Beyerlin v. Commissioner Social Security Administration
Filing
18
OPINION AND ORDER: The findings of the Commissioner are based upon substantial evidence in the record and the correct legal standards. For these reasons, the court affirms the decision of the Commissioner. (See 18 page opinion for more information) Signed on 7/25/16 by Judge Garr M. King. (dsg)
UNITED STATES DISTRICT COURT
DISTRICT OF OREGON
BRANDON T. BEYERLIN,
Plaintiff,
v.
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,
Defendant.
Kathryn Tassinari
Mark Manning
Harder, Wells, Baron & Manning, P.C.
474 Willamette, Suite 200
Eugene, OR 97401
Attorneys for Plaintiff
Billy J. Williams
United States Attorney
District of Oregon
Janice E. Hebert
Assistant United States Attorney
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Case No. 6:15-cv-01434-KI
OPINION AND ORDER
1000 SW Third Ave., Ste. 600
Portland, OR 97204-2902
Lars J. Nelson
Special Assistant United States Attorney
Office of the General Counsel
Social Security Administration
701 Fifth Ave., Ste. 2900 M/S 221A
Seattle, WA 98104-7075
Attorneys for Defendant
KING, Judge:
Plaintiff Brandon Beyerlin brings this action pursuant to section 205(g) of the Social
Security Act, as amended, 42 U.S.C. § 405(g), to obtain judicial review of a final decision of the
Commissioner denying his application for disability insurance benefits (“DIB”). I affirm the
decision of the Commissioner.
BACKGROUND
Beyerlin filed an application for DIB on September 5, 2012, alleging disability as of July
26, 2012. The application was denied initially and upon reconsideration. After a timely request
for a hearing, Beyerlin, represented by counsel, appeared and testified before an Administrative
Law Judge (“ALJ”) on February 3, 2014.
On March 7, 2014, the ALJ issued a decision finding Beyerlin was not disabled within the
meaning of the Act and therefore not entitled to benefits. This decision became the final decision
of the Commissioner when the Appeals Council declined to review the decision of the ALJ on
June 2, 2015.
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DISABILITY ANALYSIS
The Social Security Act (the “Act”) provides for payment of disability insurance benefits
to people who have contributed to the Social Security program and who suffer from a physical or
mental disability. 42 U.S.C. § 423(a)(1). In addition, under the Act, supplemental security
income benefits may be available to individuals who are age 65 or over, blind, or disabled, but
who do not have insured status under the Act. 42 U.S.C. § 1382(a).
The claimant must demonstrate an inability to engage in any substantial gainful activity
by reason of any medically determinable physical or mental impairment which can be expected to
cause death or to last for a continuous period of at least twelve months. 42 U.S.C.
§§ 423(d)(1)(A) and 1382c(a)(3)(A). An individual will be determined to be disabled only if his
physical or mental impairments are of such severity that he is not only unable to do his previous
work but cannot, considering his age, education, and work experience, engage in any other kind
of substantial gainful work which exists in the national economy. 42 U.S.C. §§ 423(d)(2)(A) and
1382c(a)(3)(B).
The Commissioner has established a five-step sequential evaluation process for
determining if a person is eligible for either DIB or SSI due to disability. The evaluation is
carried out by the ALJ. The claimant has the burden of proof on the first four steps. Parra v.
Astrue, 481 F.3d 742, 746 (9th Cir. 2007); 20 C.F.R. §§ 404.1520 and 416.920. First, the ALJ
determines whether the claimant is engaged in “substantial gainful activity.” 20 C.F.R.
§§ 404.1520(b) and 416.920(b). If the claimant is engaged in such activity, disability benefits are
denied. Otherwise, the ALJ proceeds to step two and determines whether the claimant has a
medically severe impairment or combination of impairments. A severe impairment is one
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“which significantly limits [the claimant’s] physical or mental ability to do basic work
activities[.]” 20 C.F.R. §§ 404.1520(c) and 416.920(c). If the claimant does not have a severe
impairment or combination of impairments, disability benefits are denied.
If the impairment is severe, the ALJ proceeds to the third step to determine whether the
impairment is equivalent to one of a number of listed impairments that the Commissioner
acknowledges are so severe as to preclude substantial gainful activity. 20 C.F.R. §§ 404.1520(d)
and 416.920(d). If the impairment meets or equals one of the listed impairments, the claimant is
conclusively presumed to be disabled. If the impairment is not one that is presumed to be
disabling, the ALJ proceeds to the fourth step to determine whether the impairment prevents the
claimant from performing work which the claimant performed in the past. If the claimant is able
to perform work she performed in the past, a finding of “not disabled” is made and disability
benefits are denied. 20 C.F.R. §§ 404.1520(f) and 416.920(f).
If the claimant is unable to perform work performed in the past, the ALJ proceeds to the
fifth and final step to determine if the claimant can perform other work in the national economy
in light of his age, education, and work experience. The burden shifts to the Commissioner to
show what gainful work activities are within the claimant’s capabilities. Parra, 481 F.3d at 746.
The claimant is entitled to disability benefits only if he is not able to perform other work. 20
C.F.R. §§ 404.1520(g) and 416.920(g).
STANDARD OF REVIEW
The court must affirm a denial of benefits if the denial is supported by substantial
evidence and is based on correct legal standards. Molina v. Astrue, 674 F.3d 1104, 1110 (9th Cir.
2012). Substantial evidence is “such relevant evidence as a reasonable mind might accept as
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adequate to support a conclusion” and is more than a “mere scintilla” of the evidence but less
than a preponderance. Id. (internal quotation omitted). The court must uphold the ALJ’s
findings if they “are supported by inferences reasonably drawn from the record[,]” even if the
evidence is susceptible to multiple rational interpretations. Id.
THE ALJ’S DECISION
Beyerlin, according to the ALJ, has the following severe impairments: obesity,
degenerative disc disease, status post laminectomy with spinal cord stimulator implant, and
degenerative joint disease with history of arthroscopic surgery for medial meniscus tear. The
ALJ found these impairments, either singly or in combination, did not meet or medically equal
the requirements of any of the impairments listed in 20 C.F.R. § 404, Subpart P, Appendix 1.
Given these impairments, the ALJ concluded Beyerlin retained the residual functional capacity
(“RFC”) to perform sedentary work, except that he can only occasionally stoop, crouch, crawl,
kneel, climb, and balance. He should avoid more than occasional overhead reaching bilaterally.
Given this RFC, Beyerlin could not perform his past work but he could perform other work in the
national economy, such as document preparer, survey worker, and small products bench
assembly.
FACTS
Beyerlin was 42 years old at the time of his alleged disability onset. He is a high school
graduate with a lengthy work history as a traffic maintenance technician for the City of Eugene.
Before his alleged disability onset, he was in a motorcycle accident which caused back pain.
Also before his alleged onset date, he had an L4-5 disc arthroplasty in 2010 and an L3-4
laminectomy in April 2012.
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In June 2012, at his appointment with his primary care physician Lisa Emond, M.D., he
reported chronic knee and back pain. He had gained 30 pounds in the past year, despite walking
three to four miles four days a week, kayaking on the weekends, and not overeating. Dr. Emond
prescribed oxycodone, but told him he needed to look for a job that was easier on his back. Tr.
333. Two weeks later, Beyerlin told Dr. Emond he was on temporary disability due to his
chronic back and neck pain. He wanted to talk about retraining for a position he could do. Dr.
Emond prescribed Celexa and Norco and told him that his back condition would not permit him
to do the kind of heavy work he was trying to do. Tr. 328.
An MRI on July 24, 2012 revealed wide decompression of the thecal sac at L3-4, but no
evidence of recurrent disc herniation or nerve root compromise, and no identifiable central or
foraminal stenosis. Tr. 372. It showed disc degeneration and an annular tear in the L5-SI disc.
Tr. 387.
Beyerlin stopped working at the end of July 2012. He sought treatment from the
NeuroSpine Institute, reporting pain of 8-9/10. Alicia Feldman, M.D., felt Beyerlin should
remain off work as it would be difficult for him to return to his job. She recommended bilateral
L4-5 and L5-S1 facet joint injections with IV sedation as well as a home exercise program. Tr.
392.
In August, Dr. Emond completed a work assessment for him. She noted his good
exercise habits and normal activities of daily living. He reported pain with movement of his
thoracolumbar spine, and his paraspinal muscles exhibited spasms. His flexion, extension, and
rotation of his lumbosacral spine was decreased, and the straight-leg raising test of both legs was
positive. He could not stand on his toes, his ankles were weak, his gait and stance were
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abnormal. Tr. 318. She opined that he could not bend, twist, stoop, crawl, climb or kneel, and
could not lift more than 25 pounds. He also could not pull or push more than 25 pounds. Tr.
319.
Beyerlin obtained facet joint injections later that month, without any relief. Dr. Feldman
prescribed MS Contin, and rare Vicodin for breakthrough pain. He rated his pain at 5/10 with
radiation into his thighs; he was taking Vicodin twice a day and oxycodone twice a day.
Beyerlin told Dr. Emond he was doing as well as could be expected, that he felt no side
effects from his medications, but he felt constant generalized pain. She prescribed Morpine, with
oxycodone for breakthrough pain.
Beyerlin returned to Dr. Feldman in late September 2012. He reported pain of 6-7/10,
without significant relief from the injections. The pain worsened with sitting, driving and
standing. Dr. Feldman had no other nonsurgical options for Beyerlin, and she suggested he talk
to Scott Kitchel, M.D., about possible surgery.
Dr. Kitchel noted Beyerlin felt he was doing well in terms of the back pain he suffered
two years before. Beyerlin could arise easily from a chair, he stood erect, his gait was normal,
his motor strength was 5/5, and there were no subjective sensory deficits. Dr. Kitchel released
Beyerlin to full activities as tolerated, but noted continued work-up with Dr. Feldman for
radicular symptoms.
Beyerlin’s car was rear-ended in October and he reported increased pain in his lower
back. On examination, his lumbar spine was tender, with spasms of the paraspinal muscles.
Flexion, extension, and rotation of the lumbosacral spine was decreased. He could not stand on
his toes or heels and his gait and stance were abnormal.
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In November 2012 the City of Eugene informed Beyerlin that it could not accommodate
him in his position of maintenance worker and that there was no other position to which he could
be reassigned. Tr. 252. A few days later, Beyerlin returned to Dr. Feldman reporting increasing
pain at 5/10 mostly in his low back with periodic radiation down both legs. Dr. Feldman
proceeded with a discogram on L3-4 and L5-S1. She gave him fentanyl patches, instead of MS
Contin, and Norco for breakthrough pain. The discogram showed single-level pain reproduction
at L5-S1 and Dr. Kitchel thought Beyerlin would be a good candidate for L5-S1 arthrodesis.
Following up in December 2012, Beyerlin reported pain at 5-6/10, constant in nature, and
exacerbated by bending, twisting, sitting, walking, exercise, standing and lying down. Upon
examination, Beyerlin rose from seated to standing with slight difficulty, he walked with a
normal gait, and could walk on his heels and toes. Devon Parks, PA-C, recommended evaluation
by Dr. Kitchel for further surgery or, if surgery was denied, spinal cord stimulation. About a
week later, at his appointment with Dr. Emond, Beyerlin reported feeling preoccupied with his
symptoms, but he was not feeling tired. Dr. Emond increased his Celexa as Beyerlin felt it was
helping some.
In January 2013, Parks reported that Beyerlin’s insurance company had denied his request
for fusion surgery. Beyerlin continued to demonstrate slight difficulty rising from a seated
position, and he walked with a slightly unsteady gait. Parks switched Beyerlin’s medications to
OxyContin and Percocet. Tr. 473. Carmina Angeles, M.D., Ph.D., examined Beyerlin, who
reported pain at 5/10 which was significantly affecting his quality of life. He was not feeling
tired and his neck was supple. His thoracolumbar spine demonstrated tenderness on palpation at
L5-S1, and his lumbosacral spine demonstrated decreased lordosis, limited flexion and
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extension, and the straight-leg raising test of the right leg was positive. He could not heel or toe
walk, he limped, and his deep tendon reflexes were abnormal. Dr. Angeles did not recommend
appealing the insurance denial as he did not meet the requirements for a fusion. She
recommended a spinal cord stimulator trial.
Meeting with Gregory Moore, M.D., Beyerlin reported sharp, electric and stabbing pain
that was constant and at a level of 6/10. Beyerlin conceded medication “allows him to remain
functional but he does not wish to be on the medication if possible.” Tr. 479. They discussed a
spinal cord stimulator trial.
At his appointment with Dr. Emond in early March 2013, Beyerlin reported his chief
complaints as right knee, shoulder, and elbow pain. She recommended ice and working on diet
and exercise.
Dr. Moore implanted the trial spinal cord stimulator later that month. Beyerlin reported
100% of his painful areas were covered with 70% pain relief. He was very pleased overall and
thought he was able to do more than he could normally, although he still felt breakthrough pain
in his low back.
A late-March MRI of his thoracic spine showed a small right paracentral focal disk
protrusion at T8-T9 and T9-T10 without cord or root impingement. Tr. 538. Dr. Angeles noted
Beyerlin was unable to heel walk, and he was limping. She recommended thoracic spinal cord
stimulator paddle placement. A few days later, Beyerlin underwent a T10 inferior laminectomy
and placement of the thoracic spinal cord stimulator paddle. Beyerlin reported feeling well. His
gait was normal.
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During this time, Beyerlin also sought treatment for knee pain. Beyerlin reported average
activity level, and exercising three to four times per week. Tr. 604. He was very pleased with
the surgery done more than two years before on his left knee, saying he felt no pain in his left
knee. Brick Lantz, M.D., thought Beyerlin had a medial meniscal tear on the right knee and
recommended arthroscopic surgery. At his pre-op appointment, Beyerlin reported an average
activity level, exercising three to four times a week. His hobbies included boating, camping, and
church activities. Tr. 599. After the surgery, he displayed excellent range of motion, but he had
slipped and hyperflexed his knee earlier which caused pain. Dr. Lantz aspirated the knee in
advance of Beyerlin’s traveling to Oklahoma. Beyerlin continued to complain of swelling in
June 2013, so Dr. Lantz aspirated the knee. The doctor also fitted Beyerlin with a below-knee
compression stocking to help with the swelling.
Beyerlin reported 100% coverage after the spinal cord stimulator was programmed.
When asked if the pain was improved, he responded, “Yes!” Tr. 739. He thought he received
80% pain relief with 100% of the painful areas covered. His medications were effective and did
“not cause any significant side effects.” Tr. 732. He had been more active, riding his bike and
planned to start water aerobics. Pain was intermittent in nature, and was alleviated by
medications and the stimulator. Parks decreased Beyerlin’s OxyContin.
In June 2013, Beyerlin complained of fatigue to Dr. Emond and asked for a testosterone
replacement shot. Tr. 756. To Parks, the physician’s assistant at the NeuroSpine Institute,
Beyerlin reported pain at 3/10, thought he was doing well on a decreased OxyContin dose, and
indicated he had been more active; he did note worsened pain if he did too much. Parks
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observed Beyerlin rise from seated to standing without difficulty and walk with a normal gait.
Tr. 729.
A month later, in August 2013, Beyerlin continued to rate his pain level at 3/10 and as
intermittent. He felt more pain after cleaning out a rental house of his. Parks noted Beyerlin’s
pain at 4/10 in October, that Beyerlin’s activities improved with the use of medication and the
spinal cord stimulator. The stimulator did not cover all the pain in his low back, however.
Beyerlin had a normal gait with no limp. Similarly, in November, Beyerlin noted pain at 4-5/10,
that medications helped, but that he felt more pain when he tried to be active. Parks thought his
stimulator could be reprogrammed, and that Beyerlin would benefit from an exercise program
such as yoga, pilates, or tai chi.
When Beyerlin saw Dr. Emond in November 2013, he reported chest pains and shortness
of breath with activity. He wanted a referral to OHSU for his back and he complained about
gaining weight. His gait and stance were normal. Dr. Emond discussed weight management and
thought the heart-related symptoms were reflux, neck pain or muscular-related. At his
appointment with Parks in December, Beyerlin reported pain at 4/10, that it interfered with his
sleep, but he had a normal gait with no limp. Parks scheduled Beyerlin for a CT myelogram of
his cervical spine, and an SI joint injection. Dr. Emond noted Beyerlin’s back pain was stable,
although it continued to be a problem, but he had now progressed to “frank diabetes.” Tr. 748.
He had not noticed any fatigue. Dr. Emond encouraged lifestyle changes, urged diet changes,
and weight loss. The x-ray of his chest was normal, but he did have cervical stenosis.
In 2014, Dr. Moore of the Neurospine Institute noted Beyerlin’s low back pain despite the
stimulator. He recommended bilateral L2-L5 medial branch blocks and, if they worked, to
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consider radiofrequency denervation. The doctor set Beyerlin up for weight loss and wellness
given his obesity and lack of exercise. Tr. 779. The CT myleogram revealed mild multi-level
degenerative changes. Tr. 775. When Parks saw Beyerlin in February, he noted Beyerlin had a
normal gait with no limp.
DISCUSSION
Beyerlin challenges the ALJ’s treatment of his testimony and rejection of his treating
physician’s opinion.
I.
Beyerlin’s Testimony
Beyerlin testified that he could not work because of the pain in his knees and low back.
He could not bend over, lift or squat, and he felt shooting pain down his legs. He testified his
fingers fell asleep due to neck problems, and that he had been diagnosed with diabetes. He said
he did not use the spinal cord stimulator because it only helped the pain down his legs and not his
low back pain. He lived in a one-level house with his wife and three teenage children. He did
not attend their school activities and he no longer visited anybody. He no longer went hunting.
He emptied the dishwasher, cooked dinner, he read as long as he could stay awake, and
occasionally spent time on his computer. He spent his days standing and sitting in his recliner.
Around late 2013, he remembered walking two or three times a week for less than half a mile.
He usually slept four hours a night. He reported taking so much pain medication that he felt
“halfway asleep most of the day.” Tr. 89.
The ALJ concluded Beyerlin’s testimony about the intensity of his symptoms was not
entirely credible. First, he thought Beyerlin’s activities suggested a somewhat greater level of
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functioning than he alleged. Beyerlin’s medical records also reflected improvement in his
conditions. Finally, the ALJ found Beyerlin exaggerated the side-effects from his medication.
When deciding whether to accept the subjective symptom testimony of a claimant, the
ALJ must perform a two-stage analysis. In the first stage, the claimant must produce objective
medical evidence of one or more impairments which could reasonably be expected to produce
some degree of symptom. Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007). The
claimant is not required to show that the impairment could reasonably be expected to cause the
severity of the symptom, but only to show that it could reasonably have caused some degree of
the symptom. In the second stage of the analysis, the ALJ must assess the credibility of the
claimant’s testimony regarding the severity of the symptoms. Id. The ALJ “must specifically
identify the testimony she or he finds not to be credible and must explain what evidence
undermines the testimony.” Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001).
General findings are insufficient to support an adverse credibility determination and the ALJ
must rely on substantial evidence. Id. “[U]nless an ALJ makes a finding of malingering based
on affirmative evidence thereof, he or she may only find an applicant not credible by making
specific findings as to credibility and stating clear and convincing reasons for each.” Robbins v.
Soc. Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006).1
Beyerlin argues his daily activities are not so vigorous that they could serve as a reason
for finding him not credible. Daily activities could be relevant for one of two purposes. A
1
The Commissioner suggests the clear and convincing standard need not control the
analysis, encouraging application of the more deferential regulatory requirement for specific
reasons supported by substantial evidence. Def.’s Br. 9, n.6. The Ninth Circuit has rejected her
argument. See Burrell v. Colvin, 775 F.3d 1133 (9th Cir. 2014) (reasserting that the ALJ must
provide “specific, clear and convincing reasons” to support a credibility analysis).
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claimant’s daily activities might be so substantial such that they equate to an ability to work. Orn
v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007). Alternatively, the activities might be inconsistent
with testimony purporting to be limited in some way. Id. Here, the ALJ found Beyerlin’s
activities suggested a “somewhat greater level of functioning” than Beyerlin alleged. Beyerlin
was riding his bike and walking at one point during the relevant time, and he took care of all of
the household chores including cleaning the house and cooking dinner. He could sit to travel to
Oklahoma and, contrary to Beyerlin’s suggestion, there is no evidence Beyerlin reclined the
entire trip there. I agree with Beyerlin that these activities are not egregiously contradictory to
his testimony, but there is enough evidence for the ALJ to find Beyerlin is capable of doing more
than he testified to. The ALJ’s conclusion is supported by inferences reasonably drawn from the
record, even if it is susceptible to a different interpretation. Molina, 674 F.3d at 1110.
Additionally, medical evidence is a relevant factor in determining the severity of the pain
and its disabling effects. Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001). Beyerlin
disputes the ALJ’s reading of the medical record. Again, although the record is susceptible to a
different interpretation, the medical records support the ALJ’s reading of the records which
reveals that implantation of the spinal cord stimulator was successful. His gait was normal, he
reported 80% pain relief, and his pain was intermittent. His pain level decreased to 3/10. His
medical providers encouraged exercise. As the ALJ noted, “[s]uch evidence and medical
recommendation strongly suggests that the claimant was capable of greater functioning than
alleged.” Tr. 71.
Finally, Beyerlin’s testimony about the purported side effects of his medication, and his
contradictory statements to his providers, is a clear and convincing reason to question Beyerlin’s
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credibility. Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008) (ALJ may use “ordinary
techniques of credibility evaluation, such as the claimant’s reputation for lying, prior inconsistent
statements concerning the symptoms, and other testimony by the claimant that appears less than
candid”). The ALJ pointed out the fact that Beyerlin never reported fatigue as a side effect of his
medications. Indeed, he repeatedly indicated that the medications were effective and did not
cause any side effects. Although Beyerlin disputes the relevance of this contradiction, arguing
fatigue is not one of his alleged impairments, exaggerated testimony is a permissible credibility
factor. Beyerlin also points to two places in the record where he complained about fatigue, but
one of those records reflects Beyerlin’s worsened fatigue since stopping testosterone replacement
and was not a complaint about medication side-effects. Tr. 756. The other is but one complaint
of fatigue over several years of treatment and does not undermine the ALJ’s conclusion which is
based on substantial evidence in the record. Tr. 376.
In sum, the ALJ gave clear and convincing reasons, supported by substantial evidence, to
find Beyerlin’s testimony less than credible.
II.
Medical Evidence
In December 2013, Dr. Emond opined Beyerlin’s impairments would limit him from
standing and walking less than two hours in an eight-hour day, and sitting for less than six hours
in an eight-hour day. She thought he could only occasionally lift ten pounds, and could never lift
anything more than ten pounds. She thought he would be unable to maintain a normal work
schedule more than two days per month. She reported that Beyerlin suffered drowsiness and
fatigue from his medications.
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The ALJ rejected Dr. Emond’s opinion, finding it to be inconsistent with Dr. Emond’s
treatment notes and not substantiated by clinical evidence. The weight given to the opinion of a
physician depends on whether the physician is a treating physician, an examining physician, or a
nonexamining physician. More weight is given to the opinion of a treating physician because the
person has a greater opportunity to know and observe the patient as an individual. Orn v. Astrue,
495 F.3d 625, 632 (9th Cir. 2007). If a treating or examining physician’s opinion is not
contradicted by another physician, the ALJ may only reject it for clear and convincing reasons.
Id. (treating physician); Widmark v. Barnhart, 454 F.3d 1063, 1067 (9th Cir. 2006) (examining
physician). Even if it is contradicted by another physician, the ALJ may not reject the opinion
without providing specific and legitimate reasons supported by substantial evidence in the record.
Orn, 495 F.3d at 632; Widmark, 454 F.3d at 1066. The opinion of a nonexamining physician, by
itself, is insufficient to constitute substantial evidence to reject the opinion of a treating or
examining physician. Widmark, 454 F.3d at 1066 n.2.
Beyerlin argues Dr. Emond’s opinion is uncontradicted. He disputes that the agency’s
consulting physician’s opinion can constitute a contradicting opinion when the agency’s doctor
was unaware of records after March 2013. He also contends a dispute about functional abilities
is not the kind of conflict contemplated by the law.
As the Commissioner points out, familiarity with the medical records is one factor to
consider in assessing contradicting medical opinions. 20 C.F.R. § 404.1527(c)(6). Here, making
reasonable inferences based on the record, the ALJ concluded the state agency physician, Neal
Berner, M.D., identified functional limitations which were consistent with the medical record and
with Beyerlin’s activities. Beyerlin’s condition only showed improvement after Dr. Berner
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issued his opinion. Tr. 739 (improvement in pain with stimulator); Tr. 729, 727 (pain at 3/10);
Tr. 724 (pain at 4/10); Tr. 714 (4/10 pain). Although Beyerlin required aspiration of his right
knee, he also could rise out of a chair without difficulty and walk with a normal gait. Tr. 729.
As to Beyerlin’s second objection, a conflict about functional limitations is the kind of
discrepancy which can make opinions contradictory, thereby leading to application of the specific
and legitimate standard. See Widmark, 454 F.3d at 1066 (conflict between stage agency
reviewing physician and orthopedist on manipulative limitations).
Here, the ALJ gave specific and legitimate reasons for discounting Dr. Emond’s opinion.
As the ALJ pointed out, Dr. Emond’s noted fatigue only once, and that was in the context of
testosterone treatment not medication side-effects. In fact, at the appointment closest in time to
her completion of the functional capacities form, while discussing Beyerlin’s diabetic condition,
Beyerlin denied noticing any fatigue. Tr. 748. Further, Dr. Emond’s opinion is inconsistent with
the numerous examinations in 2013 where Beyerlin displayed a normal gait. As for her treating
records, Dr. Emond treated Beyerlin on four occasions in 2013. Once for knee and elbow pain,
once for testosterone shots, and once for chest pain (at which she noted his gait was normal).
Finally, in December 2013, at the appointment closest in time to her completion of the functional
capacities form, she reported Beyerlin’s “stable” back pain that does continue to be a problem,
but he reported no sleep problems and had a normal stance and gait. Dr. Emond recommended
weight loss and exercise. An ALJ is not required to accept the opinion of a physician, even a
treating physician, if the opinion is “conclusory, brief, and unsupported by the record as a
whole[.]” Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004); see also
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Crane v. Shalala, 76 F.3d 251, 253 (9th Cir. 1996) (it is permissible to reject check-off reports
from physicians that do not contain any explanation of the bases for the conclusions).
CONCLUSION
The findings of the Commissioner are based upon substantial evidence in the record and
the correct legal standards. For these reasons, the court affirms the decision of the
Commissioner.
IT IS SO ORDERED.
DATED this
25th
day of July, 2016.
/s/ Garr M. King
Garr M. King
United States District Judge
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