EVA OCHOA v. FRANK BISIGNANO, Commissioner of Social Security

E.D. California

EVA OCHOA v. FRANK BISIGNANO, Commissioner of Social Security

District Court, E.D. California·Decided June 8, 2026·No. 1:25-cv-00509·Unknown

Opinion

1 2 3 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF CALIFORNIA 7 EVA OCHOA, Case No. 1:25-cv-00509-JLT-EGC

8 Plaintiff, FINDINGS AND RECOMMENDATIONS RECOMMENDING THAT PLAINTIFF’S 9 v. MOTION FOR SUMMARY JUDGMENT BE GRANTED AND THE ACTION BE 10 REMANDED TO THE COMMISSIONER FOR FURTHER PROCEEDINGS 11 FRANK BISIGNANO, Commissioner of Social Security1 12 (Doc. 1) Defendant. 13 14-DAY DEADLINE

14 15 _______________________________________/ 16 I. INTRODUCTION 17 Plaintiff Eva Ochoa (“Plaintiff”) seeks judicial review of a final decision of the 18 Commissioner of Social Security (the “Commissioner” or “Defendant”) denying her deceased 19 husband (“Claimant”)’s applications for disability insurance benefits (“DIB”) and supplemental 20 security income (“SSI”) under the Social Security Act (the “Act”). (Doc. 1). The matter is 21 currently before the Court on the parties’ briefs, which were submitted, without oral argument, to 22 the Honorable Erin E. Guy Castillo, United States Magistrate Judge.2 23 For the reasons set forth below, the undersigned recommends that Plaintiff’s motion for 24 summary judgment be granted and that the action be remanded to the Commissioner for further 25

26 1 On May 7, 2025, Frank Bisignano was named Commissioner of the Social Security Administration. See https://www.ssa.gov/history/commissioners.html. He is therefore substituted as the defendant in this action. See 42 27 U.S.C. § 405(g) (referring to the “Commissioner’s Answer”); 20 C.F.R. § 422.210(d) (“the person holding the Office of the Commissioner shall, in [their] official capacity, be the proper defendant.”). 28 2 The matter is referred to a United States Magistrate Judge pursuant to 28 U.S.C. § 636(b)(1)(B) and E.D. Cal. Local 1 proceedings. 2 II. BACKGROUND 3 Claimant was born in 1970. (Administrative Record (“AR”) 285). He completed sixth grade. 4 (AR 37). Claimant filed applications for DIB and SSI, alleging Claimant became disabled on 5 January 1, 2011, later amended to May 7, 2018. (AR 283–92, 860). 6 A. Relevant Evidence of Record3 7 The medical evidence of record includes various medical records (e.g. treatment records, 8 physical exams) from both before and after the onset date, (see, e.g., AR 484−850, 1130−50), and 9 medical source statements from State agency consultants and physicians, (AR 66−67, 77−79). 10 B. Administrative Proceedings 11 The Commissioner denied Claimant’s application for benefits initially on July 2, 2018, and 12 again on reconsideration on August 14, 2018. (AR 59–83). Consequently, Plaintiff requested a 13 hearing before an Administrative Law Judge (“ALJ”). (AR 113). The ALJ conducted a hearing on 14 February 2, 2021. (AR 31–46). Plaintiff appeared at the hearing with her attorney and testified as 15 to Claimant’s alleged disabling conditions and work history. (AR 37–42). 16 A Vocational Expert (“VE”) also testified at the hearing. (AR 43–46). 17 C. The ALJ’s Decision 18 In a decision dated February 23, 2021, the ALJ found that Claimant was not disabled. (AR 19 12–30). The ALJ conducted the five-step disability analysis set forth in 20 C.F.R. § 404.1520. (AR 20 17–24). The ALJ decided that Claimant had not engaged in substantial gainful activity since May 21 7, 2018. (AR 17). At step two, the ALJ found Claimant’s following impairments to be severe: 22 schizoaffective disorder; posttraumatic stress disorder (PTSD); and obesity. (AR 17–18). The ALJ 23 then determined that Claimant did not have an impairment or combination of impairments that met 24 or medically equaled one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 25 (“the Listings”) (step three). (AR 18–19). 26 27

28 3 Because the parties are familiar with the medical evidence, it is summarized here only to the extent relevant to the 1 The ALJ assessed Claimant’s residual functional capacity (RFC)4 and applied the assessment 2 at steps four and five. See 20 C.F.R. § 404.1520(a)(4) (“Before we go from step three to step four, 3 we assess your residual functional capacity . . . . We use this residual functional capacity assessment 4 at both step four and step five when we evaluate your claim at these steps.”). The ALJ determined 5 that Claimant had the following RFC: 6 [T]o perform light work as defined in 20 CFR 416.967(b) except he was able to understand, remember, and carry out only simple instructions that could have been 7 learned in 30 days or less and he was able to sustain concentration, persistence, and pace to those simple instructions for two-hour intervals with normal breaks. 8 (AR 19; see also id. 19–22). Although the ALJ recognized that Claimant’s impairments “could 9 reasonably be expected to cause the alleged symptoms,” the ALJ rejected Plaintiff’s subjective 10 testimony as to “the intensity, persistence and limiting effects of these symptoms” as being “not 11 entirely consistent with the medical evidence and other evidence in the record.” (AR 20). 12 The ALJ then determined that Claimant had no past work relevant experience (step four) 13 but that, given Claimant’s RFC, Claimant could perform a significant number of jobs in the national 14 economy (step five). (AR 23–24). In making this determination, the ALJ relied on the VE’s 15 answers to a series of hypothetical questions the ALJ posed to the VE during the hearing. (AR 23). 16 The VE testified that a person with the RFC specified above could perform the jobs of small 17 products assembler, cleaner/housekeeper, and sales attendant. (AR 43–44). The ALJ ultimately 18 concluded Claimant was not disabled at any time after May 7, 2018, the alleged onset date. (AR 19 24). 20 Plaintiff sought review of this decision before the Appeals Council, which denied review on 21 June 7, 2021. (AR 1–6). Therefore, the ALJ’s decision became the final decision of the 22 Commissioner. 20 C.F.R. § 404.981. 23 /// 24

25 4 RFC is an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis of eight hours a day, for five days a week, or an equivalent work schedule. 26 TITLES II & XVI: ASSESSING RESIDUAL FUNCTIONAL CAPACITY IN INITIAL CLAIMS, Social Security Ruling (“SSR”) 96-8P (S.S.A. July 2, 1996). The RFC assessment considers only functional limitations and restrictions that result 27 from an individual’s medically determinable impairment or combination of impairments. Id. “In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record, including, inter alia, medical records, lay 28 evidence, and ‘the effects of symptoms, including pain, that are reasonably attributed to a medically determinable 1 III. LEGAL STANDARD 2 A. Applicable Law 3 An individual is considered “disabled” for purposes of disability benefits if [they are] unable 4 “to engage in any substantial gainful activity by reason of any medically determinable physical or 5 mental impairment which can be expected to result in death or which has lasted or can be expected 6 to last for a continuous period of not less than 12 months.” 42 U.S.C.

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1 2 3 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF CALIFORNIA 7 EVA OCHOA, Case No. 1:25-cv-00509-JLT-EGC

8 Plaintiff, FINDINGS AND RECOMMENDATIONS RECOMMENDING THAT PLAINTIFF’S 9 v. MOTION FOR SUMMARY JUDGMENT BE GRANTED AND THE ACTION BE 10 REMANDED TO THE COMMISSIONER FOR FURTHER PROCEEDINGS 11 FRANK BISIGNANO, Commissioner of Social Security1 12 (Doc. 1) Defendant. 13 14-DAY DEADLINE

14 15 _______________________________________/ 16 I. INTRODUCTION 17 Plaintiff Eva Ochoa (“Plaintiff”) seeks judicial review of a final decision of the 18 Commissioner of Social Security (the “Commissioner” or “Defendant”) denying her deceased 19 husband (“Claimant”)’s applications for disability insurance benefits (“DIB”) and supplemental 20 security income (“SSI”) under the Social Security Act (the “Act”). (Doc. 1). The matter is 21 currently before the Court on the parties’ briefs, which were submitted, without oral argument, to 22 the Honorable Erin E. Guy Castillo, United States Magistrate Judge.2 23 For the reasons set forth below, the undersigned recommends that Plaintiff’s motion for 24 summary judgment be granted and that the action be remanded to the Commissioner for further 25

26 1 On May 7, 2025, Frank Bisignano was named Commissioner of the Social Security Administration. See https://www.ssa.gov/history/commissioners.html. He is therefore substituted as the defendant in this action. See 42 27 U.S.C. § 405(g) (referring to the “Commissioner’s Answer”); 20 C.F.R. § 422.210(d) (“the person holding the Office of the Commissioner shall, in [their] official capacity, be the proper defendant.”). 28 2 The matter is referred to a United States Magistrate Judge pursuant to 28 U.S.C. § 636(b)(1)(B) and E.D. Cal. Local 1 proceedings. 2 II. BACKGROUND 3 Claimant was born in 1970. (Administrative Record (“AR”) 285). He completed sixth grade. 4 (AR 37). Claimant filed applications for DIB and SSI, alleging Claimant became disabled on 5 January 1, 2011, later amended to May 7, 2018. (AR 283–92, 860). 6 A. Relevant Evidence of Record3 7 The medical evidence of record includes various medical records (e.g. treatment records, 8 physical exams) from both before and after the onset date, (see, e.g., AR 484−850, 1130−50), and 9 medical source statements from State agency consultants and physicians, (AR 66−67, 77−79). 10 B. Administrative Proceedings 11 The Commissioner denied Claimant’s application for benefits initially on July 2, 2018, and 12 again on reconsideration on August 14, 2018. (AR 59–83). Consequently, Plaintiff requested a 13 hearing before an Administrative Law Judge (“ALJ”). (AR 113). The ALJ conducted a hearing on 14 February 2, 2021. (AR 31–46). Plaintiff appeared at the hearing with her attorney and testified as 15 to Claimant’s alleged disabling conditions and work history. (AR 37–42). 16 A Vocational Expert (“VE”) also testified at the hearing. (AR 43–46). 17 C. The ALJ’s Decision 18 In a decision dated February 23, 2021, the ALJ found that Claimant was not disabled. (AR 19 12–30). The ALJ conducted the five-step disability analysis set forth in 20 C.F.R. § 404.1520. (AR 20 17–24). The ALJ decided that Claimant had not engaged in substantial gainful activity since May 21 7, 2018. (AR 17). At step two, the ALJ found Claimant’s following impairments to be severe: 22 schizoaffective disorder; posttraumatic stress disorder (PTSD); and obesity. (AR 17–18). The ALJ 23 then determined that Claimant did not have an impairment or combination of impairments that met 24 or medically equaled one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 25 (“the Listings”) (step three). (AR 18–19). 26 27

28 3 Because the parties are familiar with the medical evidence, it is summarized here only to the extent relevant to the 1 The ALJ assessed Claimant’s residual functional capacity (RFC)4 and applied the assessment 2 at steps four and five. See 20 C.F.R. § 404.1520(a)(4) (“Before we go from step three to step four, 3 we assess your residual functional capacity . . . . We use this residual functional capacity assessment 4 at both step four and step five when we evaluate your claim at these steps.”). The ALJ determined 5 that Claimant had the following RFC: 6 [T]o perform light work as defined in 20 CFR 416.967(b) except he was able to understand, remember, and carry out only simple instructions that could have been 7 learned in 30 days or less and he was able to sustain concentration, persistence, and pace to those simple instructions for two-hour intervals with normal breaks. 8 (AR 19; see also id. 19–22). Although the ALJ recognized that Claimant’s impairments “could 9 reasonably be expected to cause the alleged symptoms,” the ALJ rejected Plaintiff’s subjective 10 testimony as to “the intensity, persistence and limiting effects of these symptoms” as being “not 11 entirely consistent with the medical evidence and other evidence in the record.” (AR 20). 12 The ALJ then determined that Claimant had no past work relevant experience (step four) 13 but that, given Claimant’s RFC, Claimant could perform a significant number of jobs in the national 14 economy (step five). (AR 23–24). In making this determination, the ALJ relied on the VE’s 15 answers to a series of hypothetical questions the ALJ posed to the VE during the hearing. (AR 23). 16 The VE testified that a person with the RFC specified above could perform the jobs of small 17 products assembler, cleaner/housekeeper, and sales attendant. (AR 43–44). The ALJ ultimately 18 concluded Claimant was not disabled at any time after May 7, 2018, the alleged onset date. (AR 19 24). 20 Plaintiff sought review of this decision before the Appeals Council, which denied review on 21 June 7, 2021. (AR 1–6). Therefore, the ALJ’s decision became the final decision of the 22 Commissioner. 20 C.F.R. § 404.981. 23 /// 24

25 4 RFC is an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis of eight hours a day, for five days a week, or an equivalent work schedule. 26 TITLES II & XVI: ASSESSING RESIDUAL FUNCTIONAL CAPACITY IN INITIAL CLAIMS, Social Security Ruling (“SSR”) 96-8P (S.S.A. July 2, 1996). The RFC assessment considers only functional limitations and restrictions that result 27 from an individual’s medically determinable impairment or combination of impairments. Id. “In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record, including, inter alia, medical records, lay 28 evidence, and ‘the effects of symptoms, including pain, that are reasonably attributed to a medically determinable 1 III. LEGAL STANDARD 2 A. Applicable Law 3 An individual is considered “disabled” for purposes of disability benefits if [they are] unable 4 “to engage in any substantial gainful activity by reason of any medically determinable physical or 5 mental impairment which can be expected to result in death or which has lasted or can be expected 6 to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). However, 7 “[a]n individual shall be determined to be under a disability only if [their] physical or mental 8 impairment or impairments are of such severity that [they are] not only unable to do [their] previous 9 work but cannot, considering [their] age, education, and work experience, engage in any other kind 10 of substantial gainful work which exists in the national economy.” Id. § 423(d)(2)(A). 11 “The Social Security Regulations set out a five-step sequential process for determining 12 whether a claimant is disabled within the meaning of the Social Security Act.” Tackett v. Apfel, 180 13 F.3d 1094, 1098 (9th Cir. 1999) (citing 20 C.F.R. § 404.1520). The Ninth Circuit has provided the 14 following description of the sequential evaluation analysis: 15 In step one, the ALJ determines whether a claimant is currently engaged in substantial gainful activity. If so, the claimant is not disabled. If not, the ALJ 16 proceeds to step two and evaluates whether the claimant has a medically severe impairment or combination of impairments. If not, the claimant is not disabled. If 17 so, the ALJ proceeds to step three and considers whether the impairment or combination of impairments meets or equals a listed impairment under 20 C.F.R. pt. 18 404, subpt. P, [a]pp. 1. If so, the claimant is automatically presumed disabled. If 19 not, the ALJ proceeds to step four and assesses whether the claimant is capable of performing [their] past relevant work. If so, the claimant is not disabled. If not, the 20 ALJ proceeds to step five and examines whether the claimant has the [RFC] . . . to perform any other substantial gainful activity in the national economy. If so, the 21 claimant is not disabled. If not, the claimant is disabled. 22 Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “If a claimant is found to be ‘disabled’ or 23 ‘not disabled’ at any step in the sequence, there is no need to consider subsequent steps.” Tackett, 24 180 F.3d at 1098 (citing 20 C.F.R. § 404.1520). 25 “The claimant carries the initial burden of proving a disability in steps one through four of 26 the analysis.” Burch, 400 F.3d at 679 (citing Swenson v. Sullivan, 876 F.2d 683, 687 (9th Cir. 1989)). 27 “However, if a claimant establishes an inability to continue [their] past work, the burden shifts to 28 the Commissioner in step five to show that the claimant can perform other substantial gainful work.” 1 Id. (citing Swenson, 876 F.2d at 687). 2 B. Scope of Review 3 “This court may set aside the Commissioner’s denial of [social security] benefits [only] when 4 the ALJ’s findings are based on legal error or are not supported by substantial evidence in the record 5 as a whole.” Tackett, 180 F.3d at 1097 (citation omitted). “Substantial evidence . . . is ‘more than 6 a mere scintilla,’” and means only “such relevant evidence as a reasonable mind might accept as 7 adequate to support a conclusion.” Biestek v. Berryhill, 587 U.S. 97, 103 (2019) (quoting Consol. 8 Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); see also Ford v. Saul, 950 F.3d 1141, 1154 (9th 9 Cir. 2020). 10 “This is a highly deferential standard of review.” Valentine v. Comm’r of Soc. Sec. Admin., 11 574 F.3d 685, 690 (9th Cir. 2009). “The ALJ’s findings will be upheld if supported by inferences 12 reasonably drawn from the record.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008) 13 (citation omitted). Additionally, “[t]he court will uphold the ALJ’s conclusion when the evidence 14 is susceptible to more than one rational interpretation.” Id.; see, e.g., Edlund v. Massanari, 253 F.3d 15 1152, 1156 (9th Cir. 2001) (“If the evidence is susceptible to more than one rational interpretation, 16 the court may not substitute its judgment for that of the Commissioner.” (citations omitted)). 17 Nonetheless, “the Commissioner’s decision ‘cannot be affirmed simply by isolating a 18 specific quantum of supporting evidence.’” Tackett, 180 F.3d at 1098 (quoting Sousa v. Callahan, 19 143 F.3d 1240, 1243 (9th Cir. 1998)). “Rather, a court must ‘consider the record as a whole, 20 weighing both evidence that supports and evidence that detracts from the [Commissioner’s] 21 conclusion.’” Id. (quoting Penny v. Sullivan, 2 F.3d 953, 956 (9th Cir. 1993)). 22 Finally, courts “may not reverse an ALJ’s decision on account of an error that is harmless.” 23 Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (citing Stout v. Comm’r, Soc. Sec. Admin., 24 454 F.3d 1050, 1055–56 (9th Cir. 2006)). Harmless error “exists when it is clear from the record 25 that ‘the ALJ’s error was inconsequential to the ultimate nondisability determination.’” Tommasetti, 26 533 F.3d at 1038 (quoting Robbins v. Soc. Sec. Admin., 466 F.3d 880, 885 (9th Cir. 2006)). “[T]he 27 burden of showing that an error is harmful normally falls upon the party attacking the agency’s 28 determination.” Shinseki v. Sanders, 556 U.S. 396, 409 (2009) (citations omitted). 1 IV. DISCUSSION 2 Plaintiff asserts two claims of error: the ALJ failed to (1) comply with the remand order from 3 the Appeals Council and (2) formulate an RFC supported by substantial evidence as the RFC is 4 unsupported by any medical opinion. (See Doc. 18 at 4–9). The Commissioner counters that the 5 ALJ (1) complied with Appeals Council’s remand order and (2) adequately developed the record. 6 (Doc. 22 at 3–8). The undersigned finds that the issue of ALJ’s compliance with the Appeals 7 Council’s remand order is unreviewable but agrees with Plaintiff that the assessed RFC is not 8 supported by substantial evidence. 9 A. The ALJ’s Compliance with the Appeals Council’s Remand Order 10 “It is well settled that federal courts only have jurisdiction to review the final decisions of 11 administrative agencies.” Caravia-Moroianu v. Berryhill, No. CV 16–01848–RAO, 2018 WL 12 1187502, at *1 (C.D. Cal. Mar. 6, 2018) (citing 42 U.S.C. § 405(g)); see also Alacar v. Comm’r of 13 Soc. Sec., No. 2:22-CV-149-TLN-KJN, 2022 WL 17418356, at *3–4 (E.D. Cal. Dec. 5, 2022) (Title 14 42 U.S.C. § 405(g) “requires the court’s review to be of the final decision of the Commissioner.” 15 (citing Ramirez v. Shalala, 8 F.3d 1449, 1451 (9th Cir. 1993))). 16 Where, as here, the Appeals Council denied Plaintiff’s request for review of the ALJ’s 17 subsequent decision, (AR 851–56), thereby declining to act on the ALJ’s alleged non-compliance 18 with the remand order, the ALJ’s subsequent decision became the Commissioner’s final decision. 19 Megyesi v. Saul, 773 F. App’x 914, 914 (9th Cir. 2019) (citing Luther v. Berryhill, 891 F.3d 872, 20 876 (9th Cir. 2018)). In the unpublished decision Tyler v. Astrue, the Ninth Circuit held that 21 [t]he district court properly declined to evaluate whether the ALJ’s second decision satisfied the demands of the Appeals Council’s remand. The law of the case doctrine 22 does not apply because the Appeals Council remanded to the ALJ to make further findings; it did not decide any issues of fact or law itself. Additionally, federal courts 23 only have jurisdiction to review the final decisions of administrative agencies. See 42 U.S.C. § 405(g). When the Appeals Council denied review of the ALJ’s second 24 decision, it made that decision final, Ramirez v. Shalala, 8 F.3d 1449, 1451 (9th Cir. 1993), and declined to find that the ALJ had not complied with its remand 25 instructions. 26 305 Fed. App’x 331, 332 (9th Cir. 2008). Tyler has been followed by Ninth Circuit district courts, 27 including this one, in rejecting review of an ALJ’s compliance with a remand order of the Appeals 28 Council. See Alacar, 2022 WL 17418356, at *3–4 (declining to review the ALJ’s alleged failure to 1 follow the Appeals Council’s instructions); Parker v. Saul, No. 20CV2530-BLM, 2022 WL 2 4798162, at *9–10 (S.D. Cal. Sept. 30, 2022) (“[R]emand due to the ALJ’s alleged failure to comply 3 with the Appeals Council order is not warranted or appropriate.”); Pamela E. v. Saul, No. 4:19-CV- 4 00004-SLG, 2019 WL 6257728, at *12 (D. Alaska Nov. 22, 2019) (“This Court declines to evaluate 5 whether the ALJ’s second decision complied with the remand order of the Appeals Council.”); 6 Pierce v. Saul, No. 1:17-CV-00380-REB, 2019 WL 4696402, at *4 (D. Idaho Sept. 26, 2019) (“[T]he 7 Court agrees that Petitioner cannot prevail on a challenge that the ALJ committed reversible legal 8 error by failing to comply with the Appeals Council’s order of remand, and it will therefore not 9 consider arguments in this vein.”); McGowan v. Berryhill, No. 5:16–CV–00923 (VEB), 2017 WL 10 4712782, at *4 (C.D. Cal. Oct. 19, 2017) (finding the court only had jurisdiction to review the 11 Commissioner’s final decision and the “alleged non-compliance with an Appeals Council’s remand 12 order [was] not reviewable by the federal courts”); Webber v. Berryhill, No. 2:15-CV-00295-MKD, 13 2017 WL 722593, at *3 (E.D. Wash. Feb. 23, 2017) (“The Court does not have jurisdiction to 14 consider whether the ALJ properly followed the directions of the Appeals Council on remand.”); 15 Crooks v. Astrue, No. 09-CV-1448-BR, 2011 WL 672556, at *3–4 (D. Or. Feb. 15, 2011) (“The 16 Court concludes it lacks jurisdiction to review the ALJ’s compliance with the Appeals Council’s last 17 remand.”); cf. Megyesi, 773 F. App’x at 914 (“We lack jurisdiction to review [plaintiff's] argument 18 that the [ALJ] failed to comply with particular aspects of the Appeals Council's remand order.”). 19 In view of the foregoing, the undersigned recommends that the Court “decline[] to evaluate 20 whether the ALJ’s second decision satisfied the demands of the Appeals Council’s remand,” as such 21 matter is unreviewable by this Court. Tyler, 305 Fed. App’x at 332. 22 B. Plaintiff’s RFC 23 1. Legal Standards 24 An RFC is the most a claimant can do despite their limitations and is based upon all relevant 25 evidence in the record, including medical records, medical source statements, and symptom 26 testimony. 20 C.F.R. § 404.1545(a)(1)−(3); Shafer v. Barnhart, 120 F. Appx. 688, 698 (9th Cir. 27 2005). A determination of RFC is not a medical opinion, but a legal decision that is expressly 28 reserved for the Commissioner. 20 C.F.R. §§ 414.927(d)(2) (RFC is not a medical opinion), 1 414.946(c) (identifying the ALJ as responsible for determining RFC). And that legal determination 2 necessarily involves engaging in credibility determinations, resolving conflicts in medical 3 testimony, and resolving evidentiary ambiguities, see Andrews v. Shalala, 53 F.3d 1035, 1039–40 4 (9th Cir. 1995)—such that an ALJ’s RFC determination need not necessarily mirror any particular 5 provider’s opinion, see, e.g., Petrini v. Berryhill, 705 F. App’x. 511, 512 (9th Cir. 2017). 6 However, an ALJ may not engage in their “own exploration and assessment” of Plaintiff’s 7 functional limitations. Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975); see also E. B. v. 8 Kijakazi, 2022 WL 4595062, at *9 (S.D. Cal. Sept. 30, 2022) (finding ALJ’s RFC determination 9 was not supported by substantial evidence where ALJ found almost all medical sources who issued 10 a medical opinion “not persuasive” and independently interpreted raw medical data that did “not 11 obviously translate into functional limitations”); Temple v. Saul, 2020 WL 13912521, at *7 (C.D. 12 Cal. Oct. 21, 2020) (finding ALJ’s RFC determination was not supported by substantial evidence 13 where “no treating or examining physician provided an assessment of [p]laintiff’s physical 14 functional capacity” and the treatment records did not provide sufficient indications of functional 15 limitations); Duarte v. Saul, 2020 WL 5257597, at *5 (E.D. Cal. Sept. 3, 2020) (“Barring a few 16 exceptions, an ALJ must have a doctor’s opinion of a claimant’s functional capacity in order for 17 there to be substantial evidence supporting the decision.”). 18 2. Analysis 19 Plaintiff argues that the ALJ erred in formulating his RFC because the ALJ made an 20 independent evaluation of Claimant’s functional limitations. (Doc. 18 at 7−9). Specifically, Plaintiff 21 contends that because the record reflected no medical opinion as to Claimant’s functional limitations, 22 the Commissioner’s duty to develop the record was triggered. (Id.). The Commissioner contends 23 that (1) there was sufficient evidence in the record to evaluate Claimant’s functional limitations and 24 the ALJ was permitted to draw logical inferences from the medical evidence in formulating the RFC 25 and that (2) to accept Claimant’s argument would impermissibly shift the burden of establishing 26 disability to the Commissioner. (Doc. 22 at 3−5). The undersigned disagrees with the 27 Commissioner. 28 Here, the ALJ found that Claimant was able to perform light work except that he was unable 1 to understand, remember, and carry out only simple instructions that could have been learned in 30 2 days or less and that he was able to sustain concentration, persistence, and pace to those simple 3 instructions for two-hour intervals with normal breaks. (AR 909). 4 As to Claimant’s physical and mental impairments, there are no opinions in the record from 5 treating or examining physicians related to Claimant’s functional limitations. Nor are there records 6 from consultative examiners who could have reviewed the existing records and opined on Claimant’s 7 functional limitations. Therefore, the ALJ’s RFC determination was solely based on their own 8 interpretation of Plaintiff’s testimony and the medical evidence. Without relying on any medical 9 opinion regarding what work-related restrictions would be appropriate, the ALJ added limitations to 10 the RFC and concluded these limitations were sufficient to address Claimant’s impairments. 11 But it is well-settled that an ALJ may not render their own medical opinion and is not 12 empowered to independently assess clinical findings. Indeed, Ninth Circuit courts have found that 13 “[b]arring a few exceptions, an ALJ must have a doctor’s opinion of a claimant’s functional capacity 14 in order for there to be substantial evidence supporting the decisions.” Bradford v. Comm’r of Soc. 15 Sec. Admin., No. CV2100232TUCSHRJR, 2022 WL 4538569, at *5 (D. Ariz. Aug. 18, 2022), report 16 and recommendation adopted, No. CV2100232TUCSHRJR, 2022 WL 4535239 (D. Ariz. Sept. 28, 17 2022) (quoting Howell v. Kijakazi, No. 20-CV-2517-BLM, 2022 WL 2759090, at *7 (S.D. Cal. July 18 14, 2022)); see also Walker v. Comm’r of Soc. Sec., Case No. 2:22-cv-01871-EJY, 2024 WL 64784, 19 at *6 (D. Nev. Jan. 4, 2024) (“While the ALJ ‘can pick and choose between opinions expressed by 20 the experts,’ when an ALJ decides severity or residual functional capacity ‘without the support of 21 any of the medical opinion evidence,’ this is error.” (quoting Holtan v. Kijakazi, 2:22-cv-01222- 22 VCF, 2023 WL 2424648, at *3 (D. Nev. Mar. 9, 2023))); De Gutierrez v. Saul, No. 1:19-cv-00463- 23 BAM, 2020 WL 5701019, at *6 (E.D. Cal. Sept. 24, 2020) (“Without a medical opinion to support 24 the conclusion that Plaintiff was able to perform” a certain level of work, lift and carry certain 25 weight, or sit, stand or walk for certain periods of time, “the ALJ’s RFC lacks the support of 26 substantial evidence.”); Goolsby v. Berryhill, Case No. 1:15–cv–00615–JLT, 2017 WL 1090162, at 27 *8 (E.D. Cal. Mar. 22, 2017) (finding that an ALJ erred in including “simple routine tasks” in RFC 28 when the record did not contain medical opinions supporting this limitation); Shipp v. Colvin, No. 1 CV 13-9468 JC, 2014 WL 4829035, at *7 (C.D. Cal. Sept. 26, 2014) (“Since . . . the record contains 2 no assessment by a treating or examining doctor regarding the effect of plaintiff’s physical 3 impairments on her ability to function, it appears that the ALJ’s physical residual functional capacity 4 assessment was erroneously based solely on the ALJ’s own, lay interpretation of plaintiff’s 5 testimony and other raw medical evidence in the record.”); see also, e.g., Tackett, 180 F.3d at 1102– 6 03 (holding an ALJ erred in rejecting physicians’ opinions and rendering his own medical opinion); 7 Banks v. Barnhart, 434 F. Supp. 2d 800, 805 (C.D. Cal. 2006) (“An ALJ cannot arbitrarily substitute 8 his own judgment for competent medical opinion, and he must not succumb to the temptation to play 9 doctor and make his own independent medical findings”); Miller v. Astrue, 695 F. Supp. 2d 1042, 10 1048 (C.D. Cal. 2010) (reasoning that it is improper for the ALJ to act as the medical expert); Padilla 11 v. Astrue, 541 F. Supp. 2d 1102, 1106 (C.D. Cal. 2008) (opining that an ALJ is not qualified to 12 extrapolate functional limitations from raw medical data). 13 Here, the ALJ did not simply synthesize all the medical evidence to reach an RFC 14 determination. Instead, without any medical opinion in the record as to Claimant’s functional 15 limitations, the RFC determination was based solely on treatment notes, test results, and agency 16 consultant’s findings that included no findings as to Claimant’s functional limitations and Plaintiff’s 17 testimony. (See AR 868−74). And Claimant’s medical records did not provide sufficient indications 18 of Claimant’s functional limitations and were unclear as to their impact on Claimant’s ability to 19 work. Thus, the ALJ apparently improperly formulated an RFC based on their own interpretation 20 of the medical evidence. The undersigned finds that the underlying treatment and medical records 21 are the kinds of “raw,” Shipp, 2014 WL 4829035, at *7, and “ambiguous” evidence that themselves 22 do not provide sufficient indications of Claimant’s functional limitations and therefore, the ALJ was 23 not qualified to the translate evidence into functional limitations and engage in its “own exploration 24 and assessment” of a claimants impairments taken together. McAnally v. Berryhill, No.: 3:18-cv- 25 02272-GPC-RNB, 2020 WL 1443734, at *7 (S.D. Cal. Mar. 25, 2020) (quoting Day v. Weinberger, 26 522 F.2d 1154, 1156 (9th Cir. 1975)). The undersigned finds that the ALJ was not qualified to 27 translate the raw medical records into functional limitations and engage in their “own exploration 28 and assessment” of Claimant’s impairments. See McAnally, 2020 WL 1443734, at *7 (quoting Day 1 v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975)). Without a medical opinion to support the 2 ALJ’s assessment of Claimant’s RFC, the RFC lacks the support of substantial evidence. See Perez 3 v. Sec’y of Health & Human Servs., 958 F.2d 445, 446 (1st Cir. 1991) (“where an ALJ reaches 4 conclusions about claimant’s . . .capacity without any assessment of residual functional capacity by 5 a physician, the ALJ's conclusions are not supported by substantial evidence”); Goolsby, 2017 WL 6 1090162, at *8 (finding that an ALJ erred in including “simple routine tasks” in RFC when the record 7 did not contain medical opinions supporting this limitation); Shipp, 2014 WL 4829035, at *7. 8 Accordingly, the undersigned finds that the ALJ erred in evaluating Claimant’s RFC without 9 further developing the record to include medical opinions as to Claimant’s functional limitations. 10 See Ford, 950 F.3d at 1156; Slate v. O’Malley, No. 1:23-CV-00092-SKO, 2024 WL 967661, at *7 11 (E.D. Cal. Mar. 6, 2024) (“Because the record contained no medical opinion interpreting the 12 functional limitations resulting from Plaintiff's musculoskeletal impairments, the ALJ’s duty to 13 further develop the record was triggered, warranting either a consultative examination or medical 14 expert opinion by a physician who had access to Plaintiff's medical records.”); Breazell v. Comm’r 15 of Soc. Sec., No. 1:24-CV-01592-KES-EPG, 2025 WL 2962451, at *3 (E.D. Cal. Oct. 21, 2025), 16 report and recommendation adopted, No. 1:24-CV-01592-EPG, 2026 WL 936906 (E.D. Cal. Apr. 17 7, 2026) (“The Court finds that the interpretation of this evidence exceeded the ALJ’s lay expertise 18 and required a medical opinion to interpret and assess work limitations for the RFC. As the ALJ 19 noted, these records supported Plaintiff's claim that she suffered from a medically determinable 20 impairment. However, they did not clearly indicate what work limitations resulted from those 21 impairments. Because the ALJ lacked the medical expertise to determine those work limitations 22 from this medical evidence, the ALJ had a duty to develop the record and obtain a medical 23 opinion.”); Angel P. v. Dudek, No. 2:24-CV-348-EFS, 2025 WL 621436, at *7 (E.D. Wash. Feb. 26, 24 2025) (“This is a record that clearly establishes severe impairments but is ambiguous as to Plaintiff's 25 resulting functional limitations. Without a medical opinion, the current record is inadequate to allow 26 for proper formulation of an RFC.”).5 27 5 The Commissioner implies that because Plaintiff is deceased, it would be impossible to fulfil any duty to develop the 28 record. (Doc. 22 at 4). Not so. The ALJ could have obtained a medical opinion as to Plaintiff’s functional limitations 1 For the aforementioned reasons, the undersigned finds that the ALJ’s RFC determination is 2 not supported by substantial evidence. 3 C. Harmlessness Review 4 The undersigned must now consider whether the ALJ’s error was harmless. Molina, 674 5 F.3d at 1115. Courts look to the record as a whole to determine whether the error alters the outcome 6 of the case. Id.; March v. Colvin, 792 F.3d 1170, 1172 (9th Cir. 2015). An error is harmless “where 7 it is inconsequential to the ultimate nondisability determination.” Molina, 674 F.3d at 1115 8 (citations omitted) (first quoting Balsamo v. Chater, 142 F.3d 75, 81 (2d Cir. 1998), and then quoting 9 Rohan v. Chater, 98 F.3d 966, 970 (7th Cir. 1996)). 10 Here, the undersigned cannot find that the ALJ’s error was harmless. The ALJ determined 11 Claimant’s RFC without a medical opinion that defined Claimant’s limitations and the ALJ’s 12 specific determinations regarding Claimant’s functional limitations lacked the support of substantial 13 evidence. The undersigned cannot confidently conclude that the RFC assessment would have been 14 the same absent this error. See Karen E. v. Berryhill, 2019 WL 1405835, at *4−5 (C.D. Cal. Mar. 15 27, 2019) (remanding where ALJ assessed RFC without the benefit of any physician opinion 16 regarding the limitations, so for the ALJ to assess RFC required him to act “as his own medical 17 expert and translate the data himself, something he was not qualified to do”); Kohlbatz v. Berryhill, 18 2018 WL 2059645, at *4–5 (C.D. Cal. Apr. 30, 2018) (remanding where ALJ erred by basing RFC 19 on ALJ’s own lay interpretation of the medical record, and such RFC is not supported by substantial 20 evidence); Zazueta v. Colvin, 2014 WL 4854575, at *5 (C.D. Cal. Sept. 29, 2014) (remanding where 21 ALJ rejected only medical opinion regarding functional limitations, then assessed plaintiff’s RFC 22 on ALJ’s own lay interpretation of medical records, so the RFC assessment was not supported by 23 substantial evidence); A.S. v. O’Malley, No. 1:24-CV-00127-DKG, 2024 WL 4851214, at *5 (D. 24 Idaho Nov. 21, 2024) (finding harmful error where the ALJ relied on her own interpretation of the 25 medical records without any medical opinion of Plaintiff’s physical functioning in formulating the 26 RFC). In particular, because the record “[did] not support the assumptions in the hypothetical[s]” 27 the record contained no medical opinion interpreting the functional limitations resulting from Plaintiff's . . . 28 impairments, the ALJ’s duty to further develop the record was triggered, warranting either a consultative examination 1 posed to the VE, the hypotheticals were incomplete and therefore, the “vocational expert’s opinion 2 [had] no evidentiary value.” Lewis v. Apfel, 236 F.3d 503, 517 (9th Cir. 2001).6 Thus, the 3 undersigned finds that the error was not “inconsequential to the ultimate nondisability 4 determination.” Molina, 674 F.3d at 1115. 5 D. Remand 6 In a case where the ALJ’s determination is not supported by substantial evidence or is tainted 7 by legal error, the court may remand the matter for additional proceedings or an immediate award 8 of benefits. Remand for additional proceedings is proper where (1) outstanding issues must be 9 resolved, and (2) it is not clear from the record before the court that a claimant is disabled. See 10 Benecke v. Barnhart, 379 F.3d 587, 593 (9th Cir. 2004). 11 Here, the undersigned finds that remand for further proceedings is warranted. See de 12 Gutierrez, 2020 WL 5701019, at *6. On remand, the Commissioner shall reevaluate and develop 13 the record in order to assess an RFC supported by substantial evidence. 14 V. CONCLUSION AND ORDER 15 For the foregoing reasons, IT IS HEREBY RECOMMENDED that: 16 1. Plaintiff’s motion for summary judgment, (Doc. 18), be GRANTED; 17 2. This matter be REMANDED pursuant to sentence four of 42 U.S.C. § 405(g) for 18 further proceedings consistent with this decision; and 19 3. The Clerk of the Court be DIRECTED to enter judgment in favor of Plaintiff Eva 20 Ochoa and against Defendant Frank Bisignano, Commissioner of Social Security, 21 and to CLOSE this action. 22 These findings and recommendations are submitted to the District Judge assigned to this 23 action, pursuant to 28 U.S.C. § 636(b)(1)(B) and this Court’s Local Rule 304. Within fourteen 24 (14) days of service of these recommendations, any party may file written objections to these 25 findings and recommendations with the Court and serve a copy on all parties. Such a document 26 should be captioned “Objections to Magistrate Judge’s Findings and Recommendations.” 27

28 6 This is not to say that the disability determination will or should be different regarding the period at issue--only that ] The District Judge will review the Magistrate Judge’s findings and recommendations 2 | pursuant to 28 U.S.C. § 636(b)(1)(C). The parties are advised that failure to file objections within 3 | the specified time may result in the waiver of rights on appeal. Wilkerson v. Wheeler, 772 F.3d 4 | 834, 839 (9th Cir. 2014) (citing Baxter v. Sullivan, 923 F.2d 1391, 1394 (9th Cir. 1991)). 6 IT IS SO ORDERED. . 7 | Dated: _ June 8, 2026 Cx Lin uc | (le 3 UNITED STATES MAGISTRATE JUDGE 10 1] 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

1A

EVA OCHOA v. FRANK BISIGNANO, Commissioner of Social Security, (E.D. Cal. 2026).

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EVA OCHOA v. FRANK BISIGNANO, Commissioner of Social Security (EVA OCHOA v. FRANK BISIGNANO, Commissioner of Social Security) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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