Jones v. Saul

District Court, N.D. California·Decided September 17, 2021·No. 1:20-cv-01201·Unknown

Opinion

JARRETT J., Case No. 20-cv-01201-RMI

Plaintiff, ORDER RE: CROSS-MOTIONS FOR v. SUMMARY JUDGMENT

ANDREW SAUL, Re: Dkt. Nos. 16, 17 Defendant.

Plaintiff seeks judicial review of an administrative law judge (“ALJ”) decision denying his application for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. Plaintiff’s request for review of the ALJ’s unfavorable decision appears to have been granted by the Appeals Council, which resulted in an extensive written opinion that actually adopted the ALJ’s findings and legal conclusions upon the consideration of additional medical evidence that the ALJ had failed to include in the record; therefore, for present purposes, the opinion issued by the Appeals Council is the “final decision” of the Commissioner of Social Security which this court may review. See 42 U.S.C. §§ 405(g), 1383(c)(3).1 While the court will treat the Appeals Council’s decision as the Commissioner’s final decision, this court will also consider the ALJ’s decision.2 Both parties have consented to the jurisdiction of a 1 See Def.’s Mot. (dkt. 17) at 2 (“The Appeals Council issued the Commissioner’s final decision . . .”).

2 See Ramirez v. Shalala, 8 F.3d 1449, 1452 (9th Cir. 1993) (“[A]lthough the Appeals Council ‘declined to review’ the decision of the ALJ, it reached this ruling after considering the case on the merits; examining the entire record, including the additional material; and concluding that the ALJ’s decision was proper and that the additional material failed to ‘provide a basis for changing the hearing decision.’ For these reasons, magistrate judge (dkts. 3 & 9), and both parties have moved for summary judgment (dkts. 16 & 17). For the reasons stated below, Plaintiff’s motion for summary judgment is granted, and Defendant’s motion is denied. The Commissioner’s findings “as to any fact, if supported by substantial evidence, shall be conclusive.” 42 U.S.C. § 405(g). A district court has a limited scope of review and can only set aside a denial of benefits if it is not supported by substantial evidence or if it is based on legal error. Flaten v. Sec’y of Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995). The phrase “substantial evidence” appears throughout administrative law and directs courts in their review of factual findings at the agency level. See Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). Substantial evidence is defined as “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Id. at 1154 (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); see also Sandgathe v. Chater, 108 F.3d 978, 979 (9th Cir. 1997). “In determining whether the Commissioner’s findings are supported by substantial evidence,” a district court must review the administrative record as a whole, considering “both the evidence that supports and the evidence that detracts from the Commissioner’s conclusion.” Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1998). The Commissioner’s conclusion is upheld where evidence is susceptible to more than one rational interpretation. Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). On July 5, 2016, Plaintiff filed an application for Title II and Title XVI benefits, alleging an onset date of December 12, 2013. See Administrative Record “AR” at 19.3 As set forth in detail below, the ALJ found Plaintiff not disabled and denied the application on August 30, 2018. Id. at 19-27. The Appeals Council granted Plaintiff’s request for review, and then issued a detailed decision that largely adopted the ALJ’s findings and conclusions, and reached the same ultimate conclusion of non-disability on December 17, 2019. See id. at 4-9. Thereafter, on February 18, 2020, Plaintiff sought review in this court (dkt. 1) and argued that the ALJ and the Appeals Council erred in discrediting Plaintiff’s pain and symptom testimony, and that the ALJ and Appeals Council erred in failing to consider lay witness testimony from Plaintiff’s employer. See Pl.’s Mot. (dkt. 16) at 5. Defendant contends that no such errors were committed. See Def.’s Mot. (dkt. 17) at 5-9. Medical Evidence Plaintiff, now 43 years old, suffered injuries to his spine and head during a slip and fall incident in December of 2013 while employed as a line cook. Id. at 306. Specifically, Plaintiff slipped on a wet floor, landed on his back, struck the back of his head, and suffered a concussion and thoracic and lumbar contusions. Id. at 306, 308. Over the subsequent few months, Plaintiff received various levels of chiropractic treatment at the Muir Diablo Occupational Medicine Group, in addition to extensive MRI imaging of his spine in January and March of 2014. Id. at 307-08. Eight months after his accident, in August of 2014, Plaintiff was referred to Fulton S. Chen, M.D., for evaluation and further treatment. See id. at 306-09. Dr. Chen diagnosed Plaintiff with: (1) chronic pain in the lumbar, thoracic, and cervical spine; (2) cervical spondylosis (a condition marked by the degeneration of intervertebral disks); (3) lumbar disc degeneration at L4- L5 and L5-S1, with a 3mm disc protrusion at L4-L5 and a 2mm disc protrusion at L5-S1; and, (4) left-side lumbar radicular pain caused by radiculopathy (the pinching of a nerve root in the spinal column). Id. at 308. Upon examination, Dr. Chen found that Plaintiff still suffered from “joint stiffness over the spine, numbness over the legs, numbness over the arms, dizziness, and headaches” as a result of his injuries. Id. at 307. Dr. Chen’s examination also found that Plaintiff’s spine was still tender to palpation, while his ability to experience sensory stimulation across his lower legs remained diminished. Id. at 307. As to the frequency and severity with which Plaintiff experiences pain, Dr. Chen found as follows: (1) that Plaintiff still experiences intermittent daily pain that fluctuates between 5 and 10 (on a scale of 1 to 10); (2) that Plaintiff’s lower back pain will radiate down to the left leg on an intermittent basis; (3) that Plaintiff experiences occasional by movement. Id. at 306. In short, Dr. Chen noted that Plaintiff “has pain over the entire spine [and] may experience cervical spine pain on one day, and then thoracic spine [pain] on another day, and then lumbar spine [pain] on another day.” Id. In addition to prescribing narcotic medication for pain management (which Plaintiff reported as reducing his pain only by 50%), Dr. Chen noted that “[o]verall there is not much more to recommend for him [by way of treatment] beyond what he has already received.” Id. at 308, 310. However, a subsequent transforaminal epidural steroid injection into Plaintiff’s lower spine at L-5-S1 improved the episodes of his lower back pain such as to decrease the pain from that area from 8 to 5 (on a scale of 1 to 10). Id. at 316. More than a year after his accident, and several months after his lower lumbar steroid injection, Dr. Chen observed that Plaintiff “continues to have pain along the cervical spine, thoracic spine, and lumbar spine, [t]he severity [of which] ranges from a 3 to 8/10, [and that] [t]he pain is worse after several hours of work.” Id. at 318. Despite a full year of treatment, Dr. Chen noted in December of 2014 that Plaintiff “remains symptomatic over the entire spine.” Id. at 319. The following month, in January of

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