Frank M. Macias v. Michael J. Astrue, No. 5:2012cv00837 - Document 23 (C.D. Cal. 2013)
Court Description: MEMORANDUM OPINION AND ORDER by Magistrate Judge Jay C. Gandhi. IT IS ORDERED THAT judgment shall be entered REVERSING the decision of the Commissioner denying benefits and REMANDING the matter for further administrative action consistent with this decision. (See Order for details) (bem)
Download PDF
<![CDATA[
1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 FRANK M. MACIAS, 12 Plaintiff, 13 14 v. 15 CAROLYN W. COLVIN, ACTING COMMISSIONER OF SOCIAL 1/ SECURITY ADMINISTRATION, 16 Defendant. 17 ) Case No. CV 12-0837 JCG ) ) ) ) MEMORANDUM OPINION AND ) ORDER ) ) ) ) ) ) ) 18 Frank M. Macias ( Plaintiff ) challenges the Social Security Commissioner s 19 20 decision denying his application for disability benefits. Specifically, Plaintiff 21 contends, among other things, that the Administrative Law Judge ( ALJ ) 22 improperly rejected the opinion of his treating physicians, Drs. Victor Wu and 23 Cammy Tsai. (Joint Stip. at 5-13.) The Court agrees with Plaintiff for the reasons 24 stated below. 25 /// 26 /// 27 28 1/ Carolyn W. Colvin is substituted as the proper defendant herein. See Fed. R. Civ. P. 25(d). 1 A. Contradicted Opinion of a Treating Physician 2 3 An ALJ Must Provide Specific and Legitimate Reasons to Reject the As a general rule, more weight should be given to the opinion of a treating 4 source than to the opinion of doctors who do not treat the claimant. Lester v. 5 Chater, 81 F.3d 821, 830 (9th Cir. 1995); accord Benton ex. rel. Benton v. Barnhart, 6 331 F.3d 1030, 1036 (9th Cir. 2003). This is so because a treating physician is 7 employed to cure and has a greater opportunity to know and observe the patient as 8 an individual. Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987). 9 Where the treating doctor s opinion is contradicted by another doctor, the 10 [ALJ] may not reject this opinion without providing specific and legitimate reasons 11 supported by substantial evidence in the record[.] Lester, 81 F.3d at 830 (internal 12 quotation marks and citation omitted). The ALJ can meet the requisite specific and 13 legitimate standard by setting out a detailed and thorough summary of the facts and 14 conflicting clinical evidence, stating his interpretation thereof, and making findings. 15 Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989) (internal quotation marks 16 and citation omitted). 17 18 19 B. The ALJ Failed to Provide Specific and Legitimate Reasons for Rejecting the Opinions of Drs. Wu and Tsai Here, the ALJ provided three reasons for rejecting the opinions of Drs. Wu 20 and Tsai. (See Administrative Record ( AR ) at 26.) The Court addresses and 21 rejects all three below. 22 First, the ALJ found that the opinions of Drs. Wu and Tsai are not supported 23 by objective evidence or the treatment records. (Id. at 26.) This characterization, 24 however, is inaccurate. The medical record fully documents Plaintiff s drug 25 resistant Hepatitis C with resulting liver disease, inguinal hernia, and shoulder 26 injury. The record includes laboratory findings, radiological imaging, and clinical 27 assessments supporting Plaintiff s diagnosis and symptoms. (Id. at 317-18, 324, 28 326-27, 343-44, 356-407, 425-26, 429, 433-35, 459-61, 473, 478-79, 485-86, 4932 1 94, 495, 500, 506-10, 560-602, 606-08, 610-11, 613, 616, 618, 620-226, 630, 6472 52.) Of particular relevance are the notations in the record of Plaintiff s fatigue, 3 pain, poor concentration, and side effects to medications. (Id. at 317, 324, 356-61, 4 363-64, 433, 473, 485, 493, 560-71, 573, 648.) 5 Moreover, in finding that the treating source opinions were not supported by 6 the treatment records, the ALJ noted the entries in the record describing Plaintiff s 7 liver disease as stable. (Id. at 26.) Although many of the treatment notes classify 8 Plaintiff s condition as stable/unchanged, this appears to be more of a boilerplate 9 entry than a reasoned assessment of Plaintiff s condition. This is evidenced by the 10 fact that on May 23, 2008, Plaintiff s condition was reportedly stable/unchanged 11 while, in the same treatment note, Plaintiff s liver functioning was noted to have 12 worsened and his platelet count had decreased. (Id. at 360.) In addition, on 13 September 18, 2007, Plaintiff was reportedly asymptomatic and, on November 14, 14 2007, Plaintiff was reported to be stable. (Id. at 363.) However, on October 18, 15 2007, Plaintiff s liver functioning had declined enough that it was thought he may 16 be bumped up on [the] transplant list. (Id. at 344.) It is clear from this record that 17 Plaintiff s condition fluctuated often and a notation that he was stable or 18 asymptomatic on any given day is not a reliable indicator of Plaintiff s overall 19 condition. Nor is it proof that the opinions of the treating source as to Plaintiff s 20 ongoing limitations were invalid. Accordingly, this justification by the ALJ does not 21 amount to a legitimate reason for rejecting the opinions of Drs. Wu and Tsai. 22 Next, the ALJ rejected the opinions of Drs. Wu and Tsai on the basis that the 23 doctors appear to be advocating for the claimant to receive benefits, rather than 24 simply treating him. (AR at 26.) However, there is no indication in the record that 25 Plaintiff s treating sources offered anything other than an honest assessment. The 26 Secretary may not assume that doctors routinely lie in order to help their patients 27 collect disability benefits. Lester, 81 F.3d at 832. Accordingly, this justification by 28 the ALJ for rejecting the treating source opinions does not amount to a legitimate 3 1 reason supported by substantial evidence. 2 Finally, the ALJ rejected these medical opinions because the doctors offered 3 conclusions as to Plaintiff s ability to work, which is an issue reserved to the ALJ. 4 (AR at 26.) It is true that a treating physician s statement on an issue reserved to the 5 Commissioner, such as the ultimate determination of whether a claimant is disabled, 6 is not binding on the ALJ or entitled to special weight. See McLeod v. Astrue, 640 7 F.3d 881, 885 (9th Cir. 2011) ( The law reserves the disability determination to the 8 Commissioner. ); Ukolov v. Barnhart, 420 F.3d 1002, 1004 (9th Cir. 2005) 9 ( Although a treating physician s opinion is generally afforded the greatest weight in 10 disability cases, it is not binding on an ALJ with respect to the existence of an 11 impairment or the ultimate determination of disability. ) (citation omitted). The ALJ 12 was, therefore, not bound by the assertions that Plaintiff was unable to work. 13 However, the fact that a treating physician rendered an opinion on the ultimate issue 14 of disability does not relieve the Commissioner of the obligation to state specific and 15 legitimate reasons supported by substantial evidence for rejecting the balance of a 16 treating physician s opinion. Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998); 17 Matthews v. Shalala, 10 F.3d 678, 680 (9th Cir. 1993). This reason, therefore, was 18 insufficient to reject outright the opinions of Drs. Wu and Tsai. 19 Accordingly, for the reasons stated above, the Court determines that the ALJ 20 improperly discredited the opinions of Drs. Wu and Tsai. The Court therefore 21 concludes that the ALJ s decision is not supported by substantial evidence. Mayes v. 22 Massanari, 276 F.3d 453, 458-59 (9th Cir. 2001). 23 C. Remand is Warranted 24 With error established, this Court has discretion to remand or reverse and 25 award benefits. McAllister v. Sullivan, 888 F.2d 599, 603 (9th Cir. 1989). Where no 26 useful purpose would be served by further proceedings, or where the record has been 27 fully developed, it is appropriate to exercise this discretion to direct an immediate 28 award of benefits. See Benecke v. Barnhart, 379 F.3d 587, 595-96 (9th Cir. 2004). 4 1 But where there are outstanding issues that must be resolved before a determination 2 can be made, or it is not clear from the record that the ALJ would be required to find 3 a plaintiff disabled if all the evidence were properly evaluated, remand is 4 appropriate. See id. at 594. 5 Here, in light of the ALJ s error, the opinions of Drs. Wu and Tsai must be 6 properly assessed. Therefore, on remand, the ALJ shall reevaluate the treating 7 source opinions and either credit them as true, or provide valid reasons for any 8 portion that is rejected. 9 Based on the foregoing, IT IS ORDERED THAT judgment shall be entered 10 REVERSING the decision of the Commissioner denying benefits and 11 REMANDING the matter for further administrative action consistent with this 12 decision.2/ 13 14 Dated: August 7, 2013 15 ____________________________________ 16 Hon. Jay C. Gandhi United States Magistrate Judge 17 18 19 20 21 22 23 24 25 2/ In light of the Court s remand instructions, it is unnecessary to address 26 Plaintiff s remaining contentions. (See Joint Stip. at 5-15, 20-22.) However, on remand, the ALJ is to reconsider the issue of Plaintiff s credibility, as the ALJ s 27 internally inconsistent reasoning on this issue is insufficient to support the credibility 28 determination. (See AR at 28.) 5
]]>
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.
