Takeaway
In short, this case confirms that a well-supported credibility finding and a targeted rejection of a treating physician's unsupported limitations can sustain a disability denial, while also showing that a flawed past-work finding is harmless when a valid alternative step-five finding establishes available work.
Anthony Tommasetti sought Social Security disability benefits, alleging that lower-back pain and diabetes prevented him from working. A former electronics technician and television repair person, Tommasetti had suffered several accidents and treated intermittently with Dr. Andrea Nachenberg. Her residual-functional-capacity questionnaire stated that he could sit for only limited periods, stand or walk for two hours in a workday, needed breaks and a sit-stand option, and could lift no more than ten pounds.
At a de novo administrative hearing ordered after an extended administrative history, Tommasetti testified that he had severe physical limits but acknowledged that his diabetes was controlled by medication and was not disabling. A vocational expert testified that, under the ALJ's residual-functional-capacity finding, Tommasetti could perform electronics-assembly work as generally performed and could alternatively work as a semiconductor assembler. The ALJ discounted parts of Tommasetti's testimony and Dr. Nachenberg's opinion, found him able to return to past electronics-assembler work at step four, and alternatively found at step five that he could perform semiconductor-assembler work existing in significant numbers.
The Appeals Council declined review, and the district court affirmed. The Ninth Circuit reviewed the district court's judgment de novo, asking whether the ALJ committed legal error or lacked substantial evidence for the nondisability decision.
Issue #1
Whether the ALJ gave clear and convincing reasons for discounting Tommasetti's testimony about the severity of his pain and functional limitations.
Holding
Yes. The ALJ's adverse credibility determination was supported by specific, clear and convincing reasons and substantial evidence.
Reasoning
Because Tommasetti produced evidence of impairments that could cause some symptoms and there was no affirmative evidence of malingering, the ALJ could reject his description of symptom severity only by giving specific, clear and convincing reasons. The court emphasized that it would not second-guess a properly supported credibility determination.
The ALJ permissibly inferred that Tommasetti's pain was not as disabling as alleged because he pursued conservative treatment rather than an aggressive or more tailored program after stopping an effective medication because of mild side effects. Physical therapy, anti-inflammatory medication, a TENS unit, and a lumbosacral corset had provided favorable results, and improvement with conservative treatment undermined claims of totally disabling pain.
The ALJ also could use ordinary credibility techniques. The record supported her conclusion that Tommasetti was vague about the relevant period and his own work capacities, gave an unclear explanation for never attempting sedentary work, and could not recall whether a doctor had prescribed the cane he sometimes used.
Tommasetti's hearing testimony also contradicted his earlier reliance on diabetes as a disabling condition: he said it was controlled with medication, was not disabling, and was not why he stopped working. The ALJ could reasonably treat that inconsistency as weakening his overall account of disability.
Finally, the ALJ reasonably drew inferences from Tommasetti's $97,000 savings, which could have reduced his motivation to work, and from his extended trip to Venezuela to care for his sister. Those facts could support the conclusion that he was less limited than he claimed, even though other interpretations of the evidence were possible.
Issue #2
Whether the ALJ gave specific and legitimate reasons for partially rejecting treating physician Dr. Nachenberg's opinion that Tommasetti could not perform sedentary work.
Holding
Yes. The ALJ permissibly rejected Dr. Nachenberg's opinion only insofar as it precluded sedentary work.
Reasoning
A treating physician's opinion may be rejected only for specific and legitimate reasons supported by substantial evidence. The ALJ met that standard by thoroughly reviewing the medical evidence, identifying conflicts between Dr. Nachenberg's questionnaire and her treatment records, and explaining her interpretation of those conflicts.
The ALJ reasonably found that the questionnaire largely repeated Tommasetti's own reports of pain and limitations rather than reflecting independent clinical findings. Since the ALJ had validly found Tommasetti's symptom testimony unreliable, she could discount a medical opinion based substantially on those same discredited self-reports.
Dr. Nachenberg's treatment notes also did not substantiate the extreme sitting, standing, break, and sit-stand limitations recorded in the questionnaire. The mismatch between the questionnaire's conclusions and the physician's objective findings and treatment history was an independent specific and legitimate reason to reject the opinion to the limited extent it ruled out sedentary work.
The medical expert's testimony did not compel a different result. Although Dr. Wiseman said he accepted Dr. Nachenberg's assessment, he also suggested that it rested on Tommasetti's self-assessment, expressed doubts about the claimed restrictions, and declined to offer a definite independent assessment. Resolving such ambiguity in the medical evidence was the ALJ's responsibility.
Issue #3
Whether substantial evidence supported the ALJ's step-four finding that Tommasetti could perform his past work as an electronics assembler.
Holding
No. The ALJ improperly departed from the Dictionary of Occupational Titles without persuasive evidentiary support.
Reasoning
The ALJ found Tommasetti limited to sedentary work, including a maximum lifting capacity of ten pounds. Yet the Dictionary of Occupational Titles classifies electronics assembler as light work, and both the ALJ and vocational expert agreed that Tommasetti could not perform the job as he had actually performed it because it required greater lifting.
The DOT classification carries a rebuttable presumption. An ALJ may rely on vocational-expert testimony that conflicts with the DOT only when persuasive evidence explains and supports the departure from the DOT's job requirements.
Here, the ALJ relied on her own speculation that the job's light-work classification might rest merely on pushing or pulling arm controls, and on the vocational expert's brief, indefinite assertion that the occupation could be performed differently in the national economy. She did not identify concrete aspects of the expert's experience or record evidence that justified treating a DOT light-work occupation as compatible with Tommasetti's sedentary residual functional capacity.
Issue #4
Whether the erroneous step-four finding required reversal despite the ALJ's alternative step-five finding that Tommasetti could work as a semiconductor assembler.
Holding
No. The step-four error was harmless because substantial evidence supported the alternative step-five finding.
Reasoning
An ALJ error is harmless when it is inconsequential to the ultimate nondisability determination. The ALJ independently found that, even if Tommasetti could not return to his past work, he could perform semiconductor-assembler work, a sedentary semi-skilled occupation with 100,000 jobs nationally and 9,000 jobs regionally.
The vocational expert explained that Tommasetti's electronics-assembly skills transferred to semiconductor assembly because the work involved closely related tools, products, and subassembly components. The semiconductor job involved smaller items but required sufficiently similar skills, supporting the finding that Tommasetti could make the vocational transition.
The ALJ's result was also consistent with Medical-Vocational Rule 201.07. For a person of advanced age limited to sedentary work who has a high-school education, prior skilled or semiskilled work, and transferable skills, that rule directs a finding of not disabled.
Issue #5
Whether Lounsburry v. Barnhart required the ALJ to identify a significant range of occupations, rather than one semiconductor-assembler occupation, at step five.
Holding
No. Lounsburry's significant-range requirement for the light-work grids does not apply to the sedentary-work rule governing Tommasetti's claim.
Reasoning
Lounsburry concerned Rule 202.07, a grid rule for claimants limited to light work. That rule incorporated Rule 202.00(c), whose text requires transferable skills to apply to a significant range of skilled or semiskilled jobs; under that provision, identifying only one occupation was insufficient.
Tommasetti's case was governed instead by sedentary-work Rule 201.07. That rule does not incorporate Rule 202.00(c), and the sedentary grid provisions do not contain the significant-range language on which Lounsburry depended.
The court declined to transplant a limitation from the light-work grids into the sedentary grids. Doing so would blur distinct regulatory categories and undermine the consistency and uniformity that the grids are designed to provide.