Savanna V Roath v. Nancy A. Berryhill, No. 8:2017cv01483 - Document 26 (C.D. Cal. 2019)
Court Description: OPINION AND ORDER by Magistrate Judge Shashi H. Kewalramani. IT IS HEREBY ORDERED that the Commissioner's decision is REVERSED and this case is REMANDED for further administrative proceedings under sentence four of 42 U.S.C. § 405(g). (see order for further details) (hr)
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Savanna V Roath v. Nancy A. Berryhill Doc. 26 1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 Case No. 8:17-cv-01483-SHK S.V.R., 12 Plaintiff, 13 v. 14 OPINION AND ORDER NANCY A. BERRYHILL, Acting Commissioner of Social Security, 15 16 Defendant. 17 18 19 Plaintiff S.V.R.1 (“Plaintiff”) seeks judicial review of the final decision of the 20 Commissioner of the Social Security Administration (“Commissioner,” 21 “Agency,” “Administration,” or “Defendant”) denying her application for 22 supplemental security income (“SSI”), under Title XVI of the Social Security Act 23 (the “Act”). This Court has jurisdiction, under 42 U.S.C. § 1383(c)(3), and, 24 pursuant to 28 U.S.C. § 636(c), the parties have consented to the jurisdiction of the 25 undersigned United States Magistrate Judge. For the reasons stated below, the 26 27 28 1 The Court substitutes Plaintiff’s initials for Plaintiff’s name to protect Plaintiff’s privacy with respect to Plaintiff’s medical records discussed in this Opinion and Order. Dockets.Justia.com 1 Commissioner’s decision is REVERSED and this action is REMANDED for 2 further proceedings consistent with this Order. 3 I. BACKGROUND 4 Plaintiff filed an application for SSI on April 29, 2014, alleging disability 5 beginning on October 20, 2011. Transcript (“Tr.”) 200-08.2 Following a denial of 6 benefits, Plaintiff requested a hearing before an administrative law judge (“ALJ”) 7 and, on March 28, 2016, ALJ Joan Ho determined that Plaintiff was not disabled. 8 Tr. 24-37. Plaintiff sought review of the ALJ’s decision with the Appeals Council, 9 however, review was denied on June 29, 2017. Tr. 1-6. This appeal followed. 10 II. 11 STANDARD OF REVIEW The reviewing court shall affirm the Commissioner’s decision if the decision 12 is based on correct legal standards and the legal findings are supported by 13 substantial evidence in the record. 42 U.S.C. § 405(g); Batson v. Comm’r Soc. 14 Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). Substantial evidence is “more 15 than a mere scintilla. It means such relevant evidence as a reasonable mind might 16 accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 17 401 (1971) (citation and internal quotation marks omitted). In reviewing the 18 Commissioner’s alleged errors, this Court must weigh “both the evidence that 19 supports and detracts from the [Commissioner’s] conclusions.” Martinez v. 20 Heckler, 807 F.2d 771, 772 (9th Cir. 1986). 21 “‘When evidence reasonably supports either confirming or reversing the 22 ALJ’s decision, [the Court] may not substitute [its] judgment for that of the ALJ.’” 23 Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (quoting Batson, 359 F.3d at 24 1196); see also Thomas v. Barnhart, 278 F.3d 947, 959 (9th Cir. 2002) (“If the 25 ALJ’s credibility finding is supported by substantial evidence in the record, [the 26 27 28 2 A certified copy of the Administrative Record was filed on January 29, 2018. Electronic Case Filing Number (“ECF No.”) 12. Citations will be made to the Administrative Record or Transcript page number rather than the ECF page number. 2 1 Court] may not engage in second-guessing.”) (citation omitted). A reviewing 2 court, however, “cannot affirm the decision of an agency on a ground that the 3 agency did not invoke in making its decision.” Stout v. Comm’r Soc. Sec. Admin., 4 454 F.3d 1050, 1054 (9th Cir. 2006) (citation omitted). Finally, a court may not 5 reverse an ALJ’s decision if the error is harmless. Burch v. Barnhart, 400 F.3d 676, 6 679 (9th Cir. 2005) (citation omitted). “[T]he burden of showing that an error is 7 harmful normally falls upon the party attacking the agency’s determination.” 8 Shinseki v. Sanders, 556 U.S. 396, 409 (2009). 9 III. DISCUSSION 10 A. 11 To establish whether a claimant is disabled under the Act, it must be shown 12 Establishing Disability Under The Act that: 13 (a) the claimant suffers from a medically determinable physical or 14 mental impairment that can be expected to result in death or that has 15 lasted or can be expected to last for a continuous period of not less than 16 twelve months; and 17 (b) the impairment renders the claimant incapable of performing the 18 work that the claimant previously performed and incapable of 19 performing any other substantial gainful employment that exists in the 20 national economy. 21 Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999) (citing 42 U.S.C. 22 § 423(d)(2)(A)). “If a claimant meets both requirements, he or she is ‘disabled.’” 23 Id. 24 The ALJ employs a five-step sequential evaluation process to determine 25 whether a claimant is disabled within the meaning of the Act. Bowen v. Yuckert, 26 482 U.S. 137, 140 (1987); 20 C.F.R. § 416.920(a). Each step is potentially 27 dispositive and “if a claimant is found to be ‘disabled’ or ‘not-disabled’ at any step 28 in the sequence, there is no need to consider subsequent steps.” Tackett, 180 F.3d 3 1 at 1098; 20 C.F.R. § 416.920. The claimant carries the burden of proof at steps one 2 through four, and the Commissioner carries the burden of proof at step five. 3 Tackett, 180 F.3d at 1098. 4 The five steps are: 5 Step 1. Is the claimant presently working in a substantially gainful 6 activity [(“SGA”)]? If so, then the claimant is “not disabled” within 7 the meaning of the [] Act and is not entitled to [SSI]. If the claimant is 8 not working in a [SGA], then the claimant’s case cannot be resolved at 9 step one and the evaluation proceeds to step two. See 20 C.F.R. 10 § 404.1520(b).[3] 11 Step 2. Is the claimant’s impairment severe? If not, then the 12 claimant is “not disabled” and is not entitled to [SSI]. If the claimant’s 13 impairment is severe, then the claimant’s case cannot be resolved at 14 step two and the evaluation proceeds to step three. See 20 C.F.R. 15 § 404.1520(c). 16 Step 3. Does the impairment “meet or equal” one of a list of 17 specific impairments described in the regulations? If so, the claimant is 18 “disabled” and therefore entitled to [SSI]. 19 impairment neither meets nor equals one of the impairments listed in 20 the regulations, then the claimant’s case cannot be resolved at step 21 three and the evaluation proceeds to step four. 22 § 404.1520(d). If the claimant’s See 20 C.F.R. 23 Step 4. Is the claimant able to do any work that he or she has 24 done in the past? If so, then the claimant is “not disabled” and is not 25 entitled to [SSI]. If the claimant cannot do any work he or she did in 26 the past, then the claimant’s case cannot be resolved at step four and 27 28 3 The Court has also considered the parallel regulations set forth in 20 C.F.R. § 416.920 et seq., when analyzing the ALJ’s denial of Plaintiff’s SSI application. 4 1 the evaluation proceeds to the fifth and final step. See 20 C.F.R. 2 § 404.1520(e). 3 Step 5. Is the claimant able to do any other work? If not, then 4 the claimant is “disabled” and therefore entitled to [SSI]. See 20 5 C.F.R. § 404.1520(f)(1). If the claimant is able to do other work, then 6 the Commissioner must establish that there are a significant number of 7 jobs in the national economy that claimant can do. There are two ways 8 for the Commissioner to meet the burden of showing that there is other 9 work in “significant numbers” in the national economy that claimant 10 can do: (1) by the testimony of a vocational expert [(“VE”)], or (2) by 11 reference to the Medical-Vocational Guidelines at 20 C.F.R. pt. 404, 12 subpt. P, app. 2 [(“the Listings”)]. If the Commissioner meets this 13 burden, the claimant is “not disabled” and therefore not entitled to 14 [SSI]. See 20 C.F.R. §§ 404.1520(f), 404.1562. If the Commissioner 15 cannot meet this burden, then the claimant is “disabled” and therefore 16 entitled to [SSI]. See id. 17 Id. at 1098-99. 18 B. 19 The ALJ found at step one, that “[Plaintiff] has not engaged in [SGA] since Summary Of ALJ’s Findings 20 April 29, 2014, the application date (20 CFR 416.971 et seq.).” Tr. 26. At step 21 two, the ALJ found that “[Plaintiff] has the following severe impairments: 22 osteoarthritic changes of the right hand, depressive disorder rule out bipolar 23 disorder, paranoid personality disorder (20 CFR 416.920(c)).” Id. At step three, 24 the ALJ found that “[Plaintiff] does not have an impairment or combination of 25 impairments that meets or medically equals the severity of one of the listed 26 impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 27 416.925 and 416.926).” Id. 28 /// 5 1 2 In preparation for step four, the ALJ found that Plaintiff has the residual functional capacity (“RFC”) to: 3 perform medium work as defined in 20 CFR 416.967(c) and the 4 following limitations: she would be able to lift and/or carry up to 50 5 pounds occasionally and 25 pounds frequently; she would be able to 6 stand and/or walk approximately six hours of an eight-hour workday 7 and she would be able to sit for approximately six hours of an eight-hour 8 workday with normal breaks; she would be able to frequently finger with 9 the right upper extremity; and she would be limited to simple routine 10 and repetitive tasks, but would be able to sustain attention and 11 concentration skills sufficient to carry out work-like tasks with 12 reasonable pace and persistence. 13 Tr. 30. The ALJ then found, at step four, that “[Plaintiff] has no past relevant 14 work [(“PRW”)] (20 CFR 416.965).” Tr. 35. 15 In preparation for step five, the ALJ noted that “[Plaintiff] was born on April 16 18, 1961 and was 53 years old, which is defined as an individual closely approaching 17 advanced age, on the date the application was filed. (20 CFR 416.963).” Id. The 18 ALJ observed that “[Plaintiff] had at least a high school education and is able to 19 communicate in English (20 CFR 416.964).” Tr. 36. The ALJ then added that 20 “[t]ransferability of job skills is not an issue because [Plaintiff] does not have 21 [PRW] (20 CFR 416.968).” Id. 22 At step five, the ALJ found that “[c]onsidering [Plaintiff’s] age, education, 23 work experience, and [RFC], there are jobs that exist in significant numbers in the 24 national economy that [Plaintiff] can perform (20 CFR 416.969 and 416.969(a)).” 25 Id. Specifically, the ALJ found that Plaintiff could perform the “unskilled[,]” 26 “medium exertional level” occupations of “[h]and [p]ackager” as defined in the 27 dictionary of occupational titles (“DOT”) at DOT 920.587-018, “[w]arehouse 28 [w]orker” at DOT 922.687-058, and “[d]ay [w]orker” at DOT 301.687-014. Tr. 6 1 37. The ALJ based her decision that Plaintiff could perform the aforementioned 2 occupations “on the testimony of the [VE]” from the administrative hearing, after 3 “determin[ing] that the [VE’s] testimony [wa]s consistent with the information 4 contained in the [DOT].” Id. 5 After finding that “[Plaintiff] is capable of making a successful adjustment to 6 other work that exists in significant numbers in the national economy,” the ALJ 7 concluded that “[a] finding of not disabled is . . . appropriate under the framework 8 of the above-cited rule.” Id. (internal quotation marks omitted). The ALJ, 9 therefore, found that “[Plaintiff] has not been under a disability, as defined in the 10 . . . Act, since April 29, 2014, the date the application was filed. (20 CFR 11 416.920(g)).” Id. 12 C. 13 In this appeal, Plaintiff raises four issues, including whether: (1) “[t]he ALJ Issues Presented 14 failed to properly weigh the medical opinion evidence and failed to properly 15 determine [Plaintiff’s] [RFC]”; (2) “[t]he ALJ failed to properly evaluate 16 [Plaintiff’s] testimony”; (3) “[t]he ALJ relied on a flawed hypothetical to the 17 [VE]”; and (4) the ALJ’s decision was invalid because the ALJ was “not 18 constitutionally appointed at the time of the decision in this case.” ECF No. 19, 19 Joint Stipulation at 3; ECF No. 22, Letter to Judge at 1. 20 D. 21 Court’s Consideration Of Plaintiff’s First Issue: Whether the ALJ Properly Weighed The Medical Evidence 22 Plaintiff challenges the ALJ’s consideration of three of her doctors’ opinions, 23 including Plaintiff’s: (1) treating psychiatrist, Santi Pattara, M.D.; (2) examining 24 psychiatrist Chun Kee Ryu, M.D.; and (3) treating rheumatologist, Krishan 25 Khurana, M.D. ECF No. 19, Joint Stipulation at 3-15. Accordingly, the Court 26 examines the ALJ’s consideration of these three doctors’ opinions. 27 /// 28 /// 7 1 1. Defendants’ Response 2 Defendant responds by arguing that by not challenging the opinion 3 consulting examiner (“CE”), Dr. Sohini Parikh, M.D., who Defendant argues 4 opined that Plaintiff had “at most, . . . mild impairments in some of her mental 5 abilities[,]” Plaintiff “cannot show how the ALJ failed to rely on substantial 6 evidence” when finding that Plaintiff was not disabled. Id. at 20. Defendant also 7 argues that the ALJ gave Drs. Pattara’s, Ryu’s, and Khurana’s opinions 8 appropriate weight. Id. at 23-33. 9 10 2. ALJ’s Consideration Of Medical Opinions The ALJ began her analysis of Drs. Pattara’s, Ryu’s, and Khurana’s opinions 11 by summarizing each of their respective findings throughout the record. With 12 respect to Dr. Pattara’s opinions, the ALJ observed that Dr. Pattara opined: 13 14 on July 9, 2012, that Plaintiff “would have severe mental limitations and unable to be gainfully employed”; 15 on November 14, 2014, that Plaintiff “would have difficulty in work-like 16 situations, completing tasks, focusing, following instructions, interacting 17 with others and [ADLs]” and “would have many marked limitations with 18 understanding and memory, concentration, persistence or pace, social 19 interactions, and adaptation, and she would miss work more than three times 20 a month”; 21 on October 14, 2015, that Plaintiff “could sit less than one hour, stand/walk 22 less than one hour, lift/carry is not applicable, manipulative function is not 23 applicable, unable to tolerate stress in a competitive work environment and 24 she would miss work more than three times a month”; 25 on November 12, 2015, that Plaintiff “would have difficulty in work-like 26 situations, completing tasks, focusing, following instructions, interacting 27 with others and ADLs.” 28 Id. (citing Tr. 330, 468-71, 473-77, 495-99, 500-03). 8 1 2 With respect to Drs. Khurana’s and Ryu’s opinions, the ALJ observed that: on March 25, 2013, Dr. Ryu opined that Plaintiff “is not capable of any 3 employment and disability existed since early 2010, and there is marked 4 limits with socialization, she is unable to maintain attention and 5 concentration for any extended time, and marked limitations in carrying out 6 instructions”; 7 on March 26, 2013, Dr. Ryu opined that Plaintiff “would have a [global 8 assessment of functioning (“GAF”) scores] of 35, marked limitations in 18 9 out of 20 categories, and incapable of even low stress”; 10 on December 2, 2015, Dr. Khurana opined that Plaintiff could ‘lift/carry 11 zero to five pounds occasionally, sit one hour, stand/walk one hour, must get 12 up every 10 to 15 minutes to lie down for 40 minutes before returning to a 13 seated position, rarely grasp, handle, finger or reach[,] take unscheduled 14 breaks every 30 to 40 minutes, and she would miss work more than three 15 times a month.” 16 17 Id. (citing Tr. 536-40, 504-05, 506-13). The ALJ gave “little weight” to Drs. Pattara’s, Khurana’s, and Ryu’s 18 opinions because: (1) “they are not consistent with the sparse medical evidence 19 record as a whole,” which “shows very little treatment”; (2) “they are not familiar 20 with the . . . Administration’s precise disability guidelines as evidenced by their 21 opinions, . . . as they do not address the listings or any exertional or non-exertional 22 limitations”; and (3) “the finding of disabled [is] reserved for the Commissioner.” 23 Tr. 34. The ALJ added that Dr. Pattara’s opinions were inconsistent with “his 24 own notes[,]” and that Drs. Ryu’s and Khurana’s opinions were “too extreme and 25 restrictive in light of the record as a whole, including the many ADLs noted by Dr. 26 Pattara[,]” which included “bath ok, dress ok, cook ok, drive ok, shop ok, use of 27 fund ok.” Tr. 29, 30, 33, 34, 35 (citing Tr. 437-38, 441-44, 446-50, 452-53, 455-56) 28 (internal quotation marks omitted). 9 1 Finally, the ALJ found that “[t]he [GAF] score opinions are given little 2 weight because they are a snapshot in time and do not accurately, reflect 3 [Plaintiff’s] functional abilities[]” and “also do correlate with the . . . 4 Administration’s precise disability guidelines, including the B and C criteria of the 5 listings or an RFC.” Tr. 34. 6 3. Standard To Review ALJ’s Analysis Of Medical Opinions 7 There are three types of medical opinions in Social Security cases: those 8 from treating physicians, examining physicians, and non-examining physicians. 9 Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685, 692 (9th Cir. 2009) (citation 10 omitted). “The medical opinion of a claimant’s treating physician is given 11 ‘controlling weight’ so long as it ‘is well-supported by medically acceptable clinical 12 and laboratory diagnostic techniques and is not inconsistent with the other 13 substantial evidence in [the claimant’s] case record.’” Trevizo v. Berryhill, 871 14 F.3d 664, 675 (9th Cir. 2017) (quoting 20 C.F.R. § 404.1527(c)(2)). “When a 15 treating physician’s opinion is not controlling, it is weighted according to factors 16 such as the length of the treatment relationship and the frequency of examination, 17 the nature and extent of the treatment relationship, supportability, consistency 18 with the record, and specialization of the physician.” Id. (citing 20 C.F.R. 19 § 404.1527(c)(2)–(6)). 20 “‘To reject [the] uncontradicted opinion of a treating or examining doctor, 21 an ALJ must state clear and convincing reasons that are supported by substantial 22 evidence.’” Id. (quoting Ryan v. Comm’r Soc. Sec. Admin., 528 F.3d 1194, 1198 23 (9th Cir. 2008)). “This is not an easy requirement to meet: ‘the clear and 24 convincing standard is the most demanding required in Social Security cases.’” 25 Garrison v. Colvin, 759 F.3d 995, 1015 (9th Cir. 2014) (quoting Moore v. Comm’r 26 Soc. Sec. Admin., 278 F.3d 920, 924 (9th Cir. 2002)). 27 28 “‘If a treating or examining doctor’s opinion is contradicted by another doctor’s opinion, an ALJ may only reject it by providing specific and legitimate 10 1 reasons that are supported by substantial evidence.’” Trevizo, 871 F.3d at 675 2 (quoting Ryan, 528 F.3d at 1198). “This is so because, even when contradicted, a 3 treating or examining physician’s opinion is still owed deference and will often be 4 ‘entitled to the greatest weight . . . even if it does not meet the test for controlling 5 weight.’” Garrison, 759 F.3d at 1012 (quoting Orn v. Astrue, 495 F.3d 625, 633 6 (9th Cir. 2007)). “‘The ALJ can meet this burden by setting out a detailed and 7 thorough summary of the facts and conflicting clinical evidence, stating his 8 interpretation thereof, and making findings.’” Trevizo, 871 F.3d at 675 (quoting 9 Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)). 10 4. 11 ALJ’s Decision Is Not Supported By Substantial Evidence As an initial matter, the ALJ did not find that Drs. Pattara’s, Khurana’s, and 12 Ryu’s opinions were contradicted by the opinions of another doctor.4 Therefore, 13 the clear and convincing standard applies here. Trevizo, 871 F.3d 675. Moreover, 14 to the extent that Defendant argues that the ALJ did not err by rejecting Drs. 15 Pattara’s, Khurana’s, and Ryu’s opinions because a CE, Dr. Sohini, opined that 16 Plaintiff had only mild impairments in some of her mental abilities, the Court is not 17 persuaded. As discussed above, the ALJ must provide either specific and 18 legitimate, or clear and convincing reasons to reject a treating or examining 19 doctor’s opinion. Here, none of the three reasons provide by the ALJ for rejecting 20 Drs. Pattara’s, Khurana’s, and Ryu’s opinions meet either test. 21 a. 22 ALJ’s First Reason Fails With respect to the ALJ’s first reason for rejecting Drs. Pattara’s, 23 Khurana’s, and Ryu’s opinions—that their opinions were not consistent with the 24 medical evidence record as a whole—this reason fails because it provides no 25 information about which facts and evidence in the record were inconsistent with 26 27 28 4 The ALJ gave “significant weight” to the opinions of the state Disability Department Services (“DDS”) consultative examiners (“CE”). Tr. 33. However, the ALJ did not make specific findings of how these doctors’ opinions contradicted those of Drs. Khurana, Ryu, or Pattara. Trevizo, 871 F.3d at 675 (quoting Magallanes, 881 F.2d at 751). 11 1 which findings the doctors made. Thus, because the ALJ’s wholesale rejection of 2 the three doctor’s opinions due to inconsistencies with the record as a whole 3 includes no summary of the conflicting evidence, interpretations of that specific 4 evidence, or specific findings about that evidence, the Court finds that the first 5 reason provided by the ALJ for rejecting Drs. Pattara’s, Khurana’s, and Ryu’s 6 opinions was neither clear and convincing, nor specific and legitimate. Trevizo, 7 871 F.3d at 675 (quoting Magallanes, 881 F.2d 751). Moreover, to the extent the 8 ALJ went on to reject Dr. Pattara’s opinions due to inconsistencies with his own 9 treatment notes, and Drs. Khurana’s and Ryu’s opinions because they were too 10 extreme in light of the ADLs noted by Dr. Pattara, the Court is similarly 11 unpersuaded by the ALJ’s reasoning. 12 With respect to the ALJ finding that Dr. Pattara’s opinions were inconsistent 13 with his own treatment notes, the ALJ failed to identify which of Dr. Pattara’s 14 opinions were inconsistent with which of Dr. Pattara’s treatment notes. This bare 15 assertion that is void of any specific facts or explanation does not amount to a clear 16 and convincing, or even a specific and legitimate, reason for assigning little weight 17 to Drs. Pattara’s opinions. See Garrison, 759 F.3d at 1012 (“The ALJ must do 18 more than state conclusions. He must set forth his own interpretations and explain 19 why they, rather than the doctor’s, are correct.”); see also id. at 1012-13 (“[A]n 20 ALJ errs when he rejects a medical opinion or assigns it little weight while doing 21 nothing more than ignoring it, asserting without explanation that another medical 22 opinion is more persuasive, or criticizing it with boilerplate language that fails to 23 offer a substantive basis for his conclusion.” (citing Nguyen v. Chater, 100 F.3d 24 1462, 1464 (9th Cir. 1996))). 25 However, to be sure, the Court searched for inconsistencies in the record 26 between Dr. Pattara’s noted observations and the opinions Dr. Pattara ultimately 27 endorsed and found that the only identifiable inconsistencies indicate that 28 Plaintiff’s ADLs appear to be more limited than Dr. Pattara concluded. For 12 1 example, as the ALJ correctly noted, Dr. Pattara found that Plaintiff could “bath 2 ok, dress ok, cook ok, drive ok, shop ok, use of fund ok.” Tr. 29, 30, 33, 35 3 (citations and quotation marks omitted). An inspection of the record, however, 4 reveals that Dr. Pattara noted that Plaintiff presented to examinations “in unclean 5 and untidy clothes. She does not groom her hair properly. She has a foul smell and 6 poor body hygiene.” Tr. 332. Elsewhere in the record, Dr. Pattara noted that 7 Plaintiff presented “in untidy and unclean clothes” and that she “was brought to 8 office by her friend as [Plaintiff] [wa]s unable to drive a car” at that time. Tr. 468- 9 69. Finally, Dr. Pattara noted on another occasion that “[Plaintiff] is brought to 10 this office by her relative as she is unable to drive a car. She is in untidy and 11 unclean clothes.” Tr. 500. 12 Thus, on the record before the Court, the only inconsistencies between Dr. 13 Pattara’s observations and the limitations Dr. Pattara ultimately endorsed appear to 14 indicate a diminished capacity to adequately perform all the ADLs endorsed by Dr. 15 Pattara, as cited by the ALJ. On remand, the Agency shall identify which of Dr. 16 Pattara’s notes conflict with which of Dr. Pattara’s opinions. 17 With respect to the ALJ’s finding that Drs. Khurana’s and Ryu’s opinions 18 were too extreme in light of the ADLs noted by Dr. Pattara, again, the ALJ 19 provided no interpretation of how the ADLs noted by Dr. Pattara undercut Drs. 20 Khurana’s and Ryu’s opinions. Trevizo, 871 F.3d at 675 (quoting Magallanes, 881 21 F.2d 751); see also Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) 22 (“[D]isability claimants should not be penalized for attempting to lead normal lives 23 in the face of their limitations.”); Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989) 24 (“The . . . Act does not require that claimants be utterly incapacitated to be eligible 25 for benefits, . . . and many home activities are not easily transferable to what may be 26 the more grueling environment of the workplace, where it might be impossible to 27 periodically rest or take medication.”). Moreover, as discussed above, Plaintiff’s 28 ADLs appear to be more limited than Dr. Pattara concluded. 13 1 Thus, even assuming that Plaintiff was able to perform all the ADLs noted by 2 Dr. Pattara throughout the relevant time period, because the ALJ did not articulate 3 how Plaintiff’s ability to perform these ADLs undercuts Drs. Khurana’s and Ryu’s 4 opinions, this was not a clear and convincing, or a specific and legitimate, reason 5 for assigning little weight to Drs. Khurana’s and Ryu’s opinions. See Garrison, 759 6 F.3d at 1012-13. 7 8 b. ALJ’s Second And Third Reasons Fail With respect to the ALJ’s second and third reasons for rejecting Drs. 9 Pattara’s, Khurana’s, and Ryu’s opinions—because the doctors are not familiar 10 with the Administration’s disability guidelines, and because the finding of being 11 disabled are reserved for the Commissioner—the Court finds that these were not 12 clear and convincing, nor specific and legitimate, reasons for rejecting the doctors’ 13 opinions. 14 “Medical opinions are statements from acceptable medical sources that 15 reflect judgments about the nature and severity of [a claimant’s] impairment(s), 16 including [the claimant’s] symptoms, diagnosis and prognosis, what [the claimant] 17 can still do despite impairment(s), and [the claimant’s] physical or mental 18 restrictions.” 20 C.F.R. § 416.927(a)(1). “In determining whether [a claimant is] 19 disabled, [the Administration] will always consider the medical opinions in [the 20 claimant’s] case record together with the rest of the relevant evidence [the 21 Administration] receive[s].” Id. at § 416.927(b). 22 “Opinions on some issues, . . . are not medical opinions, . . . but are, instead, 23 opinions on issues reserved to the Commissioner because they are administrative 24 findings that are dispositive of a case; i.e., that would direct the determination or 25 decision of disability.” Id. at § 416.927(d). One issue reserved for the 26 Commissioner is “[o]pinions that [the claimant is] disabled.” Id. at 27 § 416.927(d)(1). “Although the Administration consider[s] opinions from medical 28 sources on issues such as whether [a claimant’s] impairment(s) meets or equals the 14 1 requirements of any impairment(s) in the Listing[s] . . . , [RFC] . . . , or the 2 application of vocational factors, the final responsibility for deciding these issues is 3 reserved to the Commissioner.” Id. at § 416.927(d)(2). In determining whether a 4 claimant meets the statutory definition of disability, “[the Administration] 5 review[s] all of the medical findings and other evidence that support a medical 6 source’s statement that [a claimant is] disabled.” Id. at § 416.927(d)(1). 7 Here, the regulations required the Administration to consider all the 8 medical opinions in Plaintiff’s case record to determine whether Plaintiff was 9 disabled under the Act. Id. at §§ 416.927(b), 416.927(d)(1). The regulations, 10 however, carved out an exception for opinions relating to the ultimate 11 determination of disability under the Act. Id. at § 416.927(d)(1). Therefore, the 12 ALJ was not obligated to accept Drs. Pattara’s, Khurana’s, and Ryu’s opinions 13 regarding whether Plaintiff was disabled under the Act, because that determination 14 is reserved for the Administration. Id. The carved-out exception for opinions 15 relating to the ultimate determination of disability under the Act, however, do not 16 negate the Administration’s duty to consider the remainder of the doctors’ 17 opinions that reflected judgments about the nature and severity of Plaintiff’s 18 impairment. Therefore, the Administration’s authority to determine the ultimate 19 issue of whether Plaintiff is disabled under the Act, as granted in 20 C.F.R. 20 § 416.927(d)(1), was not a clear and convincing or a specific and legitimate reason 21 to reject the portions of Drs. Pattara’s, Khurana’s, and Ryu’s opinions that 22 reflected judgments about the nature and severity of Plaintiff’s impairment, and 23 that the ALJ was required to consider under 20 C.F.R. §§ 416.927(b) and 24 416.927(d)(1). 25 Moreover, the regulations do not require—and Defendant points to no 26 authority demonstrating—that doctors who provide opinions reflecting judgments 27 about the nature and severity of a claimant’s impairments must be familiar with the 28 Administration’s disability guidelines. Thus, the court finds that the doctors’ 15 1 alleged ignorance of the Administration’s disability guidelines was not a clear and 2 convincing or a specific and legitimate reason to reject Drs. Pattara’s, Khurana’s, 3 and Ryu’s opinions. 4 c. ALJ’s Rejection Of GAF Scores Fails 5 Finally, the ALJ’s rejection of the GAF scores assessed by Drs. Pattara and 6 Ryu is not supported by substantial evidence. To the extent the ALJ rejected the 7 GAF scores because they do not accurately reflect Plaintiff’s functional abilities, 8 the ALJ fails to provide any explanation of how these scores are inconsistent with 9 Plaintiff’s functional limitations. See Garrison, 759 F.3d at 1012-13. (“The ALJ 10 must do more than state conclusions. He must set forth his own interpretations 11 and explain why they, rather than the doctor’s, are correct.”); see also id. at 1012- 12 13 (“[A]n ALJ errs when he rejects a medical opinion or assigns it little weight 13 while doing nothing more than ignoring it, asserting without explanation that 14 another medical opinion is more persuasive, or criticizing it with boilerplate 15 language that fails to offer a substantive basis for his conclusion.”) (citing Nguyen 16 v. Chater, 100 F.3d 1462, 1464 (9th Cir. 1996)). 17 Moreover, to the extent the ALJ rejected the GAF scores because they “do 18 correlate with the . . . Administration’s precise disability guidelines, including the B 19 and C criteria of the listings or an RFC[,]” Defendant does not present—and the 20 Court cannot find—any authority demonstrating that evidence which correlates 21 with the Administration’s disability guidelines should be rejected. Conversely, it 22 seems that evidence correlating with the Administration’s disability guidelines 23 would support a finding of disability. 24 Lastly, to the extent the ALJ rejected the GAF scores because they were a 25 “snapshot in time[,]” this fails to “consider factors such as the length of the 26 treating relationship, the frequency of examination, the nature and extent of the 27 treatment relationship” that Drs. Pattara and Ryu had with Plaintiff. Trevizo, 871 28 F. 3d at 676 (citing 20 C.F.R. § 404.1527(c)(2)-(6)). This lack of discussion 16 1 regarding: (1) the length of Plaintiff’s treatment relationship with Drs. Pattara and 2 Ryu; (2) the fact that Plaintiff saw, at least, Dr. Pattara frequently; and (3) the 3 nature or extent of Plaintiff’s visits with these doctors, also constitutes reversible 4 error. See id., (ALJ’s “fail[ure] to apply the appropriate factors . . . such as the 5 length of the treating relationship, the frequency of examination, the nature and 6 extent of the treatment relationship, or the supportability of the opinion” when 7 “determining the extent to which the [plaintiff’s treating doctor’s] opinion should 8 be credited . . . alone constitutes reversible legal error.”). 9 Accordingly, because the ALJ’s rejection of Drs. Pattara’s, Khurana’s, and 10 Ryu’s opinions was not supported by clear and convincing or specific and 11 legitimate reasons, the Court finds that the ALJ’s decision is not supported by 12 substantial evidence. As such, the Court does not address Plaintiff’s remaining 13 assignments of error. 14 IV. CONCLUSION 15 Because the Commissioner’s decision is not supported by substantial 16 evidence, IT IS HEREBY ORDERED that the Commissioner’s decision is 17 REVERSED and this case is REMANDED for further administrative proceedings 18 under sentence four of 42 U.S.C. § 405(g). See Garrison, 759 F.3d at 1009 19 (holding that under sentence four of 42 U.S.C. § 405(g), “[t]he court shall have 20 power to enter . . . a judgment affirming, modifying, or reversing the decision of the 21 Commissioner . . . , with or without remanding the cause for a rehearing.”) 22 (citation and internal quotation marks omitted). 23 IT IS SO ORDERED. 24 25 26 27 DATED: 1/10/2019 ________________________________ HONORABLE SHASHI H. KEWALRAMANI United States Magistrate Judge 28 17
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