Aguilar v. Colvin, No. 3:2013cv06053 - Document 25 (W.D. Wash. 2014)
Court Description: ORDER REVERSING DEFENDANTS DECISION TO DENY BENEFITS signed by Judge Karen L Strombom. This matter is REMANDED for further administrative proceedings. (MET)
Download PDF
<![CDATA[
1 2 3 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT TACOMA 4 5 6 AMY ANN AGUILAR, Case No. 3:13-cv-06053-KLS 7 8 9 Plaintiff, v. ORDER REVERSING DEFENDANT S DECISION TO DENY BENEFITS CAROLYN W. COLVIN, Commissioner of Social Security, 10 Defendant. 11 12 Plaintiff has brought this matter for judicial review of defendant s denial of her 13 application for disability insurance benefits ( DIB ) and supplemental security income ( SSI ) 14 15 benefits. Pursuant to 28 U.S.C. § 636(c), Federal Rule of Civil Procedure 73 and Local Rule 16 MJR 13, the parties have consented to have this matter heard by the undersigned Magistrate 17 Judge. After reviewing the parties briefs and the remaining record, the Court hereby finds that 18 for the reasons set forth below, defendant s decision to deny benefits should be reversed and 19 remanded for further proceedings. 20 FACTUAL AND PROCEDURAL HISTORY 21 22 On September 20, 2006, plaintiff filed applications for DIB and SSI benefits, alleging 23 disability as of July 1, 2006, due to back pain, obesity, depression, and anxiety. See 24 Administrative Record ( AR ) 114-22, 137, 388. Both applications were denied upon initial 25 administrative review and on reconsideration. See AR 73-76, 78-82. A hearing was held before 26 ORDER - 1 1 an administrative law judge ( ALJ ) on July 7, 2009, at which plaintiff, represented by counsel, 2 appeared and testified, as did vocational expert, Nancy Bloom. See AR 26-68. 3 4 On September 2, 2009, the ALJ issued a decision in which plaintiff was determined to be not disabled. See AR 12-25. Plaintiff s request for review of the ALJ s decision was denied by 5 the Appeals Council on February 16, 2011, making the ALJ s decision defendant s final 6 7 decision. See AR 1-3; see also 20 C.F.R. § 404.981, § 416.1481. Plaintiff filed a complaint in 8 this Court seeking judicial review of the ALJ s decision, which was reversed and remanded for 9 further proceedings on October 4, 2011. AR 483-87. A hearing was held before a different ALJ 10 on April 25, 2013, at which plaintiff, represented by counsel, appeared and testified. See Dkt. 11 #16. The ALJ held a supplemental hearing on July 31, 2013, at which plaintiff, represented by 12 counsel, testified further, as did vocational expert, Robert Gaffney. See AR 419-68. 13 On August 15, 2013, the ALJ issued a decision in which plaintiff was determined to be 14 15 not disabled. See AR 385-418. Plaintiff did not file written exceptions with the Appeals Council, 16 and, it does not appear from the record that the Appeals Council assumed jurisdiction of the case. 17 See 20 C.F.R. § 404.984, § 416.1484. The ALJ s decision therefore became defendant s final 18 decision after sixty days. Id. On December 10, 2013, plaintiff filed a complaint in this Court 19 seeking judicial review of the ALJ s decision. See Dkt. #1. The administrative record was filed 20 with the Court on February 20, 2014 and supplemented on May 2, 2014. See Dkt. #11, 16. The 21 22 23 24 parties have completed their briefing, and thus this matter is now ripe for judicial review and a decision by the Court. Plaintiff argues the ALJ s decision should be reversed and remanded to defendant for an 25 award of benefits, because the ALJ erred: (1) in evaluating the medical evidence in the record; 26 (2) in rejecting the lay witness evidence in the record; and (3) in discounting plaintiff s ORDER - 2 1 credibility. The Court agrees the ALJ erred in determining plaintiff to be not disabled, but, for 2 the reasons set forth below, finds that while defendant s decision should be reversed, this matter 3 should be remanded for further administrative proceedings. 4 DISCUSSION 5 The determination of the Commissioner of Social Security (the Commissioner ) that a 6 7 claimant is not disabled must be upheld by the Court, if the proper legal standards have been 8 applied by the Commissioner, and the substantial evidence in the record as a whole supports 9 that determination. Hoffman v. Heckler, 785 F.2d 1423, 1425 (9th Cir. 1986); see also Batson v. 10 Commissioner of Social Security Admin., 359 F.3d 1190, 1193 (9th Cir. 2004); Carr v. Sullivan, 11 772 F.Supp. 522, 525 (E.D. Wash. 1991) ( A decision supported by substantial evidence will, 12 nevertheless, be set aside if the proper legal standards were not applied in weighing the evidence 13 and making the decision. ) (citing Brawner v. Secretary of Health and Human Services, 839 F.2d 14 15 432, 433 (9th Cir. 1987)). 16 Substantial evidence is such relevant evidence as a reasonable mind might accept as 17 adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971) (citation 18 omitted); see also Batson, 359 F.3d at 1193 ( [T]he Commissioner s findings are upheld if 19 supported by inferences reasonably drawn from the record. ). The substantial evidence test 20 requires that the reviewing court determine whether the Commissioner s decision is supported 21 22 by more than a scintilla of evidence, although less than a preponderance of the evidence is 23 required. Sorenson v. Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975). If the evidence 24 admits of more than one rational interpretation, the Commissioner s decision must be upheld. 25 Allen v. Heckler, 749 F.2d 577, 579 (9th Cir. 1984) ( Where there is conflicting evidence 26 sufficient to support either outcome, we must affirm the decision actually made. ) (quoting ORDER - 3 1 Rhinehart v. Finch, 438 F.2d 920, 921 (9th Cir. 1971)). 1 2 I. 3 4 The ALJ s Evaluation of the Medical Evidence in the Record The ALJ is responsible for determining credibility and resolving ambiguities and conflicts in the medical evidence. See Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998). 5 Where the medical evidence in the record is not conclusive, questions of credibility and 6 7 resolution of conflicts are solely the functions of the ALJ. Sample v. Schweiker, 694 F.2d 639, 8 642 (9th Cir. 1982). In such cases, the ALJ s conclusion must be upheld. Morgan v. 9 Commissioner of the Social Sec. Admin., 169 F.3d 595, 601 (9th Cir. 1999). Determining 10 whether inconsistencies in the medical evidence are material (or are in fact inconsistencies at 11 all) and whether certain factors are relevant to discount the opinions of medical experts falls 12 within this responsibility. Id. at 603. 13 In resolving questions of credibility and conflicts in the evidence, an ALJ s findings 14 15 must be supported by specific, cogent reasons. Reddick, 157 F.3d at 725. The ALJ can do this 16 by setting out a detailed and thorough summary of the facts and conflicting clinical evidence, 17 stating his interpretation thereof, and making findings. Id. The ALJ also may draw inferences 18 logically flowing from the evidence. Sample, 694 F.2d at 642. Further, the Court itself may 19 draw specific and legitimate inferences from the ALJ s opinion. Magallanes v. Bowen, 881 20 F.2d 747, 755, (9th Cir. 1989). 21 22 1 23 24 25 26 As the Ninth Circuit has further explained: . . . It is immaterial that the evidence in a case would permit a different conclusion than that which the [Commissioner] reached. If the [Commissioner] s findings are supported by substantial evidence, the courts are required to accept them. It is the function of the [Commissioner], and not the court s to resolve conflicts in the evidence. While the court may not try the case de novo, neither may it abdicate its traditional function of review. It must scrutinize the record as a whole to determine whether the [Commissioner] s conclusions are rational. If they are . . . they must be upheld. Sorenson, 514 F.2dat 1119 n.10. ORDER - 4 1 The ALJ must provide clear and convincing reasons for rejecting the uncontradicted 2 opinion of either a treating or examining physician. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 3 1996). Even when a treating or examining physician s opinion is contradicted, that opinion can 4 only be rejected for specific and legitimate reasons that are supported by substantial evidence in 5 the record. Id. at 830-31. However, the ALJ need not discuss all evidence presented to him 6 7 or her. Vincent on Behalf of Vincent v. Heckler, 739 F.3d 1393, 1394-95 (9th Cir. 1984) 8 (citation omitted) (emphasis in original). The ALJ must only explain why significant probative 9 evidence has been rejected. Id.; see also Cotter v. Harris, 642 F.2d 700, 706-07 (3rd Cir. 1981); 10 11 12 Garfield v. Schweiker, 732 F.2d 605, 610 (7th Cir. 1984). In general, more weight is given to a treating physician s opinion than to the opinions of those who do not treat the claimant. See Lester, 81 F.3d at 830. On the other hand, an ALJ need 13 not accept the opinion of a treating physician, if that opinion is brief, conclusory, and 14 15 inadequately supported by clinical findings or by the record as a whole. Batson v. 16 Commissioner of Social Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004); see also Thomas v. 17 Barnhart, 278 F.3d 947, 957 (9th Cir. 2002); Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 18 2001). An examining physician s opinion is entitled to greater weight than the opinion of a 19 nonexamining physician. Lester, 81 F.3d at 830-31. A non-examining physician s opinion may 20 constitute substantial evidence if it is consistent with other independent evidence in the record. 21 22 23 Id. at 830-31; Tonapetyan, 242 F.3d at 1149. Robert E. Schneider, Ph.D., evaluated plaintiff on February 27, 2007, on behalf of the 24 Washington State Department of Social and Health Services. AR 287-95. Dr. Schneider 25 measured plaintiff s full scale IQ at 66 and diagnosed plaintiff with mild mental retardation, 26 depression NOS, generalized anxiety disorder, and panic disorder with agoraphobia. AR 292-93. ORDER - 5 1 Dr. Schneider noted that plaintiff had difficulty understanding and following simple and multi- 2 step instructions, she is very slow to perform tasks, has limited understanding and would have 3 difficulty dealing with the interpersonal demands of gainful employment . AR 291. Further, Dr. 4 Schneider found plaintiff to have marked limitation in her ability to exercise judgment and make 5 decisions, interact appropriately in public contacts, and respond appropriately to and tolerate the 6 7 pressure and expectations of a normal work setting. See AR 294. 8 The ALJ gave Dr. Schneider s opinion very little weight stating 9 He did not apparently review the record and based his opinion exclusively on the claimant s own reports and results of volitional testing, which were not validated. The undersigned finds the claimant is not a credible witness. As Dr. Schneider s opinion is based largely on claimant s unsubstantiated allegations of a history of traumatic head injuries, his opinion is afforded little weight. Moreover, because Dr. Schneider was unaware of the claimant s marijuana use, his opinion is even less reliable. 10 11 12 13 AR 403. Plaintiff argues these were not specific and legitimate reasons to discredit Dr. 14 Schneider s opinion. See Dkt. #18, pp. 8-15. This Court agrees. 15 16 The ALJ s primary reason for discrediting Dr. Schneider s opinion is that he found it was based on plaintiff s incredible subjective complaints. See AR 403. According to the Ninth 17 Circuit, [an] ALJ may reject a treating physician s opinion if it is based to a large extent on a 18 19 claimant self-reports that have been properly discounted as incredible. Tommasetti v. Astrue, 20 533 F.3d 1035, 1041 (9th Cir. 2008) (quoting Morgan v. Comm r. Soc. Sec. Admin., 169 F.3d 21 595, 602 (9th Cir. 1999) (citing Fair v. Bowen, 885 F.2d 597, 605 (9th Cir. 1989)). However, 22 like all findings by the ALJ, a finding that a doctor s opinion is based largely on a claimant s 23 own accounts of his symptoms and limitations must be based on substantial evidence in the 24 record as a whole. See Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir. 2005) (citing 25 26 Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). This situation is distinguishable from one in which the doctor provides his own observations in support of his assessments and opinions. ORDER - 6 1 See Ryan v.Comm r of Soc. Sec. Admin., 528 F.3d 1194, 1199-1200 (9th Cir. 2008) ( an ALJ 2 does not provide clear and convincing reasons for rejecting an examining physician s opinion by 3 questioning the credibility of the patient s complaints where the doctor does not discredit those 4 complaints and supports his ultimate opinion with his own observations ); see also Edlund v. 5 Massanari, 253 F.3d 1152, 1159 (9th Cir. 2001). Here, the ALJ s finding that Dr. Schneider s 6 7 8 opinion is based primarily on plaintiff s subjective complaints is not supported by substantial evidence. Dr. Schneider performed extensive testing on plaintiff prior to rendering his opinion. 9 10 This testing included the Wechsler Adult Intelligence test, Woodcock Johnson reading and letter- 11 word identification subtests, and the Wechsler memory test. AR 290. Further, although the ALJ 12 stated that these tests were not validated, Dr. Schneider noted that there was relatively good 13 consistency across subtest scores which indicated that the testing was an accurate reflection of 14 15 the intellectual abilities that [plaintiff] brings to her life and would bring to a job. AR 289. In 16 addition to testing, Dr. Schneider also made clinical observations noting that plaintiff presented 17 as anxious and somewhat concrete, that plaintiff had difficulty focusing, and that plaintiff 18 exhibited word finding problems. AR 289. The ALJ s conclusion that Dr. Schneider s opinion 19 was based in large part on subjective complaints was not supported by substantial evidence and 20 thus, was not a valid reason to discredit Dr. Schneider s opinion. See Bayliss, 427 F.3d at 1214 21 22 n.1. 23 The ALJ also discredits Dr. Schneider s opinion because it was based on plaintiff s 24 uncorroborated report of traumatic head injuries. AR 403. While plaintiff s report of head 25 injuries was noted by Dr. Schneider, there is no indication that this was the basis for his opined 26 limitations. In fact, Dr. Schneider did not diagnose plaintiff with traumatic brain injury, instead ORDER - 7 1 diagnosing plaintiff with mild mental retardation, depressive disorder, anxiety disorder, and 2 panic disorder. AR 293. The fact that plaintiff s head injuries have not been corroborated by 3 medical records is not a specific and legitimate reason to discredit Dr. Schneider s opinion. 4 The final reason given by the ALJ to discredit Dr. Schneider s opinion is that the doctor 5 was unaware of plaintiff s marijuana use at the time the opinion was made. AR 403. The ALJ 6 7 pointed to no contemporaneous records showing marijuana use around the time of Dr. 8 Schneider s evaluation. The ALJ noted that plaintiff testified to using marijuana; however, it is 9 unclear how often or how much plaintiff was smoking during the time of Dr. Schneider s 10 evaluation. AR 429-38. The ALJ did take judicial notice of an article asserting that [m]arijuana 11 produces well-documented, acute cognitive changes that last for several hours after the drug has 12 been ingested. AR 394-95. However, again, the ALJ points to no evidence that plaintiff was 13 under the influence of marijuana at the time of the evaluation or had ingested marijuana shortly 14 15 before the evaluation. Dr. Schneider made no mention that he suspected plaintiff had been under 16 the influence of drugs during the evaluation. The ALJ s conclusion that plaintiff s marijuana use 17 affected Dr. Schneider s opinion was not supported by substantial evidence and was not a 18 specific and legitimate reason to discredit the opinion. 19 20 The Ninth Circuit has recognized that harmless error principles apply in the Social Security Act context. Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012) (citing Stout v. 21 22 Commissioner, Social Security Administration, 454 F.3d 1050, 1054 (9th Cir. 2006) (collecting 23 cases)). The court noted that in each case we look at the record as a whole to determine [if] the 24 error alters the outcome of the case. Id. The court also noted that the Ninth Circuit has adhered 25 to the general principle that an ALJ s error is harmless where it is inconsequential to the 26 ultimate nondisability determination. Id. (quoting Carmickle v. Comm r Soc. Sec. Admin., 533 ORDER - 8 1 F.3d 1155, 1162 (9th Cir. 2008)) (other citations omitted). The court noted the necessity to 2 follow the rule that courts must review cases without regard to errors that do not affect the 3 parties substantial rights. Id. at 1118 (quoting Shinsheki v. Sanders, 556 U.S. 396, 407 (2009) 4 (quoting 28 U.S.C. § 2111) (codification of the harmless error rule)). All of the functional 5 limitations opined by Dr. Schneider were not included in the ALJ s residual functional capacity 6 7 finding. Therefore, had the opinion been given greater weight, the ultimate disability 8 determination may have changed. Thus, the ALJ s error in evaluating Dr. Schneider s opinion 9 was not harmless. 10 II. 11 12 This Matter Should Be Remanded for Further Administrative Proceedings The Court may remand this case either for additional evidence and findings or to award benefits. Smolen, 80 F.3d at 1292. Generally, when the Court reverses an ALJ s decision, the 13 proper course, except in rare circumstances, is to remand to the agency for additional 14 15 investigation or explanation. Benecke v. Barnhart, 379 F.3d 587, 595 (9th Cir. 2004) (citations 16 omitted). Thus, it is the unusual case in which it is clear from the record that the claimant is 17 unable to perform gainful employment in the national economy, that remand for an immediate 18 award of benefits is appropriate. Id. 19 20 Benefits may be awarded where the record has been fully developed and further administrative proceedings would serve no useful purpose. Smolen, 80 F.3d at 1292; Holohan 21 22 23 24 25 26 v. Massanari, 246 F.3d 1195, 1210 (9th Cir. 2001). Specifically, benefits should be awarded where: (1) the ALJ has failed to provide legally sufficient reasons for rejecting [the claimant s] evidence, (2) there are no outstanding issues that must be resolved before a determination of disability can be made, and (3) it is clear from the record that the ALJ would be required to find the claimant disabled were such evidence credited. ORDER - 9 1 Smolen, 80 F.3d 1273 at 1292; McCartey v. Massanari, 298 F.3d 1072, 1076-77 (9th Cir. 2002). 2 Because issues still remain in regard to the opinion evidence from Dr. Schneider 3 4 including whether the ALJ would be required to adopt that evidence and what impact it would have on the ALJ s assessment of plaintiff s residual functional capacity and her ability to 5 perform other work existing in significant numbers in the national economy remand for further 6 7 consideration of those issues is warranted. CONCLUSION 8 Based on the foregoing discussion, the Court hereby finds the ALJ improperly concluded 9 10 plaintiff was not disabled. Accordingly, defendant s decision is REVERSED and this matter is 11 REMANDED for further administrative proceedings in accordance with the findings contained 12 herein. 13 DATED this 10th day of September, 2014. 14 15 A 16 17 Karen L. Strombom United States Magistrate Judge 18 19 20 21 22 23 24 25 26 ORDER - 10
]]>
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.
