ARTHUR GAMEZ, Plaintiff, v. NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.
Case No. CV 16-7526 JC
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA
October 30, 2017
Honorable Jacqueline Chooljian, UNITED STATES MAGISTRATE JUDGE
I. SUMMARY
On October 7, 2016, plaintiff Arthur Gamez filed a Complaint seeking review of the Commissioner of Social Security’s denial of plaintiff’s applications for benefits. The parties have consented to proceed before the undersigned United States Magistrate Judge.
This matter is before the Court on the рarties’ cross motions for summary judgment, respectively (“Plaintiff’s Motion“) and (“Defendant’s Motion“) (collectively “Motions“). The Court has taken the Motions under submission
Based on the record as a whole and the applicable law, the decision of the Commissioner is AFFIRMED. The findings of the Administrative Law Judge (“ALJ“) are supported by substantial evidence and are free from material error.
II. BACKGROUND AND SUMMARY OF ADMINISTRATIVE DECISION
In March 2013, plaintiff filеd applications for Supplemental Security Income and Disability Insurance Benefits alleging disability beginning on December 16, 2011, due to carpal tunnel syndrome in both hands, nerve damage to his elbow, and shoulder problems. (Administrative Record (“AR“) 22, 188, 196, 262). The ALJ examined the medical record and heard testimony from plaintiff (who was represented by counsel) and a vocational expert on Mаrch 6, 2016. (AR 40-80).
On May 4, 2015, the ALJ determined that plaintiff was not disabled through the date of the decision. (AR 22-34). Specifically, the ALJ found: (1) plaintiff suffered from the following impairments that were severe “at least in combination“: bilateral carpal tunnel syndrome, bilateral ulnar entrapment, left shoulder tendinosis, bilateral ganglion cysts, disc protrusions at C5-7, and obesity (AR 25); (2) plaintiff’s impairments, considered singly or in combination, did not meet or medically equal a listed impairment (AR 25-26); (3) plaintiff essentially retained the residual functional capacity to perform light work (
On August 9, 2016, the Appeals Council denied plaintiff’s application for review. (AR 1).
III. APPLICABLE LEGAL STANDARDS
A. Administrative Evaluation of Disability Claims
To qualify for disability benefits, a claimant must show that he or she is unable “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to lаst for a continuous period of not less than 12 months.” Molina v. Astrue, 674 F.3d 1104, 1110 (9th Cir. 2012) (quoting
To assess whether a claimant is disabled, an ALJ is rеquired to use the five-step sequential evaluation process set forth in Social Security regulations. See Stout v. Commissioner, Social Security Administration, 454 F.3d 1050, 1052 (9th Cir. 2006) (citations omitted) (describing five-step sequential evaluation process) (citing
B. Federal Court Review of Social Security Disability Decisions
A federal court may set aside a denial of benefits only when the Commissioner’s “final decision” was “based on legal error or not supported by substantial evidence in the record.”
Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Trevizo, 871 F.3d at 674 (citation and quotation marks omitted). It is “more than a mere scintilla, but less than a preponderance.” Id. When determining whether substantial evidence supports an ALJ’s finding, a court “must considеr the entire record as a whole, weighing both the evidence that supports and the evidence that detracts from the Commissioner’s conclusion[.]” Garrison v. Colvin, 759 F.3d 995, 1009 (9th Cir. 2014) (citation and quotation marks omitted).
While an ALJ’s decision need not be drafted with “ideal clarity,” at a minimum it must describe the ALJ’s reasoning with sufficient specificity and clarity to “allow[] for meaningful review.” Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015) (citations and internal quotation marks omitted); see generally
C. Evaluation of Medical Opinion Evidence
In Social Security cases, the amount of weight given to medical opinions generally varies depending on the type of medical professional who provided the opinions, namely “treating physicians,” “examining physicians,” and “nonexamining physicians” (e.g., “State agency medical or psychological consultant[s]“).
An ALJ is required to consider multiple factors when evaluating medical opinions from examining and nonexamining sources, as well as treating source opinions that have not been deemed “controlling.” Trevizo, 871 F.3d at 675 (citation omitted). Appropriate factors include (i) “[l]ength of the treatment relationship and the frequency of examination“; (ii) “[n]ature and extent of the
An ALJ may reject the uncontroverted opinion of either a treating or examining physician only by providing “clear and convincing reasons that are supported by substantial evidence.” Trevizo, 871 F.3d at 675 (citation omitted). Where a treating or examining physician’s opinion is contradicted by another doctor’s opinion, an ALJ may reject such opinion only “by providing specific and legitimate reasons that are supported by substantial evidence.” Id.
An ALJ may provide sufficient reasons for rejecting a mеdical opinion by “setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his [or her] interpretation thereof, and making findings.” Id. (citation omitted). An ALJ’s findings must provide more than mere “conclusions” or “broad and vague” reasons for rejecting a particular treating or examining physician’s opinion. Embrey v. Bowen, 849 F.2d 418, 421 (9th Cir. 1988); McAllister v. Sullivan, 888 F.2d 599, 602 (9th Cir. 1989) (citation omitted). “[The ALJ] must set forth his [or her] own interpretations and explain why they, rather than the [physician’s], are correct.” Embrey, 849 F.2d at 421-22.
IV. DISCUSSION
Plaintiff contends that the ALJ improperly rejected portions of medical opinions provided by three physicians, namely (1) Dr. Patricia Hong, one of
A. Dr. Patricia Hong
The ALJ rejected medical opinions Dr. Hong provided in two separate reports (collectively “Dr. Hong’s Opinions“), which opinions the ALJ proрerly determined were not entitled to controlling weight (i.e., “they [were] controverted by multiple sources“). In a “Medical Source Statement Concerning the Nature and Severity of [Plaintiff’s] Physical Impairments” dated October 24, 2013, Dr. Hong essentially opined that plaintiff was capable of performing no more than sedentary work, and specifically that plaintiff (i) could lift and carry 10 pounds or less occasionally, and 20 pounds rarely; (ii) had “significant limitations in doing repetitive reaching, handling, fingering [and] lifting[]“; (iii) was only capable of tolerating “moderate stress“; and (iv) would likely be absent from work “[a]bout 2-3 times per month.” (AR 707-10). In a “Medical Source Statement Concerning the Nature and Severity of [Plaintiff’s] Manipulative Limitations” dated May 8, 2014, Dr. Hong noted that plaintiff had multiple signs and symptoms that affeсted his wrists, hands or fingers (i.e., tenderness, pain, muscle spasm, paresthesia, soft tissue swelling, muscle weakness, joint deformity, reduced grip strength, and intermittent tremor/stiffness), and that plaintiff had “chronic numbness and pain in both wrists/hands” and “constant numbness over all the fingertips.” (AR 711). Dr. Hong also opined that plaintiff had “significant limitations with reaching, handling, [and] fingering,” specifically that during an eight-hour working day plaintiff could grasp, turn, аnd twist objects with bilateral hands only 10% of the
The ALJ properly rejected Dr. Hong’s Opinions because they were not supported by the physician’s own notes or the record as a whole. See Bayliss v. Barnhart, 427 F.3d 1211, 1217 (9th Cir. 2005) (“The ALJ need not accept the opinion of any physician, including a treating physician, if thаt opinion is brief, conclusory, and inadequately supported by clinical findings.“) (citation and internal quotation marks omitted); Connett v. Barnhart, 340 F.3d 871, 875 (9th Cir. 2003) (treating physician’s opinion properly rejected where treating physician’s treatment notes “provide no basis for the functional restrictions he opined should be imposed on [the claimant]“). For example, as the ALJ noted, while Dr. Hong checked boxеs indicating that plaintiff’s hands had “muscle spasm” and “joint deformity” (AR 711), the record does not appear to contain (and plaintiff has not pointed to) any objective medical evidence that plaintiff ever experienced such medical signs to any material extent.
In addition, as the ALJ noted, Dr. Hong indicated that plaintiff reported “constant numbness over all the fingertips” (AR 711), but findings from aсtual clinical examinations of plaintiff’s hands repeatedly described plaintiff’s hand sensation as “intact.” (AR 29) (citing Exhibit 4F at 4 [AR 411]; Exhibit 5F at 4, 29, 72, 73, 82, 83 [AR 422, 447, 490-91, 500-01]); cf. Ghanim v. Colvin, 763 F.3d 1154, 1162 (9th Cir. 2014) (ALJ may discount medical opinion based “to a large extent” on a claimant’s “self-reports” that the ALJ found “not credible“) (internal quotation marks and citations omitted); Morgan v. Commissioner of Social Security Administration, 169 F.3d 595, 601-02 (9th Cir. 1999) (ALJ may reject medical opinion that is incоnsistent with other evidence of record). Also, Dr. Hong opined that plaintiff was limited in his ability to handle stress due, in part, to “anxiety” (AR 709-10) but, as the ALJ noted, the record lacks evidence that plaintiff was ever diagnosed with an anxiety disorder and/or that plaintiff had any
B. Dr. John Sedgh
Plaintiff challenges the ALJ’s evaluation of a single opinion expressed by Dr. Sedgh in the report of a June 19, 2013 Internal Medicine Consultation (Plaintiff’s Motion at 7) – specifically, Dr. Sedgh’s opinion that plaintiff’s “[g]ross and fine manipulations with either hand should be limited to occasional[]” (“Dr. Sedgh’s Opinion“). (AR 28, 412) (emphasis added). The ALJ, who instead assessed plaintiff with the residual functional capacity to do frequent handling and fingering (AR 26, 28-29), did not err to the extent he rejected Dr. Sedgh’s Opinion.
As the ALJ nоted, and the state agency medical consultants essentially found based on their review of the medical and other evidence in plaintiff’s file, Dr. Sedgh’s more restrictive limitations on plaintiff’s manipulation abilities were not supported by Dr. Sedgh’s own findings on examination of plaintiff’s upper extremities (which were generally “unremarkable“), and also were not supported
To the extent plaintiff suggests that the medical evidence otherwise actually supports Dr. Sedgh’s Opinion (Plaintiff’s Motion at 7-8), this Court will not second guess the ALJ’s reasonable determination that it does not, even if such evidence could give rise to inferences more favorable to plaintiff. See Robbins v. Commissioner of Social Security Administration, 466 F.3d 880, 882 (9th Cir. 2006) (citation omitted).
C. Dr. John Cook
Dr. Cook found in workers compensation terms the following “work restrictions” for plaintiff:
[Plaintiff] is prophylactically precluded from very forceful or very repetitive performance of the following types of activities with either hand; gripping, lifting, pushing, pulling, twisting, or finger dexterity activities. [¶] [Plaintiff] is prophylactically precluded from writing with his right hand for longer than five continuous minutes and then requires a five-minute break before resuming a further five continuous minutes of writing.
(collectively Dr. Cook’s Opinions“). (AR 380) (emphasis added). Plaintiff – who, in his recitation of Dr. Cook’s Opinions, both omits the word “prophylactically” and uses “two” instead of “five” where italicized above (Plaintiff’s Motion at 6) – challenges the ALJ’s evaluation of Dr. Cook’s opinions
First, as the ALJ noted, Dr. Cook’s Opinions were provided on August 24, 2011 – several months before plaintiff’s December 16, 2011 alleged onset date. (AR 22, 30, 380). See Carmickle v. Commissioner, Social Security Administration, 533 F.3d 1155, 1165 (9th Cir. 2008) (“Medical opinions that predate the alleged onset of disability are of limited relevance.“) (citation omitted); see generally Williams v. Astrue, 493 Fed. Appx. 866, 868 (9th Cir. 2012) (clear that “ALJ must consider all medical opinion evidence” even reports that predate claimant’s alleged onset date) (citations and quotation marks omitted).
Second, as noted above and not reflected in Plaintiff’s Motion, Dr. Cook’s Opinions actually state that plaintiff was “prophylactically precluded” from the various hand activities. (AR 380) (emphasis added). Since prophylactic measures are intended to prevent injury, recommendation of such measures in workers’ compensation cases do not reflect existing limitations that, on their own, would be probative of a claimant’s existing limitation that an ALJ in a Social Security case would be required to consider when evaluating residual functional capacity. Cf. Gelfo v. Lockheed Martin Corp., 140 Cal. App. 4th 34, 48 (2006) (In workers’ compensation parlance, physicians recommend “prophylactic” restrictions for a worker who reaches “permanent and stationary” disability in order “to help avoid re-injury.“); see generally Booth v. Barnhart, 181 F. Supp. 2d 1099, 1104 (C.D. Cal. 2002) (terms of art in California workers’ compensation guidelines “not equivalent” to those in Social Security disability cases) (citing Macri v. Chater, 93 F.3d 540, 544 (9th Cir. 1996); Desrosiers v. Secretary of Health and Human Services, 846 F.2d 573, 576 (9th Cir. 1988)). Consequently, the ALJ could properly have disregarded Dr. Cook’s recommendations entirely. See Vincent v. Heckler, 739 F.2d 1393, 1394-95 (9th Cir. 1984) (ALJ must provide an
Third, the ALJ also found that the work restrictions in Dr. Cook’s Opinions lacked support in the medical record which, in part, reflected “littlе subsequent medical treatment and care” related to plaintiff’s hand issues for “some 18 months” after Dr. Cook provided his opinions. Cf., e.g., Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001) (ALJ properly rejected a treating physician’s opinion who prescribed conservative treatment and where the plaintiff’s activities and lack of complaints were inconsistent with the physician’s disability assessment).
Finally, the ALJ properly rejected Dr. Cook Opinions (as well as those of Drs. Hong and Sedgh) in favor of the conflicting opinions of the state agency medical consultants, whose residual functional capacity assessment the ALJ essentially adopted. (Compare AR 26, with AR 87-88, 96-97, 108-09, 118-19). The opinions of the state agency medical consultants constituted substantial evidence supporting the ALJ’s decision since – as the ALJ explained – they were consistent with and/or supported by other independent medical evidence in the record as a whole. (AR 26-28); See Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001) (opinions of nontreating or nonexamining doctors may serve as substantial evidence when consistent with independent clinical findings); Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995) (“[R]eports of [a] nonexamining advisor need not be discounted and may serve as substantial evidence when they are supported by other evidence in the record and are consistent with it.“); see, e.g., Sportsman v. Colvin, 637 Fed.Appx. 992, 995 (9th Cir. 2016) (“ALJ did not err in assigning substantial weight to [] state agency medical consultant[] whose opinion relied on and was consistent with the medical evidence of record“) (citation omitted).
For the foregoing reasons, the decision of the Commissioner of Social Security is affirmed.
LET JUDGMENT BE ENTERED ACCORDINGLY.
DATED: October 30, 2017
/s/
Honorable Jacqueline Chooljian
UNITED STATES MAGISTRATE JUDGE