Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-05434/USCOURTS-cand-3_04-cv-05434-0/pdf.json

Parties Involved:
Jo Anne B. Barnhart
Defendant
Lisa Maher
Plaintiff

Document Text:

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UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

LISA MAHER,

Plaintiff,

v.

JO ANNE B. BARNHART,

Commissioner of Social Security

Defendant.

_____________________________________/

No. C 04-5434 MHP

MEMORANDUM & ORDER

Re: Cross-Motions for Summary

Judgment

Plaintiff Lisa Maher brought this action pursuant to 42 U.S.C. § 405(g) seeking judicial

review of the final decision of the Commissioner of Social Security (“the Commissioner”) denying

her claim for disability insurance benefits. Now before the court are the parties’ cross-motions for

summary judgment. Having considered the arguments presented and for the reasons stated below, the

court enters the following memorandum and order. 

BACKGROUND

Plaintiff is a forty-one-year-old woman with the equivalent of a high school education and

additional specialized training as a medical assistant. TR 213, 220. Prior to ceasing work in 1997,

plaintiff had been employed as a phlebotomist. Id. at 215. She has also previously been employed as

a receptionist and as a medical assistant. Id.

Plaintiff attributes her allegedly disabling injuries to the fall that she suffered in a K-Mart store

in March 1991. Subsequent to the fall, plaintiff developed back pain and bilateral hand numbness,

which required her to undergo a laminectomy in 1991 at cervical levels C5-6 and a discectomy with

fusion of her cervical vertebrae at C5-7 in 1992. Id. at 289, 299. Five years later, in 1997, plaintiff

was diagnosed with cervical strain. Id. at 290, 292. She has not been employed since that time. Id. at

214. 

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On February 12, 1999, plaintiff filed applications for Disability Insurance Benefits under Title

II of the Social Security Act, 42 U.S.C. § 423 et seq., and for Supplemental Security Income under

Title XVI of the Social Security Act, 42 U.S.C. §§ 401-33, claiming that she was unable to work

because of her injuries. In addition, plaintiff asserted that she was entitled to disability benefits based

on her history of depression.1 The regional Social Security Administration (“SSA”) office denied

plaintiff’s applications on June 29, 1999, concluding that neither her physical nor mental impairments

qualified as a “disability” within the meaning of 42 U.S.C. § 423(d). 

After the regional SSA office denied her request for reconsideration of its disability

determination, plaintiff requested an evidentiary hearing on her application for disability benefits, and

a hearing was held before an Administrative Law Judge (“ALJ”) on January 6, 2000. Of particular

relevance to the adjudication of the instant motions was the ALJ’s analysis of medical testimony

relating to plaintiff’s physical impairment. That testimony included the opinions of three physicians:

Dr. Daren Moore, plaintiff’s family practitioner; Dr. Norman Fizette, plaintiff’s treating internist; and

Dr. Joseph Grady, a physician who had examined plaintiff at the request of the Disability

Determination Service (“DDS”), a state agency. 

According to Dr. Moore’s diagnosis, plaintiff suffers from cervical disk disease with

radiculopathy. TR 309. Based on the results of Physical Functional Capacity Assessment 

that he performed in October 1999, Dr. Moore found that plaintiff can sit, stand, or walk for up to ten

minutes before needing to change position; that she can sit or stand or walk no more than a total of

two to three hours in an eight-hour workday; and that she can lift no more than five pounds

occasionally. Id. at 311-14. In addition, Dr. Moore concluded that plaintiff’s condition prevents her

from using her hands for gross and fine manipulations. Id. at 314. Upon considering these

limitations, Dr. Moore concluded that plaintiff would be unable to do fine motor activities involving

her upper extremities and that she might be absent from work three or more times a month due to her

pain. Id. at 316-17.

Dr. Fizette also evaluated plaintiff prior to the hearing before the ALJ. In an examination

conducted in March 1999, Dr. Fitzette observed mild weakness in plaintiff’s left arm, a mild

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impairment of her fine motor skills, and a reduced range of motion in her neck due to paravertebral

muscle spasms. Id. at 299. Based on these observations, he concluded that while plaintiff could no

longer work as a phlebotomist due to the impairment of her manual dexterity, she could easily

accomplish most routine daily activities. Id. 

Dr. Grady’s examination of plaintiff took place in April 1999. In that examination, he found

that plaintiff had no significant physical limitations, except that she suffered from diminished strength

in her left hand and shoulder, a limited range of cervical, dorsolumbar, and left-shoulder motion, and

a slight decrease in sensation in both arms. Id. at 300-03. Dr. Grady thus concluded that plaintiff

retained the ability to perform fine motor skills with both hands. Id.

Weighing this evidence, the ALJ found that plaintiff’s physical impairment did not interfere

with plaintiff’s ability to perform a full range of light work, including her past relevant work as a

medical assistant or as a receptionist. Id. at 160. The ALJ also reached the same conclusion

regarding plaintiff’s mental impairment. Id. at 156. Accordingly, in an order dated June 1, 2000, the

ALJ affirmed the decision of the regional SSA office and denied plaintiff’s application for disability

benefits. Id. at 154-60. 

Plaintiff appealed the termination to the SSA Appeals Council, and on April 11, 2002, the

Appeals Council remanded plaintiff’s claim to the ALJ for further consideration of the opinions of the

treating and examining physicians and for reconsideration of the extent of plaintiff’s mental

impairment. The Appeals Council also instructed the ALJ to reconsider his assessment of plaintiff’s

residual functional capacity. Id. at 177-80. 

On February 19, 2003, a second hearing was held before the ALJ. Id. at 88. In addition to the

evidence that was presented at the January 2002 hearing, the ALJ considered the testimony of Dr.

Jack Tippett, who had examined plaintiff in July 2002 at the request of DDS. Dr. Tippett observed

that plaintiff suffered from chronic neck strain and irritation of both ulnar nerves along the medial

aspect of both elbows. Id. at 354-55. However, he found no evidence of tenderness or muscle spasms

in plaintiff’s back and concluded that plaintiff exhibited a normal range of motion throughout her

shoulders, elbows, wrists, hands, and lower extremities. Id. Based on these observations, Dr. Tippett

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concluded that plaintiff’s upper extremity strength was not impaired. Id. 

The Commissioner also heard testimony from Tom Mehaffey, a vocational expert. Dr.

Mehaffey testified that a “hypothetical person” limited to low-stress work and able to lift, carry, push,

or pull up to ten pounds frequently and twenty pounds occasionally, who requires a sit or stand option

while remaining at the work station, and who can occasionally climb, balance, stoop, kneel, crouch, or

crawl would not be able to perform any of plaintiff’s past relevant work. Id. at 112-13. However,

while Dr. Mehaffey also testified that such a person would be able to perform a limited range of

alternative jobs, he observed that someone with the same functional limitations plus additional

limitations found by Dr. Moore, i.e., moderate limitations in the ability to perform activities within a

schedule, to maintain regular attendance, to sustain ordinary routine, and marked limitations on the

ability to complete a normal workweek—would not be able to perform any job whatsoever. Id. at

112-13, 116-17.

Considering this testimony together with the evidence presented at the first hearing held on

plaintiff’s application, the ALJ once again concluded that plaintiff was not disabled within the

meaning of the Social Security Act. Specifically, while the ALJ revised his previous finding that

plaintiff’s impairments did not interfere with her ability to work as a phlebotomist, he nevertheless

concluded that plaintiff retained the residual functional capacity to perform a limited range of light

work, including several identified alternative jobs, and that those jobs were available in significant

numbers in the regional and national economy. Id. at 26-34. Thus, applying the standard set forth in

20 C.F.R. § 404.1520(a)(4)(v), the ALJ again denied plaintiff’s application for disability benefits. 

On October 22, 2004, the Appeals Council denied plaintiff’s request to review the ALJ’s

determination and adopted his findings as the final decision of the Commissioner. Id. at 11-14. This

action for judicial review of the Commissioner’s decision followed, and the parties now cross-move

for summary judgment on the issue of plaintiff’s eligibility for disability benefits. The following

memorandum and order addresses that issue.

LEGAL STANDARD

A district court may disturb the Commissioner’s final decision on whether a person is disabled

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“only if [the decision] is based on legal error or if the fact findings are not supported by substantial

evidence.” Sprague v. Bowen, 812 F.2d 1226, 1229 (9th Cir. 1987). “Substantial evidence,

considering the entire record, is relevant evidence which a reasonable person might accept as

adequate to support a conclusion.” Matthews v. Shalala, 10 F.3d 678, 679 (9th Cir. 1993). The

court’s view “must consider the record as a whole,” including evidence that supports the

Commissioner’s decision and evidence that detracts from it. Desrosiers v. Secretary of Health &

Human Servs., 846 F.2d 573, 576 (9th Cir. 1988). Nonetheless, the ALJ is charged with resolving

ambiguities in the evidence, and where evidence exists to support more than one rational

interpretations, the court must defer to the ALJ’s decision. See Drouin v. Sullivan, 966 F.2d 1255,

1258 (9th Cir. 1992). On the other hand, the ALJ’s determinations of law are reviewed de novo. See

McNatt v. Apfel, 201 F.3d 1084, 1087 (9th Cir. 2000). Even if substantial evidence supports the

ALJ’s fact findings, his decision must be set aside if improper legal standards were applied in

reaching that decision. See Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978). 

DISCUSSION

The parties’ cross-motions for summary judgment require the court to determine whether the

Commissioner erred in concluding that plaintiff is not disabled within the meaning of the 42 U.S.C. §

423(d)(1)(A), which defines the term “disability” as “[the] inability to engage in any substantial

gainful activity by reason of any medically determinable physical or mental impairment which can be

expected to result in death or which has lasted or can be expected to last for a continuous period of

not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). The five-step process used to make this

determination is set forth in 20 C.F.R. § 404.1520(a). In the first step of that process, the

Commissioner asks whether the claimant is employed in “substantial gainful activity.” Id.

§ 404.1520(a)(4)(i). If not, the Commissioner proceeds to step two and examines the medical severity

of the claimant’s impairment. Id. § 404.1520(a)(4)(ii). If the impairment is found to be “severe,” step

three of the process requires the Commissioner to consider whether the claimant’s impairment is

equivalent to one of the impairments listed in Appendix 1 of 20 C.F.R. § 404.1520. Id.

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§ 404.1520(a)(4)(iii). Unless the claimant’s impairment falls within one of these categories (thereby

warranting a conclusion that he or she is disabled), the Commissioner must then proceed to step four,

which requires her to assess the claimant’s residual functional capacity and to determine whether he

or she is able to perform the physical and mental tasks associated with his or her “past relevant work.” 

Id. § 404.1520(a)(4)(iv). If not, step five requires the Commissioner to assess the claimant’s residual

functional capacity in light of his or her age, education, and work experience and to determine

whether the claimant can adjust to other work. Id. § 404.1520(a)(4)(v). A finding that the claimant is

unable to perform the duties of any job available in significant numbers in the regional or national

economy warrants a finding that he or she is disabled regardless of whether the claimant’s impairment

meets or equals one of the impairments listed in Appendix 1 of 20 C.F.R. § 404.1520. See id. §

404.1566(b); Flaten v. Secretary of Health & Human Servs., 44 F.3d 1453, 1464-65 (9th Cir. 1995). 

While the claimant bears the burden of proof at each of the first four steps of the process, the

burden of proof shifts to the Commissioner where, as here, the claimant has established that he or she

is unable to perform the duties associated with his or her “past relevant work.” See Swenson v.

Sullivan, 876 F.2d 683, 687 (9th Cir. 1989). Plaintiff argues that the Commissioner has failed to meet

her burden, characterizing her conclusion that plaintiff retains the residual functional capacity to

perform a limited range of light work (and hence a significant number of jobs that are available in the

regional and national economy) as legal error. 

Although plaintiff asserts a host of errors related to the Commissioner’s assessment of her

mental as well as her physical condition, the adjudication of the instant motions ultimately turns on

whether the Commissioner erred in basing her assessment of plaintiff’s physical impairment on the

opinions of Drs. Fizzette and Tippett, both of whom examined plaintiff at the request of DDS, rather

than on the opinion of Dr. Moore, plaintiff’s treating family practitioner. The court begins this

analysis by noting that the opinion of a disability benefits claimant’s treating physician, while not

necessarily conclusive as to either the claimant’s physical condition or the ultimate issue of disability,

is generally entitled to considerable weight in making those determinations. See Andrews v. Shalala,

53 F.3d 1035, 1041-42 (9th Cir. 1995) (citation and internal quotation marks omitted) (observing that

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“more weight is given to a treating physician’s opinion than to the opinion of a nontreating physician

because a treating physician is employed to cure and has a greater opportunity to know and observe

the patient as an individual”). Thus, even if the treating physician’s opinion is contradicted by other

testimony, the Commissioner may not reject that opinion without providing “specific and legitimate

reasons” for doing so. Rodriguez v. Bowen, 876 F.2d 759, 761-62 (9th Cir. 1989) (quoting Murray v.

Heckler, 722 F.2d 499, 502 (9th Cir. 1983)). Furthermore, the reasons given must be supported by

substantial evidence in the record. Id.

Here, plaintiff’s treating physician, Dr. Moore, testified that her physical impairment

prevented her from standing, walking, or sitting in the same position for more than ten minutes at a

time or from sitting, standing, or walking for more than two to three hours during the course of an

eight-hour workday. TR 316-17. Dr. Moore also noted that plaintiff had marked limitations on the

ability to complete a normal workweek and would be absent from work more than three times per

month. Id. This testimony, together with the testimony of Dr. Mehaffey, the vocational expert

retained by the SSA, is sufficient to establish that plaintiff is unable to perform light work, or indeed,

to perform any kind of work whatsoever. However, the Commissioner discounted Dr. Moore’s

testimony, characterizing his pessimistic assessment of plaintiff’s condition as inconsistent with his

past testimony and “out of proportion” with other evidence in the record. The Commissioner thus

concluded that the record as a whole supports a finding that plaintiff is able to perform certain types

of light work.

In reaching that conclusion, the only specific reason that the Commissioner gave for rejecting

Dr. Moore’s testimony is the purported inconsistency of the doctor’s October 1999 assessment of

plaintiff’s residual functional capacity and the findings that he set forth in a December 1999 letter to

the SSA. In particular, the Commissioner singled out two statements that Dr. Moore made

concerning plaintiff’s prognosis as probative of his lack of credibility. In the first such statement, set

forth in his October 1999 functional capacity assessment, Dr. Moore noted that plaintiff had a “[p]oor

prognosis for improvement [;] good prognosis for not worsening.” TR 309. In contrast, in his

December 1999 letter, Dr. Moore observed that “[plaintiff’s] prognosis is good prognosis; [h]er

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disease does not worsen rapidly.” Id. at 316. The Commissioner found these statements to be

contradictory, characterizing the “poor prognosis for improvement” that Dr. Moore found in October

1999 to be inconsistent with his subsequently expressed opinion that plaintiff’s prognosis is a “good

prognosis.” 

Plaintiff argues that this is not a legitimate reason for rejecting Dr. Moore’s testimony, and the

court agrees. Even assuming arguendo that it is within the Commissioner’s discretion to read the

above-cited passages of Dr. Moore’s testimony in isolation, the prognosis set forth in the October

1999 functional capacity assessment is entirely consistent with the opinion that he expressed in his

December 1999 letter to the SSA. In both documents, Dr. Moore states that plaintiff’s prognosis for

improvement was poor but that her condition was unlikely to deteriorate. In other words, plaintiff’s

condition was likely to remain the same in the foreseeable future. Id. Simply put, his opinion as to

that issue did not change between October 1999 and December 1999, and the Commissioner’s

conclusion to the contrary is not supported by substantial evidence in the record. 

Nor is there anything else in the record to suggest that Dr. Moore’s assessment of plaintiff’s

condition changed significantly between October 1999 and December 1999. In the October 1999

functional capacity evaluation, Dr. Moore concluded that plaintiff suffers from limitations on her

ability to stand, walk, or sit for extended periods of time that at least raise serious doubts about her

ability to perform light work. Id. at 309-15. His December letter contains the identical limitations;

there is no inconsistency. Id. at 316-17. In commenting on Dr. Moore's opinion of plaintiff's physical

symptoms interfering with her concentration, the ALJ found this to be inconsistent with Dr. Boyd's

report only four months earlier. This is inexplicable and the ALJ offers no explanation. The only

reference to concentration in the Boyd report states that "some mild concentration defects were

noted." Id. at 308. The remainder of the Boyd report is devoted to plaintiff's mental status

examination. As a psychologist, Dr. Boyd performed a psychological evaluation, not a physical

examination. The six words he iterates regarding plaintiff's concentration abilities make up the only

part of his report that intersects with Dr. Moore's reports. And, once again, they are not inconsistent.

Thus, the purported inconsistencies cited in the findings cannot be a “legitimate” basis for rejecting a

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treating physician’s assessment of a disability benefits claimant’s physical condition.

As this is the only “specific” reason that the Commissioner gave for rejecting Dr. Moore’s

opinion—the ALJ’s conclusion that Dr. Moore’s opinion regarding plaintiff’s functional impairment

was “out of proportion with other significant evidence in the record” could hardly be any less so—the

court is compelled to conclude that the Commissioner erred in his assessment of Dr. Moore’s

testimony. However, because it is not clear from the record that the Commissioner would be required

to find plaintiff to be disabled if Dr. Moore’s testimony were credited, since Moore stated that

plaintiff was "capable of some low-stress job", id. at 316, the court finds that it is appropriate to

remand plaintiff’s claim for further administrative proceedings, which will provide the Commissioner

with the opportunity to reconsider the evidence pertaining to plaintiff’s residual functional capacity

and, if necessary, to take additional testimony relevant to that issue. Accord Smolen v. Chater, 80

F.3d 1273, 1292 (9th Cir. 1996) (noting that remand to reconsider an error in weighing evidence of a

plaintiff’s eligibility for disability benefits is warranted unless there are no outstanding issues that

must be resolved before a determination of disability can be made and it is clear from the record that

the ALJ would be required to find the claimant disabled were such evidence credited). The court

therefore grants plaintiff’s motion for summary judgment and remands this action to the

Commissioner for further consideration of her claim.2

CONCLUSION

For the reasons stated above, the court GRANTS plaintiff’s motion for summary judgment

and DENIES defendant’s motion for summary judgment. This action is hereby REMANDED to the

Commissioner for further proceedings consistent with the foregoing order. The clerk shall close the

file.

IT IS SO ORDERED.

Date: August 5, 2005 

MARILYN HALL PATEL

District Judge

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1. For reasons that will become apparent in the following discussion, the court need not address

plaintiff’s mental impairment in any detail. 

2. In light of this disposition, the court need not reach plaintiff’s argument that the Commissioner

erred in concluding that her mental impairment was not disabling.

ENDNOTES

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