Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_15-cv-00043/USCOURTS-caed-1_15-cv-00043-4/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Nickolas W. McMahon
Plaintiff

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1

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

NICKOLAS W. McMAHON,

Plaintiff,

v.

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security,

Defendant.

Case No. 1:15-cv-00043-SMS

ORDER AFFIRMING AGENCY’S DENIAL 

OF BENEFITS

Plaintiff Nickolas W. McMahon seeks review of a final decision of the Commissioner of 

Social Security (“Commissioner”) denying his applications for disability insurance benefits (“DIB”) 

under Title II and for supplemental security income (“SSI”) under Title XVI of the Social Security 

Act (42 U.S.C. § 301 et seq.) (“the Act”). This matter is before the Court on the parties’ crossbriefs, which were submitted without oral argument to the Magistrate Judge. Following a review of 

the record and applicable law, the Court affirm the decision of the Administrative Law Judge 

(“ALJ”).

I. PROCEDURAL HISTORY AND FACTUAL BACKGROUND1

A. Procedural History

 

1

 The relevant facts herein are taken from the Administrative Record (“AR”). 

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Plaintiff applied for DIB on October 13, 2011, alleging disability beginning on July 18, 2008. 

He also applied for SSI on December 17, 2012. 2 The Commissioner denied Plaintiff’s claims on 

January 5, 2012, and upon reconsideration on August 21, 2012. AR 60, 75, 128. Plaintiff then 

requested a hearing before an ALJ. AR 89.

On January 22, 2013, Plaintiff appeared and testified before ALJ Raymond L. Souza. Also at 

the hearing were Plaintiff’s counsel and an impartial vocational expert (“VE”). AR 29. In a written 

decision dated May 24, 2013, the ALJ found Plaintiff was not disabled under the Act. AR 24. On 

November 4, 2014, the Appeals Council denied review of the ALJ’s decision, which thus became the 

Commissioner’s final decision, and from which Plaintiff filed a timely complaint. AR1; Doc. 1. 

B. Factual Background

The Court will not recount in detail all the facts of this case, discussing only what is relevant 

to this appeal. 

1. Medical Evidence

Plaintiff’s conditions stemmed from a work injury which occurred on July 18, 2008. While 

hooking up a car to be towed, his right lower leg was struck by a vehicle. Upon being admitted to 

the emergency room at Community Hospital of Los Gatos, he complained of lower right leg pain but 

denied injury elsewhere. Examinations showed a normal right knee without fractures, aside from 

swelling and tenderness to the calf area and a minor contusion of the anterior ankle joint. Plaintiff 

was discharged home and prescribed pain medication. AR 217-218. 

The breadth of Plaintiff’s medical history thereafter show him receiving treatment from 

physicians at the Los Gatos Spinal Diagnostics, South Bay Pain and Rehab Medical Group (“South 

Bay Pain and Rehab”), and Sierra Acupuncture. 

For about three years, from January 2009 to April 2012, Plaintiff saw Brian Karvelas, M.D. 

 

2

 The ALJ’s written decision states Plaintiff applied for SSI on December 17, 2012 and the parties’ 

briefs cite to it, but the AR contains no documents reflecting Plaintiff applied for SSI. 

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of South Bay Pain and Rehab on almost a monthly basis. AR 282-290, 292-314, 358, 473. At their 

first consultation, Plaintiff discussed his work injury and reported having a severe headache, lower 

back pain, and right greater than left leg pain the morning after the accident. He reported seeking 

treatment for the pain and received more than one course of physical therapy. While the last course 

of physical therapy was helpful, the pain persisted. Dr. Karvelas made the following diagnostic 

impressions: (1) L5-S1 intervertebral disc annular tear and protrusion causing mild spinal canal 

stenosis and bilateral neural foraminal stenosis, symptomatic with lumbosacral radiculopathy; (2) 

cervical strain injury versus intervertebral disc injury and/or spondylosis with associated headache 

disorder; and (3) improved right knee and ankle contusion. Dr. Karvelas requested authorization for 

a cervical spine MRI to evaluate for an intervertebral disc injury which might explain the ongoing 

neck pain symptoms and headache disorder. He recommended enrolling Plaintiff in a physical 

therapy program to address Plaintiff’s cervical spine condition. He restricted Plaintiff to light duty 

and recommended he remain on temporary disability for at least several months. AR 316-323. 

In October 2009, David K. Pang, M.D., evaluated Plaintiff for purposes of his workers’ 

compensation claim. Dr. Pang observed: (1) “no visible muscular atrophy of the muscles of the 

upper or lower extremities[;]” (2) “no visible thenar, hypothenar or intrinsic muscle atrophy of the 

muscles of either hand[;]” (3) “gait was normal and reciprocating [and] [Plaintiff] could heel and toe 

walk normally, although he complained of some pain in his lower back when he did so[;]” (4) motor 

testing of the major motor groups of the upper and lower extremities were normal; (5) sensory 

testing of the major sensory dermatomes of the upper and lower extremities were normal, except for 

“[d]iminished sensation over the lateral aspect of his left lower leg.” Dr. Pang noted chronic cervical 

and trapezial strain, chronic lumbar strain, and left leg pain. Objective findings included: “[r]ight 

and left paralumbar muscular tenderness and guarding; decreased cervical and lumbar spine motion; 

and decreased sensation of the left and lateral calf.” In conclusion, Dr. Pang did not believe Plaintiff 

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could return to his prior occupation in full capacity and “would be considered medically a qualified 

injured worker.” AR 348-356. 

In December 2010, Dr. Karvelas completed a check-the-box and fill-in-the-blank form 

setting forth his assessment of Plaintiff’s functional capacity and concluded that because Plaintiff 

had “limited tolerance for repetition, prolonged or extreme posturing,” he was limited as follows: (1) 

lifting and/or carrying no more than thirty pounds, ten pounds frequently and twenty pounds 

occasionally; (2) sitting less than four hours in an eight-hour workday; (3) standing and/or walking 

less than four hours in an eight-hour workday; (4) repetitive pushing/pulling for no more than two to 

four hours per day; (5) never crawling; (6) occasional climbing, balancing, stooping, kneeling, 

twisting, reaching and crouching; (7) frequent fingering, feeling, seeing, hearing and speaking; and 

(8) avoiding heights. AR 291. Dr. Karvelas referred Plaintiff to Randall E. Seago, M.D., of Spinal 

& Orthopaedic Surgery. 

At a June 2011 spine surgery consultation, Dr. Seago observed Plaintiff remaining “seated 

throughout the lengthy interview process” and rise from his “chair with some guarding.” His “gait 

has a short stride but is otherwise unremarkable.” Dr. Seago obtained an MRI of Plaintiff and upon 

review diagnosed him with: (1) left sciatica, (2) moderate to marked left L5-S1 foraminal stenosis 

involving the left L5 nerve root; (3) retrolisthesis at L5-S1 with a broad-based midline disc 

protrusion; and (4) grade I spondylolisthesis at L4-5 on forward bending views. Dr. Seago explained 

that “instability at L4-5 on forward bending combined with retrolisthesis at L5-S1 and the associated 

foraminal stenosis with disc protrusion are such that standing/weight bearing will certainly worsen 

his symptoms.” He recommended “electrodiagnostic studies to be performed by Dr. Karvelas.” AR 

251-255. Dr. Seago expressed general agreement with the attending physician who conducted the 

MRI scan, Murray Solomon, M.D., at Insight Imaging. Dr. Solomon’s separate findings included: 

“no marked congenital or marked acquired central canal narrowing at any lumbar level.” However, 

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“[e]xamination of the lumbar disc levels reveal[ed] disc disease and/or degenerative change at the 

L3-4, L4-5 and L5-S1 disc levels.” AR 324 (emphasis in original).

Concurrent to seeing Dr. Karvelas, Plaintiff also saw Ray Hsieh, M.D. at Pain Care of 

Silicon Valley on a regular basis from July 2009 to July 2013. AR 366-400, 486-501, 504-507, 514-

517, 523-524. Plaintiff received facet and epidural injections about every few months until March 

2012. AR 234-250, 401-412, 508-513, 518-520. On a number of occasions, namely in January,

February and April 2012, he expressed feeling a decrease in low back and left leg pain from the 

injections. In April 2012, he reported experiencing “approximately 80-90% reduction in his low 

back and left leg pain as a result of the injections” and “enjoying increased functional capacity as a 

result of the improvement, and he has been able to decrease his as-needed pain medication[,]” 

despite “not [having] had any acupuncture lately[.]” AR 366-371. In the same month, Dr. Hsieh 

completed a physical RFC questionnaire, a check-the-box and fill-in-the-blank form.

3

 Therein, he 

diagnosed Plaintiff with lumbar radiculopathy, lumbar facet arthropathy, and cervical radiculopathy. 

Plaintiff had pain in the neck, low back, and left leg, which increased with activity such as lifting, 

standing, and walking. Dr. Hsieh concluded Plaintiff was not a malingerer and that emotional 

factors did not contribute to his symptoms and functional limitations. Plaintiff experienced pain at a 

constant level such that it would interfere with the attention and concentration needed to perform 

even simple work tasks. Plaintiff’s medications caused drowsiness, dizziness, and impaired 

cognition. He could: (1) walk three city blocks without rest or severe pain; (2) sit for about thirty 

minutes before needing to get up; (3) stand for about thirty minutes before needing to sit down or 

walk around; (4) sit for less than two hours in an eight-hour workday; (5) and stand/walk for less 

than two hours in an eight-hour workday; (6) rarely lift and carry ten pounds or less in a competitive 

work environment; and (7) never twist, stoop, crouch and climb ladders or stairs. Additionally, 

 

3

 The questionnaire is a poor copy and therefore partly illegible.

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Plaintiff required: (1) a sit/stand option; (2) periods of ten-minute walks every fifteen minutes; and 

(3) unscheduled lengthy breaks often. He would be absent from work for more than four days per 

month. AR 361-364.

In January 2012, medical consultant M. Gleason, M.D., reviewed Plaintiff’s medical records 

and opined he: (1) could lift and/or carry twenty pounds occasionally and ten pounds frequently; (2) 

could sit, stand and/or walk about six hours in an eight-hour workday; (3) was limited with 

pushing/pulling of the upper and lower left extremities; (4) could occasionally climb ramps and 

stairs, stoop, kneel, crouch and crawl; (5) frequently balance; (6) never climb ladders, ropes or 

scaffolds; and (7) was limited with reaching left overhead, left front and/or laterally. According to 

Dr. Gleason, a finding of light RFC “is not unreasonable.” He reviewed Dr. Karvelas’s December 

2010 assessment and noted the finding that Plaintiff could sit and stand less than four hours in eighthour workday to be unsupported by objective evidence, pointing to the fact that “on 9/6/11 is the 

statement that there has been a 70% pain reduction indicating a good response to cortisone 

injections.”4 Dr. Gleason found Dr. Karvelas’s opinion:

- “relie[d] heavily on the subjective report of symptoms and limitations provided by [Plaintiff], 

and the totality of the evidence does not support the opinion[;]”

- “contains inconsistencies, rendering it less persuasive[;]” and

- “without substantial support from other evidence of record, which renders it less persuasive.”

Dr. Gleason believed that despite Plaintiff’s limitations, he could perform his past relevant work as 

bartender as it is generally performed in the national economy. AR 54-58.

About eight months later, another medical consultant, C. Bullard, M.D., also reviewed 

Plaintiff’s medical records and found his statements about the intensity, persistence, and functionally 

limiting effects of the symptoms unsubstantiated by the objective medical evidence alone, and that 

he was only “partially credible” because while he reported being disabled, “all objective findings in 

 

4

 A review of the record show Plaintiff made the statement on August 2, 2011 and not “9/6/11” as 

Dr. Gleason noted. AR 285.

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file would support [normal] gait and light work restrictions.” Dr. Bullard found Dr. Hsieh’s opinions 

in the April 2012 questionnaire “overly restrictive given the recent improvement from the steroid 

injections. [For example,] EPS injections in the cervical spine was [sic] performed on 7/20/11 with 

90% improvement in pain on [follow-up] of 10/3/11.” And there was an “80% reduction in his back 

pain since his [epidural steroid] injections performed on 10/12/11.” In sum, Dr. Bullard opined that 

the evidence supports adopting Dr. Gleason’s “prior determination of Light RFC w/ limitations.” 

AR 67-71, 370, 372.

In an October 2012 letter written on Plaintiff’s behalf in support of his claim for disability 

from the work-related injury, Dr. Hsieh stated:

[Plaintiff] takes medications as needed on a slightly regular basis to 

manage his pain, and this would also render it difficult to impossible 

for him to perform job-related duties because of the potential cognitive 

side effects of medications. Although he does have some 

improvement with treatment that is performed including medications, 

rehabilitative modalities, acupuncture, and epidural steroid injections, 

these are things that are done on a regular basis chronically for 

maintenance purposes. I do believe that it is unlikely to expect that 

Mr. McMahon’s condition would suddenly revert to the point where 

he has little to no pain and is able to resume a full gamut of his 

previous capacity for activities. Therefore, I do believe that disability 

is appropriate at this time.

AR 502. 

From December 2011 to March 2013, Plaintiff received nearly monthly acupuncture therapy 

at Sierra Acupuncture from Taya Stanley, D.A.O.M. The result, according to Plaintiff, was an 

overall reduction in pain. In August 2012, he reported, “overall clear decrease in pain intensity, both 

at rest and with exertion in the lumbar as well as cervical area[,]” “radiculopathy down [the] left leg 

is retreating (less numbness in toes)[,]” and “a significant pain and paresthesia reduction of the 

cervicalgia pain syndrome which initially radiated over left scapula area and down dorso-lateral left 

arm[,]” with “improved life quality and daily activities levels regarding range and duration.” Two 

months later, he reported similar improvements. In December 2012, he reported that “after the 

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present acupuncture course his life quality and the range of daily activities improved due to the 

increase in lumbar range of motion and due to less frequent and less intense lumbar pain and flareups.” These improvements led Dr. Stanley to conclude that acupuncture was beneficial to Plaintiff 

and should continue. AR 447-464, 471, 480-483. 

2. Plaintiff’s Written Testimony

In his first disability report, completed in October 2011, Plaintiff stated injuries to his 

cervical and lumbar spine and left leg limited his ability to work. He was, at the time, taking various 

medications to help alleviate the back and leg pain. Plaintiff last worked as a tow truck driver, a job 

he held from October 2003 to July 2008. Before that, he worked as a health care provider from July 

2002 to August 2003 and as a bartender from December 1998 to June 2002. AR 149-152, 161. 

In December 2011, Plaintiff completed an exertion questionnaire. Therein, he reported being 

active, on average, for about three hours a day, with the remainder being consumed by worsening 

pain. He could walk for about a third of a mile or half an hour before his knee swells. He could 

climb a flight of stairs in his apartment and lift no more than twenty pounds. He could lift a basket 

of laundry up the stairs, but not without increased pain. He did no yard work but could, in fifteenminute increments, perform housework including dishwashing, vacuuming, and cleaning the 

bathroom. He could drive for no more than thirty minutes and went grocery shopping every three 

weeks. He usually gets about two to four hours per night of “broken” sleep and therefore napped 

during the day for about thirty minutes to an hour. Plaintiff used a brace daily for stability. His 

medications included: Gabapentin, Ultracet, Metaxalone, and Dendracin. AR 158-160. 

In his second disability report, completed in March 2012, Plaintiff reported “[w]orsening of 

[low back pain], throbbing pain top of foot, cervical strain, flaring neck pain, standing limited.” His 

medications remained the same, with fatigue and loss of energy being side effects. AR 169, 171. 

And in his third disability report, completed in September 2012, Plaintiff reported “increase in leg 

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pain . . . when standing, walking, lifting, [and] bending.” His medications remained largely the 

same. AR 176, 178. 

3. Hearing Before Administrative Law Judge

At the hearing in April 2013, Plaintiff confirmed his impairments included neck and back 

pain which extended down the left side of his leg and ankle. AR 34. He testified that acupuncture 

worked well to relieve some of the pain. It allowed him to walk as much as thirty minutes, sit for 

about forty-five minutes to an hour, and stand for about thirty minutes. Without the acupuncture, he 

would be lying down most of the time with a pillow underneath his legs. AR 36. 

He had a driver’s license. He could lift a gallon of milk and was able to bathe and dress 

himself. He cleaned the bathroom, bedroom, went grocery shopping once a month with his mother 

and sometimes on his own, watched television and played video games. He tried to exercise daily 

for about ten to fifteen minutes. AR 36-38. 

Plaintiff used a back brace and TENS unit. On average, he had about six to seven good says 

a month. His medications—Gabapentin, Ultracet, Metaxalone, and Vicodin—caused Plaintiff to feel 

disconnected and dizzy when walking. Relief from the epidural steroid injections lasted from two 

weeks to a month and a half. He did not undergo surgery because a surgeon advised him that there 

was only fifty percent chance of removing fifty percent of the pain. AR 36-37, 39-41. 

4. ALJ’s Decision

A claimant is disabled under Titles II and XVI if he is unable to engage in substantial gainful 

activity because of a medically determinable physical or mental impairment that can be expected to 

result in death or has lasted or can be expected to last for a continuous period of no less than twelve

months. 20 C.F.R. §§ 404.1505(a), 416.905(a). To encourage uniformity in decision making, the 

Commissioner has promulgated regulations prescribing a five-step sequential process which an ALJ 

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must employ to evaluate an alleged disability.5

In his written decision, the ALJ found that at step one, Plaintiff had not engaged in 

substantial gainful activity since the alleged onset date of July 18, 2008. At step two, Plaintiff had 

the following severe impairments: degenerative disc disease of the cervical spine and lumbar 

degenerative disc disease with left-sided radicular pain. At step three, Plaintiff did not have an 

impairment or combination of impairments that medically met or equaled the severity of a listed 

impairment in 20 C.F.R. Part 404, Subpart P, Appendix 1. Plaintiff had the RFC to perform light 

work, except he: (1) cannot climb ladders, ropes or scaffolds; (2) occasionally climb ramps and 

chairs, balance, stoop, kneel, crouch and crawl; (3) must avoid all use of hazardous machinery and 

all exposure to unprotected heights; and (4) is limited to simple repetitive tasks. At step four, 

Plaintiff was incapable of performing any of his past relevant work. At step five, however, there 

were jobs in the national economy, namely cashier and marker, which Plaintiff could perform. 

Consequently, the ALJ concluded Plaintiff was not disabled as defined under the Act since July 18, 

2008 through the date of the decision. AR 17-24.

II. DISCUSSION

A. Legal Standards

This Court reviews the Commissioner’s final decision to determine if the findings are 

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, 401 (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 

 

5

 “In brief, the ALJ considers whether a claimant is disabled by determining: (1) whether the 

claimant is doing substantial gainful activity; (2) whether the claimant has a severe medically 

determinable physical or mental impairment or combination of impairments that has lasted for more 

than 12 months; (3) whether the impairment meets or equals one of the listings in the regulations; (4) 

whether, given the claimant’s residual functional capacity, the claimant can still do his or her past 

relevant work; and (5) whether the claimant can make an adjustment to other work. The claimant 

bears the burden of proof at steps one through four.” Molina v. Astrue, 674 F.3d 1104, 1110 (9th 

Cir. 2012). 

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a reasonable mind might accept as adequate to support a conclusion.” Richardson, 402 U.S. at 401. 

“If the evidence can reasonably support either affirming or reversing a decision, we may not 

substitute our judgment for that of the Commissioner. However, we must consider the entire record 

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

Commissioner’s conclusion, and may not affirm simply by isolating a specific quantum of 

supporting evidence.” Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007) (internal citation 

and quotations omitted). “If the evidence can support either outcome, the Commissioner’s decision 

must be upheld.” Benton v. Barnhart, 331 F.3d 1030, 1035 (9th Cir. 2003); see 42 U.S.C. § 405(g)

(2010). But even if supported by substantial evidence, a decision may be set aside for legal error. 

Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009). 

Moreover, an ALJ’s error is harmless “when it was clear from the record that [the] error was 

inconsequential to the ultimate nondisability determination.” Robbins v. Soc. Sec. Admin. 466 F.3d 

880, 885 (9th Cir. 2006).

B. Analysis

On appeal, Plaintiff contends the ALJ erred: (1) in failing to properly consider listing 1.04,

(2) in rejecting the opinions of Dr. Karvelas, and (3) in rejecting the opinions of Dr. Hsieh. 

a. Listing 1.04

Plaintiff avers his conditions met the requirements of listing 1.04 and that by “only 

provid[ing] a boilerplate conclusion that Plaintiff’s spinal disorders do not meet or medically equal a 

listed impairment,” the ALJ erred. Doc. 19, p. 11. The Commissioner counters Plaintiff did not 

meet his burden of showing he met listing 1.04. 

Listing 1.04 states in relevant part: 

Disorders of the spine (e.g., herniated nucleus pulposus, spinal 

arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, 

facet arthritis, vertebral fracture), resulting in compromise of a nerve 

root (including the cauda equina) or the spinal cord. With:

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A. Evidence of nerve root compression characterized by neuroanatomic distribution of pain, limitation of motion of the spine, motor 

loss (atrophy with associated muscle weakness or muscle weakness) 

accompanied by sensory or reflex loss and, if there is involvement of 

the lower back, positive straight-leg raising test (sitting and supine)[.]

20 C.F.R. § Pt. 404, Subpt. P, App. 1. This means to establish a spinal disorder under listing 1.04, 

subpart A, a claimant must establish a spinal disorder and present evidence of nerve root 

compression illustrated by (1) limited spinal motion, (2) motor loss with sensory or reflex loss, and 

(3) if the lower back is involved, positive straight-leg raising test. Id.; see Healy v. Astrue, 379 F. 

App’x 643, 645 (9th Cir. 2010).

6

 Moreover, underlying a disorder of the musculoskeletal system is 

the requirement of “functional loss,” which is “defined as the inability to ambulate effectively on a 

sustained basis for any reason[.]” 20 C.F.R. § Pt. 404, Subpt. P, App. 1. And the

[i]nability to ambulate effectively means an extreme limitation of the 

ability to walk; i.e., an impairment(s) that interferes very seriously 

with the individual’s ability to independently initiate, sustain, or 

complete activities. Ineffective ambulation is defined generally as 

having insufficient lower extremity functioning . . . to permit 

independent ambulation without the use of a hand-held assistive 

device(s) that limits the functioning of both upper extremities.

Id.

In support of his alleged disability under listing 1.04, Plaintiff asserts: (1) the “MRI exams 

confirm . . . multiple herniated discs, foraminal stenosis, and annular tears in [the] lumbar spine 

impinge nerve roots on at least two different vertebral levels[;]” (2) “multiple physicians have 

consistently diagnosed [him] with lumbar radiculopathy based on objective diagnosis[;]” (3) 

“physicians have repeatedly noted restricted range of motion in the lumbar spine[;]” (4) “physicians 

have repeatedly confirmed Plaintiff exhibits numbness and loss of sensation in his leg and calf and 

left sided ‘sensory disturbances’ and ‘deficits[;]’” and (5) he “exhibits” a positive straight leg raise 

 

6

 This unpublished decision is citable under Rule 32.1 of the Federal Rules of Appellate Procedure. 

See also 9th Cir. R. 36–3(b).

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test[.]” He cites to the opinions of Drs. Seago, Karvelas, Solomon, and Hsieh. Doc. 19, pp. 11-12. 

But a review of their opinions shows Plaintiff cannot meet his burden. 

Importantly, the evidence belies an inability to ambulate effectively on a sustained basis. For 

example, Dr. Seago observed Plaintiff remaining “seated throughout the lengthy interview process” 

and rise from his “chair with some guarding.” His “gait has a short stride but is otherwise 

unremarkable.” He appeared at the initial consultation with Dr. Karvelas “with a normal 

reciprocating gait pattern and normal station.” And while Plaintiff alleged worsening pain in March 

and September 2012, his December 2011 exertion questionnaire states Plaintiff could walk for about 

a third of a mile or half an hour, perform house cleaning in fifteen-minute increments, and drive for 

no more than thirty minutes. Further, he testified at the April 2013 hearing that acupuncture allowed 

him to walk for as long as thirty minutes. Collectively, these activities do not reflect an inability to 

ambulate effectively on a sustained basis. Failing to meet the requirement of functional loss, 

Plaintiff cannot therefore successfully argue that he suffers from the type of spinal disorder 

contemplated by listing 1.04. See Bennett v. Colvin, 609 F. App’x 522 (9th Cir. 2015) (“the ALJ 

was not required to explain why Bennett’s impairments do not equal Listing 1.04, because Bennett 

did not present evidence in an effort to establish medical equivalence”) (citations omitted). 

Finding, then, that Plaintiff did not satisfy the foundational requirement of listing 1.04, the 

Court need not discuss whether he has met the remaining requirements. 

b. Dr. Brian Karvelas 

The ALJ recounted Dr. Karvelas’s December 2010 assessment and stated:

Dr. Karvelas treated the claimant for more than two years and 

examined him on multiple occasions, and his opinions are partially 

consistent with the medical evidence. The restrictions he identifies in 

lifting, carrying, performing most postural tasks, and interacting with 

heights are generally supported by the evidence for the reasons set 

forth above, while those he describes in sitting, standing, and walking 

are not. 

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AR 22. From this, Plaintiff avers the ALJ “failed to provide any reasons at all for rejecting Dr. 

Karvelas’ [sic] opinion” that Plaintiff could not stand and sit a total of four hours each in an eighthour workday. Doc. 19, p. 12. He asserts the ALJ was required to provide specific and legitimate 

reasons but instead gave a generalized and unexplained conclusion which prejudiced Plaintiff. The 

Commissioner contends the ALJ properly considered Dr. Karvelas’s opinions and the decision to 

give less weight to portions thereof find support in the record. 

“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.” Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 

1995) (footnote and citation omitted). To reject a treating physician’s opinion which is contradicted 

by another physician, the ALJ must provide specific and legitimate reasons supported by substantial 

evidence in the record. Id. But an “ALJ need not accept the opinion of any physician, including a 

treating physician, if that opinion is brief, conclusory, and inadequately supported by clinical 

findings.” Chaudhry v. Astrue, 688 F.3d 661, 671 (9th Cir. 2012) (quotations and citation omitted). 

Because Dr. Karvelas’s opinions concerning Plaintiff’s capacity to sit, stand and walk is contradicted 

by Drs. Gleason and Bullard, the ALJ was required to provide specific and legitimate reasons in

discounting them. 

Plaintiff’s assertion that the ALJ provided no reasons at all is specious. In referencing “the 

reasons set forth above,” the ALJ necessarily included his discussion of the opinions of Drs. Pang, 

Seago, Gleason, Bullard, and Plaintiff’s own statements of decreased pain and improved range of 

motion. The ALJ explained that despite multiple abnormalities, Plaintiff walked with a normal gait 

and that his pain was alleviated with facet and epidural steroid injections and acupuncture, as shown 

by the physicians’ opinions and Plaintiff’s statements to Drs. Hsieh and Stanley. Indeed, the ALJ’s 

reasoning finds substantial support in the record. And from them, he could reasonably infer that it 

was unreasonable to find Plaintiff could not sit and stand/walk for four hours each in an eight-hour 

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workday. See, e.g., Gen. Ship Serv. v. Dir., Office of Workers' Comp. Programs, 938 F.2d 960, 962 

(9th Cir. 1991) (“ALJs must draw reasonable inferences based on the evidence before them.”)

The ALJ’s statement that “no treating or examining clinician has ever observed him to appear 

uncomfortable while sitting, standing or walking” is arguably inaccurate, given that Dr. Hsieh 

concluded in the April 2012 questionnaire that Plaintiff’s pain increased with lifting, standing, and

walking. AR 20. However, any error here was harmless where the ALJ also correctly relied on 

Plaintiff’s statements of decreased pain and increased functional capacity from the injections. 

Moreover, the ALJ ultimately gave Dr. Hsieh’s opinion little weight. AR 22-23. 

To conclude, then, that the ALJ gave no specific and legitimate reasons for partially rejecting 

Dr. Karvelas’s opinion, Plaintiff would have the court read the ALJ’s decision in a piecemeal 

fashion, and that it will not do. 

c. Dr. Ray Hsieh

With regard to Dr. Hsieh, the ALJ stated in pertinent part:

Although Dr. Hsieh has examined the claimant many times, his 

opinions are not consistent with the medical evidence, including his 

own treatment notes. The claimant has a greater capacity for sitting, 

standing, walking, lifting, carrying, and performing postural tasks than 

Dr. Hsieh found for the reasons explained previously. In addition, 

while the claimant has testified that he has a limited tolerance for 

activity and must rest frequently throughout the day, the observations 

of treating and examining doctors do not support this claim. No 

clinician has observed him to appear particularly tired, or to have 

difficulty functioning during appointments. Likewise, no doctor has 

ever observed the claimant to have substantial difficulty maintaining 

attention or concentration, and he remains able to drive and handle his 

own medical care. This suggests that he should be capable of 

performing simple tasks on a regular basis. Finally, Dr. Hsieh’s 

opinion is quite speculative. He indicates that the claimant’s 

medication used could cause cognitive difficulties that would interfere 

with his ability to perform work activities. Yet, he does not actually 

state that the claimant experiences such difficulties, and there is no 

evidence in his treatment notes that he has observed such problems. 

The medical evidence conflicts with Dr. Hsieh’s opinions; thus, the 

undersigned must give them little weight. 

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AR 23. Plaintiff avers the ALJ’s reasons for rejecting Dr. Hsieh’s opinions are “baseless, 

unsupported by substantial evidence, and do not constitute specific and legitimate reasons.” Doc. 

19, p. 15. The Commissioner contends the ALJ properly gave little weight to Dr. Hsieh’s opinions. 

Because Dr. Hsieh was a treating physician, whose opinions were contradicted, the ALJ was 

required, as he did with Dr. Karvelas, to provide specific and legitimate reasons for rejecting them. 

Lester, 81 F.3d at 830.

While not a model of clarity, the ALJ’s written decision essentially rejects Dr. Hsieh’s 

opinion: (1) concerning Plaintiff’s capacity for sitting, standing, walking, lifting, carrying, and 

performing postural tasks; (2) concerning Plaintiff’s need for lengthy unscheduled breaks; (3) that 

Plaintiff’s severe pain interfered with his ability to perform simple work tasks; and (4) that 

medication side effects made it difficult for Plaintiff to perform job-relate duties. 

First, because Dr. Hsieh’s opinion concerning Plaintiff’s sitting, standing and walking

capacity were more restrictive than Dr. Karvelas’s, the ALJ’s expressed reasons for rejecting the 

latter’s opinion applies here with equal force. As for Plaintiff’s capacity to lift and carry, the ALJ 

explained in his decision that Plaintiff “retains full strength in most muscle groups[.]” AR 21. This 

is supported by Dr. Pang’s observation of no visible muscle atrophy of the upper or lower 

extremities and no visible intrinsic muscle atrophy of the hand muscles. It is also supported by 

Plaintiff’s written testimony that he could lift as much as twenty pounds.7 The ALJ could therefore 

reject Dr. Hsieh’s opinion that Plaintiff could only rarely lift and carry ten pounds at most. As for 

the Plaintiff’s capacity to perform postural tasks, the ALJ adopted the opinions of Drs. Gleason and 

Bullard, which were less restrictive than Dr. Hsieh’s with regard to stooping, crouching and 

climbing stairs. And Plaintiff does not dispute their opinions. 

 

7

 The Court finds no evidence in the record of Plaintiff’s testimony that he could “lift 16 pounds,” as 

the ALJ stated in his written decision. AR 21.

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Second, the ALJ rejected the opinion that Plaintiff needed lengthy unscheduled breaks 

because no physician “observed him to appear particularly tired, or to have difficulty functioning 

during appointments[,]” or “difficulty maintaining attention or concentration.” The ALJ also noted 

the fact that Plaintiff was “able to drive and handle his own medical care.” AR 22. From these, the 

ALJ could infer that the need for lengthy unscheduled breaks were unfounded. Molina v. Astrue, 

674 F.3d 1104, 1111 (9th Cir. 2012) (“Even when the evidence is susceptible to more than one 

rational interpretation, we must uphold the ALJ's findings if they are supported by inferences 

reasonably drawn from the record.”). And for these same reasons, along with his treatment regimen 

and reported statements of decrease pain, the ALJ could infer that Plaintiff’s pain was not so severe 

as to prevent him from performing even simple work tasks. 

Finally, the ALJ’s reason for rejecting the opinion that medication side effects made it 

difficult for Plaintiff to perform job-relate duties—that it was speculative—is supported by 

substantial evidence. Dr. Hsieh rendered his opinion in his October 2012 letter written in support of 

Plaintiff’s workers’ compensation claim, and on its face the letter states the difficulty could arise 

“because of the potential cognitive side effects of medications.” The problem, however, as the ALJ 

correctly explained, is these side effects and resulting difficulty are not evident in the record. The 

ALJ is correct that while Plaintiff testified to feeling dizzy and disconnected from his medications, 

there is no record of him reporting these alleged side effects to a treating physician. As for 

Plaintiff’s written testimony of fatigue and energy loss, they, too, were not reported to a treating 

physician, and are not cognitive side effects contemplated by Dr. Hsieh. 

Thus, even if the ALJ’s reasons for rejecting part of Dr. Hsieh’s opinions are not the most 

convincing and articulately expressed, the Court would be hard pressed to conclude no specific and 

legitimate reasons were given. 

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III. CONCLUSION

Accordingly, the Court DENIES Plaintiff’s appeal from the administrative decision of the 

Commissioner of Social Security. The Clerk of Court is DIRECTED to enter judgment in favor of 

the Commissioner and against Plaintiff, Nickolas W. McMahon.

IT IS SO ORDERED.

Dated: October 20, 2016 /s/ Sandra M. Snyder 

UNITED STATES MAGISTRATE JUDGE

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