Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_07-cv-00917/USCOURTS-caed-2_07-cv-00917-0/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Por Xiong
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

1

IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

POR XIONG, 

Plaintiff, No. CIV S-07-917 KJM

vs.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant. ORDER

 /

Plaintiff seeks judicial review of a final decision of the Commissioner of Social

Security (“Commissioner”) denying an application for Supplemental Security Income (“SSI”)

under Title XVI of the Social Security Act (“Act”). For the reasons discussed below, the court

will deny plaintiff’s motion for summary judgment or remand and grant the Commissioner’s

cross-motion for summary judgment. 

/////

/////

/////

/////

/////

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 1 of 11
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

 Disability Insurance Benefits are paid to disabled persons who have contributed to the 1

Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income (“SSI”) is paid

to disabled persons with low income. 42 U.S.C. § 1382 et seq. Under both provisions, disability

is defined, in part, as an “inability to engage in any substantial gainful activity” due to “a

medically determinable physical or mental impairment.” 42 U.S.C. §§ 423(d)(1)(a) &

1382c(a)(3)(A). A five-step sequential evaluation governs eligibility for benefits. See 20 C.F.R.

§§ 423(d)(1)(a), 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987). The

following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful

activity? If so, the claimant is found not disabled. If not, proceed

to step two. 

Step two: Does the claimant have a “severe” impairment? 

If so, proceed to step three. If not, then a finding of not disabled is

appropriate. 

Step three: Does the claimant’s impairment or combination

of impairments meet or equal an impairment listed in 20 C.F.R., Pt.

404, Subpt. P, App.1? If so, the claimant is automatically

determined disabled. If not, proceed to step four. 

Step four: Is the claimant capable of performing his past

work? If so, the claimant is not disabled. If not, proceed to step

five. 

Step five: Does the claimant have the residual functional

capacity to perform any other work? If so, the claimant is not

disabled. If not, the claimant is disabled. 

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 

The claimant bears the burden of proof in the first four steps of the sequential evaluation

process. Bowen, 482 U.S. at 146 n.5. The Commissioner bears the burden if the sequential

evaluation process proceeds to step five. Id.

2

I. Factual and Procedural Background

In a decision dated December 1, 2006, the ALJ determined plaintiff was not

disabled. The ALJ’s decision became the final decision of the Commissioner when the Appeals 1

Council denied plaintiff’s request for review. The ALJ found plaintiff has severe impairments of

bilateral hearing loss and depression but these impairments do not meet or medically equal a

listed impairment; plaintiff has no exertional limitations but has environmental limitations

requiring avoidance of concentrated exposure to noise, jobs that require good hearing, and he is

limited to jobs with simple instructions that do not require literacy; plaintiff has no past relevant

/////

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 2 of 11
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

3

work; plaintiff is not credible; plaintiff is able to perform work existing in significant numbers in

the regional economy; and plaintiff is not disabled. Administrative Transcript (“AT”) 25-26.

Plaintiff contends the ALJ improperly rejected medical opinions, improperly

discredited testimony of plaintiff and his relatives, incorrectly assessed his residual functional

capacity, and improperly relied on the testimony of a vocational expert. 

II. Standard of Review

The court reviews the Commissioner’s decision to determine whether (1) it is

based on proper legal standards under 42 U.S.C. § 405(g), and (2) substantial evidence in the

record as a whole supports it. Copeland v. Bowen, 861 F.2d 536, 538 (9th Cir. 1988) (citing

Desrosiers v. Secretary of Health and Human Services, 846 F.2d 573, 575-76 (9th Cir. 1988)). 

Substantial evidence means more than a mere scintilla of evidence, but less than a

preponderance. Saelee v. Chater, 94 F.3d 520, 521 (9th Cir. 1996) (citing Sorenson v.

Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975)). “It means such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402

U.S. 389, 402, 91 S. Ct. 1420 (1971) (quoting Consolidated Edison Co. v. N.L.R.B., 305 U.S.

197, 229, 59 S. Ct. 206 (1938)). The record as a whole must be considered, Howard v. Heckler,

782 F.2d 1484, 1487 (9th Cir. 1986), and both the evidence that supports and the evidence that

detracts from the ALJ’s conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir.

1985). The court may not affirm the ALJ’s decision simply by isolating a specific quantum of

supporting evidence. Id.; see also 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 finding of either disability or nondisability, the finding of the ALJ is conclusive, see

Sprague v. Bowen, 812 F.2d 1226, 1229-30 (9th Cir. 1987), and may be set aside only if an

improper legal standard was applied in weighing the evidence, see Burkhart v. Bowen, 856 F.2d

1335, 1338 (9th Cir. 1988).

/////

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 3 of 11
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

4

III. Analysis

A. Medical Opinions

Plaintiff contends the ALJ improperly rejected the opinions of his treating

psychiatrist at San Joaquin County Mental Health Services and the opinion of an examining

psychologist, Dr. Regazzi. The weight given to medical opinions depends in part on whether

they are proffered by treating, examining, or non-examining professionals. Lester v. Chater, 81

F.3d 821, 830 (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. Id.;

Smolen v. Chater, 80 F.3d 1273, 1285 (9th Cir. 1996). 

To evaluate whether an ALJ properly rejected a medical opinion, in addition to

considering its source, the court considers whether (1) contradictory opinions are in the record,

and (2) clinical findings support the opinions. An ALJ may reject an uncontradicted opinion of a

treating or examining medical professional only for “clear and convincing” reasons. Lester, 81

F.3d at 831. In contrast, a contradicted opinion of a treating or examining professional may be

rejected for “specific and legitimate” reasons, that are supported by substantial evidence. Id. at

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

contradicted by a supported examining professional’s opinion (e.g., supported by different

independent clinical findings), the ALJ may resolve the conflict. Andrews v. Shalala, 53 F.3d

1035, 1041 (9th Cir. 1995) (citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)). In

any event, the ALJ need not give weight to conclusory opinions supported by minimal clinical

findings. Meanel v. Apfel, 172 F.3d 1111, 1113 (9th Cir.1999) (treating physician’s conclusory,

minimally supported opinion rejected); see also Magallanes, 881 F.2d at 751. The opinion of a

non-examining professional, without other evidence, is insufficient to reject the opinion of a

treating or examining professional. Lester, 81 F.3d at 831. 

The ALJ relied on the opinion of examining psychologist Dr. Wakefield, who

opined that plaintiff could not be adequately assessed because of malingering. AT 19, 150-154. 

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 4 of 11
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

 Dr. Regazzi did expressly address the potential impact of plaintiff’s cultural 2

background in her evaluation. AT 193. However, Dr. Wakefield also expressly considered

plaintiff’s cultural background in evaluating plaintiff. AT 151, 154. Given that psychiatrists are

trained to incorporate cultural differences into their psychological evaluation, it was within the

province of the ALJ to resolve the conflicting mental health assessments. See “Diagnostic and

Statistical Manual of Mental Disorders,” at xxxiii-xxxiv & Appendix 1 at 897-898 (4th Ed.

2000) (“DSM-IV-TR”). 

 65 Fed. Reg. 50746, 50764-65 (Aug. 21, 2000) provides in pertinent part:

3

Comment: Two commenters recommended that we discuss the Global

Assessment of Functioning (GAF) Scale in the introductory paragraphs of final 12.00D. They

noted that we referred to the GAF scale in the preamble to the NPRM (56 FR at 33132) and

seemed to encourage its use, but then failed to mention it in the proposed rules.

Response: We did not adopt the comment. We did not mention the GAF scale to

5

To the extent plaintiff could be assessed, Dr. Wakefield concluded that plaintiff could interact

with co-workers, supervisors, and the public at a minimally acceptable level in Hmong and that

plaintiff’s concentration, persistence and pace, although presented as deficient, were stronger

than presented. AT 154. In relying on the opinion of Dr.Wakefield, the ALJ rejected the opinion

of Dr. Regazzi, who also was an examining physician. AT 22, 189-194. The ALJ rejected Dr.

Regazzi’s opinion as relying too heavily on the credibility of plaintiff and as unsupported by

other evidence of record. AT 22, 191, 329, 342-343. While plaintiff characterizes Dr.

Wakefield’s finding of malingering on the part of plaintiff to be “aberrant,” it was within the

province of the ALJ to resolve the conflict of opinions between Drs. Wakefield and Regazzi,

each of whom relied on their own clinical observations and testing.2

With respect to plaintiff’s assertion that the ALJ improperly rejected the opinions

of his treating psychiatrist at San Joaquin County Mental Health Services, there are simply no

opinions contained in those records with respect to plaintiff’s functional limitations. Plaintiff’s

reliance on the assessed GAF of 40 is untenable. AT 332. Although the ALJ did not specifically

address the GAF assessed by plaintiff’s treating psychiatrist, the ALJ did not err in failing to do

so. The psychiatrist made no assessments with respect to work functions and the GAF does not

correlate to the severity assessments utilized in Social Security disability determinations.

3

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 5 of 11
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

endorse its use in the Social Security and SSI disability programs, but to indicate why the third

sentence of the second paragraph of proposed 12.00D stated that an individual's medical source

"normally can provide valuable additional functional information." To assess current treatment

needs and provide a prognosis, medical sources routinely observe and make judgments about an

individual's functional abilities and limitations. The GAF scale, which is described in the

DSM-III-R (and the DSM-IV), is the scale used in the multiaxial evaluation system endorsed by

the American Psychiatric Association. It does not have a direct correlation to the severity

requirements in our mental disorders listings.

 

6

AT 332-333. The psychiatrist also assessed plaintiff within the last year as having a GAF of 45;

impairment in the inability to work is only one example of the level of adaptation meriting such a

rating. AT 332. Here, there is no indication in the record that the psychiatrist’s assessment of

plaintiff’s GAFs was based on his inability to work. Rather, the psychiatrist identified as long

term treatment goals “job training” appropriate to plaintiff’s mental capacity. AT 333. 

Moreover, it is apparent from the body of the ALJ’s decision that the ALJ thoroughly reviewed

these records and incorporated them into his assessment of plaintiff’s residual functional

capacity. AT 19-22. Moreover, Dr. Regazzi, on whose opinion plaintiff contends the ALJ

should have relied, assessed plaintiff with a GAF of 55, indicating only moderate symptoms. 

AT 193. The ALJ did not err in assessing the record medical opinions. 

B. Credibility

Plaintiff further contends the ALJ improperly discredited his testimony. The ALJ

determines whether a disability applicant is credible, and the court defers to the ALJ’s discretion

if the ALJ used the proper process and provided proper reasons. See, e.g., Saelee v. Chater, 94

F.3d 520, 522 (9th Cir. 1995). If credibility is critical, the ALJ must make an explicit credibility

finding. Albalos v. Sullivan, 907 F.2d 871, 873-74 (9th Cir. 1990); Rashad v. Sullivan, 903 F.2d

1229, 1231 (9th Cir. 1990) (requiring explicit credibility finding to be supported by “a specific,

cogent reason for the disbelief”). 

In evaluating whether subjective complaints are credible, the ALJ should first

consider objective medical evidence and then consider other factors. Bunnell v. Sullivan, 947

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 6 of 11
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

7

F.2d 341, 344 (9th Cir. 1991) (en banc). If there is objective medical evidence of an impairment,

the ALJ then may consider the nature of the symptoms alleged, including aggravating factors,

medication, treatment and functional restrictions. See id. at 345-47. The ALJ also may consider:

(1) the applicant’s reputation for truthfulness, prior inconsistent statements or other inconsistent

testimony, (2) unexplained or inadequately explained failure to seek treatment or to follow a

prescribed course of treatment, and (3) the applicant’s daily activities. Smolen v. Chater, 80 F.3d

1273, 1284 (9th Cir. 1996); see generally SSR 96-7P, 61 FR 34483-01; SSR 95-5P, 60 FR

55406-01; SSR 88-13. Work records, physician and third party testimony about nature, severity

and effect of symptoms, and inconsistencies between testimony and conduct also may be

relevant. Light v. Social Security Administration, 119 F.3d 789, 792 (9th Cir. 1997). A failure

to seek treatment for an allegedly debilitating medical problem may be a valid consideration by

the ALJ in determining whether the alleged associated pain is not a significant nonexertional

impairment. See Flaten v. Secretary of HHS, 44 F.3d 1453, 1464 (9th Cir. 1995). The ALJ may

rely, in part, on his or her own observations, see Quang Van Han v. Bowen, 882 F.2d 1453, 1458

(9th Cir. 1989), which cannot substitute for medical diagnosis. Marcia v. Sullivan, 900 F.2d 172,

177 n.6 (9th Cir. 1990). “Without affirmative evidence showing that the claimant is malingering,

the Commissioner’s reasons for rejecting the claimant’s testimony must be clear and

convincing.” Morgan v. Commissioner of Social Sec. Admin., 169 F.3d 595, 599 (9th Cir.

1999).

After a thorough analysis of plaintiff’s credibility, the ALJ concluded that to the

extent plaintiff claimed he was precluded from all work activity, plaintiff was not credible. 

AT 24-25. The ALJ properly took into account the affirmative finding by Dr. Wakefield of

malingering. AT 153. She also appropriately noted several inconsistencies in the record. AT 24,

133, 274, 311, 327, 329, 331, 340, 347-348. Although plaintiff argues at length regarding the

interpretation of the inconsistencies noted by the ALJ, on the whole record, the court concludes

the ALJ’s interpretation of the noted inconsistencies is rational and should be upheld. The ALJ

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 7 of 11
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

8

considered the discrepancy between plaintiff’s minimal psychological treatment and his allegedly

debilitating psychological condition. AT 24, 169, 311, 327. The ALJ also noted plaintiff’s

activities of daily living, which included helping with household work, walking and jogging,

watching television, and doing yard work. AT 22, 342-344. The factors considered by the ALJ

all were valid and supported by the record. The ALJ’s credibility determination was based on

permissible grounds and will not be disturbed.

C. Lay Witness Testimony

Plaintiff also contends the ALJ improperly discredited the testimony of his mother

and uncle. “[L]ay witness testimony as to a claimant’s symptoms or how an impairment affects

ability to work is competent evidence, and therefore cannot be disregarded without comment.” 

Nguyen v. Chater, 100 F.3d 1462, 1467 (9th Cir. 1996); see also Dodrill v. Shalala, 12 F.3d 915,

918-19 (9th Cir. 1993) (friends and family members in a position to observe a plaintiff's

symptoms and daily activities are competent to testify to condition). “If the ALJ wishes to

discount the testimony of the lay witnesses, he must give reasons that are germane to each

witness.” Dodrill, 12 F.3d at 919. 

Plaintiff’s mother filled out a third party questionnaire and plaintiff’s uncle

testified at the hearing. AT 90-98, 362-371. The ALJ accorded little weight to this testimony. 

AT 20, 23. The ALJ discounted the testimony of plaintiff’s mother because it was inconsistent

with the daily activities reported by plaintiff himself. AT 20. The ALJ also considered the

possible financial gain to plaintiff’s mother and her household should plaintiff secure disability

benefits. AT 356. See Greger v. Barhart, 464 F.3d 968, 972 (9th Cir. 2006). The ALJ

discounted the uncle’s testimony because the record did not support the uncle’s assertion that

plaintiff became so ill as to be disabled immediately upon graduation from high school. AT 23. 

These reasons are germane to these witnesses and supported by the record. There was no error in

the ALJ’s discounting of the lay witness testimony.

/////

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 8 of 11
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

 The United States Dept. of Labor, Employment & Training Admin., Dictionary of 4

Occupational Titles (“DOT”) is routinely relied on by the SSA “in determining the skill level of a

claimant’s past work, and in evaluating whether the claimant is able to perform other work in the

national economy.” Terry v. Sullivan, 903 F.2d 1273, 1276 (9th Cir. 1990). The DOT classifies

jobs by their exertional and skill requirements. The DOT is a primary source of reliable job

information for the Commissioner. 20 C.F.R. § 404.1566(d)(1). 

9

D. Residual Functional Capacity

Plaintiff additionally contends the ALJ improperly assessed his residual functional

capacity. Social Security Ruling 96-8p sets forth the policy interpretation of the Commissioner

for assessing residual functional capacity. SSR 96-8p. Residual functional capacity is what a

person “can still do despite [the individual’s] limitations.” 20 C.F.R. §§ 404.1545(a), 416.945(a)

(2003); see also Valencia v. Heckler, 751 F.2d 1082, 1085 (9th Cir. 1985) (residual functional

capacity reflects current “physical and mental capabilities”).

In arguing that the residual functional capacity did not incorporate all of plaintiff’s

functional limitations, plaintiff is essentially raising the same arguments as he did regarding the

ALJ’s treatment of the opinions of the examining psychologists. As discussed above, it was

within the province of the ALJ to resolve the conflict between the opinions of the examining

psychologists. Moreover, the residual functional capacity assessed by the ALJ limited plaintiff to

simple job instructions, a finding consistent with the assessments of both Dr. Regazzi and Dr.

Wakefield, as well as the state agency physicians. AT 26, 154, 156, 158-160, 193. There was no

error in the residual functional capacity assessment.

E. Vocational Expert

Finally, plaintiff contends the ALJ improperly relied on hypotheticals which did

not include all of plaintiff’s limitations and that the ALJ failed to resolve a conflict between the

DOT and the vocational expert testimony. Hypothetical questions posed to a vocational expert 4

must set out all the substantial, supported limitations and restrictions of the particular claimant. 

Magallanes v. Bowen, 881 F.2d 747, 756 (9th Cir. 1989). If a hypothetical does not reflect all

the claimant’s limitations, the expert’s testimony as to jobs in the national economy the claimant

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 9 of 11
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

 Under the DOT guidelines, a language development level of one entails the ability to 5

recognize 2,500 (two- or three-syllable words), compare similarities and differences between

words, print simple sentences and speak simple sentences. DOT, Scale of General Education

Development (GED) Language Development, Level 1; see also AT 383. 

10

can perform has no evidentiary value. DeLorme v. Sullivan, 924 F.2d 841, 850 (9th Cir. 1991). 

While the ALJ may pose to the expert a range of hypothetical questions, based on alternate

interpretations of the evidence, the hypothetical that ultimately serves as the basis for the ALJ’s

determination must be supported by substantial evidence in the record as a whole. Embrey v.

Bowen, 849 F.2d 418, 422-23 (9th Cir. 1988). 

The hypothetical as posed by the ALJ, as amended with the limitation of illiteracy,

fully included all the limitations incorporated in the ALJ’s residual functional capacity finding,

which as discussed above, was supported by the record. AT 24-25, 379-381. The additional

limitation posed by plaintiff’s attorney at the hearing, of only a fair ability to maintain persistence

and pace, is not supported by substantial evidence, given Dr. Wakefield’s assessment of

malingering. AT 382.

Plaintiff also contends that he could not perform the jobs identified by the

vocational expert because of his illiteracy in light of the GED level of one required for the 5

identified jobs. AT 383-384. Plaintiff’s contention is untenable. A social security disability

applicant is not per se disabled because of illiteracy. Pinto v. Massanari, 249 F.3d 840, 845 (9th

Cir. 2001). Following plaintiff’s rationale, not a single illiterate disability applicant would be

qualified for any of the jobs listed in the DOT. Moreover, the record supports a finding that

plaintiff meets at least the identified GED level. AT 120-121, 150. The ALJ based his finding of

nondisability on the number of jobs identified by the vocational exert as available in California,

and as eroded by illiteracy. AT 25, 380-381. Because the vocational expert identified a total

26,600 such jobs available to plaintiff, substantial evidence supports the ALJ's finding that

plaintiff is not disabled. See Moncada v. Chater, 60 F.3d 521, 524 (9th Cir. 1995) (2,300 jobs in

/////

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 10 of 11
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

11

the county and 64,000 nationwide are sufficient); Barker v. Secretary HHS, 882 F.2d 1474,

1478-79 (9th Cir. 1989) (1,200 jobs in Southern California are sufficient).

The ALJ’s decision is fully supported by substantial evidence in the record and

based on the proper legal standards. Accordingly, IT IS HEREBY ORDERED that:

1. Plaintiff’s motion for summary judgment or remand is denied, and

2. The Commissioner’s cross-motion for summary judgment is granted.

DATED: September 30, 2008.

006

xiong.ss

Case 2:07-cv-00917-KJM Document 26 Filed 09/30/08 Page 11 of 11