Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_15-cv-02467/USCOURTS-caed-2_15-cv-02467-2/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Kevin Voua Lee
Plaintiff

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

KEVIN VOUA LEE, No. 2:15-CV-2467-CMK

Plaintiff, 

vs. MEMORANDUM OPINION AND ORDER

COMMISSIONER OF SOCIAL

SECURITY,

Defendant.

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Plaintiff, who is proceeding with retained counsel, brings this action under 

42 U.S.C. § 405(g) for judicial review of a final decision of the Commissioner of Social Security.

Pursuant to the written consent of all parties, this case is before the undersigned as the presiding

judge for all purposes, including entry of final judgment. See 28 U.S.C. § 636(c). Pending

before the court are plaintiff’s motion for summary judgment (Doc. 12) and defendant’s crossmotion for summary judgment (Doc. 15). 

/ / /

/ / /

/ / /

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I. PROCEDURAL HISTORY

Plaintiff applied for social security benefits on May 30, 2008. In the application,

plaintiff claimed that disability began on March 15, 2008. Plaintiff’s claim was initially denied. 

Following denial of reconsideration, plaintiff requested an administrative hearing, which was

held on July 7, 2010, before Administrative Law Judge (“ALJ”) T. Patrick Hannon. In a

September 9, 2010, decision, the ALJ concluded that plaintiff is not disabled based on the

following relevant findings:

1. The claimant has the following severe impairment(s): Gout, high blood

pressure, high cholesterol, and post-traumatic stress disorder (PTSD);

2. The claimant does not have an impairment or combination of impairments

that meets or medically equals an impairment listed in the regulations;

3. The claimant has the following residual functional capacity: the claimant

can perform sedentary work; plaintiff has moderate difficulty in

understanding and carrying out complex instructions but has no difficulty

in carrying out simple and repetitive tasks consistent with unskilled work;

and

4. Considering the claimant’s age, education, work experience, residual

functional capacity, and the Medical-Vocational Guidelines, there are jobs

that exist in significant numbers in the national economy that the claimant

can perform.

The Appeals Council declined review on August 26, 2011, and plaintiff sought judicial review.

In Lee v. Astrue, 1:11-CV-1789-GSA, the court reversed and remanded for further

proceedings. A second hearing has held before the ALJ Danny Pittman on December 3, 2013. 

At the hearing, plaintiff amended the alleged onset date to January 1, 2010. In a February 10,

2014, decision, the ALJ concluded that plaintiff is not disabled based on the following relevant

findings:

1. The claimant has the following severe impairment(s): Gout, rheumatoid

arthritis, and depressive disorder;

2. The claimant does not have an impairment or combination of impairments

that meets or medically equals an impairment listed in the regulations;

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3. The claimant has the following residual functional capacity: the claimant

can lift and carry 20 pounds occasionally and 10 pounds frequently; stand

and/or walk for 6 hours in an 8-hour day, and sit for 6 hours in an 8-hour

day; he can occasionally balance, stoop, kneel, crouch, crawl, and climb,

and frequently handle, finger, and feel; he would be limited to simple

routine tasks; and

4. Considering the claimant’s age, education, work experience, residual

functional capacity, and vocational expert testimony, there are jobs that

exist in significant numbers in the national economy that the claimant can

perform.

After the Appeals Council declined further review on September 25, 2015, this second action

followed.

II. STANDARD OF REVIEW

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cir. 1988). 

III. DISCUSSION

In his motion for summary judgment, plaintiff argues the ALJ failed to properly

evaluate the opinions of examining physician Dr. Parayno, non-examining state agency

reviewing physician Dr. S. Khan, and treating physician Dr. Apai Polyudhapoom. The weight

given to medical opinions depends in part on whether they are proffered by treating, examining,

or non-examining professionals. See Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1995). 

Ordinarily, more weight is given to the opinion of a treating professional, who has a greater

opportunity to know and observe the patient as an individual, than the opinion of a non-treating

professional. See id.; Smolen v. Chater, 80 F.3d 1273, 1285 (9th Cir. 1996); Winans v. Bowen,

853 F.2d 643, 647 (9th Cir. 1987). The least weight is given to the opinion of a non-examining

professional. See Pitzer v. Sullivan, 908 F.2d 502, 506 & n.4 (9th Cir. 1990).

In addition to considering its source, to evaluate whether the Commissioner

properly rejected a medical opinion the court considers whether: (1) contradictory opinions are

in the record; and (2) clinical findings support the opinions. The Commissioner may reject an 

uncontradicted opinion of a treating or examining medical professional only for “clear and

convincing” reasons supported by substantial evidence in the record. See Lester, 81 F.3d at 831. 

While a treating professional’s opinion generally is accorded superior weight, if it is contradicted

by an examining professional’s opinion which is supported by different independent clinical

findings, the Commissioner may resolve the conflict. See Andrews v. Shalala, 53 F.3d 1035,

1041 (9th Cir. 1995). A contradicted opinion of a treating or examining professional may be

rejected only for “specific and legitimate” reasons supported by substantial evidence. See Lester,

81 F.3d at 830. This test is met if the Commissioner sets out a detailed and thorough summary of

the facts and conflicting clinical evidence, states her interpretation of the evidence, and makes a

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finding. See Magallanes v. Bowen, 881 F.2d 747, 751-55 (9th Cir. 1989). Absent specific and

legitimate reasons, the Commissioner must defer to the opinion of a treating or examining

professional. See Lester, 81 F.3d at 830-31. The opinion of a non-examining professional,

without other evidence, is insufficient to reject the opinion of a treating or examining

professional. See id. at 831. In any event, the Commissioner need not give weight to any

conclusory opinion supported by minimal clinical findings. See Meanel v. Apfel, 172 F.3d 1111,

1113 (9th Cir. 1999) (rejecting treating physician’s conclusory, minimally supported opinion);

see also Magallanes, 881 F.2d at 751. 

1. Dr. Parayno

As to Dr. Parayno, the ALJ stated:

Dr. Parayno opined in December 2013 [Exhibit 20F] that it was apparent

to him that the claimant had both mental and medical disabilities that

impaired his ability to engage in any substantial gainful activity. . . . I give

limited weight because this opinion. . . concerns an issue reserved to the

Commissioner and is not an opinion as to the nature and severity of the

claimant’s impairment. . . . 

According to plaintiff, the ALJ erred in rejecting Dr. Parayno’s statements regarding ability to

engage in gainful employment, ability to engage in activities of daily living, and deficits in

memory and concentration. 

A review of Dr. Parayno’s December 2, 2013, report reflects the following

“discussion” offered by the doctor:

We have a 44 year old Hmong married male who suffers from Major

Depressive Disorder, recurrent, severe without psychotic features and

Post-traumatic Stress Disorder, chronic. He also suffers from several

medical problems and on one occasion he was treated overnight at the

Emergency Room. . . . The significant findings on mental status

examination are disorientation to time, place, and situation, impairment of

his recent, remote, and current memory, concentration and attention as

indicated by his inability to perform the forward digit span and serial

sevens test, inability to remember the date of births of his 5 children which

meant impaired remote memory and inability to recall 5 items after 3

minutes. He exhibited a disorientation to time, place, and situation. He

also showed poor social judgment on the envelope with the stamp and

address on it test. He definitely had poor knowledge of U.S. History &

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Civics and poor or impaired proficiency in basic English. In summary, it

is apparent [he] has both mental and medical disability that impairs his

ability to engage in any substantial gainful activity. He definitely has

restricted activities of daily living and constriction of his social life. His

family including his wife and children perform the daily activities of daily

living such as cooking, housekeeping, grocery shopping, and laundry. He

does not like to visit friends and relatives or go to socials and prefers to

stay in the bedroom or go to the living room sometimes and watch

television avoiding war movies or scenes that depict gunfights because it

triggers nightmares and flashbacks when he goes to bed at night. 

Out of this entire “discussion” – which is more a recitation of test results and plaintiff’s own

subjective report – the only opinion present is Dr. Parayno’s statement that plaintiff has a

disability precluding substantial gainful activity. As the ALJ correctly observed, such a judgment

is reserved for the Commissioner. See 20 C.F.R. § 404.1527(d)(1); McLeod v. Astrue, 640 F.3d

881 (9th Cir. 2011). 

2. Dr. Khan

As to Dr. Khan, the ALJ stated:

The State Agency medical consultant [Dr. Khan] opined that the claimant

would be able to understand and remember simple instructions, sustain

attention and concentration for two-hour periods, to complete a regular

workday at an acceptable pace and attendance schedule, interact

adequately in casual setting, and respond appropriately to constructive

instructions, and respond to simple and infrequent changes in routine. 

They also recommended non-public work setting with exposure to others

that was not too intense and/or prolonged (Exhibits 4F; 6F). I give some

weight to the State Agency opinion, but give little weight to social

interaction as it was [not] well supported and consistent with the record as

a whole. 

Plaintiff notes that Dr. Khan opined that he “can sustain simple repetitive one-two step tasks”

and argues:

In this case, the ALJ stated that he gave “some weight” to Dr.

Khan’s opinions, but gave “little weight” to social interaction. . . . AR

302. To begin with, it is unclear what “some weight” means. It does not

indicate whether the ALJ accepted or rejected the limitation to one-to-two

step tasks. In fact, it does not indicate whether the ALJ acknowledged the

difference between a simple and repetitive tasks versus a limitation to oneto-two-step tasks. 

/ / /

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What is clear, however, is that the ALJ’s ultimate finding of fact is

that Kevin Lee is limited to simple, routine tasks. AR 298. Whether

intended or not, this constitutes a rejection of Dr. Khan’s opinion that

Kevin Lee is limited to one-to-two-step tasks. And the ALJ failed to

provide any explanation for rejecting this medical source statement offered

by Dr. Khan, which is error under SSRs 96-6p and 96-8p.

Plaintiff also argues that the ALJ failed to articulate sufficient reasons supported by the record

for giving little weight to Dr. Khan’s opinion that he is limited with respect to social interaction. 

The record contains two assessments by Dr. Khan, both completed on August 4,

2008. In a mental residual function capacity assessment form, Dr. Khan rated plaintiff as “not

significantly limited” in the ability to understand, remember, and carry out “very short and simple

instructions.” In the same assessment form, Dr. Khan opined that plaintiff is “[a]ble to

understand and remember simple instructions,” though the doctor did not offer an additional

statement on plaintiff’s ability to carry out simple instructions. In a psychiatric review technique

form, Dr. Khan stated:

Allegations are credible. However extent alleged, intensity, persistence

and functional limitations are not fully credible when reviewed with the

totality of evidence in mind [¶] . . . Degree of alleged limitations exceeds

objective findings.

The claimant is partially credible with an MDI and overall considering the

MSE and ADLs it appears that the claimant can sustain simple repetitive

one-two step tasks with adequate pace and persistence, adapt and relate to

coworkers and supervisors and deal with changes but would probably do

better in a nonpublic setting with exposure/contact to others that is not too

intense and/or prolonged. 

Given this record, Dr. Khan clearly opined that plaintiff is capable of understanding,

remembering, and carrying out simple tasks. The ALJ accepted this opinion and included it in

his residual functional capacity finding. Dr. Khan’s addition of the phrase “one-two” in the

psychiatric review technique form does not appear to constitute the doctor’s opinion of an

additional limitation, particularly in the context of the doctor’s overall impression that the

[d]egree of alleged limitations exceeds objective findings.” 

/ / /

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As to limitations on social interaction, Dr. Khan assessed plaintiff is “not

significantly limited” in his ability to work in coordination with or proximity to others without

being distracted, as well as every other area of social interaction except plaintiff’s ability to

interact appropriately with the general public which Dr. Khan assessed as “moderately limited.” 

Dr. Khan also stated that plaintiff would “probably do better” in a non-public setting with

“exposure/contact to others” that is “not too intense and/or prolonged.” This equivocal statement

does not constitute a medical opinion. Again, the statement is offered in the context of Dr.

Khan’s assessment that the limitations alleged by plaintiff exceed the objective evidence. 

Additionally, while the statement suggests that plaintiff may “do better” with more limited social

interaction, the statement does not indicate an opinion that plaintiff is incapable of the level of

social interaction required for unskilled work, which primarily involves dealing with objects

rather than people. See SSR 85-15; see also Hoopai v. Astrue, 499 F.3d 1075 (9th Cir. 2007). 

3. Dr. Polyudhapoom

As to Dr. Polyudhapoom, the ALJ stated:

In March 2013, Dr. Apai Polyudhapoom reported that the claimant could

lift less than five pounds, sit for 30 minutes at one time and 30 minutes

over an 8-hour period, and stand and walk for 30 minutes at one time and

30 minutes over an 8-hour period. He must lie down or elevate his legs for

10 minutes. He could reach and handle for 30 minutes each and never

push and pull (Exhibits 10F; 19F). I give limited weight to such restrictive

limitations as the medical evidence and Dr. Polyudhapoom’s records do

not support such restrictive limitations. Dr. Polyudhapoom apparently

relied quite heavily on the subjective report of symptoms and limitations

provided by the claimant, and seemed to uncritically accept as true most, if

not all, of what the claimant reported. Yet, as explained elsewhere in this

decision, there exist good reasons for questioning the reliability of the

claimant’s subjective complaints.

Plaintiff argues that these reasons are insufficient.

The court does not agree. In concluding that the doctor’s opinion is only entitled

to limited weight, the ALJ noted that the opinion is not supported by objective evidence. The

record contains a three-page “questionnaire” completed by Dr. Polyudhapoom on March 21,

2013. When prompted to list objective findings, the doctor stated: “pain in knuckle of right

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hand” and “tender of lumbar spine area.” Other than an unexplained reference to uric acid levels,

Dr. Polyudhapoom listed no objective findings. The ALJ properly rejected this doctor’s

conclusory and unsupported opinions. 

IV. CONCLUSION

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

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

ORDERED that:

1. Plaintiff’s motion for summary judgment (Doc. 12) is denied;

2. Defendant’s cross-motion for summary judgment (Doc. 15) is granted; and

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

DATED: March 27, 2017

______________________________________

CRAIG M. KELLISON

UNITED STATES MAGISTRATE JUDGE

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