Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_15-cv-02946/USCOURTS-casd-3_15-cv-02946-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:0405id Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

RAYMOND J. DOUVILLE,

 Plaintiff,

v.

CAROLYN W. COLVIN,

 Defendant.

Case No.: 15-cv-2946 BEN (JLB)

REPORT AND 

RECOMMENDATION ON 

CROSS-MOTIONS FOR 

SUMMARY JUDGMENT

[ECF Nos. 18, 20]

I. INTRODUCTION

This matter is before the Court on cross-motions for summary judgment. Plaintiff 

Raymond J. Douville moves under 42 U.S.C. § 405(g)1 of the Social Security Act for

judicial review of the Commissioner of Social Security Carolyn W. Colvin’s final decision 

denying his application for disability insurance benefits and supplemental security income 

under Titles II and XVI of the Social Security Act. 

 

1

 Section 405(g) states, “Any individual, after any final decision of the Commissioner of Social 

Security made after a hearing to which he was a party . . . may obtain a review of such decision by a civil 

action . . . brought in the district court of the United States . . . . The court shall have power to enter, upon 

the pleadings and transcripts 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. The findings 

of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be 

conclusive.” 42 U.S.C. § 405(g). 

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This Report and Recommendation is submitted to United States District Judge Roger 

T. Benitez pursuant to 28 U.S.C. § 636(b) and Local Civil Rule 72.1(c) of the Local Rules 

of Practice for the United States District Court for the Southern District of California. After 

careful review of the moving and opposing papers, the administrative record, the facts, and 

the applicable law, for the reasons set forth below, the Court hereby RECOMMENDS that 

Plaintiff’s motion for summary judgment be DENIED and that the Commissioner’s crossmotion to affirm the Administrative Law Judge’s decision be GRANTED.

II. BACKGROUND

Plaintiff is a 52-year-old Caucasian male. (A.R. 345.) He was born and raised in 

New Hampshire and currently resides in San Diego, California. (A.R. 4884.) He has seven 

children, most of whom are adults. (A.R. 2033–34.) Plaintiff is a heavy smoker (A.R. 

2784), and he has an extensive history of drug and alcohol abuse (A.R. 2034). 

Plaintiff has not worked since approximately July 11, 2009, when his claimed 

disability began. (A.R. 345.) Plaintiff formerly worked full-time as an automotive 

technician and then as a heavy equipment technician. (A.R. 345.) Plaintiff testified that 

he is unable to work because he has seizures and has suffered strokes and heart attacks. 

(A.R. 346.) Specifically, Plaintiff testified that he cannot work because he has weakness 

in his right side from his last stroke that limits his ability to lift objects, to do gross handling 

with his right hand, and to walk, sit, and stand for long periods of time. (A.R. 349–53; 366, 

369–70.) 

On September 16, 2010, Plaintiff protectively filed an application under Title II of 

the Social Security Act for a period of disability and disability insurance benefits. (A.R. 

623–27.) On the same day, Plaintiff also protectively filed an application under Title XVI 

of the Social Security Act for supplemental security income. (A.R. 628–32.) In both 

applications, Plaintiff alleged his disability began on July 11, 2009. (A.R. 623, 628.) 

Plaintiff’s applications were denied initially on December 28, 2010 (A.R. 375–76), and 

upon reconsideration on June 29, 2011 (A.R. 377–78). 

///

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Following the denials of his applications, on August 1, 2011, Plaintiff filed a written 

request for a hearing by an Administrative Law Judge (“ALJ”). (A.R. 394–95.) On 

November 8, 2013, a hearing was held before ALJ Leland Spencer. (A.R. 341–74.) 

Plaintiff, a vocational expert, and two medical experts testified at the hearing. (Id.) In 

addition, the ALJ held a supplemental hearing on January 10, 2014, but no relevant 

testimony was taken at that time. (A.R. 336–40.) 

On March 27, 2014, the ALJ issued a written decision finding Plaintiff not disabled 

as defined by the Social Security Act. (A.R. 311–30.) On April 23, 2014, Plaintiff filed 

with the Social Security Administration’s Appeals Council a request for review of the 

ALJ’s hearing decision. (A.R. 127–28.) The Appeals Council denied his request on 

October 26, 2015, rendering the ALJ’s March 27, 2014 decision the final decision of the 

Commissioner of Social Security. (A.R. 7–13.) 

On December 29, 2015, Plaintiff filed a complaint in this Court requesting judicial 

review of the Commissioner’s final decision denying his applications for disability 

insurance benefits and supplemental security income. (ECF No. 1.) On April 29, 2016, 

Defendant filed an answer and the administrative record (“A.R.”). (ECF Nos. 11–16.) On 

May 27, 2016, Plaintiff filed a motion for summary judgment seeking reversal of the 

Commissioner’s final decision and an award of the benefits sought or, alternatively, 

remand to the Social Security Administration for further administrative proceedings. (ECF 

No. 18.) On June 16, 2016, Defendant filed a cross-motion for summary judgment (ECF 

No. 20) and an opposition to Plaintiff’s motion for summary judgment (ECF No. 21).

2

 

Despite a July 1, 2016 deadline to file an opposition to Defendant’s cross-motion for 

summary judgment and a reply to Defendant’s opposition (see ECF No. 17), Plaintiff did 

 

2

 The documents filed as Defendant’s cross-motion for summary judgment (ECF No. 20) and as 

Defendant’s opposition to Plaintiff’s motion for summary judgment (ECF No. 21) are identical. 

Therefore, the Court addresses them as a single filing. 

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not file an opposition or a reply. As no opposition to Defendant’s cross-motion was filed, 

Defendant did not file a reply. 

III. LEGAL STANDARDS

A. Determination of Disability

To qualify for disability benefits under the Social Security Act, a claimant must show 

two things: (1) that he suffers from a medically determinable physical or mental 

impairment that has lasted or can be expected to last for a continuous period of twelve 

months or more, or would result in death; and (2) the impairment renders the claimant 

incapable of performing the work he previously performed, or any other substantial gainful 

employment which exists in the national economy. 42 U.S.C. § 423(d)(1)(A), (2)(A). A 

claimant must meet both requirements to be classified as disabled. Id. 

Under the authority of the Social Security Act, the Commissioner is required to 

perform a five-step sequential analysis for determining whether an individual is disabled 

within the meaning of the Social Security Act. See 20 C.F.R. § 416.920(a). If the 

Commissioner can find that an applicant is “disabled” or “not disabled” at any step, there 

is no need to proceed further. Ukolov v. Barnhart, 420 F.3d 1002, 1003 (9th Cir. 2005) 

(quoting Schneider v. Comm’r of the Soc. Sec. Admin., 223 F.3d 968, 974 (9th Cir. 2000)). 

At step one, it is determined whether the claimant is currently engaged in substantial 

gainful activity. 20 C.F.R. § 416.920(b). At step two, it is determined whether the claimant 

has either a medically determinable impairment or combination of impairments that when 

combined is “severe.” 20 C.F.R. § 416.920(c). At step three, it is determined whether the 

claimant’s impairment or combination of impairments is of a severity that meets or 

medically equals the criteria of one or more specific impairments listed in 20 C.F.R. Part 

404, Subpart P, Appendix 1. 20 C.F.R. § 416.920(d). Before considering step four, the 

claimant’s residual functional capacity (“RFC”)—his ability to do physical and mental 

work activities on a sustained basis despite the limitations from his impairment(s)—is 

determined. 20 C.F.R. § 416.920(e). At step four, it is determined whether the claimant 

has the residual functional capacity to do any work that he has done in the past. 20 C.F.R. 

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§ 416.920(f). Lastly, at step five, it is determined whether the claimant is able to do some 

other work that exists in “significant numbers” in the national economy, taking into 

consideration the claimant’s residual functional capacity, age, education, and work 

experience. 20 C.F.R. § 416.920(g); Tackett v. Apfel, 180 F.3d 1094, 1100 (9th Cir. 1999). 

Although the Commissioner must assist the claimant in developing a record at each 

step of the sequential process, the claimant bears the burden of proof during the first four 

steps while the Commissioner bears the burden of proof at the fifth step. Id. at 1098 & n.3. 

B. Scope of Review

The Social Security Act permits unsuccessful claimants to seek judicial review of 

the Commissioner’s final agency decision. 42 U.S.C. §§ 405(g), 1383(c)(3). The scope of 

judicial review, however, is limited. The Court must affirm the Commissioner’s final 

decision unless: (1) it is based on legal error; or (2) it is not supported by substantial 

evidence. See Schneider, 223 F.3d at 973. 

Substantial evidence is “more than a mere scintilla, but may be less than a 

preponderance.” Lewis v. Apfel, 236 F.3d 503, 509 (9th Cir. 2001) (citing Tackett, 180 

F.3d at 1097). Substantial evidence is “relevant evidence which, considering the record as 

a whole, a reasonable person might accept as adequate to support a conclusion.” Flaten v. 

Sec. of Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995) (citing Tylitzki v. 

Shalala, 999 F.2d 1411, 1413 (9th Cir. 1993)). In considering the record as a whole, the 

Court must weigh both the evidence that supports and detracts from the ALJ’s conclusions. 

Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The Court must uphold the denial of 

benefits if the evidence is susceptible to more than one rational interpretation, one of which 

supports the ALJ’s decision. Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005); see 

also Flaten, 44 F.3d at 1457 (“If the evidence can reasonably support either affirming or 

reversing the Secretary’s conclusion, the court may not substitute its judgment for that of 

the Secretary.”). However, even if the Court finds that substantial evidence supports the 

ALJ’s conclusions, the Court must set aside the decision if the ALJ failed to apply the 

proper legal standards in weighing the evidence and reaching a conclusion. Benitez v. 

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Califano, 573 F.2d 653, 655 (9th Cir. 1978) (quoting Flake v. Gardner, 399 F.2d 532, 540 

(9th Cir. 1968)). 

IV. ALJ’S FINDINGS

The ALJ rendered an unfavorable decision regarding Plaintiff’s applications for 

disability benefits on March 27, 2014. (A.R. 311–30.) At step one of the sequential 

evaluation process, the ALJ found that Plaintiff “has not engaged in substantial gainful 

activity since July 11, 2009, the alleged onset date.” (A.R. 316.) 

At step two, the ALJ determined that Plaintiff suffers from the following severe 

impairments that cause more than minimal functional limitations: (1) Lupus Anticoagulant 

with long-term Coumadin use; (2) heart impairment with pacemaker; (3) back pain; 

(4) seizure disorder; (5) obesity; (6) chronic obstructive pulmonary disease;

(7) amphetamine dependence; (8) alcohol dependence; (9) anxiety disorder; and 

(10) depressive disorder. (A.R. 316.) 

At step three, the ALJ found that Plaintiff does not have an impairment or 

combination of impairments that meets or medically equals the severity of a listed 

impairment. (A.R. 316.) 

Because the ALJ found Plaintiff’s impairments do not meet or equal a listed 

impairment, he assessed Plaintiff’s RFC before moving on to step four of the sequential 

evaluation process. 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 the 

claimant must avoid workplace hazards and may have no interaction with the public.” 

(A.R. 318.) 

In determining Plaintiff’s RFC, the ALJ considered the opinions of several 

physicians, including the opinion of Phong T. Dao, D.O., who completed an internal 

medicine evaluation of Plaintiff on or around May 24, 2010. (A.R. 790–99.) With respect 

to Plaintiff’s functional limitations, Dr. Dao gave Plaintiff a light RFC and added that 

“[c]limbing, stooping, kneeling and crouching should be limited to occasionally” and 

“[m]anipulation with the right hand is limited to occasional.” (A.R. 795.) The ALJ adopted 

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Dr. Dao’s opinion to the extent he assigned Plaintiff a light RFC but rejected the postural 

and manipulative limitations opined by Dr. Dao. (A.R. 322.) 

At step four, the ALJ determined that Plaintiff “is unable to perform any past relevant 

work” because “[t]he demands of [his] past relevant work exceed the residual functional 

capacity.” (A.R. 323.)

Finally, at step five, the ALJ determined 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] can perform.” (A.R. 323.) The ALJ 

concluded that Plaintiff is not disabled and has not been under a disability as defined by 

the Social Security Act from July 11, 2009, through the date of the ALJ’s decision. (A.R. 

324.)

V. ANALYSIS

Plaintiff, in his motion for summary judgment, asserts that the ALJ committed 

reversible legal error when he failed to articulate a legally sufficient rationale for rejecting

the portion of Dr. Dao’s opinion that limited Plaintiff’s right hand manipulative 

functionality.

3

 (ECF No. 18-1 at 2–3.) Specifically, Plaintiff argues that the ALJ erred 

when he discarded this “significant probative evidence . . . without explanation setting forth 

‘specific and legitimate reasons’” for doing so. (Id. at 3.) Plaintiff argues further that the 

ALJ also erred when he did “not cite to any evidentiary basis to support his rejection of Dr. 

Dao[’s opinion].” (Id. at 5.) Instead, Plaintiff argues, the ALJ “simply substituted his own 

lay opinion for that of the medical professional; something which is not allowed.” (Id. at 

6.) Plaintiff argues that had the ALJ not rejected Dr. Dao’s opinion, the ALJ would be 

required to find Plaintiff disabled, as the vocational expert testified during Plaintiff’s 

 

3

 As noted above, the ALJ rejected two aspects of Dr. Dao’s opinion: a postural limitation and a 

manipulation limitation. (A.R. 322.) Plaintiff’s argument focuses on the ALJ’s rejection of Dr. Dao’s 

opinion as it relates to right hand manipulative functionality only. 

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hearing that no work would exist for Plaintiff if his right hand manipulative functionality 

was limited to “occasionally.” (ECF No. 18-1 at 5 (citing A.R. 365–68).) 

Defendant, in her cross-motion and opposition, argues that the ALJ’s decision to 

reject Dr. Dao’s opinion regarding Plaintiff’s right hand manipulative limitation is free 

from legal error. (ECF No. 20-1 at 9–10.) Defendant argues that the ALJ did not substitute 

his lay opinion for that of a medical professional but instead reviewed and interpreted the 

medical evidence and, in light of conflicting evidence, determined it was proper to give 

less weight to Dr. Dao’s opinion. (Id.) 

In addition, Defendant argues that the ALJ’s decision should be affirmed because

the totality of the medical evidence does not support Dr. Dao’s opinion regarding Plaintiff’s 

right hand manipulative limitation. (Id. at 7–9.) Plaintiff does not address this issue in his 

motion.

A. Background

1. Dr. Dao’s Opinion

At the request of the San Diego Department of Social Security, Dr. Dao performed 

a complete internal medicine evaluation of Plaintiff on or around May 24, 2010. (A.R. 

790–99.) Upon meeting Dr. Dao, Plaintiff complained of back pain, diabetes, and right 

hand pain. (A.R. 790.) With respect to his back pain, Plaintiff stated he had been 

experiencing the pain since 1996, after he injured himself while working in a factory 

where he did a lot of heavy lifting. (A.R. 791.) The pain had progressively worsened and 

had become constant and localized in the lumbar region without any pain radiation. (A.R. 

791.) With respect to his hand pain, Plaintiff stated that he had been experiencing the

pain for the past two days. (A.R. 791.) His right hand had started to swell slowly, and he 

noticed some warmth in the hand. (A.R. 791.) Due to the swelling and the pain, Plaintiff

had trouble making a complete fist and carrying heavy objects with his right hand. (A.R. 

791.) 

Dr. Dao completed a physical examination of Plaintiff and ordered an x-ray of 

Plaintiff’s lumbar spine. (A.R. 792–95.) Dr. Dao found that, generally, Plaintiff was “in 

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no acute distress.” (A.R. 792.) With respect to Plaintiff’s extremities, Dr. Dao found 

Plaintiff’s range of motion to be “grossly normal bilaterally” in all of his extremities

except for his right wrist. (A.R. 794.) With respect to Plaintiff’s right wrist, Dr. Dao 

found that “[t]here is a 1 inch scar on the palmar aspect of the right wrist” and that 

extension was 40 degrees, flexion was 45 degrees, ulnar flexion was 25 degrees, and radial 

flexion was 15 degrees. (A.R. 794.) Dr. Dao also found that Plaintiff’s right hand was 

swollen and warmer than the left hand. (A.R. 794.) With respect to Plaintiff’s 

neurological functioning, specifically his motor functioning, Dr. Dao found that Plaintiff 

exhibited “[g]ood tone bilaterally, with good active motion,” and his strength was “5/5 in 

all extremities.” (A.R. 794.) The x-ray of Plaintiff’s lumbar spine demonstrated “[m]ild 

anterior wedging of L1” and “[m]inimal spondylosis L2 to L5.” (A.R. 795.)

After examining Plaintiff, Dr. Dao offered the following medical impressions: 

 New onset of diabetes mellitus Type II. The claimant is currently on oral 

medication, however the claimant does not check his blood sugar on a 

frequent basis because he does not have a glucometer machine.

 Degenerative joint disease of the lumbar spine. On today’s examination, 

he had decreased range of motion of the lumbar spine with tenderness to 

palpation. He ambulated without any difficulty and without any limping. 

Motor strength and sensation in the extremities were intact.

 Possible right hand cellulitis. On today’s examination, the claimant had 

edema of the right hand with a slight pinkish coloration with increased 

warmth compared to the left hand. He had decreased range of motion of 

the right hand with tenderness to palpation. The claimant was advised to 

follow up with his primary care physician as soon as possible to have his 

right hand evaluated.

 History of lupus anticoagulant. The claimant is currently on Coumadin. 

The claimant currently still smokes and was advised to stop smoking.

(A.R. 795.) In addition, Dr. Dao offered the following functional assessment for Plaintiff:

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The claimant can lift or carry, push or pull 20 lbs. occasionally and 10 lbs. 

frequently. The claimant can stand or walk for six hours in an 8-hour 

workday. The claimant can sit for six hours in an 8-hour workday. 

Climbing, stooping, kneeling and crouching should be limited to occasionally.

Manipulation with the right hand is limited to occasional.

There are no visual, communicative or environmental limitations.

(A.R. 795–96.) 

2. ALJ’s Decision Regarding Dr. Dao’s Opinion

The ALJ’s decision stated the following with respect to Dr. Dao’s medical opinion:

Consultative examiner Dr. Dao opined the claimant retains the capacity 

to perform light exertion work with occasionally climbing, stooping, kneeling 

and crouching, and occasional manipulation with the right hand (Exhibits 

3F/6–7). 

The undersigned gives [Dr. Dao’s] opinion[] some weight. 

Specifically, while the undersigned agrees that the claimant’s impairments do 

no[t] prevent him from performing up to light exertion work activity as 

supported by the medical evidence and other factors discussed above, the 

medical evidence showing no significant and persistent neurologic deficits 

does not support [his] opined postural and manipulative limitations. 

Accordingly, this portion of [his] opinion[] is given little weight.

(A.R. 322.) 

B. Applicable Law

The Ninth Circuit distinguishes among the opinions of three types of physicians: 

(1) those who treat the claimant (treating physicians); (2) those who examine but do not 

treat the claimant (examining physicians); and (3) those who neither treat nor examine the 

claimant (nonexamining physicians). Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). 

In the instant case, it is undisputed that Dr. Dao is an examining physician. (ECF No. 18-

1 at 3; ECF No. 20-1 at 7.) 

///

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The ALJ is not bound by the medical opinions of any physician, and he may discount 

or reject the opinion of an examining physician under certain circumstances. To reject the

opinion of an examining physician that is not contradicted by another doctor’s opinion, the 

ALJ must provide “clear and convincing reasons” that are supported by substantial 

evidence in the record. Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008) 

(citing Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005); Lester, 81 F.3d at 830). 

To reject the opinion of an examining physician that is contradicted by another doctor’s 

opinion, the ALJ must provide “specific and legitimate reasons” that are supported by 

substantial evidence in the record. Id. (citing Bayliss, 427 F.3d at 1216). 

In the instant case, Dr. Dao’s opinion regarding Plaintiff’s right hand manipulative 

limitation is contradicted by the opinions of examining physician Dr. G. Taylor-Holmes

(A.R. 926–30) and nonexamining physician Dr. Howard McClure (A.R. 356–59). 

Dr. Taylor-Holmes conducted a Physical Residual Functional Capacity Assessment of

Plaintiff on December 27, 2010. He found that Plaintiff did not require any manipulative

functional limitations. (A.R. 928.) Dr. McClure, a medical expert, testified at Plaintiff’s 

November 8, 2013 hearing before the ALJ that after reviewing Plaintiff’s medical records 

through Exhibit 21F, he would give Plaintiff “a full medium RFC with seizure precautions 

and with avoiding hazardous machinery because of his anticoagulated state.” (A.R. 359.) 

Dr. McClure did not opine that Plaintiff required any right hand manipulative functional 

limitations. (See id.) Thus, to reject Dr. Dao’s controverted opinion regarding Plaintiff’s 

right hand manipulative limitation, the ALJ needed to provide specific and legitimate 

reasons that are supported by substantial evidence in the record.4

 

4 The Court notes that even if the “clear and convincing reasons” standard were to apply, the 

Court’s recommendation regarding the instant cross-motions for summary judgment would not change. 

For the reasons discussed in this Report and Recommendation, the Court concludes that in the context of 

this case, the ALJ’s reason for rejecting Dr. Dao’s opinion is both “clear and convincing” and “specific 

and legitimate,” and it is supported by substantial evidence in the record. 

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C. Discussion

1. The ALJ Did Not Commit Legal Error

The ALJ did not err in rejecting Dr. Dao’s opinion regarding Plaintiff’s right hand 

manipulative limitation. The ALJ rejected this portion of Dr. Dao’s opinion on the basis 

that the medical evidence, showing no significant and persistent neurologic deficits,5 does 

not support the opined right hand manipulative limitation. (A.R. 322.) While this reason 

may be brief, its brevity does not detract from the fact that it is non-conclusory, specific,

and legitimate. 

In addition, the ALJ’s reason for rejecting Dr. Dao’s opinion is not a “substitu[ion 

of] his own lay opinion for that of the medical professional,” as Plaintiff argues. (ECF No. 

18-1 at 6.) The ALJ specifically stated that his reason for rejecting Dr. Dao’s opinion is 

dependent on the absence of a showing of significant and persistent neurologic deficits in

the medical evidence. (A.R. 322.) The ALJ did not, on his own and without reference to 

any medical evidence, opine that Plaintiff does not suffer from significant and persistent 

neurological deficits. 

Further, Plaintiff’s argument that the “ALJ does not cite to any evidentiary basis to 

support his rejection of Dr. Dao with respect to Mr. Douville’s manipulative functional 

limitations” is without merit. (ECF No. 18-1 at 5.) The ALJ discussed the medical 

evidence “showing no significant and persistent neurologic deficits” throughout his 

decision. Specifically, the ALJ stated in his decision that in July 2009, approximately one 

month after Plaintiff suffered gait instability with left-sided numbness and generalized 

weakness, Plaintiff “had no residual symptoms with only occasional recurrence of left 

sided tingling (Exhibits 2F/3, 6, 20F)” and that “his treating provider R. Rhiew, M.D. saw 

 

5

 Although Dr. Dao’s opinion about Plaintiff’s right hand manipulative limitation was tied to 

symptoms in May 2010 consistent with possible right hand cellulitis, there is no indication in the record 

that Plaintiff continued to suffer from right hand cellulitis by the time of his November 8, 2013 

administrative hearing. At the hearing, Plaintiff testified that his right hand manipulative limitation was 

due to right arm weakness resulting from a stroke in November 2012 (A.R. 349–53; 366, 369–70); hence 

the relevance of the lack of medical evidence of neurological deficits. 

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nothing in his job description that was medically contraindicated other than hazards of 

accidental injury (Exhibits 2F/7, 10).” (A.R. 319.) In addition, the ALJ stated in his 

decision that Plaintiff “sought outpatient care for his physical impairments with S. Cheffet, 

D.O. at the Lemon Grove Family Health Center” and “Dr. Cheffet’s progress notes 

frequently show the claimant’s . . . extremities were normal (Exhibits 20F/7, 14, 19, 22, 

25, 30, 31, 33, 38, 52, 55, 59, 62, 65).” (A.R. 319.) Further, the ALJ stated in his decision

that in June 2012, treating emergency department physician A. Letai, M.D., reviewed 

Plaintiff’s 

12 head CT scans, 1 orbital CT scan, 1 soft tissue neck CT scan, 4 chest CT 

scans, 2 abdominal CT scans, a brain MRI and MRA and carotid duplex 

studies and found that all of the scans and studies were “completely negative” 

(Exhibit 16F/118). Dr. Letai found it hard to believe that the claimant had 

multiple strokes because all of the imaging was completely negative (Exhibit 

16F/118). Noting the claimant had been seen in a hospital 12 times, Dr. Letai 

felt the claimant’s only “real” medical problems were chronic obstructive 

pulmonary disease and history of alcohol, tobacco and substance abuse and 

did not see any evidence that the claimant ever had a cardiovascular accident 

(Exhibit 16F/118). 

(A.R. 319.) 

“[I]n interpreting the evidence and developing the record, the ALJ does not need to 

‘discuss every piece of evidence.’” Howard ex rel. Wolff v. Barnhart, 341 F.3d 1006, 1012 

(9th Cir. 2003) (citing Black v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998)). ALJs need only 

“make fairly detailed findings in support of the administrative decisions to permit courts to 

review those decisions intelligently.” Vincent ex rel. Vincent v. Heckler, 739 F.2d 1393, 

1394 (9th Cir. 1984). Here, the ALJ supported his decision to reject a portion of Dr. Dao’s

opinion with detailed findings and citations to the medical records that were sufficient to 

allow the Court to complete an intelligent review of his decision. Having reviewed the 

decision, the Court concludes that the ALJ’s reason for rejecting Dr. Dao’s opinion 

regarding Plaintiff’s right hand manipulative limitation is specific, legitimate, and free 

from legal error. 

/// 

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2. The ALJ’s Decision is Supported by Substantial Evidence 

In addition, the Court concludes that the ALJ’s decision to reject Dr. Dao’s opinion

regarding Plaintiff’s right hand manipulative limitation is supported by substantial 

evidence in the record. First, the totality of Plaintiff’s medical records does not support 

Dr. Dao’s opinion regarding Plaintiff’s right hand manipulative limitation. As evidenced 

by the lengthy administrative record in this case, Plaintiff has an extensive medical history. 

Plaintiff’s medical records show that from June 2009, approximately one month before 

Plaintiff’s alleged disability onset date, through the date of the ALJ’s decision, Plaintiff 

was either seen in a hospital emergency department or admitted to a hospital over 50 times, 

and he was seen by a primary care physician or at a walk-in clinic over 40 times. Of these 

more than 90 medical visits, there is no indication in the record that Plaintiff ever

complained of or sought treatment for a loss of, or reduction in, the manipulative 

functionality of his right hand. 

In addition, a general physical examination of Plaintiff’s extremities and

neurological functioning was conducted at almost every visit to a medical facility, and the 

record is replete with normal examinations of Plaintiff. For example, Plaintiff’s right hand 

grip strength was assessed on numerous occasions as “moderate” (A.R. 2230, 2238, 2751), 

“strong” (A.R. 2256, 2380, 2638, 2658, 3035, 3044), “five out of five” (A.R. 876), or equal 

to that of his left hand (A.R. 2230, 2238, 2256, 2334, 3552, 4613). His motor strength and 

function in his right upper extremity was assessed on multiple occasions as “five out of 

five” (A.R. 714, 741, 1026, 1217, 1223, 3536), “full” (A.R. 789), “excellent” (A.R. 4905),

or without detectable deficit (A.R. 869, 1865, 2045–46, 2296, 2338, 3975, 4665, 4763, 

4770, 4775, 4963). He was assessed on multiple occasions as having a range of motion in 

his right upper extremity that was “full” (A.R. 876, 1971), “active” (A.R. 2643, 2662, 2672, 

2937, 2939), or within normal limits (A.R. 1217, 1223, 1865, 2194, 2207, 2780). He was 

noted as having “no joint pain or swelling” in his extremities during most visits. (A.R.

844–45, 985, 1026, 3754, 3759, 3912, 3971, 4116, 4897–98, 4901, 4926, 4962.) Further, 

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Plaintiff underwent multiple CT scans of his brain and head and they were all negative. 

(A.R. 724, 861, 2027, 3005, 3041–42, 3531, 3975, 4278, 4614, 4927, 4952.) 

The only significant indication that Plaintiff suffered decreased right hand strength 

and grip abduction was noted by Plaintiff’s primary care physician in 2007. (A.R. 753, 

763.) However, Plaintiff underwent corrective carpal tunnel surgery in early 2008, more 

than one year before his alleged disability onset date. (A.R. 747.) Plaintiff’s medical 

records do not indicate that he suffered any residual right hand pain or functional 

limitations as a result of the surgery. On a more recent occasion, on April 14, 2011,

Plaintiff’s motor strength in his right upper extremity was measured as a three out of five 

while Plaintiff was experiencing the onset of a cerebrovascular accident (“CVA”). (A.R. 

1089.) However, the CVA was timely aborted via tPA administration (A.R. 1083), and by 

the next day, all of Plaintiff’s extremities were measured as equal in strength and no 

neurological deficits were noted. (A.R. 1192.) In addition, Plaintiff had difficulty moving 

his right upper extremity on February 1, 2012 (A.R. 3844), but that problem appeared to 

have resolved by February 4, 2012 (A.R. 3912). 

Second, as discussed above, Dr. Dao’s opinion regarding Plaintiff’s right hand 

manipulative limitation was contradicted by the opinions of Drs. Taylor-Holmes and 

McClure. Examining physician Dr. Taylor-Holmes performed an RFC assessment of 

Plaintiff and opined that Plaintiff did not require any manipulative functional limitations.

(A.R. 928.) He also noted that Plaintiff had a history of a CVA without significant residual 

effects and that neurologically, Plaintiff was without deficits. (A.R. 930.) Nonexamining 

physician Dr. McClure testified at Plaintiff’s hearing that he would give Plaintiff a full 

medium RFC with seizure precautions and with avoiding hazardous machinery, but 

without any limiting instruction with respect to Plaintiff’s right hand manipulative 

functionality. (A.R. 359.) 

Third, Dr. Dao’s own medical assessment of Plaintiff provides support for the ALJ’s 

rejection of the portion of Dr. Dao’s opinion that addresses Plaintiff’s right hand 

manipulative limitation. Dr. Dao opined that at the time he examined Plaintiff, Plaintiff 

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presented with “[p]ossible right hand cellulitis.” (A.R. 795.) In addition, Plaintiff stated 

to Dr. Dao that his right hand pain and swelling had started only two days prior. (A.R. 

791.) Thus, it is probable that Dr. Dao’s opined right hand manipulative limitation was 

based only on the temporary inflammation of Plaintiff’s right hand and not on a persistent

neurologic deficit. 

Finally, Plaintiff’s own hearing testimony does not support Dr. Dao’s opinion

regarding Plaintiff’s right hand manipulative limitation. Plaintiff testified at his November 

8, 2013 hearing that he has difficulty performing gripping movements with his right hand 

and that this difficulty developed after he suffered a stroke in November 2012. (A.R. 349–

50, 366, 369–70.) Thus, according to Plaintiff, his alleged right hand manipulative 

limitation was established in 2012, approximately two years after Dr. Dao offered his 

opinion. This further supports the likelihood that Dr. Dao’s opinion regarding Plaintiff’s 

right hand manipulative limitations was based on the temporary inflammation of Plaintiff’s 

right hand and not on a persistent neurologic deficit. In addition, there is no indication in 

the medical records that Plaintiff suffered a stroke in November 2012 that would have 

caused his alleged right hand manipulative limitation.

6 While it was noted that Plaintiff 

experienced decreased strength in his right upper extremity on February 25, 2013 (A.R. 

4931), and on March 15, 2013 (A.R. 4951), a physical examination of Plaintiff on 

December 24, 2013, showed that Plaintiff exhibited no motor neurological deficits (A.R. 

4963). 

Considering the evidence as a whole, the Court concludes that Dr. Dao’s opinion 

regarding Plaintiff’s right hand manipulative limitation is conflicted by the substantial 

evidence in the record. Accordingly, the ALJ’s decision to reject Dr. Dao’s opinion 

 

6

 The administrative record contains no medical records for Plaintiff from approximately October 

19, 2012, through February 9, 2013. This is likely because Plaintiff was incarcerated during this period. 

On February 13, 2013, Plaintiff explained to Dr. Sherry Braheny at Sharp Grossmont Hospital that he was 

released from jail on February 4, 2013, after serving a four-month sentence. (A.R. 4903.) 

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regarding Plaintiff’s right hand manipulative limitation is supported by substantial 

evidence in the record. 

VI. CONCLUSION

The Court concludes that the ALJ’s decision to reject Dr. Dao’s opinion regarding 

Plaintiff’s right hand manipulative limitation is both free from legal error and supported by 

substantial evidence in the record. Accordingly, the Court RECOMMENDS that 

Plaintiff’s motion for summary judgment be DENIED and that the Commissioner’s crossmotion to affirm the Administrative Law Judge’s decision be GRANTED.

IT IS HEREBY ORDERED that any written objections to this Report and 

Recommendation shall be filed with the Court and served on all parties no later than 

January 30, 2017. The document should be captioned “Objections to Report and 

Recommendation.” 

IT IS FURTHER ORDERED that any reply to the objections shall be filed with 

the Court and served on all parties no later than February 13, 2017. 

The parties are advised that failure to file objections within the specified time may 

waive the right to raise those objections on appeal of the Court’s order. Turner v. Duncan, 

158 F.3d 449,445 (9th Cir 1998); Martinez v. Ylst, 951 F.2d 1153, 1157 (9th Cir 1991).

IT IS SO ORDERED. 

Dated: January 13, 2017

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