Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_14-cv-01193/USCOURTS-azd-2_14-cv-01193-0/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 

Carlos Moreno Gamez, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant. 

No. CV-14-01193-PHX-NVW 

ORDER 

Plaintiff Carlos Moreno Gamez seeks review under 42 U.S.C. § 405(g) of the final 

decision of the Commissioner of Social Security (“the Commissioner”), which denied 

him disability insurance benefits and supplemental security income under sections 216(i), 

223(d), and 1614(a)(3)(A) of the Social Security Act. Because the decision of the 

Administrative Law Judge (“ALJ”) is supported by substantial evidence and is not based 

on legal error, the Commissioner’s decision will be affirmed. 

I. BACKGROUND 

Plaintiff was born in March 1962 and has a ninth grade education. He is able to 

communicate in English. He worked primarily as a plastering supervisor during the 

fifteen years before April 2011. Although he has multiple medical conditions, his 

primary complaints are chronic right knee pain, type 2 diabetes with mild peripheral 

neuropathy, and pain in his back, head, hands, and fingers. 

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In May 2011, Plaintiff applied for disability insurance benefits and supplemental 

security income, alleging disability beginning April 1, 2011. On January 9, 2013, he 

appeared with his attorney and testified at a hearing before the ALJ with an interpreter. 

A vocational expert also testified. On March 7, 2013, the ALJ issued a decision that 

Plaintiff was not disabled within the meaning of the Social Security Act. The Appeals 

Council denied Plaintiff’s request for review of the hearing decision, making the ALJ’s 

decision the Commissioner’s final decision. On May 30, 2014, Plaintiff sought review by 

this Court. 

II. STANDARD OF REVIEW 

The district court reviews only those issues raised by the party challenging the 

ALJ’s decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court 

may set aside the Commissioner’s disability determination only if the determination is 

not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 

625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion considering the record as a whole. Id. In determining whether 

substantial evidence supports a decision, the court must consider the record as a whole 

and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. 

As a general rule, “[w]here the evidence is susceptible to more than one rational 

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be 

upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted); 

accord Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (“Even when the evidence 

is susceptible to more than one rational interpretation, we must uphold the ALJ’s findings 

if they are supported by inferences reasonably drawn from the record.”). 

III. FIVE-STEP SEQUENTIAL EVALUATION PROCESS 

To determine whether a claimant is disabled for purposes of the Social Security 

Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears 

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the burden of proof on the first four steps, but the burden shifts to the Commissioner at 

step five. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 

At the first step, the ALJ determines whether the claimant is engaging in 

substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not 

disabled and the inquiry ends. Id. At step two, the ALJ determines whether the claimant 

has a “severe” medically determinable physical or mental impairment. 

§ 404.1520(a)(4)(ii). If not, the claimant is not disabled and the inquiry ends. Id. At step 

three, the ALJ considers whether the claimant’s impairment or combination of 

impairments meets or medically equals an impairment listed in Appendix 1 to Subpart P 

of 20 C.F.R. Pt. 404. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to 

be disabled. Id. If not, the ALJ proceeds to step four. At step four, the ALJ assesses the 

claimant’s residual functional capacity and determines whether the claimant is still 

capable of performing past relevant work. § 404.1520(a)(4)(iv). If so, the claimant is not 

disabled and the inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, 

where he determines whether the claimant can perform any other work based on the 

claimant’s residual functional capacity, age, education, and work experience. 

§ 404.1520(a)(4)(v). If so, the claimant is not disabled. Id. If not, the claimant is 

disabled. Id. 

At step one, the ALJ found that Plaintiff meets the insured status requirements of 

the Social Security Act through March 31, 2012, and that he has not engaged in 

substantial gainful activity since April 1, 2011. At step two, the ALJ found that Plaintiff 

has the following severe impairments: asthma, gastroesophageal reflux disease, diabetes 

mellitus, right knee pain status post arthroscopy, sleep apnea, peripheral neuropathy, 

sensorineural hearing loss, and lower back spondylolisthesis. At step three, the ALJ 

determined that Plaintiff does not have an impairment or combination of impairments that 

meets or medically equals an impairment listed in 20 C.F.R. Part 404, Subpart P, 

Appendix 1. 

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At step four, the ALJ found that Plaintiff: 

has the residual functional capacity to perform light work as defined in 20 

CFR 404.1567(b) and 416.967(b) with the ability to occasionally perform 

postural activities such as climbing ramps and stairs and kneeling and 

crouch[ing], but must avoid climbing ladders, ropes or scaffolds, exposure 

to dusts, gases, and chemical irritants, and excessive background noise. 

The ALJ further found that Plaintiff is unable to perform any past relevant work. At step 

five, the ALJ concluded that, considering Plaintiff’s age, education, work experience, and 

residual functional capacity, there are jobs that exist in significant numbers in the national 

economy that Plaintiff could perform. 

IV. ANALYSIS 

A. The ALJ Did Not Err in Weighing Medical Source Opinion Evidence. 

1. Legal Standard 

In weighing medical source opinions in Social Security cases, the Ninth Circuit 

distinguishes among three types of physicians: (1) treating physicians, who actually 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). The Commissioner must give weight to the 

treating physician’s subjective judgments in addition to his clinical findings and 

interpretation of test results. Id. at 832-33. Where a treating physician’s opinion is not 

contradicted by another physician, it may be rejected only for “clear and convincing” 

reasons, and where it is contradicted, it may not be rejected without “specific and 

legitimate reasons” supported by substantial evidence in the record. Id. at 830; Orn v. 

Astrue, 495 F.3d 625, 632 (9th Cir. 2007) (where there is a conflict between the opinion 

of a treating physician and an examining physician, the ALJ may not reject the opinion of 

the treating physician without setting forth specific, legitimate reasons supported by 

substantial evidence in the record). 

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Further, an examining physician’s opinion generally must be given greater weight 

than that of a non-examining physician. Lester, 81 F.3d at 830. As with a treating 

physician, there must be clear and convincing reasons for rejecting the uncontradicted 

opinion of an examining physician, and specific and legitimate reasons, supported by 

substantial evidence in the record, for rejecting an examining physician’s contradicted 

opinion. Id. at 830-31. 

The opinion of a non-examining physician is not itself substantial evidence that 

justifies the rejection of the opinion of either a treating physician or an examining 

physician. Id. at 831. “The opinions of non-treating or non-examining physicians may 

also serve as substantial evidence when the opinions are consistent with independent 

clinical findings or other evidence in the record.” Thomas v. Barnhart, 278 F.3d 947, 957 

(9th Cir. 2002). 

Factors that an ALJ may consider when evaluating any medical opinion include 

“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 

ALJ may discount a physician’s opinion that is based only the claimant’s subjective 

complaints without objective evidence. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 

1190, 1195 (9th Cir. 2004). The opinion of any physician, including that of a treating 

physician, need not be accepted “if that opinion is brief, conclusory, and inadequately 

supported by clinical findings.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 

1228 (9th Cir. 2009). An ALJ may reject standardized, check-the-box forms that do not 

contain any explanation of the bases for conclusions. Molina v. Astrue, 674 F.3d 1104, 

1111 (9th Cir. 2012). 

Generally, more weight should be given to the opinion of a treating physician than 

to the opinions of physicians who do not treat the claimant, and the weight afforded a 

non-examining physician’s opinion depends on the extent to which he provides 

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supporting explanations for his opinions. Garrison v. Colvin, 759 F.3d 995, 1012 (9th 

Cir. 2014). 

2. Examining Physician Elizabeth Ottney, D.O. 

Defendant alleges disability beginning April 1, 2011. On August 9, 2011, Dr. 

Ottney examined Plaintiff and provided a written assessment. Dr. Ottney reported that 

Plaintiff’s chief complaints were chronic right knee pain and type 2 diabetes. For typical 

daily activities, Dr. Ottney wrote, “The claimant walks.” Under the heading “review of 

systems,” she wrote, “The claimant reports weight loss, fatigue, fainting spells, dizziness, 

frequent falls, headaches, shortness of breath, and racing heart.” There is no mention 

Plaintiff reported lower extremity numbness or pain except for right knee pain. 

Upon testing, Dr. Ottney found Plaintiff’s muscle strength of the upper and lower 

extremities and grip strength to be 5/5 bilaterally. She found Plaintiff’s balance and 

coordination to be normal. She observed that Plaintiff demonstrated “a normal stance 

and fine and gross motor function of the upper extremities bilaterally while manipulating 

his shoes and wallet.” She observed that Plaintiff used a cane for walking but also could 

walk without a cane, moved on and off the examination table without assistance, and was 

able to rise from a seated position. Dr. Ottney found normal range of motion of all the 

major joints, but reported Plaintiff had pain with full flexion of the right knee. 

Dr. Ottney also completed a Medical Source Statement of Ability to Do WorkRelated Activities (Physical). Although she did not respond to the question asking for 

her diagnosis, she stated, “The following limitations are secondary to his chronic right 

knee pain.” She opined that Plaintiff’s maximum capacity to lift and/or carry is 20 

pounds occasionally and 10 pounds frequently. She opined that he had no limitations in 

sitting. She opined that Plaintiff’s ability to stand and/or walk is four hours in an eighthour day. For each of these opinions, she did not respond to the follow-up question 

asking her to identify the findings on which she based her conclusion. She stated that 

Plaintiff used a cane and appeared to need it for pain, but not for balance. 

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In his reply brief, Plaintiff contends that “[a] closer look at the report from Dr. 

Ottney finds the doctor seeing lessening of lower extremity senses and restrictions in 

lower extremity capacity (TR 319).” Close scrutiny of Dr. Ottney’s report yields no such 

finding. Dr. Ottney expressly found limitations based solely on Plaintiff’s reported right 

knee pain. Nothing in the report suggests that Dr. Ottney was aware that Plaintiff had 

any complaints of painful feet and numbness. 

3. Treating Neurologist Victor Salazar-Calderon, M.D. 

The record includes Dr. Salazar-Calderon’s treatment notes from June 28, 2011, 

through November 19, 2012. On June 28, 2011, Dr. Salazar-Calderon described Plaintiff 

as “a diabetic patient with painful feet and numbness suggestive of diabetic sensory 

peripheral neuropathy.” He opined that the numbness in Plaintiff’s “left big toe is due to 

a local sensory neuropathy probably [due] to wearing tight shoes.” His treatment plan 

included prescribing gabapentin and vitamin B6 and conducting nerve conduction 

velocity testing. His notes show Plaintiff was to follow up within one month, but Dr. 

Salazar-Calderon did not see him again until September 28, 2011. Dr. Salazar-Calderon 

conducted nerve conduction velocity testing, which showed “well controlled diabetic 

polyneuropathy.” Dr. Salazar-Calderon reported that Plaintiff was doing well. 

On October 27, 2011, Dr. Salazar-Calderon noted that Plaintiff was doing well on 

his medications and the results of physical and neurological examinations were 

unchanged. Dr. Salazar-Calderon’s assessment was “well controlled painful diabetic 

peripheral neuropathy.” On November 29, 2011, Dr. Salazar-Calderon again noted that 

Plaintiff was doing well on his medications and the results of physical and neurological 

examinations were unchanged. He also noted that Plaintiff “occasionally” gets numbness 

in his toes and has chronic neck and low back pain. Dr. Salazar-Calderon’s assessment 

was “well controlled painful diabetic peripheral neuropathy in a patient with chronic neck 

and low back pain secondary to degenerative disc disease.” 

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On February 29, 2012, May 4, 2012, July 19, 2012, September 19, 2012, and 

November 19, 2012, Dr. Salazar-Calderon again noted that Plaintiff was doing well on 

his medications, the results of physical and neurological examinations were unchanged, 

and Plaintiff’s diabetic peripheral neuropathy was well controlled. The record does not 

include an opinion from Dr. Salazar-Calderon regarding Plaintiff’s functionality or ability 

to do work-related activities. 

4. State Agency Medical Consultant John B. Kurtin, M.D. 

On April 17, 2012, Dr. Kurtin reviewed Plaintiff’s function report, his medical 

records, and Dr. Ottney’s medical opinion. Dr. Kurtin opined that Plaintiff can lift and/or 

carry twenty pounds occasionally and ten pounds frequently, stand and/or walk about six 

hours in an eight-hour workday, and sit about six hours in an eight-hour workday. He 

further opined that Plaintiff was limited to occasionally climbing ramps/stairs, never 

climbing ladders/ropes/scaffolds, frequently stooping, occasionally kneeling, and 

occasionally crawling. Dr. Kurtin stated that his conclusions were based on evidence of 

right knee pain status post-surgery. 

Dr. Kurtin provided additional explanation for his opinion. He explained that 

Plaintiff alleged right knee injury and diabetes and that he cannot walk, but his treating 

orthopedic surgeon had difficulty reconciling Plaintiff’s subjective pain with no obvious 

arthritic changes. Dr. Kurtin also noted that Plaintiff had been observed by an 

investigator for the Phoenix Cooperative Disability Investigations Unit walking without 

difficulty and without an assistive device, standing up from a sitting position, bending 

over numerous times, and hosing down the driveway and plants. 

5. The ALJ’s Hearing Decision 

Plaintiff contends the ALJ erred by giving little weight to Dr. Ottney’s opinion 

that Plaintiff is limited to standing and/or walking for four hours out of an eight-hour 

workday. The ALJ identified the limitations opined by Dr. Ottney and gave significant 

weight to most of the opinion. The ALJ gave little weight to Dr. Ottney’s assessment that 

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Plaintiff was limited to standing and/or walking for four hours out of an eight-hour 

workday because the substantial evidence of record did not support it. The ALJ noted 

that Plaintiff has minimal changes in the lumbar spine that would interfere with his ability 

to stand and/or walk and his knee pain was expected to improve with arthroscopy. The 

ALJ cited evidence that Plaintiff’s diabetic peripheral neuropathy was well controlled 

although it caused pain and that Plaintiff had been observed moving around his front yard 

with no apparent signs of physical impairment. The ALJ also found that Plaintiff’s 

analgesic medication history was inconsistent with allegations of severe pain. Thus, the 

ALJ gave specific and legitimate reasons for rejecting Dr. Ottney’s opinion regarding the 

standing and/or walking limitation. 

Plaintiff also contends the ALJ erred by giving significant weight to Dr. Kurtin’s 

opinion that Plaintiff can stand and/or walk about six hours in an eight-hour workday. 

The ALJ found that Dr. Kurtin’s opinion was well supported by the medical evidence, 

including Plaintiff’s medical history, clinical and objective signs and findings, and 

treatment notes. The ALJ also found Dr. Kurtin’s opinion was consistent with other 

substantial evidence of record. It was not legal error to give significant weight to a nonexamining physician’s opinion that was consistent with independent clinical findings and 

other evidence in the record where the physician provided supporting explanations for his 

opinion. The ALJ provided clear and convincing reasons for giving greater weight to Dr. 

Kurtin’s opinion than to Dr. Ottney’s opinion regarding the length of time that Plaintiff 

can stand and/or walk in an eight-hour day. 

B. The ALJ Did Not Err by Misinterpreting the Evidence. 

Plaintiff contends the ALJ must have misinterpreted the evidence regarding 

Plaintiff’s lower extremity numbness and pain because the ALJ found that Dr. Ottney’s 

opinion that Plaintiff is limited to standing and/or walking for four hours out of an eighthour workday was not supported by substantial evidence. Plaintiff identifies four items 

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in the record that he contends are substantial evidence in support of Dr. Ottney’s 

limitation on standing and/or walking. 

First, Plaintiff cites Dr. Salazar-Calderon’s June 28, 2011 treatment note as 

showing “an early indication of lower extremity numbness and pain,” even though he 

alleges he was disabled as of April 1, 2011. Dr. Salazar-Calderon conducted a complete 

sensory exam and found only decreased vibration sensation in Plaintiff’s toes and 

decreased pinprick sensation in stocking distribution (i.e., feet and ankles). Based on 

Plaintiff’s subjective complaints of painful feet and numbness, Dr. Salazar-Calderon 

stated his examination was “suggestive of diabetic sensory peripheral neuropathy” and 

therefore he planned to conduct nerve conduction velocity tests. However, Dr. SalazarCalderon stated that the numbness in Plaintiff’s left big toe was probably caused by 

wearing tight shoes. Dr. Salazar-Calderon observed that Plaintiff “favored” his right leg 

when walking, but did not report that Plaintiff was unable to walk or stand for any length 

of time. 

Second, Plaintiff cites the September 12, 2011 results of nerve conduction velocity 

testing, which were “suggestive of a mild left common peroneal demyelinating motor 

neuropathy and a mild left posterior tibial demyelinating motor neuropathy.” The test 

results indicate only mild neuropathy in the left lower extremity and are not evidence of 

any functional impairment. 

Third, Plaintiff cites Dr. Ottney’s report to show that he complained of knee pain 

on August 9, 2011. He misrepresents the results of Dr. Ottney’s examination as finding 

“several indications of lessened lower extremity capacity.” She expressly found lower 

extremity muscle strength 5/5 bilaterally, balance and coordination normal, and stance 

normal. Lower extremity examination revealed “mild right crepitus and pain with full 

flexion of the right knee.” Nothing suggests that Dr. Ottney found any indication of 

lessened lower extremity capacity. 

Fourth, Plaintiff cites to the medical record documenting that he had surgery on 

October 25, 2012, for medical and lateral meniscus tears on his right knee. It is not 

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substantial evidence in support of Dr. Ottney’s August 9, 2011 opinion limiting Plaintiff 

to walking and/or standing no more than four hours in an eight-hour workday. 

Thus, the ALJ did not err by misinterpreting evidence when he concluded that Dr. 

Ottney’s walk/stand limitation was not supported by substantial evidence of record. 

IT IS THEREFORE ORDERED that the final decision of the Commissioner of 

Social Security is affirmed. The Clerk shall enter judgment accordingly and shall 

terminate this case. 

Dated this 7th day of November, 2014. 

Neil V. Wake

United States District Judge

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