Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-5_14-cv-05181/USCOURTS-cand-5_14-cv-05181-0/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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Case No.: 5:14-cv-05181-PSG

ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA 

SAN JOSE DIVISION

LUCIA GRANDE,

 Plaintiff,

v.

CAROLYN COLVIN, Acting Commissioner, 

Social Security Administration,

 Defendant. 

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Case No. 5:14-cv-05181-PSG

ORDER RE: MOTIONS FOR 

SUMMARY JUDGMENT

(Re: Docket Nos. 16, 19)

At issue before the court is whether the administrative determination that Plaintiff Lucia 

Grande’s thyroid condition was not severe and that Grande was not disabled within the meaning of 

the Social Security Act prior to December 31, 2011 is supported by substantial evidence. Because 

the ALJ’s reasons for finding Grande’s thyroid condition is non-severe are not supported by the 

record as a whole, and because the ALJ failed to provide sufficient reasons for discrediting the 

medical opinions of Grande’s treating physicians, the ALJ’s decision is not supported by

substantial evidence. The court GRANTS Grande’s motion for summary judgment and remands 

for further proceedings in accordance with this ruling. The Commissioner’s motion for summary 

judgment is DENIED.

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Case No.: 5:14-cv-05181-PSG

ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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I.

Through its administrative law judges, the Commissioner of Social Security determines the 

disability status of claimants by following a five-step evaluation process.1 The five-step evaluation 

process is identical in applications for supplemental security income2and disability insurance 

benefits.3

At step one, the ALJ must determine if the claimant is engaged in substantial gainful 

activity. If so, the claimant is not disabled.4 If not, the ALJ continues to step two.

At step two, the ALJ must determine whether the claimant has a medical impairment or 

combination of impairments that is severe and meets the duration requirement in Section 

404.1509.

5

 An impairment or combination of impairments is not severe if the evidence establishes 

only a slight abnormality or combination of abnormalities that would have no more than a minimal 

effect on an individual’s ability to work.6 If the impairment is severe, the analysis proceeds to step 

three.

At step three, the ALJ must determine whether the claimant’s impairment meets or 

medically equals the criteria of an impairment listed in 20 C.F.R. § 404, Subpart P, Appendix 1.7 If 

so, the claimant is disabled.8 If not, the analysis proceeds to step four.

 

1

See 20 C.F.R §§ 404.1520, 416.920.

2

See 20 C.F.R. § 416.920.

3

See, e.g., Bowen v. Yukert, 482 U.S. 137, 140 (1986); see also, 20 C.F.R. § 404.1520.

4

See 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i).

5

See 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii).

6

See 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii).

7

See 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).

8

See 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).

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Case No.: 5:14-cv-05181-PSG

ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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At step four, the ALJ must first evaluate the claimant’s residual functional capacity (RFC)

based on all relevant medical and other evidence.9 The ALJ must then determine whether the 

claimant is able to perform the requirements of her past relevant work in light of her RFC.

10 If the 

claimant is not able to perform any past relevant work or does not have any past relevant work, the 

analysis proceeds to the final step.

At step five, the ALJ must determine whether the claimant is able to do any other work 

considering her RFC, age, education, and work experience.11 At this stage, the Commissioner 

bears the burden of proving other work exists in significant numbers in the national economy 

considering the claimant’s RFC.

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 If the claimant cannot make an adjustment to other work, she is 

disabled.13

Grande suffers from a combination of physical and mental impairments, namely 

hypothyroidism, generalized anxiety and depression. Grande applied for disability insurance 

benefits and supplemental security income under Title II and Title XVI of the Social Security Act. 

After her application was denied, Grande requested a hearing before an administrative law judge.14 

At the hearing, the ALJ found that Grande was disabled as of April 1, 2012 and was therefore 

entitled to supplemental security income.15 The ALJ also found that Grande was not disabled 

within the meaning of the Social Security Act at any time up through December 31, 2011, the last 

 

9

See 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv). 

10 See 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).

11 See 20 C.F.R §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).

12 See 20 C.F.R. § 404.1512(f).

13 See 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).

14 See Docket No. 14-5 at 21.

15 See Docket No. 14-3 at 20-21.

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ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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date that Grande was insured, and therefore was not eligible for disability insurance benefits.16 

After the Appeals Council denied Grande’s subsequent request for review, the ALJ’s decision 

became the final decision of the Commissioner.17

In her motion for summary judgment, Grande challenges the ALJ’s finding that she was not 

disabled within the meaning of the Social Security Act before December 31, 2011.18 In particular, 

Grande contends: (1) the ALJ’s decision that Grande’s thyroid condition was non-severe in that 

period is not supported by substantial evidence; (2) there is not substantial evidence to support the 

ALJ’s decision to ignore the opinions of Grande’s treating physicians, Dr. Shakir and Dr. Kardong; 

and (3) the letters submitted by Grande’s physicians to the Appeals Council further demonstrate 

that the ALJ’s decision is not supported by substantial evidence.19 Grande therefore requests 

reversal and instructions for the immediate award of benefits or, alternatively, that the case be 

remanded for a new hearing.20

The Commissioner opposes Grande’s motion and likewise moves for summary judgment on 

the basis that the ALJ’s assessment of Grande’s medical impairments and her decision to ignore the 

opinions of Grande’s treating physicians are supported by substantial evidence.21 Alternatively, 

even if reversible error is present, the Commissioner contends that remand for a new hearing, not 

immediate award of benefits, is the appropriate remedy.22

 

16 See id.

17 See Docket No. 14-3 at 2.

18 See Docket No. 16.

19 See id. at 11-13.

20 See id. at 13.

21 See Docket No. 19 at 2.

22 See id. at 8.

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Case No.: 5:14-cv-05181-PSG

ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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II.

This court has jurisdiction under 28 U.S.C. § 1331. The parties further consented to the 

jurisdiction of the undersigned magistrate judge under 28 U.S.C. § 636(c) and Fed. R. Civ. P. 

72(a).23 The court finds this motion suitable for disposition on the papers in light of this court’s 

local rules and procedural order.24

Under 42 U.S.C. § 405(g), a district court may review the Commissioner’s decision to deny 

benefits. The court may set aside the Commissioner’s decision when the ALJ’s findings are based 

on legal error or are not supported by substantial evidence considering the record as a whole.25 

“Substantial evidence” means “more than a mere scintilla, but less than a preponderance”26 and is 

“such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”27 

In determining whether substantial evidence supports an ALJ’s subsidiary factual determinations, 

the court may not substitute its judgment for that of the ALJ, but must nonetheless weigh both 

evidence supporting and detracting from the ALJ’s conclusion.28 In affirming the ALJ, the court 

 

23 See Docket Nos. 10, 12.

24 See Docket No. 6; Civ. L.R. 7–1(b) (“In the Judge’s discretion, or upon request by counsel and 

with the Judge’s approval, a motion may be determined without oral argument or by telephone 

conference call.”); Civ. L.R. 16–5. 

25 See Bray v. Comm’r of the Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009); Aukland v. 

Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001); Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 

1996).

26 Bray, 554 F.3d at 1222.

27 Id. 

28 See Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). 

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ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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may not consider alternative supporting grounds, but instead must rely only on the reasons 

provided by the ALJ.29

“The ALJ is responsible for determining credibility, resolving conflicts in medical 

testimony, and for resolving ambiguities.”30 Generally, “the opinion of a treating physician must 

be given more weight than the opinion of a reviewing physician.”31 To reject a treating physician’s 

opinion that is not contradicted, the ALJ must provide “clear and convincing reasons that are 

supported by substantial evidence.”32 If the evidence is susceptible to more than one rational 

interpretation, the court must uphold the Commissioner’s decision.33

Usually, “[i]f additional proceedings can remedy defects in the original administrative 

proceeding, a social security case should be remanded.”34 The Ninth Circuit has devised a three 

part credit-as-true standard, each part of which must be satisfied in order for a court to remand to 

an ALJ with instructions to calculate and award benefits: (1) the record has been fully developed 

and further administrative proceedings would serve no useful purpose; (2) the ALJ has failed to 

provide legally sufficient reasons for rejecting evidence, whether claimant testimony or medical 

 

29 See Garrison v. Colvin, 759 F.3d 995, 1010 (9th Cir. 2014) (citing Connett v. Barnhart, 340 F.3d

871, 874 (9th Cir. 2003)). 

30 See Garrison, 759 F.3d at 1010 (citing Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). 

31 See Ghanim v. Colvin, 763 F.3d 1154, 1160 (9th Cir. 2014). 

32 Id. at 1161 (quoting Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005)). 

33 See Andrews, 53 F.3d at 1039-40.

34 See Garrison, 759 F.3d at 1019 (citing Lewin v. Schweiker, 654 F. 2d 631, 635 (9th Cir. 1981)). 

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ORDER RE: MOTIONS FOR SUMMARY JUDGMENT

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opinion; and (3) if the improperly discredited evidence were credited as true, the ALJ would be 

required to find the claimant disabled on remand.35

III.

Because the court agrees with Grande that the ALJ partially erred in her decision, the court 

grants Grande’s motion and remands as follows.

First, there is not substantial evidence to support the ALJ’s determination at step two that 

Grande’s thyroid condition was not severe. The ALJ found that as of the alleged onset date of 

September 20, 2011, the medical records maintained by Grande’s treating physicians reflect a 

stable thyroid condition following the treatment for hypothyroidism.36 In support of this view, the 

ALJ cites portions of Grande’s medical reports from her treating physicians, which they created 

between May 2011 and January 2013.37 

Rather than demonstrate that Grande’s thyroid condition was stable during this time period, 

these selections indicate that Grande’s physicians made multiple adjustments to her thyroid 

medications, and that Grande exhibited abnormal TSH levels and varying results for T3 and T4 

thyroid hormones in her lab reports.38 Moreover, these results are consistent with other portions of 

Grande’s medical record indicating adjustments to her thyroid medications39 and low TSH levels.40 

Because the ALJ failed to provide any other basis for finding Grande’s thyroid condition was not 

 

35 See Garrison, 759 F.3d at 1020-21; Lingenfelter, 504 F.3d at 1041; Orn v. Astrue, 495 F.3d 625, 

640 (9th Cir. 2007); Benecke v. Barnhart, 379 F.3d 587, 595 (9th Cir. 2004); Smolen, 80 F.3d at 

1292.

36 See Docket No. 14-3 at 24.

37 See id. (citing Docket No. 14-9 at 38, 40, 45, 57-59, 69).

38 See, e.g., Docket No. 14-9 at 45, 59, 69.

39 See id. at 48.

40 See id. at 53.

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severe, this decision is not supported by substantial evidence. Consequently, the ALJ’s assessment 

of Grande’s RFC at steps four and five also are not supported by substantial evidence.

Second, the ALJ erred in discrediting the opinions of Grande’s treating physicians, Dr. 

Kardong and Dr. Shakir. Generally, an ALJ may only reject the opinion of a treating physician if 

she provides “specific and legitimate reasons that are supported by substantial evidence.”41 Here, 

the ALJ provided three primary reasons for discrediting the opinions of Dr. Kardong and Dr. 

Shakir with respect to the severity of Grande’s depression and anxiety before April 2012. 

The ALJ first noted that both Dr. Kardong’s and Dr. Shakir’s reports lacked foundation 

with regard to Grande’s condition before the start of treatment.42 The ALJ reasoned that these 

reports were not reliable because Dr. Kardong and Dr. Shakir had only been providing treatment 

for a short period when they offered their opinions; the ALJ also noted that Dr. Kardong and Dr. 

Shakir lacked personal knowledge of Grande’s condition before they began treating her.

In reply, Grande explains that these opinions relied on the treatment notes of Dr. Grellet and 

Dr. Benson, who had treated Grande for depression since 2008, until referring her to Dr. Kardong 

and Dr. Shakir. Dr. Grellet and Dr. Benson prescribed medication for Grande’s depression and 

changed the dosage several times. Thus, Grande contends that even though Dr. Kardong and Dr. 

Shakir did not personally care for Grande before September 2011 and January 2012, their opinions 

that Grande has suffered from severe depression and anxiety for two years before beginning 

treatment are supported by the medical record.43

 

41 See Ghanim, 763 F.3d at 1161 (quoting Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 1198 (9th 

Cir. 2008).

42 See Docket No. 14-3 at 27 (explaining that the opinions are “vague and ambiguous as to the 

onset date of the assessed limitations, inconsistent with the record, and lack foundation”).

43 See Docket No. 20 at 2.

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Generally, the ALJ will give more weight to opinions from treating sources.44 The ALJ 

may, however, afford more or less weight to a treating source opinion based on the length of 

treatment and the frequency of examination.45 Considering the short length of treatment, the ALJ 

properly recognized that Dr. Kardong’s and Dr. Shakir’s opinions should receive less weight. 

However, the limited duration of treatment and the lack of foundation before treatment do not 

provide substantial evidence for rejecting these opinions entirely, particularly with regard to the 

period after treatment began. Accordingly, this reason does not, by itself, provide substantial 

evidence to support the ALJ’s decision to discredit these opinions entirely.

The ALJ next noted that Dr. Kardong’s and Dr. Shakir’s assessments largely relied upon 

subjective complaints and situational concerns expressed by Grande.46 An ALJ may discount a 

treating physician’s opinion that is largely based on a claimant’s self-reports and not on clinical 

evidence if the ALJ determines that the claimant is not credible.47 In assessing a claimant’s 

credibility, “the ALJ must first 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.”48 If so, “the ALJ can only reject the claimant’s testimony about the 

severity of the symptoms if she gives ‘specific, clear, and convincing reasons’ for the rejection.”49

Here, the ALJ determined that Grande’s impairments “could reasonably be expected to 

cause the alleged symptoms; however, [her] statements concerning the intensity, persistence and 

 

44 See Ghanim, 763 F.3d at 1160.

45 See, e.g., 20 C.F.R. § 404.1527(c)(2)(i).

46 See Docket No. 14-3 at 26-27.

47 See Ghanim, 763 F.3d at 1163 (citing Vasquez v. Astrue, 572 F.3d 586, 591 (9th Cir. 2009)).

48 Id.

49 Id.

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limiting effects of these symptoms [were] not entirely credible.”50 Grande testified that she could 

not work because her impairments caused her to experience low energy and motivation, difficulty 

with sustained concentration, memory, staying on task and difficulty communicating with the 

public.51 However, the ALJ found that Grande’s own reports “reflect her doing well in response to

drug therapy and that despite her alleged social phobia she has engaged in social activities, she has 

regularly cared for herself, and began going to college again in September 2011.”52 The ALJ 

further noted that these reports were not contradicted by subsequent treatment records, medical 

opinions or other record evidence through March 31, 2012.

In light of these inconsistencies, the ALJ determined that Grande’s testimony was only 

partially credible. It was therefore appropriate for the ALJ to afford less weight to Dr. Kardong’s

and Dr. Shakir’s opinions, which relied upon these self-assessments. There was not, however, 

substantial evidence to support the ALJ’s decision to discredit these opinions in their entirety. As a 

result, Dr. Kardong’s and Dr. Shakir’s reliance on Grande’s self-assessments does not provide 

substantial evidence to support the ALJ’s decision to summarily reject these opinions.

Finally, the ALJ reasoned that Dr. Kardong’s notes are inconsistent with the overall record 

and that Dr. Shakir’s notes reflect a positive response to treatment, which is inconsistent with the 

limitations assessed.53 Although “[a] conflict between treatment notes and a treating provider’s 

 

50 See Docket No. 14-3 at 29.

51 See id.

52 Id. The ALJ further explained that on July 6, 2009, the claimant did not feel that her symptoms 

were the cause of an inability to work; however, this testimony is less relevant for determining the 

severity of Grande’s impairments at the alleged onset date of September 1, 2011, and therefore 

lends little support to the ALJ’s credibility determination.

53 See Docket No. 14-3 at 27. 

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opinion may constitute an adequate reason to discredit the opinions of a treating physician,”54 such 

notes must be “read in context of the overall diagnostic picture.”55 Here, the longitudinal medical 

record demonstrates that Grande often fluctuated between feeling better and worse and that, as 

treatment progressed, Grande’s depression and anxiety worsened.56 As a result, the fact that Dr. 

Kardong and Dr. Shakir noted some positive responses to treatment does not provide sufficient 

basis for discrediting these opinions entirely. 

In sum, the ALJ provides several specific reasons for rejecting the opinions of Dr. Kardong 

and Dr. Shakir regarding the severity of Grande’s impairments. Although these reasons provide 

substantial support for the position that these treating source opinions should not be afforded full 

(much less controlling) weight, they do not support the ALJ’s determination that these opinions 

should be ignored altogether. Accordingly, the decision to reject these opinions for any 

consideration of the severity of Grande’s depression and anxiety conditions is not supported by 

substantial evidence.

57

Finally, the court must consider whether to credit-as-true the opinions of Dr. Kardong and 

Dr. Shakir and grant Grande’s request for an instruction directing the immediate award of benefits. 

Under the Ninth Circuit’s credit-as-true standard, the court may reverse a decision of the 

Commissioner with instructions for the immediate award of benefits if: (1) the record has been 

 

54 See Ghanim, 763 F.3d at 1161.

55 Id. at 1162 (“The fact that a person suffering from depression makes some improvement ‘does 

not mean that the person’s impairment no longer seriously affects his ability to function in a 

workplace.’”).

56 See, e.g., Docket No. 14-9 at 4-5. 

57 Having established that the ALJ erred in concluding that Grande’s hypothyroidism was nonsevere and in discrediting the treating source opinions, it is unnecessary for this court to decide 

whether the newly-submitted letters from Dr. Shakir and Dr. Grellet provide additional information 

that would further demonstrate that the ALJ’s decision is not supported by substantial evidence. 

See Docket No. 14-9 at 86-87, 89. The court therefore does not reach that argument.

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fully developed and further administrative proceedings would serve no useful purpose; (2) the ALJ 

has failed to provide legally sufficient reasons for rejecting evidence; and (3) if the improperly 

discredited evidence were credited as true, the ALJ would be required to find the claimant disabled 

on remand.58

As discussed above, the ALJ erred by wholly rejecting the opinions of Dr. Kardong and Dr. 

Shakir. Nevertheless, there is substantial evidence to support the conclusion that these opinions 

should not receive full weight. Accordingly, further administrative proceedings are necessary to 

determine what weight should be given to Dr. Kardong’s and Dr. Shakir’s opinions. Because the 

record has not been fully developed on this point, reversal with instructions for the award of 

benefits under the credit-as-true standard is not warranted at this time.

IV.

For these reasons, the court GRANTS Grande’s motion for summary judgment and the 

ALJ’s decision is reversed and remanded for further proceedings consistent with this opinion. The 

Commissioner’s motion for summary judgment is DENIED.

SO ORDERED.

Dated: November 24, 2015

_________________________________

PAUL S. GREWAL

United States Magistrate Judge

 

58 See Garrison 759 F.3d at 1020-21; Lingenfelter, 504 F.3d at 1041; Orn, 495 F.3d at 640; 

Benecke, 379 F.3d at 595; Smolen, 80 F.3d at 1292.

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