Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_05-cv-01540/USCOURTS-azd-2_05-cv-01540-0/pdf.json

Parties Involved:
Amada Estrada
Plaintiff
Social Security Administration
Defendant

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Amada Estrada, 

Plaintiff, 

vs.

Social Security Administration, 

Defendant. 

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No. CV05-1540-PHX-NVW

ORDER

[Not for Publication]

Before the court are Plaintiff's Motion for Summary Judgment (doc. # 14),

Defendant's Response (doc. # 20) and Cross-Motion for Summary Judgment (doc. # 21), and

Plaintiff's Response to Cross-Motion (doc. # 24) and Reply in Support of Motion for

Summary Judgment (doc. # 25). Plaintiff Amada Estrada ("Estrada") filed this action

challenging the Social Security Administration Commissioner's ("Commissioner") denial of

her applications for Disability Insurance and Supplemental Security Income benefits. The

court affirms the Commissioner's decision.

I. Background

Estrada turned fifty years-old in August of 2004. (doc. # 15 at 2 at ¶ 2.) She has a

fifth grade education obtained in Mexico and is unable to speak, read or write in English.

(Id.) Her prior work experience consists of unskilled factory work and as a self-employed

caregiver. (Tr. at 93.)

Estrada filed applications for Disability Insurance and Supplemental Security

Insurance benefits in late 2002 (Tr. at 19), alleging a disability onset date of January 1, 2002.

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(Doc. # 15 at 1:22-23.) Her applications were denied initially and upon reconsideration. (Tr.

at 19.) After proper notice, a hearing was held before an ALJ on May 21, 2004. (Id.) The

ALJ found that Estrada could perform her prior work as a machine operator and consequently

denied Estrada's applications. (Id. at 27.) The Appeals Counsel denied Estrada's request for

review. (Id. at 10.)

Estrada based her disability applications on three main medical problems. First and

foremost, Estrada has had persistent problems with her right knee. After originally hurting

her knee in Mexico, Estrada had arthroscopic surgery in July of 2001, after which she

underwent physical therapy. (Id. at 22.) Four months after the alleged disability onset date,

in May of 2002, Estrada had further knee surgery. (Id.) X-rays in January of 2003 showed

no acute fracture or dislocation and a metallic plate with two threaded screws that transfixed

the proximal tibia. (Id.) While continuing to ambulate with a crutch and to complain of pain,

progress notes in June of 2004 indicated that effusion had ceased and that Estrada retained

excellent range of motion. (Id. at 22-23.) 

Second, Estrada has had intermittent shoulder pain for between one and two years.

(Id. at 20.) A magnetic resonance imaging scan on April 2004 showed a possible rotator cuff

tear as well as minimal osteoarthritis of the acromioclavicular joint. (Id.) She has been

diagnosed with rotator cuff tendinopathy and has undertaken physical therapy exercises to

address the issue. (Id.) 

Third, Estrada suffers from depression. Although she has denied mental health

treatment, her general practicitioner prescribed her Lexapro for her symptoms. (Id. at 23.)

She has had sleeping problems and does not cook, do laundry, or clean the house. (Id.) She

spends most of the day listening to music and watching television. (Id. at 23-24.) The State

Agency medical consultant diagnosed her with a mild depressive disorder. (Id. at 24.) 

Estrada has also complained of secondary medical problems. Estrada reports pain in

both hands. (Id. at 20.) Her hands evince mild degenerative changes about the distal

interphalangeal joints, although X-rays in January of 2003 were unremarkable. (Id.) Estrada

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has also complained of back pain, although X-rays in April of 2003 were unremarkable. (Id.)

Upon examination there were no muscle spasms and straight leg raise was negative. (Id.)

II. Standard Of Review

The court reviews only those issues raised by the party challenging the ALJ's decision.

See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). In its review the court "may set

aside a denial of disability benefits only if it is not supported by substantial evidence or if it

is based on legal error." Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 1997) (citations

omitted); see Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996). "Substantial evidence

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

accept as adequate to support a conclusion." Flaten v. Sec’y of Health & Human Servs., 44

F.3d 1453, 1457 (9th Cir. 1995) (citations omitted). Such evidence is "more than a scintilla"

but "less than a preponderance." Smolen, 80 F.3d at 1279 (citations omitted). As a general

rule, "[w]here the evidence is susceptible to more than one rational interpretation, one of

which supports the ALJ’s decision, the ALJ’s conclusion must be upheld." Thomas v.

Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted). 

III. Legal Standard

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

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

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

the impairment meets or equals an impairment in Appendix 1 of Subpart P of the regulations,

4) whether the claimant can perform work performed in the past, and 5) whether the claimant

has the ability to perform other work. 20 C.F.R. § 404.1520(a)(4)(i-v). The questions are

addressed in order; certain responses to these questions will lead to automatic eligibility or

ineligibility. See id. In this case, the ALJ determined at step four that Estrada was not

disabled.

"At step four, claimants have the burden of showing that they can no longer perform

their past relevant work." Pinto v. Massanari, 249 F.3d 840, 844 (9th Cir. 2001) (citations

omitted). To decide whether a claimant has met her burden, the ALJ must make "specific

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findings as to the claimant's residual functional capacity, the physical and mental demands

of the past relevant work, and the relation of the residual functional capacity to the past

work." Id. at 845 (citing SSR 82-62). A claimant will be determined ineligible for benefits

at step four if the claimant is found able to perform either "1. The actual functional demands

and job duties of a particular past relevant job; or 2. The functional demands and job duties

of the occupation as generally required by employers throughout the national economy." Id.

at 845 (citing SSR 82-61). The ALJ here decided at step four that Estrada retained sufficient

residual functional capacity to return to her particular past work as a machine operator.

IV. Estrada's Past Relevant Work Was Consistent with Her Residual Functional

Capacity as Determined by the ALJ

As an initial matter, Estrada argues that even if the residual functional capacity

determined by the ALJ was accurate, the ALJ erred in finding that residual functional

capacity compatible with the demands of Estrada's specific past relevant work as a machine

operator. Estrada relies on a check-box form filled out by her on October 8, 2002, nineteen

months before her hearing, on which she indicated that her work as a machine operator

required her to walk for three hours per day, stand for one hour per day, and sit for five hours

per day. (Tr. at 93.) Given that the ALJ assessed Estrada's residual functional capacity as

limiting her to standing and walking for two hours in an eight-hour workday (Tr. at 26),

Estrada argues that the ALJ erred in concluding that her residual functional capacity

permitted her to fulfill the requirements of her past relevant work as a machine operator.

The ALJ properly relied on Estrada's hearing testimony to determine the standing and

walking requirements of her past relevant work, and those requirements did not exceed her

residual functional capacity as assessed by the ALJ. At the hearing, Estrada testified that as

a machine operator, she was allowed to work in a sitting position but was required to stand

and walk in order to take parts that she worked on to be washed. (Tr. at 35.) The answers

she gave to specific questions from the ALJ belie any assertion that she was required to stand

or walk for more than two hours per day at that job:

Q: And for the majority of the day you'd be sitting down to

perform that job?

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A: It would be both ways. Standing or sitting.

Q: Would you[r] employer permit you to sit all day to perform

that job?

A: Yes.

Q: About how many times a day did you have to get up to move

the parts?

A: Whenever the bucket of – it would take about an hour that it

would take to fill this basket of screws or parts, to take them to

wash.

Q: About an hour a day or an hour at a time?

A: One or two hours per day.

(Tr. at 35-36 (emphasis added).) Considering Estrada's testimony on the issue, the ALJ could

properly have found that Estrada's past work as a machine operator allowed her to "sit all

day" and to stand and walk only "[o]ne or two hours per day." Given that the ALJ assessed

Estrada as having the residual functional capacity to stand and walk at least two hours per

day, the machine operator position would fall within Estrada's limits as assessed by the ALJ.

V. Calculation of Estrada's Residual Functional Capacity

Estrada next argues that the ALJ erred in calculating her residual functional capacity.

Estrada contends that the ALJ committed legal error in calculating her residual functional

capacity by (1) discrediting the opinion evidence from Dr. Sandoval, Dr. Lopez and Dr.

Sanders, all of whom were treating physicians, and (2) discrediting Estrada's own subjective

pain testimony.

A. The ALJ Properly Discredited the Opinion Evidence Supplied by

Estrada's Treating Physicians

According to Social Security Administration regulations, physicians' opinions on

residual functional capacity are not "medical opinions" requiring deference by the

Commissioner, and the source of such opinions are not given "any special significance" by

the Commissioner. 20 C.F.R. § 404.1527(e). Part 404.1527(e) of Title 20, C.F.R., provides:

(e) Medical source opinions on issues reserved to the

Commissioner. Opinions on some issues, such as the examples

that follow, are not medical opinions, as described in paragraph

(a)(2) of this section, but are, instead, opinions on issues

reserved to the Commissioner because they are administrative

findings that are dispositive of the case; i.e., that would direct

the determination or decision of disability.

(1) Opinions that you are disabled. We are responsible for

making the determination or decision about whether you meet

the statutory definition of disability. . . . 

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(2) Other opinions on issues reserved to the Commissioner. We

use medical sources, including your treating source, to provide

evidence, including opinions, on the nature and severity of your

impairment(s). Although we consider opinions from medical

sources on issues such as whether your impairment(s) meets or

equals the requirements of any impairment(s) in the Listing of

Impairments in appendix 1 to this subpart, your residual

functional capacity (see §§ 404.1545 and 404.1546), or the

application of vocational factors, the final responsibility for

deciding these issues is reserved to the Commissioner.

(3) We will not give any special significance to the source of an

opinion on issues reserved to the Commissioner described in

paragraphs (e)(1) and (e)(2) of this section.

Id. at 404.1527(e) (emphasis added). Nevertheless, this circuit has regularly required the

ALJ to provide "clear and convincing" or "specific and legitimate" reasons for rejecting a

treating physician's opinion, even on issues purportedly reserved to the Commissioner. E.g.,

Morgan v. Apfel, 169 F.3d 595, 601 (9th Cir. 1999); Lester v. Chater, 81 F.3d 821, 830 (9th

Cir. 1995); Roberts v. Shalala, 66 F.3d 179, 183-84 (9th Cir. 1995); Embrey v. Bowen, 849

F.2d 418, 421-22 (9th Cir. 1988); Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir. 1986).

Where as here, a treating physician's opinion is controverted by other medical opinions in the

record, the ALJ's decision to discredit the treating physician's opinion must be supported by

"specific and legitimate reasons" based on substantial evidence in the record. Morgan, 169

F.3d at 600; Batson v. Comm'r of the Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004);

Cotton, 799 F.2d at 1408. "The ALJ can meet this burden 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)

(citing Cotton, 799 F.2d at 1408). In reviewing the ALJ's reasoning, the court is "not

deprived of [its] faculties for drawing specific and legitimate inferences from the ALJ's

opinion." Id. at 755. 

In this case, the ALJ relied on the opinions of two State Agency medical consultants

and Dr. Cunningham, an evaluating physician, in making his determination of Estrada's

residual functional capacity. The ALJ determined that Estrada had the residual functional

capacity to lift and carry no more than 20 pounds occasionally and 10 pounds frequently,

walk and/ or stand at least 2 hours in an 8-hour workday, and sit for 6 hours in an 8-hour

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workday. (Tr. at 26, ¶ 6.) The ALJ further found that kneeling, crawling, and working near

extreme temperatures were precluded, as was any more than occassional climbing, balancing,

stooping, and crouching. (Id.) 

All three of Estrada's treating physicians filled out check-boxes assessing Estrada's

residual functional capacity as somewhat less than that determined by the ALJ. Dr.

Sandoval, for example, opined that Estrada could lift and carry 10 pounds occassionally and

less than 10 pounds frequently, and could stand and walk less than two hours in an eight-hour

workday. (Tr. at 139-140.) Dr. Sanders, in turn, concluded that Estrada could lift and carry

less than 10 pounds, could stand for less than two hours, and could walk less than one hour.

(Tr. at 257.) Finally, Dr. Lopez found that Estrada could lift and carry 10 pounds

occassionally, and could stand and walk less than two hours in an eight-hour workday. (Tr.

at 206-07.) 

Where an examining physician supports his opinion with independent clinical

findings, his opinion will constitute substantial evidence supporting the ALJ's decision to

discredit the differing opinion of a treating physician. Allen v. Heckler, 749 F.2d 577, 579

(9th Cir. 1984) (holding that examining physician's opinion contradicting a treating

physician's opinion could be relied upon by ALJ as substantial evidence where the examining

physician's opinion was based on different findings than the findings of the treating

physician). Here, Dr. Cunningham, an examining physician, made specific and wellexplained clinical findings related to Estrada's limitations. (Tr. at 142-44.) Moreover, Dr.

Cunningham's opinion was supported by the opinions of two State Agency medical

consultants. As noted by the court in Andrews v. Shalala, 53 F.3d 1035 (9th Cir. 1995), 

Reports of consultative physicians called in by the Secretary

may serve as substantial evidence. Indeed, the analysis and

opinion of an expert selected by the ALJ may be helpful to the

ALJ's adjudication, and we should not impose burdensome

procedural requirements that facilitate second-guessing the

ALJ's resolution of conflicting medical testimony.

Id. at 1041 (citations, alterations and internal quotations omitted); see also Thomas v.

Barnhart, 278 F.3d 947, 957 (9th Cir. 2002) ("The opinions of non-treating or nonCase 2:05-cv-01540-NVW Document 26 Filed 05/03/06 Page 7 of 12
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examining physicians may also serve as substantial evidence [supporting the rejection of a

treating physician's testimony in favor of an examining physician] when the opinions are

consistent with . . . other evidence in the record." (citations omitted)). Dr. Cunningham and

the two State Agency medical consultants determined that Estrada could stand and walk for

at least two hours in an eight-hour day and could lift and carry 10 pounds frequently and 20

pounds occassionally. (Tr. at 145, 150, 225.) Their concerted opinions alone constitute

substantial evidence upon which the ALJ could base his disbelief of Estrada's treating

physicians' opinions regarding her residual functional capacity. 

Nevertheless, the ALJ also provided individualized specific and legitimate reasons for

discrediting the opinions of each of Estrada's three treating doctors. For example, the ALJ

discredited the opinion of Dr. Sandoval in part because Dr. Sandoval had not examined

Estrada since early 2002. (Tr. 25, ¶ 1.) In the time elapsed before Dr. Sandoval issued his

opinion in January of 2003, Estrada had undergone another surgery. (Tr. at 22, ¶ 4.)

Moreover, Dr. Sandoval indicated that Estrada required a cane for ambulation, although no

doctor currently treating Estrada had suggested that a cane was necessary. (Tr. at 25.) Dr.

Sandoval's willingness to assert that Estrada still needed to use a cane long after having

ceased his treatment of her could reasonably lead the ALJ to conclude that Dr. Sandoval was

partial to Estrada or exaggerating to some extent her symptomology. 

The ALJ likewise provided individualized reasons for discrediting the opinions of Dr.

Lopez. The ALJ discredited the opinions of Dr. Lopez in part because Dr. Lopez indicated

that Estrada could not sit for more than one hour. (Tr. at 25, ¶ 2; 206-07.) Given that

nothing in the record or in Dr. Lopez's treatment notes would suggest Estrada had any issue

with sitting, the ALJ properly viewed such a restiction as cause for suspicion. Moreover, Dr.

Lopez's 2004 opinion was different from a previous opinion Dr. Lopez had provided about

Estrada, and nothing had occurred in the interim to suggest Estrada's residual functional

capacity had declined. (Tr. at 250-252.) Such an extreme and unexplained change in opinion

can be a legitimate reason for discounting the validity of Dr. Lopez's assessments. See

Thomas, 278 F.3d at 957 (holding that ALJ properly discounted validity of treating

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physician's changed opinion where the record contained no information supporting a change

of that opinion); Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001) (holding that ALJ

properly rejected unexplained change in treating physician's opinion).

Finally, the ALJ discredited Dr. Sanders' opinion in part because his opinion was not

supported by Dr. Sanders' own evaluation notes, which were themselves highly attenuated.

(Tr. at 25, ¶ 2.) "The 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." Thomas, 278 F.3d at 957 (citations omitted); accord Batson, 359 F.3d at 1195.

Dr. Sanders cursorily indicated that Estrada had arthritis in her knee and shoulder problems,

providing no further explanation for his conclusions about her residual functional capacity.

(Tr. at 257.) Dr. Sanders' highly-specific conclusions based on such vague clinical findings

could properly be accorded less weight by the ALJ. Moreover, Dr. Sanders subsequently

opined in a follow-up examination that Estrada's knee had excellent range of motion and that

there was no effusion. (Tr. at 264.) "Where medical reports are inconclusive, questions of

credibility and resolution of conflicts in the testimony are functions solely of the

Commissioner." Morgan, 169 F.3d at 601 (citations, alterations and internal quotations

omitted). The ALJ could properly rely on the more recent report as a basis for discounting

the prior.

The ALJ in this case faced conflicting medical opinions as to the severity of Estrada's

physical limitations. The ALJ's decision to discount the treating physicians' check-box

conclusions in favor of the well-articulated findings of Dr. Cunningham was within his

discretion. See Crane v. Shalala, 76 F.3d 251, 253 (9th Cir. 1995) (holding that ALJ

permissibly rejected evaluative physician's reports "because they were check-off reports that

did not contain any explanation of the bases of their conclusions" (citations omitted)). 

B. The ALJ Properly Discredited Estrada's Subjective Complaints of Pain

"If there is medical evidence establishing an objective basis for some degree of pain

and related symptoms, and no evidence affirmatively suggesting that the claimant was

malingering, the Secretary's reason for rejecting the claimant's testimony must be 'clear and

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convincing' and supported by specific findings." Dodrill v. Shalala, 12 F.3d 915, 918 (9th

Cir. 1993) (citations omitted); accord Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995). It

is undisputed here that the medical evidence established an objective basis for pain. The ALJ

found that Estrada suffered from three "severe" impairments, including an arthritic right knee

and knee pain specifically. (Tr. at 20, ¶ 3.) The Commissioner does not argue that Estrada

was malingering, and nothing in the record or the ALJ's report would affirmatively suggest

that she was. The ALJ therefore needed to provide clear and convincing reasons for

discounting the testimony of Estrada regarding her level of pain.

The ALJ provided clear and convincing reasons for discounting Estrada's pain

testimony. First and most predominantly, the ALJ relied on the absence of objective medical

support for Estrada's alleged levels of pain. The extent to which objective medical evidence

supports a claimant's contentions is relevant in assessing credibility and may be properly

relied upon by the ALJ. Rollins, 261 F.3d at 857 ("While subjective pain testimony cannot

be rejected on the sole ground that it is not fully corroborated by objective medical evidence,

the medical evidence is still a relevant factor in determining the severity of the claimant's

pain and its disabling effects."). However, this circuit has noted that "'[e]xcess pain' is, by

definition, pain that is unsupported by objective medical findings. If the Secretary were free

to disbelieve excess-pain testimony solely on the ground that it was not supported by

objective medical findings, then the Secretary would be free to reject all excess-pain

testimony." Cotton, 799 F.2d at 1407. The ALJ therefore needed to provide at least some

additional reasons for disbelieving Estrada's pain testimony.

Taken together with the lack of supporting objective medical evidence, the additional

reasons provided by the ALJ were sufficient to discredit Estrada's excess pain testimony. To

begin with, the ALJ noted that Estrada uses a cane to ambulate but that no currently treating

physican had suggested she needed one. (Tr. at 24, ¶ 4.) If Estrada were truly in the amount

of pain she suggests and used a cane because of it, one would assume that she would have

discussed the pain and the cane with her treating physician. That no currently treating

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physician mentioned Estrada's cane suggests that Estrada has not done so or that they did not

believe Estrada's pain justified use of a cane. 

Similarly, the ALJ discredited Estrada in part because no treating physician had

suggested that she needed to elevate her leg two to three times per day. (Tr. at 24.) Like the

cane, if Estrada uses such a technique to alleviate her pain, she might have discussed it with

her physician. Again, Estrada apparently had not done so.

The ALJ also found not credible Estrada's testimony that she had trouble sitting for

extended periods of time. (Tr. at 24, ¶ 4.) The ALJ discounted this testimony in part because

it seemed contradicted by Estrada's other testimony that she watches television and listens

to the radio for most of the day. (Id.) Inconsistency in a claimant's testimony is a proper

basis for discrediting the testimony. Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996).

The ALJ's inference that Estrada watches television and listens to the radio in a sitting

position is not unreasonable in light of Estrada's nonspecific testimony on the issue, and the

ALJ's decision to partially disbelieve Estrada on that basis was therefore not improper. See

Rollins, 261 F.3d at 857 (holding that although ALJ's interpretation of claimant's testimony

was not the only reasonable one, it was a reasonable interpretation and the court should

therefore not second-guess it).

Finally, the ALJ discredited Estrada's depression testimony based in part on the fact

that she denied any mental health treatment. The court places no importance on the ALJ's

rejection of this testimony because it is largely irrelevant to the ALJ's determination of

Estrada's ability to sit, stand and walk, which were the relevant limitations in his decision.

Although the ALJ properly did not rely solely on the lack of supporting medical

evidence in discrediting Estrada's testimony, substantial reliance in this case was proper.

"[A] claimant's self-serving statements may be disregarded to the extent they are unsupported

by objective findings." Nyman v. Heckler, 779 F.2d 528, 531 (9th Cir. 1985) (citations

omitted). Nothing in the record substantiates Estrada's claims of severe pain, instead

suggesting only that Estrada suffers from "intermittent," "mild" and "minimal" impairments.

(E.g. Tr. at 144, 284, 260; see also id. at 264, 154.) The one ailment potentially engendering

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severe pain, her right knee, was noted by her treating physician to be functioning properly

in follow-up exam. (Id. at 264.) When combined with the ALJ's other reasons for

discrediting Estrada's pain testimony, the court finds the ALJ's explanation clear and

convincing. 

IT IS THEREFORE ORDERED that the Commissioner's motion for summary

judgment (doc. # 21) is granted. Estrada's motion for summary judgment (doc. # 14) is

denied.

IT IS FURTHER ORDERED that the clerk shall enter judgment in favor of Defendant

and that Plaintiff take nothing. The clerk shall terminate this case.

DATED this 2nd day of May 2006.

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