Chelsea Brooke Schnetzler v. Commissioner of Social Security

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 11 CHELSEA BROOKE SCHNETZLER, No. 2:25-cv-01605-CKD 12 Plaintiff, 13 v. ORDER 14 COMMISSIONER OF SOCIAL SECURITY, 15 Defendant. 16

17 18 Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 19 (“Commissioner”) denying an application for Disability Income Benefits (“DIB”) under Title II 20 of the Social Security Act (“Act”). For the reasons discussed below, the court will grant 21 plaintiff’s motion for summary judgment and remand for further proceedings, and deny the 22 Commissioner’s cross-motion for summary judgment. 23 BACKGROUND 24 Plaintiff, born in 1990, applied on May 9, 2022 for DIB, alleging disability beginning 25 June 12, 2021. Administrative Transcript (“AT”) 11, 20. Plaintiff alleged she was unable to 26 work due to systemic lupus erythematosus. AT 80. In a decision dated May 21, 2024, the ALJ 27 / / / 28 / / / 1 determined that plaintiff was not disabled.1 AT 11-22. The ALJ made the following findings 2 (citations to 20 C.F.R. omitted): 3 1. The claimant meets the insured status requirements of the Social Security Act through December 31, 2024. 4 2. The claimant has not engaged in substantial gainful activity since 5 June 12, 2021, the alleged onset date. 6 3. The claimant has the following severe impairments: systemic lupus erythematosus (SLE), inflammatory arthritis, postural 7 orthostatic tachycardia syndrome (POTS), premature ventricular contractions (PVCs), gastroparesis, attention deficit hyperactivity 8 disorder (ADHD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and major depressive disorder 9 (MDD). 10 1 Disability Insurance Benefits are paid to disabled persons who have contributed to the 11 Social Security program, 42 U.S.C. § 401 et seq. Supplemental Security Income is paid to 12 disabled persons with low income. 42 U.S.C. § 1382 et seq. Both provisions define disability, in part, as an “inability to engage in any substantial gainful activity” due to “a medically 13 determinable physical or mental impairment. . . .” 42 U.S.C. §§ 423(d)(1)(a) & 1382c(a)(3)(A). A parallel five-step sequential evaluation governs eligibility for benefits under both programs. 14 See 20 C.F.R. §§ 404.1520, 404.1571-76, 416.920 & 416.971-76; Bowen v. Yuckert , 482 U.S. 137, 140-142, 107 S. Ct. 2287 (1987). The following summarizes the sequential evaluation: 15 Step one: Is the claimant engaging in substantial gainful 16 activity? If so, the claimant is found not disabled. If not, proceed to step two. 17 Step two: Does the claimant have a “severe” impairment? If 18 so, proceed to step three. If not, then a finding of not disabled is appropriate. 19 Step three: Does the claimant’s impairment or combination 20 of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P, App.1? If so, the claimant is automatically determined 21 disabled. If not, proceed to step four. 22 Step four: Is the claimant capable of performing his past work? If so, the claimant is not disabled. If not, proceed to step five. 23 Step five: Does the claimant have the residual functional 24 capacity to perform any other work? If so, the claimant is not disabled. If not, the claimant is disabled. 25

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 26

27 The claimant bears the burden of proof in the first four steps of the sequential evaluation process. Bowen, 482 U.S. at 146 n.5, 107 S. Ct. at 2294 n.5. The Commissioner bears the 28 burden if the sequential evaluation process proceeds to step five. Id. 1 4. The claimant does not have an impairment or combination of impairments that meets or medically equals one of the listed 2 impairments in 20 CFR Part 404, Subpart P, Appendix 1. 3 5. After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform 4 light work except that she can no more than occasionally climb ladders, ropes, scaffolds, ramps or stairs, balance, stoop, kneel, 5 crouch, or crawling. The claimant is further limited to simple and repetitive tasks in a routine work setting. 6 6. The claimant is capable of performing past relevant work as a 7 cashier and as a vending machine attendant. This work does not require the performance of work-related activities precluded by the 8 claimant’s residual functional capacity.2 9 7. The claimant has not been under a disability, as defined in the Social Security Act, from June 12, 2021, through the date of this 10 decision.

11 AT 13-22. 12 ISSUES PRESENTED 13 Plaintiff argues that the ALJ committed the following errors in finding plaintiff not 14 disabled: (1) the ALJ erred in discounting plaintiff’s subjective symptom testimony; and (2) the 15 ALJ erred in evaluating the medical opinion of the psychological consultative examiner. 16 LEGAL STANDARDS 17 The court reviews the Commissioner’s decision to determine whether (1) it is based on 18 proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in the record 19 as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial 20 evidence is more than a mere scintilla, but less than a preponderance. Connett v. Barnhart, 340 21 F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence as a reasonable 22 mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d 625, 630 (9th 23 Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is 24 responsible for determining credibility, resolving conflicts in medical testimony, and resolving 25 ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations omitted). 26 2 The ALJ found that, in addition to past relevant work, there are other jobs the claimant could 27 also perform considering her RFC, age, and other qualities. Relying on the testimony of the vocational expert (VE), the ALJ found she could perform unskilled, light jobs such as parts 28 assembler, sorter, and hotel housekeeper. AT 20-21. 1 “The court will uphold the ALJ’s conclusion when the evidence is susceptible to more than one 2 rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 3 The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th 4 Cir. 1986), and both the evidence that supports and the evidence that detracts from the ALJ’s 5 conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not 6 affirm the ALJ’s decision simply by isolating a specific quantum of supporting evidence. Id.; see 7 also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports the 8 administrative findings, or if there is conflicting evidence supporting a finding of either disability 9 or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d 1226, 10 1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was applied in 11 weighing the evidence. See Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). 12 ANALYSIS 13 A. Subjective Symptom Testimony 14 1. Plaintiff’s Testimony 15 At the April 2024 hearing on her claim, plaintiff testified in part that she experienced 16 “debilitating fatigue” and had to nap for two hours a day. AT 43, 51. She testified that, after 17 standing up for ten minutes, she had to lie down for a few minutes and rest. AT 52; see also AT 18 242-244 (August 2022 adult function report noting daily fatigue and pain). During episodes of 19 tremors caused by POTS, which occurred about once a month, plaintiff spent “upwards of a week 20 having to be flat in bed, not . . . able to be mobile.” AT 42-43. Plaintiff also testified that she had 21 swelling in her hands “where it’s very tight and I can’t . . . make a fist.” AT 47. 22 The ALJ summarized plaintiff’s symptom allegations as follows: 23 The claimant cannot work due to [POTS], lupus, connective tissue disorder, migraines, [ADHD], and gastroparesis. Her POTS causes 24 episodes of vision and hearing loss, rapid heart rate, shortness of breath, pain, fatigue, and tremors, which occur when she is upright 25 and can be relieved by lying flat. Episodes of POTS symptoms occur once a month and last for a week or longer, during which time she 26 must remain lying down in order to avoid her symptoms. . . . The claimant’s lupus and connective tissue disease cause symptoms of 27 rashes, fatigue, and joint pain, particularly in her knees, elbows, shoulders, and hips. She has constant pain every day, which is helped 28 by only rest. . . . She has symptoms of swelling and tightness in her 1 hands. The claimant suffers from migraines about once a month, lasting about a week at a time. During severe migraines, she must 2 remain in a dark room and cannot function. . . . The claimant’s gastroparesis causes symptoms of severe stomach pain and nausea. 3 The claimant’s mental health problems cause symptoms of depression, fatigue, and drowsiness. 4 5 AT 17; see AT 40-53 (hearing testimony). 6 The ALJ found that plaintiff’s “statements concerning the intensity, persistence, and 7 limiting effects of [her] symptoms are not entirely consistent with the medical evidence and other 8 evidence of record[.]” AT 17. He elaborated as follows: 9 Overall, the evidence supports a finding that the claimant’s physical impairments would limit her to work at a light exertional level with . 10 . . additional postural activities[.] However, in contrast with the claimant’s allegations, the medical evidence does not indicate that 11 the claimant’s symptoms would cause the claimant to lie down frequently or for long periods during the workday, to take naps or 12 frequent rest breaks during the day, or to have difficulty using her hands. 13 14 AT 18 (emphasis added). 15 2. Legal Standard 16 The ALJ determines whether a disability applicant is credible, and the court defers to the 17 ALJ’s discretion if the ALJ used the proper process and provided proper reasons. See, e.g., 18 Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1995). If credibility is critical, the ALJ must make an 19 explicit credibility finding. Albalos v. Sullivan, 907 F.2d 871, 873-74 (9th Cir. 1990). “Without 20 affirmative evidence showing that the claimant is malingering, the Commissioner’s reasons for 21 rejecting the claimant’s testimony must be clear and convincing.” Morgan v. Commissioner of 22 Social Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); see also Lambert v. Saul, 980 F.3d 1266, 23 1277–78 (9th Cir. 2020). 24 In evaluating whether subjective complaints are credible, the ALJ should first consider 25 objective medical evidence and then consider other factors. Bunnell v. Sullivan, 947 F.2d 341, 26 344 (9th Cir. 1991) (en banc). If there is objective medical evidence of an impairment, the ALJ 27 then may consider the nature of the symptoms alleged, including aggravating factors, medication, 28 1 treatment and functional restrictions. See id. at 345-47. The ALJ also may consider: (1) the 2 applicant’s reputation for truthfulness, prior inconsistent statements or other inconsistent 3 testimony, (2) unexplained or inadequately explained failure to seek treatment or to follow a 4 prescribed course of treatment, and (3) the applicant’s daily activities. Smolen v. Chater, 80 F.3d 5 1273, 1284 (9th Cir. 1996). Work records, physician and third party testimony about nature, 6 severity and effect of symptoms, and inconsistencies between testimony and conduct also may be 7 relevant. Light v. Social Security Administration, 119 F.3d 789, 792 (9th Cir. 1997). A failure to 8 seek treatment for an allegedly debilitating medical problem may be a valid consideration by the 9 ALJ in determining whether the alleged associated pain is not a significant nonexertional 10 impairment. See Flaten v. Secretary of HHS, 44 F.3d 1453, 1464 (9th Cir. 1995). 11 When discounting subjective testimony, an ALJ must provide “specific, clear, and convincing 12 reasons for doing so.” Wade v. Saul, 850 F. App’x 568, 569 (9th Cir. 2021) (emphasis in 13 original), citing Lambert, 980 F.3d at 1277–78. This standard does “not require ALJs to perform 14 a line-by-line exegesis of the claimant’s testimony[.]” Lambert, 980 F.3d at 1277. However, an 15 ALJ’s detailed overview of the claimant’s medical history—coupled with a nonspecific 16 boilerplate conclusion that her testimony is “not entirely consistent” with her medical treatment— 17 is not enough to satisfy the minimal requirements for assessing credibility. Id. at 1277–78. 18 3. Discussion 19 Here, the ALJ found objective medical evidence of multiple severe impairments, including 20 POTS. AT 13. “The primary symptoms of POTS are lightheadedness, fainting, a rapid increase in 21 heartbeat, chest pain, exhaustion, high/low blood pressure, nausea, blurred vision, diarrhea, 22 forgetfulness, headaches, and many others.” Agans v. Saul, No. 2:20-cv-00508 AC, 2021 WL 23 1388610, *12 (E.D. Cal. Apr. 13, 2021). At an August 2023 exam, the ALJ noted, the examining 24 neurologist wrote that plaintiff’s “presentation is consistent with POTS.” AT 18, 1584. 25 The ALJ explained why he did not find plaintiff’s testimony about swelling in her hands 26 fully credible: 27 While the claimant testified at the hearing that she has symptoms of swelling and tightness in her hands, examinations of her hands were 28 consistently normal, showing no deformities and an ability to make 1 a full fist with both hands. 2 AT 18 (record citations omitted). 3 However, the ALJ did not explain why he found plaintiff’s testimony about “debilitating 4 fatigue” less than credible. The ALJ did not cite, for example, any unexplained failure to seek 5 treatment or follow a prescribed course of treatment for this symptom. Nor did he explain how 6 plaintiff’s daily activities undercut her testimony that she needed to lie down frequently each day 7 and for approximately one week per month. Nor did the ALJ reason that plaintiff’s symptoms of 8 fatigue were adequately controlled with medication. Rather, the ALJ cited plaintiff’s “largely 9 normal” mental and physical examinations without connecting them to her alleged fatigue. AT 10 18, 19. 11 Defendant argues that the ALJ’s reliance on medical opinions finding plaintiff capable of 12 light work is sufficient to discount her allegations of disabling fatigue. Under Lambert, however, 13 the ALJ’s conclusory finding that “the medical evidence does not indicate that the claimant’s 14 symptoms would cause [her] to lie down frequently or for long periods . . . [or] to take naps or 15 frequent rest breaks” is not legally sufficient to disregard these alleged symptoms, which are not 16 uncommonly associated with POTS. 17 Moreover, “lack of supporting medical evidence cannot form the sole basis for 18 discounting . . . symptom testimony.” Blasl v. O’Malley, No. 1:22-cv-01374-BAM, 2024 WL 19 584075, *7 (E.D. Cal. Feb. 13, 2024); see Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 2005); 20 see also Robbins v. Comm’r of Soc. Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006) (holding 21 ALJ may not disregard claimant’s testimony “solely because it is not substantiated by objective 22 medical evidence”); Bunnell v. Sullivan, 947 F.2d 341, 345 (9th Cir. 1991) (“an adjudicator may 23 not reject a claimant's subjective complaints based solely on a lack of objective medical evidence 24 to fully corroborate the alleged severity of the [symptoms].”). Plaintiff is entitled to summary 25 judgment on this claim.3 26 //// 27 ////

28 3 The court does not reach the remaining claim. 1 REMEDY 2 With error established, the court has the discretion to remand or reverse and award 3 benefits. McAllister v. Sullivan, 888 F.2d 599, 603 (9th Cir. 1989). A case may be remanded 4 under the “credit-as-true” rule for an award of benefits where: 5 (1) the record has been fully developed and further administrative proceedings would serve no useful purpose; (2) the ALJ has 6 failed to provide legally sufficient reasons for rejecting evidence, 7 whether claimant testimony or medical opinion; and (3) if the improperly discredited evidence were credited as true, the ALJ 8 would be required to find the claimant disabled on remand.

9 10 Garrison v. Colvin, 759 F.3d 995, 1020 (9th Cir. 2014). Even where all the conditions for the 11 “credit-as-true” rule are met, the court retains “flexibility to remand for further proceedings when 12 the record as a whole creates serious doubt as to whether the claimant is, in fact, disabled within 13 the meaning of the Social Security Act.” Id. at 1021; see also Dominguez v. Colvin, 808 F.3d 14 403, 407 (9th Cir. 2015) (“Unless the district court concludes that further administrative 15 proceedings would serve no useful purpose, it may not remand with a direction to provide 16 benefits.”); Treichler, 775 F.3d at 1105 (“Where . . . an ALJ makes a legal error, but the record is 17 uncertain and ambiguous, the proper approach is to remand the case to the agency.”). 18 Here, the record as a whole creates serious doubt as to whether the claimant was, in fact, 19 disabled during the relevant period. On remand, the ALJ is free to develop the record as needed, 20 including asking a vocational expert hypothetical questions about available jobs based on a 21 revised RFC. The court expresses no opinion regarding how the evidence should ultimately be 22 weighed, and any ambiguities or inconsistencies resolved, on remand. The court also does not 23 instruct the ALJ to credit any particular opinion or testimony. The ALJ may ultimately find 24 plaintiff disabled during the entirety of the relevant period; may find plaintiff eligible for some 25 type of closed period of disability benefits; or may find that plaintiff was never disabled during 26 the relevant period, provided that the ALJ’s determination complies with applicable legal 27 standards and is supported by the record as a whole. 28 1 | CONCLUSION 2 For the reasons stated herein, IT IS HEREBY ORDERED that: 3 1. Plaintiff's motion for summary judgment (ECF No. 9) is GRANTED; 4 2. The Clerk of Court shall enter judgment for plaintiff; and 5 3. This matter is remanded for further proceedings in accordance with this order. 6 | Dated: June 4, 2026 Card □ fe Le a. —

8 UNITED STATES MAGISTRATE JUDGE 9 10 1] 12 || 2/schn1605.dib.ckd 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28