Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_06-cv-02127/USCOURTS-caed-2_06-cv-02127-0/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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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

DANIEL PACHECO, 

Plaintiff, No. CIV S-06-2127 KJM

vs.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant. ORDER

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

Security (“Commissioner”) denying applications for Disability Income Benefits (“DIB”) and

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

(“Act”), respectively. For the reasons discussed below, the court will deny plaintiff’s motion for

summary judgment or remand and grant the Commissioner’s cross-motion for summary

judgment. 

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 Disability Insurance Benefits are paid to disabled persons who have contributed to the 1

Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income (“SSI”) is paid

to disabled persons with low income. 42 U.S.C. § 1382 et seq. Under both provisions, disability

is defined, 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. §§ 423(d)(1)(a) &

1382c(a)(3)(A). A five-step sequential evaluation governs eligibility for benefits. See 20 C.F.R.

§§ 423(d)(1)(a), 416.920 & 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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I. Factual and Procedural Background

In a decision dated August 8, 2005, the ALJ determined plaintiff was not

disabled. The ALJ’s decision became the final decision of the Commissioner when the Appeals 1

Council denied plaintiff’s request for review. The ALJ found plaintiff has severe impairments of

degenerative disc disease of the lumbar and cervical spine, possible mild osteoarthritis of the

shoulders and hips, possible mild depression and borderline intellectual functioning but these

impairments do not meet or medically equal a listed impairment; plaintiff is not totally credible;

plaintiff can perform unskilled light work with certain limitations; plaintiff cannot perform his

past relevant work; and based on the testimony of a vocational expert, there are a significant

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number of jobs in the national economy that plaintiff could perform; and plaintiff is not disabled. 

Administrative Transcript (“AT”) 34. Plaintiff contends the ALJ erroneously found he does not

meet or equal Listing 12.05C. 

II. Standard of Review

The court reviews the Commissioner’s decision to determine whether (1) it is

based on proper legal standards under 42 U.S.C. § 405(g), and (2) substantial evidence in the

record as a whole supports it. Copeland v. Bowen, 861 F.2d 536, 538 (9th Cir. 1988) (citing

Desrosiers v. Secretary of Health and Human Services, 846 F.2d 573, 575-76 (9th Cir. 1988)). 

Substantial evidence means more than a mere scintilla of evidence, but less than a

preponderance. Saelee v. Chater, 94 F.3d 520, 521 (9th Cir. 1996) (citing Sorenson v.

Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975)). “It means such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402

U.S. 389, 402, 91 S. Ct. 1420 (1971) (quoting Consolidated Edison Co. v. N.L.R.B., 305 U.S.

197, 229, 59 S. Ct. 206 (1938)). The record as a whole must be considered, Howard v. Heckler,

782 F.2d 1484, 1487 (9th Cir. 1986), and both the evidence that supports and the evidence that

detracts from the ALJ’s conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir.

1985). The court may not affirm the ALJ’s decision simply by isolating a specific quantum of

supporting evidence. Id.; see also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If

substantial evidence supports the administrative findings, or if there is conflicting evidence

supporting a finding of either disability or nondisability, the finding of the ALJ is conclusive, see

Sprague v. Bowen, 812 F.2d 1226, 1229-30 (9th Cir. 1987), and may be set aside only if an

improper legal standard was applied in weighing the evidence, see Burkhart v. Bowen, 856 F.2d

1335, 1338 (9th Cir. 1988).

III. Analysis 

Plaintiff contends he meets or equals the requirements for Listing 12.05C (Mental

Retardation). The Social Security Regulations “Listing of Impairments” is comprised of

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 Section 12.00A states in pertinent part that “[l]isting 12.05 contains an introductory 2

paragraph with the diagnostic description for mental retardation. It also contains four sets of

criteria (paragraphs A through D). If your impairment satisfies the diagnostic description in the

introductory paragraph and any one of the four sets of criteria, we will find that your impairment

meets the listing.” 20 C.F.R. Part 404, Subpt. P, App.1, § 12.00A (emphasis added).

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impairments to certain categories of bodily systems and/or diseases severe enough to preclude a

person from performing gainful activity. Young v. Sullivan, 911 F.2d 180, 183 (9th Cir. 1990);

20 C.F.R. § 404.1520(d). Conditions described in the listings are considered so severe as to be

irrebuttably presumed disabling. 20 C.F.R. § 404.1520(d). In meeting or equaling a listing, all

of the requirements of that listing must be met. Key v. Heckler, 754 F.2d 1545, 1550 (9th Cir.

1985). 

To meet a listed impairment, a claimant must establish that he meets each

characteristic of a listed impairment relevant to his claim. To equal a listed impairment, a

claimant must establish symptoms, signs and laboratory findings "at least equal in severity and

duration" to the characteristics of a relevant listed impairment, or, if a claimant's impairment is

not listed, then to the listed impairment "most like" the claimant's impairment. 20 C.F.R.

§ 404.1526. A finding of equivalence must be based on medical evidence only. 20 C.F.R.

§ 404.1529(d)(3). 

As a prerequisite to a finding of disability under Listing 12.05, subaverage general

intellectual functioning with deficits in adaptive behavior must initially be manifested before age

22. 20 C.F.R. Part 404, Subpt. P, App.1, § 12.05. Under Listing 12.05C, once the prerequisite 2

is satisfied, a plaintiff is presumptively disabled if he or she has a “valid, verbal, performance, or

full scale IQ of 60 through 70 and a physical or other mental impairment imposing additional and

significant work-related limitation of function.” Id. 

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 The validity of the IQ scores was called into doubt by Dr. Walter, the testifying 3

consulting clinical psychologist. AT 418.

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The ALJ acknowledged that plaintiff had IQ scores in the 60-70 range and that 3

plaintiff also has a severe physical impairment. AT 28, 29, 294. The ALJ found, however, that

plaintiff failed to demonstrate deficits in adaptive behavior during the developmental stage and

thus failed to meet or equal the prerequisite of Listing 12.05. AT 29. There is substantial

evidence in the record that plaintiff does not meet the diagnostic description of mental retardation

as set forth in the regulation.

As noted by the ALJ, the examining and state agency physicians diagnosed

borderline intellectual functioning, not mental retardation. AT 29, 291, 319, 343. The ALJ also

relied on plaintiff’s ability to perform a number of common activities inconsistent with mental

retardation, including working for several decades, living on his own, managing his own finances

and household, managing his own support, preparing simple meals and managing his own

personal care. AT 28, 29, 134, 420; see 20 C.F.R. pt. 404, subpt. P, app. 1 § 12.00(C)(1) (stating

that adaptive functions include “cleaning, shopping, cooking, taking public transportation, paying

bills, maintaining a residence, caring appropriately for [one's] grooming and hygiene, using

telephones and directories, and using a post office”). The testifying expert stated plaintiff’s

mental condition was probably unchanged since childhood. AT 419. Because there is

substantial evidence that plaintiff did not have deficits in adaptive functioning during the

developmental stage, there is substantial evidence that he does not meet listing 12.05C.

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The ALJ’s decision is fully supported by substantial evidence in the record and

based on the proper legal standards. Accordingly, IT IS HEREBY ORDERED that:

1. Plaintiff’s motion for summary judgment or remand is denied, and

2. The Commissioner’s cross-motion for summary judgment is granted.

DATED: March 27, 2008.

006/pacheco.ss

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