Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_06-cv-02487/USCOURTS-casd-3_06-cv-02487-1/pdf.json

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

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06cv2487

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

EVA TUDINO,

Plaintiff,

v.

MICHAEL J. ASTRUE, Commissioner

of Social Security

Administration,

Defendant. 

 

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Case No. 06-CV-2487-BEN (JMA)

REPORT AND RECOMMENDATION OF

UNITED STATES MAGISTRATE JUDGE

RE (1) GRANTING IN PART AND

DENYING IN PART PLAINTIFF’S

MOTION FOR SUMMARY JUDGMENT

[DOC. NO. 12], (2) GRANTING IN

PART AND DENYING IN PART

DEFENDANT’S CROSS-MOTION FOR

SUMMARY JUDGMENT [DOC. NO.

16], AND (3) REMANDING CASE

FOR FURTHER PROCEEDINGS

Plaintiff Eva Tudino (“Plaintiff”) seeks judicial review of

Social Security Commissioner Michael J. Astrue’s determination

that she is not entitled to disability and supplemental security

income (“SSI”) benefits. Plaintiff has filed a Motion for

Summary Judgment, and Defendant has filed a Cross-Motion for

Summary Judgment. For the reasons set forth below, the Court

recommends that Plaintiff’s motion be GRANTED IN PART and DENIED

IN PART, that Defendant’s motion be GRANTED IN PART and DENIED IN

PART, and that the case be remanded for further proceedings.

//

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I. PROCEDURAL HISTORY

Plaintiff filed applications for disability insurance and

SSI benefits on June 16, 2004, alleging a disability onset date

of June 10, 1999. (Admin. R. at 18, 78-80.) Plaintiff’s claim

was denied initially and again upon reconsideration. (Id. at 27-

32, 36-40.) Plaintiff requested a hearing before an

administrative law judge (“ALJ”). (Id. at 41.) ALJ Peter J.

Valentino, after conducting an administrative hearing on July 25,

2005, determined that Plaintiff was not disabled. (Id. at 17-

24.) The Appeals Council for the Social Security Administration

declined further review. (Id. at 4-6.) Subsequently, Plaintiff

commenced this action pursuant to 42 U.S.C. § 405(g). 

II. FACTUAL BACKGROUND

Plaintiff was born on June 22, 1960 and was 45 years old at

the time of the administrative hearing. (Id. at 78, 325.) She

has a fifth grade education. (Id. at 100, 325.) She states that

she is “technically” married to John Tudino, but the two have

been separated for over 20 years. (Id. at 206.) Plaintiff is

not sure if their divorce was ever finalized. (Id.) She

currently has a live-in boyfriend who supports her. (Id. at 206,

342.) She has one child, a son, who she gave birth to at age 13. 

(Id. at 206.) Plaintiff describes her daily activities as

eating, doing the dishes, making coffee, watching TV, doing

laundry once a week, vacuuming once a week, and sometimes

swimming in her pool. (Id. at 118.) 

Between 1988 and 2003, Plaintiff worked off and on as a spa

attendant for Tubs of San Diego, Inc. (“The Tubs”). (Id. at 96.) 

As a spa attendant, Plaintiff scrubbed jacuzzis, did laundry,

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Plaintiff eventually amended her disability onset date to April

14, 2004. (Id. at 18.)

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checked people in and out, cleaned the rooms, and monitored the

cash register. (Id. at 96, 328.) Plaintiff initially alleged

that she became disabled on June 10, 1999. (Id. at 96.) Around

that time, she reduced the number of hours she worked because she

kept “getting sick.” (Id. at 127.) She stopped working

altogether on November 1, 2003. (Id. at 96.)1 Plaintiff alleges

that she is unable to work due to injuries to her hand and ankle,

asthma, bronchitis, and arthritis. (Id. at 95.) 

III. MEDICAL EVIDENCE

A. Scripps Mercy Hospital (October 22, 2000)

Plaintiff went to the Scripps Mercy Hospital emergency

department in October 2000 complaining of generalized neck pain. 

(Id. at 160.) She complained that the pain shot down into her

shoulders and was so excruciating that when she stood up she felt

anxious and short of breath. (Id.) It was noted that Plaintiff

had a past medical history of osteoporosis, and that Plaintiff

believed she had arthritis as well. (Id.) Plaintiff was

diagnosed with a neck strain. (Id. at 161.)

B. Scripps Mercy Hospital (February 12, 2003)

Plaintiff went to the Scripps Mercy Hospital emergency

department after falling on her right shoulder. (Id. at 148.) 

X-rays of the right shoulder were negative and Plaintiff was

diagnosed with a right shoulder strain. (Id. at 149, 165.) 

C. Grossmont Hospital (November 1-3, 2003)

Plaintiff was admitted into Grossmont Hospital in November

2003 after taking 45 tablets of nortriptyline hydrochloride in an

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attempt to commit suicide after a “loved one left her.” (Id. at

174-76.) Plaintiff tested positive for amphetamines in her

urine. (Id. at 174.) A chest X-ray revealed no signs of

aspiration. (Id.) Plaintiff’s discharge diagnoses included

tricyclic antidepressant overdose, amphetamine abuse, depression,

and a history of urinary tract infections. (Id.)

D. Scripps Mercy Hospital (December 25-26, 2003)

Plaintiff was admitted overnight into Scripps Mercy Hospital

in December 2003 after enduring five days of a “hacking cough.” 

(Id. at 179.) The reporting physician thought that there was

likely a psychiatric component involved as Plaintiff’s cough

appeared to be “very self-induced and exacerbated.” (Id. at 179-

80.) Plaintiff was diagnosed with bronchitis and discharged. 

(Id. at 179.) 

E. Grossmont Hospital (April - June 2004)

Plaintiff was admitted into Grossmont Hospital in April 2004

with an ankle fracture after sustaining a twisting injury to her

left ankle. (Id. at 185.) After receiving counseling regarding

treatment options, Plaintiff elected to undergo open reduction

internal fixation. Following that procedure, Plaintiff

demonstrated poor progress with physical therapy and with

ambulation. (Id.) Plaintiff remained hospitalized for two

additional days for mobilization and gait training with crutches. 

(Id.) Dr. Steven R. Allsing, the operating surgeon, anticipated

Plaintiff would need a six week period of time during which she

could not put weight on the ankle. (Id. at 191.)

On June 3, 2004, Plaintiff began physical therapy for her

ankle. (Id. at 196-97.) On June 21, 2004, Dr. Allsing, during a

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follow-up examination, noted that Plaintiff was “doing well” and

had minimal discomfort at the fracture site. (Id. at 200.) On

June 24, 2004, Plaintiff cancelled all appointments for continued

physical therapy because she said she needed to deal with other

health issues. (Id.) 

F. Dr. Jaga Nath Glassman, M.D. (August 16, 2004)

Plaintiff underwent a psychiatric disability evaluation by

Dr. Glassman, a board-certified psychiatrist, in August 2004 at

the request of the Department of Social Services. (Id. at 206-

11.) Plaintiff stated that her physical health kept her from

performing even very simple or basic work. (Id. at 207.) She

stated that although she had been depressed to some degree

because of her physical problems, she did not understand why she

would be sent to a psychiatrist for evaluation. (Id.) Plaintiff

confirmed that she had a history of methamphetamine abuse,

starting at age 19 up to the date of the examination. (Id.) 

Dr. Glassman found Plaintiff’s thought processes to be

coherent, relevant, and goal-directed, and did not find any

evidence of psychotic symptoms. (Id. at 209.) Cognitively, Dr.

Glassman considered Plaintiff to be of average to low-average

intelligence. (Id.) Dr. Glassman reviewed a prior medical

report prepared by Dr. Michael A. Jaffe, M.D., who conducted a

psychiatric evaluation of Plaintiff in 1994. (Id. at 210.) Dr.

Jaffe had diagnosed Plaintiff with Methamphetamine Dependence and

Borderline Personality Disorder, and opined that “her stress

tolerance seem[ed] poor, but she probably could sustain simple,

repetitive, menial work tasks.” (Id.) Dr. Glassman agreed with

Dr. Jaffe’s findings, and stated “that although [Plaintiff]

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likely [had] difficulty with stress, she could probably work in a

simple job from a psychiatric perspective.” (Id. at 211.) Dr.

Glassman found that Plaintiff was “largely socially appropriate,

was able to follow all directions, and performed fairly well on

the cognitive portion of the exam.” (Id.) 

G. Dr. Steven E. Gerson (September 15, 2004)

Dr. Gerson of Seagate Medical Group performed an Internal

Medicine Evaluation of Plaintiff at the request of the Department

of Social Services in September 2004. (Id. at 223-27.) 

Plaintiff exhibited mild wheezing, shortness of breath, and

coughing spasms. (Id. at 226.) She also displayed tenderness in

her left wrist, left ankle, both of her knees, and her left hip. 

(Id.) Plaintiff’s grip strength and fine motor coordination were

intact. (Id. at 227.) She walked with a mild to moderate limp. 

(Id.) Dr. Gerson concluded that Plaintiff was able to lift ten

pounds frequently and twenty pounds occasionally. (Id. at 227.) 

He also believed that Plaintiff could stand, walk, or sit for up

to six hours in an eight-hour work day. (Id.)

H. Dr. Majid Naficy, M.D. (January 12, 2005)

Dr. Majid Naficy of the Department of Health Services for

the County of San Diego conducted a psychiatric assessment of

Plaintiff in January 2005. (Id. at 299-302.) Plaintiff

explained to Dr. Nacify that she had last worked in November

2003, but since then, her battles with pneumonia, shingles,

asthma, osteoporosis, arthritis, back pain, a broken ankle, and a

double compound fracture in her hand had prevented her from

obtaining employment. (Id. at 300.) She also complained of

having persistent feelings of dysphoria (anxiety) and depression. 

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(Id. at 299.) She denied any current suicidal ideation. (Id. at

300-01.) 

Plaintiff admitted being a heavy user of methamphetamines. 

(Id. at 299.) Plaintiff explained that she had been able to

remain sober for two years in the past while incarcerated and on

probation, but that when her probation ended, she had relapsed. 

(Id.) Despite experiencing strong cravings, she stated that she

had been clean from illicit drugs for a “brief period” and was

trying to stay that way for her boyfriend. (Id.) 

Cognitively, Dr. Nacify found that Plaintiff was alert and

fully oriented. (Id. at 301.) Dr. Naficy concluded that

Plaintiff demonstrated fair insight and judgment and good

behavior control with no overt signs of cognitive deficits. 

(Id.) Dr. Naficy recommended Paxil for Plaintiff’s depression

and encouraged her to consider residential drug rehabilitation to

treat her drug abuse. (Id.) Plaintiff agreed to start a trial

of Paxil but was hesitant and resistant to the idea of

residential drug rehabilitation. (Id.) 

I. East County Mental Health (January - June 2005)

Plaintiff obtained treatment at East County Mental Health,

associated with the Health and Human Services Agency of the

County of San Diego, between January and June 2005. (Id. at 286-

98.) Plaintiff received prescriptions for Paxil and Trazodone

to help with her depression and with her difficulty sleeping,

respectively. (Id. at 289, 291, 295, 298.) Plaintiff was also

repeatedly counseled on drug rehabilitation programs. (Id. at

290, 293, 296.) Plaintiff indicated several times that she did

not wish to enter any such program. (Id. at 287, 293, 296.) She

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Dr. Patel’s treatment records between March 2002 and December

2004 are contained within the administrative record. (See id. at 249-

76.)

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also stated that the Paxil and Trazodone were helping her. (Id.

at 292, 296.) 

J. Dr. Rakesh Patel, M.D. (February 10, 2005)

Plaintiff’s general practitioner, Dr. Rakesh Patel of

Neighborhood Healthcare El Cajon, completed a Physical Residual

Functional Capacity Questionnaire at the request of Plaintiff’s

counsel in February 2005. (Id. at 283-85.) Dr. Patel indicated

that Plaintiff’s diagnoses included chronic obstructive pulmonary

disease (COPD), left hand grip weakness secondary to fracture,

and left shoulder tendinitis. (Id. at 283.) Dr. Patel believed

that Plaintiff could occasionally lift less than ten pounds,

rarely lift ten pounds, and never lift twenty pounds or more. 

(Id. at 284.) Dr. Patel also noted that Plaintiff could lift

nothing with her left upper extremity. (Id.) Dr. Patel

indicated that Plaintiff could sit for at least six hours in an

eight-hour workday, but that she could only stand or walk about

two hours in an eight-hour workday. (Id.) Dr. Patel estimated

that Plaintiff would miss three days from work per month due to

her physical impairments. (Id. at 285.)2

K. Scripps Mercy Hospital (March 23, 2005)

Plaintiff went to the Scripps Mercy Hospital emergency

department in March 2005 complaining of hyperventilation. (Id.

at 311.) Plaintiff was diagnosed with bronchitis,

hyperventilation, asthma, anxiety disorder, and hypokalemia (low

potassium), and was prescribed antibiotics. (Id. at 313.) 

//

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IV. THE ADMINISTRATIVE HEARING

The ALJ conducted an administrative hearing on July 25,

2005.

A. Plaintiff’s Testimony

Plaintiff testified that she stopped working at The Tubs in

November 2003 because of a series of medical conditions which

prevented her from carrying on as a spa attendant. (Id. at 328.) 

Plaintiff explained that she had contracted shingles for two

months, pneumonia for two months, and then broke her left ankle

all within the same year. (Id.) Doctors installed a metal plate

and screws in Plaintiff’s left ankle as a result of her ankle

fracture. (Id. at 333.) 

With respect to her pulmonary issues, Plaintiff testified of

her belief that working with chemicals at The Tubs had led to her

bronchitis. (Id. at 329.) Plaintiff explained that after

developing double pneumonia a year and a half before, she became

aware that she also had asthma. (Id. at 330.) As a result of

her asthma, she has difficulty walking and breathing. (Id. at

331.) She uses inhalers and sometimes feels that she is

“suffocating.” (Id.) Plaintiff testified that she could stand

without walking for 15-20 minutes. (Id. at 339.) When asked

what would prevent her from standing longer, Plaintiff replied,

“I can’t breathe.” (Id.) 

Plaintiff testified that she has had arthritis in both knees

for quite some time, and she said that “the Social Security

Doctor” (Dr. Gerson) confirmed her belief. (Id. at 332.) 

Plaintiff believed she could walk, at most, about half a block,

but even then would need assistance. (Id. at 339-40.)

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Plaintiff testified further that she was in a car accident

which caused a double compound fracture in her left wrist,

resulting in a loss of feeling in the fingers on her left hand as

well as difficulty squeezing and gripping objects with that hand. 

(Id. at 334.) Plaintiff stated that she could not lift and carry

anything with her left arm, and that she could carry ten pounds

at most with her right arm “like once and then maybe a little bit

later.” (Id. at 339.) 

Plaintiff also testified that she suffers from depression

which keeps her from venturing outside the home. (Id. at 335.) 

She stated that she was taking Paxil for her depression and

Trazodone to help her sleep at night. (Id. at 337.) Plaintiff

admitted having a 35-year history of abusing drugs but testified

that she had been clean since Christmas 2004. (Id. at 338, 340.) 

Plaintiff described her daily activities as doing the

dishes, laundry, making the bed, and feeding the cat with her

boyfriend. (Id. at 345.) Plaintiff said she occasionally drives

to her girlfriend’s house. (Id. at 344-45.) Plaintiff expressed

that she wants to return to work but she does not feel she can. 

(Id. at 346-47.) 

B. Medical Expert Testimony 

Medical expert (“ME”) witness John R. Morse, M.D. testified

at the hearing. (Id. at 350-57.) With respect to Plaintiff’s

pulmonary impairments, the ME testified that Plaintiff has some

element of asthma with intermittent bronchitis or infection which

exacerbates it. (Id. at 350-51.) He observed that in between

acute attacks or exacerbations, her asthma should be stable. 

(Id. at 351.) He noted that Plaintiff had not exhibited evidence

of asthma during her weekly medical examinations. (Id.) The ME

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testified further that Plaintiff has post-traumatic arthritis of

her left wrist and right ankle, and mild degenerative changes or

arthritis in both knees. (Id.) 

The ME testified that based on Plaintiff’s post-traumatic

arthritic issues and mild knee pain, as well as her history of

respiratory problems, she could work in a light capacity, lifting

ten pounds frequently and twenty pounds occasionally. (Id. at

353.) The ME believed that Plaintiff could sit or stand for six

hours out of an eight-hour workday and walk for six hours out of

an eight-hour day. (Id.) The ME stated that Plaintiff has

manipulative limitations with respect to her left wrist –-

specifically, she could perform handling only occasionally--

along with postural limitations given her weight and the pain in

her knees. (Id. at 353-54.) The ME also opined that Plaintiff

should avoid fumes and dust which might irritate her asthma. 

(Id. at 353.) 

At this point in the hearing, the ALJ made a finding that

Plaintiff has a degree of bronchitis and asthma, and that

notwithstanding the ME’s testimony that Plaintiff could work in a

light capacity, she is reduced to a “sedentary sit-down job” with

a sit/stand option. (Id. at 358.)

C. Vocational Expert Testimony

Vocational expert (“VE”) witness Alan E. Cummings testified

at the hearing. The VE provided testimony in response to a

series of hypothetical questions posed by the ALJ. The VE

testified that Plaintiff could not do her past work as a spa

attendant if the ALJ found that Plaintiff’s impairments limited

her to sedentary, unskilled work, without even moderate exposure

to dust fumes or extreme changes in temperature, with a sit/stand

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Specific Vocational Preparation (SVP) indicates “the amount of

lapsed time required by a typical worker to learn the techniques,

acquire the information, and develop the facility needed for average

performance in a specific jobworker situation.” Dictionary of

Occupational Titles, app. B. A SVP of 2 requires “[a]nything beyond

[a] short demonstration up to and including 1 month.” (Id.) 

12 06cv2487

option for two hours of the work day, and only occasional

handling with her left hand. (Id. at 358-59.) Under such

restrictions, the VE testified that Plaintiff could work as an

“inspector” or “order clerk” for which there are 1,000 jobs of

each in San Diego County and 40,000 jobs of each nationally. 

(Id. at 359.) The VE acknowledged that a restriction to the

occasional use of Plaintiff’s non-dominant hand would

significantly reduce the number of sedentary jobs, but stated

that both jobs identified above would still be appropriate for

Plaintiff. (Id. at 359.) The VE continued that if Plaintiff, in

addition to the above restrictions, was limited to non-public

simple, repetitive tasks, both jobs would remain appropriate for

her to perform. (Id. at 360.) The VE explained that the

inspector job has a SVP level of two3 and consists of monitoring

small toy items at a work station, looking for defects. (Id. at

360-61.) Although the job requires frequent handling, it does

not require bilateral handling, and thus can be performed with

one hand. (Id. at 361.) He also testified that the order clerk

position could be performed with one hand. (Id. at 362.) 

V. THE ALJ DECISION

After considering the record, ALJ Valentino made the

following findings:

. . . .

2. The claimant has not engaged in substantial gainful

activity since April 14, 2004.

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3. The medical evidence establishes that the claimant has

severe obstructive pulmonary disease; minimal early

degenerative changes of her thoracic spine; is statuspost open reduction and internal fixation of a left

ankle fracture with good clinical results; a history of

methamphetamine dependence; a possible substanceinduced mood disorder and a possible borderline

personality disorder, but that she does not have an

impairment or combination of impairments listed in, or

medically equal to one listed in Appendix 1, Subpart P,

Regulations No. 4.

4. Pursuant to the law of the Ninth Circuit Court of

Appeals and Social Security Rulings 96-3p and 96-7p,

the undersigned finds that with the exertional and nonexertional limitations identified in Finding No. 5, the

claimant would not experience severe or disabling pain

or any other disabling symptoms, including shortness of

breath, depression or anxiety. This finding is

predicated on the reasons identified in the rationale

portion of this decision.

5. The claimant has the residual functional capacity to

perform the physical exertion and nonexertional

requirements of work except for lifting and carrying

more than five pounds frequently or 10 pounds

occasionally, standing and/or walking for more than two

hours in an eight-hour day, requires a sit/stand option

allowing for change of position after two hours, and is

limited to occasional handling with her left hand. 

Nonexertionally, the claimant must avoid concentrated

exposure to extreme heat and cold, toxic fumes, odors

and other respiratory irritants and is precluded from

any work at unprotected heights or near dangerous or

moving machinery or which would expose her to

vibrations [citation omitted].

. . . . 

7. The claimant’s residual functional capacity for the

full range of sedentary work is reduced by [the] abovecited limitations.

. . . .

 11. If the claimant had the exertional capacity for the

full range of sedentary work, ... the [Social Security]

Regulations ... would direct a conclusion of “not

disabled.”

12. Although the claimant’s additional nonexertional

limitations do not allow her to perform the full range

of sedentary work, using the above-cited rule as a

framework for decisionmaking, there are a significant

number of jobs in the national economy which she could

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perform. Examples of such jobs are: inspector and

order clerk of which there are 40,000 jobs each in the

national economy. This finding is predicated on expert

vocational testimony provided at the hearing.

13. The claimant was not under a “disability,” as defined

in the Social Security Act, at any time through the

date of this decision [citation omitted].

(Id. at 22-23.) 

VI. STANDARD OF REVIEW

To qualify for disability benefits under the Social Security

Act, an applicant must show that: (1) He or she suffers from a

medically determinable impairment that can be expected to result

in death or that has lasted or can be expected to last for a

continuous period of twelve months or more, and (2) the

impairment renders the applicant incapable of performing the work

that he or she previously performed or any other substantially

gainful employment that exists in the national economy. See 42

U.S.C.A. § 423(d)(1)(A), (2)(A) (West 2004). An applicant must

meet both requirements to be “disabled.” Id. Further, the

applicant bears the burden of proving that he or she was either

permanently disabled or subject to a condition which became so

severe as to disable the applicant prior to the date upon which

his or her disability insured status expired. Johnson v.

Shalala, 60 F.3d 1428, 1432 (9th Cir. 1995). 

A. Sequential Evaluation of Impairments

The Social Security Regulations outline a five-step process

to determine whether an applicant is "disabled." If an applicant

is found to be “disabled” or “not disabled” at any step, there is

no need to proceed further. Tackett v. Apfel, 180 F.3d 1094,

1098 (9th Cir. 1999) (citing 20 C.F.R. § 404.1520). Although the

ALJ must assist the applicant in developing a record, the

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applicant bears the burden of proof as to the first four steps. 

Id. If the fifth step is reached, the burden shifts to the

Commissioner. Id.

The evaluation process is as follows:

Step 1. Is the claimant presently working in a 

substantially gainful activity? If so, then the

claimant is “not disabled” within the meaning of the

Social Security Act and is not entitled to disability

insurance benefits. If the claimant is not working in

a substantially gainful activity, then the claimant's

case cannot be resolved at step one, and the evaluation

proceeds to step two.

Step 2. Is the claimant's impairment severe? If

not, then the claimant is “not disabled” and is not

entitled to disability insurance benefits. If the

claimant's impairment is severe, then the claimant's

case cannot be resolved at step two, and the evaluation

proceeds to step three.

Step 3. Does the impairment “meet or equal” one

of a list of specific impairments described in the

regulations? If so, the claimant is “disabled” and

therefore entitled to disability insurance benefits. 

If the claimant’s impairment neither meets nor equals

one of the impairments listed in the regulations, then

the claimant's case cannot be resolved at step three,

and the evaluation proceeds to step four.

Step 4. Is the claimant able to do any work that

he or she has done in the past? If so, then the

claimant is “not disabled” and is therefore not

entitled to disability insurance benefits. If the

claimant cannot do any work he or she did in the past,

then the claimant's case cannot be resolved at step

four, and the evaluation proceeds to the fifth and

final step.

Step 5. Is the claimant able to do any other

work? If not, then the claimant is “disabled” and

therefore entitled to disability insurance benefits. 

If the claimant is able to do other work, then the

Commissioner must establish that there are a

significant number of jobs in the national economy that

claimant can do. There are two ways for the

Commissioner to meet the burden of showing that there

is other work in “significant numbers” in the national

economy that claimant can do: (1) by the testimony of a

vocational expert, or (2) by reference to the MedicalVocational Guidelines . . . . If the Commissioner

meets this burden, the claimant is “not disabled” and

therefore not entitled to disability insurance

benefits. If the Commissioner cannot meet this burden,

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then the claimant is “disabled” and therefore entitled

to disability insurance benefits.

Tackett, 180 F.3d at 1098-99 (footnotes and citations omitted).

B. Judicial Review

Sections 205(g) and 1631(c)(3) of the Social Security Act

allow unsuccessful applicants to seek judicial review of the

Commissioner's final agency decision. 42 U.S.C.A. §§ 405(g),

1383(c)(3). The scope of judicial review is limited. The

Commissioner’s final decision should not be disturbed unless: 

(1) The ALJ's findings of fact are not supported by substantial

evidence or (2) the ALJ failed to apply the proper legal

standards. See Flaten v. Sec'y of Health & Human Servs., 44 F.3d

1453, 1457 (9th Cir. 1995).

The term “substantial evidence” refers to evidence that a

reasonable person might accept as adequate to support the ALJ's

conclusion, considering the record as a whole. See Richardson v.

Perales, 402 U.S. 389, 401 (1971); Thomas v. Barnhart, 278 F.3d

947, 954 (9th Cir. 2002). Substantial evidence means “more than

a scintilla but less than a preponderance” of the evidence. 

Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 1997). The

Court must consider the record as a whole, weighing both the

evidence that supports and detracts from the Commissioner’s

conclusions. See Mayes v. Massanari, 276 F.3d 453, 459 (9th Cir.

2001); Desrosiers v. Sec'y of Health & Human Servs., 846 F.2d

573, 576 (9th Cir. 1988). Even if the ALJ's findings are

supported by substantial evidence, they must be set aside if the

ALJ failed to apply the proper legal standards in weighing the

evidence and reaching his or her decision. See Benitez v.

Califano, 573 F.2d 653, 655 (9th Cir. 1978). 

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Section 405(g) permits this Court to enter a judgment

affirming, modifying, or reversing the Commissioner’s decision. 

42 U.S.C.A. § 405(g). The matter may also be remanded to the

Social Security Administration for further proceedings. Id. 

VII. DISCUSSION

Plaintiff contends that the ALJ’s decision to deny her

benefits was based on legal error and was not supported by

substantial evidence. (Pl.’s Mem. at 5-9.) Plaintiff makes two

arguments: First, that the ALJ’s finding that other work exists

in significant numbers that Plaintiff can do is not supported by

substantial evidence and is based on legal error; and second,

that the ALJ’s rejection of Plaintiff’s subjective complaints is

based on legal error and is not supported by substantial

evidence. (Id.) 

A. The ALJ Erred By Not Inquiring Whether the VE’s Testimony

Conflicted with the Dictionary of Occupational Titles

Social Security Ruling (“SSR”) 00-4p states that before

relying on VE evidence to support a disability determination or

decision, the ALJ must inquire whether the VE testimony is

consistent with the Dictionary of Occupational Titles (“DOT”). 

See SSR 00-4p, “Titles II and XVI: Use of Vocational Expert and

Vocational Specialist Evidence, and Other Reliable Occupational

Information in Disability Decisions,” 2000 WL 1898704; see also

Massachi v. Astrue, 486 F.3d 1149, 1152 (9th Cir. 2007) (holding

that an ALJ has an affirmative duty under SSR 00-4p to inquire

whether the VE’s testimony conflicts with the DOT). When there

is an apparent unresolved conflict, the ALJ must inquire, on the

record, about the inconsistency, and must obtain a reasonable

explanation for the conflict. SSR 00-4p at *2. The failure to

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The Court notes that the ALJ did not expressly limit Plaintiff

to “simple repetitive tasks” in his formal findings. (See Admin. R.

at 22-23.) Instead, he merely indicated in the “Evaluation of the

Evidence” section of his decision that Plaintiff can perform “simple,

repetitive tasks consistent with unskilled work.” (Id. at 20.) 

Nonetheless, the Court construes the ALJ’s findings as including a

limitation to simple repetitive tasks as the ALJ relied on the

findings of Dr. Glassman, the examining psychiatrist, who specifically

opined that Plaintiff had such a limitation. (Id. at 20, 210-11.) 

Moreover, the hypotheticals set forth by the ALJ to the VE lead the

Court to believe that the ALJ intended to find Plaintiff limited to

simple repetitive work. (Id. at 360.)

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do so constitutes procedural error. Massachi, 486 F.3d 1149,

1153-54 & n.19. Such error is harmless only if there was no

conflict or if the VE provided sufficient support for his or her

conclusion so as to justify any potential conflicts. Id. at 1154

n.19.

Here, the VE’s testimony provided that the jobs of inspector

and order clerk were appropriate for a person with a limitation

to simple repetitive tasks. (Admin. R. at 360.)4 Plaintiff

argues that the DOT indicates that both jobs, however, have a

Reasoning Level of 3 which is beyond the ability to perform

simple repetitive tasks. (Pl.’s Mem. at 5.) Plaintiff argues

that by failing to ask for a reasonable explanation as to why the

VE’s testimony conflicted with the DOT, the ALJ’s finding that

other work exists in significant numbers that Plaintiff can do is

not supported by substantial evidence. (Id. at 6-7.) 

 Defendant argues in response that there is no conflict

between the VE’s testimony and the DOT. (Def.’s Mem. at 17.) 

Defendant contends that because both jobs referred to by the VE

have SVP levels of 2, indicating that they can be learned in 30

days, they are consistent with unskilled work. (Id. at 18,

citing 20 C.F.R. §§ 404.1568(a), 416.968(a).) 

By lumping together the concept of unskilled work with the

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ability to perform simple repetitive tasks, Defendant has

conflated two separate vocational considerations. See, e.g.,

Meissl v. Barnhart, 403 F.Supp.2d 981, 982-85 (C.D. Cal. 2005). 

In Meissl, the court stated that “the SVP level in a DOT listing

indicating unskilled work [] does not address whether a job

entails only simple, repetitive tasks.” Id. at 983, citing Lucy

v. Chater, 113 F.3d 905, 909 (8th Cir. 1997); Cooper v. Barnhart,

2004 WL 2381515, at *4 (N.D. Okla. Oct. 15, 2004); Hall v.

Barnhart, 2004 WL 1896969, at *3 (D.Me. Aug. 25, 2004). Rather,

“the one vocational consideration directly on point with [a

limitation to simple repetitive tasks] is a job’s reasoning level

score.” Meissl, 403 F.Supp.2d at 983.

The DOT defines a position with a reasoning level of 3 as

requiring the abilities to “[a]pply commonsense understanding to

carry out instructions furnished in written, oral, or diagrammic

form [and to] [d]eal with problems involving several concrete

variables in or from standardized situations.” DOT, app. C. The

Tenth Circuit has determined that a limitation to “simple and

routine work tasks” is inconsistent with the demands of levelthree reasoning. See Hackett v. Barnhart, 395 F.3d 1168, 1176

(10th Cir. 2005). In Hackett, the court directed that the case

be remanded to allow the ALJ to address the conflict between the

plaintiff’s inability to perform more than simple and repetitive

tasks and the level-three reasoning required by the jobs

determined appropriate by the VE. Id. Similarly, the court in

Estrada v. Barnhart remanded the case to the ALJ for

consideration of whether jobs with reasoning levels of 3 exceeded

the claimant’s limitation to simple interactions and tasks. 

Estrada v. Barnhart, 417 F.Supp.2d 1299, 1303-04 (M.D. Fla.

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2006). Citing Hackett and Estrada, the Central District of

California recently determined in an unreported opinion that a

reasoning level of three is “inconsistent with a limitation to

simple repetitive work.” Squier v. Astrue, 2008 WL 2537129, at

*5 (C.D. Cal. June 24, 2008).

Level-two reasoning appears to be the breaking point for

those individuals limited to performing only simple repetitive

tasks. See, e.g., Hackett, 395 F.3d at 1176 (“[L]evel-two

reasoning appears more consistent with Plaintiff’s [residual

functional capacity]” to perform “simple and routine work”);

Meissl v. Barnhart, 403 F.Supp.2d at 984-85 (finding that

plaintiff’s ability to perform “simple tasks...that had some

element of repetitiveness to them” indicated a reasoning level of

two); Flaherty v. Halter, 182 F.Supp.2d 824, 850 (D. Minn. 2001)

(“the DOT’s level two reasoning requirement did not conflict with

the ALJ’s prescribed limitation” to “simple, routine, repetitive,

concrete, tangible tasks”).

In the instant case, the VE testified that Plaintiff could

perform the positions of Order Clerk and Inspector. Although the

VE did not give a DOT number for the Order Clerk position, both

Plaintiff and Defendant agree that he was referring to DOT

209.567-014: Order Clerk, Food and Beverage. See DICOT 209.567-

014, 1991 WL 671794. The DOT classifies Order Clerk as sedentary

work with a reasoning level of 3 and a SVP of 2. Id. By deeming

the Order Clerk position to be appropriate work for Plaintiff,

given the imposed limitations set forth in the ALJ’s

hypotheticals, a conflict existed between the VE’s testimony and

the DOT because the ability to perform simple repetitive tasks is

inconsistent with level-three reasoning. The ALJ was thus

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required to inquire about the inconsistency between the VE’s

testimony and the DOT. He failed to do so, and in so doing, also

failed to ask for a reasonable explanation for the unresolved

conflict. Accordingly, the Court recommends that the case be

remanded to allow the ALJ to address the conflict between

Plaintiff’s limitation to “simple repetitive tasks” and the

level-three reasoning required for the Order Clerk position.

With respect to the Inspector job, although the VE described

the position as one involving the inspection of small toy items,

the DOT number he provided, 669.687-014, corresponds to a Dowel

Inspector. See DICOT 669.687-014, 1991 WL 686074. Although the

DOT classifies Dowel Inspector as sedentary work with a reasoning

level of one, which is consistent with the ability to perform

simple repetitive tasks, the ALJ never inquired about the

discrepancy between the job titles and descriptions provided by

the VE versus those set forth in the DOT. Hence, when the VE

testified that a significant number of Inspector positions

existed in the national economy, the ALJ could not know whether

the VE spoke of the inspector of small toys or the dowel

inspector. Therefore, the ALJ did not have substantial evidence

supporting a conclusion that a significant number of Inspector

positions existed in the national economy. Accordingly, the

Court recommends that the case be remanded to allow the ALJ to

address this conflict.

Plaintiff additionally argues in her Reply that the finding

that there are 40,000 inspector jobs and 40,000 order clerk jobs

in the national economy is not supported by substantial evidence

because the VE testified that a restriction to the occasional use

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of Plaintiff’s non-dominant hand would “reduce the numbers

significantly.” (Pl.’s Reply at 2, citing Admin. R. at 359.) 

The Court normally declines to consider arguments raised for the

first time in a reply brief. However, because the Court believes

the VE’s statement, cited above, was ambiguous, and because the

Court is already recommending that the case be remanded, the

Court further recommends that the ALJ be directed, upon remand,

to obtain clarification from the VE regarding this statement.

B. The ALJ Did Not Err in Discounting Plaintiff’s Subjective

Complaints

Plaintiff argues that the ALJ’s rejection of her subjective

complaints is based on legal error and is not supported by

substantial evidence. (Pl.’s Mem. at 7-8.) When considering a

claimant’s subjective symptom testimony, “if the record

establishes the existence of a medically determinable impairment

that could reasonably give rise to the reported symptoms, an ALJ

must make a finding as to the credibility of the claimant’s

statements about the symptoms and their functional effect.” 

Robbins v. Social Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006)

(citations omitted). “While an ALJ may find testimony not

credible in part or in whole, he or she may not disregard it

solely because it is not substantiated affirmatively by objective

evidence.” Id. Rather, an ALJ may only find a claimant not

credible by making specific findings as to credibility and

stating clear and convincing reasons to discount the claimant’s

subjective symptom testimony. Id. An ALJ may consider at least

the following factors when weighing the claimant’s credibility: 

the claimant’s reputation for truthfulness, inconsistencies in

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the claimant’s testimony or between the claimant’s testimony and

his conduct, the claimant’s daily activities, his work record,

and testimony from physicians and third parties regarding the

nature, severity, and effect of the symptoms of which the

claimant complains. Thomas, 278 F.3d at 958-59 (citing Light v.

Soc. Sec. Admin., 119 F.3d 789, 792 (9th Cir. 1997)). 

An ALJ’s assessment of pain, severity, and claimant

credibility is entitled to “great weight.” Weetman v. Sullivan,

877 F.2d 20, 22 (9th Cir. 1989). Here, the ALJ set forth the

following reasons for rejecting Plaintiff’s subjective

complaints:

First, no examining physician has reported any

objective, clinical findings which would support a

finding that the claimant is totally or permanently

disabled. Indeed, an examining physician, Dr. Gerson,

concluded that the claimant could perform the full

range of even light work.

Second, although the claimant sustained a fracture of

her left ankle in April 2004, follow-up x-rays have

revealed excellent alignment and fixation of her

fracture site. Nor is there any credible evidence

that, for a continuous period of at least 12 months,

the claimant could not have walked or stood for at

least two hours in an eight-hour day, which is all that

is necessary for sedentary work. Moreover, the

undersigned has conceded that the claimant requires a

sit/stand option allowing her to change position after

two hours.

Third, while the claimant has a history of asthma,

bronchitis and pneumonia, she has not required frequent

emergency room treatment or hospitalizations for these

complaints. Her pulmonary impairment is not of Listing

level severity and, with a preclusion against any

exposure to respiratory irritants and extreme heat and

or cold, the claimant would not experience any

significant work-related limitations.

Fourth, the claimant’s activities of daily living

include going to the grocery store, doing light

household chores, and swimming in a pool [citation

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omitted]. At the hearing, the claimant reported at

least occasional driving of an automobile and actively

seeking employment requiring a sedentary level of

exertion.

Fifth, although the claimant is taking Paxil and

Trazodone, which are psychotropic medications, she is

not receiving any mental health treatment at the

present time. Nor has she had any mental health

treatment in the past. She has never had any

psychiatric hospitalizations, except for brief

treatment following an attempted overdose in November

2003.

Sixth, an examining psychiatrist, Dr. Glassman,

concluded that the claimant can perform unskilled work,

a finding concurred in by another physician, Dr. Jaffe

[citation omitted].

(Id. at 20-21.)

With respect to the ALJ’s first finding, the record

demonstrates that no examining physician reported any objective,

clinical findings indicating that Plaintiff is totally or

permanently disabled. Dr. Gerson, Dr. Glassman, and Dr. Jaffe

all opined that Plaintiff was capable of performing work. 

(Admin. R. at 227, 210-11.) Moreover, the Plaintiff’s own

primary care physician, Dr. Patel, implied that Plaintiff could

perform sedentary work. (See id. at 283-85.) An ALJ may

permissibly rely on examining physicians’ opinions regarding

whether the claimant is disabled to discredit excessive pain

allegations. See Moncada v. Chater, 60 F.3d 521, 524 (9th Cir.

1995). The Court thus finds this constitutes a clear and

convincing reason to discount Plaintiff’s subjective symptom

testimony. 

With respect to the ALJ’s second finding, the Court agrees

that no credible evidence exists to show Plaintiff could not walk

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or stand for at least two hours in an eight-hour work day. While

Plaintiff’s testimony implies that she could not walk or stand

for this amount of time (see Admin. R. at 339-40), evidence from

the medical records contradicts this assertion. The record shows

that Plaintiff experienced excellent alignment and fixation in

her fractured ankle. (Id. at 199.) Furthermore, Dr. Gerson and

Dr. Patel both concluded that Plaintiff could stand and walk for

up to 6 hours in an 8 hour workday. (Id. at 227, 284.) 

With respect to the ALJ’s third finding, the record

demonstrates that Plaintiff’s pulmonary impairments have not

required frequent emergency room treatment or hospitalizations. 

According to the record, the first time Plaintiff went to the

hospital for a pulmonary issue was December 2003 for a “hacking

cough,” and the reporting physician noted the condition was “very

self-induced and exacerbated.” (Id. at 179-80.) Fifteen months

later, Plaintiff went to the hospital complaining of

hyperventilation. (Id. at 311.) Although the record contains

evidence of other doctor visits in 2004 regarding pulmonary

complaints, it appears that only conservative treatment was

necessary. (Id. at 251-52, 261-62.) An ALJ may properly

consider whether a plaintiff has only required minimal medical

treatment to discredit his or her allegations of disabling pain. 

See Williams v. Bowen, 790 F.2d 713, 715 (8th Cir. 1986); see

also Flaten v. Sec’y of Health & Human Servs., 44 F.3d 1453, 1464

(9th Cir. 1995) (stating that an ALJ is permitted to draw

rational inferences from a plaintiff’s treatment history).

With respect to the ALJ’s fourth finding, the Court finds

that the ALJ’s rejection of Plaintiff’s excess complaints based

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on her daily activities (going to the grocery store, doing light

household chores, swimming in a pool, occasionally driving, and

actively seeking out employment) is not supported by substantial

evidence. Plaintiff admits going to the grocery store only once

a week, doing light household chores once a week, and swimming at

her pool sometimes. (Id. at 118-25 [emphases added].) Plaintiff

testified that she occasionally drives and has actively sought

out employment, but there is no evidence she performs these

activities daily. (See id. at 343-47.) In fact, the only

activity Plaintiff seems to perform daily is watching television. 

(Id. at 122.) More importantly, however, in order to discredit

Plaintiff’s excess complaints based on evidence of daily

activities, the ALJ must find that Plaintiff is able to spend a

substantial part of the day engaged in pursuits that involve

physical functions that are transferable to a work setting. 

Gonzalez v. Sullivan, 914 F.2d 1197, 1201 (9th Cir. 1990). While

the activities Plaintiff performs do require a sedentary level of

exertion, the ALJ did not make the requisite specific findings

concerning the transferability of Plaintiff’s activities of daily

living to her ability to perform work. Thus, the fourth reason

proffered by the ALJ to discredit Plaintiff’s subjective symptom

testimony does not constitute a clear and convincing reason

supported by substantial evidence. 

Substantial evidence also does not support the ALJ’s fifth

finding that Plaintiff has not had any mental health treatment in

the past. Plaintiff obtained treatment for depression with East

County Mental Health from January through June 2005. (See Admin.

R. at 286-98.) Furthermore, although discounted as a “brief

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treatment,” Plaintiff was put on a 72 hour hold by the

psychiatric evaluation team at Grossmont Hospital following her

attempted suicide in 2003. (Id. at 21, 174.) 

With respect to the ALJ’s sixth finding, Dr. Glassman and

Dr. Jaffe clearly concluded that Plaintiff can perform unskilled

work. Dr. Glassman opined that Plaintiff displayed no evidence

of psychotic symptoms, and he agreed with Dr. Jaffe’s findings

that Plaintiff could perform simple work from a psychiatric

standpoint. (Id. at 209-11.) As set forth above, it is

permissible for an ALJ to rely on an examining physician’s

opinion that a claimant could perform sedentary work to discredit

an allegation of excessive pain. Moncada, 60 F.3d at 524.

Notwithstanding the Court’s finding that two of the ALJ’s

six findings were insufficient to discredit Plaintiff’s

subjective complaints, the Court finds that the ALJ otherwise

articulated clear and convincing reasons, supported by the

record, to discount the Plaintiff’s subjective symptom testimony. 

Contrary to Plaintiff’s contention that the ALJ merely discounted

her credibility in general, the ALJ proffered several permissible

and accurate reasons why he discounted Plaintiff’s excess

complaints. “Where ... the ALJ has made specific findings

justifying a decision to disbelieve an allegation of excessive

pain, and those findings are supported by substantial evidence in

the record, [the Court’s] role is not to second-guess that

decision.” Fair v. Bowen, 885 F.2d 597, 604 (9th Cir. 1989).

VIII. CONCLUSION

For the reasons set forth above, Plaintiff’s Motion for

Summary Judgment should be GRANTED IN PART and DENIED IN PART,

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Defendant’s Cross-Motion for Summary Judgment should be GRANTED

IN PART and DENIED IN PART, and the case should be remanded for

further proceedings.

This report and recommendation will be submitted to the

Honorable Roger T. Benitez, United States District Judge assigned

to this case, pursuant to the provisions of 28 U.S.C. 

§ 636(b)(1). Any party may file written objections with the

Court and serve a copy on all parties on or before August 25,

2008. The document should be captioned “Objections to Report and

Recommendation.” Any reply to the Objections shall be served and

filed on or before September 8, 2008. The parties are advised

that failure to file objections within the specified time may

waive the right to appeal the district court’s order. Martinez

v. Ylst, 951 F.2d 1153 (9th Cir. 1991).

IT IS SO ORDERED.

DATED: August 6, 2008

Jan M. Adler

U.S. Magistrate Judge

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