LUCY H. KOH, District Judge.
Plaintiff Jose Castanon ("Castanon") appeals a final decision of the Commissioner of Social Security denying his application for a period of disability and disability insurance benefits under Title II of the Social Security Act. Before the Court are the parties' cross-motions for summary judgment, which have been fully briefed. See ECF Nos. 19, 21, 22. Upon consideration of the briefing
Castanon was born in Mexico on December 7, 1966; he spent his childhood there before moving to the United States in 1982. Admin. R. ("AR") 91, 865. He has past relevant work as a sheet metal worker, spray painter, and construction worker. AR 103-11, 903. On April 2, 2009, he filed an application for a period of disability and disability insurance benefits with a protective filing date of March 17, 2009.
Castanon's application was denied initially and upon reconsideration. AR 47, 53. An Administrative Law Judge ("ALJ") conducted a hearing on January 11, 2011. AR 19, 862-914. On May 9, 2011, the ALJ issued a written decision concluding that Castanon was not disabled and thus was not entitled to benefits. AR 19-36. The Appeals Council denied review, making the ALJ's decision the final decision of the Commissioner. AR 7. Castanon now seeks judicial review of the denial of benefits.
This Court has the authority to review the Commissioner's decision to deny benefits. 42 U.S.C. § 405(g). The Commissioner's 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. Morgan v. Comm'r of Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Moncada v. Chater, 60 F.3d 521, 523 (9th Cir. 1995). In this context, the term "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; see also Drouin v. Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992). When 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; Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). Where evidence exists to support more than one rational interpretation, the court must defer to the decision of the Commissioner. Moncada, 60 F.3d at 523; Drouin, 966 F.2d at 1258.
Disability benefits are available under Title II of the Social Security Act when an eligible claimant is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A).
"ALJs are to apply a five-step sequential review process in determining whether a claimant qualifies as disabled." Bray v. Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009). At step one, the ALJ determines whether the claimant is performing "substantial gainful activity." 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not disabled; if not, the analysis proceeds to step two. Id. At step two, the ALJ determines whether the claimant suffers from a severe impairment or combination of impairments. 20 C.F.R. § 404.1520(a)(4)(ii). If not, the claimant is not disabled; if so, the analysis proceeds to step three. Id. At step three, the ALJ determines whether the claimant's impairment or combination of impairments meets or medically equals an impairment listed in the Listing of Impairments ("Listing"), 20 C.F.R. § 404, subpt. P, app. 1. 20 C.F.R. § 404.1520(a)(4)(iii). If so, the claimant is disabled; if not, the analysis proceeds to step four. Id. At step four, the ALJ determines whether the claimant has the residual functional capacity ("RFC") to do his or her past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). If so, the claimant is not disabled; if not, the analysis proceeds to step five. Id. At step five, the ALJ determines whether the claimant can do other jobs in the national economy. 20 C.F.R. § 404.1520(a)(4)(v). If so, the claimant is not disabled; if not, the claimant is disabled. Id. "The burden of proof is on the claimant at steps one through four, but shifts to the Commissioner at step five." Bray, 554 F.3d at 1222.
The ALJ determined that Castanon's earnings records showed that he had acquired sufficient quarters of coverage to remain insured through December 31, 2011. AR 19. At step one, the ALJ found that Castanon had not performed substantial gainful activity since his alleged onset date of April 4, 2006. AR 21. At step two, the ALJ found that Castanon had a severe combination of impairments consisting of "[s]tatus post trauma injury to the left hand; status post carpal tunnel release of the left hand; and myofascial pain in the left upper extremity"; however, the ALJ found that Castanon's claimed mental impairment of adjustment disorder with depressed and anxious mood caused only minimal limitation and thus was non-severe. Id. At step three, the ALJ concluded that Castanon's impairments did not meet or medically equal an impairment in the Listing. AR 23. At step four, the ALJ determined that Castanon could not perform his past relevant work. AR 34.
The ALJ found that Castanon has the RFC to perform light work with the restriction that "[t]he claimant is limited to using the left arm as an assist to the right upper extremity. The left arm can be used as an assist one third of the time." AR 23. The ALJ found no limitation with respect to Castanon's dominant right upper extremity. Id. Based upon this RFC and the testimony of a vocational expert, the ALJ concluded at step five that Castanon could do jobs that existed in significant numbers in the national economy. AR 35. Castanon challenges the ALJ's step five determination, asserting that the ALJ erred by: failing to give sufficient weight to the opinions of his treating physicians; failing to consider his mental limitation of depression when determining his RFC; and making unsupported factual findings regarding his education.
When evaluating medical evidence, an ALJ must give a treating physician's opinion "substantial weight." Bray v. Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1228 (9th Cir. 2009). "When evidence in the record contradicts the opinion of a treating physician, the ALJ must present `specific and legitimate reasons' for discounting the treating physician's opinion, supported by substantial evidence." Id. (citing Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). When a treating physician's opinion is not contradicted by another physician, the ALJ must provide "clear and convincing" reasons for disbelieving the treating physician. Id. at 1228 n.8.
With respect to Castanon's physical limitations, the ALJ gave significant weight to the opinion of consulting physician Woodrow Janese, M.D. and less weight to the opinions of treating physician Hessam Noralahi, M.D. and examining physicians Allen Kaisler-Meza, M.D. and Jaehoon Chung, M.D. AR 23-31. With respect to Castanon's mental limitations, the ALJ gave significant weight to the opinion of examining psychiatrist Antoinette Acenas, M.D. and less weight to the opinion of treating psychiatrist Tahami, D.O. AR 31-34. Because the ALJ relied upon other physicians' opinions as bases for discounting the treating physicians' opinions, the ALJ need only articulate "specific and legitimate" reasons for doing so, supported by substantial evidence. See Bray, 554 F.3d at 1228.
The record evidence regarding Castanon's limitations is summarized below:
Castanon saw Dr. Eric Chan in April 2006 following his initial emergency room visit on the date of the injury to his left hand. AR 214. Dr. Chan diagnosed possible injury to the left carpal tunnel with possible median nerve and flexor tendon injuries. Id. He recommended surgery. Id. During the surgery, which was performed on April 20, 2006, Dr. Chan found that the median nerve and flexor tendon were intact; the tendon sheath and synovium were thickened and swollen and were repaired; and a moderate size hematoma was removed. AR 215.
Castanon saw Dr. Michael Butcher, an orthopaedic surgeon, for follow-up on July 11, 2006. Dr. Butcher prepared a report dated July 12, 2006, in which he diagnosed Castanon with reflex sympathetic dystrophy ("RSD") and recommended immediate pain management including possible sympathetic nerve blocks, as well as physical therapy. AR 238-39. Dr. Butcher prepared an additional report dated July 13, 2006, noting that he had received a report from Dr. Allen Kaisler-Meza, who also believed that Castanon had RSD. AR 236. Dr. Butcher saw Castanon again on July 17, 2006, and noted that he appeared much more comfortable since he had started taking prescribed medication. AR 234. Dr. Butcher recommended sympathetic nerve block injections and prescribed further physical therapy. Id. Dr. Butcher opined that Castanon could not do his job and that he should be on temporary total disability. Id. Dr. Butcher saw Castanon again on July 31, 2006. Although Castanon "was adamant about being unable to drive and perform any work involving the left upper extremity," Dr. Butcher noted that electrodiagnostic tests were negative, recommended that Castanon use his left hand as much as possible, and recommended that he return to modified work. AR 230.
Castanon was seen by Dr. Hessam Noralahi, an industrial disability evaluator, on August 22, 2006. AR 247-51. It appears that this visit was scheduled in connection with a worker's compensation claim, as Dr. Noralahi's report of the same date refers to a claims adjuster and contains a notation that it was copied to an attorney.
Dr. Noralahi and other doctors from Dr. Noralahi's office prepared reports periodically throughout 2006, 2007, and 2008. A report dated May 16, 2007 stated that Castanon's symptoms seemed to be "reasonably controlled with medications," that the option of nerve blocks had been refused because Castanon felt the medications were controlling his symptoms, and that Castanon had been referred to Dr. Hosein Tahami for psychiatric issues. AR 280. A report dated May 17, 2007 indicated that Castanon had reported depression; depression screening by Dr. Tahami was recommended again. AR 278. A report dated September 12, 2007 noted that medication was effective in controlling some of Castanon's symptoms and that Castanon continued to refuse recommended ganglion nerve block. AR 272. A report dated January 21, 2008 indicated that Castanon had not followed up with Dr. Tahami. AR 264. A report dated February 20, 2008 noted that medication was effective in decreasing Castanon's symptoms and again stated that he should see Dr. Tahami for psychiatric treatment. AR 260.
On May 18, 2010, Dr. Noralahi submitted a RSD medical assessment form, opining that Castanon's condition would cause occasional interference with attention and concentration and that Castanon would be unable to perform routine repetitive tasks at a consistent pace, perform detailed or complicated tasks, meet strict deadlines, perform fast paced tasks, work near hazards such as heights or moving machinery, or do any lifting, pushing, pulling or repeated wrist movements. AR 552. Dr. Noralahi also opined that Castanon would need to take six ten-minute breaks each workday. AR 553.
Castanon saw Dr. Allen Kaisler-Meza, M.D. for agreed medical examinations on a number of occasions, which were summarized in reports dated May 15, 2007 and May 11,2009. AR 597-606, 682-92. Dr. Kaisler-Meza noted Castanon's reports of pain and weakness. AR 600, 686. After lengthy examinations, Dr. Kaisler-Meza diagnosed Castanon with complex regional pain syndrome("CRPS") and RSD caused by the puncture to his palm and resulting surgery, and recommended a ganglion block. AR 604-05, 688. He opined that Castanon was temporarily totally disabled, but it is not clear whether Dr. Kaisler-Meza meant disabled only from his past work or from any work. AR 605, 691.
On October 11, 2009, Dr. Kaisler-Meza prepared a supplemental report after viewing surveillance videos of Castanon; the videos are discussed below. AR 663-67. Dr. Kaisler-Meza described the videos as showing Castanon "employing his left hand freely and lifting, pulling, handling beyond his description of his abilities to me." AR 666. Dr. Kaisler-Meza stated that there was a discrepancy between the activities he viewed on the videos and Castanon's prior representations of "complete disuse of his left hand." Id.
On February 3, 2010, Dr. Kaisler-Meza prepared an agreed medical reevaluation. AR 654-657. In that report, Dr. Kaisler-Meza stated that he viewed the surveillance footage a second time with Castanon and his wife. AR 655. Dr. Kaisler-Meza concluded that he had been mistaken when he viewed the footage the first time, and that many instances in which he believed Castanon to be using his left hand and arm actually showed Castanon using his right hand and arm. Id. After observing the footage closely, Dr. Kaisler-Meza determined that Castanon did use his left hand but only for "simple, non-forceful, and nonrepetitive activities," and that the hand was in a semi-claw position. AR 655-56. Dr. Kaisler-Meza stated that these activities did not contradict Castanon's self-reported limitations and reverted to his earlier opinion as stated in his May 11, 2009 report. AR 656.
Castanon underwent an internal medical evaluation by Dr. Jaehoon Chung on February 13, 2010. AR 543-546. Dr. Chung's diagnoses were "status post trauma/injury to the left hand and status post surgical repair"; "Status post post-surgical RSD/CRPS-1"; and "Myofascial pain, left upper extremity referred from the left hand." AR 545. He concluded that Castanon could not hold anything with the left hand, and could not reach, handle, finger, or feel with the left hand. AR 546.
Dr. C. Fracchia, a medical consultant, prepared a physical RFC assessment on August 4, 2009. Dr. Fracchia concluded that Castanon had significant limitations with respect to his left upper extremity: lifting twenty pounds occasionally and ten pounds frequently; pushing and pulling occasionally; crawling occasionally; balancing never; and reaching, handling, fingering, and feeling occasionally. AR 506-07.
Dr. Woodrow Janese, a neurologist and neurosurgeon, testified at the administrative hearing as an impartial medical expert. AR 867-68. Dr. Janese had reviewed the medical evidence of record. Id. Dr. Janese opined that Castanon had suffered a puncture wound to his palm that had healed and resolved. AR 874. Dr. Janese found no objective basis to support a diagnosis of CRPS
Castanon testified through an interpreter; he stated that he did not speak English at all, that he had grown up in Mexico, that he had never learned English, and that he had been able to speak Spanish at all his jobs in the United States. AR 865-66. He also stated that he completed the eighth grade in Mexico. AR 898-99. Castanon testified that his injury occurred when he was using a "viper nail gun," and that "the piston went inside" his hand. AR 894. He had carpal tunnel surgery to address the puncture wound. Id. He said that he takes pain medicine but it makes him feel dizzy, tired, and "without will." AR 895. He claimed that physical therapy and acupuncture had not helped his pain or lack of function. Id. He stated that he cannot close his hand into a fist. AR 896. When asked about the surveillance video, Castanon stated that he was using his right hand throughout the footage, and that others erroneously had said he was using his left hand. Id. He also described his depression following his accident, and said that he was unable to concentrate because of the pain, and was unable to sleep. AR 897-98.
An EMG/nerve conduction study dated July 21, 2006 was normal. AR 228-29. An MRI taken on December 27, 2007 was normal. AR 377. An x-ray taken February 5, 2008 was normal. AR 373.
Surveillance video was taken of Castanon in connection with his worker's compensation claim. AR Ex. 19E.
Dr. Hosein Tahami saw Castanon for a psychiatric evaluation on June 5, 2007. AR 587. Dr. Tahami noted that Castanon did not appear to be in acute distress and was able to complete a lengthy evaluation. Id. Castanon reported feeling sad, anxious, and irritable. AR 589. He reported finishing the twelfth grade. AR 590. Dr. Tahami observed Castanon to be pleasant and cooperative; oriented as to time, place, person, and situation; and to have no significant impairment of short-term or long-term memory. AR 590-91. Dr. Tahami's diagnosis was adjustment disorder with depressed and anxious mood, with notations of chronic pain and discomfort, physical limitations, and financial difficulties. AR 591. Dr. Tahami prescribed antidepressant medication and group therapy. AR 592.
Dr. Tahami saw Castanon for routine follow-ups for the next several years. In reports dated June 12, 2007, July 3, 2007, July 31, 2007, August 14, 2007, September 4, 2007, September 18, 2007, October 23, 2007, November 27, 2007, February 5, 2008, March 11, 2008, April 10, 2008, May 8, 2008, July 8, 2008, and August 5, 2008, Dr. Tahami reported slow improvement to Castanon's mood. AR 408-425, 445-451, 460-62, 472-74, 484-86, 576-92. In several reports, Dr. Tahami noted that Castanon had said that his medications "helped significantly." See, e.g., AR 416, 423. In reports dated March 27, 2009, May 8, 2009, June 5, 2009, August 14, 2009, October 30, 2009, March 4, 2010, May 7, 2010, and July 20, 2010, Dr. Tahami noted Castanon's frustration with his worker's compensation case and Social Security application. AR 634, 641-42, 648-49, 660-61, 673-74, 694, 698. All of the reports noted normal memory, thought process, and thought content. Id.
Dr. Ann Allen completed an agreed medical evaluation of Castanon on October 10, 2007, an agreed supplemental report on February 25, 2008, an agreed medical reevaluation on April 14, 2008, and an agreed supplemental report on May 13, 2008.
On April 15, 2008, Dr. Jonathan Dunn completed a psychological assessment of Castanon. AR 426-432. Dr. Dunn found that at face value Castanon's responses indicated psychological distress, conflicts, and problems. AR 431. However, Dr. Dunn concluded that Castanon's results showed that he might be exaggerating. Id.
On February 6, 2010, Dr. Antoinette Acenas conducted a psychiatric evaluation of Castanon. AR 537-540. Dr. Acenas indicated that Castanon had been born in Mexico, had immigrated to the United States at the age of seventeen,
The ALJ considered all of the above evidence in concluding that Castanon has the RFC to perform light work with the specified restriction that "[t]he claimant is limited to using the left arm as an assist to the right upper extremity. The left arm can be used as an assist one third of the time." AR 23.
With respect to Castanon's physical limitations, the ALJ gave significant weight to the opinion of consulting physician Dr. Janese because the ALJ believed that Dr. Janese's opinion was the most consistent with the record as a whole. AR 29-30. Dr. Janese summarized the diagnostic testing, which did not reveal any nerve damage or other damage that would explain the extent of Castanon's claimed symptoms. AR 29. Dr. Janese opined that Dr. Noralahi's assessment, which was based in part upon Castanon's self-reporting, was not reliable given the surveillance video showing Castanon using his left hand repeatedly. AR 30. Dr. Janese also found persuasive the psychiatric evaluations that concluded that Castanon might be exaggerating. Id. However, while Dr. Janese opined that Castanon was capable of the full range of medium work with no limitation on the left extremity, the ALJ concluded that more restrictive limitations were appropriate given evidence that Castanon had some continuing impairment post injury and post surgery. Id.
The ALJ noted the discrepancies between Dr. Kaisler-Meza's initial conclusion that Castanon was severely impaired, then subsequent conclusion that the surveillance footage was inconsistent with Castanon's self-reported severe impairment, and then final conclusion that the surveillance footage was not inconsistent with the initial conclusion. AR 28. The ALJ credited the conclusion that the surveillance footage was inconsistent with Castanon's self-reports based upon the ALJ's own multiple viewings of the video footage. AR 26-28. As is discussed above, the ALJ's decision contains a meticulous list of forty-two instances in which the surveillance video shows Castanon using his left hand and/or arm. AR 26-27.
The ALJ also concluded that treating physician Dr. Noralahi's RSD assessment form, which indicated significant limitations on work, was inconsistent with Dr. Noralahi's numerous status reports noting improvement to Castanon's mood, efficacy of his medications, and ability to return to modified work. AR 29.
The ALJ gave little weight to the opinions of examining physicians Dr. Chung and Dr. Fracchia on the ground that those opinions appeared to be based primarily upon Castanon's subjective complaints, which the ALJ found not credible as discussed above. AR 28-30. The ALJ concluded that the opinions were not consistent with the record as a whole. Id.
After considering all of the evidence presented, including the normal EMG study, normal x-ray, and normal MRI noted above in Section III.A.1.i., the surveillance video, and the full medical record, the ALJ found Castanon's "subjective allegations to be exaggerated and not supported by the record." AR 30.
With respect to Castanon's mental limitations, the ALJ gave significant weight to examining physician Dr. Acenas's opinion because it was consistent with the record as a whole. AR 33. The ALJ gave less weight to Dr. Tahami's opinions, which were based in large part on Castanon's subjective complaints, which the ALJ found not credible as discussed above. AR 33. The ALJ noted that Dr. Tahami consistently had found Castanon's mental status to be normal, and his mood to be improving once he was on appropriate medication. Id. The ALJ also noted the opinions of Dr. Allen and Dr. Dunn that Castanon likely was exaggerating his symptoms. AR 31. Based upon all of the evidence in the record, the ALJ concluded that although Castanon reasonably could be expected to have some depression based upon his physical symptoms, there was insufficient evidence from which the ALJ could credit the reported intensity, persistence, and limiting effects of the depression. AR 34.
The Court concludes that the ALJ articulated "specific and legitimate" reasons, supported by substantial evidence in the record, for the weights that he assigned to the opinions of the treating, examining, and consulting physicians in this case. The Court likewise concludes that the ALJ's RFC determination is supported by substantial evidence in the record, including the physicians' opinions discussed above, the diagnostic tests, and the surveillance video. Castanon argues that Dr. Janese's testimony contained a number of errors that undermine the ALJ's reliance upon Dr. Janese's opinion. However, the asserted errors either are irrelevant to the ALJ's decision or do not undermine it. For example, Castanon argues that Dr. Janese erred when he testified that certain handwritten treatment notes indicated "no complaints" when actually the symbols used on the notes indicated "no change." Pl.'s Br. at 9, ECF No. 19. However, the ALJ did not rely on that portion of Dr. Janese's testimony. Castanon also points out that Dr. Janese erred in testifying that Castanon had a "fake-bad" during psychological testing. Id. at 10. What Dr. Dunn actually said was that although Castanon's responses were not totally invalid because of a "fake-bad" negative response bias, Castanon's responses did suggest intentional or unintentional exaggeration. AR 427. Thus although Dr. Janese misspoke at the hearing, the gist of his testimony — that Castanon's responses may have been exaggerated — was supported.
Castanon also argues that the ALJ erred in failing to credit Dr. Tahami's reports, and in particular Dr. Tahami's conclusions that Castanon showed no signs of embellishment, exaggeration, or malingering. Pl.'s Br. at 15, ECF No. 19. The ALJ explained that he chose not to credit Dr. Tahami's opinions because they were based upon Castanon's subjective pain complaints, which the ALJ found not credible. AR 33.
The ALJ posed a number of hypotheticals to Ronald Morrell, a vocational expert ("VE") who testified at the hearing. As most relevant here, the ALJ asked whether there would be jobs in the national economy for an individual who is less than fifty years old, who has a high school diploma, who does not speak English, who has prior work similar to Castanon, and who is limited to light work with a limitation that the non-dominant left hand can be used hardly at all, maybe just to carry keys. AR 904-05. The VE opined that such an individual could work in light machine operator positions. AR 905. The VE then clarified that the non-dominant left hand could be used only as an assist to the right hand, but that it must be used as an assist at least thirty percent of the time for there to be jobs available. AR 906. The VE concluded that such an individual could do jobs such as buffing machine tender, power press tender, tension machine operator, and the like. AR 908. The VE opined that there were approximately 45,000 such jobs in the semi-skilled and unskilled categories in California and approximately ten times that many in the national economy. Id. The ALJ then changed the hypothetical to an individual who did not have a high school diploma but instead had finished only the eighth grade. Id. The VE stated that would have no impact on the number of jobs available.
Based upon the VE's testimony, the ALJ concluded that Castanon could do jobs that exist in significant numbers in the local and national economies. However, when the ALJ reduced his decision to writing, he made two statements that Castanon now attacks: he said that Castanon has a high school diploma and that he is able to communicate in English. See AR 34. Castanon asserts that these statements about his education are erroneous and that the ALJ's decision therefore is not supported by substantial evidence. Pl.'s Br. at 16, ECF No. 19.
As an initial matter, the Court concludes that the challenged statements are supported by substantial evidence in the record. Although Castanon testified at the administrative hearing that he completed only the eighth grade, see AR 899, Castanon represented that he completed high school on his Social Security application, see AR 120, when he spoke to Dr. Tahami, see AR 590, and when he spoke to Dr. Acenas, see AR 538. Moreover, although Castanon testified at the administrative hearing that he could not speak English, and used an interpreter throughout the hearing, Castanon's Social Security application stated that he speaks and understands English. AR 112. Where evidence exists to support more than one rational interpretation, the court must defer to the decision of the Commissioner. Moncada, 60 F.3d at 523; Drouin, 966 F.2d at 1258.
Even if the Court were to conclude that the challenged statements were not supported by substantial evidence in the record, the ALJ expressly included in his hypotheticals to the VE an individual who had completed high school but does not speak English, AR 905, and then later an individual who had completed only the eighth grade but does not speak English, AR 908. Accordingly, the ALJ's determination that Castanon is not disabled is supported by substantial evidence in the record.
For the foregoing reasons, IT IS ORDERED THAT: