[00:00:05] Speaker 05:
Good morning, Your Honors.

[00:00:08] Speaker 05:
I'm here, I represent Ms.

[00:00:10] Speaker 05:
Sandberg.

[00:00:10] Speaker 05:
My name is Justin Prado.

[00:00:12] Speaker 05:
And I'm here to argue her case, that her case should be remanded back to Social Security for a re-decision of her benefits applying the proper law.

[00:00:23] Speaker 05:
This case is just another example of the Social Security's ALJs not following the Ninth Circuit precedent regarding subjective symptoms and pain.

[00:00:40] Speaker 05:
This case commits the same error that this court has seen time and time again.

[00:00:46] Speaker 05:
in cases that were cited to my brief such as Brown Hunter or Smogan or Virigan in that the ALJ laundry lists 29 paragraphs as I laid out in my brief of medical

[00:01:02] Speaker 05:
with no discussion about how that medical is inconsistent or consistent with any of my client's subjective symptom testimony.

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My client testified that she had difficulty due to pain lifting, standing, walking.

[00:01:19] Speaker 05:
Some of her doctors, which he didn't accept, stated that she was limited in these areas.

[00:01:25] Speaker 05:
Nowhere does the ALJ discuss with any kind of detail that's required under the case law why these tests are inconsistent with her testimony.

[00:01:40] Speaker 02:
So her medical conditions, they were consistent with having those subjective symptoms, correct?

[00:01:51] Speaker 05:
Yes.

[00:01:52] Speaker 02:
Diagnosed medical conditions.

[00:01:54] Speaker 05:
Yes.

[00:01:55] Speaker 05:
She was found in the case to have degenerative disc, fibromyalgia, dandrel disc of the spine, Raymond's disease.

[00:02:07] Speaker 05:
Now, the judge did state the one part where he says her testimony was inconsistent, the one paragraph.

[00:02:13] Speaker 05:
He states that she said she experienced pain from

[00:02:20] Speaker 05:
one of her conditions that was found not to be existent.

[00:02:23] Speaker 05:
So I will say that the LJ found that she said she was receiving, she had pain from this particular condition, but then the LJ found that in the medical that condition was not found to actually, but as I argued in my papers, my client is a lay person.

[00:02:40] Speaker 05:
She's not going to know which exact condition is causing which problem.

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All she knows is that she's in pain.

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And I think that in this case that the LJ just did not explain

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why he came, to me the RFC that is provided in this case seems like it comes out of almost nowhere.

[00:02:59] Speaker 02:
And what was the RFC in this case?

[00:03:01] Speaker 02:
Refresh my memory on that.

[00:03:13] Speaker 05:
It was a reduction to light, which would be 10 pounds, 20 pounds lifting, six hours max stand sit walk.

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There were additional restrictions that had to do with no stooping, hazardous exposure.

[00:03:31] Speaker 05:
And then the judge did found that she required the use of a cane, because she does require the use of a cane.

[00:03:38] Speaker 05:
If you look at this RFC where he states that she needs to use a cane, yet she can stand and sit and walk for six hours and an eight hour day.

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And in a work, and that's the other key I'm going to get to with the daily activities.

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This is in a work.

[00:03:55] Speaker 05:
Context as the court has routinely stated the difference between doing things at home when you can take your time You can lay down you can put your foot up And and having to be strenuously working for six to eight hours Especially with the light jobs that were found where she'd be standing almost the entire day um and

[00:04:14] Speaker 05:
It's different and the judge needs to provide clear and convincing evidence as to why the medical things like the grip strength is at four.

[00:04:25] Speaker 05:
I mean, how does that relate to her ability to carry?

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How does that relate to her ability to stand?

[00:04:28] Speaker 05:
It doesn't.

[00:04:29] Speaker 04:
Well, we've said before that the judge doesn't need to go line by line comparing things and as you've opened your argument, the ALJ was quite exhaustive in going and listing

[00:04:42] Speaker 04:
the abundant medical evidence that was relied upon there.

[00:04:47] Speaker 04:
So what more would you have the ALJ do in this case?

[00:04:51] Speaker 05:
At least some discussion of how that medical is inconsistent with her statements.

[00:04:59] Speaker 05:
Nowhere does he say, I don't believe she can only lift three pounds because, look, she has this particular test or this particular grip strength, or she said this to her doctor.

[00:05:08] Speaker 05:
And I'm not asking for a line by line of every piece of testimony, but at least something to justify the RFC.

[00:05:15] Speaker 05:
And the only other thing that he provides is with the daily activities, which, again, there's no discussion of how these, what I would consider mundane everyday life activities, such as, I believe he put brushing her teeth is one of the daily activities that he found that was inconsistent with her,

[00:05:37] Speaker 05:
her pain testimony.

[00:05:38] Speaker 04:
But why isn't the ALJ's decision to rely on the abundant medical evidence enough given our deferential standard of review?

[00:05:49] Speaker 05:
I believe under the case law that just objective evidence, just because

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There's no objective evidence to support the extent of the pain.

[00:06:03] Speaker 05:
That in and of itself does not defeat the pain testimony.

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The ALJ is required to either show inconsistencies or use other evidence such as activities of daily living in order to discount that pain testimony.

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Because if objective tests, if just listing the objective tests,

[00:06:23] Speaker 05:
and stating this defeats your pain testimony was enough, there would be no need for the ALJ to weigh other evidence.

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I mean, the objective tests would show pain or would not show pain.

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But as I believe this court has recognized multiple times in the past, pain is difficult.

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So there are not tests that can show pain in many cases.

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And in this circumstance, just relying on saying there's these tests and some of these things are negative and some of these things are not is not enough under the precedent to defeat

[00:06:51] Speaker 04:
So how do you distinguish smart or suggest where the allegation is that the pain is entirely debilitating, that daily activities are relevant to contradicting that?

[00:07:05] Speaker 05:
I agree.

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I think in the smart case, the ALJ did a better job of going through and actually providing an analysis in that case than compared to this one.

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But additionally, I don't believe my client is stating her pain is completely debilitating.

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I think my client should give a list of limitations, her ability to stand, sit,

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lift things that I don't believe she's saying that she can't do anything.

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And then also, on the counter end, it's not the claimant's burden to prove that they're completely debilitated.

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That's been a ruling many times, particularly in the Gerson case, and again, in the Solman case and the Vertigan case, that you don't have to be completely bedridden to qualify for benefits.

[00:07:57] Speaker 05:
And so all we're asking is for the ALJ to look through and explain how he came to an RF, where he finds a client, a person who has multiple degenerative discs, needs to use a cane, fibromyalgia for pain.

[00:08:15] Speaker 05:
How does he come to an RFC of light work, stand, sit, six hours lift,

[00:08:25] Speaker 05:
without any explanation when the client stating that she can't do that due to her pain.

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All we're asking is, show me on the test how that is done.

[00:08:35] Speaker 05:
Daily activities, how is going to church?

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counter anything that my client said.

[00:08:41] Speaker 05:
How does meeting with people at her house counter any of the testimony?

[00:08:47] Speaker 05:
How is it inconsistent?

[00:08:48] Speaker 05:
The LJ likes to say it's inconsistent, but doesn't explain why these things are inconsistent.

[00:08:54] Speaker 05:
And again, some of them are as mundane as brushing her teeth or, I believe, cooking, light cooking, I believe, was one.

[00:09:05] Speaker 05:
And these are things that people need to do every day, and they shouldn't be penalized for trying to live their life with their disability.

[00:09:15] Speaker 05:
And all we're asking is that explain, explain how these things are inconsistent with what my client said her limitations are.

[00:09:23] Speaker 05:
I understand that the ALJ does not have to just take my client's limitations on their face, but I would expect, especially after so many different rulings with very similar cases where

[00:09:34] Speaker 05:
The judge uses a laundry list of medical, then just states that these mundane daily activities are inconsistent with the pain testimony and rules that the client can do a light RFC or medium RFC when they really can't without further explanation.

[00:09:52] Speaker 05:
And that's what our position is, is really this decision doesn't have the explanations that it's required to have.

[00:10:00] Speaker 02:
All right.

[00:10:00] Speaker 02:
Thank you, counsel.

[00:10:03] Speaker 02:
You're slightly over your time.

[00:10:04] Speaker 02:
We will hear from the government.

[00:10:07] Speaker 02:
And then if you need a minute for rebuttal, let me know.

[00:10:10] Speaker 05:
OK.

[00:10:11] Speaker 05:
I think I asked for five minutes.

[00:10:12] Speaker 02:
Five minutes?

[00:10:13] Speaker 02:
Well, I don't think, since you're over, I don't think you get five minutes.

[00:10:16] Speaker 02:
Oh, no problem.

[00:10:17] Speaker 02:
But we'll see what counsel argues.

[00:10:19] Speaker 02:
Thank you.

[00:10:20] Speaker 02:
How we proceed.

[00:10:21] Speaker 02:
OK.

[00:10:21] Speaker 02:
Thank you.

[00:10:27] Speaker 01:
Good afternoon, Your Honor.

[00:10:28] Speaker 01:
Katherine Watson for the Commissioner.

[00:10:31] Speaker 00:
Good afternoon.

[00:10:36] Speaker 01:
My counsel argued that the LJ did not sufficiently explain her findings when discounting the claimant's testimony, Sandberg's testimony.

[00:10:46] Speaker 01:
I'd like to note that the very cases that my counsel cited outlines the standard

[00:10:51] Speaker 01:
that the findings need only be sufficiently specific to allow this court to conclude that the ALJ rejected the testimony on permissible grounds and did not arbitrarily discount the testimony.

[00:11:02] Speaker 01:
What that means is outlined in Brown V. Hunter.

[00:11:06] Speaker 01:
Brown Hunter is that the ALJ identifies the testimony that she finds not credible, and then she discusses the evidence that undermines that testimony.

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And that is exactly what we have here.

[00:11:17] Speaker 01:
NCAR 17 through 18,

[00:11:20] Speaker 01:
The ALJ discusses Sandberg's allegations of debilitating limitations.

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I note these are quite extreme allegations.

[00:11:28] Speaker 01:
She's arguing that she cannot lift more than three pounds, that she can stand minutes at a time, walk minutes at a time, sit minutes at a time.

[00:11:37] Speaker 01:
And the ALJ then on Car 23 references back to those very allegations

[00:11:44] Speaker 01:
and says that those allegations of disabling symptoms and limitations are inconsistent with the imaging and electrodiagnostic studies, laboratory studies, Dr. Karamloo's exam, treatment history, activities, and medical opinions as detailed above.

[00:12:02] Speaker 01:
The ALJ previously had detailed that evidence.

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So there is sufficient linkage here.

[00:12:08] Speaker 01:
In addition to that, as Judge Johnstone noted, the ALJ does not need to go through a line-by-line exegesis of the claimant's testimony.

[00:12:18] Speaker 01:
Even though the ALJ doesn't need to do that, the ALJ did line-by-line on card 13 through 16, again on card 23, reference very specific testimony that the medical record contradicted.

[00:12:31] Speaker 01:
For example, on CAR 14, where the LJ discusses the electrodiagnostic studies in the records, the LJ just says despite claims of significant symptomology and limitation in the hands, electrodiagnostic studies showed mild carpal tunnel syndrome.

[00:12:49] Speaker 01:
On CAR 23, the LJ discusses how the Sandberg alleged significant limitations from scleroderma,

[00:12:58] Speaker 01:
And yet, her provider ruled out that diagnosis because workup or laboratory testing here was negative.

[00:13:06] Speaker 01:
Again, on car 23, Sandberg had alleged testimony of bony growths from ankylosing spondylitis.

[00:13:14] Speaker 01:
And yet, Dr. Karamloo noted that there was no support for that diagnosis, although the LJ nevertheless gave Sandberg the benefit of the doubt, found it a significant impairment, but noted that the imaging that the LJ discussed earlier was generally unremarkable of the lumbar spine or revealed mild findings.

[00:13:32] Speaker 01:
On CAR 18, the LJ discussed how an MRI showed minimal

[00:13:37] Speaker 01:
sacroilias, and again this contradicts her testimony that her sacroilias was very troublesome, affected her ability to sit, stand, walk.

[00:13:46] Speaker 01:
The LJ also discussed her allegations of shoulder pain, yet Unkar 18 and 22 discusses how imaging of her shoulder was normal.

[00:13:55] Speaker 01:
The LJ discussed how it was inconsistent with the medical opinions.

[00:13:59] Speaker 01:
Unkar

[00:14:00] Speaker 01:
The ALJ found on CAR 22, every doctor, Dr. Karamlew as well as state agency medical consultants, found that she could perform a range of light work.

[00:14:11] Speaker 01:
I note this is where the ALJ developed the RFC.

[00:14:14] Speaker 01:
However, the ALJ's RFC was actually more restrictive

[00:14:18] Speaker 01:
than every single doctor who assessed her functioning.

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And by doctor, I mean a physician here.

[00:14:23] Speaker 01:
So we do have a chiropractor.

[00:14:24] Speaker 02:
So I'm in trouble by the fact that she has to use a cane, a walker, and a scooter.

[00:14:29] Speaker 02:
And how is that consistent with the types of work that the ALJ found in the RFC?

[00:14:36] Speaker 01:
Yeah, thank you for that.

[00:14:38] Speaker 01:
The ALJ did find that she could use a cane any time that she walked.

[00:14:43] Speaker 01:
And looking at the medical evidence, the LJ does appear to give her the benefit of the doubt here.

[00:14:48] Speaker 01:
There was medical evidence showing abnormal gait, and there was medical evidence showing that she used a cane.

[00:14:54] Speaker 01:
So I don't believe there was evidence from doctors saying that she needed a cane.

[00:14:58] Speaker 01:
I don't believe the cane was prescribed.

[00:15:00] Speaker 01:
But looking at that evidence as a whole is the LJ is required to do discuss evidence both that supports and also evidence that detracts from her claim.

[00:15:08] Speaker 01:
The LJ did seem to give her the benefit of the doubt there and found that if she needed to walk,

[00:15:13] Speaker 01:
she could use a cane.

[00:15:14] Speaker 01:
And the vocational expert testified that every single job that the vocational expert found that she could perform would allow for that.

[00:15:25] Speaker 01:
But I would note that that need for a cane every time she walked was a generous finding in favor of Sandberg, that Dr. Karamloo found that she would only need a cane to walk long distances.

[00:15:38] Speaker 01:
The state agency medical consultants reviewed the record and found she would not need to use a cane at all.

[00:15:43] Speaker 01:
So the LJ is giving her some benefit here.

[00:15:47] Speaker 01:
But according to the VE testimony, she could perform a significant number of jobs in the national economy with the use of the cane every single time that she walked.

[00:15:59] Speaker 01:
I would also note the OJ specifically referenced the opinions when discounting her testimony.

[00:16:05] Speaker 01:
So here, for example, Dr. Karen Liu, he opined that she could perform a range of light work.

[00:16:11] Speaker 01:
This would be up to 20 pounds of lifting.

[00:16:14] Speaker 01:
This would be sitting and standing up to six hours a day.

[00:16:17] Speaker 01:
This directly conflicts with her testimony that she could lift only three pounds, that she could walk, sit, stand minutes at a time.

[00:16:25] Speaker 01:
So we have clear contradiction here.

[00:16:27] Speaker 01:
And under Carmichael,

[00:16:28] Speaker 01:
The LJ can discount a claimant's testimony in favor of a contradictory opinion.

[00:16:33] Speaker 01:
That's what we have here.

[00:16:34] Speaker 01:
The LJ also referenced Dr. Karamloo's exam.

[00:16:38] Speaker 01:
He describes on CAR 22 what Dr. Karamloo's exam says.

[00:16:42] Speaker 01:
It shows largely normal findings.

[00:16:45] Speaker 01:
So, for example, Sandberg alleged that she could lift up to three pounds.

[00:16:49] Speaker 01:
Dr. Karamloo's exam shows normal strength, including normal grip strength.

[00:16:53] Speaker 01:
It actually, if one turns to CAR 1133, actually shows on the top of that that she could generate 30 pounds of force using her right hand and 30 pounds using her left hand.

[00:17:04] Speaker 01:
That's on CAR 1133 under vital signs in Dr. Caramelou's exam.

[00:17:10] Speaker 01:
Ten times more than she said that she could lift.

[00:17:13] Speaker 01:
Doctor, she alleged difficulty with pain in her neck.

[00:17:17] Speaker 01:
Dr. Caramelou's exam shows normal neck range of motion.

[00:17:21] Speaker 01:
She alleged debilitating pain.

[00:17:23] Speaker 01:
Dr. Caramelou's exam shows no pain on motion in the extremities.

[00:17:27] Speaker 01:
She alleged swelling.

[00:17:28] Speaker 01:
Dr. Caramelou's exam shows no swelling.

[00:17:31] Speaker 01:
It also shows sensation intact to light touch.

[00:17:37] Speaker 01:
The OJ referenced activities.

[00:17:39] Speaker 01:
He described those activities on CAR 19.

[00:17:45] Speaker 01:
Yes, these are routine activities, but I would turn this court's attention to SMART.

[00:17:51] Speaker 01:
This is very similar to SMART.

[00:17:54] Speaker 01:
In SMART, the claimant's allegations similarly were extreme debilitating pain.

[00:17:58] Speaker 01:
In SMART, it was 10 out of 10 pain.

[00:18:01] Speaker 01:
And this court has held not only can an ALJ discount a claimant's activities when they're transferable to a work setting, but also when they conflict with her allegations.

[00:18:11] Speaker 01:
So whereas here, a claimant is alleging total disability, extreme pain,

[00:18:15] Speaker 01:
Then the LJ can use activities, even if the claimant has some difficulty performing those activities, to discount such extreme allegations.

[00:18:26] Speaker 01:
And that's what we have here.

[00:18:27] Speaker 01:
We have a claimant alleging she can lift three pounds, barely walk.

[00:18:32] Speaker 01:
And yet she can attend her son's games twice a week.

[00:18:35] Speaker 01:
She can, napping up to six hours a day.

[00:18:38] Speaker 01:
And yet she's able to perform a fairly normal life, even with some assistance.

[00:18:42] Speaker 03:
The explanation that counsel's looking for, you're arguing, is really found in the ALJ's finding of the contradictions?

[00:18:51] Speaker 01:
Correct.

[00:18:52] Speaker 01:
The ALJ discusses extreme allegations of debilitating limitations and symptoms on 70 through 18.

[00:18:59] Speaker 01:
On CAR 23, the ALJ references those allegations directly and then ties that to the evidence that the ALJ finds inconsistent with those allegations and discusses that evidence in more detail throughout the decision.

[00:19:13] Speaker 01:
And this court, as it held in Kauffman, must look to all the pages of the ALJ's decision to determine if substantial evidence supports the ALJ's finding.

[00:19:22] Speaker 01:
And I'd also note on CAR 13 through 23, as well as CAR 23,

[00:19:26] Speaker 01:
The LJ noted specific inconsistencies.

[00:19:29] Speaker 01:
So for example, the LJ discussed on CAR 15, she alleges a thyroid disorder, yet she's denying a thyroid disorder to providers.

[00:19:38] Speaker 01:
The LJ discusses on CAR 15 as well.

[00:19:41] Speaker 01:
She testified to hearing loss, yet exams showed normal hearing.

[00:19:45] Speaker 01:
She testified to vision loss, exams showed normal vision.

[00:19:49] Speaker 01:
CAR 15 through 16 alleges problem with memory.

[00:19:51] Speaker 01:
The exam shows normal memory.

[00:19:54] Speaker 01:
So the LJ is going, if anything, beyond what is required because line by line, he's also going through specific testimony and showing why the evidence contradicts that testimony.

[00:20:08] Speaker 01:
If there are no more questions, I'll ask the court to affirm.

[00:20:10] Speaker 01:
No more questions?

[00:20:11] Speaker 02:
No.

[00:20:12] Speaker 02:
Okay.

[00:20:12] Speaker 02:
Thank you, counsel.

[00:20:17] Speaker 02:
Mr. Prado, I'll give you a minute or so for rebuttal.

[00:20:26] Speaker 05:
Thank you, Your Honor.

[00:20:29] Speaker 05:
Just quickly, this case, just because a person alleges that they have extreme disabilities and they can do daily activities does not automatically disqualify them.

[00:20:39] Speaker 05:
I would say this case is more like the Garrison case than the Smart case.

[00:20:42] Speaker 05:
And I would also like to note that in the record,

[00:20:48] Speaker 05:
My client has significant, on significant medications and pain medications, none of which was discussed.

[00:20:54] Speaker 05:
And all the things such as a minor finding in the back, a minor degenerated back can cause pain.

[00:21:01] Speaker 05:
So that's what we're looking for.

[00:21:02] Speaker 05:
Yes, it was easy for the judge to find a handful of little things where he said, you don't have blindness.

[00:21:08] Speaker 05:
Okay, she doesn't have blindness.

[00:21:09] Speaker 05:
That's why blindness is not part of the RFC.

[00:21:11] Speaker 05:
But what our concern is, is the explaining of why that RFC has those limitations on standing and walking based on the record.

[00:21:23] Speaker 05:
Thank you.

[00:21:23] Speaker 02:
Thank you very much, Council.

[00:21:25] Speaker 02:
Sandberg versus King will be submitted.