FILED
NOT FOR PUBLICATION MAR 30 2010
MOLLY C. DWYER, CLERK
UNITED STATES COURT OF APPEALS U.S . CO UR T OF AP PE A LS
FOR THE NINTH CIRCUIT
MARIA BECERRA DE HERRERA, No. 08-17554
Plaintiff - Appellant, D.C. No. 2:07-cv-01952-MHM
v.
MEMORANDUM *
MICHAEL J. ASTRUE, Commissioner of
Social Security Administration,
Defendant - Appellee.
Appeal from the United States District Court
for the District of Arizona
Mary H. Murguia, District Judge, Presiding
Argued and Submitted March 11, 2010
San Francisco, California
Before: REINHARDT and BYBEE, Circuit Judges, and GWIN, ** District Judge.
Maria Becerra De Herrera appeals from the district court's order affirming
the Commissioner's decision to deny her social security disability benefits. She
argues that the ALJ made four errors in determining that she was not disabled. We
*
This disposition is not appropriate for publication and is not precedent
except as provided by 9th Cir. R. 36-3.
**
The Honorable James S. Gwin, United States District Judge for the
Northern District of Ohio, sitting by designation.
find De Herrera's arguments unpersuasive and we affirm the judgment of the
district court.
De Herrera begins by arguing that the ALJ erred in rejecting the opinion of
Nurse Practitioner David Glass. Under the regulations, nurse practitioners are
considered 'other sources,' 20 C.F.R. y 404.1513(d)(1), not 'acceptable medical
sources,' id. y 404.1513(a). As a result, the ALJ could reject Glass's opinion for
'reasons that are germane to [Glass].'1 Dodrill v. Shalala, 12 F.3d 915, 919 (9th
Cir. 1993).
In rejecting Glass's testimony, the ALJ explained that Glass's opinion had
been rejected by two reviewing physicians, that Glass's opinion ran contrary to the
weight of the evidence, that Glass's opinion of complete disability was undermined
by the fact that treatment seemed to improve De Herrera's condition, and that
Glass's opinion was based on De Herrera's subjective complaints. Each of the
ALJ's reasons is 'germane to [Glass],' and is therefore sufficient to reject Glass's
testimony.
1
Social Security Ruling 06-03p is not to the contrary. Although the Ruling
discusses the importance of other sources' testimony in establishing disability,
nowhere does it purport to overrule the regulations' classification of nurse
practitioners as 'other sources.'
2
Next, De Herrera argues that the ALJ erred in partially rejecting the opinion
of Dr. Bencomo. Dr. Bencomo diagnosed De Herrera with pain disorder due to
medical and psychological factors and an adjustment disorder with depressed mood
secondary to pain. [ER 233.] He indicated that De Herrera had a good or fair
ability to deal with most aspects of a worµ environment, but concluded that De
Herrera had only a fair to poor ability to deal with worµ stresses. [ER 234.] The
ALJ found 'Dr. Bencomo's opinions persuasive, but [did] not assign[] controlling
weight to [Dr. Bencomo's] opinion regarding the claimant's ability to deal with
worµ stress because it appear[ed] that he based his opinion at least in part upon the
claimant's subjective complaints of pain related to her physical impairments.' [ER
10.]
The record indicates that Dr. Bencomo relied more heavily on De Herrera's
complaints than 'his own observations' in maµing his diagnosis. Ryan v. Comm'r
of Soc. Sec., 528 F.3d 1194, 1200 (9th Cir. 2008). Dr. Bencomo opined that it was
De Herrera's pain, rather than her 'depressed mood and anxiety,' that was the
'main source of [her] functional limitations.' [ER 233.] And Dr. Bencomo's own
report indicates that his understanding of De Herrera's level of pain was based
primarily on her subjective complaints. [ER 232.] As a result, the ALJ was 'free
to disregard Dr. [Bencomo's] opinion,' Tonapetyan v. Halter, 242 F.3d 1144, 1149
3
(9th Cir. 2001), so long as De Herrera's complaints with respect to her pain were
'properly discounted as incredible,' Tommasetti v. Astrue, 533 F.3d 1035, 1041
(9th Cir. 2008); see also Andrews v. Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995)
('[A]n opinion of disability premised to a large extent upon the claimant's own
accounts of [her] symptoms and limitations may be disregarded, once those
complaints have themselves been properly discounted.'). As we explain below,
the ALJ properly discounted De Herrera's testimony, and was therefore free to
disregard Dr. Bencomo's opinion.
We thinµ the ALJ adequately explained his reasons for rejecting De
Herrera's testimony. First, the ALJ noted that De Herrera's testimony was not
supported by objective medical evidence. We agree. Nothing in the medical
record evidence supports De Herrera's testimony that at the time of the hearing she
could sit and stand for only one half-hour at a time. Second, the record supports
the ALJ's statement that this testimony was contradicted by De Herrera's earlier
report to a doctor that she could stand for four hours. Third, the ALJ observed that
De Herrera's condition improved with treatment, and favorable responses to
treatment can undermine a claimant's complaints of debilitating pain. See
Tommasetti, 533 F.3d at 1040. Finally, the ALJ relied 'in significant part' on her
husband's reports regarding De Herrera's daily activities. The husband said that
4
De Herrera continued to get her daughter ready for school, prepare simple meals
every third day, drive for a short time, shop, sew, attend church every other weeµ,
and spend time with other people. As the ALJ concluded, De Herrera's activities
significantly undercut her claim that she is completely disabled.
Lastly, De Herrera argues that the ALJ erred in determining De Herrera's
residual functional capacity. The ALJ's determination was based on an examining
doctor's findings, with additional limitations. Even if not every limitation the ALJ
identified was directly supported by the record, the addition of more limitations
than the evidence warranted was harmless error. See Stout v. Comm'r, Soc. Sec.
Admin., 454 F.3d 1050, 1055 (9th Cir. 2006) ('We have . . . affirmed under the
rubric of harmless error where the mistaµe was nonprejudicial to the claimant . . .
.').
AFFIRMED.
5
FILED
De Herrera v. Astrue 08-17554 MAR 30 2010
MOLLY C. DWYER, CLERK
Judge Reinhardt, dissenting: U.S . CO UR T OF AP PE A LS
The Social Security Disability Act provides a safety net for those in our
society unfortunate enough to be afflicted by disabilities, whether mental, physical
or both, that prevent them from worµing. See 42 U.S.C. y423(d)(1)(a). Because
the ALJ's reasons for denying disability benefits to De Herrera were not supported
by the evidence before him, I dissent.
Dr. Bencomo's uncontroverted testimony was that De Herrera has a fair to
poor ability to deal with worµ stress. A vocational expert testified that there are no
jobs available for a person with such a condition. Accordingly, had the ALJ
credited Dr. Bencomo's testimony, he would have been compelled to find De
Herrera disabled within the meaning of the statute. The ALJ's entire reasoning for
disregarding Dr. Bencomo's testimony as to this condition was that Dr. Bencomo
relied on De Herrera's subjective complaints of pain, which the ALJ viewed as not
credible. Because De Herrera provided objective evidence of an underlying
impairment, and there was no affirmative evidence of malingering, the ALJ was
required to provide 'specific, clear, and convincing reasons' for discrediting her
testimony about the severity of her pain. See Tomasetti v. Astrue, 533 F.3d 1035,
1039 (2008).
Page 1 of 6
The reasons offered by the ALJ and embraced by the majority were far from
clear and convincing. Perhaps the worst of them is the assertion that information
provided by De Herrara's husband about her daily life undercut her claims of pain
and disability. The ALJ based his conclusions as to her lacµ of disability and
concomitant lacµ of credibility 'in significant part' on the report provided by her
husband. Yet there is nothing in the husband's report to contradict her claim that
she is too disabled to worµ, and much to support it. I simply cannot see how the
fact that every third day she is able to muster herself to put a frozen meal in the
microwave would indicate that she is able to worµ a regular job. Nor do I see how
it is contrary to her testimony: she told the ALJ she could stand for half an hour at
a time, which is perhaps twenty-five minutes more than would be necessary to
prepare the meals that her husband describes. I also cannot fathom how the fact
that people visit De Herrera in her home, including one friend who comes over to
do some of the houseworµ that De Herrera is unable to do, demonstrates that she is
able to function at a higher level or that she has less pain than she claimed. Social
isolation is not a requirement for a disability finding.
Similarly, her claims of disability are hardly undercut by her husband's
reports that once or twice a weeµ she is able to taµe herself around a grocery store
in a motorized chair, that she drives short distances no more than a couple times a
Page 2 of 6
weeµ, or that once every two weeµs she goes to church. Particularly bizarre are the
ALJ's assertions that her sewing or watching movies 'every now and then'
demonstrated a lacµ of disability. Is it necessary to begin warning Social Security
claimants that use of a DVD player or a needle and thread, even while supine, may
disqualify them for benefitsá As for the claim that she continued to get her
daughter ready for school, her husband did not report that she was ever able to
accomplish all the tasµs necessary to send their daughter to school, but only that
she tried, and that such effort might be all she was able to accomplish in a day:
'She does very little chores around the house, mostly try to get things done for our
girl to go to school. Rest of the day she sits or lies down because of the pain.'
Neither the ALJ nor the majority taµes stocµ of other important information
in the husband's report, which corroborate her claims of disability: because of her
pain, de Herrera is often unable to get out of bed before 11 a.m.; she spends most
of the day sitting or lying down; she cannot put on pants, shave her legs or tie her
shoes; and she can walµ no more than 5 to 10 minutes before needing a rest of 10
to 20 minutes. Moreover, she is 'in a constant state of depression because she
cannot be as she used to be, she cannot be the mother or wife she was before.' In
short, her husband's report describes De Herrera as afflicted by physical pain and
psychological difficulties arising out of that pain. There is nothing in it to suggest
Page 3 of 6
that she is in less pain or retains more functionality than she claimed, or that she
would be able to worµ anything close to regular hours in a regular job.
The rest of the ALJ's reasons are no more convincing. The first, that the
objective medical evidence, while sufficient to establish some level of pain, did not
support her reports as to the severity of her pain, 'is exactly the type [of
justification of an adverse credibility finding that] we have previously recognized
the regulations prohibit.' Robbins v. Social Sec. Admin., 466 F.3d 880, 884 (9th
Cir. 2006); see also SSR 96-7p, 1996 WL 374186, at *1. The second, that she
previously reported to a doctor that she could stand for four hours, drew on a
statement that she made three years prior to the hearing. During the three years
between that statement and her hearing testimony, De Herrera did not worµ, rarely
left the house, and spent most of her days sitting and lying down. It is not a
surprise-much less an inconsistency to support a finding that De Herrera was not
credible-that after three years of near inactivity, her physical abilities had
diminished. See SSR 96-7p, 1996 WL 374186, at *5 ('[T]he lacµ of consistency
between an individualùs statements and other statements that he or she has made at
other times does not necessarily mean that the individualùs statements are not
credible. Symptoms may vary in their intensity, persistence, and functional effects,
or may worsen or improve with time, and this may explain why the individual does
Page 4 of 6
not always allege the same intensity, persistence, or functional effects of his or her
symptoms.')
Finally, the majority and the ALJ assert that De Herrera's condition
improved with treatment, and that a favorable response to treatment can undermine
a claimant's complaints of debilitating pain. As a preliminary matter, De Herrera
made no statement that suggests that the treatment improved her condition to the
point that she could worµ: she stated only that epidurals she received three years
before the hearing 'improved' her sciatica and that Vicodin 'helps' her bacµ pain.
Moreover, pain can be 'improved' and 'helped' without bringing an applicant
anywhere close to being able to function. Further, there is no rule that favorable
response to any treatment undermines a claim of debilitating pain. The case law
discusses only favorable responses to conservative, noninvasive treatments that
themselves do not preclude worµ, such as use of a bacµ corset, physical therapy
and electromagnetic stimulation. See Tommasetti, 533 F.3d at 1040. The rule
clearly has no application to powerful narcotics liµe Vicodin, which De Herrera
described, quite plausibly, as maµing her 'dumb' and interfering with her ability to
maµe it to doctor's appointments. [ER 232] A treatment that incapacitates as it
eases pain cannot be considered evidence that the underlying pain is not
debilitating.
Page 5 of 6
Refusing disability benefits to qualified persons for reasons that are not clear
and convincing, let alone without any merit, defeats the will of Congress and
damages those individuals least able to absorb the occasional errors made by our
systems of adjudication. The majority opinion affirms an administrative decision
that appears to do exactly that. Accordingly, I dissent.
Page 6 of 6