Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_05-cv-02269/USCOURTS-azd-2_05-cv-02269-0/pdf.json

Parties Involved:
Benito Joya
Plaintiff
Social Security Administration
Defendant

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Benito Joya, 

Plaintiff, 

vs.

Commissioner of Social Security, 

Defendant. 

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No. CV 05-2269-PHX-NVW

ORDER

[Not for Publication]

The Court has before it Plaintiff's Motion for Summary Judgment, Doc. # 9, which

includes Plaintiff's Statement of Facts; Defendant's Cross-Motion for Summary Judgment

and Response to Plaintiff's Motion for Summary Judgment, Doc. # 11; Defendant's Statement

of Facts, Doc. # 12; and Plaintiff's Response and Reply to Defendant's Cross-Motion for

Summary Judgment, Doc. # 14. 

Plaintiff Benito Joya ("Joya") brought this action against the Commissioner of Social

Security ("Commissioner"), alleging that his application for Social Security Income was

wrongly denied. Joya now moves for reversal of the decision below and for a remand for a

new hearing or an award of benefits. The Commissioner cross-moves for summary

judgment.

I. Statement of the Case

On May 1, 2001, Joya filed an application for Supplemental Security Income ("SSI")

payments, claiming disability due to chronic lower back pain, status post annular tear with

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protruded discs at L5-S1, edematous right S1 nerve root, and annular tear and herniated discs

at L4-5with moderately severe impingement on the spinal canal and right neural foramen.

Defendant Statement of Facts ("DSOF") at ¶ 1. Joya alleged an onset-of-disability date of

January 1, 1990, and was forty-nine years old at the time of the June 22, 2004 hearing.

DSOF at ¶ 15. 

 In 2001, Joya underwent back surgery to fuse his spine in an attempt to alleviate his

back pain. Plaintiff Statement of Facts ("PSOF") at ¶ 13. The surgery was unsuccessful.

Joya's doctors also prescribed various pain medications. In May 2003, Dr. Corbett, Joya's

treating physician, completed a form for the Arizona Department of Economic Security in

which Dr. Corbett opined that Joya's back condition rendered him unable to work. PSOF at

¶ 18. Dr. Angelo L. Chirban, a doctor at the Phoenix Pain Management Center, began

treating Joya for his back pain in 2003. PSOF at ¶ 23. In October 2004, another specialist

from the Phoenix Pain Management Center evaluated Joya, concluding that Joya's pain

rendered him unable to work. PSOF at ¶ 26. 

An initial hearing before an ALJ was held on January 21, 2003. The ALJ issued an

unfavorable decision on February 21, 2003. The Appeals Council granted Joya's request to

review the decision and remanded the case to the ALJ for a new hearing, directing the ALJ

to (1) evaluate the medical opinions and residual functional capacity findings, (2) evaluate

Joya's credibility, and (3) allow for a supplemental hearing to address all of the record

evidence. PSOF at ¶ 3. At the second hearing on June 22, 2004, both Joya and a vocational

expert testified. According to the testimony of the vocational expert, if Joya actually

experienced the pain he described, he would be unable to work. Tr. at 82. 

On July 21, 2004, the ALJ issued a second unfavorable decision, concluding that Joya

could still work as an assembly worker and quality control inspector. DSOF at ¶ 15. The

ALJ found Joya's pain testimony not credible. The Appeals Council modified the ALJ's

decision but declined Joya's request to review the ALJ's decision, making the modified ALJ's

decision the final decision of the Commissioner. PSOF at ¶ 10. Joya appeals the modified

ALJ decision.

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While the appeal was pending, Joya filed a new application for SSI benefits. He was

found disabled as of March 21, 2005. PSOF at ¶ 4. Joya is now seeking SSI benefits from

his May 1, 2001 filing date to March 21, 2005, the date he was deemed disabled. 

II. Standard of Review

The court reviews only those issues raised by the party challenging the Secretary's

decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001); Bergfield v. Barnhart,

361 F. Supp. 2d 1102, 1110 (D. Ariz. 2005) ("A reviewing federal court will only address

the issues raised by the claimant in his appeal from the ALJ's decision."). In its review, the

court "may set aside a denial of disability benefits only if it is not supported by substantial

evidence or if it is based on legal error." Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir.

1997) (citations omitted); see also Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996).

"Substantial evidence is relevant evidence which, considering the record as a whole, a

reasonable person might accept as adequate to support a conclusion." Flaten v. Sec’y of

Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995) (citations omitted). Such

evidence is "more than a scintilla" but "less than a preponderance." Smolen, 80 F.3d at 1279

(citations omitted). As a general rule, "[w]here the evidence is susceptible to more than one

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

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

In this case, the Appeals Council modified the ALJ's decision and added new medical

evidence to the record. In such a case, the court reviews both the Appeals Council's

reasoning and the ALJ's decision. See Ramirez v. Shalala, 8 F.3d 1449, 1452 (9th Cir. 1993);

see also Bates v. Sullivan, 894 F.2d 1059, 1063-64 (9th Cir. 1990) (concluding that the

Appeals Council properly rejected the claimant's additional medical evidence and therefore

properly declined to review the ALJ's decision). The ALJ's decision, as modified by the

Appeals Council, is the final decision of the Secretary. Taylor v. Heckler, 765 F.2d 872, 875

(9th Cir. 1985) ("The Secretary is empowered to affirm, modify or reverse the ALJ's

decision. Such a decision then becomes final and is binding upon the parties unless review

is sought in district court.").

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III. Legal Standard

Part 404.1520 of the Code of Federal Regulations describes the five-step sequential

evaluation process used in determining whether a claimant is disabled. The five steps are (1)

whether the claimant is currently working, (2) whether the alleged impairment is severe, (3)

whether the alleged impairment meets the definition of an “impairment” as set forth in

Appendix 1 of Subpart P of the regulations, (4) whether the claimant can perform work

performed in the past, and (5) whether the claimant has the ability to perform other work.

20 C.F.R. § 404.1520(a)(4)(i-v). The questions are addressed in order; certain responses to

these questions will lead to automatic eligibility or ineligibility. See id. The ALJ in Joya's

case made his decision at step five of the analysis. 

Although the claimant bears the burden of proving disability during the first four steps

of the sequential evaluation, "the burden shifts to the Commissioner in step five to show that

the claimant can perform other substantial gainful work." Burch v. Barnhart, 400 F.3d 676,

679 (9th Cir. 2005) (citations omitted); see also Smolen, 80 F.3d at1289 ("A claimant

establishes a prima facie case of disability by showing that her impairment prevents her from

performing her previous occupation.") (citations omitted). Where applicable, the MedicalVocational Guidelines can provide evidence of other jobs so as to allow the Commissioner

to carry that burden. Heckler v. Campbell, 461 U.S. 458, 468 (1983). 

IV. Analysis

Joya advances three arguments why the ALJ erred as a matter of law: (1) the ALJ

improperly discredited Joya's testimony; (2) the ALJ improperly disregarded Joya's treating

physician's opinion, and (3) the ALJ failed to utilize a medical expert's testimony when

determining whether Joya's medical conditions were equivalent to any of the Social Security

Regulation's Listed Impairments. 

A. Credibility Determination

 "The ALJ is responsible for determining credibility and resolving conflicts in medical

testimony and ambiguities." Lewis v. Apfel, 236 F.3d 503, 509 (9th Cir. 2001). In weighing

a claimant's credibility, the ALJ may consider various factors, including the claimant's daily

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activities, the claimant's reputation for truthfulness, inconsistencies either in her testimony

or between her testimony and her conduct, her work record, and testimony from physicians

and third parties concerning the nature, severity, and effect of the symptoms of which he

complains. Smolen, 80 F.3d at 1284. If the ALJ finds particular testimony of the claimant

not credible, he must provide clear and convincing reasons for rejecting it. Vertigan v.

Halter, 260 F.3d 1044, 1049 (9th Cir. 2001) ("[A]bsent affirmative evidence of malingering,

an ALJ cannot reject a claimant's testimony without giving clear and convincing reasons.")

(citations omitted). The ALJ also "must specifically identify the testimony she or he finds

not to be credible and must explain what evidence undermines the testimony." Holohan v.

Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001) (citations omitted). "General findings are

insufficient; rather, the ALJ must identify what testimony is not credible and what evidence

undermines the claimant's complaints." Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1996).

"The evidence upon which the ALJ relies must be substantial." Id. (citations omitted). 

The ALJ did not find credible Joya's testimony regarding his pain and functional

limitations, and the Appeals Council did not find credible Joya's claim that he is illiterate.

These arguments will be addressed in turn. 

1. Joya's Testimony Regarding His Pain and Functional Limitations

The ALJ determined that Joya's testimony regarding his pain and functional

limitations was not credible because (1) contrary to Joya's allegations, his doctor's treating

notes suggest that Joya's pain had stabilized at a lower level, and (2) Joya had calloused

hands, demonstrating that Joya had been more physically active than his testimony

supported. Tr. at 53.

a. Treatment Notes

The ALJ concluded that Joya's recent treatment notes demonstrated that Joya was

exaggerating his pain. Specifically, the ALJ stated: "The claimant's allegations that he

continues to experience high levels of pain, even as high as 10 on a scale of 1 to 10, despite

taking narcotic pain medications, is inconsistent with more recent medical records from his

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pain management specialist, which demonstrate a stabilization of pain (Exhibit 15F)." Tr.

at 53. 

The record simply does not support the ALJ’s claim that Joya “alleg[ed] that he

continues to experience high levels of pain.” The court has reviewed the transcript from the

administrative hearing, and it appears that Joya made no such statement. In fact, the only

time that Joya claimed to have experienced a pain level of “ten”–as far as the court has been

able to discern–was during his initial visit at the Phoenix Pain Management Center on

February 2, 2004. Tr. at 484. Meanwhile, Joya’s doctors stated that Joya’s pain level

stabilized between February 2004 and June 2004. There is no inconsistency between these

accounts. If Joya had testified that he continued to experience a pain level of “ten” after June

2004, such a statement would arguably be inconsistent with his doctors’ statements. But, as

stated above, Joya offered no such testimony at the hearing. 

b. Calloused Hands

The ALJ also relied on the fact that a medical professional had observed Joya as

having a calloused hand. The ALJ determined that the presence of callouses demonstrated

that Joya had engaged in some form of repetitive physical activity, and therefore his

testimony about his functional limitations was not credible. Tr. at 53. 

This reasoning is unpersuasive. Some courts have flatly concluded that the presence

or absence of callouses has no impeachment value in a disability case. See, e.g., Schmidt v.

Bowen, 1987 U.S. Dist. LEXIS 9974, *13-16 (E.D. Pa. 1987) ("the ALJ exceeded the bounds

of a factfinder. He did not explain how these alleged calloused hands contradicted the

plaintiff's claim of disability. The ALJ does not state this 'condition' undermines the plaintiff

complaints, such as the inability to stand or sit for prolonged periods of time, which might

prevent plaintiff from working. He did not explain how callouses necessarily showed that

the plaintiff could perform employment activities"). Here, the import of Joya's callouses is

ambiguous. They might be relevant and they might not be relevant. The ALJ only stated that

Joya's calloused hand demonstrated that Joya had engaged in repetitive physical

activity–proof, presumably, that Joya was not as disabled as he claimed to be. However,

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Other ALJs have questioned the claimant about the presence of callouses at the

hearing. See e.g., Suratt v. Secretary of HHS, 786 F.2d 1166, *7 (6th Cir. 1986) (the ALJ

provided the claimant with an opportunity to explain why he had callouses on his hands);

Givens v. Chater, 1997 U.S. Dist. LEXIS 3847, *27-8 (E.D. N.C. 1997) (same). 

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there may be a perfectly reasonable explanation for the presence of the callouses that is

consistent with Joya's testimony. Perhaps the callouses predate Joya's disabling back injury.

Perhaps Joya was able to continue engaging in activities involving his hands even after he

sustained his back injury. The point is that the ALJ did not explore these possible alternative

explanations.1

 Thus, while the callouses may tend to impeach Joya's testimony, they do not

provide the sort of clear and convincing evidence necessary for an ALJ to disregard a

claimant's testimony. 

c. Clear and Convincing Evidence

In sum, the ALJ provided two reasons for determining that Joya's testimony was not

credible: first, alleged inconsistencies between Joya’s testimony and medical records

concerning his pain level; and second, the fact that Joya had a calloused hand. Yet, as

discussed above, the first explanation is simply unsupported by the record. Accordingly, the

ALJ's adverse credibility determination rests solely on the presence of callouses. This single,

ambiguous fact is insufficient under Vertigan's clear and convincing standard. The ALJ

therefore improperly discredited Joya's testimony about his pain and functional limitations.

2. Literacy Testimony

At the June 22, 2004 hearing, Joya testified that he was illiterate. Tr. at 66-67. The

ALJ concluded that Joya was illiterate and had a marginal education. Tr. at 57. The ALJ

then concluded that Joya was not disabled pursuant to 20 C.F.R. Part 404, Subpt. P, App. 2,

Rule 201.18, which provides that a younger, literate, unskilled individual is not disabled.

The ALJ's decision was internally inconsistent because he concluded that Joya was illiterate

and then applied the Medical-Vocational Rule for literate individuals. 

Joya pointed out this error to the Appeals Council, which concluded that the ALJ had

applied the wrong definition of illiterate but had applied the correct Medical-Vocational

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Joya also argues that the ALJ relied on an inaccurate hypothetical because the ALJ

stated that Joya had marginal reading and writing skills. Because the Appeals Council

concluded that Joya was literate, the ALJ did not err by posing a hypothetical to the

vocational expert that accurately reflected Joya's reading and writing skills. 

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Rule. The Appeals Council stated that 20 CFR 416.964(b)(1) provides that an individual is

illiterate "if the person cannot read or write a simple message such as instructions or

inventory lists even though the person can sign his or her name." The Appeals Council

concluded that evidence in the record demonstrated that, under this definition, Joya was

literate.

As discussed above, to discredit a claimant's testimony, an ALJ must provide clear and

convincing reasons. In this case, the Appeals Council modified the ALJ's reasoning but did

not alter the ALJ's ultimate conclusion. The Appeals Council's modifications therefore

represent the Commissioner's final decision, and the Appeals Council needed to provide clear

and convincing reasons supporting its conclusion to discredit Joya's testimony regarding his

literacy. 

 To satisfy this burden, the Appeals Council cited two pieces of evidence. First, the

Appeals Council cited Joya's initial application for SSI, in which Joya checked a box stating

that he could read English and could write more than his name in English. Tr. at 160. This

is probative evidence demonstrating that Joya can in fact read and write simple statements.

Second, the Appeals Council cited a form filled out by an employee of the Social Security

Administration in which an interviewer checked a box indicating that the interviewer did not

witness Joya having any difficulty reading or writing. This evidence also supports the

Appeals Council's determination that Joya is literate.

These two pieces of evidence undermine Joya's testimony that he was illiterate. The

Appeals Council therefore provided clear and convincing reasons supporting its decision to

discredit Joya's literacy testimony. Because Joya is literate, the ALJ did not err on that

ground in applying Rule 201.18.2

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However, Rule 201.18 is no longer applicable on a different ground. In applying Rule

201.18, the ALJ relied on the vocational expert's testimony. Tr. at 56 ("Based upon a

thorough review of the entire record, in conjunction with the testimony of the vocational

expert, the undersigned concludes that . . . he [the claimant] is capable of making a successful

adjustment to work that exists in significant numbers in the economy. A finding of not

disabled is therefore reached within the framework of Medical-Vocational Rule 201.18.").

Specifically, the ALJ relied on the portions of the vocational expert's testimony in which the

ALJ asked hypothetical questions to the vocational expert that did not fully reflect Joya's

testimony regarding his pain and functional limitations. Because the ALJ improperly

discredited this testimony of Joya, and the vocational expert testified that Joya would be

disabled if all of his testimony about his pain were true, the vocational expert's testimony no

longer supports the ALJ's application of Rule 201.18. 

B. Treating-Physician Rule

There are three types of physicians: (1) treating physicians, who treat the plaintiff; (2)

examining physicians, who examine but do not treat the plaintiff, and (3) nonexamining

physicians, who neither examine nor treat the plaintiff. Lester v. Chater, 81 F.3d 821, 830

(9th Cir. 1995). Case law establishes:

As a general rule, more weight should be given to the opinion of a treating source than

to the opinion of doctors who do not treat the claimant. At least where the treating

doctor's opinion is not contradicted by another doctor, it may be rejected only for

"clear and convincing" reasons. We have also held that "clear and convincing"

reasons are required to reject the treating doctor's ultimate conclusions. Even if the

treating doctor's opinion is contradicted by another doctor, the Commissioner may not

reject this opinion without providing "specific and legitimate reasons" supported by

substantial evidence in the record for so doing.

Id. Treating physicians’ opinions receive special weight "[b]ecause treating physicians are

employed to cure and thus have a greater opportunity to know and observe the patient as an

individual, their opinions are given greater weight than the opinion of other physicians."

Smolen, 80 F.3d at 1285.

In May 2003, Dr. Corbett, Joya's treating physician, completed a form for the Arizona

Department of Economic Security in which he stated that Joya's back condition rendered him

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 It is unclear whether the specialist at the Phoenix Pain Management Center, who

filled out the evaluation in October 2004, was one of Joya's treating physicians. As a result,

that opinion will not receive the special weight normally accorded to the opinion of a treating

physician.

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completely unable to work. Tr. at 500. In October 2004, following the ALJ's decision, a

specialist at the Phoenix Pain Management Center filled out a Physical Capacities Evaluation

and concluded that Joya's pain was of such a level that he was unable to work. Tr. at 535-36.

 Finally, on March 6, 2002, Dr. McPhee, an examining physician retained by the Social

Security Administration, concluded that Joya was not disabled and could perform sedentary

work.

Because Dr. Corbett's medical opinion was contradicted by that of Dr. McPhee, the

ALJ needed to provide specific and legitimate reasons supported by substantial evidence for

disregarding Dr. Corbett's medical opinion.3

 However, no such reasons were ever provided.

Joya submitted Dr. Corbett’s opinion to the Appeals Council, and the Appeals Council added

Dr. Corbett’s opinion to the record, but the Appeals Council did not mention–let alone

provide specific and legitimate reasons for discarding–Dr. Corbett’s opinion in its letter

declining to review the ALJ's decision. Tr. at 25-29. 

Defendant contends that under Magallanes v. Bowen, 881 F.2d 747 (9th Cir. 1989),

it is unnecessary for the ALJ or Appeals Council to provide "magic words" rejecting the

treating physician's opinion. Yet Defendant’s reliance on Magallanes is misplaced. There,

the ALJ "summarized the facts and conflicting clinical evidence in detailed and thorough

fashion, stating his interpretation and making findings." Id. at 755. Here, the Appeals

Council does not even mention Dr. Corbett's opinion or acknowledge the presence of

conflicting medical opinions in the record, one of which was from Joya’s treating physician.

Providing no explanation (as the Appeals Council did here) is not tantamount to providing

a detailed analysis that clearly, if not explicitly, rejects the treating physician's opinion (as

in Magallanes). The Appeals Council therefore improperly disregarded Dr. Corbett's

medical opinion. 

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C. Medical-Expert Testimony

Joya also argues that the ALJ erred at stage three of the sequential analysis, by failing

to receive expert testimony on whether Joya's alleged impairments met or equaled any of the

listed impairments in the regulations. However, the court need not reach this issue because

Joya is entitled to an award of benefits on the grounds discussed above. 

V. Award of Benefits

"The decision whether to remand a case for additional evidence, or simply to award

benefits is within the discretion of the court." Sprague v. Bowen, 812 F.2d 1226, 1232 (9th

Cir. 1987) (citation omitted). "If additional proceedings can remedy defects in the original

administrative proceedings, a social security case should be remanded." Lewin v. Schweiker,

654 F.2d 631, 635 (9th Cir. 1981). However, "[i]n cases where there are no outstanding

issues that must be resolved before a proper disability determination can be made, and where

it is clear from the administrative record that the ALJ would be required to award benefits

if the claimant's excess pain testimony were credited, we will not remand solely to allow the

ALJ to make specific findings regarding that testimony." Varney v. Sec'y of Health &

Human Serv., 859 F.2d 1396, 1400 (9th Cir. 1988). 

Here, the ALJ failed to provide clear and convincing reasons for discrediting Joya's

testimony regarding the severity of his pain and his functional limitations. Under Varney,

Joya's testimony is therefore credited as true. Because the vocational expert stated that if

Joya's testimony were true, he would be disabled, a remand would be inappropriate under

Varney. 

An award of benefits is therefore proper in this case. The fact that the Appeals

Council improperly disregarding Joya's treating physician's opinion without providing

specific and legitimate reasons further supports an award of benefits. 

IT IS THEREFORE ordered that Plaintiff's Motion for Summary Judgment, Doc. #

9, is granted. 

IT IS FURTHER ORDERED that Defendant's Cross-Motion for Summary Judgment,

Doc. # 11, is denied. 

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IT IS FURTHER ORDERED that this action is remanded to the Commissioner of

Social Security for an award of benefits.

DATED this 3rd day of April 2006.

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