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49 soc.sec.rep.ser. 23, unempl.ins.rep. (Cch) P 14838b, 95 Cal. Daily Op. Serv. 7257, 95 Daily Journal D.A.R. 12,367 Monica Roberts v. Donna E. Shalala, Secretary of Health & Human Services

Citation: 66 F.3d 179Docket: 93-35806

Court: Court of Appeals for the Ninth Circuit; October 23, 1995; Federal Appellate Court

Narrative Opinion Summary

This case concerns a claimant’s appeal challenging the denial of Supplemental Security Income benefits based on alleged disability from obesity, arthritis, and mental health conditions. After an initial denial and remand for further evaluation, an Administrative Law Judge (ALJ) found the claimant not disabled, a decision affirmed by the Appeals Council and the district court. The claimant asserted presumptive disability due to obesity, but the court determined she failed to satisfy the Social Security Act’s duration requirement, as her qualifying weight was maintained for only seven months rather than the requisite twelve. The court also rejected application of Social Security Ruling 82-59 and SSR 85-15, as neither was applicable under the circumstances—SSR 82-59 only applies where a claimant is otherwise disabled, and SSR 85-15 does not govern cases involving both exertional and nonexertional impairments. The ALJ’s credibility determinations, particularly favoring one medical expert’s assessment over another, were upheld as supported by substantial evidence. Further, the ALJ’s reliance on vocational expert testimony based on supported hypotheticals was deemed proper. The district court’s judgment affirming the Secretary’s denial was ultimately sustained, with the court noting the claimant could file a new application should her impairment persist beyond the statutory duration threshold.

Legal Issues Addressed

Applicability of SSR 85-15 to Claims Involving Both Exertional and Nonexertional Impairments

Application: SSR 85-15, which addresses nonexertional impairments, does not apply where the claimant alleges both exertional and nonexertional impairments.

Reasoning: Roberts's claim that SSR 85-15, which addresses nonexertional impairments, necessitates an award of benefits was rejected. The ruling is inapplicable since Roberts asserts both exertional and nonexertional impairments. Specifically, she testified that knee pain limited her physical capabilities, which further invalidates the applicability of SSR 85-15.

Application of Social Security Ruling 82-59 (SSR 82-59) to Disability Claims

Application: The court found that SSR 82-59, which governs benefit denial due to non-compliance with treatment, only applies to claimants who otherwise meet the disability criteria; because Roberts was not disabled under the Act, SSR 82-59 protections did not apply.

Reasoning: Roberts also claimed entitlement to benefits under Social Security Ruling 82-59, which outlines the protocol for denying benefits based on non-compliance with treatment. However, this ruling only applies to claimants who would otherwise qualify as disabled. Since Roberts was not deemed disabled due to her failure to meet the duration requirement, she was not entitled to the protections under SSR 82-59.

Court Review Standard under 42 U.S.C. Sec. 405(g)

Application: The district court’s review of the Secretary’s decision is limited to determining whether substantial evidence supports the decision and whether the correct legal standards were applied.

Reasoning: Roberts's appeal to the court challenges the Secretary's denial of benefits, with the court applying de novo review to ensure substantial evidence supported the Secretary's decision and that the law was correctly applied.

Duration Requirement for Disability under the Social Security Act

Application: The court affirmed that to qualify for disability benefits based on obesity, the claimant must meet both the weight requirement and demonstrate that the impairment has lasted or is expected to last for at least twelve months.

Reasoning: Although Roberts met the weight requirement for presumptive disability for only seven months and failed to provide evidence indicating her weight would remain above the threshold continuously for twelve months, the Secretary's decision was upheld.

Rejection of Medical Testimony and Credibility Determinations by ALJ

Application: The ALJ's decision to credit one medical expert’s testimony over another was upheld where substantial evidence supported the credibility determination and reasons for rejecting the contrary opinion.

Reasoning: Regarding Dr. Kurlychek's assessment of Roberts's mental residual functional capacity, the ALJ's rejection of this testimony was found to be adequately justified. The ALJ noted discrepancies between Dr. Kurlychek's ratings and those of a medical expert, Dr. Moulton, who based his conclusions on neuropsychological test scores. The ALJ found Dr. Moulton's testimony to be more credible, citing substantial evidence from the record to support his decision.

Use of Vocational Expert Testimony Based on Supported Hypotheticals

Application: The ALJ may rely on vocational expert testimony based on hypotheticals that accurately reflect the claimant's limitations as supported by substantial evidence, and is not required to incorporate limitations proposed by claimant’s counsel unless supported by the record.

Reasoning: Despite Roberts offering alternative hypotheticals during the hearing, the ALJ was entitled to rely on Dr. Moulton’s testimony, as the ALJ is not obligated to accept the restrictions proposed by the claimant's counsel if they are not supported by substantial evidence. The court noted that substantial evidence backed Dr. Moulton's conclusions, making the hypothetical sufficient for demonstrating Roberts's capacity to engage in alternative work.