Lillie D Stephens v. Michael J Astrue, No. 2:2007cv02191 - Document 21 (C.D. Cal. 2008)

Court Description: MEMORANDUM OPINION AND ORDER by Magistrate Judge Patrick J. Walsh. For all these reasons, the Agencys decision is affirmed and the Complaint is dismissed with prejudice. (see attached order for further details) (es)

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1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 LILLIE D. STEPHENS, Plaintiff, 11 12 13 14 v. MICHAEL J. ASTRUE, COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, Defendant. 15 ) ) ) ) ) ) ) ) ) ) ) ) Case No. CV 07-2191-PJW MEMORANDUM OPINION AND ORDER 16 17 Plaintiff appeals a decision by Defendant Commissioner of Social 18 Security (hereinafter the Agency ), denying her claim for disability 19 insurance benefits. 20 judge ( ALJ ) erred when he concluded that she did not have a severe 21 mental impairment. 22 examining psychiatrist s opinion that her mental impairment was 23 severe, instead of a non-examining psychiatrist s opinion that it was 24 not severe. 25 the ALJ did not err in finding that Plaintiff s mental impairment was 26 not severe. 27 28 Plaintiff claims that the administrative law She argues that the ALJ should have accepted an For the reasons set forth below, the Court concludes that 1 Plaintiff was born in 1953 and was 52 years old when she 2 testified at the last administrative hearing in this case in March 3 2006. 4 years in a hospital as a psychiatric technician. 5 she stopped working due to physical injuries incurred on the job. 6 608.) 7 benefits, alleging that she became disabled in January 1998, due to 8 musculoskeletal injuries and stress. 9 initially and on reconsideration. (Administrative Record ( AR ) 72.) Plaintiff had worked for 20 (AR 336.) In 1998, (AR In February 1998, she applied for disability insurance (AR 266.) Her claim was denied She then requested and was granted 10 a hearing before an ALJ. 11 ALJ. 12 affirmed the ALJ s decision in July 2000. 13 not appeal the Appeals Council s decision. 14 (AR 266-72.) In August 1999, her claim was denied by the Plaintiff appealed, but the Appeals Council (AR 281-82.) Plaintiff did In March 2001, Plaintiff filed a new claim, again alleging 15 disability as of January 1998, due to musculoskeletal impairments. 16 (AR 334-43.) 17 granted a hearing before an ALJ. 18 denied her claim. 19 other things, that Plaintiff did not have a severe mental impairment, 20 relying on the opinions of examining psychiatrist Inderjit Seehrai and 21 reviewing psychiatrist Patrick Ryan. 22 to the Appeals Council, which denied review. 23 appealed to this Court. 24 decision and remanded the case to the Agency with instructions to 25 reconsider the issue of Plaintiff s mental impairment in light of 26 examining psychiatrist Nader Oskooilar s opinion that Plaintiff had a 27 severe impairment, which the ALJ had failed to mention in his 28 decision. Her claim was denied initially and she requested and was (AR 36-48.) (AR 602-21.) In July 2003, the ALJ In doing so, he determined, among (AR 43-44.) Plaintiff appealed (AR 8-10.) She then In March 2005, the Court reversed the ALJ s (AR 695-704.) 2 1 In March 2006, the ALJ held another hearing. (AR 725-37.) In 2 October 2006, he issued a decision, again denying Plaintiff s claim 3 for benefits. 4 had concluded that Plaintiff s psychiatric impairment would preclude 5 work, but he gave the opinion no weight because: 6 1. (AR 665-71.) This time, he did note that Dr. Oskooilar It was inconsistent with the Global Assessment of 7 Functioning ( GAF ) score of 65-70 that Dr. Oskooilar 8 assigned to Plaintiff at the same time that he concluded 9 that Plaintiff had a moderately significant psychiatric 10 11 impairment; 2. It was contradicted by Dr. Abejuela s, Dr. Ryan s, and Dr. 12 Seehrai s opinions that Plaintiff did not have a severe 13 mental or psychiatric impairment; and 14 3. Plaintiff s treating doctor (an osteopath) reported not 15 having seen any signs or symptoms of a mental impairment and 16 had not referred Plaintiff for mental health treatment. 17 18 (AR 669-70.) The ALJ concluded at step two that Plaintiff s mental impairment 19 was not severe. 20 below, Plaintiff s argument is rejected. Plaintiff argues that this was error. As explained 21 At step two of the sequential evaluation process, the ALJ is 22 tasked with determining which impairments are severe and which are not 23 severe. 24 that significantly limit a claimant s ability to perform basic work 25 activities. 26 impairment, like the one alleged herein, the basic work activities 27 that come into play are: 20 C.F.R. § 404.1520(c). Severe impairments are impairments 20 C.F.R. § 404.1521(a). 28 3 In the context of a psychiatric 1 1. 2 Understanding, carrying out, and remembering simple instructions; 3 2. Use of judgment; 4 3. Responding appropriately to supervision, co-workers, and 5 6 7 8 9 10 11 usual worker situations; and 4. Dealing with changes in a routine work setting. 20 C.F.R. § 404.1521(b). Step two is intended to be a de minimus screening test, used to cull out groundless claims. See Smolen v. Chater, 80 F.3d 1273, 1290 (9th Cir. 1996). There were four psychiatrists, one psychologist, and an osteopath 12 who provided input regarding Plaintiff s mental/psychological health 13 in this case. 14 Plaintiff at the Agency s request in connection with Plaintiff s prior 15 application. 16 suffered from mild depression and anxiety. 17 she also had mild cognitive impairment, but no severe limitations due 18 to mental or emotional problems. 19 In April 1998, psychiatrist Reynaldo Abejuela examined (AR 224-28.) Dr. Abejuela concluded that Plaintiff (AR 227.) He found that (AR 227.) In June 2001, the Agency sent Plaintiff to psychiatrist Nader 20 Oskooilar for a consultative examination. 21 diagnosed Plaintiff with depressive disorder, not otherwise specified, 22 and schizo-type personality disorder features. 23 Oskooilar s view, Plaintiff had a moderately significant psychiatric 24 impairment which would interfere with her ability to work. 25 At the same time, however, Dr. Oskooilar determined that Plaintiff s 26 GAF was 65-70, (AR 512), which suggested that her mental impairment 27 28 4 (AR 510-13.) Dr. Oskooilar (AR 512.) In Dr. (AR 512.) 1 was not that severe and that it would not interfere with her ability 2 to work. 3 Fourth Ed. (2000) ( DSM-IV-TR ) at 34.1 4 See Diagnostic and Statistical Manual of Mental Disorders, In June 2001, Plaintiff s osteopath, Dr. Philip Wunder, completed 5 a form that the Agency had sent him, which included seven questions 6 directed at whether he had witnessed any signs of mental illness while 7 treating Plaintiff over the previous three years. 8 Wunder indicated that he had not seen any such signs and that he had 9 not referred her for mental health treatment. 10 (AR 483-84.) Dr. (AR 483-84.) In August 2001, the Agency forwarded the medical records to 11 psychiatrist Patrick Ryan and asked him to review them and offer an 12 opinion as to Plaintiff s condition. 13 out a check-the-box form, indicating that Plaintiff did not have a 14 severe psychiatric impairment. 15 offered for this opinion is cryptic, at best. 16 has labored to interpret his note as follows: (AR 539-52.) (AR 539-52.) Dr. Ryan filled The explanation he (AR 551.) The Court 17 ALJ decision in 8/99 for non-severe [psychiatric 18 impairment]; no [psychiatric treatment] prior to start date 19 ÷ [more] weight to 6/01 [psychiatric consultative 20 examination] ÷ coherent, spontaneous speech, some 21 of affect despite 22 status section] states some trouble with memory[,] 23 concentration - but not severe. 24 findings at [consultative examination] and lack of 25 [psychiatric treatment] ÷ do[es] not meet the burden of , linear thought process, [mental ÷ objective 26 27 1 28 A score of 61-70 denotes, some mild symptoms ... but generally functioning pretty well .... DSM-IV-TR at 34. 5 1 rebutting the presumption of continuing non-disability per 2 the ALJ decision.2 3 (AR 551.) 4 In January 2002, the Agency sent Plaintiff to psychiatrist 5 Inderjit Seehrai. (AR 559-62.) He diagnosed Plaintiff with 6 depression and concluded that she may have moderate impairment in 7 completing a normal workday and workweek because of her depression. 8 (AR 562.) He also opined that she would have problems concentrating. 9 (AR 562.) He assigned Plaintiff a GAF score of 65. (AR 562.) 10 In September 2002, Plaintiff was referred by her treating doctor 11 to psychologist Philip Corrado to develop strategies for dealing with 12 pain. 13 depressed, but he did not report any mental or psychiatric 14 impairments. 15 (AR 742-44.) Dr. Corrado noted that Plaintiff reported being (AR 743.) Thus, the ALJ was faced with a confusing, conflicting record to 16 sort out to determine whether Plaintiff s mental impairment was 17 severe. 18 was not severe (Dr. Abejuela), one believed it was (Dr. Oskooilar), 19 and a third fell somewhere in the middle (Dr. Seehrai). 20 consulting doctor (Dr. Ryan) clearly believed Plaintiff s impairment 21 was not severe.3 22 Plaintiff s impairment was not severe. 23 valid reasons, which are supported by substantial evidence in the 24 record, i.e., Dr. Oskooilar s opinion was internally inconsistent and One of the examining doctors believed Plaintiff s impairment The The ALJ sided with the doctors who concluded that He based this decision on 25 26 2 Brackets indicate interpretations by the Court of what it believed Dr. Ryan s symbols and abbreviations were intended to mean. 27 3 28 The psychologist (Dr. Corrado) and the osteopath (Dr. Wunder) did not technically offer opinions on Plaintiff s mental health. 6 1 was contradicted by the other doctors opinions and Dr. Wunder did not 2 observe any signs of a mental impairment.4 3 resolving conflicts and ambiguities in the medical record, Andrews v. 4 Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995), and the Court cannot say 5 that he erred here. 6 The ALJ was tasked with Plaintiff sees the evidence differently. First, it seems, he 7 believes that Dr. Abejeula s report should be ignored because it was 8 completed in 1998 and Plaintiff s amended alleged onset date was 9 August 1999. (Joint Stip. at 4.) There is no support in law or fact 10 for ignoring a medical opinion because it was completed before the 11 alleged onset date. 12 weight should attach to the opinion, the ALJ was right when he took it 13 into account. 14 Though Plaintiff might properly argue that less Next, Plaintiff has a different interpretation of Dr. Seehrai s 15 opinion than the Court and the ALJ. 16 Plaintiff s view, Dr. Seehrai determined that Plaintiff had a severe 17 impairment. 18 Seehrai s opinion to say that. 19 Plaintiff would have difficulty performing detailed and complex tasks 20 due to her mental impairments, he also found that she would not have 21 any problems performing simple and repetitive tasks. 22 Further, Dr. Seehrai s opinion that Plaintiff may have difficulty 23 completing a workday or workweek because of her depression, 24 concentration problems, and sedative medication cannot be read to mean (Joint Stip. at 8.) (Joint Stip. at 8.) In The Court does not read Dr. Though Dr. Seehrai concluded that (AR 562.) 25 26 27 28 4 Because Dr. Oskooilar was not a treating physician, the ALJ was not required to contact him to resolve the apparent ambiguity in his report. See Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002). 7 1 that Plaintiff would have these problems, as Plaintiff seems to 2 suggest. 3 that Dr. Seehrai found that Plaintiff had a severe mental impairment 4 conflicts with Dr. Seehrai s finding that Plaintiff had a GAF score of 5 65.5 6 (Joint Stip. at 10.) Finally, Plaintiff s interpretation Plaintiff takes exception to the ALJ s reliance on Dr. Wunder s 7 observation that Plaintiff did not exhibit signs of any psychiatric 8 problems, arguing that Dr. Wunder was a treating osteopath, not a 9 treating psychiatrist. (Joint Stip. at 18-19.) Though the Court 10 would agree that Dr. Wunder s input did not rise to the level of a 11 treating opinion, it was proper for the ALJ to attach some weight to 12 the fact that Plaintiff never exhibited any signs of a mental 13 impairment when she was with him 19 times over the course of three 14 years. 15 In addition to the reasons set forth above, the Court s 16 conclusion that the ALJ did not err in finding that Plaintiff s mental 17 impairment was not severe is bolstered by additional evidence in the 18 record. 19 application for benefits nor did she stop working because of a mental 20 impairment. 21 not credible, (AR 669-70), a finding Plaintiff does not challenge. 22 This is important because the doctors opinions in this case were 23 based primarily on Plaintiff s allegations regarding her symptoms. First, Plaintiff never raised a mental impairment in her (AR 334-56.) Second, the ALJ found that Plaintiff was If 24 5 25 26 27 28 Plaintiff argues in her brief that the ALJ s analysis of the GAF scores amounts to a medical conclusion, which, she contends, the ALJ was not competent to make. (Joint Stip. at 20.) The Court does not agree. The GAF score itself, i.e., the number, does not require any specialized training, it is what it is. The meaning of that score is set forth in the DSM-IV-TR in laymen s terms, which ALJs and others can read and understand. 8 1 the allegations cannot be believed, the doctors opinions based on 2 those allegations are suspect. 3 underwent any mental health treatment. 4 once when she was getting divorced and once when she was being 5 harassed at work. 6 time to help manage pain. 7 reinforces the ALJ s finding that Plaintiff, a psychiatric technician 8 by trade, did not suffer from a severe mental impairment.6 9 Third, Plaintiff essentially never (AR 510-13.) She saw a psychiatrist twice, She also visited a psychologist one (AR 742-44.) This lack of treatment Though the Court might have concluded that Plaintiff s impairment 10 was severe had it been tasked with making that call at the 11 administrative level, the Court cannot substitute its judgment for the 12 ALJ s where, as here, the decision is supported by substantial 13 evidence. 14 1999). 15 the Complaint is dismissed with prejudice. See Tackett v. Apfel, 180 F.3d 1094, 1097-98 (9th Cir. For all these reasons, the Agency s decision is affirmed and 16 IT IS SO ORDERED. 17 DATED: September 23 , 2008. 18 19 PATRICK J. WALSH UNITED STATES MAGISTRATE JUDGE 20 21 S:\PJW\Cases-Soc Sec\STEPHENS, L 2191\Memo_Opinion.wpd 22 23 24 25 26 27 28 6 Plaintiff testified at the administrative hearing in 2003 that she had been receiving psychiatric care for nine months, and had stopped because she ran out of money. (AR 617.) In the decision that followed, the ALJ rejected this claim because Plaintiff had not submitted any records to substantiate it. (AR 44.) Three years later, and in the face of the ALJ s previous finding regarding the lack of evidence for this treatment, Plaintiff did not produce any evidence to show that she had received this treatment. The Court presumes that she never received psychiatric treatment and her testimony that she did was untrue. 9

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