Keyser v. Commissioner Social Security Administration

Filing 18

Findings & Recommendation: Pursuant to sentence four of 42 USC § 405 (g), it is recommended that the decision of the Commissioner be affirmed. Objections to the Findings and Recommendation are due by 2/26/2010. If objections are filed, any res ponse to the objections are due within 17 days of service of the objections, see Federal Rules of Civil Procedure 72 and 6. Please access entire text by document number hyperlink. Ordered and Signed on 02/09/2010 by Magistrate Judge Mark D. Clarke. (rsm)

FILED~ 10FEB 09 08 :55uSIJc{i~tl

I N T H E UNITED STATES DISTRICT C O U R T F O R THE DISTRICT O F O R E G O N

PAMELA A N N K E Y S E R ,
C i v i l No. 0 8 - 1 2 6 8 - C L Plaintiff,

Report & R e c o m m e n d a t i o n
v.

M I C H A E L J. A S T R U E , Commissioner, Social S e c u r i t y Commission,
Defendant.

C L A R K E , M a g i s t r a t e Judge.
P l a i n t i f f P a m e l a A n n K e y s e r ("Plaintiff") b r i n g s t h i s a c t i o n p u r s u a n t to 4 2 U . S . C . §

4 0 5 ( g ) t o o b t a i n j u d i c i a l r e v i e w o f t h e C o m m i s s i o n e r ' s final d e c i s i o n d e n y i n g P l a i n t i f f ' s c l a i m for Social Security Disability Insurance ("SSD") benefits and Supplemental Security I n c o m e ("SSI") d i s a b i l i t y b e n e f i t s . F o r the s e v e r a l r e a s o n s s e t f o r t h b e l o w , t h e d e c i s i o n o f t h e C o m m i s s i o n e r s h o u l d b e affirmed.

Report & Recommendation - 1

I.

Background
P l a i n t i f f a l l e g e s d i s a b i l i t y b e g i n n i n g O c t o b e r 31, 2 0 0 5 , b a s e d o n c o m b i n e d i m p a i r m e n t s

including b u l l o u s emphysema, depression, anxiety, and b i p o l a r disorder. (Tr. 124.) P l a i n t i f f w a s b o r n i n 1957, a n d w a s 5 0 y e a r s o l d at t h e t i m e o f t h e A L l ' s d e c i s i o n . S h e a t t e n d e d s c h o o l t h r o u g h t h e t w e l f t h g r a d e b u t d i d n o t g r a d u a t e . (Tr. 2 6 ; P l . ' s B r . 2 . ) P l a i n t i f f s w o r k h i s t o r y i n c l u d e s a c a s h i e r , a p o s i t i o n at a f u r n i t u r e store, a n d a w a i t r e s s . M o s t recently s h e w a s employed as a cashier, a j o b w h i c h she held for approximately 15 years. ( T r . 11.) P l a i n t i f f l e f t t h i s p o s i t i o n o n O c t o b e r 3 1 , 2 0 0 5 , w h e n h e r l u n g c o l l a p s e d . O n J u l y 2 1 , 2 0 0 5 , a c h e s t x - r a y s h o w e d t h a t s h e h a d e m p h y s e m a t o u s l u n g d i s e a s e . (Tr. 12.) A f t e r h e r l u n g c o l l a p s e d t h a t O c t o b e r , s h e w a s a d m i t t e d t o t h e h o s p i t a l w i t h a s p o n t a n e o u s pneumothorax (collapsed lung) and released eight days later o n N o v e m b e r 8, 2005. W h i l e i n the hospital she h a d a thoracoscopic bleb resection performed. (Tr. 12.) P l a i n t i f f s surgeon Dr. E d w a r d B o y l e n o t e d a t d i s c h a r g e that h e r p a i n w a s w e l l controlled. H e r t r e a t i n g p h y s i c i a n D r . Knapp restricted h e r from working for four to six weeks. (Tr. 12.) In N o v e m b e r 2005, P l a i n t i f f saw Dr. Knapp and complained p r i m a r i l y o f anger a n d stress. Dr. K n a p p d i a g n o s e d h e r w i t h s i t u a t i o n a l s t r e s s a n d g e n e r a l i z e d a n x i e t y d i s o r d e r . ( T r . 12.) O n D e c e m b e r 5, 2005, he restricted h e r from w o r k for another four to six weeks. (Tr. 12.) Three days later, P l a i n t i f f returned to Dr. Knapp who then recommended a decrease i n h e r narcotic medication. H e also stated, "[Plaintiff] certainly should qualify for" disability benefits. (Tr. 12.) Dr. Bo y l e s a w P l a i n t i f f o n December 7, 2005, for post-operative treatment. H e believed t h a t h e r a n x i e t y w a s c a u s i n g m o r e d i f f i c u l t y for h e r t h a n t h e r e s i d u a l p a i n f r o m h e r N o v e m b e r Report & R e c o m m e n d a t i o n - 2

thoracoscopic procedure. (Tr 13.) He referred her to the pain management specialist Dr. Marc Jacobs. (Tr. 13.) Dr. Jacobs saw Plaintiff on January 11, 2006. He believed that she was a candidate for pulmonary rehabilitation. (Tr. 13.) P l a i n t i f f visited several physicians in early 2006. Dr. Knapp saw her o n January 18, 2 0 0 6 . H e r e p o r t e d t h a t she h a d a stable r i g h t l o w e r l o n g n o d u l e and d i d n o t h a v e a n y o t h e r increased problems. (Tr. 13.) On January 19, 2006, Dr. Maloney noted that she had h y p e r s e n s i t i v i t y a l o n g t h e r i g h t c h e s t wall, h e r o v e r a l l a c t i v i t y l e v e l w a s reduced, a n d s h e h a d restriction in trunk flexibility. She also noted that P l a i n t i f f had an altered mood state, characterized as depression and stress. (Tr. 13.) A month later, P l a i n t i f f reported to Dr. M a l o n e y that h e r pain had improved, and she changed medications. (Tr. 13.) On M a y 17, 2006, Kristy Keller, an adult nurse practitioner at Dr. Knapp's office, noted that P l a i n t i f f was doing well and that the pain medication was working. Plaintiff also reported that her medication for h e r anxiety symptoms was working well. (Tr. 13.) Several doctors opined on Plaintiffs ability to work. On M a y 1 8 , 2 0 0 6 , Dr. Jacobs wrote a letter to P l a i n t i f f s Social Security disability attorney. H e explained that Plaintiff had severe emphysema w i t h significant exercise limitation and that P l a i n t i f f would not b e able to w o r k in any kind o f strenuous activity. (Tr. 13.) Dr. Knapp also wrote a letter o n June 2, 2006, explaining that P l a i n t i f f could n o t perform any w o r k because o f h e r severe emphysema. He noted that she h a d to b e hospitalized to repair an area o f h e r l u n g a n d t h a t t h e r e w a s t h e p o s s i b i l i t y o f n e e d i n g s i m i l a r t r e a t m e n t o n o t h e r a r e a s o f her lungs. (Tr. 13.) Also that month, Dr. Knapp determined from a chest x-ray and e x a m that P l a i n t i f f s emphysema w a s clinically stable with no documented symptoms. (Tr. 14.) Report & R e c o m m e n d a t i o n - 3

On November 15, 2006, Dr. Knapp provided an additional letter to Plaintiffs attorney n o t i n g t h a t P l a i n t i f f w a s s u f f e r i n g from s e v e r e d e p r e s s i o n a n d g e n e r a l i z e d a n x i e t y d i s o r d e r w i t h panic attacks. (Tr. 14.) H e concluded that based o n her mental health conditions and her chronic obstructive pulmonary disease, "she is basically unable to work due to the combination o f these issues." (Tr. 14.) O n December 2 7 , 2 0 0 6 , Dr. Jacobs also provided an additional letter describing P l a i n t i f f s bullous emphysema. H e indicated that she was at risk for recurrent pneumothoraces based o n h e r persist bulbous emphysema: "Given the severity o f her buflous [sic] emphysema and her [prebronchodilator] F E V I o f 46% o f predicted, would recommend disability." (Tr. 14.) However, Dr. Jacobs noted in his examination report dated December 2 7 , 2 0 0 6 that P l a i n t i f f was doing reasonably well, and, though not working, she was singing. He explained that while she h a d some acute bronchodilator responsiveness she wanted to use a long-acting bronchodilator. A spirometry completed at the hospital o n the same date reflected that h e r postbronchodilator F E V I reading was 1.89L (72% predicted). (Tr. 14.)
I n April 2007, Dr. Knapp determined that P l a i n t i f f would benefit from a psychiatric

consultation: "Pam is losing weight and [is] severely psychologically stressed now." (Tr. 14.) P l a i n t i f f saw Dr. Monteverdi for four sessions from late M a y to August. He assessed P l a i n t i f f to have bipolar disorder w i t h some psychotic features along with some paranoid and schizotypal personality traits. (Tr. 15.) H e also learned that while living in Colorado she was first diagnosed with bipolar disorder. (Tr. 15.) H e r husband reported that this diagnosis was i n 1995. (Tr. 55.)
In M a y 2007, Dr. Monteverdi reported that she had varying moods, and her m o o d fluctuated for a

period o f a couple o f weeks to several months. He noted that in the past six months P l a i n t i f f h a d Report & Recommendation - 4

some expansive and irritable affect, some flight o f ideas, and a volatile mood. (Tr. 15; 314.) H e stated, "[i]t doesn't sound as though she has such profound depressive episodes but she o c c a s i o n a l l y w i l l g e t m i x e d e p i s o d e s a n d i t d o e s a p p e a r t h a t ' s w h a t ' s she's i n the m i d s t o f n o w a s she has some m i l d feelings o f hopelessness." (Tr. 15; 314.) She had a tangential thought process but did not have suicidal o r homicidal ideation. She admitted to intermittent auditory hallucinations in the p a s t b u t denied any command hallucinations. (Tr. 15; 314.) H e r global assessment score was between 55 to 65. (Tr. 15; 314.) Though medication and visits with Dr. Monteverdi appeared to help Plaintiff, this treatment was a financial strain for her, and she requested not to see h i m any more because o f the cost. (Tr. 320.) Dr. Monteverdi assessed that overall Plaintiff had maintained stable o n her medication and h e r bipolar disorder was in partial remission. (Tr. 321.) Dr. Monteverdi also completed a medical source statement in October 2007 although he was not treating h e r at that time. He noted that she had mild limitations with most functions, but h e did find moderate limitations in the following: ability to understand and remember detailed instructions, ability to maintain attention and concentration for extended periods, ability to i n t e r a c t a p p r o p r i a t e l y w i t h t h e general p u b l i c o r c u s t o m e r s , a c c e p t i n s t r u c t i o n s a n d r e s p o n d a p p r o p r i a t e l y t o c r i t i c i s m from s u p e r v i s o r s , g e t a l o n g w i t h c o - w o r k e r s , m a i n t a i n s o c i a l l y appropriate behavior, and respond to unexpected changes in the work place. (Tr. 16; 343-45.) B y June 2007, P l a i n t i f f s chest condition appeared to have stabilized. Dr. Jacobs reported o n June 21 that h e r emphysema was clinically stable. He noted that she was n o t getting regular at:robic activity, but she w a s not having increased breathlessness, chest pain, cough o r p h l e g m production. She continued to sing in a band. (Tr. 15.) Report & R e c o m m e n d a t i o n - 5

Plaintiffs administrative hearing was held October 30, 2007, before an Administrative L a w Judge ("ALJ"). P l a i n t i f f testified to her shortness o f breath and need for breaks and naps throughout the day. She testified that doing household chores makes her sore and though she w a s advised to wa l k as far as she can, she does not do this because o f shortness o f breath. (PI.'s Br. 2.) Three times a week she rehearses with a rock band. During the two-hour practice s::ssions, she takes at least three breaks. She testified that she sings to exercise her lungs. (Tr. 11,49.) P l a i n t i f f s h u s b a n d J o h n K e y s e r t e s t i f i e d a b o u t P l a i n t i f f s m e n t a l c o n d i t i o n . He r e p o r t e d t h a t e v e n b e f o r e h e r l u n g injury, s h e w a s h a v i n g p r o b l e m s w i t h d e p r e s s i o n a n d b i p o l a r d i s o r d e r . H e e x p l a i n e d t h a t t h o u g h P l a i n t i f f does p r a c t i c e w i t h a band, s h e h a s p r o b l e m s w i t h e n d u r a n c e that have reduced the number o f t i m e s she has played. (PI.'s Br. 3.) He also explained that due to exhaustion P l a i n t i f f is lying down 90 percent o f t h e time. (PI. 's Br. 4.) A vocational expert (VE) also testified at the hearing and explained that an individual w i t h limitations as described b y the ALJ could not perform P l a i n t i f f s past relevant work. (PI.'s
B r . 4.) She testified that P l a i n t i f f could perform at least two cashiering occupations that n u m b e r

about 1.2 million i n the national economy and 43,000 in the state o f Oregon. Accounting for a sit/stand option, the Oregon number is reduced to 12,696 positions. (Tr. 64.) T h e A L J i s s u e d h i s d e c i s i o n o n N o v e m b e r 3 0 , 2 0 0 7 , f i n d i n g P l a i n t i f f n o t disabled. T h e Appeals Council declined review o n August 28, 2008, making the A L l ' s decision the final order o f the agency. (PI.'s Br. 1-2.)

Report & Recommendation - 6

II.

Standards

This court must a f f i n n the Commissioner's decision i f it is based on the proper legal standards and the findings are supported b y substantial evidence in the record. Hammock v. Bowen, 879 F.2d 4 9 8 , 5 0 1 (9th Cir. 1989). Substantial evidence is "more than a mere scintilla.
I t means such relevant evidence as a reasonable mind might accept as adequate to support a

conclusion." Richardson v. Perales, 402 U.S. 3 8 9 , 4 0 1 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 1 9 7 , 2 2 9 (1938)). The court considers the record as a whole and weighs "both the evidence that supports and detracts from the [Commissioner's] conclusion." Martinez v. Heckler, 807 F.2d 771, 772 (9th Cir. 1986). Where the evidence is susceptible o f more than one rational interpretation, the Commissioner's conclusion must be upheld. Sample v. Sehweiker, 694 F.2d 6 3 9 , 6 4 2 (9th Cir. 1982). Questions o f credibility and resolution o f conflicts in the testimony are functions solely o f the Commissioner, Waters v. Gardner, 452 F.2d 8 5 5 , 8 5 8 n.7 (9th Cir. 1971), but any negative credibility findings must b e supported b y findings on the record and supported b y substantial evidence. Ceguerra v. Sec'y o f Health & Human Servs., 933 F.2d 735, 738 (9th Cir. 1991). The findings o f the Commissioner as to any fact, i f supported b y substantial evidence, shall b e conclusive. 42 U.S.C. § 405(g). However, even where findings are supported b y substantial evidence, "the decision should b e set aside i f the proper legal standards were not applied in weighing the evidence and making the decision." Flake v. Gardner, 399 F.2d 5 3 2 , 5 4 0 (9th Cir. 1968); see also Allen v. Heckler, 749 F.2d 577, 579 (9th Cir. 1984). Under sentence four o f 42 U.S.C. § 405(g), the court has the power to enter, u p o n t h e p l e a d i n g s a n d t r a n s c r i p t record, a j u d g m e n t a f f i n n i n g , m o d i f y i n g , o r r e v e r s i n g t h e decision o f the Commissioner, with or without remanding the case for a rehearing.
Rl~port

& Recommendation - 7

III.

Commissioner's Decision
The initial burden o f p r o o f rests upon the claimant to establish disability. Howard v.

Heckler, 782 P.2d 1484, 1486 (9th Cir. 1986). To meet this burden, a claimant must demonstrate an "inability to engage in any substantial gainful activity by reason o f any medically determinable physical o r mental impairment which can be expected to result in death o r which has lasted o r can b e expected to last for a continuous period o f not less than 12 months . . . . " 42 U . S . c . § 4 2 3 (d ) ( l )(A). A five-step sequential process exists for determining whether a person is disabled. B o w e n v. Yuckert, 482 U.S. 137, 140 (1987); 20 c . P . R . §§ 404.1520, 416.920.
I n step one, the Commissioner determines whether a claimant is engaged in "substantial

gainful activity." Yuckert, 482 U.S. at 140; 20 c . P . R . §§ 404. 1520(b), 416.920(b). I n the p r e s e n t c a s e , t h e A L J found t h a t P l a i n t i f f h a d n o t e n g a g e d i n s u b s t a n t i a l g a i n f u l a c t i v i t y s i n c e October 3 1 , 2 0 0 5 , the alleged onset date. (Tr. 10.)
I n s t e p t w o , t h e C o m m i s s i o n e r d e t e r m i n e s w h e t h e r the c l a i m a n t h a s a " m e d i c a l l y s e v e r e

impairment o r combination o f impairments." I f the Commissioner finds no medically severe impairment, the claimant is deemed not disabled. I f the Commissioner finds a severe impairment o r combination thereof, the inquiry moves to step three. Yuckert, 482 U.S. at 140-41; 20 C.P.R. §§ 404. 1520(c)), 416.920(c)). Here, the ALJ found that Plaintiff had a severe impairment o f emphysema and a non-severe impairment o f bipolar disorder in partial remission. (Tr. 10.) Accordingly, the inquiry moved to step three. S t e p t h r e e focuses o n w h e t h e r t h e i m p a i r m e n t o r c o m b i n a t i o n o f i m p a i r m e n t s m e e t s o r e q u a l s " o n e o f a n u m b e r o f l i s t e d i m p a i r m e n t s t h a t t h e [ C o m m i s s i o n e r ] a c k n o w l e d g e s are so Report & Recommendation - 8

s(~vere

as to preclude substantial gainful activity." Yuckert, 482 U.S. at 140-41; see 20 C.F.R. §§

404.1520(d), 416.920(d). I f so, the claimant is conclusively presumed disabled; i f not, the analysis proceeds to step four. Yuckert, 482 U.S. at 141. I n this case, the ALJ found that P l a i n t i f f d i d n o t h a v e an i m p a i r m e n t o r c o m b i n a t i o n o f i m p a i r m e n t s t h a t m e e t s o r e q u a l s o n e o f the listed impairments. (Tr. 11.)
I n step four, the Commissioner determines whether the claimant has the residual

functional capacity (RFC) to perform h e r "past relevant work." 20 C.F.R. § 404.1560(a). T h e RFC is based o n all relevant evidence i n the case record, including the treating physician's medical opinions about what an individual can still do despite impairments. S S R 96-8p. "Past relevant work" refers to work that "was done within the last 15 years, lasted long enough for [the claimant] to learn to do it, and was substantial gainful activity." 20 C.F.R. § 404. 1565(a). I t does n o t consider "off-and-on" work during that period. Id. I f she c a n p e r f o r m p a s t r e l e v a n t

work, t h e n the Commissioner finds the claimant "not disabled." I f the claimant cannot perform p a s t relevant work, the inquiry advances to step five. 20 C.F.R. §§ 404. 1520(e), 416.920(e). T h e A L J f o u n d t h a t P l a i n t i f f h a d t h e f o l l o w i n g e x e r t i o n a l and n o n e x e r t i o n a l l i m i t a t i o n s : the claimant has the residual functional capacity to lift, push, o r p u l l 10 p o u n d s frequently and 20 pounds maximum; she can sit, stand, o r w a l k up to six hours i n an eight h o u r w o r k day, though she m u s t be able to alternate b e t w e e n positions; s h e h a s n o p o s t u r a l o r c o m m u n i c a t i o n l i m i t a t i o n s ; she s h o u l d a v o i d e v e n moderate exposure to respiratory irritants, i.e. dust, fumes, o r gases; and she has n o m e n t a l limitations. (1'r. 11.) T h e A L J found that P l a i n t i f f could n o t perform any past relevant work. (Tr. 17.) I n step five, the burden is on the Commissioner to establish that the claimant is capable o f p e r f o r m i n g o t h e r w o r k t h a t e x i s t s i n t h e n a t i o n a l e c o n o m y . Y u c k e r t , 4 8 2 U . S . at 1 4 1 - 4 2 ; 2 0

Report & Recommendation - 9

C.F.R. §§ 404. 1520(f), 416.920(f). I f t h e Commissioner fails to meet this burden, then the claimant is deemed disabled. Here, the ALJ did find that Plaintiff had acquired skills from past relevant work as cashier o r checker that could transfer to further employment. For example, Plaintiff could perform this work o f checker o r cashier with a sit-stand option as described in the Dictionary o f Occupational Titles. (Tr. 17.) However, no specific findings as to skills and occupations were given. The ALJ determined that there are j o b s that exist in significant numbers in the national eeonomy that Plaintiff can perform. (Tr. 17-18.) The VE determined that an individual with P l a i n t i f f s limitations could perform the occupations o f cashier I and cashier II. She explained that there is an array o f cashier-checker positions and subclassifications. (Tr. 18.) The ALJ diet ermined that Plaintiff has not been under a disability from October 3 1 , 2 0 0 5 , through the date o f the decision, November 30, 2007.

IV.

The Commissioner's Decision Should Be Affirmed
Plaintiff asserts that the ALJ's decision should be reversed and remanded for benefits

because it is not supported b y substantial evidence and because it is based on the application o f improper legal standards. Plaintiff argues that: (1) (2) (3) (4) (5) (6) the ALJ improperly rejected treating physician opinions. the ALJ improperly rejected Plaintiffs testimony. the ALJ improperly rejected lay witness testimony. the ALJ improperly evaluated Plaintiffs mental impairments. the ALJ provided an inaccurate RFC and hypothetical question to the VE. the ALJ's Step 5 determination is not supported b y substantial evidence.

Report & Recommendation - 10

A.

T h e A L J Properly Rejected P l a i n t i f f s Treating Physicians' O p i n i o n s

P l a i n t i f f argues that the A L I erred when he rejected the opinions o f t r e a t i n g physicians Drs. J a c o b s , K n a p p , and M o n t e v e r d i . Controlling weight will b e given to a treating physician's opinion o n the issues o f the nature and severity o f a claimant's impairment(s) i f the opinion "is well-supported b y medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent w i t h the other substantial evidence" in the case record. 2 0 C.F.R. §§ 404. I 527(d)(2), 416.927(d)(2). "The treating physician's opinion is not, however, necessarily conclusive as to either a physical condition o r the ultimate issue o f disability." Magallanes v. Bowen, 881 F . 2 d 747, 751 (9th Cir. 1989) (citing Rodriguez v. Bowen, 876 F.2d 759, 761-62 & n.7 (9th Cir. 1989)); 2 0 C.F.R. §§ 404. 1527(e), 416.927(e); see also Montijo v. Secretary o f H H S , 729 F.2d 5 9 9 , 6 0 1 (9th Cir. 1984). I f the ALJ does not find that the treating physician's opinion warrants "controlling weight," under 2 0 C.F.R. §§ 404. 1527(d)(2), 416.927(d)(2), the ALJ evaluates several factors to determine the weight to give the opinion. These include (1) the length o f the treatment relationship and the frequency o f the examination, (2) the nature and extent o f t h e treatment relationship, (3) supportability o f the opinion w i t h evidence in the record, (4) consistency o f the opinion w i t h the record o n a whole, (5) the specialization o f t h e physician as it relates to the subject o f the opinion, and (6) other factors brought to the A L l ' s attention. 2 0 C.F.R. § 404.1527(d)(2)-(6). I f the ALJ chooses to disregard a treating physician's o r an examining p h y s i c i a n ' s o p i n i o n , a n d t h a t o p i n i o n i s n o t c o n t r a d i c t e d b y a n o t h e r doctor, h e m u s t s e t f o r t h c l e a r a n d Report & Recommendation - 11

convincing reasons for doing so. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995); Magallanes, 881 F . 2 d at 751; Gallant v. Heckler, 753 F.2d 1450, 1454 (9th Cir. 1984). I f a treating o r examining physician's opinion is contradicted b y that o f another doctor, the ALJ must set forth s p e c i f i c a n d l e g i t i m a t e reasons, b a s e d o n s u b s t a n t i a l e v i d e n c e i n t h e record, f o r d i s r e g a r d i n g t h e opinion o f t h e treating o r examining physician. Lester, 81 F.3d at 830-31; Nguyen v. Chater, 100 F . 3 d 1462, 1466, (9th Cir. 1996). The ALJ can meet this burden by setting out a detailed and thorough summary o f the facts and conflicting medical evidence, then stating his interpretation, and lastly making findings. Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir. 1986); Rodriguez, 876 F . 2 d at 762. "The opinion o f a nonexamining physician cannot b y i t s e l f constitute s u b s t a n t i a l e v i d e n c e t h a t j u s t i f i e s the r e j e c t i o n o f t h e o p i n i o n o f e i t h e r a n e x a m i n i n g p h y s i c i a n o r a treating physician." Lester, 81 F. 3d at 831.
1.

Dr. Jacobs

The ALJ rejected Dr. Jacobs's recommendation o f disability, and P l a i n t i f f argues several reasons for error. First, she argues that the ALJ improperly substituted his opinion for Dr. Jacobs's expert opinion; second, that the ALJ had a duty to expand the record; and third that the ALJ's conclusion regarding her future visits "misses the point." (Pl.'s Br. 12.) T h e court disagrees with P l a i n t i f f s reasons for error. The ALJ has provided clear and convincing evidence for rejecting Dr. Jacobs's opinion. As he presented in his decision, the ALJ did n o t find that Dr. Jacobs's opinion was well-supported b y the record, and h e found it to b e inconsistent w i t h other evidence in the record. See 2 0 C.F.R. § 404. 1527(d)(2). The A L J explained the conflicting medical evidence that led to his conclusion. As the court explained i n Bayliss v. Barnhart, such a contradiction suffices as clear and convincing Report & Recommendation - 12

evidence: "[ s] u c h a discrepancy is a clear and convincing reason for not relying o n t h e doctor's o p i n i o n r e g a r d i n g B a y l i s s ' s l i m i t e d a b i l i t y to s t a n d a n d w a l k . . . . T h e A L J ' s r e j e c t i o n o f D r . T o b i n ' s o p i n i o n is s u p p o r t e d b y s u b s t a n t i a l e v i d e n c e a n d w a s b a s e d o n a p e r m i s s i b l e determination w i t h i n the ALJ's province." 427 F.3d 1211, 1216 (9th Cir. 2005). T h e A L J found it inconsistent for Dr. Jacobs to write i n the December 27, 2 0 0 6 letter that h e r e c o m m e n d e d d i s a b i l i t y b u t t h e n n o t e d i n h i s e x a m i n a t i o n r e p o r t , a l s o d a t e d o n D e c e m b e r 27, 2006, t h a t c l a i m a n t w a s "doing reasonably w e l l w i t h o u t any increasing breathlessness o r c h e s t p a i n . " (Tr. 1 4 . ) T h e A L J a l s o n o t e d t h a t t h e p o s t - b r o n c h o d i l a t o r r e s u l t s t h a t w e r e m o r e p o s i t i v e o f P l a i n t i f f s b r e a t h i n g c a p a b i l i t i e s w e r e n o t d i s c u s s e d i n t h e letter. S p e c i f i c a l l y , h e r p r e b r o n c h o d i l a t o r F E V I reading was 4 6 % o f predicted while h e r post-bronchodilator F E V l w a s 7 2 % o f p r e d i c t e d . T h e A L J also f o u n d i t s u s p e c t t h a t P l a i n t i f f " d i d n o t r e p o r t d e t e r i o r a t i o n related to h e r l u n g condition o r other related symptoms at future visits." (Tr. 14.) T h e A L J has r e j e c t e d D r . J a c o b s ' s o p i n i o n o f P l a i n t i f f s d i s a b i l i t y b e c a u s e h e f o u n d i t c o n t r a d i c t o r y to t h e o t h e r evidence, a n d this is entirely within his province as an ALJ. F u r t h e r , t h e r e w a s n o d u t y to d e v e l o p t h e r e c o r d . " A n A L J ' s d u t y to d e v e l o p t h e r e c o r d f u r t h e r i s t r i g g e r e d o n l y w h e n t h e r e is a m b i g u o u s e v i d e n c e o r w h e n t h e r e c o r d i s i n a d e q u a t e t o allow for p r o p e r evaluation o f t h e evidence." Mayes v. Massanari, 276 F . 3 d 4 5 3 , 4 5 9 - 6 0 , ( 9 t h CJlr. 2001); citing Tonapetyan v. Halter, 242 F.3d 1444, 1150 (9th Cir. 2001). H e r e , P l a i n t i f f a r g u e s t h a t t h e d u t y is t r i g g e r e d b e c a u s e t h e A L J r e f e r e n c e d t h e l a c k o f r e p o r t e d d e t e r i o r a t i o n i n P l a i n t i f f s future m e d i c a l records. F r o m t h e d e c i s i o n , i t i s c l e a r t h a t t h e

A U f o u n d t h e l a c k o f d e t e r i o r a t i o n to b e e v i d e n c e o f P l a i n t i f f s c o n d i t i o n . H i s s t a t e m e n t d o e s
not s u g g e s t t h a t t h e r e c o r d w a s i n a d e q u a t e b u t t h a t P l a i n t i f f s l u n g c o n d i t i o n w a s n o t w o r s e n i n g . Report & R e c o m m e n d a t i o n - 13

(Tr. 14.) P l a i n t i f f s argument that the ALJ has "miss[ ed] the point" is also unpersuasive. She states with no case authority, "[i]t is Dr. Jacobs's opinion that Plaintiff is disabled based o n the condition she h a d at the time o f his report. The fact that Plaintiff did not report a deterioration at future visits merely reflects that her disability continued without further deterioration." (Pl.s' Br. 12.) However, as previously discussed, the ALJ's role is to resolve conflicts in the testimony. While the P l a i n t i f f m a y offer her own interpretation o f the medical evidence, so long as the A L l ' s interpretation is rational, his will be upheld. Given the discrepancies and contradictions i n the record, it was rational for the ALJ to conclude Dr. Jacobs's recommendation disability to b e unsubstantiated.

2.

Dr. Knapp

The ALJ termed Dr. Knapp's assessment that Plaintiff was unable to work to b e "unpersuasive." (Tr. 14.) Dr. Knapp stated in his November 15, 2006 letter to P l a i n t i f f s

attorney: "[Plaintiff] is suffering from severe depression and generalized anxiety disorder, w i t h p a n i c a t t a c k s . S h e also h a s d e f i n i t e c h r o n i c o b s t r u c t i v e p u l m o n a r y d i s e a s e o r e m p h y s e m a . S h e is basically unable to w o r k due to the combination o f these issues." (Tr. 307.) Like Dr. Jacobs, he also stated that P l a i n t i f f should qualify for disability. (Tr. 12.) The ALJ rejected Dr. Knapp's conclusion and noted that Dr. Knapp was not a mental health professional; there were no treating records for emphysema referring to symptoms o r clinical findings since M a y 2007; and Dr. Knapp has not provided any functional restrictions that could b e understood to support his b e l i e f that P l a i n t i f f is unable to work. (Tr. 14.) The ALJ concluded, "Dr. Knapp offered no medical rationale for such opinion, nor is there any indication Report & Recommendation - 14

that he understands the eligibility requirements for establishing entitlement to disability benefits." (Tr. 13.) P l a i n t i f f objects to the A L l ' s conclusion arguing the ALJ had a duty to develop the record, h e unfairly substituted his opinion for Dr. Knapp's, and he wrongly rejected Dr. Knapp's opinion because he is not a mental health professional. (Tr. 14-15.) The ALJ's reasons for rejecting Dr. Knapp's opinion do not contravene circuit precedent o r S S A regulations, as Plaintiff claims. She has not shown that the record was inadequate o r ambiguous. B y noting that there were no medical records to support Dr. Knapp's November 15, 2006 letter, the ALJ was explaining how Dr. Knapp's opinion was not supported b y the evidence. See 20 C.F.R. § 404. 1527(d)(2). Further the ALJ was not substituting his opinion for Dr. Knapp's; he was resolving w h at he saw as a conflict in the testimony. He explained that Dr. Knapp's opinion contradicted other e v i d e n c e i n t h e r e c o r d , s p e c i f i c a l l y t h a t x-rays s h o w e d P l a i n t i f f s e m p h y s e m a w a s c l i n i c a l l y stable in June 2006. (Tr. 14.) He stressed that mere speculation o f what could happen is n o t enough for disability. He referenced Dr. Knapp's June 2, 2006 letter in which h e wrote, "[w ]hile she continued to recover [from a surgical procedure to repair a ruptured area o f her lung], she has been discovered to have several other spots that could do the same thing and require h e r to have other treatment." (Tr. 13; 306.) Lastly, the ALJ is permitted to evaluate the specialization o f the treating professional i n his decision o f h o w much weight to apply to treating physician opinions. 20 C.F.R. § 404.1 527(d)(2)-(6). When a physician treats a claimant for her psychiatric impairment, s u c h as a p r e s c r i p t i o n f o r a p s y c h o t r o p i c m e d i c a t i o n , "his o p i n i o n c o n s t i t u t e s c o m p e t e n t p s y c h i a t r i c

Report & Recommendation - 15

evidence and m a y not be discredited o n the ground that he is not a board certified psychiatrist." Lester, 81 F.3d at 833. Here, P l a i n t i f f argues the ALI erred b y discrediting Dr. Knapp's opinion because h e is not a mental health specialist. Dr. Knapp treated P l a i n t i f f for her mental health conditions and prescribed medication. (Tr. 224.) The A L I did point out that Dr. Knapp is not a mental health professional in his opinion, but that is not the only reason for rejecting his opinion. There were clear and convincing reasons to reject Dr. Knapp's opinion, even excluding the ALI's improper c o m m e n t t h a t h e w a s n o t a m e n t a l h e a l t h specialist. T h e A L I p r o p e r l y r e j e c t e d h i s o p i n i o n .

3.

Dr. Monteverdi

Dr. Monteverdi concluded in his October 2 9 , 2 0 0 7 medical source statement that P l a i n t i f f had moderate limitations i n several areas: t h e a b i l i t y t o u n d e r s t a n d and r e m e m b e r d e t a i l e d instructions; t h e a b i l i t y t o maintain attention and concentration for extended periods; the ability to maintain attention and concentration for extended periods; the ability to interact a p p r o p r i a t e l y w i t h the g e n e r a l p u b l i c o r c u s t o m e r s ; a c c e p t i n s t r u c t i o n s a n d respond appropriately to criticism from supervisors; get along w i t h co-workers; maintain socially appropriate behavior; and respond to unexpected changes in the workplace. (Tr. 16; 343-45.) The A L I rejected this opinion because he found no medical rationale from Dr. M o n t e v e r d i e x p l a i n i n g t h e functional l i m i t a t i o n s . H e c o m p l e t e d a c h e c k - t h e - b o x f o r m b u t provided no further explanations. (Tr. 16.) I n Crane v. Shalala, the A L I rejected the check-theb o x d i a g n o s i s b e c a u s e t h e diagnosis did n o t i n c l u d e e x p l a n a t i o n s and t h e r e w a s i n s u f f i c i e n t evidence o f the impairment during the first year o f t h e alleged onset date. 76 F.3d 2 5 1 , 2 5 3 (9th Cir. 1996). Report & Recommendation - 16

In rejecting the opinion, the ALJ noted Dr. Monteverdi's short treatment history w i t h

Plaintiff. P l a i n t i f f saw Dr. Monteverdi for the first time in April 2007 and b y August 2007 she had requested to cease treatment because o f the expense. I t was 2 months after Dr. Monteverdi discontinued care that he completed the assessment at issue here. Using this as a factor in his conclusion o f h o w to treat Dr. Monteverdi's testimony is consistent with S S A regulations. See 2 0 C.F.R. § 404. 1527(d)(2)-(6) (noting length o f treatment as a factor to determine weight). F u r t h e r , t h e A L J e x p l a i n e d that t h e r e w e r e o t h e r i n c o n s i s t e n c i e s a m o n g t h e f u n c t i o n a l limitations, his treatment notes, and the other evidence in the record. She had a successful work h i s t o r y d e s p i t e n e a r l y a d e c a d e - o l d b i p o l a r diagnosis. H e r doctors h a d n o t e d t h a t s h e r e s p o n d e d well to medication, and Dr. Monteverdi assessed that overall the claimant had been stable o n Zyprexz and h e r bipolar disorder was in partial remission. (Tr. 16.) The court sees nothing irrational in the ALJ's reliance o n these records to base his opinion. The A L J properly rejected Dr. Monteverdi's opinion.

B.

The A L J Properly Rejected Plaintifrs Testimony

T h e A L J found t h a t P l a i n t i f f s c r e d i b i l i t y w a s u n d e r m i n e d b e c a u s e h e r t e s t i m o n y o f d i s a b i l i t y w a s i n c o n s i s t e n t w i t h h e r t e s t i m o n y o f d a i l y activities. P l a i n t i f f d i s a g r e e s , a r g u i n g t h a t her activities and testimony were not inconsistent and her activities do n o t transfer to a w o r k setting. (Pl.'s Br. 20-21.)
I n r e j e c t i n g t h e c l a i m a n t ' s testimony, t h e C o m m i s s i o n e r m u s t p e r f o r m a t w o s t a g e

analysis o f claimant's evidence. Smolen v. Chater, 80 F.3d 1273, 1281 (9 th Cir. 1996); see also Cotton v. Bowen, 799 F.2d 1403 (9th Cir. 1986). First, the A L I must determine that the claimant has m e t t h e t h r e s h o l d t e s t o f p r o d u c i n g o b j e c t i v e m e d i c a l e v i d e n c e o f a n u n d e r l y i n g i m p a i r m e n t Report & Recommendation - 17

that could reasonably b e expected to produce the pain o r other symptoms alleged. Smolen, 80 F.3d at 1281. There must be no evidence o f malingering. Id. Under the second part o f the analysis, the Commissioner analyzes the credibility o f the claimant's testimony regarding the severity o f claimant's symptoms. Smolen, 80 F.3d at 1281. T h e C o m m i s s i o n e r c a n r e j e c t a claimant's symptom t e s t i m o n y o n l y i f h e p r o v i d e s c l e a r a n d convincing reasons for doing so and makes specific findings. Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993). General findings are insufficient; rather, the A L I must identify w h a t t e s t i m o n y i s n o t c r e d i b l e and w h a t e v i d e n c e suggests t h a t t h e t e s t i m o n y i s n o t credible. R e d d i c k v. Chater, 157 F . 3 d 715, 722 (9th Cir. 1998). The Commissioner cannot reject a claimant's symptom testimony solely because it is not fully corroborated b y objective medical findings. Cotton, 799 F.2d 1403.
I n d e t e r m i n i n g a claimant's credibility the C o m m i s s i o n e r m a y c o n s i d e r

(1) ordinary techniques o f credibility evaluation, such as the claimant's reputation for lying, prior inconsistent statements concerning the symptoms, and other testimony b y the claimant that appears less than candid; (2) unexplained o r inadequately explained failure to seek treatment o r to follow a prescribed course o f t r e a t m e n t ; and (3) the claimant's daily activities . . . . I n evaluating the credibility o f the symptom testimony, the A L I must also consider the factors set out i n S S R 88-13 . . . . Those factors include the claimant's work record and observations o f t r e a t i n g a n d e x a m i n i n g physicians and o t h e r t h i r d p a r t i e s regarding, a m o n g o t h e r m a t t e r s , t h e n a t u r e , o n s e t , duration, a n d frequency o f t h e c l a i m a n t ' s s y m p t o m s ; precipitating and aggravating factors; functional restrictions caused b y the s y m p t o m s ; a n d t h e c l a i m a n t ' s d a i l y activities. Smolen, 80 F . 3 d at 1284. While a claimant need not b e "utterly incapacitated to b e eligible for benefits," F a i r v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989), daily activities may undermine her credibility. T h e N i n t h C i r c u i t h a s r e c o g n i z e d t w o i n s t a n c e s in w h i c h d a i l y a c t i v i t i e s p l a y e d a r o l e i n t h e Report & Recommendation - 18

credibility d e t e n n i n a t i o n : (1) w h e n the claimant is able to spend a substantial part o f h e r d a y engaging i n activities that involve physical functions that are transferrable to a w o r k setting o r (2) w h e n the t e s t i m o n y about daily activities contradicts o t h e r testimony. O m v. Astrue, 495 F . 3 d 6 2 5 , 6 3 9 ( 9 t h Cir. 2 0 0 7 ) . The N i n t h Circuit explained that the A L l m u s t identify "what t e s t i m o n y is not credible a n d w h a t evidence u n d e n n i n e s the claimant's complaints." Lester, 81 F.3d at 834. O n c e that determination is made, t h e court defers to the A L l . " I f an A L l explicitly discredits t h e claimant's testimony and gives g o o d reason for doing so, w e will normally defer to the A L l ' s credibility determination." Gregg v. Barnhart, 354 F.3d 710, 714 (8th Cir. 2003). " W h e n evidence r e a s o n a b l y s u p p o r t s e i t h e r c o n f i r m i n g o r r e v e r s i n g t h e A L l ' s decision, w e m a y n o t s u b s t i t u t e o u r j u d g m e n t for t h a t o f t h e A L l . " Batson v. Barnhart, 359 F.3d 1190, 1195 (9th Cir. 2004). In Rollins v. Massanari, the court found that the A L l had provided c l e a r a n d c o n v i n c i n g e v i d e n c e to r e j e c t t h e c l a i m a n t ' s t e s t i m o n y . H e n o t e d t h e i n c o n s i s t e n c i e s b e t w e e n t h e t e s t i m o n y a n d d a i l y a c t i v i t i e s , a n d e x p l a i n e d h o w t h e p l a i n t i f f s c l a i m "to h a v e t o t a l l y d i s a b l i n g p a i n w a s u n d e r m i n e d b y h e r o w n testimony about her daily activities, such as attending to t h e n e e d s o f her t w o y o u n g c h i l d r e n , c o o k i n g , housekeeping, laundry, s h o p p i n g , a t t e n d i n g t h e r a p y a n d v a r i o u s other meetings e v e r y week, a n d so forth." 261 F . 3 d 8 5 3 , 8 5 7 (9th Cir. 2001). T h e c o u r t u l t i m a t e l y d e f e r r e d t o t h e A L l : "the A L l ' s i n t e r p r e t a t i o n o f [ p l a i n t i f f s ] t e s t i m o n y m a y n o t b e t h e o n l y reasonable one. But, it is still a reasonable interpretation and is supported b y substantial evidence; thus it is n o t o u r role to second-guess it." Id. (citing Fair, 885 F . 2 d at 604). H e r e , P l a i n t i f f a l l e g e s d i s a b i l i t y b a s e d o n e m p h y s e m a , d e p r e s s i o n , s t r e s s , c o l l a p s e d lung, and chronic o b s t r u c t i v e p u l m o n a r y disease (COPD). (Tr. 124.) She c l a i m e d that these Report & R e c o m m e n d a t i o n - 19

conditions precluded h e r from working: "[I] cannot stand for any length o f t i m e , m y ability to breath[ e] is poor. 1 can't lift anything more than few pounds, m y depression makes it difficult to d e a l w i t h p e o p l e . " (Tr. 1 2 4 . ) H o w e v e r , P l a i n t i f f a l s o t e s t i f i e d t h a t s h e p r a c t i c e s w i t h a b a n d t h r e e t i m e s a w e e k to e x e r c i s e h e r lungs. S h e a l s o s h o p s o c c a s i o n a l l y w i t h h e r h u s b a n d a n d d o e s some h o u s e w o r k and cooking. (Tr. 12.) T h e A L J c o n c l u d e d t h a t h e r activities w e r e i n c o n s i s t e n t w i t h h e r testimony. S p e c i f i c a l l y , i t is i n c o n s i s t e n t f o r P l a i n t i f f t o a s s e r t t h a t s h e is u n a b l e t o s t a n d f o r a n y p e r i o d o f t i m e a n d y e t practice w i t h a b a n d three times a week. (Tr. 16.) P l a i n t i f f argues that h e r activities do n o t s h o w t h a t s h e is a b l e t o w o r k . S h e q u a l i f i e s t h a t s i n g i n g e x e r c i s e s h e r l u n g s a n d s h e t a k e s m a n y b r e a k s through the rehearsals. (Tr. 57.) She points out that h e r husband testified that after h e r l u n g i n j u r y s h e h a s p r o b l e m s w i t h e n d u r a n c e a n d n e e d s to r e s t e v e r y t e n o r f i f t e e n m i n u t e s to a v o i d g e t t i n g sore. ( P l . ' s Br. 4 . ) T h e r e i s e v i d e n c e o n b o t h s i d e s o f t h e c r e d i b i l i t y issue. T h e c o u r t c a n s e e w h y t h e A L J found P l a i n t i f f s daily activities to b e inconsistent w i t h h e r testimony. In this case, as i n R o l l i n s discussed above, there m a y b e m o r e t h a n one rational interpretation. See 261 F . 3 d at 857. T h e A L l ' s c o n c l u s i o n t h a t " h e r c r e d i b i l i t y i s u n d e r m i n e d b y t h e fact t h a t s h e e n g a g e s r e g u l a r l y i n singing a n d participation i n a b a n d o n average three times a week" (tr. 16) is rational, a n d t h e c o u r t d e f e r s t o t h e ALJ.
C.

T h e A L J Properly Rejected L a y Witness T e s t i m o n y

P l a i n t i f f a r g u e s t h a t t h e A L J e r r e d b y n o t i n c l u d i n g l a y w i t n e s s Mr. K e y s e r ' s l i m i t a t i o n s into t h e R F C . D e f e n d a n t asserts t h a t t h e s e l i m i t a t i o n s w e r e p r o p e r l y rejected. T h e C o m m i s s i o n e r w i l l c o n s i d e r n o n - m e d i c a l s o u r c e s to e v a l u a t e t h e s e v e r i t y o f t h e Report & R e c o m m e n d a t i o n - 20

impainnent, s u c h as t e s t i m o n y from spouses and o t h e r family members. 2 0 C.F.R. § 404. 1513(d)(4). W h e n t h e c l a i m a n t i n d i c a t e s t h a t p a i n is a s i g n i f i c a n t f a c t o r o f h i s / h e r a l l e g e d inability to w o r k , a n d the allegation is not s u p p o r t e d b y objective medical e v i d e n c e i n t h e file, t h e a d j u d i c a t o r s h a l l o b t a i n d e t a i l e d d e s c r i p t i o n s o f d a i l y a c t i v i t i e s b y d i r e c t i n g s p e c i f i c i n q u i r i e s a b o u t t h e p a i n a n d its effects to t h e c l a i m a n t , h i s / h e r p h y s i c i a n s f r o m w h o m m e d i c a l e v i d e n c e is b e i n g r e q u e s t e d , a n d o t h e r third p a r t i e s w h o w o u l d b e likely to h a v e such knowledge. S S R 8 8 - 1 3 a t *3. " L a y t e s t i m o n y as t o a c l a i m a n t ' s s y m p t o m s is c o m p e t e n t e v i d e n c e t h a t a n A L J m u s t t a k e i n t o a c c o u n t , u n l e s s h e o r s h e e x p r e s s l y d e t e n n i n e s to d i s r e g a r d s u c h t e s t i m o n y a n d g i v e s r e a s o n s g e n n a n e to e a c h w i t n e s s for doing so." Lewis v. Apfel, 236 F . 3 d 5 0 3 , 5 1 1 (9th Cir. 2 0 0 1 ) ( c i t i n g N g u y e n , 1 0 0 F . 3 d at 1467. I n e v a l u a t i n g l a y w i t n e s s o p i n i o n s , " i t w o u l d b e a p p r o p r i a t e to c o n s i d e r s u c h f a c t o r s as t h e n a t u r e a n d e x t e n t o f t h e r e l a t i o n s h i p , w h e t h e r t h e e v i d e n c e i s c o n s i s t e n t w i t h o t h e r evidence, and any other factors t h a t t e n d to support o r refute t h e evidence." S S R 0 6 - 0 3 p a t *6. I n G r e g e r v. B a r n h a r t , the court a f f i n n e d the ALJ's decision to reject l a y w i t n e s s testimony. T h e A L J c o n c l u d e d that the witness s t a t e m e n t s w e r e i n c o n s i s t e n t w i t h c l a i m a n t ' s p r e s e n t a t i o n s to h i s d o c t o r s a n d n o t e d t h e w i t n e s s ' s " c l o s e r e l a t i o n s h i p , " w h i c h m a y h a v e i n f l u e n c e d h e r d e s i r e to h e l p t h e c l a i m a n t . T h e c o u r t c o n c l u d e d , " [ t ] h e A L J ' s r e a s o n s f o r d o u b t i n g [ t h e w i t n e s s ' s ] c r e d i b i l i t y a r e g e n n a n e t o her; a c c o r d i n g l y , i t w a s n o t e r r o r f o r t h e A L J t o d i s r e g a r d h e r t e s t i m o n y . " 4 6 4 F . 3 d 9 6 8 , 972 ( 9 t h C i r . 2 0 0 6 ) . H e r e , t h e A L J c o n c l u d e d , "Mr. K e y s e r ' s r e p o r t i n g i s c r e d i b l e b u t d o e s n o t c h a n g e t h e c o n c l u s i o n t h a t t h e c l a i m a n t i s c a p a b l e o f r e t u r n i n g t o w o r k . " (Tr. 1 7 . ) I n c o m i n g t o h i s d e c i s i o n ,

R e p o r t & R e c o m m e n d a t i o n - 21

the A L I explained that medical records did not support the claim that h e r conditions precluded work. H e r e f e r e n c e d m e d i c a l records t h a t s h o w h e r lung c o n d i t i o n w a s s t a b l e a n d t h a t s h e w a s able to work. (Tr. 15-17.) P l a i n t i f f argued t h a t " [b ]ecause the A L I found Mr. Keyser's testimony to b e credible, the l i m i t a t i o n s h e i d e n t i f i e d s h o u l d h a v e b e e n i n c o r p o r a t e d i n t o t h e A L l ' s R F C finding." ( P l . ' s R e p l y 7.) However, j u s t because the A L I believes the witness to be honest and truthful does n o t m a k e t h e w i t n e s s ' s t e s t i m o n y c o m p e t e n t evidence. The A L I m a y evaluate several factors, one o f which is whether the evidence is consistent w i t h other evidence. See S S R 06-03p at *6. As previously discussed, the A L I found that P l a i n t i f f s daily activities were inconsistent with her claimed abilities. Mr. Keyser's testimony that his wife is "horizontal" o r on h e r back 90% o f the time is also inconsistent with h e r activities and the medical evidence. (Tr. 57.) See Part IV.A. The A L I gave germane reasons for rejecting Mr. Keyser's testimony. There was no error.

D.

The ALJ Properly Evaluated Plaintiffs Mental Impairments

P l a i n t i f f a r g u e s t h a t t h e A L l ' s d e c i s i o n r e g a r d i n g h e r m e n t a l i m p a i r m e n t s i s i n error. F i r s t , s h e a r g u e s t h a t t h e A L I d i d n o t follow t h e a p p r o p r i a t e p r o c e d u r e s i n a s s e s s i n g h e r m e n t a l i m p a i r m e n t . S e c o n d , s h e argues that t h e A L I d i d n o t p r o p e r l y c o n s i d e r w h e t h e r h e r i m p a i r m e n t s o r c o m b i n e d i m p a i r m e n t s m e e t o r m e d i c a l l y equal o n e o f t h e l i s t e d i m p a i r m e n t s . ( p l . ' s Br. 9 . )
1.

P l a i n t i f f s Mental Impairments

A n A L I m u s t follow the technique set out in 20 C.F.R. § 4 0 4 . l 5 2 0 a to evaluate the severity o f a mental impairment. The degree o f functional limitation is rated i n four areas: a c t i v i t i e s o f d a i l y l i v i n g ; s o c i a l functioning; c o n c e n t r a t i o n , p e r s i s t e n c e a n d p a c e ; a n d e p i s o d e s o f

Report & R e c o m m e n d a t i o n - 22

decompensation. 20 C.F.R. § 404. 1520a(c)(3). SSA regulations explain, t h e w r i t t e n d e c i s i o n m u s t i n c o r p o r a t e t h e p e r t i n e n t findings a n d c o n c l u s i o n s b a s e d o n the t e c h n i q u e . T h e d e c i s i o n m u s t s h o w the s i g n i f i c a n t h i s t o r y , i n c l u d i n g e x a m i n a t i o n a n d l a b o r a t o r y f i n d i n g s a n d the f u n c t i o n a l l i m i t a t i o n s t h a t w e r e c o n s i d e r e d i n r e a c h i n g a c o n c l u s i o n a b o u t the s e v e r i t y o f t h e m e n t a l i m p a i r m e n t s . 2 0 C.F.R. § 404. 1520a(e)(2). P l a i n t i f f argues that the A L l ' s step two finding is in error because the ALJ did not following this technique. First, P l a i n t i f f argues there is error because the ALJ did not mention o r discuss the four broad functional areas and instead only provided a summary. (Pl.'s Br. 8.) Second, she essentially argues that it was in error to use the state agency assessment as a basis for this opinion because it pre-dates other available mental health records. (Pl.'s Br. 8.) Lastly, she finds fault with the A L l ' s purported standard o f a "longitudinal history documenting significant limitations o n her ability to work caused b y the bipolar disorder." (Tr. 11). Though the ALJ did not detail his ratings o f the four functional areas in his findings, he s u f f i c i e n t l y a d d r e s s e d t h e ratings b y incorporating b y reference t h e state agency m e d i c a l c o n s u l t a n t ' s a s s e s s m e n t . T h e A L J explained, " w h i l e t h e c l a i m a n t ' s b i p o l a r d i s o r d e r i s a m e d i c a l l y determinable impairment, it is not severe. Such was the conclusion o f t h e state agency medical consultant Frank Lathan, PhD o n February 24, 2006, as found in the psychiatric review technique form." (Tr. 10.) Dr. Latham assessed mild limitations in activities; mild difficulties in m a i n t a i n i n g s o c i a l f u n c t i o n i n g ; m i l d d i f f i c u l t i e s in m a i n t a i n i n g c o n c e n t r a t i o n , p e r s i s t e n c e , a n d p a c e ; a n d n o e p i s o d e s o f d e c o m p e n s a t i o n . ( T r . 2 7 5 . ) T h e s e f i n d i n g s do n o t m e e t o r e q u a l t h e l i s t i n g s for a s e v e r e i m p a i r m e n t . P l a i n t i f f argues that the A L l ' s "rote recitation fails to comply w i t h the regulatory

Report & Recommendation - 23

requirement that the A L I ' s decision must 'show t h e significant history, including examination a n d l a b o r a t o r y findings, a n d t h e f u n c t i o n a l l i m i t a t i o n s t h a t w e r e c o n s i d e r e d i n r e a c h i n g a c o n c l u s i o n a b o u t the severity o f the m e n t a l impainnent(s).'" (Pl.'s R e p l y 9; citing 20 C.F.R. § 404.1 5 2 0 a ( e ) ( 2 ) . ) T h e court disagrees. T h e A L l did n o t s o l e l y rely o n t h e medical assessment o f Dr. L a t h a m . H e i n c o r p o r a t e d t h e a s s e s s m e n t into h i s f i n d i n g s , s t a t e d t h a t h e a g r e e d w i t h it, a n d h e detailed other medical evidence i n his decision to support his conclusion. T h e A L l reported that Dr. Monteverdi assessed that P l a i n t i f f did not have profound episodes o f depression, that she i m p r o v e d o n medication, a n d that she had maintained stable o n medication. Dr. Monteverdi also c o n f i n n e d that h e r b i p o l a r disorder was in partial remission. (Tr. 15; 321.) P l a i n t i f f s c l a i m t h a t t h e A L l hastily d e t e n n i n e d h e r mental i m p a i n n e n t w a s non-severe b e c a u s e h e r e l i e d o n t e h F e b r u a r y 2 0 0 7 a s s e s s m e n t is a l s o u n t r u e a n d u n s u p p o r t e d . I n h i s d e c i s i o n , t h e A L l c l e a r l y s u m m a r i z e s and r e f e r e n c e s m e d i c a l r e c o r d s s p a n n i n g t h e t i m e f r o m h e r alleged disability up to t h e hearing. See Lombardo v. Schweiker, 749 F . 2 d 5 6 5 , 5 6 7 ( 9 t h Cir. 1984) (noting t h a t t h e A L l ' s s u m m a r i e s o f claimant's physicians' r e p o r t s i n d i c a t e d t h e A L l h a d t h o r o u g h l y c o n s i d e r e d t h e c o m b i n e d effects). H e g a v e s e v e r a l r e a s o n s f o r h i s c o n c l u s i o n o f a n o n - s e v e r e i m p a i n n e n t t h a t r e l y o n medical evidence throughout the p e r i o d i n question. Notably, i n A u g u s t 2007, she w a s responding well to medication (tr. 15;323) and h a d successfully maintained employment o v e r the past 15 years after her first diagnosis o f b i p o l a r disorder. (Tr. 10.) M o r e o v e r , D r . M o n t e v e r d i ' s t r e a t m e n t r e c o r d s n o t e t h a t h e r b i p o l a r d i s o r d e r w a s i n p a r t i a l remission, o n l y a few m o n t h s p r i o r tot he ALI's decision. (Tr. 15; 321.) T h e A L l d i d n o t a p p l y t h e l e g a l s t a n d a r d o f " l o n g i t u d i n a l h i s t o r y " as t h e P l a i n t i f f c l a i m s . Report & Recommendation - 2 4

He commented, "the undersigned agrees . . . that her mental condition is n o t severe, as there is an absence o f longitudinal history documenting any significant limitations o n her ability to work caused b y the bipolar disorder." (Tr. 11.) As Defendant explained, the ALJ was not applying this as a standard but highlighting e v i d e n c e t h a t s u p p o r t e d h i s decision. " [ T ] h e a b s e n c e o f a l o n g i t u d i n a l h i s t o r y d o c u m e n t i n g a n y s i g n i f i c a n t l i m i t a t i o n s w a s s i m p l y further e v i d e n c e that P l a i n t i f f s b i p o l a r d i s o r d e r d i d n o t p r e v e n t P l a i n t i f f from performing substantial gainful activity for a continuous period o f twelve months." (Def.'s Br. 18; citing 42 U . S . c . § 423(d)(l)(A); 20 C.F.R. § 404.1509.) The S S A regulations e x p l a i n t h a t the A L I ' s d e c i s i o n m u s t include significant history that w a s c o n s i d e r e d i n r e a c h i n g t h e d e t e r m i n a t i o n , a n d b y n o t i n g the a b s e n c e o f h i s t o r y , the A L J w a s f o l l o w i n g t h e r e g u l a t i o n s . S e e 2 0 C . F . R . § 404. 1 5 2 0 a ( e ) ( 2 ) . The ALI's determination that Plaintiffs bipolar disorder was not a severe impairment is s u p p o r t e d b y s u b s t a n t i a l evidence. 2.

P l a i n t i f f s C o m b i n e d Impairments

A t s t e p three, t h e A L J m u s t d e t e r m i n e i f t h e i m p a i r m e n t s o r c o m b i n a t i o n o f i m p a i r m e n t s meets o r equals in severity one o f t h e listed impairments. 20 C.F.R. § 404. 1520(a)(4)(iii); Lester 81 F . 3 d at 829-30; 2 0 C.F.R. Part 404, Subpart P, Appendix 1 (Listing).
I n e v a l u a t i n g t h e e q u i v a l e n c y o f t h e c o m b i n e d i m p a i r m e n t s w i t h t h o s e i n t h e L i s t i n g , the

A L I "is not required to discuss the combined effects o f a claimant's impairments o r compare t h e m to any listing in an equivalency determination, unless the claimant presents evidence in an effort to establish equivalence." Burch v. Barnhart, 400 F.3d 676, 683 (2005). I n M a r c i a v. S u l l i v a n , t h e N i n t h C i r c u i t e x p l a i n e d , " W e hold, t h a t i n d e t e r m i n i n g w h e t h e r a c l a i m a n t e q u a l s a Report & Recommendation - 25

listing u n d e r Step 3 . . . , the A L l m u s t explain a d e q u a t e l y his evaluation o f alternative tests a n d the c o m b i n e d effects o f the impairments." 900 F . 2 d 172, 176 (9th Cir. 1990.) H o w e v e r , this e v a l u a t i o n n e e d n o t b e i n t h e A L l ' s "Findings" s e c t i o n . T h e c o u r t i n L e w i s c l a r i f i e d t h a t t h e holding i n M a r c i a " s i m p l y requires an A L l to discuss a n d evaluate the evidence t h a t s u p p o r t s h i s o r h e r conclusion; i t does n o t specify that the A L l m u s t do so u n d e r the h e a d i n g o f 'Findings.'" 2 3 6 F . 3 d a t 513. P l a i n t i f f c o n t e n d s that the A L l did n o t p r o p e r l y consider h e r combined impairments. S h e a r g u e s t h a t t h e A L l " d i d l i t t l e m o r e t h a [ n ] s i m p l y m a k e t h e c o n c l u s o r y finding" ( P I . ' s B r . 8) a n d t h e n failed to m e n t i o n h e r m e n t a l impairments. (PI. 's Br. 9.) I n h e r brief, P l a i n t i f f suggests t h a t t h e " A L l m i g h t h a v e f o u n d " i m p a i r m e n t s e q u a l t o L i s t i n g s 1 2 . 0 4 , 1 2 . 0 4 , 12.06, o r a n o t h e r L i s t i n g . (PI.'s B r . 10.) H o w e v e r , P l a i n t i f f p r o v i d e s n o s u p p o r t f o r h e r h y p o t h e s i s o f w h a t t h e A L l m i g h t h a v e found. D e f e n d a n t a r g u e s t h e r e i s no e r r o r i n t h e A L l ' s a n a l y s i s b e c a u s e P l a i n t i f f d i d n o t p r e s e n t evidence to e s t a b l i s h equivalence. (Def.'s Br. 18.) " P l a i n t i f f d i d n o t p r e s e n t evidence o f e q u i v a l e n c e to t h e A L l a n d d o e s n o t argue w i t h s p e c i f i c i t y . . . h o w h e r i m p a i r m e n t s w o u l d e q u a l a l i s t i n g . " ( D e f . ' s Br. 1 9 . ) T h e c o u r t a g r e e s w i t h D e f e n d a n t . T h o u g h P l a i n t i f f h a s p r o v i d e d h e r t h e o r y as t o w h a t t h e A L l m i g h t h a v e f o u n d , t h i s is n o t e v i d e n c e . F u r t h e r , h e r t h e o r y i s b a s e d o n D r . M o n t e v e r d i ' s f u n c t i o n a l a s s e s s m e n t t h a t t h e A L l d i d n o t adopt. T h e r e w a s n o e r r o r i n t h e A L l ' s a n a l y s i s o f h e r combined impairments.

E.

RFC Determination and Corresponding Hypothetical Were Not in E r r o r

P l a i n t i f f argues t h a t the A L l ' s R F C was in error b e c a u s e i t d i d n o t include l i m i t a t i o n s l a y R e p o r t & R e c o m m e n d a t i o n - 26

witness Mr. Keyser described, and thus she argues the hypothetical based o n the RFC was also inaccurate. Where opinion evidence is properly discounted, the ALJ is not required to include it in the RFC finding. Batson, 359 F.3d at 1197. As previously discussed, the ALJ properly discredited his testimony. Accordingly, the ALJ was not required to include these limitations in h i s R F C o r hypothetical.

F.

S t e p Five D e t e r m i n a t i o n W a s N o t in E r r o r

P l a i n t i f f argues the ALJ erred at step five because he failed to comply with S S A regulations about making findings o f transferability o f skills. (PI. 's Br. 23.) She also argues that there are not j o b s that exist in the national economy in significant number to j u s t i f y his determination o f not disabled. (Pl.'s Br. 24.) When a decision involves a transferability o f skills, the ALJ is required to make certain findings o f fact and include them in the decision. SSR 82-41 at *7. "When a finding is m a d e t h a t a c l a i m a n t h a s t r a n s f e r a b l e s k i l l s , the a c q u i r e d w o r k s k i l l s m u s t b e i d e n t i f i e d , a n d s p e c i f i c occupations to which acquired work skills are transferrable must b e cited i n t h e . . . A L l ' s decision." Id. T h e A L J found t h a t t h e P l a i n t i f f h a d a c q u i r e d w o r k s k i l l s from p a s t r e l e v a n t w o r k . " T h e vocational expert testified that the claimant's past relevant work as cashier o r checker was semiskilled w i t h a specific vocational preparation (SVP) code o f three, and she would b e able to perform a cashier o r checker existing within the national economy and as described b y the DOT." (Tr. 17.) However, the A L J did not adequately identify the acquired work skills o r specific occupations. Report & Recommendation - 27

Defendant concedes that failing to identify the transferrable skills is reversible error. H o w e v e r , h e a l s o a r g u e s t h a t t h e d e c i s i o n is s a v e d b e c a u s e t h e A L J a l s o f o u n d t h a t P l a i n t i f f c o u l d p e r f o n n the unskilled representative occupations o f cashier II. (Def.'s Br. 20.) T h e V E testified t h a t P l a i n t i f f w o u l d b e able to p e r f o n n positions o f cashier I and cashier II. T h e p o s i t i o n o f c a s h i e r II i s " u n s k i l l e d , s i m p l e a n d r o u t i n e p e r t h e D O T " a n d d o e s n o t r e q u i r e P l a i n t i f f s a l l e g e d l y t r a n s f e r r e d skills. T h e V E testified that i n the state o f Oregon, there are 43,000 cashiers, and i n t h e national e c o n o m y there are 1.2 million. (Tr. 63.) Because P l a i n t i f f needs a sit/stand o p t i o n b e c a u s e o f h e r R F C , t h e V E n a r r o w e d t h e r a n g e to 1 2 , 6 9 6 p o s i t i o n s . T h e V E a l s o e x p l a i n e d t h a t c a s h i e r p o s i t i o n s s p e c i f i c a l l y l i m i t e d to r e c e i v i n g p a y m e n t s , t i c k e t i n g o r t i c k e t i n g s e l l i n g n u m b e r a t 6 , 8 2 0 . (Tr. 6 4 . ) A s Defendant acknowledges, there is no bright line test for what qualifies as a "significant n u m b e r " at step five. Several circuits have found a "significant number" w h e r e there are far fewer t h a n 12,000 positions. I n Martinez v. Heckler, 807 F.2d 771, 775 (9th Cir.1986), t h e court u p h e l d t h e ALJ's finding that 3,750 to 4,250 j o b s were a significant number. T h e S i x t h Circuit has f o u n d t h a t 1,350 j o b s i n the local economy constituted a significant number. H a l l v. B o w e n , 837 F . 2 d 2 7 2 , 2 7 5 (6th Cir.1988). The Eighth Circuit has h e l d that as few as 500 j o b s w e r e a significant number. Jenkins v. Bowen, 861 F . 2 d 1083, 1087 (8th Cir.1988). H e r e , t h e r e are o v e r 1 2 , 0 0 0 j o b s i n t h e s t a t e e c o n o m y t h a t P l a i n t i f f c o u l d p e r f o n n . T h i s i s s u b s t a n t i a l e v i d e n c e t h a t t h e A L J c o u l d r e l y upon. H i s d e c i s i o n w a s n o t i m p r o p e r .

V.

Conclusion
T h e A L l ' s d e c i s i o n w a s b a s e d o n s u b s t a n t i a l evidence. I n h i s d e c i s i o n , t h e A L I p r o p e r l y

R e p o r t & R e c o m m e n d a t i o n - 28

rejected physician, plaintiff, and lay witness testimony. He properly evaluated her mental impairments and provided an accurate RFC and hypothetical. There are over 12,000 j o b s i n t h e s t a t e e c o n o m y t h a t P l a i n t i f f c a n p e r f o r m . T h e A L J ' s d e c i s i o n s h o u l d b e affirmed.

VI.

Recommendation
Based o n the foregoing, and pursuant to sentence four o f 42 U.S.C. § 405(g), it is

r e c o m m e n d e d t h a t t h e d e c i s i o n o f t h e C o m m i s s i o n e r b e affirmed. This recommendation is not an order that is immediately ap'pealable to the Ninth Circuit Court o fAppeals. A n y notice o f appeal pursuant to Rule 4 ( a ) ( l ) , Federal Rules o f Appellate Procedure, should not b e filed until entry o f the district court's judgment o r appealable order. The Report and Recommendation will b e referred to a district judge. Objections to this Report a n d Recommendation. i f any. are due by February 2 6 . 2 0 1 0 . f f o b j e c t i o n s are filed, a n y response to the objections are due within 1 7 days o fservice o f t h e objections, see Federal R u l e s o f Civil Procedure 72 a n d 6. Failure to timely file objections to any factual determinations o f the Magistrate Judge will b e considered a waiver o f a party's right to de novo consideration o f the factual issues and will constitute a waiver o f a party's right to appellate review o f the findings o f fact in an order o r j u d g m e n t entered pursuant to the Magistrate Judge's recommend~ D A T E D this
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D.CLARKE U n i t e d States M a g i s t r a t e J u d g e

Report & Recommendation - 29