Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_13-cv-00321/USCOURTS-azd-2_13-cv-00321-0/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 

Rick Lee Albery, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant. 

No. CV-13-00321-PHX-BSB

ORDER 

 Plaintiff Rick Lee Albery seeks judicial review of the final decision of the 

Commissioner of Social Security (the Commissioner), denying his application for 

disability insurance benefits under the Social Security Act (the Act). The parties have 

consented to proceed before a United States Magistrate Judge pursuant to 28 

U.S.C. § 636(b) and have filed briefs in accordance with Local Rule of Civil Procedure 

16.1.1

 For the following reasons, the Court reverses the Commissioner’s decision and 

remands for an award of benefits. 

I. Procedural Background 

 In September and October 2009, Plaintiff applied for disability insurance benefits 

and supplemental security income under Titles II and XVI of the Act based on disability 

beginning August 2009. (Tr. 14.)2

 After the Social Security Administration (SSA), 

 

1

 This matter is suitable for resolution based on the briefs. Accordingly, the Court denies Plaintiff’s request for oral argument. See LRCiv. 7.2(f). 

2

 Citations to “Tr.” are to the certified administrative transcript. (Doc. 12.) 

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denied Plaintiff’s initial application and his request for reconsideration, he requested a 

hearing before an administrative law judge (ALJ).3

 After conducting a hearing, the ALJ 

issued a decision finding Plaintiff not disabled under the Act. (Tr. 14-29.) This decision 

became the final decision of the Commissioner when the Social Security Administration 

Appeals Council denied Plaintiff’s request for review. (Tr. 1-5); see 20 C.F.R. § 404.981 

(explaining the effect of a disposition by the Appeals Council.) Plaintiff now seeks 

judicial review of this decision pursuant to 42 U.S.C. § 405(g). 

II. Medical Record 

 The record before the Court establishes the following history of diagnosis and 

treatment related to Plaintiff’s physical impairments. The record also includes an opinion 

from a state agency physician who reviewed the records related to Plaintiff’s 

impairments, but who did not provide treatment. 

A. Surgical Procedures in 2009 

 In August 2009, Plaintiff was admitted to the hospital for chest pains. (Tr. 799.) 

Testing revealed a left ventricular apical aneurysm with thrombus and ischemic 

cardiomyopathy, with a forty percent ejection fraction. (Tr. 798-99.) Plaintiff also had 

an eighty percent blockage of the left anterior descending coronary artery. (Tr. 260.) On 

August 23, 2009, Dr. Roger Hucek, M.D., performed coronary artery bypass surgery and 

left ventricular aneurysm repair on Plaintiff. (Tr. 262-64.) An echocardiogram the next 

month showed normal left ventricular systolic function (with an ejection fraction of sixty 

percent) and mild enlargement of the left ventricle. (Tr. 791.) However, Plaintiff’s 

sternum was cracked during the bypass surgery and he developed an infection at the 

fracture site, which required hospitalization in September 2009 for a wound debridement 

procedure that Dr. Hucek performed. (Tr. 381, 306.) At the time of that procedure, 

transesophageal echocardiography revealed an ejection fraction of thirty percent (Tr. 

 

3

 The initial and reconsideration determinations are made by state agencies acting under the authority of the Commissioner. See 20 C.F.R. §§ 404.1503, 416.903, 

416.1013. 

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306), and a regular echocardiogram showed left ventricular ejection fraction of fifty to 

fifty-five percent, but with impaired left ventricular function (filling defect). (Tr. 398.) 

B. Treatment from 2010 through 2011 

 In March 2010, Plaintiff began treatment with Robert Bear, D.O., at 

Cardiovascular Consultants. Plaintiff presented with palpitations associated with 

shortness of breath. (Tr. 515.) Plaintiff had a decreased pulse in both legs. (Tr. 516.) 

Dr. Bear ordered diagnostic tests including an echocardiogram, which showed a forty 

percent ejection fraction. (Tr. 513.) He also ordered a nuclear stress test, which showed 

a thirty-six percent ejection fraction and an anteroapical myocardial infarction (heart 

attack) with inferior wall perfusion defect. (Tr. 514.) He also ordered ankle-brachial 

indices, which indicated abnormal blood flow to the left leg. (Tr. 528.) Dr. Bear noted 

Plaintiff’s history of coronary artery disease, type II diabetes, and palpitations. (Tr. 515.) 

At a follow-up appointment in May 2010, Dr. Bear noted that the diagnostic tests 

indicated “peripheral arterial disease involving the lower left extremity,” which was 

consistent with Plaintiff’s left leg claudication. (Tr. 551.) 

 In June 2010, Dr. Bear reported that Plaintiff also suffered from neuropathy in the 

feet, probably unrelated to the claudication symptoms. (Tr. 549.) Plaintiff also had slow 

blood flow to the lower extremities. (Tr. 545.) At the end of June 2010, Plaintiff started 

using a walker due to leg weakness. (Tr. 669.) His pulses were markedly impaired (1+) 

in the lower extremities, and he had demonstrable weakness in both lower extremities. 

(Tr. 670.) 

 A September 2010 stress test showed findings consistent with a prior myocardial 

infarction and a thirty-nine percent ejection fraction. (Tr. 644-45.) When Plaintiff 

presented to Cardiovascular Consultants later that month, he had swelling in his feet, 

paroxysmal nocturnal dyspnea (shortness of breath), and occasional palpitations. 

(Tr. 666.) Nurse Practitioner Darlene Bidwell noted Plaintiff was using a wheelchair 

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because he became short of breath walking short distances. (Id.) She also noted that 

Plaintiff was “NYHA Class III to IV.”4

 (Id.) 

 In October 2010, Plaintiff saw Thomas Perry, M.D., at Maryvale Cardiology with 

complaints of dyspnea, insomnia, and dizziness. (Tr. 643.) Dr. Perry noted that Plaitiff 

used a wheelchair because he was afraid of falling. (Id.) He ordered a Holter monitor for 

Plaintiff. (Tr. 642.) An echocardiogram that month showed decreased left ventricular 

function. (Tr. 641.) On November 3, 2010, Dr. Perry noted that Plaintiff complained of 

shortness of breath, chest pains, and dizziness. (Tr. 639.) He advised Plaintiff to 

continue with cardiac rehabilitation and adjusted Plaintiff’s medications. (Id.) In January 

2011, while he was at a cardiac rehabilitation appointment, Plaintiff was sent to the 

emergency room for chest pains and shortness of breath. (Tr. 694.) Cardiac 

catheterization showed diffuse ninety-five percent narrowing in the left anterior 

descending artery in the mid-segment. There was also moderate left ventricular systolic 

dysfunction. (Tr. 692.) A transesophageal echocardiogram showed there was no 

thrombus of the left atrium and a fifty percent ejection fraction, described as “low 

normal.” (Tr. 688-89.) 

 Plaintiff returned to Cardiovascular Consultants for further treatment in 2011. 

(Tr. 654-56.) During a June 2011 appointment, Dr. Bear noted that Plaintiff’s lower 

extremity pulses were moderately impaired (2+), and continued his medications. 

(Tr. 651-53.) A transesophageal echocardiogram in July 2011 was normal, with no sign 

of thrombus. (Tr. 683.) Plaintiff returned to the emergency room in July 2011 because 

of chest pain, and testing ruled out a heart attack. (Tr. 679-82.) 

 

4

 Plaintiff states that The New York Heart Association Functional Classification 

III means “[p]atients have cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue. palpitation, dyspnea, or angina pain.” (Doc. 22 at 10 (citing Elliott M. Antman et al., 

Ischemic Heart Disease, Harrison’s Principles of Internal Medicine at 2000).). Plaintiff 

further explains that Class IV means “[p]atients have cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the angina syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.” (Doc. 22 at 10.) The Commissioner does not 

dispute these definitions. 

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 From 2009 through 2011, Kevin Cleary, D.O., was Plaintiff’s primary care 

physician. His diagnoses included coronary artery disease, non-insulin dependent 

diabetes mellitus, peripheral neuropathy, and anxiety (for which he prescribed Ativan and 

Trazadone).. (Tr. 698-745.) Dr. Cleary prescribed a wheelchair because Plaintiff 

suffered falls. (Tr. 569, 714) Dr. Cleary also noted that Plaintiff used a walker. 

(Tr. 700.) 

C. Functional Capacity Assessments 

 1. Jerry Dodson, M.D., Reviewing Physician 

 In February 2010, as part of the initial disability determination, Jerry Dodson, 

M.D., a state agency physician, completed a Physical Residual Functional Capacity 

(RFC) Assessment. (Tr. 493-500.) He reviewed the existing medical record regarding 

Plaintiff’s cardiac impairment and specifically discussed the August 2000 surgery and 

subsequent sternum repair. (Tr. 500.) Dr. Dodson rated capacities for light work as 

defined in the regulations. (Tr. 494, 500.) He opined that Plaintiff could not climb 

ladders, ropes, or scaffolds, but could occasionally climb ramps or stairs, balance, stoop, 

kneel, crouch, and crawl (Tr. 495), and could perform limited reaching and gross 

manipulation. (Tr. 496.) He opined that Plaintiff should avoid concentrated exposure to 

extreme cold or hazards such as machinery or heights. (Tr. 497.) The ALJ’s RFC 

determination largely adopted this assessment. (Tr. 19.) 

 2. Dr. Bear 

 In May 2010, Dr. Bear completed a Cardiac Residual Functional Capacity 

Questionnaire (Cardiac Questionnaire). (Tr. 566-67.) Dr. Bear noted Plaintiff’s 

diagnoses of hypertension, peripheral vascular disease, claudication, and osteomyelitis. 

Dr. Bear found that Plaintiff suffered from chest pain, palpitations, and shortness of 

breath due to these diagnosed impairments. (Tr. 566.) He opined that Plaintiff had 

“significant limitation of physical activity as demonstrated by fatigue, palpitations, 

dyspnea, or anginal discomfort.” (Tr. 567.) He further opined that these symptoms 

would often interfere with attention and concentration. (Id.) In an updated Cardiac 

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Questionnaire in October 2011, Dr. Bear listed diagnoses of coronary artery disease, 

status post-coronary artery bypass grafting in 2009, cardiomyopathy, and diabetes. 

(Tr. 817.) Plaintiff’s symptoms included chest pain, fatigue, weakness, and shortness of 

breath. Again, Dr. Bear noted that these symptoms would often interfere with Plaintiff’s 

attention and concentration and resulted in “significant limitation of physical activity.” 

(Tr. 817-18.) 

3. Dr. Cleary 

 Dr. Cleary completed a Medical Assessment of Ability to do Work Related 

Physical Activity assessment in October 2011. Dr. Cleary found that Plaintiff could sit 

for less than six hours and stand/walk less than two hours in an eight-hour day. (Tr. 748.) 

Dr. Cleary noted that Plaintiff experienced increased “SOB [shortness of breath] with 

exertion due to his CHF [congestive heart failure] and COPD [chronic obstructive 

pulmonary disease].” (Tr. 750.) Dr. Cleary also completed a Fatigue Residual 

Functional Capacity Assessment. He opined that Plaintiff needed to nap for about one 

hour during an eight-hour day. (Tr. 746-47.) He concluded that fatigue would often 

interfere with Plaintiff’s attention and concentration, resulting in an inability to sustain 

work on a regular and continuing basis, eight hours a day, five days a week. (Tr. 746.) 

III. Administrative Hearing Testimony 

 Plaintiff appeared and testified at the October 12, 2011 administrative hearing. 

Plaintiff was in his late forties at the time. He had a high school education and past 

relevant work as a preparation cook. (Tr. 72.) Plaintiff testified that he was limited by 

shortness of breath and chest pains. (Tr. 63.) He also testified that he suffered from 

fatigue, and that he lay down “half an hour to an hour” five to six times a day. He stated 

that “[w]hen I get out of breath, I really want to lay down.” (Tr. 67.) 

 Vocational expert Linda Tolley also testified at the administrative hearing. 

(Tr. 75.) She testified in response to a hypothetical question from the ALJ that an 

individual with the abilities assessed by the initial state agency reviewer, Dr. Dodson, 

could perform jobs at the light exertional level, such as parking lot attendant, ticket seller, 

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and small parts assembler, (Tr. 72-73), which are the jobs the ALJ relied upon in her 

determination that Plaintiff was not disabled. (Tr. 29.) The ALJ conceded that the 

limitations assessed by the treating physicians Dr. Bear and Dr. Cleary would preclude 

sustained work. (Tr. 75.) The vocational expert testified that a person with the 

limitations to which Plaintiff testified, who needed to lie down throughout the day for a 

combined total of approximately five hours, would be unable to sustain work on a 

continuing and regular basis. (Tr. 76-77.) 

IV. The ALJ’s Decision 

 A claimant is considered disabled under the Social Security Act if he is unable “to 

engage in any substantial gainful activity by reason of any medically determinable 

physical or mental impairment which can be expected to result in death or which has 

lasted or can be expected to last for a continuous period of not less than 12 months.” 42 

U.S.C. § 423(d)(1)(A); see also 42 U.S.C. § 1382c(a)(3)(A) (nearly identical standard for 

supplemental security income disability insurance benefits). To determine whether a 

claimant is disabled, the ALJ uses a five-step sequential evaluation process. See 20 

C.F.R. §§ 404.1520, 416.920. 

A. Five-Step Evaluation Process 

 In the first two steps, a claimant seeking disability benefits must initially 

demonstrate (1) that he is not presently engaged in a substantial gainful activity, and 

(2) that his impairment is severe. 20 C.F.R. § 404.1520(a)(c). If a claimant meets steps 

one and two, he may be found disabled in two ways at steps three through five. At step 

three, he may prove that his impairment or combination of impairments meets or equals 

an impairment in the Listing of Impairments found in Appendix 1 to Subpart P of 20 

C.F.R. pt. 404. 20 C.F.R. § 404.1520(a)(4)(iii). If so, the claimant is presumptively 

disabled. If not, the ALJ determines the claimant’s RFC. At step four, the ALJ 

determines whether a claimant’s RFC precludes him from performing his past work. 20 

C.F.R. § 404.1520(a)(4)(iv). If the claimant establishes this prima facie case, the burden 

shifts to the government at step five to establish that the claimant can perform other jobs 

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that exist in significant number in the national economy, considering the claimant’s RFC, 

age, work experience, and education. If the government does not meet this burden, then 

the claimant is considered disabled within the meaning of the Act. 

B. ALJ’s Application of Five-Step Evaluation Process 

 Applying the five-step sequential evaluation process, the ALJ found that Plaintiff 

had not engaged in substantial gainful activity during the relevant period. (Tr. 16.) At 

step two, the ALJ found that Plaintiff had the following severe impairments: “intermittent 

claudication in the left leg, coronary artery disease status post bypass grafting, obstructive 

sleep apnea, mild obstructive pulmonary disease, ventricular aneurysm resection, obesity, 

diabetes mellitus, status post umbilical hernia repair, and adjustment disorder.” (Tr. 16.) 

At the third step, the ALJ found that the severity of Plaintiff’s impairments did not meet 

or medically equal the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, 

Appendix 1. (Id.) The ALJ next determined that Plaintiff retained the RFC “to perform 

light work” as defined in 20 C.F.R. § 404.1567(b) and § 416.967 with postural, 

manipulative, and environmental limitations.5

 (Tr. 19.) The ALJ also concluded that 

Plaintiff’s mental impairments limited him to simple work. (Id.) At step four, the ALJ 

concluded that Plaintiff could not perform his past relevant work. (Tr. 28.) At step five, 

the ALJ found that, considering Plaintiff’s age, education, work experience, and RFC, he 

could perform other “jobs that exist in significant numbers in the national economy.” 

(Id) The ALJ concluded that Plaintiff was not disabled within the meaning of the Act. 

(Tr. 29.) 

V. Standard of Review 

 The district court has the “power to enter, upon the pleadings and transcript of 

record, a judgment affirming, modifying, or reversing the decision of the Commissioner, 

 

5

 Specifically, the ALJ found that “[Plaintiff] is limited to lifting and carrying no more than ten pounds. He is also able to stand or walk for six hours in an eight-hour day, with normal breaks. He is limited to occasional balancing, stooping, kneeling, crouching, crawling, and climbing ramps and stairs. The claimant is unable to climb ladders, ropes, or scaffolds. The claimant is limited to frequent reaching and gross manipulation. He must avoid concentrated exposure to extreme cold and hazards, including moving machinery and heights.” (Tr. 19.) 

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

court reviews the Commissioner’s final decision under the substantial evidence standard 

and must affirm the Commissioner’s decision if it is supported by substantial evidence 

and it is free from legal error. Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996); 

Ryan v. Comm’r of Soc. Sec. Admin., 528 F.3d 1194, 1198 (9th Cir. 2008). Even if the 

ALJ erred, however, “[a] decision of the ALJ will not be reversed for errors that are 

harmless.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). 

 Substantial evidence means more than a mere scintilla, but less than a 

preponderance; it is “such relevant evidence as a reasonable mind might accept as 

adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) 

(citations omitted); see also Webb v Barnhart, 433 F.3d 683, 686 (9th Cir. 2005). In 

determining whether substantial evidence supports a decision, the court considers the 

record as a whole and “may not affirm simply by isolating a specific quantum of 

supporting evidence.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (internal 

quotation and citation omitted). 

 The ALJ is responsible for resolving conflicts in testimony, determining 

credibility, and resolving ambiguities. See Andrews v. Shalala, 53 F.3d 1035, 1039 (9th 

Cir. 1995). “When the evidence before the ALJ is subject to more than one rational 

interpretation, [the court] must defer to the ALJ’s conclusion.” Batson v. Comm’r of Soc. 

Sec. Admin., 359 F.3d 1190, 1198 (9th Cir. 2004) (citing Andrews, 53 F.3d at 1041). 

VI. Plaintiff’s Claims 

 Plaintiff asserts that the ALJ erred in her assessment of the medical source opinion 

evidence and by rejecting Plaintiff’s symptom testimony without providing clear and 

convincing reasons for doing so. (Doc. 20.) Plaintiff asks the Court to remand this 

matter for a determination of disability benefits. In response, the Commissioner argues 

that the ALJ’s decision is free from legal error and is supported by substantial evidence in 

the record. (Doc. 26.) For the reasons discussed below, the Court reverses the 

Commissioner’s determination and remands for an award of benefits. 

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 A. Weight Assigned to Medical Source Opinions 

 In weighing medical source evidence, the Ninth Circuit distinguishes between 

three types of physicians: (1) treating physicians, who treat the claimant; (2) examining 

physicians, who examine but do not treat the claimant; and (3) non-examining physicians, 

who neither treat nor examine the claimant. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 

1995). Generally, more weight is given to a treating physician’s opinion. Id. The ALJ 

must provide clear and convincing reasons supported by substantial evidence for 

rejecting a treating or an examining physician’s uncontradicted opinion. Id.; Reddick v. 

Chater, 157 F.3d 715, 725 (9th Cir. 1998). An ALJ may reject the controverted opinion 

of a treating or an examining physician by providing specific and legitimate reasons that 

are supported by substantial evidence in the record. Bayliss v. Barnhart, 427 F.3d 1211, 

1216 (9th Cir. 2005); Reddick, 157 F.3d at 725. 

 Opinions from non-examining medical sources are entitled to less weight than 

treating or examining physicians. Lester, 81 F.3d at 831. Although an ALJ generally 

gives more weight to an examining physician’s opinion than to a non-examining 

physician’s opinion, a non-examining physician’s opinion may nonetheless constitute 

substantial evidence if it is consistent with other independent evidence in the record. 

Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002). When evaluating medical 

opinion evidence, the ALJ may consider “the amount of relevant evidence that supports 

the opinion and the quality of the explanation provided; the consistency of the medical 

opinion with the record as a whole; [and] the specialty of the physician providing the 

opinion . . . .” Orn, 495 F.3d at 631. 

The record here includes opinions regarding Plaintiff’s physical functional 

abilities from treating physicians Dr. Bear and Dr. Cleary. Plaintiff asserts that the ALJ 

erred by rejecting those opinions in favor of the opinion of the state agency reviewing 

physician. (Doc. 20 at 1.) As discussed below, under either the “clear and convincing” 

or the “specific and legitimate” standard, the ALJ erred in the weight he assigned to these 

opinions. 

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 1. Weight Assigned Dr. Bear’s Opinion 

 In the May 2010 Cardiac Questionnaire, Dr. Bear opined that Plaintiff had 

palpitations and shortness of breath related to his diagnoses of chest pain, hypertension, 

peripheral vascular disease, claudication, and osteomyolitis. (Tr. 566.) He also noted 

that Plaintiff experienced anginal pain for one-half hour to one hour. (Id.) He checked 

“yes” in response to whether the patient had “significant limitation of physical activity, as 

demonstrated by fatigue, palpitation, dyspnea, or angina discomfort on ordinary physical 

activity.” (Tr. 567.) He further noted that Plaintiff “often” experienced 

“symptoms . . . severe enough to interfere with attention and concentration.”6

 (Doc. 567.) 

The ALJ rejected this opinion as “vague and conclusory” stating that Dr. Bear provided 

little explanation of the evidence relied upon in reaching this conclusion. (Tr. 26.) 

 An ALJ may properly reject a treating physician’s opinion that is conclusory and 

unsupported by medical findings. See Batson, 359 F.3d at 1195 (holding that the ALJ did 

not err in giving minimal evidentiary weight to the opinion of the claimant’s treating 

physician when the opinion was in the form of a checklist, did not have supportive 

objective evidence, was contradicted by other statements and assessments of the 

claimant’s medical condition, and was based on the claimant’s subjective descriptions of 

pain); see also Crane v. Shalala, 76 F.3d 251, 253 (9th Cir. 1996) (ALJ permissibly 

rejected psychological evaluations because they were check-the-box reports that did not 

contain explanations of the bases of their conclusions). 

 Although the Cardiac Questionnaires that Dr. Bear completed contained several 

check-the-box type questions, they also required Dr. Bear to provide support for those 

conclusions by citing medical findings, and he noted specific medical findings in support 

of his opinion. (Tr. 566, 817.) The Cardiac Questionnaires instructed Dr. Bear to “base 

[his] assessment on [his] independent clinical judgment” (Tr. 566, 817), and it appears 

that he relied on his treatment history of Plaintiff to complete the Cardiac Questionnaires. 

 

6

 Dr. Bear chose “often” from a range of “never,” “seldom,” “often,” 

“frequently,” and “constantly.” (Tr. 567.) 

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See Mansour v. Astrue, 2009 WL 272865, at *6 n.14 (C.D. Cal. Feb. 2, 2009) (rejecting 

contention that treating physician’s opinion on a “check-the-box” form lacked supporting 

evidence to substantiate the responses on the form because the physician’s treatment 

notes in the record supported his finding on the opinion form). Accordingly, the 

Commissioner’s assertion that Dr. Bear did not sufficiently explain the basis for his 

opinions is not a legally sufficient reason for rejecting his opinions. See Orn, 495 F.3d at 

629 (permitting reliance on “Multiple Impairment Questionnaire[s]” completed by 

treating physician); see also Howell v. Comm’r So. Sec. Admin., 349 Fed. Appx. 181, 184 

(9th Cir. 2009) (stating that “[a]n ALJ ought not dismiss a treating physician’s testimony 

merely because it was contained on [a check off] form” but finding any error in doing so 

harmless because ALJ had “enough evidence” to reject the physician’s testimony). 

 The ALJ also stated that he rejected Dr. Bear’s assessments because they 

contained “little indication of the specific limitations that the claimant’s impairments 

impose.” (Tr. 26.) The record reflects that the ALJ responded to all of the inquiries on 

the Cardiac Questionnaires and indicted that Plaintiff had “significant limitation of 

physical activity,” and that his symptoms often interfered with his attention and 

concentration. (Tr. 567, 818.) During the administrative hearing, the ALJ recognized 

that Dr. Bear’s assessment that Plaintiff’s “symptoms often interfere with attention and 

concentration . . . .” (Tr. 75.) The ALJ conceded that such limitations would preclude 

sustained work. (Id.) Dr. Bear sufficiently identified Plaintiff’s limitations; therefore the 

ALJ’s description of the Dr. Bear’s opinions contained on the 2010 and 2011 Cardiac 

Questionnaires is unsupported by the record and is not a legally sufficient basis for 

rejecting his opinions. 

 2. Weight Assigned Dr. Cleary’s Opinion 

 On an October 4, 2011 Fatigue RFC Questionnaire, Dr. Cleary opined that 

Plaintiff’s fatigue imposed moderate limitations on his ability to function. (Tr. 746.) He 

found that Plaintiff’s fatigue “often” interfered with his attention and concentration. (Id.) 

He also noted that Plaintiff needed to take naps during the day. (Id.) Dr. Clearly also 

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completed a Medical Assessment of Ability to do Work Related Physical Activities and 

opined that Plaintiff could stand/walk for less than two hours in an eight-hour work day, 

and that he could sit less than six hours in an eight-hour work day.7

 (Tr. 748.) 

 The ALJ rejected Dr. Cleary’s opinion as inconsistent with the treating record 

showing that Plaintiff’s cardiac impairments were “stable.” (Tr. 27.) In support of this 

conclusion, the ALJ cited several treatment records. (Tr. 27 (citing Admin. Hrg. Exs. 4F, 

pp. 4-7, 13-16, 5F pp. 1-4, 10F pp. 1-2, 15F pp. 5-6, 28F pp. 5-11).) Administrative 

hearing exhibit 4F at 4-6 (Tr. 297-299) mainly concerns Plaintiff’s umbilical hernia and 

anxiety and includes an October 5, 2009 notation that Plaintiff “uses a walker” because 

he “gets vertigo and falls.” (Tr. 297-299.) These treatment records do not support the 

ALJ’s conclusion that Dr. Cleary’s opinion was inconsistent with the treatment records. 

 The ALJ also cites administrative hearing exhibit 4F at 7, 13-16 (Tr. 300, 306-

309), which includes treatment notes from Roger Hucek, M.D. These notes describe the 

September 16, 2009 sternal debridement procedure that Dr. Hucek performed to treat an 

infection around Plaintiff’s lower sternum. (Tr. 306.) These records indicate that 

Plaintiff was “in satisfactory condition” when he was taken to the recovery room postsurgery. (Admin. Hrg. Ex. 4F at 13-16, Tr. 309.) These treatment notes also indicate that 

Plaintiff’s recovery was going “well” one month after surgery. (Tr. 300.) Although these 

treatment notes reflect that Plaintiff did well after a surgical procedure, they do not 

indicate that Plaintiff was no longer limited by his cardiac impairment-related symptoms 

and do not demonstrate that Dr. Cleary’s opinion was inconsistent with the treatment 

records. 

 In rejecting Dr. Cleary’s opinion, the ALJ also relied on administrative hearing 

exhibit 5F at 1-4 (Tr. 310-313). This exhibit includes treatment notes from Dr. Michael 

 

7

 Dr. Cleary also found that Plaintiff was limited to “frequent” grasping, fine manipulation, and feeling. (Tr. 28.) The ALJ rejected Dr. Cleary’s opinion regarding Plaintiff’s use of his upper extremities because Plaintiff had not reported any difficulties related to his upper extremities to his treating physicians. (Tr. 27.) Although the ALJ stated that he rejected these findings, his RFC assessment included similar limitations 

except that the ALJ found that Plaintiff could frequently reach and Dr. Cleary assessed that Plaintiff was limited to occasional reaching. (compare Tr. 19 with Tr. 749.) 

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Desvigne, M.D., at Banner Boswell Medical Center regarding follow-up treatment in 

October 2009 for Plaintiff’s“flap coverage of sternal wound with a history of coronary 

artery bypass with secondary infection.” (Tr. 310.) These treatment notes indicated that 

Plaintiff was “doing well post-operatively” and that his incision was “well-healed.” 

(Tr. 311-313.) These records do not support the ALJ’s conclusion that Dr. Cleary’s 

assessment of Plaintiff’s fatigue and physical limitations was inconsistent with the 

treating record. 

 The ALJ next cites administrative hearing exhibit 10F at 1-2 (Tr. 514-15). This 

portion of the record details a stress test performed on referral from Dr. Bear on April 19, 

2010. This notation indicates that Plaintiff had “no obvious reversible ischemia and that 

his “left ventricular ejection fraction by stress gated SPECT is 36%.” (Tr. 514.) This 

stress test from 2010 does not conflict with Dr. Cleary’s assessment of Plaintiff’s 

functional abilities over one year after that stress test. The ALJ also relies on a July 13, 

2010 treatment note by Physician Assistant (PA) C. Robert Vanselow at Cardiovascular 

Consultants stating that Plaintiff “was stable from a cardiovascular standpoint” (Admin. 

Hrg. Ex. 15F at 5-6, Tr. 553-54), and several similar treatment notes from Dr. Bear and 

Dr. Rahool Karnik, M.D.8

 (Admin. Hrg. Exs. 28F at 5-11, Tr. 650-656.) 

 Although these treatment notes use the term “stable,” they do no define that term. 

Plaintiff argues that “stable” is a relative term that does not shed light on the extent to 

which Plaintiff’s impairments limited his functional abilities. (Doc. 20 at 21.) When the 

treatment notes are read in their entirety, “it appears clear that ‘stable’ in this context does 

not mean “improved” or ‘controlled,’ but rather ‘has not worsened,’ or ‘has not 

increased.’” Vasquez v. Astrue, 2013 WL 491977, at *9 (D. Ariz. Feb. 8, 2013). 

Although PA Vanselow noted that Plaintiff was “stable,” he also assessed “chest pain” 

and noted that Plaintiff had “weakness in both lower extremities.” (Tr. 554.) Similarly, 

although Dr. Bear and Dr. Karnik considered Plaintiff “stable” from a cardiovascular 

 

8

 The record reflects that Dr. Bear, Dr. Karnik, and NP Vanselow treated Plaintiff 

at Cardiovascular Consultants. (Tr. 646-97.) 

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standpoint, they described “chest pain” and “shortness of breath” as “active problems.” 

(Tr. 651-653, 654-656.) In short, substantial evidence does not support the ALJ’s 

determination that Dr. Cleary’s assessment was inconsistent with the medical record and, 

thus, the ALJ’s rejection of his opinion is legal error. 

B. The Two-Step Credibility Analysis 

 Plaintiff also asserts that the ALJ erred in rejecting his subjective complaints. An 

ALJ engages in a two-step analysis to determine whether a claimant’s testimony 

regarding subjective pain or symptoms is credible. Lingenfelter v. Astrue, 504 F.3d 1028, 

1035-36 (9th Cir. 2007). “First, the ALJ must determine whether the claimant has 

presented objective medical evidence of an underlying impairment ‘which could 

reasonably be expected to produce the pain or other symptoms alleged.’” Id. at 1036 

(quoting Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir. 1991) (en banc)). 

 The claimant is not required to show objective medical evidence of the pain itself 

or of a causal relationship between the impairment and the symptom. Smolen, 80 F.3d at 

1282. Instead, the claimant must only show that an objectively verifiable impairment 

“could reasonably be expected” to produce his pain. Lingenfelter, 504 F.3d at 1036 

(quoting Smolen, 80 F.3d at 1282); see also Carmickle v. Comm’r of Soc. Sec., 533 F.3d 

at 1160-61 (9th Cir. 2008) (“requiring that the medical impairment could reasonably be 

expected to produce pain or another symptom . . . requires only that the causal 

relationship be a reasonable inference, not a medically proven phenomenon”). 

 Second, if a claimant produces medical evidence of an underlying impairment that 

is reasonably expected to produce some degree of the symptoms alleged, and there is no 

affirmative evidence of malingering, an ALJ must provide “clear and convincing 

reasons” for an adverse credibility determination. See Smolen, 80 F.3d at 1281; Gregor 

v. Barnhart, 464 F.3d 968, 972 (9th Cir. 2006). 

 In evaluating a claimant’s credibility, the ALJ may consider the objective medical 

evidence, the claimant’s daily activities, the location, duration, frequency, and intensity 

of the claimant’s pain or other symptoms, precipitating and aggravating factors, 

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medication taken, and treatments for relief of pain or other symptoms. See 20 C.F.R. 

§ 404.1529(c); Bunnell, 947 F.2d at 346. An ALJ may also consider such factors as a 

claimant’s inconsistent statements concerning his symptoms and other statements that 

appear less than candid, the claimant’s reputation for lying, unexplained or inadequately 

explained failure to seek treatment or follow a prescribed course of treatment, medical 

evidence tending to discount the severity of the claimant’s subjective claims, and vague 

testimony as to the alleged disability and symptoms. See Tommasetti v. Astrue, 533 F.3d 

1035, 1040 (9th Cir. 2008); Smolen, 80 F.3d 1273, 1284 (9th Cir. 1996). If substantial 

evidence supports the ALJ’s credibility determination, that determination must be upheld, 

even if some of the reasons cited by the ALJ are not correct. Carmickle, 533 F.3d at 

1162. 

C. Plaintiff’s Pain and Symptom Testimony 

 Because there was no record evidence of malingering, the ALJ was required to 

provide clear and convincing reasons for concluding that Plaintiff’s subjective complaints 

were not wholly credible. Plaintiff argues that the ALJ failed to do so. (Doc. 20 at 24-

32.) The Commissioner has not responded to this claim. (Doc. 26.) The ALJ listed 

several factors in support of her credibility assessment including that: (1) Plaintiff’s 

“daily activities [were] not limited to the extent one would expect, given the complaints 

of disabling symptoms and limitations;” (2) treatment had been “generally successful” in 

controlling his symptoms; and (3) the objective medical record did not substantiate the 

limitations Plaintiff alleged and Plaintiff’s hearing testimony regarding the frequency of 

his falls was inconsistent with the medical record. (Tr. 24-25.) 

 As an initial matter, the ALJ stated that “the objective findings in the record do not 

confirm the limitations alleged by” Plaintiff. (Tr. 24.) The absence of fully corroborative 

medical evidence cannot form the sole basis for rejecting the credibility of a claimant’s 

subjective complaints. See Cotton v. Bowen, 799 F.2d 1403, 1407 (9th Cir.1986) (it is 

legal error for “an ALJ to discredit excess pain testimony solely on the ground that it is 

not fully corroborated by objective medical findings”), superseded by statute on other 

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grounds as stated in Bunnell v. Sullivan, 912 F.2d 1149 (9th Cir. 1990); see also Burch, 

400 F.3d at 681 (explaining that the “lack of medical evidence” can be “a factor” in 

rejecting credibility, but cannot “form the sole basis”); Rollins v. Massanari, 261 F.3d 

853, 856–57 (9th Cir. 2001) (same). Thus, absent some other stated legally sufficient 

reason for discrediting Plaintiff, the ALJ’s credibility determination cannot stand. 

 As discussed below, although the ALJ’s other reasons for discrediting Plaintiff’s 

subjective complaints could constitute clear and convincing reasons in support of a 

credibility determination, they are not supported by substantial evidence in the record, 

and therefore, do not support the ALJ’s credibility determination in this case. 

 1. Plaintiff’s Activities 

 In discounting Plaintiff’s credibility, the ALJ noted that, although Plaintiff uses a 

walker and a wheelchair, he “testified at the hearing that he is able to perform some 

household tasks, including housecleaning and vacuuming,” and “tried to go grocery 

shopping with his wife.” (Tr. 24.) The ALJ also noted that Plaintiff “went to cardiac 

rehab prior to his hernia surgery.” (Id.) 

 Although an ALJ may rely on activities that “contradict claims of a totally 

debilitating impairment” to find a claimant less than credible, Molina v. Astrue, 674 F.3d 

1104, 1113 (9th Cir. 2012), the ALJ’s finding here is not supported by substantial 

evidence. While the record contains evidence that Plaintiff went to cardiac rehabilitation 

(Tr. 656, 694, 743), the record indicates that Plaintiff’s treating physicians advised him to 

pursue such treatment. (Tr. 656.) Plaintiff’s participation in rehabilitation at the advice 

of his treating physicians is not inconsistent with his claims of limitations. See Vertigan 

v. Halter, 260 F.3d 1044, 1050 (9th Cir. 2001) (claimant’s ability to swim, do physical 

therapy, and exercise at home did not detract from claimant’s credibility); Clark v. 

Colvin, 2013 WL 6189726, at *5 (W.D. Wash. Nov. 26, 2013) (concluding that 

claimant’s swimming and stretching were not inconsistent with her reports of pain 

because her doctors encouraged her to exercise). 

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 The ALJ also considered Plaintiff’s activities — housecleaning, vacuuming, and 

limited grocery shopping with his wife — and concluded those activities were 

inconsistent with his complaints of disabling limitations. (Doc. 24.) However, the Ninth 

Circuit has stated that the fact a claimant engages in normal daily activities “does not in 

any way detract from [his] credibility as to [his] overall disability.” Vertigan, 260 F.3d at 

1050. The Ninth Circuit explained that, “[o]ne does not need to be ‘utterly incapacitated’ 

in order to be disabled.” Id. (quoting Fair, 885 F.2d at 603). Rather, the daily activities 

must involve skills that could be transferrable to a workplace and a claimant must spend a 

“substantial part of his day” engaged in those activities. See Orn, 495 F.3d at 639 

(finding that the ALJ erred in failing to “meet the threshold for transferable work skills, 

the second ground for using daily activities in credibility determinations”). 

 Here, the ALJ did not find that Plaintiff’s limited activities could be transferred to 

a work setting, or indicate whether Plaintiff spent a “substantial” part of his day engaged 

in such activities. The Ninth Circuit has opined that, “[d]aily household chores and 

grocery shopping are not activities that are easily transferable to a work environment.” 

Blau v. Astrue, 263 Fed. Appx 635, 637 (9th Cir. 2008). Thus, Plaintiff’s limited 

activities of daily living were not clear and convincing evidence to discount his 

credibility. See Lewis v. Apfel, 236 F.3d 503, 517 (9th Cir. 2001) (limited activities did 

not constitute convincing evidence that the claimant could function regularly in a work 

setting). 

 2. Symptoms Controlled by Treatment 

 In assessing a claimant’s credibility about his symptoms, the ALJ may consider 

“the type, dosage, effectiveness, and side effects of any medication.” 20 C.F.R. 

§ 404.1529(c). Additionally, the treatment the claimant received, especially when 

conservative, is a legitimate consideration in a credibility finding. See Meanel v. Apfel, 

172 F.3d 1111, 1114 (9th Cir. 1999) (the ALJ properly considered the physician’s failure 

to prescribe, and the claimant’s failure to request, medical treatment commensurate with 

the “supposedly excruciating pain” alleged); see also Burch, 400 F.3d at 681 (finding the 

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ALJ’s consideration of the claimant’s failure to see treatment for a three or four month 

period was “powerful evidence” and an “ALJ is permitted to consider lack of treatment in 

his credibility determination). 

 Here, the ALJ found that, although Plaintiff had received various forms of 

treatment, including bypass surgery and procedures related to an infection in 2009, 

treatment had been “generally successful” in controlling his symptoms and treatment 

notes indicated that Plaintiff was “stable” from a cardiovascular standpoint in 2010 and 

2011. (Tr. 24.) Plaintiff argues that “stable” is “a relative term that does not inform as to 

the effect of [Plaintiff’s] medical impairments on his ability to function.” (Doc. 20 at 29.) 

Evidence that treatment can effectively control an impairment may be a clear and 

convincing reason to find a claimant less credible. See 20 C.F.R. §§ 404.1529(c)(3)(iv), 

416.929(c)(3)(iv); Warre v. Comm’r, of Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 

2006) (stating that “[i]mpairments that can be controlled effectively with medication are 

not disabling for purposes of determining eligibility for SSI benefits.”). 

 Here, as the ALJ noted, the record reflects that Plaintiff recovered from bypass 

surgery and related procedures in 2009. (Tr. 24, 300, 310-313.) However, he continued 

receiving treatment for cardiac impairments. In support of his conclusion that Plaintiff’s 

symptoms were controlled, the ALJ cites a July 13, 2010 treatment note (Admin. Hrg. 

Ex. 15F at 5-6, Tr. 553-54), in which Plaintiff denied “dizziness, chest pain or 

discomfort, palpitations, shortness of breath, edema, and PND” and in which his cardiac 

status was described as “stable.” (Tr. 554.) However, that same treatment note assessed 

“chest pain” and lower extremity weakness. (Id.) 

 The ALJ also relied on Dr. Karnik’s January 27, 2011 treatment note in which 

Plaintiff denied “chest pain or discomfort palpitations, dizziness, shortness of breath, 

edema, PND, orthopnea and syncope.” (Admin. Hrg. Ex. 28F at 11, Tr. 654.) Dr. Karnik 

noted that Plaintiff was “stable” from a cardiovascular standpoint and that he could safely 

resume cardiac rehab. (Tr. 655-56.) However, on that same treatment note, Dr. Karnik 

included “chest pain” and “shortness of breath” as active problems and noted that 

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Plaintiff had recently been hospitalized for “chest discomfort symptoms.” (Tr. 654.) 

Finally, the ALJ cites Dr. Bear’s July 21, 2011 treatment note that described Plaintiff as 

“stable from a cardiovascular standpoint.” (Tr. 650.) Again, the ALJ overlooked 

Dr. Bears’s assessment of “chest pain.” (Id.) 

 Additionally, the ALJ overlooked other treatment notes indicating that, even if 

Plaintiff’s cardiovascular condition was considered “stable,” he continued to experience 

symptoms related to his cardiac impairments including Dr. Bear’s June 16, 2011 

treatment note describing “chest pain” and “shortness of breath” as “active problems” and 

noting that Plaintiff was “stable from a cardiovascular standpoint.” (Tr. 651-653.) In 

addition, on August 11, 2011, Dr. Cleary referred Plaintiff to a specialist, Pulmonary 

Associates, for “dysnea/SOB [shortness of breath].” (Tr. 703.) 

 Although responsiveness to treatment can constitute a clear and convincing reason 

for discounting a claimant’s subjective complaints, the ALJ’s determination in this case is 

not supported by substantial evidence in the record. The record reflects that Plaintiff 

received ongoing treatment for his cardiac impairments and continued to experience 

related symptoms. 

3. Inconsistencies between the Record and Testimony 

 The ALJ also discounted Plaintiff’s credibility because of alleged inconsistencies 

between his testimony and the medical record. (Tr. 25.) The ALJ noted that although 

Plaintiff had reported frequent falls to treating sources, at the hearing he testified that he 

had only fallen “a couple of times” at cardiac rehab. (Id.) At that administrative hearing, 

the ALJ asked Plaintiff, “You ever fall?” Plaintiff responded, “Yeah, I’ve fallen a couple 

of times, in the bathtub I fell a couple times over at rehab.” (Tr. 71.) Considering the 

manner in which the ALJ phrased the question, Plaintiff may have reported the frequency 

of his falls at the time of the administrative hearing. Plaintiff’s testimony regarding his 

then-current history of falling was not inconsistent with his past history of falling 

contained in the medical record, but merely reflected a change in the frequency of that 

particular symptom. 

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VII. Summary and Remedy 

 Considering the record as a whole, the Court concludes that the ALJ erred in 

rejecting the treating physicians’ opinions and in rejecting Plaintiff’s subjective 

complaints. Accordingly, the Court reverses the Commissioner’s disability 

determination. 

 Because the Court has decided to vacate the Commissioner’s decision, it has the 

discretion to remand the case for further development of the record or for an award 

benefits. See Reddick, 157 F.3d at 728. In Smolen, the Ninth Circuit held that evidence 

should be credited as true and an action remanded for an immediate award of benefits 

when the following three factors are present: (1) the ALJ failed to provide legally 

sufficient reasons for rejecting evidence; (2) there are no outstanding issues that must be 

resolved before a determination of disability can be made; and (3) it is clear from the 

record that the ALJ would be required to find the claimant disabled were such evidence 

credited.9

 Smolen, 80 F.3d at 1292; see Varney v. Sec. of Health & Human Servs., 859 

F.2d 1396, 1400 (9th Cir. 1988) ( Varney II ) (stating that “[i]n cases where there are no 

outstanding issues that must be resolved before a proper determination can be made, and 

where it is clear from the record that the ALJ would be required to award benefits if the 

claimant’s excess pain testimony were credited, we will not remand solely to allow the 

ALJ to make specific findings regarding that testimony.”); Rodriguez v. Bowen, 876 F.2d 

759, 763 (9th Cir. 1989) (“In a recent case where the ALJ failed to provide clear and 

convincing reasons for discounting the opinion of claimant’s treating physician, we 

 9

 The Commissioner argues that the credit-as-true rule is inconsistent with the Act 

and with the dissenting opinion in Vasquez v. Astrue, 572 F.3d 572, 586 (9th Cir. 2009) 

(O’Scannlain, J., dissenting) (stating that the Commissioner’s argument that the “creditas-true” rule is invalid as contrary to the statute and Supreme Court precedent appeared 

“strong.”). (Doc. 26 at 12 n.11.) However, the dissent in Vasquez also noted that 

“because the crediting-as-true rule is part of [the Ninth] circuit’s law, only an en banc 

court can change it.” Vasquez, 572 F.3d at 602 (O’Scannlain, J. dissenting). This Court 

cannot ignore the credit-as-true rule based on the Commissioner’s claims that it conflicts 

with the Social Security Act and usurps the ALJ’s role as finder of fact. 

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accepted the physician’s uncontradicted testimony as true and awarded benefits.”) (citing 

Winans v. Bowen, 853 F.2d 643, 647 (9th Cir. 1987)). The Ninth Circuit has frequently 

reaffirmed that improperly rejected evidence should be credited as true. See Harman v. 

Apfel, 211 F.3d 1172, 1178 (9th Cir. 2000); Lester, 81 F.3d at 834; Reddick, 157 F.3d at 

729; McCartey v. Massanari, 298 F.3d 1072, 1076–77 (9th Cir. 2002). 

 The Court has found that the ALJ failed to provide legally sufficient reasons 

supported by substantial record evidence for rejecting the treating physicians’ opinions 

and for rejecting Plaintiff’s subjective complaints. There are no outstanding issues to be 

resolved before a disability determination may be made because the record shows that the 

ALJ would find Plaintiff incapable of any sustained work, and thus disabled, if Dr. Bear’s 

or Dr. Cleary’s opinions were credited as true.10 (See Tr. 75.) Additionally, the 

vocational expert testified that an individual with the need to lie down for “a combined 

total of approximately five hours per day,” limitations to which Plaintiff testified, would 

be unable to sustain work on a regular and continuing basis. (Tr. 76-77.) Thus, “a 

remand for further proceedings would serve no useful purpose.” Reddick, 157 F.3d at 

730. On the record before the Court, the treating physicians’ assessment and Plaintiff’s 

subjective complaints of disabling pain should be credited as true and the case remanded 

for an award of benefits.11 See Smolen, 80 F.3d at 1284. 

 

10 The ALJ concluded that “Dr. Cleary indicates his opinion that a full time work schedule cannot be sustained, so I have no questions on that.” (Tr. 75.) He also stated 

that “Dr. Bear stated that symptoms often interfere with attention and concentration and I 

believe if attention and concentration is often interfered with throughout a workday, there’s no work that can be sustained.” (Tr. 75.) 

11 The Commissioner argues that the case should be remanded for further 

proceedings because the ALJ did not obtain testimony from the vocational expert regarding whether an individual with the limitations assessed by Dr. Bear or Dr. Cleary could sustain work on a regular and continuing basis. (Doc. 26 at 14.) Although the ALJ did not obtain expert testimony on that issue, she conceded that she would find Plaintiff 

disabled based on Dr. Bear’s or Dr. Cleary’s opinions. Because it is clear that the ALJ 

would find Plaintiff disabled based on Dr. Bear’s or Dr. Cleary’s opinion, remanding for further proceedings is unnecessary. 

Moreover, the Court’s determination that Plaintiff’s subjective complaints should be credited as true by itself supports remand of this matter for an award of benefits. The 

Court notes that an ALJ cannot find disability based solely on the claimant’s testimony. Rather, there must also be medically acceptable clinical or laboratory evidence which 

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 Accordingly, 

IT IS ORDERED that the Commissioner’s decision denying benefits is reversed

and that this matter is remanded for an award of benefits. 

IT IS FURTHER ORDERED that the Clerk of Court shall enter judgment 

accordingly and terminate this case. 

 Dated this 12th day of March, 2014. 

 “could reasonably be expected to produce the pain or other symptoms alleged.” 42 U.S.C. § 423(d)(5)(A). Here, it is not disputed that Plaintiff has a medical impairment which could reasonably be expected to cause the alleged symptoms. (Tr. 24 (“After careful consideration of the evidence, the undersigned finds that the claimant's medically determinable impairments could reasonably be expected to cause the alleged symptoms”).) Rather, the issue is the “intensity and persistence” of those symptoms which may be established by “statements of the individual or his physician.” 42 U.S.C. § 423(d)(5)(A). 

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