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Judge v. Astrue

August 16, 2010


The opinion of the court was delivered by: Patrick J. Walsh United States Magistrate Judge



Before the Court is Plaintiff's appeal of a decision by Defendant Social Security Administration ("the Agency"), denying her application for Disability Insurance benefits ("DIB"). Plaintiff claims that the Administrative Law Judge ("ALJ") erred when he concluded that she had the residual functional capacity to work, despite the fact that she suffered from depression and anxiety. (Joint Stip. at 3-5.) For the following reasons, the Agency's decision is affirmed.


Plaintiff was a psychiatric technician at a state mental hospital in December 1995 when she witnessed a psychotic patient strangle and attempt to kill a co-worker. (Administrative Record ("AR") 202.) The worker survived only because Plaintiff and another patient intervened and saved the worker's life. (AR 202.) This incident caused considerable trauma for Plaintiff and she was forced to stop working. In 1997, the state determined that she was entitled to state disability retirement as a result. (AR 214-15.)

In 2004, Plaintiff applied for DIB, alleging that she had been unable to work since December 1995, due to post-traumatic stress. (AR 28, 132-33.) In 2005, the Agency denied the application initially and on reconsideration. (AR 27, 28.) Plaintiff then requested a hearing before an ALJ. (AR 40.) The Agency lost Plaintiff's file, resulting in a long delay of her hearing. Eventually, Plaintiff appeared with counsel and testified at the hearing on November 25, 2008. (AR 235-50.) On December 30, 2008, the ALJ issued a decision denying benefits. (AR 10-19.) The ALJ concluded that, though Plaintiff could not perform her past work as a psychiatric technician due to post-traumatic stress triggered by that environment, she was capable of performing other jobs. (AR 16, 18-19.) Plaintiff appealed to the Appeals Council, which denied review. (AR 3-8.) She then commenced the instant action.


Plaintiff contends that the ALJ erred when he concluded that she had the residual functional capacity to perform work. She argues that this finding was inconsistent with the opinion of an examining psychiatrist, Khang Nguyen, who found that Plaintiff was too impaired to work. (Joint Stip. at 3-5.) For the reasons set forth below, the Court concludes that the ALJ did not err.

ALJs are tasked with resolving conflicts and ambiguities in the medical record. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). They are often confronted with contradictory medical opinions from different doctors and must determine which to accept and which to reject. In doing so, they are required to provide proper reasons for accepting one doctor's opinion over another's. In order to reject an examining doctor's opinion that, as here, is contradicted by another doctor's opinion, an ALJ need only provide specific and legitimate reasons for doing so. Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1995); Andrews, 53 F.3d at 1041-42. "Where medical reports are inconclusive, questions of credibility and resolution of conflicts in the testimony are functions solely of the [ALJ]." Morgan v. Comm'r of Soc. Sec., 169 F.3d 595, 601 (9th Cir. 1999) (internal quotation marks omitted).

Plaintiff was referred to psychiatrist Nguyen in connection with her claim for DIB. On September 14, 2007, she met with Dr. Nguyen, who interviewed her and conducted a complete psychiatric evaluation. (AR 173-79.) Dr. Nguyen found Plaintiff "highly anxious, distraught, jittery and tremulous, and [] sweating profusely." (AR 175.) He concluded that Plaintiff was suffering from chronic, post-traumatic stress disorder and, as a result, was not able to "perform her work-related duties and adapt to commonplace stressors of a work environment, from a psychiatric standpoint." (AR 175.) He opined that Plaintiff's condition was severe and would last for more than 12 months. (AR 175.)

The ALJ discounted these findings, explaining: I do not accept the assessment offered by Dr. Nguyen because it is inconsistent with the claimant's presentation to her treating doctor in 1997; inconsistent with her presentation to Dr. McGee in September 2008, only 9 months after seeing Dr. Nguyen; inconsistent with her admitted activities of daily living, including her short-term work assignments as a movie extra and coin show worker, activities that require social contact with others and belie the claimant's allegation that she avoids everything; and inconsistent with the lack of ongoing mental health care for over 10 years, despite the access provided by her Workers' Compensation claim. (AR 15.)

Plaintiff interprets the first part of the above quoted language to mean that the ALJ rejected Dr. Nguyen's opinion because it was inconsistent with Dr. Bassett's and Dr. McGee's opinions. (Joint Stip. at 4.) She claims that this was error because Dr. Nguyen's opinion was, in fact, consistent with Dr. Bassett's and because Dr. McGee's opinion was not supported by the record. (Joint Stip. at 5.)

The Court does not interpret the ALJ's language as Plaintiff has. It is not entirely clear what the ALJ meant when he stated that he was rejecting Dr. Nguyen's "assessment" because "it [was] inconsistent with the claimant's presentation to [Dr. Bassett] in 1997." (AR 15.) It is not obvious to the Court how an "assessment" by one doctor can be inconsistent with a patient's "presentation" to another. The Court assumes that the ALJ was focusing on the fact that Plaintiff presented herself as being significantly more impaired to Dr. Nguyen in 2007, almost 12 years after the incident that caused her trauma, than she did to Dr. Bassett in January 1997, 13 months after it happened. Reading between the lines, the Court believes that the ALJ was discounting Dr. Nguyen's report because it was based on Plaintiff's feigned or exaggerated symptoms when she went to see him.

Assuming that that was the reason the ALJ rejected Dr. Nguyen's opinion, it is a legally valid reason. See Sandgathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997) (affirming ALJ's rejection of treating physician's opinion based on claimant's self-reports, which ALJ found were not credible); and Fair v. Bowen, 885 F.2d 597, 605 (9th Cir. 1989) (holding doctor's opinion of disability "premised to a large extent upon the claimant's own accounts of his symptoms and limitations," may be disregarded where those complaints have been "properly discounted."). Further, it is supported by the facts. Plaintiff exhibited symptoms before Dr. Nguyen that she had never exhibited before, symptoms that were way out of ...

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