Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_14-cv-01581/USCOURTS-caed-1_14-cv-01581-4/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Parrish Jean Moore
Plaintiff

Document Text:

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

Plaintiff Parrish Jean Moore asserts she is entitled to supplemental security income under Title

XVI of the Social Security Act. Plaintiff argues the administrative law judge erred in finding her 

mental impairments did not satisfy a Listing, and in rejecting the opinion of an examining physician. 

Because the ALJ applied the proper legal standards, the administrative decision is AFFIRMED. 

BACKGROUND

On January 28, 2011, Plaintiff filed his applications for benefits, in which he alleged disability 

beginning January 2, 2001. (Doc. 16-3 at 3) The Social Security Administration denied the 

applications at the initial level on October 25, 2011, and upon reconsideration on March 9, 2012. (Id.; 

Doc. 16-5 at 2-6, 10-14) Plaintiff requested a hearing, and testified before an ALJ on March 22, 2013. 

(Id. at 13, 30) The ALJ determined Plaintiff was not disabled under the Social Security Act, and issued 

an order denying benefits on June 26, 2013. (Id. at 13-23) Plaintiff filed a request for review of the 

decision with the Appeals Council, which denied the request on August 20, 2014. (Id. at 2-4) 

PARRISH JEAN MOORE,

 Plaintiff,

v.

CAROLYN W. COLVIN, 

Acting Commissioner of Social Security,

Defendant.

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Case No.: 1:14-cv-01581 - JLT

ORDER DIRECTING ENTRY OF JUDGMENT IN 

FAVOR OF DEFENDANT, CAROLYN COLVIN, 

ACTING COMMISSIONER OF SOCIAL 

SECURITY, AND AGAINST PLAINTIFF 

PARRISH JEAN MOORE

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Therefore, the ALJ’s determination became the final decision of the Commissioner of Social Security. 

STANDARD OF REVIEW

District courts have a limited scope of judicial review for disability claims after a decision by 

the Commissioner to deny benefits under the Social Security Act. When reviewing findings of fact, 

such as whether a claimant was disabled, the Court must determine whether the Commissioner’s 

decision is supported by substantial evidence or is based on legal error. 42 U.S.C. § 405(g). The ALJ’s 

determination that the claimant is not disabled must be upheld by the Court if the proper legal standards 

were applied and the findings are supported by substantial evidence. See Sanchez v. Sec’y of Health & 

Human Serv., 812 F.2d 509, 510 (9th Cir. 1987).

Substantial evidence is “more than a mere scintilla. It means such relevant evidence as a 

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

389, 401 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197 (1938)). The record as a whole 

must be considered, because “[t]he court must consider both evidence that supports and evidence that 

detracts from the ALJ’s conclusion.” Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). 

DISABILITY BENEFITS

To qualify for benefits under the Social Security Act, Plaintiff must establish she is unable to 

engage in substantial gainful activity due to a medically determinable physical or mental impairment 

that has lasted or can be expected to last for a continuous period of not less than 12 months. 42 U.S.C. 

§ 1382c(a)(3)(A). An individual shall be considered to have a disability only if:

his physical or mental impairment or impairments are of such severity that he is not only 

unable to do his previous work, but cannot, considering his age, education, and work 

experience, engage in any other kind of substantial gainful work which exists in the 

national economy, regardless of whether such work exists in the immediate area in 

which he lives, or whether a specific job vacancy exists for him, or whether he would be 

hired if he applied for work. 

42 U.S.C. § 1382c(a)(3)(B). The burden of proof is on a claimant to establish disability. Terry v. 

Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990). If a claimant establishes a prima facie case of disability, 

the burden shifts to the Commissioner to prove the claimant is able to engage in other substantial 

gainful employment. Maounis v. Heckler, 738 F.2d 1032, 1034 (9th Cir. 1984).

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ADMINISTRATIVE DETERMINATION

To achieve uniform decisions, the Commissioner established a sequential five-step process for 

evaluating a claimant’s alleged disability. 20 C.F.R. §§ 404.1520, 416.920(a)-(f). The process requires 

the ALJ to determine whether Plaintiff (1) engaged in substantial gainful activity during the period of 

alleged disability, (2) had medically determinable severe impairments (3) that met or equaled one of the 

listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1; and whether Plaintiff (4) had 

the residual functional capacity to perform to past relevant work or (5) the ability to perform other work 

existing in significant numbers at the state and national level. Id. The ALJ must consider testimonial 

and objective medical evidence. 20 C.F.R. §§ 404.1527, 416.927. 

A. Relevant Medical Evidence

On February 3, 2011, Plaintiff visited the emergency room Community Regional Medical 

Center, complaining of chronic back pain. (Doc. 16-8 at 3) Plaintiff reported she had the pain for 

about 20 years, but her pain had increased. (Id.) She described the pain has dull, and said it was 

exacerbated by movement. (Id.) Upon examination, Plaintiff had negative straight-leg raising tests 

and full range of motion in her arms and legs. (Id. at 4) X-rays of Plaintiff’s lumbar spine showed 

“no evidence spondylysis or spondylolisthesis.” (Id. at 5) In addition, Dr. Tarau found “no significant 

narrowing of the disc spaces.” (Id.) However, Dr. Tarau determined Plaintiff had “prominent 

osteophytes arising from the superior endplate of L3, inferior endplate of L2, superior endplate of T12 

and T11.” (Id.)

Dr. Tomas Rios performed a comprehensive internal medicine evaluation on June 3, 2011. 

(Doc. 16-8 at 6-10) Plaintiff reported she had “chronic back problems” after she was stabbed in the 

back. (Id. at 6) Dr. Rios noted the pain described by Plaintiff was “most pronounced around the right 

paralumbar region,” and she had “radiating numbness to the right gluteal region down to her toes.” 

(Id.) In addition, Plaintiff reported she had “chronic knee pain,” after a fall during which she “twisted 

her right knee 10 years ago.” (Id.) Further, Plaintiff had “a self diagnosis of carpal tunnel syndrome” 

and “describe[d] pain and numbness” in her wrists and first three fingers on each hand, which she said 

was occasionally severe enough to wake her up at night. (Id. at 6-7) Plaintiff reported she lived with a 

friend and was independent in activities of daily living, though she did not drive. (Id. at 7)

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Dr. Rios noted Plaintiff “move[d] about in the room with ease,” without a gait altercation. 

(Doc. 16-8 at 7) He observed that Plaintiff had “antalgia of the hands,” as well as “positive Tinel’s 

signs” in both wrists. (Id. at 7, 9) In addition, Dr. Rios found Plaintiff’s “[f]ine and gross finger 

manipulations remain[ed] preserved with adequate grip strength.” (Id. at 9) Dr. Rios opined that 

Plaintiff was able to lift and carry “20 pounds occasionally and 10 pounds frequently.” (Id.) Dr. Rios 

concluded Plaintiff was “limited on account of the bilateral carpal tunnel syndrome,” and concluded she 

was “capable of performing frequent reaching and handling, and occasional feeling and fingering.” 

(Id.) Further, Dr. Rios believed Plaintiff had postural limitations due to the pain in her lower back and 

right knee, and he opined Plaintiff could occasionally climb, kneel, crouch, and crawl, and frequently 

balance and stoop. (Id.) 

Dr. Mary Lewis conducted a comprehensive psychiatrist evaluation on June 12, 2011. (Doc. 

16-8 at 11) Plaintiff reported she was unable to work due to pay in her back, which she described as 

an “eight” on “a scale of 1-10.” (Id. at 11) Plaintiff said she “attempt[ed] to relieve the pain by taking 

Tylenol,” but the pain “stopped [her] from doing anything.” (Id.) Plaintiff told Dr. Lewis she had a 

history of using marijuana from the ages of 16 to 40 and “smoking crack cocaine at the age of 18 

through 42.” (Id. at 12) She told Dr. Lewis that she had not worked for fifteen years, and was last 

employed as a food server for four months. (Id.) Plaintiff reported she stopped working because she 

“didn’t have transportation,” but also said she was “not willing to work in any position, [and] not 

actively seeking employment.” (Id.)

Dr. Lewis noted Plaintiff entered the room walking with a cane, and she appeared “older than 

her stated age.” (Doc. 16-8 at 12) Dr. Lewis found Plaintiff’s thoughts were linear, logical, coherent, 

and goal directed.” (Id. at 13) She determined Plaintiff was “not significantly impaired” with her 

“global capacity to act purposefully, to think rationally, and to deal effectively with her environment.” 

(Id.) In addition, Dr. Lewis opined Plaintiff’s recent memory recall, attention, and concentration were 

“satisfactory” based upon her “ability to successfully complete” forward recall of three numbers, 

backward recall of the three numbers, and remember “three items after five minutes.” (Id. at 14) 

Plaintiff was also able to complete a three-step command and “successfully count by 2s to 20 and back 

to zero.” (Id.) Dr. Lewis observed:

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The claimant’s limitations appear to be primarily due to reported medical concerns. 

When asked her reason for applying for SSI benefits, she did not report any 

psychological distress and did not exhibit symptoms consistent with a major mental 

disorder. From a mental health perspective, the claimant appears to be able to function 

adequately. 

(Id. at 15) Dr. Lewis gave Plaintiff a GAF score of 661, and concluded Plaintiff was “not significantly 

impaired” with her ability to understand and remember either very short and simple instructions or 

detailed instructions. (Id.) According to Dr. Lewis, Plaintiff was “not significantly impaired” with her 

ability to maintain attention and concentration, perform daily activities, deal with changes, and 

“complete a normal workday and workweek without interruptions at a consistent pace.” (Id. at 15-16)

On October 13, 2011, Dr. Antonio Medina reviewed the record and completed a physical 

residual functional capacity assessment. (Doc. 16-8 at 17-25) Dr. Medina noted there was “[n]o 

evidence of any atrophy on either thenar eminences to suggest carpal tunnel compression” at the 

consultative examination, and Plaintiff’s motor strength was 5/5. (Id. at 17) Dr. Medina also found 

“[]no evidence of any severe disabling findings on exam of the lumbar spine, knees and hands.” (Id.

at 18) He found Plaintiff was able to lift and carry 25 pounds frequently and 50 pounds occasionally, 

sit about six hours in an eight-hour day, and stand about six hours in an eight-hour day. (Id. at 19) In 

addition, he opined Plaintiff was able to occasionally climb ramps and stairs, stoop, and crouch; 

frequently balance, kneel, and crawl; but never climb ladders, ropes, or scaffolds. (Id. at 20) Dr. 

Medina concluded Plaintiff did not establish any manipulative, visual, communicative, or 

environmental limitations. (Id. at 21-22) Dr. Medina explained that his opinion differed from Dr. 

Rios, because the opinion by Dr. Rios appeared to be “based on [Plaintiff’s] subjective limitations 

with no objective evidence to support the allged [sic] limitations.” (Id. at 24) 

Dr. Barry Rudnick completed a case analysis on October 17, 2011. He noted Plaintiff reported 

she “uses alcohol and has a history of crack cocaine abuse ending in 2010.” (Doc. 16-8 at 26) 

According to Dr. Rudnick, Plaintiff had “a medically determinable nonsevere mental impairment” of 

 

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GAF scores range from 1-100, and in calculating a GAF score, the doctor considers “psychological, social, and 

occupational functioning on a hypothetical continuum of mental health-illness.” American Psychiatric Association, 

Diagnostic and Statistical Manual of Mental Disorders, 34 (4th ed.) (“DSM-IV). A GAF score between 61-70 indicates 

“[s]ome mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school 

functioning . . . but generally functioning pretty well, has some meaningful interpersonal relationships.” Id.

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“alcohol abuse; history of polysubstance abuse.” (Id. at 26, 35) Dr. Rudnick noted that Plaintiff did not 

have any treatment for a mental impairment, and that Dr. Lewis found “[n]o significant functional 

limitations.” (Id. at 26) Dr. Rudnick concluded Plaintiff had mild restrictions in her activities of daily 

living; mild difficulties in maintaining social functioning; and mild difficulties in maintaining 

concentration, persistence, or pace. (Id. at 26, 37) Further, Dr. Rudnick found Plaintiff did not have 

any episodes of decompensation of extended duration. (Id.)

In November 2011, Plaintiff visited Clinica Sierra Vista to establish care. (Doc. 16-8 at 56) 

Plaintiff reported she had suffered from depression and trichotillomania since she was six years old, 

and her energy and ability to concentrate had decreased. (Id. at 54) In addition, Plaintiff said she had 

pain in her knees and back, and x-rays were ordered. (Id. at 51-56) Dr. Robert Port reviewed the 

images, and found “[m]ild hypertrophic changes at T11-T12 and L2-L3.” (Id. at 51) The images of 

Plaintiff’s right knee showed “[p]robable joint effusion,” and “no significant arthritic changes.” (Id. at 

53) In her left knee, there were was “[m]inimal joint line spurring on the medial side.” (Id. at 52) 

In January 2012, Plaintiff returned to Clinica Sierra Vista for follow-up appointments and to 

receive her flu shot. (Doc. 176-8 at 45-47) Dr. Sarah Morgan observed that Plaintiff appeared tearful, 

depressed, and anxious. (Id. at 45) She found Plaintiff’s memory and thought process were intact. 

(Id.) Further, Dr. Morgan opined that Plaintiff’s concentration, judgment, insight, and impulse control 

were “fair.” (Id.) She diagnosed Plaintiff with Trichotillomania and Major Depressive Disorder, 

Moderate, Recurrent. (Id.) Dr. Morgan gave Plaintiff a GAF score of 502on January 24, 2012. (Id.)

In February 2012, Dr. Morgan noted Plaintiff was taking her medication as prescribed, and did 

not report any side effects. (Doc. 16-8 at 44) Dr. Morgan observed that Plaintiff was “very guarded” 

and exhibited a dysphoric mood. (Id.) Plaintiff reported she did not have any suicidal or homicidal 

ideations. (Id.) Dr. Morgan concluded Plaintiff’s concentration and insight remained fair, and her 

memory was intact. (Id.)

Dr. Ian Ocrant reviewed the record related to Plaintiff’s physical impairments in March 2012

 

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A GAF score between 41-50 indicates “[s]erious symptoms (e.g., suicidal ideation, severe obsessional rituals, 

frequent shoplifting) OR any serious impairments in social, occupational, or school functioning (e.g., no friends, unable to 

keep a job).” DSM-IV. at 34.

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and noted the documents did “not show any worsening of condition.” (Doc. 16-8 at 58) He affirmed

the assessment of Dr. Medina, finding Plaintiff was able to perform medium work with some postural 

limitations. (Id.) Similarly, Dr. Aquino reviewed the record related to Plaintiff’s mental impairments, 

and “agree[d] to affirm [the] initial decision,” finding Plaintiff’s mental impairments continued to be 

“non-severe.” (Id.)

In May 2012, Plaintiff reported she had not been pulling her hair. (Doc. 16-8 at 69) Dr. Morgan 

noted that Plaintiff’s concentration and insight were fair, and her thought process was intact. (Id.) 

Plaintiff failed to keep her appointments in June 2012. (Doc. 16-8 at 66-67). In July, Plaintiff reported 

she had insomnia, crying episodes, and her irritability and anger had increased. (Id. at 68) Because 

Plaintiff believed this increase could be due to anger at her roommate, Dr. Morgan “[e]ncouraged [her] 

to get out & do things.” (Id.)

Plaintiff went to the hospital in August 2012, complaining of pain in her hands. Dr. Jeffrey 

Cochiolo ordered x-rays and found “[m]inimal narrowing of the DIP joints with minimal marginal 

osteophytosis” in her left hand. (Doc. 16-9 at 50) Dr. Cochiolo believed the results were “consistent 

with very mild early osteoarthritis.” (Id.) He concluded Plaintiff did not have any degenerative 

changes in her right hand. (Id.)

In September 2012, Plaintiff reported she continued to have difficulty sleeping and have pain. 

(Doc. 16-8 at 64; Doc. 16-9 at 55) However, Plaintiff reported she was feeling “OK,” and she had no 

suicidal or homicidal ideations. (Doc. 16-8 at 64) Dr. Christoper Nerantzinis determined that 

Plaintiff’s hand grip was “loose but 5/5 strength.” (Doc. 16-9 at 55, 56)

On December 16, 2012, Plaintiff went to the emergency room at Community Medical Center, 

reporting her depression had increased during the week and she wanted “to cut her wrist.” (Doc. 16-9 

at 78) Dr. Rais Vohra noted Plaintiff also described “anhedonia, insomnia, hypersomnia, appetite 

changes, fatigue, psychomotor retardation, feelings of worthlessness, attention impairment, euphoric 

mood and poor judgment.” (Id. at 74) Plaintiff was placed on a 5150 hold, and referred “to inpatient 

psych for treatment and stabilization.” (Id. at 79) Approximately three hours later, Plaintiff reported 

she no longer had plans to commit suicide and did not contemplate harming herself or others. (Id. at 

74) Plaintiff was discharged the same afternoon to Exodus Recovery Center, where she remained for 

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one night. (Id. at 73; Doc. 16-10 at 16) 

On December 27, 2012, Plaintiff told Dr. Morgan about going to the emergency room, and said 

she no longer had suicidal ideations. (Doc. 16-8 at 63) Dr. Morgan increased Plaintiff’s prescription 

for Gabapentin to address Plaintiff’s anxiety symptoms. (Id.) Dr. Morgan noted Plaintiff “need[ed] a 

higher level of care,” and referred Plaintiff to a substance abuse counselor and Exodus Recovery 

Center. (Id.)

Plaintiff went to the hospital again on January 29, 2013, again reporting she had “thoughts of 

slitting her wrist or overdosing on her pills.” (Doc. 16-10 at 18) Plaintiff “was admitted as being a 

danger to self,” and was “[p]ositive for altered mental status, depression and suicidal ideas.” (Id. at 

21) She was discharged on January 31, 2013. (Id.) Plaintiff’s medication was changed, and February 

she reported that it was “helping more of her symptoms.” (Doc. 16-8 at 62)

Plaintiff went to the hospital a third time on March 18, 2013, and described “severe depression 

and auditory hallucinations telling her to kill herself.” (Doc. 16-10 at 23) She attributed the increase in 

her depression to the fact that her stepson was convicted of murdering his cellmate and was facing the 

death penalty. (Id.) Dr. Manolito Castillo increased Plaintiff’s prescription for Prozac and “added 

Abilify 2 mg every morning.” (Id.) Plaintiff was discharged from the hospital on March 21, 2013. (Id.) 

B. Administrative Hearing Testimony3

Plaintiff testified before the ALJ at a hearing on March 22, 2013. (Doc. 16-3 at 30) Plaintiff 

reported she had not worked since 1988. (Id. at 33) She believed she was unable to work due to 

depression, anxiety, and arthritis. (Id. at 34.) Plaintiff said she went to a family doctor at Clinica Sierra 

Vista for treatment, and she attended group therapy for her anxiety and depression. (Id. at 38) 

Vocational expert Stephen Schmidt also testified at the hearing. The ALJ asked the VE to 

consider a hypothetical individual who had limitations similar to those assessed by Dr. Rios. (Doc. 16-

3 at 55). Specifically, the VE considered an individual who “had a maximum standing and walking 

capacity up to six hours; maximum sitting capacity up to six hours; [and did] not require an assistive 

 

3

The ALJ found Plaintiff's subjective complaints lacked credibility, and Plaintiff does not challenge this finding, 

or the ALJ’s reasons given to explain the conclusion. Accordingly, her testimony is summarized only briefly to provide a 

context for her alleged impairments and the ALJ’s findings.

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device.” (Id.) The hypothetical person was also able to “lift 20 pounds occasionally and 10 pounds 

frequently,” and was “capable of frequent reaching and handling and occasional feeling and finger.” 

(Id.) Further, the ALJ said the “individual [was] capable of performing occasional ... climbing, 

kneeling, crouch, crawling, and frequent balancing and stooping.” (Id.) The VE believed there were 

not any jobs in the national economy an individual with these limitations could perform “based upon 

the manipulative limitations.” (Id.) However, if the person did not have any manipulative limitations, 

the VE believed the person would be able to perform light work as a cashier, DOT 211.462-010; fast 

food worker, DOT 311.472-010; and cleaner, DOT 323.687-014.4 (Id.)

Next the ALJ asked the VE to consider an individual with the same physical limitations, but 

who was also “limited to simple, repetitive tasks.” (Doc. 16-3 at 57) The VE opined such a person 

would be able to perform each of the jobs previously identified. (Id.)

C. The ALJ’s Findings

Pursuant to the five-step process, the ALJ determined Plaintiff did not engage in substantial 

activity after the alleged disability date of January 28, 2011. (Doc. 16-3 at 15) Second, the ALJ found 

Plaintiff “has the following severe impairments: back and knee pain likely due to osteoarthritis, obesity, 

major depressive disorder, posttraumatic stress disorder (PTSD) and drug abuse.” (Id.) At step three, 

the ALJ opined these impairments did not meet or medically equal a listed impairment, including 

Listings 12.04, 12.06, and 12.09. (Id. at 15-17) Next, the ALJ determined:

[T]he claimant has the residual functional capacity to perform light work as defined in 

20 CFR 416.967(b). She is able to lift or carry 10 lbs. frequently and 20 lbs. 

occasionally. She can sit, stand and walk about 6 hours in an 8-hour workday, 

occasionally climb, kneel, crouch and crawl, and frequently balance and stoop. 

[Citation] There is no credible evidence supporting any manipulative limitations. The 

claimant is limited to simple repetitive tasks.

(Id. at 17, citation omitted) With this residual functional capacity, the ALJ found Plaintiff retained the 

ability to perform “jobs that exist in significant numbers in the national economy.” (Id. at 22) Thus, 

the ALJ concluded Plaintiff was not disabled as defined by the Social Security Act. (Id. at 23)

 

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The Dictionary of Occupational Titles (“DOT”) by the United States Dept. of Labor, Employment & Training 

Admin., may be relied upon “in evaluating whether the claimant is able to perform 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, and may 

be a primary source of information for the ALJ or Commissioner. 20 C.F.R. § 404.1566(d)(1).

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DISCUSSION AND ANALYSIS

Plaintiff asserts the ALJ failed “to sufficiently determine whether [her] diagnosed major 

depressive disorder meets or equals a listed impairment.” (Doc. 21 at 8, emphasis omitted) In addition, 

Plaintiff contends the ALJ “erred by failing to accord proper weight” to the opinion of Dr. Rios. (Id. at 

10, emphasis omitted) On the other hand, Defendant argues any error in assessing Plaintiff’s mental 

impairments was harmless, and the ALJ’s findings related to Plaintiff’s physical limitations are 

supported by substantial evidence in the record. (Doc. 22 at 4-8)

A. The ALJ’s Step Three Findings

The Listings set forth by the Commissioner “define impairments that would prevent an adult, 

regardless of his age, education, or work experience, from performing any gainful activity, not just 

‘substantial gainful activity.’” Sullivan v. Zebley, 493 U.S. 521, 532 (1990) (citation omitted, emphasis 

in original). At step three of the sequential evaluation, the claimant bears the burden of demonstrating 

her impairments equal a listed impairment. Bowen v. Yuckert, 482 U.S. 137, 141, 146 n. 5 (1987); 20 

C.F.R. §§ 404.1520(d), 416.920(d). “If the impairment meets or equals a listed impairment, the 

claimant is conclusively presumed to be disabled. If the impairment is not one that is conclusively 

presumed to be disabling, the evaluation proceeds to the fourth step.” Bowen, 482 U.S. at 141; Tackett 

v. Apfel, 180 F.3d 1094, 1099 (9th Cir. 1999). 

Here, Plaintiff asserts the ALJ erred in finding she did not satisfy the “paragraph B” criteria of 

Listings 12.04, 12.06 and 12.09. (Doc. 21 at 8-9) The “paragraph B” criteria set forth in 20 C.F.R., Pt. 

404, Subpart P, App. 1 are used to evaluate the mental impairments of a claimant, and include: 

activities of daily living; social functioning; concentration, persistence, or pace; and episodes of 

decompensation. 

Considering “paragraph B” criteria, the ALJ concluded Plaintiff had “mild restriction” in 

activities of daily living and “mild difficulties” with social functioning and concentration, persistence, 

or pace. (Doc. 16-3 at 15) In addition, the ALJ noted the “evidence shows two hospital admissions 

for self-reported suicidal ideation in December 2012 and January 2013 . . . [that] could be episodes of 

decompensation.” (Id.) The ALJ concluded: “Because the claimant’s mental impairment does not 

cause at least two ‘marked’ limitations or one ‘marked’ limitation and ‘repeated episodes of 

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decompensation, each of extended duration, the ‘paragraph B’ criteria are not satisfied.” (Id.) Plaintiff 

argues the ALJ erred in finding she did not suffer a third episode of decompensation because the ALJ 

did not discuss the third time Plaintiff went to the hospital in March 2013. (Doc. 21 at 9) According 

to Plaintiff, the failure “to consider evidence that potentially establishes meeting a listed impairment 

constitutes legal error and warrants a remand.” (Id.)

Under the Listings, episodes of decompensation are defined as “exacerbations or temporary 

increase in symptoms or signs accompanied by a loss of adaptive functioning, as manifested by 

difficulties in performing activities of daily living, maintaining social relations, or maintaining 

concentration, persistence, or pace.” 20 C.F.R., Part 404, Subpart P, App. 1, § 12.00(C)(4). Further, 

the Regulations explain:

Episodes of decompensation may be demonstrated by an exacerbation in symptoms or 

signs that would ordinarily require increased treatment or a less stressful situation (or a 

combination of the two). Episodes of decompensation may be inferred from medical 

records showing significant alteration in medication; or documentation of the need for a 

more structured psychological support system (e.g., hospitalizations, placement in a 

halfway house, or a highly structured and directing household); or other relevant 

information in the record about the existence, severity, and duration of the episode.

Id. Because an episode of decompensation may be inferred from a hospitalization, the fact that 

Plaintiff was admitted for suicidal ideations in March 2012 could be considered a third episode of 

decompensation. 

Significantly, however, Plaintiff fails to acknowledge that “paragraph B” requires her to not 

only identify repeated episodes of decompensation, but also that each episode be of “extended 

duration.” See 20 C.F.R., Pt. 404, Subpart P, App. 1, §§ 12.04(B), 12.06(B). An episode of 

decompensation is of “extended duration” when it “last[s] for at least 2 weeks.” Id., §12.00(C)(4). The 

evidence related to her third hospitalization shows Plaintiff remained for three days. (See Doc. 16-10 at 

23) Plaintiff does not identify any evidence supporting a conclusion that any of her episodes of 

decompensation—including the third not discussed by the ALJ— were of “extended duration,” as 

required by “paragraph B.” To the contrary, Plaintiff’s first hospitalization lasted for less than six

hours. (See Doc. 16-9 at 73) She was discharged in March 2013 after three days. (Doc. 16-10 at 23)

Moreover, Plaintiff does not challenge the ALJ’s findings related to the other “paragraph B” 

considerations--or the conclusions that Plaintiff had mild restrictions in activities of daily living; mild 

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difficulties with social functioning; and mild difficulties with concentration, persistence, or pace.5 

(See Doc. 21 at 8-9) To satisfy “paragraph B” of the Listings related to mental disorders, a claimant 

has the burden to show:

[A]t least two of the following:

1. Marked restriction of activities of daily living; or

2. Marked difficulties in maintaining social functioning; or

3. Marked difficulties in maintaining concentration, persistence, or pace; or

4. Repeated episodes of decompensation, each of extended duration.

See e.g., 20 C.F.R., Pt. 404, Subpart P, App. 1, §§ 12.04(B), 12.06(B) (emphasis added). Because 

Plaintiff had only “mild” restrictions and difficulties, she fails to carry her burden to show her mental 

impairments satisfy the Listings. See Sullivan, 493 U.S. at 530 (“For a claimant to show that [her]

impairment matches a listing, it must meet all of the specified medical criteria. An impairment that 

manifests only some of those criteria, no matter how severely, does not qualify.”) 

Accordingly, any failure of the ALJ to discuss the third hospitalization at step three was 

harmless, because Plaintiff fails to satisfy the remaining criteria for paragraph B under the Listings. 

B. Evaluation of Dr. Rios’ Opinion

In this circuit, courts distinguish three categories of physicians: (1) treating physicians; (2) 

examining physicians, who examine but do not treat the claimant; and (3) non-examining physicians, 

who neither examine nor treat the claimant. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1996). In 

general, the opinion of a treating physician is afforded the greatest weight but it is not binding on the 

ultimate issue of a disability. Id.; see also 20 C.F.R. § 404.1527(d)(2); Magallanes v. Bowen, 881 F.2d 

747, 751 (9th Cir. 1989). Further, an examining physician’s opinion is given more weight than the 

opinion of non-examining physician. Pitzer v. Sullivan, 908 F.2d 502, 506 (9th Cir. 1990); 20 C.F.R. 

§§ 404.1527(d)(2), 416.927(d)(2). 

The opinion of a physician may be rejected with “specific and legitimate” reasons, supported by 

substantial evidence in the record. Lester, 81 F.3d at 830; see also Thomas v. Barnhart, 278 F.3d 947, 

958-59 (9th Cir. 2002). When there is conflicting medical evidence, “it is the ALJ’s role to determine 

 

5

The Ninth Circuit instructs that the Court will “review only issues which are argued specifically and distinctly.”

Indep. Towers of Wash. v. Washington, 350 F.3d 925, 929 (9th Cir. 2003). Accordingly, any argument regarding an error 

in the ALJ’s conclusions related to the remaining “paragraph B” requirements—including Plaintiff’s ability to perform 

daily activities, maintain social functioning; and maintain concentration, persistence, or pace—is WAIVED.

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credibility and to resolve the conflict.” Allen v. Heckler, 749 F.2d 577, 579 (9th Cir. 1984). The ALJ’s 

resolution of the conflict must be upheld by the Court when there is “more than one rational 

interpretation of the evidence.” Id.; see also Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992) 

(“The trier of fact and not the reviewing court must resolve conflicts in the evidence, and if the 

evidence can support either outcome, the court may not substitute its judgment for that of the ALJ”). 

Plaintiff asserts the ALJ erred by finding she did not have any manipulative limitations, which 

were identified by Dr. Rios. (Doc. 21 at 9) Specifically, Dr. Rios determined Plaintiff was “capable 

of performing frequent reaching and handling, and occasional feeling and fingering.” (Doc. 16-8 at 9) 

However, the ALJ rejected these limitations, finding there was “no credible evidence supporting any 

manipulative limitations.” (Doc. 16-3 at 17) The ALJ noted Plaintiff had self-diagnosed her carpal 

tunnel syndrome, and Drs. Medina and Ocrant opined the evidence did not support manipulative 

limitations. (Id. at 18-19)

Importantly, the Ninth Circuit has determined that the opinion of a physician may be rejected 

when it is “unsupported by the record as a whole.” Mendoza v. Astrue, 371 Fed. Appx. 829, 831-32 

(9th Cir. 2010). When an ALJ believes a physician’s opinion is unsupported by the objective medical 

evidence, the ALJ must “set[] out a detailed and thorough summary of the facts and conflicting clinical 

evidence, stating his interpretation thereof, and making findings.” Cotton v. Bowen, 799 F.2d 1403, 

1408 (9th Cir. 1986). The Ninth Circuit explained: “To say that medical opinions are not supported by 

sufficient objective findings or are contrary to the preponderant conclusions mandated by the objective 

findings does not achieve the level of specificity our prior cases have required.” Embrey v. Bowen, 849 

F.2d 418, 421-22 (9th Cir. 1988). 

The ALJ noted Dr. Rios indicated Plaintiff had “antalgia of the hands” and “some abnormal 

findings” involving her wrists, where she had positive Tinel’s signs. (Doc. 16-3 at 18; Doc. 16-8 at 7, 

9) However, the ALJ noted also that treatment notes indicated Plaintiff’s “[h]andgrips were loose, but 

5 out of 5 strength.” (Doc. 16-3 at 18) Thus, the ALJ met the obligation to identify the evidence that 

undermined the opinion of Dr. Rios. Further, the ALJ’s determination was supported by substantial 

evidence in the record, including the opinions of Drs. Medina and Ocrant who opined Plaintiff did not 

have any manipulative limitations despite her assertion that she suffered from carpel tunnel 

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syndrome.6

Regardless, any error from rejecting the opinion of Dr. Rios is also harmless, because Plaintiff 

would be able to perform work identified by the ALJ, even if the manipulative limitations were 

adopted. In the Dictionary of Occupational Titles, the physical demands for “cleaner” include 

reaching and handling “frequently,” or “up to 2/3 of the time.” DOT 323.687-014. Fingering may be 

performed “occasionally,” and feeling is “not present” because the activity “does not exist” with the 

position. Id. Consequently, the physical demands for “cleaner” do not exceed the manipulative 

abilities assessed by Dr. Rios.7 According to the VE, there were 43,000 jobs regionally and 375,000 

jobs nationally for this position. (Doc. 16-3 at 57) Consequently, although Plaintiff would not be able 

to perform work as a cashier or fast food worker, the jobs for cleaners are sufficiently numerous. See, 

e.g., Meanel v. Apfel, 172 F.3d 1111, 1115 (9th Cir. 1999) (finding the ALJ “properly concluded that 

there was a significant number of... jobs in the local area,” where the ALJ found “there were between 

1,000 and 1,500” regional positions); Thomas v. Barnhart, 278 F.3d 947, 959 (9th Cir. 2002) (finding 

1,300 regional positions satisfied the “significant number” requirement).

CONCLUSION AND ORDER

For the reasons set for above, the Court finds the ALJ applied the proper legal standards in 

finding Plaintiff’s mental impairments did not satisfy the “paragraph B” criteria and in rejecting the 

manipulative limitations assessed by Dr. Rios. Further, any error by the ALJ in evaluating Plaintiff’s 

manipulative limitations was harmless because the error did not negate the ultimate conclusion that 

Plaintiff is able to perform work existing in significant numbers in the regional and national economies. 

See Batson v. Comm'r of the Soc. Sec. Admin, 359 F.3d 1190, 1195-97 (9th Cir. 2003) (applying a 

harmless error standard). Accordingly, the ALJ’s determination that Plaintiff is not disabled must be 

 

6

The opinions of non-examining physicians—such as Drs. Medina and Ocrant—are substantial evidence when 

“consistent with other independent evidence in the record,” such as the treatment notes which do not indicate any 

manipulative limitations or difficulty gripping items. See Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001).

7

As Plaintiff notes, the VE testified a worker with the manipulative limitations assessed by Dr. Rios would not be 

able to perform this work. However, the Dictionary of Occupational Titles clearly indicates the physical requirements of the 

position less than the abilities assessed by Dr. Rios. The VE did not acknowledge that his testimony conflicted with these 

limitations. Because the Ninth Circuit has recognized that the Dictionary of Occupational Titles is a “primary source of 

reliable job information,” Zavalin v. Colving, 778 F.3d 842, 845-46 (9th Cir. 2015), the Court adopts the limitations 

identified in the Dictionary of Occupational Titles.

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upheld by the Court. Sanchez, 812 F.2d at 510.

Based upon the foregoing, IT IS HEREBY ORDERED:

1. The decision of the Commissioner of Social Security is AFFIRMED; and

2. The Clerk of Court IS DIRECTED to enter judgment in favor of Defendant 

Carolyn W. Colvin, Acting Commissioner of Social Security, and against Plaintiff 

Parrish Jean Moore.

IT IS SO ORDERED.

Dated: December 23, 2015 /s/ Jennifer L. Thurston 

UNITED STATES MAGISTRATE JUDGE

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