Rose Williams v. Michael J. Astrue, No. 2:2011cv02634 - Document 15 (C.D. Cal. 2012)

Court Description: DECISION AND ORDER by Magistrate Judge Carla Woehrle, IT IS ORDERED that: 1. The decision of the Commissioner is REVERSED. 2. This action is REMANDED to defendant, pursuant to Sentence Four of 42 U.S.C. §405(g), for further administrative proceedings consistent with instructions set forth in the body of the decision. (SEE ORDER FOR FURTHER DETAILS) (lmh)

Download PDF

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 12 ROSE WILLIAMS, Plaintiff, 13 v. 14 15 MICHAEL J. ASTRUE, Commissioner, Social Security Administration, 16 Defendant. 17 ) ) ) ) ) ) ) ) ) ) ) No. CV 11-2634 CW DECISION AND ORDER 18 19 The parties have consented, under 28 U.S.C. § 636(c), to the 20 jurisdiction of the undersigned Magistrate Judge. 21 review of the Commissioner s denial of supplemental security income 22 ( SSI ) benefits. 23 reversed and remanded for further administrative proceedings 24 consistent with this decision and order. 25 26 Plaintiff seeks For the reasons stated below, this matter should be I. BACKGROUND Plaintiff Rose Anne Williams was born on May 7, 1965, and was 27 forty-four years old at the time of her administrative hearing. 28 [Administrative Record ( AR ) 64, 165.] She completed tenth grade, and 1 1 2 3 has no significant past work experience.[AR 179-188.] Plaintiff alleged disability due to: stomach cramps, diarrhea, fatigue, pain, nausea, and depression. 4 5 II. [See AR 184.] PROCEEDINGS IN THIS COURT On April 6, 2011, Plaintiff s complaint was filed in this court. 6 On October 28, 2011, Defendant filed an answer and the certified 7 administrative record. On January 2, 2012, the parties filed their 8 Joint Stipulation ( JS ) identifying matters not in dispute, issues in 9 dispute, the positions of the parties, and the relief sought by each 10 party. 11 argument. 12 13 This matter has been taken under submission without oral III. PRIOR ADMINISTRATIVE PROCEEDINGS On August 10, 2007, Plaintiff filed an application for 14 supplemental security income alleging disability beginning October 29, 15 2001.1 16 Plaintiff requested an administrative hearing, which was held on 17 October 14, 2009, before Administrative Law Judge ( ALJ ) Robert S. 18 Eisman. 19 testimony was taken from Plaintiff and vocational expect ( VE ) Randi 20 Langford-Hetrick. 21 decision dated October 20, 2009. 22 Council denied review on January 28, 2011, the ALJ s decision became 23 the Commissioner s final decision. [AR 64, 165-66.] [AR 75-131.] After the application was denied initially, Plaintiff appeared without counsel, and [Id.] The ALJ denied benefits in an administrative [AR 64-72.] [AR 1.] When the Appeals This action followed. 24 25 26 27 28 1 Plaintiff subsequently filed a second application for benefits and was found to be disabled beginning December 17, 2009. [AR 2.] This action involves only the first application for benefits and addresses only whether Plaintiff was disabled prior to December 17, 2009. 2 1 2 IV. STANDARD OF REVIEW Under 42 U.S.C. § 405(g), a district court may review the 3 Commissioner s decision to deny benefits. The Commissioner s (or 4 ALJ s) findings and decision should be upheld if they are free of 5 legal error and supported by substantial evidence. 6 court determines that a finding is based on legal error or is not 7 supported by substantial evidence in the record, the court may reject 8 the finding and set aside the decision to deny benefits. 9 v. Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001); Tonapetyan v. However, if the See Aukland 10 Halter, 242 F.3d 1144, 1147 (9th Cir. 2001); Osenbrock v. Apfel, 240 11 F.3d 1157, 1162 (9th Cir. 12 1097 (9th Cir. 1999); Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 13 1998); Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996); Moncada 14 v. Chater, 60 F.3d 521, 523 (9th Cir. 1995)(per curiam). 15 2001); Tackett v. Apfel, 180 F.3d 1094, Substantial evidence is more than a scintilla, but less than a Reddick, 157 F.3d at 720. It is relevant evidence 16 preponderance. 17 which a reasonable person might accept as adequate to support a 18 conclusion. 19 a finding, a court must review the administrative record as a whole, 20 weighing both the evidence that supports and the evidence that 21 detracts from the Commissioner s conclusion. 22 can reasonably support either affirming or reversing, the reviewing 23 court may not substitute its judgment for that of the Commissioner. 24 Reddick, 157 F.3d at 720-721; see also Osenbrock, 240 F.3d at 1162. Id. To determine whether substantial evidence supports V. 25 Id. If the evidence DISCUSSION 26 A. 27 To be eligible for disability benefits a claimant must 28 THE FIVE-STEP EVALUATION demonstrate a medically determinable impairment which prevents the 3 1 claimant from engaging in substantial gainful activity and which is 2 expected to result in death or to last for a continuous period of at 3 least twelve months. 4 721; 42 U.S.C. § 423(d)(1)(A). 5 Tackett, 180 F.3d at 1098; Reddick, 157 F.3d at Disability claims are evaluated using a five-step test: 6 Step one: Is the claimant engaging in substantial 7 gainful activity? 8 disabled. 9 If so, the claimant is found not If not, proceed to step two. Step two: Does the claimant have a severe impairment? 10 If so, proceed to step three. 11 If not, then a finding of not disabled is appropriate. 12 Step three: Does the claimant s impairment or 13 combination of impairments meet or equal an impairment 14 listed in 20 C.F.R., Part 404, Subpart P, Appendix 1? 15 so, the claimant is automatically determined disabled. 16 not, proceed to step four. 17 If If Step four: Is the claimant capable of performing his 18 past work? 19 proceed to step five. If so, the claimant is not disabled. If not, Step five: Does the claimant have the residual 20 21 functional capacity to perform any other work? 22 claimant is not disabled. If so, the If not, the claimant is disabled. 23 Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995, as amended 24 April 9, 1996); see also Bowen v. Yuckert, 482 U.S. 137, 140-142, 107 25 S. Ct. 2287, 96 L. Ed. 2d 119 (1987); Tackett, 180 F.3d at 1098-99; 20 26 C.F.R. § 404.1520, § 416.920. 27 not disabled at any step, there is no need to complete further 28 steps. If a claimant is found disabled or Tackett, 180 F.3d 1098; 20 C.F.R. § 404.1520. 4 1 Claimants have the burden of proof at steps one through four, 2 subject to the presumption that Social Security hearings are non- 3 adversarial, and to the Commissioner s affirmative duty to assist 4 claimants in fully developing the record even if they are represented 5 by counsel. 6 1288. 7 made, and the burden shifts to the Commissioner (at step five) to 8 prove that, considering residual functional capacity ( RFC )2, age, 9 education, and work experience, a claimant can perform other work Tackett, 180 F.3d at 1098 and n.3; Smolen, 80 F.3d at If this burden is met, a prima facie case of disability is 10 which is available in significant numbers. Tackett, 180 F.3d at 1098, 11 1100; Reddick, 157 F.3d at 721; 20 C.F.R. § 404.1520, § 416.920. 12 B. THE ALJ S EVALUATION IN PLAINTIFF S CASE 13 Here, the ALJ found Plaintiff had not engaged in substantial 14 gainful activity since August 10, 2007, the application date (step 15 one); that she has the severe impairment(s) of depression, anxiety, 16 HIV/AIDS, and a history of polysubstance abuse/addiction (step two); 17 and that Plaintiff did not have an impairment or combination of 18 impairments that met or equaled a listing (step three). [AR 66.] 19 The ALJ found that Plaintiff retains the RFC to: 20 [P]erform light work as defined in 20 CFR 416.967(b), in 21 that she can exert up to 20 pounds of force occasionally 22 and/or up to 10 pounds of force frequently and/or a 23 2 24 25 26 27 28 Residual functional capacity measures what a claimant can still do despite existing exertional (strength-related) and nonexertional limitations. Cooper v. Sullivan, 880 F.2d 1152, 1155 n.s. 5-6 (9th Cir. 1989). Nonexertional limitations limit ability to work without directly limiting strength, and include mental, sensory, postural, manipulative, and environmental limitations. Penny v. Sullivan, 2 F.3d 953, 958 (9th Cir. 1993); Cooper, 800 F.2d at 1155 n.7; 20 C.F.R. § 404.1569a(c). Pain may be either an exertional or a nonexertional limitation. Penny, 2 F.3d at 959; Perminter v. Heckler, 765 F.2d 870, 872 (9th Cir. 1985); 20 C.F.R. § 404.1569a(c). 5 1 negligible amount of force constantly to move objects. A 2 job should be rated as light work when it involves walking 3 or standing to a significant degree or requires sitting most 4 of the time but entails pushing or pulling of arm or leg 5 controls and/or requires working at a production rate pace 6 entailing the constant pushing and pulling of materials even 7 though the weight of those materials is negligible. 8 claimant can stand and walk up to a total of 6 hours in an 9 8-hour workday, with normal breaks. The She can perform work 10 that does not require climbing ladders, ropes, or scaffolds, 11 and no more than occasional climbing of ramps or stairs, 12 stooping, kneeling, crouching and crawling. 13 can perform work that does not involve any exposure to 14 hazardous machinery, unprotected heights, or other high 15 risk, hazardous or unsafe conditions. 16 that is limited to simple, routine, and repetitive tasks in 17 a low stress environment, which is defined as work requiring 18 no (i.e. rare) decision making or judgment, no changes in 19 work setting, and not requiring any usual, very fast pace or 20 production rate requirements. 21 that does not require interaction with the public or 22 coworkers and does not require the performance of tandem 23 tasks with coworkers. The claimant She can perform work The claimant can perform work 24 [AR 67-68.] He found that Plaintiff has no past relevant work (step 25 four). 26 younger individual ), limited education, lack of past work 27 experience, and RFC, Plaintiff could perform other work existing in 28 significant numbers in the national economy (step five). [AR 71.] [AR 72.] He found, however, that given Plaintiff s age (as a 6 1 Accordingly, Plaintiff was found not disabled as defined by the 2 Social Security Act. [AR 72.] 3 C. 4 The Joint Stipulation identifies as disputed issues whether the 5 6 ALJ: 1. 7 8 ISSUES IN DISPUTE Should have afforded heavier weight to the opinions of the treating mental health professionals [JS at 4-14]; 2. 9 Provided clear and convincing reasons to reject Plaintiff s subjective statements [JS at 15-22.] 10 Issue one is dispositive. 11 D. 12 The crux of issue one is whether the Commissioner employed proper ISSUE ONE: TREATING MENTAL HEALTH PROFESSIONALS 13 legal standards in rejecting the opinion of treating psychiatrist 14 Christine Schneider, M.D.3, who, after visits with Plaintiff in 15 September and October 2009, diagnosed her with Chronic Paranoid 16 Schizophrenia and possible Shizoaffective Disorder, and opined that 17 Plaintiff was unable to work for at least one year due to this mental 18 illness. [See AR 374.] 19 The relevant background is as follows. In the October 20, 2009 20 3 21 22 23 24 25 26 27 A physician will be considered a treating physician when, as here, that physician sees plaintiff twice within a 14-month period preceding the hearing, where plaintiff requested that the physician treat plaintiff, and the physician is the one with the most extensive contact with plaintiff. Ghokassian v. Shalala, 41 F.3d 1300, 1303 (9th Cir. 1994). Similarly, a physician may be considered a treating physician pursuant to 20 C.F.R. § 404.1502 where, as appears also to have been the case here, the physician is responsible for prescribing and monitoring medication and treatment but leaves most of the direct patient contact to others within a treatment team. Benton v. Barnhart, 331 F.3d 1030, 1035 (9th Cir. 2003) (finding psychiatrist may be considered a treating physician pursuant to 20 C.F.R. § 404.1502 where the psychiatrist is responsible for prescribing and monitoring medication but leaves most of the direct patient contact to others within the treatment team). 28 7 1 hearing decision, the ALJ rejected Dr. Schneider s diagnosis and 2 opinion because: the determination of disability is reserved for the 3 Commissioner; the diagnosis of schizophrenia was not mentioned in any 4 prior treatment record; she treated plaintiff only twice; and her 5 diagnosis was contradicted by her treatment notes. [AR 70.] Plaintiff 6 subsequently submitted records to the Appeals Council establishing 7 that in March 2010 she was admitted for six-weeks of in-patient 8 treatment for schizophrenia. [AR 10.] 9 the new evidence of Plaintiff s schizophrenia and found that it did The Appeals Council considered 10 not alter the ultimate conclusion of non-disability because the 11 treatment post-dated the hearing decision by approximately five 12 months. 13 [AR 2.] In reviewing the denial of benefits here, the court considers the 14 rulings of both the ALJ and the Appeals Council, including the new 15 evidence, which was incorporated into the Administrative record and 16 considered by the Appeals Council. 17 1451-52 (9th Cir. 1993)(citations omitted). 18 a whole, including this new evidence, establishes the Commissioner did 19 not articulate legally sufficient reasons for rejecting Dr. Shneider s 20 opinion. 21 Ramirez v. Shalala, 8 F.3d 1449, A review of the record as If the opinion of a treating physician, such as that of Dr. 22 Schneider, is well-supported by medically acceptable clinical and 23 laboratory diagnostic techniques and is not inconsistent with other 24 substantial evidence in [the] case record, [it will be given] 25 controlling weight. 26 opinion is not given controlling weight, it is because it is not 27 well-supported or because it is inconsistent with other substantial 28 evidence in the record. 20 C.F.R. § 416.927(d)(2). If the physician s See Orn v. Astrue, 495 F.3d 625, 631 (9th 8 1 Cir. 2007). 2 Schneider s opinion. 3 or examining physician s opinion, the most that existed in this case 4 (and one of the few reasons cited by the ALJ for rejecting Dr. 5 Schneider s opinion) does not constitute a conflict with that 6 opinion. 7 Thus, the Commissioner was required to articulate clear and convincing 8 reasons to reject Dr. Schneider s opinion. 9 10 Here, no evidence in the record contradicts Dr. The mere absence of corroboration for a treating Widmark v. Barnhart, 454 F.3d 1063, 1066 (9th Cir. 2006). No such clear and convincing reasons are present. First, it is well-settled, and should be self-evident, that the 11 diagnosis of a condition may properly occur after the onset of that 12 condition; the Appeals Council is thus not entitled to outright reject 13 a medical opinion on that basis. Lester v. Chater, 81 F.3d 821, 832 14 n.9 (9th Cir. 1995); see also Smith v. Bowen, 849 F.2d 1222, 1225 (9th 15 Cir. 1988)(citation omitted)(holding that the mere fact that a medical 16 report was issued retrospectively is not a basis to disregard that 17 report). 18 credit the evidence of Plaintiff s March 2010 treatment. 19 reason to suggest that Plaintiff s schizophrenia might have suddenly 20 appeared in March 2010, the month that in-patient treatment was found 21 to be necessary. 22 ordered Plaintiff to obtain in-patient treatment shortly after Dr. 23 Schneider issued her diagnosis strongly supports Dr. Schneider s 24 opinion that Plaintiff was suffering from listing-level schizophrenia 25 by no later than October 9, 2009. 26 Council s conclusion that the new evidence was irrelevant to the 27 non-disability finding, it directly contradicts the ALJ s conclusion 28 that Dr. Schneider s opinion was unsupported and inconsistent with Thus, the Appeals Council materially erred in declining to It strains To the contrary, the fact that another psychiatrist And, thus, contrary to the Appeals 9 1 the mental health treatment record as a whole. Thus, the rejection of 2 Dr. Schneider s opinion is not based upon the requisite clear and 3 convincing quantum of evidence required to reject the opinion of a 4 treating physician. The proper course of action in such a case would 5 have been for the Appeals Council to remand to the ALJ for further 6 review. See Booz v. Sec y of Health and Human Servs., 734 F.2d 1378, 7 1380 (9th Cir. 1984). 8 the denial of benefits is materially in error. Because the Appeals Council failed to do so, 9 Because the Appeals Council did not properly consider the new 10 evidence before it, and the ALJ s rejection of Dr. Schneider s opinion 11 is not based upon clear and convincing record evidence, reversal is 12 required. 13 E. REMAND FOR FURTHER PROCEEDINGS 14 The decision whether to remand for further proceedings is within 15 the discretion of the district court. 16 1175-1178 (9th Cir. 2000). 17 further proceedings, or where the record has been fully developed, it 18 is appropriate to exercise this discretion to direct an immediate 19 award of benefits. 20 remand for further proceedings turns upon their likely utility). 21 However, where there are outstanding issues that must be resolved 22 before a determination can be made, and it is not clear from the 23 record that the ALJ would be required to find the claimant disabled if 24 all the evidence were properly evaluated, remand is appropriate. 25 26 Harman v. Apfel, 211 F.3d 1172, Where no useful purpose would be served by Harman, 211 F.3d at 1179 (decision whether to Id. Here, a remand for further administrative proceedings, including reevaluation of Plaintiff s credibility in light of the record as a 27 28 10 1 whole, is appropriate.4 2 Admin., 635 F.3d 1135, 1136 (9th Cir. 2011) (remand for automatic 3 payment of benefits inappropriate unless evidence unequivocally 4 establishes disability). Because the evaluation of Dr. Schneider s 5 opinion was materially in error, this evidence shall be credited as 6 true. 7 crediting this evidence as true, and considering it in light of the 8 record as a whole, the evidence strongly suggests Plaintiff suffered 9 from listing-level schizophrenia for some period of time prior to See e.g., Strauss v. Comm r of Soc. Sec. Vasquez v. Astrue, 572 F.3d 586, 594 (9th Cir. 2009). When 10 October 2009. The Listing of Impairments for schizoprenic, paranoid or 11 other psychotic disorders requires a finding of disability when the 12 requirements within the following categories A and B, both, are 13 satisfied, or when the requirements in category C are satisfied: 14 A. Medically documented persistence, either continuous or 15 intermittent, of one or more of the following: 16 1. Delusions or hallucinations; or 17 2. Catatonic or other grossly disorganized behavior; or 18 3. Incoherence, loosening of associations, illogical 19 thinking, or poverty of content of speech if associated 20 with one of the following: 21 a. Blunt affect; or 22 b. Flat affect; or 23 c. Inappropriate affect; or 24 25 4. Emotional withdrawal and/or isolation; And 26 27 28 4 The ALJ s credibility determination is not materially in error such that a remand for automatic payment of benefits would be merited on that basis alone. 11 1 B. Resulting in at least two of the following: 2 1. Marked restriction of activities of daily living; or 3 2. Marked difficulties in maintaining social functioning; 4 or 5 3. 6 persistence, or pace; or 7 4. 8 Repeated episodes of decompensation, each of extended duration; 9 10 Marked difficulties in maintaining concentration, Or C. Medically documented history of a chronic schizophrenic, 11 paranoid, or other psychotic disorder of at least 2 years' 12 duration that has caused more than a minimal limitation of 13 ability to do basic work activities, with symptoms or signs 14 currently attenuated by medication or psychosocial support, 15 and one of the following: 16 1. 17 18 Repeated episodes of decompensation, each of extended duration; or 2. A residual disease process that has resulted in such 19 marginal adjustment that even a minimal increase in 20 mental demands or change in the environment would be 21 predicted to cause the individual to decompensate; or 22 3. Current history of 1 or more years' inability to 23 function outside a highly supportive living 24 arrangement, with an indication of continued need for 25 such an arrangement. 26 27 28 See 20 C.F.R. Pt. 404, Subpt. P, App. 1, Listing 12.03. The record contains evidence showing that Plaintiff suffered from depression and anxiety since at least 2007, that she reported 12 1 suffering from hallucinations and hearing voices by at least 2007, 2 that she suffered from years of drug addiction, that she was often 3 homeless, that she was able to function best inside a supportive 4 living arrangement, and that she did not ever engage in regular work 5 activity. [AR 246, 255, 377.] Furthermore, based upon this and other 6 evidence, the ALJ found that Plaintiff s mental functioning was 7 limited to: 8 [S]imple, routine, and repetitive tasks in a low stress 9 environment, which is defined as work requiring no (i.e., 10 rare) decision making or judgment, no change in work 11 setting, and not requiring any usual, very fast pace or 12 production rate requirements. [Plaintiff] can perform work 13 that does not require interaction with the public or 14 coworkers and does not require tandem tasks with coworkers. 15 16 [AR 68.] Crediting Dr. Schneider s opinion as true, and given this other 17 evidence and the ALJ s findings, the question remaining for the 18 Commissioner on remand is when Plaintiff s schizophrenia developed to 19 such a degree that it was disabling, as that term is defined in the 20 Social Security Act. In such a circumstance, the proper course of 21 action is for the ALJ to call a medical expert to aid in the 22 determination of the actual onset date of Plaintiff s condition and 23 the nature of the limitations it might impose. See Armstrong v. 24 Commissioner of Social Security Administration, 160 F.3d 587, 589-90 25 (9th Cir. 1998). In Armstrong, the court pointed to record evidence 26 suggesting that the plaintiff suffered from mental functional 27 limitations long before he was diagnosed with depression. Noting that 28 the depression could thus have been disabling long before any 13 1 diagnosis was made, the court held that, because [e]xactly when that 2 happened was unclear, the ALJ was required to call a medical expert 3 to help him clarify the dates and extent of the plaintiff s 4 disability. Id. 5 situation, because the record strongly suggests limitations consistent 6 with schizophrenia long predating Plaintiff s diagnosis. This reasoning applies with equal force in this 7 VI. ORDERS 8 Accordingly, IT IS ORDERED that: 9 1. The decision of the Commissioner is REVERSED. 10 2. This action is REMANDED to defendant, pursuant to Sentence 11 Four of 42 U.S.C. §405(g), for further administrative 12 proceedings consistent with instructions set forth in the 13 body of the decision. 14 15 3. The Clerk of the Court shall serve this Decision and Order and the Judgement herein on all parties or counsel. 16 17 18 19 DATED: May 1, 2012 ________________________________ CARLA M. WOEHRLE United States Magistrate Judge 20 21 22 23 24 25 26 27 28 14

Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.