Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_09-cv-01103/USCOURTS-caed-1_09-cv-01103-1/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Ted Leach
Plaintiff

Document Text:

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

TED LEACH, )

)

)

)

Plaintiff, )

)

v. )

)

MICHAEL J. ASTRUE, Commissioner )

of Social Security, )

)

)

Defendant. )

 )

1:09-CV-01103-GSA

ORDER REGARDING PLAINTIFF’S SOCIAL

SECURITY COMPLAINT

BACKGROUND

Plaintiff Ted Leach (“Plaintiff”) seeks judicial review of a final decision of the

Commissioner of Social Security (“Commissioner” or “Defendant”) denying his application for

supplemental security income pursuant to Title XVI of the Social Security Act. The matter is

currently before the Court on the parties’ briefs, which were submitted, without oral argument, to

the Honorable Gary S. Austin, United States Magistrate Judge.1

//

//

The parties consented to the jurisdiction of the United States Magistrate Judge. See Docs. 9 & 10.

1

1

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 1 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

FACTS AND PRIOR PROCEEDINGS2

Plaintiff filed his application on or about May 5, 2004, alleging disability beginning

February 1, 1993. AR 63-65. His application was denied initially (AR 25-29) and on

reconsideration (AR 32-37); thereafter Plaintiff requested a hearing before an Administrative

Law Judge (“ALJ”). AR 38. ALJ Patrieia Leary Flierl held a hearing on October 25, 2006 (AR

455-486) and issued an order denying benefits on February 22, 2007. AR 8-18. Plaintiff

requested a review of the hearing (AR 19) and the Appeals Council denied review. AR 5-7.

Hearing Testimony

ALJ Flierl held a hearing on October 25, 2006, in Fresno, California. Plaintiff appeared

and testified. He was represented by attorney Melissa Proudian. Vocational Expert (“VE”)

Judith Najarian also testified. AR 455-486.

Plaintiff was born on November 21, 1959. He is 47 years old. AR 457. He is six feet

tall, weighs 239 pounds, and is right handed. AR 458. Two to four years ago he weighed 200

pounds. The increase in weight is due to medication, depression, and anxiety. AR 458. Plaintiff

is not married. AR 458. He has a 15-year old son, who was put in long term foster care. AR

458, 477. He took parenting classes, participated in rehabilitation, and is seeking parental

reunification rights. AR 477-478.

When asked about where he lives, Plaintiff testified that he lost his home because he

could not pay the mortgage. AR 464-465. He has been staying with friends and living in his car

for one and a half years. AR 459, 465. Plaintiff has a cellular telephone and a post office box. 

AR 458-460. He has a valid California driver’s license, and he drives a little bit every day to

move his car around. AR 460.

Plaintiff graduated from high school. AR 460. In 1980 and 1981, he attended Fresno

City College but did not complete any units. AR 460. He withdrew because his of his brother’s

“major criminal case.” AR 460. He has had no other educational or vocational training. AR

461.

References to the Administrative Record will be designated as “AR,” followed by the appropriate page

2

number.

2

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 2 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

In a typical day, Plaintiff runs errands, reads, and sits at the park. AR 465. He bathes

himself every day or every other day. AR 465. Stover Springs lets him use their kitchen and

bathroom, or he goes to the gym at Fresno State. AR 465. He likes to fish but has not fished for

two to three years. AR 465. 

When asked about his work history, Plaintiff indicated that he last worked for about ten

days in 2001, performing handyman services such as painting and construction work. AR 461. 

He was laid off because he could not do the work. AR 461. As a handyman, he had to lift 40 to

50 pounds. AR 461. 

In 1993, Plaintiff did shipping and receiving work at a warehouse. AR 462. The

warehouse work was part time through a temporary agency. AR 462. He was injured on the job

and settled a workers’ compensation case. AR 462, 473. He did 14 to 16 weeks of rehabilitation

and physical therapy and went back to construction. AR 473-474. He hurt his back again but did

not have another workers’ compensation case. AR 473. He did not have an attorney nor did he

obtain any settlement. AR 474. Plaintiff did not remember working in 1992. AR 475. 

In 1990 and 1991, Plaintiff did some piece work in construction, such as roof sheeting

and fascia. AR 461, 474. Before that, construction work was sporadic. AR 461. He has always

done construction or something related to construction. AR 461. He also worked at Denny’s. 

AR 461. Between 1985 and 1990, Plaintiff worked off and on because he “couldn’t find any

work” and “didn’t have all the tools.” AR 475. He was paid by check but his bosses weren’t

paying Social Security. AR 475. 

Plaintiff is not working now. AR 461. His source of income is general relief and he also

receives food stamps. AR 470. Plaintiff cannot work because of his back and knees, and

because he has problems concentrating and remembering things. AR 462. He also has bad

headaches, muscle spasms, and cramps. AR 463. Plaintiff’s back has been “messed up” since

1993. AR 461. The pain affects his ability to sit and stand. He can sit in a chair for about 15 to

20 minutes, then he has to get up and walk around. AR 468. He can stand for approximately 20

minutes. AR 468. He can walk for about 15 or 20 minutes out of an hour. He can walk about a

block before he has to stop. AR 468. He can lift up to 10 pounds without pain. AR 469.

3

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 3 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

When asked about his ability to concentrate and focus his attention, Plaintiff stated that it

varies from day to day depending on stress and what he has to do. AR 469. On his worst day,

the longest he can concentrate is 30 minutes. Then he has to take a break for 10 to 15 minutes to

try and remember what he was doing and why. AR 469. His problems concentrating are because

of attention-deficit hyperactivity disorder (ADHD). AR 469. Plaintiff indicated he would not be

able to concentrate for successive 30-minute periods, with breaks in between, during an eight

hour day. AR 470.

Plaintiff was diagnosed with posttraumatic stress disorder (PTSD). AR 480. He is

severely depressed most of the time. AR 464. When he is depressed, he does not want to see or

talk to anybody. He isolates himself. AR 464. His depression makes him unable to focus. AR

471. He has suicidal thoughts once or twice per month. AR 471.

Sometimes when Plaintiff is by himself, he hears the voices of a man, woman, or child. 

AR 466. They call his name and say certain things, but he cannot quite make out what they are

saying. AR 466. This happens a couple times per week. AR 466. When it does happen,

Plaintiff takes his medication and listens to the radio on his headphones. AR 466.

When Plaintiff is around large groups of people in an enclosed room, he withdraws and

has anxiety attacks. AR 472. This happens two to three times per week. AR 472. They are

relieved by leaving the area where he is. AR 473. He also has panic attacks once every two or

three days, caused by nightmares. AR 472.

Fresno County Mental Health treats Plaintiff for depression, anxiety, and stress, which

affect his ability to function. AR 463. He started treating there a little over two years ago. AR

479-480. Plaintiff had mental health problems before but never received treatment. AR 480. He

“pretty much grew up with [depression].” AR 463.

Plaintiff takes 200 milligrams of Zoloft and 100 milligrams of Elavil every night for

depression. AR 467. They help “somewhat.” AR 471. He takes Tramadol, Gabapentin, and

Naproxen for pain several times per day. AR 467-468. When he takes the pain medication, it

takes away the pain for “a couple of hours.” AR 467-468. He also takes Methocarbamol for

muscle relaxation, Lipitor for high cholesterol, and Triamterene for high blood pressure. AR

4

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 4 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

467. Side effects of the medication include buzzing and ringing in his ears, blurry vision,

dizziness, drowsiness, muscle spasms, cramps, and shooting pains. AR 466-468.

Dr. Chu is Plaintiff’s mental health treating source. Plaintiff sees him for prescriptions of

Zoloft and Elavil every two to three months. AR 471. He has told Dr. Chu about the voices he

hears several times. AR 471. The doctor said that the medications can only help so much and

that he cannot up the dosage because Plaintiff is taking the maximum dosage of each drug. AR

472. 

Plaintiff was treated for abuse of alcohol and marijuana. He went through a rehabilitation

program. AR 463, 477. He is not currently being treated for alcohol or drug abuse, and his last

drug test was one and a half years ago. AR 464. He does not do illegal drugs, and the last time

he had marijuana was months or years ago. AR 464, 476. The last time he had alcohol was the

previous weekend. He drank two beers at a friend’s barbecue. AR 464. He drinks one to two

beers every one to two weeks, and at most a beer each day. AR 464, 476. When Plaintiff is not

drinking alcohol, the symptoms of his depression do not change. AR 464. 

VE Najarian testified that Plaintiff’s previous work as a warehouse laborer was

considered a heavy physical demand, unskilled (AR 481), the short order cook is light, semiskilled (AR 480), and construction is heavy, semi-skilled. AR 482. VE Najarian was asked to

consider a hypothetical individual of Plaintiff’s age, education, and vocational background, who

is able to do sedentary work with occasional climbing, balancing, crouching, crawling, and

stooping, and is further limited to simple repetitive tasks. AR 482. The VE indicated that this

hypothetical individual could perform sedentary skilled work, of which there are 134 job titles

corresponding to about 80,000 jobs in California. AR 483. She offered examples including:

assembler, 5,317 jobs in California; almond blancher, 6,650 jobs in California; and nut sorter,

1,770 jobs in California. AR 484. Approximately nine times this number of jobs exist in the

national economy. AR 484.

VE Najarian was asked to consider a second hypothetical individual of Plaintiff’s age,

education, and vocational background, who is able to do light work with occasional balancing,

crouching, and crawling, and is further limited to simple repetitive tasks. AR 482. The VE

5

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 5 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

indicated that such an individual could not perform any of Plaintiff’s past relevant work. AR

484. She further indicated that this hypothetical individual could perform 1,571 job titles

corresponding to about 741,036 jobs in California. AR 484-485. She offered examples

including: small products assembly, 33,232 jobs in California; hand washer, 32,508 jobs in

California; and bottle line attendant, 31,055 jobs in California. AR 485. Approximately nine

times this number of jobs exist in the national economy. AR 485.

Finally, VE Najarian was asked to consider a third hypothetical individual, as posed by

Plaintiff’s counsel, with the same vocational factors as in the first hypothetical, with the added

nonexertional limitation that he could not consistently show up to work every day due to severe

mental impairments, and therefore possibly could not complete a full work week. AR 485. VE

Najarian indicated that no work would be available to such an individual. AR 485.

Medical Record

The entire medical record was reviewed by the Court. A summary of the reports and

treatment notes is provided below.

Benjamin Chang, M.D.

On July 26, 2003, orthopedist Benjamin Chang, M.D. performed a comprehensive

evaluation. AR 150-152. Plaintiff’s chief complaint was chronic low back pain. He stated that

he injured his lower back in 1987 and again in 1993. AR 150. Dr. Chang noted that Plaintiff

was able to walk on toes, heels, and in tandem, and had no trouble getting on or off the

examination table. AR 151. The doctor’s physical examination revealed limited range of motion

and mild tenderness on palpation of the lower lumbar spine, but no spasm, crepitus, effusion, or

deformities. AR 151-152. The neurological examination was unremarkable. AR 152. The

doctor diagnosed Plaintiff with chronic low back pain. He ruled out left lower extremity lumbar

radiculopathy. AR 152. 

Dr. Chang opined that: (1) Plaintiff could stand, walk, and sit for about six hours in an

eight-hour workday with normal breaks; (2) there was no need for assistive devices; (3) Plaintiff

could lift and carry 20 pounds frequently and 50 pounds occasionally; (4) postural limitations

6

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 6 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

included occasional bending, stooping, crouching, crawling, pushing, and pulling; and (5) there

were no other manipulative limitations. AR 152.

On October 16, 2004, Dr. Chang performed an orthopedic consultation. AR 267-271. 

Plaintiff’s chief complaint was chronic neck and back pain. AR 267. The doctor noted that

Plaintiff smoked 20 cigarettes per day and consumed two to three alcoholic drinks per day. AR

268. The doctor also noted that Plaintiff had some difficulty getting on and off the examination

table and walking on his toes and heels. AR 268. The examination revealed decreased range of

motion in the cervical spine, and mild spasm and tenderness on the posterior cervical paraspinal

muscles. The examination also revealed decreased range of motion and mild tenderness to

percussion in the lumbar spine. Plaintiff could flex the lumbar spine to 50 degrees with pain, and

recover with difficulty. AR 268-269. Plaintiff had decreased strength is his left hip and left

knee. AR 270. Other findings were unremarkable. AR 267-271. The doctor’s impression

included chronic neck and back pain, “probably due to myofascial pain syndrome.” He ruled out

mild radiculitis in the left cervical and lumbar spine. AR 271.

Dr. Chang opined that Plaintiff had the functional capacity to lift and carry 10 pounds

frequently and 20 pounds occasionally. He could stand and walk six hours out of an eight hour

day with normal breaks, and he could sit without restriction and occasionally kneel, squat, and

climb stairs. The doctor further opined that Plaintiff was unable to do work which requires

repetitive bending and heavy lifting. AR 271. 

Chinatown Family Medicine and Midwifery Medical Office

On June 9, 2004, Plaintiff was seen for complaints of increased back pain, body aches,

and insomnia. Tylenol ES, 500 milligrams, and Elavil, 50 milligrams, were prescribed. AR 181.

On July 5, 2004, Plaintiff’s dosage of Elavil was increased to 100 milligrams and his

prescription for Tylenol ES was changed to Ibuprofen, 800 milligrams. AR 184.

Donald K. Farris, LCSW

Between July 5, 2004 and August 16, 2004, Plaintiff was treated for anxiety and

depression by Licensed Clinical Social Worker (LCSW) Donald K. Farris. AR 197-199.

7

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 7 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

In an undated statement, Mr. Farris indicated that Plaintiff has been depressed and

anxious since his wife died in October 2001 and had complained of severe back pain, a pinched

nerve with shooting pain in his arms and legs, dental pain, auditory and visual hallucinations,

panic attacks, insomnia, and vivid nightmares in bright colors. Mr. Farris stated that Plaintiff

“appear[ed] unfit for any employment.” AR 200.

Fresno New Connections

On August 19, 2004, Teresa Liebig, a counselor at Fresno New Connections, an alcohol

and drug abuse treatment facility, opined that Plaintiff had chronic depression and suffers from

back pain. AR 241.

Fresno County

From April 1, 2004 to October 8, 2004 and from June 21, 2005 to August 29, 2006,

Plaintiff was treated by Fresno County Human Services and Fresno County Mental Health for

anxiety and depression. AR 201-238, 242-263, 301-348, 429-454. Plaintiff’s alcohol and

marijuana abuse was frequently noted. AR 243, 246, 251, 253, 306-308, 311, 331, 333.

On April 28, 2004, a comprehensive assessment was performed. Plaintiff was diagnosed

with alcohol dependence primarily, and panic disorder without agoraphobia and “physical abuse

of child” secondarily. AR 218. The clinician noted that referral information from Child

Protective Services indicated that Plaintiff’s son reported that Plaintiff consumed 6 to 12 beers

daily and was frequently intoxicated. AR 234. The clinician also noted Plaintiff’s history of

marijuana use and that his “[a]bility to determine an accurate [diagnosis] is contaminated due to

[Plaintiff’s] substance abuse.” AR 234.

Ekram Michiel, M.D.

On October 16, 2004, board certified psychiatrist Ekram Michiel performed a psychiatric

evaluation. AR 264-266. Plaintiff complained of feeling sad since he had been hurt on the job in

1993 and stated that it became worse when his wife passed away. AR 264. He stated that he

used marijuana until April 2004, and presently drinks “three beers twice per week.” AR 264. 

Dr. Michiel noted that Plaintiff is able to take care of his personal hygiene, shop, cook, and do

8

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 8 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

light household chores. AR 265. The doctor noted that Plaintiff “was using a cane to assist with

ambulation and posture was normal.” AR 265. 

The mental status examination revealed no involuntary movements or specific

mannerisms, good eye contact, and normal speech with no latency. AR 265. Plaintiff was

oriented to person, place, and date. He could recall three out of three objects in one minute and

five minutes, respectively. He knew the names of the two most recent United States Presidents. 

AR 265. He could interpret proverbs and identify similarities. When asked what he would do if

he found a letter on the street, Plaintiff stated he would “mail the envelope.” AR 265. When

asked what he would do if he was in a movie theater and someone yelled “fire,” Plaintiff stated

he would “call the police.” AR 265. Dr. Michiel described Plaintiff’s mood as depressed and his

affect as blunted. Plaintiff denied suicidal or homicidal ideations. AR 265. 

Dr. Michiel’s diagnoses included cannabis dependence in early remission, alcohol abuse,

depressive disorder not otherwise specified (“NOS”), and history of back injury with pain. The

doctor assigned Plaintiff a Global Assessment of Functioning (“GAF”) score of 60-65. AR 266. 3

He opined that Plaintiff could maintain attention and concentration and could carry out one or

two step simple job instructions, but could not carry out an extensive variety of technical and/or

complex instructions. The doctor further opined that Plaintiff could relate and interact with

coworkers, supervisors, and the general public. AR 266.

Physical RFC Assessment

On November 19, 2004, state agency physician Brian Ginsburg, M.D. completed a

Residual Functional Capacity (“RFC”) Assessment. AR 292-299. The doctor concluded that

Plaintiff could lift and/or carry 10 pounds frequently and 20 pounds occasionally, could stand

and/or walk about six hours in an eight-hour workday and could sit about six hours in an eightThe Global Assessment of Functioning or “GAF” scale reflects a clinician’s judgment of the individual’s

3

overall level of functioning. American Psychiatric Association, Diagnostic & Statistical Manual of Mental

Disorders 32 (4 ed. 2000) (“DSM IV”). A GAF between 61 and 70 indicates “[s]ome mild symptoms (e.g.,

th

depressed mood and mild insomnia) or some difficulty in social, occupational, or school functioning (e.g., occasional

truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal

relationships.” A GAF between 51 and 60 indicates “[m]oderate symptoms (e.g., flat affect and circumstantial

speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few

friends, conflicts with peers or co-workers).” DSM- IV at 34.

9

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 9 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

hour workday. AR 293. The doctor further concluded that Plaintiff could occasionally stoop and

crouch and could frequently climb, balance, kneel, and crawl. AR 294. The doctor found no

restrictions on pushing and pulling and no manipulative, visual, communicative, or

environmental limitations. AR 293, 296.

On May 3, 2005, state agency physician Alfred Torre, M.D. reviewed the Physical RFC

Assessment and agreed with the assessment. AR 290-291.

Mental RFC Assessment

On November 22, 2004, state agency psychiatrist Evangeline Murillo, M.D. completed a

Mental RFC Assessment. AR 272-289. The doctor opined that Plaintiff had the medically

determinable impairments of depression and drug addiction/alcohol use, which cause him mild

difficulties in maintaining concentration, persistence, or pace. AR 275, 280, 282. The doctor

further opined that Plaintiff is moderately limited in his ability to understand, remember, and

carry out detailed instructions. AR 286. The doctor noted, “[Plaintiff] can do simple and less

complex tasks. Cannot perform complex and detailed tasks on a sustained basis. [Plaintiff] can

adjust, adapt, and interact appropriately if only performing less complex tasks, and simple tasks.” 

AR 288.

On April 29, 2005, state agency psychiatrist Archimedes Garcia, M.D. reviewed the

Mental RFC Assessment and agreed with its findings. AR 290-291. 

Sierra Adult Health Center

On May 31, 2005, Plaintiff was seen for complaints of swollen legs. He was diagnosed

with edema. AR 425.

University Medical Center

On February 8, 2006, Plaintiff was seen for complaints of pain in his lower back and

knees. He also complained of difficulty hearing. The doctor noted that he had difficulty walking

and walked with a cane. AR 414. The doctor also noted that wax was clogging Plaintiff’s left

ear and partially clogging his right ear. Dosages relating to prescription medications Robaxin

and Tramadol were increased. AR 414.

10

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 10 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

On July 10, 2006, Plaintiff was seen for complaints of back pain and his stated need for a

new cane and walker. Plaintiff’s requests for a cane and walker were accommodated. AR 393.

ALJ’s Findings

The ALJ found that Plaintiff has not engaged in substantial gainful activity since February

1, 1993, and has the severe impairments of left knee Pellegrini-Stieda syndrome, degenerative

disc disease in the lumbar spine, history of alcohol and marijuana abuse, and depression. AR 13. 

Nonetheless, the ALJ determined that the severe impairments do not meet or exceed one of the

listed impairments. AR 13.

Based on his review of the medical evidence, the ALJ determined that Plaintiff has the

RFC to lift and carry up to 20 pounds occasionally and 10 pounds frequently. He is able to walk

and/or stand for two hours and sit for eight hours in an eight-hour workday. He is able to climb

(stairs, ladders, ropes, or scaffolds), balance, crawl, kneel, stoop, or crouch occasionally. 

Plaintiff is limited to simple repetitive tasks. AR 14.

The ALJ determined that Plaintiff has no past relevant work, is a younger individual with

at least a high school education, and is able to communicate in English. AR 16. Transferability

of job skills was not an issue because Plaintiff had no past relevant work. AR 16. The ALJ

further determined that, considering the Plaintiff’s age, education, work experience, and RFC,

there are jobs that exist in significant numbers in the national economy that he can perform. AR

17. Accordingly, the ALJ found that Plaintiff was not disabled, as defined in the Social Security

Act. AR 17.

SCOPE 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

11

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 11 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

401. The record as a whole must be considered, weighing both the evidence that supports and

the evidence that detracts from the Commissioner’s conclusion. Jones v. Heckler, 760 F.2d 993,

995 (9th Cir. 1985). In weighing the evidence and making findings, the Commissioner must

apply the proper legal standards. E.g., Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). 

This Court must uphold the Commissioner’s determination that the claimant is not disabled if the

Secretary applied the proper legal standards, and if the Commissioner’s findings are supported by

substantial evidence. See Sanchez v. Sec’y of Health and Human Serv., 812 F.2d 509, 510 (9th

Cir. 1987). 

 REVIEW

In order to qualify for benefits, a claimant must establish that he 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 not less than twelve months. 42

U.S.C. § 1382c (a)(3)(A). A claimant must show that he has a physical or mental impairment of

such severity that he is not only unable to do her previous work, but cannot, considering his age,

education, and work experience, engage in any other kind of substantial gainful work which

exists in the national economy. Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). 

The burden is on the claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th

Cir. 1990).

In an effort to achieve uniformity of decisions, the Commissioner has promulgated

regulations which contain, inter alia, a five-step sequential disability evaluation process. 20

C.F.R. §§ 404.1520 (a)-(f), 416.920 (a)-(f) (1994). Applying this process in this case, the ALJ

found that Plaintiff: (1) had not engaged in substantial gainful activity since the alleged onset of

his disability; (2) has an impairment or a combination of impairments that is considered “severe”

based on the requirements in the Regulations (20 CFR §§ 416.920(b)); (3) does not have an

impairment or combination of impairments which meets or equals one of the impairments set

forth in Appendix 1, Subpart P, Regulations No. 4; (4) had no past relevant work; and (5) could

perform jobs that exist in significant numbers in the national economy. AR 13-17.

12

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 12 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Here, Plaintiff argues that the ALJ improperly rejected the medical evidence regarding his

prescription and use of a cane, and that the ALJ failed to account for the breadth of limitations

described by the examining and consulting physicians.

DISCUSSION

A. Prescription and Use of Cane

Plaintiff argues that the ALJ failed to state reasons for rejecting the prescription for a cane

and Plaintiff’s statement about the use of a cane. Plaintiff also argues that the ALJ failed to

address his use of a cane when questioning the VE. Defendant contends that the ALJ properly

considered Plaintiff’s use of a cane.

“The ALJ need not accept the opinion of any physician . . . if that opinion is brief,

conclusory, and inadequately supported by clinical findings.” Thomas v. Barnhart, 278 F.3d 947,

957 (9th Cir. 2002); Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992).

Here, the ALJ’s findings do state that a “cane and walker were prescribed to assist”

Plaintiff. AR 15; see also AR 393. In fact, the “Progress Record/Physician’s Orders” dated July

10, 2006, referred to by the ALJ noted that Plaintiff’s chief subjective complaint was that he

needed a new cane and walker. The physician himself however made no objective observations

regarding Plaintiff’s need for a cane, and neither did he diagnose any medical condition that

necessitated one. Nevertheless, the doctor included a cane and walker in his treatment plan. AR

393. The prescription of a cane and walker thus appears to be an accommodation of Plaintiff’s

request, rather than a medical determination that a cane was necessary. Even assuming the

doctor’s notation is an opinion, it is brief, conclusory, and inadequately supported by clinical

findings. Thomas v. Barnhart, 278 F.3d at 957. Therefore, the ALJ was not required to accept it. 

Social Security Ruling provides that “[t]o find that a hand-held assistive device is

medically required, there must be medical documentation establishing the need for a hand-held

assistive device to aid in walking or standing, and describing the circumstances for which it is

needed . . ..” SSR 96-9p. Here, as noted above, Plaintiff fails to cite any medical evidence

supporting the use of a cane. Moreover, neither Plaintiff nor counsel discussed or argued about

13

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 13 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

the use of a cane at the hearing. AR 455-486. Therefore, there is no medical documentation

establishing need, nor are there medical records describing the circumstances of that need.

Notably, Plaintiff himself indicated in an April 7, 2005, SSA Function Report that he

used a cane, walker, and wheelchair, yet none had been prescribed by a doctor. AR 126. This

Court’s review of the medical record reveals that no physician has determined a cane or walker is

a medical necessity for Plaintiff. In fact, to the contrary, in 2003, examining physician Dr. Chang

opined that “[t]here is no need for assistive devices.” AR 152. In 2004, Dr. Chang opined that

“[Plaintiff] can stand and walk six hours out of an eight hour day with normal breaks. [Plaintiff]

can sit without restriction.” There was no mention whatsoever of an assistive device. AR 271. 

Also in 2004, state agency physician Dr. Ginsburg did not find a medically required hand-held

assistive device was necessary. AR 293.

Assuming, arguendo, the ALJ should have considered Plaintiff’s subjective statements

about his use of a cane, any error was harmless because it did not affect the ALJ’s RFC finding

that Plaintiff could perform sedentary work. “Even when medically required, the use of a cane

does not rule out the ability to perform sedentary work.” Harris v. Astrue, 2009 WL 2912655

(C.D. Cal.); see also SSR 96-9p; Thomas v. Barnhart, 278 F.3d 947, 960 (9th Cir. 2002) (holding

that where the ALJ’s hypothetical incorporated the option of sitting while working, Plaintiff’s

alleged use of a cane or wheelchair would be irrelevant); Holt v. Astrue, 2008 WL 4965877 (C.D.

Cal.) (holding that the RFC found by the ALJ “did not require that Plaintiff ambulate, and

therefore did not require a decision on whether a cane was necessary or not”). An error by the

ALJ is harmless where the mistake is “nonprejudicial to the claimant or irrelevant to the ALJ’s

ultimate disability conclusion.” Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 1055 (9th

Cir. 2006). Here, the ALJ found that Plaintiff had the RFC to perform sedentary work and, thus,

any possible error regarding the cane is harmless. 

Plaintiff further argues that the ALJ failed to address his use of a cane when questioning

the VE. This argument is unpersuasive. Hypothetical questions need not include a plaintiff’s

subjective impairments if the ALJ makes specific findings that the plaintiff is not credible. See

Thomas v. Barnhart, 278 F.3d at 959 (holding that where Plaintiff’s need for assistive devices

14

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 14 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

was based on conclusory statements and not objective medical evidence, and in light of a finding

of lack of credibility, there was no reason to include Plaintiff’s subjective use of devices in

hypothetical to VE); Copeland v. Bowen, 861 F.2d 536, 540-41 (9th Cir. 1988). Here, the ALJ

stated that “[Plaintiff’s subjective statements . . . are not found credible in light of the medical

evidence and [Plaintiff’s] statements and conduct.” AR 16. Hence, the ALJ was not required to

include Plaintiff’s use of a cane in hypothetical questions posed to the VE.

In sum, the ALJ properly considered Plaintiffs prescription of a cane and testimony of the

use of a cane, and posed proper inquiries to the VE. Thus, ALJ’s decision is supported by

substantial evidence and is free of error. 

B. Breadth of Limitations

Plaintiff argues that the ALJ failed to account for the breadth of limitations described by

Drs. Michiel and Murillo. Specifically, Plaintiff argues that Dr. Murillo determined Plaintiff was

“unable to sustain detailed or complex work” and Dr. Michiel limited Plaintiff to “one- and twostep instructions” but that the ALJ erred by posing a hypothetical to the VE which limited

Plaintiff to “simple repetitive tasks.” This argument is unpersuasive.

Plaintiff does not dispute the ALJ’s RFC finding that he is limited to simple, repetitive

tasks, nor does he dispute the ALJ’s step-five finding that he can perform a substantial range of

sedentary work. See AR 14. Further, Plaintiff concedes that the jobs identified by the VE -

assembler, almond blancher, and nut sorter - have the requisite characteristics of simple and

repetitive work. See AR 483-484. Nor does Plaintiff argue that those jobs do not constitute a

significant number of jobs in the national economy that Plaintiff can perform.

Notably too, Plaintiff does not argue that the case should be remanded on this issue alone. 

Plaintiff does argue that if the case is remanded on the issue of the cane, the Court should direct

the ALJ to properly consider the limitations described by Drs. Murillo and Michiel. Because the

Court has determined the issue regarding the cane adversely to Plaintiff, the argument is

essentially moot.

Nonetheless, the ALJ’s finding that Plaintiff is limited to simple, repetitive tasks is

consistent with the opinions espoused by Drs. Murillo and Michiel. Dr. Murillo stated that

15

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 15 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Plaintiff can perform simple and less complex tasks. AR 288. Dr. Michiel stated that Plaintiff

was able to carry out one or two step simple job instructions. AR 266.

This Court additionally notes that courts within the Ninth Circuit have consistently held

that a limitation regarding simple or routine instructions encompasses a reasoning level of one

and two. In Meissl v. Barnhart, 403 F.Supp.2d 981, 983-985 (C.D. Cal. 2005), the Central

District of California held that a limitation to simple and repetitive tasks was consistent with

level two reasoning positions as provided for in the Dictionary of Occupational Titles (DOT). In

that case, the claimant was limited to “simple tasks performed at a routine or repetitive pace.” 

Id., at 982. The court explained that while the Social Security regulations provided only two

categories of abilities with regard to understanding and remembering instructions - “short and

simple” and “detailed” or “complex” - the DOT has six gradations for measuring that ability. Id.,

at 984. The Meissl court held that to 

equate the Social Security regulations’ use of the term “simple” with its use in the DOT

would necessarily mean that all jobs with a reasoning level of two or higher are

encapsulated within the regulations’ use of the word “detail.” Such a “blunderbuss”

approach is not in keeping with the finely calibrated nature in which the DOT measures a

job’s simplicity.

Meissl v. Barnhart, 403 F.Supp.2d at 984. The use of the term “uninvolved” and “detailed” in

the DOT qualifies the term and refutes any attempt to equate the SSR use of the term “detailed”

with its use in the DOT. Id. The court found a claimant’s RFC must be compared with the

DOT’s reasoning scale. Level one reasoning requires slightly less than simple tasks that are in

some way repetitive. An example of a level one reasoning job would include the job of counting

cows as they come off a truck. The court in Meissl determined that a limitation to simple

repetitive tasks is not inconsistent with positions requiring level two reasoning. Id.; StubbsDanielson v. Astrue, 539 F.3d 1169, 1174 (9th Cir. 2008) (a restriction to simple, repetitive tasks

adequately captures deficiencies in concentration, persistence and pace). 

Here, the reasoning levels for all three jobs identified by the VE involve only level one

reasoning. Plaintiff’s suggestion of remand for the “ALJ to consider a limitation to one- and

two-step instructions” is therefore unnecessary.

16

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 16 of 17
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

This Court finds the limitations posed by the ALJ to the VE adequately described

Plaintiff’s limitations and are therefore supported by substantial evidence and are free of legal

error.

CONCLUSION

Based on the foregoing, the Court finds that the ALJ’s decision is supported by

substantial evidence in the record as a whole and is based on proper legal standards. 

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

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

favor of Defendant Michael J. Astrue, Commissioner of Social Security, and against Plaintiff Ted

Leach.

IT IS SO ORDERED. 

Dated: July 1, 2010 /s/ Gary S. Austin 

6i0kij UNITED STATES MAGISTRATE JUDGE

17

Case 1:09-cv-01103-GSA Document 15 Filed 07/01/10 Page 17 of 17