Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_15-cv-02676/USCOURTS-caed-2_15-cv-02676-2/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Pixie Mechelle Marie Flores
Plaintiff

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UNITED STATES DISTRICT COURT 

FOR THE EASTERN DISTRICT OF CALIFORNIA 

PIXIE MECHELLE MARIE FLORES 

Plaintiff, 

v. 

COMMISSIONER OF SOCIAL 

SECURITY, 

Defendant. 

No. 2:15-cv-2676-KJN 

ORDER 

 Plaintiff seeks judicial review of a final decision by the Commissioner of Social Security 

(“Commissioner”) denying plaintiff’s application for Supplemental Security Income (“SSI”) 

under Title XVI of the Social Security Act (“Act”).1

 In her motion for summary judgment, 

plaintiff principally contends that the Commissioner erred by finding that plaintiff was not 

disabled from June 6, 2012, the date plaintiff’s SSI application was filed, through the final 

administrative decision. (ECF No. 12.) The Commissioner filed an opposition to plaintiff’s 

motion and a cross-motion for summary judgment. (ECF No. 16.) Thereafter, plaintiff filed a 

reply brief. (ECF No. 17.) 

 

1

 This action was referred to the undersigned pursuant to Local Rule 302(c)(15), and both parties 

voluntarily consented to proceed before a United States Magistrate Judge for all purposes. (ECF 

Nos. 7, 8.) 

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After carefully considering the parties’ written briefing, the court’s record, and the 

applicable law, the court DENIES plaintiff’s motion for summary judgment, GRANTS the 

Commissioner’s cross-motion for summary judgment, and AFFIRMS the final decision of the 

Commissioner. 

BACKGROUND 

 Plaintiff was born on January 4, 1955; has at least a high school education; is able to 

communicate in English; and previously worked primarily as a janitor and parking lot attendant. 

(Administrative Transcript (“AT”) 25, 67, 90, 176, 178.)2 On June 6, 2012, plaintiff applied for 

SSI, alleging that her disability began on June 30, 1998, and that she was disabled primarily due 

to kidney problems, lupus, migraines, high blood pressure, leukemia, and muscle spasms. (AT 

67-68, 172, 177.) After plaintiff’s application was denied initially and on reconsideration, 

plaintiff requested a hearing before an administrative law judge (“ALJ”), which took place on 

February 13, 2014, and at which plaintiff, represented by an attorney, and a vocational expert 

(“VE”) testified. (AT 18, 32-65.) The ALJ subsequently issued a decision dated April 25, 2014, 

determining that plaintiff had not been under a disability, as defined in the Act, from June 6, 

2012, the date that plaintiff’s SSI application was filed, through the date of the ALJ’s decision. 

(AT 18-27.) The ALJ’s decision became the final decision of the Commissioner when the 

Appeals Council denied plaintiff’s request for review on October 30, 2015. (AT 1-6.) Plaintiff 

then filed this action in federal district court on December 28, 2015, to obtain judicial review of 

the Commissioner’s final decision. (ECF No. 1.) 

ISSUES PRESENTED 

 On appeal, plaintiff raises the sole issue of whether the ALJ erroneously failed to 

incorporate into the residual functional capacity assessment a limitation that plaintiff was 

restricted to carrying out one- to two-step instructions. 

 

2

 Because the parties are familiar with the factual background of this case, including plaintiff’s 

medical and mental health history, the court does not exhaustively relate those facts in this order. 

The facts related to plaintiff’s impairments and treatment will be addressed insofar as they are 

relevant to the issues presented by the parties’ respective motions. 

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LEGAL STANDARD 

 The court reviews the Commissioner’s decision to determine whether (1) it is based on 

proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in the record 

as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial 

evidence is more than a mere scintilla, but less than a preponderance. Connett v. Barnhart, 340 

F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d 625, 630 (9th 

Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is 

responsible for determining credibility, resolving conflicts in medical testimony, and resolving 

ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citation omitted). “The 

court will uphold the ALJ’s conclusion when the evidence is susceptible to more than one rational 

interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 

THE ALJ’S FINDINGS 

 The ALJ evaluated plaintiff’s entitlement to SSI pursuant to the Commissioner’s standard 

five-step analytical framework.3 At the first step, the ALJ concluded that plaintiff had not 

 

3

 Disability Insurance Benefits are paid to disabled persons who have contributed to the Social 

Security program. 42 U.S.C. §§ 401 et seq. Supplemental Security Income is paid to disabled 

persons with low income. 42 U.S.C. §§ 1382 et seq. Both provisions define disability, in part, as 

an “inability to engage in any substantial gainful activity” due to “a medically determinable 

physical or mental impairment. . . .” 42 U.S.C. §§ 423(d)(1)(a) & 1382c(a)(3)(A). A parallel 

five-step sequential evaluation governs eligibility for benefits under both programs. See 20 

C.F.R. §§ 404.1520, 404.1571-76, 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-

42 (1987). The following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful activity? If so, the 

claimant is found not disabled. If not, proceed to step two. 

Step two: Does the claimant have a “severe” impairment? If so, proceed to step 

three. If not, then a finding of not disabled is appropriate. 

Step three: Does the claimant’s impairment or combination of impairments meet or 

equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P, App. 1? If so, the 

claimant is automatically determined disabled. If not, proceed to step four. 

Step four: Is the claimant capable of performing her past relevant work? If so, the 

claimant is not disabled. If not, proceed to step five. 

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engaged in substantial gainful activity since June 6, 2012, plaintiff’s SSI application date.4 (AT 

20.) At step two, the ALJ found that plaintiff had the following severe impairments: migraines, 

hypertension, obesity, dermatitis, and depression not otherwise specified. (Id.) However, at step 

three, the ALJ determined that plaintiff did not have an impairment or combination of 

impairments that met or medically equaled the severity of an impairment listed in 20 C.F.R. Part 

404, Subpart P, Appendix 1. (Id.) 

 Before proceeding to step four, the ALJ assessed plaintiff’s residual functional capacity 

(“RFC”) as follows: 

After careful consideration of the entire record, the undersigned 

finds that the claimant has the residual functional capacity to 

perform medium work as defined in 20 CFR 416.967(c) except the 

claimant should avoid concentrated exposure to extreme cold, 

extreme heat, and wetness. She should avoid all exposure to 

operational control of dangerous moving machinery and 

unprotected heights. The claimant is limited to work involving 

simple, routine, and repetitive tasks. 

(AT 21.) 

 At step four, the ALJ determined that plaintiff was unable to perform any past relevant 

work. (AT 25.) However, at step five, the ALJ found that, in light of plaintiff’s age, education, 

work experience, and RFC, and based on the VE’s testimony, there were jobs that existed in 

significant numbers in the national economy that plaintiff could perform. (AT 26.) Specifically, 

the VE testified that plaintiff would be able to perform the representative occupations of stubber, 

patient transporter, and bagger. (Id.) Thus, the ALJ concluded that plaintiff had not been under a 

 

Step five: Does the claimant have the residual functional capacity to perform any 

other work? If so, the claimant is not disabled. If not, the claimant is disabled. 

 

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 

 

 The claimant bears the burden of proof in the first four steps of the sequential evaluation 

process. Bowen, 482 U.S. at 146 n.5. The Commissioner bears the burden if the sequential 

evaluation process proceeds to step five. Id. 

 

4

 Regardless of the alleged disability onset date, SSI is not payable prior to the month following 

the month in which the application was filed. 20 C.F.R. § 416.335. 

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disability, as defined in the Act, from June 6, 2012, plaintiff’s SSI application date, through the 

date of the ALJ’s decision. (Id.) 

DISCUSSION 

 Plaintiff does not challenge the ALJ’s findings with respect to her physical impairments 

and limitations; nor does she challenge the ALJ’s adverse credibility findings. Instead, plaintiff 

only challenges the ALJ’s evaluation of the mental component of the RFC; more specifically, the 

restriction limiting plaintiff to work involving simple, routine, and repetitive tasks. 

 Plaintiff’s argument is relatively straightforward: according to plaintiff, non-examining 

state agency physician Dr. Balson restricted plaintiff to carrying out one- to two-step instructions, 

and although the ALJ purportedly gave substantial weight to Dr. Balson’s opinion, the ALJ 

erroneously failed to incorporate that specific limitation into the RFC or explain why that 

limitation was not adopted. Furthermore, plaintiff argues that such purported error was not 

harmless. Based on the ALJ’s RFC for simple, routine, repetitive tasks, the VE identified the 

representative occupations of stubber, patient transporter, and bagger, which are all reasoning 

level 2 occupations. In reliance on Rounds v. Comm’r of Soc. Sec. Admin., 807 F.3d 996, 1002-

04 (9th Cir. 2015), plaintiff points out that a restriction to only carrying out one- to two-step 

instructions is narrower than a restriction to simple, routine, repetitive tasks, and a person so 

limited would generally be restricted to reasoning level 1 occupations. Thus, if plaintiff’s RFC 

had included such a limitation, it would have potentially precluded the reasoning level 2 

occupations identified by the VE. 

 The fundamental problem with plaintiff’s argument is its initial premise: that Dr. Balson 

actually restricted plaintiff to only carrying out one- to two-step instructions. Although that is 

one potential interpretation, Dr. Balson’s opinion, considered as a whole, is in fact ambiguous. 

To be sure, in one portion of his opinion, Dr. Balson indicates that plaintiff was able to “carry out 

one and two-step instructions with adequate concentration, persistence and pace over a normal 

workday/workweek.” (AT 87.) However, in other portions of the opinion, Dr. Balson states that 

plaintiff was able to understand, remember, and carry out short and simple instructions; only 

moderately limited in her ability to understand, remember, and carry out detailed instructions; and 

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that he recommended limiting plaintiff merely to unskilled work. (AT 81-82, 86.) See Barbosa 

v. Colvin, 2014 WL 4929420, at *6 (E.D. Cal. Sep. 30, 2014) (finding simple, routine work 

consistent with unskilled work); Chase v. Colvin, 2014 WL 4544096, at *14 (N.D. Cal. Sep. 12, 

2014) (same). In light of those ambiguities, the ALJ’s interpretation was at least equally 

plausible. 

 Moreover, based on the record, the court cannot say that the ALJ’s resolution of the 

ambiguity was irrational. Indeed, the ALJ’s interpretation of state agency physician Dr. Balson’s 

opinion is more consistent with the opinion of the consultative examiner, Dr. Ko Fang, who did 

not restrict plaintiff to only carrying out one- to two-step instructions, but instead found that 

plaintiff’s ability to perform simple and repetitive tasks was only mildly impaired, her ability to 

perform detailed and complex tasks was only moderately impaired, and her ability to perform 

work activities on a consistent basis without special or additional instruction was only mildly 

impaired. (AT 339.) Dr. Fang also observed that plaintiff was able to concentrate during the 

interview with no redirection needed. (AT 337.) Because Dr. Fang personally examined plaintiff 

and made independent clinical findings, his opinion constitutes substantial evidence on which the 

ALJ was entitled to rely. Significantly, in this case, Dr. Balson’s opinion also specifically 

indicated that he agreed with Dr. Fang’s findings from the consultative examination, further 

supporting the ALJ’s interpretation. (AT 87.) Indeed, even if the ALJ had interpreted Dr. 

Balson’s opinion to be inconsistent with Dr. Fang’s opinion, he would have been required by 

applicable law to provide specific and legitimate reasons to reject Dr. Fang’s examining opinion 

and could not have relied solely on Dr. Balson’s non-examining opinion to do so. Lester, 81 F.3d 

at 830-31. 

 Finally, the court notes that the ALJ’s interpretation of Dr. Balson’s opinion is also 

consistent with other evidence in the record. Notably, the record contains minimal evidence of 

any mental health treatment. On May 20, 2013, after the consultative examination with Dr. Fang, 

plaintiff requested her treating provider, Dr. Thao Nguyen, to fill out disability paperwork and 

complained of a depressed mood since her mother passed away 26 years prior. Dr. Nguyen 

assessed a sad mood, but linear thought processes and intact insight and judgment; did not declare 

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plaintiff disabled or issue any specific mental limitations; prescribed Zoloft; and referred plaintiff 

for therapy, although the record does not show any evidence of subsequent therapy. (AT 344-45.) 

On her next visit to the same clinic on July 18, 2013, plaintiff did not report any mental health 

symptoms. (AT 342-43.) Additionally, although plaintiff alleged disability as of 1998, she 

actually worked full time from 2006-2010 until she was laid off due to a conflict with her 

supervisor, and at the time of the hearing she continued to work as a janitor for five full days a 

month. (AT 38, 46-48, 51-52, 58-59, 177-78.) Plaintiff herself testified that she had no problems 

thinking at work and was able to follow the directions of her supervisors. (AT 46.) 

 In sum, the ALJ did not improperly reject a portion of Dr. Balson’s opinion. Instead, Dr. 

Balson’s opinion was ambiguous; the ALJ’s interpretation of that opinion was reasonable, 

rational, and consistent with the record as a whole; and the court defers, as it must, to that 

interpretation. 

V. CONCLUSION 

 In light of the above, the ALJ’s decision was free from prejudicial legal error and 

supported by substantial evidence in the record as a whole. Accordingly, IT IS HEREBY 

ORDERED that: 

 1. Plaintiff’s motion for summary judgment (ECF No. 12) is DENIED. 

 2. The Commissioner’s cross-motion for summary judgment (ECF No. 16) is 

GRANTED. 

 3. The final decision of the Commissioner is AFFIRMED, and judgment is entered 

for the Commissioner. 

 4. The Clerk of Court shall close this case. 

 IT IS SO ORDERED. 

Dated: December 27, 2016 

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