McPherson v. Commissioner of Social Security Administration

• Court: District Court, D. Arizona
• Decided: April 22, 2024
• Docket: 3:23-cv-08107
• Status: Unknown

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA

9 Denise McPherson, No. CV-23-08107-PCT-JAT

10 Plaintiff, ORDER

11 v.

12 Commissioner of Social Security Administration, 13 Defendant. 14 15 Pending before the Court is Plaintiff Denise McPherson’s appeal from the 16 Commissioner of the Social Security Administration’s (“SSA”) final decision denying 17 social security disability benefits. (Doc. 1). The appeal is fully briefed (Docs. 10, 16, 17), 18 and the Court now rules. 19 I. BACKGROUND 20 The issues presented in this appeal are: 21 1. Whether the Administrative Law Judge (“ALJ”) failed to give clear and convincing 22 evidence to reject Plaintiff’s symptom testimony. 23 2. Whether the ALJ supported her finding that Plaintiff’s vision impairments did not 24 equal a listing under 2.02, 2.03, or 2.04 with substantial evidence. 25 3. Whether the ALJ supported her decision with substantial evidence. 26 (Doc. 10 at 5).1 27 28 1 The Court has reordered and reworded Plaintiff’s issues to better facilitate discussion. 1 A. Factual Overview 2 Plaintiff was fifty-six years old on her alleged disability onset date of February 20, 3 2016. (Doc. 10 at 2). She graduated high school and reports past work as a caregiver, 4 concessions seller, crisis driver, housekeeper, and mentor. (Doc. 16 at 3). On May 23, 5 2016, Plaintiff filed her application for disability insurance benefits under Title II and Title 6 XVI of the Social Security Act (“the Act”). (Doc. 10 at 2). Plaintiff alleged that she suffered 7 from headaches, total vision impairment, primary open-angle glaucoma, plateau iris 8 syndrome, adhesions and disruptions of pupillary membranes, acute and chronic open- 9 angle glaucoma, pain in and around her eye, rubeosis iridis, phacolytic glaucoma, nuclear 10 sclerosis, a total or mature senile cataract, and glaucoma associated with vascular disorders 11 of her eye. (Id.) After administrative review, the SSA denied Plaintiff’s application. (Doc. 12 16 at 2). However, on judicial review, the Court ordered remand to the agency. (Id. at 3). 13 In accordance with the Court’s Order, the SSA Appeals Council remanded the matter back 14 to an ALJ for a new hearing. (Id.) Plaintiff appeared via telephone in front of a new ALJ 15 on November 30, 2022. (Doc. 6-10 at 45). The ALJ issued an unfavorable decision on 16 December 20, 2022. (Id. at 57). In her decision, the ALJ found that based on Plaintiff’s 17 May 23, 2016, social security application and Plaintiff’s October 25, 2018, social security 18 application, Plaintiff has not been disabled—as defined in the Social Security Act—from 19 February 20, 2016, through the date of the decision. (Id.) The SSA Appeals Council denied 20 Plaintiff’s request for review of the ALJ’s decision and adopted that decision as the SSA’s 21 final decision. (Doc. 16 at 3). Plaintiff then sought review in this Court. (Doc. 1). 22 B. The SSA’s Five-Step Evaluation Process 23 To qualify for social security disability insurance benefits, a claimant must show 24 that she “is under a disability.” 42 U.S.C. § 423(a)(1)(E). To be “under a disability,” the 25 claimant must be unable to engage in “substantial gainful activity” due to any medically 26 determinable physical or mental impairment that can be expected to result in death or that 27 has lasted or can be expected to last for a continuous period of not less than twelve months. 28 Id. § 423(d)(1). The impairment must be of such severity that the claimant cannot do her 1 previous work or any other substantial gainful work within the national economy. Id. 2 § 423(d)(2). The SSA has created a five-step sequential evaluation process for determining 3 whether an individual is disabled. See 20 C.F.R. § 404.1520(a)(1). The steps are followed 4 in order, and each step is potentially dispositive. See id. § 404.1520(a)(4). 5 At step one, the ALJ determines whether the claimant is engaging in “substantial 6 gainful activity.” Id. § 404.1520(a)(4)(i). “Substantial gainful activity” is work activity that 7 is (1) “substantial,” e.g., doing “significant physical or mental activities;” and (2) “gainful,” 8 e.g., usually done “for pay or profit.” 20 C.F.R. § 416.972(a)(b). If the claimant is engaging 9 in substantial gainful work activity, the ALJ will find the claimant is not disabled. Id. 10 § 404.1520(a)(4)(i). 11 At step two, the ALJ determines whether the claimant has “a severe medically 12 determinable physical or mental impairment” or severe “combination of impairments.” Id. 13 § 404.1520(a)(4)(ii). To be “severe,” the claimant’s impairment must “significantly limit” 14 the claimant’s “physical or mental ability to do basic work activities.” Id. § 404.1520(c). 15 If the claimant does not have a severe impairment or combination of impairments, the ALJ 16 will find the claimant is not disabled. Id. § 404.1520(a)(4)(ii). 17 At step three, the ALJ determines whether the claimant’s impairment(s) “meets or 18 equals” an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Part 404. Id. 19 § 404.1520(a)(4)(iii). If so, the ALJ will find the claimant is disabled, but if not, the ALJ 20 must assess the claimant’s “residual functional capacity” (“RFC”) before proceeding to 21 step four. Id. §§ 404.1520(a)(4)(iii), 404.1520(e). The claimant’s RFC is her ability to do 22 physical and mental work activities “despite [her] limitations,” based on all relevant 23 evidence in the case record. Id. § 404.1545(a)(1). To determine RFC, the ALJ must 24 consider all the claimant’s impairments, including those that are not “severe,” and any 25 related symptoms that “affect what [the claimant] can do in a work setting.” Id. 26 §§ 404.1545(a)(1)–(2). 27 At step four, the ALJ determines whether the claimant has the RFC to perform the 28 physical and mental demands of “[her] past relevant work.” Id. §§ 404.1520(a)(4)(iv), 1 404.1520(e). “Past relevant work” is work the claimant has “done within the past 15 years, 2 that was substantial gainful activity.” Id. § 404.1560(b)(1). If the claimant has the RFC to 3 perform her past relevant work, the ALJ will find the claimant is not disabled. Id. 4 § 404.1520(a)(4)(iv). If the claimant cannot perform her past relevant work, the ALJ will 5 proceed to step five in the sequential evaluation process. 6 At step five, the last in the sequence, the ALJ considers whether the claimant “can 7 make an adjustment to other work,” considering her RFC, age, education, and work 8 experience. Id. § 404.1520(a)(v). If so, the ALJ will find the claimant not disabled. Id. If 9 the claimant cannot make this adjustment, the ALJ will find the opposite. Id. 10 C. The ALJ’s Application of the Factors 11 Here, at step one, the ALJ concluded that Plaintiff “has not engaged in substantial 12 gainful activity since February 20, 2016, the alleged onset date.” (Doc. 6-10 at 48). 13 At step two, the ALJ determined the following impairments are “severe”: 14 headaches, glaucoma, and a prosthetic left eye. (Id.) The ALJ found that Plaintiff’s severe 15 impairments “significantly limit the ability to perform basic work activities as required by 16 SSR 85-28.” (Id.) The ALJ also considered Plaintiff’s hyperlipidemia diagnosis and 17 determined that the medical record fails to support a finding that it has caused more than a 18 minimal limitation in Plaintiff’s ability to perform basic work activities, and thus is 19 considered non-severe. (Id.) 20 At step three, the ALJ concluded that Plaintiff does not have an impairment or 21 combination of impairments that meets or medically equals the severity of one of the listed 22 impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Id.) The ALJ determined that 23 Plaintiff has the RFC to perform a full range of work at all exertional levels but with the 24 following non-exertional limitations: 25 The claimant can never climb ladders/ropes/scaffolds. The claimant can work with occasional concentrated exposure to non-weather related extreme 26 cold, non-weather-related extreme heat, non-weather[-]related wetness, and 27 non-weather[-]related humidity. The claimant can work with occasional exposure to excessive loud noise, excessive vibration, occasional 28 concentrated exposure to pulmonary irritants, such as 1 fumes/odors/dust/gases, and occasional concentrated exposure to poorly ventilated areas. The claimant can work with no exposure to dangerous 2 moving machinery or unprotected heights. The claimant can perform no 3 work involving occupational driving. The claimant can perform tasks that do not require precise depth perception like threading a needle and can have 4 only occasional exposure to direct sunlight in the work environment. 5 (Id. at 50). 6 At step four, the ALJ determined that Plaintiff is capable of performing past relevant 7 work as a hospital housekeeper, reasoning that “[t]his work does not require the 8 performance of work-related activities precluded by the [Plaintiff]’s residual functioning 9 capacity.” (Id. at 55). 10 At step five, as an alternative to Plaintiff returning to past relevant work, the ALJ 11 determined that Plaintiff could make a successful adjustment to other work. (Id. at 56). In 12 making this determination, the ALJ consulted a vocational expert because Plaintiff’s 13 “ability to perform work at all exertional levels has been compromised by non-exertional 14 limitations.” (Id.) The vocational expert testified that given all the factors of Plaintiff’s age, 15 education, work experience, and RFC, she would be able to perform the requirements of 16 representative occupations such as laundry laborer, industrial cleaner, and kitchen helper. 17 (Id. at 57). Accordingly, the ALJ found Plaintiff has not been under a disability—as defined 18 in the Social Security Act—from February 20, 2016, through the date of the decision. (Id.) 19 II. LEGAL STANDARD 20 This Court may not set aside a final denial of disability benefits unless the ALJ 21 decision is “based on legal error or not supported by substantial evidence in the record.” 22 Revels v. Berryhill, 874 F.3d 648, 654 (9th Cir. 2017) (quoting Benton ex rel. Benton v. 23 Barnhart, 331 F.3d 1030, 1035 (9th Cir. 2003)). Substantial evidence refers to “such 24 relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” 25 Id. (quoting Desrosiers v. Sec’y of Health & Human Servs., 846 F.2d 573, 576 (9th Cir. 26 1988)). The Court, in its review, must consider the record in its entirety, “weighing both 27 the evidence that supports and evidence that detracts from the [ALJ’s] conclusion.” Id. 28 (quoting Garrison v. Colvin, 759 F.3d 995, 1009 (9th Cir. 2014)). 1 The ALJ—not this Court—is responsible for resolving ambiguities, resolving 2 conflicts in medical testimony, determining credibility, and drawing logical inferences 3 from the medical record. See Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995) (citing 4 Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989); Gallant v. Heckler, 753 F.2d 5 1450, 1453 (9th Cir. 1984)). Therefore, when the evidence of record could result in more 6 than one rational interpretation, “the ALJ’s decision should be upheld.” Orn v. Astrue, 495 7 F.3d 625, 630 (9th Cir. 2007). Further, this Court may only review the reasons the ALJ 8 provides in the disability determination; it “may not affirm the ALJ on a ground upon which 9 he did not rely.” Garrison, 759 F.3d at 1010. 10 III. DISCUSSION 11 Plaintiff raises three claims of error in the ALJ’s decision: (1) the ALJ improperly 12 discounted Plaintiff’s symptom testimony; (2) The ALJ did not support her finding that 13 Plaintiff’s vision impairments did not equal a listing under 2.02, 2.03, or 2.04 with 14 substantial evidence; and (3) the ALJ did not support her decision with substantial 15 evidence. 16 A. Plaintiff’s Symptom Testimony 17 In assessing the credibility of a claimant’s testimony regarding subjective pain or 18 the intensity of her symptoms, the ALJ must engage in a two-step analysis. Molina v. 19 Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012). First, as a threshold matter, “the ALJ must 20 determine whether the claimant has presented objective medical evidence of an underlying 21 impairment ‘which could reasonably be expected to produce the pain or other symptoms 22 alleged.’” Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (quoting Bunnell v. 23 Sullivan, 947 F.2d 341, 344 (9th Cir. 1991)). Second, if the claimant meets the first test, 24 then “the ALJ ‘may not discredit a claimant’s testimony of pain and deny disability benefits 25 solely because the degree of pain alleged by the claimant is not supported by objective 26 medical evidence.’” Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir. 1995) (quoting Bunnell, 27 947 F.2d at 346–47). Rather, “unless an ALJ makes a finding of malingering based on 28 affirmative evidence thereof,” the ALJ may only find the claimant not credible by making 1 specific findings supported by the record that provide clear and convincing reasons to 2 explain her credibility evaluation. Robbins v. Soc. Sec. Admin., 466 F.3d 880, 883 (9th Cir. 3 2006) (citing Smolen v. Chater, 80 F.3d 1273, 1283–84 (9th Cir. 1996)); Lingenfelter, 4 504 F.3d at 1036. An adverse credibility finding is sufficiently specific if the ALJ identifies 5 “what testimony is not credible and what evidence undermines the claimant’s complaints.” 6 Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (citation omitted). 7 In assessing credibility, the ALJ may consider, among other factors, “(1) ordinary 8 techniques of credibility evaluation, such as the claimant’s reputation for lying, prior 9 inconsistent statements concerning the symptoms, and other testimony by the claimant that 10 appears less than candid; (2) unexplained or inadequately explained failure to seek 11 treatment or to follow a prescribed course of treatment; and (3) the claimant’s daily 12 activities.” Ghanim, 763 F.3d at 1163 (citation omitted). If the ALJ relies on these factors, 13 and her reliance is supported by substantial evidence, the Court “may not engage in second- 14 guessing.” Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008) (quoting Thomas v. 15 Barnhart, 278 F.3d 947, 958 (9th Cir. 2002)). 16 Regarding Plaintiff’s symptom testimony, the ALJ concluded that Plaintiff’s 17 medically determinable impairments “could reasonably be expected to cause the alleged 18 symptoms; however, the claimant’s statements concerning the intensity, persistence and 19 limiting effects of these symptoms are not entirely consistent with the medical evidence 20 and other evidence in the record . . . .” (Doc. 6-10 at 51). Plaintiff asserts that the ALJ 21 discounted Plaintiff’s symptom testimony using “boilerplate” language without specific 22 reference to clear and convincing reasons supported by substantial evidence. However, the 23 Court’s examination of the ALJ’s analysis does not support Plaintiff’s argument. 24 As to Plaintiff’s alleged blindness, the ALJ states: 25 [W]hile the claimant has no vision in the left eye, her right eye vision is fairly normal (1F, 3F-21F). In 2016, the claimant is diagnosed with neovascular 26 glaucoma in the left eye and acute angle closure in the right eye (1F/10, 39; 27 2F/2; 3F/16). She scores a fifteen (15) on the Glasgow Coma Scale which is within normal limits (1F/9). Initial treatment includes eye drops and Avastin 28 injections, albeit with little benefit per the claimant’s report (1F/3, 4, 12: 1 3F/22; 11F 41). As a result of her eye impairment, she underwent laser surgery of the right eye in June 2016, followed by additional Avastin 2 injections (3F/25, 34, 37; 4F/2). During an October 2016 consultative eye 3 exam, the claimant was noted to have 20/50 visual acuity (distance) in the right eye and 20/100 visual acuity (near) without correction (6F/3). The 4 claimant’s corrected vision in the right eye is 20/70 near and 20/30-1 for 5 distance (Id).

6 . . . . 7 In March 2019, the claimant reports an achy pressure sensation in the right 8 eye that began one month prior (21F/1). She reports eye irritation and tearing 9 (Id). An assessment at the time shows the claimant has 20/80 vision, the claimant’s OCT is normal, and her IOP was good (21F/4). During a physical 10 consultative exam later that month, the claimant is noted to have 20/50 right 11 eye vision, 20/200 left eye vision, and 20/50 vision in both eyes (20F/2). The claimant’s right eye extraocular movements were intact, cranial nerves are 12 intact, and oropharynx is clear (20F/3). The examiner noted the claimant’s 13 right eye has quiet conjunctiva and the pupil is round and reactive (20F/3). Further, an exam showed the claimant walked with a normal gait and could 14 navigate the office (20F/2). She can stand on one leg independently and heel/toe walk (20F/2). She exhibits normal coordination testing and a normal 15 motor exam (20F/3). Indeed, she did not need to hold onto walls or stumble 16 in an unfamiliar environment, despite alleging legal blindness.

17 . . . . 18 In conjunction with the above-noted findings, the claimant also has retained 19 abilities. Despite her reports of severe vision issues and/or headaches, she 20 indicates that she remains independent with personal care such as dressing, bathing, and feeding, and she completes most household chores (22E/4; 21 22F/2). Although the claimant testifies that she tries to complete chores at 22 night due to sunlight irritation, the claimant walks, uses public transportation, goes out alone, and shops in stores (22E/7; Hearing Record). 23 In a function report, the claimant indicates she cares for her dog with the 24 help of her son (22E/3). While the claimant often reports pain associated with both her headaches and visual impairments, she says she needs no 25 reminders for personal care or taking medication or going places, she can 26 prepare daily meals, and reports no issues getting along with others (22E/5- 6, 10, 12). The claimant says she can follow spoken and written instructions 27 well with no reference to deficits as a result of her impairment related symptoms (22E/12). The claimant’s retained abilities further support the 28 residual functional capacity. 1 (Id. at 51–53). The ALJ discusses, at length, medical evidence that undermines Plaintiff’s 2 symptom testimony of legal blindness as well as Plaintiff’s own reported daily activities 3 being at odds with her testimony. The ALJ makes specific findings that give clear and 4 convincing reason for rejecting Plaintiff’s testimony in part. Further, the ALJ supports 5 these reasons with substantial evidence by giving specific references to the record. 6 As for Plaintiff’s alleged disabling headaches, the ALJ stated: 7 The claimant reports facial pain and photophobia as a result of her headaches (1F/31, 39, 60). An exam confirms tenderness to palpation around the right 8 ear as well as extreme light sensitivity with noted erythematous of the right 9 eye (1F/33, 57). However, despite the claimant’s symptoms, she remains cooperative, alert, oriented, obeys commands, and exhibits normal speech 10 throughout March 2016 examinations (1F/39, 60). No cognitive or functional 11 deficits are noted (1F/61). 12 (Id. at 51). There is robust evidence supporting the ALJ’s determination that Plaintiff’s 13 headaches are not as debilitating as she alleges. The ALJ properly pointed to 14 inconsistencies in Plaintiff’s reports of her debilitation and Plaintiff’s ability to engage in 15 normal daily activities without significant debilitation from her ailment. The ALJ finishes 16 her analysis by stating: 17 the residual functional capacity takes into account the totality of the record by finding the claimant has postural and environmental limitations. These 18 limitations account for the claimant’s impairments, including her vision with history of injections, surgery, and laser treatment(s), difficulty being in 19 sunlight, reported inability to drive, and reported pain from her vision and 20 headache impairments (1F/31, 39, 60; 3F/34; 12F/1, 6; 15F/6; 16F/3; 21F/1). However, even when evaluating the combination of the claimant’s 21 impairments, the record fails to support a greater degree of limitation. 22 Specifically, there is nothing in the record to support the claimant is legally blind. In fact, right eye exams are generally within normal limits (11F/19; 23 22F/3). Despite the claimant’s testimony regarding dizziness or balance 24 issues, the record shows the claimant generally denies these symptoms during doctor appointments (7F/2). Further, exams consistently show the 25 claimant exhibits a normal gait, normal coordination, normal motor activity, 26 and she has normal neurological findings (7F/3-4; 20F/2; 22F/3). There is no evidence of emergent care due to falls or the claimant’s migraines. Indeed, 27 the record does not show significant concern for headaches, including intense 28 treatment such as nerve blocks. She testified she avoids sunlight and takes over the counter medication. Finally, exams consistently show normal 1 musculoskeletal, extremity, and neurological findings, including strength, which fail to support the claimant’s reports of being only able to lift ten (10) 2 pounds due to her condition (7F/3; 20F/2-3; 22F/3). 3 (Id. at 53). This final statement summarizes the ALJ’s clear and convincing reasons for 4 rejecting the degree of debilitation alleged by Plaintiff. The ALJ specifically addresses 5 each alleged disabling impairment and supports her analysis with citations to the record 6 verified by the Court. The Court finds that the ALJ gave clear and convincing reasons 7 supported by substantial evidence to reject Plaintiff’s symptom testimony in part. 8 B. Plaintiff’s Vision Impairments 9 Plaintiff next challenges the ALJ finding that Plaintiff’s vision impairments did not 10 meet a listing under 2.02, 2.03, or 2.04. (Doc. 10 at 11). Plaintiff appears to argue that the 11 ALJ erred because Plaintiff meets the criteria for a per se disabling impairment listed in 12 Appendix 1 of 20 C.F.R. Part 404, Subpart P. To meet the listing requirements, a claimant 13 “must have a medically determinable impairment(s) that satisfies all of the criteria in the 14 listing.” 20 C.F.R. § 404.1525(d). An impairment is “medically equivalent” to a listed 15 impairment “if it is at least equal in severity and duration to the criteria of any listed 16 impairment.” 20 C.F.R. § 404.1526(a). 17 Regarding a listing under 2.02, Plaintiff points to no evidence in the record that 18 supports the notion that the vision in her right eye was 20/200 or worse, and the ALJ cites 19 to multiple points in the record that show her better eye after best correction is greater than 20 20/200. (See Doc. 6-10 at 48). 21 Regarding a listing under 2.03, Plaintiff again cites no evidence to refute the ALJ’s 22 finding that “[t]here is no evidence in the record that meets the criteria in listing 2.03. (19F; 23 20F/2; 22F/1–3).” (Id. at 49). The exhibits cited by the ALJ show that Plaintiff had a normal 24 confrontation visual field test in her right eye and an examination that showed no visual 25 field abnormalities. (AR 593, 936). 26 Finally, under 2.04, Plaintiff uses an outlier consultative examination’s visual acuity 27 impairment value combined with an assumed visual field impairment value to argue that 28 her visual impairment value would be over the threshold of 1.0. However, the ALJ cited 1 evidence showing that Plaintiff had no visual field abnormalities, and there were multiple 2 other examinations showing her best corrected vision would be 20/30 to 20/80 which does 3 not meet the threshold for a listing under 2.04. (See AR 423, 549, 599, 608, 935). The 4 ALJ—not this Court—is responsible for resolving ambiguities, resolving conflicts in 5 medical testimony, determining credibility, and drawing logical inferences from the 6 medical record. See Andrews, 53 F.3d at 1039 (citing Magallanes, 881 F.2d at 750); 7 Gallant, 753 F.2d at 1453). The Court finds there was substantial evidence to support the 8 ALJ’s finding that Plaintiff’s vision impairments did not meet a listing under 2.02, 2.03, or 9 2.04. 10 C. Substantial Evidence 11 In her final argument, as best the Court can determine, Plaintiff appears to argue 12 that the ALJ’s determination that Plaintiff’s medical records and symptom testimony did 13 not support finding her disabled under the Act was not supported by substantial evidence. 14 (Doc. 10 at 5–10). The substantial evidence standard is a general standard of review for 15 social security disability cases appealed to district court, and the Court considers the record 16 in its entirety “weighing both the evidence that supports evidence that detracts from the 17 [ALJ’s] conclusion.” Berryhill, 874 F.3d at 654 (quoting Garrison, 759 F.3d at 1009). 18 Plaintiff’s generalized argument that the ALJ erred by not supporting her decision with 19 substantial evidence relies, in a large part, on a supposition that the ALJ and this Court 20 accept her symptom testimony in whole. However, the Court has considered Plaintiff’s 21 symptom testimony and found that substantial evidence supports the ALJ’s discounting of 22 said testimony. Accordingly, Plaintiff’s argument fails. 23 IV. CONCLUSION 24 For the foregoing reasons, 25 IT IS ORDERED that the ALJ’s decision is AFFIRMED. 26 /// 27 /// 28 /// 1 IT IS FURTHER ORDERED that the Clerk of the Court shall enter judgment 2|| accordingly. 3 Dated this 22nd day of April, 2024. 4

° James A. Teilborg 7 Senior United States District Judge 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

-12-