Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_07-cv-00348/USCOURTS-caed-2_07-cv-00348-0/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Minh-Dung T. Nguyen
Plaintiff

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

MINH-DUNG T. NGUYEN, No. CIV S-07-0348-CMK

Plaintiff, 

vs. MEMORANDUM OPINION AND ORDER

COMMISSIONER OF SOCIAL 

SECURITY,

Defendant.

 /

Plaintiff, who is proceeding pro se, brings this action for judicial review of a final

decision of the Commissioner of Social Security under 42 U.S.C. § 405(g). Pursuant to the

consent of the parties, this case is before the undersigned for final decision on plaintiff’s motion

for summary judgment (Doc. 18) and defendant’s cross-motion for summary judgment (Doc. 22). 

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I. PROCEDURAL HISTORY

Plaintiff, who is a lawful permanent resident alien, applied for social security

benefits on May 10, 2004. In her application, plaintiff claims that disability began on July 13,

2002. In a disability report submitted with her application, plaintiff describes her disability as

follows:

I have osteoarthritis (back pain, knee pain) which results in

restrictions such as “no prolonged standing/walking,” “no

climbing/squatting/kneeling,” etc.

In her motion for summary judgment, plaintiff adds that her osteoarthritis also affects her left

shoulder, both arms, right elbow, hips, and thumbs. Plaintiff’s claim was initially denied. 

Following denial of her request for reconsideration, plaintiff requested an administrative hearing,

which was held on March 7, 2006, before Administrative Law Judge (“ALJ”) Charles D. Reite. 

In his September 7, 2006, decision, the ALJ made the following findings:

1. Claimant has not engaged in substantial gainful activity since her alleged

onset date of July 13, 2002;

2. Claimant has the following severe impairments: back pain; knee pain; and

left shoulder pain;

3. Claimant does not have any of the related clinical findings so as to meet or

equal the level of severity in the listings in Appendix 1, Subpart P,

Regulations No. 4;

4. Claimant’s subjective complaints are not fully credible;

5. Claimant has the residual functional capacity for light work with a

sit/stand option, frequent use of the upper extremities, and no overhead

reaching with the dominant right upper extremity;

6. Claimant is unable to perform her past relevant work

7. Claimant is 39 years old, and will be 40 years old on September 14, 2006,

which is defined as a younger person;

8. Claimant completed high school and college and has both a Bachelor’s

degree and a Master’s degree;

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9. Based on the vocational expert testimony, claimant would be able to

perform other work that exists in significant numbers in the regional and

national economies, considering her age, education, past work, and

residual functional capacity; and

10. Claimant was not “disabled” as defined in the Social Security Act, at any

time through the date of this decision. 

After the Appeals Council declined review on January 26, 2007, this appeal followed.

II. SUMMARY OF THE EVIDENCE

The certified administrative record (“CAR”) contains the following medical

evidence: (1) July 22, 2002, physical report from Workers’ Compensation Medical Centers (Ex.

1F, CAR 175-76); (2) diagnostic imaging report dated June 24, 2004 (Ex. 2F, CAR 179-80); 

(3) July 12, 2004, medical report by Steve Redmond, M.D. (Ex. 2F, CAR 177-80); (4) July/

August 2004 residual functional capacity assessment by agency physician Frederick Entwistle, 

M.D. (Ex. 3F, CAR 181-88); (5) medical record dated May 26, 2005, from Avera United Clinic

(Ex. 6F, CAR 192-93); (6) diagnostic imaging reports dated January 13, 2006 (Ex. 7F, CAR 194-

96); (7) diagnostic imaging report dated March 13, 2006 (Ex. 10F, CAR 212); (8) report of May

6, 2006, orthopedic evaluation by agency physician Jane Wang, M.D. (Ex. 9F, CAR 200-09); 

(9) diagnostic imaging report dated June 7, 2006 (Ex. 10F, CAR 210-11); and (10) photocopy of

undated diagnostic images of both knees (Ex. AC-2, CAR 230). 

2002

A July 22, 2002, report from Workers’ Compensation Medical Centers indicates a

diagnosis of thigh strain. The doctor prescribed six physical therapy visits and further evaluation. 

There are no additional records for 2002.

2003

There are no records for 2003.

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2004

On June 24, 2004, Douglas Kimmel, M.D., reported on x-rays of plaintiff’s right

knee. In his report, Dr. Kimmel noted: “No fractures, dislocations, or other significant osseous

abnormalities are identified.” Also on June 24, 2004, Dr. Kimmel reported on an x-ray of

plaintiff’s lumbosacral spine and noted:

FINDINGS: Mild anterior wedging of the L1 vertebral body is identified. 

no fractures, spondylosis, or spondylolisthesis otherwise evidence. The

intervertebral disk spaces are maintained. [¶] 7-mm calcification is

projected upon the left kidney which may represent nephrolithiasis.

 

On July 12, 2004, Dr. Redmond reported on his recent evaluation of plaintiff. In

his report, Dr. Redmond stated that he did not observe any muscle spasm and that plaintiff had a

full range of motion in her spine and both knees. He did not report any reflex abnormalities,

swelling, redness, or puffiness. Dr. Redmond assessed the following functional capacity:

Based on the examination [plaintiff] should be able to lift and carry thirty

pounds frequently. Standing and walking should not have any limitations. 

Sitting because it aggravates her low back she would nee [sic.] to have

some breaks during and [sic.] eight hour day and probably would not have

her sit more than two hours in a chair and do not have her sit on the floor. 

I would have her avoid stopping [sic.], climbing, and kneeling since that

tends to aggravate her knee and her low back. She has no difficulty

handling objects. No difficulty hearing, seeing. Speaking she does have

an accent but I was able to understand her well. No problems with travel. 

No problems with exposure to dust, fumes, or temperature changes.

 

Dr. Redmond concluded that plaintiff had chronic low back and knee pain “which comes and

goes” and did not think her condition would improve. 

In the summer of 2004, agency physician Dr. Entwistle prepared a physical

residual functional capacity assessment based on his evaluation of the medical records. He

concluded that plaintiff could occasionally lift 50 pounds and frequently lift 25 pounds; that

plaintiff could stand, sit, and/or walk six hours in an eight-hour day; and that plaintiff was

unlimited in her ability to push and/or pull. As to postural limitations, Dr. Entwistle concluded

that plaintiff could frequently climb, stoop, kneel, crouch, and/or crawl, but that she should never

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perform balancing activities. The doctor did not note any manipulative, visual, environmental, or

communicative limitations. He noted: “Severity of pain complaints and self-limitations of

activity seem rather disproportionate to the objective findings on review of the records.”

2005

The record contains a note dated May 26, 2005, apparently prepared following

plaintiff’s treatment at Avera United Clinic. Subjectively, plaintiff complained of knee pain “on

and off.” She also complained of a “pop in the knee.” Objectively, the examining physician

noted that plaintiff “has full range of motion, the pop was not felt.” The doctor also observed

“[n]o tenderness along the joint line” and that “ACL, MCL, LCL were all intact.” 

2006

On January 13, 2006, James Bronk, M.D., reported on x-ray of plaintiff’s thoracic

spine, cervical spine, and chest. As to the thoracic spine, he noted:

Two views show a slight convex curve right scoliosis along with mild

straightening of the normal kyphosis. The skeletal structures are intact and

the paraspinous soft tissues are normal. The disk space height is

maintained throughout.

His final impression was: “No focal or acute skeletal abnormalities.” As to plaintiff’s cervical

spine, Dr. Bronk reported on a normal cervical spine. Similarly, Dr. Bronk did not note any

acute cardiopulmonary pathology revealed by plaintiff’s chest imaging. 

Dr. James McMahon, M.D., reported on a March 13, 2006, x-ray of plaintiff’s left

shoulder and noted a normal shoulder. 

The record contains a report by agency Dr. Wang following her comprehensive

orthopedic examination on May 6, 2006. Dr. Wang noted that plaintiff complained of low back

pain, knee pain, and left shoulder pain. Under “History of Present Illness” Dr. Wang reported:

The claimant initially refused examination, tossing a letter from the

disability office and stating, “Do you know you how to read this?” She

brought some x-rays to the examination and stated that the radiologist lied

about the report and that she read it by herself and it showed that there are

“no strained cartilage, decreased to 1/3 to 1/6 level.” (emphasis in

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original). She also stated that she had x-rays in 2004, which did not show

serious damage. She thinks “the radiologist lied about it, since she could

not see it herself.” She brought x-rays from March 13, 2006, which were

studies of the shoulder and neck. She proceeded to show me what she

thought was a fracture of her humerus. 

On physical examination, Dr. Wang noted:

The claimant walks normally from her car into the waiting room. She then

leaned against the wall while waiting to be examined. The claimant does

not require any assistive devices. Her gait pattern is normal. She refuses

to do a squat, but is able to toe stand, heel stand, and tandem walk toe to

heel. She is able to balance on either foot. 

Dr. Wang did not note any back pain in either the sitting or supine positions. Plaintiff’s range of

motion of her back, hips, knees, shoulders, elbows, and wrists was normal. As to plaintiff’s

functional capacity, Dr. Wang concluded that plaintiff “could be expected to stand, sit, and walk

with no restrictions.” The doctor did not assess any restrictions on lifting, carrying, bending,

stooping, crouching, or kneeling. Similarly, Dr. Wang did not note any manipulative, visual,

communicative, or environmental limitations. 

On June 7, 2006, Dr. McMahon, reported on x-rays of plaintiff’s knees. As to

both knees, Dr. McMahon noted only “[m]inimal degenerative change medial compartment.” 

III. STANDARD OF REVIEW

The court reviews the Commissioner’s final decision to determine whether it is: 

(1) based on proper legal standards; and (2) supported by substantial evidence in the record as a

whole. See Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). “Substantial evidence” is

more than a mere scintilla, but less than a preponderance. See Saelee v. Chater, 94 F.3d 520, 521

(9th Cir. 1996). It is “. . . such evidence as a reasonable mind might accept as adequate to

support a conclusion.” Richardson v. Perales, 402 U.S. 389, 402 (1971). The record as a whole,

including both the evidence that supports and detracts from the Commissioner’s conclusion, must

be considered and weighed. See Howard v. Heckler, 782 F.2d 1484, 1487 (9th Cir. 1986); Jones

v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not affirm the Commissioner’s

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decision simply by isolating a specific quantum of supporting evidence. See Hammock v.

Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports the administrative

findings, or if there is conflicting evidence supporting a particular finding, the finding of the

Commissioner is conclusive. See Sprague v. Bowen, 812 F.2d 1226, 1229-30 (9th Cir. 1987). 

Therefore, where the evidence is susceptible to more than one rational interpretation, one of

which supports the Commissioner’s decision, the decision must be affirmed, see Thomas v.

Barnhart, 278 F.3d 947, 954 (9th Cir. 2002), and may be set aside only if an improper legal

standard was applied in weighing the evidence, see Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th

Cir. 1988). 

IV. DISCUSSION

In her motion for summary judgment, plaintiff lists the following “claims”:

1. The 06/07/2006 Xray report of “minimal degenerative change” for both

knees by the Radiologist James F. McMahon is a lie (the reality is that the

muscles, tendons, and ligaments of both my knees have been extremely

weak, which certainly results in my extremely weak, slow walking these

days);

2. The Administrative Law judge ignored the detail “bony sclerosis” included

in the 06/07/2006 Xray reports for both knees when making the decision

on 09/07/2006 (while this critical detail “bony sclerosis” implies that the

bone/joint has been hardened or stiffened, which can also explain why my

walking has become weak, slow);

3. In the 09/07/2006 Decision by the Administrative Law Judge, Findings

numbered 5 that “claimant [had] the residual functional capacity for light

work with a sit/stand option” is erroneous (because Dr. Steven Redmond

in the 07/12/2004 report did list the medical restriction of “not hav[ing]

[the patient] sit more than two hours in a chair”);

4. The 12/07/2006 second opinion Xray report of “normal right elbow” by

the Radiologist James F. McMahon is also an obvious lie (the reality is

that there is no more nerve response at the right hand, then no more use of

the right hand/arm could be sustained by the elbow joint); and

5. In the 01/26/2007 Notice of Appeals Council Action, the Appeals Council

lied about “reports from Solano County Health and Services Department”

or “X-ray film of the right knee” listed as Exhibit AC-2 in the “Order of

Appeals Council” (because in the “Administrative Transcript,” there was

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no report nor X-ray film of the right knee from Solano County Health and

Social Services Department). 

As to plaintiff’s last “claim” – that the Appeals Council’s decision referenced a non-existent

exhibit – the record reflects that x-ray images of plaintiff’s knees were in fact taken. Therefore,

this argument has no factual basis. Plaintiff’s third “claim” – that the ALJ’s residual functional

capacity assessment, which included a sit/stand option, is inconsistent with Dr. Redmond’s July

12, 2004, report – also lacks merit because Dr. Redmond’s restriction of not sitting more than

two hours at a time is entirely consistent with the ALJ’s finding. In fact, the hearing decision

reveals that the ALJ accepted Dr. Redmond’s assessment. As to plaintiff’s arguments that x-ray

reports from Dr. McMahon are “lies,” there is no evidence that plaintiff is a medical doctor or

otherwise qualified to render medical opinions. Therefore, the court rejects plaintiff’s first and

fourth “claims.” 

At best, plaintiff’s motion for summary judgment presents one issue which has an

arguable basis in either fact or law. Specifically, it appears that at her second “claim” plaintiff

asserts that the ALJ failed to account for “bony sclerosis,” and at her first and fourth claims that

the ALJ did not account for muscle, ligament, tendon, and nerve deficits. These arguments

challenge ALJ’s residual functional capacity assessment and are the gravamen of plaintiff’s

motion. Therefore, the court will consider whether the ALJ’s residual functional capacity

assessment was based on substantial evidence in the record as a whole. 

Residual functional capacity is what a person “can still do despite [the

individual’s] limitations.” 20 C.F.R. §§ 404.1545(a), 416.945(a) (2003); see also Valencia v.

Heckler, 751 F.2d 1082, 1085 (9th Cir. 1985) (residual functional capacity reflects current

“physical and mental capabilities”). In this case, the ALJ concluded that plaintiff has severe

impairments related to her back, knees, and left shoulder. Based on these impairments, the LAJ

found that plaintiff had the residual functional capacity to perform light work with a sit/stand

option. The hearing decision shows that, in making this finding, the ALJ considered all of the

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medical evidence of record and did not reject any source. In particular, the ALJ noted that “all

the medical evidence . . . [is] consistent [with a finding of] a greater residual functional capacity .

. . than the RFC submitted in the hypothetical questions to the vocational expert.” 

The court finds that this is indeed an accurate assessment of the medical evidence

summarized above. All of the reports of plaintiff’s x-rays were unremarkable and none showed

any significant abnormality. Dr. Redmond’ s assessment is consistent with light work with a

sitting limitation. Similarly, Dr. Entwistle opined that plaintiff’s functional capacity permitted at

least light work. The examining doctor at Avera United Clinic observed in 2005 that plaintiff

had a full range of motion and did not observe any popping or abnormalities in plaintiff’s joints. 

Finally, Dr. Wang found that plaintiff’s functional capability was unrestricted. 

The only evidence to suggest a more limited functional capacity is plaintiff’s

testimony, which the ALJ rejected as not fully credible. The Commissioner determines whether

a disability applicant is credible, and the court defers to the Commissioner’s discretion if the

Commissioner used the proper process and provided proper reasons. See Saelee v. Chater, 94

F.3d 520, 522 (9th Cir. 1995). An explicit credibility finding must be supported by specific,

cogent reasons. See Rashad v. Sullivan, 903 F.2d 1229, 1231 (9th Cir. 1990). General findings

are insufficient. See Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995). Rather, the

Commissioner must identify what testimony is not credible and what evidence undermines the

testimony. See id. Moreover, unless there is affirmative evidence in the record of malingering,

the Commissioner’s reasons for rejecting testimony as not credible must be “clear and

convincing.” See id.

If there is objective medical evidence of an underlying impairment, the

Commissioner may not discredit a claimant’s testimony as to the severity of symptoms merely

because they are unsupported by objective medical evidence. See Bunnell v. Sullivan, 947 F.2d

341, 347-48 (9th Cir. 1991) (en banc). The Commissioner may, however, consider the nature of

the symptoms alleged, including aggravating factors, medication, treatment, and functional

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restrictions. See id. at 345-47. In weighing credibility, the Commissioner may also consider: (1)

the claimant’s reputation for truthfulness, prior inconsistent statements, or other inconsistent

testimony; (2) unexplained or inadequately explained failure to seek treatment or to follow a

prescribed course of treatment; (3) the claimant’s daily activities; (4) work records; and (5)

physician and third-party testimony about the nature, severity, and effect of symptoms. See

Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996) (citations omitted). 

Regarding plaintiff’s credibility, the ALJ stated:

I have considered claimant’s subjective complaints. . . . In this regard, I

find her complaints are not fully credible. The objective evidence does not

support her allegations to the extent alleged. Claimant has medically

determinable impairments that could reasonably be expected to produce

her pain and other symptoms. (citation omitted). However, the medical

evidence does not support a finding that she is precluded from all work.

Claimant overstates her limits and pain. Her activities of daily living have

been extensive and have included looking for jobs . . ., writing complaints

to the State of California Medical Board . . ., and writing long letters in

support of her claims for SSI benefits. . . . At Exhibit 9E/2, she indicated

that she had an ER visit for hemorrhoids on July 16, 2005, but there do not

appear to be any medical records regarding this ER visit in the file. At

Exhibit 10E/7, she describes at length her problems with trying to obtain

workers’ compensation benefits. At Exhibit 9E/1, claimant alleges that

she needs a cane to stand up from a sitting position, but there is no

prescription . . . indicating that she requires a cane. 

The court finds that the ALJ’s analysis is based on proper legal principles and substantial

evidence. In particular, the ALJ noted inconsistencies in the record, the lack of treatment

consistent with plaintiff’s subjective complaints, and her activities of daily living. Further, the

court recalls that Dr. Entwistle opined: “Severity of pain complaints and self-limitations of

activity seem rather disproportionate to the objective findings on review of the records.”

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V. CONCLUSION

Based on the foregoing, the court concludes that the Commissioner’s final

decision is based on substantial evidence and proper legal analysis. Accordingly, IT IS HEREBY

ORDERED that:

1. Plaintiff’s motion for summary judgment (Doc. 18) is denied;

2. Defendant’s cross-motion for summary judgment (Doc. 22) is granted; and

3. The Clerk of the Court is directed to enter judgment and close this file.

DATED: July 2, 2008

______________________________________

CRAIG M. KELLISON

UNITED STATES MAGISTRATE JUDGE

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