United States District Court, C.D. California
May 29, 2014
DANYLLE SIMMONS, Plaintiff,
CAROLYN W. COLVIN, Commissioner of Social Security, Defendant.
MEMORANDUM OPINION AND ORDER
ALICIA G. ROSENBERG, Magistrate Judge.
Plaintiff Danylle Simmons filed this action on August 14, 2013. Pursuant to 28 U.S.C. § 636(c), the parties consented to proceed before the magistrate judge on September 18 and 27, 2013. (Dkt. Nos. 12, 13.) On February 19, 2014, the parties filed a Joint Stipulation ("JS") that addressed the disputed issues. The court has taken the matter under submission without oral argument. Having reviewed the entire file, the court affirms the decision of the Commissioner.
On May 8, 2008, an application for supplemental security income was filed on behalf of Simmons, who was then a child under the age of 18. AR 25, 228-30. On September 8, 2008, an application for child's benefits under Title II of the Social Security Act was filed on behalf of Simmons. AR 25. In both applications, Simmons alleged a disability onset date of November 23, 1990, her date of birth. AR 25. The applications were denied initially and on reconsideration. AR 25, 93-95. Simmons requested a hearing before an Administrative Law Judge ("ALJ"). AR 131. On February 22, 2010, the ALJ conducted a hearing at which Simmons and a vocational expert ("VE") testified. AR 45-67. On April 9, 2010, the ALJ issued a decision denying benefits. AR 99-105. Simmons requested review by the Appeals Council. AR 110.
On May 18, 2011, the Appeals Council vacated the decision and remanded the case to the ALJ to obtain additional evidence concerning Simmons' musculoskeletal condition; further evaluate Simmons' subjective complaints; obtain evidence from a medical expert, if necessary; give further consideration to Simmons' residual functional capacity ("RFC") during the entire period at issue; and obtain supplemental evidence from a VE, if warranted. AR 110-12. On November 22, 2011, the ALJ conducted a hearing at which Simmons, a medical expert, and a VE testified. AR 68-92. On January 10, 2012, the ALJ issued a decision finding Simmons disabled until the age of 18 and not disabled as an adult. AR 22-40. On May 31, 2013, the Appeals Council denied the request for review. AR 1-5. This action followed.
STANDARD OF REVIEW
Pursuant to 42 U.S.C. § 405(g), this court reviews the Commissioner's decision to deny benefits. The decision will be disturbed only if it is not supported by substantial evidence, or if it is based upon the application of improper legal standards. Moncada v. Chater, 60 F.3d 521, 523 (9th Cir. 1995) (per curiam); Drouin v. Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992).
"Substantial evidence" means "more than a mere scintilla but less than a preponderance - it is such relevant evidence that a reasonable mind might accept as adequate to support the conclusion." Moncada, 60 F.3d at 523. In determining whether substantial evidence exists to support the Commissioner's decision, the court examines the administrative record as a whole, considering adverse as well as supporting evidence. Drouin, 966 F.2d at 1257. When the evidence is susceptible to more than one rational interpretation, the court must defer to the Commissioner's decision. Moncada, 60 F.3d at 523.
"An individual under the age of 18 shall be considered disabled... if that individual has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 1382c(a)(3)(C)(i). An impairment is "marked and severe" if it meets, medically equals, or functionally equals an impairment listed in 20 C.F.R. § 404, Subpart P, Appendix I. 20 C.F.R. § 416.924(d)(1). A claimant's condition "meets" a listed impairment if the claimant's impairment matches the listed impairment. Id. A claimant's condition "medically equals" the listed impairment by demonstrating medical findings that are of equal medical significance to the listed impairment. 20 C.F.R. § 416.926(b)(1)(ii). A claimant's condition "functionally equals" a listed impairment by showing either a marked limitation in two functional domains (out of six) or an extreme limitation in one domain. 20 C.F.R. § 416.926a(a). The six domains are acquiring and using information, attending and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for yourself, and health and physical well-being. 20 C.F.R. § 416.926a(b)(1)(i-vi).
The standard for determining disability in individuals who have attained the age of 18 is different from the childhood standard. At age 18 and older, a person qualifies as disabled, and thereby eligible for such benefits, "only if his physical or mental impairment or 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." Barnhart v. Thomas, 540 U.S. 20, 21-22, 124 S.Ct. 376, 157 L.Ed.2d 333 (2003) (citation and quotation marks omitted).
B. The ALJ's Findings
The ALJ found that Simmons had not engaged in substantial gainful activity since November 23, 1990, the alleged onset date. AR 30. Before attaining age 18, Simmons had the severe impairments of neonatal right brachial plexus injury with right arm paralysis and obesity. AR 31. Before attaining age 18, Simmons had an impairment or combination of impairments that functionally equaled a listing. Id. The ALJ found Simmons disabled prior to attaining age 18. AR 32.
Since attaining age 18, Simmons has not developed any new impairments and did not meet or medically equal a listed impairment. Id. She had the RFC to perform light work, except she can lift and/or carry 20 pounds occasionally and 10 pounds frequently with the left upper extremity; stand, walk or sit for six hours out of an eight-hour workday with regular breaks; and climb stairs. She cannot climb ladders, work at heights or balance. She cannot use her right upper extremity except as a helper. AR 33. She has no past relevant work. AR 38. There are jobs that exist in significant numbers in the national economy that she can perform such as ticket taker, information clerk and charge account clerk. AR 39. She has not been under a disability from the day she attained age 18 on November 22, 2008 through the date of the ALJ's decision. AR 40.
C. Treating Physician
Simmons contends the ALJ erred in rejecting the opinion of treating physician, Dr. Fang.
An opinion of a treating physician is given more weight than the opinion of non-treating physicians. Orn v. Astrue, 495 F.3d 625, 631 (9th Cir. 2007). To reject an uncontradicted opinion of a medically acceptable treating source, an ALJ must state clear and convincing reasons that are supported by substantial evidence. Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005). When a treating physician's opinion is contradicted by another doctor, "the ALJ may not reject this opinion without providing specific and legitimate reasons supported by substantial evidence in the record. This can be done by setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings." Orn, 495 F.3d at 632 (citations and quotation marks omitted). "When there is conflicting medical evidence, the Secretary must determine credibility and resolve the conflict." Thomas v. Barnhart, 278 F.3d 947, 956-57 (9th Cir. 2002).
The record contains a Residual Functional Capacity Questionnaire ("RFC Questionnaire"), dated February 26, 2009, from Dr. Fang. AR 38, 338-39. Dr. Fang indicated Simmons was paralyzed in her right arm and could not use it. AR 338-39. He indicated that Simmons would need to recline or lie down during a hypothetical 8-hour workday in excess of the typical breaks. AR 338. However, the form contains a direct question as to whether the claimant will need to take unscheduled breaks during an 8-hour workday. Dr. Fang did not answer yes or no, and instead wrote a question mark. He indicated that Simmons did not have any other limitations that would affect her ability to work at a regular job on a sustained basis. AR 339.
The ALJ gave "some weight" to Dr. Fang's opinion. AR 38. He noted that Dr. Fang indicated that Simmons was paralyzed in her right arm and could not use it. AR 38. He noted that "Dr. Fang did not opine as to any additional limitations for [Simmons]." AR 38 (citing AR 339). He noted that Dr. Fang's opinion was "without substantial support" from the evidence in the record and lacked findings or an assessment of capacity. AR 38.
Simmons argues that the ALJ failed to consider and evaluate Dr. Fang's opinion that she would need to recline or lie down during a hypothetical 8-hour workday in excess of the typical breaks. However, Dr. Fang did not appear to know whether Simmons would require unscheduled breaks. Dr. Fang's treatment notes do not mention fatigue. It is the ALJ's province to resolve conflicts in the medical evidence. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); see also Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989). When the evidence is susceptible to more than one rational interpretation, the court must defer to the Commissioner's decision. Moncada, 60 F.3d at 523.
D. RFC Determination
Simmons contends the ALJ's RFC assessment is not supported by substantial evidence.
The RFC determination measures the claimant's capacity to engage in basic work activities. Bowen v. New York, 476 U.S. 467, 471, 106 S.Ct. 2022, 90 L.Ed.2d 462 (1986). The RFC is a determination of "the most [an individual] can still do despite [his or her] limitations." 20 C.F.R. § 404.1545(a). It is an administrative finding, not a medical opinion. 20 C.F.R. § 404.1527(e)(2). The RFC takes into account both exertional limitations and non-exertional limitations. The RFC must contain "a narrative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical evidence (e.g., daily activities, observations)." Social Security Ruling ("SSR") 96-8p. The ALJ must also explain how he or she resolved material inconsistencies or ambiguities in the record. Id. "When there is conflicting medical evidence, the Secretary must determine credibility and resolve the conflict." Thomas, 278 F.3d at 956-57 (citation omitted).
The ALJ's RFC determination was that since attaining age 18, Simmons can perform light work, except she can lift and/or carry 20 pounds occasionally and 10 pounds frequently with her left upper extremity; stand, sit, and/or walk for six hours out of an eight-hour workday with regular breaks; and climb stairs. She cannot climb ladders, work at heights or balance. AR 33. She is unable to use her right upper extremity except as a helper. Id.
Simmons argues that the ALJ made three errors in determining her RFC: (1) he failed to include functional limitations based on his findings that she suffered from marked limitations in attending and completing tasks; (2) he failed to account for the pain she experiences; and (3) he found that she could use her right hand as a "helper" even though substantial evidence in the record demonstrates she is completely unable to use her right hand.
The Commissioner correctly argues that the ALJ's finding of marked limitations in attending and completing tasks was part of the childhood disability analysis, which differs from the adult disability analysis. The ALJ found marked limitations when he was determining, under the childhood standards of disability, whether an impairment or combination of impairments functionally equaled a listing. AR 31; 20 C.F.R. § 416.926a(b)-(e).
With respect to Simmons' argument about pain, the ALJ properly discounted her credibility for the reasons discussed below.
To the extent the ALJ erred in finding Simmons could not use her right arm except as a helper, any error was harmless. The ALJ's hypothetical to the VE included a limitation of "no use of the right upper extremity except as a helper, minimally as a helper." AR 87. The VE testified that there would be work in the national economy that a claimant could perform such as ticket taker, information clerk and charge account clerk. AR 88. The ALJ asked whether these jobs required bilateral dexterity. The VE answered no. The ALJ asked whether these jobs could be performed with one arm. The VE responded: "These positions would allow for unilateral or just one, one arm use." AR 88. The claimant's attorney cross examined the VE on that testimony. AR 89-90. The record is clear that the VE identified jobs that could be done with only one arm. See McLeod v. Astrue, 640 F.3d 881, 887-88 (9th Cir. 2011) (harmless error rule).
Simmons contends the ALJ improperly rejected her testimony regarding her pain and functional limitations.
"To determine whether a claimant's testimony regarding subjective pain or symptoms is credible, an ALJ must engage in a two-step analysis." Lingenfelter v. Astrue, 504 F.3d 1028, 1035-36 (9th Cir. 2007). At step one, "the ALJ must determine whether the claimant has presented objective medical evidence of an underlying impairment which could reasonably be expected to produce the pain or other symptoms alleged.'" Id. (quoting Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir.1991) (en banc)). The ALJ found that since attaining age 18, Simmons' medically determinable impairments could reasonably be expected to produce the alleged symptoms. AR 35.
"Second, if the claimant meets this first test, and there is no evidence of malingering, the ALJ can reject the claimant's testimony about the severity of her symptoms only by offering specific, clear and convincing reasons for doing so." Lingenfelter, 504 F.3d at 1036 (citation and quotation marks omitted). "In making a credibility determination, the ALJ must specifically identify what testimony is credible and what testimony undermines the claimant's complaints[.]'" Greger v. Barnhart, 464 F.3d 968, 972 (9th Cir. 2006) (citation omitted).
In weighing credibility, the ALJ may consider factors including: the nature, location, onset, duration, frequency, radiation, and intensity of any pain; precipitating and aggravating factors (e.g., movement, activity, environmental conditions); type, dosage, effectiveness, and adverse side effects of any pain medication; treatment, other than medication, for relief of pain; functional restrictions; the claimant's daily activities; and "ordinary techniques of credibility evaluation." Bunnell, 947 F.2d at 346 (citing SSR 88-13) (quotation marks omitted). The ALJ may consider: (a) inconsistencies or discrepancies in a claimant's statements; (b) inconsistencies between a claimant's statements and activities; (c) exaggerated complaints; and (d) an unexplained failure to seek treatment. Thomas, 278 F.3d at 958-59.
The ALJ found that since attaining age 18, Simmons' statements concerning the intensity, persistence and limiting effects of her symptoms were not credible to the extent they were inconsistent with the RFC. AR 35. The ALJ relied on four reasons: (1) conservative treatment; (2) inconsistent and contradictory statements; (3) inconsistency between Simmons' statements and daily activities; and (4) the objective evidence did not support the severity of the alleged symptoms. AR 34-35.
"[E]vidence of conservative treatment' is sufficient to discount a claimant's testimony regarding severity of an impairment." Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 2007) (citation omitted). The ALJ noted that the treatment records reveal that Simmons received routine and conservative treatment. AR 35. In October 2008, Simmons reported she was taking Tylenol Extra Strength. AR 324. She testified in February 2010 that she took prescription-strength Tylenol and used Icy-Hot for her pain. AR 59. When the ALJ asked why she did not request stronger medication for pain that is allegedly at level 10, she testified that she had "never thought of it like that." AR 60. In August 2011, Simmons reported she was taking no medications. AR 536. In November 2011, Simmons testified she was taking Ibuprofen 800 mg and Gabapentin 300 mg, which took away some of the pain. AR 81-82. Impairments that can be controlled effectively with medication are not considered disabling. Warre v. Comm'r of Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 2006).
An ALJ may consider inconsistencies in a claimant's statements when weighing a claimant's credibility. Thomas, 278 F.3d at 958-59. The ALJ noted that Simmons denied smoking or drinking alcohol even though the medical record that she had once been transported to the hospital in an unresponsive condition and was diagnosed with substance abuse, alcohol intoxication and hypokalimia. AR 34-35. Simmons tested positive for amphetamines and cannabinoids. AR 35-36, 52-53, 387, 391, 400.
The ALJ cited inconsistencies between Simmons' statements and daily activities. AR 34. The ALJ noted that while Simmons alleged she was unable to do household chores, care for her young children without assistance, or dress herself, the record indicated that she could ambulate independently and could perform all activities of daily living without assistance. AR 34, 79-80, 252-53, 392, 503, 546. An ALJ may consider a claimant's daily activities when weighing credibility. Bunnell, 947 F.2d at 346.
Although lack of objective medical evidence supporting the degree of limitation "cannot form the sole basis for discounting pain testimony, " it is a factor that an ALJ may consider in assessing credibility. Burch, 400 F.3d at 681. Simmons argues that the medical records support her contention that she suffers from pain in her right arm. AR 327, 339, 590-91. However, the medical records are consistent with conservative treatment. Tommasetti v. Astrue, 533 F.3d 1035, 1040 (9th Cir. 2008) (describing anti-inflammatory medication as conservative treatment).
The ALJ's credibility finding is supported by substantial evidence, and this court "may not engage in second-guessing." Thomas, 278 F.3d at 959 (citing Morgan v. Comm'r of Soc. Sec. Admin., 169 F.3d 595, 600 (9th Cir. 1999)).
IT IS HEREBY ORDERED that the decision of the Commissioner is affirmed.
IT IS FURTHER ORDERED that the Clerk serve copies of this Order and the Judgment herein on all parties or their counsel.