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Luz Vasquez v. Jo Anne B Barnhart - PDF EBook Free Download
Luz Vasquez v. Jo Anne B Barnhart
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 1 of 31 Page ID #:11 1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CAL...
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 1 of 31 Page ID #:11
LUZ VASQUEZ,
) ) Plaintiff, ) ) v. ) ) JO ANNE B. BARNHART, Commissioner ) of the Social Security ) Administration, ) ) Defendant. ) )
No. ED CV 04-537-PJW MEMORANDUM OPINION AND ORDER
16 I. 17 INTRODUCTION 18 Plaintiff brings this action pursuant to 42 U.S.C. §§ 405(g) and 19 1383(c)(3), seeking reversal of the decision by Defendant Social 20 Security Administration (“Agency”) denying Supplemental Security 21 Income (“SSI”) benefits.
Alternatively, she asks the Court to remand
22 the case to the Agency for further proceedings.
23 discussed below, the Agency’s decision is REVERSED and the case is 24 REMANDED for further proceedings. 25 26 27 28
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 2 of 31 Page ID #:12
Plaintiff was born on June 27, 1964, and was 38 years-old at the
time of the relevant administrative hearing.
has an eighth-grade education and past relevant work as an assembler.
(AR 333, 338, 498.)
(AR 25, 319, 498.)
Plaintiff filed her first application for SSI on June 29, 1993;
upon determining that her asthma was disabling, the Agency paid her
SSI from July 1993 to April 1999.
(AR 24.)
After a continuing
disability review, however, the Agency concluded that Plaintiff was no
longer disabled and terminated her SSI effective April 30, 1999.
law judge (“ALJ”) Mason D. Harrell, Jr., affirmed the Agency’s finding
of non-disability.
She appealed that decision but, on June 15, 2000, administrative
(AR 266-73.)
Plaintiff filed the current application for SSI benefits on
June 23, 1993, because of asthma and a lower back impairment.
332.)
reconsideration, she timely requested a hearing before an ALJ.
(AR 319-22.)
In it she alleged disability since (AR 24,
After Plaintiff’s claim was denied initially and on (AR
On March 18, 2003, ALJ Samuel A. Durso held an administrative
534.)
vocational expert.
Plaintiff appeared with counsel and testified.
(AR 493-
The ALJ also heard testimony from Ms. Sandra Fioretti, a (AR 534.)
Plaintiff testified that she was raised in Puerto Rico, and that
she reads and writes only Spanish.
(AR 498.)
had been employed as an assembly worker and an order filler at various
sites from March 2000 until September 2001, with each job lasting from 2
She explained that she
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 3 of 31 Page ID #:13
a few weeks to four months.
she could no longer perform this kind of work, however, because of her
asthma, which caused shortness of breath and insomnia.
Plaintiff testified that she used to smoke, but claimed that she had
kicked her half-pack-a-day cigarette habit in early 2003.
533-34.)
pain, it did not cause her insomnia and she did not take any
medication for this pain.
(See AR 499-509.)
Plaintiff stated that
(See AR 510.)
(See AR
She added that, although she also suffered from low back
(AR 525.)
Additionally, Plaintiff described her recent history of treatment
for symptoms of asthma, both during scheduled appointments and at
emergency rooms.
Prednizone, Singulair, Advair, Proventil, and Benadryl, all of which
helped alleviate her symptoms without causing side-effects.
she also had a nebulizer machine at home that she used to assist her
when she had more severe attacks; on average, she used the nebulizer
approximately three hours every day resting quietly while recovering
from asthma attacks.
claimed to be unable to stand for more than an hour at a time, and
incapable of lifting more than five to ten pounds.
Although Plaintiff admitted that her asthma would not preclude her
from sedentary work, she claimed that her back pain prevented her from
sitting longer than an hour at a time and precluded her from bending
She added, however, that she had no difficulty kneeling
or squatting.
(AR 526-28.)
(AR 510-13.)
Doctors prescribed Plaintiff
(AR 513-
Plaintiff used her inhalers approximately four times per day;
(AR 518-22.)
She testified that she spent
(AR 523-25.)
Because of her asthma, Plaintiff
Plaintiff also described her daily activities.
(AR 526-27.)
(AR 528-34.)
a typical day, Plaintiff would get up in the morning, lay out clothing 3
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 4 of 31 Page ID #:14
for her three children, cook them breakfast, drive them to school, and
return home to make the beds, wash dishes, launder a few loads of
clothes, watch television for two or three hours, help her children
with their homework when they came home from school, and begin
other day at the grocery store, although sometimes her daughter or a
neighbor would accompany her to load the groceries into the cart and
daily or every other day for up to an hour at a time.
(AR 528-32.)
(AR 532.)
She also would spend an hour every
Plaintiff stated that she visited a neighbor (AR 533.)
Vocational Expert Sandra Fioretti also testified.
(See AR 534-
assembler would be classified as “laborer storage” under the
Dictionary of Occupational Titles (“DOT”), an unskilled position
performed at the light- to medium-level of exertion.
The ALJ then asked her whether a woman of Plaintiff’s age, education,
and language capabilities would be capable of returning to that job if
she was limited to light work and “need[ed] to avoid concentrated
exposure to extreme cold or extreme heat, as well as fumes, odors,
dust, poor ventilation and gases.”
person with these limitations could not perform Plaintiff’s former
limitations could perform other jobs--including those of fast food
worker, assembler of hospital products, and cashier--all of which
existed in significant numbers in the local economy.1
She stated that Plaintiff’s four-month-long job as a cable box
(AR 536.)
(AR 535-36.)
(AR 534-35.)
She testified that a
She added, however, that a person with these
The vocational expert made clear that her estimate of the number of fast food jobs available assumed that Plaintiff’s need to avoid exposure to fumes and smoke would confine her to the front counter, and excluded cooking positions within the fast-food category. (AR 541-42.) 4
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 5 of 31 Page ID #:15
vocational expert also added that, even if this hypothetical person
were limited to sedentary work, a significant number of sedentary
assembly jobs existed locally.
however, that if Plaintiff’s claimed sit/stand limitations were
credited, the number of sedentary assembly jobs available would be
eroded by 75%.
claimed nebulizer usage and her recent frequent absences from work to
obtain medical care were fully credited and extrapolated into the
future, these additional limitations would “eliminate 90 percent, if
(AR 543-44.)
She acknowledged,
She also stated that, if Plaintiff’s
not all, jobs.”
account of her limitations were found fully credible, then she could
not perform other work.
(AR 551-52.)
(AR 536-37.)
She also opined that if Plaintiff’s
(AR 537-38.)
On April 24, 2003, the ALJ issued a decision analyzing
Plaintiff’s claims under the Agency’s five-step sequential evaluation
Plaintiff’s alleged onset date of June 23, 1993 already had been
adjudicated in ALJ Harrell’s decision denying benefits, that prior
decision was res judicata and would not be reopened.
Accordingly, the ALJ only assessed Plaintiff’s claim of disability as
of June 16, 2000--the day after the date of ALJ Harrell’s decision--
forward.2
(AR 23-23.)
At the outset, the ALJ noted that, insofar as
(AR 24-25.)
(See AR 25.)
At step one, the ALJ found that Plaintiff had “not engaged in
substantial gainful activity since June 16, 2000.”
(AR 31.)
two, the ALJ found that Plaintiff’s impairments--including asthma and
a back impairment--were, taken in combination, “severe” within the
As the Agency points out, Plaintiff has not challenged the ALJ’s refusal to revisit the Agency’s determination that she was not disabled before June 16, 2000. (See Cross-Motion at 3 n.1.) 5
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meaning of the regulations.
At step three, however, the
ALJ found that these impairments did not meet or equal a listing.
(See AR 28.)
residual functional capacity to perform “at least a sedentary level of
work activity.”3
for rejecting as “not credible” Plaintiff’s subjective complaints and
her claims relating to her limitations.
vocational expert’s testimony, the ALJ found Plaintiff unable to
resume any of her past relevant work.
The ALJ then determined that Plaintiff retained the
The ALJ offered ten separate reasons
(AR 29.)
At step five,
however, he determined that Plaintiff’s residual functional capacity
left her fit for other jobs--specifically, sedentary assembly work--
and noted that 12,000 such jobs existed in the local economy.
as defined in the Social Security Act (the “Act”) at any time through
the date of the decision.
Accordingly, the ALJ concluded that Plaintiff was not disabled
(AR 30.)
Plaintiff timely requested review of the ALJ’s decision.
and the decision of the ALJ became the final decision of the Agency.
(AR 8-10.)
On April 5, 2004, however, the Appeals Council denied review,
“Disability” under the applicable statute is defined as the
inability to perform any substantial gainful activity because of “any
medically determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be expected to
Because Plaintiff raises a specific challenge to the ALJ’s determination of her residual functional capacity, (see Motion at 6), the particulars of that assessment are set below. 6
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 7 of 31 Page ID #:17
last for a continuous period of not less than twelve months.”
U.S.C. § 1382c(a)(3)(A).
that a claimant is not disabled only if the decision is not supported
by substantial evidence or is based on legal error.
Bowen, 881 F.2d 747, 750 (9th Cir. 1989).
The Court may overturn the ALJ’s decision
See Magallanes v.
Substantial evidence “‘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, 229 (1938).)
It is “more than a mere
scintilla but less than a preponderance,” Tidwell v. Apfel, 161 F.3d
599, 601 (9th Cir. 1998), and “does not mean a large or considerable
amount of evidence,” Pierce v. Underwood, 487 U.S. 552, 565 (1988).
“The Court must uphold the ALJ’s conclusion even if the evidence
in the record is susceptible to more than one rational
599 (9th Cir. 1999).
support either affirming or reversing the Agency’s decision, this
Court must not substitute its judgment for that of the ALJ.
Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999).
committed error but the error was harmless, reversal is not required.
See Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1197 (9th
Cir. 2003)(applying the harmless error standard).
Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, Indeed, if the record evidence can reasonably
If the ALJ
Plaintiff claims that the ALJ erred by (1) finding that her
asthma was not sufficiently severe to meet or equal Listing 3.03B at
step three of the sequential process; by (2) failing to offer proper
reasons for finding Plaintiff’s subjective symptom complaints to be 7
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 8 of 31 Page ID #:18
not credible; and by (3) determining that she retained the residual
functional capacity to perform sedentary assembly work at step five of
the sequential process.4
(See Motion at 4-10.)
Each of Plaintiff’s arguments will be addressed in the order
For the reasons set forth below, the Court determines that
the matter must be reversed and remanded for further proceedings.
The ALJ’s Conclusion That Plaintiff’s Asthma Did Not Meet Or
Equal Listing 3.03B
Under listing 3.03B, asthmatics are deemed disabled if their
pulmonary impairment is sufficiently severe and persistent.
pertinent regulation provides that an applicant is disabled if she
suffers from asthma with:
Attacks [. . .] occurring in spite of treatment and
requiring physician intervention, occurring once every two
months or at least six times a year.
hospitalization for longer than 24 hours for control of
asthma counts as two attacks, and an evaluation period of at
least twelve consecutive months must be used to determine
the frequency of attacks.
Each in-patient
See 20 C.F.R. § 404, Subpart P, App. 1, Section 3.03B. For purposes of Listing 3.03B, “attacks” are defined as
“prolonged symptomatic episodes lasting one or more days and requiring
intensive treatment, such as intravenous bronchodilator or antibiotic
Although Plaintiff briefs these second and third arguments as though they were part of an overarching challenge to the ALJ’s assessment of her residual functional capacity, (see Motion at 6-10), the Court will address them separately in this Order because they are, in fact, analytically-distinct claims implicating steps three, four, and five of the sequential process. 8
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 9 of 31 Page ID #:19
administration or prolonged inhalation bronchodilator therapy in a
hospital, emergency room, or equivalent setting.”
§ 404, Subpart P, App. 1, Section 3.00C.
satisfies all of the elements of Listing 3.03B, the analysis ends at
step three, and she is considered “disabled” for purposes of the Act.
See Bowen v. City of New York, 476 U.S. 467, 471 (1986).
If a claimant’s condition
In Plaintiff’s case, the ALJ determined that she no longer met the requirements of Listing 3.03B, reasoning: In order for [Plaintiff] to be considered disabled under
this listing, she must show emergency room visits averaging
at least six times per year.
in 2000, three emergency room visits in 2001, two visits to
the emergency room in 2002, and only two visits so far to
the emergency room in 2003.
medical office visits, one on January 16, 2003 and the other
on January 20, 2003.
visits, but rather office visits.
emergency room visits or inpatient visits, which count as
was in 1994.
room visits two times per year.
This requirement is far from
[Plaintiff] had only one visit to the emergency room
[Plaintiff] also had two
However, these were not emergency room The listing requires
However, the last inpatient hospital stay for asthma So [Plaintiff] is only averaging emergency
(AR 28.) Plaintiff faults the ALJ for omitting to count her emergency room
visit of December 1, 2001.
reflects that Plaintiff visited the emergency room and was discharged
approximately four hours after receiving treatment for an asthma
attack, (see AR at 411), the regulations assess the severity of a
(See Motion at 5.)
Although the record
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 10 of 31 Page ID #:20
claimant’s asthma by examining her course of treatment over 12
the December 1, 2001 emergency-room visit because it fell outside the
period from February 11, 2002 to February 11, 2003: the 12-month span
in which Plaintiff logged the most hospital and emergency-room visits
for asthma attacks.
See Section 3.03B.
The ALJ properly disregarded
Plaintiff also argues that, during two of her hospital visits--on
January 16, 2003, and two weeks later, on January 30, 2003--she
required treatment for asthma “exacerbations.”
Had the ALJ counted these two visits as “equivalent” to emergency room
visits or hospitalizations, Plaintiff argues that she would have
suffered exactly six “attacks” within a 12-month period, as Listing
3.03B requires.
medical records for these two dates do not document “attacks” within
the meaning of Listing 3.00C, but merely reflect Plaintiff’s return
for follow-up office visits.
The Agency counters that the
(See Cross-Motion at 5.)
The Court concludes that the Agency has the better of the two
arguments on this issue.
treatment records for January 2003 show that these two visits were,
indeed, regularly-scheduled follow-up office visits.
465.)
Courts have declined to count routine office visits as “attacks” for
purposes of these Listings.
94-2920-VRW, 1996 WL 24764, at *3 (N.D. Cal. Jan. 16, 1996)(refusing
to count a claimant’s “routine” office visit as an asthma attack); see
also Bomeisl v. Apfel, No. 96 CIV 9718(MBM), 1998 WL 430547, at *5
(S.D.N.Y. July 30, 1998)(holding that, although the record showed that
the claimant visited the hospital several times in a 12-month period
As the Agency points out, Plaintiff’s
Plaintiff admitted as much at the hearing.
(See AR 463,
(See AR 512-13.)
See Lintz for Robinson v. Shalala, No. C-
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 11 of 31 Page ID #:21
for treatment for his asthma, his condition did not meet or equal
Listing 3.03B where “these visits were brief and there is no evidence
that any was prompted by an ‘attack’ as that concept is defined by the
regulations” and where “most of [his] hospital visits were for the
purpose of renewing prescriptions for his asthma medication”).
Additionally, a review of the medical records for those dates
provides no support for Plaintiff’s contention that she required
“steroid and medical nebulizer treatments for asthma exacerbations”
during those visits.
Instead, on both occasions
Plaintiff’s doctor told her to continue taking her regularly-
prescribed medications; during the January 30th visit, Plaintiff also
was advised to resume taking Prednisone, which her doctor previously
had discontinued.
erroneously believed that Listing 3.03B required proof of emergency
room visits to establish an “attack,” this error was harmless because
--however characterized--Plaintiff’s previously-scheduled visits of
January 16 and 30, 2003 did not meet the criteria of Section 3.00C.
See Batson, 359 F.3d at 1197.5
(See AR 464, 466.)
Thus, although the ALJ
Plaintiff suggests, however, that “the ALJ should not be allowed
to disregard [her] use of a breathing nebulizer machine at home.”
(See Motion at 9.)
On this score, Plaintiff maintains:
Most certainly, if the Plaintiff did not have the nebulizer
machine at home, she would be going to the emergency room on
a much more frequent basis than is reported in the
Although the ALJ’s mistaken belief that an asthma “attack” must be evidenced by an emergency-room visit was harmless error, other errors in the decision require remand for further proceedings, as will be explained below. Accordingly, the ALJ will have the opportunity to correct this error in a third decision. 11
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 12 of 31 Page ID #:22
nebulizer machine on a regular and frequent basis, is the
Plaintiff capable of staying out of the emergency room.
Only by using this breathing
(See Motion at 9.) Certainly, a claimant’s home nebulizer usage may diminish her
need for emergency room visits or hospitalization.
cites no authority for the proposition, some courts have held that
asthmatic episodes treatable with a home nebulizer may be considered
the equivalent of “attacks” within the meaning of Listing 3.00C.
Although claimant
Riley v. Barnhart, No. Civ.A. 03-0288, 2004 WL 2423840, at *6-7 (E.D.
La. Oct. 28, 2004)(remanding to permit the ALJ to determine whether a
claimant’s use of a home nebulizer would satisfy Listings 3.00C and
3.03B); Pogozelski v. Barnhart, No. 03 CV 2914(JG), 2004 WL 1146059,
at *19 (E.D.N.Y. May 19, 2004)(remanding with orders to reassess an
asthmatic claimant’s residual functional capacity where the ALJ had
ignored her daily use of a nebulizer and failed to consider that such
usage “might have obviated any need for hospitalization”).
courts, however, have declined to count a claimant’s home nebulizer
usage as though it were the “attack” it forestalled.
v. Secretary of Health & Human Servs., 830 F.2d 594, 595 (6th Cir.
1987)(holding that the ALJ’s finding of non-disabling asthma condition
was supported by substantial evidence where the claimant used a
“nebulizer which alleviated his need to receive these treatments at a
hospital”); see also Goodenow-Boatsman v. Apfel, No. C-99-4776 VRW,
2001 WL 253200, at *3 (N.D. Cal. Feb. 27, 2001)(affirming the ALJ’s
finding of non-disability where the claimant “went to an emergency
room only several times over two years preceding the hearing when the
home nebulizer could not adequately suppress asthma attacks”); 12
See, e.g., Auer
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 13 of 31 Page ID #:23
Anderson on behalf of Anderson v. Shalala, No. CV-93-4753, 1994 WL
722810, at *2 (E.D.N.Y. June 20, 1994)(affirming the ALJ’s finding of
non-disability where the claimant’s use of a home nebulizer obviated
the need to visit a hospital or emergency room for acute attacks).
This Court agrees with the latter line of authorities, and declines
Plaintiff’s invitation to count her home nebulizer usage toward the
requisite six “attacks” within a 12-month span.
would contravene the spirit of the regulations, which focus on attacks
“occurring in spite of treatment and requiring physician
See Listing 3.03B (emphasis added).
In sum, Plaintiff has not demonstrated that her asthma met or
equaled Listing 3.03B.
steps four and five of the sequential evaluation.
Zebley, 493 U.S. 521, 530 (1990)(“For a claimant to show that his
impairment matches a listing it must meet all of the specified medical
no matter how severely, does not qualify.”)(emphasis in original).
That being so, the ALJ properly proceeded to See Sullivan v.
An impairment that manifests only some of those criteria,
The ALJ’s Adverse Credibility Determination Plaintiff next argues that the ALJ erred in evaluating her
credibility and subjective symptom complaints.
(See Motion at 6-9.)
The Court concludes that the ALJ’s assessment of Plaintiff’s
credibility was defective in that it contained no specific finding
regarding the credibility of Plaintiff’s claimed need for bi-weekly
home nebulizer treatments.
offer for his adverse credibility finding were inadequate because they
were not linked to any of Plaintiff’s claimed limitations or symptoms.
These errors must be corrected on remand.
Additionally, the reasons that the ALJ did
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 14 of 31 Page ID #:24
“Credibility determinations are the province of the ALJ.”
v. Bowen, 885 F.2d 597, 604 (9th Cir. 1989).
claimant’s testimony as not credible by specifically identifying the
incredible testimony and by identifying the evidence that undermines
that testimony.
1996)(emphasis added).
supports the ALJ’s credibility finding, this Court may not
second-guess it.
reverse an ALJ’s credibility determination based on contradictory or
See Lester v. Chater, 81 F.3d 821, 834 (9th Cir. As long as substantial evidence in the record
See Morgan, 169 F.3d at 600.
ambiguous evidence.
An ALJ may reject a
Nor will the Court
See Allen v. Heckler, 749 F.2d 577, 579 (9th Cir.
The Ninth Circuit recognizes that pain testimony is difficult to
weigh because “pain is a highly idiosyncratic phenomenon, varying
according to the pain threshold and stamina of the individual victim.”
Howard v. Heckler, 782 F.2d 1484, 1488 (9th Cir. 1986).
expansively, the circuit has observed:
Unlike most medical conditions capable of supporting a
finding of disability, pain cannot be objectively verified
or measured . . . .
completely subjective phenomenon.
The amount of pain caused by a given physical impairment can
vary greatly from individual to individual.
[T]he very existence of pain is a So is the degree of pain:
Fair, 885 F.2d at 601. The inherent difficulty in evaluating another person’s experience
of subjective symptoms has prompted the Ninth Circuit to require the
ALJ to undertake a two-step analysis when considering a claimant’s
symptom testimony.
determine whether the claimant has met her burden of producing
First, the ALJ must examine the evidence to
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 15 of 31 Page ID #:25
objective medical evidence of an impairment, and of showing that the
impairment reasonably could be expected to produce a symptom.
Smolen v. Chater, 80 F.3d 1273, 1281-82 (9th Cir. 1996).
In Plaintiff’s case, the ALJ did not acknowledge that Plaintiff’s
impairments could cause the symptoms she alleged.
explained that “the objective evidence of [Plaintiff’s] medical record
does not establish impairments likely to produce disabling pain or
other limitations as alleged [. . .].”
tempting to interpret this as a finding that Plaintiff’s subjective
Instead, the ALJ
symptom complaints did not satisfy the first Smolen step, such a
construction cannot be reconciled with the fact that this particular
finding was offered as the tenth of ten substantive reasons why the
ALJ believed that Plaintiff’s testimony was not credible.
with Smolen is to conclude that he skipped the first Smolen step
entirely and jumped directly to the second step: which required the
ALJ to assess Plaintiff’s credibility as to the severity of her
subjective symptoms.
(See AR 28-
Thus, the only way to reconcile the ALJ’s credibility findings
See Smolen, 80 F.3d at 1282.
At the second Smolen step, the claimant must produce medical
evidence of an underlying impairment reasonably likely to be the cause
of her alleged symptoms, although she is not required to submit
medical findings to substantiate the severity of those symptoms.
Drouin v. Sullivan, 966 F.2d 1255, 1258 (9th Cir. 1992).
ALJ may not reject the claimant’s subjective complaints regarding the
extent and severity of her symptoms merely because they cannot be
supported by objective medical evidence.
F.2d 341, 343 (9th Cir. 1991)(en banc)(citation omitted).
claimant’s testimony concerning the severity of her symptoms can only 15
See Bunnell v. Sullivan, 947 Rather, a
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 16 of 31 Page ID #:26
be rejected for specific, clear, and convincing reasons.
966 F.2d at 1258; see also Lester, 81 F.3d at 834 (“For the ALJ to
reject the claimant’s complaints, [the ALJ] must provide specific,
cogent reasons for the disbelief.”)(internal quotation marks and
See Drouin,
In Plaintiff’s case, the ALJ enumerated ten distinct reasons for
finding her subjective symptom complaints to be not credible to the
extent alleged.
credibility findings that the ALJ did make below, what is most
(See AR 28-29.)
Although the Court will address the
conspicuous is the credibility finding that the ALJ did not make:
specifically, nowhere among the ALJ’s ten reasons is there any finding
that Plaintiff’s claimed need for bi-weekly home nebulizer treatments
was anything other than fully credible.
omission alone requires remand.
Courts have recognized that a claimant’s need for home nebulizer
treatments may limit her ability to perform other jobs in the national
1606459, at *12 (W.D. Va. July 8, 2005)(noting that the expert
testified the claimant’s home nebulizer usage would render her
unemployable); with Carroll v. Barnhart, 291 F.Supp.2d 783, 796 (N.D.
Ill. 2003)(noting vocational expert testimony to the effect that a
claimant’s home nebulizer usage would not affect her ability to
perform other work).
at all, her use of a home nebulizer machine would affect her ability
to perform other work.
to the ALJ’s very broad hypothetical question, that--if all of
Plaintiff’s subjective complaints were found credible--she would be
Cf. Mullins v. Barnhart, No. Civ.A 2:04CV00082, 2005 WL
In Plaintiff’s case, it is unclear how much, if
The vocational expert did testify, in response
(See AR 537-38.)
To curtail what he viewed as redundant 16
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 17 of 31 Page ID #:27
questioning by counsel, the ALJ voiced his assumption that this
sweeping hypothetical covered Plaintiff’s use of a nebulizer as well
as all of her other claimed limitations, and the vocational expert did
not contradict him.6
(See AR 544-46.)
Where, as here, there is evidence that an asthmatic claimant’s
nebulizer usage may impact her ability to perform other work, the ALJ
must offer specific reasons if he considers this particular limitation
not to be credible.
2005 WL 1036336, at *19 (S.D.N.Y. May 3, 2005)(finding ALJ’s
See Hogue v. Barnhart, No. 03-Civ.-4963(SHS),
credibility discussion inadequate where it failed to explain whether
the ALJ rejected an asthmatic claimant’s testimony “regarding the need
for daily nebulizer treatments”).
he finds a claimant’s nebulizer usage to be credible, reversal is
v. Barnhart, No. 04-2197-GTV, 2005 WL 589758, at *9 (E.D. Pa. Mar. 11,
2005)(reversing where the ALJ “merely stated that she found [an
asthmatic plaintiff’s] claims partially credible, without discerning
what was credible, what was not, and why,” and holding that “on
remand, the ALJ should offer reasons why she finds that [p]laintiff
does not need to use a nebulizer breathing machine on a regular
basis”); Wilson v. Commissioner of Social Sec. Admin., No. 03 C 3662,
2004 WL 1687086, at *4 (N.D. Ill. July 23, 2004)(noting that, on
remand, the claimant’s professed need for multiple daily nebulizer
If an ALJ fails to explain whether
See Hogue, No. 03-Civ.-4963(SHS), at *19; see also Smith
The sloppiness of the hypothetical questions posed at the hearing and the chaotic nature of counsel’s questioning of the vocational expert hopelessly obscured the expert’s ultimate conclusion on the impact that Plaintiff’s nebulizer usage would have on her employability. (See AR 538-51.) As explained below, this defect must be rectified at another hearing with the testimony of a vocational expert. 17
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 18 of 31 Page ID #:28
treatments “must be either included in the hypothetical questions or
the ALJ must provide a more sufficient explanation for her finding
that they are incredible claims”).
As the above-cited authorities reflect, this omission alone is
serious enough to warrant remand to permit the ALJ to reassess
Plaintiff’s credibility.
offer reveals, however, that each is compromised by a common fatal
defect: all are general, and none is tied to any particular claimed
limitation or symptom.
A review of the ten reasons that the ALJ did
In regards to credibility, “[g]eneral findings
are insufficient; rather, the ALJ must identify what testimony is not
credible and what evidence undermines the claimant’s complaints.”
Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998)(citations
several of the ALJ’s reasons for discounting Plaintiff’s credibility.
In light of the teaching of Reddick, the Court addresses
First, the ALJ’s reliance on the fact that Plaintiff continued to
smoke in finding her testimony to be incredible is not adequately
explained.7
could provide a legitimate reason for discounting the credibility of
her subjective symptom testimony.
253200, at *4 (noting that “Plaintiff’s smoking habit in this case
serves as relevant evidence in discrediting [her] testimony by
illustrating inconsistencies between [her] own conduct and the
(See AR 29 (reason Two).)
A claimant’s smoking habit
See Goodenow-Boatsman, 2001 WL
Also in the context of Plaintiff’s cigarette smoking, the ALJ noted that her credibility was undermined by the fact that she told the examining physician that she kept a small pet at home. (See AR 29.) What Plaintiff actually said was that she had a dog at home, but that she kept it outside to avoid an asthmatic reaction to it. (AR 392.) The fact that Plaintiff’s family kept a pet outdoors has little bearing on her credibility, particularly in light of her testimony that she spends most of her time inside her house. (See AR 528-34.) 18
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 19 of 31 Page ID #:29
severity of asthma as claimed by [P]laintiff”).
have concurred.
WL 2658077, at *5 (N.D. Ill. Oct. 14, 2004)(upholding an ALJ’s adverse
credibility determination where “[t]he claimant has asthma but medical
records and testimony show she continues to smoke”); Mooney v.
Shalala, 889 F.Supp. 27, 32 (D.N.H. 1994)(upholding the ALJ’s
reference to an asthmatic claimant’s cigarette smoking in finding that
subjective symptom testimony was not credible, stating: that “[t]his
type of relevant contradiction in [his] testimony, as to what he can
and cannot do, provided ample evidence for the ALJ to determine that
[his] subjective complaints, including pain, were not entirely
credible.”).
at 8), and the record confirms that she did.8
that the ALJ articulated no clear connection between Plaintiff’s
tobacco addiction and her credibility.
for discounting a smoker’s credibility lies in her non-compliance with
a prescribed course of treatment–-i.e., her unwillingness to quit
smoking as her doctor has ordered.
2374 MMC, 2004 WL 329332, at *5 (N.D. Cal. Feb. 18, 2004)(approving
the ALJ’s adverse credibility determination based in part on the
See, e.g., Clemons v. Barnhart, No. 03 C 4200, 2004
Plaintiff does not contest that she smoked, (see Motion Rather, the problem is
Usually, the analytical basis
See Saephan v. Barnhart, No. C-02-
The record confirms that Plaintiff was a smoker at least as early as August 2000. (See AR 442). On February 25, 2001, Plaintiff told Dr. Robert Yang, the examining physician, that she was an occasional smoker and that she kept a small dog outdoors at home. (See AR 392.) In October 2001, Plaintiff was prescribed Nicoderm for her tobacco addiction (see AR 443); during an emergency-room visit three weeks later, Plaintiff told Dr. Jonathan Lee that she had quit smoking. (AR 422.) By February 2003, however, the medical records reflect that Plaintiff had resumed smoking. (See AR 467.) At the hearing in March 2003, Plaintiff told the ALJ that she again quit smoking in January or February 2003. (AR 533-34.) 19
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 20 of 31 Page ID #:30
claimant’s “failure to stop smoking as directed by his treating
physician”)(emphasis added); see also Goodenow-Boatsman, 2001 WL
253200, at *3 (upholding an ALJ’s adverse credibility determination
against an asthmatic claimant who smoked where, “[d]espite repeated
recommendations by doctors, plaintiff never stopped smoking”); Leach
v. Apfel, No. C-96-4099-CAL,
1998)(refusing to disturb an ALJ’s finding that a claimant’s refusal
to quit smoking made his subjective symptom testimony less credible
where “the ALJ chose to believe the medical records indicating that
the doctors considered quitting smoking a way for [the claimant] to
treat his condition”); Higgins v. Callahan, 983 F. Supp. 865, 871
(E.D. Mo. 1997)(holding that a claimant’s “failure to stop smoking,
when some of his impairments are related to his smoking habit, as his
physicians recommended, militates against a finding of disability”)
evidence that any of Plaintiff’s doctors ever recommended that she
to her credibility insofar as it casts doubt on her asserted
sensitivity to--and need to work in an environment free of--airborne
Goodenow-Boatsman, 2001 WL 253200, at *3; Mooney, 889 F.Supp. at 32.
But the ALJ did not draw this connection, either.
Plaintiff’s credibility on remand, the ALJ must explain which of
Plaintiff’s testimony regarding her limitations, subjective
complaints, or compliance with treatment is undermined by the fact
that she is, or was, a smoker.
1998 WL 246704, at *3 (N.D. Cal. May 6,
Here, however, the ALJ has not pointed to any
Conceivably, Plaintiff’s smoking also could be relevant
See Mullins, 2005 WL 1606459, at *13; see also
When reassessing
Three of the other reasons the ALJ offered are tangentially grounded in his determination that Plaintiff received conservative 20
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 21 of 31 Page ID #:31
treatment for her symptoms and “responded well to bronchodilators.”
(see AR 29 (reasons Three, Seven, and Nine).)
only conservative treatment for her symptoms, without offering any
explanation for failing to seek more aggressive treatment, can be
considered when evaluating her credibility.
60 F.3d 1428, 1434 (9th Cir. 1995); see also Meanel v. Apfel, 172 F.3d
1111, 1114 (9th Cir. 1999).
question as to whether the treatment Plaintiff received for her
asthma--conservative or otherwise--was effective in controlling her
A claimant’s pursuit of
See Johnson v. Shalala,
Here, however, the record raises some
(See, e.g., AR 422 (noting that Plaintiff’s Albuterol “has
not helped”); AR 464, 466 (noting that Plaintiff’s asthma was “poorly
controlled” with medication).)
that Plaintiff’s asthma was controllable with bronchodilators with
this conflicting evidence.
claimant] has seen has suggested effective treatment [. . . ], the
amount of medical treatment [the claimant] has received is not
necessarily inconsistent with his complaints.”9
Comm’r of Soc. Sec. Admin., 166 F.3d 1294, 1296 (9th Cir. 1999)
The ALJ did not reconcile his belief
Where “none of the many physicians [a
See Regennitter v.
At any rate, and as Plaintiff points out, the ALJ appears to have bootstrapped his third and ninth reasons into his step-three finding that her asthma was not severe enough to meet or equal a Listing. (See Motion at 8-9.) The same can be said of the ALJ’s sixth reason, which implies that Plaintiff’s testimony is not credible because the results of a pulmonary function study did not meet or equal Listing 3.02A. (See AR 29.) But a finding that a claimant’s impairment falls short of a Listing is neither dispositive of, nor particularly relevant to, the question whether her limitations are, nevertheless, sufficiently serious--and her subjective symptom complaints, sufficiently credible--to support the conclusion that she is disabled at step five. For that reason, the ALJ should eliminate or explain these three justifications for finding Plaintiff’s subjective symptom testimony not credible, if he re-adopts them in his credibility findings on remand. 21
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 22 of 31 Page ID #:32
reason in his post-remand credibility finding, he must explain what
evidence he is relying upon in assuming that Plaintiff’s treatment has
been conservative; if the ALJ concludes that Plaintiff’s asthma is
controlled with conservative treatment, he must reconcile that
conclusion with the evidence that her asthma is poorly controlled.
If the ALJ wishes to reiterate this particular
The ALJ’s adverse credibility finding also rested, at least in
part, on the fact that Plaintiff did not display symptoms during some
of her examinations.
(See AR 29 (reasons Four and Five).)
the record supports the ALJ’s conclusion that Plaintiff was
asymptomatic on February 25, 2001, the day she was examined by Dr.
Yang, (see AR 393), this evidence is of little value, especially
considering the highly sporadic nature of the symptoms that asthmatics
asthma are not representative of the record as a whole, which
documents numerous instances when Plaintiff sought medical attention
for serious symptoms and attacks.
the ALJ’s credibility finding rests upon selective, unrepresentative
citations to the record, the finding cannot stand.
Massanari, 246 F.3d 1195, 1203-05 (9th Cir. 2001)(reversing an adverse
credibility finding and remanding for an award of benefits where the
ALJ selectively quoted a doctor’s records out of context).
Moreover, Dr. Yang’s observations about Plaintiff’s
(See AR 458-86.)
Where, as here,
See Holohan v.
Finally, the ALJ discounted Plaintiff’s credibility because of
the fact that she continued to perform household chores, (see AR 29
(reason One)), a fact that Plaintiff admitted at the hearing.
528-34.)
was not improper.
1995)(noting that “[a]n ALJ is clearly allowed to consider the ability
In the abstract, the ALJ’s consideration of this activity See Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir.
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 23 of 31 Page ID #:33
to perform household chores” when assessing a claimant’s degree of
limitation); see also Fair, 885 F.2d at 602 (explaining how a
claimant’s performance of household chores could impact her
credibility).
activities “would not be dispositive of her ability to work.”
Cross-Motion at 6.)
perform household activities only bears on her credibility to the
extent that her level of activity is in fact inconsistent with the
claimed limitations.
As the Agency concedes, however, Plaintiff’s daily
A claimant’s ability to
See Reddick, 157 F.3d at 722.
Here, although
the record may or may not contain evidence that Plaintiff “is able to
spend a substantial part of [her] day performing household chores or
other activities that are transferable to a work setting” or that the
level of her activity is in fact inconsistent with her claimed
limitations, see Smolen, 80 F.3d at 1284 n.7, the ALJ did not so find,
let alone point to any evidence in the record that would support the
The ALJ also cited the fact that the objective medical evidence
showed only a “moderate obstructive lung defect.” (See AR 29 (reason
Seven).)
claimant’s subjective complaints incredible because of lack of medical
findings to substantiate the severity of her symptoms.
966 F.2d at 1258.
Plaintiff’s testimony incredible in part because her doctor’s
conclusion that she as unable to work was unsupported by clinical
findings was a reason to discount the opinion of Plaintiff’s doctor
(which the ALJ also did, see AR 27-28), it was not a legitimate reason
to determine that Plaintiff’s own testimony was not credible.
Again, at the second Smolen step, the ALJ may not find a
Additionally, the ALJ stated that he was finding
(See AR 29 (reason Eight).)
Although the lack of objective
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 24 of 31 Page ID #:34
If the ALJ wishes to reiterate this reason for discounting
Plaintiff’s credibility in his post-remand decision, he must point to
substantial evidence in the record that Plaintiff is more active than
her claimed limitations would permit, or that the type and level of
her activity is transferrable to a work setting.
In sum, reversal and remand is necessary to permit the ALJ to
reassess Plaintiff’s credibility.
specifically explain whether he finds Plaintiff’s claimed need to use
a home nebulizer to be credible, a finding he failed to make in the
On remand, the ALJ must
findings that he did make, specifically identifying any of Plaintiff’s
claimed limitations or symptoms that he finds to be incredible and
stating with particularity why he disbelieves them.
F.3d at 722.
Additionally, the ALJ must revisit the credibility
See Reddick, 157
The ALJ’s Determination That Plaintiff Retained The Residual
Functional Capacity To Perform Other Jobs
Finally, Plaintiff contends that the ALJ erred in reaching the
step-five conclusion that she retained the residual functional
capacity to perform other jobs in the local economy.
In light of the foregoing discussion of the ALJ’s analysis of
Plaintiff’s credibility, the Court concludes that, on remand, the ALJ
must reassess Plaintiff’s residual functional capacity at step four,
and revisit his step-five finding that Plaintiff can perform other
(See AR 6, 10.)
A claimant’s residual functional capacity reflects what she can
still do despite her physical, mental, nonexertional, and other
claimant’s “residual functional capacity and the physical and mental
See 20 C.F.R. § 404.1545.
The Agency examines a
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 25 of 31 Page ID #:35
demands” of her past relevant work at step four of the sequential
249 F.3d 840, 844-45 (9th Cir. 2001).
“function-by-function” analysis of a claimant’s capacity to work
according to exertional categories.
must include the individual’s functional limitations or restrictions
and assess her work-related abilities on a function-by-function basis,
including the functions in paragraphs (b), (c), and (d) of 20 C.F.R.
§§ 404.1545 and 416.945.
See 20 C.F.R. § 404.1520(e); see also Pinto v. Massanari, This assessment entails a
The residual functional capacity
In determining a claimant’s residual
functional capacity, the ALJ must consider the limiting effects of all
of her impairments, even those that were not severe.
§ 404.1545(e); see also SSR 96-8p at 5.
express the claimant’s residual functional capacity in terms of
exertional levels of work: sedentary, light, medium, heavy, and very
capacity is assessed at step four, the ALJ must make the requisite
factual findings to support his assessment.
See SSR 96-8p.
Only after that may the ALJ
Although a claimant’s residual functional
See SSR 82-62.
It bears emphasis that an ALJ’s “[h]ypothetical questions posed
to the vocational expert must set out all the limitations and
restrictions of the particular claimant . . . .”
F.2d 418, 422 (9th Cir. 1988)(emphasis in original); see also Thomas,
278 F.3d at 956 (cautioning that, “[i]n order for the testimony of a
vocational expert to be considered reliable, the hypothetical posed
must include all of the claimant’s functional limitations, both
physical and mental[,] supported by the record”)(citation and internal
poses to the vocational expert “does not reflect all the claimant’s
limitations, . . . [then] the expert’s testimony has no evidentiary
Embrey v. Bowen, 849
If the hypothetical question that the ALJ
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 26 of 31 Page ID #:36
value to support a finding that the claimant can perform jobs in the
national economy.”
DeLorme v. Sullivan, 924 F.2d 841, 850 (9th Cir.
In his decision, the ALJ concluded that Plaintiff could do
sedentary assembly work.
of Plaintiff’s residual functional capacity was as follows:
(See AR 31.)
The ALJ’s specific assessment
[Plaintiff] can lift up to ten pounds at a time and she can
occasionally lift and carry articles like docket files,
ledgers, and small tools.
[Plaintiff] can stand/and or walk
approximately two hours in an eight-hour workday and sit
approximately six hours in an eight-hour workday.
[Plaintiff] would also need to avoid pulmonary irritants,
such as fumes, odors, dusts, gases, poor ventilation, etc.
Plaintiff faults the ALJ for “fail[ing] to discuss any of [her]
testimony [. . .] regarding her use of a breathing nebulizer machine
at her home for minor exacerbations which occur on a frequent basis.”
capacity assessment is there any mention of the uncontroverted
evidence that Plaintiff requires twice-weekly use of her home
nebulizer machine to forestall asthma attacks.
522.)
proceedings on remand.
need to use a nebulizer machine outside of a hospital setting is a
potentially-significant limitation that may reduce the number of jobs
available to her.
(recounting vocational expert testimony to the effect that an
asthmatic claimant “who had to use a nebulizer at work generally could
Indeed, nowhere in the ALJ’s residual functional
(Compare AR 28 with AR
The Court concludes that this omission will require further As noted previously, an asthmatic claimant’s
Compare Mullins, 2005 WL 1606459, at *12
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 27 of 31 Page ID #:37
not perform any jobs”) with Carroll, 291 F.Supp.2d at 796 (affirming
the ALJ’s finding of non-disability where the vocational expert
testified that the claimant’s limitations, including her need for
nebulizer treatments, would not preclude employment).
cited conflict in the district court authorities suggests, however,
the impact a claimant’s nebulizer usage will have on her employability
turns on factual circumstances best left to a vocational expert.
As the above-
Where the ALJ omits a claimant’s home nebulizer usage from his hypothetical question to the vocational expert, remand is appropriate.
See Eback v. Chater, 94 F.3d 410, 411-12 (8th Cir. 1996)(reversing an
ALJ’s step-five finding of non-disability where the ALJ assumed that
an asthmatic claimant could use her nebulizer during breaks without
including this assumption in his hypothetical question to the
vocational expert); see also Smith, 2005 WL 589758, at *9 (remanding
for further proceedings where the ALJ failed to include several of an
asthmatic claimant’s physical limitations in her hypothetical
questions to the vocational expert, including her need for a home
nebulizer); Wilson, 2004 WL 1687086, at *4 (remanding where the ALJ
did not include the claimant’s “stated need for multiple daily
nebulizer treatments” in his hypothetical question to the vocational
expert); Neely v. Apfel, No. 99 C 4132, 2000 WL 1285427, at *6 (N.D.
Ill. Sept. 11, 2000)(remanding for further proceedings where the ALJ’s
finding that an asthmatic claimant “would be able to administer the
[nebulizer] treatments in a manner that would not interfere with her
performance of work-related activities” was made without the benefit
of the testimony of a vocational expert and had “no support in the
record”).
In Plaintiff’s case, however, the situation is not clear-
As explained above, Plaintiff attested to the various 27
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 28 of 31 Page ID #:38
limitations her asthma causes, including her need to use a nebulizer
instructed the vocational expert to assume that all of Plaintiff’s
claimed limitations were found “fully believable,” (see AR 537-38),
and the ALJ later stated that this assumption included, among many
other things, Plaintiff’s claimed nebulizer use.
(See AR 522.)
One of the ALJ’s hypothetical questions
(AR 545.)
A more searching review of the record convinces the Court,
however, that the vocational expert was confused as to what a
“nebulizer” is.
Counsel appears to have described the apparatus as
“something that is plugged into the wall and that [Plaintiff] then has
to administer,” and added that a nebulizer “take[s] longer than [the]
seconds that it takes to use an inhaler.”
several interruptions by the ALJ, (see AR 542, 545-51), the vocational
expert opined that Plaintiff would require “[e]xtra breaks when using
the nebulizer and I’m not sure how long that takes, other than I know
it’s leaving the worksite.”
emphasized portion suggests, the vocational expert testified that she
was speculating regarding Plaintiff’s nebulizer usage.
ALJ’s cue to clarify the hypothetical question, elicit additional
testimony from Plaintiff, or both: yet he did neither.
circumstances, reversal for further proceedings is proper.
DeLorme, 924 F.2d at 850 (remanding “when the vocational expert
described confusion over” the content of a hypothetical question and
“the ALJ did not clarify the hypothetical”); see also Burnett v.
Barnhart, No. 02-C-8462, 2004 WL 1093271, at *10 (N.D. Ill. May 6,
2004)(remanding where the ALJ’s decision was based in part on “the
testimony of a confused medical expert”).
vocational expert assumed that using such a device necessarily would
(See AR 544-45.)
(AR 551-52 (emphasis added).)
In these See
And to the extent that the
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 29 of 31 Page ID #:39
involve “leaving the worksite,” she injected an assumption into the
hypothetical question that was not supported by the evidence.
Magallanes, 881 F.2d at 756 (holding that a vocational expert’s
testimony on a claimant’s residual functional capacity “has no
evidentiary value if the assumptions in the hypothetical are not
supported by the record”).
On remand, the ALJ’s hypothetical questions to the vocational
expert must reflect all of Plaintiff’s claimed limitations for which
there is substantial evidence in the record.
As the record now
stands, there is--in addition to the other limitations the ALJ
included in his hypothetical questions to the vocational expert--
substantial evidence that Plaintiff required bi-weekly usage of a home
limitation in a hypothetical question to the vocational expert;
changes in the frequency of Plaintiff’s nebulizer usage since the last
hearing, if any, should be reflected in separate hypothetical
clarification on the nature of a nebulizer--including how it works,
how long it takes to use one, and how portable it is–-additional
clarification from Plaintiff or even a medical expert may prove
The ALJ must include this
To the extent that the vocational expert requires
Remand Is Appropriate The determination whether to remand for further proceedings or
for payment of benefits lies within the discretion of the Court.
McAllister v. Sullivan, 888 F.2d 599, 603 (9th Cir. 1989).
circumstances in Social Security disability cases, remand is
See Moisa v. Barnhart, 367 F.3d 882, 886-87 (9th Cir.
Remand may be productive where additional proceedings can 29
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 30 of 31 Page ID #:40
remedy defects in the original administrative proceedings.
Celaya v. Halter, 332 F.3d 1177, 1184 (9th Cir. 2003).
In this case, as explained above, the vagueness of the
hypothetical questions that the ALJ posed to the vocational expert--
along with the confusion caused when the ALJ interrupted counsel
during his examination of this witness--make it unclear what impact,
if any, the use of a home nebulizer would have on her ability to
perform other work.
particular limitation in the course of his otherwise-detailed
Nor did the ALJ explain whether he rejected this
credibility findings. Remand is, therefore, necessary to enable the ALJ to retrace
these steps in the sequential process.
the ALJ must update the record, retain the services of another
vocational expert, and conduct another hearing for the purpose of
determining whether Plaintiff can perform other jobs existing in
significant numbers in the local economy.
must pose hypothetical questions that include all of Plaintiff’s
limitations for which there is substantial evidence; at a minimum,
such questions must include a characteristic that would account for
Plaintiff’s use of a home nebulizer machine.
vocational expert requires clarification of any of Plaintiff’s
limitations, including her use of a nebulizer, the ALJ must develop
the record to provide the expert with sufficient information.
As the foregoing indicates,
At that hearing, the ALJ
To whatever extent the
After the hearing, the ALJ must issue a new decision.
explained above, the ALJ should correct his erroneous step-three
characterization of the requirements of Listing 3.03B.
must reassess Plaintiff’s credibility, offering clear and convincing
reasons for rejecting her testimony about her subjective symptoms and 30
The ALJ also
Case 5:04-cv-00537-PJW Document 13 Filed 08/01/05 Page 31 of 31 Page ID #:41
limitations--including her claimed use of a nebulizer at home--
specifically connecting such testimony with the particular evidence
that contradicts it.
ALJ must then reassess Plaintiff’s residual functional capacity at
step four of the sequential process, and redetermine whether she can
perform other jobs at step five.
In light of those new credibility findings, the
For the reasons set forth above, this Court finds that the
Agency’s findings were not supported by substantial evidence and were
not free from material legal error.
the decision of the Agency and REMANDS for further proceedings.
Accordingly, the Court REVERSES
16 /s/ 17 18
PATRICK J. WALSH UNITED STATES MAGISTRATE JUDGE
S:\PJW\Cases-Soc Sec\VASQUEZ, L 537\Memo Opinion_Ord.wpd
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