Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_07-cv-00338/USCOURTS-azd-4_07-cv-00338-1/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:402 Social Security Benefits

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

GABRIELA ENRIQUEZ,

Plaintiff, 

vs.

MICHAEL J. ASTRUE, 

Commissioner of the Social 

Security Administration,

Defendant. 

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No. CIV 07-338-TUC-CKJ 

ORDER

On February 2, 2009, Magistrate Judge Charles R. Pyle issued a Report and

Recommendation [Doc. # 18] in which he recommended that Plaintiff’s Motion for Summary

Judgment [Doc. # 12] be denied and Defendant's Motion for Summary Judgment [Doc. # 15]

be granted. On February 20, 2009, Plaintiff Gabriela Enriquez (“Enriquez”) filed Objections

to Report and Recommendation. The Commissioner has not filed a response.

Magistrate Judge’s Recitation of the Procedural and Factual History

No objections having been made to the magistrate judge’s recitation of the procedural

and factual history, the Court adopts those recitations.

Standard of Review

The findings of the Commissioner are meant to be conclusive, 42 U.S.C. §§ 405(g),

1383(c)(3), and a decision to overturn a denial of benefits is appropriate only if the denial “is

not supported by substantial evidence or [if the denial] is based on legal error.” Matney v.

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Sullivan, 981 F2d 1016, 1019 (9th Cir. 1992), citations omitted; Massachi v. Astrue, 486 F.3d

1149 (9th Cir. 2007). “Substantial evidence is such relevant evidence as a reasonable mind

might accept as adequate to support a conclusion.” Parra v. Astrue, 481 F.3d 742, 746 (9th

Cir. 2007). The standard is less than a “preponderance of the evidence” standard. Matney,

981 F.2d at 1019. Further, a denial of benefits is to be set aside if the Commissioner has

failed to apply the proper legal standards in weighing the evidence even though the findings

may be supported by substantial evidence. Frost v. Barnhart, 314 F.3d 359, 367 (9th Cir.

2002). Indeed, this Court must consider both evidence that supports, and evidence that

detracts from, the conclusion of the Administrative Law Judge (“ALJ”). Frost, 314 F.3d at

366-67.

Medically Determinable Impairment

Enriquez asserts the ALJ either determined that Enriquez had a medically

determinable impairment (that could reasonably cause her alleged symptoms) or the ALJ’s

decisions are inconsistent because the ALJ determined that Enriquez’ description of her

symptoms were not fully credible. The Commissioner asserted, in his Memorandum in

Support of Defendant’s Motion for Summary Judgment and in Opposition to Plaintiff’s

Motion for Summary Judgment (“Opposition”), that the ALJ conducted a proper analysis of

the medical and opinion evidence and of Enriquez’ credibility. The magistrate judge

determined that the ALJ’s determinations were not inconsistent. In addressing Enriquez’

claim that the ALJ unnecessarily addressed Enriquez’ credibility, the magistrate judge stated

that Enriquez had not offered any statutory or case law authority to support her position.

Enriquez asserts that the standard is set forth in the regulations and it is unclear what

authority the magistrate judge found missing.

While the Ninth Circuit has affirmed a finding of a lack of impairment without

considering credibility, Ukolov v. Barnhart, 420 F.3d 1002 (9th Cir. 2005), Enriquez has not

pointed to any Ninth Circuit authority that states that credibility may not be considered in

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Deference is given to SSRs. Bunnell, 947 F.2d at 346 n. 3. However, they are

considered with caution and will not be upheld if their application will produce a result that

is inconsistent with statutes and regulations. Id.

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determining whether there is a medical impairment. Compare Craig v. Chater, 76 F.3d 585

(4th Cir. 1996) (assessment of credibility of subjective claims of pain should only be

undertaken if it is determined claimant has an identifiable medical impairment). However,

the Ninth Circuit has stated “once the claimant produces objective medical evidence of an

underlying impairment, an adjudicator may not reject a claimant’s subjective complaints

based solely on a lack of objective medical evidence to fully corroborate the alleged severity

of pain.” Bunnell v. Sullivan, 947 F.2d 341, 345 (9th Cir. 1991); see also Orteza v. Shalala,

50 F.3d 748 (9th Cir. 1995). The court further stated that once “the claimant establishes a

medical impairment reasonably likely to be the cause of the pain, the Secretary directs the

ALJ to consider ‘all of the available evidence’ because the Secretary recognizes that ‘pain

is subjective and not susceptible to measurement by reliable techniques.’” Bunnell, 947 F.2d

at 346, citing SSR 88-13.1

 The Ninth Circuit case law indicates that the medical impairment

is to be considered prior to a consideration of credibility, but the case law does not prohibit

an earlier consideration. See e.g., Lingenfelter v. Astrue, 504 F.3d 1028 (9th Cir. 2007).

However, the relevant regulation states that the finding that an “impairment(s) could

reasonably be expected to produce [the claimant’s] pain or other symptoms does not involve

a determination as to the intensity, persistence, or functionally limiting effects of [the

claimant’s] symptoms.” 20 C.F.R. § 404.1529(b). The regulation also provides that, “[w]hen

the medical signs or laboratory findings show that [the claimant has] a medically

determinable impairment(s) that could reasonably be expected to produce [the claimant’s]

symptoms, such as pain, [the Social Security Administration will] then evaluate the intensity

and persistence of [the claimant’s] symptoms so that [the Administration] can determine how

[the claimant’s] symptoms limit [the claimant’s] capacity for work.” 20 C.F.R. §

404.1529(c). Although the Ninth Circuit has not specifically stated that credibility is not to

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be considered before a determinable medical impairment decision is made, the regulations

make that sequence clear. 

In this case, the ALJ stated that the “medical evidence presented does not establish

any impairment or impairments which resulted in more than minimal or slight abnormalities

or caused more than a minimal effect upon her ability to work.” Administrative Record

(“AR”), p. 28. A claimant’s credibility is to be considered in determining whether the

impairment is more than minimal in severity. 20 C.F.R. § 404.1529(c). The ALJ also stated:

Through her last insured date, the claimant did not have an underlying medically

determinable impairment(s) that could reasonably cause the pain or other symptoms

alleged. The evidence does not show that her symptoms were fully credible, and she

was not precluded from engaging in substantial gainful activity.

AR, p. 28. The ALJ considered Enriquez’ credibility in making her determination that

Enriquez did not have a medical impairment. This consideration was error.

Case law considering this error is limited. In Bradley v. Barnhart, 463 F.Supp.2d 577,

581-83 (S.D.W.Va. 2006), the court remanded the matter because the ALJ failed to consider

the threshold question of whether there was a determinable medical impairment prior to

considering the credibility of claimant’s subjective allegations. However, that decision was

based on Craig in which the Fourth Circuit had specifically set forth procedures to follow.

In this case, the Commissioner asserted, in his Opposition, that the ALJ had properly

analyzed Enriquez’ credibility and, therefore, did not assert that any error was harmless.

Moreover, the Commissioner did not respond to Enriquez’ objections. Courts, “to protect

due process, must be particularly vigilant and must hold agencies, such as the Social Security

Administration, to a strict adherence to both the letter and the spirit of their own rules and

regulations.” Call v. Heckler, 647 F.Supp. 560, 561 (1986), citing Powell v. Heckler, 789

F.2d 176 (3rd Cir. 1986). Although the Court agrees with the magistrate judge that the

findings of the ALJ are not inconsistent, the Court must determine if the error is harmless.

The harmless error rule applies to the review of administrative decisions regarding

disability. See Batson v. Commissioner of SSA, 359 F.3d 1190, 1196 (9th Cir. 2004)

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The regulations only provide that a treating physician’s opinion may be given

controlling weight. See 20 C.F.R. § 404.1527(d)(2). The ALJ did not give controlling

weight to the opinion of treating physician Karen Smith, M.D. (“Dr. Smith”).

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(applying harmless error standard). However, a decision of an agency cannot be affirmed

“on a ground that the agency did not invoke in making its decision.” Stout v. Commissioner,

SSA, 454 F.3d 1050, 1054 (9th Cir. 2006), quoting Pinto v. Massanari, 249 F.3d 840, 547

(9th Cir. 2001). The Court agrees with the magistrate judge that the ALJ’s finding that

Enriquez was not credible in her symptoms does not change the fact that the ALJ specifically

made a finding that Enriquez did not have an underlying medically determinable impairment.

The ALJ’s error was harmless.

Testimony of Toomajian – Controlling Weight

Enriquez asserts the ALJ erred in giving controlling weight to the opinion of Armon

H. Toomajian, M.D. (“Dr. Toomajian”).2

 The magistrate judge agreed, but determined that

Dr. Toomajian’s opinion was supported and consistent with other evidence in the record and

it could serve as substantial evidence. The magistrate judge found that the “fact that the ALJ

stated she gave Dr. Toomajian’s opinion controlling weight did not change the fact that the

ALJ’s reliance on Dr. Toomajian’s testimony over Dr. Smith’s testimony was supported by

substantial evidence in the record.” Report and Recommendation, p. 16, ll. 5-7.

Enriquez asserts that, to accept the recommendation of the magistrate judge would

involve the weighing of Dr. Toomajian’s testimony under the proper legal standard by the

Court in the first instance because the ALJ apparently did not realize that she was not

required to accept Dr. Toomajian’s testimony. Enriquez asserts that it is not appropriate for

this Court to weigh Dr. Toomajian’s testimony under the proper legal standard when the ALJ

did not. Indeed, Enriquez asserts that “[l]ong-standing principles of administrative law

require [the Court] to review the ALJ’s decision based on the reasoning and factual findings

offered by the ALJ – not post hoc rationalizations that attempt to intuit what the adjudicator

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Dr. Toomajian, when asked if he agreed with Dr. Smith that the claimant was

disabled as of December 1999, testified, “Well I know if I could find some medical evidence

in the records I might agree with her. But from what I saw I don’t agree with that.” AR, p.

587. 

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may have been thinking.” Bray v. Commissioner of SSA, 554 F.3d 1219, 1225 (9th Cir.

2009). Enriquez argues that an ALJ’s error was harmless only if the Court “can confidently

conclude that no reasonable ALJ, when” not making the same error as the ALJ herein,

“would have reached a different disability determination.” Stout, 454 F.3d at 1056. Enriquez

asserts that “a reasonable ALJ who did not believe that he or she was required to adopt Dr.

Toomajian’s testimony could have instead agreed with treating physician Dr. Smith that

Enriquez was unable to work at her date last insured.” Objections, p. 11; see also Orn v.

Astrue, 495 F.3d 625 (9th Cir. 2007) (discussing factors in determining weight to be given

medical opinions). Indeed, Enriquez asserts that Dr. Toomajian may have improperly

required Enriquez’ functional limitations to be corroborated by contemporaneous medical

evidence in making his opinion.3

 See SSR 83-20 (“In some cases, it may be possible, based

on the medical evidence to reasonably infer that the onset of a disabling impairment(s)

occurred some time prior to the date of the first recorded medical examination, e.g., the date

the claimant stopped working”); Enriquez’ asserts the ALJ erred in not ascertaining whether

Dr. Toomajian indeed required such evidence to reach an opinion of a disabling impairment.

See 20 C.F.R. § 404.944 (ALJ is to fully look into the issues); see also Armstrong v.

Commissioner of SSA, 160 F.3d 587 (9th Cir. 1998), citation omitted (ALJ is “to call upon

the services of a medical advisor and to obtain all evidence which is available to make the

determination”) 

The Court disagrees with Enriquez that a reasonable ALJ, when not making the same

error as the ALJ herein, may have reached a different result. Initially, the Court considers

that Enriquez’ interpretation of Dr. Toomajian’s testimony does not alter the fact that he did

not state that he required Enriquez’ functional limitations to be corroborated by

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The Court notes that the magistrate judge summarized at length Enriquez’ medical

records that pre-dated Enriquez’ date of last insured. 

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contemporaneous medical evidence in making his opinion. The Court also consider that

“[d]ecisions based on multiple errors, harmless or otherwise, put the Court in the improper

position of fact-finder and promote remand or reversal based on cumulative error.”

Dickinson v. Commissioner, SSA, 2008 WL 5423366 n. 9 (D.Id. 2008); see also Renaudette

v. Astrue, 482 F.Supp.2d 121 (D.Mass. 2007) (cumulative factual errors and misstatements

undermined confidence that evidence was fully and fairly considered or that the decision was

supported by substantial evidence). However, where the evidence presented to the ALJ (and

submitted to this Court on review) clearly establishes that Enriquez only began consistently

complaining of lupus symptoms after December 1999, the Court “can confidently conclude

that no reasonable ALJ, when” not making the same error as the ALJ herein, “would have

reached a different disability determination.” Stout, 454 F.3d at 1056.4

 Additionally,

although the ALJ gave controlling weight to Dr. Toomajian’s opinion, this Court can

confidently find the ALJ’s findings are supported by substantial evidence in the record as a

whole. Taylor v. Heckler, 765 F.2d 872, 875 (9th Cir. 1985) (The limited role of the court

is to ensure that the “Secretary’s findings are [not] based upon legal error [and are] supported

by substantial evidence in the record as a whole.”). The Court finds the error of the ALJ to

be harmless.

Testimony of Smith

Enriquez asserts that substantial evidence does not support the ALJ’s step-two

decision because the ALJ did not give the required clear and convincing reasons for rejecting

the retrospective opinions of treating rheumatologist Dr. Smith. In evaluating evidence to

determine whether a claimant is disabled, the opinions of treating physicians are entitled to

great weight. Curry v. Sullivan, 925 F.2d 1127, 1129 (9th Cir. 1989). Where a treating

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The Court disagrees with Enriquez’ assertion that the ALJ was required to state clear

and convincing reasons for rejecting Dr. Smith’s opinion.

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The magistrate judge found that the ALJ’s credibility finding was irrelevant.

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physician’s opinion contradicts the opinion of an examining or consulting physician, there

must be “‘specific and legitimate reasons’ supported by substantial evidence in the record”

to reject a treating physician’s opinion. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1996),

quoting Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983). Where the treating

physician’s opinion is not contradicted, the opinion may be rejected as long as clear and

convincing reasons are given. Montijo v. Secretary of HHS, 729 F.2d 599, 601 (9th Cir.

1984). 

In this case, Dr. Toomajian’s opinion contradicted Dr. Smith’s opinion. The Court

agrees with the magistrate judge that the ALJ set forth specific and legitimate reasons

supported by substantial evidence in the record to reject Dr. Smith’s opinion.5

 The ALJ

found that Dr. Smith’s opinion was inconsistent with medical records prior to December 31,

1999, and that the retrospective opinion was based on Enriquez’ subjective statements. The

ALJ also noted that Dr. Smith’s notes from May 2001 stated Enriquez’ symptoms had been

present only since August 2000. The Court agrees with the magistrate judge that Dr. Smith’s

assertion that Enriquez was “disabled by lupus prior to December 31, 1999, is not supported

by the record. The ALJ did not err in rejecting Dr. Smith’s retrospective opinion.” Report

and Recommendation, p. 18, ll..11-13. 

Credibility of Enriquez

Enriquez objects to the magistrate judge’s failure to address the credibility of

Enriquez.6

 However, the Ninth Circuit has stated:

[T]o discredit a claimant’s testimony when a medical impairment has been

established, the ALJ must provide “‘specific, cogent reasons for the disbelief.’” The

ALJ must “cit[e] the reasons why the [claimant’s testimony is unpersuasive.” Where,

as here, the ALJ did not find “affirmative evidence” that the claimant was a

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malingerer, those “reasons for rejecting the claimant’s testimony must be clear and

convincing.”

Orn, 495 F.3d at 635, citations omitted. Where, as here, the ALJ did not find that a medical

impairment has been established, it is not clear what standard should be applied in reviewing

an ALJ’s reasons for rejecting a claimant’s testimony. The Court does not find it appropriate

to assume, as Enriquez argues, that the ALJ found a medical impairment solely because the

ALJ addressed Enriquez’ credibility. Such a conclusion would directly contradict the finding

as stated by the ALJ: “Through her last insured date, the claimant did not have an underlying

medically determinable impairment(s) that could reasonably cause the pain or other

symptoms alleged.” AR, p. 28. Rather, the Court finds review is not appropriate because,

as previously stated, the ALJ’s consideration of Enriquez’ credibility is harmless error.

Accordingly, after an independent review, IT IS ORDERED:

1. The Report and Recommendation [Doc. # 18] is ADOPTED;

2. Plaintiff's Motion for Summary Judgment [Doc. # 12] is DENIED;

3. Defendant's Cross-Motion for Summary Judgment [Doc. # 15] is GRANTED;

4. The decision of the ALJ is AFFIRMED; 

5. Judgment is awarded in favor of Defendant and against Plaintiff, and;

6. The Clerk of the Court shall enter judgment in this case and shall then close

its file in this matter.

DATED this 26th day of March, 2009.

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