Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-02872/USCOURTS-cand-3_04-cv-02872-0/pdf.json

Parties Involved:
Jo Anne B. Barnhart
Defendant
Van Do
Plaintiff

Document Text:

United States District Court

For the Northern District of California

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

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

VAN DO,

Plaintiff,

 v

JO ANNE B BARNHART, Commissioner

of Social Security,

Defendant.

 /

No C 04-2872 VRW

 ORDER

Plaintiff Van Do appeals from the decision of the Social

Security Administration (SSA) denying her application for social

security income (SSI) under title XVI of the Social Security Act

(Act). The court has jurisdiction over the appeal pursuant to 42

USC § 405(g). The court now considers cross-motions for summary

judgment. For the reasons stated herein, the court DENIES

plaintiff’s motion and GRANTS defendant’s motion. 

\\

\\

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 1 of 17
United States District Court

For the Northern District of California

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

2

I

Plaintiff was born in around 1974 in Vietnam. She

attended school through the fifth grade in Vietnam, immigrated to

the United States as a teenager and has never worked. 

Administrative record (AR), Doc # 16 at 55, 271. She is a

naturalized United States citizen. AR 40, 270. Plaintiff

contended in connection with her application for benefits that she

did not speak English. AR 54. Up to and including the time period

in which her application for benefits was pending, plaintiff was

unmarried and lived in Oakland with her three children, the

youngest of whom was born in October 2000. AR 114-16. The record

contains scant evidence regarding the children’s paternity, except

that they are “from three different fathers” (AR 248) and no

reference to the father(s) playing any financial or participatory

role in plaintiff’s life or that of her children. Her sole source

of income was AFDC/CALWORKS benefits. AR 41, 45, 269. According

to her testimony, plaintiff took and passed the exam to perform

manicures and completed one month of the on-the-job training (AR

276-77), but did not seek a job afterward because of a sinus

infection (AR 271), planned sinus surgery (AR 278) and because

“they don’t let [people who have psoriasis] do the manicure.” AR

279. 

On May 28, 2002, plaintiff applied for SSI benefits

alleging an onset date of January 1, 1997. AR 40, 44. Her

application listed “depression, anxiety skin disease, back pain,

migraine headaches, asthma, inability to smell” as limiting her

ability to work because “I have a hard time concentrating,

difficulty sleeping, and back pain and headaches which limit my

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 2 of 17
United States District Court

For the Northern District of California

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

3

ability to complete tasks.” AR 55. The application stated “I do

not need help in personal care, hygiene or upkeep of a home.” AR

45. In her daily activities questionnaire, plaintiff stated that

she sleeps and watches television a lot, and that her brother takes

her out to shop for food almost every day, carries the groceries

and handles the money transactions and “sometimes” comes to her

apartment to help cook. AR 68-73. The questionnaire contains

several references to pain and headaches, but also states that

plaintiff takes painkillers less than once a day, AR 68, and that

upon receiving a referral from her primary care doctor to “a

specialist for my headaches,” “I called once to make an appointment

but they were full, so I gave up.” AR 72. 

Plaintiff underwent an agency-ordered internal medicine

evaluation with Lloyd Johnson, MD of QTC Medical Group in Oakland.

A September 10, 2002 report from that evaluation relates that

plaintiff appeared with a professional translator. Dr Johnson’s

report noted plaintiff’s history of asthma, “which appears to be

well-controlled with albuterol dose inhaler,” history of headaches,

which “sound like migraine[s],” and mild memory loss, “which

appears to be non-pathological.” AR 130. He also stated that

plaintiff had complained of high blood pressure, but had normal

blood pressure on examination. Id. Of plaintiff’s complaints of

back pain, Dr Johnson noted “slight subjective evidence” on exam. 

Id. He also observed “plaque-type lesions, which are probably

psoriatic.” Id. 

Dr Johnson concluded that “patient’s primary physical

function limitations relate to her asthma. She should not be

employed in a capacity where she is exposed to dusts, noxious

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 3 of 17
United States District Court

For the Northern District of California

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

4

chemicals, pollens, animal danders or rapid changes in

temperatures. Patient has no other functional limitations except

those appropriate to her age and body habitus.” Id. 

The administrative record also contains an abundance of

records from plaintiff’s treating physicians, especially primary

care physician Thanh K Bui, MD and dermatologist Ervin Epstein, MD.

Dr Bui’s records (AR 147-219 and 257-61) reflect that plaintiff

visited him approximately fifteen times in 1995, twenty-one times

in 1996, twenty-two times in 1997, twenty-one times in 1998,

fourteen times in 1999, seventeen times in 2000, twelve times in

2001, thirteen times in 2002 and eight times before the record

closed in 2003. The progress notes contain regular, repeated

references to sinusitis, allergic rhinitis, headaches and asthma,

but only occasional, discontinuous references to back strain (e g

AR 183 dated August 24, 1998; AR 156 dated September 29, 2001). 

For her psoriasis, Dr Bui referred plaintiff to Dr Epstein, whom

she saw numerous times for psoriasis treatments beginning in 1997. 

AR 133-45; 254-56. In a letter dated January 2003, Dr Epstein

stated that while plaintiff’s lesions were “usually quite

extensive,” they were not disabling per se for most jobs. AR 16,

221. 

The record also includes documentation of plaintiff’s

1997 sinus surgery. AR 102A-107. 

Because her disability application included a claim of

depression, plaintiff underwent an agency-ordered psychological

exam at the QTC Medical Group with Carol L Lewis-Wintrode, PhD. 

Her September 10, 2003 report from the exam noted that plaintiff’s

grooming and hygiene was “consistent with a good level of self-care

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 4 of 17
United States District Court

For the Northern District of California

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

5

skills and personal hygiene competence,” that she “understands the

US currency, and can handle money, shop, and make change [and] care

for her personal affairs.” AR 122. Dr Lewis-Wintrode found

plaintiff “oriented in all dimensions” and that while she “appeared

to have a short attention span and limited concentration * * *

[she] was able to focus on the tasks and complete the tasks” and

could “follow instructions without difficulty or repetition.” Id.

The report described plaintiff’s insight and judgment as “intact,”

her fund of knowledge as “intact,” her speech was “clear” and her

thoughts “relevant and productive,” and immediate memory (of

numbers and the like) “intact.” AR 123. Plaintiff’s IQ tested at

68, a level described as “high mildly deficient,” but the examiner

stated that plaintiff “functions in the borderline range” noting

that “she is able to care for her three children and appears to

have adequate adaptive skills [and can] handle finances.” AR 123-

24. She found “no evidence of psychomotor retardation.” Id. Dr

Lewis-Wintrode diagnosed plaintiff with “mild to low borderline

intellectual functioning and depression, not otherwise specified

with a Global Assessment of Functioning (GAF) of 60. Id. She

found plaintiff able to avoid simple hazards, interact adequately

with others, follow one- and two-part instructions and handle

simple tasks. AR 125. 

An agency-prepared mental RFC worksheet prepared on

October 7, 2002 by TM Gragg, MD found plaintiff “not significantly

limited” in eighteen of twenty work-related abilities, and

“moderately limited” only in “ability to understand and remember

detailed instructions” and “ability to carry out detailed

instructions.” AR 239-41.

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 5 of 17
United States District Court

For the Northern District of California

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

6

In November of 2002, plaintiff’s primary care physician 

referred her to Tuong Vi Ta, MD because of “poor sleep, headache,

low energy level.” AR 248. Dr Ta’s records reflect visits or

other contact on November 20 and December 17, 2002 and on March 4,

April 7, May 5 and June [illegible], 2003. AR 253-56. A barely

legible, worksheet-style report from March 10, 2003 noted

“pyschomotor retardation” and “depression,” “slow” thought

processes and “significant impairment in [several areas] of life

functioning”: symptom management, [illegible] functioning and

parenting skills. Id at 248-53. The report appears to contain a

diagnosis of “depressive disorder” with a GAF of 50. AR 249. 

Plaintiff’s application for benefits was denied initially

and upon reconsideration. AR 14. She submitted a timely request

for a hearing before an Administrative Law Judge (ALJ). 

On October 30, 2003, The ALJ opened the hearing with

plaintiff, her attorney and an interpreter present. AR 265-87. 

Plaintiff testified that “at one time” she had been able to speak a

little English but could no longer do so although she had taken

some ESL classes. AR 270. She testified that she could read and

write in Vietnamese. AR 271. In answer to the question “do you

know how to add numbers and figure the right change on money?” she

testified that she could “before” but could no longer remember how

to do so. Id. 

After asking about plaintiff’s sole, brief occupational

training as a manicurist, the ALJ asked why plaintiff thought she

could not work, to which plaintiff answered “Of course I have

psoriasis * * * and when I went to work all the other employees

look at me as though I’m – was ashamed, and I’m scared too.” AR

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 6 of 17
United States District Court

For the Northern District of California

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

7

272. She also stated that asthma prevented her from working at

“heavy-duty job[s]” and that her headaches required her to take

one-hour breaks. Id. The ALJ asked plaintiff to approach and show

him the psoriasis on her hands and arms. AR 273. Plaintiff

further testified that she gave up ESL classes because fellow

students made comments about her psoriasis. AR 276. Plaintiff’s

attorney questioned her about her treatments for psoriasis as well

as her headaches and back pain. At the end of the hearing, the

attorney asked why plaintiff had not looked for a job, to which

plaintiff answered “they wouldn’t hire me with the kind of sickness

that I have.” AR 286. The attorney then asked “what about right

now? You can’t really see her sickness. I mean I can’t see it on

her face or her hands.” Id. Plaintiff answered, “ Because I don’t

speak English.” Id. When asked whether she’d considered taking

English classes again, plaintiff replied that she wanted to, but

was waiting for her condition to improve. AR 287. 

On November 28, 2003, the ALJ issued a decision finding

plaintiff not disabled because she had no impairment or combination

of impairments precluding the performance of work existing in

significant numbers in the national economy. AR 14-19. Applying

the five-step sequential disability analysis set forth at 20 CFR §

416.920 (infra), the ALJ found that plaintiff had engaged in no

substantial gainful activity since the date of her application for

benefits (step one). AR 15. He found that plaintiff suffered from

medically determinable impairments —— depression, psoriasis,

asthma, allergic rhinitis and migraine headaches —— that, in

combination, significantly limited her ability to perform basis

work activities and were therefore “severe” (step two). Id. 

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 7 of 17
United States District Court

For the Northern District of California

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

8

The ALJ next found, at step three, that none of

plaintiff’s impairments met or equaled the criteria set forth in

the Listing of Impairments at 20 CFR Part 404, Subpart P, Appendix

1, which includes asthma, psoriasis or depression. Regarding

depression, found that: plaintiff could care for her three

children, do chores, shop and cook and therefore suffered only a

“mild” restriction in activities of daily living; that according to

the consulting psychologist plaintiff had no significant difficulty

relating to others nor significant deficits in concentration, and

therefore suffered only “mild” difficulties in social functioning

and concentration, persistence and pace; and the record contained

no evidence of episodes of decompensation. AR 15-16. Based on

those findings, the ALJ concluded that plaintiff did not suffer

from “Listing level depression.” Id. 

Noting plaintiff’s lack of employment history, the ALJ

dispensed with step four and moved to step five –— consideration of

plaintiff’s residual functional capacity (RFC) for employment. The

ALJ concluded that even with the limitations of avoiding both harsh

environmental irritants and extensive interaction with the public,

plaintiff was able to perform a wide range of unskilled work –— i e,

work dealing with objects, rather than data or people –— available

in significant numbers in the national economy. AR 17-18.

In reaching this conclusion, the ALJ discounted the March

2003 report by treating physician Dr Ta on the grounds that it was

inconsistent with his own November 2002 report and was not

supported by medically acceptable diagnostic techniques and that Dr

Ta was not a mental health professional. AR 17. The ALJ also

discounted plaintiff’s own testimony, finding it not “particularly

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 8 of 17
United States District Court

For the Northern District of California

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

9

convincing or credible.” Id. In specific, the ALJ set forth the

following observations:

I note that the claimant has reported that she has

been able to, and continues to be able to, raise

three children on her own and she has reported

that she has also been able to do chores, shop and

cook. [ ] In addition, at the hearing the claimant

appeared well-groomed and interacted with me

without difficulty – a presentation that is

inconsistent with an alleged degree of discomfort

with her appearance that she is unable to function

adequately outside of her home. I also note that

despite her allegedly disabling depression and

headaches, the frequency of her visits to her

doctors over the years for treatment of her

allergic rhinitis and psoriasis suggests that the

claimant has been quite adept and sophisticated in

accessing regular, ongoing medical care. I also

note that while the claimant stated that she was

unable to speak any English, she takes ESL courses

and has become a citizen after taking testing in

English. She responded to my requests to show the

psoriasis on her arms without waiting for

translation. She is now only 29 years old and has

lived in the United States 10 years. 

AR 17-18. 

The Appeals Council declined review, making the ALJ's

decision final. AR 5-7. Plaintiff timely requested judicial

review. 

II

In appealing the SSA’s final decision, plaintiff contends

the ALJ erred in discounting her own testimony and that of treating

physician Dr Ta. She also contends that the ALJ erred in failing

to consider Listed Impairment 12.05 (mental retardation) in his

analysis. Finally, she contends that the ALJ failed to consider

“all of the relevant evidence” in evaluating her RFC and, moreover,

should have consulted a vocational expert to determine the

availability of suitable employment, not the “grids,” —— i e, the

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 9 of 17
United States District Court

For the Northern District of California

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

10

medical-vocational guidelines set forth at 20 CFR Part 404, Subpart

P, Appendix 2. The court disagrees with these contentions. On the

contrary, the ALJ applied the SSA’s regulations governing

disability determinations correctly. Because his conclusions are

supported by substantial evidence and free of legal error, the

court affirms his decision. 

The court's jurisdiction is limited to determining

whether the SSA's denial of benefits is supported by substantial

evidence in the administrative record. 42 USC § 405(g). A

district court may overturn a decision to deny benefits only if the

decision is not supported by substantial evidence or if the

decision is based on legal error. See Andrews v Shalala, 53 F3d

1035, 1039 (9th Cir 1995); Magallanes v Bowen, 881 F2d 747, 750

(9th Cir 1989). The Ninth Circuit defines "substantial evidence"

as "more than a mere scintilla but less than a preponderance; it is

such relevant evidence as a reasonable mind might accept as

adequate to support a conclusion." Andrews, 53 F3d at 1039. 

The SSA’s regulations specify in detail how an ALJ is to

approach the task of determining whether a claimant is disabled. 

20 CFR § 416.920 sets forth a five-step sequential analysis for

ALJs to use in evaluating claims of disability: (1) first, the ALJ

considers whether the claimant is currently employed in substantial

gainful activity; (2) if not, the second step asks whether the

claimant has a severe impairment; (3) in step three, the ALJ

determines whether the claimant has a condition which meets or

equals any listed condition according to the criteria set forth in

the Listings of Impairments in Appendix 1, Subpart P of Part 404;

(4) if the claimant does not have such a condition, step four asks

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 10 of 17
United States District Court

For the Northern District of California

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

11

whether the claimant can perform his past relevant work; (5) if

not, in step five the ALJ considers whether the claimant has the

ability to perform other work which exists in substantial numbers

in the national economy. 20 CFR § 416.960(c). The ALJ found at

step two that plaintiff did have “severe” impairments ——

specifically depression, psoriasis, asthma, allergic rhinitis and

migraine headaches, but not back pain —— that significantly limited

her ability to perform basic work activities, but found at step

three that none of the severe impairments met or equaled the

listing criteria that would establish plaintiff as disabled. 

The court notes that although there are frequent

references in the record to plaintiff’s asthma and psoriasis,

plaintiff does not contend on appeal that she is disabled by either

of these ailments. The ALJ found that plaintiff’s asthma did not

meet the criteria for listing-level asthma, which include regular

attacks requiring intensive treatment up to and including

hospitalization. See 20 CFR Part 404, Subpt P, App I, Listing

3.03. Similarly, plaintiff does not actually contend on appeal

that she is disabled by psoriasis. Psoriasis is a listed

impairment, but the listing criteria for skin lesions are as

follows:

a. Skin lesions that interfere with the motion of

your joints and that very seriously limit your use

of more than one extremity, that is, two upper

extremities, two lower extremities, or one upper

and one lower extremity. 

b. Skin lesions on the palms of both hands that

very seriously limit your ability to do fine and

gross motor movements.

c. Skin lesions on the soles of both feet, the

perineum, or both inguinal areas that very

seriously limit your ability to ambulate.

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 11 of 17
United States District Court

For the Northern District of California

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

12

20 CFR Pt 404, Subpt P, App 1, Listing 8.00, 8.05. Plaintiff does

not contend that her psoriasis meets or equals the listing criteria

for psoriasis. Rather, her complaints about psoriasis appear to be

based upon cosmetic concerns. Yet the record of the hearing

transcript suggests that the lesions were not visible on

plaintiff’s face and hands. This, therefore, leaves psychological

impacts as the only possible basis upon which plaintiff’s psoriasis

could form the basis for disability. Plaintiff’s depression is

discussed in more detail below; first, the court will address

plaintiff’s challenges to the ALJ’s weighing of evidence. 

The regulations cover in detail how different types of

evidence are to be weighed against each other. Several provisions

are directly on point in this case. 20 CFR § 416.929(b), entitled

“how we evaluate symptoms, including pain,” effectively disposes of

plaintiff’s challenges to the ALJ’s handling of her pain testimony: 

Your symptoms, such as pain * * * will not be found

to affect your ability to do basic work activities

unless medical signs or laboratory finding show

what a medically determinable impairment(s) is

present. Medical signs and laboratory findings,

established by medically acceptable clinical or

laboratory diagnostic techniques, must show the

existence of a medical impairment(s) which results

from anatomical [or] physiological * * *

abnormalities and which would reasonably be

expected to produce the pain or other symptoms

alleged.

Substantial evidence in the record supports the ALJ’s conclusion

that the required medical signs and laboratory findings that would

require him to give credence to plaintiff’s pain testimony are

absent. There is no medical evidence showing any specific work-up

by treating physicians of plaintiff’s headaches and alleged back

pain. As noted above, the progress notes from plaintiff’s many

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 12 of 17
United States District Court

For the Northern District of California

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

13

visits to her treating physician indicate only sporadic episodes of

“back strain” with no follow-up. Plaintiff admitted taking pain

medication for headaches no more than once a day and failing to

follow through with a referral to a specialist for headache pain. 

On this record, the ALJ was entitled to discount plaintiff’s

allegations of disabling pain. 

20 CFR § 416.927(d), in the regulation entitled

“evaluating opinion evidence,” covers “how we weigh medical

opinions.” It explains that the ALJ evaluates every medical

opinion and generally gives more weight to treating sources. A

treating physician’s opinion is given “controlling weight” only if

“well-supported by medically acceptable clinical and laboratory

diagnostic techniques and not inconsistent with the other

substantial evidence” in the record. If an ALJ does not give

controlling weight to a treating source, he must consider other

factors, including length of the treatment relationship and

frequency of examination, nature and extent of the treatment

relationship, supportability, consistency, specialization and other

factors. § 416.927(d)(2)-(6). Regarding supportability, the

regulation provides: “[t]he more a medical source presents relevant

evidence to support an opinion, particularly medical signs and

laboratory findings, the more weight we will give that opinion.” 

§ 416.927(d)(3). 

Plaintiff challenges the ALJ’s decision to discount the

opinion of Dr Ta giving plaintiff a GAF score of 50, but Dr Ta’s

report was neither detailed nor carefully analyzed and was contrary

to substantial other evidence in the record –— specifically, the

much more thorough report of Dr Lewis-Weintrode. The ALJ is

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 13 of 17
United States District Court

For the Northern District of California

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

14

responsible for resolving conflicts in medical testimony and

resolving ambiguity. Morgan v Comm’r of Soc Sec Admin, 169 F3d

595, 603 (9th Cir 1999). The ALJ stated that Dr Ta was a “general

physician and surgeon” and not a trained mental health

practitioner, which plaintiff contends, based on a Google search,

is incorrect. Pl Mot (Doc # 17) at 13. But it is the social

security claimant’s burden to furnish to the agency evidence that

he or she is disabled (see, e g, 20 CFR § 404.1512) and nothing in

the record identifies Dr Ta’s specialty. In any event, the alleged

discrepancy is immaterial; the ALJ was entitled to give more weight

to the more detailed, comprehensive report of the examining

psychologist than to that of Dr Ta, which does not specifically

address plaintiff’s ability to work. 

Returning to plaintiff’s contentions regarding the ALJ’s

handling of her alleged mental impairments –— depression and mental

retardation –— the court finds no error. To evaluate a claim of

disability based on mental impairment, the regulations require the

ALJ to employ a “special technique” at the administrative hearing

level to assist in identifying the need for additional evidence,

considering and evaluating the functional consequences of the

mental disorder on the claimant’s ability to work and organizing

and presenting the facts. See 20 CFR § 404.1520a(b). The

regulation provides: 

(b)(1) Under the special technique, we must first

evaluate your pertinent symptoms, signs, and laboratory

findings to determine whether you have a medically

determinable mental impairment(s). [] If we determine

that you have a medically determinable mental

impairment(s), we must specify the symptoms, signs, and

laboratory findings that substantiate the presence of

the impairment(s) and document our findings in

accordance with paragraph (e) of this section. * * *

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 14 of 17
United States District Court

For the Northern District of California

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

15

(c)(1) * * * We will consider all relevant and

available clinical signs and laboratory findings, the

effects of your symptoms, and how your functioning may

be affected by factors including, but not limited to,

chronic mental disorders, structured settings,

medication, and other treatment. * * * (3) We have

identified four broad functional areas in which we

will rate the degree of your functional limitation:

Activities of daily living; social functioning;

concentration, persistence, or pace; and episodes of

decompensation. [] (4) When we rate the degree of

limitation in the first of three functional areas []

we will use the following five-point scale: None,

mild, moderate, marked, and extreme. When we rate the

degree of limitation in the fourth functional area

(episodes of decompensation) we will use the following

four-point scale: None, one or two, three, four or

more. The last point on each scale represents a

degree of limitation that is incompatible with the

ability to do any gainful activity.

(d) * * * After we rate the degree of functional

limitation resulting from your impairment(s), we will

determine the severity of your mental impairment(s). 

* * *

(e) Documenting application of the technique. * * * At the administrative law judge hearing and

Appeals Council levels[], we will document application

of the technique in the decision. * * * (2) At the

administrative law judge hearing and Appeals Council

levels, the written decision issued by the

administrative law judge or Appeals Council must

incorporate the pertinent findings and conclusions

based on the technique. The decision must show the

significant history, including examination and

laboratory findings, and the functional limitations

that were considered in reaching a conclusion about

the severity of the mental impairment(s). The

decision must include a specific finding as to the

degree of limitation in each of the functional areas

described in paragraph (c) of this section.

20 CFR § 404.1520a. The ALJ’s decision documents application of

the special technique vis-a-vis depression to the evidence in

plaintiff’s case. AR 15-16. Plaintiff incorrectly contends that

the ALJ was required to perform a similar analysis for mental

retardation based on the outcome of her psychological testing even

though Dr Lewis-Wintrode’s report does not place plaintiff within

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 15 of 17
United States District Court

For the Northern District of California

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

16

striking distance of meeting the listing criteria for that

disorder. For example, Listing 12.05 requires for an individual

with “a valid verbal, performance, or full scale IQ of 60 through

70" evidence of marked difficulties in “at least two” of the areas

of activities of daily living, social functioning, maintaining

concentration, persistence or pace or repeated episodes of

decompensation. The ALJ found that plaintiff lacked such

difficulties, whatever the cause, and was not required to repeat

the analysis for Listing 12.05 based solely on the IQ score

reported in the psychological evaluation. 

Finally, plaintiff challenges the ALJ’s decision to use

the “grids,” more formally known as the Medical-Vocational

Guidelines at 20 CFR Part 404, Subpart P, Appendix 2, in lieu of

consulting a vocational expert to determine her RFC. The grids are

an administrative tool the SSA may rely on when considering

claimants with substantially uniform levels of impairment and may

be used when they “accurately and completely describe the

claimant’s abilities and limitations.” Burkhart v Bowen, 856 F2d

1335, 1340 (9th Cir 1988). The regulations address directly the

circumstances in which a vocational expert is employed to assist

the SSA with a particular claim:

If the issue in determining whether you are

disabled is whether your work skills can be used

in other work and the specific occupations in

which they can be used, or there is a similarly

complex issue, we may use the services of a

vocational expert or other specialist. We will

decide whether to use a vocational expert or other

specialist.

20 CFR § 404.1566(e). The Ninth Circuit has interpreted this

regulation to provide that “the use of vocational experts is left

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 16 of 17
United States District Court

For the Northern District of California

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

17

to the Commissioner’s discretion,” further stating that “[a]t the

most, the Commissioner need use a vocational expert only if there

is an absence of other reliable evidence of the claimant’s ability

to perform specific jobs.” 74 F3d 967, 971 (9th Cir 1996). 

The introduction to the regulations in question provides

that the grids “may not be fully applicable” in cases in which, as

here, an individual’s limitations are not primarily exertional, but

rather non-exertional (mental, sensory, postural or environmental). 

Social Security Ruling 85-15, which the ALJ cited in his decision,

explains how the regulations and Medical-Vocational Guidelines can

be used to make disability determinations when only non-exertional

limitations are present –— clearly contemplating, therefore, that

the grids can and should be used in many or most such cases. 

It was not error, therefore, for the ALJ to determine by

means of the grids that plaintiff possessed the RFC to perform a

wide range of unskilled work —— that is, “jobs ordinarily

involv[ing] dealing primarily with objects, rather than with data

or people,” AR 18, citing SSR 85-15, subject only to the nonexertional limitations of avoiding exposure to harsh environmental

irritants and extensive interaction with the public. 

 The clerk is directed to enter judgment in favor of

defendant and against plaintiff. The clerk is further directed to

close the file and terminate all pending motions. 

IT IS SO ORDERED.

 

VAUGHN R WALKER

United States District Chief Judge

Case 3:04-cv-02872-VRW Document 29 Filed 03/30/06 Page 17 of 17