Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_15-cv-00745/USCOURTS-azd-2_15-cv-00745-0/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 (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

John Lee McLaughlin, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant. 

No. CV-15-00745-PHX-NVW 

ORDER 

Plaintiff John Lee McLaughlin seeks review under 42 U.S.C. § 405(g) of the final 

decision of the Commissioner of Social Security (“the Commissioner”), which denied 

him disability insurance benefits and supplemental security income under sections 216(i), 

223(d), and 1614(a)(3)(A) of the Social Security Act. Because the decision of the 

Administrative Law Judge (“ALJ”) is supported by substantial evidence and is not based 

on legal error, the Commissioner’s decision will be affirmed. 

I. BACKGROUND 

Plaintiff was born in June 1973 and was 37 years old on the alleged disability 

onset date. He has at least a high school education and is able to communicate in 

English. He worked as a day laborer, a garbage truck driver, a dump truck driver, an ink 

mixer, and a convenience store clerk. He is 5’11” and weighs about 265-285 pounds. 

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Plaintiff suffered a lower back injury at work in 2004. He has not worked since 

2007. In 2008, he had back surgery for a herniated disk at L5-S1 on the left. In 2010 

Plaintiff reported pain and left radiculopathy, and an MRI showed some possible disk 

bulge at the surgery site and a midline herniated disk at L4-5 that was present several 

years before. In December 2010, Plaintiff’s neurosurgeon found the MRI did not show 

any definitive nerve root compression at S1 despite reported symptoms that were 

consistent with a left S1 radiculopathy, and he recommended nerve blocks rather than 

surgery. Plaintiff did not have nerve blocks. In February 2011, Plaintiff reported to his 

primary care physician that he had been advised to have epidural injections, but he 

refused because his father had a bad experience and because he was concerned the 

injections could leave scars. In July 2011, Plaintiff’s primary care physician prescribed a 

back brace with built-in electrodes and a TENS unit to treat Plaintiff’s pain. 

Plaintiff alleges constant back pain and numbness as well as nerve pain radiating 

down his left leg. To manage his pain, Plaintiff is prescribed Lyrica (nerve pain 

medicine), Soma (muscle relaxer), oxycodone (opioid pain medicine), and 

hydromorphone (opioid pain medicine). He testified the medication makes his pain 

tolerable and the only side effects he experiences are weight gain from the Lyrica and 

occasional insomnia from the hydromorphone. Medical records indicate Plaintiff has 

been taking opioid pain medicine since at least 2010.1

Plaintiff applied for disability insurance benefits on May 18, 2011, and for 

supplemental security income on April 5, 2013, alleging disability beginning April 28, 

2011. On August 5, 2013, he appeared with his attorney and testified at a hearing before 

the ALJ. A vocational expert also testified. On September 17, 2013, the ALJ issued a 

decision that Plaintiff was not disabled within the meaning of the Social Security Act. 

The Appeals Council denied Plaintiff’s request for review of the hearing decision, 

 1

 In December 2010 Plaintiff’s neurosurgeon noted that Plaintiff “should be 

weaned from the large dose of narcotics he is currently taking.” 

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making the ALJ’s decision the Commissioner’s final decision. On April 24, 2015, 

Plaintiff sought review by this Court. 

II. STANDARD OF REVIEW 

The district court reviews only those issues raised by the party challenging the 

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court 

may set aside the Commissioner’s disability determination only if the determination is 

not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 

625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. In determining whether 

substantial evidence supports a decision, the court must consider the record as a whole 

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. 

As a general rule, “[w]here 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) (citations omitted); 

accord Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (“Even when the evidence 

is susceptible to more than one rational interpretation, we must uphold the ALJ’s findings 

if they are supported by inferences reasonably drawn from the record.”). “Overall, the 

standard of review is highly deferential.” Rounds v. Comm’r Soc. Sec. Admin., 807 F.3d 

996, 1002 (9th Cir. 2015). 

III. FIVE-STEP SEQUENTIAL EVALUATION PROCESS 

To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears 

the burden of proof on the first four steps, but the burden shifts to the Commissioner at 

step five. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

At the first step, the ALJ determines whether the claimant is engaging in 

substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not 

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disabled and the inquiry ends. Id. At step two, the ALJ determines whether the claimant 

has a severe medically determinable physical or mental impairment. § 404.1520(a)(4)(ii). 

If not, the claimant is not disabled and the inquiry ends. Id. At step three, the ALJ 

considers whether the claimant’s impairment or combination of impairments meets or 

medically equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404. 

§ 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. Id. If 

not, the ALJ proceeds to step four. At step four, the ALJ assesses the claimant’s residual 

functional capacity and determines whether the claimant is still capable of performing 

past relevant work. § 404.1520(a)(4)(iv). If so, the claimant is not disabled and the 

inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, where he determines 

whether the claimant can perform any other work based on the claimant’s residual 

functional capacity, age, education, and work experience. § 404.1520(a)(4)(v). If so, the 

claimant is not disabled. Id. If not, the claimant is disabled. Id. 

At step one, the ALJ found that Plaintiff meets the insured status requirements of 

the Social Security Act through December 30, 2012, and that he has not engaged in 

substantial gainful activity since April 28, 2011, the alleged onset date. At step two, the 

ALJ found that Plaintiff has the following severe impairments: degeneration of the 

lumbar spine intervertebral disk, obesity, and lumbar radiculitis. At step three, the ALJ 

determined that Plaintiff does not have an impairment or combination of impairments that 

meets or medically equals an impairment listed in 20 C.F.R. Part 404, Subpart P, 

Appendix 1. 

At step four, the ALJ found that Plaintiff: 

has the residual functional capacity to perform light work as defined in 20 

CFR 404.1567(b) and 416.967(b) with the following exceptions. The 

claimant cannot crawl, crouch, climb, squat, or kneel. The claimant cannot 

use the lower extremities for pushing/pulling and must have a sit/stand 

option, which would allow him to sit or stand alternatively at will provided 

that the claimant is not off task more than 10% of the work period. 

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The ALJ further found that Plaintiff is unable to perform any past relevant work. At step 

five, the ALJ concluded that, considering Plaintiff’s age, education, work experience, and 

residual functional capacity, there are jobs that exist in significant numbers in the national 

economy that Plaintiff could perform. Representative occupations include parking lot 

attendant, cashier, and ticket taking positions. 

IV. ANALYSIS 

A. The ALJ Provided Specific, Clear, and Convincing Reasons for 

Discrediting Plaintiff’s Symptom Testimony. 

If a claimant’s statements about pain or other symptoms are not substantiated by 

objective medical evidence, the ALJ must consider all of the evidence in the case record, 

including any statement by the claimant and other persons, concerning the claimant’s 

symptoms. SSR96-7p. Then the ALJ must make a finding on the credibility of the 

claimant’s statements about symptoms and their functional effects. Id. 

In evaluating the credibility of a claimant’s testimony regarding subjective pain or 

other symptoms, the ALJ is required to engage in a two-step analysis: (1) determine 

whether the claimant presented objective medical evidence of an impairment that could 

reasonably be expected to produce some degree of the pain or other symptoms alleged; 

and, if so with no evidence of malingering, (2) reject the claimant’s testimony about the 

severity of the symptoms only by giving specific, clear, and convincing reasons for the 

rejection. Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009). 

To ensure meaningful review, the ALJ must specifically identify the testimony 

from a claimant the ALJ finds not to be credible and explain what evidence undermines 

the testimony. Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1102 (9th Cir. 

2014). The ALJ must make findings “sufficiently specific to permit the court to conclude 

that the ALJ did not arbitrarily discredit claimant’s testimony.” Thomas v. Barnhart, 278 

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

In making a credibility determination, an ALJ “may not reject a claimant’s 

subjective complaints based solely on a lack of objective medical evidence to fully 

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corroborate the claimant’s allegations.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 

1219, 1227 (9th Cir. 2009) (internal quotation marks and citation omitted). But “an ALJ 

may weigh inconsistencies between the claimant’s testimony and his or her conduct, 

daily activities, and work record, among other factors.” Id. The ALJ must consider all of 

the evidence presented, including the claimant’s daily activities; the location, duration, 

frequency, and intensity of the pain or other symptoms; factors that precipitate and 

aggravate the symptoms; effectiveness and side effects of any medication taken to 

alleviate pain or other symptoms; treatment other than medication; any measures other 

than treatment the claimant uses to relieve pain or other symptoms; and any other factors 

concerning the claimant’s functional limitations and restrictions due to pain or other 

symptoms. SSR 96-7p. 

First, the ALJ found that Plaintiff’s “medically determinable impairments could 

reasonably be expected to cause some of the alleged symptoms.” Second, the ALJ found 

Plaintiff’s “statements regarding the intensity, persistence, and limiting effects of these 

symptoms are not entirely credible for the reasons explained in this decision.” 

Plaintiff testified that he quit working because of excessive pain and that he is 

unable to work now because he is in constant pain. He said the longest he can stand and 

walk is 15–20 minutes and the longest he can sit is 30–35 minutes. He testified that on a 

typical day he gets up about 8:00 a.m., gets coffee, lies down for an hour or two, walks 

around for 15–20 minutes including going outside to smoke a cigarette, and then sits or 

lies back down. He said he spends the rest of the day in a similar manner, lying down for 

about 8 hours a day while watching television. Plaintiff also testified that on a typical 

day he experiences pain in his back and leg at a level of six on a scale of one to ten. 

The ALJ found Plaintiff’s claims of constant and excessive pain lacked credibility. 

In addition to identifying objective medical evidence that does not support Plaintiff’s 

claims, the ALJ identified specific evidence that Plaintiff’s pain is successfully managed 

by medication. The ALJ noted that Plaintiff testified he does not obtain treatment from a 

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pain clinic and his medications bring his pain to a “tolerable level.” The ALJ noted 

treatment records showing Plaintiff’s medications provided “good pain relief.” Further, 

the ALJ found that Plaintiff’s normal motor strength and lack of significant muscle 

atrophy were inconsistent with his reports of lying in bed and watching television or 

sleeping most of the time.2

 Therefore, the ALJ did not err in evaluating Plaintiff’s 

credibility. 

B. The ALJ Did Not Err in Weighing a Third-Party Report. 

Plaintiff contends that the ALJ committed legal error by giving little weight to a 

third-party report by Brenda McLaughlin, Plaintiff’s mother. When an ALJ discounts the 

testimony of lay witnesses, he must give reasons that are germane to each witness. 

Valentine v. Comm’r of Soc. Sec., 574 F.3d 685, 694 (9th Cir. 2009). When an ALJ has 

provided clear and convincing reasons for finding that a claimant’s subjective complaints 

lack credibility, the ALJ may reject a third party’s statement because it is similar to the 

claimant’s allegations. Id. 

The ALJ stated that the Third Party Function Report by Brenda McLaughlin, 

Plaintiff’s mother, was given little weight because “it essentially mirrors the claimant’s 

subjective allegations.” That is a reason germane to this witness. 

C. The ALJ Did Not Err in Weighing Medical Source Opinion Evidence. 

1. Legal Standard 

Generally, more weight should be given to the opinion of a treating physician than 

to the opinions of physicians who do not treat the claimant, and the weight afforded a 

non-examining physician’s opinion depends on the extent to which he provides 

supporting explanations for his opinions. Garrison v. Colvin, 759 F.3d 995, 1012 (9th 

Cir. 2014). Where a treating physician’s opinion is not contradicted by another 

physician, it may be rejected only for “clear and convincing” reasons, and where it is 

 2

 The ALJ did not find Plaintiff’s activities of daily living were inconsistent with 

his claims of constant and excessive pain. 

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contradicted, it may not be rejected without “specific and legitimate reasons” supported 

by substantial evidence in the record. Orn v. Astrue, 495 F.3d 625, 632 (9th Cir. 2007). 

In deciding the weight to give any medical opinion, the ALJ considers not only 

whether the source has a treating or examining relationship with the claimant, but also 

whether the treatment or examination is related to the alleged disability, the length of the 

relationship, frequency of examination, supporting evidence provided by the source, and 

medical specialization of the source. 20 C.F.R. § 404.1527(c). Generally, more weight is 

given to the opinion of a specialist about medical issues related to his area of specialty 

than to the opinion of a source who is not a specialist. 20 C.F.R. § 404.1527(c)(5). The 

ALJ may discount a physician’s opinion that is based only the claimant’s subjective 

complaints without objective evidence. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 

1190, 1195 (9th Cir. 2004). The opinion of any physician, including that of a treating 

physician, need not be accepted “if that opinion is brief, conclusory, and inadequately 

supported by clinical findings.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 

1228 (9th Cir. 2009). An ALJ may reject standardized, check-the-box forms that do not 

contain any explanation of the bases for conclusions. Molina v. Astrue, 674 F.3d 1104, 

1111 (9th Cir. 2012). 

2. Treating Primary Care Physician Stacia Kagie, D.O. 

The record includes three functional assessments dated February 2011, July 2011, 

and May 2013, on check-the-box forms completed by Dr. Kagie. In February 2011 and 

May 2013, Dr. Kagie identified Plaintiff’s impairment/diagnosis as left lumbar 

radiculopathy. In July 2011, she identified it as back pain and lumbar degenerative disk 

disease. 

In both 2011 assessments, Dr. Kagie opined that in an eight-hour work day 

Plaintiff could sit less than two hours and stand/walk less than two hours. On both forms 

she said she had not tested his ability to lift and carry. In February 2011, Dr. Kagie said 

that Plaintiff suffered from moderate fatigue and memory impairment from Lyrica and 

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Percocet;3 in July 2011, she said he suffered from mild fatigue as a medication side 

effect. Regarding other symptoms that limit Plaintiff’s ability to work, Dr. Kagie said 

moderately severe “pain, fatigue, unsteadiness” in February 2011 and moderate “pain, 

fatigue” in July 2011. 

In her 2013 assessment, Dr. Kagie did not check any boxes regarding Plaintiff’s 

capacity to sit, stand/walk, lift, or carry, but merely wrote “same.” She also wrote 

“same” for additional limitations and medication side effects. The form used in 2013 

asked whether the patient would need to alternate between sitting, standing, and walking. 

Dr. Kagie opined that Plaintiff should alternate positions every 21-45 minutes with 5-9 

minutes of rest with each position change. The 2013 form also asked whether the patient 

would miss time from work due to his medical condition. Dr. Kagie opined that Plaintiff 

would miss six or more days per month due to his medical condition. 

The ALJ gave Dr. Kagie’s opinions little weight for three reasons: (1) they were 

inconsistent with the overall objective medical record including Dr. Kagie’s own reports, 

(2) the assessments were “simply check sheets” without explanation, and (3) Dr. Kagie 

was Plaintiff’s primary care physician, not a specialist. The ALJ was required to consider 

Dr. Kagie’s opinions because she had a treating relationship with Plaintiff, but the ALJ 

was entitled to take into account her medical specialization. See 20 C.F.R. § 404.1527(c). 

Moreover, the ALJ need not accept any opinion that is brief, conclusory, and 

inadequately supported by clinical findings. Bray, 554 F.3d at 1228. Dr. Kagie’s 

opinions were brief and conclusory on their face, and Dr. Kagie did not identify any 

supporting clinical findings. 

Regarding the overall objective medical record, Plaintiff contends the ALJ 

improperly “cherry picked” from mixed medical evidence, but the evidence Plaintiff 

contends the ALJ should have cited does not demonstrate that Plaintiff’s medical 

 3

 Percocet is a combination of acetaminophen and oxycodone. 

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impairment prevents him from sitting or standing/walking more than a total of four hours 

a day. Plaintiff contends the ALJ should have relied on the September 2010 MRI results 

instead of x-ray results, but the MRI showed only mild impairment at L4-5. When 

Plaintiff’s neurosurgeon reviewed the MRI results, he concluded the S1 nerve root was 

not compromised and the L4-5 impairment had not changed from several years before. 

Most of what Plaintiff relies on is not objective medical evidence, but rather 

documentation that Plaintiff reported chronic lower back pain and was prescribed large 

amounts of narcotic pain medications for years. 

Dr. Kagie’s own treatment reports rely primarily on Plaintiff’s subjective reports, 

stating that his chronic lower back pain is usually well managed with a TENS unit, 

Lyrica, and oxycodone, without side effects or worsening symptoms, and with 

hydromorphone for occasional flares or spasms. In August 2010 Dr. Kagie noted that 

Plaintiff’s back pain was characterized as a dull ache in the lumbosacral area, it did not 

radiate, and Plaintiff continued to be “very stable with current pain mgt treatment of 

percocet, soma, and lyrica.” Plaintiff reported that he could sit for one hour before 

needing to change position. Dr. Kagie’s physical examination revealed normal gait and 

posture. There were no musculoskeletal findings. 

Dr. Kagie’s treatment report in September 2010 repeated that Plaintiff’s back pain 

was a dull ache in the lumbosacral area and did not radiate. Dr. Kagie noted that Plaintiff 

reported he developed sudden pain and was taken to ER by ambulance the night before. 

He was treated with hydromorphone and valium and sent home. He requested that Dr. 

Kagie order an MRI and increase his pain medication. She ordered the MRI and 

prescribed hydromorphone for “break through” pain in addition to his regular oxycodone 

dosing schedule. Dr. Kagie noted his gait as antalgic, slow, and cautious. She observed 

tenderness over the lumbar vertebra at the site of his previous surgery. 

Dr. Kagie’s next treatment report in the record is dated February 2011. Plaintiff’s 

back pain is described the same as before, but with the additional comment that 

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occasionally he has radiating pain down his left leg, which is significantly improved by 

taking Lyrica twice a day. Dr. Kagie also noted Plaintiff had been taking oxycodone 3-4 

times a day and would alternate it with the hydromorphone, and “he has had good pain 

relief.” Physical examination findings included normal posture and antalgic gait. There 

were no musculoskeletal findings. 

In May 2011, Dr. Kagie noted that Plaintiff reported he had been taking 

oxycodone 3-4 times a day, had stopped taking hydromorphone, and “continues to have 

good pain relief.” He reported occasional pain radiating down his left leg and “it is 

significantly improved with the Lyrica.” Physical examination findings included normal 

posture and normal gait. There were no musculoskeletal findings. 

In July 2011, Dr. Kagie noted that Plaintiff reported he had been taking oxycodone 

3-4 times a day and had stopped the hydromorphone, but then started taking it again after 

a recent flare. He reported being seen in the ER due to his extreme pain where he was 

treated with a muscle relaxer. Physical examination findings included normal posture 

and gait, tenderness over lumbar vertebra, and painful flexion and extension. 

In August 2011, Plaintiff saw a nurse practitioner for medication refills. He 

reported that his low back pain had been improving and that using the TENS unit was 

helping significantly. 

On November 2, 2011, Plaintiff presented for medication management. Dr. Kagie 

noted that Plaintiff had a history of chronic low back pain and was stable with his TENS 

unit and medications. She also noted that he had not needed to take hydromorphone 

because his back pain had been stable. There were no physical examination findings. On 

November 15, 2011, Plaintiff returned to Dr. Kagie for an apparent dental infection. 

In January 2012, Plaintiff received prescriptions for refills of medications, 

including hydromorphone and oxycodone. Dr. Kagie noted Plaintiff was stable with his 

TENS unit and medications, without side effects or worsening symptoms. She said he 

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had not needed to take hydromorphone because his back pain had been stable, but he did 

use it intermittently with his dental pain. There were no physical examination findings. 

In April 2012, Plaintiff received prescriptions for refills of medications, including 

hydromorphone and oxycodone. Dr. Kagie noted Plaintiff was stable with his TENS unit 

and medications, without side effects or worsening symptoms. She noted that Plaintiff 

continued to take hydromorphone only as needed because his back pain had been stable, 

but occasionally flared up. He recently reached too high to install a bird feeder at home 

and his back went into spasm. There were no physical examination findings. 

In July 2012, Plaintiff received prescriptions for refills of medications, including 

hydromorphone and oxycodone. Dr. Kagie noted Plaintiff was stable with his TENS unit 

and medications, without side effects or worsening symptoms. She noted that Plaintiff 

continued to take hydromorphone only as needed, but he recognized when his pain may 

flare up and would take hydromorphone for several days to prevent having several weeks 

of pain. Upon physical examination, Dr. Kagie observed tenderness to palpation at left 

iliolumbar ligaments. 

In October 2012, Plaintiff’s pain medications were refilled, and Dr. Kagie’s 

physical examination did not refer to Plaintiff’s back or legs. Dr. Kagie noted Plaintiff 

was stable with his TENS unit and medications, without side effects or worsening 

symptoms. She noted that Plaintiff takes the hydromorphone as needed, but he had 

needed it more frequently for dental pain. She noted that Plaintiff is unable to afford 

dental care, is waiting for his Social Security disability hearing, and then should be able 

to afford dental care. 

In December 2012, Plaintiff received prescriptions for refills of medications, 

including hydromorphone and oxycodone. Dr. Kagie noted that Plaintiff takes his 

medications as prescribed without side effects or worsening symptoms. She noted that 

Plaintiff takes the hydromorphone as needed, he had taken one that morning, and he had 

taken it several times the past week. Under “musculoskeletal,” Dr. Kagie said, “Patient 

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reports arthritis.” Dr. Kagie’s physical examination did not refer to Plaintiff’s back or 

legs. 

On March 26, 2013, Plaintiff did not show for his appointment. In April 2013, 

Plaintiff received prescriptions for refills of medications, including hydromorphone and 

oxycodone. Dr. Kagie noted Plaintiff had been having “some increasing body aches 

recently but feels like his left leg numbness has been stable (but he does run into things 

recurrently since he doesn’t feel it/sense it).” Dr. Kagie’s physical examination findings 

included: lower extremity muscle strength 5/5 on all of the right side, 4/5 on the left hips 

and knees, and 3+/5 on the left foot. She also found Plaintiff had decreased sensation to 

light touch in his left lateral leg and foot. 

Dr. Kagie’s treatment records show only that for three years she prescribed pain 

medication and Plaintiff continued to report that the pain medication kept his pain level 

stable without side effects or worsening symptoms. Dr. Kagie did not assess Plaintiff’s 

functional capacity and made almost no physical examination findings. The ALJ gave 

three clear and convincing reasons for giving Dr. Kagie’s opinions little weight, and 

those reasons are supported by substantial evidence. 

D. The ALJ Did Not Err in Determining Plaintiff’s Residual Functional 

Capacity. 

The ALJ determined that Plaintiff has the residual functional capacity to perform 

light work as defined in 20 CFR 404.1567(b) and 416.967(b), except no crawling, 

crouching, climbing, squatting, kneeling, or pushing/pulling with the lower extremities. 

The ALJ also determined that Plaintiff must have a sit/stand option that allows him to sit 

or stand alternatively at will, provided he is not off task more than 10% of the work 

period. Plaintiff contends the ALJ’s residual functional capacity assessment is based on 

legal error and/or not supported by substantial evidence because no medical source 

opined that Plaintiff can perform light work. But Plaintiff cites no authority for this 

contention. 

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A residual functional capacity finding involves a detailed assessment of how a 

claimant’s medical impairments affect his ability to work. In determining a claimant’s 

residual functional capacity, the ALJ “must consider all relevant evidence in the record, 

including, inter alia, medical records, lay evidence, and ‘the effects of all symptoms, 

including pain, that are reasonably attributed to a medically determinable impairment.’” 

Robbins v. SSA, 466 F.3d 880, 883 (9th Cir. 2006). The evidence that a claimant submits 

or the Commissioner obtains may contain medical opinions. 20 C.F.R. § 404.1527(a)(2). 

The ALJ must evaluate any medical opinion submitted and consider certain factors in 

deciding how much weight to give it. 20 C.F.R. § 404.1527(c). But the ALJ considers 

medical opinions together with the rest of the relevant evidence submitted. 20 C.F.R. 

§ 404.1527(b). 

Plaintiff also contends the ALJ erred by failing to identify the specific limitations 

opined to by the treating source and State agency consultants that she rejected and cite to 

evidence conflicting with the medical opinions. As discussed above, Dr. Kagie gave no 

opinion regarding Plaintiff’s capacity to lift and carry and no explanation for her opinion 

that Plaintiff can sit less than 2 hours and stand/walk less than 2 hours in an eight-hour 

day. In July 2011, Dr. Kagie opined that in an eight-hour day Plaintiff can use both 

hands continuously and both feet frequently. She opined that he can bend, stoop, 

balance, and kneel occasionally and never crawl, climb, or crouch. In 2013, Dr. Kagie 

also opined that Plaintiff requires a sit/stand option. Thus, the ALJ adopted some 

limitations equal to or greater than those opined to by Dr. Kagie. The ALJ stated specific 

reasons for rejecting Dr. Kagie’s opinion that Plaintiff can sit less than 2 hours and 

stand/walk less than 2 hours, i.e., it is inconsistent with the overall objective medical 

record including Dr. Kagie’s own reports and Dr. Kagie’s assessments do not include an 

explanation of Plaintiff’s medical condition. 

Two State agency medical consultants reviewed Plaintiff’s file and opined that 

Plaintiff is capable of performing sedentary work, sitting for a total of six hours with 

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normal breaks and standing and/or walking for two hours with normal breaks. They did 

not opine that Plaintiff required a sit/stand option. They opined Plaintiff had no 

limitation for pushing and pulling with hands or feet. They opined that Plaintiff was 

limited to occasional climbing, balancing, stooping, kneeling, crouching, and crawling. 

They found the MRI and x-rays of the lumbar spine to be “fairly normal” and in 2012 no 

current evidence of radiculopathy. They did not provide any explanation for their 

conclusion that Plaintiff is limited to sedentary work. The ALJ’s residual functional 

capacity assessment includes greater postural limitations than do the opinions of the State 

agency medical consultants, but does not limit Plaintiff to sedentary work. 

The ALJ gave little weight to the opinions of the State agency medical consultants 

because Plaintiff’s spine study revealed “minimal disc space narrowing at L4-L5” and 

medical reports revealed Plaintiff’s back pain was stable with medications and TENS 

therapy. Plaintiff correctly states the spine study shows more than disk narrowing, but 

most of what it shows is “unremarkable” or “mild.” In fact, when Plaintiff’s 

neurosurgeon reviewed the spine study, he found it did not show any definitive nerve root 

compression at S1 despite reported symptoms that were consistent with a left S1 

radiculopathy. 

Finally, Plaintiff contends the ALJ erred by presuming Plaintiff’s need for position 

changes would not result in him being off task more than 10% of the work day. The ALJ 

did not presume how long Plaintiff would be off task between sitting and standing. 

Rather, in her credibility finding and weighing of medical source evidence, the ALJ 

determined that Plaintiff did not need to lie down as much as he claimed or rest as often 

and for as long as Dr. Kagie opined. The ALJ concluded Plaintiff did not need to rest 

more than 10% of the work day. 

The ALJ’s residual functional capacity assessment is supported by substantial 

evidence and is not based on legal error. 

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IT IS THEREFORE ORDERED that the final decision of the Commissioner of 

Social Security is affirmed. The Clerk shall enter judgment accordingly and shall 

terminate this case. 

Dated this 4th day of May, 2016. 

Neil V. Wake

United States District Judge 

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