Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_05-cv-00473/USCOURTS-cand-3_05-cv-00473-2/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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 Pursuant to the local rules of this district, the motions have been submitted on the

papers without oral argument. See Civil L.R. 16-5.

United States District Court

For the Northern District of California

 IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

SON CHENG,

Plaintiff,

 v.

JO ANNE B. BARNHART, Commissioner of

Social Security,

Defendant

 /

No. C-05-00473 MMC

ORDER GRANTING IN PART

PLAINTIFF’S MOTION FOR SUMMARY

JUDGMENT; DENYING DEFENDANT’S

CROSS-MOTION FOR SUMMARY

JUDGMENT; REMANDING ACTION

Before the Court is plaintiff Son Cheng’s motion for summary judgment or, in the

alternative, for remand; the Commissioner of the Social Security Administration’s

(“Commissioner”) opposition and cross-motion for summary judgment; and plaintiff’s reply. 

Having considered the papers filed in support of and in opposition to the motions, the Court

rules as follows.1

BACKGROUND

A. Procedural History

Plaintiff Son Cheng brings this action under 42 U.S.C. § 405(g) for judicial review of a

final decision of the Commissioner. Plaintiff alleges she is a 60 year-old Cambodian woman

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 "The Commissioner follows a five-step sequential evaluation process in assessing

whether a claimant is disabled. 

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, 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." 

McCartey v. Massanari, 298 F.3d 1072, 1074 n. 6 (9th Cir.2002).

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who fled the Khmer Rouge regime in 1979, and emigrated to the United States in 1984. (See

Certified Transcript of Administrative Proceedings (“Tr.”) at 142.) Plaintiff has held only one

substantial job since arriving in the United States: packaging Halloween costumes during

2000 and 2001. (See Tr. at 16, 32, 102.) 

On August 12, 2002, plaintiff, who was then 57 years old, filed with the Social Security

Administration (“SSA”) an application for Supplemental Security Income (“SSI”) benefits,

alleging therein and in an accompanying Disability Report that she has been unable to work

since September 1, 2001, as a result of “headache[s], backpain, polyarthralgia, poor vision,

memory loss, energy loss, depression, post-traumatic stress, [and] phobia.” (See Tr. at 101.) 

After the SSA denied plaintiff’s application, both initially, (see Tr. at 65-68), and on

reconsideration, (see Tr. at 70-73), plaintiff requested a hearing before an administrative law

judge (“ALJ”), (see Tr. at 74), and retained an attorney, (see Tr. at 75-78). On May 11, 2004,

the ALJ conducted a hearing, at which time the ALJ heard testimony from plaintiff and

plaintiff’s daughter, Sokham Mok (“Mok”). (See Tr. at 23-62.) 

On May 28, 2004, the ALJ issued a decision, finding plaintiff’s depression to be

“severe,” but that it does not preclude her from “perform[ing] her past relevant work as a

packager,” and, consequently, she is not disabled and not entitled to SSI benefits. (See Tr. at

15-22.) The ALJ analyzed plaintiff’s claim using the SSA’s five-step evaluation process. See

20 C.F.R. § 404.1520.2 At the first step, the ALJ found plaintiff had not engaged in substantial

gainful activity since at least September 1, 2001. (See Tr. at 16.) At the second step, the ALJ

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 “Clinicians use a GAF to rate the psychological, social, and occupational functioning

of a patient.” Morgan v. Commissioner of the Social Security Administration, 169 F.3d 595,

598 n. 1 (9th Cir. 1999). “A GAF between 41 and 50 indicates serious symptoms (e.g.

suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in

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

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found plaintiff does suffer from a "severe” mental impairment, namely major depression, but

that her physical impairments were not “severe.” (See id.) Under the third step, the ALJ found

plaintiff’s impairments do not equal the criteria of the listed impairments. (See Tr. at 17-18.) 

Finally, at step four, the ALJ found plaintiff is capable of performing her past work, and

therefore not disabled as a result of her depression. (See Tr. at 21.)

Plaintiff next filed a request with the Appeals Council, seeking review of the ALJ’s May

28, 2004 decision. (See Tr. at 11.) After the Appeals Council denied plaintiff’s request for

review, (see Tr. at 6-9), plaintiff filed the instant action. Plaintiff challenges herein only the

ALJ’s finding as to her alleged mental disability; she does not challenge the ALJ’s finding as

to her alleged physical disability. 

B. Plaintiff’s Psychiatric Treatment History

1. Dr. Ta

Plaintiff began treatment with a psychiatrist, Tuong-Vi Ta, M.D. (“Dr. Ta”), in August

2002. (See Tr. at 204-13.) In a report prepared for Alameda County Behavioral Health Care

Services, dated September 15, 2002, Dr. Ta diagnosed plaintiff with “major depression,” and

described plaintiff’s affect as “within normal limits,” her thought process as “slow” and

“simplistic,” and her thought content as indicating “hopelessness” with “no desire, no goal.” 

(See Tr. at 149.) Dr. Ta rated plaintiff’s Global Assessment of Functioning (“GAF”) score at

50,3 and noted that plaintiff was “cooperative.” (See id.) Throughout the course of treating

plaintiff, Dr. Ta frequently described plaintiff’s condition as “stable.” (See Tr. at 206, 209, 210,

211.)

/ /

2. Dr. Gracer

Plaintiff began visiting Jewish Family and Children Services of the East Bay (“JFCS”)

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in July 2002, to obtain counseling from a mental health paraprofessional. (See Tr. at 214-16.) 

In September 2003, plaintiff met once with James Gracer, M.D. (“Dr. Gracer”), a psychiatrist

who saw clients from JFCS on a volunteer basis. (See Tr. at 214, 221.) Dr. Gracer noted

plaintiff’s depression and that she had no “plan or intent.” (See id. at 221.) He also reported

problems concerning plaintiff’s relationship with her daughter, and noted that plaintiff only slept

two to three hours per night. (See id.) Dr. Gracer prescribed Lexapro and Trazodone to help

plaintiff sleep. (See id.) 

C. Examining Psychologists

1. Dr. Khoi

On September 5, 2002, Sokley Khoi, Ph.D. (“Dr. Khoi”), a licensed psychologist,

performed a “Neuropsychological Screening Evaluation” of plaintiff on behalf of the SSA. 

(See Tr. at 18, 57, 142-45.) Plaintiff told Dr. Khoi that she is able “to wash and dress herself,

fix meals, do laundry, take public transportation, and do limited household chores,” but stated

that “she lacks motivation in performing these activities.” (See Tr. at 142.) Plaintiff reported

she suffered from “headache, chest pain, and low back pain” and further stated: “I’m

depressed, I forget a lot, I can’t concentrate, I always feel really stressed . . . I’ve been having a

lot of nightmares.” (See id.) Dr. Khoi noted that plaintiff’s affect was “blunted,” and that she

was unable to perform “serial sevens.” (See Tr. at 143.) Plaintiff reported “intrusive thoughts,

nightmares, flashbacks, irritability, being easily startled, hypervigilance, and avoidance of

stimuli that remind her of her experiences” with the Khmer Rouge. (See id.) 

Dr. Khoi tested plaintiff’s nonverbal intelligence using the TONI-3 test and reported

plaintiff’s ability as “poor”; Dr. Khoi also tested plaintiff’s “visuo-construction/organicity” using

the Bender-Gestalt Test and found plaintiff to be “in the impaired range and characteristic of

organic impairment”; finally, Dr. Khoi tested plaintiff for malingering using the Rey 15-Item Test

and found plaintiff had “adequate motivation and effort.” (See Tr. at 144.) Dr. Khoi diagnosed

plaintiff with major depression and post-traumatic stress disorder. (See Tr. at 144.) 

Additionally, Dr. Khoi concluded that plaintiff was not impaired in her “[a]bility to follow simple

instructions”; mildly impaired in her “[a]bility to maintain adequate pace or persistence to

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perform one or two step simple repetitive tasks”; mildly to moderately impaired in her “[a]bility

to maintain adequate attention/concentration”; mildly to moderately impaired in her “[a]bility to

adapt to changes in job routine”; markedly impaired in her “[a]bility to withstand the stress of a

routine work day”; and moderately to markedly impaired in her “[a]bility to interact

appropriately with co-workers, supervisors, and [the] public on a regular basis.” (See Tr. at

145.) Aside from noting these impairments in abilities relevant to the workplace, Dr. Khoi did

not opine as to whether plaintiff could perform any type of work.

2. Dr. Afary

Mona Afary, Ph.D. (“Dr. Afary”) examined plaintiff on one occasion in connection with

plaintiff’s treatment at JFCS, (see Tr. at 216), for purposes of performing a “disability

evaluation,” (see Tr. at 214). In a report dated April 29, 2004, Dr. Afary described plaintiff’s

affect as “depressed, anxious, and hopeless,” and found her attitude to be “resigned and

gullible.” (See Tr. at 218.) Dr. Afary reported that plaintiff “does not cook” and “does not

socialize with anyone.” (See Tr. at 219.) Dr. Afary noted that plaintiff “does not feel safe

among a group of people,” and that “[k]eeping attendance, work schedules, making decisions

and relating to co-workers and supervisors seem impossible to her.” (See Tr. at 219.) Dr.

Afary found that plaintiff was “forgetful and unable to concentrate,” and diagnosed her with

major depression. (See Tr. at 218-19.) Dr. Afary rated plaintiff’s GAF score at 45 and stated

that plaintiff’s prognosis was “poor” and that she “is not able to work and keep a job.” (See Tr.

at 220.)

D. Nonexamining Psychiatric Assessment

1. Dr. Gragg

A state agency medical consultant, T.M. Gragg, M.D. (“Dr. Gragg”), reviewed plaintiff’s

file on September 27, 2002, and prepared two reports, one titled “Mental Residual Functional

Capacity Assessment,” and the other titled “Psychiatric Review Technique.” (See Tr. at 151-

163.) In one of the two reports, Dr. Gragg found plaintiff’s social functioning was “moderately”

impaired and that she “often” had “deficiencies of concentration, persistence or pace resulting

in failure to complete tasks in a timely manner.” (See Tr. at 162.) In the other report, however,

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Dr. Gragg rated plaintiff as “not significantly limited” in “social interaction” or in her ability to

“maintain attention and concentration for extended periods.” (See Tr. at 151-52.) Dr. Gragg

noted plaintiff’s history of post-traumatic stress disorder and depression, yet concluded that

plaintiff is capable of performing simple repetitive tasks. (See Tr. at 153.)

2. Dr. Chokatos

After plaintiff’s request for reconsideration, John Chokatos, M.D. (“Dr. Chokatos”),

reviewed the evidence in plaintiff’s medical file, including the report of Dr. Khoi, and affirmed

Dr. Gragg’s assessment that plaintiff nonetheless was capable of performing simple repetitive

tasks. (See Tr. at 64, 166.)

STANDARD OF REVIEW

The Commissioner's denial of disability benefits will not be disturbed if it is supported

by substantial evidence and based on the application of correct legal standards. See

Reddick v. Chater, 157 F.3d 715, 720 (9th Cir.1998). "Substantial evidence means more

than a mere scintilla, but less than a preponderance; it is such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion." Andrews v. Shalala, 53

F.3d 1035, 1039 (9th Cir.1995). If the evidence is susceptible of more than one rational

interpretation, the reviewing court will uphold the decision of the ALJ. See id.

DISCUSSION

Plaintiff contends in her motion for summary judgment that the ALJ erred in finding she

was not disabled because of her severe depression. Plaintiff argues the ALJ erred by: (1)

improperly discounting plaintiff’s testimony; (2) rejecting the testimony of plaintiff’s daughter,

Mok, without providing adequate reasons; and (3) improperly discounting the opinions of

plaintiff’s treating and examining physicians and psychologists without providing adequate

reasons.

A. The ALJ’s Rejection of Plaintiff’s Testimony

Plaintiff testified that for “four or five day[s]” per week, her depression prevents her from

leaving her bedroom, cooking for herself, and talking to people. (See Tr. at 48-49.) The ALJ

found plaintiff was not credible and “not . . . to be as impaired as she claims.” (See Tr. At 19.) 

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Although the ALJ is responsible for determining credibility and resolving ambiguities, his

findings “must be supported by specific, cogent reasons.” See Reddick, 157 F.3d at 722.

“Unless there is affirmative evidence showing that the claimant is malingering, the

Commissioner’s reasons for rejecting the claimant’s testimony must be ‘clear and

convincing.’” Id. Moreover, “[g]eneral findings are insufficient; rather, the ALJ must identify

what testimony is not credible and what evidence undermines the claimant’s complaints.” See

Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1996). As noted above, Dr. Khoi specifically

tested for malingering using the Rey 15-Item Test, and found adequate motivation and effort. 

(See Tr. at 144.) No medical practitioner reported any sign of malingering. Accordingly, the

ALJ’s reasons for rejecting plaintiff’s testimony must be “clear and convincing.” See Reddick,

157 F.3d at 722. 

“To determine whether the claimant’s testimony regarding the severity of her symptoms

is credible, the ALJ may consider, for example: (1) ordinary techniques of credibility

evaluation, such as the claimant’s reputation for lying, prior inconsistent statements concerning

the symptoms, and other testimony by the claimant that appears less than candid; (2)

unexplained or inadequately explained failure to seek treatment or to follow a prescribed

course of treatment; and (3) the claimant’s daily activities.” See Smolen v. Chater, 80 F.3d

1273, 1284 (9th Cir. 1996). When evaluating the credibility of symptom testimony, the ALJ

must consider “the claimant’s work record and observations of treating and examining

physicians and other third parties regarding, among other matters, the nature, onset, duration,

and frequency of the claimant’s symptom; precipitating and aggravating factors; functional

restrictions caused by the symptoms; and the claimant’s daily activities.” See id.

Here, the ALJ listed several reasons in support of his finding that plaintiff was not

credible: (1) plaintiff’s allegedly disabling physical impairments did not appear in medical

records until the time she applied for benefits, (see Tr. at 19); (2) plaintiff told the SSA in

December 2002 that she was unable to work due to “hallucinations,” despite medical reports

stating that she did not suffer from hallucinations, (see id.); (3) plaintiff claimed to have

permanently injured her back in the late 1970s to the extent that she can no longer lift anything,

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yet she worked in 2000 and 2001 (see id.); (4) Burton Brody, M.D. (“Dr. Brody”), who

examined plaintiff on behalf of the SSA to evaluate her physical disability, observed that

plaintiff “tended to answer positively to any symptom mentioned, without any actual

diagnoses,” (see id.); and (5) plaintiff told the SSA she left her packaging job in San Diego

because it was difficult to work with pain, yet told Dr. Khoi she left because she was laid off,

and told Dr. Brody she quit to return to the Bay Area, (see id.).

1. Timing of Treatment for Physical Impairments in Relation to 

 Application for Benefits 

The ALJ stated that although plaintiff “alleges a [physical] disability onset date of

September 1, 2001, her medical records are all after August 12, 2002, the date of her

application for benefits.” (See Tr. at 17.) The ALJ opined, “[i]t is just too coincidental that, in

the absence of any accident or other triggering event, the claimant would suddenly develop

disabling impairments just around the time that she filed her claim for benefits.” (See id.) 

Plaintiff does not dispute her lack of medical records before August, 2002. Plaintiff, however,

explained to Dr. Brody that she “had no medical attention over the past years, with no

diagnosis, being unable to afford medical care.” (See Tr. at 139.) Moreover, during her

testimony before the ALJ, plaintiff stated that once she moved to Oakland, she obtained

Medicare and sought treatment. (See Tr. at 39 (“When I come to Oakland I applied for

Medicare so I go to check it out”).) “Where a claimant provides evidence of a good reason for

not taking medication for her symptoms, her symptom testimony cannot be rejected for not

doing so.” Smolen, 80 F.3d at 1284. The ALJ’s decision fails to take into account plaintiff’s

stated reasons for the absence of medical records prior to August 2002.

2. Hallucinations and Inability to Lift

 

The ALJ noted that a Reconsideration Disability Report filed with the SSA in

connection with plaintiff’s request for reconsideration, signed by plaintiff and dated December

9, 2002, (see Tr. at 19, 114-15), states she is “unable to perform any work due to, inter alia,

“hallucinations”; the ALJ further noted there is “no indication from the claimant’s treatment

records, Dr. Khoi’s report, or Dr. Ta’s notes, that the claimant experiences hallucinations in

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any form.” (See Tr. at 19 (emphasis in original).)

Plaintiff states in her motion, albeit without citation to evidence in the record, that she

cannot read or write English, and that she relied on “some other person” to fill out the report. 

(See Pl.’s Mot. for Summ. J. at 20.) Plaintiff testified that she has dreams about her past: “I

dream sometime I see my mom to call me. Sometime I see the people that [INAUDIBLE] in

1975 they call me go to work.” (See Tr. at 37.) Similarly, Dr. Afary notes that plaintiff told her:

“I see my mother in my sleep calling for me from her grave.” (See Tr. at 216.) Given plaintiff’s

less than complete fluency in English, as demonstrated by her testimony at the hearing, the

reference in the Reconsideration Disability Report to “hallucinations” is not particularly

probative of plaintiff’s credibility. 

The ALJ also found plaintiff lacked credibility by reason of her statements “that she

permanently injured her back in Cambodia in the late 70's carrying 80 kilos of rice and that

she now cannot lift anything, even though she was well able to work in 2000 and 2001.” (See

Tr. at 19.) Plaintiff argues that a literal meaning of plaintiff’s statement, that she “cannot carry

anything,” (see Tr. at 215), is implausible as it would mean she was not capable of even

dressing herself. Additionally, plaintiff notes she made the statement to Dr. Afary for purposes

of obtaining a mental evaluation, not for purposes of determining the extent of any physical

impairment. (See Pl.’s Mot. for Summ. J. at 17.) Moreover, plaintiff notes that in her

application for SSI benefits, she reported to the SSA that her previous job required her to lift

no more than ten pounds. Contrary to the ALJ’s decision, there is no significant inconsistency

between plaintiff’s statement to Dr. Afary about her back injury and her history of light work in

2000 and 2001. 

3. Dr. Brody’s Observation

The ALJ further found plaintiff’s credibility to be “strained,” with respect to her claim of

mental disability, in light of Dr. Brody’s observation that plaintiff “tended to answer positively to

any symptom mentioned, without any actual diagnoses.” (See Tr. at 19.) Dr. Brody’s

assessment is particularly relevant with respect to plaintiff’s asserted physical impairments. 

With respect to plaintiff’s mental impairments, however, the ALJ failed to acknowledge that Dr.

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Khoi specifically tested plaintiff for malingering, using the Rey 15-Item test, and found

“adequate motivation and effort.” (See Tr. at 144.) There is no medical opinion or medical

evidence contradicting this test result. The opinion of an examining physician “can only be

rejected for specific and legitimate reasons that are supported by substantial evidence in the

record.” See Lester, 81 F.3d at 830-31. Here, the ALJ failed to provide any reason for failing

to credit Dr. Khoi’s assessment.

4. Plaintiff’s Reasons for Leaving San Diego

The ALJ also questioned plaintiff’s veracity because of disparities among her stated

reasons for leaving San Diego and returning to Oakland. (See Tr. at 19.) As noted by the

ALJ, plaintiff told the SSA “that she left her job because it was difficult for her to work with pain

[see Tr. at 101], while the same month she told Dr. Khoi that she left her job because she was

laid off [see Tr. at 143], and the next month she told Dr. Brody that she quit her job to come to

the Bay Area [see Tr. at 139].” (See Tr. at 19.)

 Plaintiff argues that the statements at issue are not inherently inconsistent, as all three

accurately describe what happened. Plaintiff’s statements that she quit her job because of

pain and in order to come to the Bay Area are not inherently inconsistent. Although plaintiff’s

statement that she was laid off does appear to be inconsistent with her statement that she quit

her job, the statements are reconcilable if plaintiff was laid off from her seasonal job and

decided not to return to work the following season. Plaintiff testified that her packing job in

San Diego was seasonal, lasting “only six month[s],” (see Tr. at 33), and Dr. Brody’s report

indicates that plaintiff came to the Bay Area in November 2001, shortly after the conclusion of

the Halloween season, (see Tr. at 139). Plaintiff explained to the ALJ that when the job ended

for the season, she applied for unemployment and moved to Oakland. (See Tr. at 33.) 

Nevertheless, the significance of the disparities noted by the ALJ is not solely that the

statements are different, but also that plaintiff, when discussing with medical practitioners her

reasons for leaving her previous job, never mentioned that pain played any role in that

decision. Again, however, this circumstance is more probative of plaintiff’s physical disability

claim. To the extent such evidence may be considered relevant as to plaintiff’s general

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character for honesty, and thus probative of plaintiff’s mental disability claim, the ALJ, as

noted, nonetheless failed to discuss Dr. Khoi’s finding that plaintiff was not malingering. 

5. Conclusion

The ALJ improperly discounted plaintiff’s credibility on the basis of plaintiff’s

statements, as described above. The ALJ noted no significant inconsistencies with respect to

plaintiff’s reports as to the severity of plaintiff’s mental impairments. See Smolen, 80 F.3d at

1284 (listing inconsistent statements among factors ALJ may consider in assessing

credibility). Most significantly, in assessing plaintiff’s credibility, the ALJ failed to credit the

results of the standardized tests administered by Dr. Khoi, none of which suggest any reason

to question her credibility and, in fact, support a finding that she is not malingering. Given the

medical evidence that plaintiff is not malingering with respect to her mental impairment, which

evidence the ALJ did not discuss in finding plaintiff lacked credibility, the ALJ’s stated

reasons for finding plaintiff not credible are not “clear and convincing.” See Reddick, 157

F.3d at 722.

B. Mok’s Testimony

Plaintiff argues that the ALJ rejected Mok’s testimony as to plaintiff’s mental condition

without providing any reason. Mok testified that plaintiff awakens in the middle of the night,

“panicking,” “sweaty,” and out of breath. (See Tr. at 53.) Mok also testified that plaintiff cannot

cook for herself or do laundry, and that plaintiff frequently cries. (See Tr. at 53-54.)

 “Disregard of the testimony of friends and family members violates 20 C.F.R. §

404.1513(c)(2).” Smolen, 80 F.3d at 1288. “[T]he ALJ can reject the testimony of lay

witnesses only if he gives reasons germane to each witness whose testimony he rejects.” Id.

Here, the ALJ did not reject Mok’s testimony; rather, the ALJ found such testimony did not

provide “much other support for the claimant’s claims that she cannot perform any work at all.” 

(See Tr. at 20.) There was no dispute that plaintiff suffers from nightmares as Mok testified. 

Mok’s testimony did not, however, bear on the issue of plaintiff’s ability to work. Accordingly,

the Court finds the ALJ did not improperly disregard the testimony of plaintiff’s daughter.

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4Psychologists are considered to be “acceptable medical sources” and their opinions

are given the same weight as medical doctors. See 20 C.F.R. § 404.1527 (defining “medical

opinions” as “statements from physicians and psychologists and other medical sources”).

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C. The ALJ’s Rejection of the Treating and Examining Mental 

 Professionals’ Assessments

The ALJ rejected the opinions of all of plaintiff’s treating and examining psychiatrists

and psychologists in favor of the opinions of nonexamining physicians. In particular, the ALJ

rejected the opinion of examining psychologist Dr. Afary, specifically, that plaintiff’s severe

depression and her GAF score of 45 rendered her “unable to work and keep a job.” (See Tr.

at 18, 220.) The ALJ also rejected examining psychologist Dr. Khoi’s opinion that plaintiff was

markedly impaired in her ability to withstand the stress of a routine work day, and moderately

to markedly impaired in her ability to interact appropriately with coworkers, supervisors and

the public on a regular basis. (See Tr. at 19, 144.) The ALJ also found unpersuasive treating

physician Dr. Ta’s diagnosis that plaintiff suffered from major depression and had a GAF

score of 50. Instead, the ALJ agreed with non-examining physician Dr. Gragg, who opined

that plaintiff’s depression limits her to the performance of “simple repetitive tasks only,” and

non-examining physician Dr. Chokatos, who affirmed Dr. Gragg’s assessment. (See Tr. at

20-21.) As a result, the ALJ found plaintiff not to be disabled, on the ground she could perform

her past relevant work as a packager. (See Tr. at 21.) Plaintiff argues that the ALJ erred by

rejecting the opinions of Drs. Khoi, Afary, and Ta without providing adequate reasons. 

1. Legal Standards

“Because treating physicians are employed to cure and thus have a greater opportunity

to know and observe the patient as an individual, their opinions are given greater weight than

the opinions of other physicians.” Smolen, 80 F.3d at 1285 (citations omitted).4 Where the

treating physician’s opinion contradicts the opinion of an examining or consulting physician,

the Commissioner must provide “‘specific and legitimate reasons’ supported by substantial

evidence in the record” for rejecting the treating physician’s opinion. See Lester, 81 F.3d at

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830 (quoting Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)). Likewise, “[t]he opinion of

an examining physician is, in turn, entitled to greater weight than the opinion of a

nonexamining physician” and, if controverted, “can only be rejected for specific and legitimate

reasons that are supported by substantial evidence in the record.” See Lester, 81 F.3d at

830-31. 

2. Self-Reported Symptoms

Based on a battery of tests, Dr. Khoi concluded that plaintiff exhibited a “marked”

impairment to “withstand the stress of a routine work day.” (See Tr. at 144-45.) Moreover, Dr.

Khoi specifically tested for malingering, using the Rey 15-Item Test, and found no indication

that plaintiff was malingering. (See Tr. at 144.) The ALJ nevertheless rejected Dr. Khoi’s

opinion in favor of that of Drs. Gragg and Chokatos, and, as a result, concluded plaintiff could

perform her past work as a packager. (See Tr. at 21.) The ALJ stated he was “suspicious of

Dr. Khoi’s recitation of the claimant’s Vegetative Signs/Symptoms and her PTSD symptoms

because these sound suspiciously like the claimant’s ‘tendency to answer positively [to] any

symptom mentioned’ that was noted by Dr. Brody.” (See Tr. at 19.) The ALJ attributed Dr.

Khoi’s findings more to her “power of suggestion than to their real presence in claimant’s life.” 

(See id.) Plaintiff argues that the ALJ erred by failing to recognize or address the fact that Dr.

Khoi’s opinion was based on the results of standardized psychological tests.

“A physician’s opinion of disability premised to a large extent upon the claimant’s own

accounts of his symptoms and limitations may be disregarded where those complaints have

been properly discounted.” Morgan, 169 F.3d at 602 (internal quotation and citation omitted). 

When, however, a psychologist finds no malingering or deception, and conducts independent

psychological testing, the psychologist is not taking plaintiff’s complaints “at face value.” See

Regennitter v. Commissioner of the Social Security Administration, 166 F.3d 1294, 1300 (9th

Cir. 1998) (holding psychologist should not be “faulted” for believing claimant’s complaints

where no evidence of malingering and where findings are based on independent testing). As

noted above, Dr. Khoi, who conducted a battery of tests, found no evidence of malingering,

despite specifically testing for it. The ALJ failed to discuss Dr. Khoi’s finding that plaintiff was

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It is not clear whether the ALJ realized this report was authored by Dr. Ta, as the ALJ

does not attribute it to him. (See Tr. at 18.)

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not malingering, and, consequently, has not set forth specific and legitimate reasons for

rejecting Dr. Khoi’s opinion on the ground that it is based on self-reporting. 

3. Treatment Records

Next, plaintiff argues that the ALJ erred because the ALJ rejected the opinions of Drs.

Khoi and Afary on the ground such opinions were unsupported by ongoing treatment records. 

In particular, the ALJ found the opinions of Drs. Khoi and Afary were “not supported by the

records of ongoing treatment the claimant received from 2002 through 2004 with Dr. Ta.” 

(See Tr. at 20.) The ALJ further noted that “[a]lthough Dr. Khoi’s August 2002 evaluation and

Dr. Afary’s April 2004 report ‘bookend’ Dr. Ta’s records, they are, interestingly, more similar

to each other than each is to Dr. Ta’s monthly observations of the claimant.” (See id.) In so

finding, the ALJ focuses on Dr. Ta’s repeated description of plaintiff as “stable,” deeming such

notations evidence that plaintiff was not suffering significant impairment. (See Tr. at 20.) 

“Stable,” however, means “resisting sudden change of . . . condition.” See Webster’s II New

College Dictionary 1073 (1995). Dr. Ta, in a report prepared at Alameda County Behavioral

Health Services, diagnosed plaintiff “with major depression” and found her “to have significant

impairments in the area of life functioning.” (See Tr. at 149.)5 Dr. Ta’s treatment notes, when

read in connection with the above-referenced report, suggest only that plaintiff’s major

depression with significant impairments has not changed. Consequently, the ALJ’s rejection

of the opinions of Drs. Khoi and Afary, on the basis of Dr. Ta’s finding, is not supported by the

record. 4. Rejection of Dr. Ta’s Opinion

Plaintiff argues that the ALJ improperly ignored the opinion of Dr. Ta. See Winans v.

Bowen, 853 F.2d 643, 647 (9th Cir. 1988) (holding failure of ALJ to give specific reasons for

ignoring treating physician’s opinion constitutes grounds for reversal.). As noted above, the

ALJ used Dr. Ta’s notes as support for discounting the opinions of Drs. Khoi and Afary,

whereas Dr. Ta’s records actually supported the opinions of Drs. Khoi and Afary. In

concluding plaintiff could perform her past work, the ALJ makes no reference to Dr. Ta’s rating

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of plaintiff’s GAF score at 50, which score, as noted earlier, reflects serious impairment. As a

result, the ALJ failed to provide “specific and legitimate” reasons for disregarding the opinion

of Dr. Ta.

5. Reliance on Opinion of Non-Examining Physicians

Other than his findings as to plaintiff’s credibility, the ALJ’s sole reason for rejecting the

opinions of plaintiff’s treating and examining physicians and psychologists is the ALJ’s

reliance on the opinion of two non-examining physicians. “The opinion of a non-examining

physician cannot by itself constitute substantial evidence that justifies the rejection of the

opinion of either an examining physician or a treating physician.” Lester, 81 F.3d at 831

(emphasis in original); see also Gallant v. Heckler, 753 F.2d 1450, 1456 (9th Cir. 1984)

(holding “report of non-treating, non-examining physician, combined with the ALJ’s own

observance of claimant’s demeanor at the hearing” did not constitute “substantial evidence”). 

Accordingly, Dr. Gragg’s report, either alone or in combination with Dr. Chokatos’ affirmation,

does not constitute substantial evidence for purposes of refuting the opinions of Drs. Khoi,

Afary, and Ta. See Lester, 81 F.3d at 831. 

D. Form of Relief

The Court has found that the ALJ failed to adequately explain his reasons: (1) for

finding plaintiff not credible; (2) for rejecting the opinions of plaintiff’s examining psychologists;

and (3) for ignoring the opinion of plaintiff’s treating physician.

Where the ALJ has improperly rejected relevant evidence, the Ninth Circuit has, on

occasion, declined to “remand solely to allow the ALJ to make specific findings” regarding

that evidence, and instead has credited the improperly rejected evidence as true and

remanded solely for an award of benefits. See Lester, 81 F.3d at 834 (internal quotation and

citation omitted); see also Smolen, 80 F.3d at 1292 (holding court may remand for award of

benefits “where the record has been fully developed and where further administrative

proceedings would serve no useful purpose”). In other such instances, however, the Ninth

Circuit has remanded for further proceedings rather than for an award of benefits. See

Connett v. Barnhart, 340 F.3d 871, 876 (9th Cir. 2003) (stating: “We are not convinced that

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the ‘crediting as true’ doctrine is mandatory in the Ninth Circuit.”; discussing cases; remanding

for reconsideration of claimant’s pain testimony); see also Bunnell v. Barnhart, 336 F.3d 1112,

1115-16 (9th Cir. 2003) (remanding for reconsideration where, inter alia, ALJ “failed to

provide adequate reasons for rejecting the opinion of the treating physicians” and “did not

properly reject [the claimant’s] subjective complaints”). In particular, those courts have

remanded when “outstanding issues must be resolved before a proper determination can be

made.” See id. at 1115. 

In a case such as this, there are outstanding issues that must be resolved before a

proper determination can be made. As discussed, the ALJ found plaintiff can perform work

involving “simple repetitive tasks,” (see Tr. at 21), but failed to credit evidence that may bear

on such finding. Consequently, issues remain as to whether sufficient reasons in fact exist for

the ALJ’s ultimate determination.

Under such circumstances, the Court does not find “the record has been fully

developed” or that “further administrative proceedings would serve no useful purpose.” See

Smolen, 80 F.3d at 1292. Accordingly, the Court will remand the action for further

administrative proceedings to allow the ALJ to develop the record as necessary and set forth

his conclusions. 

CONCLUSION

For the reasons stated above, plaintiff’s motion for summary judgment is hereby

GRANTED in part, defendant’s cross-motion for summary judgment is DENIED, and the

matter is REMANDED for further proceedings consistent with this decision.

The Clerk shall close the file.

IT IS SO ORDERED.

Dated: December 19, 2005

____________________________

MAXINE M. CHESNEY

United States District Judge

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