Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_10-cv-01923/USCOURTS-azd-2_10-cv-01923-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Robert A. Maltsberger, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV-10-1923-PHX-GMS

ORDER

Presently before the Court is a Motion to Remand pursuant to sentence four of 42

U.S.C. § 405(g), filed by Defendant Michael J. Astrue, Commissioner of Social Security.

(Doc. 27). For the reasons set forth below, the Court grants Defendant’s Motion and remands

this matter to the Commissioner for payment of benefits.

BACKGROUND

On June 30, 2005, claimant Robert Maltsberger prospectively filed applications for

Disability Insurance Benefits and Supplement Security Income, alleging a disability onset

date of July 1, 2001. (R. at 18). The claim was denied initially on October 21, 2005 and upon

reconsideration on March 29, 2007. Plaintiff filed a timely request for a hearing, and, on

December 1, 2008, an Administrative Law Judge (“ALJ”) conducted a hearing on Plaintiff’s

claims. The claimant amended his alleged disability onset date to April 21, 2005. 

In a decision dated June 25, 2009, the ALJ found Plaintiff had not engaged in

substantial gainful activity since the alleged onset of his disability on April 21, 2005, and that

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he had the following severe impairments: chronic obstructive pulmonary disease, asthma,

diabetes, alcohol abuse and tobacco dependence, and osteoporosis resulting from steroid use.

(R. at 20). At step three, the ALJ found that Plaintiff “does not have an impairment or

combination of impairments that meets or medically equals one of the listed impairments in

20 C.F.R. Part 404, Subpart P, Appendix 1.” (Id.). The ALJ further determined that “the

claimant has the residual functional capacity to perform a limited range of sedentary work

as defined in 20 C.F.R. 404.” (R. at 21). Based on the vocational expert’s testimony, the ALJ

found that while Plaintiff could not return to his past relevant work, he could perform other

work existing in significant numbers in the national economy, including the sedentary jobs

of assembly production worker, office helper, and inspector/tester/sorter. (R. at 25–26). Thus,

the ALJ concluded he “was not under a disability, as defined in the Social Security Act, at

any time from April 21, 2005 through the date of this decision.” (R. at 26). The ALJ’s

decision became the final decision of the Commissioner when the Appeals Council denied

Plaintiff’s request for review. (R. at 6–9). 

The Commissioner concedes that the ALJ’s step-three analysis of whether Plaintiff

has an impairment that meets or medically equals an impairment listed at 20 C.F.R. pt. 404,

subpt. P, app. 1 was insufficient. Specifically, the Commissioner “concedes that the record

contains evidence which may support a finding that Plaintiff met one or more listings,”

including 3.02(C)(2) (chronic pulmonary insufficiency) and 3.03(B) (asthma). (Doc. 28 at

5). Nevertheless, neither the examining physician nor the State agency doctor found that

either listing had been met. Thus, Commissioner seeks remand for further administrative

proceedings to determine whether Plaintiff met the heightened standard for disability at step

three by consulting a medical expert, if necessary. (Id.). 

Further, the Commissioner also concedes that the ALJ erred in evaluating Dr. Jean

Weaver’s opinion that Plaintiff was unable to work full-time. In her report, Dr. Weaver, a

treating physician, failed to “reconcile her opinion that Plaintiff could sit, stand, and walk for

a full eight-hour day with her opinion that Plaintiff was unable to complete an eight-hour

workday or 40-hour workweek.” (Doc. 28 at 6) (citing R. at 208–09). Dr. Weaver also failed

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1

 Sentence four orders are made pursuant to the following statutory language: “The

court shall have power to enter, upon the pleadings and transcript of the record, a judgment

affirming, modifying, or reversing the decision of the Commissioner of Social Security, with

or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). 

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to “address information in her own treatment notes indicating that Plaintiff continued to work

despite his impairments.” (Id.). The Commissioner contends that the ALJ erred by adopting

Dr. Weaver’s opinion regarding Plaintiff’s ability to sit, stand/walk, and perform postural

activities without discussing Dr. Weaver’s opinion that due to shortness of breath at rest,

Plaintiff was unable to complete an eight-hour workday or 40-hour workweek. (Id.). The

Commissioner requests that on remand the ALJ be instructed to reevaluate the medical

source opinions on record, including Dr. Weaver’s opinion. While both parties agree that the

ALJ erred, they disagree over the proper remedy, namely whether Maltsberger’s case should

be remanded pursuant to sentence four1

 for an award of benefits, which Plaintiff contends

would be proper, or for further administrative proceedings. 

DISCUSSION

In Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir. 2000), the Ninth Circuit set forth

a test to determine when it is appropriate to remand for benefits versus further administrative

proceedings. Remand for further administrative proceedings is appropriate if enhancement

of the record would be useful. See id. Conversely, where the record has been developed fully

and further administrative proceedings would serve no useful purpose, the district court

should remand for an immediate award of benefits. See Smolen v. Chater, 80 F.3d 1273,

1292 (9th Cir. 1996); Varney v. Sec’y of Health & Human Servs., 859 F.2d 1396, 1399 (9th

Cir. 1988). More specifically, the district court should credit evidence that was rejected

during the administrative process and remand for an immediate award of benefits if (1) the

ALJ failed to provide legally sufficient reasons for rejecting the evidence; (2) there are no

outstanding issues that must be resolved before a determination of disability can be made;

and (3) it is clear from the record that the ALJ would be required to find the claimant

disabled were such evidence credited. Harman, 211 F.3d at 1178; see also McCartey v.

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2

 Because Plaintiff’s arterial blood gas studies were performed at testing sites in Lake

Havasu City, Arizona and Parker, Arizona, both situated at elevations less than 3,000 feet

above sea level, Table III-A is appropriate. 

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Massanari, 298 F.3d 1072, 1076–77 (9th Cir. 2002); Smolen, 80 F.3d at 1292. 

At step three of the sequential evaluation process, the ALJ was required to determine

whether Plaintiff’s impairments, or combinations thereof, met or equaled an impairment

listed in the regulations. One who claims upon review that the ALJ erred in not determining

and finding that a claimant’s combined impairments met a listing must offer a theory of how

the impairments combined to equal a listed impairment and point to evidence that shows that

his combined impairments equal a listed impairment. Lewis v. Apfel, 236 F.3d 503, 514 (9th

Cir. 2001). Generally, specific medical findings are needed to support the diagnosis and

establish the required level of severity. 20 C.F.R. §§ 404.1525(c)-(d), 416.925(c). Plaintiff

argues that the ALJ erred in step three by failing to address whether his impairments met or

equaled Listing 3.02(C)(2), chronic pulmonary insufficiency, and 3.02(B), asthma. The

Commissioner concedes that the ALJ failed to provide legally sufficient reasons, at step

three, for rejecting evidence related to whether Plaintiff’s condition met or medically equaled

a listed impairment. Even more, the Commissioner concedes that the “record contains

evidence which may support a finding that Plaintiff met one or more listings,” including

Listings 3.02(C)(2) and 3.03(B). (Doc. 28 at 5). 

Listing 3.02(C)(2) requires: 

C. Chronic impairment of gas exchange due to clinically documented

pulmonary disease. With:

2. Arterial blood gas values of PO2 and simultaneously

determined PCO2 measured while at rest (breathing room air,

awake and sitting or standing) in a clinically stable condition on

at least two occasions, three or more weeks apart within a 6-

month period, equal to or less than the values specified in the

applicable table III-A or III-B or III-C. 20 C.F.R. Subpt. P, App.

1, 3.02(C)(2). 

The tables associated with this Listing (Doc. 29, Ex. 1)2

 indicate that an individual, with

findings occurring “at least two occasions, three or more weeks apart within a 6-month

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period” would meet the requirements of Listing 3.02(C)(2) in at least these two instances:

(1) a PCO2 measurement of 30 mm Hg or below with a simultaneous PO2 measurement of

65 mm Hg or less; and (2) with a PCO2 measurement of 40 mm Hg or above with a

simultaneous PO2 measurement of 55 mm Hg or less. Id. Plaintiff meets the listings as to the

PCO2 and PO2 measurements. See R. at 538 (PCO2 = 29.7 mm Hg; PO2 = 54.2 mm Hg), 399

(PCO2 = 41.9 mm Hg; PO2 = 52.2 mm Hg). Plaintiff also satisfies the duration requirement

specified in the Listing because his first examination took place on January 15, 2006 and the

second on February 14, 2006, nearly a month later. (R. at 538, 399). Thus, the two

examinations are at least three weeks apart yet within a six-month period. Further, the

evidence reveals that Plaintiff met the requirements of Listing 3.02(C)(2) as of his alleged

disability onset date of April 21, 2005. Plaintiff had listing-level blood gas values on January

8, 2005, February 17, 2005, February 18, 2005, and April 21, 2005. (R. at 494). 

Nevertheless, the ALJ’s complete explanation at step three states: “The Disability

Determination Service (DDS) determined that the claimant’s impairments do not meet the

criteria of any of the listed impairments. No treating or examining physician has mentioned

findings equivalent in severity to the criteria of any listed impairment. The administrative law

judge has reviewed the records and finds that the claimant does not have impairments which

meet or equal the requirements of any section of Appendix 1.” (R. at 20–21). The Court’s

review of the record indicates that the examining physician, Dr. Ray Hughes, notes in his

report that Plaintiff’s January 2006 examination “suggest[s] listing level, but only 1 trial.”

(R. at 138). However, the record indicates that Plaintiff underwent a second examination in

February 2006, and that exam also satisfied the listing level. See R. at 399. In his written

decision, the ALJ fails to consider this evidence or to provide any explanation for why the

arterial blood gas studies should be disregarded. Based on the foregoing, the Court finds that

the ALJ erred in concluding that Plaintiff did not meet or equal Listing 3.02(C)(2). 

Additionally, Listing 3.03(B) requires: 

Asthma. 

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3

 Listing 3.00C defines “attacks” as “prolonged symptomatic episodes lasting one or

more days and requiring intensive treatment, such as intravenous bronchodilator or antibiotic

administration or prolonged inhalational bronchodilator therapy in a hospital, emergency

room or equivalent setting.” 

4

 Beyond these three incidents of hospitalization, Plaintiff was also hospitalized for

his asthma from September 18–24, 2005 (R. at 317), January 15, 2006 (R. at 501–03),

February 13, 2006 (R. at 414), and February 14–17, 2006 (R. at 362–63).

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B. With: Attacks (as defined in 3.00C)3

, in spite of prescribed treatment and

requiring physician intervention, occurring at least once every 2 months or at

least six times a year. Each in-patient hospitalization for longer than 24 hours

for control of asthma counts as two attacks, and an evaluation period of at least

12 consecutive months must be used to determine the frequency of attacks. 20

C.F.R. pt. 404, subpt. P, app. 1.

Plaintiff contends that he meets the criteria of Listing 3.03(B) as a result of several inpatient

hospitalizations. Indeed, the record establishes that Plaintiff was hospitalized on an inpatient

basis for treatment of asthma at least three different times during a 12-month period

commencing April 27, 2005. These include: (1) inpatient hospitalization from April 27, 2005

through May 3, 2005 for “asthma exacerbation” and “left lower lobe pneumonia,” which was

treated, in part, with IV antibiotics, albuterol SVN, and IV Solu-Medrol, which can be used

as a bronchodilator. (R. at 757–792); (2) inpatient hospitalization from December 14, 2005

through December 22, 2005 for “exacerbation of asthma chronic obstructive pulmonary

disease”, which was treated, in part, with IV antibiotics and IV Solu-Medrol (R. at 481–84);

and (3) inpatient hospitalization from January 24, 2006 through January 30, 2006 for

“exacerbation of underlying asthma/chronic obstructive pulmonary disease” and “anaerobic

pneumonia”, which was treated, in part, with IV antibiotics and IV Solu-Medrol. (R. at

540–43). Because each inpatient hospitalization lasting for longer than 24 hours counts as

two episodes towards the requisite six episodes in a 12-month period, Plaintiff’s three

hospitalizations satisfy the requirements of Listing 3.03(B).4

 The ALJ’s failure to consider

this evidence constitutes legal error. When the hospitalization data is credited, it becomes

clear that Plaintiff’s condition is sufficient to meet or equal Listing 3.03(B). 

Because the ALJ failed to provide legally sufficient reasons for rejecting relevant

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5

 If step 3 is answered affirmatively, that the applicant meets or equals the severity

requirements of a listed impairment, then the applicant is conclusively deemed to be disabled

and the sequential evaluation process ends. 20 C.F.R. § 404.1520(a) and (d). 

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evidence related to Plaintiff’s chronic pulmonary insufficiency and asthma, the Court credits

the evidence as true. See Harman, 211 F.3d at 1179; Smolen, 80 F.3d at 1281–83; Varney,

859 F.2d at 1398. With respect to the other two prongs of the Harman inquiry, the Court

concludes that there are no outstanding issues that must be resolved before a determination

of disability can be made and that it is clear from the record that the ALJ would be required

to find the claimant disabled if the evidence is credited.5 See Harman, 211 F.3d at 1178.

Because the Court finds Plaintiff disabled at step three of the sequential evaluation process,

it is not necessary to discuss the Commissioner’s request for remand on grounds that the

ALJ erred in his evaluation of Dr. Jean Weaver’s opinion regarding Plaintiff’s ability to

work. (Doc. 28 at 6–7). Consideration of Plaintiff’s ability to engage in past relevant work

or other work existing in significant numbers in the national economy is only relevant at

steps four and five of the five-step sequential evaluation process, as set forth in 20 C.F.R. §

404.1520(a)(4). See Lester v. Chater, 81 F.3d 821, 828 (9th Cir. 1995) (“Conditions

contained in the ‘Listing of Impairments’ are considered so severe that they are irrebuttably

presumed disabling, without any specific finding as to the claimant’s ability to perform his

past relevant work or any other jobs.” (citing 20 C.F.R. § 404.1520(d))). Thus, there are no

remaining issues that must be resolved by further administrative proceedings. The record is

fully developed and additional proceedings would serve no useful purpose. See Benecke v.

Barnhart, 379 F.3d 587, 593 (9th Cir. 2004). 

In cases where it is evident from the record that benefits should be awarded,

remanding for further proceedings would needlessly delay effectuating the primary purpose

of the Social Security Act, “to give financial assistance to disabled persons because they are

without the ability to sustain themselves.” Gamble v. Chater, 68 F.3d 319, 322 (9th Cir.

1995) (internal quotation marks and citation omitted). As a result, the Court reverses and

remands for payment of benefits. See Lester, 81 F.3d at 834 (stating that, when evidence that

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was improperly rejected demonstrates that the claimant meets or equals the Listing, then the

court should remand for payment of benefits; Smolen, 80 F.3d at 1292 (same); Ramirez v.

Shalala, 8 F.3d 1449, 1455 (9th Cir. 1993) (same). 

CONCLUSION

The ALJ committed legal error by failing to provide legally sufficient reasons for not

finding Plaintiff disabled at step three. The record establishes that if evidence of Plaintiff’s

arterial blood gas studies and his episodes of hospitalization as a result of his pulmonary

condition are credited as true, which must be done in the instant case, the Plaintiff’s

impairment definitively meets or medically equals the criteria for chronic pulmonary

insufficiency (3.02(C)(2)) and asthma (3.03(B)). Because the record has been developed fully

and further administrative proceedings would serve no useful purpose, remand for an

immediate award of benefits is appropriate. 

IT IS HEREBY ORDERED that:

1. The ALJ’s decision is REVERSED; 

2. Defendant’s Motion to Remand to the Social Security Administration

pursuant to sentence four of 42 U.S.C. § 405(g) is GRANTED (Doc. 27); and 

3. The Clerk of the Court is directed to REMAND back to the Social Security

Administration pursuant to 42 U.S.C. § 405(g), sentence four, for payment of benefits. 

Dated this 6th day of June, 2011. 

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