Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_10-cv-00130/USCOURTS-azd-2_10-cv-00130-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:205 Denial Social Security Benefits

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Cynthia Kyoko Takeuchi Pierre,

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV 10-0130-PHX-EHC

ORDER

This is an action for judicial review of a denial of disability insurance benefits under

the Social Security Act, 42 U.S.C. § 405(g). The matter is fully briefed (Doc. 17, 18 & 22).

Plaintiff applied for disability benefits in April 2007 at approximately 26 years of age

(Administrative Record [Tr.] 25, 85-87). Plaintiff alleged an onset of disability beginning June

15, 2007 (Tr. 85-87). She amended her disability onset date to August 7, 2007 (Tr. 109).

Plaintiff is insured for benefits through June 30, 2011 (Tr. 15). The Administrative Law Judge

(“ALJ”) listed Plaintiff’s severe impairments as seizure disorder, migraine headaches,

cognitive disorder not otherwise specified, and borderline intellectual functioning (Tr. 17).

Plaintiff’s past relevant work was listed as health care worker and office clerk (Tr. 24). 

Plaintiff’s application was denied initially and upon reconsideration (Tr. 73-75, 79-82).

After a hearing before an ALJ (Tr. 34-69), Plaintiff’s application was denied (Tr. 12-26).

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The Social Security Appeals Council denied Plaintiff’s request for review (Tr. 4-6), which

was a final decision.

I.

Standard of Review

A person is “disabled” for purposes of receiving social security benefits if he or she

is unable to engage in any substantial gainful activity due to a 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 at least twelve months. Drouin v.

Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992). Social Security disability cases are evaluated

using a five-step sequential evaluation process to determine whether the claimant is disabled.

The claimant has the burden of demonstrating the first four steps. Tackett v. Apfel, 180 F.3d

1094, 1098 (9th Cir. 1999). 

In the first step, the ALJ must determine whether the claimant currently is engaged in

substantial gainful activity; if so, the claimant is not disabled and the claim is denied. The

second step requires the ALJ to determine whether the claimant has a “severe” impairment

or combination of impairments which significantly limits the claimant’s ability to do basic

work activities; if not, a finding of “not disabled” is made and the claim is denied. At the

third step, the ALJ determines whether the impairment or combination of impairments meets

or equals an impairment listed in the regulations; if so, disability is conclusively presumed and

benefits are awarded. If the impairment or impairments do not meet or equal a listed

impairment, the ALJ will make a finding regarding the claimant’s “residual functional

capacity” based on all the relevant medical and other evidence in the record. A claimant’s

residual functional capacity (“RFC”) is what he or she can still do despite existing physical,

mental, nonexertional and other limitations. Cooper v. Sullivan, 880 F.2d 1152, 1155 n.5 (9th

Cir. 1989). At step four, the ALJ determines whether, despite the impairments, the claimant

can still perform “past relevant work”; if so, the claimant is not disabled and the claim is

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denied. The Commissioner bears the burden as to the fifth and final step of establishing that

the claimant can perform other substantial gainful work. Tackett, 180 F.3d at 1099. 

The Court has the “power to enter, upon the pleadings and transcript of record, a

judgment affirming, modifying, or reversing the decision of the Commissioner of Social

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

decision to deny benefits should be upheld unless it is based on legal error or is not supported

by substantial evidence. Ryan v. Commissioner of Social Security, 528 F.3d 1194, 1198 (9th

Cir. 2008). Substantial evidence means “such relevant evidence as a reasonable mind might

accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401, 91

S.Ct. 1420, 1427 (1971). “Substantial evidence is more than a mere scintilla but less than a

preponderance.” Bayliss v. Barnhart, 427 F.3d 1211, 1214 n. 1 (9th Cir. 2005) (internal

quotation marks and citation omitted). The Court must consider the record in its entirety and

weigh both the evidence that supports and the evidence that detracts from the Commissioner’s

conclusion. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir.1985).

II.

Background Facts

Plaintiff’s condition includes a history of a benign brain tumor, seizure disorder and

migraine headaches (Tr. 310). Between July 2006 and August 2007, Plaintiff was treated by

George Wang, M.D., of Neurology and Sleep Medicine Associates, for several seizure

episodes, including one clonic/tonic (epileptic) seizure (Tr. 212, 215, 220, 223, 226, 310).

Plaintiff reported a decrease in the frequency of her migraine headaches in July and August

2007 (Tr. 212, 215). Plaintiff’s seizures, migraines, and rebound headaches were treated with

medication, for which she reported no side effects (Tr. 212, 215, 220, 223, 226, 310). In July

2006, an electroencephalography (“EEG”) was “mildly abnormal” but showed no epileptic

activity (Tr. 323). An ambulatory EEG in June 2007 was normal (Tr. 218). Dr. Wang’s

mental status examinations from September 2006 to August 2007 showed that Plaintiff had

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intact recent and remote memory, and good attention span and concentration (Tr. 213, 216,

221, 227, 309).

In September 2007, Jamshid Mirzaei, M.D., conducted a consultative examination of

Plaintiff (Tr. 239-242). Plaintiff described her daily activities as caring for her 3-year old son,

and performing household chores such as cleaning, washing dishes, laundry, vacuuming,

cooking, mopping and sweeping (Tr. 239-240). Plaintiff’s neurological examination was

normal but Dr. Mirzaei recommended an evaluation by a neurologist based on Plaintiff’s

reports of uncontrolled headaches and seizures (Tr. 242). Dr. Mirzaei found that, if Plaintiff’s

seizure activity is controlled, Plaintiff was not restricted from engaging in work-related

activities, except that she should avoid moving machinery, working at heights, and excessive

noise, temperatures, or sounds (Tr. 242).

In October 2007, Patricia A. Abbott, Psy.D., conducted a psychological evaluation of

Plaintiff (Tr. 261-268). Plaintiff reported that she began to experience seizures in 1999 as a

result of a work-related accident, that she had continued to work, her seizures occurred twice

a month on average, and that her medication affected her ability to concentrate and focus (Tr.

261-262). Plaintiff described her daily activities as full-time care of her 4-year-old son; caring

and attending to the personal needs of her autistic sister with the aid of her mother; and,

cleaning, mopping, sweeping, cooking, feeding pets, and taking care of her own personal

needs (Tr. 263). Plaintiff said she had managed her own money in the past, although she had

no income at the time (Tr. 263).

Dr. Abbott observed that Plaintiff seemed to have difficulty with focus and

concentration and possibly had a headache (Tr. 263). Dr. Abbott’s test results suggested

borderline intellectual functioning but no organic brain disorder (Tr. 263, 267). Plaintiff’s

non-verbal reasoning skills, spatial processing skills, attentiveness to details, and visual motor

integration skills were in the low-average range (Tr. 263-264). Plaintiff had stronger skills

in visual memory tasks than with auditory memory tasks (Tr. 265). Dr. Abbott diagnosed

Plaintiff with cognitive disorder, borderline intellectual functioning, a seizure disorder, and

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history of migraine headaches (Tr. 268). Plaintiff had significant deficits in working memory

skills that were likely to make Plaintiff less efficient than her peers in holding information to

perform specific tasks, and in the ability to learn new information especially when presented

orally (Tr. 267).

With respect to Plaintiff’s ability to perform mental work-related activities, Dr. Abbott

found that Plaintiff was not significantly limited in the ability to remember locations and

work-like procedure; understand, remember, and carry out very short and simple instructions;

sustain an ordinary routine without special supervision; work in coordination with or

proximity with others without being distracted by them; and make simple work-related

decisions (Tr. 269-271). Plaintiff had moderate difficulties in understanding, remembering

and carrying out detailed instructions; in performing activities within a schedule, maintaining

regular attendance, and being punctual within customary tolerances; in completing a normal

workday and workweek without psychological interruptions; and in performing at a consistent

pace without an unreasonable number and length of rest periods (Tr. 270-271). Dr. Abbott

reported that Plaintiff was markedly limited in her ability to maintain attention and

concentration for extended periods, noting “poor skills in focused attention.” Plaintiff was

not significantly limited in all aspects of social interaction and was moderately limited in all

aspects of adaptation (Tr. 270-272).

In October 2007, Brady Dalton, Psy.D., a State Agency psychologist, reviewed

Plaintiff’s medical records and completed a Psychiatric Review Technique Form (Tr. 243-

256). Dr. Dalton diagnosed cognitive disorder and possible borderline intellectual functioning

but no organic mental disorders (Tr. 244). Dr. Dalton opined that Plaintiff had no restrictions

in activities of daily living; mild difficulties in maintaining social functioning; marked

difficulties in maintaining concentration, persistence or pace; and no episodes of

decompensation (Tr. 253). Based in part on Dr. Abbott’s report, Dr. Dalton found that

Plaintiff was capable of engaging in simple, unskilled, repetitive work and that if engaged in

simple tasks, Plaintiff was capable of sustaining attention and working a normal work

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schedule (Tr. 255). With respect to mental work-related activities, Dr. Dalton’s assessment

was identical to Dr. Abbott’s assessment except that Dr. Dalton found that Plaintiff was

moderately limited in the ability to maintain attention and concentration for extended periods

(Tr. 257-258 ). Dr. Dalton found that Plaintiff had the ability to sustain attention for up to 2

hours at a time and perform at a consistent pace, particularly if she was engaged in simple,

repetitive tasks (Tr. 259).

In February 2008, Eugene Campbell, Ph.D., a State Agency psychologist, reviewed

Plaintiff’s medical records and affirmed Dr. Dalton’s assessment of Plaintiff’s ability to

perform mental work-related activities (Tr. 194). 

Between October 2007 and November 2008, Plaintiff continued to see Dr. Wang,

reporting several seizures, including one “big” one in October 2007, migraines, and daily

headaches (Tr. 197-211). A November 2007 EEG showed intermittent diffuse slowing

activities and slightly slow posterior rhythm (nonspecific), but no epileptic activity (Tr. 207-

208). Between December 2007 and April 2008, Plaintiff reported two seizures a month, and

at times worsening migraines and headaches (Tr. 197, 199, 201, 203, 206, 355, 358). Plaintiff

said Ibuprofen, drinking hot tea and a new medication helped her headaches and migraines

(Tr. 209, 197, 201, 204, 353, 355, 356). In May 2008, Plaintiff reported an increased number

of seizures, and memory problems (Tr. 347, 350). Her headaches were less severe and

responsive to Tylenol and Ibuprofen (Tr. 352, 350). An EEG in May 2008 recorded seizure

activity, consistent with complex partial seizure (Tr. 345-346). Between July and August

2008, Plaintiff reported seizures, headaches, memory problems and medication side effects

such as being sleepy and tired, mood swings, and weight gain (Tr. 333, 335, 339). In October

2008, Plaintiff reported fewer seizures, noting some connection with whether she had timely

taken her medication, and “strong” headaches but that prescription medication and Ibuprofen

were helpful (Tr. 327-332). By November 2008, Plaintiff reported no seizure activity, two

“strong” headaches per week, and increased memory loss (Tr. 324). Mental status

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examinations showed intact recent and remote memory and “fair” attention span and

concentration (Tr. 330, 325, 328). 

In October 2008, Plaintiff was treated by a licensed counselor who diagnosed

depressive disorder, anxiety disorder, and possible major depressive disorder (Tr. 374). The

counselor assessed Plaintiff’s global assessment of functioning score at 60, which indicates

moderate symptoms or moderate difficulty in social, occupational or school functioning (Tr.

375; Doc. 18 at 9 n.5). Plaintiff reported that she could not work due to the seizures, that she

spent 80% of her time taking care of her autistic sister, and that she cared for her son (Tr. 365,

378). Plaintiff was “completely independent” with activities of daily living (Tr. 378). 

 III.

The Hearing Before the ALJ: January 8, 2009

Plaintiff and Vocational Expert (“VE”) Sandra Richter testified at the hearing.

Plaintiff, who was 28 years of age at the time of the hearing, has a high school degree and her

past work includes taking care of her sister, heath care worker and office clerk (Tr. 44-45).

Plaintiff said that between the seizure disorder and migraine headaches, the seizures were the

worst (Tr. 46). Plaintiff said she was still having seizures even with medication (Tr. 47). Her

medication included Dilantin and Topamax (Tr. 47-48). 

Plaintiff testified that the smaller seizures occur about 3 or 4 times a week, come out

of the blue, feel like being hypnotized, and last 3 to 4 minutes to 15 minutes (Tr. 48-49).

After the seizure, Plaintiff feels tired and confused for about 3 or 4 hours (Tr. 49-50).

Plaintiff said she also has partial complex seizures, which involve staring off into space, about

4 times a week (Tr. 50). Afterwards, she feels confused (Tr. 51). Plaintiff described having

the “falling down” kind of seizure about 4 or 5 times a year (Tr. 51-52). During these

seizures, Plaintiff may bite herself, such as her tongue or at the side of her cheek, become

incontinent, and has been told she once removed her clothes (Tr. 51-52). Plaintiff once went

to the emergency room because of a seizure when she fell and hit her head (Tr. 53). Plaintiff

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said that increased stress from physical activity and emotional stress can bring on a seizure

(Tr. 53-54). Plaintiff testified that her seizure activity is unpredictable (Tr. 55).

Plaintiff said she was taking Tylenol with Codeine, Ibuprofen 600 milligrams and

Maxalt for her migraine headaches (Tr. 55). She said she had migraine headaches about 4

times a week, they cause pain and blurry vision, and are unpredictable (Tr. 56-57). Plaintiff’s

other medications included Topamax, Tegretol and Keppra (Tr. 56). 

Plaintiff testified that she lives with her mother, her 26-year-old autistic sister, and her

5-year old son (Tr. 45, 58-59). Plaintiff said she cannot take her son out by herself because

she is scared she might have a seizure (Tr. 58). Plaintiff said she takes a companion with her

(Tr. 58). Plaintiff took care of her sister 80% of her time because her mother was mostly

away from home (Tr. 63). Plaintiff reported performing household chores but said she took

a break every 45 minutes to an hour to avoid becoming tired and prompting a seizure (Tr. 59-

60). Plaintiff said her medication made her tired (Tr. 60). Plaintiff is not allowed to drive and

depends on her mother to do groceries, etc. (Tr. 60). Plaintiff calls the [AHCCCS] taxi to

provide transportation for the doctors (Tr. 60).

 The VE testified that Plaintiff’s past relevant work as health care worker was semiskilled, medium; and as office clerk was semi-skilled, light (Tr. 64). The VE testified that a

person of Plaintiff’s age, education and work history who has the mental residual functional

capacity as indicated by Dr. Dalton to perform only simple, unskilled, repetitive work would

not be able to perform Plaintiff’s past relevant work (Tr. 65). However, such a person could

perform a variety of unskilled jobs in the national economy, including the light work of an

inspector; the light and medium work as an assembler; and the light unskilled work of an

office clerk (Tr. 65-66). When asked by the ALJ to include a person with the marked

limitation defined as “poor or no ability for focused attention,” the VE testified that if the

person could not attend to or complete tasks timely, she would be unable to sustain full-time

work activity (Tr. 66). Plaintiff’s counsel upon questioning the VE confirmed that “the

marked limitation on focus, attention” precludes all sustained work (Tr. 66). 

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IV.

The ALJ’s Findings

In a written decision dated August 4, 2009 (Tr. 15-26), the ALJ found that Plaintiff had

not engaged in substantial gainful activity since August 7, 2007, her amended onset date, and

that she had the following severe impairments: seizure disorder, migraine headaches,

cognitive disorder not otherwise specified, and borderline intellectual functioning (Tr. 17).

These impairments or combination of impairments did not meet the listing criteria in the

regulations (Tr. 18). The ALJ found that Plaintiff’s mental impairments did not cause any

restrictions in Plaintiff’s activities of daily living, caused only mild difficulties in social

functioning, and caused marked difficulties in Plaintiff’s concentration, persistence or pace

(Tr. 18). This latter finding was supported by the results of the consultative psychological

evaluation and a Full Scale IQ of 76 (Tr. 18-19). Plaintiff had no episodes of decompensation

(Tr. 19). 

The ALJ found that Plaintiff had the residual functional capacity to perform medium

work except that she cannot climb ladders, ropes, scaffolds; she can occasionally climb ramps,

stairs and frequently balance, stoop, kneel, crouch and crawl; she must avoid moderate

exposure to hazards and concentrated exposure to noise; she should not drive; and Plaintiff

is limited to simple, unskilled repetitive work (Tr. 19). The ALJ reported that this finding was

supported by the objective medical evidence, the minimal abnormal clinical findings, the

longitudinal treatment record, and observations of her treating and examining physicians (Tr.

19). The ALJ found that Plaintiff’s allegations of disabling headache pain, incapacitating

seizures and limitations were not fully supported in the medical records and were inconsistent

with her activities of daily living (Tr.19). The ALJ found that although Plaintiff had some

cognitive deficits, she should still be able to sustain simple repetitive work (Tr. 19, 22).

The ALJ discussed the medical records of Dr. Wang, the evidence as a whole,

including Plaintiff’s high level of activities, and whether Plaintiff was compliant with her

medication. Plaintiff’s activities included sole care-giver of her 5-year old son, 80% care for

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her sister who is autistic and dependent on Plaintiff and her mother, and household activities

(Tr. 22). The ALJ noted discrepancies in Plaintiff’s credibility, citing inconsistent statements

regarding the frequency and type of seizures she experienced, her travel to California and

attendance at a party, and her occasional noncompliance with medications (Tr. 22-23). 

The ALJ stated that the residual functional capacity conclusion was supported by the

October 2007 opinion of Dr. Abbott, the psychological consultative evaluator (Tr. 24). The

ALJ gave “some weight” to the September 2007 opinion of Dr. Mirzaei (Tr. 24). The ALJ

gave substantial weight to the State Agency medical consultants who reviewed the medical

evidence and determined Plaintiff’s physical and mental residual functional capacities (Tr.

24). The ALJ found that Plaintiff could not perform her past relevant work but that there are

jobs that exist in significant numbers in the national economy that Plaintiff can perform.

These unskilled simple occupations included inspector (light), assembler (medium and light),

and clerk (light and sedentary) (Tr. 25-26). The ALJ concluded that Plaintiff was not under

a disability (Tr. 26). 

V.

Discussion

Plaintiff argues that the ALJ erred in purporting to rely on Dr. Abbott’s report when

the VE testified that a person with the limitations assessed by Dr. Abbott would be unable to

work; in rejecting Plaintiff’s symptom testimony absent clear and convincing reasons; in

finding other jobs in the economy that Plaintiff could perform based on the VE’s testimony

that was inconsistent with job data in the Dictionary of Occupational Titles; and, in

determining Plaintiff’s residual functional capacity without undertaking the function-byfunction analysis required under the social security rules. Plaintiff seeks a remand for an

award of benefits or, in the alternative, remand for further administrative proceedings.

Defendant argues that the ALJ’s findings are supported by substantial evidence but if not, the

Court should remand for further proceedings.

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 With respect to the first issue, Plaintiff argues that the ALJ relied on Dr. Abbott’s

assessment without explicitly rejecting any portion of it, and then failed to provide adequate

reasons for not considering that part of Dr. Abbott’s assessment finding that Plaintiff is

markedly limited in attention and concentration which, according to the VE, precludes all

work.

Defendant argues that the ALJ’s mental residual functional capacity finding that

Plaintiff is limited to simple, unskilled, repetitive work is supported by the findings and

opinions of both Dr. Dalton and Dr. Abbott (Doc. 18 at 15-16). Defendant further argues that

Dr. Abbott did not assess or comment on whether Plaintiff could perform simple, repetitive

types of unskilled work on a sustained basis (Doc. 18 at 17). Rather, Dr. Dalton rated

Plaintiff’s abilities in the general areas and then reached this specific assessment as arguably

consistent with other record evidence (Doc. 18 at 17-18). According to Defendant, given the

medical record, the ALJ reasonably relied on Dr. Dalton’s ultimate conclusion that limited

Plaintiff to simple, unskilled, repetitive tasks (Doc. 18 at 18).

In this case, Dr. Abbott conducted a psychological evaluation of Plaintiff on October

16, 2007. Dr. Abbott completed a “Psychological Evaluation,” a narrative report that included

background information, behavioral observations, test results and assessments (Tr. 261-268);

and a “Medical Source Statement Of Ability To Do Work Related Activities (Mental)”, a

check-box style assessment (Tr. 269-273). In the Psychological Evaluation, Dr. Abbott

included Plaintiff’s reports that her seizure medication seemed to interfere with her ability to

concentrate and focus (Tr. 261 & 262). Dr. Abbott wrote regarding behavioral observations

that: “[Plaintiff] seemed to have difficulties with focus and concentration and this became

more of a problem as the evaluation progressed. She seemed to have developed a headache

during the evaluation which may have contributed to her impaired focus” (Tr. 263). With

respect to Plaintiff’s overall verbal abilities, Plaintiff scored in the 5th percentile (Tr. 264). Dr.

Abbott noted that Plaintiff “scored significantly lower on Letter Number Sequencing which

is a measure of working memory and requires focus and concentration skills” (Tr. 264).

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Regarding Working Memory indices, Dr. Abbott noted that Plaintiff’s scores were

significantly below expectation when compared to Plaintiff’s Full Scale IQ (Tr. 264). Dr.

Abbott reported that “[t]his type of deficit could result from a long standing attentional deficit.

It may also be related to changes in focus and attention skills related to her medications or the

presence of migraine. In any event, difficulties in working memory can make many routine

cognitive tasks quite difficult” (Tr. 264). In the “Medical Source Statement Of Ability To Do

Work Related Activities (Mental)”, Dr. Abbott reported that Plaintiff was “markedly limited

(poor or none)” in “[t]he ability to maintain attention and concentration for extended periods,”

including a handwritten note “has poor skills in focused attention” (Tr. 270). 

Dr. Dalton, a consultative reviewing physician, completed a Psychiatric Review

Technique Form on October 22, 2007 (Tr. 243-256), which included a “Rating of Functional

Limitations” (Tr. 253-254) and “Consultant’s Notes” (Tr. 255-256). In the “Rating of

Functional Limitations,” Dr. Dalton noted Plaintiff’s “marked” limitation regarding

“Difficulties in Maintaining Concentration, Persistence, or Pace” (Tr. 253). In the

“Consultant’s Notes,” Dr. Dalton discussed various aspects of Dr. Abbott’s report and stated

in the analysis section that there was evidence of intellectual functioning in the borderline

range and memory impairments but that the severity of these limitations did not appear to

prevent Plaintiff from engaging in “simple, unskilled repetitive work” (Tr. 255). Dr. Dalton

also completed a “Mental Residual Functional Capacity Assessment” (Tr. 257-259) wherein

he reported that Plaintiff was “moderately limited” in “[t]he ability to maintain attention and

concentration for extended periods” (Tr. 257) and assessed that Plaintiff appeared capable of

simple, unskilled repetitive work (Tr. 259). 

The ALJ concluded that Plaintiff had the residual functional capacity to perform the

demands of medium work with certain expressed limitations, and that Plaintiff was limited

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Dr. Griffith’s RFC report concerns Plaintiff’s physical RFC assessment (Tr. 229-237)

and is not at issue in this appeal (Doc. 18 at 3 n. 3). 

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to simple, unskilled, repetitive work, referencing the RFC reports of Dr. Griffith1

 and Dr.

Dalton (Tr. 19), without mentioning these professionals by name. Following this finding, the

ALJ discussed various medical reports of record, including those of treating physician Dr.

Wang and examining professionals Drs. Mirzaei and Abbott, and evidence that purported to

show that Plaintiff had a high level of functioning and that the severity of her seizures and

headaches would not likely preclude all work activity (Tr. 19-24). The ALJ found that the

record did not support the severity of Plaintiff’s allegations regarding her depression, her

inability to focus and her poor ability to concentrate (Tr. 21). The ALJ also found that

Plaintiff’s statements to Dr. Abbott that her seizure medication caused her to have poor focus

and concentration and Plaintiff’s claim of medication side effects were not supported by the

medical record (Tr. 23).

With respect to the RFC finding, the ALJ specifically stated in the decision: “As for

the opinion evidence, the residual functional capacity reached herein is supported by the

opinion of Dr. Abbott, the psychological consultative evaluator who examined the claimant

in October of 2007" (Tr. 24). In making this finding, the ALJ referred to Dr. Abbott’s

Psychological Evaluation report (Exhibit 1F, pages 81-87 [bottom page numbering]) but not

to Dr. Abbott’s “Medical Source Statement Of Ability To Do Work Related Activities

(Mental).” The ALJ further credited the opinions of the non-examining expert sources to the

extent they were consistent with the substantive weight of the objective medical evidence (Tr.

24). The ALJ gave substantial weight to the State Agency medical consultants who reviewed

Plaintiff’s file and determined Plaintiff’s physical and mental residual functional capacities

(Tr. 24), stating that these medical opinions were compelling as supported by the great weight

of the record evidence (Tr. 24). Regarding this latter conclusion, the ALJ again referenced the

RFC findings of non-examining professionals Dr. Griffith and Dr. Dalton. The ALJ did not

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mention these doctors by name, discuss their findings or opinions, or set forth more specific

reasons for crediting their opinions. 

During the hearing, in response to the ALJ’s hypothetical question that included a

person of Plaintiff’s age, education and work history, who can perform medium work with

some physical limitations in climbing, etc., and exposure to hazards, who is restricted to

performing simple unskilled repetitive work, and who has marked limitation defined as poor

or no ability for focused attention, the VE testified: “I believe if you cannot attend that - - to

the job that you’re doing and complete it in the time allowed, you cannot work” (Tr. 64-66).

The ALJ’s hypothetical question included the limitation expressed by examining professional

Dr. Abbott regarding Plaintiff’s marked limitation in attention and concentration (see Tr. 66

wherein the ALJ cited “Exhibit 1F, page 90" [bottom page numbering]). However, as

previously discussed, the ALJ ultimately found that Plaintiff has the residual functional

capacity for simple, unskilled, repetitive work by crediting the report of non-examining

professional Dr. Dalton. 

Plaintiff’s medical records as reported by Dr. Wang show Plaintiff’s treatment for

seizures, migraines and headaches of varying intensity and frequency between July 2006 and

November 2008. In May 2008, Plaintiff reported memory problems that continued into

November 2008 when Plaintiff reported memory loss and two “strong headaches” per week

(Tr. 324). Regarding a July 2008 exam, Dr. Wang reported that Plaintiff presented “with

more memory loss, she is unsure of the medications she is taking and what they do. The

patient has had difficulty with her memory in the past” (Tr. 339). While Dr. Wang’s mental

status exams of Plaintiff showed intact recent and remote memory, they showed Plaintiff’s

attention span and concentration as “fair” between April 2008 and November 2008 (Tr. 330,

325, 328, 334, 338, 342, 348, 351, 354). Dr. Wang’s reports appear consistent with Dr.

Abbott’s October 2007 report regarding Plaintiff’s limitation in attention and concentration.

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A treating physician’s opinion is afforded more weight than the opinion of an

examining physician, and an examining physician’s opinion is afforded more weight than a

non-examining reviewing or consulting physician’s opinion. See Benecke v. Barnhart, 379

F.3d 587, 592 (9th Cir. 2004); Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). The

Commissioner must set forth “clear and convincing” reasons for rejecting the uncontradicted

opinion of a treating or examining physician. If the opinion is contradicted, it can be rejected

for specific and legitimate reasons that are supported by substantial evidence in the record.

Lester, 81 F.3d at 830. “The opinion of a nonexamining physician cannot by itself constitute

substantial evidence that justifies the rejection of the opinion of either an examining physician

or a treating physician”; such an opinion may serve as substantial evidence only when it is

consistent and supported by other independent evidence in the record. Lester, 81 F.3d at 830-

831. 

The ALJ erred in giving substantial weight to Dr. Dalton’s opinion regarding the

finding that Plaintiff was capable of simple, unskilled repetitive work in assessing Plaintiff’s

residual functional capacity. Dr. Dalton was not Plaintiff’s treating physician and never

personally evaluated her. “Without a personal medical evaluation it is almost impossible to

assess the residual functional capacity of any individual.” Penny v. Sullivan, 2 F.3d 953, 958

(9th Cir. 1993). Moreover, in assessing Plaintiff’s RFC, the ALJ discussed and relied on Dr.

Abbott’s Psychological Evaluation report without rejecting any part of it and then ignored Dr.

Abbott’s finding in the “Medical Source Statement Of Ability To Do Work Related Activities

(Mental)” that Plaintiff was markedly limited in her ability to maintain attention and

concentration for extended periods. “The ALJ is not entitled to pick and choose from a

medical opinion, using only those parts that are favorable to a finding of nondisability.”

Robinson v. Barnhart, 366 F.3d 1078, 1083 (10th Cir. 2004). 

The decision whether to remand for further proceedings or for immediate payment of

benefits is within the discretion of the court. Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir.

2000). The issue turns on the utility of further proceedings. The VE testified that including

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the marked limitation “poor or no ability for focused attention,”as reported by Dr. Abbott, all

work is precluded. No outstanding issue remains to be resolved and it is clear the ALJ would

be required to find Plaintiff disabled. Varney v. Sec’y of HHS, 859 F.2d 1396, 1400-1401

(9th Cir. 1988). The decision of the Commissioner will be reversed and the matter will be

remanded for an award of benefits.

 Accordingly, 

IT IS ORDERED that the decision of the Commissioner denying Plaintiff’s claim for

benefits is reversed. 

IT IS FURTHER ORDERED that the case is remanded for an award of benefits to

Plaintiff.

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

accordingly.

DATED this 12th day of May, 2011.

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