Lavores S. v. Commissioner of Social Security

• Court: District Court, W.D. Washington
• Decided: October 15, 2025
• Docket: 2:25-cv-00101
• Status: Unknown

Opinion

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5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 LAVORES S., CASE NO. 2:25-cv-00101-GJL 11 Plaintiff, v. SOCIAL SECURITY DISABILITY 12 APPEAL ORDER COMMISSIONER OF SOCIAL 13 SECURITY, 14 Defendant.

15 This Court has jurisdiction pursuant to 28 U.S.C. § 636(c), Federal Rule of Civil 16 Procedure 73, and Local Magistrate Judge Rule 13. See also Consent to Proceed Before a United 17 States Magistrate Judge, Dkt. 3. This matter has been fully briefed. See Dkts. 11, 14, 15, 21, 26, 18 27. 19 After considering and reviewing the record, the Court concludes the Administrative Law 20 Judge (“ALJ”) erred in finding Plaintiff not disabled. The Court accordingly REVERSES and 21 REMANDS this matter pursuant to sentence four of 42 U.S.C. § 405(g) for further proceedings 22 consistent with this Order. 23 // 24 1 I. PROCEDURAL HISTORY 2 Plaintiff’s application for Supplemental Security Income disability benefits under Title 3 XVI of the Social Security Act was denied initially and following reconsideration. See AR 130. 4 Plaintiff’s requested hearing was held before the ALJ on May 31, 2022. Id. On June 16, 2022,

5 the ALJ issued a written decision concluding Plaintiff was not disabled. AR 142. 6 Plaintiff appealed the ALJ’s decision, and the Appeals Council remanded the case for 7 further administrative proceedings on April 19, 2023. AR 151. The ALJ held an additional 8 hearing on January 18, 2024, and issued a second written decision concluding Plaintiff was not 9 disabled on February 26, 2024. AR 17–34, 44–66. On November 12, 2024, the Appeals Council 10 declined Plaintiff’s request for review, making the ALJ’s decision the Commissioner’s final 11 decision subject to judicial review. AR 1–6. On January 15, 2025, Plaintiff filed a Complaint in 12 this Court seeking judicial review of the ALJ’s decision. Dkt. 1. Defendant filed the sealed AR in 13 this matter on March 21, 2024. See Dkts. 5–9. 14 II. BACKGROUND

15 Plaintiff was born in 1996 and was 9 years old on September 1, 2006, the alleged date of 16 disability onset. AR 17, 32. Plaintiff has a limited education. AR 32. According to the ALJ, 17 Plaintiff suffers from, at a minimum, the following severe impairments: diabetes mellitus; 18 cannabinoid hyperemesis syndrome; gastroparesis; generalized anxiety disorder; posttraumatic 19 stress disorder (“PTSD”); diabetic retinopathy; and substance abuse. AR 19. The ALJ found 20 Plaintiff had a Residual Functional Capacity (“RFC”) to perform light work with the following 21 limitations: 22 sitting, standing, and walking are each available for six hours in an eight-hour workday; [Plaintiff] can frequently perform all postural activities, except 23 occasional climbing of ladders, ropes, or scaffolds; must avoid concentrated exposure to pulmonary irritants, hazards such as unprotected heights, and 24 1 dangerous moving machinery; right visual acuity is frequent; can interact superficially and occasionally with the general public; can work in the same room 2 as coworkers, but not in coordination with them; and can adapt to simple workplace changes. 3 AR 22. Based on the assessed RFC, the ALJ found Plaintiff could perform work existing in 4 significant numbers in the national economy and therefore was not disabled. AR 33. 5 III. DISCUSSION 6 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 7 social security benefits if the ALJ’s findings are based on legal error or not supported by 8 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 9 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). 10 “[H]armless error principles apply in the Social Security Act context.” Molina v. Astrue, 11 674 F.3d 1104, 1115 (9th Cir. 2012), superseded on other grounds by 20 C.F.R. § 404.1502(a). 12 Generally, an error is harmless if it is not prejudicial to the claimant and is “inconsequential to 13 the ultimate nondisability determination.” Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 14 1055 (9th Cir. 2006); see also Molina, 674 F.3d at 1115. 15 In his Opening Brief, Plaintiff alleges the ALJ erred in evaluating Plaintiff’s testimony, 16 mental health opinions, and lay witness testimony. Dkt. 11 at 1. In his supplemental briefing, he 17 argues the ALJ failed to properly account for Plaintiff’s Drug Addiction or Alcoholism (“DAA”) 18 throughout the decision as required under SSR 13-2p and Bustamante v. Massanari, 262 F.3d 19 949, 955 (9th Cir. 2001).1 Given the significance of a proper DAA analysis to the overall RFC 20 determination, the Court first considers the DAA objection raised in Plaintiff’s supplemental 21 briefing. 22 23 1 On September 2, 2025, the Court granted Plaintiff’s request to file supplemental briefing raising the DAA issue 24 outside of Plaintiff’s Opening Brief. See Dkt. 24. 1 A. Two-Step DAA Analysis under SSR 13-2p and Bustamante 2 Pursuant to 42 U.S.C. § 423(d)(2)(C), an individual “shall not be considered to be 3 disabled … if drug addiction or alcoholism would ... be a contributing factor material to the 4 Commissioner’s determination that the individual is disabled.” Sousa v. Callahan, 143 F.3d

5 1240, 1245 (9th Cir. 1998). The key factor in determining whether DAA is a contributing factor 6 material to the determination of disability is whether an individual would still be found disabled 7 if she stopped using alcohol or drugs. Id. (citing 20 C.F.R. § 404.1535(b)(1)). 8 When analyzing substance abuse in a disability determination, the ALJ must first 9 determine whether the claimant is disabled under the standard five-step process, including 10 claimant’s DAA. Debra C. v. Dudek, No. 3:24-cv-05518-TLF, 2025 WL 2538968 at *3 (Sep. 4, 11 2025) (citing Bustamante, 262 F.3d at 955). If the ALJ makes a disability finding at step one, the 12 ALJ must then conduct the five-step sequence a second time to separate out the effects of DAA 13 and determine whether the plaintiff would be found disabled if they ceased using drugs or 14 alcohol. Id. Moreover, SSR 13-2p requires an ALJ to determine the nature of plaintiff's DAA,

15 whether it is medically determinable, and how it interacts with each of plaintiff's impairments 16 after a disability has been established. 17 Plaintiff argues the ALJ impermissibly relied upon Plaintiff’s cannabis use to reject 18 Plaintiff’s subjective testimony that he was disabled by his frequent abdominal pain, nausea, and 19 vomiting without first determining whether Plaintiff would have been disabled absent his 20 substance use. Dkt. 21 at 4. Plaintiff emphasizes the ALJ failed to address whether his symptoms 21 would be reduced to non-disabling levels absent his DAA, particularly because physicians 22 attribute Plaintiff’s symptoms to either gastroparesis or cannabis hyperemesis or both. Id. at 3 23 (citing AR 2060; 2082; 2521).

24 1 In response, the Commissioner argues the ALJ did not need to perform the second step of 2 the Bustamante analysis in this case because the ALJ concluded Plaintiff was not disabled at the 3 outset. Dkt. 26 at 2–3. 4 The Court acknowledges the second step of the Bustamante is not always required.

5 However, an ALJ may only avoid the second step of the analysis when the Plaintiff is found not 6 disabled without separating out the impact of alcoholism or drug addiction. Bustamante, 262 7 F.3d at 955 (emphasis added). In this instance, the ALJ did not perform the initial step as 8 contemplated by Bustamante and SSR 13-2p when DAA is at issue. 9 As argued by Plaintiff, the ALJ discounted Plaintiff’s frequent abdominal pain and 10 vomiting at the outset on the basis that their severity was likely caused, at least in part, by his 11 continued cannabis use against his physician’s advice. See AR 24 (finding Plaintiff’s testimony 12 inconsistent with the medical record as his nausea and stomach pain were likely “related to and 13 adversely impacted by” his cannabis use); AR 24 (noting inconsistencies in Plaintiff’s testimony 14 and reports to medical providers regarding his DAA)2; AR 25 (finding Plaintiff’s testimony

15 regarding the severity and limitations of his symptoms to be greater than expected in part 16 because of his cannabis hyperemesis exacerbating his abdominal pain and nausea); AR 26–28 17 (detailing Plaintiff lengthy history of emergency room visits for abdominal pain and vomiting 18 while undercutting each instance by noting Plaintiff’s ongoing cannabis use against doctor’s 19 orders).3 In doing so, the ALJ improperly referenced Plaintiff’s DAA to cast doubt on the 20

2 The ALJ frames Plaintiff’s testimony as contradictory simply because Plaintiff indicated “his ongoing cannabis use 21 adversely affected his nausea, but then later stated it helped control his nausea.” AR 24. The Court disagrees. Plaintiff acknowledging the long-term consequences of cannabis hyperemesis on his nausea symptoms as relayed to 22 him by his physicians is not inconsistent with Plaintiff also experiencing the well-known, if admittedly temporary, nausea relief afforded by cannabis use. 23 3 Notably, the ALJ’s decision does not address Plaintiff’s potential for chronic absenteeism given his impairments, with DAA or otherwise, despite acknowledging Plaintiff’s extensive history of emergency department visits and 24 1 credibility of Plaintiff’s symptom testimony, the necessity of his extensive medical record, and 2 the credibility of the lay witness testimony. See Debra C., 2025 WL 2538968 at *3 (finding 3 Bustamante prohibits ALJs from “discounting medical opinions or subjective reports because of 4 DAA before making a threshold determination whether the claimant is disabled, including all

5 impairments”). 6 The ALJ’s decision impermissibly commingles Plaintiff’s physical health issues with his 7 DAA without making the required initial finding of disability. See Debra C., 2025 WL 2538968 8 at *3; see also Norman Kijakazi, 650 F. Supp. 3d 1096, 1102 (D. Or. 2022) (“The ALJ erred 9 when he failed to conduct the separate DAA analysis and yet, nevertheless, concluded Plaintiff 10 was more functional and, therefore, not disabled when abstinent from substance abuse.”). The 11 ALJ’s analysis treats Plaintiff’s ongoing cannabis use as a material contributing factor to his 12 disabling symptoms from the outset rather than performing the second step to determine if 13 Plaintiff would still be found disabled without ongoing cannabis use. 14 Without a properly considered disability finding followed by a materiality analysis, the

15 Court cannot determine whether the overall denial was legally proper. As such, the ALJ’s legal 16 error was not harmless. The ALJ’s treatment of Plaintiff’s cannabis use had a material impact on 17 the ultimate disability determination, and thus remand for further consideration is warranted. 18 B. Remaining Issues 19 Having found remand necessary for a proper SSR13-2p and Bustamante-compliant DAA 20 analysis, the Court declines to address Plaintiff’s remaining objections. Rather, the Court directs 21

22 hospitalizations. See AR 26 (noting Plaintiff’s 29 emergency department visits over a 12-month period for abdominal symptoms); AR 27 (noting continued visits to the emergency department through July 2019 for 23 abdominal symptoms); AR 65–66 (vocational expert testimony that Plaintiff needing to miss four days of work a month would preclude employment). On the whole, Plaintiff’s medical history suggests its unlikely Plaintiff will be 24 able to perform competitive work such that a DAA materiality determination is necessary. See Dkt. 21 at 2. 1 the ALJ on remand to consider Plaintiff’s subjective testimony, medical history, and lay witness 2 testimony within the framework set forth above. 3 IV. CONCLUSION 4 For these reasons, the Court concludes the ALJ committed harmful error, and the Court

5 ORDERS that this matter be REVERSED and REMANDED for additional administrative 6 proceedings pursuant to sentence four of 42 U.S.C. § 405(g) for further administrative 7 proceedings consistent with this Order. 8 9 Dated this 15th day of October, 2025. 10 A 11 12 Grady J. Leupold United States Magistrate Judge 13 14 15 16 17 18 19 20 21 22 23 24