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Samuel E. v. Saul

United States District Court, C.D. California

December 4, 2019

SAMUEL E.,[1] Plaintiff,
ANDREW M. SAUL, Commissioner of Social Security,[2] Defendant.



         Plaintiff filed this action seeking review of the Commissioner's final decision denying his applications for disability insurance benefits and supplemental security income. In accordance with the Court's case management order, the parties have filed memorandum briefs addressing the merits of the disputed issues. The matter is now ready for decision.


         In October 2013, Plaintiff applied for disability insurance benefits and supplemental security income, alleging disability beginning September 24, 2012. Plaintiff's applications were denied initially and upon reconsideration. (Administrative Record [“AR”] 139-143, 150-154.) A hearing took place on April 8, 2015 before an Administrative Law Judge (“ALJ”). Plaintiff, who was represented by counsel, and a vocational expert (“VE”) testified at the hearing. (AR 64-94.) In a decision dated May 29, 2015, the ALJ found that Plaintiff suffered from the severe impairments of cervical degenerative disc disease and hypertension. (AR 54.) The ALJ determined that Plaintiff's residual functional capacity (“RFC”) included the ability to perform a range of medium work as follows: Plaintiff can lift and/or carry 50 pounds occasionally and up to 25 pounds frequently; can stand and/or walk for at least six hours in an eight-hour workday; can sit for at least six hours in an eight-hour workday; can frequently climb, balance, kneel, crouch, or crawl; and is limited to occasional use of ladders, ropes, and scaffolds. (AR 55.) Relying on the testimony of the VE, the ALJ concluded that Plaintiff could perform his past relevant work. Accordingly, the ALJ concluded that Plaintiff was not disabled. (AR 58-59.)

         The Appeals Council subsequently denied Plaintiff's request for review (AR 43-48), rendering the ALJ's decision the final decision of the Commissioner.


         1. Whether the ALJ properly assessed Plaintiff's RFC.

         2. Whether the ALJ properly rejected Plaintiff's subjective complaints.


         Under 42 U.S.C. § 405(g), this Court reviews the Commissioner's decision to determine whether the Commissioner's findings are supported by substantial evidence and whether the proper legal standards were applied. See Treichler v. Comm'r of Soc. Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 2014). Substantial evidence means “more than a mere scintilla” but less than a preponderance. See Richardson v. Perales, 402 U.S. 389, 401 (1971); Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson, 402 U.S. at 401. This Court must review the record as a whole, weighing both the evidence that supports and the evidence that detracts from the Commissioner's conclusion. Lingenfelter, 504 F.3d at 1035. Where evidence is susceptible of more than one rational interpretation, the Commissioner's decision must be upheld. See Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007).


         I. Medical Record

         Plaintiff alleged disability due to neck pain resulting from a neck injury he sustained in September 2012. (AR 260.) The ALJ summarized the relevant medical record, stating that the “objective diagnostic records revealed a moderate musculoskeletal pathology at most.” (AR 56.) The ALJ discussed the MRI studies of Plaintiff's cervical spine, which showed a mild-to-moderate degenerative disc disease. The ALJ observed that the most significant finding was severe right neural foraminal stenosis at ¶ 6-C7. However, the studies revealed no impingement of the spinal cord at any level. (AR 56-57, citing AR 538, 539-542.) The ALJ also noted a positive EMG/NCS study of Plaintiff's right upper extremity, which was consistent with right C7 radiculopathy, and indicated mild, asymptomatic, neuropathy at the wrist. (AR 57, citing AR 324.) Physical examinations in 2013 revealed mild positive findings of tenderness to palpation at the right lumbar paraspinal musculature and spasm, but no neurological deficits. (AR 57, citing AR 328, 333.)

         In January 2014, Plaintiff underwent a consultative orthopedic examination by Herman Schoene, M.D. Dr. Schoene reviewed MRIs of Plaintiff's cervical spine and performed a physical examination. He reported Plaintiff's blood pressure was elevated to 160/90. Plaintiff's posture and gait were normal, and he ambulated without difficulty and without the use of an assistive device. Plaintiff's neck range of motion was mildly diminished with a positive Spurling test. Plaintiff exhibited normal range of motion in his shoulders as well as his upper and lower extremities. Plaintiff retained full motor strength. Plaintiff's sensation was intact throughout. X-ray imaging performed on that date showed anterior osteophyte formation and narrowed disc spaces at ¶ 5-C6 and C6-C7. In Dr. Schoene's opinion, Plaintiff could perform a full range of medium work with no postural restrictions. (AR 418-422.)

         The ALJ observed that treatment notes in 2014 indicate that Plaintiff remained on narcotic pain medication for his neck pain. He noted the absence of evidence suggesting that Plaintiff had been referred for surgery or for epidural steroid injections. (AR 57, citing AR 573-580.) Instead, Plaintiff reported that his medication was effective in relieving his pain. (AR 57, citing AR 322.)

         The ALJ discussed the opinions of the State agency medical consultants, observing that they were generally consistent with Dr. Schoene's opinion. (AR 57-58, citing AR 95-105, 106-115.) Unlike Dr. Schoene, however, the State agency medical consultants precluded Plaintiff from more than occasional use of the upper extremities for pushing and pulling and limited Plaintiff to frequent postural activities and occasional use of ladders, ropes and scaffolds. (AR 58.) The ALJ found Dr. Schoene's opinion failed to fully account for Plaintiff's subjective complaints of pain. On the other hand, the ALJ found the State agency consultants' limitations on the upper extremities were overly restrictive considering Plaintiff's activities of daily living, intact neurological examinations, and lack of significant treatment for his alleged symptoms. (AR 58.) Consequently, the ALJ assessed the RFC outlined above.[4]

         With regard to Plaintiff's elevated blood pressure, the ALJ noted that there was no evidence of any end organ damage, history of stroke, cardiovascular disease, or functional limitations related to Plaintiff's blood pressure. (AR 57, citing AR 573-580, 581-587.) Thus, the ALJ concluded the condition “should be amenable to proper ...

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