting them or exhibiting behavioral extremes. AR 387-89. He would have

an increased level of impairment beyond those indicated above with unruly, demanding, or

disagreeable customers even on an infrequent basis, production demands or quotas, demand for

precision, a need to make quick and accurate, independent decisions in problem solving. AR

389. Dr. Kalman opined that plaintiff was not the type of person for whom a routine, repetitive,

simple, entry-level job would serve as a stressor which would exacerbate instead of mitigate

psychological symptoms in the workplace. Id. 

III. ISSUES PRESENTED

Plaintiff contends that the Commissioner erred in sustaining the ALJ’s determination that

he is not disabled by (1) minimizing plaintiff’s mental illness based on an erroneous finding that

plaintiff was malingering and that he did not have any limitations arising from his mental

impairment; (2) finding, contrary to the vocational expert’s specific testimony, that plaintiff

would be able to use his breathing apparatus during the work day during lunch and other breaks;

and (3) failing to articulate specific and legitimate reasons for not crediting the consulting

examining opinions of Drs. Richwerger and Kalman. Dckt. No. 17 at 4.

IV. LEGAL STANDARDS

The Commissioner’s decision that a claimant is not disabled will be upheld if the findings

of fact are supported by substantial evidence in the record and the proper legal standards were

applied. Schneider v. Comm’r of the Soc. Sec. Admin., 223 F.3d 968, 973 (9th Cir. 2000);

Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Tackett v. Apfel,

180 F.3d 1094, 1097 (9th Cir. 1999).

 The findings of the Commissioner as to any fact, if supported by substantial evidence,

are conclusive. See Miller v. Heckler, 770 F.2d 845, 847 (9th Cir. 1985). Substantial evidence is

more than a mere scintilla, but less than a preponderance. Saelee v. Chater, 94 F.3d 520, 521

(9th Cir. 1996). “‘It means such evidence as a reasonable mind might accept as adequate to

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support a conclusion.’” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol.

Edison Co. v. N.L.R.B., 305 U.S. 197, 229 (1938)). 

“The ALJ is responsible for determining credibility, resolving conflicts in medical

testimony, and resolving ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir.

2001) (citations omitted). “Where the evidence is susceptible to more than one rational 

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

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

V. ANALYSIS

A. ALJ’s Finding that Plaintiff’s Schizophrenia Was Not a Severe Impairment

Plaintiff contends that the ALJ erred in failing to find that plaintiff suffered from a severe

mental impairment and in minimizing the limitations arising from his psychosis and

schizophrenia. Pl.’s Mot. for Summ. J. at 12. Plaintiff contends that the ALJ “completely

discounts the existence of a mental impairment due to her implicit finding that he was

malingering, even though multiple providers opined that [plaintiff] suffered from significant

mental limitations arising from his mental impairment.” Id. at 12-13. Plaintiff argues that the

malingering finding “is contrary to his medical history and the opinions of multiple medical

sources - including the government’s own expert.” Id. at 13.

According to plaintiff, the ALJ heavily relied upon a January 2006 progress note in

which Dr. Graff assigned plaintiff an Axis One diagnosis of malingering but also assigned

plaintiff an Axis II diagnosis of personality disorder. Id. at 13 (citing AR 213). Plaintiff

contends that the ALJ ignored the personality disorder diagnosis and therefore mistakenly

concluded that plaintiff did not have a mental impairment that caused any limitations. Id. 

Plaintiff notes that in May 2006 Charles Wood, plaintiff’s treating therapist, again diagnosed

plaintiff with an Axis II diagnosis of 301.9, which corresponds to personality disorder, not

otherwise specified, and assigned plaintiff a GAF of 50, indicating serious symptoms and

limitations due to his mental impairment. Id. (citing AR 357). Plaintiff argues the “ALJ never

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discussed Dr. Graff’s opinion that [plaintiff] suffered from personality disorder and instead

jumped to the conclusion that he was malingering as to mental illness in general.” Id. at 14. 

Plaintiff also contends that “the ALJ’s opinion that the medical experts (including Dr.

Richwerger who was the Commissioner’s own expert) were ‘taken in’ when they diagnosed

[plaintiff] with schizophrenia (Tr. 263) and psychosis not otherwise specified (Tr. 384) was

based on an incorrect assumption that did not include a co-diagnosis of personality disorder.” Id.

Plaintiff adds that “all evidence has been consistent as to a personality disorder at a minimum.” 

Id. at 17.

Defendant counters that “based on the medical evidence, the ALJ properly found only

Plaintiff’s COPD as a severe impairment.” Def.’s Mot. for Summ. J. at 4. Defendant contends

the ALJ relied on various medical sources, and that “[c]ontrary to Plaintiff’s contention, the ALJ

did not base her mental impairment finding solely on a medical opinion that Plaintiff engaged in

malingering. . . . The ALJ also found that Plaintiff’s testimony was not credible, a challenge

Plaintiff does not contest.” Id. at 4, 5. Defendant further contends that “[b]ecause the ALJ in

this case found that Plaintiff had severe impairments at step two, the question of whether she

characterized any other alleged impairments as ‘severe’ or ‘not severe’ was of little significance,

as long as she accommodated any actual limitations Plaintiff had in the RFC finding. . . . Here,

the ALJ fully considered all of Plaintiff’s impairments, including his mental impairments, and

accommodated Plaintiff’s limitations that were supported in the record in the RFC finding.” Id.

at 5.

To the extent plaintiff challenges the step two determination that plaintiff’s mental

impairments were not severe, plaintiff’s argument fails. “The step-two inquiry is a de minimis

screening device to dispose of groundless claims.” Smolen v. Chater, 80 F.3d 1273, 1290 (9th

Cir. 1996). The purpose is to identify claimants whose medical impairment is so slight that it is

unlikely they would be disabled even if age, education, and experience were taken into account. 

Bowen, 482 U.S. at 153. At step two of the sequential evaluation, the ALJ determines which of

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4

 To the extent plaintiff argues that the ALJ minimized the limitations arising from his

psychosis and schizophrenia at steps four or five in the sequential evaluation, the ALJ did

consider all of plaintiff’s impairments, including his mental impairments, that the ALJ found to

be credible. AR 12. Plaintiff does not challenge the ALJ’s credibility findings. See Rudebusch

v. Hughes, 313 F.3d 506, 521 (9th Cir. 2002) (refusing to address argument that was not raised in

party’s opening brief). Plaintiff’s specific argument that the ALJ erred during step five of the

sequential evaluation by failing to articulate specific and legitimate reasons for not crediting the

consulting examining opinions of Dr. Richwerger and Dr. Kalman is addressed below in

subsection (C).

14

claimant’s alleged impairments are “severe” within the meaning of 20 C.F.R. § 404.1520(c). A

severe impairment significantly limits a person’s physical or mental ability to do basic work

activities. Id. “An impairment is not severe if it is merely ‘a slight abnormality (or combination

of slight abnormalities) that has no more than a minimal effect on the ability to do basic work

activities.” Webb v. Barnhart, 433 F.3d 683, 686 (9th Cir. 2005) (citing Social Security Ruling

(“SSR”) 96-3p (1996)). If a severe impairment exists, all medically determinable impairments

must be considered in the remaining steps of the sequential analysis. 20 C.F.R. § 404.1523. The

ALJ “must consider the combined effect of all of the claimant’s impairments on her ability to

function, without regard to whether each alone [i]s sufficiently severe.” Smolen, 80 F.3d at

1290; 20 C.F.R. § 404.1523.

Here, the ALJ found that plaintiff’s only severe impairment was COPD. Plaintiff

argues that the ALJ should have also found her mental impairments to be “severe” at step two.

Regardless of whether plaintiff’s mental impairments were in fact severe, plaintiff’s argument

ignores the function of step two as a gatekeeping mechanism to dispose of groundless claims.

Once a plaintiff prevails at step two, regardless of which condition is found to be severe, the

Commissioner proceeds with the sequential evaluation, considering at each step all other alleged

impairments and symptoms that may impact her ability to work. See 42 U.S.C. § 423(d)(2)(B).

Here, plaintiff prevailed at step two. Therefore, plaintiff cannot prevail based on his argument

that the ALJ failed by not finding his mental impairments to be severe.4

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5

 Also, although plaintiff contends the ALJ erred by failing to consider Dr. Graff’s

personality disorder diagnosis, a mere diagnosis of an impairment is not sufficient to show

severity. See Sample v. Schweiker, 694 F.2d 639, 642-43 (9th Cir. 1989) (“The existence of an

emotional disorder . . . is not per se disabling . . . [t]here must be proof of the impairment’s

disabling severity”).

6

 As noted above, plaintiff does not challenge the ALJ’s credibility findings. 

15

Moreover, the ALJ relied on several sources in reaching her conclusion that plaintiff did

not suffer from a severe mental impairment. The ALJ noted that although plaintiff was “initially

diagnosed with Psychosis NOS,” in February 2006, Dr. Graff’s assessments “were malingering

and drug abuse.” AR 11 (referencing AR 213). Although the ALJ stated that the consultative

examiners (Drs. Richwerger and Kalman) appeared to be “taken in” by plaintiff, the ALJ

specifically noted that Richwerger was unable to objectively test plaintiff for malingering and

that plaintiff was uncooperative during his interview with Kalman. AR 11-12. Plaintiff

contends it was erroneous for the ALJ to “ignore” Dr. Graff’s additional personality disorder

diagnosis and to disregard the opinions of Drs. Richwerger and Kalman as having been “taken

in” by plaintiff. However, the ALJ provided significant support for her decision.5

 The ALJ

pointed out that the most recent chart notes from May 2006 indicated that despite plaintiff’s

allegation of difficulty sleeping because of hearing voices, “he did not appear to be sleep

deprived or responding to internal stimuli” and there was no evidence plaintiff was responding to

voices. AR 11 (referencing AR 356). The ALJ further noted that plaintiff gave inconsistent

information concerning his drug use.6

 AR 11. The ALJ also relied on the opinion of state

agency physician, Dr. Schrift, who found that plaintiff had no psychiatric symptoms that would

interfere with his ability to do work-related activities, that the medical evidence concerning

plaintiff’s COPD described him as intact, oriented, not psychotic, and able to give a coherent

history, as well as Dr. Tashijian, who affirmed Dr. Schrift’s assessment. AR 11 (referencing AR

289, 309, 348). Because the ALJ had significant evidence to support her finding that plaintiff

did not suffer from a severe mental condition, plaintiff is not entitled to relief on this ground.

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B. Plaintiff’s Breathing Device

Plaintiff further contends that the ALJ erred by mischaracterizing the vocational expert’s

testimony regarding plaintiff’s use of a breathing device. Pl.’s Mot. for Summ. J. at 18. Plaintiff

contends that the ALJ’s conclusion that although plaintiff “may at times be symptomatic, he

could use inhalers/nebulizers before and/or after work, and during lunch or other breaks,” AR

14, is “directly contrary to the vocational expert’s response that specifically stated all work

would be precluded.” Pl.’s Mot. for Summ. J. at 18 (citing AR 37). According to plaintiff, the

ALJ made a finding of fact in the hearing decision that plaintiff would need to use his

“nebulizer/inhaler” from time to time during the workday but could accomplish this during

lunches and breaks, while the VE specifically testified that plaintiff would not be able to use his

breathing apparatus during lunches and breaks because he is limited to unskilled work. Id. at 19. 

Defendant argues that, irrespective of the vocational expert’s testimony, which is not a

medical opinion, plaintiff “has not demonstrated that he needed to use his breathing apparatus

for 45 minutes. The only evidence for this is Plaintiff’s testimony which the ALJ properly found

incredible based on, among other things, the minimal treatment Plaintiff has received for his

COPD, his noncompliance with his physicians’ advice that he stop smoking, and history of drug

abuse.” Def.’s Mot. for Summ. J. at 6 (citing AR 13, 32, 259, 309, 329). Defendant also notes

that plaintiff has not challenged the ALJ’s credibility finding. Id. Defendant further contends

that “the ALJ did not state that using a breathing device for 45 minutes was necessary. Rather,

the ALJ stated that ‘[a]lthough [Plaintiff] may at times be symptomatic, he could use his inhaler

before and/or after work, and during lunch or other breaks. He could also stop smoking

cigarettes, as he has been advised by his physicians.” Id. (citing AR 14). Accordingly,

defendant contends, “the ALJ did not state that Plaintiff needed 45 minutes to use his breathing

device [and instead] indicated that Plaintiff also had the option of quitting smoking.” Id. 

The VE did testify that if plaintiff required “at least a 45 minute, straight 45 minute break

to use his [breathing device] during the working day,” that would preclude employment since

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“the types of jobs he’s going to be working with . . . are generally half hour lunches . . . .” AR

37. However, plaintiff’s arguments regarding that testimony suggest that plaintiff had no other

alternatives to using the breathing device for that time interval. To the contrary, the ALJ

expressly stated in her decision that plaintiff “could also stop smoking cigarettes, as he had been

advised by his physicians.” AR 14.

Moreover, there was no evidence before the ALJ that plaintiff needed to use his breathing

device for 45 minutes straight or that he needed to do so during the work day. Rather, when

asked about how long it takes plaintiff to set up the device and how long he wears the mask on

his face, plaintiff indicated that it takes him “about 10 minutes” to set up, and he wears the mask

for “about 45 minutes to an hour . . . because of the solution [he puts in], that’s how long it takes

to run out.” AR 24. When specifically asked if it takes “an hour to use it,” he responded “yes.” 

AR 25. Further, when asked how often he uses the device, plaintiff stated “I probably use it

three to four times a day.” AR 24. When he was asked what times of day he is using it, he

responded, “I use it starting at eight in the morning, then two in the afternoon, then like eight at

night.” AR 25. Plaintiff’s responses did not suggest that he needed to use a certain amount of

solution or that he needed to use the device at any particular time of the day. Additionally, the

ALJ specifically found that plaintiff was not entirely credible and that his symptoms were not as

severe as he alleged. The ALJ stated: “Considering the factors set forth in SSR 96-7p, I would

expect more treatment and even hospitalizations from one with symptoms as severe as the

claimant alleges. I also note that he has at times been noncompliant, has a significant history of

drug abuse, and continues to smoke cigarettes. He does not present as one highly motivated to

work, especially in light of his attempt to get food stamps when he was doing relatively well.” 

AR 14. The ALJ obviously questioned whether plaintiff really needed to use the device during

the workday or that he needed at least 45 minutes of uninterrupted time to use the device, since

the ALJ stated that plaintiff “could use his inhalers/nebulizers before and/or after work, and

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7

 Plaintiff contends that “[t]o the extent the Commissioner tries to argue that [plaintiff]

did not require a breathing machine or that it could be performed in less than 45 minutes (even

though there is no evidence to this effect), the ALJ’s decision stands as the final decision of the

Commissioner.” Pl.’s Mot. for Summ. J. at 20-21. However, as noted above, the ALJ’s decision

did expressly call into question plaintiff’s statements that he requires a breathing machine during

the workday and that it requires at least 45 minutes to operate. 

18

during lunch or other breaks.”7 AR 14. As noted above, plaintiff does not challenge the ALJ’s

credibility finding. Accordingly, plaintiff is not entitled to relief on this ground.

C. Consideration of Opinions of Consulting Examining Physicians

Lastly, plaintiff argues that the ALJ erred by “failing to articulate specific and legitimate

reasons for discrediting Dr. Richwerger’s (a psychologist) or Dr. Kalman’s (a psychiatrist)

opinions other than a general statement that the consultants were ‘taken in’ by plaintiff.” Pl.’s

Mot. for Summ. J. at 21 (citing AR 12). Plaintiff contends that the ALJ failed to recognize that

Dr. Graff, Mr. Woods, Dr. Kalman, and Dr. Richwerger all agreed that plaintiff had a personality

disorder and erroneously misread Dr. Graff’s progress note and missed the diagnosis for

personality disorder. Id. at 21. Accordingly, plaintiff contends, the ALJ’s analysis of the two

consultant opinions was “very skewed due to the ALJ’s own bias based on a presumption of

malingering and lack of any mental impairment.” Id. at 22. Plaintiff contends that the ALJ

never engaged in the proper analysis of Dr. Richwerger’s and Dr. Kalman’s opinions. Id.

Defendant acknowledges that an ALJ must give specific, legitimate reasons based on

substantial evidence if she rejects the opinion of a treating or examining physician, but contends

that ALJ did just that. Def.’s Mot. for Summ. J. at 6-7. The ALJ provided specific and

legitimate reasons for rejecting Dr. Richwerger’s opinion; found that Dr. Richwerger’s opinion

was inconsistent with treatment notes from Charles J. Wood, a psychologist who treated plaintiff

on May 17, 2006 and May 23, 2006, and who noted that there was no evidence that Plaintiff was

responding to internal stimuli or hearing voices; and did not reject Dr. Kalman’s opinion (which

was not inconsistent with the ALJ’s decision). Id. 

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The weight given to medical opinions depends in part on whether they are proffered by

treating, examining, or non-examining professionals. Lester, 81 F.3d at 830. Ordinarily, more

weight is given to the opinion of a treating professional, who has a greater opportunity to know

and observe the patient as an individual. Id.; Smolen, 80 F.3d at 1285. To evaluate whether an

ALJ properly rejected a medical opinion, in addition to considering its source, the court

considers whether (1) contradictory opinions are in the record; and (2) clinical findings support

the opinions. An ALJ may reject an uncontradicted opinion of a treating or examining medical

professional only for “clear and convincing” reasons. Lester, 81 F.3d at 831. In contrast, a

contradicted opinion of a treating or examining professional may be rejected for “specific and

legitimate” reasons, that are supported by substantial evidence. Id. at 830. While a treating

professional’s opinion generally is accorded superior weight, if it is contradicted by a supported

examining professional’s opinion (e.g., supported by different independent clinical findings), the

ALJ may resolve the conflict. Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995) (citing

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

Here, the ALJ considered all medical opinions in the record, including those of Drs.

Richwerger and Kalman. AR 10-12. The ALJ set out a thorough summary of the facts and

conflicting clinical evidence, discussing the treating and examining physicians’ findings and

conclusions. Id.

First, the ALJ provided specific, legitimate reasons based on substantial evidence for

rejecting the opinion of Dr. Richwerger, a consulting, examining psychologist. The ALJ found

that Dr. Richwerger’s opinion was inconsistent with treatment notes from Charles J. Wood, a

psychologist who treated plaintiff on May 17, 2006 and May 23, 2006, who noted that despite

plaintiff’s allegation of difficulty sleeping because of hearing voices, “he did not appear to be

sleep deprived or responding to internal stimuli” and there was no evidence plaintiff was

responding to voices. AR 11. Dr. Wood’s opinion was also consistent with the February 2006 

assessment by Dr. Graff that plaintiff was malingering, and the August 2006 opinion of Dr.

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Schrift that plaintiff had no medically determinable mental impairment. Id. 

The ALJ also discredited Dr. Richwerger’s opinion because Dr. Richwerger was unable

to objectively test plaintiff for malingering and his examination of plaintiff lacked various

scorable test results. AR 11. The ALJ noted that Dr. Richwerger was unable to test for memory

malingering because plaintiff did not appear able to focus; the Bender-Gestalt-II, an intelligence

test, could not be scored because of plaintiff’s “scribbles”; no results from Trails B were

provided because plaintiff “became agitated and would not focus on the test”; and plaintiff

became “agitated and paranoid” when attempting the Wechsler Memory Scales III or the Wide

Range Achievement Test, III. Id. The ALJ specifically stated that Dr. Richwerger “was

obviously persuaded by [plaintiff’s] presentation or performance but . . . was unable to

objectively test him for malingering.” Id.; see Andrews, 53 F.3d at 1043; Reddick v. Chater, 157

F.3d 715, 725 (9th Cir. 1998); Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001) (ALJ

may reject opinion of treating physician if it is unsupported by treatment notes or objective

medical findings). Moreover, Dr. Richwerger’s opinion was based on plaintiff’s own subjective

complaints and behavior, which the ALJ found to not be credible. See Morgan v. Comm’r of

Soc. Sec. Admin., 169 F.3d 595, 602 (9th Cir. 1999) (physician’s opinion properly disregarded if

premised on claimant’s discounted subjective complaints). Significantly here, plaintiff does not

challenge the ALJ’s assessment discrediting significant aspects of his testimony. Accordingly,

the ALJ properly rejected Dr. Richwerger’s opinion.

Second, the ALJ did not reject, and was not inconsistent with, the opinion of Dr. Kalman,

a consulting, examining psychiatrist. As the ALJ noted, Dr. Kalman’s examination showed that

plaintiff had only moderate limitations and was not cooperative with the interview. AR 12. Dr.

Kalman opined that plaintiff was not significantly limited in his ability to understand and

remember very short and simple repetitive instructions; was mildly limited in his ability to

remember locations and work-like procedures, to carry out short and simple instructions or tasks,

to maintain attention and concentration for extended periods, to perform activities within a

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schedule, to sustain an ordinary routine without special supervision, to make simple work-related

decisions, to ask simple questions or request assistance, to maintain socially appropriate

behaviors, to respond appropriately to expected or unexpected changes, to be aware of hazards

and take precautions, to travel in unfamiliar places, and to set realistic goals; and he was

moderately limited in his ability to understand and remember detailed instructions or tasks, to

carry out detailed instructions, to work in coordination with or proximity to others without being

unduly distracted by them, to complete a normal workday and workweek without interruption

from psychologically based symptoms, to perform at a consistent pace without an unreasonable

number and length of rest periods, to interact appropriately with the general public or customers,

to accept instructions and to respond appropriately to criticism from supervisors, and to get along

with co-workers or peers without unduly distracting them or exhibiting behavioral extremes. AR

387-89. Importantly, Dr. Kalman opined that plaintiff was not the type of person for whom a

routine, repetitive, simple, entry-level job would serve as a stressor which would exacerbate

instead of mitigate psychological symptoms in the workplace. Id. To the extent plaintiff

contends that Dr. Kalman’s opinion suggests a more severe mental impairment, that opinion is

also inconsistent with the treatment notes from Dr. Wood, the assessment by Dr. Graff that

plaintiff was malingering, and the opinion of Dr. Schrift that plaintiff had no medically

determinable mental impairment, and for the reasons stated above with regard to Dr. Richwerger,

the ALJ found those other opinions more persuasive. Id. 

The ALJ took into account all medical evidence and opinions relating to plaintiff’s

impairments, and appropriately resolved conflicts in the evidence. Therefore, plaintiff is not

entitled to relief on this ground. 

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VI. CONCLUSION

In conclusion, the court finds that the ALJ’s decision is supported by substantial evidence

in the record and based on the proper legal standards. Therefore, IT IS RECOMMENDED that:

1. Plaintiff’s motion for summary judgment be denied; 

2. The Commissioner’s cross-motion for summary judgment be granted; and

3. The Clerk be directed to enter judgment in the Commissioner’s favor.

These findings and recommendations are submitted to the United States District Judge

assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within fourteen days

after being served with these findings and recommendations, any party may file written

objections with the court and serve a copy on all parties. Such a document should be captioned

“Objections to Magistrate Judge’s Findings and Recommendations.” Failure to file objections

within the specified time may waive the right to appeal the District Court’s order. Turner v.

Duncan, 158 F.3d 449, 455 (9th Cir. 1998); Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991).

DATED: February 8, 2010.

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