Sanford v. Astrue

Filing 24

Order by Hon. Charles R. Breyer granting 21 Defendant's Motion for Summary Judgment. (crblc4, COURT STAFF) (Filed on 10/18/2013)

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IN THE UNITED STATES DISTRICT COURT

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FOR THE NORTHERN DISTRICT OF CALIFORNIA

United States District Court
For the Northern District of California

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ERIC SANFORD,
Plaintiff,

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v.

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No. C 12-04751 CRB
ORDER GRANTING DEFENDANT’S
MOTION FOR SUMMARY
JUDGMENT

CAROLYN W. COLVIN, Acting
Commissioner of Social Security,

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Defendant.
____________________________________/
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Plaintiff Eric Sanford appeals the Social Security Commissioner’s denial of his

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request for disability benefits and supplemental security income (“SSI”). See Sanford Mot.

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(dkt. 21). Defendant Carolyn Colvin, Acting Commissioner of Social Security, cross-moves

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for summary judgment, see Colvin Mot. (dkt. 22). Finding that the Administrative Law

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Judge (“ALJ”) based her decision on substantial evidence in the record as a whole, the Court

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DENIES Plaintiff’s motion and GRANTS Defendant’s cross-motion.

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I.

BACKGROUND

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A.

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Sanford was diagnosed with SLE in either the late 1970s or early 1980s, id. at 25, and

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received treatment from his doctor, Dr. Lieberman, for lupus and hypertension approximately

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Sanford’s Medical History And Application for Benefits

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once a year from 1986 through 2006, Colvin Mot. at 2. In 1999, Dr. Lieberman found

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Sanford capable of a very restricted range of activity. AR at 29. Sanford underwent surgery

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to address his injuries in 1999 and worked full time at various jobs afterwards. Id.

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Sanford filed for disability benefits on July 17, 2008, and for supplemental security

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income on July 31, 2008, alleging disability beginning January 1, 2008, due to systemic

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lupus erythematosus (“SRE”). AR at 21. In his application, he claimed to suffer from dizzy

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spells, migraines, and joint tension as a result of his SLE and stated that he was not able to

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afford medication or schedule regular doctor visits. AR at 25-26.

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As reflected in Sanford’s treatment records, Dr. Lieberman consistently reported that

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Sanford’s lupus was stable or in remission and was well-controlled, id. at 233, 236, 311, 317,

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319, 321, 322, 325, 327, 438. Sanford’s records contain a number of lapses between

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appointments, however, as well as missed appointments. Id. at 26. For example, in 2008,

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Sanford did not see Dr. Lieberman until November of that year. Id. At that time, Sanford’s

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blood pressure was elevated and he was given prescriptions for high blood pressure

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medications. Id.

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In October 2008, after applying for disability benefits, Sanford visited Dr. Sanders, a

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consultative psychologist, for a psychological examination. Id. at 262. Sanford denied any

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history of psychiatric illness or drug abuse. Id. at 262-63. Sanford told Dr. Sanders that he

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quit his last job delivering newspapers because he had to attend a family funeral during his

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scheduled shift. Id. at 263. The examination showed Sanford had no suicidal ideation and

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no mental impairments. Id. at 265. Dr. Sanders noted that some of Sanford’s responses to

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questions appeared to be inconsistent with his background and work history, including the

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fact that he was working until the time of the examination. Id. at 27.

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On November 15, 2008, Dr. Siekerkotte, a consultative internist, examined Sanford.

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Id. at 269-74. Sanford reported constant pain and swelling, said he could not drive and had

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to lie down all day, and claimed to have suicidal thoughts. Id. at 269. Sanford told Dr.

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Siekerkotte he quit his last job as a newspaper deliveryman because of pain and joint

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swelling. Id. at 269. Dr. Siekerkotte observed a butterfly rash on Sanford’s face and noted
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that Sanford had cold sweats and was unable to take his shoes and socks off by himself. Id.

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at 270. According to the doctor, Sanford’s upper extremities looked “rather muscular” and

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he walked with a normal gait, but was unable to stoop forward and had limited hip motion

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and muscle spasms in both arms and legs. Id. at 271. Sanford also exhibited decreased grip

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strength and decreased sensation in his palms. Id. at 272.

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Dr. Siekerkotte concluded that Sanford was limited to standing and walking for two

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hours per day in fifteen-minute increments; limited to sitting for two hours per day in twenty-

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minute increments; could lift less than ten pounds; and could never climb, balance, stoop,

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kneel, crouch, or use his arms. Id. Dr. Siekerkotte opined that Sanford put forth full effort

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during the examination and that his limitations would be present for the next twelve months.

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Id. at 272-74.

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In December 2008, Dr. Kammen, a state agency physician, noted discrepancies in Dr.

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Siekerkotte’s examination. Id. at 287. Specifically, Dr. Kammen observed that Dr.

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Siekerkotte did not find any joint swelling or deformity, the sensory loss in Sanford’s palms

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did not coincide with the possible effects of lupus, and Sanford’s lack of muscle loss was

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inconsistent with his diminished grip strength. Id. at 287. Due to these inconsistencies, Dr.

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Kammen concluded that Sanford’s physical impairments were not severe and referred the

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matter to the Cooperative Disability Investigation (“CDI”) unit. Id. at 287-88.

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In May 2009, CDI Special Agent Durrell Mackey began an investigation and found

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that Sanford had a criminal history that included possession of marijuana and cocaine, as

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well as filing a false workers’ compensation claim. Id. at 292. Sanford informed Agent

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Mackey that he was laid off from his last job delivering newspapers. Id. Sanford also

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represented that he could walk for one hour at a time and rode his bicycle three times per

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week for one mile at a time. Id. Finally, Sanford revealed to Agent Mackey that he recently

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applied to work as a truck driver and believed he could work as a medical assistant or

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phlebotomist if he could sit most of the day. Id. at 293, 295. In June 2009, Dr. Bonner, a

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state agency physician, reviewed Sanford’s records and agreed with Dr. Kammen that the

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record was insufficient to determine whether Sanford was disabled. Id. at 339.
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The Commissioner denied Sanford’s application initially on January 16, 2009, and

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upon reconsideration on June 9, 2009. Id. Sanford filed a timely written request for a

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hearing, and ALJ Regina L. Sleater heard the appeal on July 11, 2010. Id. Sanford was

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represented, and an impartial Vocational Expert testified. Id.
On May 13, 2010, Dr. Lieberman provided a statement of Sanford’s treating history

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Sanford suffers from hypertension, chronic mechanical low back pain, and chronic

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headaches, and is unable to afford regular follow-up and proper medication. Id. at 341, 347.

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On May 20, 2010, Dr. Lieberman provided a medical source statement reflecting his

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assessment that Sanford could lift up to ten pounds, could stand less than two hours and sit

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less than two hours in an eight-hour workday, was limited in pushing, reaching, and pulling,

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and had substantial postural limitations. Id. at 342-44.

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At the hearing, Sanford testified that he quit work in January 2008 due to joint pain,

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suffered from lupus flare-ups at least once per week, and rode his bicycle as often as every

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day. Id. at 39, 42, 46. He also represented that he had never used cocaine or marijuana. Id.

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at 38.

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B.

The ALJ’s Decision

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In a written decision dated August 27, 2010, the ALJ found Sanford not disabled. Id.

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At step one, the ALJ determined Sanford had not engaged in substantial gainful activity

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(‘SGA”) at any time since the date of his application. Id. at 23. At step two, the ALJ found

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that Sanford suffers from SLE and high blood pressure. Id. at 24. The ALJ concluded,

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however, that Sanford’s statements concerning the intensity, persistence, and limiting effects

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of his symptoms were not credible. Id. Because the record was riddled with inconsistencies,

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exaggeration, and untruthful or conflicting statements, the ALJ concluded that Sanford’s

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credibility was “poor.” Id. at 29. With respect to the medical opinion evidence, the ALJ

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gave the greatest weight to Dr. Sanders, the consultative psychologist, and Drs. Kammen and

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Bonner, the state agency physicians, and very little or no weight to the opinions of Dr.

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Siekerkotte, the consultative internist, and Dr. Lieberman, Sanford’s treating physician. Id.

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at 29.
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The ALJ concluded that Sanford’s impairments were not severe because they did not

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significantly limit, or were not expected to significantly limit, his ability to perform basic

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work-related activities for twelve consecutive months. Id. at 24. Finding that Sanford was

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not disabled within the meaning of the Social Security Act, the ALJ denied his application.

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Id. at 30.1 The Appeals Court denied Sanford’s request for review on July 5, 2012, making

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the ALJ’s decision the final decision of the Commissioner. Id. at 1.

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Sanford filed the present action on September 5, 2012, alleging that the

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Commissioner’s actions, findings, and conclusions were not supported by substantial

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evidence. Compl. (dkt. 1) ¶ 9. Sanford urges the Court to vacate the Commissioner’s final

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decision and remand for payment of benefits, or for rehearing. Sanford Mot. at 2.

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II.

LEGAL STANDARD

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A.

Standard For Determining Disability

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A person is “disabled” for purposes of receiving disability benefits and SSI if he or

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she is unable to engage in SGA due to a physical or mental impairment that has lasted for a

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continuous period of not less than twelve months. 42 U.S.C. § 423(d)(1)(A). The

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Commissioner is governed by a five-step sequential process when determining whether a

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claimant is disabled. 20 C.F.R. § 416.920(a)(4).2 At step one, the Commissioner evaluates

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whether the claimant has engaged in SGA since filing for benefits. § 404.1520(a)(4)(i). At

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step two, if the claimant has not engaged in SGA, the Commissioner determines whether the

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alleged impairment is sufficiently severe to limit the claimant’s ability to do basic work

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activities. § 404.1520(a)(4)(ii). Basic work activities are defined as the abilities and

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aptitudes necessary to do most jobs, such as walking, standing, sitting, and lifting.

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§§ 404.1521, 416.921.

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The ALJ deemed it unnecessary to address steps three through five. AR at 30.

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All citations to the Code of Federal Regulations are from Title 20.

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In steps one and two, which are at issue in this case, the burden is on the claimant to

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demonstrate a severe impairment and the inability to perform past work. Id. The claimant

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must provide medical evidence proving the impairment; the claimant’s own statement of

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symptoms alone will not suffice. §§ 404.1508, 416.908.

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B.

Judicial Review Of Commissioner’s Final Decision

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The district court “reviews the Commissioner’s final decision for substantial evidence,

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and the Commissioner’s decision will be disturbed only if it is not supported by substantial

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evidence or is based on legal error.” Hill v. Astrue, 698 F.3d 1153, 1158-59 (9th Cir. 2012)

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(citing 42 U.S.C. § 405(g)); see also Parra v. Astrue, 481 F.3d 742, 746 (9th Cir. 2007).

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“Substantial evidence” is more than a mere scintilla, but less than a preponderance. See

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Molina v. Astrue, 674 F.3d 1104, 1110-11 (9th Cir. 2012). It is “such relevant evidence as a

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

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402 U.S. 389, 401 (1971); Webb v. Barnhart, 433 F.3d 683, 686 (9th Cir. 2005). The court

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must consider the record as a whole, including both the evidence that supports and the

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evidence that detracts from the Commissioner’s conclusion. Frost v. Barnhart, 314 F.3d 359,

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367 (9th Cir. 2002) (citing Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985)).

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The court may not affirm the Commissioner’s decision “simply by isolating a specific

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quantum of supporting evidence.” Frost, 341 F.3d at 367. However, if substantial evidence

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supports the administrative findings, or if there is conflicting evidence supporting a particular

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finding, the Commissioner’s finding is conclusive. See Sprague v. Bowen, 812 F.2d 1226,

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1230 (9th Cir. 1987). Therefore, where the evidence is susceptible to more than one rational

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interpretation, one of which supports the Commissioner’s decision, the decision must be

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affirmed, and may be set aside only if an improper legal standard was applied in weighing the

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evidence. See Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002).

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1.

Relative Weight of Medical Opinions

In the Ninth Circuit, courts “distinguish among the opinions of three types of

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physicians: (1) those who treat the claimant (treating physicians); (2) those who examine but

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do not treat the claimant (examining physicians); and (3) those who neither examine nor treat
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the claimant (nonexamining physicians).” Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995).

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Generally, more weight is given to a treating physician’s opinion as to the nature and severity

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of a claimant’s impairment(s). § 416.927(c)(2); see Winans v. Bowen, 853 F.2d 643, 647

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(9th Cir. 1987). Nevertheless, a treating physician’s opinion is only regarded as controlling

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where it is “well-supported by medically acceptable clinical and laboratory diagnostic

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techniques and is not inconsistent with the other substantial evidence in [the] case record.” §

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416.927(c)(2). Where the treating doctor’s opinion is not contradicted by another doctor, it

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may be rejected only for “clear and convincing” reasons. Baxter v. Sullivan, 923 F.2d 1391,

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1396 (9th Cir. 1991). Even if the treating doctor’s opinion is contradicted by another

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doctor’s, the Commissioner may not reject the treating doctor’s opinion without providing

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“specific and legitimate” reasons supported by substantial evidence in the record. Chaudhry

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v. Astrue, 688 F.3d at 671.

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The opinion of an examining physician, in turn, is entitled to greater weight than the

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opinion of a nonexamining physician. Pitzer v. Sullivan, 908 F.2d 502, 506 (9th Cir. 1990);

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Gallant v. Heckler, 753 F.2d 1450 (9th Cir. 1984). The Commissioner must provide “clear

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and convincing” reasons for rejecting the uncontradicted opinion of an examining physician.

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Turner v. Comm’r of Soc. Sec., 613 F.3d 1217, 1222 (9th Cir. 2010); see also Pitzer, 908

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F.2d at 506. Even if controverted by another doctor, the opinion of an examining physician

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may only be rejected for “specific and legitimate” reasons that are supported by substantial

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evidence in the record. Turner, 613 F.3d at 1222; Andrews v. Shalala, 53 F.3d 1035, 1043

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(9th Cir. 1995).

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An ALJ is reasonably expected to give more weight to medical opinions that are
consistent with the record. See § 416.927(d)(4).

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2.

Credibility Determinations

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“[T]he ALJ can reject the claimant’s testimony about the severity of her symptoms

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only by offering specific, clear and convincing reasons for doing so.” Tommasetti v. Astrue,

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533 F.3d 1035, 1039 (9th Cir. 2008). When weighing a claimant’s credibility, the ALJ may

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consider “(1) ordinary techniques of credibility evaluation, such as the claimant’s reputation
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for lying, prior inconsistent statements concerning the symptoms, and other testimony by the

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claimant that appears less than candid; (2) unexplained or inadequately explained failure to

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seek treatment or to follow a prescribed course of treatment; and (3) the claimant’s daily

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activities.” Chaudhry v. Astrue, 688 F.3d 661, 672 (9th Cir. 2012) (quoting Tommasetti, 533

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F.3d at 1039). “If the ALJ’s [credibility] finding is supported by substantial evidence, the

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court may not engage in second-guessing.” Id.

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III.

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DISCUSSION
Sanford asserts that the Commissioner’s decision denying benefits should be vacated

and remanded because the ALJ improperly discounted the opinions of Dr. Lierberman, his

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treating physician, and Dr. Siekerkotte, his consultative internist, without substantial

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evidence. See Sanford Mot. at 7. The Commissioner responds that the ALJ’s decision

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denying benefits was properly supported by substantial evidence and should therefore be

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upheld. See generally Colvin Mot. The Court addresses Sanford’s argument as to each

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physician in turn.

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Sanford contends that the ALJ did not properly credit the medical opinions of his

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treating physician of twenty years, Dr. Lieberman, or his consultative examining physician,

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Dr. Siekerkotte. Sanford Mot. at 7-9. The Court finds that the ALJ provided “specific and

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legitimate” reasons supported by substantial evidence in the record for rejecting these

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treating and examining source opinions. Specifically, the opinions of Drs. Lieberman and

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Siekerkotte were contradicted by consultative examining psychologist, Dr. Sanders, and

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nonexamining state agency physicians, Drs. Kammen and Bonner, neither of whom found

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Sanford’s physical impairments to be severe. AR at 29.

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A.

The ALJ’s Rejection Of The Treating Physician’s Opinion Was Supported
by Substantial Evidence

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The ALJ provided “specific and legitimate” reasons for discounting Dr. Lieberman’s
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opinion about Sanford’s restricted range of activity. Dr. Lieberman’s treatment notes did not
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support his assessment of Sanford as capable of only a very restricted range of activity. AR
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at 29. The records indicated that he saw Sanford approximately once a year from 1986
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through 2006, during which time he treated Sanford for SLE and hypertension. Colvin Mot.

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at 2. However, the records showed no abnormal findings or significant problems; contained

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little, if any, discussion of pain or chronic headaches; and reported that Sanford’s lupus was

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stable. AR at 29. The inconsistency between Dr. Lieberman’s treatment notes and his

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opinion that Sanford would be significantly limited at work provided a legitimate reason for

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the ALJ to reject Dr. Lieberman’s opinion. See Batson v. Comm’r of Soc. Sec. Admin., 359

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F.3d 1190, 1195 n.3 (9th Cir. 2004) (holding that the ALJ properly rejected the treating

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source’s opinion because his “treatment notes do not provide objective medical evidence of

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the limitations asserted in his report”).

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Moreover, the ALJ concluded that Dr. Lieberman’s opinion was inconsistent with the

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record as a whole. All available evidence indicated that Sanford’s injuries were satisfactorily

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addressed with surgery in 1999. AR at 29. In fact, Sanford worked full-time at various jobs

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after 1999 and was medically cleared for work in 2006. Id. While Sanford alleged onset in

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January 2008, he did not see Dr. Lieberman at all that month, and Sanford took no

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medications other than aspirin for his high blood pressure. Id. at 26. Dr. Lieberman

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suggested that Sanford could not afford medication or more frequent checkups because he

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did not have a job, but even when working Sanford did not regularly visit Dr. Lieberman or

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take medication. Id. at 26. Dr. Lieberman believed Sanford to be capable of only a very

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restricted range of activity, yet Sanford admitted to CDI Special Agent Mackey in May 2009

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that he rode a bicycle three times per week for one mile at a time and that he could walk for

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one hour at a time. Id. at 28. Additionally, state agency physicians, Drs. Kammen and

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Bonner, found that Sanford’s physical impairments were not severe. Id. at 29. It was not

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unreasonable for the ALJ to discount Dr. Lieberman’s opinion in light of the other medical

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evidence, or to discount the parts of the opinion that were inconsistent with the record. See

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Andrews, 53 F.3d at 1041; see also Magallanes, 881 F.2d 747, 753 (9th Cir. 1989).

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Sanford asserts that his credibility and efforts to pursue a non-aggressive treatment

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plan should have no bearing on Dr. Lieberman’s opinion. Sanford Mot. at 9-10. First, the

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Ninth Circuit has held that evidence of conservative treatment is sufficient to discount a
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claimant’s testimony regarding severity of an impairment. See Meanel v. Apfel, 172 F.3d

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1111, 1114 (9th Cir. 1999) (rejecting subjective pain complaints where petitioner’s “claim

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that she experienced pain approaching the highest level imaginable was inconsistent with the

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minimal, conservative treatment that she received”) (internal quotation marks omitted).

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Further, “[i]f a claimant complains about disabling pain but fails to seek treatment, or fails to

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follow prescribed treatment, for the pain, an ALJ may use such failure as a basis for finding

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the complaint unjustified or exaggerated.” Chaudhry, 688 F.3d at 671 (quoting Orn v.

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Astrue, 495 F.3d 625, 638 (9th Cir. 2007)).
Second, an ALJ may reject a treating physician’s opinion if it is based “to a large

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extent” on a claimant’s self-reports that have been properly discounted as incredible.

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Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595, 602 (9th Cir. 1999) (citing Fair v.

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Bowen, 885 F.2d 597, 605 (9th Cir. 1989)). Here, the ALJ pointed to “specific, clear, and

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convincing” reasons for concluding that Sanford’s credibility was poor. See Tommasetti,

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533 F.3d at 1039; Thomas, 278 F.3d at 959.
Sanford, who worked part-time at two different jobs after his alleged onset date, AR at

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27, reported three different reasons for leaving his job delivering newspapers: He informed

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(1) Dr. Sanders, a consultative psychologist, that he quit to attend a funeral, id. at 263; (2) Dr.

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Siekerotte, a consultative internist, that he quit due to pain and joint swelling, id. at 269, and

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(3) Special Agent Mackey that he was laid off, id. at 292. In May 2009, Sanford also told

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Special Agent Mackey that he could walk unassisted for up to one hour a day, rode his bike

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three times a week for one mile at a time, and believed he could return to work as a medical

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assistant or phlebotomist. Id. At a psychological examination with Dr. Sanders, Sanford

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“may have attempted” to portray false limitations inconsistent with his background and work

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history. Id. at 27. And although Sanford never indicated to Dr. Sanders that he had suicidal

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thoughts, he claimed to have them just one month later. Finally, the CDI noted that Sanford

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had a criminal history of possession of marijuana and cocaine—contrary to his testimony that

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he never used drugs— as well as a history of filing false workers’ compensation claims. Id.

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at 28.
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A review of Dr. Lieberman’s records reveals that they largely reflect Sanford’s self-

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reports and directly contradict other evidence in the record. Thus, the ALJ’s adverse

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credibility determination supports her rejection of Dr. Lieberman’s opinion, which was

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primarily based on Sanford’s subjective comments concerning his condition. See, e.g.,

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Vargas v. Apfel, 211 F.3d 1276 (9th Cir. 2000) (finding that the ALJ provided specific

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reasons for discrediting claimant’s subjective symptom evidence when stating that claimant

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“only infrequently sought medical treatment for these symptoms, he received only minimal,

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conservative treatment for the pain, such as non-prescription-strength Tylenol, and he was

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able to walk and ride on his exercise bike regularly.”).
In sum, the ALJ provided specific and legitimate reasons for rejecting Dr.

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Lieberman’s opinion based on substantial evidence in the record. See Magallanes, 881 F.2d

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at 753.

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B.

The ALJ’s Rejection Of The Consultative Examiner’s Opinion Was
Supported By Substantial Evidence

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The ALJ also provided “specific and legitimate” reasons for discounting Dr.
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Siekerkotte’s opinion that Sanford had a restricted residual functional capacity. The Ninth
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Circuit has upheld the Commissioner’s decision to reject the opinion of a treating or
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examining physician based in part on the testimony of a nonexamining medical advisor. See
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Andrews, 53 F.3d at 1042-43 (upholding the ALJ’s rejection of an examining psychologist’s
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opinion where there was legitimate conflicting testimony between the examining
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psychologist and the nonexamining medical expert, and the ALJ pointed to “specific,
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legitimate reasons” in the record for doing so.); see also, e.g., Lester, 81 F.3d at 831;
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Magallanes, 881 F.2d at 751-55; Roberts v. Shalala, 66 F.3d 179 (9th Cir. 1995).
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Here, the ALJ found discrepancies in Dr. Siekerkotte’s examination report that were
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not adequately explained and drew objections from state agency medical consultants. AR at
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29. Although Sanford told Dr. Siekerkotte he had daily pain and swelling, he did not take
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any medications other than aspirin for his high blood pressure. Id. at 27. Sanford alleged he
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could not take off his shoes and socks at the examination, yet he appeared “rather muscular”
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and told Agent Mackey that he rode his bike three times a week. Id. at 28. Sanford also

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complained of hip pain, yet walked normally, and complained of suicidal thoughts, even

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though he had not reported any to the psychologist just one month earlier. Id. at 27.

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Although Dr. Siekerkotte concluded Sanford could walk and sit for only fifteen minutes at a

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time, Sanford’s statements to Agent Mackey, including that he believed he could work as a

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medical assistant or phlebotomist, contradicted this opinion. Id. at 28.

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Sanford argues that, in discounting Dr. Siekerkotte’s opinion, the ALJ failed to take

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into consideration the fact that Dr. Siekerkotte viewed him during a lupus flare-up. Sanford

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Mot. at 8. The record does not contain medical support for this argument, however. Sanford

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and the Commissioner disagree whether, and to what extent, the butterfly rash on Sanford’s

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face at the time of his examination indicated a flare-up.3 Id. Because“the ALJ is the final

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arbiter with respect to resolving ambiguities in the medical evidence,” Tommasetti, 533 F.3d

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at 1041-42, and may reject a medical opinion by giving specific, legitimate reasons based on

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substantial evidence, Andrews, 53 F.3d at 1043, Sanford’s argument that the ALJ improperly

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discounted Dr. Siekerkotte’s opinion lacks merit.

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Additionally, Sanford argues Dr. Siekerkotte’s opinion was bolstered by an

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addendum stating her belief that Sanford’s pain was genuine. Nevertheless, where “the ALJ’s

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[credibility] finding is supported by substantial evidence, the court may not engage in

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second-guessing.” Chaudhry, 688 F.3d at 672 ) (quoting Tommasetti, 533 F.3d at 1039).

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In sum, the Commissioner’s final decision in this case —that Sanford’s alleged

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impairment did not limit his ability to perform basic work-related activities and was thus not

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sufficiently severe—was based on substantial evidence of the record as a whole. See

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Tackett, 180 F.3d at 1097. Consequently, this Court may set aside the denial of benefits only

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if the Commissioner’s decision was based on legal error. See Thomas, 278 F.3d at 954. The

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The Commissioner argues that a butterfly rash is merely a sign of lupus, see Colvin’s Mot.
at 7, while Sanford contends that the rash is a sign of a flare-up (“The first sign of a flare is often the
. . . ‘butterfly’ rash . . .”), see Sanford Reply (dkt. 23) at 4.

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Court finds no such legal error. The ALJ provided “specific and legitimate” reasons

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supported by substantial evidence for discounting the opinions of Drs. Lieberman and

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Siekerkotte. See Magallanes, 881 F.2d at 753.

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IV.

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CONCLUSION
For the foregoing reasons, the Court DENIES Sanford’s motion for summary

judgment and GRANTS the Commissioner’s cross-motion for summary judgment.
IT IS SO ORDERED.

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Dated: October 15, 2013

_________________________________
CHARLES R. BREYER
UNITED STATES DISTRICT JUDGE

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