1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA
9 Robert Grant Hendrix, No. CV-23-01113-PHX-DLR
10 Plaintiff, ORDER
11 v.
12 Commissioner of Social Security Administration, 13 Defendant. 14 15 16 On December 21, 2018, Claimant Robert Grant Hendrix filed applications for Social 17 Security Disability Insurance Benefits and Supplemental Security Income benefits. 18 (Administrative Record (“AR.”) 13.) He alleges disability beginning March 31, 2018. (Id., 19 AR. 555.) The Social Security Administration denied his claim initially and again on 20 reconsideration. (AR. 127, 151, 178, 201.) After an administrative hearing, the 21 Administrative Law Judge (“ALJ”) issued an unfavorable decision. (AR. 10.) The Appeals 22 Council denied review of the decision, making the ALJ’s finding the final decision of the 23 Commissioner of the Social Security Administration. (AR. 1.) 24 Hendrix seeks judicial review of the Commissioner’s decision under 42 U.S.C. § 25 405(g). He challenges only the finding relating to his Supplemental Security Income 26 Benefits, not his Social Security Disability Income benefits. (Doc. 13 at 2.) For the reasons 27 set forth herein, the Court reverses the ALJ’s decision and remands the case for a 28 calculation of benefits. 1 I. Five-Step Process 2 To determine whether a claimant is disabled, the ALJ engages in a five-step process. 3 20 C.F.R. § 404.1520(a). The claimant bears the burden of proof for the first four steps, 4 but the burden shifts to the Commissioner at the fifth step. Tackett v. Apfel, 180 F.3d 1094, 5 1098 (9th Cir. 1999). First, the ALJ determines whether the claimant is presently engaging 6 in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). Second, the ALJ determines 7 whether the claimant has a “severe” medically determinable physical or mental 8 impairment. Id. § 404.1520(a)(4)(ii). Third, the ALJ considers whether the claimant’s 9 impairment or combination of impairments meets or medically equals an impairment listed 10 in Appendix 1 to Subpart P of 20 C.F.R. Part 404. Id. § 404.1520(a)(4)(iii). If so, the 11 claimant is automatically considered disabled. Otherwise, the ALJ moves to the fourth step, 12 where she assesses the claimant’s residual functioning capacity (“RFC”) and determines 13 whether the claimant is still capable of performing past relevant work. Id. § 14 404.1520(a)(4)(iv). If the claimant is not so capable, as the fifth and final step, the ALJ 15 must determine whether the claimant can perform any other work in the national economy 16 based on the claimant’s RFC, age, education, and work experience. Id. § 404.1520(a)(4)(v). 17 If not, the claimant is disabled. Id. 18 II. Legal Standard 19 This Court reviews only those issued raised by the party challenging the ALJ’s 20 decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). An ALJ’s factual 21 findings are “conclusive if supported by substantial evidence.” Biestek v. Berryhill, 139 S. 22 Ct. 1148, 1153 (2019) (quotation and citation omitted). Substantial evidence is “more than 23 a mere scintilla” and “means—and means only—such relevant evidence as a reasonable 24 mind might accept as adequate to support a conclusion.” Id. at 1154 (quotations and 25 citations omitted). “When evidence reasonably supports either confirming or reversing the 26 ALJ’s decision, [the Court] may not substitute [its] judgment for that of the ALJ.” Batson 27 v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1196 (9th Cir. 2004). The substantial 28 evidence standard is a “highly deferential standard of review.” Valentine v. Comm’r of Soc. 1 Sec. Admin., 574 F.3d 685, 690 (9th Cir. 2009). Still, this Court cannot affirm the ALJ’s 2 decision based on grounds on which the ALJ did not rely. Garrison v. Colvin, 759 F.3d 3 995, 1010 (9th Cir. 2014). 4 III. Analysis 5 Hendrix raises a single issue for the Court’s consideration: whether the ALJ 6 properly evaluated the opinion of Hendrix’s treating physician, Susan Horne, M.D. 7 For claims filed on or after March 27, 2017, including Hendrix’s, ALJs give no 8 specific evidentiary weight to any medical opinion. 20 C.F.R. § 416.920c(a). Instead, an 9 ALJ is required to consider all medical opinions and articulate how persuasive she finds 10 them. Id. § 416.920c(b). The ALJ considers several factors in assessing the persuasiveness 11 of a medical opinion, but she need only articulate in her decision her findings regarding the 12 supportability and consistency of the opinion with other evidence in the record. 13 Id. § 416.920c(b)(2). Supportability examines the relevant objective medical evidence and 14 supporting explanations presented by the source. Id. § 404.1520c(c)(1). Consistency 15 examines the evidence from other medical and nonmedical sources. Id. § 404.1520c(c)(2). 16 For claims to which these regulations apply, ALJs are also not required to provide “clear 17 and convincing” or “specific and legitimate” reasons to reject a treating physician’s 18 opinion. See Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022). Instead, the ALJ’s 19 evaluation of each opinion must be supported by substantial evidence. Id. 20 Dr. Horne has treated Hendrix since March 2021. Dr. Horne noted Hendrix’s 21 diagnoses of pyloric stenosis, gastroparesis, and chronic vomiting. (AR. 2286.) She opined 22 that he would be absent from work, on average, fifteen times per month, and that his 23 chronic vomiting would prevent him from completing an eight-hour workday about thirty 24 days a month. (Id.) 25 The ALJ found Dr. Horne’s opinion unpersuasive. (AR. 33.) She summarily rejected 26 Dr. Horne’s opinion as “extreme” and stated there is no support for the opinion “other than 27 noting his reported daily vomiting.” (AR. 34.) The ALJ explained that Dr. Horne’s 28 assessment was not supported by her records because the Dr. Horne’s notes only span from 1 March through August of 2021, so there was no evidence of chronic vomiting beyond that 2 period. (Id.) Specifically, the ALJ pointed to medical evidence from after November 2021, 3 where medical records include fewer reports of vomiting and several instances where 4 Hendrix denied nausea and vomiting altogether. (Id.) She added that Hendrix provided no 5 evidence that he followed up with specialists to whom Dr. Horne referred him. (Id.) The 6 ALJ also explained that Dr. Horne’s assessment was “not fully consistent” with the 7 longitudinal record. (Id.) 8 The ALJ’s evaluation of Dr. Horne’s opinion is not supported by substantial 9 evidence. The ALJ’s claim that at Hendrix’s initial visit to Dr. Horne there was “little 10 mention of problems with daily vomiting” (AR. 34) is demonstrably false. The report from 11 that visit specifically discusses Hendrix’s chronic vomiting problem and notes Hendrix’s 12 abdominal pain, nausea, and vomiting. (AR. 978.) The ALJ’s assertion that Hendrix failed 13 to follow up with specialists is similarly untrue.
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1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA
9 Robert Grant Hendrix, No. CV-23-01113-PHX-DLR
10 Plaintiff, ORDER
11 v.
12 Commissioner of Social Security Administration, 13 Defendant. 14 15 16 On December 21, 2018, Claimant Robert Grant Hendrix filed applications for Social 17 Security Disability Insurance Benefits and Supplemental Security Income benefits. 18 (Administrative Record (“AR.”) 13.) He alleges disability beginning March 31, 2018. (Id., 19 AR. 555.) The Social Security Administration denied his claim initially and again on 20 reconsideration. (AR. 127, 151, 178, 201.) After an administrative hearing, the 21 Administrative Law Judge (“ALJ”) issued an unfavorable decision. (AR. 10.) The Appeals 22 Council denied review of the decision, making the ALJ’s finding the final decision of the 23 Commissioner of the Social Security Administration. (AR. 1.) 24 Hendrix seeks judicial review of the Commissioner’s decision under 42 U.S.C. § 25 405(g). He challenges only the finding relating to his Supplemental Security Income 26 Benefits, not his Social Security Disability Income benefits. (Doc. 13 at 2.) For the reasons 27 set forth herein, the Court reverses the ALJ’s decision and remands the case for a 28 calculation of benefits. 1 I. Five-Step Process 2 To determine whether a claimant is disabled, the ALJ engages in a five-step process. 3 20 C.F.R. § 404.1520(a). The claimant bears the burden of proof for the first four steps, 4 but the burden shifts to the Commissioner at the fifth step. Tackett v. Apfel, 180 F.3d 1094, 5 1098 (9th Cir. 1999). First, the ALJ determines whether the claimant is presently engaging 6 in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). Second, the ALJ determines 7 whether the claimant has a “severe” medically determinable physical or mental 8 impairment. Id. § 404.1520(a)(4)(ii). Third, the ALJ considers whether the claimant’s 9 impairment or combination of impairments meets or medically equals an impairment listed 10 in Appendix 1 to Subpart P of 20 C.F.R. Part 404. Id. § 404.1520(a)(4)(iii). If so, the 11 claimant is automatically considered disabled. Otherwise, the ALJ moves to the fourth step, 12 where she assesses the claimant’s residual functioning capacity (“RFC”) and determines 13 whether the claimant is still capable of performing past relevant work. Id. § 14 404.1520(a)(4)(iv). If the claimant is not so capable, as the fifth and final step, the ALJ 15 must determine whether the claimant can perform any other work in the national economy 16 based on the claimant’s RFC, age, education, and work experience. Id. § 404.1520(a)(4)(v). 17 If not, the claimant is disabled. Id. 18 II. Legal Standard 19 This Court reviews only those issued raised by the party challenging the ALJ’s 20 decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). An ALJ’s factual 21 findings are “conclusive if supported by substantial evidence.” Biestek v. Berryhill, 139 S. 22 Ct. 1148, 1153 (2019) (quotation and citation omitted). Substantial evidence is “more than 23 a mere scintilla” and “means—and means only—such relevant evidence as a reasonable 24 mind might accept as adequate to support a conclusion.” Id. at 1154 (quotations and 25 citations omitted). “When evidence reasonably supports either confirming or reversing the 26 ALJ’s decision, [the Court] may not substitute [its] judgment for that of the ALJ.” Batson 27 v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1196 (9th Cir. 2004). The substantial 28 evidence standard is a “highly deferential standard of review.” Valentine v. Comm’r of Soc. 1 Sec. Admin., 574 F.3d 685, 690 (9th Cir. 2009). Still, this Court cannot affirm the ALJ’s 2 decision based on grounds on which the ALJ did not rely. Garrison v. Colvin, 759 F.3d 3 995, 1010 (9th Cir. 2014). 4 III. Analysis 5 Hendrix raises a single issue for the Court’s consideration: whether the ALJ 6 properly evaluated the opinion of Hendrix’s treating physician, Susan Horne, M.D. 7 For claims filed on or after March 27, 2017, including Hendrix’s, ALJs give no 8 specific evidentiary weight to any medical opinion. 20 C.F.R. § 416.920c(a). Instead, an 9 ALJ is required to consider all medical opinions and articulate how persuasive she finds 10 them. Id. § 416.920c(b). The ALJ considers several factors in assessing the persuasiveness 11 of a medical opinion, but she need only articulate in her decision her findings regarding the 12 supportability and consistency of the opinion with other evidence in the record. 13 Id. § 416.920c(b)(2). Supportability examines the relevant objective medical evidence and 14 supporting explanations presented by the source. Id. § 404.1520c(c)(1). Consistency 15 examines the evidence from other medical and nonmedical sources. Id. § 404.1520c(c)(2). 16 For claims to which these regulations apply, ALJs are also not required to provide “clear 17 and convincing” or “specific and legitimate” reasons to reject a treating physician’s 18 opinion. See Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022). Instead, the ALJ’s 19 evaluation of each opinion must be supported by substantial evidence. Id. 20 Dr. Horne has treated Hendrix since March 2021. Dr. Horne noted Hendrix’s 21 diagnoses of pyloric stenosis, gastroparesis, and chronic vomiting. (AR. 2286.) She opined 22 that he would be absent from work, on average, fifteen times per month, and that his 23 chronic vomiting would prevent him from completing an eight-hour workday about thirty 24 days a month. (Id.) 25 The ALJ found Dr. Horne’s opinion unpersuasive. (AR. 33.) She summarily rejected 26 Dr. Horne’s opinion as “extreme” and stated there is no support for the opinion “other than 27 noting his reported daily vomiting.” (AR. 34.) The ALJ explained that Dr. Horne’s 28 assessment was not supported by her records because the Dr. Horne’s notes only span from 1 March through August of 2021, so there was no evidence of chronic vomiting beyond that 2 period. (Id.) Specifically, the ALJ pointed to medical evidence from after November 2021, 3 where medical records include fewer reports of vomiting and several instances where 4 Hendrix denied nausea and vomiting altogether. (Id.) She added that Hendrix provided no 5 evidence that he followed up with specialists to whom Dr. Horne referred him. (Id.) The 6 ALJ also explained that Dr. Horne’s assessment was “not fully consistent” with the 7 longitudinal record. (Id.) 8 The ALJ’s evaluation of Dr. Horne’s opinion is not supported by substantial 9 evidence. The ALJ’s claim that at Hendrix’s initial visit to Dr. Horne there was “little 10 mention of problems with daily vomiting” (AR. 34) is demonstrably false. The report from 11 that visit specifically discusses Hendrix’s chronic vomiting problem and notes Hendrix’s 12 abdominal pain, nausea, and vomiting. (AR. 978.) The ALJ’s assertion that Hendrix failed 13 to follow up with specialists is similarly untrue. One of Dr. Horne’s reports states that she 14 and Hendrix discussed referral to a specialist but ultimately decided that Dr. Horne herself 15 could perform the recommended surgery. (AR. 995.) The other noted that Hendrix was 16 “agreeable” to following up with a specialist. (AR. 1005.) The ALJ offers no explanation 17 as to how these two instances would render Dr. Horne’s opinion unsupported. See Reddick 18 v. Chater, 157 F.3d 715, 722–23 (9th Cir. 1998) (remanding for benefits when ALJ 19 “developed his evidentiary basis by not fully accounting for the context of materials or all 20 parts of the testimony and reports” and ALJ’s “paraphrasing of record material [was] not 21 entirely accurate regarding the content or tone of the record”). The ALJ failed to provide 22 substantial evidence that Dr. Horne’s opinion is unsupported by her own records. 23 Further, the ALJ’s assertion that it is difficult to locate evidence of chronic vomiting 24 outside of the period during which Dr. Horne treated Hendrix is simply untrue; the ALJ 25 herself highlighted records of the issue dating back to 2019 in her decision. (AR. 24.) The 26 ALJ’s references to instances where Hendrix “denied nausea and vomiting” are all 27 emergency room visits where Hendrix was admitted for problems other than his chronic 28 vomiting and responded to inquiries as part of a “review of systems.” In other words, he 1 was denying nausea and vomiting symptoms at that moment. This evidence is not 2 inconsistent with a chronic, recurring, unpredictable condition and cannot serve to 3 undermine Dr. Horne’s opinion. See Johnson v. Comm’r of Soc. Sec. Admin., No. CV-18- 4 00012-PHX-JJT, 2019 WL 1375688, at *2 (D. Ariz. Mar. 27, 2019) (remanding for 5 benefits where ALJ incorrectly decided that evidence of “normal range of motion, muscle 6 strength, and gait” was inconsistent with chronic pain). In fact, there is substantial evidence 7 in the record that Hendrix continued to deal with chronic vomiting through 2022, when Dr. 8 Horne opined as to his limitations. (See, e.g., AR. 1049–51, 1054, 2259.) The ALJ failed 9 to provide substantial evidence from other medical and non-medical sources that is 10 inconsistent with Dr. Horne’s opinion. 11 IV. Scope of Remand 12 Hendrix requests that the Court remand for a calculation of benefits rather than for 13 further proceedings. The credit-as-true rule provides that the Court has the discretion to 14 decide to remand for a calculation of benefits if each part of a three-part test is satisfied. 15 Garrison, 759 F.3d at 1014. First, the Court determines whether the ALJ must have failed 16 to provide legally sufficient reasons for rejecting the claimant’s testimony or medical 17 opinions. Id. Second, the Court determines whether the record has been fully developed, 18 whether outstanding issues remain, and whether further administrative proceedings would 19 serve no useful purpose. Id. Third, the Court must determine whether, if the improperly 20 discredited evidence were credited as true, the ALJ would be required to find the claimant 21 disabled. Id. 22 Remand for a calculation of benefits is appropriate in this instance. As the 23 discussion above demonstrates, the ALJ failed to provide legally sufficient reasons for 24 rejecting Dr. Horne’s opinion. The record has been fully developed, and no outstanding 25 issues remain. The other medical opinions available assess different limitations, but they 26 do not address Hendrix’s chronic vomiting at all. (See AR. 115–16, 139–40.) If Dr. Horne’s 27 opinion were credited, the ALJ would have to conclude Hendrix is disabled. Dr. Horne 28 opined that Hendrix would be absent from work around fifteen times a month. As the 1 || vocational expert testified, an individual who is absent from work even ten times a month || would be precluded from all work. (AR. 73.) Accordingly, remand for further proceedings || would merely serve to delay Hendrix receiving benefits. Varney v. Sec’y of Health & Hum. Servs., 859 F.2d 1396, 1399 (9th Cir. 1988) (“Where remand would unnecessarily delay || the receipt of benefits, judgment for the claimant is appropriate.) The case is instead 6 || remanded for a calculation of benefits. 7 IT IS ORDERED that the ALJ’s decision (AR. 10-45) is REVERSED and 8 || REMANDED for a calculation of benefits. 9 Dated this 17th day of March, 2025. 10 11 12 {Z, 13 _- Ae 14 So United States District Judge 15 16 17 18 19 20 21 22 23 24 25 26 27 28
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