Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_07-cv-00585/USCOURTS-caed-2_07-cv-00585-0/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Samuel Vega
Plaintiff

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

SAMUEL VEGA, No. CIV S-07-0585-CMK

Plaintiff, 

vs. MEMORANDUM OPINION AND ORDER

COMMISSIONER OF SOCIAL 

SECURITY,

Defendant.

 /

Plaintiff, who is proceeding with retained counsel, brings this action for judicial

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

Pursuant to the consent of the parties, this case is before the undersigned for final decision on

plaintiff’s motion for summary judgment (Doc. 19) and defendant’s cross-motion for summary

judgment (Docs. 20 and 21). 

/ / /

/ / /

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I. PROCEDURAL HISTORY

Plaintiff applied for social security benefits on November 28, 2003. In his

application, plaintiff claims that disability began on December 7, 2002. Plaintiff was found to be

disabled for a closed period but, due to medical improvement, was found not disabled after

December 30, 2003. Plaintiff describes his impairments as follows:

Mr. Vega continues to suffer from severe impairments which give

rise to debilitating symptoms, including severe pain, which combine to

preclude him from performing substantial gainful activity. He suffers

from the following severe impairments: right knee pain, status-post

patellar subluxation, inferior patellar tendinitis, chronic fibular head

fracture, restrictive lung disease, asthma, allergies, obesity, and GERD. 

Mr. Vega is also illiterate in English, as well as Spanish, his language of

origin. Mr. Vega’s impairments cause severe limitations in his ability to

function on a sustained basis necessary for full-time or continuous

employment at any exertional level.

Plaintiff’s claim was initially denied as to the period after December 30, 2003. Following denial

of his request for reconsideration, plaintiff requested an administrative hearing, which was held

on February 10, 2006, before Administrative Law Judge (“ALJ”) Antonio Acevedo-Torres In

his May 10, 2006, decision, the ALJ made the following findings:

1. The claimant met the insured status requirements of the Social Security

Act as of December 7, 2002, the date the claimant became disabled;

2. The claimant has not engaged in [substantial gainful activity] at any time

relevant to this decision. . .;

3. At all times relevant to this decision, the claimant has had the following

severe impairments: obstructive and restrictive respiratory disease and

right knee derangement. . .;

4. From December 7, 2002, through December 29, 2003, the period during

which the claimant was disabled, the claimant did not have an impairment

or combination of impairments that met or medically equaled an

impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. . .;

5. After careful consideration of the entire record, the undersigned finds that,

from December 7, 2002, through December 29, 2003, the claimant was

unable to perform even the minimal standing and walking involved in

sedentary work due to his knee impairment;

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6. From December 7, 2002, through December 29, 2003, the claimant was

unable to perform past relevant work. . .;

7. The claimant was born on November 25, 1966, and was 36 years old on

the alleged disability onset date, which is defined as a younger individual

18-44. . .;

8. The claimant is illiterate and is not able to communicate well in English;

9. The claimant’s acquired job skills do not transfer to other occupations

within the residual functional capacity assessed for the period from

December 7, 2002, through December 29, 2003, due to his severe standing

and walking limitations which preclude the performance of even sedentary

work. . . ;

10. From December 7, 2002, through December 29, 2003, considering the

claimant’s age, education, work experience, and residual functional

capacity, there were no jobs that existed in significant numbers in the

national economy that the claimant could have performed. . .;

11. The claimant was under a disability, as defined in the Social Security Act,

from December 7, 2002, through December 29, 2003. . .;

12. Medical improvement occurred as of December 30, 2003, the date the

claimant’s disability ended. . .;

13. Beginning on December 30, 2003, the claimant has not had an impairment

or combination of impairments that meets or medically equal one of the

impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. . .;

14. After careful consideration of the entire record, the undersigned finds that,

beginning on December 30, 2003, the claimant has had the residual

functional capacity to perform a narrow range of light work and full range

of sedentary work that involves lifting no more than 20 pounds

occasionally or 10 pounds frequently; standing or walking no more than

two hours total in an eight hour work day; and climbing, balancing,

stooping, crawling, crouching, or kneeling no more than occasionally; he

should avoid exposure to concentrated levels of respiratory irritants;

15. The medical improvement that has occurred is related to the ability to

work. . .;

16. Beginning on December 30, 2003, the claimant has been unable to perform

past relevant work. . .;

17. Beginning on December 30, 2003, transferability of job skills is not

material to the determination of disability due to the claimant’s age. . .;

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18. Beginning on December 30, 2003, considering the claimant’s age,

education, work experience, and residual functional capacity, the claimant

has been able to perform a significant number of jobs in the national

economy. . .; and

19. The claimant’s disability ended on December 30, 2003. . . .

After the Appeals Council declined review on January 25, 2007, this appeal followed.

II. SUMMARY OF THE EVIDENCE

The certified administrative record (“CAR”) contains medical records from the

following sources: (1) records from Folsom Orthopedic Surgery covering the period from

December 2002 through November 2003 (Exs. 1F and 2F, CAR 99-181); (2) records from

Manzanita Medical Center covering the period from January 2002 through November 2003 (Ex.

3F, CAR 183-206); (3) records from Antelope Physical therapy covering the period from April

2003 through December 2003 (Ex. 4F, CAR 208-72); (4) report and residual functional capacity

assessment dated December 30, 2003, by agency consultative physician Corazon C. David, M.D.

(Exs. 5F and 6F, CAR 273-83); (5) records from Mercy San Juan Hospital covering the period

from December 2002 through May 2004 (Ex. 7F, CAR 285-94); (6) records from Pulmonary

Medicine, Infectious Disease, and Critical Care Consultants covering the period from February

2002 through June 2004 (Ex. 8F, CAR 296-352); (7) records from Joseph T. Marino, M.D.,

covering the period from August 2003 through August 2004 (Ex. 9F, CAR354-67); (8) records

from Jose R. Sanchez, M.D., covering the period from November 2003 through October 2004

(Ex 10F, CAR 369-419); (9) report of right knee MRI dated March 28, 2003, from Sacramento

MRI Center (CAR 422); (10) report of right knee MRI dated September 26, 2003, from Open

System Imaging (CAR 420-21); (11) report and residual functional capacity assessment dated

October 28, 2004, by agency consultative physician (Exs. 11F and 12F, CAR 423-31); 

(12) records from Mercy San Juan Hospital dated December 22, 2004 (Ex. 13F, CAR 433-39);

(13) records from Joseph T. Marino, M.D., covering the period from February 2004 through

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November 2005 (Ex. 14F, CAR 61); and (14) records from U.C. Davis Health System covering

the period from May 2005 through January 2006 (Ex. 16F, CAR 471-98). 

Because the primary issue in this case is whether there was medical improvement

in plaintiff’s right knee impairment as of December 30, 2003, the court will focus on those

records just before and after this date. Further, as discussed below, while plaintiff states that he

is disabled due to asthma, he does not raise any arguments in his motion for summary judgment

relating to the ALJ’s findings regarding asthma. Therefore, the court does not focus on records

from Pulmonary Medicine, Infectious Disease, and Critical Care Consultants or Dr. Marino, who

treated plaintiff’s asthma. 

2003

An MRI of the right knee was performed on March 28, 2003, at Sacramento MRI

Center. Test results revealed trace effusion, edema, bursitis, and tendinitis. 

Physical therapist Gregory Rice examined plaintiff’s right knee on April 1, 2003,

and reported that plaintiff was able to complete 50% of a squat secondary to pain, that flexion of

the right knee was 124 degrees and extension 0 degrees. The therapist’s treatment plan called for

physical therapy. 

Plaintiff underwent a right knee arthroscopic chondroplasty on June 13, 2003,

performed by Dr. Guilfoy of Folsom Orthopedic Surgery. Dr. Guilfoy reported that the

procedure went well and stated that plaintiff would begin weight-bearing assisted with a brace.

On June 26, 2003, Dr. Guilfoy reported that plaintiff was doing well two weeks following

surgery on his right knee. 

A July 21, 2003, note from the physical therapist indicates that right knee

extension was 11 degrees and flexion 69 degrees. The therapist indicated that plaintiff reported a

significant amount of pain and could not perform a quadricep extension. 

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On August 27, 2003, the physical therapist reported that, while plaintiff’s progress

had been slow, he had improved his range of motion of the right knee from 11 degrees extension

and 69 degrees flexion to full extension and 117 degrees flexion. The therapist observed that

plaintiff “is able to walk without assistive device with fairly normal pattern.” 

On September 23, 2003, Dr. Guilfoy prepared a follow-up treatment note. On

physical examination of the right knee, Dr. Guilfoy observed:

He has puffy edema over the area of the infrapatellar tendon, with some

minimal tenderness. He has significant difficulty with active extension. 

His quadriceps measurements are done at 5 and 15 cm above the superior

pole of the patella. These demonstrate a deficit at 5 cm of 2.5 cm, and at

15 cm, there is a 6 cm difference. 

A second MRI of plaintiff’s right knee was performed on September 26, 2003, at

Open System Imaging. The report of this test revealed “abnormal thickening of the patellar

tendon at its insertion site on the inferior pole of the patella, consistent with tendinitis or chronic

tendinosis.” 

On October 2, 2003, Dr. Guilfoy of Folsom Orthopedic Surgery prepared a

progress note. Dr. Guilfoy reported very slow progress “rehabbing from an infrapatellar tendon

repair done in June.” The doctor concluded that plaintiff “could be released to light duty, as long

as it were sitting work only.” 

By November 14, 2003, plaintiff continued to make slow progress with physical

therapy. The physical therapist reported that, while plaintiff complained subjectively of his knee

“giving out,” he was objectively “tolerating more regular weightbearing activities.” Plaintiff was

able to perform leg presses to 145 pounds bilaterally and to 70 pounds with the right leg. 

Dr. Sanchez performed a new patient consultation and examination on November

14, 2003, for treatment incident to an injury on December 7, 2002. The doctor provided the

following history:

At the time of the injury, the patient was working for a moving company. 

His job description was that of a mover. On the date of the injury, he was

unloading cubicle panels. The panels are used in big offices for cubicles. 

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He was using a dolly that held about 10 of them, for a total weight of about

150 pounds, moving it down a ramp with a high grade. The patient was

being helped by a co-worker. The co-worker let go of the dolly and the

patient was holding on to it to avoid dropping the cargo. This resulted in

his knee locking and twisting, and ended up having a patellar dislocation,

by his description. He states he let go of the dolly and had a spontaneous

reduction of the patella. 

He was then seen at Mercy San Juan emergency room where x-rays were

unremarkable. He was told to follow up with his primary care physician. 

The patient follows up at the Manzanita Medical Clinic with Dr. Berchan. 

He eventually underwent an MRI of the right knee, which revealed some

abnormalities. I do not have that report. Based on the findings, he 

underwent arthroscopic surgery on May 23, 2003, by Dr. Guilfoy. The

diagnosis was patellar subluxation, patellar tendinitis. The patient

underwent right knee arthroscopy, chondroplasty, open debridement

patellar tendon, and lateral release. The patient has been in physical

therapy for nearly four months and he does not feel that it is helping him. 

His current complaint is that of weakness and instability of the right knee. 

On physical examination of the right knee, Dr. Sanchez reported:

On exam of the knees, on the right knee, there is moderate amount of

swelling in the right knee. There are well-healed portals as well as a wellhealed vertical scar over the mid patella. A small effusion is noted. No

crepitus is felt. Range of motion at the right knee for extension is 76

degrees and flexion is 108 degrees. Lachman and McMurray tests are

negative. Anterior and posterior drawer signs are negative. There is

moderate amount of pain while doing these maneuvers. 

Dr. Sanchez completed a “Certificate of Disability” in which he stated that plaintiff could return

to sedentary work as of November 15, 2003. He recommended continuation of physical therapy.

On December 1, 2003, plaintiff reported to Dr. Sanchez that his right knee pain

was worse with cold weather. On examination, Dr. Sanchez noted a moderate amount of

swelling, small effusion, and well-healed ports. Anterior and posterior drawer signs were

negative. He noted that there was no hyper-laxity of the lateral collateral ligaments, although

plaintiff reported pain during the testing maneuver. Lachman and McMurray tests were negative. 

Dr. Sanchez recommended continuation of physical therapy. 

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On December 29, 2003 – which the ALJ concluded was the last day plaintiff was

disabled due to his work injury – Dr. Sanchez performed a physical examination of the right knee

and reported the following findings:

. . . The right knee continues to have a small amount of swelling,

especially over the suprapatellar tendon. An effusion is noted. Range of

motion of the knee reveals lack of 7 degrees of full extension. Flexion is

58 degrees. Anterior and posterior drawer signs are negative. There is no

hyper-laxity of the lateral collateral ligaments. Lachman and McMurray

signs are negative. 

Dr. Sanchez reported that plaintiff could return to “semi-sedentary” work and that plaintiff “can

be considered Permanent and Stationary as of today.” 

On December 30, 2003 – the first date on which the ALJ concluded plaintiff was

no longer disabled – agency consultative physician Corazon C. David completed a review of

plaintiff’s medical records and provided a residual functional capacity assessment. Dr. David

concluded that plaintiff is “capable of sedentary w/ post. limitations and environmental

precautions.” 

2004

Plaintiff was seen by Dr. Sanchez on January 9, 2004. The doctor reported that

plaintiff “had an accident today” when he was “sitting on the toilet and when he got up his right

knee buckled.” Dr. Sanchez observed that range of motion of the right knee was “about 5

degrees short.” No other testing was performed due to acute pain. Dr. Sanchez stated plaintiff

could return to semi-sedentary work. 

On January 26, 2004, Dr. Sanchez prepared a “Primary Treating Physician’s

Permanent and Stationary Report” in which he summarized plaintiff’s medical records to date

and reported on a current physical examination. The doctor stated that the report was being

provided “as the patient’s condition has become either permanent and stationary or reached

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maximum medical improvement.” On examination of the right knee, Dr. Sanchez noted:

. . . There is a small effusion noted as well as tenderness to the right lateral

aspect of the patella. No crepitus is felt. Anterior and posterior drawer

signs are negative. Lachman and McMurray signs are negative. Range of

motion for extension is 21 degrees short of full extension. Flexion is 90

degrees. 

Dr. Sanchez concluded that plaintiff could perform semi-sedentary work only. 

On February 26, 2004, Dr. Sanchez opined that plaintiff would not benefit from

any further physical therapy. Instead, he recommended a self-directed aqua therapy program

(i.e., swimming) at a gym and use of a stationary bike. 

On April 22, 2004, Dr. Sanchez noted on physical examination that extension of

the right knee was full and flexion was 85 degrees, an improvement since March 2004 when the

doctor observed 60 degrees extension of 58 degrees flexion. By October 12, 2004, flexion was

105 degrees and extension was only 5 degrees short of full range of motion. Dr. Sanchez

continued to recommend only semi-sedentary work. 

The record contains a report and residual functional capacity assessment dated

October 24, 2004, by an agency consultative physician. This doctor did not conduct an

examination. The doctor concluded that plaintiff was limited to semi-sedentary work. However,

the doctor also noted that plaintiff was making progress at the gym and suggested that more than

semi-sedentary work may be appropriate. As to postural limitations, the doctor opined that

plaintiff could occasionally climb, crouch, balance, crawl, stoop, and kneel. 

III. 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

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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

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

Cir. 1988). 

IV. DISCUSSION

In his motion for summary judgment, plaintiff raises three claims of error. 

Specifically, plaintiff argues: (1) the ALJ improperly rejected the opinion of his treating

physician, Dr. Sanchez, without providing legally sufficient reasons for doing so; (2) the ALJ

improperly rejected his testimony as not credible without providing legally sufficient reasons for

doing so; and (3) given plaintiff’s non-exertional limitations, the ALJ improperly applied the

Medical-Vocational Guidelines (“Grids”) at 20 C.F.R., Part 404, Subpart P, Appendix 2, in

determining disability.

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A. Evaluation of Medical Opinions

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

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

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Plaintiff also states that the ALJ erred with respect to the opinion of an agency 1

examining psychologist. However, plaintiff does not allege disabling mental problems.

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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. 

In this case, plaintiff argues that the ALJ “erred in rejecting the opinions of Dr.

Sanchez, Mr. Vega’s treating physician. . . .” Specifically, plaintiff contends that the ALJ failed 1

to give specific and legitimate reasons for rejecting Dr. Sanchez’ opinions provided after

December 29, 2003 – the date on which the ALJ concluded plaintiff’s disability ended due to

medical improvement. As to Dr. Sanchez, the ALJ stated:

Medical records from Jose Sanchez, M.D., and physical therapy records

show that the claimant had gained additional strength and flexibility in his

knee by December 30, 2003, thus resulting in medical improvement

(Exhibits 1F, 10F).

* * *

The record shows that by December 30, 2003, the claimant’s knee

condition was permanent and stationary. Jose Sanchez, M.D., a treating

source, originally released the claimant to perform sedentary work but later

referred to a “semi-sedentary” work status (Exhibit 10F). He appears to be

using the workers’ compensation term which contemplates that the

individual can do work approximately one half the time in a sitting

position, and one half the time in a standing or walking position, with a

minimum of demands for physical effort, whether standing, walking, or

sitting. 

However, the undersigned finds no basis for including sitting limitations in

the claimant’s residual functional capacity assessment. The claimant’s

primary disorder involved his knee which provides a basis for limiting

standing and walking, but not sitting. . . .

The record reflects that, on November 14, 2003, Dr. Sanchez concluded that

plaintiff could return to sedentary work. In the social security context, “sedentary work” involves

lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket

files, ledgers, and small tools. See 20 C.F.R. §§ 404.1567(a) and 416.967(a). There is no

restriction to sitting (or, limitation on standing) for all or part of the time. In later assessments,

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Dr. Sanchez concluded that plaintiff was limited to “semi-sedentary work.” As the ALJ noted, in

the California workers’ compensation context, “semi-sedentary work” contemplates sitting half

of the time. See Glass v. Workers’ Compensation Appeals Board, 105 Cal.App.3d 297, 304 (2nd

Dist. 1980). Specifically, on December 29, 2003, Dr. Sanchez concluded that plaintiff was

“permanent and stationary” and indicated a limitation to semi-sedentary work. He also indicated

a limitation to semi-sedentary work on January 9, 2004, January 26, 2004, and April 22, 2004. 

Thus, by changing his functional assessment from sedentary work to semi-sedentary work, Dr.

Sanchez essentially added a half-time sitting restriction. Or, “semi-sedentary” can be seen as the

doctor’s opinion that plaintiff was limited in his ability to stand. The question is whether the

ALJ properly rejected this limitation. 

In concluding that such a limitation was not warranted, the ALJ did not rely on the

record but, instead, relied on the reasoning that a knee problem does not impact plaintiff’s ability

to sit. While this is true, the ALJ’s logic is flawed in that Dr. Sanchez did not conclude that

plaintiff had a limited ability to sit. He concluded that plaintiff could only do work which

allowed for sitting half of the time. In other words, Dr. Sanchez believed that plaintiff was

limited in his ability to stand. The ALJ concedes that a knee problem would impact plaintiff’s

ability to stand and walk. 

Moreover, while agency consultative physician Dr. David concluded on December

30, 2003 – the apparent basis for the improvement date cited by the ALJ – that plaintiff could do

sedentary work, Dr. David added that plaintiff’s ability to do sedentary work was eroded by

posterior limitations. Thus, Dr. David appears to agree with Dr. Sanchez that plaintiff can do

something less than the full range of sedentary work, as that term is used in social security cases. 

In addition, an agency consultative doctor concluded in October 2004 that plaintiff was limited to

semi-sedentary work. To the extent the ALJ concluded that Dr. David opined that plaintiff could

do the full range of sedentary work, the ALJ does not discuss the conflict between such a

conclusion and the conclusions reached by Dr. Sanchez and the agency doctor in October 2004. 

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As to the October 2004 assessment by the agency doctor, defendant states in his

brief that “[t]he ALJ also referenced the findings of the state agency medical consultant who

opined that plaintiff should be able to perform sedentary work. (Tr. 21, 426-27).” Defendant is

apparently basing this statement on the ALJ’s reference in the hearing decision to Exhibits 11F

and 12F at CAR 21. Exhibit 11F is the October 2004 assessment in which the agency

consultative doctor concluded that plaintiff was limited to “semi sed” work. In Exhibit 12F, the

doctor references “sed” work. However, this slight inconsistency in terminology is hardly

conclusive evidence contradicting Dr. Sanchez’ limitation to semi-sedentary work, especially in

light of Dr. David’s conclusion that plaintiff was limited to something less than the full range of

sedentary work (i.e., sedentary work with postural limitations). 

As to physical therapy records which do show slow improvement, they do not set

forth any medical opinion on functional capacity which would tend to contradict Dr. Sanchez’

opinion as plaintiff’s treating physician. To the contrary, slow improvement supports Dr.

Sanchez’ opinion that plaintiff was still limited to less than sedentary work as of December 30,

2003, and beyond. In fact, Dr. Sanchez believed that physical therapy was not helping plaintiff,

as evidenced by his recommendation that plaintiff switch to a self-directed swimming and weight

training program at a gym. 

The court notes that, with respect to the period of time before December 30, 2003,

the ALJ concluded that plaintiff “was unable to stand or walk even two hours in an eight hour

day and was therefore unable to perform even sedentary work.” It appears from the record that

this status was permanent and stationary as of December 29, 2003. Given Dr. Sanchez’

conclusions after this date that plaintiff still had standing limitations, and given the agency

consultative doctor’s October 2004 similar opinion, the court questions whether plaintiff in fact

experienced sufficient improvement to permit him to perform at least the full range of sedentary

work. In particular, the court observes that Dr. Sanchez’ objective findings on physical

examinations before and after December 29, 2003, are substantially similar in that he consistently

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found limited range of motion on flexion and extension of the right knee and concluded that

plaintiff would not do the full range of sedentary work. While plaintiff’s condition may indeed

have improved at some point, it does not appear that it was improved as of December 30, 2003. 

The court will remand this matter to the agency to re-consider the issue of medical

improvement in light of Dr. Sanchez’ findings and those of the agency consultative doctor in

October 2004. 

B. Plaintiff’s Credibility

The Commissioner determines whether a disability applicant is credible, and the

court defers to the Commissioner’s discretion if the Commissioner used the proper process and

provided proper reasons. See Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1995). An explicit

credibility finding must be supported by specific, cogent reasons. See Rashad v. Sullivan, 903

F.2d 1229, 1231 (9th Cir. 1990). General findings are insufficient. See Lester v. Chater, 81 F.3d

821, 834 (9th Cir. 1995). Rather, the Commissioner must identify what testimony is not credible

and what evidence undermines the testimony. See id. Moreover, unless there is affirmative

evidence in the record of malingering, the Commissioner’s reasons for rejecting testimony as not

credible must be “clear and convincing.” See id.

If there is objective medical evidence of an underlying impairment, the

Commissioner may not discredit a claimant’s testimony as to the severity of symptoms merely

because they are unsupported by objective medical evidence. See Bunnell v. Sullivan, 947 F.2d

341, 347-48 (9th Cir. 1991) (en banc). The Commissioner may, however, consider the nature of

the symptoms alleged, including aggravating factors, medication, treatment, and functional

restrictions. See id. at 345-47. In weighing credibility, the Commissioner may also consider: (1)

the claimant’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; (3) the claimant’s daily activities; (4) work records; and (5)

physician and third-party testimony about the nature, severity, and effect of symptoms. See

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Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996) (citations omitted). 

As to plaintiff’s credibility, the ALJ stated:

The claimant testified that he was disabled due to knee pain. He stated

that he could stand 15 to 20 minutes at a time and sit 25 minutes at a time. 

He said he could lift 10 pounds. He said that his activities of daily living

included going to the store with his wife, helping her with the household

chores, and doing some cooking. He said that he experienced knee pain

when he walked a lot. He spent time watching movies, listening to music,

and talking to his wife. . . . He also said that he started using a cane the

prior year. He said that he was afraid that he would fall in the shower. He

also used a brace on his knee. 

After considering the evidence of record, the undersigned finds that the

claimant’s medically determinable impairments could reasonably be

expected to produce the alleged symptoms, but that the claimant’s

statements concerning the intensity, duration, and limiting effects of these

symptoms are not entirely credible beginning on December 30, 2003. 

* * *

. . . The claimant testified that when he sat more than 20 minutes, he

experienced inflammation and pain. However, this allegation is not

credible because it is not supported by any evidence of record. 

The claimant also testified that he could lift no more than 10 pounds. But,

Disability Determination Service sources concluded that he could lift 20

pounds occasionally and 10 pounds frequently. (Exhibits 11F, 12F). This

is generally consistent with the fact that the claimant has no upper

extremity impairment. By early 2004, he was in an exercise program

including some weight resistance training. He was doing swimming,

stationary bicycling, and other activities. These activities are consistent

with the established residual functional capacity. 

Based on this discussion, the ALJ found plaintiff’s testimony credible as it related to limitations

before December 30, 2003. As to his testimony regarding limitations after this date, it appears

that the ALJ rejected plaintiff’s testimony as to his limitations because: (1) it was “not supported

by any evidence of record”; (2) he was in an exercise program by early 2004; and (3) he was

doing “other activities,” presumably activities of daily living. 

/ / /

/ / /

/ / /

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Regarding the first reason – that plaintiff’s testimony was not supported by the

evidence – the court does not agree for the reasons discussed above. Specifically, Dr. Sanchez

opined, based on objective findings and observations, that plaintiff could only do semi-sedentary

work. This is entirely consistent with plaintiff’s testimony that he could only stand for limited

periods of time. Moreover, the state agency doctor agreed in 2004 that plaintiff could only do

semi-sedentary work. 

Regarding plaintiff’s participation in an exercise program, the record reflects that

this program was very conservative and included aqua fitness and some mild weight training to

improve strength in the right knee. The record, however, does not indicate that plaintiff’s

exercise regime was extensive or consistent with the ALJ’s conclusion as to plaintiff’s

capabilities after December 30, 2003. 

Finally, as to “other activities” – presumably plaintiff’s daily activities – plaintiff

testified that he helps his wife with some of the household chores. What the ALJ does not

mention, however, is that plaintiff testified at the hearing that he has problems completing chores

due to knee pain. In particular, plaintiff stated that, while doing chores, he has to “take breaks in

between.” He stated that, if he’s doing dishes, he has to rest after ten minutes of standing. In

addition, plaintiff testified that he also has problems showering because he is afraid his knee “is

not working.” This testimony is consistent with a standing limitation. 

On remand, the ALJ should reconsider the credibility of plaintiff’s testimony

regarding his limitations after December 30, 2003. 

C. Application of the Grids

The Medical-Vocational Guidelines (“Grids”) provide a uniform conclusion about

disability for various combinations of age, education, previous work experience, and residual

functional capacity. The Grids allow the Commissioner to streamline the administrative process

and encourage uniform treatment of claims based on the number of jobs in the national economy

for any given category of residual functioning capacity. See Heckler v. Campbell, 461 U.S. 458,

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460-62 (1983) (discussing creation and purpose of the Grids). 

The Commissioner may apply the Grids in lieu of taking the testimony of a

vocational expert only when the grids accurately and completely describe the claimant’s abilities

and limitations. See Jones v. Heckler, 760 F.2d 993, 998 (9th Cir. 1985); see also Heckler v.

Campbell, 461 U.S. 458, 462 n.5 (1983). Thus, the Commissioner generally may not rely on the

Grids if a claimant suffers from non-exertional limitations because the Grids are based on

strength factors only. See 20 C.F.R., Part 404, Subpart P, Appendix 2, § 200.00(b). “If a

claimant has an impairment that limits his or her ability to work without directly affecting his or

her strength, the claimant is said to have non-exertional . . . limitations that are not covered by

the Grids.” Penny v. Sullivan, 2 F.3d 953, 958 (9th Cir. 1993) (citing 20 C.F.R., Part 404,

Subpart P, Appendix 2, § 200.00(d), (e)). The Commissioner may, however, rely on the Grids

even when a claimant has combined exertional and non-exertional limitations, if non-exertional

limitations do not impact the claimant’s exertional capabilities. See Bates v. Sullivan, 894 F.2d

1059, 1063 (9th Cir. 1990); Polny v. Bowen, 864 F.2d 661, 663-64 (9th Cir. 1988).

In cases where the Grids are not fully applicable, the ALJ may meet his burden

under step five of the sequential analysis by propounding to a vocational expert hypothetical

questions based on medical assumptions, supported by substantial evidence, that reflect all the

plaintiff’s limitations. See Roberts v. Shalala, 66 F.3d 179, 184 (9th Cir. 1995). Specifically,

where the Grids are inapplicable because plaintiff has sufficient non-exertional limitations, the

ALJ is required to obtain vocational expert testimony. See Burkhart v. Bowen, 587 F.2d 1335,

1341 (9th Cir. 1988). 

In this case, the ALJ applied the Grids to conclude that plaintiff’s residual

functional capacity for the full range of sedentary work and narrow range of light work allowed

him to perform jobs which existed in the national economy. For the reasons discussed above,

however, the court concludes that the ALJ erred in concluding that plaintiff had the ability as of

December 30, 2003, for at least sedentary work. Specifically, this conclusion does not properly

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account for the medical evidence indicating a standing limitation consistent with semi-sedentary

work. It also does not properly account for plaintiff’s testimony.

On remand, the ALJ should reconsider whether there are jobs plaintiff can

perform given his functional capabilities. It may be necessary to obtain vocational expert

testimony.

V. CONCLUSION

For the foregoing reasons, this matter will be remanded under sentence four of 42

U.S.C. § 405(g) for further development of the record and/or further findings addressing the

deficiencies noted above. 

Accordingly, IT IS HEREBY ORDERED that:

1. Plaintiff’s motion for summary judgment (Doc. 19) is granted;

2. The Commissioner’s cross motion for summary judgment (Docs. 20 and

21) is denied;

3. This matter is remanded for further proceedings consistent with this order;

and

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

DATED: April 30, 2008

______________________________________

CRAIG M. KELLISON

UNITED STATES MAGISTRATE JUDGE

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