1 UNITED STATES DISTRICT COURT SEAN F. MCAVOY, CLERK 2 EASTERN DISTRICT OF WASHINGTON
4 JENNIFER P., No. 4:25-CV-05083-ACE 5 Plaintiff, ORDER GRANTING PLAINTIFF’S 6 MOTION 7 v.
8 FRANK BISIGNANO, ECF Nos. 11, 16 9 COMMISSIONER OF SOCIAL SECURITY, 10
11 Defendant. 12 13 BEFORE THE COURT is Plaintiff’s Opening Brief and Defendant’s Brief 14 in response. ECF No. 11, 16. Attorney Chad L. Hatfield represents Plaintiff; 15 Special Assistant United States Attorney Benjamin J. Groebner represents 16 Defendant. After reviewing the administrative record and the briefs filed by the 17 parties, the Court GRANTS Plaintiff’s Motion; DENIES Defendant’s Motion; and 18 REMANDS the matter to the Commissioner for an immediate calculation of 19 benefits pursuant to 42 U.S.C. § 405(g). 20 JURISDICTION 21 Plaintiff filed applications for Disability Insurance Benefits (DIB) and 22 Supplemental Security Income (SSI) in December 2014, alleging onset of 23 disability on December 16, 2014. Tr. 256, 263. The applications were denied 24 initially and upon reconsideration. Administrative Law Judge (ALJ) R.J. Payne 25 held a hearing on January 5, 2018, and issued an unfavorable decision on February 26 22, 2018. 27 On December 13, 2019, the matter was remanded for additional proceedings 28 by Senior United States District Judge Edward F. Shea, Tr. 1220-1239, a new 1 administrative hearing was held, and ALJ Marie Palachuk issued an unfavorable 2 decision on October 2, 2020, Tr. 1091-1108. 3 On January 20, 2022, the matter was again remanded for additional 4 proceedings by Senior Judge Shea, Tr. 1684-1686 (stipulated remand), a new 5 administrative hearing was held, and ALJ Marie Palachuk issued another 6 unfavorable decision on February 8, 2023, Tr. 1560-1578. 7 On March 11, 2024, the undersigned remanded this matter for additional 8 proceedings for a third time. Tr. 2286-2308. 9 On April 29, 2024, ALJ Jesse Shumway held a new hearing. On May 12, 10 2025, ALJ Shumway denied Plaintiff’s DIB claim, denied Plaintiff’s SSI claim 11 prior to January 29, 2024, and granted Plaintiff’s SSI claim beginning on January 12 29, 2024 (age category change). Tr. 2171-2196. 13 Plaintiff filed the instant action for judicial review on July 7, 2025. ECF No. 14 1. 15 STANDARD OF REVIEW 16 The ALJ is tasked with “determining credibility, resolving conflicts in 17 medical testimony, and resolving ambiguities.” Andrews v. Shalala, 53 F.3d 1035, 18 1039 (9th Cir. 1995). The ALJ’s determinations of law are reviewed de novo, with 19 deference to a reasonable interpretation of the applicable statutes. McNatt v. Apfel, 20 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed 21 only if it is not supported by substantial evidence or if it is based on legal error. 22 Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is 23 defined as being more than a mere scintilla, but less than a preponderance. Id. at 24 1098. Put another way, substantial evidence “is such relevant evidence as a 25 reasonable mind might accept as adequate to support a conclusion.” Richardson v. 26 Perales, 402 U.S. 389, 401 (1971), quoting Consolidated Edison Co. v. NLRB, 305 27 U.S. 197, 229 (1938). If the evidence is susceptible to more than one rational 28 interpretation, the Court may not substitute its judgment for that of the ALJ. 1 Tackett, 180 F.3d at 1098; Morgan v. Comm’r of Social Sec. Admin., 169 F.3d 595, 2 599 (9th Cir. 1999). If substantial evidence supports the administrative findings, or 3 if conflicting evidence supports a finding of either disability or non-disability, the 4 ALJ’s determination is conclusive. Sprague v. Bowen, 812 F.2d 1226, 1229-1230 5 (9th Cir. 1987). Nevertheless, a decision supported by substantial evidence will be 6 set aside if the proper legal standards were not applied in weighing the evidence 7 and making the decision. Brawner v. Sec’y of Health and Human Servs., 839 F.2d 8 432, 433 (9th Cir. 1988). 9 SEQUENTIAL EVALUATION PROCESS 10 The Commissioner has established a five-step sequential evaluation process 11 for determining whether a person is disabled. 20 C.F.R. §§ 404.1520(a), 12 416.920(a); Bowen v. Yuckert, 482 U.S. 137, 140-142 (1987). In steps one through 13 four the claimant bears the burden of establishing a prima facie case of disability. 14 Tackett, 180 F.3d at 1098-1099. This burden is met once a claimant establishes 15 that a physical or mental impairment prevents the claimant from engaging in past 16 relevant work. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). If a claimant cannot 17 perform past relevant work, the ALJ proceeds to step five, and the burden shifts to 18 the Commissioner to show: (1) that Plaintiff can perform other substantial gainful 19 activity; and (2) that a significant number of jobs exist in the national economy 20 which Plaintiff can perform. Kail v. Heckler, 722 F.2d 1496, 1497-1498 (9th Cir. 21 1984); Beltran v. Astrue, 700 F.3d 386, 389 (9th Cir. 2012). If a claimant cannot 22 make an adjustment to other work in the national economy, the claimant will be 23 found disabled. 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v). 24 ADMINISTRATIVE FINDINGS 25 On May 12, 2025, ALJ Shumway issued a decision finding Plaintiff was not 26 disabled prior to January 29, 2024, but became disabled, as defined in the Social 27 Security Act, beginning on January 29, 2024 (age category change). Tr. 2171- 28 2196. 1 At step one, the ALJ found Plaintiff had not engaged in substantial gainful 2 activity since the December 16, 2014, alleged onset date. Tr. 2174. 3 At step two, the ALJ determined Plaintiff had the following severe 4 impairments: obesity; fibromyalgia; left trigger thumb, status post surgical release; 5 bilateral ulnar neuropathy, status post surgical releases; osteoarthritis of the 6 bilateral hips, knees, and hands; sacralization of the L5 vertebra; depressive 7 disorder; and anxiety disorder. Id. 8 At step three, the ALJ found Plaintiff did not have an impairment or 9 combination of impairments that met or medically equaled the severity of one of 10 the listed impairments. Tr. 2175. 11 The ALJ assessed Plaintiff’s Residual Functional Capacity (RFC) and found 12 she could perform sedentary work with the following additional limitations: 13
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1 UNITED STATES DISTRICT COURT SEAN F. MCAVOY, CLERK 2 EASTERN DISTRICT OF WASHINGTON
4 JENNIFER P., No. 4:25-CV-05083-ACE 5 Plaintiff, ORDER GRANTING PLAINTIFF’S 6 MOTION 7 v.
8 FRANK BISIGNANO, ECF Nos. 11, 16 9 COMMISSIONER OF SOCIAL SECURITY, 10
11 Defendant. 12 13 BEFORE THE COURT is Plaintiff’s Opening Brief and Defendant’s Brief 14 in response. ECF No. 11, 16. Attorney Chad L. Hatfield represents Plaintiff; 15 Special Assistant United States Attorney Benjamin J. Groebner represents 16 Defendant. After reviewing the administrative record and the briefs filed by the 17 parties, the Court GRANTS Plaintiff’s Motion; DENIES Defendant’s Motion; and 18 REMANDS the matter to the Commissioner for an immediate calculation of 19 benefits pursuant to 42 U.S.C. § 405(g). 20 JURISDICTION 21 Plaintiff filed applications for Disability Insurance Benefits (DIB) and 22 Supplemental Security Income (SSI) in December 2014, alleging onset of 23 disability on December 16, 2014. Tr. 256, 263. The applications were denied 24 initially and upon reconsideration. Administrative Law Judge (ALJ) R.J. Payne 25 held a hearing on January 5, 2018, and issued an unfavorable decision on February 26 22, 2018. 27 On December 13, 2019, the matter was remanded for additional proceedings 28 by Senior United States District Judge Edward F. Shea, Tr. 1220-1239, a new 1 administrative hearing was held, and ALJ Marie Palachuk issued an unfavorable 2 decision on October 2, 2020, Tr. 1091-1108. 3 On January 20, 2022, the matter was again remanded for additional 4 proceedings by Senior Judge Shea, Tr. 1684-1686 (stipulated remand), a new 5 administrative hearing was held, and ALJ Marie Palachuk issued another 6 unfavorable decision on February 8, 2023, Tr. 1560-1578. 7 On March 11, 2024, the undersigned remanded this matter for additional 8 proceedings for a third time. Tr. 2286-2308. 9 On April 29, 2024, ALJ Jesse Shumway held a new hearing. On May 12, 10 2025, ALJ Shumway denied Plaintiff’s DIB claim, denied Plaintiff’s SSI claim 11 prior to January 29, 2024, and granted Plaintiff’s SSI claim beginning on January 12 29, 2024 (age category change). Tr. 2171-2196. 13 Plaintiff filed the instant action for judicial review on July 7, 2025. ECF No. 14 1. 15 STANDARD OF REVIEW 16 The ALJ is tasked with “determining credibility, resolving conflicts in 17 medical testimony, and resolving ambiguities.” Andrews v. Shalala, 53 F.3d 1035, 18 1039 (9th Cir. 1995). The ALJ’s determinations of law are reviewed de novo, with 19 deference to a reasonable interpretation of the applicable statutes. McNatt v. Apfel, 20 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed 21 only if it is not supported by substantial evidence or if it is based on legal error. 22 Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is 23 defined as being more than a mere scintilla, but less than a preponderance. Id. at 24 1098. Put another way, substantial evidence “is such relevant evidence as a 25 reasonable mind might accept as adequate to support a conclusion.” Richardson v. 26 Perales, 402 U.S. 389, 401 (1971), quoting Consolidated Edison Co. v. NLRB, 305 27 U.S. 197, 229 (1938). If the evidence is susceptible to more than one rational 28 interpretation, the Court may not substitute its judgment for that of the ALJ. 1 Tackett, 180 F.3d at 1098; Morgan v. Comm’r of Social Sec. Admin., 169 F.3d 595, 2 599 (9th Cir. 1999). If substantial evidence supports the administrative findings, or 3 if conflicting evidence supports a finding of either disability or non-disability, the 4 ALJ’s determination is conclusive. Sprague v. Bowen, 812 F.2d 1226, 1229-1230 5 (9th Cir. 1987). Nevertheless, a decision supported by substantial evidence will be 6 set aside if the proper legal standards were not applied in weighing the evidence 7 and making the decision. Brawner v. Sec’y of Health and Human Servs., 839 F.2d 8 432, 433 (9th Cir. 1988). 9 SEQUENTIAL EVALUATION PROCESS 10 The Commissioner has established a five-step sequential evaluation process 11 for determining whether a person is disabled. 20 C.F.R. §§ 404.1520(a), 12 416.920(a); Bowen v. Yuckert, 482 U.S. 137, 140-142 (1987). In steps one through 13 four the claimant bears the burden of establishing a prima facie case of disability. 14 Tackett, 180 F.3d at 1098-1099. This burden is met once a claimant establishes 15 that a physical or mental impairment prevents the claimant from engaging in past 16 relevant work. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). If a claimant cannot 17 perform past relevant work, the ALJ proceeds to step five, and the burden shifts to 18 the Commissioner to show: (1) that Plaintiff can perform other substantial gainful 19 activity; and (2) that a significant number of jobs exist in the national economy 20 which Plaintiff can perform. Kail v. Heckler, 722 F.2d 1496, 1497-1498 (9th Cir. 21 1984); Beltran v. Astrue, 700 F.3d 386, 389 (9th Cir. 2012). If a claimant cannot 22 make an adjustment to other work in the national economy, the claimant will be 23 found disabled. 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v). 24 ADMINISTRATIVE FINDINGS 25 On May 12, 2025, ALJ Shumway issued a decision finding Plaintiff was not 26 disabled prior to January 29, 2024, but became disabled, as defined in the Social 27 Security Act, beginning on January 29, 2024 (age category change). Tr. 2171- 28 2196. 1 At step one, the ALJ found Plaintiff had not engaged in substantial gainful 2 activity since the December 16, 2014, alleged onset date. Tr. 2174. 3 At step two, the ALJ determined Plaintiff had the following severe 4 impairments: obesity; fibromyalgia; left trigger thumb, status post surgical release; 5 bilateral ulnar neuropathy, status post surgical releases; osteoarthritis of the 6 bilateral hips, knees, and hands; sacralization of the L5 vertebra; depressive 7 disorder; and anxiety disorder. Id. 8 At step three, the ALJ found Plaintiff did not have an impairment or 9 combination of impairments that met or medically equaled the severity of one of 10 the listed impairments. Tr. 2175. 11 The ALJ assessed Plaintiff’s Residual Functional Capacity (RFC) and found 12 she could perform sedentary work with the following additional limitations: 13
she needs the option to use a cane when walking; she needs the option 14 to stand at the workstation for one to two minutes after every hour of 15 sitting; she could occasionally balance, stoop, and climb ramps and stairs; she could never kneel, crouch, crawl, or climb ladders, ropes, or 16 scaffolds; she could frequently push, pull, reach, handle, finger, and 17 feel with the upper extremities; she could occasionally use foot controls with the left lower extremity; she could have occasional 18 exposure to extreme cold and heat, humidity, and pulmonary irritants; 19 she could have no exposure to uneven terrain, vibration, or hazards (e.g., unprotected heights, moving mechanical parts); she could have 20 occasional interaction with the public and supervisors; she could have 21 occasional, superficial interaction with co-workers, with no 22 collaborative tasks; and she would need a predictable work environment with no more than occasional changes. 23 24 Tr. 2178. 25 At step four, the ALJ found Plaintiff had no past relevant work. Tr. 2193. 26 At step five, the ALJ found that based on the testimony of the vocational 27 expert, and considering Plaintiff’s age, education, work experience, and RFC, 28 Plaintiff could perform jobs that existed in significant numbers in the national 1 economy, including the jobs of document preparer and document addresser, prior 2 to January 29, 2024. Tr. 2193-2194. The ALJ found that beginning on January 29, 3 2024, the date the claimant’s age category changed, and considering the claimant’s 4 age, education, work experience, and residual functional capacity, there are no jobs 5 that exist in the national economy that Plaintiff can perform. Tr. 2195. 6 The ALJ thus concluded Plaintiff was not under a disability within the 7 meaning of the Social Security Act before January 29, 2024, but became disabled 8 on that date and has continued to be disabled through the date of the decision, May 9 12, 2025. Tr. 2195-2196. 10 ISSUES 11 The question presented is whether substantial evidence supports the ALJ’s 12 decision denying benefits and, if so, whether that decision is based on proper legal 13 standards. 14 Plaintiff asserts the ALJ erred (1) in improperly evaluating the medical 15 opinion evidence; (2) by failing to find Plaintiff disabled as meeting or equaling a 16 listing; (3) in rejecting Plaintiff’s subjective complaints; and (4) in failing to 17 conduct an adequate analysis at step five. ECF No. 11 at 9. 18 DISCUSSION 19 A. Medical Opinions 20 Plaintiff first contends the ALJ erred by improperly evaluating the medical 21 opinions of five medical providers. ECF No. 11 at 12-23. Defendant’s cursory 22 response asserts that while the record contains conflicting medical opinions 23 necessitating a remand, there is reason, although not specifically explained by 24 Defendant, to seriously doubt that Plaintiff is disabled. ECF No. 16 at 3. 25 Defendant requests that the Court not award disability benefits and instead remand 26 the matter for further administrative proceedings and a fifth ALJ decision. ECF 27 No. 16. 28 /// 1 1. Jean You, M.D. 2 The record reflects hundreds of pages of treatment records from Plaintiff’s 3 treating physician, Jean You, M.D., a chronic pain specialist, from 2014 on. 4 During this time, Dr. You consistently found Plaintiff positive for more than 11 of 5 18 tender points and, consequently, has diagnosed her with fibromyalgia. Dr. You 6 consistently indicated Plaintiff exhibited widespread tenderness over the 7 fibromyalgia tender points and utilized a cane. Dr. You also noted chronic fatigue, 8 exercise intolerance, and difficulty performing daily activities and has prescribed 9 opiate medications for pain control. 10 On November 8, 2022, Dr. You provided a medical source statement 11 indicating the following: (1) Plaintiff suffers from fibromyalgia, osteoarthritis of 12 the right knee, and hip osteoporosis; (2) she suffers widespread pain, especially in 13 the hip and knee, as well as fibromyalgia pain mostly in her fatty tissue areas, 14 causing difficulty walking and sitting; (3) she must lie down and/or elevate her legs 15 for 20-30 minutes per day upon completing regular activities and light housework; 16 (4) she suffers from depression and anxiety; (5) regular and continuous work 17 would result in deterioration and absenteeism occurring four days per month or 18 more; (6) her functional capacity is between severely limited and sedentary work; 19 (7) she is limited to frequent use of her upper extremities; (8) she would be off task 20 and unproductive over 30% of the time during a 40-hour workweek; (9) her 21 limitations have existed since at least December 2019; and (10) Dr. You’s opinion 22 is based on Plaintiff’s subjective complaints and Dr. You’s professional experience 23 treating her for fibromyalgia for the past eight years. Tr. 2165-2167. On April 16, 24 2025, Dr. You provided a subsequent opinion that confirms her earlier opinions 25 and notes that Plaintiff’s limitations date back to November 2014. Tr. 2946-2948. 26 The ALJ accorded the November 8, 2022 and April 16, 2025 reports of Dr. 27 You “partial weight,” finding the check-box questionnaires provided no 28 meaningful explanations of the limitations assessed and relied, “at least to a 1 significant extent,” on Plaintiff’s subjective allegations. Tr. 2187. The ALJ noted 2 “Dr. You’s near-decade of reports are unremarkable as a whole and repetitive in 3 their detail, and her conclusion that the claimant would be off task and require four 4 or more days off of work each month is only speculated and unsupported.” Tr. 5 2187. The ALJ ventured that any of Plaintiff’s medical visits could be 6 accommodated on lunch breaks or during non-working hours.1 Id. 7 First, because Defendant fails to mention Dr. You in briefing, Defendant 8 apparently concedes that the ALJ erred by failing to properly evaluate her 9 opinions. See Stichting Pensioenfonds ABP v. Country Financial Corp., 802 10 F.Supp.2d 1125, 1132 (C.D. Cal. 2011) (finding, in most circumstances, that the 11 failure to respond in an opposition brief to an argument put forward in an opening 12 brief constitutes a waiver or abandonment in regard to the uncontested issue). 13 Second, the rationale cited by the ALJ to discount Dr. You’s opinions was 14 previously rejected by this Court in the most recent remand order. See Tr. 2293- 15 2295 (finding Dr. You’s years of physical exams and assessment for fibromyalgia 16 and osteoarthritis of the hip and knee show documentation of consistent findings 17
18 1There is no evidence of record to support the ALJ’s opinion that Plaintiff 19 would not need to be absent from work because her medical visits could be 20 accommodated on lunch breaks or during non-working hours. It is well-settled that 21 an ALJ may not arbitrarily substitute his own judgment for competent medical 22 evidence. See Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975) (It is 23 improper for the ALJ to act as his own medical expert.); Rohan v. Chater, 98 F.3d 24 966, 970 (7th Cir. 1996) (An ALJ “must not succumb to the temptation to play 25 doctor and make [his] own independent medical findings.”); Nguyen v. Chater, 172 26 F.3d 31, 35 (1st Cir. 1999) (As a lay person, an ALJ is “not at liberty to ignore 27 medical evidence or substitute his own views for uncontroverted medical 28 opinion.”). 1 and there is no evidence Dr. You relied more on Plaintiff’s subjective reports than 2 her own physical exam findings and expertise in Plaintiff’s condition). Finally, the 3 undersigned concludes that the opinions of Dr. You are supported by her years of 4 examination findings and the opinions of other medical professionals of record, 5 discussed below, that demonstrate Plaintiff suffers fibromyalgia flares of severe 6 pain at least one day per month. 7 The ALJ’s rejection of the opinions of Dr. You is not supported by 8 substantial evidence. 9 2. James Opara, M.D.2 10 James Opara, M.D., completed an examination of Plaintiff on August 1, 11 2015. Tr. 655-660. Dr. Opara opined that Plaintiff is limited to lifting/carrying 10 12 pounds, her standing/walking capacity is less than two hours in an eight-hour 13 workday due to tenderness and limited motion of both hips, and the use of a cane is 14 medically necessary. Tr. 659. Dr. Opara noted Plaintiff was in obvious painful 15 discomfort, ambulated with the use of a cane and exhibited a duckling and antalgic 16 gait, was unable to stand and bend down on her own, and exhibited decreased 17 range of motion of her bilateral hips. Tr. 657-658. 18 The ALJ assigned Dr. Opara’s opinion “significant weight,” accepting that a 19 cane is medically necessary at times for Plaintiff. Tr. 2188. However, the ALJ 20 determined Plaintiff could stand and/or walk two hours total, not the less than two 21 hours assessed by Dr. Opara. Id. The ALJ’s rationale for rejecting Dr. Opara’s 22 “less than two hours” assessment was merely that Dr. Opara “did not elaborate 23 how much less than two hours she could stand and/or walk.” Tr. 2188. 24 Dr. Opara’s opinion is supported by his review of treatment records, 25 including imaging, and his own observations and findings on physical 26
27 2Defendant does not discuss Dr. Opara in the response briefing, see Stichting 28 Pensioenfonds ABP, 802 F.Supp.2d at 1132. 1 examination. Upon physical exam, Dr. Opara observed that Plaintiff displayed 2 “obvious painful discomfort,” was “unable to walk or stand without the cane,” and 3 that she had a “duckling and antalgic gait” and “diminished range of motion of 4 both hip joints.” Tr. 656-658. Dr. Opara’s opinion that Plaintiff’s capacity to 5 stand/walk was restricted to less than two hours in an eight-hour workday is fully 6 supported, and the ALJ failed to provide a specific and legitimate reason supported 7 by substantial evidence for rejecting Dr. Opara’s opinion in this regard. 8 3. Medical Experts Pierko and Krishnamuathi 9 At Plaintiff’s initial administrative hearing on January 5, 2018, medical 10 expert Dr. Eliza Pierko testified that Plaintiff’s fibromyalgia would flare up one 11 day a month or more. Tr. 63-64. At Plaintiff’s September 2, 2020 administrative 12 hearing, medical expert Subramaniam Krishnamuathi testified that Plaintiff’s 13 fibromyalgia pain would be worse some days than other days due to its waxing and 14 waning nature. Tr. 1128. Defendant again fails to mention either medical 15 professional in the briefing. See Stichting Pensioenfonds ABP, 802 F.Supp.2d at 16 1132. 17 The ALJ determined that the opinions of these medical professionals merit 18 “significant weight” because they are supported by and consistent with the record. 19 Tr. 2189. However, as asserted by Plaintiff, the ALJ did not include any allowance 20 for absenteeism in the RFC determination based on an interpretation of their 21 opinions regarding Plaintiff’s documented fibromyalgia flare ups. ECF No. 11 at 22 21. The Court notes that while the opinions of Drs. Pierko and Krishnamuathi may 23 be interpreted as suggesting absenteeism, the record does not reflect that these 24 doctors specifically stated that Plaintiff would be absent from work one day a 25 month or more due to fibromyalgia. 26 Although the Court finds the ALJ did not err with respect to Drs. Pierko and 27 Krishnamuathi, the opinions of these doctors provide support for a finding that 28 Plaintiff’s fibromyalgia symptoms wax and wane and that she would experience 1 fare ups one day a month or more. A logical conclusion, consistent with the 2 opinions of Dr. You and Dr. Amusa (see infra) is that one day or more of 3 fibromyalgia pain flares per month would lead to absenteeism of at least one day 4 per month. 5 4. Medical Expert Amusa 6 At Plaintiff’s April 29, 2025 administrative hearing, medical expert Kweli 7 Amusa testified that due to flares of chronic pain, Plaintiff would be absent from 8 work at least one day per month. Tr. 2227-2228 (opining Plaintiff’s absenteeism 9 “would not be less than one day per month, but, certainly, it could be more”). 10 The ALJ accorded Dr. Amusa’s opinion “great weight,” but rejected Dr. 11 Amusa’s absenteeism opinion by finding there was “no evidence that her medical 12 visits are so frequent or of long duration that they could not be accommodated on 13 lunch breaks or during non-working hours.” Tr. 2190-2191. 14 As discussed in footnote 1, above, there is simply no evidence of record to 15 support the ALJ’s opinion that Plaintiff’s medical visits could be accommodated 16 on lunch breaks or during non-working hours. This statement by the ALJ is pure 17 conjecture. See Green v. Apfel, 204 F.3d 780, 782 (7th Cir. 2000) (A typical case 18 of an ALJ impermissibly “playing doctor” is when the ALJ draws medical 19 conclusions themselves about a claimant without relying on medical evidence.). 20 The ALJ has failed to provide a specific and legitimate reason supported by 21 substantial evidence for rejecting Dr. Amusa’s opinion that Plaintiff would be 22 absent from work at least one day per month. 23 The Court finds the opinions of Drs. You, Opara, Pierko, Krishnamuathi, 24 and Amusa, opinions which Defendant has failed to specifically challenge in 25 briefing, demonstrate that Plaintiff’s impairments during the relevant time period 26 would cause her to be absent form work at least one day per month. 27 /// 28 /// 1 B. Step Five 2 Plaintiff contends the ALJ’s step five determination is flawed. ECF No. 11 3 at 28-30. 4 Plaintiff’s first argument with respect to step five is that, pursuant to Leitz v. 5 Kijakazi, 2023 WL 4342114 at *2 (9th Cir. July 5, 2023),3 the ALJ’s limitation of 6 Plaintiff to occasional interaction with coworkers and supervisors bars all job 7 training and, consequently, precludes all competitive employment. The 8 undersigned does not agree with the proposition that a limitation to occasional 9 interaction with supervisors is per se disabling. See Justin P. v. O’Malley, 2024 10 WL 1559545 at *7-8 (E.D. Wash. April 10, 2024) (the Court applied Leitz and 11 determined that the ALJ did not err). 12 Nevertheless, the Court finds Plaintiff’s second argument, that the ALJ 13 relied on an incomplete hypothetical to the vocational expert, does have merit. 14 When the opinions of the medical professionals discussed in Section A, above, are 15 credited, greater limitations, including being absent from work more than five to 16 eight days per year, would be included in Plaintiff’s residual functional capacity 17 determination. At the administrative hearing held on April 29, 2025, the 18 vocational expert opined that being absent from work more than five to eight days 19 per year would preclude all competitive employment. Tr. 2246-2247. 20
21 3In Leitz, the ALJ held that the claimant “can have brief, superficial 22 interaction with co-workers and the public; and can have occasional interaction 23 with supervisors (although additional time for training is acceptable).” Leitz, 2023 24 WL 4342114 at *2. The Ninth Circuit determined that the “training-period caveat” 25 was not supported by the record, and that there was no evidence that the claimant’s 26 mental problems were “somehow alleviated during training periods because they 27 are less likely to include supervisor interactions than other work periods, or that 28 employers would be willing to tolerate her limitations during training periods.” Id. 1 Based on the opinions of the medical professionals discussed above, coupled 2 with the testimony of the vocational expert, the Court finds there is no work 3 available with which Plaintiff could have performed. The ALJ erred at step five. 4 C. Symptom Claims 5 Plaintiff contends the ALJ also erred by improperly rejecting Plaintiff’s 6 subjective complaints. ECF No. 11 at 25-28. Defendant, again, failed to 7 specifically address Plaintiff’s symptom claims assertion in the briefing. 8 It is the province of the ALJ to make determinations regarding a claimant’s 9 subjective statements. Andrews, 53 F.3d at 1039. However, the ALJ’s findings 10 must be supported by specific, cogent reasons. Rashad v. Sullivan, 903 F.2d 1229, 11 1231 (9th Cir. 1990). Once the claimant produces medical evidence of an 12 underlying medical impairment, the ALJ may not discredit testimony as to the 13 severity of an impairment merely because it is unsupported by medical evidence. 14 Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998). Absent affirmative evidence 15 of malingering, the ALJ’s reasons for rejecting the claimant’s testimony must be 16 “specific, clear and convincing.” Smolen v. Chater, 80 F.3d 1273, 1281 (9th Cir. 17 1996). “General findings are insufficient: rather the ALJ must identify what 18 testimony is not credible and what evidence undermines the claimant’s 19 complaints.” Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993). 20 Here, the ALJ concluded Plaintiff’s medically determinable impairments 21 could reasonably be expected to cause some of the alleged symptoms; however, 22 Plaintiff’s statements concerning the intensity, persistence, and limiting effects of 23 those symptoms were not fully supported. Tr. 2179. In assessing Plaintiff’s 24 subjective complaints, the ALJ found some objective medical findings conflicted 25 with Plaintiff’s allegations, Plaintiff’s course of treatment was incompatible with 26 her allegations, Plaintiff’s statements were inconsistent with her allegations, and 27 her assertion that “she lies down 90 percent of the time on any day she is home” is 28 /// 1 inconsistent with the medical evidence of record.4 Tr. 2179-2193. While some of 2 these reasons for discounting Plaintiff’s testimony may find support in the record, 3 the undersigned finds substantial evidence, and specially the medical opinions 4 discussed above, corroborate Plaintiff allegations of disabling limitations during 5 the relevant time period. This matter shall be remanded for an immediate 6 calculation of benefits; therefore, the Court need not specifically address the issue 7 of Plaintiff’s subjective complaints. 8 D. Step Three 9 Plaintiff contends that the ALJ also erred at step three by failing to find that 10 she meets or equals a listing based on the improperly rejected opinions of the 11 medical providers discussed above. ECF No. 11 at 23-25. Defendant did not 12 respond to the step three assertion. Because the case is being remanded for an 13 immediate calculation of benefits based on the Court’s conclusion that the medical 14 evidence of record demonstrates Plaintiff had disabling limitations during the 15 relevant time period, see supra, the Court will not specifically address the step 16 three issue raised by Plaintiff. 17 CONCLUSION 18 Having reviewed the record and the ALJ’s findings, the Court finds the 19 ALJ’s decision is not supported by substantial evidence and not free of harmful 20 error. The Court has the discretion to remand the case for additional evidence and 21 findings or to award benefits. Smolen, 80 F.3d at 1292. The Court may award 22 benefits if the record is fully developed and further administrative proceedings 23 would serve no useful purpose. Id. Remand is appropriate when additional 24 4The ALJ incorrectly held that Plaintiff testified to lying down 90% of the 25 time any day that she is home. Tr. 2183-2184. She actually testified to lying down 26 or reclining 90% of the time on the two to three days per month when she suffers 27 larger flare ups of her fibromyalgia. Tr. 2237-2238. 28 1 administrative proceedings could remedy defects. Rodriguez v. Bowen, 876 F.2d 2 759, 763 (9th Cir. 1989). In this case, the record is adequate for a proper 3 determination to be made and further development is not necessary. 4 The Ninth Circuit has set forth a three part standard for determining when to 5 credit improperly discounted evidence as true: (1) the record has been fully 6 developed and further administrative proceedings would serve no purpose; (2) the 7 ALJ has failed to provide legally sufficient reasons for rejecting the evidence in 8 question; and (3) if the improperly discredited evidence were credited as true the 9 ALJ would be required to find Plaintiff eligible for benefits. Garrison v. Colvin, 10 759 F.3d 995, 1020 (9th Cir. 2014). 11 In this case, all three parts of the standard are met. The record has been fully 12 developed and further proceedings are not necessary. As discussed above, the ALJ 13 improperly evaluated the opinions of several medical professionals. Therefore, the 14 second prong of the credit-as-true rule is met. The third prong of the credit-as-true 15 rule is satisfied because if the opinions of these medical professionals were 16 credited as true, the ALJ would be required to find Plaintiff disabled. Finally, the 17 record as a whole does not leave serious doubt as to whether Plaintiff was disabled 18 during the relevant time period. See Garrison, 759 F.3d at 1021. The record 19 reflects that Plaintiff had disabling limitations. 20 Moreover, the credit-as-true rule is a “prophylactic measure” designed to 21 motivate the Commissioner to ensure that the record will be carefully assessed and 22 to justify “equitable concerns” about the length of time which has elapsed since a 23 claimant has filed their application. Treichler v. Comm’r of Soc. Sec. Admin., 775 24 F.3d 1090, 1100 (9th Cir. 2014) (internal citations omitted). Here, Plaintiff filed 25 for benefits in 2014, an ALJ has erred on four occasions by failing to properly 26 evaluate the medical opinion evidence, and this is the fourth time the case has been 27 before a reviewing court. It has been approximately eleven years since Plaintiff 28 applied for benefits. Considering this delay and the harmful errors by the ALJs in 1|| four prior decisions, it is appropriate for this Court to apply the “credit as true” doctrine pursuant to Ninth Circuit precedent and remand this case for an award of benefits. 4 Accordingly, the Commissioner’s final decision is REVERSED and this 5|| case is REMANDED for an immediate calculation of benefits. IT IS HEREBY 6|| ORDERED: 7 l. Plaintiff's motion to reverse and remand for an immediate award of benefits, ECF No. 11, is GRANTED. 9 2. Defendant’s motion to reverse and remand for additional proceedings, 10|| ECF No. 16, is DENIED. 11 3. The matter is REMANDED to the Commissioner for an immediate 12]| calculation of benefits. 13 4. An application for attorney fees may be filed by separate motion. 14 IT ISSO ORDERED. The District Court Executive shall file this Order and provide copies to counsel. Judgment shall be entered for Plaintiff and the 16|| file shall be CLOSED. 17 DATED January 21, 2026. : Agente C Shedém Maer gp ALEXANDER C. EKSTROM UNITED STATES MAGISTRATE JUDGE
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