1 FILED IN THE U.S. DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 2 Jul 28, 2025 3 SEAN F. MCAVOY, CLERK 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF WASHINGTON
8 JENNIFER C., No. 1:24-CV-03043-RHW
9 Plaintiff, REPORT AND RECOMMENDATION 10 11 v.
12 FRANK BISIGNANO, 13 COMMISSIONER OF SOCIAL ECF Nos. 9, 11 SECURITY,1 14
15 Defendant. 16 17
BEFORE THE COURT is Plaintiff’s Opening Brief and the 18 Commissioner’s Brief in response. ECF Nos. 9, 11. Attorney D. James Tree 19 represents Jennifer C. (Plaintiff); Special Assistant United States Attorney Lori A. 20 Lookliss represents the Commissioner of Social Security (Defendant). This matter 21 was referred to the undersigned magistrate judge for issuance of a report and 22 recommendation. ECF No. 13. After reviewing the administrative record and the 23 24 25 1 Pursuant to Federal Rule of Civil Procedure 25(d), Frank Bisignano, 26 Commissioner of Social Security, is substituted as the defendant in this suit. No 27 further action need be taken to continue this suit. See 42 U.S.C. § 405(g). 28 1 briefs filed by the parties, the Court RECOMMENDS Plaintiff’s Motion, ECF 2 No. 9, be GRANTED and Defendant’s Motion, ECF No. 11, be DENIED. 3 JURISDICTION 4 Plaintiff filed applications for Disability Insurance Benefits and 5 Supplemental Security Income on December 17, 2019, alleging onset of disability 6 beginning January 1, 2008. Tr. 17, 104, 241-53. The applications were denied 7 initially and upon reconsideration. Tr. 145-60, 162-73. Administrative Law Judge 8 (ALJ) Cecilia LaCara held a hearing on January 12, 2023, Tr. 54-95, and issued an 9 unfavorable decision on February 16, 2023. Tr. 17-30. The Appeals Council 10 denied Plaintiff’s request for review on January 25, 2024, Tr. 1-6, and the ALJ’s 11 February 16, 2023, decision became the final decision of the Commissioner, which 12 is appealable to the district court pursuant to 42 U.S.C. § 405(g). Plaintiff filed this 13 action for judicial review on March 25, 2024. ECF No. 1. 14 STANDARD OF REVIEW 15 The ALJ is tasked with “determining credibility, resolving conflicts in 16 medical testimony, and resolving ambiguities.” Andrews v. Shalala, 53 F.3d 1035, 17 1039 (9th Cir. 1995). The ALJ’s determinations of law are reviewed de novo, with 18 deference to a reasonable interpretation of the applicable statutes. McNatt v. Apfel, 19 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed 20 only if it is not supported by substantial evidence or if it is based on legal error. 21 Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is 22 defined as being more than a mere scintilla, but less than a preponderance. Id. at 23 1098. Put another way, substantial evidence “is such relevant evidence as a 24 reasonable mind might accept as adequate to support a conclusion.” Richardson v. 25 Perales, 402 U.S. 389, 401 (1971), (quoting Consolidated Edison Co. v. NLRB, 26 305 U.S. 197, 229 (1938)). If the evidence is susceptible to more than one rational 27 interpretation, the Court may not substitute its judgment for that of the ALJ. 28 Tackett, 180 F.3d at 1098; Morgan v. Comm’r of Social Sec. Admin., 169 F.3d 595, 1 599 (9th Cir. 1999). If substantial evidence supports the administrative findings, or 2 if conflicting evidence supports a finding of either disability or non-disability, the 3 ALJ’s determination is conclusive. Sprague v. Bowen, 812 F.2d 1226, 1229-1230 4 (9th Cir. 1987). Nevertheless, a decision supported by substantial evidence will be 5 set aside if the proper legal standards were not applied in weighing the evidence 6 and making the decision. Brawner v. Sec’y of Health and Human Servs., 839 F.2d 7 432, 433 (9th Cir. 1988). 8 SEQUENTIAL EVALUATION PROCESS 9 The Commissioner has established a five-step sequential evaluation process 10 for determining whether a person is disabled. 20 C.F.R. § 404.1520(a); Bowen v. 11 Yuckert, 482 U.S. 137, 140-142 (1987). In steps one through four the claimant 12 bears the burden of establishing a prima facie case of disability. Tackett, 180 F.3d 13 at 1098-1099. This burden is met once a claimant establishes that a physical or 14 mental impairment prevents the claimant from engaging in past relevant work. 20 15 C.F.R. § 404.1520(a)(4). If a claimant cannot perform past relevant work, the ALJ 16 proceeds to step five, and the burden shifts to the Commissioner to show (1) that 17 Plaintiff can perform other substantial gainful activity and (2) that a significant 18 number of jobs exist in the national economy which Plaintiff can perform. Kail v. 19 Heckler, 722 F.2d 1496, 1497-1498 (9th Cir. 1984); Beltran v. Astrue, 700 F.3d 20 386, 389 (9th Cir. 2012). If a claimant cannot make an adjustment to other work in 21 the national economy, the claimant will be found disabled. 20 C.F.R. §§ 22 404.1520(a)(4)(v), 416.920(a)(4)(v). 23 ADMINISTRATIVE DECISION 24 On February 16, 2023, the ALJ issued a decision finding Plaintiff was not 25 disabled as defined in the Social Security Act. Tr. 17-30. 26 At step one, the ALJ found Plaintiff, who met the insured status 27 requirements of the Social Security Act through September 30, 2008, had not 28 1 engaged in substantial gainful activity since January 1, 2008, the alleged onset 2 date. Tr. 20. 3 At step two, the ALJ determined Plaintiff had the following severe 4 impairments: lumbar degenerative disk disease and obesity. Id. 5 At step three, the ALJ found Plaintiff did not have an impairment or 6 combination of impairments that met or medically equaled the severity of one of 7 the listed impairments. Tr. 23. 8 The ALJ assessed Plaintiff’s Residual Functional Capacity (RFC) and found 9 she could perform medium work, with the following limitations:
10 [s]he is limited to occasional climbing ladders, ropes, and scaffolds. 11 She can balance frequently. She must avoid moderate exposure to 12 unprotected heights and hazards. 13 Tr. 24. 14 At step four, the ALJ found Plaintiff was able to perform past relevant work 15 as a personal attendant; telephone solicitor; hospital cleaner; collector; residence 16 leasing agent; nursery school attendant; and the composite job of gas station 17 attendant/self-service laundry attendant. Tr. 28.
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1 FILED IN THE U.S. DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 2 Jul 28, 2025 3 SEAN F. MCAVOY, CLERK 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF WASHINGTON
8 JENNIFER C., No. 1:24-CV-03043-RHW
9 Plaintiff, REPORT AND RECOMMENDATION 10 11 v.
12 FRANK BISIGNANO, 13 COMMISSIONER OF SOCIAL ECF Nos. 9, 11 SECURITY,1 14
15 Defendant. 16 17
BEFORE THE COURT is Plaintiff’s Opening Brief and the 18 Commissioner’s Brief in response. ECF Nos. 9, 11. Attorney D. James Tree 19 represents Jennifer C. (Plaintiff); Special Assistant United States Attorney Lori A. 20 Lookliss represents the Commissioner of Social Security (Defendant). This matter 21 was referred to the undersigned magistrate judge for issuance of a report and 22 recommendation. ECF No. 13. After reviewing the administrative record and the 23 24 25 1 Pursuant to Federal Rule of Civil Procedure 25(d), Frank Bisignano, 26 Commissioner of Social Security, is substituted as the defendant in this suit. No 27 further action need be taken to continue this suit. See 42 U.S.C. § 405(g). 28 1 briefs filed by the parties, the Court RECOMMENDS Plaintiff’s Motion, ECF 2 No. 9, be GRANTED and Defendant’s Motion, ECF No. 11, be DENIED. 3 JURISDICTION 4 Plaintiff filed applications for Disability Insurance Benefits and 5 Supplemental Security Income on December 17, 2019, alleging onset of disability 6 beginning January 1, 2008. Tr. 17, 104, 241-53. The applications were denied 7 initially and upon reconsideration. Tr. 145-60, 162-73. Administrative Law Judge 8 (ALJ) Cecilia LaCara held a hearing on January 12, 2023, Tr. 54-95, and issued an 9 unfavorable decision on February 16, 2023. Tr. 17-30. The Appeals Council 10 denied Plaintiff’s request for review on January 25, 2024, Tr. 1-6, and the ALJ’s 11 February 16, 2023, decision became the final decision of the Commissioner, which 12 is appealable to the district court pursuant to 42 U.S.C. § 405(g). Plaintiff filed this 13 action for judicial review on March 25, 2024. ECF No. 1. 14 STANDARD OF REVIEW 15 The ALJ is tasked with “determining credibility, resolving conflicts in 16 medical testimony, and resolving ambiguities.” Andrews v. Shalala, 53 F.3d 1035, 17 1039 (9th Cir. 1995). The ALJ’s determinations of law are reviewed de novo, with 18 deference to a reasonable interpretation of the applicable statutes. McNatt v. Apfel, 19 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed 20 only if it is not supported by substantial evidence or if it is based on legal error. 21 Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is 22 defined as being more than a mere scintilla, but less than a preponderance. Id. at 23 1098. Put another way, substantial evidence “is such relevant evidence as a 24 reasonable mind might accept as adequate to support a conclusion.” Richardson v. 25 Perales, 402 U.S. 389, 401 (1971), (quoting Consolidated Edison Co. v. NLRB, 26 305 U.S. 197, 229 (1938)). If the evidence is susceptible to more than one rational 27 interpretation, the Court may not substitute its judgment for that of the ALJ. 28 Tackett, 180 F.3d at 1098; Morgan v. Comm’r of Social Sec. Admin., 169 F.3d 595, 1 599 (9th Cir. 1999). If substantial evidence supports the administrative findings, or 2 if conflicting evidence supports a finding of either disability or non-disability, the 3 ALJ’s determination is conclusive. Sprague v. Bowen, 812 F.2d 1226, 1229-1230 4 (9th Cir. 1987). Nevertheless, a decision supported by substantial evidence will be 5 set aside if the proper legal standards were not applied in weighing the evidence 6 and making the decision. Brawner v. Sec’y of Health and Human Servs., 839 F.2d 7 432, 433 (9th Cir. 1988). 8 SEQUENTIAL EVALUATION PROCESS 9 The Commissioner has established a five-step sequential evaluation process 10 for determining whether a person is disabled. 20 C.F.R. § 404.1520(a); Bowen v. 11 Yuckert, 482 U.S. 137, 140-142 (1987). In steps one through four the claimant 12 bears the burden of establishing a prima facie case of disability. Tackett, 180 F.3d 13 at 1098-1099. This burden is met once a claimant establishes that a physical or 14 mental impairment prevents the claimant from engaging in past relevant work. 20 15 C.F.R. § 404.1520(a)(4). If a claimant cannot perform past relevant work, the ALJ 16 proceeds to step five, and the burden shifts to the Commissioner to show (1) that 17 Plaintiff can perform other substantial gainful activity and (2) that a significant 18 number of jobs exist in the national economy which Plaintiff can perform. Kail v. 19 Heckler, 722 F.2d 1496, 1497-1498 (9th Cir. 1984); Beltran v. Astrue, 700 F.3d 20 386, 389 (9th Cir. 2012). If a claimant cannot make an adjustment to other work in 21 the national economy, the claimant will be found disabled. 20 C.F.R. §§ 22 404.1520(a)(4)(v), 416.920(a)(4)(v). 23 ADMINISTRATIVE DECISION 24 On February 16, 2023, the ALJ issued a decision finding Plaintiff was not 25 disabled as defined in the Social Security Act. Tr. 17-30. 26 At step one, the ALJ found Plaintiff, who met the insured status 27 requirements of the Social Security Act through September 30, 2008, had not 28 1 engaged in substantial gainful activity since January 1, 2008, the alleged onset 2 date. Tr. 20. 3 At step two, the ALJ determined Plaintiff had the following severe 4 impairments: lumbar degenerative disk disease and obesity. Id. 5 At step three, the ALJ found Plaintiff did not have an impairment or 6 combination of impairments that met or medically equaled the severity of one of 7 the listed impairments. Tr. 23. 8 The ALJ assessed Plaintiff’s Residual Functional Capacity (RFC) and found 9 she could perform medium work, with the following limitations:
10 [s]he is limited to occasional climbing ladders, ropes, and scaffolds. 11 She can balance frequently. She must avoid moderate exposure to 12 unprotected heights and hazards. 13 Tr. 24. 14 At step four, the ALJ found Plaintiff was able to perform past relevant work 15 as a personal attendant; telephone solicitor; hospital cleaner; collector; residence 16 leasing agent; nursery school attendant; and the composite job of gas station 17 attendant/self-service laundry attendant. Tr. 28. 18 At step five, the ALJ found that in the alternative, based on the testimony of 19 the vocational expert, and considering Plaintiff’s age, education, work experience, 20 and RFC, Plaintiff could also perform jobs that existed in significant numbers in 21 the national economy, including the jobs of machine packager; hand packager; and 22 cleaner II. Tr. 29. 23 The ALJ thus concluded Plaintiff was not under a disability within the 24 meaning of the Social Security Act at any time from at any time from the alleged 25 onset date through the date of the decision. Tr. 30. 26 ISSUES 27 Plaintiff seeks judicial review of the Commissioner’s final decision denying 28 her disability insurance benefits under Title II and Title XVI of the Social Security 1 Act. The question presented is whether substantial evidence supports the ALJ’s 2 decision denying benefits and, if so, whether that decision is based on proper legal 3 standards. Plaintiff raises the following issues for review (1) whether the ALJ 4 properly evaluated Plaintiff’s symptom complaints; and (2) whether the ALJ 5 properly evaluated the medical opinion evidence. ECF No. 9 at 2. 6 DISCUSSION 7 A. Symptom Claims 8 Plaintiff contends the ALJ erred by improperly rejecting Plaintiff’s 9 subjective complaints. ECF No. 9 at 4-15. 10 It is the province of the ALJ to make determinations regarding a claimant’s 11 subjective statements. Andrews, 53 F.3d at 1039. However, the ALJ’s findings 12 must be supported by specific, cogent reasons. Rashad v. Sullivan, 903 F.2d 1229, 13 1231 (9th Cir. 1990). Once the claimant produces medical evidence of an 14 underlying medical impairment, the ALJ may not discredit testimony as to the 15 severity of an impairment merely because it is unsupported by medical evidence. 16 Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998). Absent affirmative evidence 17 of malingering, the ALJ’s reasons for rejecting the claimant’s testimony must be 18 “specific, clear and convincing.” Smolen v. Chater, 80 F.3d 1273, 1281 (9th Cir. 19 1996); Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995). “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 at 834; Dodrill v. Shalala, 22 12 F.3d 915, 918 (9th Cir. 1993); see also Smartt v. Kijakazi, 53 F.4th 489, 499 23 (9th Cir. 2022) (“Ultimately, the ‘clear and convincing’ standard requires an ALJ 24 to show [their] work[.]”). Thus, to satisfy the substantial evidence standard, the 25 ALJ must provide specific, clear, and convincing reasons which explain why the 26 medical evidence is inconsistent with the claimant’s subjective symptom 27 testimony. Ferguson v. O’Malley, 95 F.4th 1194, 1200 (9th Cir. 2024) (emphasis 28 in original). 1 The ALJ concluded Plaintiff’s medically determinable impairments could 2 reasonably be expected to cause few of the alleged symptoms; and that Plaintiff’s 3 statements concerning the intensity, persistence, and limiting effects of those 4 symptoms were not entirely consistent with her symptom reports to providers, the 5 conservative nature of her treatment, and the objective medical findings. Tr. 25. 6 1. Objective Evidence 7 The ALJ discounted Plaintiff’s symptom complaints because objective 8 findings did not provide strong support for Plaintiff’s allegations. Id. An ALJ may 9 not discredit a claimant’s symptom testimony and deny benefits solely because the 10 degree of the symptoms alleged is not supported by objective medical evidence. 11 Rollins v. Massanari, 261 F.3d 853, 856 (9th Cir. 2001); Bunnell v. Sullivan, 947 12 F.2d 341, 346-47 (9th Cir. 1991); Fair v. Bowen, 885 F.2d 597, 601 (9th Cir. 13 1989); Burch v. Barnhart, 400 F.3d 676, 680 (9th Cir. 2005). However, the 14 objective medical evidence is a relevant factor, along with the medical source’s 15 information about the claimant’s pain or other symptoms, in determining the 16 severity of a claimant’s symptoms and their disabling effects. Rollins, 261 F.3d at 17 857; 20 C.F.R. §§ 404.1529(c)(2), 416.929(c)(2). Additionally, an ALJ must 18 consider all of the relevant evidence in the record and may not point to only those 19 portions of the records that bolster the ALJ’s findings. See, e.g., Holohan v. 20 Massanari, 246 F.3d 1195, 1207-08 (9th Cir. 2001) (citations omitted). 21 Here, the ALJ noted the record “shows complaints and treatment for back 22 pain” as well as imaging “reflecting abnormalities in the lumbar spine.” Tr. 26. 23 The ALJ noted in Plaintiff’s most recent record, Plaintiff “reported that her back 24 pain was mild,” but the ALJ cited to a page that does not exist in the record. Id. 25 (citing “2F/142”). The ALJ appears to be referencing 3F/142 (Tr. 609), a 26 discharge summary from hospitalization April 29-May 2, 2019, where Plaintiff’s 27 diagnoses included severe opioid use disorder, morbid obesity, community 28 acquired pneumonia, and chronic obstructive pulmonary disease (COPD); records 1 show Plaintiff was there in 2019 for “opioid medical detox” for medications she 2 “first started . . . 7 years ago for her lower back and hip pain.” Tr. 602, 609. The 3 records cited by the ALJ do note Plaintiff’s report of mild back pain upon hospital 4 admission, but the provider also noted Plaintiff had last used a narcotic painkiller 5 “earlier today” and was “now complaining of mild pain in her lower back as well 6 as in her let hip.” Tr. 609. The ALJ left out context related to her reported pain 7 level at that time, and the ALJ failed to mention the impairment(s) that were the 8 focus of the 2019 hospitalization, including “severe opiate use disorder,” as well as 9 COPD. Tr. 26, 611. Records show diagnoses and treatment for chronic pain as 10 well as COPD throughout much of the period at issue, however, which the ALJ 11 failed to mention or adequately discuss in the decision.2 12 While the ALJ cited a record unrelated to Plaintiff’s back impairment to 13 discount her symptom complaints, the ALJ failed to discuss relevant objective 14 findings that supported Plaintiff’s symptom claims. Tr. 26. Indeed, the ALJ cited 15 a 2015 MRI to support the finding that “imaging studies reflect[ed] abnormalities 16 in the lumbar spine” and that “imaging revealed only mild to moderate 17 abnormalities at one level of the lumbar spine,” Tr. 26 (citing Tr. 582), but failed to 18 discuss later imaging including a MRI in 2016 that showed “degenerative 19 spondylosis of the lumbar spine, especially at L3-4, L4-5, and L5-S1” or 2016 20 imaging of her left hip, which showed likely “partial tear of the gluteus medius 21 tendon.” Tr. 579. 22 Additionally, the ALJ discounted Plaintiff’s symptom reports of vertigo and 23 dizziness because there was no evidence of a diagnosis of vertigo based on 24
2 Records show diagnoses including COPD, chronic bronchitis, and asthma, and 25 26 although the ALJ noted some “shortness of breath/upper respiratory symptoms,” 27 the ALJ concluded, without analysis, that respiratory issues were nonsevere; and 28 the ALJ failed to include a limitation in the RFC for respiratory issues. 1 objective findings, and because workups with “brain scans were negative for 2 abnormalities to establish a diagnosis correlated with claimant’s reports of vertigo 3 symptoms.” Tr. 20, 27. The ALJ noted “imaging showed a small left ear issue 4 that was described as stable and benign, and was not associated with vertigo or 5 other symptoms.” Id. (citing Tr. 1323). The imaging cited by the ALJ, however, 6 is a follow up to a 2010 brain and auditory canal MRI which showed a 6mm 7 finding at the left petrous apex, which was noted “may represent trapped fluid in 8 the petrous apex, cholesteatoma of the petrous apex, apical petrositis, etc.” Tr. 9 1347. A follow up MRI a year later showed “no change in the subcentimeter 10 presumed benign, complex cystic focus at the left petrous apex . . . reassuring for 11 benign process” and it was again noted that it “may represent a small focus of 12 complex fluid trapped within a partially pneumatized petrous bone versus 13 cholesteatoma.” Tr. 1323. 14 While the ALJ concluded this finding was “not associated with vertigo or 15 other symptoms,” it is not clear how the ALJ reached this conclusion, as it is not 16 found in the MRI report cited or elsewhere in the record. Id. In fact, medical 17 providers who were aware of the imaging appear to have associated this finding 18 with her reports of vertigo during the period at issue, and it is listed repeatedly in 19 her medical records as a concern. See, e.g., Tr. 434, 479 (past medical history 20 noted with “chronic vertigo, 6mm spot trapped fluid in petrouse apex”), 484 21 (same), 487 (same), 519, 557, 874-75, 942, 1324. The ALJ’s discounting 22 Plaintiff’s reports of vertigo because it was not associated with a diagnosis based 23 on objective findings and that “imaging . . . was not associated with vertigo or 24 other symptoms” is not supported by substantial evidence and is not an accurate 25 characterization of the evidence of record. 26 On this record the ALJ’s conclusion that objective findings did not provide 27 strong support for Plaintiff’s allegations is not supported by substantial evidence. 28 Without further analysis, this was not a clear and convincing reason to discount her 1 symptom claims. Additionally, the ALJ failed to discuss relevant evidence and 2 selectively presented evidence in a manner that minimized Plaintiff’s impairments 3 and/or subjective complaints, resulting in mischaracterization of the record. 4 2. Conservative Treatment/Caregiver 5 The ALJ also found that Plaintiff’s conservative treatment was inconsistent 6 with her allegations. Tr. 26. Evidence of conservative treatment is sufficient to 7 discount a claimant’s testimony regarding the severity of an impairment. See 8 Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008). Here, the ALJ 9 concluded Plaintiff required only conservative treatment for back pain, consisting 10 of medication, and that Plaintiff failed to substantiate “either the existence of a 11 caregiver or the medical need for a caregiver due to vertigo symptoms” and “the 12 overall record does not reflect vertigo symptoms severe enough to warrant 13 caregiving services.” Tr. 26. As discussed supra, records show treatment during 14 the period at issue for chronic pain including back pain with opiate pain 15 medications, and the ALJ failed to properly assess objective evidence related to her 16 back impairment and chronic pain, as well as treatment for these issues and 17 resultant opiate use disorder. On this record, the ALJ’s conclusion Plaintiff’s 18 symptom claims were inconsistent with her conservative treatment is not supported 19 by substantial evidence. 20 In terms of a caregiver, while Plaintiff contends DSHS records show 21 Plaintiff was eligible for a caregiver, this is not evident from the records Plaintiff 22 cited. Tr. 964-65, 970-71, 976-83. The ALJ has an independent duty, however, to 23 fully and fairly develop a record in order to make a fair determination as to 24 disability, even where, as here, the claimant is represented by counsel. Celaya v. 25 Halter, 332 F.3d 1177, 1183 (9th Cir. 2003); see also Tonapetyan v. Halter, 242 26 F.3d 1144, 1150 (9th Cir. 2001); Crane v. Shalala, 76 F.3d 251, 255 (9th Cir. 27 1995). “Ambiguous evidence, or the ALJ’s own finding that the record is 28 inadequate to allow for proper evaluation of the evidence, triggers the ALJ's duty 1 to ‘conduct an appropriate inquiry.’” See Tonapetyan, 242 F.3d at 1150 (quoting 2 Smolen, 80 F.3d at 1288). 3 Here, Plaintiff testified her daughter is paid by the State of Washington 4 DSHS/Aging and Long-Term Care to provide caregiving services to Plaintiff 166 5 hours a month and has been for several years. Tr. 65. Plaintiff testified that she 6 requires these services to assist in self-care including bathing and dressing due to 7 her back issues, as well as vertigo. Tr. 65-67. The ALJ, however, discounted her 8 claims without analysis because she “did not provide evidence to substantiate the 9 caregiver or medical need for a caregiver due to vertigo symptoms.” Tr. 26. This 10 is insufficient. 11 It is not clear, however, why Plaintiff’s representative did not assist in 12 providing additional supporting evidence and on remand Plaintiff will assist the 13 ALJ in developing the record with any documentation available to support 14 Plaintiff’s need for a caregiver. 15 On this record, the ALJ’s conclusion Plaintiff’s conservative treatment was 16 inconsistent with her allegations is not supported by substantial evidence and this 17 was not a clear and convincing reason to discount her symptom claims. 18 3. Inconsistent Statements 19 The ALJ also found Plaintiff’s allegations and hearing testimony were 20 inconsistent with her symptom reports and complaints to providers. Tr. 25-26. In 21 evaluating a claimant’s symptom claims, an ALJ may consider the consistency of 22 an individual’s own statements made in connection with the disability-review 23 process with any other existing statements or conduct under other circumstances. 24 Smolen, 80 F.3d at 1284. 25 Here, the ALJ found most recent evidence of record reflected almost no 26 specific complaints of vertigo symptoms and that the evidence was not consistent 27 with Plaintiff’s allegations about need for a caregiver. Tr. 25-26. As discussed 28 supra, however, the ALJ failed to discuss relevant evidence, including evidence of 1 Plaintiff’s impairments, and failed to develop the record in terms of her need for a 2 caregiver. On this record, without further discussion, the ALJ’s conclusion 3 Plaintiff’s allegations and hearing testimony were inconsistent with her symptom 4 reports and complaints to providers is also not supported by substantial evidence. 5 While the ALJ concluded Plaintiff’s medically determinable impairments 6 could be expected to cause few of the alleged symptoms, the ALJ failed to mention 7 or discuss several impairments, failed to discuss relevant evidence, and selectively 8 presented evidence in a manner that minimized Plaintiff’s impairments and/or 9 subjective complaints, resulting in mischaracterization of the record. Records 10 show Plaintiff was treated with opiate medication for lumbar stenosis and chronic 11 pain syndrome during the period at issue, that she was also treated for opiate use 12 disorder, and she was had chronic respiratory issues including COPD, which the 13 ALJ failed to adequately assess. See, e.g., Tr. 611, 836. Accordingly, the ALJ’s 14 analysis is insufficient. 15 Upon remand, the ALJ will reassess all relevant medical evidence with the 16 assistance of medical expert testimony, reperform the sequential analysis, and 17 reassess Plaintiffs symptom claims. 18 B. Medical Opinions 19 Plaintiff contends the ALJ improperly evaluated the medical opinion 20 evidence. ECF No. 9 at 15-19. 21 As the claim is remanded for reconsideration of Plaintiff’s symptom claims 22 and reconsideration of all relevant medical evidence with the assistance of medical 23 expert testimony, the ALJ will also reconsider all relevant medical opinions. As 24 there are no recent medical opinions, Plaintiff’s representative and the ALJ will 25 assist Plaintiff in obtaining a consultative examination or opinion from current 26 provider(s) to determine her current level of functioning; the ALJ will determine 27 whether medical opinions between her date last insured and her Title XVI claim 28 1 are relevant to her current claim(s), and the ALJ will obtain medical expert 2 testimony to assist in determining her impairments and level of functioning. 3 CONCLUSION 4 Having reviewed the record and the ALJ’s findings, the Court finds the 5 ALJ’s decision is not supported by substantial evidence and not free of harmful 6 error. Plaintiff argues the decision should be reversed and remanded for the 7 payment of benefits. ECF No. 9 at 19. The Court has the discretion to remand the 8 case for additional evidence and findings or to award benefits. Smolen, 80 F.3d at 9 1292. The Court may award benefits if the record is fully developed and further 10 administrative proceedings would serve no useful purpose. Id. Remand is 11 appropriate when additional administrative proceedings could remedy defects. 12 Rodriguez v. Bowen, 876 F.2d 759, 763 (9th Cir. 1989). The Court will also not 13 remand for immediate payment of benefits if “the record as a whole creates serious 14 doubt that a claimant is, in fact, disabled.” Garrison, 759 F.3d at 1021. 15 Here, it is not clear that the ALJ would be required to find Plaintiff disabled, 16 or disabled through the entire period at issue, if all the evidence were properly 17 evaluated. Plaintiff’s date last insured was in 2008, and she has alleged disability 18 beginning in 2008. See Tr. 20. Despite explaining that Plaintiff had prior 19 administrative final determinations on a 2012 Title II claim and had received Title 20 XVI benefits from 2012 through 2016, Tr. 17-18, and despite finding there was no 21 support for reopening any prior denials and/or cessation of benefits, the ALJ went 22 on to make a determination on both Plaintiff’s current Title II and Title XVI claims 23 for the entire period at issue from 2008 through the date of the decision. Tr. 17-18, 24 30. Neither Plaintiff or Defendant has offered any explanation of why or how the 25 ALJ reached already decided and administratively final claims through 2016, and 26 there is no evidence of the prior grant and then cessation of benefits in the 27 administrative record, aside from the ALJ’s brief discussion in the procedural 28 history of the claim. Upon remand the ALJ will determine the actual period at 1 issue and decide Plaintiff’s claim(s) based on relevant evidence for the period at 2 issue. 3 Accordingly, the Court finds further proceedings are necessary to resolve 4 conflicts in the record and to determine the actual period at issue, as well as to 5 further develop the record with updated medical evidence and medical expert 6 testimony to determine Plaintiff’s level of functioning during the period at issue; 7 the ALJ will obtain a consultative exam, if necessary. 8 Upon remand, the ALJ will obtain all updated medical records and 9 reevaluate the medical evidence. The ALJ is instructed to reassess Plaintiff’s 10 subjective complaints as well as relevant medical opinion evidence, and to perform 11 the sequential analysis anew with the assistance of medical expert testimony. The 12 ALJ will make new findings on each of the five steps of the sequential evaluation 13 process, take the testimony of a vocational expert, and issue a new decision. The 14 ALJ will take into consideration any other evidence or testimony relevant to 15 Plaintiff’s disability claim. 16 Accordingly, IT IS HEREBY RECOMMENDED Plaintiff’s Motion for 17 Summary Judgment, ECF No. 9, be GRANTED; Defendant’s Motion for 18 Summary Judgment, ECF No. 11, be DENIED; and the District Court Executive 19 enter Judgment for Plaintiff REVERSING and REMANDING the matter for 20 further proceedings consistent with this recommendation pursuant to sentence four 21 of 42 U.S.C. § 405(g). 22 OBJECTIONS 23 Any party may object to a magistrate judge’s proposed findings, 24 recommendations or report within fourteen (14) days following service with a copy 25 thereof. Such party shall file written objections with the Clerk of the Court and 26 serve objections on all parties, specifically identifying the portions to which 27 objection is being made, and the basis therefor. Any response to the objection 28 shall be filed within fourteen (14) days after receipt of the objection. Attention is directed to Fed. R. Civ. P. 6(d), which adds additional time after certain kinds of 2 || service. 3 A district judge will make a de novo determination of those portions to 4|| which objection is made and may accept, reject, or modify the magistrate judge’s 5|| determination. The judge need not conduct a new hearing or hear arguments and 6|| may consider the magistrate judge’s record and make an independent determination thereon. The judge may, but is not required to, accept or consider 8 || additional evidence, or may recommit the matter to the magistrate judge with instructions. United States v. Howell, 231 F.3d 615, 621 (9th Cir. 2000); 28 U.S.C. 10|| § 636(b)(1)(B) and (C), Fed. R. Civ. P. 72; LMJR 2, Local Rules for the Eastern District of Washington. 12 A magistrate judge’s recommendation cannot be appealed to a court of 13 || appeals; only the district judge’s order or judgment can be appealed. 14 The District Court Executive is directed to update the docket sheet to reflect the substitution of Frank Bisignano as Defendant, file this Report and 16|| Recommendation, and provide copies to counsel. 17 DATED July 28, 2025.
: Clan ( Glidim awl de ALEXANDER C. EKSTROM UNITED STATES MAGISTRATE JUDGE
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