Cardenas v. Saul, No. 1:2019cv03259 - Document 18 (E.D. Wash. 2020)
Court Description: ORDER GRANTING 14 PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT; denying 15 Defendant's Motion for Summary Judgment. Signed by Chief Judge Stanley A Bastian. (SG, Case Administrator)
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Cardenas v. Saul Doc. 18 1 2 3 FI LED I N THE U.S. DI STRI CT COURT EASTERN DI STRI CT OF WASHI NGTON 4 Sep 22, 2020 5 SEAN F. MCAVOY, CLERK 6 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 7 8 RENE C., No: 1:19-CV-03259-FVS Plaintiff, 9 v. 10 11 ANDREW M. SAUL, Commissioner of the Social Security Administration, 12 Defendant. ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT 13 14 15 BEFORE THE COURT are the parties’ cross-motions for summary 16 judgment. ECF Nos. 14, 15. This matter was submitted for consideration without 17 oral argument. Plaintiff is represented by attorney D. James Tree. Defendant is 18 represented by Special Assistant United States Attorney Benjamin J. Groebner. 19 The Court, having reviewed the administrative record and the parties’ briefing, is 20 fully informed. For the reasons discussed below, the Court GRANTS, in part, 21 Plaintiff’s Motion for Summary Judgment, ECF No. 14, DENIES Defendant’s ORDER ~ 1 Dockets.Justia.com 1 Motion for Summary Judgment, ECF No. 15, and REMANDS the case for 2 additional proceedings consistent with this Order. 3 4 JURISDICTION Plaintiff Rene C. 1 filed an application for Supplemental Security Income 5 (SSI) on September 19, 2016, Tr. 92, alleging disability since December 1, 2015, 6 Tr. 201, due to back injury/pain, left ankle injury, depression, and anxiety, Tr. 219. 7 Benefits were denied initially, Tr. 111-19, and upon reconsideration, Tr. 123-29. 8 A hearing before Administrative Law Judge Tom L. Morris (“ALJ”) was 9 conducted on March 16, 2018. Tr. 33-77. Plaintiff was represented by counsel 10 and testified at the hearing. Id. The ALJ also took the testimony of vocational 11 expert Carrie Whitlow. Id. The ALJ denied benefits on August 23, 2018. Tr. 15- 12 27. The Appeals Council denied Plaintiff’s request for review on September 12, 13 2019. Tr. 1-6. The matter is now before this Court pursuant to 42 U.S.C. §§ 14 405(g), 1383(c)(3). 15 BACKGROUND 16 The facts of the case are set forth in the administrative hearing and 17 transcripts, the ALJ’s decision, and the briefs of Plaintiff and the Commissioner. 18 19 1 In the interest of protecting Plaintiff’s privacy, the Court will use Plaintiff’s 20 first name and last initial, and, subsequently, Plaintiff’s first name only, throughout 21 this decision. ORDER ~ 2 1 2 Only the most pertinent facts are summarized here. Plaintiff was 44 years old at the date of application. Tr. 201. The highest 3 grade he completed was the seventh. Tr. 220. Plaintiff’s past work includes jobs 4 as a cement finisher, a laborer, a pipe layer, and an operator of a top cutter 5 machine. Id. At application, he stated that he stopped working on September 1, 6 2009, due to his conditions. Tr. 219. 7 8 9 STANDARD OF REVIEW A district court’s review of a final decision of the Commissioner of Social Security is governed by 42 U.S.C. § 405(g). The scope of review under § 405(g) is 10 limited; the Commissioner’s decision will be disturbed “only if it is not supported 11 by substantial evidence or is based on legal error.” Hill v. Astrue, 698 F.3d 1153, 12 1158 (9th Cir. 2012). “Substantial evidence” means “relevant evidence that a 13 reasonable mind might accept as adequate to support a conclusion.” Id. at 1159 14 (quotation and citation omitted). Stated differently, substantial evidence equates to 15 “more than a mere scintilla[,] but less than a preponderance.” Id. (quotation and 16 citation omitted). In determining whether the standard has been satisfied, a 17 reviewing court must consider the entire record as a whole rather than searching 18 for supporting evidence in isolation. Id. 19 In reviewing a denial of benefits, a district court may not substitute its 20 judgment for that of the Commissioner. “The court will uphold the ALJ's 21 conclusion when the evidence is susceptible to more than one rational ORDER ~ 3 1 interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 2 Further, a district court will not reverse an ALJ’s decision on account of an error 3 that is harmless. Id. An error is harmless where it is “inconsequential to the 4 [ALJ’s] ultimate nondisability determination.” Id. (quotation and citation omitted). 5 The party appealing the ALJ’s decision generally bears the burden of establishing 6 that it was harmed. Shinseki v. Sanders, 556 U.S. 396, 409-10 (2009). 7 8 9 FIVE-STEP EVALUATION PROCESS A claimant must satisfy two conditions to be considered “disabled” within the meaning of the Social Security Act. First, the claimant must be “unable to 10 engage in any substantial gainful activity by reason of any medically determinable 11 physical or mental impairment which can be expected to result in death or which 12 has lasted or can be expected to last for a continuous period of not less than twelve 13 months.” 42 U.S.C. § 423(d)(1)(A). Second, the claimant’s impairment must be 14 “of such severity that he is not only unable to do his previous work[,] but cannot, 15 considering his age, education, and work experience, engage in any other kind of 16 substantial gainful work which exists in the national economy.” 42 U.S.C. § 17 423(d)(2)(A). 18 The Commissioner has established a five-step sequential analysis to 19 determine whether a claimant satisfies the above criteria. See 20 C.F.R. § 20 416.920(a)(4)(i)-(v). At step one, the Commissioner considers the claimant’s work 21 activity. 20 C.F.R. § 416.920(a)(4)(i). If the claimant is engaged in “substantial ORDER ~ 4 1 gainful activity,” the Commissioner must find that the claimant is not disabled. 20 2 C.F.R. § 416.920(b). 3 If the claimant is not engaged in substantial gainful activity, the analysis 4 proceeds to step two. At this step, the Commissioner considers the severity of the 5 claimant’s impairment. 20 C.F.R. § 416.920(a)(4)(ii). If the claimant suffers from 6 “any impairment or combination of impairments which significantly limits [his] 7 physical or mental ability to do basic work activities,” the analysis proceeds to step 8 three. 20 C.F.R. § 416.920(c). If the claimant’s impairment does not satisfy this 9 severity threshold, however, the Commissioner must find that the claimant is not 10 11 disabled. 20 C.F.R. § 416.920(c). At step three, the Commissioner compares the claimant’s impairment to 12 severe impairments recognized by the Commissioner to be so severe as to preclude 13 a person from engaging in substantial gainful activity. 20 C.F.R. § 14 416.920(a)(4)(iii). If the impairment is as severe or more severe than one of the 15 enumerated impairments, the Commissioner must find the claimant disabled and 16 award benefits. 20 C.F.R. § 416.920(d). 17 If the severity of the claimant’s impairment does not meet or exceed the 18 severity of the enumerated impairments, the Commissioner must pause to assess 19 the claimant’s “residual functional capacity.” Residual functional capacity 20 (“RFC”), defined generally as the claimant’s ability to perform physical and 21 mental work activities on a sustained basis despite his limitations, 20 C.F.R. § ORDER ~ 5 1 2 416.945(a)(1), is relevant to both the fourth and fifth steps of the analysis. At step four, the Commissioner considers whether, in view of the claimant’s 3 RFC, the claimant is capable of performing work that he or she has performed in 4 the past (past relevant work). 20 C.F.R. § 416.920(a)(4)(iv). If the claimant is 5 capable of performing past relevant work, the Commissioner must find that the 6 claimant is not disabled. 20 C.F.R. § 416.920(f). If the claimant is incapable of 7 performing such work, the analysis proceeds to step five. 8 At step five, the Commissioner considers whether, in view of the claimant’s 9 RFC, the claimant is capable of performing other work in the national economy. 10 20 C.F.R. § 416.920(a)(4)(v). In making this determination, the Commissioner 11 must also consider vocational factors such as the claimant’s age, education, and 12 past work experience. 20 C.F.R. § 416.920(a)(4)(v). If the claimant is capable of 13 adjusting to other work, the Commissioner must find that the claimant is not 14 disabled. 20 C.F.R. § 416.920(g)(1). If the claimant is not capable of adjusting to 15 other work, analysis concludes with a finding that the claimant is disabled and is 16 therefore entitled to benefits. 20 C.F.R. § 416.920(g)(1). 17 The claimant bears the burden of proof at steps one through four. Tackett v. 18 Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). If the analysis proceeds to step five, 19 the burden shifts to the Commissioner to establish that (1) the claimant is capable 20 of performing other work; and (2) such work “exists in significant numbers in the 21 national economy.” 20 C.F.R. § 416.960(c)(2); Beltran v. Astrue, 700 F.3d 386, ORDER ~ 6 1 389 (9th Cir. 2012). 2 THE ALJ’S FINDINGS 3 At step one, the ALJ found that Plaintiff has not engaged in substantial 4 gainful activity since September 19, 2016, the application date. Tr. 17. At step 5 two, the ALJ found that Plaintiff has the following severe impairments: spine 6 disorder; left ankle injury; obesity; affective disorder; anxiety disorder; 7 somatoform disorder; alcohol and substance addiction disorders. Tr. 17. At step 8 three, the ALJ found that Plaintiff does not have an impairment or combination of 9 impairments that meets or medically equals the severity of a listed impairment. Tr. 10 17. The ALJ then found that Plaintiff has the RFC to perform light work as 11 defined in 20 C.F.R. § 416.967(b) except he has the following limitations: 12 13 14 15 16 17 18 19 the claimant can lift and/or carry 20 pounds occasionally and 10 pounds frequently. He can stand and/or walk (with normal breaks) for a total of about four hours in an eight-hour workday. He can work on tasks that permits a sit stand option. He can sit (with normal breaks) for a total [of] about six hours in an eight-hour workday. He can frequently balance, kneeling, and crouching. He can occasionally climb ramps, stairs, ladders, ropes, and scaffolds. He can occasionally stoop, and crawl. He must avoid concentrated exposure to hazards such as dangerous machinery, and unprotected heights. He must avoid concentrated exposure to vibrations. He may be off tasks up to 10 percent over the course of an eight-hour workday. Tr. 19. At step four, the ALJ identified Plaintiff’s past relevant work as a 20 construction worker, a farm machine operator, and a flagger, and found that he is 21 not capable of performing his past relevant work. Tr. 25. At step five, the ALJ ORDER ~ 7 1 found that considering Plaintiff’s age, education, work experience, and RFC, there 2 were other jobs that exist in significant numbers in the national economy that 3 Plaintiff could perform, including: assembler production; inspector and hand 4 packager; and parking lot attendant. Tr. 26. On that basis, the ALJ concluded that 5 Plaintiff was not under a disability, as defined in the Social Security Act, from 6 September 19, 2016, the date of application, through the date of his decision. Tr. 7 27. 8 ISSUES 9 Plaintiff seeks judicial review of the Commissioner’s final decision denying 10 him SSI under Title XVI. ECF No. 14. Plaintiff raises the following issues for 11 this Court’s review: 12 1. Whether the ALJ erred in weighing the medical source opinions; 13 2. Whether the ALJ properly considered Plaintiff’s symptom claims; and 14 3. Whether the ALJ made a proper step four determination. 15 16 17 18 19 DISCUSSION 1. Medical Source Opinions Plaintiff challenges the weight the ALJ assigned to the medical opinions of K. Scott Reinmuth, M.D. and Alexander Patterson, Psy.D. ECF No. 14 at 8-13. If a treating or examining physician's opinion is uncontradicted, the ALJ 20 may reject it only by offering “clear and convincing reasons that are supported by 21 substantial evidence.” Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005). ORDER ~ 8 1 Conversely, “[i]f a treating or examining doctor's opinion is contradicted by 2 another doctor's opinion, an ALJ may only reject it by providing specific and 3 legitimate reasons that are supported by substantial evidence.” Id. (citing Lester v. 4 Chater, 81 F.3d 821, 830-31 (9th Cir. 1995)). Social Security Ruling (S.S.R.) 96- 5 8p states that the RFC assessment “must always consider and address medical 6 source opinions. If the RFC assessment conflicts with an opinion from a medical 7 source, the adjudicator must explain why the opinion was not adopted.” 8 A. 9 On March 30, 2017, Dr. Reinmuth completed a Medical Report form. Tr. K. Scott Reinmuth, M.D. 10 364-65. He opined that Plaintiff would need to lie down and stretch during the day 11 for 45 minutes at a time. Tr. 364. He also opined that regular and continues work 12 would cause Plaintiff’s condition to deteriorate. Tr. 365. He further opined that 13 Plaintiff would likely miss four or more days per month if he attempted to work a 14 40-hour a week schedule. Id. He stated that Plaintiff’s limitations had been 15 present since late 2015 or early 2016. Id. 16 The ALJ gave the opinion little weight because Plaintiff’s reported activities 17 were consistent with the ability to perform medium and light work. Tr. 24. A 18 claimant's testimony about his daily activities may be seen as inconsistent with the 19 presence of a disabling condition. See Curry v. Sullivan, 925 F.2d 1127, 1130 (9th 20 Cir. 1990). Here, the ALJ focuses on Plaintiff’s abilities to make simple meals, do 21 the laundry, wash dishes, take out the trash, mow the lawn, sweep, vacuum, and go ORDER ~ 9 1 grocery shopping. Tr. 24. Additionally, the ALJ cited Plaintiff’s testimony of 2 helping his mother with her home chores, taking her to the store, and providing 3 verbal guidance for his disabled brother. Id. The ALJ supported his rejection of 4 Dr. Reinmuth’s opinion by stating that “[t]hese abilities are consistent with the 5 ability to perform work at the medium exertional level. These abilities are 6 consistent with the ability to perform work at the light exertional level.” Id. 7 However, the ALJ failed to state how Plaintiff’s activities are inconsistent with Dr. 8 Reinmuth’s opinion. The ALJ’s finding that Plaintiff’s activities are consistent 9 with medium and light exertional work fails to demonstrate any inconsistencies 10 with the opinion itself. Dr. Reinmuth did not limit Plaintiff to a specific exertional 11 range, but stated Plaintiff would need additional breaks and would likely miss 12 work if attempting to work full time. Tr. 364-65. Therefore, the ability to perform 13 household chores in a manner that would allow for these breaks is not inconsistent 14 with Dr. Reinmuth’s opinion. See Trevizo v. Berryhill, 871 F.3d 664, 682 (9th Cir. 15 2017). Therefore, this case is remanded for additional proceedings to allow the 16 ALJ to properly evaluate the opinion. 17 B. 18 On November 16, 2016, Dr. Patterson competed a consultative evaluation of Alexander Patterson, Psy.D. 19 Plaintiff. Tr. 338-42. Dr. Patterson diagnosed Plaintiff with adjustment disorder 20 with depressed mood, somatic symptom disorder, and cocaine use disorder in 21 sustained full remission. Tr. 341. He opined that Plaintiff “would have difficulty ORDER ~ 10 1 completing a normal workday without interruptions from his psychiatric condition 2 due to severe depression symptoms,” and “would have difficulty dealing with the 3 usual stress encountered in the workplace due to his chronic high level of 4 emotional distress and resigned demeanor.” Tr. 342. The ALJ gave little weight to 5 the opinion because it was based on Plaintiff’s self-reports and because he did not 6 participate in any mental health treatment. Tr. 25. The ALJ also implied that the 7 opinion was not supported by the evidence. Tr. 25. 8 The ALJ’s first reason for rejecting the opinion, that it was based on 9 Plaintiff’s self-reports, is not specific and legitimate. A doctor’s opinion may be 10 discounted if it relies on a claimant’s unreliable self-report. Bayliss, 427 F.3d at 11 1217; Tommasetti, 533 F.3d at 1041. But the ALJ must provide the basis for his 12 conclusion that the opinion was based on a claimant’s self-reports. Ghanim v. 13 Colvin, 763 F.3d 1154, 1162 (9th Cir. 2014). Here, the ALJ provided no such 14 basis for his conclusion. Therefore, this reason fails to meet the specific and 15 legitimate standard. 16 The ALJ’s second reason for rejecting the opinion, that Plaintiff did not 17 participate in mental health treatment, is not specific and legitimate. The Ninth 18 Circuit has found that “it is a questionable practice to chastise one with a mental 19 impairment for the exercise of poor judgment in seeking rehabilitation.” Nguyen v. 20 Chater, 100 F.3d 1462, 1465 (9th Cir. 1996). Simply because Plaintiff failed to 21 seek treatment for mental health impairments does not mean that the impairments ORDER ~ 11 1 did not limit his abilities. Therefore, this reason does not meet the specific and 2 legitimate standard. 3 The ALJ then implied that Dr. Patterson’s opinion was not supported by the 4 medical evidence by stating that “[d]espite his complaints, the claimant was 5 oriented to time, place, person, and situation, had appropriate mood and affect and 6 was cooperating during his examinations.” Tr. 25. However, implied reasons do 7 not meet the specific and legitimate standard. Therefore, this is insufficient to 8 support the ALJ’s rejection of the opinion. Upon remand, the ALJ will also 9 readdress Dr. Patterson’s opinion. 10 11 12 13 2. Plaintiff’s Symptom Statements Plaintiff challenges the ALJ’s treatment of his symptom statements. ECF No. 14 at 18-21. It is generally the province of the ALJ to make determinations regarding the 14 reliability of Plaintiff’s symptom statements, Andrews v. Shalala, 53 F.3d 1035, 15 1039 (9th Cir. 1995), but the ALJ’s findings must be supported by specific cogent 16 reasons, Rashad v. Sullivan, 903 F.2d 1229, 1231 (9th Cir. 1990). Absent 17 affirmative evidence of malingering, the ALJ’s reasons for rejecting the claimant’s 18 testimony must be “specific, clear and convincing.” Smolen v. Chater, 80 F.3d 19 1273, 1281 (9th Cir. 1996); Lester, 81 F.3d at 834. “General findings are 20 insufficient: rather the ALJ must identify what testimony is not credible and what 21 evidence undermines the claimant’s complaints.” Lester, 81 F.3d at 834. ORDER ~ 12 1 The ALJ found Plaintiff’s “statements concerning the intensity, persistence, 2 and limiting effects of these symptoms are not entirely consistent with the medical 3 evidence and other evidence in the record for the reasons explained in this 4 decision.” Tr. 20. The ALJ provided two reasons for rejecting Plaintiff’s 5 symptom statements: (1) that the objective medical evidence did not support 6 Plaintiff’s allegations regarding the severity of his impairments, Tr. 20; and (2) 7 Plaintiff’s own statements regarding his physical and mental limitations were 8 inconsistent with his reported activities, Tr. 23. 9 The ALJ’s first reason for rejecting Plaintiff’s symptom statements, that they 10 were inconsistent with the objective medical evidence, is not specific, clear and 11 convincing. Objective medical evidence is a “relevant factor in determining the 12 severity of the claimant’s pain and its disabling effects,” but it cannot serve as the 13 only reason for rejecting a claimant’s symptom statements. Rollins v. Massanari, 14 261 F.3d 853, 857 (9th Cir. 2001). As addressed below, the ALJ failed to provide 15 other reasons that met the specific, clear and convincing standard. Therefore, this 16 reason alone cannot support the ALJ’s rejection of Plaintiff’s symptom statements. 17 The ALJ’s second reason for rejecting Plaintiff’s symptom statements, that 18 they were inconsistent with Plaintiff’s reported activities, is not specific, clear and 19 convincing. The ALJ found that Plaintiff’s testimony that he helped his mother 20 with chores and by taking her to the store undermined his symptom statements. Tr. 21 23. He also found that Plaintiff helping with his disabled brother by providing ORDER ~ 13 1 guidance was inconsistent with his reported limitations. Id. The Ninth Circuit has 2 warned ALJs against using simple household activities against a person when 3 evaluating their testimony: 4 We have repeatedly warned that ALJs must be especially cautious in concluding that daily activities are inconsistent with testimony about pain, because impairments that would unquestionably preclude work and all the pressures of a workplace environment will often be consistent with doing more than merely resting in bed all day. 5 6 7 Garrison v. Colvin, 759 F.3d 995, 1016 (9th Cir. 2014). Therefore, this reason is 8 insufficient to meet the specific, clear and convenience standard. 9 Defendant argues that the ALJ also rejected Plaintiff’s symptom statements 10 because they were unsupported by Plaintiff’s course of treatment. ECF No. 15 at 11 4. The ALJ did state that Plaintiff did not pursue treatment options presented by 12 providers. Tr. 23. However, the ALJ provided this information as part of his 13 summary of the medical evidence, and not as a distinct reason for rejecting 14 Plaintiff’s statements. As such, Defendant’s assertion is a post hoc rationalization, 15 which will not be considered by this Court. See Orn v. Astrue, 495 F.3d 625, 630 16 (9th Cir. 2007) (The Court will “review only the reasons provided by the ALJ in 17 the disability determination and may not affirm the ALJ on a ground upon which 18 he did not rely.”). 19 20 21 Upon remand, the ALJ will readdress Plaintiff’s symptom statements. 3. Step Five Plaintiff also challenges the ALJ’s step five determination by arguing that ORDER ~ 14 1 the numbers provide by the vocational expert were unsupported. ECF No. 14 at 2 13-18. 3 Since the ALJ has been instructed to readdress the medical opinions in the 4 record and Plaintiff’s symptom statements, a new RFC determination will be 5 required. 20 C.F.R. § 416.945. A new RFC determination means the ALJ will 6 also have to make a new step four and a new step five determination. Upon 7 remand, the ALJ will call a vocational expert to provide testimony at steps four 8 and, if necessary, step five. 9 CONCLUSION 10 The decision whether to remand for further proceedings or reverse and 11 award benefits is within the discretion of the district court. McAllister v. Sullivan, 12 888 F.2d 599, 603 (9th Cir. 1989). An immediate award of benefits is appropriate 13 where “no useful purpose would be served by further administrative proceedings, 14 or where the record has been thoroughly developed,” Varney v. Sec'y of Health & 15 Human Servs., 859 F.2d 1396, 1399 (9th Cir. 1988), or when the delay caused by 16 remand would be “unduly burdensome[.]” Terry v. Sullivan, 903 F.2d 1273, 1280 17 (9th Cir. 1990); see also Garrison, 759 F.3d at 1021 (noting that a district court 18 may abuse its discretion not to remand for benefits when all of these conditions are 19 met). This policy is based on the “need to expedite disability claims.” Varney, 20 859 F.2d at 1401. But where there are outstanding issues that must be resolved 21 before a determination can be made, and it is not clear from the record that the ALJ ORDER ~ 15 1 would be required to find a claimant disabled if all the evidence were properly 2 evaluated, remand is appropriate. See Benecke v. Barnhart, 379 F.3d 587, 595-96 3 (9th Cir. 2004); Harman v. Apfel, 211 F.3d 1172, 1179-80 (9th Cir. 2000). 4 The Court finds that further administrative proceedings are appropriate. See 5 Treichler v. Comm'r of Soc. Sec. Admin., 775 F.3d 1090, 1103-04 (9th Cir. 2014) 6 (remand for benefits is not appropriate when further administrative proceedings 7 would serve a useful purpose). Here, it is not clear from the record that the ALJ 8 would be required to find a claimant disabled if all the evidence were properly 9 evaluated. Therefore, the Court remands this case for further proceedings 10 consistent with this Order. On remand, the ALJ shall weigh the opinions of Dr. Reinmuth and Dr. 11 12 Patterson, readdress Plaintiff’s symptom statements, form a new RFC, and make 13 new determinations at steps four and five. In addition, the ALJ should supplement 14 the record with any outstanding medical evidence and take the testimony of a 15 vocational expert at remand proceedings. 16 ACCORDINGLY, IT IS HEREBY ORDERED: 17 1. Plaintiff’s Motion for Summary Judgment, ECF No. 14, is GRANTED, 18 in part, and the matter is remanded for further proceedings consistent 19 with this Order. 20 /// 21 /// ORDER ~ 16 1 2. Defendant’s Motion for Summary Judgment, ECF No. 15 is DENIED. 2 The District Court Executive is hereby directed to enter this Order and 3 provide copies to counsel, enter judgment in favor of the Plaintiff, and CLOSE the 4 file. 5 DATED: September 22, 2020. 6 7 8 9 10 Stanley A. Bastian Chief United States District Judge 11 12 13 14 15 16 17 18 19 20 21 ORDER ~ 17
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