Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_06-cv-00914/USCOURTS-caed-1_06-cv-00914-0/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Robert Hunter
Plaintiff

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28 On October 31, 2006, the Honorable Oliver W. Wanger ordered the case assigned to the undersigned 1

Magistrate Judge for all purposes, including the entry of final judgment, 

1

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

ROBERT HUNTER, )

)

Plaintiff, )

v. )

)

MICHAEL J. ASTRUE, )

Commissioner of Social )

Security, )

)

Defendant. )

)

 )

1:06-cv-00914-SMS

DECISION AND ORDER DENYING

PLAINTIFF’S SOCIAL SECURITY

COMPLAINT (DOC. 1)

ORDER DIRECTING THE ENTRY OF

JUDGMENT FOR DEFENDANT MICHAEL J.

ASTRUE, COMMISSIONER OF SOCIAL

SECURITY, AND AGAINST PLAINTIFF

ROBERT HUNTER

Plaintiff is proceeding in forma pauperis and with counsel

against the Commissioner of Social Security. Pursuant to 42

U.S.C. §§ 405(g) and 1383(c)(3), Plaintiff seeks judicial review

of a final decision of the Commissioner denying an application

for Supplemental Security Income (SSI) benefits under Title XVI

of the Social Security Act (the Act). Pursuant to 28 U.S.C. §

636(c)(1), the parties have consented to the jurisdiction of the

Magistrate Judge to conduct all proceedings in this matter,

including ordering the entry of final judgment pursuant to 28

U.S.C. § 636(c). The matter is currently before the Court on the 1

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parties’ briefs, which have been submitted without oral argument

to the Honorable Sandra M. Snyder, United States Magistrate

Judge.

I. Procedural Summary

Plaintiff filed an application for SSI benefits on October

21, 2003, alleging disability since March 1, 2001. (A.R. 295-98,

20.) Plaintiff’s application was denied initially and on

reconsideration. (A.R. 54-62, 63-68.) A hearing was held on

December 1, 2005, before SSA Administrative Law Judge (ALJ)

Michael J. Haubner, which Plaintiff attended with representation

by an attorney, and at which Plaintiff testified. (A.R. 19.) The

ALJ concluded that Plaintiff was not disabled by a decision dated

February 17, 2006. (A.R. 19-26.) 

Plaintiff had previously filed an application for SSI

benefits on September 19, 2001, which was determined unfavorably

to Plaintiff on August 25, 2003. (A.R. 85-88, 20.) The ALJ in the

proceeding presently under review determined that under the

doctrine of res judicata, he would not consider a disability

onset date before August 25, 2003, the date of denial of the

previous application. (A.R. 20.)

The Appeals Council denied Plaintiff’s request for review on

May 19, 2006. (A.R. 9-11.) 

Plaintiff filed the instant action on July 14, 2007.

Briefing commenced with the filing of Plaintiff’s opening brief 

on February 23, 2007; Respondent filed a brief on March 19, 2007,

and Plaintiff’s reply brief was filed on March 29, 2007.

The ALJ found that Plaintiff had severe impairments of right

hip effusion, status post-right hip arthroplasty, left hip

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osteoarthritis, osteonecrosis of the bilateral hips, history of

mild compression fractures of T10-12, osteoarthritis of the

thoracic spine, mild cervical degenerative joint disease, and

bulging cervical spine. (A.R. 20.) These impairments did not meet

or medically equal a listing; further, Plaintiff had the residual

functional capacity (RFC) to perform a wide range of sedentary

work; although he could not perform his past relevant work, he

could perform the world of unskilled sedentary jobs, of which a

vocational expert testified there were 81,000 in California and

810,000 in the United States. (A.R. 24.) Accordingly, considering

Plaintiff’s capacity for sedentary work in combination with his

age (forty-two years old at the time of the decision), education

(high school GED), and work experience, pursuant to Rule 201.28

of Appendix 2, Subpart P, Regulations No. 4, Plaintiff was not

disabled. (A.R. 24-25.)

II. Scope and Standard of Review

Congress has provided a limited scope of judicial review of

the Commissioner's decision to deny benefits under the Act. In

reviewing findings of fact with respect to such determinations,

the Court must determine whether the decision of the Commissioner

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 Court must consider the record

as a whole, weighing both the evidence that supports and the

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evidence that detracts from the Commissioner's conclusion; it may

not simply isolate a portion of evidence that supports the

decision. Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9 Cir. th

2006); Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). It

is immaterial that the evidence would support a finding contrary

to that reached by the Commissioner; the determination of the

Commissioner as to a factual matter will stand if supported by

substantial evidence because it is the Commissioner’s job, and

not the Court’s, to resolve conflicts in the evidence. Sorenson

v. Weinberger, 514 F.2d 1112, 1119 (9 Cir. 1975). th

In weighing the evidence and making findings, the

Commissioner must apply the proper legal standards. Burkhart v.

Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). This Court must

review the whole record and uphold the Commissioner's

determination that the claimant is not disabled if the

Commissioner applied the proper legal standards, and if the

Commissioner's findings are supported by substantial evidence.

See, Sanchez v. Secretary of Health and Human Services, 812 F.2d

509, 510 (9th Cir. 1987); Jones v. Heckler, 760 F.2d at 995. If

the Court concludes that the ALJ did not use the proper legal

standard, the matter will be remanded to permit application of

the appropriate standard. Cooper v. Bowen, 885 F.2d 557, 561 (9th

Cir. 1987). 

III. Disability

In order to qualify for benefits, a claimant must establish

that she 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

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not less than twelve months. 42 U.S.C. § 1382c(a)(3)(A). A

claimant must demonstrate a physical or mental impairment of such

severity that the claimant is not only unable to do the

claimant’s previous work, but cannot, considering age, education,

and work experience, engage in any other kind of substantial

gainful work which exists in the national economy. 42 U.S.C.

1382c(a)(3)(B); Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th

Cir. 1989). The burden of establishing a disability is initially

on the claimant, who must prove that the claimant is unable to

return to his or her former type of work; the burden then shifts

to the Commissioner to identify other jobs that the claimant is

capable of performing considering the claimant's residual

functional capacity, as well as her age, education and last

fifteen years of work experience. Terry v. Sullivan, 903 F.2d

1273, 1275 (9 Cir. 1990). th

The regulations provide that the ALJ must make specific

sequential determinations in the process of evaluating a

disability: 1) whether the applicant engaged in substantial

gainful activity since the alleged date of the onset of the

impairment, 2) whether solely on the basis of the medical

evidence the claimed impairment is severe, that is, of a

magnitude sufficient to limit significantly the individual’s

physical or mental ability to do basic work activities; 3)

whether solely on the basis of medical evidence the impairment

equals or exceeds in severity certain impairments described in

Appendix I of the regulations; 4) whether the applicant has

sufficient residual functional capacity, defined as what an

individual can still do despite limitations, to perform the

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28 All citations to the Code of Federal Regulations are to the 2006 version unless otherwise stated. 2

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applicant’s past work; and 5) whether on the basis of the

applicant’s age, education, work experience, and residual

functional capacity, the applicant can perform any other gainful

and substantial work within the economy. See 20 C.F.R. § 416.920.2

IV. Credibility

Plaintiff argues that the ALJ’s credibility determination

was in error because the medical evidence supported Plaintiff’s

allegation of disabling pain and because the ALJ failed to

consider Plaintiff’s persistent efforts to obtain relief from his

pain.

It is true, as Plaintiff argues, that persistent efforts to

obtain relief from pain tend to enhance credibility. Soc. Sec.

Ruling 96-7p. However, these efforts are only one factor to be

considered in the established course of analysis of a claimant’s

subjective complaints. 

The existence and severity of a person's reaction to a

physical ailment, such as the existence and severity of pain, are

subjective phenomena, the extent of which cannot be objectively

measured. Byrnes v. Shalala, 60 F.3d 639, 642 (9th Cir. 1995). In

order to reject a claimant’s subjective complaints, the ALJ must

provide specific, cogent reasons for the disbelief. Lester v.

Chater, 81 F.3d 821, 834 (9 Cir. 1995). Once the claimant th

introduces medical evidence of an underlying impairment that

could reasonably be expected to produce some degree of the

subjective symptoms, the Commissioner may not discredit the

claimant’s testimony as to subjective symptoms merely because

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they are unsupported by objective evidence such as objective

medical findings. Id.; Smolen v. Chater, 80 F.3d 1273, 1282 (9th

Cir. 1996). Unless there is affirmative evidence tending to show

that the claimant is malingering, the reasons for rejecting the

claimant’s testimony must be clear and convincing, and the ALJ

must set forth the rejection by identifying what testimony is not

credible and what evidence undermines the claimant’s complaints.

Lester v. Chater, 81 F.3d at 834. The findings of the adjudicator

must be properly supported by the record and must be sufficiently

specific to allow a reviewing court to conclude that the

adjudicator rejected the claimant's testimony on permissible

grounds and did not arbitrarily discredit a claimant's testimony.

Bunnell v. Sullivan, 947 F.2d 341, 345-46; Byrnes v. Shalala, 60

F.3d at 641-42 (9 Cir. 1995); see 20 C.F.R. § 404.1529(c) th

[disability] and 20 C.F.R. § 416.929(c) [supplemental security

income].

 Social Security Ruling 96-7p directs the adjudicator to

consider not only objective medical evidence of signs, laboratory

findings, and medical opinions, but also the following factors

when assessing the credibility of an individual’s statements:

 1. The individual’s daily activities;

 2. The location, duration, frequency, and intensity

 of the individual’s pain or other symptoms;

 3. Factors that precipitate and aggravate the symptoms;

 4. The type, dosage, effectiveness, and adverse

 side effects of any medication for pain or other

 symptoms;

 5. Treatment, other than medication, for relief of

 pain or other symptoms;

 6. Any measures other than treatment used by the

 individual to relieve the pain or other symptoms; and

 7. Any other factors concerning the individual’s

 functional limitations and restrictions due to

 pain or other symptoms.

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See also Bunnell v. Sullivan, 947 F.2d at 346. 

Here, the ALJ considered Plaintiff’s testimony that he did

not drive, last shopped a year before and never went clothes

shopping, did not go to church, visit, make the bed, sweep, do

yard work, dust, mop, feed the dog, or help the children with

homework; he watched television for three hours in the afternoon

and lay down for four hours in the afternoon after lunch; he used

a cane prescribed several years ago; he could sit and stand for

thirty to forty-five minutes, walk eighty feet, and concentrate

for thirty minutes at a time; he had back and hip problems,

arthritis, a spur in the neck and lower back, pain from head to

feet and headaches twenty-four hours a day that were both an

eight on a scale of one to ten; and he had pain from his neck

down into his hands since March 2001. He had not been to the

emergency room for the past two years. (A.R. 23, 441-52.) 

The Court rejects Plaintiff’s argument that the ALJ erred in

his determination that Plaintiff’s subjective complaints were not

supported by the medical evidence and were not entirely credible

when evaluated under Social Security Ruling 96-7p. (A.R. 23.) The

ALJ expressly stated numerous reasons that were clear and

convincing in force and supported by substantial evidence in the

record. 

It is established that included in the factors that an ALJ

may consider in weighing a claimant’s credibility are the

claimant’s reputation for truthfulness; inconsistencies either in

the claimant’s testimony or between the claimant’s testimony and

the claimant’s conduct, daily activities, or work record; and

testimony from physicians and third parties concerning the

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nature, severity, and effect of the symptoms of which the

claimant complains. Thomas v. Barnhart, 278 F.3d 947, 958-59 (9th

Cir. 2002). The ALJ may consider whether the Plaintiff’s

testimony is believable or not. Verduzco v. Apfel, 188 F.3d 1087,

1090 (9 Cir. 1999). th

The ALJ here relied on several inconsistencies between

Plaintiff’s representations and the record. He noted that

although Plaintiff told Dr. Jergesen that he had a cervical

fracture, the evidence from the prior hearing indicated that

Plaintiff had no acute fracture and no significant impingement.

(A.R. 23.) The record shows that Plaintiff reported a cervical

fracture to Dr. Jergesen in August 2005 that allegedly caused him

to be disabled in 2003. (A.R. 393.) However, a cervical spine

study without contrast taken on July 10, 2001, showed that no

acute fracture of the cervical spine; further, an MRI scan dated

July 27, 2001, revealed that although there was mild disc

protrusion at C3-4, C4-5, and C5-6, there was no significant

impingement on the cervical cord, and no significant narrowing of

the canal. (A.R. 137, 133.)

The ALJ stated that although Plaintiff told Dr. Jergesen on

July 12, 2005, that he was not taking any medication, in May 2005

and July 2005, Dr. Shabhakar refilled the Plaintiff’s Soma,

Ultram, Elavil, Patanol, Loratadine, and Promethazine. (AR. 23.)

The record supports this finding. (A.R. 423 [letter from Dr.

Jergesen], 360, 362.)

The ALJ recited Plaintiff’s statement to Dr. Jergesen that

Plaintiff had hip pain for two years before seeking treatment

(A.R. 23, 383, 393 [report of Dr. Jergesen dated August 24,

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2005]); the ALJ then noted that Plaintiff never mentioned any hip

pain to consultative orthopedic examiner Dr. Young in January

2004 (A.R. 23, 326-28).

The ALJ also noted Plaintiff’s failure to report significant

symptoms to his treating physician. The ALJ noted Plaintiff’s

Social Security report that he had bladder and bowel problems

(A.R. 24, 120), and yet the month before he denied any such

problems in reporting to his treating physician (A.R. 144 [letter

from Dr. Ehteshami to Dr. Wadhwani]). Plaintiff alleged daily

headaches since March 2001 with pain an eight on a scale of one

to ten; however, he denied having headaches to his treating

physician in July 2001. (A.R. 24, 450, 132 [Sierra View District

Hospital nursing history notes showing no headaches often, with

Dr. Siddhu as treating physician].) Plaintiff claimed in

testimony to have had right upper extremity symptoms and problems

for one year in 2001, yet he denied these to his treating

physician in September 2001. (A.R. 24, 450-51, 144 [letter from

Dr. Ehteshami noting that Plaintiff denied any right upper limb

symptoms].)

These conflicts with respect to Plaintiff’s subjective

claims were supported by substantial evidence in the record and

constituted clear and convincing reasons.

The ALJ further noted that Dr. Jergesen wrote that

Plaintiff’s severe hip pain exceeded what one might expect from

the x-rays. (A.R. 23, 424.)

The ALJ also relied on Plaintiff’s “dismal” work history,

which showed no years of full, substantial gainful activity in

the past relevant fifteen years, and only three years of full

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substantial gainful activity in his entire life. (A.R. 23.)

Substantial evidence supported this reason. (A.R. 438-40, 95.) A

claimant's extremely poor work history shows that he has little

propensity to work and negatively affects her credibility

regarding her inability to work. Thomas v. Barnhart, 278 F.3d

947, 959 (9th Cir. 2002).

The ALJ also mentioned Dr. Young’s notation that Plaintiff

had positive right and left straight leg raising in the supine

position at forty-five degrees, yet in the seated position had

completely normal leg raising. (A.R. 23-24, 327.) The ALJ

reasoned that such a significant variance of the bilateral lower

extremities is indicative of functional overlay, such as

exaggeration or malingering.

The ALJ also stated that although Plaintiff testified that

he could only concentrate for thirty minutes, the ALJ observed

that Plaintiff paid attention and responded appropriately

throughout the hearing of fifty minutes. (A.R. 24.) Observations

by the ALJ of a person’s functioning may not form the sole basis

for discrediting a person’s testimony; rather, they may be used

only in the overall evaluation of the credibility of the

individual’s statements. Orn v. Astrue, 495 F.3d 625, 639-40 (9th

Cir. 2007) (citing S.S.R. 96-7p at 7). The Court is satisfied

that the ALJ’s consideration of Plaintiff’s ability to

concentrate and respond during the lengthy hearing was only one

of many reasons and was mentioned in the overall evaluation of

the credibility of Plaintiff’s statements.

The ALJ expressly concluded with respect to Plaintiff’s

credibility that because of the lack of medical evidence and

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because of the inconsistencies in the record and testimony, he

was constrained to give little weight to Plaintiff’s allegations.

(A.R. 24.)

With respect to the medical evidence, the findings of the

ALJ concerning the inconsistency of Plaintiff’s complaints with

the medical record have previously been set forth. The ALJ

further detailed the medical history presented in the medical

records. (A.R. 21-23.) The treatment of the treating physicians’

opinions will be further discussed hereinbelow. 

Plaintiff points to evidence that Plaintiff continued to

seek medical treatment for his pain, and Plaintiff argues that

the ALJ’s finding concerning credibility was erroneous because

the ALJ failed to consider Plaintiff’s efforts to seek medical

treatment and to follow the treatment prescribed. 

Pursuant to Soc. Sec. Ruling 96-7p, a longitudinal record of

persistent efforts to obtain pain relief in general lends support

to an individual’s allegations of intense and persistent pain or

other symptoms; further, persistent attempts, such as by

increasing medications, trials of a variety of treatment

modalities in an attempt to find one that works or does not have

side effects, referrals to specialists, or changing treatment

sources may be a strong indication that the symptoms are a source

of distress to the individual. Soc. Sec. Ruling 96-7p at 6-7.

Here, there were indications that Plaintiff continued to

seek treatment. However, Plaintiff has not demonstrated that the

record necessarily must be interpreted only to indicate a

persistent attempt to seek treatment; rather, there is an absence

of trials of a variety of treatment modalities or changes in

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treatment sources that would compel an inference in Plaintiff’s

favor. The record shows a continued reliance on medications

despite allegedly constant, severe pain throughout major portions

of Plaintiff’s body. It is for the ALJ in the first instance to

evaluate all the evidence concerning Plaintiff’s credibility. To

the extent that medical evidence is inconsistent or conflicting,

it is the responsibility of the ALJ to resolve any conflicts.

Morgan v. Commissioner, 169 F.3d 595, 603 (9 Cir. 1999); Saelee th

v. Chater, 94 F.3d 520, 522 (9 Cir. 1996); Matney on Behalf of th

Matney v. Sullivan, 981 F.2d 1016, 1020 (9 Cir. 1992). An ALJ is th

entitled to draw inferences logically flowing from the evidence.

Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). 

Here, although there was evidence that could have been

interpreted in Plaintiff’s favor, there was also substantial

evidence supporting the reasons relied on by the ALJ, who

carefully considered all the evidence, including the medical

evidence. Where the evidence supporting an ALJ’s rejection of a

claimant’s credibility is substantial, and where it demonstrates

that the ALJ did not arbitrarily reject the Plaintiff’s

testimony, the finding will be upheld even though the finding is

not as extensive as possible and does not consider all possible

factors. Crane v. Shalala, 76 F.3d 251, 254 (9 Cir. 1996) (where th

the AlJ’s conclusion was based on the claimant’s daily

activities, treating therapist’s notes, and good response to

treatment); Tidwell v. Apfel, 161 F.3d 599, 602 (9 Cir. 1999) th

(upholding an ALJ’s rejection of a claimant’s credibility based

on medical evidence, daily activities, and Plaintiff’s testimony

that a medication aided intermittent pain).

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Here, the ALJ reviewed the evidence and sufficiently

articulated clear and convincing reasons, supported by

substantial evidence, in rejecting Plaintiff’s specific

subjective complaints. 

V. Rejection of the Treating Physician’s Opinion

Plaintiff argues that the ALJ erred in rejecting the opinion

of Plaintiff’s treating physician, Dr. Shubhakar, that he was

disabled from work. The opinion was pertinent to Plaintiff’s RFC,

which the ALJ determined was to perform a wide range of sedentary

work because Plaintiff was able to lift and carry no more than

fifteen pounds at one time, stand and walk for no more than two

hours and sit for no more than six hours in an eight-hour

workday, bend and stoop occasionally but not use his bilateral

upper extremities for work at or above shoulder level. (A.R. 21.)

The ALJ summarized the pertinent medical record which

pertained to the numerous impairments (hip problems,

osteoarthritis of the thoracic spine and mild compression

fractures of T10-12, and cervical degenerative joint disease and

bulging cervical spine) claimed by Plaintiff. 

The ALJ noted treatment in May and June 2003 by medication

for Plaintiff’s low back pain by Dr. Wadhwani, who diagnosed low

back pain and disc protrusion and opined that Plaintiff should

not engage in heavy lifting and standing for long periods;

although there was a reference in June 2003 to disability, the

context was found to be unclear because of illegibility. (A.R.

21, 351, 350.) The ALJ found the limitations to be consistent

with a RFC for sedentary work and thus supportive of the ALJ’s

decision. (A.R. 21.)

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The ALJ noted the opinion of Plaintiff’s treating physician

in June 2003 that because of disc protrusion at C3-C6, Plaintiff

could not work as a construction worker and could not bend down.

(A.R. 23, 234.) The ALJ stated that the opinion was consistent

with a sedentary residual functional capacity because it

precluded construction work and bending. (A.R. 23.) 

The ALJ detailed the treatment by Plaintiff’s new treating

physician, Dr. Shubhakar, in November and April 2003 with Keflex,

Soma, Ultram, Elavil, and Vicodin for chronic back pain,

herniated cervical disc, and a compression fracture in the T10,

T11, or T12 area; Plaintiff reported in July 2004 that the

medications helped relieve his low back pain. (A.R. 21, 345, 342,

377.) The ALJ disregarded Dr. Shubhakar’s report for Tulare

County Health and Human Services Agency of September 2004, in

which the doctor stated that Plaintiff was permanently disabled,

prevented from caring for children, and was required to have

someone care for him. (A.R. 21, 359.) The ALJ’s reasons for

disregarding the report were that the ultimate determination of

disability was an issue reserved to the Commissioner under Soc.

Sec. Ruling 96-5p, and that the form had no explanation of the

nature of the purported disability and proposed no functional

limitations. (A.R. 21.) The ALJ noted that the form was a fillin-the-blanks, check-block form indicating only the Plaintiff was

permanently disabled. (A.R. 22.) The ALJ stated that the form

lacked bases for the conclusion such as signs or test results,

and it was not clear whether the opinion was based on the

claimant’s subjective complaints, or on objective findings or

observation. (Id.) 

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The Court notes that the report concerned whether or not

Plaintiff could participate in Welfare-to-Work activities. In the

blank provided for the dates of any current inability to work or

participate in a training or education program, the doctor wrote,

“PERMANENT DISABILITY,” and he checked “Yes” next to queries

concerning whether the patient’s condition prevented him from

providing care for children in the home and required someone to

be in the home with Plaintiff. (A.R. 359.) 

The Court further notes that a determination of whether or

not a claimant meets the statutory definition of disability is a

legal conclusion reserved to the Commissioner; the opinion of a

medical source on the ultimate issue of disability is not

conclusive. Magallanes v. Bowen, 881 F.2d 747, 751 (9 Cir. th

1989). Additionally, it is established that it is appropriate for

an ALJ to prefer an opinion supported by specific clinical

findings and an explanation thereof over a check-off type of form

lacking an explanation of the basis for the conclusions. Crane v.

Shalala, 76 F.3d 251, 253 (9 Cir. 1996) (citing Murray v. th

Heckler, 722 F.2d 499, 501 (9 Cir. 1983)); see Batson v. th

Commissioner of the Social Security Administration, 359 F.3d

1190, 1195 (9 Cir. 2004). th

The ALJ noted the opinion of consultive orthopedic examiner

Dr. Frederick R. Young, who in examining Plaintiff in February

2004 found no spinous process tenderness or spasm in the neck or

back; range of motion was not tested because of Plaintiff’s

statement of pain with the effort. Straight leg raising was to

forty-five degrees left and right, and to ninety degrees left and

right while seated. Sensory perception was normal to pinprick in

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both lower extremities, deep tendon reflexes were normal, gait

was normal despite use of a cane, which was not used in cadence

sequence repetitively but rather seemed to switch back and forth;

the ALJ noted that although Dr. Young opined that Plaintiff had a

history of a back injury, there was little medical evidence to

support a significant back injury. (A.R. 22, 326-28.)

The ALJ stated that he gave some weight to the opinion of

Dr. Young that Plaintiff did not have a significant back injury

and noted that the evidence showed an old, mild compression

fracture of T10-12 and mild cervical bulging and disc disease.

(A.R. 23.) The ALJ stated that the primary source of pain seemed

to be the hips, but Plaintiff did not reveal that information to

Dr. Young. (Id.) 

The ALJ mentioned the state agency analyst and medical

reviewer who in March 2004 opined that Plaintiff could perform

sedentary work with occasional stooping, frequent climbing,

balancing, kneeling, crouching, and crawling, and no use of

either upper extremity to work above shoulder level. (A.R. 22,

329-37.) The ALJ noted that these opinions relied on Chavez v.

Bowen to uphold the prior decision of the ALJ. (A.R. 22, 334.)

However, the ALJ had previously noted that Chavez did not create

a continuing presumption of disability in the present case

because Plaintiff had presented evidence of a new impairment,

namely, hip pain. (A.R. 20.) The ALJ also stated that he gave

some weight to the opinion because it was consistent with a

sedentary residual functional capacity. (A.R. 23.)

After detailing this medical evidence, the ALJ then

addressed the opinion of Plaintiff’s treating physician, Dr.

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Shubhakar, of September 2004 that Plaintiff was disabled. (A.R.

22, 359). 

The ALJ also detailed the history of Plaintiff’s problem

with his hips; he noted Dr. Shubhakar’s notation in January 2005

that Plaintiff had paraspinal spasm from T6 to T12, limited back

range of motion, positive straight leg raising, and inability to

sit down for a long time. (A.R. 21, 368.) An x-ray of Plaintiff’s

right hip in April 2005 showed moderate osteoarthritis with

possible avascular necrosis, although Plaintiff’s medications

helped; an MRI in May 2005 showed significant bilateral hip

avascular necrosis. (A.R. 363-65.) Referral to orthopedic surgeon

H. Jergesen, M.D., at UCSF Medical Center, resulted in Dr.

Jergesen’s report of hip pain that was severe, daily, and was

exacerbated by standing, walking, and movement of the legs, and

his opinion that Plaintiff had osteonecrosis of the right hip at

stage IV on the right and stage II on the left. (A.R. 423-24.)

Right hip total arthroplasty in August 2005 left Plaintiff making

excellent progress with physical therapy and weight bearing.

(A.R. 22, 383, 398-99.)

After summarizing the medical record, the ALJ stated that

because of the importance of the outstanding issues concerning

the treating physician’s opinion, during the hearing the ALJ

asked Plaintiff’s counsel to obtain clarification from the doctor

who wrote the form and stated he would hold the record open for

two weeks for that submission. (A.R. 22, 447.) The ALJ asked for

the basis for any limitations, specific limitations such as an

RFC, the onset and duration, number of visits at which the doctor

saw the patient, if part of a treatment team, the number of

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consults with the other team members, date the patient was last

seen, any subjective limitations, and the doctor’s

qualifications. (A.R. 447.) 

In his decision, the ALJ stated that the letter that he

received from Dr. Shubhakar (A.R. 425) only said that Plaintiff

was under care for chronic low back and hip pain; Plaintiff had a

total hip replacement of the right side and was awaiting an

operation for the left side; he was unable to stand for a

prolonged time or bend or stoop; and he should not lift more than

five pounds. (A.R. 22-23.) The doctor diagnosed osteoarthritis of

the hip secondary to avascularnecrosis, degenerative disc disease

and disc prolapse (neck area). (A.R. 425.) The ALJ stated that

because the doctor had failed to respond to most of his

questions, he was not able to give the opinion controlling

weight, but he could give it some weight because it was

consistent with his decision that Plaintiff was able to perform

sedentary work. (A.R. 23.) 

Plaintiff argues that the opinions of the other doctors do

not amount to evidence substantial enough to support the finding

that Plaintiff was not disabled because the other doctors had not

considered Plaintiff’s hip surgery in 2005. Plaintiff asserts

that the ALJ erred in rejecting the treating doctor’s opinion

simply because the doctor failed to respond to all the ALJ’s

questions; instead, the opinion should be given great weight

because it is the only one that considered the totality of the

medical record, including Plaintiff’s right total hip

arthroplasty done in August 2005. 

The law pertinent to evaluating the opinions of treating

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physicians was recently summarized:

The opinions of treating doctors should be given

more weight than the opinions of doctors who do not

treat the claimant. Lester [v. Chater, 81 F.3d 821, 830

(9th Cir.1995) (as amended).] Where the treating

doctor's opinion is not contradicted by another doctor,

it may be rejected only for “clear and convincing”

reasons supported by substantial evidence in the

record. Id. (internal quotation marks omitted). Even if

the treating doctor's opinion is contradicted by

another doctor, the ALJ may not reject this opinion

without providing “specific and legitimate reasons”

supported by substantial evidence in the record. Id. at

830, quoting Murray v. Heckler, 722 F.2d 499, 502 (9th

Cir.1983). This can be done by setting out a detailed

and thorough summary of the facts and conflicting

clinical evidence, stating his interpretation thereof,

and making findings. Magallanes [v. Bowen, 881 F.2d

747, 751 (9th Cir.1989).] The ALJ must do more than

offer his conclusions. He must set forth his own

interpretations and explain why they, rather than the

doctors', are correct. Embrey v. Bowen, 849 F.2d 418,

421-22 (9th Cir.1988).

Reddick v. Chater, 157 F.3d 715, 725 (9th

Cir.1998); accord Thomas, 278 F.3d at 957;

Lester, 81 F.3d at 830-31.

Orn v. Astrue, 495 F.3d 625, 632 (9 Cir. 2007). th

Further, the criteria for evaluating expert decisions was

likewise addressed in Orn v. Astrue:

By rule, the Social Security Administration favors

the opinion of a treating physician over non-treating

physicians. See 20 C.F.R. § 404.1527. If a treating

physician's opinion is “well-supported by medically

acceptable clinical and laboratory diagnostic

techniques and is not inconsistent with the other

substantial evidence in [the] case record, [it will be

given] controlling weight.” Id. § 404.1527(d)(2). If a

treating physician's opinion is not given “controlling

weight” because it is not “well-supported” or because

it is inconsistent with other substantial evidence in

the record, the Administration considers specified

factors in determining the weight it will be given.

Those factors include the “[l]ength of the treatment

relationship and the frequency of examination” by the

treating physician; and the “nature and extent of the

treatment relationship” between the patient and the

treating physician. Id. § 404.1527(d)(2)(i)-(ii).

Generally, the opinions of examining physicians are

afforded more weight than those of non-examining

physicians, and the opinions of examining non-treating

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physicians are afforded less weight than those of

treating physicians. Id. § 404.1527(d)(1)-(2).

Additional factors relevant to evaluating any medical

opinion, not limited to the opinion of the treating

physician, include the amount of relevant evidence that

supports the opinion and the quality of the explanation

provided; the consistency of the medical opinion with

the record as a whole; the specialty of the physician

providing the opinion; and “[o]ther factors” such as

the degree of understanding a physician has of the

Administration's “disability programs and their

evidentiary requirements” and the degree of his or her

familiarity with other information in the case record.

Id. § 404.1527(d)(3)-(6).

Orn v. Astrue, 495 F.3d 625, 631 (9 Cir. 2007). th

With respect to proceedings under Title XVI, the Court notes

that an identical regulation has been promulgated. See, 20 C.F.R.

§ 416.927.

Here, the ALJ acknowledged that he needed to know the basis

of the doctor’s opinion as well as to ascertain the substance of

the opinion itself with respect to specific limitations, onset

date of restrictions and the reasons for choosing that date, the

duration of the condition, whether or not it had or was expected

to endure less than twelve continuous months, and at what

severity level. Further, the ALJ desired information useful to

evaluating the treatment relationship. To the extent that the ALJ

needed to develop the record in order to know the basis of the

doctor’s opinion or otherwise to evaluate it, he performed his

duty in articulating the precise information needed and leaving

the record open for a reasonable time period for supplementation.

Tidwell v. Apfel, 161 F.3d 599, 602 (9 Cir. 1999); Smolen v. th

Chater, 80 F.3d 1273, 1288 (9 Cir. 1996) (noting regulations th

providing that an appropriate inquiry could include subpoenaing

the physicians, submitting further questions to them, or

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continuing the hearing to augment the record). 

The ALJ here sought the necessary information in order to

evaluate the treating physician’s opinion. Although the medical

record independently could have provided some evidence of

longevity of treatment, the evidence requested by the ALJ was

specific and pertinent. Yet the doctor did not provide any basis

for the opinion other than a very general diagnosis and a summary

of Plaintiff’s past and expected treatment for his hip pain. He

referred to limitations on standing, bending, stooping, and

lifting. However, he did not respond otherwise to the request for

a statement of the basis for the opinion; the ALJ still did not

know whether it was based on any particular tests, on Plaintiff’s

subjective claims, a combination thereof, or even other,

unspecified data. The only data arguably relevant to severity

were the limitations and treatment. Further, the doctor did not

give any information with respect to onset, duration, or expected

duration in the future. Finally, the doctor did not provide any

information concerning the frequency of the patient-doctor

contact, the extent of the doctor’s participation in any team

treatment, or other factors pertinent to evaluating the treatment

relationship underlying the opinion.

As the foregoing legal standards indicate, the absence of an

explanation or a sound basis for an opinion is appropriately

considered. Likewise, the nature of the treatment relationship is

an important factor. The opinions of the other physicians

contradicted the treating doctor’s opinion with respect to

Plaintiff’s spinal impairments and his RFC, and thus, the

specific and legitimate reasons stated by the ALJ were sufficient

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to cite in rejecting the treating physician’s opinion on these

matters. With respect to the hip problem, Plaintiff was given an

opportunity to provide the ALJ with information needed to

evaluate the treating doctor’s opinion; when he did not, the ALJ

did not determine that the record was inadequate, but rather

proceeded to evaluate the information in the record. Based on the

limited information before him, the ALJ followed correct legal

standards and stated specific and legitimate reasons for his 

decision. 

Although the ALJ was not presented with the information that

he desired, it was Plaintiff’s burden to prove that he was

disabled, i.e., that he was precluded from engaging in not only

his previous work, but also from performing any other kind of

substantial gainful work due to the impairment. Matthews v.

Shalala, 10 F.3d 678, 680 (citing 42 U.S.C. § 423(d)(1)(A)).

Further, Plaintiff must establish that an impairment has lasted

or is expected to last at least twelve continuous months, and the

inability to work caused by the impairment must last at least

twelve continuous months. 20 C.F.R. §§ 404.1509, 416.909;

Barnhart v. Walton, 535 U.S. 212, 214-22 (2002). Plaintiff did

not meet his burden in this regard. 

VI. Disposition

Based on the foregoing, the Court concludes that the ALJ’s

decision was supported by substantial evidence in the record as a

whole and was based on proper legal standards. 

Accordingly, the Court AFFIRMS the administrative decision

of the Defendant Commissioner of Social Security and DENIES

Plaintiff’s Social Security complaint.

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The Clerk of the Court IS DIRECTED to enter judgment for

Defendant Michael J. Astrue, Commissioner of Social Security, 

and against Plaintiff Robert Hunter.

IT IS SO ORDERED.

Dated: January 23, 2008 /s/ Sandra M. Snyder 

icido3 UNITED STATES MAGISTRATE JUDGE

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