Esselstrom v. Chater

67 F.3d 869, 95 Daily Journal DAR 13549, 95 Cal. Daily Op. Serv. 7881, 1995 U.S. App. LEXIS 27943, 1995 WL 584430
CourtCourt of Appeals for the Ninth Circuit
DecidedOctober 6, 1995
DocketNo. 94-35506
StatusPublished
Cited by6 cases

This text of 67 F.3d 869 (Esselstrom v. Chater) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Esselstrom v. Chater, 67 F.3d 869, 95 Daily Journal DAR 13549, 95 Cal. Daily Op. Serv. 7881, 1995 U.S. App. LEXIS 27943, 1995 WL 584430 (9th Cir. 1995).

Opinion

FERNANDEZ, Circuit Judge:

Craig Esselstrom appeals the district court’s order affirming the decision of the Secretary of Health & Human Services denying his application for disability insurance benefits under Title II of the Social Security Act. Esselstrom claims that he is disabled by schizophrenia. We reverse.

BACKGROUND FACTS

Esselstrom, who was born in 1950, worked in a timber mill from 1974 to 1979, at which time he quit to attend college. Shortly thereafter, however, his mental condition began to deteriorate. His strange public behavior and self-destructiveness caused him to be hospitalized several times in 1981 and 1983. He was ultimately diagnosed as suffering from chronic undifferentiated schizophrenia, with some paranoid tendencies. Es-selstrom is also apparently hindered by alcoholism.

Esselstrom applied for and was granted Title II disability benefits effective September 1984. With medication, his condition stabilized. In December 1985, he began working at a plywood mill. In July 1986, the Secretary determined that he was no longer disabled and terminated his benefits. In August 1991, Esselstrom was laid off from the mill. Others who were laid off at the same time have since been rehired, but not Essel-strom.

Esselstrom’s relationship with his coworkers had begun to deteriorate shortly before he was laid off. He was also involved in a work-related accident at around that time, which may have been caused by his inability to concentrate.

For ten years, until mid-1992, when he was evicted on account of his drinking, Essel-strom lived in a group home with other individuals undergoing treatment for mental illness. The home did not have a great deal of structure, and he took care of most of his own daily needs, such as cooking and cleaning his room. However, the government concedes that the living arrangement qualified as highly supportive. At the time of the administrative hearing in late 1992, Essel-strom was again living in a group-home situation with other people taking medication to help their mental illness.

In December 1991, Esselstrom again applied for Title II disability benefits, alleging an onset date of August 22,1991. The application was denied both initially and upon reconsideration on the ground that Essel-strom’s condition does not meet or equal in severity a listed impairment. A hearing before an ALJ was held on December 2, 1992, and on January 29,1993, he issued a decision denying the application. In February 1993, Esselstrom was again hospitalized because of his mental condition, this time for ten days. The ALJ’s decision became final when the Appeals Council denied review on June 1, 1993. The district court affirmed the ALJ, and this appeal followed.

JURISDICTION AND STANDARD OF REVIEW

The district court had jurisdiction under 42 U.S.C. § 405(g). We have jurisdiction under 28 U.S.C. § 1291.

[872]*872A district court’s order upholding the Secretary’s denial of benefits is reviewed de novo. Travers v. Shalala, 20 F.3d 993, 995-96 (9th Cir.1994). The decision of the Secretary must be affirmed if it is supported by substantial evidence. Matthews v. Shalala, 10 F.3d 678, 679 (9th Cir.1993). Substantial evidence, considering the entire record, is relevant evidence that a reasonable person might accept as adequate to support a conclusion. Id.

The Secretary’s interpretation of the Social Security regulations is generally given great deference. Mines v. Sullivan, 981 F.2d 1068, 1070 (9th Cir.1992), cert. denied, — U.S. -, 113 S.Ct. 2993, 125 L.Ed.2d 688 (1993). “This principle is not, however, absolute. A court need not accept an agency’s interpretation of its own regulations if that interpretation is inconsistent with the wording of the regulation or inconsistent with the statute under which the regulations were promulgated.” Id.

DISCUSSION

The Social Security Act sets out a five-step process for determining the existence of a disability. “If it can be determined that a claimant is disabled or not disabled at any point in the review, that finding is made, and the review is ended.” Matney ex rel. Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir.1992).

Esselstrom challenges the Secretary’s determination, at stage three of the review process, see 20 C.F.R. § 404.1520(d), that his impairment does not meet or equal any of the impairments listed in part 404, subpart P, appendix 1. He contends that his schizophrenia meets the severity of No. 12.03(C) in appendix 1. If so, that would create a conclusive, not a rebuttable, presumption that he was disabled under Title II of the Act. See Bowen v. Yuckert, 482 U.S. 137, 141, 146 n. 5, 107 S.Ct. 2287, 2291, 2294 n. 5, 96 L.Ed.2d 119 (1987).

In order to be presumptively disabled under No. 12.03(C), a claimant must show that he has a “[m]edically documented history of one or more episodes of acute symptoms, signs and functional limitations which at the time met the requirements in A and B of this listing, although these symptoms or signs are currently attenuated by medication or psychosocial support.” In addition, he must show either (1) that he has undergone “[r]e-peated episodes of deterioration or decom-pensation in situations which cause the individual to withdraw from that situation or to experience exacerbation of signs or symptoms” or (2) that he has a “[d]ocumented current history of two or more years of inability to function outside of a highly supportive living situation.” 20 C.F.R. pt. 404, subpt. P, App. 1, 12.03(C)(1), (2).

The ALJ found that Esselstrom could not satisfy any of the three component parts of No. 12.03(C). The Secretary concedes that Esselstrom has a “medically documented history of one or more episodes of acute symptoms, signs and functional limitations” sufficient to satisfy the first part of 12.03(C), and that only the two numbered components are in issue. Indeed, substantial evidence did not support the ALJ’s contrary conclusion, given Esselstrom’s history of hospitalization and of auditory hallucinations, even while he was working.

As to the first numbered component, 12.03(C)(1), in attempting to intuit the ALJ’s theory of this case from his decidedly skimpy findings, the district court incorrectly interpreted the subsection and in doing so made it more difficult for Esselstrom to satisfy its requirements. In his report and recommendation, the magistrate judge stated that 12.03(C)(1) requires that a claimant show that he has had repeated episodes of deterioration or decompensation in the workplace. That is not accurate.

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67 F.3d 869, 95 Daily Journal DAR 13549, 95 Cal. Daily Op. Serv. 7881, 1995 U.S. App. LEXIS 27943, 1995 WL 584430, Counsel Stack Legal Research, https://law.counselstack.com/opinion/esselstrom-v-chater-ca9-1995.