Melinda Coe v. Carolyn W. Colvin, No. 5:2016cv00238 - Document 26 (C.D. Cal. 2016)
Court Description: MEMORANDUM OPINION AND ORDER REVERSING DECISION OF COMMISSIONER AND REMANDING FOR FURTHER ADMINISTRATIVE PROCEEDINGS by Magistrate Judge Alexander F. MacKinnon. (See document for details). (ib)
Download PDF
<![CDATA[
Melinda Coe v. Carolyn W. Colvin Doc. 26 1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 MELINDA COE, 12 Case No. ED CV 16-00238 AFM Plaintiff, 13 v. 14 15 CAROLYN W. COLVIN, Acting Commissioner of Social Security, MEMORANDUM OPINION AND ORDER REVERSING DECISION OF COMMISSIONER AND REMANDING FOR FURTHER ADMINISTRATIVE PROCEEDINGS 16 Defendant. 17 18 19 I. 20 BACKGROUND 21 Plaintiff Melinda Coe filed her application for disability benefits under Title 22 II of the Social Security Act on November 19, 2012, and her application for 23 supplemental security income under Title XVI of the Social Security Act on 24 January 14, 2013. After denial on initial review and on reconsideration, a hearing 25 took place before an Administrative Law Judge (ALJ) on August 18, 2014, at 26 which Plaintiff testified on her own behalf. In a decision dated September 5, 2014, 27 the ALJ found that Plaintiff was not disabled within the meaning of the Social 28 Security Act for the period from January 2, 2012 through the date of the decision. Dockets.Justia.com 1 The Appeals Council declined to set aside the ALJ’s unfavorable decision in a 2 notice dated January 14, 2016. Plaintiff filed a Complaint herein on February 8, 3 2016, seeking review of the Commissioner’s denial of her application for benefits. 4 In accordance with the Court’s Order Regarding Further Proceedings, 5 Plaintiff filed a memorandum in support of the complaint on August 8, 2016 (“Pl. 6 Mem.”); the Commissioner filed a memorandum in support of her answer on 7 October 12, 2016 (“Def. Mem.”); and Plaintiff filed a reply on October 27, 2016 8 (“Pl. Reply”). This matter now is ready for decision. 1 II. 9 DISPUTED ISSUES 10 As reflected in the parties’ memoranda, the disputed issues that Plaintiff is 11 12 raising are as follows: 1. 13 Whether the ALJ failed to properly evaluate the opinions of plaintiff’s treating physicians Dr. Morales and Dr. Taylor. 14 2. 15 Whether the ALJ improperly rejected the Plaintiff’s testimony regarding pain and function limitations. 16 17 III. 18 STANDARD OF REVIEW 19 Under 42 U.S.C. § 405(g), this Court reviews the Commissioner’s decision to 20 determine whether the Commissioner’s findings are supported by substantial 21 evidence and whether the proper legal standards were applied. See Treichler v. 22 Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 2014). Substantial 23 evidence means “more than a mere scintilla” but less than a preponderance. See 24 Richardson v. Perales, 402 U.S. 389, 401 (1971); Lingenfelter v. Astrue, 504 F.3d 25 1028, 1035 (9th Cir. 2007). Substantial evidence is “such relevant evidence as a 26 1 27 28 The decision in this case is being made based on the pleadings, the administrative record (“AR”), the parties’ memoranda in support of their pleadings, and plaintiff’s reply. (See AR 10 at ¶ 2.) 2 1 reasonable mind might accept as adequate to support a conclusion.” Richardson, 2 402 U.S. at 401. This Court must review the record as a whole, weighing both the 3 evidence that supports and the evidence that detracts from the Commissioner’s 4 conclusion. Lingenfelter, 504 F.3d at 1035. Where evidence is susceptible of more 5 than one rational interpretation, the Commissioner’s decision must be upheld. See 6 Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). 7 IV. 8 FIVE-STEP EVALUATION PROCESS 9 The Commissioner (or ALJ) follows a five-step sequential evaluation process 10 in assessing whether a claimant is disabled. 20 C.F.R. §§ 404.1520, 416.920; 11 Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995), as amended April 9, 1996. 12 In the first step, the Commissioner must determine whether the claimant is 13 currently engaged in substantial gainful activity; if so, the claimant is not disabled 14 and the claim is denied. Id. If the claimant is not currently engaged in substantial 15 gainful activity, the second step requires the Commissioner to determine whether 16 the claimant has a “severe” impairment or combination of impairments significantly 17 limiting his ability to do basic work activities; if not, a finding of nondisability is 18 made and the claim is denied. Id. If the claimant has a “severe” impairment or 19 combination of impairments, the third step requires the Commissioner to determine 20 whether the impairment or combination of impairments meets or equals an 21 impairment in the Listing of Impairments (“Listing”) set forth at 20 C.F.R. part 22 404, subpart P, appendix 1; if so, disability is conclusively presumed and benefits 23 are awarded. Id. If the claimant’s impairment or combination of impairments does 24 not meet or equal an impairment in the Listing, the fourth step requires the 25 Commissioner to determine whether the claimant has sufficient “residual functional 26 capacity” to perform his past work; if so, the claimant is not disabled and the claim 27 is denied. Id. The claimant has the burden of proving that he is unable to perform 28 past relevant work. Drouin v. Sullivan, 966 F.2d 1255, 1257 (9th Cir. 1992). If the 3 1 claimant meets this burden, a prima facie case of disability is established. Id. The 2 Commissioner then bears the burden of establishing that the claimant is not 3 disabled, because he can perform other substantial gainful work available in the 4 national economy. Id. The determination of this issue comprises the fifth and final 5 step in the sequential analysis. 20 C.F.R. §§ 404.1520, 416.920; Lester, 81 F.3d at 6 828 n.5; Drouin, 966 F.2d at 1257. 7 V. 8 THE ALJ’S APPLICATION OF THE FIVE-STEP PROCESS 9 At step one, the ALJ found that Plaintiff had not engaged in substantial 10 gainful activity since January 2, 2012, the alleged onset date. (AR 22.) At step 11 two, the ALJ found that Plaintiff had the following severe impairments: 12 fibromyalgia, atrial fibrillation, obesity, and adjustment disorder with mixed 13 anxiety and depressed mood. (Id.) At step three, the ALJ found that Plaintiff did 14 not have an impairment or combination of impairments that meets or medically 15 equals the severity of one of the listed impairments. (AR 23.) At step four, the 16 ALJ found that Plaintiff had the residual functional capacity (RFC) to perform a 17 reduced range of light work as defined in 20 C.F.R. §§ 404.1567(b), 416.967(c) and 18 was limited to simple and routine tasks. (AR 25.) Plaintiff’s RFC prevented her 19 from performing any of her past relevant work. (AR 30.) Finally, at step five, 20 based on Plaintiff’s age, education, work experience, and RFC, the ALJ concluded 21 that there are other jobs (fundraiser, survey worker, and information clerk) that 22 exist in significant numbers in the national economy that the Plaintiff can perform. 23 (AR 31-32.) Accordingly, the ALJ concluded that Plaintiff was not disabled as 24 defined in the Social Security Act since January 2, 2012. (AR 32.) 25 /// 26 /// 27 /// 28 /// 4 1 VI. 2 DISCUSSION 3 A. Opinion of Treating Physician Morales 4 It is well established in this Circuit that a treating physician’s opinion is 5 entitled to special weight, because a treating physician is employed to cure and has 6 a greater opportunity to know and observe the patient as an individual. 7 McAllister v. Sullivan, 888 F.2d 599, 602 (9th Cir. 1989). “The treating physician’s 8 opinion is not, however, necessarily conclusive as to either a physical condition or 9 the ultimate issue of disability.” Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 10 1989). The weight given a treating physician’s opinion depends on whether it is 11 supported by sufficient medical data and is consistent with other evidence in the 12 record. See 20 C.F.R. §§ 404.1527 and 416.927(d)(2). If the treating physician’s 13 opinion is uncontroverted by another doctor, it may be rejected only for “clear and 14 convincing” reasons. See Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1996); 15 Baxter v. Sullivan, 923 F.3d 1391, 1396 (9th Cir. 1991). Where an examining 16 physician’s opinion is uncontroverted, an ALJ must provide “clear and convincing” 17 reasons to reject it. Where, as in this case, an examining physician’s opinion is 18 contradicted by that of another doctor, the ALJ must provide “specific and 19 legitimate” reasons that are supported by substantial evidence in the record to reject 20 it. See Regennitter v. Commissioner of Social Sec. Admin., 166 F.3d 1294, 1298-99 21 (9th Cir. 1999); Lester, 81 F.3d at 830-31; Andrews v. Shalala, 53 F.3d 1035, 1041 22 (9th Cir. 1995); see also Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005). 23 Thus, the mere fact that a treating physician’s opinion is controverted by another 24 physician’s opinion is not in itself a sufficient reason to reject the treating 25 physician’s opinion, but rather is merely determinative of the governing standard 26 for rejecting the treating physician’s opinion. See 27 In this case, the ALJ stated that “little weight” was given to the opinion of 28 Plaintiff’s “primary care physician, Dr. Raymundo Morales, M.D., . . .” (AR 27.) 5 1 The ALJ summarized certain functional limitations opined to by Dr. Morales in 2 Exhibit 10F. (AR 27-28, citing AR 521-22.) The ALJ then provided one reason for 3 rejecting Dr. Morales’ opinion: “Given the lack of significant positive findings in 4 the medical records, the evidence does not substantiate the extent of the limitations 5 expressed by Dr. Morales. Indeed, the doctor’s estimation that the claimant must 6 be absent from work every 3 days is not borne out by the medical evidence.” (AR 7 28.) 8 The Court finds that the sole reason given by the ALJ for rejecting 9 Dr. Morales’ evaluation i.e., that it is not supported by “significant positive 10 findings in the medical records” is the same kind of non-specific boilerplate 11 language rejected by the Ninth Circuit as insufficient in Embrey v. Bowen, 849 F.2d 12 418, 421-22 (9th Cir. 1988). There, the Ninth Circuit observed, “To say that 13 medical opinions are not supported by sufficient objective findings or are contrary 14 to the preponderant conclusions mandated by the objective findings does not 15 achieve the level of specificity our prior cases have required, even when the 16 objective factors are listed seriatim.” Id. at 421. 17 Although the decision discusses the record medical evidence, the ALJ did not 18 provide his view of what specific evidence was inconsistent with Dr. Morales’ 19 opinion and why the ALJ’s views, rather than Dr. Morales’ were correct. That does 20 not comply with Ninth Circuit law: 21 conclusions. He must set forth his own interpretations and explain why they, rather 22 than the doctors’, are correct.” Id. at 421-22; see also McAllister, 888 F.2d at 602 23 (treating physician’s opinion improperly rejected where ALJ offered only “broad 24 and vague” reasons and failed “to specify why the ALJ felt the treating physician’s 25 opinion was flawed”). 26 evidence that would need to be addressed in assessing Dr. Morales’ opinion at 27 pages 3 through 5 of the memorandum in support of the complaint. In addition, it 28 appears that the ALJ misread Dr. Morales’ opinion in stating that the doctor “The ALJ must do more than offer his Plaintiff has cited examples of the pertinent medical 6 1 estimated plaintiff “must be absent from work every 3 days . . . .” (AR 28.) The 2 opinion states that Plaintiff would have to be absent on average three days. (AR 3 523.) Questioning at the administrative hearing indicates that this was interpreted 4 to mean three days out of a month (AR 65-66), and neither party suggests that 5 Dr. Morales opined Plaintiff would be absent once every three days (i.e., 10 days 6 per month), as the ALJ seemed to believe. 7 While the Commissioner purports to set forth additional reasons why 8 Dr. Morales’s opinions should not be credited (see Def. Mem. at 10-12), the Court 9 is unable to consider those reasons. See Connett v. Barnhart, 340 F.3d 871, 874 10 (9th Cir. 2003); Ceguerra v. Sec’y of Health & Human Svcs., 933 F.2d 735, 738 11 (9th Cir. 1991) (“A reviewing court can evaluate an agency’s decision only on the 12 grounds articulated by the agency.”). Accordingly, the ALJ’s decision erred in giving little weight to the opinion 13 14 from Plaintiff’s primary care physician, Dr. Morales. 15 B. Opinion of Treating Psychologist Taylor 16 Dr. Taylor is a psychologist who provided treatment to Plaintiff for her 17 mental impairments. The ALJ gave “little weight” to Dr. Taylor’s opinion for two 18 reasons: (1) “evidence denoting minimal mental health treatment” and (2) “the 19 treatment relationship between Dr. Taylor and [Plaintiff] was relatively brief . . . .” 20 (AR 29.) The Commissioner does not directly discuss the first reason, but argues as 21 to the second reason that the ALJ could dismiss Dr. Taylor’s opinion because she 22 only had four sessions with Plaintiff. The Court concludes this is not a specific and 23 legitimate reason. As Dr. Taylor noted, and as Plaintiff testified, Plaintiff’s limited 24 number of treatment sessions was due to her financial limitations and her difficulty 25 in leaving home. (See AR 399 (“Ms. Coe stated that she could not afford to 26 continue and that it was extremely difficult for her to leave her home”); AR 54 27 (“Once I can afford the copay again, God willing, I will be going back because she 28 was helping me”).) The Court notes the Commissioner’s argument that the longer a 7 1 source has treated a claimant, the more weight will be given to the source’s opinion. 2 (Def. Mem. at 14, citing 20 C.F.R. 404.1527(c)(2)(i).) However, here, the ALJ 3 credited portions of the opinion of a consultative examiner (Dr. Rathana- 4 Nakintara), who only saw Plaintiff once. (AR 29, citing AR 366-70.) The ALJ 5 does not explain why four visits was a basis to discredit Dr. Taylor, while only one 6 visit allowed a portion of Dr. Rathana-Nakintara’s assessment to be given great 7 weight. Nor does the ALJ give any express consideration to Plaintiff’s limited 8 financial means as impacting the number of treatment sessions with Dr. Taylor. 9 And, as with the prior treating physician discussed above, the ALJ failed to state 10 specifically what evidence was inconsistent with Dr. Taylor’s and why the ALJ’s 11 interpretations of the medical record, rather than the Dr. Taylor’s, are correct. See 12 Embrey, 849 F.2d at 421-22. 13 Finally, the Commissioner again purports to set forth additional reasons why 14 Dr. Taylor’s opinions should not be credited (see Def. Mem. at 13-15). However, 15 those reasons not stated in the decision as support for giving little weight to 16 Dr. Taylor’s opinion cannot be considered by the Court. See Connett, 340 F.3d 17 at 874; Ceguerra, 933 F.2d at 738. 18 VII. 19 DECISION TO REMAND 20 The law is well established that the decision whether to remand for further 21 proceedings or simply to award benefits is within the discretion of the Court. See, 22 e.g., Salvador v. Sullivan, 917 F.2d 13, 15 (9th Cir. 1990); McAllister, 888 F.2d at 23 603; Lewin v. Schweiker, 654 F.2d 631, 635 (9th Cir. 1981). Before a case may be 24 remanded for an immediate award of benefits, three requirements must be met: 25 “(1) the record has been fully developed and further administrative proceedings 26 would serve no useful purpose; (2) the ALJ has failed to provide legally sufficient 27 reasons for rejecting evidence, whether claimant testimony or medical opinion; and 28 (3) if the improperly discredited evidence were credited as true, the ALJ would be 8 1 required to find the claimant disabled on remand.” Garrison v. Colvin, 759 F.3d 2 995, 1020 (9th Cir. 2014); see also Brown-Hunter v. Colvin, 806 F.3d 487, 495 (9th 3 Cir. 2015). If the record is “uncertain and ambiguous, the proper approach is to 4 remand the case to the agency” for further proceedings. See Treichler, 775 F.3d at 5 1105. 6 ambiguities in the record. Id. at 1103-04 (in evaluating whether further 7 administrative proceedings would be useful, the reviewing court should consider 8 “whether the record as a whole is free from conflicts, ambiguities, or gaps, whether 9 all factual issues have been resolved, and whether the claimant’s entitlement to 10 benefits is clear under the applicable legal rules”); Burrell v. Colvin, 775 F.3d 1133, 11 1141-42 (9th Cir. 2014). In particular, remand proceedings would be useful in 12 clarifying the record here and resolving conflicts relating to the medical opinion 13 evidence. Here, further proceedings would be useful to resolve conflicts and 14 Because of the Court’s finding and conclusion that remand is necessary due 15 to the ALJ’s failure to properly consider the opinions of Dr. Morales and 16 Dr. Taylor, it is unnecessary for the Court to reach the issue of whether the ALJ 17 properly assessed Plaintiff’s credibility (Disputed Issue Two). On remand, 18 however, Plaintiff’s credibility may also be assessed in connection with the proper 19 consideration of Dr. Morales’ and Dr. Taylor’s opinions.2 * 20 * * * 21 IT THEREFORE IS ORDERED that Judgment be entered reversing the 22 decision of the Commissioner of Social Security and remanding this matter for 23 further administrative proceedings consistent with this Order. 24 DATED: November 15, 2016 ____________________________________ ALEXANDER F. MacKINNON UNITED STATES MAGISTRATE JUDGE 25 26 27 28 2 It is not the Court’s intent to limit the scope of the remand. 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.
