Maria De Jesus Flores v. Commissioner of Social Security Administration, No. 8:2012cv01993 - Document 26 (C.D. Cal. 2013)
Court Description: MEMORANDUM OPINION AND ORDER OF REMAND by Magistrate Judge Charles F. Eick. Plaintiff's and Defendant's motions for summary judgment are denied and this matter is remanded for further administrative action consistent with this Opinion. (sp)
Download PDF
<![CDATA[
1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 12 13 14 15 16 MARIA DE JESUS FLORES, ) ) Plaintiff, ) ) v. ) ) COMMISSIONER OF SOCIAL ) SECURITY ADMINISTRATION, ) ) Defendant. ) ____________________________________) NO. CV 12-1993-E MEMORANDUM OPINION AND ORDER OF REMAND 17 18 Pursuant to sentence four of 42 U.S.C. section 405(g), IT IS 19 HEREBY ORDERED that Plaintiff s and Defendant s motions for summary 20 judgment are denied, and this matter is remanded for further 21 administrative action consistent with this Opinion. 22 23 PROCEEDINGS 24 25 Plaintiff filed a complaint on November 20, 2012, seeking review 26 of the Commissioner s denial of benefits. The parties consented to 27 proceed before a United States Magistrate Judge on May 1, 2013. 28 Plaintiff filed a motion for summary judgment on April 30, 2013. 1 Defendant filed a motion for summary judgment on August 30, 2013. 2 Plaintiff filed a reply brief on September 17, 2013. 3 taken the motions under submission without oral argument. 4 15; Order, filed November 27, 2012. The Court has See L.R. 7- 5 6 BACKGROUND 7 8 9 In 2009, Plaintiff filed an application for disability benefits (Administrative Record ( A.R. ) 49, 72-75, 492). Plaintiff asserts 10 disability since April 1, 2007, based on alleged high blood 11 pressure/chronic bronchitis/diabetes (A.R. 74, 105-06).1 12 Administrative Law Judge ( ALJ ) found that Plaintiff suffers from 13 severe hypertension, diabetes mellitus, left knee arthritis, chest 14 pain, and morbid obesity (A.R. 23 (adopting consultative internal 15 medical examiner s diagnoses at A.R. 160, 163)). An 16 17 The ALJ determined that Plaintiff retains the residual functional 18 capacity to perform a limited range of light work (A.R. 24 (adopting 19 consultative examiner s opinion at A.R. 163 and State agency physician 20 P. N. Ligot s Physical Residual Functional Capacity Assessment at A.R. 21 154-58); see also A.R. 25-29 (ALJ discussing bases for assessment)). 22 Relying on the testimony of a vocational expert, the ALJ found that, 23 with this capacity, Plaintiff could perform her past relevant work as 24 a maid (A.R. 29-30 (adopting vocational expert s testimony at A.R. 25 26 1 27 28 Plaintiff initially asserted disability since February 2, 2007, but later amended her application to the April 1, 2007 date. See A.R. 72, 74, 106. The Administration considered the earlier onset date. See A.R. 21. 2 1 521)). Thus, the ALJ found Plaintiff not disabled through April 21, 2 2011, the date of the ALJ s decision (A.R. 30). 3 the Appeals Council denied review (A.R. 5-8).2 On November 5, 2012, 4 5 STANDARD OF REVIEW 6 7 Under 42 U.S.C. section 405(g), this Court reviews the 8 Administration s decision to determine if: (1) the Administration s 9 findings are supported by substantial evidence; and (2) the 10 Administration used correct legal standards. See Carmickle v. 11 Commissioner, 533 F.3d 1155, 1159 (9th Cir. 2008); Hoopai v. Astrue, 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2 On or about October 27, 2011, on initial review of a new benefits application filed on May 24, 2011, the Administration found Plaintiff disabled beginning April 22, 2011 (the day after the ALJ s adverse decision on the prior application). See Defendant s Motion, Exhibits 1 through 3. Records provided from this review indicate that Plaintiff was assessed with a less than sedentary residual functional capacity precluding Plaintiff from all work. Id., Exhibit 3 (Medical/Vocational Decision Guide); see also id., Exhibit 4 (October 18, 2011 Physical Residual Functional Capacity Assessment form indicating, inter alia, that Plaintiff could stand or walk two hours in an eight-hour workday with a medically required hand-held assistive device for ambulation (a walker) due to Plaintiff s left knee osteoarthritis); id., Exhibit 5 (October 8, 2011 Complete Internal Medicine Evaluation for Plaintiff finding same standing/walking limitation, and noting that a walker would be necessary for all distances unless and until a successful knee replacement surgery might be performed). It appears these later records were not a part of the record the Appeals Council considered in denying review of the Administration s decision on the current application for benefits. See A.R. 11 (referencing the additional evidence the Appeals Council considered). The Appeals Council did consider the finding of disability on the later application, but stated that the finding did not warrant a change in the ALJ s decision. See A.R. 6. 3 1 499 F.3d 1071, 1074 (9th Cir. 2007). Substantial evidence is such 2 relevant evidence as a reasonable mind might accept as adequate to 3 support a conclusion. 4 (1971) (citation and quotations omitted); see also Widmark v. 5 Barnhart, 454 F.3d 1063, 1067 (9th Cir. 2006). Richardson v. Perales, 402 U.S. 389, 401 6 7 DISCUSSION 8 9 10 The ALJ Materially Erred Regarding the Determination of Plaintiff s Residual Functional Capacity. 11 12 In connection with the application at issue, internist Dr. John 13 Sedgh examined Plaintiff and provided a July 1, 2009 consultative 14 report (A.R. 159-63).3 15 light work, limited only by a restriction to occasional kneeling, Dr. Sedgh opined that Plaintiff could perform 16 17 18 19 20 21 22 23 24 25 26 27 28 3 Plaintiff complained of hypertension, diabetes, chest pain and a left knee problem (A.R. 159; see also A.R. 114, 116 (Exertion Questionnaire dated June 25, 2009 reflecting limitations were due to Plaintiff s high blood pressure and diabetes)). Plaintiff claimed that her left knee problem had been present for four years and was worsened by standing and walking (A.R. 159). A treatment record from February 2003 provided to the Administration indicates that Plaintiff reported left knee pain that was getting worse following a fall. An x-ray at the time was negative. See A.R. 469-82. On examination, Dr. Sedgh indicated: (1) blood pressure of 135/74; (2) morbid obesity; (3) no evidence of muscle spasm or tenderness to Plaintiff s cervical and lumbar spine, range of motion within normal limits, and negative straight leg raising test; (4) no upper extremity abnormalities; (5) no evidence of lower extremity abnormalities except crepitation in Plaintiff s left knee, but with normal range of motion; and (6) gait within normal limits (A.R. 160-63). Dr. Sedgh found that Plaintiff has hypertension, diabetes, left knee arthritis, and chest pain (A.R. 163). 4 1 crouching, and stooping (A.R. 163; see also 20 C.F.R. § 404.1567(b) 2 (defining light work )). 3 24-25). 4 evidence supporting an administrative finding of non-disability. 5 Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001); see also 6 Orn v. Astrue, 495 F.3d 625, 632 (9th Cir. 2007) (consultative opinion 7 based on independent clinical findings can be substantial evidence on 8 which the ALJ may rely). The ALJ adopted Dr. Sedgh s findings (A.R. A consultative examiner s opinion can furnish substantial See 9 10 In a July 21, 2009 assessment, state agency review physician Dr. 11 Ligot agreed with Dr. Sedgh s residual functional capacity 12 determination. 13 expert does not contradict all other evidence in the record, the 14 Administration properly may rely upon such opinion. 15 Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995); Curry v. Sullivan, 925 16 F.2d 1127, 1130 n.2 (9th Cir. 1990). See A.R. 154-58. Where the opinion of a non-examining See Andrews v. 17 18 As argued by Plaintiff, however, the medical evidence available 19 to Drs. Sedgh and Ligot for their review was limited. See 20 C.F.R. 20 § 404.1527 (c)(6) (factor to consider in evaluating medical opinion 21 evidence is the extent to which the source is familiar with other 22 information in claimant s case record); see also Orn v. Astrue, 495 23 F.3d at 633-34 (a more recent medical opinion may be entitled to 24 greater deference than an older opinion, where the more recent opinion 25 describes or considers later significant medical events or 26 conditions). 27 /// 28 /// Many if not most of Plaintiff s treatment records post- 5 See A.R. 140-490.4 1 date the reviews by Drs. Sedgh and Ligot. 2 Notably, the evidence available for review by Drs. Sedgh and Ligot did 3 not include: 4 knee which showed marginal osteophytes and degenerative changes and 5 spurs . . . [with] first degree spondylolisthesis with a 1 cm foreword 6 slippage of L5 on S1 characterized as degenerative changes (A.R. 7 203), and joint space narrowing about the medial compartment of the 8 knee (A.R. 484); (2) Dr. Meka s treatment notes from November 2009 9 through December 2010 indicating that Plaintiff reported right hip (1) the 2010 x-rays of Plaintiff s lumbar spine and left 10 pain, left leg pain, low back pain, and, when examined, had back 11 tenderness and limited range of motion (A.R. 200-02, 236-37, 243-44, 12 286-316, 466-67); (3) emergency room records from September 2010 for 13 treatment of left knee pain with pain medications (A.R. 372-73, 377- 14 82); or (4) emergency room records from May 2009, December 2009, May 15 2010, August 2010, and October 2010 for treatment of chest pain and 16 shortness of breath with some notation of anxiety (A.R. 186-97, 199, 17 216-18, 231-34, 245-80, 368-69, 394-403).5 18 19 20 While the ALJ summarized some of this evidence in his decision (A.R. 25-26), he did not explain what impact, if any, the conditions 21 22 23 24 25 26 27 28 4 Moreover, it appears that Dr. Sedgh may not have reviewed the limited medical records that were available. See A.R. 159-60 (Dr. Sedgh stating that medical history was obtained from Plaintiff and referencing no specific medical records reviewed). 5 Plaintiff testified that she stopped working in 2007 because she became ill in part due to a lot of pain in her left knee and lower back (A.R. 515-16). Plaintiff explained that at the time she stopped working, she was finding chores very difficult because she would have to rest to take pain medication for her knee and low back (A.R. 518-19). 6 1 reflected in the additional treatment records may have had on 2 Plaintiff s residual functional capacity.6 3 the ALJ s adverse decision, no State agency doctor opined regarding 4 what impact these conditions may have had on Plaintiff s capacity, and 5 the ALJ rejected Dr. Meka s opinion suggesting greater limitations as 6 assertedly unsupported by Dr. Meka s clinical examinations and 7 treatment notes. 8 x-ray as revealing only joint space narrowing in the medial 9 compartment and characterized the lumbar spine x-ray as revealing See A.R. 26-27. Significantly, prior to The ALJ characterized the left knee 10 only marginal osteophytes and degenerative changes and spurs, as well 11 as a first degree spondylolisthesis with a one centimeter forward 12 slippage on L5 and S1 (A.R. 26-27) (emphasis added). 13 characterizations suggest that the ALJ gave minimal weight to this 14 evidence in determining Plaintiff s residual functional capacity. These 15 16 Absent expert medical assistance, the ALJ could not competently 17 translate the additional medical evidence into a residual functional 18 capacity assessment. 19 his or her own medical opinion or substitute his or her own diagnosis 20 for that of a claimant s physician. 21 1094, 1102-03 (9th Cir. 1999) (ALJ erred in rejecting physicians 22 opinions and finding greater residual functional capacity based on 23 claimant s testimony concerning a road trip; there was no medical 24 evidence to support the ALJ s determination); Balsamo v. Chater, 142 25 F.3d 75, 81 (2d Cir. 1998) (an ALJ cannot arbitrarily substitute his It is well-settled that an ALJ may not render See Tackett v. Apfel, 180 F.3d 26 27 28 6 Contrary to Defendant s assertion, the ALJ did not assess Plaintiff s lumbar spine condition as severe. Compare Defendant s Motion, p. 14, with A.R. 23. 7 1 own judgment for competent medical opinion ) (internal quotation marks 2 and citation omitted); Rohan v. Chater, 98 F.3d 966, 970 (7th Cir. 3 1996) ( ALJs must not succumb to the temptation to play doctor and 4 make their own independent medical findings ); Day v. Weinberger, 522 5 F.2d 1154, 1156 (9th Cir. 1975) (an ALJ is forbidden from making his 6 or her own medical assessment beyond that demonstrated by the record). 7 In this case, before the ALJ determined that a particular residual 8 functional capacity purportedly would account for all of Plaintiff s 9 medical conditions, the ALJ should have called on a medical expert to 10 provide competent evidence with respect to such issues. See id.; see 11 also Brown v. Heckler, 713 F.2d 441, 443 (9th Cir. 1983) ( The ALJ has 12 a special duty to fully and fairly develop the record to assure that 13 the claimant s interests are considered. 14 the claimant is represented by counsel). This duty exists even when 15 16 Because the circumstances of this case suggest that further 17 administrative review could remedy the ALJ s errors,7 remand is 18 appropriate. 19 generally INS v. Ventura, 537 U.S. 12, 16 (2002) (upon reversal of an 20 administrative determination, the proper course is remand for 21 additional agency investigation or explanation, except in rare 22 circumstances). 23 /// McLeod v. Astrue, 640 F.3d 881, 888 (9th Cir. 2011); see 24 25 26 27 28 7 There are outstanding issues that must be resolved before a proper disability determination can be made in the present case. For at least this reason, the Ninth Circuit s decision in Harman v. Apfel, 211 F.3d 1172 (9th Cir.), cert. denied, 531 U.S. 1038 (2000) does not compel a reversal for the immediate payment of benefits. 8 1 CONCLUSION 2 3 For all of the foregoing reasons,8 Plaintiff s and Defendant s 4 motions for summary judgment are denied and this matter is remanded 5 for further administrative action consistent with this Opinion. 6 7 LET JUDGMENT BE ENTERED ACCORDINGLY. 8 9 DATED: September 20, 2013. 10 11 ______________/S/__________________ CHARLES F. EICK UNITED STATES MAGISTRATE JUDGE 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 8 27 28 The Court has not reached any other issue presented except insofar as to determine that reversal with a directive for the immediate payment of benefits would not be appropriate at this time. 9
]]>
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.
