Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_09-cv-00702/USCOURTS-caed-1_09-cv-00702-2/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Maria Ortiz-Arreola
Plaintiff

Document Text:

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

MARIA ORTIZ-ARREOLA, Case No. 1:09-cv-00702-JLT

Plaintiff, ORDER REGARDING PLAINTIFF’S 

SOCIAL SECURITY COMPLAINT

vs.

ORDER DIRECTING REMAND PURSUANT

TO SENTENCE FOUR OF 42 U.S.C. § 4-5(g)

MICHAEL J. ASTRUE,

Commissioner of Social Security ORDER DIRECTING ENTRY OF

JUDGMENT IN FAVOR OF PLAINTIFF AND

AGAINST DEFENDANT MICHAEL J.

ASTRUE

Defendant. 

 /

BACKGROUND

Plaintiff Maria Ortiz-Arreola (“Plaintiff”) seeks judicial review of an administrative decision

denying her claim for Supplemental Security Income (“SSI”) benefits under Title XVI of the Social

Security Act (the “Act”). 

FACTS AND PRIOR PROCEEDINGS1

On August 1, 2006, Plaintiff filed an application for SSI benefits under Title XVI of the Act

alleging that disability had prevented her from working since January 1, 2005. See AR at 111. 

After the agency denied benefits, Plaintiff requested a hearing before an Administrative Law Judge

References to the Administrative Record will be designated as “AR,” followed by the appropriate page

1

number.

1

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 1 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

(“ALJ”). Id. at 90. The ALJ held a hearing on May 29, 2008. Id. at 19-60. On July 23, 2008, the

ALJ issued a decision denying benefits. Id. at 7-18. Specifically, the ALJ found that Plaintiff was

not disabled within the meaning of the Act. Id. at 18. On March 27, 2009, the Appeals Council

affirmed and it became the decision of the Commissioner. Id. at 1-3. 

Hearing Testimony

Plaintiff testified that she lived alone with her two sons, ages 10 and 16. AR at 23. She

indicated that she had a 10 grade education, but stated that she was in special education classes th

exclusively from the third grade. Id. at 24-25. She asserted that she couldn’t write in English, but

clarified that “probably,” with difficulty, she could write a note to her boys if she was going to be

away from the house. Id. at 25-26. She stated that she was “embarrassed” because she couldn’t

write. Id. at 46. As an example, she recounted that while working as a hotel housekeeper, she was

unable to write a note to a patron if she needed to leave a message. Id. 

Plaintiff testified that she could read in English but was not sure if she could read a

newspaper. AR at 26. She stated that she could not write or read in Spanish. Id. at 26. She

indicated she had no vocational training. Id.

Plaintiff testified that she had not worked since 1995. AR at 26. She stated that she last

worked cleaning private homes. Id. Before that, she reported that she cleaned hotel rooms. Id. For

a brief period in 2003, Plaintiff stated that she was paid to provide in-home care for her two children,

who she described as suffering from mental problems. Id. at 27, 47. She indicated that the need to

care for her children prompted her to quit working between 1995 and 2003. Id. at 47.

Plaintiff testified that her life changed completely in January 2005, after she developed breast

cancer and had a mastectomy. AR at 28. Following surgery, Plaintiff stated that she went through

months of radiation and chemotherapy treatments. Id. at 29-30. She believed that even after these

treatments ended, the chemotherapy, in particular, “messed up a lot of things inside me.” Id. at 31. 

Plaintiff believed that her cancer continued to cause her to bleed from time to time, mostly when she

went to the bathroom. AR at 32. She stated that she was scheduled to have a colonoscopy “pretty

soon.” Id. 

Plaintiff testified that she had difficulty with her right hand and arm. AR at 32. She stated

2

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 2 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

that this problem was diagnosed by doctors as lymphedema. Id. She indicated that she used a

“sleeve” for her arm to help with this problem. Id. at 33. She believed that the sleeve helped with

the pain, but stated that if she wore it for too long it caused pain as well. Id. at 34. 

Plaintiff described pain in her right hand, arm and shoulder. AR at 34. She stated that this

pain hindered her ability to hold things. Id. at 37. She did not believe that she could use her right

arm for more than five minutes at a time. Id. at 35. After that, she estimated that she would have to

rest her arm for about one hour before using it again. Id. Also, she stated that she could not reach

overhead with her right arm or get things out of a cupboard because of the pain. Id. She believed

that she could reach out at shoulder level if she was “careful.” Id. at 36. She believed that she was

incapable of repetitive use of her right arm at or above shoulder level and stated that a treating doctor

told her not to use her arm in this way. Id.

Plaintiff described swelling in her right hand and wrist on a daily basis. AR at 36. She stated

that she elevated her arm to alleviate her pain. Id. at 36-37. She described doing this each day for

about 30 minutes. Id. at 37. In addition, she stated that she performed exercises prescribed by the

doctor and believed that this helped with the swelling but not the pain. Id. She testified that this

problem prevented her from holding and grasping with her right hand. Id. 

Plaintiff stated that her problems with her right hand and arm made vacuuming difficult. AR

at 38. She believed that she could lift a gallon of milk for about five minutes at one time but stated

that this would cause a lot of pain. Id. at 39. After doing this, she estimated that she would need to

rest her hand and arm for about 30 minutes. Id. at 40. 

Plaintiff testified that she had difficulty concentrating. AR at 46. She believed that she could

concentrate for no more than 30 minutes at one time. Id. After that, she believed she would need to

rest for about one hour. Id.

Plaintiff testified that she took the drug Tamoxifen because of her cancer. AR at 31. She

stated that she took the Tamoxifen twice daily. Id. at 40. She believed that the Tamoxifen made her

sleepy. Id. She described this sleepiness as lasting about one hour and stated that she would need to

lie down. Id. at 41. In addition, she stated that she took aspirin for a congenital heart condition (a

small hole in her heart). 

3

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 3 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

In all, Plaintiff estimated that she needed to lie down three- to-four times a day for at least 30

minutes. AR at 41. She believed that the medication she took hindered her ability to do her prior

cleaning-type work. Id. at 47. In addition, she believed that the pain she experienced from her

impairments hindered her ability to do that type of work. Id. at 47. 

Plaintiff testified that she had difficulty walking. AR at 42. She stated that one leg was

shorter than the other and this caused her to walk with a limp. Id. She believed that she could walk

about 30 minutes at one time. Id. She believed that she could stand about 30 minutes at one time. 

Id. She described needing to shift her legs if she tried to stand and do the dishes because of pain. Id. 

She estimated that she could sit for about one hour at one time. Id.

Plaintiff testified that she could not do any physical activity for longer than 30 to 40 minutes

without needing to lie down and rest. AR at 43. She stated that she did not do much house work but

cooked for her children as often as two-to-three times a day. Id. at 44. She stated that cleaning the

house was very difficult and made her hand hurt. Id. at 45. She reiterated that vacuuming was

particularly difficult. Id. She reported that she talked to her doctors about her pain but they told her

that she would have to learn to deal with it. Id. She wished that someone could help her with the

housework. Id. at 44.

A vocational expert (“VE”), Judith Najarian, testified. She described Plaintiff’s past work as

a motel housekeeper as light and unskilled work. AR at 48. She characterized her work as a house

cleaner (day cleaner) as medium and unskilled, but modified this to “light” work because of

Plaintiff’s description of her actual work. Id. She described Plaintiff’s work as a home attendant as

unskilled and medium. Id.

The ALJ posed a hypothetical to the VE in which he described a person of Plaintiff’s age,

educational background and work history, who was limited to light exertional activity, with no

pushing/pulling or reaching with the right dominant upper extremity above the shoulder but had no

restriction with the left extremity. AR at 49. Also, hypothetical limited the person to work involving

simple, repetitive tasks with no writing. Id. The VE opined that this person could not perform

Plaintiff’s past work, but could perform other light, unskilled work involving no arm activity above

the shoulder. AR at 49. As examples, she cited the jobs of poultry cutter, fruit cutter and ticket

4

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 4 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

taker. Id.

The ALJ posed a second hypothetical, the same as the first, but with additional limitations

prohibiting frequent handling, fingering and feeling with the right hand. AR at 50. Again, the VE

stated that this person could not perform Plaintiff’s past work but could perform other work. Id. 

While she did not believe that such a person could perform the jobs of poultry cutter and fruit cutter,

she believed that the person could perform the job of ticket taker. Id. In addition, she believed that

the person could perform the jobs of store greeter and swatch clerk. Id. at 51.

In a third hypothetical, the ALJ added limitations based on chronic fatigue and pain that

would limit the person to working in increments of no more than two hours. AR at 51. The VE

stated that such a person could not do any full-time work. Id.

Relevant Medical Evidence

Notes from Dr. Bruce McAllister at the California Cancer Center document that Plaintiff

underwent a mastectomy on January 3, 2005. AR at 195. Following this surgery, Plaintiff

underwent several months of radiation and chemotherapy treatments. Id. By early 2006, x-rays and

a mamogram indicated that Plaintiff was cancer-free. Id. at 186.

Dr. Izhar Hasan examined Plaintiff on October 8, 2006. Plaintiff’s main complaints involved

general fatigue, increasing weakness and mild shortness of breath. AR at 215. Dr. Hasan found

Plaintiff to be awake, alert and oriented in all spheres. AR at 216. He detected no hypertrophy in her

neck muscles and described her range of motion as normal. Id. at 217. He found no abnormalities in

her back, but noted “mild lymphedema” in her right upper extremity. Id. at 218. He characterized

her motor strength, reflexes and gait as normal. Id.

Dr. Hasan diagnosed Plaintiff with fatigue, likely a medication-related side effect, and also

noted her breast cancer history and history of a congenital heart defect. AR at 219. He believed that

she could lift and carry 20 pounds occasionally and 10 pounds frequently, stand/walk for six hours in

an 8-hour day and sit without restriction. Id.

On October 20, 2006, Dr. Richard Engeln, a clinical psychologist, examined Plaintiff. He

described Plaintiff as alert and oriented, with no evidence of delusions, hallucinations or confusion. 

AR at 221. He found Plaintiff to be well-kempt and groomed. Id. 

5

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 5 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Dr. Engeln characterized Plaintiff’s verbal expression as appropriate but noted that she was

anxious about the examination. AR at 222. Dr. Engeln administered several tests, including the

Wechsler Adult Intelligence Scale III, the Wechsler Memory Scale III, the Bender-Gestalt Test II,

and the Wide Range Achievement Test R. Id. He determined that Plaintiff had a verbal IQ of 69, a

performance IQ of 68 and a full scale IQ of 66. Id. He characterized these findings as indicative of a

mild range of mental retardation. Id.

Dr. Engeln interpreted the various memory measurements taken of Plaintiff as indicating

borderline to low average functioning. AR at 222. He characterized her academic skills as reading

at fourth-grade level, spelling at second-grade level and arithmetic at fifth-grade level. Id. 

Dr. Engeln found no evidence of mental or emotional illness. AR at 222. He noted that her

interview presentation suggested mid-borderline intelligence skills, with her verbal and visual

intelligence in the mild mental retardation range. Id. However, he believed that her abilities might

be understated and thought that she might have “educational issues” because her memory scores

were significantly higher than her intelligence measurements. Id.

Dr. Engeln concluded that Plaintiff was verbally, cognitively and socially capable of job

adjustment and managing her funds. AR at 223. He believed that she could perform one- to-two

step simple job instructions but not complex or technical ones. Id. He opined that she was mentally

capable of work that was consonant to her previous work. Id. Primarily, he believed any restrictions

to job adjustment were physical in nature. Id.

Dr. A.H. Middleton, a non-examining agency consultant, completed a “Psychiatric Review

Technique” on November 15, 2006. He described Plaintiff’s primary mental problems as affective

disorder and mental retardation. AR at 252. While noting significant subaverage general intellectual

functioning and “mild academic delay,” he found only mild restrictions in activities of daily living

and in maintaining concentration, persistence and pace. Id. at 255, 260.

Dr. R. Amaro, another non-examining agency consultant, completed a mental Residual

Functional Capacity (“RFC”) assessment that same day. He noted moderate limitations in Plaintiff’s

ability to understand, remember and carry out detailed instructions. AR at 263. In all other cognitive

areas, Dr. Amaro found no significant limitations. Id. at 263-64. He believed that Plaintiff was

6

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 6 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

capable of following simple directions, but would have difficulty with detailed directions. Id. at 265.

Dr. R.D. Fast, a third non-examining agency consultant, provided a case analysis on March

29, 2007. He noted Plaintiff’s IQ scores in the 60s, and believed that initial agency reviewers

overlooked Listing 12.05C, which relates to presumed disability based upon mental retardation. AR

at 266. However, he noted Dr. Engeln’s belief that Plaintiff’s memory scores indicated a

significantly higher level of functioning than the IQ scores. Id. Also, he highlighted “questions”

about Plaintiff’s credibility, noting her allegations of fatigue and complaints of side effects from her

medications despite the fact that she was no longer receiving chemotherapy treatments. Id. 

Dr. Fast concluded that if the mental retardation findings were not accurate, Plaintiff could

perform work involving simple, repetitive tasks. AR at 266. However, he believed that if the mental

retardation findings were accurate, that diagnosis satisfied the listings for presumed disability, in

particular, Listing 12.05C. Id.

ALJ Findings

The ALJ evaluated Plaintiff pursuant to the customary five-step sequential evaluation. First,

the ALJ determined that Plaintiff had not engaged in substantial gainful activity since July 14, 2006. 

AR at 12. Second, he found that Plaintiff had the following severe impairments: right upper

extremity lymphedema, history of right breast cancer and status post mastectomy, and borderline

intellectual functioning. Id. Third, the ALJ determined that no impairment, or combination of

impairments, met or exceeded the level required under agency guidelines for presumed disability. Id.

at 13.

Fourth, the ALJ determined that Plaintiff had the RFC to lift and carry 20 pounds

occasionally and 10 pounds frequently; sit, stand, and walk for six hours out of an eight-hour day;

but was limited to frequent handling, fingering, and feeling with the right dominant hand with no

work with the right dominant upper extremity above the shoulder level; and to performing simple

repetitive tasks with no writing duties. AR at 10. Based on his RFC finding and the VE’s testimony,

the ALJ determined that Plaintiff could not perform any of her past relevant work. See id. at 16-17. 

However, at Step Five, the ALJ determined, again based on his RFC assessment and the VE’s

testimony, that Plaintiff retained the ability to perform other work in the national economy,

7

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 7 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

specifically citing the jobs of ticket taker, greeter, and swatch clerk. Id. at 17. As a result, the ALJ

determined that Plaintiff was not disabled as defined by the Act. Id. at 18.

SCOPE OF REVIEW

Congress has provided a limited scope of judicial review of the Commissioner’s decision to

deny benefits under the Act. When reviewing the findings of fact, the Court must determine whether

the Commissioner’s decision is supported by substantial evidence. 42 U.S.C. 405 (g). 

Substantial evidence means “more than a mere scintilla,” Richardson v. Perales, 402 U.S.

389, 402 (1971), but less than a preponderance. Sorenson v. Weinberger, 514 F.2d 1112, 1119, n. 10

(9th Cir. 1975). It is “such relevant evidence as a reasonable mind might accept as adequate to

support a conclusion.” Richardson, 402 U.S. at 401. The record as a whole must be considered,

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

conclusion. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The Court must uphold the

determination that the claimant is not disabled if the Commissioner applied the proper legal

standards and if the findings are supported by substantial evidence. See Sanchez v. Sec’y of Health

and Human Serv., 812 F.2d 509, 510 (9th Cir. 1987). 

REVIEW

In order to qualify for benefits, a claimant must establish that he is unable to engage in

substantial gainful activity due to a 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. 42 U.S.C. §

1382c (a)(3)(A). A claimant must show that he has a physical or mental impairment of such severity

that he is not only unable to do her previous work, but cannot, considering his age, education and

work experience, engage in any other kind of substantial gainful work which exists in the national

economy. Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). The burden is on the

claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990).

In an effort to achieve uniformity of decisions, the Commissioner has promulgated

regulations which include the five-step sequential disability evaluation process described above. 20

8

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 8 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

C.F.R. §§ 404.1520 (a)-(f), 416.920 (a)-(f) (1994). As noted, applying this process in this case, the 2

ALJ found that Plaintiff: (1) had not engaged in substantial gainful activity since July 14, 2006; (2)

had medically determinable severe impairments (right upper extremity lymphedema, history of right

breast cancer and status post-mastectomy, and borderline intellectual functioning); (3) did not have

an impairment or combination of impairments which met or equaled one of the listed impairments

set forth in Appendix 1, Subpart P, Regulations No. 4; (4) was not able to perform her past relevant

work; but (5) retained the ability to perform other work in significant number at the state and

national level. AR at 12-17. The ALJ then determined that Plaintiff was not under a “disability” as

defined in the Act. Id. at 18. 

Plaintiff challenges the ALJ’s determination at Step Five of the sequential evaluation process,

where her ability to perform other work in the state and national economy was assessed based upon

her RFC. In particular, Plaintiff challenges the ALJ’s reliance on the VE’s opinion that she could

perform jobs such as ticket taker, greeter and swatch clerk. (See Doc. 17 at 8-14). Plaintiff alleges

also that the ALJ erred by failing to consider whether she was presumptively disabled at Step Three

based on her mental impairment. (See id. at 14-18). 

DISCUSSION

1. The ALJ’s reliance upon the VE’s opinion to conclude Plaintiff could

perform other work was error

At the hearing, the ALJ posed a hypothetical to the VE describing a person of Plaintiff’s age,

educational background and work history, who was limited to a light exertional level, with no

pushing/pulling with the right dominant upper extremity above shoulder level, who was limited to

simple repetitive tasks where no writing is required and limited to frequent handling, fingering and

feeling with the right dominant hand. See AR at 49, 50. The VE opined that such a person could not

perform Plaintiff’s past work, but could perform “light, unskilled [jobs] where the arm activity is not

above shoulder level.” Id. at 49. As an example, she cited jobs such as ticket taker, greeter, and

swatch clerk. Id. at 49-50. The ALJ incorporated the limitations in this hypothetical in his RFC

 All references are to the 2000 version of the Code of Federal Regulations unless otherwise noted.

2

9

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 9 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

finding and cited specifically the VE’s opinion in concluding that Plaintiff could perform other work

(noting the jobs identified by the VE). Id. at 17.

Plaintiff argues first that the hypothetical posed to the VE, and relied upon by the ALJ as his

basis for his ultimate conclusion, failed to encompass all of her educational limitations. (See Doc.

17 at 8-12). As a result, Plaintiff argues that the VE’s conclusion that Plaintiff retained the ability to

perform the jobs of ticket taker, greeter, and swatch clerk was without evidentiary support and the

ALJ’s reliance upon the VE’s opinion was error. (See id.)

The Commissioner may carry his burden of showing an ability to do other work by eliciting

the testimony of a VE in response to a hypothetical that sets out all the limitations and restrictions of

the claimant that are supported by the record. Andrews v. Shalala, 53 F.3d 1035, 1043 (9 Cir. th

1995). A hypothetical question posed to a VE must include all impairments supported by substantial

evidence. Osenbrock v. Apfel, 240 F.3d 1157, 1164-65 (9 Cir. 2001). Reliance on a hypothetical th

that fails to include all accepted limitations is insufficient to carry the agency’s burden of proving the

ability to engage in alternative work. Andrews, 53 F.3d at 1044.

As an initial matter, Plaintiff notes that the ALJ wrote in his decision that Plaintiff had a

“high school education.” AR at 17; see 20 C.F.R. § 416.964(4) (defining a “high school education”

as involving “reasoning, arithmetic, and language skills acquired through formal schooling at a 12th

grade level or above.”) Defendant concedes that this was incorrect and describes this as a

“typographical error.” (Doc. 18 at 6). In addition, he contends that this error was harmless because

no reference to a “high school education” was presented in the hypotheticals the ALJ posed to the

VE. (See id. at 7). 

The Court agrees. No reference to this level of education was made by the ALJ at the hearing

or posed in any of the hypotheticals. Thus, the VE’s opinion was not predicated on Plaintiff having a

high school education. On the contrary, the VE was present and heard Plaintiff testify that she had a

10 grade education and was exclusively in special education classes from the third grade. See AR th

at 21, 24. Thus, despite the ALJ’s erroneous statement in his order, there is no evidence that the VE

did not rely upon Plaintiff’s testimony concerning her level of education. In fact, Plaintiff

acknowledges that “[t]he record does not reveal any evidence that the vocational expert ever

10

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 10 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

considered Ms. Ortiz to be a high school graduate.” (Doc. 17 at 8)

Nevertheless, Plaintiff argues that the even if the VE relied upon Plaintiff’s testimony in

responding to the hypothetical, the VE’s information was incomplete because she was not provided

the results of the objective testing which indicated that Plaintiff functioned at a much lower level

than her testimony revealed. In particular, Plaintiff cites testing conducted by Dr. Engeln that

indicated that she read at a fourth grade level and spelled at a second grade level. See id. at 9-10; AR

at 222. 

As noted, although the ALJ’s hypotheticals describe vaguely a person of Plaintiff’s

“educational background,” the VE was present for Plaintiff’s testimony. She heard Plaintiff testify to

a 10th grade education that was almost exclusively spent in special education classes. She also heard

Plaintiff testify to serious deficiencies with respect to writing and reading. In light of this, and the

ALJ’s limitation in the hypothetical to jobs involving simple, repetitive tasks with no writing

required, the hypothetical addressed Plaintiff’s testimony that she was, effectively, functionally

illiterate. See Buffin v. Astrue, 2009 WL 4254403 (E.D. Cal., Nov. 24, 2009) at *9-10 (indicating

that where the ALJ’s hypotheticals referred to a person of the plaintiff’s educational background, and

the VE was present and heard the plaintiff’s testimony as to that background, the hypotheticals were

complete and supported by substantial evidence). Plaintiff concedes that the Medical-Vocational

Guidelines establish that a person of her age who is capable of performing light and unskilled work

is not per se disabled even if she is illiterate. (See Doc. 17 at 9); see also 20 C.F.R., Part 404, Subpt.

P, App. 2, Table 2, Rule 202.16.

This does not end the inquiry, however. Plaintiff alleges an inconsistency between the

functional requirements of the jobs of ticket taker, greeter, and swatch clerk outlined in the DOT,

particularly for reasoning, reading and writing, and the VE’s opinion that she was capable of

performing these jobs. (See Doc. 17 at 12-14). Social Security Ruling (“SSR”) 00-4p states, in

pertinent part:

Occupational evidence provided by a VE or VS generally should be consistent with

information supplied by the DOT. When there is an apparent conflict between the VE

or VS evidence and the DOT, the adjudicator must elicit a reasonable explanation for

the conflict before relying on the VE or VS evidence to support a determination or

decision about whether the claimant is disabled. At the hearings level, as part of the

11

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 11 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

adjudicator’s duty to fully develop the record, the adjudicator will inquire, on the

record, as to whether or not there is such consistency. 

Neither the DOT nor the VE or VS evidence automatically “trumps” when there is a

conflict. The adjudicator must resolve the conflict by determining if the explanation

given by the VE or VS is reasonable and provides a basis for relying on the VE or VS

testimony rather than on the DOT information.

Because the “best source” for how a job is generally performed is “usually” the DOT (Pinto

v. Massanari, 249 F.3d 840, 845 (9 Cir. 2001)), for the ALJ to accept vocational expert testimony th

that conflicts with the DOT, the record must contain “‘persuasive evidence to support the

deviation.’” Id. at 846. Moreover, the ALJ has an affirmative duty to ask “whether [the VE’s]

testimony conflicts with the Dictionary of Occupational Titles.” Massachi v. Astrue, 486 F.3d 1149,

1152 (9 Cir. 2007). Not only must the ALJ ask the VE if his or her opinion is consistent with the th

DOT, the ALJ must “obtain a reasonable explanation for any apparent conflict.” Id. at 1152-53

(emphasis added).

With respect to the jobs of ticket taker and swatch clerk, the DOT provides the following

reading and writing requirements under “GENERAL EDUCATIONAL DEVELOPMENT -

Language:

Level 2 - READING: Passive vocabulary of 5,000 - 6,000 words. Read at rate of 190-

215 words per minute. Read adventure stories and comic books, looking up

unfamiliar words in dictionary for meaning, spelling, and pronunciation. Read

instructions for assembling model cars and airplanes.

WRITING: Write compound and complex sentences, using cursive style, proper

pronunciation, and employing adjectives and adverbs.

(Doc. 17, Ex. 2 at 2, 10). In addition, the lowest reasoning level for these jobs (applicable to the jobs

of ticket taker and swatch clerk) is classified by the DOT as Level Two. This level requires an

ability to “[a]pply common sense understanding to carry out detailed but uninvolved written or oral

instructions.” (Doc. 17, Ex. 2 at 1, 9). 

Similarly, the reading and writing requirements for the job of “Goodwill Ambassador” or

“Welcome-Wagon Host/Hostess” provide:

Level 3 - READING: Read a variety of novels, magazines, atlases, and encyclopedias. 

Road safety rules, instructions in the use of maintenance shop tools and equipment,

and methods and procedures in mechanical drawing and layout work.

WRITING: Write reports and essays with proper format, punctuation, spelling, and

12

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 12 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

grammar, using all parts of speech.

(Doc. 17, Ex. 2 at 6). 

After the VE offered her opinion that Plaintiff could perform these jobs, the ALJ asked her if

her findings were “consistent” with the DOT. AR at 50. The VE responded simply “Yes.” Id. The

ALJ did not ask any further questions or seek any additional explanation. This was inadequate. As

noted, the lowest reading and writing level for any of these jobs, requires a “[p]assive vocabulary of

5,000-6,000 words” and a reading rate of “190-215 words per minute.” (Doc. 17, Ex. 2 at 2, 10). In

contrast, Plaintiff testified she could not read a newspaper. AR at 26. The DOT standard requires

the ability to write “compound and complex sentences, using cursive style, proper end punctuation,

and employing adjectives and adverbs.” (Doc. 17, Ex. 2 at 2, 10). Plaintiff testified that her writing

and spelling skills were so poor that she was incapable of writing notes to patrons at the hotel where

she last worked. AR at 46. The lowest applicable reasoning level for these jobs under the DOT,

Level 2 (ticket taker and swatch clerk), requires the ability to “[a]pply commonsense understanding

to carry out detailed but uninvolved written and oral instructions.” (Doc. 17, Ex. 2 at 1, 9) (emphasis

added). The evidence is consistent that Plaintiff could complete only simple, one-to-two step

instructions. Notably, the ALJ did not dispute Plaintiff’s testimony concerning her severe limitations

for reading, writing and spelling. In fact, he tacitly accepted her testimony because in the pertinent

hypotheticals posed to the VE and, ultimately in his RFC finding, he included a limitation to jobs

“where no writing is required as a job duty.” AR at 50; see also AR at 14.

While a claimant is not per se disabled simply because he or she is illiterate or mentally

impaired, “in order for an ALJ to rely on a job description in the Dictionary of Occupational Titles

that fails to comport with a claimant’s noted limitations, the ALJ must definitively explain this

deviation.” See Pinto, 249 F.3d at 847. In this case, the ALJ merely accepted the VE’s one word

response that her opinions, based on the ALJ’s hypothetical, were consistent with the DOT. At the

very least, the ALJ needed to ask the VE for further explanation in light of the apparent differences. 

See Massachi, 486 F.3d at 1152-53 (holding that in asking the VE if the evidence he or she is

providing is consistent with the DOT, the ALJ should “obtain a reasonable explanation of an

apparent conflict”); see also Pinto, 249 F.3d at 846 (“Illiteracy seriously impacts an individual’s

13

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 13 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

ability to perform work-related functions such as understanding and following instructions,

communicating in the work place, and responding appropriately to supervision.”) 

For these reasons, the Court concludes that the ALJ erred in accepting the VE’s opinion that

Plaintiff could work as a ticket taker, greeter, or swatch clerk without obtaining an explanation of

how that opinion comports with the requirements for these jobs provided in the DOT.3

2. The ALJ erred by failing to address whether Plaintiff met or equaled the requirements

for presumed disability at Step Three based on mental retardation

Plaintiff contends next that the ALJ erred at Step Three by failing to consider whether her

condition met or equaled the requirements for presumed disability based on mental retardation found

at 20 C.F.R., Part 404, Subpt. P, App. 1, § 12.05C. (Doc. 17 at 14-18). 

It is Plaintiff’s burden to establish that his impairment met a listing. Bowen v. Yuckert, 482

U.S. 137, 146 n. 5 (1987). Mere diagnosis of a listed impairment is not sufficient to sustain a finding

of disability; there must also be the findings required in the listing. Young v. Sullivan, 911 F.2d 180,

183 (9 Cir. 1990). It has been held that it is not necessary for the ALJ to state specifically what th

evidence supports the conclusion that the claimant’s impairments do not meet or exceed a listing;

rather, it is sufficient for an ALJ to summarize the pertinent record, including the doctor’s

information regarding symptoms and the claimant’s testimony, and to make specific findings

essential to the conclusion such that a reviewing court may know the basis for the conclusion. It is

unnecessary to require the Commissioner, as a matter of law, to state why Plaintiff failed to satisfy

every listing. Gonzalez v. Sullivan, 914 F.2d 1197, 1200-01 (9 Cir. 1990). th

The introductory paragraph of § 12.05 states that,

Mental retardation refers to significantly subaverage general intellectual functioning

with deficits in adaptive functioning initially manifested during the developmental

period; i.e., the evidence demonstrates or supports onset of the impairment before age

In addition, the Court notes an incongruity between the VE’s determination that Plaintiff could work as a

3

“greeter such as you find in the front of stores,” see AR at 51, and her corresponding citation to the job designation for

“Goodwill Ambassador” and/or “Welcome Wagon Host/Hostess” in section 293.357-018 of the DOT. Id. The DOT

describes the latter job as encompassing several characteristics beyond that of a store front greeter. For instance, the

DOT describes the ability to develop lists “of prospective clients from such sources as newspaper items, utility company

records, and local merchants,” and the ability to prepare reports. These functions go well beyond the skills required to

serve as a simple store greeter and well beyond the limitations the ALJ propounded in his hypothetical restricting

Plaintiff to jobs involving simple, repetitive tasks with no writing duties. AR at 50.

14

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 14 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

22.

20 C.F.R., Part 404, Subpt. P, App. 1, § 12.05. In addition, subsection C requires an additional

showing of “[a] valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other

mental impairment imposing an additional and significant work-related limitation of function.” Id. 

In Gomez v. Astrue, 695 F.Supp.2d 1049 (C.D. Cal. 2010), the court noted that

In order to meet most of the mental disorder listings, a claimant must demonstrate the

existence of impairment-related functional limitations that are incompatible with the

ability to do substantial gainful activity and that are the result of the mental disorder

described in [the] listing, which must be manifested by the medical findings specified

for that disorder. Section 12.05 does not follow that pattern. “The structure of the

listing for mental retardation (12.05) is different from that of other mental disorders

listings. Listing 12.05 contains an introductory paragraph with the diagnostic

description for mental retardation. It also contains four sets of criteria (paragraphs A

through D). If [a claimant’s] impairment satisfies the diagnostic description in the

introductory paragraph and any one of the four sets of criteria, we will find that [the

claimant’s] impairment meets the listing.”

Id. at 1052-53 (citation omitted). 

Plaintiff contends that her IQ scores satisfy the requirements for presumed disability under §

12.05C. In addition, she asserts that the ALJ never questioned the validity of the IQ scores, and

argues that his failure to address whether Plaintiff’s mental condition satisfied this listing was error

warranting remand. (See Doc. 17 at 17). Defendant concedes that the ALJ failed to address whether

Plaintiff’s mental condition satisfied the requirements for presumed disability found in § 12.05 of the

listings. However, he argues that this failure was not error because Plaintiff “fails to point to

anything in the record that could even arguably satisfy the [diagnostic] criteria [in the introductory

paragraph].” (Doc. 18 at 8). 

The Court disagrees. Testing by Dr. Engeln indicated IQ scores (Verbal IQ of 69,

Performance IQ of 68, and Full Scale IQ of 66) which he characterized as being in the “mild range of

mental retardation.” Doc. 17 at 16; AR at 222. Moreover, Dr. Fast concluded that if her IQ scores

were valid, she satisfied the listings for presumed disability under Listing 12.05C. AR at 266. 

In addition, Plaintiff’s testimony reflected that her intelligence delays were “manifested”

prior to age 22 and were apparent from at least third grade. She testified that she did not function

well in school, could not keep up with other kids in normal classes and had been in special education

classes from that time. See Doc. 19 at 2; AR at 24-25. This evidence, plus the ALJ’s conclusion that

15

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 15 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Plaintiff suffered from other “severe” physical impairments (lymphedema and history of right breast

cancer) is sufficient to satisfy the requirements in § 12.05's introductory paragraph and refutes

Defendant’s assertion that Plaintiff has failed to produce evidence which could satisfy the

requirements of § 12.05C. See Lewis v. Astrue, 2008 WL 191415 at *5 (N.D. Cal., Jan. 22, 2008)

(holding that even one IQ score in the 60- to-70 range, in combination with another impairment

“will, by itself, satisfy the intellectual functioning requirement” in § 12.05's introductory paragraph if

Plaintiff can “put forth evidence that this level of functioning was “initially manifested” prior to age

22).

Other cases support remand. In Gomez, the plaintiff contended that he had a valid IQ and

other functional limitations that met the requirements of § 12.05C. See 695 F.Supp.2d at 1052. As

in this case, consultative psychological examiners documented valid IQ scores within the 60- to-70

range or lower, and the ALJ found that Plaintiff had a medically determinable impairment of

“borderline intelligence.” See id. at 1052-1055. Nevertheless, the ALJ, while not challenging the

validity of the IQ scores, relied on testimony from another doctor “and other evidence suggesting that

plaintiff had ‘mild functional limitations [that] did not equal’ any listing.” Id. at 1057.

The Gomez Court reversed and noted that “section 12.05 is structured differently than other

mental disorder listings,” and held that “a clamant can meet the “C” criteria . . . without having to

demonstrate a disabling, or even severe, level of mental functional impairment.” Gomez, 695

F.Supp.2d at 1057 (quoting Thresher v. Astrue, 283 Fed.Appx. 473, 475 (9 Cir., June 19, 2008)). 

th

The court stated that “the ALJ cannot disregard a valid IQ simply because other evidence in the

record could support a finding of nondisability in the absence of such a score.” Id. (quoting

Thresher v. Astrue, 283 Fed.Appx. 473, 475 (9 Cir., June 19, 2008)). 

th

In Thresher, the claimant argued that she satisfied “one of the four sets that comprise [§

12.05].” 283 Fed.Appx. at 474. Evidence indicated that Plaintiff had two IQ scores within the 60-70

range as required in subsection C. Id. at 475. Noting that the ALJ failed to discuss the applicability

of § 12.05, the Court ordered the matter remanded.

The ALJ did not expressly discuss [§ 12.05], but the evidence will support a

determination that Thresher does come within [subsection C] because two of her IQ

scores were in the 60 through 70 range, that mental condition began before she was

16

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 16 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

22 years of age, and she does have an additional physical impairment. Here the ALJ

did suggest that Thresher was not functionally mentally retarded, but the ALJ’s failure

to reference § 12.05 and, in particular, Listing 12.05C makes it unclear whether the

ALJ came to grips with the specific requirements of that section when she issued her

decision. We do not doubt that an ALJ can decide that an IQ score is invalid. The

regulations’ inclusion of the word “valid” in Listing 12.05C makes the ALJ’s

authority clear. But here, while the ALJ pointed to the level of Thresher’s

functioning, she did not find that the score was invalid, and the listing does not speak

to functioning - it speaks only to the IQ score itself. Thus, we remand to the

Commissioner for clarification regarding the nature of the considerations applied at

step 3 and, particularly, precisely what was decided and why.

Id. at 475 (citations omitted).

In this case, the ALJ never discussed the IQ scores determined by Dr. Engeln. Thus, the

record is devoid of any finding by the ALJ as to whether he accepted the validity of those scores. 

Although the ALJ discussed Plaintiff’s mental limitations within the context of § 12.00, see AR at

13-14, as noted in Thresher and Gomez, the criteria used to assess mental impairments in that section

has no application to a § 12.05 determination which deals exclusively with mental retardation. In

4

light of Plaintiff’s IQ scores, evidence that Plaintiff suffered from her mental condition from an early

age and his finding that Plaintiff suffered other severe impairments, including lymphedema and a

history of right breast cancer, the ALJ erred by failing to specifically discuss whether Plaintiff’s

mental condition satisfied the requirements for presumptive disability found at § 12.05C.

3. Remand for further consideration is appropriate

 The decision whether to remand a matter pursuant to sentence four of 42 U.S.C. § 405(g) or

to order immediate repayment of benefits is within the discretion of the district court. Harman v.

Apfel, 211 F.3 1172, 1178 (9 Cir. 2000). When a court reverses an administrative agency th

determination, the proper course, except in rare instances, is to remand to the agency for additional

investigation or explanation. Moisa v. Barnhart, 367 F.3d 882, 886 (9 Cir. 2004) (citing INS v. th

Ventura, 537 U.S. 12, 16 (2002)). Generally, an award of benefits is directed where no useful

Defendant suggests that Thresher and Gomez do not bolster Plaintiff’s position because, unlike this case, in

4

those cases “the claimant made an argument that satisfied the diagnostic criteria of Listing 12.05C, and . . . there was,

apparently, an issue regarding the validity of the IQ scores obtained.” (Doc. 18 at 9). As noted, the record in this case

reveals evidence to support the requirements of the introductory paragraph of section 12.05. See Lewis, 2008 WL

191415 at *5. In addition, as in this case, the ALJ in Thresher failed to assess, let alone make a determination as to the

validity of, the claimant’s IQ scores. This failure was a prime basis for remand. See Thresher, 283 Fed.Appx. at 475.

Thus, the Court disagrees that those cases are inapplicable.

17

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 17 of 18
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

purpose would be served by further administrative proceedings, or where the record is fully

developed. Varney v. Secretary of Health and Human Services, 859 F.2d 1396, 1399 (9 Cir. 1988). th

Because the issues addressed in this order require further clarification, and because it is not

clear that an award of benefits to Plaintiff should result after these issues are addressed, the Court

will order the matter remanded. McAllister v. Sullivan, 888 F.2d 599, 603 (9 Cir. 1989) (the 5 th

decision to remand for further proceedings or simply award benefits is within the discretion of the

court).

CONCLUSION

Based on the foregoing, this case is HEREBY REMANDED to the Secretary for further

proceedings consistent with this decision. The Clerk of Court IS DIRECTED to enter judgment in

favor of Plaintiff. 

IT IS SO ORDERED.

Dated: July 28, 2010 /s/ Jennifer L. Thurston 

9j7khi UNITED STATES MAGISTRATE JUDGE 

Plaintiff agrees that remand for further consideration by the Commissioner is appropriate. (Doc. 15 at 5, 6).

5

18

Case 1:09-cv-00702-JLT Document 20 Filed 07/28/10 Page 18 of 18