1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 | ARTHUR C.,! Case No. 5:18-cv-01948-MAA Plaintiff, 13 MEMORANDUM DECISION AND Vv. ORDER REVERSING DECISION OF 14 THE COMMISSIONER AND REMANDING FOR FURTHER 15 | ANDREW M. SAUL-2 ADMINISTRATIVE PROCEEDINGS Commissioner of Social Security, Defendant. 17 18 19 On September 12, 2018, Plaintiff filed a Complaint seeking review of the 20 || Social Security Commissioner’s final decision denying his application for 21 || Supplemental Security Income pursuant to Title XVI of the Social Security Act. 22 || This matter is fully briefed and ready for decision. For the reasons discussed 23 || below, the Commissioner’s final decision is reversed, and this action is remanded 24 || for further administrative proceedings. 25 | | Plaintiff's name is partially redacted in accordance with Federal Rule of Civil Procedure > 2(c)(2}t ) and the recommendation of the Committee on Court 26 Administration and Case Management of the Judicial Conference of the United 34 tates. 2 The Commissioner of Social Security is substituted as the Defendant pursuant to 28 | Federal Rule of Civil Procedure 25(d).
1 PROCEDURAL HISTORY 2 On March 4, 2013, an Administrative Law Judge (“prior ALJ”) denied 3 || Plaintiffs disability claim by a written decision. (AR 151-61.) On September 12, 4 || 2014, the Appeals Council denied Plaintiffs request for review. (AR 166-70.) 5 || Plaintiff did not seek review in federal court of the prior ALJ’s March 4, 2013 6 || decision. 7 On October 3, 2014, Plaintiff protectively filed another application for 8 || Supplemental Security Income, which is the subject of this action. (Administrative 9 || Record [AR] 14, 288-94.) In this latest application, Plaintiff alleged disability 10 || beginning on October 3, 2014 (AR 87) due to depression, severe lower back pain, 11 || high blood pressure, pain in both feet, severe neck pain, severe hip pain, anxiety, 12 || sleep apnea, schizophrenia, bipolar disorder, anger outbursts, and trouble getting 13 || along with people (AR 171-72, 189-90). 14 After the application was denied initially and upon reconsideration, Plaintiff 15 || requested a hearing before an ALJ (“present ALJ” or “ALJ”). (AR 226-28.) Ata 16 || hearing held on July 13, 2017, at which Plaintiff appeared with counsel, the ALJ 17 || heard testimony from Plaintiff and a vocational expert. (AR 80-98.) 18 In a decision issued on October 16, 2017, the ALJ denied Plaintiff's 19 || application. (AR 14-25.) Asa preliminary matter, the ALJ found that the prior 20 || ALJ’s decision on March 4, 2013 had created a rebuttal presumption of continuing 21 || non-disability and that Plaintiff failed to rebut the presumption by showing 22 || changed circumstances. (AR 14.) 23 The ALJ then made the following findings pursuant to the Commissioner’s 24 || five-step evaluation. Plaintiff had not engaged in substantial gainful activity since 25 || his application date of October 3, 2014. (AR 16.) He had severe impairments 26 || consisting of degenerative disc disease of the lumbar and cervical spine. (AR 17.) 27 || He did not have an impairment or combination of impairments that met or 28 || medically equaled the requirements of one of the impairments from the
1 || Commissioner’s Listing of Impairments. (AR 21.) He had a residual functional 2 || capacity to perform medium work. (/d.) He could no longer perform his past 3 || relevant work as a bus driver. (AR 23-24.) However, he could perform other work 4 || in the national economy, in the occupations of industrial cleaner, hand packager, 5 || and night cleaner. (AR 25.) Thus, the ALJ concluded that Plaintiff was not 6 || disabled as defined by the Social Security Act. (/d.) 7 On July 13, 2018, the Appeals Council denied Plaintiff's request for review. 8 || (AR 1-7.) Thus, ALJ’s decision became the final decision of the Commissioner. 9 | Plaintiff timely filed this action on September 12, 2018. (ECF No. 1.) 10 11 DISPUTED ISSUE 12 The parties raise the following disputed issue: whether the ALJ improperly 13 || rejected Plaintiff's testimony regarding pain and functional limitations. (ECF No. 14 |) 24, Parties’ Joint Stipulation [Joint Stip.”] at 2.) 15 16 STANDARD OF REVIEW 17 Under 42 U.S.C. § 405(g), the Court reviews the Commissioner’s final 18 || decision to determine whether the Commissioner’s findings are supported by 19 || substantial evidence and whether the proper legal standards were applied. See 20 || Treichler v. Commissioner of Social Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 21 || 2014). Substantial evidence means “more than a mere scintilla” but less than a 22 || preponderance. See Richardson v. Perales, 402 U.S. 389, 401 (1971); Lingenfelter 23 || v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). Substantial evidence is “such 24 || relevant evidence as a reasonable mind might accept as adequate to support a 25 || conclusion.” Richardson, 402 U.S. at 401. The Court must review the record as a 26 || whole, weighing both the evidence that supports and the evidence that detracts from 27 || the Commissioner’s conclusion. Lingenfelter, 504 F.3d at 1035. Where evidence is 28 || susceptible of more than one rational interpretation, the Commissioner’s
1 || interpretation must be upheld. See Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2 || 2007). 3 4 DISCUSSION 5 | 1. Disputed Issues. 6 A. Presumption of Continuing Non-Disability. 7 As a preliminary issue, the parties disagree as to whether the ALJ correctly 8 || found that Plaintiff failed to rebut the presumption of continuing nondisability 9 || arising from the prior ALJ’s decision on March 4, 2013. (Joint Stip. at 6-7, 13; see 10 || also AR 14.) 11 A prior ALJ’s decision that a claimant is not disabled creates a rebuttable 12 || presumption that a claimant continues to be able to work beyond the date of that 13 || decision. See Chavez v. Bowen, 844 F.2d 691, 693 (9th Cir. 1988). “This decision 14 |) as of that date [is] entitled to res judicata effect.” Lyle v. Secretary of Health and 15 || Human Services, 700 F.2d 566, 568 (9th Cir. 1983). The effective date of the 16 || decision is the date of the prior ALJ’s decision, rather than the date on which the 17 || Appeals Council later denies review. See Russell v. Bowen, 856 F.2d 81, 83 (9th 18 || Cir. 1988). 19 “The claimant, in order to overcome the presumption of continuing 20 || nondisability arising from the first administrative law judge’s findings of 21 || nondisability, must prove ‘changed circumstances’ indicating greater disability.” 22 || Chavez, 844 F.2d at 693 (quoting Taylor v. Heckler, 765 F.2d 872, 875 (9th Cir. 23 || 1985)).
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1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 | ARTHUR C.,! Case No. 5:18-cv-01948-MAA Plaintiff, 13 MEMORANDUM DECISION AND Vv. ORDER REVERSING DECISION OF 14 THE COMMISSIONER AND REMANDING FOR FURTHER 15 | ANDREW M. SAUL-2 ADMINISTRATIVE PROCEEDINGS Commissioner of Social Security, Defendant. 17 18 19 On September 12, 2018, Plaintiff filed a Complaint seeking review of the 20 || Social Security Commissioner’s final decision denying his application for 21 || Supplemental Security Income pursuant to Title XVI of the Social Security Act. 22 || This matter is fully briefed and ready for decision. For the reasons discussed 23 || below, the Commissioner’s final decision is reversed, and this action is remanded 24 || for further administrative proceedings. 25 | | Plaintiff's name is partially redacted in accordance with Federal Rule of Civil Procedure > 2(c)(2}t ) and the recommendation of the Committee on Court 26 Administration and Case Management of the Judicial Conference of the United 34 tates. 2 The Commissioner of Social Security is substituted as the Defendant pursuant to 28 | Federal Rule of Civil Procedure 25(d).
1 PROCEDURAL HISTORY 2 On March 4, 2013, an Administrative Law Judge (“prior ALJ”) denied 3 || Plaintiffs disability claim by a written decision. (AR 151-61.) On September 12, 4 || 2014, the Appeals Council denied Plaintiffs request for review. (AR 166-70.) 5 || Plaintiff did not seek review in federal court of the prior ALJ’s March 4, 2013 6 || decision. 7 On October 3, 2014, Plaintiff protectively filed another application for 8 || Supplemental Security Income, which is the subject of this action. (Administrative 9 || Record [AR] 14, 288-94.) In this latest application, Plaintiff alleged disability 10 || beginning on October 3, 2014 (AR 87) due to depression, severe lower back pain, 11 || high blood pressure, pain in both feet, severe neck pain, severe hip pain, anxiety, 12 || sleep apnea, schizophrenia, bipolar disorder, anger outbursts, and trouble getting 13 || along with people (AR 171-72, 189-90). 14 After the application was denied initially and upon reconsideration, Plaintiff 15 || requested a hearing before an ALJ (“present ALJ” or “ALJ”). (AR 226-28.) Ata 16 || hearing held on July 13, 2017, at which Plaintiff appeared with counsel, the ALJ 17 || heard testimony from Plaintiff and a vocational expert. (AR 80-98.) 18 In a decision issued on October 16, 2017, the ALJ denied Plaintiff's 19 || application. (AR 14-25.) Asa preliminary matter, the ALJ found that the prior 20 || ALJ’s decision on March 4, 2013 had created a rebuttal presumption of continuing 21 || non-disability and that Plaintiff failed to rebut the presumption by showing 22 || changed circumstances. (AR 14.) 23 The ALJ then made the following findings pursuant to the Commissioner’s 24 || five-step evaluation. Plaintiff had not engaged in substantial gainful activity since 25 || his application date of October 3, 2014. (AR 16.) He had severe impairments 26 || consisting of degenerative disc disease of the lumbar and cervical spine. (AR 17.) 27 || He did not have an impairment or combination of impairments that met or 28 || medically equaled the requirements of one of the impairments from the
1 || Commissioner’s Listing of Impairments. (AR 21.) He had a residual functional 2 || capacity to perform medium work. (/d.) He could no longer perform his past 3 || relevant work as a bus driver. (AR 23-24.) However, he could perform other work 4 || in the national economy, in the occupations of industrial cleaner, hand packager, 5 || and night cleaner. (AR 25.) Thus, the ALJ concluded that Plaintiff was not 6 || disabled as defined by the Social Security Act. (/d.) 7 On July 13, 2018, the Appeals Council denied Plaintiff's request for review. 8 || (AR 1-7.) Thus, ALJ’s decision became the final decision of the Commissioner. 9 | Plaintiff timely filed this action on September 12, 2018. (ECF No. 1.) 10 11 DISPUTED ISSUE 12 The parties raise the following disputed issue: whether the ALJ improperly 13 || rejected Plaintiff's testimony regarding pain and functional limitations. (ECF No. 14 |) 24, Parties’ Joint Stipulation [Joint Stip.”] at 2.) 15 16 STANDARD OF REVIEW 17 Under 42 U.S.C. § 405(g), the Court reviews the Commissioner’s final 18 || decision to determine whether the Commissioner’s findings are supported by 19 || substantial evidence and whether the proper legal standards were applied. See 20 || Treichler v. Commissioner of Social Sec. Admin., 775 F.3d 1090, 1098 (9th Cir. 21 || 2014). Substantial evidence means “more than a mere scintilla” but less than a 22 || preponderance. See Richardson v. Perales, 402 U.S. 389, 401 (1971); Lingenfelter 23 || v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). Substantial evidence is “such 24 || relevant evidence as a reasonable mind might accept as adequate to support a 25 || conclusion.” Richardson, 402 U.S. at 401. The Court must review the record as a 26 || whole, weighing both the evidence that supports and the evidence that detracts from 27 || the Commissioner’s conclusion. Lingenfelter, 504 F.3d at 1035. Where evidence is 28 || susceptible of more than one rational interpretation, the Commissioner’s
1 || interpretation must be upheld. See Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2 || 2007). 3 4 DISCUSSION 5 | 1. Disputed Issues. 6 A. Presumption of Continuing Non-Disability. 7 As a preliminary issue, the parties disagree as to whether the ALJ correctly 8 || found that Plaintiff failed to rebut the presumption of continuing nondisability 9 || arising from the prior ALJ’s decision on March 4, 2013. (Joint Stip. at 6-7, 13; see 10 || also AR 14.) 11 A prior ALJ’s decision that a claimant is not disabled creates a rebuttable 12 || presumption that a claimant continues to be able to work beyond the date of that 13 || decision. See Chavez v. Bowen, 844 F.2d 691, 693 (9th Cir. 1988). “This decision 14 |) as of that date [is] entitled to res judicata effect.” Lyle v. Secretary of Health and 15 || Human Services, 700 F.2d 566, 568 (9th Cir. 1983). The effective date of the 16 || decision is the date of the prior ALJ’s decision, rather than the date on which the 17 || Appeals Council later denies review. See Russell v. Bowen, 856 F.2d 81, 83 (9th 18 || Cir. 1988). 19 “The claimant, in order to overcome the presumption of continuing 20 || nondisability arising from the first administrative law judge’s findings of 21 || nondisability, must prove ‘changed circumstances’ indicating greater disability.” 22 || Chavez, 844 F.2d at 693 (quoting Taylor v. Heckler, 765 F.2d 872, 875 (9th Cir. 23 || 1985)). Examples of changed circumstances include a change in the claimant’s age 24 || category, an increase in the severity of the claimant’s impairments, the alleged 25 || existence of an impairment that was not previously considered, or a change in the 26 || criteria for determining disability. See Acquiescence Ruling 97-4(9), 1997 WL 27 || 742758, at *3. 28 ///
1 The relevant change in circumstances here involves Plaintiff's age category 2 || on the date of the prior ALJ’s decision and on the date of his alleged disability 3 || when he later reapplied for benefits. “[A] change in the claimant’s age category, as 4 | defined in the Medical-Vocational Guidelines, constitutes a changed circumstance 5 || that precludes the application of res judicata.” Lester v. Chater, 81 F.3d 821, 827 6 || (Oth Cir. 1995). Plaintiff was born on November 30, 1963. (AR 171, 187, 189, 7 || 487, 494.) When the prior ALJ issued her decision on March 4, 2013, Plaintiff was 8 || 49 years old, placing him in the age category of a “younger person.” See 20 C.F.R. 9 | § 416.963(c). But when Plaintiff later reapplied for benefits on October 3, 2014, 10 || alleging disability on the same date, Plaintiff was 50 years old, which changed his 11 || age category to that of a person “closely approaching advanced age.” See 20 C.F.R. 12 || § 416.963(d). Indeed, the ALJ even acknowledged at the hearing that “there’s been 13 || an age change” since the prior ALJ’s decision. (AR 84.) 14 The change in age category was sufficient to rebut the Chavez presumption 15 || of continuing nondisability. See Lester, 81 F.3d at 828 (holding that res judicata 16 || did not apply where the claimant turned 50 years old after the date of the prior 17 || ALJ’s decision); Vasquez v. Astrue, 572 F.3d 586, 597 (9th Cir. 2009) (same); 18 || Oberg v. Astrue, 472 F. App’x 488, 490 (9th Cir. 2012) (same); see also Chavez, 19 || 844 F.2d at 693 (same where the claimant turned 55 years old after the date of the 20 || prior ALJ’s decision, thus changing his age category to “advanced age”); Hammock 21 || v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989) (“[I]t is significant that the claimant 22 || turned 55 prior to the present benefits application. Her attainment of advanced age 23 || constitutes a changed circumstance precluding the application of res judicata to the 24 || first administrative law judge’s ultimate finding against disability.”) Thus, the ALJ 25 || erred in finding that the Chavez presumption continued to apply 26 The remaining question is whether the error was harmless. An error in a 27 || Social Security proceeding is harmless when “it is inconsequential to the ultimate 28 || nondisability determination.” See Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th
1 || Cir. 2015). In the specific context here, an ALJ’s misapplication of the Chavez 2 || presumption would be harmless error if the ALJ otherwise makes an independent 3 || finding of nondisability for the current period that is supported by substantial 4 || evidence and free of legal error. See Plummer v. Berryhill, 747 F. App’x 631, 632 5 || (9th Cir. 2019) (holding that an ALJ’s misapplication of the Chavez presumption 6 || was harmless error where the ALJ otherwise “conducted a thorough review of the 7 || medical records and testimony to make an independent nondisability finding”); Cha 8 || Yang v. Commissioner of Social Sec. Admin., 488 F. App’x 203, 204 (9th Cir. 2012) 9 || (same where the ALJ otherwise reformulated the claimant’s residual functional 10 || capacity by weighing the medical evidence). Thus, the error here would be 11 || harmless if the present ALJ’s decision, for the period of alleged disability 12 || beginning on October 3, 2014, is otherwise supported by substantial evidence and 13 || free of legal error. Here, Plaintiff's sole challenge to the present ALJ’s decision 14 || involves the assessment of Plaintiffs subjective symptom testimony, which is 15 || discussed below. 16 17 B. _ Plaintiff’s Subjective Symptom Testimony. 18 1. Legal Standard. 19 An ALJ must make two findings in assessing a claimant’s pain or symptom 20 || allegations. Social Security Ruling (“SSR”) 16-3P, 2017 WL 5180304, at *3; 21 || Treichler, 775 F.3d at 1102. “First, the ALJ must determine whether the claimant 22 || has presented objective medical evidence of an underlying impairment which could 23 || reasonably be expected to produce the pain or other symptoms alleged.” Treichler, 24 || 775 F.3d at 1102 (citation omitted). “Second, if the claimant has produced that 25 || evidence, and the ALJ has not determined that the claimant is malingering, the ALJ 26 || must provide specific, clear and convincing reasons for rejecting the claimant’s 27 || testimony regarding the severity of the claimant’s symptoms” and those reasons 28 || ///
1 || must be supported by substantial evidence in the record. Jd.; see also Marsh v. 2 || Colvin, 792 F.3d 1170, 1174 n.2 (9th Cir. 2015). 3 “A finding that a claimant’s testimony is not credible ‘must be sufficiently 4 || specific to allow a reviewing court to conclude the adjudicator rejected the 5 || claimant’s testimony on permissible grounds and did not arbitrarily discredit a 6 || claimant’s testimony regarding pain.’” Brown-Hunter v. Colvin, 806 F.3d 487, 493 7 | (9th Cir. 2015) (quoting Bunnell v. Sullivan, 947 F.2d 341, 345-46 (9th Cir. 1991) 8 || (en banc)). 9 Beginning on March 28, 2016, SSR 16-3P rescinded and superseded the 10 |) Commissioner’s prior rulings as to how the Commissioner will evaluate a 11 || claimant’s statements regarding the intensity, persistence, and limiting effects of 12 || symptoms in disability claims. See SSR 16-3P, 2017 WL 5180304, at *1. Because 13 || the ALJ’s decision in this case was issued on October 16, 2017, it is governed by 14 | SSR 16-3P. See id. at *13 and n.27. In pertinent part, SSR 16-3P eliminated the 15 |) use of the term “credibility” and clarified that the Commissioner’s subjective 16 || symptom evaluation “is not an examination of an individual’s character.” SSR 16- 17 || 3P, 2017 WL 5180304, at *2; see also Trevizo v. Berryhill, 871 F.3d 664, 678 n.5 18 || (9th Cir. 2017). These changes are largely stylistic and are consistent in substance 19 || with Ninth Circuit precedent that existed before the effective date of SSR16-3P. 20 || See Trevizo, 871 F.3d at 678 n.5. 21 22 2. Background. 23 Plaintiff testified about his medical condition as follows: 24 He cannot work because of back pain that does not respond to treatment. 25 || (AR 87.) He dislocated his shoulder during a fall, and his leg “goes out at any 26 || time.” (AR 88.) He also has problems with concentration and memory. (Id.) 27 /// 28 || ///
1 On a typical day, Plaintiff wakes up and then goes back to sleep. (AR 88.) 2 || Eventually, he brushes his teeth and prepares a meal in the microwave. (/d.) He 3 || does light chores and avoids lifting anything that is heavy. (AR 89.) 4 His current medications for back pain do not work, and past treatments such 5 || as Vicodin and steroid shots worked only temporarily. (AR 89-90.) His hands 6 || have become brittle from medication, so he can lift only five pounds. (AR 91.) He 7 || has used a cane for three or four years. (/d.) 8 In addition to testifying at the hearing, Plaintiff completed a written Function 9 || Report about his condition. (AR 333-41.) In pertinent part, Plaintiff wrote that his 10 || treatment consisted of Hydrocodone, Gabapentin, Diazepam, Sertraline, Naproxen, 11 || Alprazolam, Omeprazole, and steroid injections. (AR 340.) The record further 12 || shows that Plaintiff's treatment also included a Toradol injection (AR 560), 13 || radiofrequency ablation (AR 660), and medial branch blocks (AR 666). 14 15 3. Analysis. 16 The ALJ first found that that Plaintiff's medically determinable impairments 17 || could reasonably be expected to cause the alleged symptoms. (AR 22.) However, 18 || the ALJ next found that Plaintiffs statements concerning the intensity, persistence, 19 || and limiting effects of these symptoms were not entirely consistent with the 20 || medical evidence and other evidence in the record. (/d.) As support, the ALJ 21 |) stated two reasons. (AR 22-23.) The Court will address the second reason first. 22 23 a. conservative treatment. 24 The ALJ discounted Plaintiffs allegations because his “treatment has 25 || continued to be largely routine and conservative.” (AR 22-23.) “[E]vidence of 26 || “conservative treatment’ is sufficient to discount a claimant’s testimony regarding 27 || severity of an impairment.” Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 2007) 28 || (citing Johnson v. Shalala, 60 F.3d 1428, 1434 (9th Cir. 1995)); see also
1 || Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008 (holding that a claimant’s 2 || favorable response to conservative treatment permitted an inference that the pain 3 || was “not as all-disabling as he reported”). 4 The ALJ supported this reason with examples of Plaintiff's treatment for 5 || back pain: pain medication, Toradol injections, epidural steroid injections, medial 6 || branch blocks, and radiofrequency ablation. (AR 23.) However, numerous courts 7 || have rejected characterizations of these types of treatment as conservative. See 8 | Huber v. Berryhill, 732 F. App’x 451, 456-57 (7th Cir. 2018) (finding “misguided” 9 || an ALJ’s characterization of a claimant’s treatment as conservative where it 10 || included radiofrequency ablation); Childers v. Berryhill, 2019 WL 1474030, at *9 11 || (D. Nev. Mar. 12, 2019) (rejecting an ALJ’s characterization of treatment as 12 || conservative where it included narcotics and steroid lumbar injections, and 13 | collecting similar cases); Douglas K.T. v. Berryhill, 2019 WL 1670941, at *9 (C.D. 14 || Cal. Apr. 17, 2019) (refusing to characterize prescription pain medication and 15 || epidural steroid injections as routine or conservative, and collecting similar cases); 16 || Martinez v, Berryhill, 2018 WL 1415163, at *8 (C.D. Cal. Mar. 20, 2018) (rejecting 17 || an ALJ’s characterization of radiofrequency ablation as conservative); Pontzious v. 18 |) Berryhill, 2017 WL 6276371, at *7 (D. Az. Dec. 11, 2017) (“[E]pidural injections 19 || and medial branch blocks are not conservative treatment.”) (citing Garrison v. 20 || Colvin, 759 F.3d 995, 1015 n.20 (9th Cir. 2014) (“[W]e doubt that epidural steroid 21 || shots to the neck and lower back qualify as ‘conservative’ medical treatment.”)); 22 || Bradley v. Commissioner of Social Security, 2016 WL 1047015, at *4 (E.D. Cal. 23 || Mar. 16, 2016) (finding that multiple epidural/branch block injections, along with 24 || narcotic pain medications, were not conservative treatments); Kephart v. Colvin, 25 || 2014 WL 2557676, at *5 (C.D. Cal. June 6, 2014) (“The court agrees with plaintiff 26 || that Toradol injections and medial branch block treatment would not be considered 27 || conservative treatments.”) (citing Christie v. Astrue, 2011 WL 4368189, at *4 (C.D. 28 || Cal. Sept. 16, 2011) (refusing to categorize trigger point injections, epidural shots,
1 || and narcotic pain medication as conservative treatments)); Green v. Astrue, 2012 2 || WL 6574762, at *5 (D. Az. Dec. 17, 2012) (rejecting an ALJ’s characterization of 3 || treatment as conservative where it included medial branch blocks and steroid 4 || injections); see also Padilla v. Commissioner of Social Security Administration, 5 | 2018 WL 4770807, at *7 (D. Az. Oct. 3, 2018) (finding unjustified, under the more 6 || deferential “specific and legitimate” standard, an ALJ’s characterization of 7 || treatment as conservative where it included epidural steroid injections, medial 8 || branch blocks, radiofrequency ablation, and pain medication). The Court likewise 9 || finds that the ALJ’s characterization of Plaintiffs treatment as conservative was not 10 || aclear and convincing reason. 11 The ALJ further supported his characterization of Plaintiff's treatment as 12 | conservative by noting treatment that was not received: Plaintiff had not been 13 || recommended surgery or other aggressive treatment, he had visited the emergency 14 || room not primarily for an emergency condition but rather because he was out of his 15 || prescribed medication, and he had not been admitted to the hospital overnight. (AR 16 || 23.) But these facts also fail to establish clearly and convincingly that Plaintiffs 17 || treatment was conservative. 18 In the first place, the absence of a surgery recommendation is not dispositive 19 || of whether treatment is conservative. See Huber, 732 F. App’x at 456 (“The 20 || absence of recommendations for back surgery or narcotics does not suggest that 21 | [claimant’s] treatment was necessarily conservative.”); Hunter v. Berryhill, 2018 22 || WL 4026995, at *15 (C.D. Cal. Aug. 21, 2018) (rejecting characterization of a 23 | claimant’s treatment as conservative even though the treating physician had failed 24 || to recommend back surgery); Yang v. Barnhart, 2006 WL 3694857, at *4 (C.D. 25 || Cal. Dec. 12, 2006) (same). Moreover, although the record does contain evidence 26 || that Plaintiff visited the emergency room to refill his medication (AR 710), it also 27 || shows that he visited the emergency room for acute back pain (AR 525, 675, 681- 28 || 82, 700-01). Finally, the absence of evidence of hospitalization is insufficient here 10
1 || to discredit Plaintiffs testimony about his back pain. See Jordan v. Astrue, 262 F. 2 || App’x 843, 845 (9th Cir. 2008) (“The fact that [the claimant] never required 3 || hospitalization [for his back pain] or ‘intensive treatment with pain medication,’ or 4 || that he may have rejected certain kinds of treatment, are not, on their own, 5 || convincing reasons for disregarding his pain testimony.”).? Thus, this was not a 6 || clear and convincing reason based on substantial evidence in the record to discount 7 || Plaintiffs subjective symptom testimony. 8 9 b. inconsistency with objective medical findings. 10 The ALJ’s sole remaining reason to discount Plaintiff’s allegations was that 11 | his “medical history is not fully consistent with the alleged intensity, persistence, 12 || and limiting effects of his symptoms.” (AR 22.) As examples, the ALJ cited 13 |) objective medical findings from Plaintiff's imaging tests and physical 14 || examinations. (/d.) 15 Even if the record fully supports this reason, it still would be legally 16 || insufficient because it is the sole remaining reason for the ALJ’s assessment of 17 || Plaintiffs allegations. See Robbins v. Social Sec. Admin., 466 F.3d 880, 884 (9th 18 |} Cir. 2006) (finding insufficient an ALJ’s sole remaining rationale that the 19 | claimant’s testimony was “not consistent with or supported by the overall medical 20 || evidence of record”); SSR 16-3P, 2017 WL 5180304, at *5 (“[W]e will not 21 || disregard an individual’s statements about the intensity, persistence, and limiting 22 || effects of symptoms solely because the objective medical evidence does not \ 23 /// 24 os ° The absence of evidence of a hospitalization can be a clear and convincing reason in other contexts. See Fair v. Bowen, 885 F.2d 597, 604 (9th Cir. 1989) || (finding the absence of a hospitalization convincing where, inter alia, the claimant also had not received physical therapy for two years and had otherwise received 57 || conservative treatment). Fair does not control the outcome here because the facts are dissimilar: Plaintiff has not had a significant gap in treatment or therapy since his alleged onset date, and his treatment cannot be fairly characterized as 28 || conservative for the reasons discussed above. 11
1 |) substantiate the degree of impairment-related symptoms alleged by the 2 || individual.”). Thus, the ALJ’s assessment cannot be upheld on this basis. 3 4 C. Conclusion. 5 The Chavez presumption of continuing disability was rebutted because of a 6 || legally significant change in Plaintiff's age category after the prior ALJ’s decision. 7 || The error in continuing to apply the presumption was not harmless because the 8 || assessment of Plaintiffs subjective symptom testimony otherwise was not 9 || supported by clear and convincing reasons based on substantial evidence. Thus, 10 || reversal is warranted. 11 12 | If. Remand for Further Administrative Proceedings. 13 Ninth Circuit case law “precludes a district court from remanding a case for 14 || an award of benefits unless certain prerequisites are met.” Dominguez v. Colvin, 15 | 808 F.3d 403, 407 (9th Cir. 2015) (citations omitted). “The district court must first 16 | determine that the ALJ made a legal error, such as failing to provide legally 17 || sufficient reasons for rejecting evidence.” Jd. “If the court finds such an error, it 18 |) must next review the record as a whole and determine whether it is fully developed, 19 || is free from conflicts and ambiguities, and all essential factual issues have been 20 || resolved.” Jd. (citation and internal quotation marks omitted). 21 Although the Court has found legal error and an absence of substantial 22 || evidence, essential factual issues remain outstanding. The record raises factual 23 || conflicts about Plaintiff's level of functioning that “should be resolved through 24 || further proceedings on an open record before a proper disability determination can 25 || be made by the ALJ in the first instance.” See Brown-Hunter v. Colvin, 806 F.3d 26 |) 487, 496 (9th Cir. 2015); see also Treichler, 775 F.3d at 1101 (stating that remand 27 || for an award of benefits is inappropriate where “there is conflicting evidence, and 28 || not all essential factual issues have been resolved”) (citation omitted); Strauss v. 12
1 || Commissioner of the Social Sec. Admin., 635 F.3d 1135, 1138 (9th Cir. 2011) 2 || (same where the existing record does not clearly demonstrate that the claimant is 3 || disabled within the meaning of the Social Security Act). 4 Therefore, based on its review and consideration of the entire record, the 5 || Court has concluded on balance that a remand for further administrative 6 || proceedings pursuant to sentence four of 42 U.S.C. § 405(g) is warranted here. It is 7 || not the Court’s intent to limit the scope of the remand. 8 9 ORDER 10 It is ordered that Judgment be entered reversing the decision of the 11 || Commissioner of Social Security and remanding this matter for further 12 || administrative proceedings. 13 14 || DATED: October 23, 2019 15 MARIA fads 47 UNITE ATES MAGISTRATE JUDGE 18 19 20 21 22 23 24 25 26 27 28 13