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JOHNSON v. SHALALA | FindLaw
Sabrina JOHNSON, Plaintiff-Appellant, v. Donna E. SHALALA, Secretary of Health and Human Services, Defendant-Appellee.
No. 93-56607.
Before: FLETCHER, WIGGINS, and FERNANDEZ, Circuit Judges. Joel D. Leidner, Los Angeles, CA, for plaintiff-appellant. Kaladharan M.G. Nayar, Dept. of Health and Human Services, San Francisco, CA, for defendant-appellee.
Sabrina Johnson (“claimant”) appeals the denial of her claim for social security disability benefits. The final decision of the Secretary of Health and Human Services was affirmed by the district court. We affirm.
On November 18, 1986, neurologist Dr. Rafael examined claimant and found that she “continued to be able to function as a mother and a housekeeper but is in constant pain” and “has learned to ‘live with it.’ ” (Letter from Dr. Rafael to Dr. Hunt.) He noted that prolonged sitting worsened her pain, but using a lordotic pillow and stretching exercises afforded some relief.
Based upon the examinations noted above, Dr. Hunt concluded on December 4, 1986 that because of the condition of her lower back, claimant was “temporarily disabled” and should “continue a program of conservative care.”
Claimant was reinjured in a second automobile accident on December 4, 1989, “resulting in increased upper back and neck pain” (Dr. Hunt's letter dated July 6, 1990) for which she was treated by Dr. Hunt over the next few months. However, when claimant sought treatment for her lower back, Dr. Hunt reported as interim history that “[t]he patient states that she has aggravated her condition on 12/4/89 at which time she was involved in an automobile [sic] and was rearended.” (Dr. Hunt's letter dated July 6, 1990.)
Dr. Hunt provided a Supplemental Report on February 12, 1992 stating that claimant was “well known to this office” and concluded that claimant was “for all practical purposes, disabled as a consequence of her lumbar condition ․ since the date of her initial evaluation in this office, 10/23/86, and probably before then.”
At the administrative hearing on February 19, 1992, claimant testified that between the date of her injury in 1981 and the expiration of her disability insurance, she experienced pain which radiated from her back down her left leg to the knee, and sometimes down her right leg. She said her condition “did not change” between 1981 and the date of the hearing, but contradictorily complained of aggravation over the last several years. She testified that the pain was unpredictable, prevented participation in numerous recreational and social activities because she could sit only one to one and one-half hours at a time, and it required her to lie down and elevate her feet three to four hours per day.
A vocational expert, Mr. Edward Kurata, also testified at the hearing. He accepted as fact that claimant “could not do [her] previous job” because it required sitting up to two hours or more at a time. Nonetheless, based on the understanding that claimant was limited to sedentary work and had other specified limitations,1 the expert found that claimant could work as a production assembler or office helper, jobs available in large numbers in the Los Angeles area.
We have jurisdiction pursuant to 28 U.S.C. § 1291 and 42 U.S.C. § 405(g).
Claimant must produce complete and detailed objective medical reports of her condition from licensed medical professionals. 20 C.F.R. §§ 404.1512(a)-(b), 404.1513(d). As a first step, the medical reports, together with such other evidence as is adduced, must establish that she is disabled to the extent that she cannot return to her former job. It is undisputed here that the claimant satisfactorily showed that her condition precluded return to her former job.
She next complains that the ALJ erred in relying on the vocational expert's opinion because he improperly testified that she could perform two types of jobs that he described as “sedentary” whereas the Dictionary of Occupational Titles (DOT) classifies the jobs as “light.”
First, the ALJ found that the doctor's retrospective assessment in the letter dated February 12, 1992, was conclusory because it included “no specific assessment of her functional capacity prior to December 31, 1986.” A review of Dr. Hunt's assessment itself confirms the absence of any named limitations such as the inability to lift, stoop, walk, stand or sit. The letter states only the diagnosis and then concludes that “the patient's subjective complaints and clinical findings are felt to be entirely consistent” and that she was disabled “for all practical purposes” as of October 23, 1986.
The medical reports during the relevant time period 3 make only limited references to medically observed limitations on functional capacity; therefore they fall short of the substantial medical evidence required to establish a disability listed in or equal to those appearing in appendix 1.4 We agree with the ALJ that Dr. Hunt's conclusory letter was not substantiated by medical evidence relevant to the period in question.
Additionally, Dr. Hunt's retrospective conclusion that claimant was totally disabled by October 23, 1986 contradicts his own contemporaneous finding in 1986 that claimant was only “temporarily disabled” and needed only “a program of conservative care.” In light of the facts that claimant's condition improved during the two months preceding Dr. Hunt's characterization of claimant as “temporarily disabled,” and that the functional assessments indicating disability were prepared on January 31, 1991, after the two exacerbating automobile accidents, the ALJ's conclusion is supported by substantial evidence in the record and the ALJ gave clear and convincing reasons why she disregarded Dr. Hunt's conclusion that the claimant was disabled.
Pain is subjective in both existence and degree. Fair v. Bowen, 885 F.2d 597, 601 (9th Cir.1989). Yet despite the inability to measure it objectively, it can have “severe debilitating effects”-even to the point of disabling a person who does not meet or equal the impairments listed in Appendix 1 and who would not objectively be expected to experience pain to the degree subjectively expressed. 20 C.F.R. § 404.1545(e) (“pain or other symptoms may cause a limitation of function beyond ․ the anatomical, physiological or psychological abnormalities considered alone”); Fair, 885 F.2d at 601.
The regulations state that subjective complaints of pain will not establish disability “unless medical signs or laboratory findings show that a medically determinable impairment(s) is present.” 20 C.F.R. § 404.1529(b). However, once an impairment is medically established, the ALJ cannot require medical support to prove the severity of the pain. Bunnell v. Sullivan, 947 F.2d 341, 343 (9th Cir.1991).
The ALJ cannot discount a claim of “excess pain” without making “specific findings justifying that decision.” Fair, 885 F.2d at 602. These findings must be supported by clear and convincing reasons why the claimant's testimony of excess pain was not credible, and must be supported by substantial evidence in the record as a whole. See Swenson v. Sullivan, 876 F.2d 683, 687 (9th Cir.1989).
In addition to the inconsistencies within claimant's testimony, the ALJ noted the absence of medical treatment for claimant's back problem between 1983 and October 23, 1986, suggesting that if the claimant had actually been suffering from the debilitating pain she claimed she had, she would have sought medical treatment during that time. She cited the doctor's records of the examinations of 1983 and 1986 to show that medical evidence does not support the degree of functional limitation claimed. For example, the ALJ noted that Dr. Hunt prescribed only “conservative treatment” in 1986, suggesting a lower level of both pain and functional limitation.
The ALJ pointed out the conflict between claimant's testimony that pain and medication interfered with her ability to think and the fact that claimant failed to tell her doctor of any mental limitations resulting from her condition. Dr. Rafael's neurological evaluations underscore this contradiction since he concluded in November 1986 that claimant's “memory, orientation, judgment, intellect and affect are within normal limits.”
The ALJ directed the vocational expert to assume that claimant was restricted to sedentary work and had a number of non-exertional limitations.5 The expert testified that claimant could not perform her former job, but could work either as an office worker or production assembler. Both occupations are classified in the DOT 6 as “light” work, considered a more strenuous category than “sedentary.”
Claimant argues that under Terry v. Sullivan, 903 F.2d 1273, 1277 (9th Cir.1990), the DOT's classification of those occupations as “light” precludes a finding that a person restricted to sedentary work can perform them. In Terry, we held that without reason and support in the record, the ALJ erred in finding certain identified occupations “semi-skilled” when the DOT and the Regulations classified them as “unskilled.” Id. at 1278. We overturned the ALJ's decision that contradicted the job descriptions in the DOT because the Secretary offered “no explanation why those job descriptions (on which the agency regularly relies) do not apply in this case.” Terry, 903 F.2d at 1278.7 The claimant would have us read Terry too broadly. She argues that Terry entirely precludes a finding that a claimant with limitations that classified her as restricted to sedentary work could perform some types of jobs that are classified as “light” in the DOT.8 To the contrary, Terry supports the proposition that although the DOT raises a presumption as to the job classification, it is rebuttable. We make explicit here that an ALJ may rely on expert testimony which contradicts the DOT, but only insofar as the record contains persuasive evidence to support the deviation. Here, there was persuasive testimony of available job categories in the local rather than the national market, and testimony matching the specific requirements of a designated occupation with the specific abilities and limitations of the claimant. This is entirely consistent with Villa v. Heckler, 797 F.2d 794, 798 (9th Cir.1986), where we held that the claimant could “overcome the presumption that the Dictionary 's entry for a given job title applies to him by demonstrating that the duties in his particular line of work were not those envisaged by the drafters of the category.” Id. (citing DeLoatche v. Heckler, 715 F.2d 148, 151 (4th Cir.1983)).
The DOT “is not the sole source of admissible information concerning jobs.” Barker v. Shalala, 40 F.3d 789, 795 (6th Cir.1994). “The Secretary may take administrative notice of any reliable job information, including ․ the services of a vocational expert.” Whitehouse v. Sullivan, 949 F.2d 1005, 1007 (8th Cir.1991) (internal quotation marks and citations omitted).
The Sixth Circuit recently held in a case similar to ours, that “the ALJ was within his rights to rely solely on the vocational expert's testimony. The Social Security regulations do not require the Secretary or the expert to rely on classifications in the Dictionary of Occupational Titles.” Conn v. Secretary of Health and Human Services, 51 F.3d 607, 610 (6th Cir.1995). In Conn, the expert described certain jobs as sedentary which the DOT classified as light or medium. Nevertheless, the court held that “the ALJ may rely on the testimony of the vocational expert even if it is inconsistent with the job descriptions set forth in the Dictionary.” Id. We agree.
The regulations, themselves, provide that the DOT classifications are rebuttable. They recognize vocational experts and several published sources other than the DOT as authoritative. 20 C.F.R. §§ 404.1566(d)(2)-(5), (e) (the use of vocational experts is particularly important where “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”); see also Barker, 40 F.3d at 795. Here, the ultimate issue of whether the claimant is disabled turns on whether her limitations are such that she cannot perform any work available in the economy. The testimony of the vocational expert was particularly important in establishing precisely which available jobs the claimant could perform. See Sample v. Schweiker, 694 F.2d 639, 643 (9th Cir.1982) (essential role of a vocational expert is to “translate[ ] factual scenarios into realistic job market probabilities”). It was therefore proper for the ALJ to rely on expert testimony to find that the claimant could perform the two types of jobs the expert identified, regardless of their classification by the DOT as “light.”
The expert's opinion was based on an understanding of the limitations of the claimant even more generous to her in the hypothetical than the ALJ's findings, particularly with respect to pain,9 and his knowledge as an expert of the existence and characteristics of jobs available in the Los Angeles area. Therefore his testimony that claimant could work in two specific types of jobs despite her limitations was sufficient to overcome the presumption drawn from the DOT that a person limited to some sedentary work could not perform jobs with titles classified as “light.” See Sample, 694 F.2d at 643-44 (as long as the hypothetical question posed by the ALJ is properly based on all relevant evidence in the case, the testimony of the vocational expert is valuable). In response to the ALJ's hypothetical, the vocational expert testified that a production assembler and office helper are low stress occupations with sit/stand options which require lifting of objects weighing mostly from one to five pounds. Because these demands do not exceed the abilities the ALJ found the claimant to possess, the vocational expert rebutted the presumption that the claimant could not perform the occupations classified as light by the DOT.
1. The ALJ asked Kurata to assume thatthe claimant is limited to sedentary work and that she must change positions or be able in a job that would permit her to change positions after thirty minutes of sitting, and that also because of pain that-and decreased concentration, that she should be limited to doing simple work with of a lower stress nature․
2. Total disability is established if the claimant suffers an impairment listed in or equal to those required by Appendix 1 to Subpart P of the governing regulations. 20 C.F.R. § 404.1501-99 (1994) (hereinafter “Appendix 1”).
3. These reports include Dr. Hunt's initial examination report of October 23, 1986, Dr. Glenn's evaluation of the CT and MPR tests of November 5, 1986, Dr. Rafael's neurology report of November 18, 1986, and Dr. Hunt's concluding report of claimant's temporary disability which prescribed only “conservative” care.
4. Appendix 1 requires that in order to establish debilitating vertebregenic disorders including herniated nucleus puplosus and spinal stenosis, the claimant must provide detailed orthopedic and neurologic examinations that establish both1. Pain, muscle spasm, and significant limitation of motion in the spine; and2. Appropriate radicular distribution of significant motor loss with muscle weakness and sensory and reflex loss.Appendix 1, 1.05(C) (emphasis added). Here, during the relevant period, the medical evidence produced by the claimant establishes only pain, some limited range of motion, and negligible sensory loss.
6. The DOT is “the Secretary's primary source of reliable job information.” Terry, 903 F.2d at 1276. Cf., 20 C.F.R. § 404.1566(d)(1). One purpose of the DOT is to classify identified job titles by their exertional and skill requirements. Terry, 903 F.2d at 1276.
7. In this case the ALJ's explanation is satisfactory because the ALJ made findings of fact that support a deviation from the DOT. The ALJ noted that the vocational expert described the characteristics and requirements of jobs in the local area. Since the DOT is not invariably controlling, particularly where local job characteristics are concerned, the ALJ provided findings that fully satisfy this aspect of Terry. See infra; DOT at iii; Barker v. Shalala, 40 F.3d 789, 795 (6th Cir.1994).
8. Although claimant did not cite the following cases in her brief, we are cognizant of the determinations by other courts which have given great weight to the DOT by holding that where the testimony of a vocational expert is in conflict with the DOT, the latter controls. Smith v. Shalala, 46 F.3d 45, 47 (8th Cir.1995); Tom v. Heckler, 779 F.2d 1250, 1255-56 (7th Cir.1985); Mimms v. Heckler, 750 F.2d 180, 186 (2d Cir.1984); Atkins v. Shalala, 837 F.Supp. 318, 324 (D.Or.1993). We agree that the DOT carries great weight, Terry, 903 F.2d at 1276, but we disagree that in all cases it trumps expert testimony.
9. The ALJ apparently contradicted herself by including in the hypothetical as fact that claimant was mentally limited to jobs that required no public interaction due to pain and medication even though the ALJ ultimately discounted claimant's relevant pain testimony as not credible. However, this overinclusion of debilitating factors is harmless simply because if a person can do a job that requires increased concentration, the claimant is also capable of performing work that requires less concentration. This, of course, would not be true where the government is required to produce evidence of work above a minimum skill level. See, e.g., Terry v. Sullivan, 903 F.2d 1273 (9th Cir.1990). However, here no such issue was raised nor requirement found relevant.