Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_05-cv-04383/USCOURTS-cand-3_05-cv-04383-0/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 (DIWC)

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United States District Court

For the Northern District of California

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United States District Court

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

ARTHUR FISHER,

Plaintiff,

 v

MICHAEL J ASTRUE,

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

 /

No C 05-4383 VRW

ORDER

Plaintiff Arthur Fisher brings this action under 42 USC §

405(g) seeking judicial review of the Social Security

Administration’s (SSA’s) final decision denying his applications for

both disability insurance benefits and supplemental security income

benefits under the Social Security Act (Act), 42 USC §§ 401-33. The

parties have filed cross-motions for summary judgment. Doc #13; Doc

#14. For the reasons stated herein, plaintiff’s motion is GRANTED

and defendant’s motion for summary judgment is DENIED. The case is

remanded for further proceedings. 

\\

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I

A

Plaintiff was born on August 5, 1958. At the time of his

administrative hearing, plaintiff was five feet four inches tall and

weighed approximately 125 pounds. Plaintiff’s highest level of

education completed was the eleventh grade. He has no specific

vocational skills. His occupational history includes work as a

laborer for a roofing company, a restaurant waiter, a security guard

and, most recently, a temporary worker folding t-shirts. 

Plaintiff suffers from a number of ailments. He suffers

degenerative arthritis affecting his back, hips and knees; his knees

have a tendency to dislocate causing him to fall. He has hepatitis

C that was not acute at the time of the proceedings under review on

this appeal. Mental impairments include depression and psychotic

symptoms of uncertain etiology. The medical records also note

cannabis abuse with a possibility of cannabis-induced psychosis. AR

13. Plaintiff’s orthopedic conditions limit his exertional

activities, including sitting and standing. Plaintiff contends that

the combination of his ailments renders him unable to maintain

employment. AR 28. Although plaintiff has had recurring

dislocation of the knees since childhood, he claims that the onset

date of his disability is September 3, 2003. AR 13. 

Plaintiff has seen a number of doctors for his ailments

and in connection with his applications for disability benefits. 

Medical records in the record from plaintiff’s treating physicians

date from January 2000 to May 2004. AR 136-52, 196-218. His primary

treating physician during these years was Dr Kenneth Matsumura of

the West Oakland Health Center. 

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On October 24, 2003, Dr Walker, an internal medicine

specialist at the James A Watson Wellness Center, examined plaintiff

and completed an “Employability/Medical Statement” to determine

eligibility for food stamps and assistance from the Alameda County

Social Services Agency. AR 219. Dr Walker noted that plaintiff

complained of arthritis in both knees and “chronic” dislocation of

the knees. Id. Dr Walker also reported that plaintiff felt as

though “the Devil” was holding him down while in his sleep. Id. Dr

Walker classified plaintiff as “unemployable” and checked off boxes

stating that plaintiff could not lift even five pounds, reach,

climb, kneel, do knee bends or stand. AR 220.

On January 11, 2004, in connection with his application

for social security benefits, plaintiff saw consulting orthopedist

Dr Ray Raven. AR 126-29, 130-35. Dr Raven noted that plaintiff

could stand and walk no more than two hours in an eight-hour day but

that there were no restrictions on the number of hours plaintiff

could be expected to sit in an eight-hour day and that plaintiff

could frequently and/or occasionally lift up to ten pounds. AR 129. 

Dr Raven’s report found no manipulative limitations in his upper

extremities and did not mention a pinched nerve. The report listed

plaintiff’s medications as amitriptyline, diclofenac, benadryl and

vicodin. AR 127. 

On January 12, 2004, plaintiff saw Dr April Young,

consulting psychologist, for his alleged mental impairments. She

conducted a full psychological evaluation of plaintiff that included

a memory test, an adult intelligence scale test and a visual motor

test. AR 132. Dr Young noted that plaintiff was alert and oriented

during the mental status exam and that he displayed adequate

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attention and concentration for conversation. AR 132. Dr Young

also noted that he denied past or current use of drugs. Id. To Dr

Young, plaintiff listed his medications as amitriptyline/

perphenazine and diclofenac and stated that he had been taking these

medications for fifteen years. AR 132. After noting that her

results should be “interpreted with caution given the claimant’s

variable effort during [the] exam,” Dr Young found that plaintiff’s

ability to relate to others, including potential co-workers and

supervisors, in an appropriate manner was moderately impaired, his

ability to “maintain the appropriate level of concentration, pace,

and persistence necessary to perform a one or two-step simple

repetitive task [was] unimpaired,” but his ability to perform a

detailed or complex task was impaired. AR 134. 

Dr Young noted that plaintiff told her he had “bad

nerves,” disliked loud noises and had episodes during which he felt

pinned down to his bed by “the Devil.” AR 132-33. Dr Young

diagnosed plaintiff with psychotic disorder NOS, anxiety disorder

NOS and noted the possibility of cognitive disorder NOS. AR 133. 

Dr Young also noted that plaintiff’s performance on measures of

intelligence ranged from “extremely low to average” and opined that

he was incapable of managing his supplementary funds in his best

interest at that time. AR 133-34. 

Among “behavioral observations,” Dr Young noted

plaintiff’s “gross motor functioning was remarkable for disrupted

gait. Upon rising from his seat, he braced himself in the doorway

and stated that he had been sitting too long.” AR 132.

From February 28, 2005 to March 4, 2005, plaintiff sought 

treatment for depression from the Alameda County Department of

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Behavioral Health Care Service’s Mental Health Division’s crisis

program. There, plaintiff admitted using marijuana twice per week. 

Plaintiff presented as “depressed, teary-eyed and unable to express

his thoughts.” AR 190. He also complained of interruptions during

sleep, hearing mumbling noises at night, seeing lights and feeling

restrained upon awakening. AR 192. Plaintiff was given Zoloft and

Trazodone, two commonly-prescribed antidepressants. AR 189. 

On April 8, 2005, plaintiff saw Dr Luisito Roxas, a

psychiatrist at the Sausal Creek Clinic, who completed a report

evaluating plaintiff’s ability to do work-related activities. AR

221. Dr Roxas noted that plaintiff “seem[ed] to be quite capable of

following instructions.” Id. Dr Roxas checked boxes indicating

that plaintiff was moderately impaired in five out of five workrelated mental activities. AR 222. He made note of plaintiff’s

reported general discomfort around groups of people and his tendency

to withdraw from such settings. He also wrote that plaintiff “has

reduced cannabis abuse which seems to have created greater energy +

improved mood” and “initial depression symptoms have lifted with

antidepressant meds and recomm of altering [marijuana] use.” Id. 

On April 11, 2005, Dr Matsumura, the treating physician at

the West Oakland Health Center whom plaintiff had seen regularly for

five years or more (see, e g, AR 212), completed a Residual

Functional Capacity (RFC) assessment in which he opined that

plaintiff could stand for less than two hours and sit for less than

six hours in an eight-hour workday, explaining that plaintiff “has a

severe form of degenerative arthritis involving multiple joints,

including knees, hips and back being most symptomatic.” AR 224. Dr

Matsumura also noted that plaintiff was “also developing symptoms

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suggestive of [a] nerve pinch of cervical region —— this results in

pain of shoulder.” Id. Dr Matsumura further reported that

plaintiff was limited in his ability to carry out pushing and

pulling activities and was “absolutely” limited in performing

manipulative functions, such as reaching for or handling objects. 

AR 225. His handwritten annotation explained that “[a]lthough these

activities may appear to be related only to the hands, actually

entire upper limbs become involved in such activities —— therefore

his symptomatology related to cervical disc impairment will likely

worsen.” Id. Dr Matsumura noted that seeing, hearing and speaking

functions were unaffected, but recommended evaluation for

scintillating scotoma, a precurser to migraine headaches, of recent

onset. Id. Of note, the RFC assessment form covered physical

issues only and did not ask Dr Matsumura’s opinion about

mental/physchological RFC issues. 

B

On November 12, 2003 plaintiff filed applications for

disability insurance benefits and supplemental security income

benefits giving a disability onset date of September 3, 2003. AR

50-52. The application was denied initially and on reconsideration. 

AR 24-27, 30-34. Plaintiff then requested a hearing and the case

was assigned to an Administrative Law Judge (ALJ). AR 37. 

During the hearing before the ALJ on April 13, 2005,

plaintiff testified that he had worked at the Claremont House as a

waiter sometime during 2002 and had previously worked as a security

guard and a roofer. AR 273. He also testified that he had problems

with his knees, back and shoulders. AR 275. Plaintiff testified

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that he suffered from “constant dislocation of his knees,” which

happened anywhere “from three or four times a week to twice a week.” 

AR 275-76. Plaintiff also added that when the dislocation happened,

he would fall and “It’s like extreme pain for like five, maybe ten

minutes, and then it goes down to an ache and then it swells” and

that his “knees hurt constantly.” AR 276. Plaintiff also

complained of lower back pain when sitting for a long period of

time. AR 279. When asked whether he took public transportation,

plaintiff said no, because it was “too hard to get up and down,”

“not safe” and he could not be around “the people, * * * kids on the

bus making noise, laughing, talking [].” AR 283. 

The ALJ asked plaintiff about his “mental problems.”

AR 280. Plaintiff testified that the episodes of feeling restrained

and unable to move or speak on awakening as well as hearing voices

in the form of a “mumbling noise” had been present since childhood. 

AR 279-80. Plaintiff admitted to using marijuana for medical

purposes and found it effective in reducing the pain in his knees;

specifically, he testified that he used marijuana once or twice a

month only about five times before going to see Dr Roxas. AR 288.

 The ALJ also heard testimony from Dennis Contreras, a

vocational expert (VE). The ALJ posed a hypothetical question to

the VE describing a worker with plaintiff’s age, education and

experience. The ALJ also specified a “combined sit, stand and walk

up to a full eight hour day” with various terrain and postural

restrictions. AR 292. When the ALJ asked what jobs such a worker

could perform, the VE listed four: information clerk, small product

assembler I, general clerk and hand packager. AR 293-95. Only one

of the jobs, information clerk, was listed as “sedentary” in the

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Dictionary of Occupational Titles (DOT). AR 293. Two of the jobs,

small product assembler I and general clerk, were listed as “light.” 

Id. The fourth, hand packager, was listed as “medium.” Id. The VE

testified, however, that a subset of sedentary jobs was available in

each of these categories. Id. For example, he testified that of

56,000 product assembler jobs in the national economy, there were

380 sedentary positions in the local economy. Id. 

Plaintiff’s attorney also examined the VE in an effort to

determine whether his opinion would vary if (1) mental health and/or

cognitive limitations missing from the ALJ’s hypothetical were

included and (2) in accordance with Dr Matsumura’s opinion,

plaintiff were limited to six, rather than eight, hours of sitting. 

The VE generally responded that if “moderate” mental impairment

meant plaintiff’s concentration, persistence and/or pace were

affected 10-20% of the time, employers would tolerate it, but not

more than 20%. AR 300-02. The VE also responded that a very low

range of intellectual functioning would make it difficult for

plaintiff to obtain or maintain employment as an information clerk

or a general clerk. AR 303. Regarding whether a limitation to six

hours per day of sitting would erode an applicant’s job base, the VE

responded that “there might be some erosion” but many of the

sedentary jobs were sitting or standing at will. AR 309. He

testified, however, that the need to use a cane when standing would

not be an issue if limited to five minutes per hour. AR 310-11. 

On June 28, 2005, the ALJ issued a decision, finding that

while plaintiff suffered from degenerative joint disease and

recurrent dislocation of the knees, he was not disabled as defined

by the Act because there were “jobs existing in significant numbers

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in the national economy that [the] claimant can perform.” AR 19-20. 

The ALJ relied on much, but not all, of Dr Raven’s opinion to

determine plaintiff’s RFC, finding him able to sit for eight hours

and stand/walk for less than two hours in an eight-hour day, but

able to climb, stoop, crouch and crawl “on only rare occasions” and

to lift/carry no more than ten pounds. 

The ALJ did not accord treating physician Dr Matsumura’s

assessment controlling weight. AR 16. The ALJ wrote that the

medical evidence did not document clinical findings to support Dr

Matsumura’s theory of a pinched nerve in the cervical spine and that

this problem was, in any event, of less than twelve months’

duration. Id. Also, the ALJ determined that plaintiff’s

symptomatic and conservative medical regimen was “inconsistent” with

Dr Matsumura’s opinion that plaintiff exhibited significantly

diminished functional ability. Id. 

The ALJ made note of the medical evaluation for the

Alameda County Social Services Agency which concluded that plaintiff

was “unemployable” (supra part I.A), but seemed to discount this

opinion because plaintiff’s “reported daily activities also exceed

the functional limitations assessed.” AR 16. The ALJ noted that

plaintiff “is able to perform some cooking, shopping, laundry, and

watering plants, * * * read the daily newspaper and play chess.” Id. 

With respect to mental impairments, the ALJ noted Dr

Young’s statement that the results of the psychological exam should

be “interpreted with caution given the claimant’s variable effort

during the evaluation.” Id at 17 and supra. Based on this

statement, the ALJ concluded that the results of the examination did

not reflect plaintiff’s actual mental condition. Id. The ALJ made

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note of Dr Young’s mention of plaintiff’s fifteen-year history of

taking amitriptyline/perphenazine and diclofenac but did not mention

these medications again in his decision. AR 14. 

Instead, the ALJ discussed the reports from the Alameda

County Behavioral Health Care Services, Mental Health Services and

determined that they supported a diagnosis of depression which he

found not to have existed for twelve continuous months. AR 17. The

ALJ concluded that plaintiff was “only mildly impaired with regard

to activities of daily living and in concentration, persistence or

pace” and that, socially, he was only “mildly-moderately limited.” 

Id. The ALJ seized on plaintiff’s admission of occasional medical

marijuana use as an explanation for his psychotic and depressive

symptoms:

The progress notes show good response and

improvement of the depression symptoms (concurrent

with a decline in cannabis use) to permit work

activity without significant limitation. 

* * *

At the hearing, claimant testified that he had

smoked marijuana although not on a continuous

basis. This evidence leads me to find that

claimant’s complaints of auditory and visual

hallucinations can be attributed to the drug

abuse. 

AR 17. 

Regarding plaintiff’s credibility, the ALJ acknowledged

“[t]here are certainly medical disorders to account for claimant’s

subjective complaints” but found that the “alleged intensity,

persistence and functionally limiting effects of his symptoms are

not entirely credible.” AR 18. The ALJ noted: plaintiff’s

complaints of lower back pain were not supported by the medical

findings and treatment; the mental symptoms responded to

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conservative treatment; plaintiff denied drug use to Dr Young, but

later admitted it at the Alameda County Behavioral Health Care

Services. Id. Based on these seemingly inconsistent statements,

the ALJ determined that plaintiff had not been “honest and

forthcoming.” Id. The ALJ observed that although the knee

condition had affected plaintiff for “many years,” plaintiff had 

still been able to work as a “waiter and roofer for extended

periods.” Id. The ALJ then concluded that the severity of the

symptoms alleged was “not entirely credible,” and found that

plaintiff retained at least some capacity for work. Id.

II

“The findings of the Commissioner of Social Security as to

any fact, if supported by substantial evidence, shall be

conclusive.” 42 USC § 405(g). Accordingly, a district court may

overturn a decision to deny benefits only if the decision is not

supported by substantial evidence or if the decision is based on

legal error. Andrews v Shalala, 53 F3d 1035, 1039 (9th Cir 1995)

(citing Magallanes v Bowen, 881 F2d 747, 750 (9th Cir 1989)). The

Ninth Circuit defines substantial evidence as more than a “mere

scintilla but less than a preponderance; it is such relevant

evidence as a reasonable mind might accept as adequate to support a

conclusion.” Id. 

“Disability” is defined as “the inability to do any

substantial gainful activity by reason of any medically determinable

physical or mental impairment * * * which has lasted or can be

expected to last for a continuous period of not less than 12

months.” 20 CFR § 404.1505(a). The ALJ conducts a five-step test

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to determine whether a claimant is disabled and eligible for

benefits. Step one asks whether the claimant is currently engaged

in substantial gainful activity. If the claimant is not working,

step two considers whether the claimant has a severe medically

determinable impairment that is expected to last more than twelve

months. If so, the next step asks whether the impairment meets or

equals a listed impairment in Part 404, Subpart P, Appendix 1. If

so, the claimant is deemed disabled. If not, step four considers 

whether the impairments prevent the claimant from doing his past

relevant work. If the claimant shows that he cannot perform his

past relevant work, the burden then shifts to the government to show

that there are other jobs in the economy that can be performed by

the claimant at step five. 20 CFR § 404.1520, § 416.920. 

III

The court notes at the outset that this is a close case. 

If plaintiff is not disabled, he is very nearly so. The medicalvocational guidelines (known as the “grids”) at 20 CFR Part 404

Subpart P Appendix 2 apply when an individual is able to perform the

full range of work at a particular level. Tackett v Apfel, 180 F3d

1094 (9th Cir 1999). The grids do not apply to plaintiff’s

situation because (1) he cannot perform the full range of sedentary

work and (2) plaintiff suffers from both exertional and nonexertional limitations, whereas the grids only apply where “a

claimant’s functional limitations fall into a standardized pattern

‘accurately and completely’ described by the grids.” Id at 1103. 

The introduction to the grid regulations is nonetheless instructive

here to the extent that it addresses the challenges individuals

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without relevant skills face in transitioning to sedentary work due

to physical limitations: 

Vocational adjustment to sedentary work may be

expected where the individual has special skills

or experience relevant to sedentary work or where

age and basic educational competences provide

sufficient occupational mobility to adapt to the

major segment of unskilled sedentary work. 

Inability to engage in substantial gainful

activity would be indicated where an individual

who is restricted to sedentary work because of a

severe medically determinable impairment lacks

special skills or experience relevant to sedentary

work, lacks educational qualifications relevant to

most sedentary work (e g has a limited education

or less) and the individual’s age, though not

necessarily advanced, is a factor which

significantly limits vocational adaptability. 

20 CFR Part 404, Subpart P, Appendix 2, § 201(c). Plaintiff’s

eleventh-grade education is “limited” under the social security

regulations, meaning “not enough to allow a person * * * to do most

of the more complex job duties needed in semi-skilled or skilled

jobs.” 20 CFR § 404.1564(c), 416.964(c). Under grid rule 201.17,

were plaintiff able to perform the full range of sedentary work but

illiterate or unable to communicate in English, he would have been

deemed disabled even as a “younger individual” of forty-six in view

of his limited education and lack of specific vocational skills. 20

CFR Part 404, Subpart P, App 2 § 201(g) and § 201.17. Although

plaintiff is able to speak English, this strength appears

counterweighed by the dual burdens of impaired ambulation and

significant, chronic mental health issues. These limitations are

more fully discussed in the following sections.

Turning to plaintiff’s specific contentions, plaintiff’s

appeal argues that the ALJ committed legal error by: (1) not

properly considering whether plaintiff’s impairment met or equaled

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the listings (Doc #13 at 3-4); (2) failing to set forth “legally

sufficient reasons for rejecting the opinions of Kenneth Matsumura,

MD, [plaintiff’s] treating physician” (Doc #13 at 7); (3) not

properly considering the “impact [plaintiff’s] mental impairment

would have on the occupational base” (Doc #13 at 7-8); (4)

improperly discrediting his subjective testimony; and (5) relying on

testimony by the VE that he asserts was flawed by its reliance on

jobs in the “medium” and “light” work categories. Doc #13 at 9-13. 

The court addresses each of these points in turn. 

A

1

Plaintiff first contends that the ALJ committed legal

error by not properly considering whether the knee impairment

equaled the criteria for disability due to “major dysfunction of a

joint” in 20 CFR Part 404 Subpart P, Appendix 1. “Major dysfunction

of a joint” requires: 

gross anatomical deformity (e g, subluxation,

contracture, bony or fibrous ankylosis,

instability) and chronic joint pain and

stiffness with signs of limitation of motion

or other abnormal motion of the affected

joint(s)

and 

findings on appropriate medically acceptable

imaging of joint space narrowing, bony

destruction, or ankylosis of the affected

joints(s) 

with

(A)Involvement of one major peripheral weightbearing joint (i e, hip, knee, or ankle),

resulting in inability to ambulate

effectively, as defined in 1.00B2b.

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20 CFR Pt 404, Subpt P, App 1 § 1.02(A). The Listing defines

ineffective ambulation as “an extreme limitation of the ability to

walk; i e, an impairment(s) that interferes very seriously with the

individual’s ability to independently initiate, sustain or complete

activities.” 20 CFR Pt 404, Subpt P, App 1 § 1.00(B)(2)(b)(1). 

Examples of ineffective ambulation “include, but are not limited

to”:

the inability to walk without use of a walker,

two crutches or two canes, the inability to

walk a block at a reasonable pace on rough or

uneven surfaces, the inability to use standard

public transportation, the inability to carry

out routine ambulatory activities, such as

shopping and banking, and the inability to

climb a few steps at a reasonable pace with

the use of a single hand rail.

20 CFR Pt 404, Subpt P, App 1 § 1.00(B)(2)(b)(2). “Effective

ambulation” requires that “individuals must be capable of sustaining

a reasonable walking pace over a sufficient distance to be able to

carry out activities of daily living.” Id. Independently walking

around one’s home without assistive devices “does not, in an of

itself, constitute effective ambulation.” Id.

The ALJ must find that a claimant is disabled if he

determines at step three that he has an impairment that meets or

equals one of the listings in 20 CFR Part 404 Subpart P, Appendix 1. 

20 CFR § 404.1520(a)(4)(iii). “To meet a listed impairment, a

claimant must establish that he or she meets each characteristic of

a listed impairment relevant to his or her claim.” Tackett v Apfel,

180 F3d 1094, 1099 (9th Cir 1999). “To equal a listed impairment, a

claimant must establish symptoms, signs and laboratory findings ‘at

least equal in severity and duration’ to the characteristics of a

relevant listed impairment * * *.” Id. The ALJ, in his decision,

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“must adequately explain his evaluation of the evidence and the

combined effects of the impairments.” Marcia v Sullivan, 900 F2d

172, 176 (9th Cir 1990).

Here, there is no dispute that plaintiff meets one of the

criteria mentioned in Listing § 1.02(A): knees that sublux, or

dislocate, spontaneously. AR 128. It is also undisputed that

plaintiff has not shown any findings on appropriate medically

acceptable imaging of joint space narrowing, bony destruction or

ankylosis of the affected joint(s). The effectiveness of

plaintiff’s ambulation, an important issue not specifically

addressed in the ALJ’s decision, is discussed below. Plaintiff’s

symptoms fail to meet Listing § 1.02, but plaintiff contends on

appeal that the ALJ erred in not considering whether his impairments

equaled the listing. 

Plaintiff argues that the ALJ’s decision did not

adequately explain the ALJ’s evaluation of the evidence as required

under Marcia v Sullivan. The court agrees. The ALJ determined that

“[t]he clinical and laboratory findings * * * [did] not meet or

equal any listed impairment of Appendix 1 to Subpart P of Regulation

No 4.” AR 253. The ALJ’s decision, however, failed to discuss

“equivalence” in determining that plaintiff was not disabled under

the listing. The ALJ also failed to explain his evaluation of the

evidence as required by Marcia v Sullivan on the issue of whether

plaintiff could ambulate effectively.

The record is less than clear as to whether plaintiff’s

ambulation is effective or ineffective within the meaning of 20 CFR

Part 404, Subpart P, Appendix 1 § 1.00(B)(2)(b). The record

suggests that an ever-present risk of spontaneous dislocation of the

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knees attends plaintiff’s walking. According to plaintiff’s

testimony: dislocation occurs spontaneously while he is walking (AR

276); he has difficulty going up and down stairs because of an

increased risk of dislocation (AR 284-85); and he does not take

public transportation because it is “too hard to get up and down.” 

AR 283. This latter limitation —— the inability to use public

transportation —— is specifically listed among examples of

ineffective ambulation in the regulation. 

While plaintiff acknowledged his ability to carry out some

activities around the house and the ALJ seized on these facts in

discounting the medical opinion that plaintiff was “unemployable”

(AR 16), the regulations state that the ability to walk around the

home unassisted does not alone constitute effective ambulation. 20

CFR Pt 404, Subpt P, App 1 § 1.00(B)(2)(b)(2). Moreover, the Ninth

Circuit has held that “the mere fact that a plaintiff has carried on

certain daily activities * * * does not in any way detract from her

credibility as to her overall disability. One does not need to be

‘utterly incapacitated’ in order to be disabled.” Benecke v

Barnhart, 379 F3d 587, 594 (9th Cir 2004). 

This court’s review of the record indicates that the ALJ

ignored important evidence suggesting that plaintiff’s difficulties

with ambulation were sufficient to equal Listing 1.02 and that

remand for more careful review of this issue is required. 

2

Plaintiff argues that the ALJ erred in failing adequately

to assess the impact of his mental impairments. Doc #13 at 8. 

To evaluate a claim of disability based on mental

impairment, the ALJ is required to employ a “special technique” at

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the administrative hearing level to assist in (1) identifying the

need for additional evidence, (2) considering and evaluating the

functional consequences of the mental disorder on the claimant’s

ability to work and (3) organizing and presenting the facts. See 20

CFR § 404.1520a(a), 416.920a(a). Applying the special technique,

the ALJ must first evaluate all pertinent symptoms, signs and

laboratory findings to determine whether the claimant has a mental

impairment. If the ALJ determines that the claimant has a

“medically determinable mental impairment,” the ALJ must specify how

the claimant’s functioning is affected by such factors as chronic

mental disorders, structured settings, medication and other

treatment. The ALJ must rate the degree of functional limitation in

four areas: activities of daily living; social functioning;

concentration, persistence or pace; and episodes of decompensation. 

20 CFR § 404.1520a(c)(3). “The last point on each scale represents

a degree of limitation that is incompatible with the ability to do

any gainful activity.” 20 CFR § 404.1520a(c)(4). The ALJ then

determines the severity of the claimant’s mental impairment(s). 20

CFR § 404.1520a(d). 

The regulation specifically requires the ALJ to document

use of the special technique in the decision:

The decision must show the significant history,

including examination and laboratory findings,

and the functional limitations that were

considered in reaching a conclusion about the

severity of the mental impairment(s). The

decision must include a specific finding as to

the degree of limitation in each of the

functional areas described in paragraph (c) of

this section.

20 CFR § 404.1520a(e). A record containing evidence of mental

impairment allegedly preventing claimant from working requires

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adherence to the procedures set forth in the regulations for

evaluating the potential mental impairment and requires

documentation of those procedures. Gutierrez v Apfel, 199 F3d 1048,

1051 (9th Cir 2000), quoting Hill v Sullivan, 924 F2d 972, 975 (10th

Cir 1991). An ALJ’s failure to complete required documentation when

a colorable claim of mental impairment exists provides sufficient

cause for remand. Gutierrez, 199 F3d at 1051. Only when “no viable

claim of mental impairment” exists does a failure to complete

required documentation not require reversal. Id. 

Here, Dr Young diagnosed plaintiff with psychotic disorder

NOS, anxiety disorder NOS and wanted to rule out cognitive disorder

NOS. AR 133. Dr Young noted that plaintiff complained about “bad

nerves,” hearing from the Devil and having episodes where he felt

pinned down to his bed. AR 133. In a subsequent examination at the

Alameda County Department of Behavioral Heath Care Service,

plaintiff complained of interruptions during sleep, hearing mumbling

noises at night and seeing lights. AR 187-88. 

The record contains several references to plaintiff having

a fifteen-year history of taking amitriptyline and perphenazine,

which plaintiff stated was prescribed by Dr Matsumura. See, e g, AR

95, AR 105. There are no legible treatment notes confirming that

plaintiff received these prescriptions, but the ALJ did not indicate

disbelief or skepticism about plaintiff’s use of these medications. 

Amitriptyline is a tricyclic anti-depressant. MedlinePlus Drug

Information webpage, National Institutes of Health,

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682388.html,

consulted 10/1/07. Perphenazine is an anti-psychotic medication

used to treat “schizophrenia and symptoms such as hallucinations,

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delusions, and hostility.” Id at a682388.html, consulted 9/23/07. 

Plaintiff was also prescribed antidepressants during an episode of

severe depression in February 2005. AR 189. This evidence gives

rise to a colorable claim of mental impairment. Accordingly, the

ALJ was required to follow the procedures set forth in

20 CFR § 404.1520a/416.920a.

The ALJ’s compliance with the “special technique” rules

was perfunctory and, in the court’s view, insufficient. Although

plaintiff admitted to at most sporadic and recent cannabis use, the

ALJ found that plaintiff’s psychotic symptoms were attributable to

“the drug abuse.” AR 17. This finding is not supported by

substantial evidence, but rests rather on a comment in a report by a

consulting psychiatrist who saw plaintiff only once. See AR 222. 

Given this doctor’s lack of a treating relationship with plaintiff,

his report that plaintiff “has reduced cannabis abuse which seems to

have created greater energy and improved mood” appears likely to

have been based on a comment by plaintiff himself expressing such an

opinion –– hardly an appropriate foundation for a determination that

plaintiff’s mental health problems are not disabling and of short

duration. Although the ALJ mentioned plaintiff’s other psychotropic

drugs in his factual narrative (AR 14), he did not mention them in

his analysis. The decision only discussed cannabis-induced

psychosis, but did not consider the evidence of psychosis from other

causes. To the extent that the ALJ addressed the impact of mental

impairments on RFC, he did so in a cursory manner (e g, “I do not

find that depression further erodes claimant’s occupational base” AR

17), and, of note, he included no mental-health-related limitations

in his hypothetical to the VE.

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In a case in which a claimant has at least one severe

impairment, the SSA is required to consider the limiting effects of

all the claimant’s impairments, even those that are not severe, in

determining RFC. It does not appear that the ALJ did so here. 20

CFR § 404.1545(e), § 416.945(e).

The SSA’s errors in handling the evidence pertaining to

plaintiff’s alleged mental impairments requires remand to the agency

for re-evaluation in compliance with 20 CFR § 404.1520a/416.920a and

20 CFR § 404.1545(e)/416.945(e). 

B

Next, plaintiff argues that the ALJ erred in discounting

the testimony of treating physician Dr Matsumura in determining

plaintiff’s RFC and that he failed to set forth legally sufficient

reasons for rejecting Dr Matsumura’s opinion.

More weight is given to opinions from treating sources

since these sources “are likely to be the medical professionals most

able to provide a detailed longitudinal picture of [claimant’s]

medical impairments.” 20 CFR § 404.1527(d)(2), 416.927(d)(2). The

longer a treating physician has treated a claimant and the more

times he has seen him/her, the more weight the SSA “will give” to

that physician’s opinion. 20 CFR § 404.1527(d)(2)(ii), § 

416.927(d)(2)(ii). When the treating physician’s opinion is

contradicted by another medical opinion, the ALJ must provide

“‘specific and legitimate reasons’ supported by substantial

evidence” when rejecting the opinion of a treating physician. 

Lester v Chater, 81 F3d 821, 830 (9th Cir 1995), quoting Murray v

Heckler, 722 F2d 499, 502 (9th Cir 1983). 

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Here, the ALJ relied more heavily on the opinion of Dr

Raven, a consulting examining physician, over the opinion of Dr

Matsumura in the RFC determination. Dr Raven opined that plaintiff

could stand and/or walk for less than two hours in an eight-hour day

and could sit without restrictions. AR 129. Dr Matsumura reported,

however, that plaintiff could sit for less than about six hours in

an eight-hour day, must periodically alternate sitting and standing

to relieve pain or discomfort and noted the possibility of a pinched

nerve in the cervical region of the spine contributing to functional

loss, on the strength of which he noted significant postural and

manipulative limitations. AR 224. 

The ALJ found the “symptomatic and conservative medical

care” prescribed by Dr Matsumura inconsistent with the opinion that

plaintiff suffered from significantly diminished functional ability

and discounted the pinched-nerve theory due to lack of objective

clinical findings. AR 16. 

The reasons provided by the ALJ in discounting Dr

Matsumura’s opinion are not sufficiently specific and legitimate. 

The ALJ discounted Dr Matsumura’s opinion because no other doctor

mentioned the possibility of a pinched nerve, but he failed to take

into account that Dr Matsumura’s report was dated more than one full

year after Dr Raven’s, such that plaintiff’s condition may have

deteriorated in the time between the two examinations. Given the

diagnosis of degenerative joint disease, plaintiff’s RFC might well

have deteriorated in the thirteen months after Dr Raven’s

examination. The most up-to-date examination results in the record

are those by Dr Matsumura.

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The ALJ also rejected Dr Matsumura’s opinion partly

because of the perceived inconsistency between the diagnosis of

“significantly diminished functional ability” and the provision of

only “symptomatic and conservative medical care.” Defendant

contends that Johnson v Shalala, 60 F3d 1428, 1433 (9th Cir 1995),

allows an ALJ to discredit a treating physician’s opinion if it is

contradicted by a prescription of conservative care. Doc #14 at 5. 

However, Johnson does not apply here. In Johnson, the treating

physician first reported that the claimant was temporarily disabled

and needed only a program of conservative care. 60 F3d at 1433. 

Some years later the physician concluded that the claimant had been

totally disabled all along. Id. The court held that the

contradictions in the report allowed the ALJ to disregard the

physician’s opinions. Id. 

Here, the contradiction can be explained in a manner not

considered by the ALJ. Plaintiff received a certain level of care

for his documented degenerative joint disease. At the April 11,

2005, examination Dr Matsumura noted reduced functional ability, the

possibility of a pinched nerve and a “cervical disc impairment.” AR

225. He also noted that “scintillating scotoma,” a precursor to

migraine headaches, had recently developed. Id. Dr Matsumura’s

report suggests a dynamic, worsening situation not inconsistent with

past conservative care. 

Substantial evidence does not support the ALJ’s decision

to discount Dr Matsumura’s opinion. The reasons given by the ALJ

are insufficient to overcome the presumption of controlling weight

given to the treating physician. 

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When the ALJ improperly rejects the opinion of a treating

physician, the opinion is credited as a matter of law. Lester, 81

F3d at 834, citing Hammock v Bowen, 879 F2d 498, 502 (9th Cir 1989). 

The ALJ noted correctly, however, that the upper-spine pain and the

functional limitations recommended because of it were of less than

twelve months’ duration. Therefore, this part of the opinion was

excluded from the disability determination. Cf 20 CFR § 404.1512

(“Unless your impairment is expected to result in death, it must

have lasted or must be expected to last for a continuous period of

at least 12 months.”) Dr Matsumura’s opinions regarding plaintiff’s

exertional limitations (AR 223-24) must, however, be credited for

purposes of plaintiff’s disability determination. 

C

Plaintiff maintains that the ALJ erred by not proposing a

complete and accurate hypothetical to the vocational expert. 

Doc #13 at 9. Plaintiff argues that the VE’s testimony has no

evidentiary value because the hypotheticals did not include any

mental limitations.

Hypothetical questions posed to the vocational expert must

include all of the claimant’s limitations and restrictions. Embrey

v Bowen, 849 F2d 418, 422 (9th Cir 1988). Here, plaintiff’s mental

impairments were addressed by the VE during the administrative

hearing, albeit only under questioning from plaintiff’s attorney. 

The hypothetical questions posed by the ALJ only included physical

limitations. Plaintiff’s attorney, however, asked the VE such

questions as whether an individual moderately impaired in the

ability to maintain concentration, persistence or pace or with

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modest cognitive abilities in the “borderline” range would be able

to maintain employment in the four job categories and obtained

answers to these questions on the record. The VE’s opinion

therefore has evidentiary value. 

D

Plaintiff contends that the ALJ erred by not properly

considering his subjective symptoms of pain and rejecting his

testimony on the grounds that he was not credible. Doc #13 at 9. 

Plaintiff also contends that the ALJ failed to support his

credibility findings with legally sufficient reasons for the

disbelief. Doc #13 at 10. 

The ALJ is required to make a full and detailed finding as

to the claimant’s credibility whenever it is a critical factor in

the decision. Albalos v Sullivan, 907 F2d 871, 873-74 (9th Cir

1990). An ALJ’s rejection of a claimant’s testimony on subjective

complaints is valid if the findings are “sufficiently specific to

allow a reviewing court to conclude” that the ALJ’s decision was

made on permissible grounds. Bunnell v Sullivan, 947 F2d 341, 346

(9th Cir 1991) (en banc). 

Here, the ALJ’s disbelief of plaintiff’s subjective

complaints was based on seemingly inconsistent statements about the

extent of his marijuana use and on the fact that plaintiff’s last

job ended when the work was completed, not because he became unable

to work. AR 18. The ALJ pointed to the latter fact as an

indication that plaintiff “retains some capacity for work.” Id. 

Given that the court has determined that a remand is

necessary for other issues, it declines to review the ALJ’s

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determination regarding plaintiff’s credibility. Plaintiff’s

credibility should be considered anew as appropriate for the redetermination of issues on remand. 

E

Finally, plaintiff argues that the ALJ erred in

considering the VE’s testimony on the grounds that the VE deviated

from the job descriptions in the DOT. Plaintiff contends that

because the VE provided jobs classified as “light” or “medium” 

instead of “sedentary,” the ALJ erred by not providing reasons for

accepting the VE’s deviations. This contention lacks merit. 

In determining whether suitable jobs exist that plaintiff,

with all his impairments, can perform, the ALJ may refer to the

classifications in the DOT and to testimony from an expert witness.

Light v Social Security Administration, 119 F3d 789, 793 (9th Cir

1997). When expert witness testimony contradicts the DOT, the ALJ

may rely on the expert’s testimony if there is persuasive evidence

in the record to support the testimony. Johnson v Shalala, 60 F3d

1428, 1435 (9th Cir 1995). In Moncada v Chater, the Ninth Circuit

held “the fact that some jobs listed by the vocational expert as

sedentary are also listed as ‘light’ work in the DOT is irrelevant,”

and that vocational experts can testify whether a claimant could

perform a subset of jobs at a lower level than the job’s

classification in the DOT. 60 F3d 521, 524 (9th Cir 1995), citing

Distasio v Shalala, 47 F3d 348, 350 (9th Cir 1995). 

The VE’s testimony properly focused on the subset of jobs

in each of the categories he proposed for plaintiff that could be

performed at the sedentary level. 

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IV

“Remand for further administrative proceedings is

appropriate if enhancement of the record would be useful.” Benecke,

379 F3d at 593. 

For the reasons stated above, plaintiff’s motion for

summary judgment is GRANTED, the defendant’s motion for summary 

judgment is DENIED and the case is remanded for re-evaluation

beginning at step three consistent with this opinion.

IT IS SO ORDERED.

 

VAUGHN R WALKER

United States District Chief Judge

 

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