United States District Court, D. Oregon
JONA B. HEFFNER, Plaintiff,
NANCY A. BERRYHILL, Commissioner of the Social Security Administration, Defendant.
OPINION AND ORDER
Michael McShane United States District Judge.
Jona Bernae Heffner brings this action for judicial review of
the Commissioner's decision denying her application for
disability insurance benefits (“DIB”). This court
has jurisdiction under 42 U.S.C. §§ 405(g).
December 13, 2012, Heffner protectively filed a Title II
application for DIB, alleging disability as of June 13, 2012.
Tr. 9. During the hearing before the
administrative law judge (“ALJ”), Heffner amended
her alleged onset date to January 1, 2014. Tr. 9. After the
ALJ concluded Heffner was not disabled, Hefner filed this
argues the ALJ erred in rejecting the opinion of her treating
physician, her subjective complaints of symptoms and
limitations, and the opinion of her partner. Because the
Commissioner's decision is based on proper legal
standards and supported by substantial evidence, the
Commissioner's decision is AFFIRMED.
reviewing court shall affirm the decision of the Commissioner
of Social Security if her decision is based on proper legal
standards and the legal findings are supported by substantial
evidence in the record. 42 U.S.C. § 405(g); Batson
v. Comm'r Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th
Cir. 2004). “Substantial evidence is ‘more than a
mere scintilla but less than a preponderance; it is such
relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.'” Hill v.
Astrue, 698 F.3d 1153, 1159 (9th Cir. 2012) (quoting
Sandgathe v. Chater, 108 F.3d 978, 980 (9th Cir.
1997)). To determine whether substantial evidence exists, the
district court must review the administrative record as a
whole, weighing both the evidence that supports and detracts
from the ALJ's decision. Davis v. Heckler, 868
F.2d 323, 326 (9th Cir. 1989).
Social Security Administration utilizes a five-step
sequential evaluation to determine whether a claimant is
disabled. 20 C.F.R. §§ 404.1520 & 416.920
(2012). The initial burden of proof rests upon the claimant
to meet the first four steps. If the claimant satisfies his
burden with respect to the first four steps, the burden
shifts to the Commissioner for step five. 20 C.F.R. §
404.1520. At step five, the Commissioner must show that the
claimant is capable of making an adjustment to other work
after considering the claimant's residual functional
capacity (“RFC”), age, education, and work
experience. Id. If the Commissioner fails to meet
this burden, then the claimant is disabled. 20 C.F.R.
§§ 404.1520(a)(4)(v); 416.920(a)(4)(v). If,
however, the Commissioner proves that the claimant is able to
perform other work existing in significant numbers in the
national economy, the claimant is not disabled.
Bustamante v. Massanari, 262 F.3d 949,
953-54 (9th Cir. 2001).
two, the ALJ found that Heffner had the following severe
impairments: orthostatic hypotension; vertigo with no
evidence of labyrinthine disorder; moderate cervical
degenerative disc disease and degenerative joint disease;
anxiety; and depression. Tr. 11. In formulating Heffner's
RFC, the ALJ concluded that Heffner could perform sedentary
work with the following limitations: she is unable to use a
computer screen or video monitor; and she can carry out only
simple instructions in a setting with no public contact and
no team assignments. Tr. 14. Based on the vocational
expert's (“VE”) testimony, a person with
Heffner's RFC could perform the jobs of addressor,
sorter, or electronic inspector. Tr. 21, 58. As noted,
Heffner makes several assignments of error.
Weight Assigned to the Opinion of Dr.
first to Heffner's argument that the ALJ improperly
rejected the medical opinion of her treating physician, Dr.
Clark Cullen. The ALJ is responsible for resolving conflicts
in the medical record, including conflicts among
physicians' opinions. Carmickle v. Comm'r,
533 F.3d 1155, 1164 (9th Cir. 2008). Generally, a treating
doctor's opinion is entitled to more weight than an
examining doctor's opinion, which in turn is entitled to
more weight than a reviewing doctor's opinion.
Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir.
2014). When a treating physician's opinion is
contradicted by another medical opinion, the ALJ may reject
the treating physician's opinion only by providing
“specific and legitimate reasons supported by
substantial evidence in the record.” Orn v.
Astrue, 495 F.3d 625, 632 (9th Cir. 2007).
Cullen has been Heffner's primary care physician since
February 2013. Tr. 391. On March 4, 2015, Dr. Cullen
completed a “Dizziness Medical Source Statement”
(“DMMS”) outlining his opinion on Heffner's
functional limitations. Tr. 391-95. Dr. Cullen opined that
Heffner's was incapable of low-stress work because,
“as a consequence of relentless dizziness and
incapacity her mental state is fragile.” Tr. 393. Dr.
Cullen described Heffner's dizziness episodes as
“24/7 constant.” Tr. 391. He noted Heffner used a
walker to prevent falls. Tr. 391-92. Heffner suffered visual
disturbances and mood changes, exhaustion, mental confusion,
and severe headaches. Tr. 391. These symptoms were
“incapacitating” and lasted all day, every day.
Tr. 391-92. According to Dr. Cullen, Heffner had “no
gave little weight to Dr. Cullen's opinion because it
conflicted with his own treatment notes. Tr. 18. A
“discrepancy” between a doctor's examination
notes and his medical opinion “is a clear and
convincing reason for not relying on the doctor's
opinion.” Bayliss v. Barnhart, 427 F.3d 1211,
1216 (9th Cir. 2005). An examination of Dr. Cullen's
treatment notes against his opinions in the DMMS supports the
ALJ's conclusion to assign little weight to Dr.
same day Dr. Cullen filled out the DMMS, he examined Heffner
and reported that she had normal gait and ambulation, normal
coordination, and normal movement in all extremities. Tr. 18,
453. Dr. Cullen described Heffner as
“healthy-appearing, ” having “normal mood
and affect, ” and presenting with “good
judgment.” Tr. 18, 453. Dr. Cullen recorded the above
objective findings upon physical examination despite
Heffner's report that day of “no change in
incapacitating dizziness.” Tr. 453. At a November 2014
examination-Heffner's last appointment with Dr. Cullen
before Dr. Cullen filled out the DMMS-Dr. Cullen noted
Heffner's report that although she still felt as if she
was “on a boat on an ocean, ” her “severe
vertigo episodes have subsided.” Tr. 397. At that
appointment, Heffner was fully oriented, ambulated normally
with normal movement of all extremities, and had no ataxia.
Tr. 397. The objective findings Dr. Cullen reported on the
two appointments closest in time to the DMMS mirrored those
reported by Dr. Cullen during earlier appointments.
See Tr. 16, 265 (describing “normal”
mental status and ambulation); 275 (reporting “no
ataxia” and normal Romberg sign); 278 (stating that
Heffner was “ambulating ...