text:
PERTH AMBOY – Last week, a state appeals court overturned the conviction of a Perth Amboy man accused of beating his father to death with a baseball bat in the backyard of their Front Street home in 2004.
Family Day And Sidewalk Sale Slated For Linden
by staff report • • 0 Comments
LINDEN—The City of Linden will host Family Day, with a sidewalk sale, on Saturday, Aug. 22.
Area Students Earn Degrees
by staff report • • 0 Comments
NEW YORK, N.Y.—The following local students were among the students of The Art Institute of New York City to be awarded degrees by Dean David Moughalian on June 22:
Registration Begins For Polish Language Classes
by staff report • • 0 Comments
CLARK—The studies program of the Polish Cultural Foundation in Clark is currently accepting registration for its language classes, which begin the week of Sept. 17. Classes in beginner's Polish, part I and part II, and intermediate Polish will meet on Thursday evenings. All classes meet from 7 to 9 p.m. and run for twelve weeks. Early registration is suggested.
Shoplifting Cop Dropped
by staff report • • 0 Comments
EDISON—A township police officer lost his job and will be permanently barred from future public employment as a result of shoplifting $42.27 worth of goods from a local supermarket.
Police Investigate Robberies
by staff report • • 0 Comments
UNION COUNTY – Police are investigating two robberies that happened hours apart in the Union County area on July 31.
Remembering The Past: Sayreville Through The Years
by Diane Harrison • • 0 Comments
SAYREVILLE-After my July 2 column on the Morgan Family cemetery in the Morgan section of Sayreville, I received an e-mail from South Amboy resident Ed Campbell.
Sex Teacher Avoids Jail
by staff report • • 0 Comments
OLD BRIDGE – Lisa Glide, a former drama teacher at Old Bridge High School who had a relationship with teenage student, was sentenced to five years on probation.
Volunteers Needed
by staff report • • 0 Comments
ELIZABETH – The Union County Rape Crisis Center is seeking volunteer advocates to provide support and guidance for victims of sexual assault. A new training session for prospective volunteers will start on Sept. 22.
Shareholders Approve Merck/Schering-Plough Merger
by staff report • • 0 Comments
WHITEHOUSE STATION – Shareholders approved drugmaker Merck & Co.'s acquisition of Schering-Plough Corp. last week.


text:
Throughout the Heat Roadmap Europe projects, maps have been produced both at a European and at a national scale. For more information on how to use the maps, including the interactive Pan-European Thermal Atlas, watch the Video Tutorial for Using the Maps (15 minutes).
One of the first outcomes of the development of HRE4 are the high definition heat demand atlases for the 14 countries studied in this report.
An integrated, interactive version of them will be available by the end of 2016.
These versions (Peta4alpha) are PDF representations of the GIS data, and are best viewed at full resolution when downloaded. The interactive version will include further refinement, and overlay between heat demands and sustainable and renewable resources.
One of the main outcomes of the HRE projects has been the development and continued improvements on the interactive Pan-European Thermal Atlas (Peta).
Discover heating and cooling demands at a high resolution, sources and availability of excess heat, renewable heat potentials, and prospective district heating systems.
A video tutorial (15 mins) is available.
In the context of Stratego, 5 national maps were created. In HRE4, these 5 will be substantially enhanced and 10 more will be added.
The current available national maps:
Czech Republic (CZ)
Croatia (HR)
Italy (IT)
Romania (RO)
United Kingdom (UK)
Hover over the relevant map to obtain more details. Click on the thumbnail to obtain a large image.
Using this map, you can download a variety of resources linked to specific countries in Europe. The map includes some reports and maps made by other parties, where indicated. To include your maps or add a link, please contact us.
This system presents the geothermal resource assessment and highlights the areas where potential for geothermal district heating exists. Based on currently available information in terms geological data, already operational district heating systems, and heat demand, it shows the potential in the 14 project countries: Italy, France, Germany, Netherlands, Ireland, United Kingdom, Slovakia, Slovenia, Czech Republic, Romania, Bulgaria, Poland, Denmark, and Hungary.
This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 695989.

subset: commoncrawl


text:
Check in from 1:00 PM / Check out prior to 11:00 AM
Hotel Les Bruyeres Morlaix: Find photos, reviews, information, amenities and compare prices for 2 stars hotels in Morlaix, France.
The hotel is set in Morlaix and is within a 10-minute walk of Morlaix Train Station. It is ideally positioned for those wishing to visit local attractions.
Hotel description
There are a range of amenities at Hotel Les Bruyeres Morlaix on offer to guests, including meeting rooms, tour desk and a golf course. Guests can also unwind in the hotel's garden.
A buffet breakfast is prepared each morning at Les Bruyeres Hotel Morlaix, and there are numerous cafés and eateries close by.
Hotel Les Bruyeres Morlaix is less than a 35-minute drive from Brest Bretagne Airport. The Cairn of Barnenez and the Saint-Pol-de-Leon Cathedral are only an easy drive from the hotel.
Hotel features
Pet Friendly
Multilingual Staff, Meeting Rooms
Tour Desk, Golf Course, Garden
Availability and Prices
Booking Site
Room Type
Per room
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Users who viewed Hotel Les Bruyeres Morlaix also viewed these 2 stars Morlaix hotels:
Hotel Saint Melaine Morlaix
75 Rue Ange De Guernisac, Morlaix
75 Rue Ange De Guernisac, Morlaix
Hotel Du Port Morlaix
3 Quai de Leon, Morlaix
3 Quai de Leon, Morlaix
Hotel Fontaine
7, rue Jean Francois Périou. ZA La boissière, Morlaix
7, rue Jean Francois Périou. ZA La boissière, Morlaix
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text:
Words formed when one letter is changed in metro
Letter 1 (M) changed: 1 word found:
No words found when changing letter 2 (E).
No words found when changing letter 3 (T).
No words found when changing letter 4 (R).
Letter 5 (O) changed: 1 word found:
A total of 2 words can be formed from metro by changing one letter.
Some random words: re fub ceanothus glabella kier glioblastoma otalgia
This is not a dictionary, it's a word game wordfinder.
- Help and FAQ - Examples - Home
Privacy and Cookies Policy - Share - © Copyright 2004-2016 Morewords.com - 97.894mS


text:
Free personalized radio that
plays the music you love
La Bamba
Features of This Trackfemale lead vocals
electric guitar riffs
acoustic guitar
a string orchestra
piano playing
a brass horn ensemble
prominent percussion
These are just a few of the hundreds of attributes cataloged for this track by the Music Genome Project.show more
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text:
tpmunoz Review
Beautiful Sink
The color is great and I prefer the shape instead of round bowls that I've seen. Don't forget to buy the drain along with it.
- How did the color on site compare with the actual product? The sink looked clearer than the picture on the site, but I expected that since its glass
- Please tell us about the quality of the product. The sink is sturdy and looks great in my downstairs bathroom
- How accurate was the on site description of the product? Very accurate
Was This Review Helpful?


text:
- tdoghong
- USA, Male, 31-40
- Avid Traveller
- 14 reviews
Terribly slow internet. I had to go to a local restaurant to use it. Not even worthy the 1euro they charge for wifi.
- Anonymous
- Australia, Male, 41+
- Novice Nomad
- 9 reviews
This was a last minute choice made purely out of necessity and had I researched it I would not have stayed there. The rooms were bereft of charm and or warmth. The place had zero atmosphere, the area wasn't particularly nice and upon leaving I was interrogated about a window that was broken during the night. If they want to maintain some semblance of security there maybe they should invest in some security cameras. It was a basic, no frills place and not cheap given its failings
- Anonymous
- Ireland, Female, 18-24
- Novice Nomad
- 1 review
I spent a lovely weekend in Florence, using the hostel as my base to explore the city. The staff were very friendly, polite and helpful. The room was clean and quiet so it would be perfect for someone looking for a break from typical rowdy hostels! I traveled on my own and was made to fell very welcome. Although there is a bus into the town, the walk takes only twenty minutes or so and is very pretty, walking along cobbled streets or by the River Arno, with incredible views of the city!
Hostelworld Mobile Apps
Book on the go with the new Hostelworld mobile apps.


text:
In Stock
Swirl, Tap, Buff
1. Swirl a small amount of the bareMinerals Mineral Veil into the lid with a buffing brush until it disappears into the bristles.
2. Tap off any excess product on the brush.
3. Buff the product in swirling, circular motions over the face for optimal coverage.


text:
TopAgencies @topagencies
RT @HudsonIntegratd: Happy Birthday, Chris! Enjoy these yummy cupcakes! https://t.co/VbBuq81t9Z
Top Interactive Agencies / Best Digital Agencies | December 9, 2016
Avatar is an independent digital native agency. It has 15 years of experience and a permanent staff of 150 professionals in 5 offices located in Buenos Aires, Quito, Mexico, Santiago and Miami. From these premises, Avatar provides top quality service


text:
The Meaning of XGA
You have found the definitive source for the meaning of XGA. This page contains all the definitions of XGA, crowd sourced, moderated and curated by real people who care about the true definitions of XGA.
The Top Definition of XGA
The most popular meaning of XGA is: eXtended Graphics Array/Adaptor
What Other Meanings of XGA Are There?
There are no other definitions for XGA at this time. Add your own definition of XGA.
What is XGA?
XGA is eXtended Graphics Array/Adaptor
XGA Means
The definition of XGA is "eXtended Graphics Array/Adaptor".
XGA Definition
The meaning of XGA
XGA means eXtended Graphics Array/Adaptor.
Now you understand the definition of XGA - XGA means "eXtended Graphics Array/Adaptor".
We're glad to be of assistance. Click here to thank us:
What does XGA mean? XGA is an acronym, abbreviation or slang word that is explained above. If you ever forget what XGA means, just come back to Slang.org and we'll define any acronym you need help with.


text:
AASHTO LTS 6th Edition, 2013
Complete Document
Standard Specifications for Structural Supports for Highway Signs, Luminaires, and Traffic Signals
Includes all amendments and changes through Interim Amendment , 2015
Page Count:312
Print :
In Stock
The provisions of these Standard Specifications for Structural Supports for Highway Signs, Luminaires, and Traffic Signals, hereinafter referred to as the Specifications, are applicable to the structural design of supports for highway signs, luminaires, and traffic signals. The types of supports covered in these Specifications are discussed in Article 1.4. The Specifications are intended to serve as a standard and guide for the design, fabrication, and erection of these types of supports.
These Specifications are not intended to supplant proper training or the exercise of judgment by the designer, and they include only the minimum requirements necessary to provide for public safety. The Owner or the designer may require the design and quality of materials and construction to be higher than the minimum requirements.
The commentary directs attention to other documents that provide suggestions for carrying out the requirements and intent of these Specifications. However, those documents and the commentary are not intended to be a part of the Specifications.


text:
Reviewed By Richard M (Bronx, NY) Reviewed for a 2015 Chevy Silverado —10/11/2016 4:47 AM
Hella horns r hella good
Reviewed By Rick S (VENICE, FL) Reviewed for a 2015 Dodge Ram —8/3/2016 2:57 PM
It took me about a month to find someone I felt could do a good job installing this kit. The mechanic has installed many train horns, but was very impressed with the quality of all the components in the Kleinn horn system. Needless to say the sound is fantastic !!
Installing an air horn is a simple task that can be completed in your own driveway. Before you begin, however, you'll want to read this article to get an idea of just what the job entails.


text:
Tim McGraw and Faith Hill Still as in Love as Ever — See Their Adorable Selfie!
Tim McGraw and Faith Hill have been cornerstones in country music for years, and their time-tested marriage is an inspiration to many.
Tim McGraw and Faith Hill have been cornerstones in country music for years, and their time-tested marriage is an inspiration to many.
Tim McGraw has been a family man ever since he and Faith Hill had their first daughter, Gracie, 18 years ago, and lately he has been letting that side of him shine.
I can't say that I crossed off meeting Tim McGraw from my bucket list, but what I experienced at his concert over the weekend will probably be the closest I'll get to that wish.
Tim McGraw has revealed the release date for what's likely his next studio album.
The Morning Bull Pen was out making deliveries Friday morning.
One key stop: the Yakima Valley School in Selah, where they dropped off some Tim McGraw tickets to one very surprised Bull listener...
It's no secret that when Tim McGraw is on the road, he makes sure to keep up his workouts and eat well, but the artist says his regimen is not just about keeping his biceps camera-ready.
Tim McGraw's hometown show became a family affair on Saturday night. Wife Faith Hill joined the "Shotgun Rider" singer on stage, as did his cousin, his daughter Gracie and several country newcomers.
Tim McGraw keeps it mellow with the first single from an upcoming project. "Top of the World" is a gentle way for the singer to describe his love to someone. McGraw uses a familiar metaphor to make it clear this woman couldn't make him feel any finer.
Country veteran Lynn Anderson passed away on July 30 after suffering a heart attack, and many artists and industry members have been expressing their sadness and condolences after hearing the news.
Tim McGraw may enjoy being a "Real Good Man," but on screen he prefers to be a "Real Bad Boy." The singer and actor talked about his new film project 'The Shack,' and one other acting project he's working on before headlining day three of Country Jam on Saturday night.
Tim McGraw returned to the venue at which he proposed to wife Faith Hill on Saturday night (June 20), and put on a concert that for the thousands in attendance, was just as memorable.
Country Jam 2015 will soon draw to a close, but there's still a full day of country music ahead — and the party shows no signs of slowing down. Day 3 of the festival was a huge one, with headliner Tim McGraw drawing a massive crowd after several other talented artists took the big stage.


text:
Student Activities seeks to build community, pride and tradition and inspire the growth of the whole student by enhancing co-curricular student learning, development and civic responsibility that is both enriching and entertaining.
Campus Wide Programs
University-wide programs and events: University Welcome, Family Weekend, etc.
Late Night
Discover exciting things to do on campus after hours with Late Night UB.
Lake Lasalle
For the first time in 40 years, Lake LaSalle is open for recreational use! Come enjoy this beautiful lake from April until November.


text:
5035 Poston Drive
San Jose, CA 95136
Get Directions
Phone (408) 629-1185
Fax (408) 629-1181
Email email@example.com
Major Cross StreetsSnell Ave & Chynoweth Ave
School CampusHayes Elementary School
Hours6:30a.m. - 6:00p.m.
Preschool, School Age
License Number434403619 & 430709907
Schedule a Tour
Fill out the information below and we'll contact you!


text:
Product Description
Message: Saved.
Featuring a stone-carved look, this inspirational collection touches the hearts of those who believe with messages of hope and faith. Artist Bill Stross' inspirational pieces capture the look of intricate carved stone and are accented with universal, faith-based sentiments that touch the soul.
Artist: Bill Stross
Artist Information
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text:
There is a content revolution happening in India contributed by the English-speaking educated population in the country in addition to the affordable rates. This has made India a destination for companies to outsource their content writing works so as to reduce the costs incurred from content creation.
Even though Indian content factories can churn out content faster than onsite companies, outsourcing product documentation to India comes with serious quality problems. Scott Abel, content management strategist, writes that even though some Indian writers do produce good quality works, others seem to have serious quality issues.
For example, in the case of technical writing, which requires high quality, clear and concise content, many US writers have lost their jobs in favor of their Indian counterparts. The lucky ones who were spared seem to have found that their wages lowered as well.
The US employers outsourced the content to hundreds of affordable Indian writers churning out large amounts of content as opposed to content from small, slow and expensive teams of writers back home.
However, even though there are cost benefits to offshore outsourcing, it has been offset by the quality problems of many Indian writers who do not have command over Americanized English. As a result, even after the content has been created, it becomes subject to much more editing, restricting and sometimes, complete rewriting.
Displaced technical writers argue that technical writing is a skill as opposed to being a commodity. They are baffled at why companies consider cost-reduction as priority considering the huge quality issues that the content created by Indian writers posed. They claimed that the job required experience, training, understanding of audience, niche market knowledge etc., most of which are lacking in the writers at Indian content factories.
However, the blame lies not only with Indian writers. According to Alyssa Fox, director of information development, NetIQ, poor quality content can be produced by American tech writers as well. She said that the problems are not dependent on location or nationality but the management, training and planning problems. She blames the managers for not imparting adequate training to writers for improving their skills.
When a company in US outsources content creation to manifold offshore writers as compared to domestic writers and reduces the timeline of project significantly, much time cannot be allocated to planning, training, strategy and so on. This, by default, gives time only for the writing part, with the result being poor quality content.
Paul Perotta, who is the director of Information Experience Shared Content Services at Juniper Networks, enumerated the problems that accompany outsourcing content creation overseas. He said that the challenges include hiring practice differences, management and governance issues, time zone differences, quality checks, expenses, volatile labor pool etc.
However, Perotta added that outsourcing product documentation is not a bad idea if reasonable goals are set, the power of the new workers is leveraged and successful teams are created. The problem lies with leaders who, without adequate preparation, end up blaming the off-shore writers for poor planning skills and lack of imagination.


text:
Gender: Boy
Meaning: Snow
Origin: Hindi, Indian, Marathi, Sanskrit
Religion: Hindu
Tushar is a Hindu Boy name, meaning of the name is Snow and origin of the name is Hindi, Indian, Marathi, Sanskrit. This name is mostly used in Hindu.
If you select the name Tushar for your baby, Congratulations! But if you don't like Tushar then please continue searching our site.
External References
Similar Names


text:
Incorrect. The bandwidth would remain constant - what would double if the distance doubled is what is usually called a "bandwidth-delay product". This quantity represents the pipe capacity of a given length, or in other words the amount of data in transit at any given moment. This is of course assuming you have an unlimited number of pigeons you can keep sending out.
You would be correct, using the term bandwidth loosely, if the number of pigeons stayed constant. However, using the strict definition, bandwidth is totally unrelated to line latency/round trip time.
Can anyone remember when the times were not hard, and money not scarce?


text:
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June 25, 2010
TERRENCE W. CAMPBELL, PLAINTIFF,v.MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.
Plaintiff Terrence W. Campbell ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner" or "Defendant") denying his application for disability insurance benefits pursuant to Title II of the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to the Honorable Gary S. Austin, United States Magistrate Judge.*fn1
FACTS AND PRIOR PROCEEDINGS*fn2
Plaintiff filed his application on or about September 7, 2005, alleging disability beginning April 29, 2005. AR 72. His application was denied initially (AR 48-52) and on reconsideration (AR 39-43); thereafter Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). AR 39. ALJ Plauche F. Villere, Jr. held a hearing on August 14, 2007 (AR 172-195), and issued an order denying benefits on April 12, 2008. AR 12-24. Plaintiff requested a review of the decision (AR 10-11) and on February 26, 2009, the Appeals Council denied review. AR 4-6.
Hearing Testimony
ALJ Villere held a hearing on August 14, 2007, in Sacramento, California. Plaintiff appeared and testified. Plaintiff was represented by attorney Charles Oren. AR 172-195.
Plaintiff's date of birth is March 13, 1953; he was 54 years old on the date of the hearing. AR 177. He is five feet, eight inches tall and weighs 250 pounds. AR 192. He has a twelfth grade education and can read and write. AR 179. Plaintiff lives at home with his wife and five-year-old granddaughter, of whom he and his wife have permanent guardianship. AR 191.
When asked about his work history, Plaintiff testified that he last worked as an order man for Certified Grocers, selecting orders at a dry grocery warehouse. AR 180. The job required heavy lifting. AR 181. He stopped working there in April 2005 because he was "unable to pace [himself] for the production standard required." AR 179, 181. His back hurt too much and his hands "were unable to grasp." AR 181. Even if Plaintiff's job did not require heavy lifting, he still would not be able to do it now because his hands are weak and fatigued. AR 181.
Degenerative disc disease makes it difficult for Plaintiff to stand, stoop, bend, and lift. AR 182. The pain is aggravated with physical activity and excruciating if he has to bend over. AR 190, 193. Plaintiff takes Vicodin for his back pain. AR 187. However, he does not need a cane or brace. AR 177. Plaintiff's doctor recommended swimming to treat his back pain. He has a pool and swims "pretty much every day" for 15 or 20 minutes. AR 184, 194.
In response to the ALJ's inquiry about performing a job without heavy lifting, Plaintiff stated he could not do it because he has had problems with his hands since his carpal tunnel surgery in 1998. AR 181-182, 187. The surgery was successful but the side effects are fatigue and lack of "grasping power." AR 182. Plaintiff cannot do any type of repetitive work with his hands, such as writing or lifting, for more than 10 or 15 minutes. AR 181, 186. Plaintiff can write a quarter to a half page before he has to stop and take a break. AR 187. He takes Motrin to relieve the pain. AR 187.
With regard to the diagnosis of Type II diabetes, Plaintiff's condition is controlled through oral medication. AR 182-183. Plaintiff also has high blood pressure and high cholesterol, which are also controlled through medication. AR 183. Additionally, Plaintiff has diverticulitis, which is controlled through a high-fiber diet. AR 183. Plaintiff also has peripheral neuropathy, which is a burning sensation in his leg that occurs two to three times per week for about an hour, and is extremely uncomfortable. AR 193-194. Plaintiff used to have a problem with the use of marijuana but quit twelve years ago. AR 177-178. He does not smoke tobacco. AR 178.
Side effects of Plaintiff's medication include dizziness, headaches, upset stomach, diarrhea, and constipation. AR 189-190, 192. The dizziness is cause by Plaintiff's blood pressure medication and occurs on a daily basis. AR 183, 192. The diarrhea occurs two or three times per week. AR 190. The headaches occur once or twice per week. AR 189. Once or twice per month he has "migraine type" headaches, caused by stress. AR 189. When he gets the "migraine type" headaches he is "completely incapacitated," and will take medication and try to sleep in a quiet dark room. Those headaches typically last "a day." AR 189.
Plaintiff can lift approximately 10 pounds but drops things occasionally. AR 186. He can stand for 15 minutes before needing to sit, recline, or lie down. AR 194. He can sit for 30 minutes at one time and can walk approximately 300 to 500 feet, no more than 10 to 15 minutes, before he has to take a break. AR 190. Plaintiff can mow the lawn on a "good day." AR 187. His bad days are approximately every other day. AR 187-188. On a bad day, even after taking Vicodin, Plaintiff described his pain as an eight out of ten. AR 188. On a bad day, he lies down, sits in a recliner, sleeps, and avoids physical labor of any sort, including cleaning around the house. AR 188.
When asked about daily activities that he can perform, Plaintiff testified that he does not need assistance with personal hygiene and grooming, however, he cannot put on or take off his own shoes. AR 179-180, 193. He cooks, cleans up around the house, and does light grocery shopping. AR 180. Plaintiff also looks after his granddaughter. AR 191. He can drive for one hour before he has to stop and walk around to take a break. AR 180, 191.
Medical Record
The entire medical record was reviewed by the Court. A summary of the reports and treatment notes is provided below.
Xing-Jian Lu, M.D.
On August 12, 2004, Plaintiff was seen by Xing-Jian Lu, M.D., his primary treating physician, for complaints of bilateral foot problems, numbness and tingling in his feet and legs, and severe dry cough. Dr. Lu diagnosed Plaintiff with diabetes, hypertension, and high cholesterol. AR 117-118.
On September 3, 2004, Dr. Lu diagnosed Plaintiff as having Diabetes Mellitus Type 2 and obesity, and recommended "DM class" and a weight management program. Dr. Lu noted that Plaintiff's blood sugar continued to fluctuate and Plaintiff had not attended DM class yet. AR 115-116.
On April 29, 2005, Plaintiff was seen for complaints of bilateral lower back pain. The pain had existed for three to five days but was not precipitated by injury. AR 109. Dr. Lu prescribed Vicodin and Robaxin and put Plaintiff on light duty for one month. AR 110. At the time, Plaintiff was five feet, eight inches tall, weighed 250 pounds, and his body mass index ("BMI") was 40. AR 109.
On May 31, 2005, Plaintiff was again seen for complaints of lower back pain. Plaintiff requested an extension of light duty. AR 105. Dr. Lu's examination revealed tenderness in the sciatic and lower lumbar paraspinal areas. The doctor ordered an X-ray, refilled Plaintiff's Vicodin prescription, and referred him to physical therapy. AR 106.
On June 30, 2005, Plaintiff reported no change in his back pain and requested another extension of light duty. AR 103. Dr. Lu placed Plaintiff on light duty until August 31, 2005. The doctor also noted that Plaintiff declined physical therapy but said he would do water therapy. AR 104.
On July 15, 2005, Plaintiff was seen by Lan Zhang, M.D., another Kaiser Permanente physician, for complaints of nausea caused by his medications, yet Plaintiff did not want to change medications. AR 102.
June 25, 2007 and July 9, 2007 notations indicate that Plaintiff was noncompliant with "all labs outreach." AR 137-138.
Philip Seu, M.D.
On December 8, 2005, Philip Seu, board certified surgeon, performed a comprehensive internal medicine evaluation of Plaintiff. AR 122-125. Plaintiff's chief complaints were low back pain and carpal tunnel syndrome. AR 122. Dr. Seu reviewed X-ray reports dated June 1, 2005, and August 23, 2005, as well as medical reports dated July 11, 2005, and August 31, 2005. AR 122.
Plaintiff reported that he had low back pain for three to four years as the result of heavy lifting. He complained of pain across his lower back with occasional radiation to his left buttock and left upper leg. AR 122. Plaintiff stated that he was treated with pain medication and tries to swim everyday as recommended. AR 122. Plaintiff also reported that he had carpal tunnel surgery on both wrists, which eliminated the numbness, however, he still experiences fatigue in his hands after 10 to 15 minutes of working with them. AR 122. Plaintiff indicated to the doctor that he spends most of his time at home. He takes the trash out, babysits, swims, and drives. He can walk approximately 500 yards, but he cannot lift heavy objects. AR 123.
Dr. Seu's findings indicate that Plaintiff was obese, moved slowly, and had difficulty bending over and getting on and off the examination table. AR 123. Plaintiff was five feet, eight inches in height and weighed 274 pounds. AR 123. Dr. Seu's general findings included decreased range of motion of the lumbar spine, positive bilateral lumbar tenderness, and healed surgical incisions on both wrists. AR 124. The doctor opined that Plaintiff's low back pain was due to lumbosacral strain. AR 125. The X-rays showed minimal L1-L2 findings. AR 122. Dr. Seu noted "no objective findings" regarding Plaintiff's carpal tunnel syndrome, only a subjective fatigue after prolonged use. AR 125.
Dr. Seu determined that Plaintiff could stand and/or walk six hours in an eight-hour day with more frequent breaks, and could sit without restriction. He could lift 20 pounds occasionally and 10 pounds frequently. Plaintiff has postural limitations due to decreased range of motion in his back, yet Dr. Seu found no manipulative or environmental limitations. AR 125.
Nazar R. Alsaffar, M.D.
On February 9, 2006, Nazar R. Alsaffar, M.D. performed an MRI of Plaintiff's lumbar spine at the request of Dr. Lu. Dr. Alsaffar noted significant degenerative disc disease at L1-2 with posterior spurs and bulging disc, probably causing mild degree of spinal stenosis. He found no focal disc herniation and no significant spinal stenosis. AR 150.
C. Lawlor, D.P.M
On February 17, 2006, podiatrist C. Lawlor conducted a routine diabetic foot check of Plaintiff. Plaintiff complained of toenail fungus, indicating that he only walks barefoot or wears flip flops. AR 99. Upon examination, Dr. Lawlor found no signs of infection; however, he noted that Plaintiff's hygiene was poor and advised Plaintiff to wear socks and lace-up athletic shoes. AR 108.
On April 28, 2006, Dr. Lawlor conducted another routine diabetic foot check. He noted minimal improvement. The doctor also noted that Plaintiff wore flip flops again and that his feet were very dirty and green from mowing the lawn in bare feet. Dr. Lawlor told Plaintiff he was low risk at that time, but that could change in the future if Plaintiff did not take better care of his feet. AR 145.
Michael M. Kiekhaefer, M.D.
On August 21, 2006, neurologist Michael M. Kiekhaefer examined Plaintiff at the request of Dr. Lu. Dr. Kiekhaefer noted that the MRI showed relatively mild degenerative changes, at L1-2, but no significant nerve root impingement and only mild spinal stenosis. The doctor's physical examination of Plaintiff revealed 5/5 motor strength in all extremities, bilateral deep tendon reflexes in the upper and lower extremities, and normal toe/heel walking. Plaintiff's sensation was intact to light touch and pinprick in all extremities with the exception of decreased pinprick at the left anterolateral proximal thigh. Dr. Kiekhaefer found no need for surgery. AR 143. He diagnosed Plaintiff with chronic low back pain and meralgia paresthetica in the left thigh. Dr. Kiekhaefer encouraged weight loss and exercise but noted that Plaintiff refused a physical therapy referral. He also discussed with Plaintiff that he try a chronic pain medication, but Plaintiff deferred. AR 143.
Fariba Vesali, M.D.
On October 4, 2007, Fariba Vesali, M.D. performed a comprehensive orthopedic evaluation of Plaintiff. AR 162-165. Plaintiff complained of chronic low back pain, chronic hand pain, and diabetes. AR 162. He stated that he has had lower back pain for 10 to 12 years, that lifting more than a gallon of milk or walking more than 250 feet aggravates his pain, and that sitting and raising his legs decreases the pain. AR 162. Plaintiff also stated that his hand pain included fatigue and numbness and had been present since the early 1990s. He underwent carpal tunnel surgery in 2000 with some improvement in numbness. AR 162.
Dr. Vesali noted Plaintiff was five feet, seven inches tall and weighed 263 pounds. His gait was normal and he had no difficulty getting on and off the examination table. AR 163. Dr. Vesali noted decreased range of motion and tenderness in Plaintiff's lumbar spine. Straight leg raising was negative bilaterally. Axial compression of the hip caused increased low back pain. Otherwise, the findings were unremarkable. AR 165. Plaintiff was diagnosed with chronic low back pain, chronic hand pain, status-post carpel tunnel release, diabetes, and malignant melanoma on chest (status-post excision of tumor). AR 164-165.
Dr. Vesali determined that Plaintiff should be able to sit for six hours and walk for six hours in an eight-hour day with normal breaks. He does not need an assistive device to walk. He should be able to lift and carry 25 pounds occasionally and 10 pounds frequently. The doctor did not identify any postural limitations on bending, stooping, or crouching. Additionally, he found no manipulative limitations on reaching, handling, feeling, or grasping. Neither did the doctor identify any visual, communicative, or workplace environmental limitations. AR 165.
On October 7, 2007, Dr. Vesali completed an SSA Medical Source Statement. AR 155-160. Dr. Vesali opined that Plaintiff could lift or carry 10 pounds frequently and 20 pounds occasionally. Dr. Vesali found Plaintiff could sit, stand, or walk for two hours each, without interruption at one time. Further, the doctor found he could sit, stand, or walk for a total of six hours each, in an eight-hour day. AR 156. Dr. Vesali found Plaintiff could reach, handle, finger, feel, push, and pull frequently with either hand and operate foot controls frequently with either foot. AR 157. He could occasionally climb, balance, and crawl, and could frequently stoop, kneel, and crouch. The doctor found he could frequently tolerate various environmental conditions. AR 158-159. Lastly, Dr. Vesali opined that Plaintiff could also shop, travel alone, ambulate, walk a block, use public transportation, climb steps, prepare meals, care for personal hygiene, and sort, handle, and use paper/files. AR 160.
Physical RFC Assessment
On December 30, 2005, state agency physician S. A. Jaituni, M.D. completed a Physical Residual Functional Capacity ("RFC") Assessment of Plaintiff. AR 126-133. The doctor determined that Plaintiff could lift and/or carry 20 pounds occasionally and 10 pounds frequently, and sit, stand and/or walk for a total of about six hours in an eight-hour day. The doctor also determined that Plaintiff could push and/or pull (including operate hand and/or foot controls) without restriction, could frequently balance, kneel, and crouch, and could occasionally climb stairs, stoop, and crawl. AR 127-128. Dr. Jaituni noted no manipulative, visual, communicative, or environmental limitations. AR 129-130.
ALJ's Findings
The ALJ found that Plaintiff had not engaged in substantial gainful activity since April 29, 2005, and had the severe impairments of status post carpal tunnel release in 2000, lumbosacral strain, diabetes, malignant melanoma on chest (status post excision of tumor), and obesity. AR 17. Nonetheless, the ALJ determined that the severe impairments did not meet or exceed one of the listed impairments. AR 19.
The ALJ reviewed the medical evidence and determined that Plaintiff had the RFC to perform the full range of light work. The ALJ found that Plaintiff could occasionally climb stairs, ramps, ladders, or scaffolds, could occasionally balance or crawl, and could frequently stoop, kneel, or crouch. AR 20. The ALJ also found that Plaintiff was unable to perform any of his past relevant work, and that because it was unskilled, transferability of job skills was not an issue. AR 23. The ALJ identified Plaintiff as "closely approaching advanced age" and noted that he had at least a high school education and could communicate in English. AR 23. The ALJ considered Plaintiff's age, education, work experience, and RFC, and concluded that jobs exist in significant numbers in the national economy that Plaintiff could perform. AR 23. Accordingly, a finding of "not disabled" was made, as defined in the Social Security Act. AR 24.
Congress has provided a limited scope of judicial review of the Commissioner's decision to deny benefits under the Act. In reviewing findings of fact with respect to such determinations, the Court must determine whether the decision of the Commissioner is supported by substantial evidence. 42 U.S.C. § 405 (g). Substantial evidence means "more than a mere scintilla," Richardson v. Perales, 402 U.S. 389, 402 (1971), but less than a preponderance. Sorenson v. Weinberger, 514 F.2d 1112, 1119, n. 10 (9th Cir. 1975). It is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson, 402 U.S. at 401. The record as a whole must be considered, weighing both the evidence that supports and the evidence that detracts from the Commissioner's conclusion. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). In weighing the evidence and making findings, the Commissioner must apply the proper legal standards. E.g., Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). This Court must uphold the Commissioner's determination that the claimant is not disabled if the Secretary applied the proper legal standards, and if the Commissioner's findings are supported by substantial evidence. See Sanchez v. Sec'y of Health and Human Serv., 812 F.2d 509, 510 (9th Cir. 1987).
In order to qualify for benefits, a claimant must establish that he is unable to engage in substantial gainful activity due to a medically determinable physical or mental impairment which has lasted or can be expected to last for a continuous period of not less than twelve months. 42 U.S.C. § 1382c (a)(3)(A). A claimant must show that he has a physical or mental impairment of such severity that he is not only unable to do her previous work, but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. Quang Van Han v. Bowen, 882 F.2d 1453, 1456 (9th Cir. 1989). The burden is on the claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990).
In an effort to achieve uniformity of decisions, the Commissioner has promulgated regulations which contain, inter alia, a five-step sequential disability evaluation process. 20 C.F.R. §§ 404.1520 (a)-(f), 416.920 (a)-(f) (1994). Applying this process in this case, the ALJ found that Plaintiff: (1) had not engaged in substantial gainful activity since the alleged onset of his disability; (2) has an impairment or a combination of impairments that is considered "severe" based on the requirements in the Regulations (20 CFR §§ 416.920(b)); (3) does not have an impairment or combination of impairments which meets or equals one of the impairments set forth in Appendix 1, Subpart P, Regulations No. 4; (4) could not perform his past relevant work; and (5) could perform jobs that exist in significant numbers in the national economy. AR 10-12.
Here, Plaintiff argues that: (1) the ALJ's step-two finding that Plaintiff's only severe back impairment is "lumbosacral strain" is not supported by substantial evidence; (2) the ALJ's evaluation of Plaintiff's obesity is based on the application of incorrect legal standards; (3) the ALJ erred in failing to call a vocational expert ("VE"); (4) the ALJ improperly rejected the opinions of Drs. Seu and Vesali; (5) the ALJ's mechanical application of the grids is reversible error; and (6) the ALJ improperly rejected Plaintiff's allegations.
A. ALJ's Step-Two Findings
Plaintiff contends that the ALJ's finding at step two of the sequential evaluation - that Plaintiff's only severe back impairment is "lumbosacral strain" - is not supported by substantial evidence. Defendant counters that the ALJ properly found that Plaintiff's lumbosacral strain was severe.
Specifically, Plaintiff points out that "lumbosacral strain" was diagnosed by Dr. Seu, who did not review Plaintiff's February 9, 2006 MRI. This is correct. However, the ALJ did not rely solely on Dr. Seu's opinion in making his finding at step two. AR 17-19. The ALJ considered Plaintiff's February 9, 2006 MRI, as well as the opinion of examining physician, Dr. Kiekhaefer, who did review the February 9, 2006 MRI. AR 18.
The ALJ states:
In February of 2006, an MRI of [Plaintiff's] lumbar spine showed significant degenerative disease at L1-2 with posterior spurs and bulging disc causing mild degree of spinal stenosis. However, there was no evidence of focal disc herniation or any significant spinal stenosis.
In August of 2006, [Plaintiff] attended a neurological consultation with Dr. Michael M. Kiekhaefer. The doctor noted that his MRI only showed relatively mild degenerative changes with no significant nerve root impingement. He had no surgical pathology.
AR 18 (citations omitted).
At the second step of the sequential evaluation of disability, the ALJ determines whether a claimant has a severe impairment or combination of impairments. A severe impairment is one that significantly limits the claimant's physical or mental ability to do basic work activities. 20 C.F.R. § 1520(c). The Ninth Circuit has clearly articulated that an impairment or combination of impairments may be found to be not severe only if the evidence establishes a slight abnormality that has no more than a minimal effect on an individual's ability to work. Smolen v. Chater, 80 F.3d 1273, 1290 (9th Cir. 1996).
Here, the ALJ determined that Plaintiff suffered from a "severe" medically determinable impairment or combination of impairments which were more than slight abnormalities and had more than a minimal effect on his ability to work. The ALJ described these impairments as "status post carpal tunnel release in 2000, lumbosacral strain, diabetes, malignant melanoma on chest (status post excision of tumor), and obesity." AR 17.
Plaintiff argues that had the ALJ properly recognized the nature and severity of his lumbar spine impairment at step two, both that impairment and Plaintiff's obesity would have warranted greater restrictions than the ALJ found. Contrary to Plaintiff's argument, the ALJ's finding at step two that Plaintiff suffered from "lumbosacral strain" did not preclude a RFC to perform less than the full range of light work. As noted, the analysis at each step is separate and distinct and one finding does not dictate any particular outcome. A person found to have a "severe" impairment at step two may still be found to have a RFC to perform light work. A "severe" impairment at step two is merely an impairment or combination of impairments that has more than a minimal effect on the claimant's abilities to perform basic work activities. See Social Security Ruling ("SSR") 85-28.*fn3 The Commissioner has stated in SSR 85-28 that "if an adjudicator is unable to determine clearly the effect of an impairment or combination of impairments on the individuals's ability to do basic work activities, the sequential evaluation should not end with the non-severe evaluation step." Thus, it is well settled that step two is a "de minimis screening device [used] to dispose of groundless claims." Smolen, 80 F.3d at 1290. An ALJ may only find that a claimant lacks a medically severe impairment or combination of impairments when such a conclusion is "clearly established by medical evidence." SSR 85-28. Further, while a claimant's statements about pain or other symptoms do not alone establish disability, such evidence, in combination with medical signs and laboratory findings demonstrating a medical impairment, is clearly relevant. See 20 C.F.R. § 416.929(a) (2010). Where a claimant provides testimony in the form of subjective pain reports or other symptoms, and there is no evidence of malingering, such relevant evidence may only be rejected under a "clear and convincing" standard. See Webb v. Barnhart, 433 F.3d 683, 687 (9th Cir. 2005), citing Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998).
The ALJ's finding that Plaintiff's status post carpal tunnel release in 2000, lumbosacral strain, diabetes, malignant melanoma on chest (status post excision of tumor), and obesity, passed this minimal threshold did not dictate any particular outcome, but rather allowed the ALJ to go further with the sequential evaluation where he could consider both medical and vocational evidence.
Thus, the ALJ's decision was free of error, and supported by substantial evidence.
B. Plaintiff's Obesity
Plaintiff argues that the ALJ's evaluation of his obesity is based on the application of incorrect legal standards. Specifically, Plaintiff argues that the ALJ failed to comply with SSR 02-1p when evaluating the impact of his obesity on his overall functioning. Defendant counters that the ALJ properly considered Plaintiff's obesity.
Plaintiff's argument has little merit. First, Plaintiff attempts to draw a distinction between the ALJ's finding of a BMI of less than 40 and Plaintiff's calculation of a BMI of 40 or greater. Although this accurately reflects the cutoff between obesity levels II and III, a finding of level III obesity does not prescribe a finding that Plaintiff's obesity, in combination with his other impairments, increases the severity or functional limitations of Plaintiff's other impairments. See SSR 02-1p.
The Clinical Guidelines recognize three levels of obesity. Level I includes BMIs of 30.0-34.9. Level II includes BMIs of 35.0-39.9. Level III, termed "extreme" obesity and representing the greatest risk for developing obesity-related impairments, includes BMIs greater than or equal to 40. These levels describe the extent of obesity, but they do not correlate with any specific degree of functional loss.
SSR 02-1p.
Second, Plaintiff argues that the ALJ has failed to comply with SSR 02-1p because the ALJ asserted, in support of his finding, that there was no evidence in the record to show that "[Plaintiff] has followed any type of diet to control his caloric intake, or any sustained exercise program to combat the effects of obesity." AR 19.
According to the Social Security Rules, in evaluating obesity to determine a claimant's RFC, the ALJ's assessment "must consider an individual's maximum remaining ability to do sustained work activities in an ordinary work setting on a regular and continuing basis." SSR 02-01p (2002). As with other impairments, the ALJ should explain how he determined whether obesity caused any physical or mental impairments. See Id.
Burch v. Barnhart, 400 F.3d 676, 683 (9th Cir. 2005).
Here, the ALJ did not rely solely on Plaintiff's failure to follow prescribed treatment in his analysis, as Plaintiff contends. AR 19. He acknowledged Plaintiff's obesity, as reflected in the medical record. AR 19. He also found that:
The record does not show evidence that [Plaintiff's] obesity has led to such complications as peripheral vascular disease, or hypertensive cardiovascular disease. Although he complained of multiple body pain symptoms, that could be exacerbated by his obesity, the record shows no evidence of debilitating arthritis and limitation of function of weight-bearing joints. Therefore, [Plaintiff's] obesity in combination with his other impairments does not increase the severity or functional limitations of those other impairments.
The ALJ proceeded to weigh the evidence and concluded that Plaintiff had the RFC to perform the full range of light work, despite his obesity. AR 20-23. Plaintiff has not proffered on appeal any functional limitations as a result of his obesity that the ALJ has failed to consider, nor is there any evidence of such functional limitations in the record. Thus, the ALJ's determination of the effects of Plaintiff's obesity on his other impairments is consistent with SSR 02-1p and free of error.
C. VE Testimony
Plaintiff argues that the ALJ erred in failing to obtain testimony from a VE. More particularly, Plaintiff contends that the existence of significant non-exertional restrictions in Plaintiff's RFC precluded the ALJ's exclusive use of the medical-vocational guidelines ("the grids") and required the testimony of a VE to reach a finding of disability. Defendant contends that the ALJ properly applied the grids.
The claimant has the initial burden of proving the existence of a disability within the meaning of the Social Security Act. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990). The claimant establishes a prima facie case of disability by showing that a physical or mental impairment prevents him or her from engaging in his or her previous occupation. Gallant v. Heckler, 753 F.2d 1450, 1452 (9th Cir. 1984); 20 C.F.R. §§ 404.1520(f) and 416.920(f). However, once the claimant establishes a prima facie case of disability, the burden of going forward with the evidence shifts to the Secretary. Hammock v. Bowen, 867 F.2d 1209 (9th Cir. 1989). The Secretary bears the burden of establishing the existence of alternative jobs available to the claimant, given his or her age, education, and medical-vocational background. In an appropriate case, the Secretary may meet this burden through application of the medical- vocational guidelines set forth in the regulations.*fn4 See 20 C.F.R. Pt. 404, Subpt. P, App. 2 ("Appendix 2"); Heckler v. Campbell, 461 U.S. 458 (1983); Odle v. Heckler, 707 F.2d 439, 440 (9th Cir. 1983). If the guidelines do not accurately describe a claimant's limitations, the Secretary may not rely on them alone to show availability of jobs for the claimant. Desrosiers v. Secretary, 846 F.2d 573 (9th Cir. 1988). However, the mere allegation of the presence of a non-exertional impairment is not sufficient to preclude application of the guidelines. Such non-exertional impairment must be found to significantly limit the range of work permitted by a claimant's exertional limitations before the Secretary will be required to obtain expert vocational testimony regarding the availability of other work. See, e.g., Polny v. Bowen, 864 F.2d 661 (9th Cir. 1988); Burkhart v. Bowen, 856 F.2d 1335 (9th Cir. 1988); Razey v. Heckler, 785 F.2d 1426, 1430 (9th Cir. 1986) (modified 794 F.2d 1348 (1986)); and Perminter v. Heckler, 765 F.2d 870 (9th Cir. 1985).
Here, the ALJ found that Plaintiff had the RFC to perform the full range of light work, despite the non-exertional limitations that Plaintiff could occasionally climb stairs, ramps, ladders, or scaffolds, could occasionally balance or crawl, and could frequently stoop, kneel, or crouch. AR 20. The ALJ applied the grids as a framework, according to SSRs 83-12, 83-14, and 85-15, and determined that jobs exist in significant numbers in the national economy that Plaintiff can perform. AR 23-24. SSR 83-14 states, "[T]here are nonexterional limitations or restrictions which have very little or no effect on the unskilled light occupational base. Examples are inability to ascend or descend scaffolding, poles, and ropes [and] inability to crawl on hands and knees."
SSR 85-15 states:
Limitations in climbing and balancing can have varying effects on the occupational base, depending on the degree of limitation and the type of job. Where a person has some limitation in climbing and balancing and it is the only limitation, it would not ordinarily have a significant impact on the broad world of work.
If a person can stoop occasionally . . . the sedentary and light occupational base is virtually intact. This is also true for crouching. [C]rawling on hands and knees and feet is a relatively rare activity even in arduous work, and limitations on the ability to crawl would be of little significance in the broad world of work. This is also true of kneeling.
See also, Mitchell v. Astrue, 2009 WL 542216 (C.D. Cal.) (ALJ properly determined that claimant's non-exertional limitations, i.e., her inability to perform more than occasional climbing, balancing, stooping, kneeling, crouching and crawling, did not significantly limit the range of light exertional work.)
Here, the ALJ considered Plaintiff's non-exertional impairments and properly determined that they did not significantly limit the range of light work that Plaintiff could perform. Plaintiff has not cited to any facts in the record that support a finding that his non-exertional limitations significantly limited the range of work permitted. In addition, Plaintiff has failed to provide legal authority that supports a requirement of VE testimony in circumstances where a non-exertional limitation does not significantly limit the occupational base.
Plaintiff also argues that the ALJ erroneously relied on the state agency determination that Plaintiff could perform specific unskilled light work such as cleaner, housekeeper, photocopying machine operator, or collator operator, but did not articulate the incidence of such work in the region in which Plaintiff lives or several other regions of the country. See AR 23-24.
When determining that unskilled sedentary, light, or medium jobs exist in significant numbers in the national economy, the ALJ may take administrative notice of job data from many sources, including occupational analyses prepared for the Social Security Administration by various State employment agencies. 20 C.F.R. § 416.966(d); Smith v. Astrue, 2010 WL 1558728 (E.D.Cal.). In Smith, the court held:
Having relied on the grids, the ALJ was not required to give specific examples of potential positions and the number of such positions in the national economy. This renders Plaintiff's argument that the ALJ improperly cited the analyst's findings moot. Contrary to Plaintiff's suggestion, the ALJ did not rely solely on the positions identified by the analyst, but instead used the occupational information to support the conclusion directed by the grids.
Smith, at *7. This Court has determined that application of the grids was appropriate in this case and VE testimony was not required. Thus, the state agency determination is irrelevant.
In sum, the ALJ appropriately relied on the grids in finding Plaintiff "not disabled," and the ALJ did not err by failing to obtain the testimony of a VE.
D. Medical Opinion Evidence
Plaintiff argues that the ALJ improperly rejected the opinions of examining physicians Drs. Seu and Vesali. Specifically, Plaintiff argues that portions of the examining physicians' opinions were not discussed by the ALJ in his RFC finding, and thus the ALJ's failed to give "clear and convincing" or "specific and legitimate" reasons, supported by substantial evidence in the record, for rejecting those portions of the opinions. Defendant counters that the ALJ properly considered the medical opinion evidence.
Cases in this circuit distinguish among the opinions of three types of physicians: (1) those who treat the claimant (treating physicians); (2) those who examine but do not treat the claimant (examining physicians); and (3) those who neither examine nor treat the claimant (nonexamining physicians). As a general rule, more weight should be given to the opinion of a treating source than to the opinion of doctors who do not treat the claimant. Winans v. Bowen, 853 F.2d 643, 647 (9th Cir. 1987). At least where the treating doctor's opinion is not contradicted by another doctor, it may be rejected only for "clear and convincing" reasons. Baxter v. Sullivan, 923 F.2d 1391, 1396 (9th Cir. 1991). Even if the treating doctor's opinion is contradicted by another doctor, the Commissioner may not reject this opinion without providing "specific and legitimate reasons" supported by substantial evidence in the record for so doing. Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983).
The opinion of an examining physician is, in turn, entitled to greater weight than the opinion of a nonexamining physician. Pitzer v. Sullivan, 908 F.2d 502, 506 (9th Cir. 1990); Gallant v. Heckler, 753 F.2d 1450 (9th Cir. 1984). As is the case with the opinion of a treating physician, the Commissioner must provide "clear and convincing" reasons for rejecting the uncontradicted opinion of an examining physician. Pitzer, 908 F.2d at 506. And like the opinion of a treating doctor, the opinion of an examining doctor, even if contradicted by another doctor, can only be rejected for specific and legitimate reasons that are supported by substantial evidence in the record. Andrews v. Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995).
Here, the ALJ found as follows:
[T]he undersigned accords substantial weight to the opinions of consulting physicians, Dr. Philip Seu and Dr. Fariba Vesali. Dr. Vesali examined the claimant in October of 2007 and as Dr. Seu did before him determined that [Plaintiff] could perform light work. Based upon his examination, Dr. Vesali, found that [Plaintiff] had decreased range of motion in his lumbar spine with tenderness over the lumbar spine. However, his straight leg-raising test was negative bilaterally. Axial compression of his hip caused increased low back pain, but there were no neurological deficits.
Dr. Vesali assessed [Plaintiff] as able to walk six hours in an eight-hour day with normal breaks. He did not need an assistive device for ambulation. Due to his low back pain, he should be able to lift and carry 25 pounds occasionally and 10 pounds frequently. He had no postural limitation on bending, stooping, or crouching. He had no manipulative limitation on reaching, handling, feeling, and grasping. Nor were there visual, communicative, or workplace environmental limitations.
AR 20 (citations omitted).
The ALJ accorded "substantial weight" to the examining physician opinions (AR 20), consistent with legal authority. Pitzer, 908 F.2d at 506; Gallant, 753 F.2d at 1450. The ALJ did not reject either opinion and thus was not required to provide "clear and convincing" or "specific and legitimate" See Pitzer, 908 F.2d at 506; Andrews, 53 F.3d at 1043. Furthermore, the ALJ is not required to comment on every detail in every report. As noted in Vincent v. Heckler, 739 F.2d 1393, 1394-1395 (9th Cir. 1984), "[t]he Secretary . . . need not discuss all evidence presented to her. Rather, she must explain why 'significant probative evidence has been rejected.'" Here, the evidence which the ALJ failed to discuss was neither significant nor probative. Both physicians opined that Plaintiff could perform light work. Had the evidence been significant or probative enough to affect the physicians' opinions of work Plaintiff could perform, they would not have concluded that Plaintiff could perform light work.
In addition, although both physicians determined that Plaintiff could perform light work, the ALJ imposed the additional non-exertional limitations that Plaintiff could occasionally climb stairs, ramps, ladders, or scaffolds, could occasionally balance or crawl, and could frequently stoop, kneel, or crouch. AR 20; see also AR 122-125, 162-165.
The ALJ accorded proper weight to the opinions of examining physicians Drs. Vesali and Seu in determining that Plaintiff could perform light work. The ALJ's finding is supported by substantial evidence.
E. Application of the Grids
Plaintiff argues that the ALJ's mechanical application of the grids is reversible error. Specifically, Plaintiff argues that his situation is a "borderline situation," thus precluding mechanical application of the grids. Defendant does not dispute that a borderline situation exists, but counters that the ALJ was not obligated to apply the medical-vocational rule for the higher age category.
We will not apply the age categories mechanically in a borderline situation. If you are within a few days to a few months of reaching an older age category, and using the older age category would result in a determination or decision that you are disabled, we will consider whether to use the older age category after evaluating the overall impact of all the factors of your case.
20 C.F.R. 404.1563(b). The operative age is the age at the time of the Commissioner's final decision. Russell v Bowen, 856 F.2d 81, 83 (9th Cir. 1988). Here, at the time of the ALJ's decision, Plaintiff was two months and five days from reaching 55 years of age. AR 24, 177. Two months and five days is "within a few days to a few months." This satisfies the first requirement of a borderline situation under 20 C.F.R. 404.1563(b).
Plaintiff asserts that had the ALJ applied the grids to him as an individual of advanced age (age 55 or older), Plaintiff would have been found disabled under Rule 202.04. However, this assertion is not necessarily correct.
If you are of advanced age (age 55 or older), and you have a severe impairment(s) that limits you to sedentary or light work, we will find that you cannot make an adjustment to other work unless you have skills that you can transfer to other skilled or semiskilled work (or you have recently completed education which provides for direct entry into skilled work) that you can do despite your impairment(s).
20 C.F.R. 404.1568 (emphasis in original).
Given the ALJ's finding that Plaintiff's past relevant work is unskilled (AR 23), a finding of either "disabled" or "not disabled" could have been found under either Rule 202.04 or Rule 202.05, respectively. This determination hinges on whether Plaintiff's education provides for direct entry into skilled work. See 20 C.F.R. Pt. 404, Subpt. P, App. 2. The record establishes that the ALJ did not evaluate whether Plaintiff's education provides for direct entry into skilled work. AR 23-24.
If the ALJ finds that Plaintiff's education provides for direct entry into skilled work, application of the higher age category would require a finding of "not disabled" and a borderline situation would not exist. If the ALJ finds that Plaintiff's education does not provide for direct entry into skilled work, application of the higher age category would require a finding of "disabled" and the second requirement of a borderline situation would be satisfied.
If a borderline situation exists, mechanical application of the grids is precluded. 20 C.F.R. 404.1563(b). Defendant is correct in asserting that the ALJ is not required to use the older age category. However, the ALJ is required to "consider whether to use the older age category after evaluating the overall impact of all the factors of [Plaintiff's] case." 20 C.F.R. 404.1563(b). The regulations do not explicitly require the ALJ to address the issue in his decision, and the Ninth Circuit has not published a decision on point. However, this Court is persuaded by a recent decision out of the Central District wherein it held that "the absence of any indication in the record that the ALJ exercised his discretion to consider Plaintiff's borderline age status and determine whether to apply the higher age category precludes meaningful review of the ALJ's decision under the substantial evidence standard." Aguilar v. Astrue, 2010 WL 1999560 (C.D. Cal. 2010) (holding that the ALJ's application of the grids was not supported by substantial evidence and warranted reversal; adhering to reasoning of Schiel v. Comm'r of Social Sec., 267 Fed. Appx 660, 2008 WL 467773 (9th Cir. 2008); relying on Daniels v. Apfel, 154 F.3d 1129 (10th Cir. 1998), Kane v. Heckler, 776 F.2d 1130 (3d Cir. 1985)); see also Pickard v. Comm'r of Soc. Sec., 224 F.Supp.2d 1161 (W.D.Tenn. 2002).
Here, there is no indication in the record that the ALJ considered Plaintiff's borderline age status. The ALJ simply found that "[t]he claimant was born on March 13, 1953 and was 52 years old, which is defined as an individual closely approaching advanced age, on the alleged disability onset date," and, "[b]ased on a residual functional capacity for the full range of light work, considering the claimant's age, education, and work experience, a finding of "not disabled" is directed by Medical-Vocational Rule 202.13." AR 23. In determining whether a borderline situation existed, the disability onset date was the incorrect date to use. The ALJ should have considered the date of the decision and found Plaintiff to be 54 years old, only two months and five days from age 55. See Russell, 856 F.2d at 83.
In light of the foregoing, the ALJ's application of the grids is not supported by substantial evidence and warrants reversal and remand for the limited purpose of resolving this issue. If, on remand, a borderline situation is found to exist, the ALJ must consider whether to use the older age category after evaluating the overall impact of all the factors of Plaintiff's case, pursuant to 20 C.F.R. 404.1563(b).
F. Plaintiff's Credibility
Lastly, Plaintiff argues that the ALJ improperly rejected his subjective complaints because the ALJ failed to identify the specific evidence that establishes Plaintiff's testimony is not credible. Defendant counters that the ALJ properly considered Plaintiff's subjective complaints.
The ALJ is required to make specific findings assessing the credibility of plaintiff's subjective complaints. Ceguerra v. Secretary of Health & Human Services, 933 F.2d 735, 738 (9th Cir. 1991). "An ALJ is not 'required to believe every allegation of disabling pain' or other non-exertional impairment," Orn v. Astrue, 495 F.3d at 635 (citation omitted). In rejecting the complainant's testimony, "the ALJ must identify what testimony is not credible and what evidence undermines the claimant's complaints." Lester v. Chater, 81 F.3d at 834 (quoting Varney v. Secretary of Health and Human Services, 846 F.2d 581, 584 (9th Cir. 1988)). Pursuant to Ninth Circuit law, if the ALJ finds that the claimant's testimony as to the severity of claimant's pain and impairments is unreliable, the ALJ must make a credibility determination with findings sufficiently specific to permit the court to conclude that the ALJ did not arbitrarily discredit claimant's testimony. Thomas v. Barnhart, 278 F.3d at 958. "The ALJ may consider at least the following factors when weighing the claimant's credibility: '[claimant's] reputation for truthfulness, inconsistencies either in [claimant's] testimony or between [her] testimony and [her] conduct, [claimant's] daily activities, [her] work record, and testimony from physicians and third parties concerning the nature, severity, and effect of the symptoms of which [claimant] complains." Id. (citing Light v. Soc. Sec. Admin., 119 F.3d 789, 792 (9th Cir. 1997)). "If the ALJ's credibility finding is supported by substantial evidence in the record, we may not engage in second-guessing." Id.
Here, the ALJ identified the following reasons for finding Plaintiff's statements not entirely credible:
When [Plaintiff] filed this claim, he was interviewed by telephone and the SSA interviewer did not report any difficulties. [Plaintiff] did not exhibit any problems with hearing, breathing, understanding, concentrating, talking, or answering.
In October of 2005, [Plaintiff] completed a pain questionnaire in which he reported that he had been taking the medications Methocarbamol (muscle relaxant), Hydrocodone (for pain), and Acetaminophen (for pain) since April 29, 2005. He also reported that his medications caused drowsiness, dizziness, nausea, and the inability to concentrate. Again, [Plaintiff] does not have a high volume of medical records and none of the available records shows that he ever complained of side effects from his medications.
The evidence demonstrates that [Plaintiff] has been noncompliant in caring for his feet, although he has continually complained of diabetic-related symptoms of numbness, and tingling. He has attended a class about diabetes and has been counseled about the importance of caring for his extremities. Yet, the evidence shows that he has participated in dangerous activities such as mowing his lawn in bare feet. Additionally, although physical therapy has been suggested to treat his low back pain, [Plaintiff] declined to participate in June of 2005 and again in August of 2006. The record does not indicate that he has made a concerted effort in his own exercise program of swimming in his pool.
[Plaintiff] is not a credible historian in that he initially testified that he had very successful carpal tunnel releases then testified that he has had problems with his hands ever since the surgery. The undersigned notes that [Plaintiff] uses exaggerated terminology when describing his symptoms. He testified that even when he takes a potent medication such as Vicodin, on a "bad" day he still has a pain level of 8/10 in his back. A reasonable individual would believe that this level of pain in spite of medication would be quite debilitating and cause him to be bedridden. Therefore, the undersigned is not persuaded by [Plaintiff's] testimony that he has a "bad" day every other day. Nor was he persuasive when he testified that he is completely incapacitated by severe migraine-type headaches once or twice a month, and has diarrhea two or three times a week. The objective medical evidence does not support his testimony about such chronic severe side effects from his medications.
[Plaintiff] contradicted his own testimony about excruciating back pain and having "bad" days every other day when he also testified that he swims pretty much every day or most of the time.
AR 22-23 (citations omitted).
The ALJ offered several examples of specific testimony by Plaintiff that the ALJ found incredible, supported by specific evidence in the record. He considered specific inconsistencies between the record and Plaintiff's hearing testimony, his reputation for truthfulness, and his daily activities. Thomas v. Barnhart, 278 F.3d at 958. The ALJ was not required to believe every allegation of Plaintiff's disabling pain. Orn v. Astrue, 495 F.3d at 635. The ALJ did not arbitrarily discredit Plaintiff's testimony. Thus, the Court finds that the ALJ's credibility assessment is supported by substantial evidence and is free of error.
Because the record is insufficient to support a finding as to whether Plaintiff's education provides for direct entry into skilled work, and a finding as to whether a borderline situation exists, substantial evidence does not support the Commissioner's decision that Plaintiff is not disabled.
Based on the foregoing, the Court finds that the ALJ's decision is not supported by substantial evidence and is therefore REVERSED and the case is REMANDED to the ALJ for further proceedings consistent with this opinion. The ALJ shall make specific findings with regard to application of the grids in light of Plaintiff's age. The Clerk of this Court is DIRECTED to enter judgment in favor of Plaintiff Terrence W. Campbell and against Defendant Michael J. Astrue, Commissioner of Social Security.
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You have to drive a couple miles off I5 however, it is well worth the drive. The staff had more knowledge then nearly any other store I have been in. The price was better then another store just down the road. Quality far surpasses the other store.
River City is worth the drive.


text: Children continue to practice ad build upon basic skills, now performing more skills without the aid of a flotation device. they are introduced to the front and back crawl, sidestroke, breaststroke and elementary backstroke. Children can swim a length of the pool without assistance at the end of this level.


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Discussion in 'iTunes App Store Games & Apps' started by ZeroMercy, Dec 20, 2009.
what are some games i should get? i have igun and touchgrind and the gba emulator.
I could suggest some game to you but I don't know what kind you want like shooting or driving or simulations. If you want shooting I could suggest NOVA.
yes NOVA is sick! you could also try Hero of Sparta, i like it.
Modern combat sandstorm is really fun
get modern combat sandstorm its like counter strike!!!amazing
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STATE BANK OF INDIA RTGS HO Branch in BOBBILI - Address, IFSC, MICR Code
SBIN0017070MICR Code
BOBBILI BAZARContact
D.NO 17 85BALIJIPETACHURCH CENTREBOBBILIDISTT.VIZIANAGARAMANDHRA PRADESH 535558City
What is IFSC Code of STATE BANK OF INDIA situated at BOBBILI BAZAR- RTGS-HO?
IFSC Code of STATE BANK OF INDIA situated at BOBBILI BAZAR - RTGS-HO is
What is the meaning of IFSC Code, MICR Codes in Banking industry?
IFSC or Indian Financial System Code is the code allocated to all banks branches. Bank branches use this code to participate in RTGS and NEFT transactions.
What is the significance of IFSC Code and how we can use it?
IFSC Code is a 11 digit code and we can use this code to communicate between different branches of different banks. Upon receiving the request for fund transfer it is easy for a bank to identify the payee branch. First four characters are code of bank, last six digits are branch code and fifth character is left 0, for any future use.


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- Product Details
There's no need to make your own Christmas ornaments this year when you can give someone something as stunning as this Personalised Festive Wreath Round Ceramic Decoration.
Each one will be as unique as if you made it yourself, yet the quality of the end result will be something your lucky recipient will be happy to receive.
Carefully chosen full colour inks provide an eye catching display on the top of this solid ceramic decoration. Hang it on the tree, on the window or in the hall, the personal touch it offers is truly quite magical.
Order it for the Grandchildren to give to their grandparents, and they can then spend their free time doing something they actually enjoy.
But with your own chosen words under our 'Merry Christmas' caption, that special someone will still get a very unique festive gift.
Decorations come supplied with a ribbon ready to hang. Colour of ribbon may vary.
Measures: 7cm x 7cm.
- Delivery & Returns
We are aware of how important it is for you to receive your gifts in time. Therefore, once you place your order we will process straight away and dispatch as soon as they are ready to go. We usually dispatch all items within 1-3 days however, this may be a little longer during special occasions such as Christmas. If multiple items ordered, we may dispatch items separately or all together, depending on the process.
Hassle Free Returns Policy:
We're sure that you will be satisfied with your purchase and we also understand that sometimes you may want to return. We keep this process simple! Just contact us if you wish to return goods. Please note: personalised, made-to-order and perishable items are non-refundable.
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Reviewed By Robert R (WEST END, NC) Reviewed for a 2007 Nissan Frontier —11/2/2016 7:39 AM
Excellent brake pads, easy install. It's my second set of green stuff pads, I won't use anything else.
Reviewed By Steve P (Exton, PA) Reviewed for a 2013 Nissan Frontier —10/27/2016 4:53 PM
Much better than the OEM Nissan Rotors. I matched these up with Raybestos Advanced Technology Pads. Together they made a tremendous difference in the stopping performance of my Frontier.
Reviewed By Kit F (DECATUR, GA) Reviewed for a 2001 Nissan Frontier —10/14/2016 9:08 AM
Well made rotors from EBC as expected. They come with a coating of black paint on the front and edges, the back are not painted. The black coating helps with rust prevention on the edges and hub but they wear off on the rotors where the pads meet naturally. Stops well, grips well depending on pads used. Fit just like OEM. Will see if they last 100k miles like the originally OEM ones. Good price for the pair for the front rotors.
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Nissan Frontier PRO-4X Brakes & Brake Pads
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A little TLC will go a long way to make this home a home. Living room opens to dining room. kitchen is updated and leads to utility room. 2 bedrooms and a full bath down while upstairs are 2 more bedrooms.. Sun room, large yard and mature trees. AS-IS. good rehab candidate.


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Ever wondered what your 'Giving Footprint' is? A new project is encouraging consumers to find out.
Ed Cotton delves into the meaning of 'local' beyond the food and restaurant industry and what it means in the face of a world that is still very dependant on mass-produced products developed in faraway lands.
What would the world look like if we packed into Texas? What about Texas and Louisiana?
PSFK interviews Reem Al-Thawadi, the Communications Officer of the Emirates Wildlife Society-World Wide Fund for Nature, discussing effective messages which motivate UAE locals to buy local and get smart about overall energy consumption.