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Holguin v. Berryhill

United States District Court, N.D. California

July 18, 2017



          HOWARD R. LLOYD, United States Magistrate Judge

         Claimant Sandra Holguin (“Claimant”) appeals a decision denying social security disability benefits and supplemental security income under Titles II and XVI of the Social Security Act. Dkt. No. 1. She seeks a reversal of the Commissioner's decision and a judgment on the record in her favor or, alternatively, remand for further administrative proceedings. Dkt. No. 14. Defendant filed a cross-motion for summary judgment defending the ALJ's decision. Dkt. No. 15. Each party consented to magistrate judge jurisdiction. Dkt. Nos. 8, 11. For the reasons described below, the court denies Claimant's motion for summary judgment and grants the Commissioner's cross-motion for summary judgment.


         Claimant was born in 1963 and completed part of high school. AR 37, 61. From 2001 to 2002, she worked in electronics assembly, a job she performed primarily in a sitting position. AR 34-35. From 2002 to 2003, Claimant wrapped baked goods in a wholesale store. AR 34. And in 2005 and 2006, she worked as an in-home caregiver. AR 33. While working as a caregiver, Claimant injured her back after several months of transferring her patient without assistance. AR 38. By late 2006, she stopped working due to the “excruciating” pain: “I could not sit, squat, bend, I mean, just moving all the way around, nothing.” AR 38.

         Claimant applied for social security disability benefits and supplemental social security income in December 2012 and January 2013, respectively, alleging a disability on-set date of October 1, 2008. AR 10. Her claims-which alleged disability based on degenerative disc disease, chronic back problems, nerve damage, high blood pressure, and anxiety, AR 61-were denied initially and on reconsideration. AR 10.

         The record contains numerous reports and various physicians' opinions. A 2010 MRI of Claimant's spine identified a mild disc bulge consistent with an annular tear. AR 308. The MRI report observed that the annular tear “may act as a source of chemical irritation to the nerve root.” Id. A 2012 MRI report indicated that three osteophyte complexes were “mildly indenting” the spinal cord. AR 425. And a 2014 MRI found mild central canal stenosis. AR 751.

         Claimant was examined by Dr. Robinson in January of 2007. Dr. Robinson observed that Claimant had a positive straight leg-raising test and recommended that she be limited to “sedentary to semi-sedentary occupations.” AR 275, 286. Claimant, Dr. Robinson stated, “could probably sit for fairly long periods of time provided she is able to take breaks for about 1-2 minutes every 30-45 minutes to relieve back pain.” AR 286.

         Doctor Feinberg examined Claimant in 2010. He reported that Claimant had no muscular atrophy in her lower body and that her lower body strength was normal. AR 323. He also stated that “straight leg-raising was negative for sciatica, ” and that her gait was normal. Id. Dr. Feinberg seemed skeptical of the results of the MRI described above, stating: “She was reported to have an abnormal MRI, although quite frankly her objective physical examination today is normal and I had her return for electrodiagnostic testing which revealed no abnormalities.” AR 326. As for Claimant's range of motion, Dr. Feinberg noted that “lumbar flexibility was reduced with some discomfort at the ends of range, ” but that “[h]ip and lower body range of motion was otherwise within normal limits.” AR 323. The doctor stated that he would not have Claimant work in a position as rigorous as her prior in-home caregiving job and concluded that she was precluded from “heavy lifting, repeated bending and stooping” and “prolonged weight bearing.” AR 326.

         Claimant was treated from 2009 to 2011 by Dr. Fujimoto. Dr. Fujimoto observed that Claimant had an antalgic gait in July 2010, but that she had not had an antalgic gait several months earlier. AR 370, 378. He stated in 2011 that Claimant's functional limitations were being managed by her medication. AR 354. Dr. Fujimoto also noted that Claimant had a mild decrease in sensation to pinprick and light touch on her right foot and a negative straight-leg raising test. AR 366. He prescribed “modified” work duty, with “no heavy lifting, repeated bending or stooping for the spine, and no prolonged weight bearing.” AR 352.

         Dr. Hsieh treated Claimant from 2008 to 2013. In 2008, he observed evidence of “a right L5-S1 radiculopathy.” AR 485, 495. He later reported that Claimant's gait was “mildly antalgic, ” that her lumbar range of motion was “moderately limited to flexion, with pain, ” and that her straight-leg raising test was negative on the left and positive on the right. AR 428. In 2015, Doctor Hsieh wrote a letter stating that, though he had last seen Claimant for treatment in 2013, he “would be doubtful that she would be able to continue working” due to “pain and functional limitation” unless her symptomatology had “significantly improve[d].” AR 878.

         Another treating doctor, Doctor Lifshutz, also wrote a letter in 2015 stating that Claimant (a current patient of his) could not work at that time. AR 879.

         Finally, Claimant was examined by a psychologist, Dr. Goldman. Dr. Goldman found Claimant to be an unreliable historian and assessed “malingering.” AR 702. She observed that Claimant was “only superficially cooperative throughout the evaluation” and “did not make an adequate effort on the tasks presented to her.” AR 702. Dr. Goldman further observed that Claimant drove without restriction, bathed and groomed herself without help, and could pay bills independently. AR 701. She concluded that Claimant's functional limitations “were unable to be accurately assessed due to malingering.” AR 702.

         In addition to the above, the record contains evidence of Claimant's drug use. Claimant reportedly used cocaine in the 1980s and in 1999, as well as in 2005 and 2006. AR 315, 316. When asked by Dr. Feinberg, Claimant stated that “she does not remember having a cocaine problem in 2005” but that she could not recall the last time she used cocaine. AR 325. Claimant also may have lied to Dr. Fujimoto about her cocaine use: she tested positive for cocaine in 2011, though she denied having used the drug and demanded a re-test (which was denied). AR 351. After discovering the positive test and the fact that Claimant had obtained Vicodin from five other doctors besides himself, Dr. Fujimoto terminated his relationship with her. AR 351.

         At the hearing before the ALJ, Claimant testified that she stopped working in 2006 due to her injury. AR 38. She stated that she experienced constant back pain, which radiated down the right side of her body. AR 41. Due to the pain, she could stand for 20 minutes before needing a ...

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