Michelle H. v. Commissioner of Social Security Administration

Opinion

1 2 U.S. F D IL IS E T D R I I N C T T H C E O URT EASTERN DISTRICT OF WASHINGTON 3 May 06, 2026 4 SEAN F. MCAVOY, CLERK 5 6 UNITED STATES DISTRICT COURT 7 EASTERN DISTRICT OF WASHINGTON 8 9 10 MICHELLE H., No. 1:25-CV-03205-SAB 11 Plaintiff, 12 v. ORDER REVERSING THE 13 COMMISSIONER OF SOCIAL DECISION OF COMMISSIONER 14 SECURITY ADMINISTRATION, 15 Defendant. 16 17 Plaintiff brings this action seeking juridical review of the Commissioner of 18 Social Security’s final decision, denying her application for social security 19 benefits. Plaintiff is represented by D. James Tree. The Commissioner is 20 represented by L. Jamala Edwards and Joseph Derrig. Pending before the Court is 21 Plaintiff’s Opening Brief, ECF No. 11, and the Commissioner’s Brief, ECF No. 12. 22 After reviewing the administrative record and briefs filed by the parties, the 23 Court is now fully informed. For the reasons set forth below, the Court reverses the 24 Commissioner’s decision and remands for an immediate award of benefits. 25 I. Jurisdiction 26 On October 24, 2018, Plaintiff filed an application for supplemental security 27 income, alleging disability beginning July 27, 2017. Plaintiff’s application was 28 denied initially and on reconsideration. Plaintiff requested a hearing and on May 1 21, 2020, a telephonic hearing was held. The ALJ found that Plaintiff was not 2 disabled and Plaintiff appealed that decision. While the decision was pending on 3 appeal, Plaintiff filed a subsequent application, and she was found disabled as of 4 January 18, 2021. Her appeal was successful, and the case was remanded on July 5 12, 2022. 6 Another hearing was held on January 9, 2024. The ALJ determined the 7 relevant period of adjudication was from October 24, 2018 to January 17, 2021. 8 The ALJ issued an unfavorable decision on February 14, 2024. Plaintiff appealed 9 that decision and the district court remanded. 10 A hearing was held on July 3, 2025. Plaintiff participated and was 11 represented by Robert Tree. The ALJ found Plaintiff was not disabled from 12 October 24, 2018, through January 17, 2021. 13 Plaintiff filed a timely appeal with the United States District Court for the 14 Eastern District of Washington on November 20, 2025. ECF No. 1. The matter is 15 before this Court pursuant to 42 U.S.C. § 405(g). 16 II. Five-Step Sequential Evaluation Process 17 The Social Security Act defines disability as the “inability to engage in any 18 substantial gainful activity by reason of any medically determinable physical or 19 mental impairment which can be expected to result in death or which has lasted or 20 can be expected to last for a continuous period of not less than twelve months.” 42 21 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A claimant shall be determined to be 22 under a disability only if their impairments are of such severity that the claimant is 23 not only unable to do their previous work, but cannot, considering claimant’s age, 24 education, and work experiences, engage in any other substantial gainful work that 25 exists in the national economy. 42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B). The 26 Commissioner has established a five-step sequential evaluation process to 27 determine whether a person is disabled in the statute. See 20 C.F.R. §§ 28 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v). 1 Step One: Is the claimant engaged in substantial gainful activities? 20 2 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). Substantial gainful activity is work 3 done for pay and requires compensation above the statutory minimum. Keyes v. 4 Sullivan, 894 F.2d 1053, 1057 (9th Cir. 1990). If the claimant is engaged in 5 substantial activity, benefits are denied. 20 C.F.R. § 404.1520(b), 416.920(b). If 6 the claimant is not, the ALJ proceeds to step two. 7 Step Two: Does the claimant have a medically-severe impairment or 8 combination of impairments? 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). A 9 severe impairment is one that lasted or must be expected to last for at least 12 10 months and must be proven through objective medical evidence. Id. §§ 404.1509, 11 416.909. If the claimant does not have a severe impairment or combination of 12 impairments, the disability claim is denied. Id. § 404.1520(a)(4)(ii), 13 416.920(a)(4)(ii). If the impairment is severe, the evaluation proceeds to the third 14 step. 15 Step Three: Does the claimant’s impairment meet or equal one of the listed 16 impairments acknowledged by the Commissioner to be so severe as to preclude 17 substantial gainful activity? 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If 18 the impairment meets or equals one of the listed impairments, the claimant is 19 conclusively presumed to be disabled. 20 C.F.R. §§ 404.1520(d), 416.920(d). If the 20 impairment is not one conclusively presumed to be disabling, the evaluation 21 proceeds to the fourth step. 22 Before considering to the fourth step, the ALJ must first determine the 23 claimant’s residual functional capacity. An individual’s residual functional 24 capacity is their ability to do physical and mental work activities on a sustained 25 basis despite limitations from their impairments. 20 C.F.R. §§ 404.1545(a)(1), 26 416.945(a)(1). The residual functional capacity is relevant to both the fourth and 27 fifth steps of the analysis. 28 Step Four: Does the impairment prevent the claimant from performing work 1 they have performed in the past? 20 C.F.R. §§ 404.1520(a)(4)(iv), 2 416.920(a)(4)(iv). If the claimant is able to perform their previous work, they are 3 not disabled. 20 C.F.R. §§ 404.1520(f), 416.920(f). If the claimant cannot perform 4 this work, the evaluation proceeds to the fifth and final step. 5 Step Five: Is the claimant able to perform other work in the national 6 economy in view of their age, education, and work experience? 20 C.F.R. §§ 7 404.1520(a)(4)(v), 416.920(a)(4)(v). The initial burden of proof rests upon the 8 claimant to establish a prima facie case of entitlement to disability benefits. Tackett 9 v. Apfel, 108 F.3d 1094, 1098 (9th Cir. 1999). This burden is met once a claimant 10 establishes that a physical or mental impairment prevents him from engaging in her 11 previous occupation. Id. At step five, the burden shifts to the Commissioner to 12 show that the claimant can perform other substantial gainful activity. Id. 13 III. Standard of Review 14 The Commissioner’s determination will be set aside only when the ALJ’s 15 findings are based on legal error or are not supported by substantial evidence in the 16 record as a whole. Matney v. Sullivan, 981 F.2d 1016, 1018 (9th Cir. 1992) (citing 17 42 U.S.C. § 405(g)). Substantial evidence is “more than a mere scintilla,” 18 Richardson v. Perales, 402 U.S. 389, 401 (1971), but “less than a preponderance,” 19 Sorenson v. Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975). Substantial 20 evidence is “such relevant evidence as a reasonable mind might accept as adequate 21 to support a conclusion.” Richardson, 402 U.S. at 401. 22 A decision supported by substantial evidence will be set aside if the proper 23 legal standards were not applied in weighing the evidence and making the decision. 24 Brawner v. Secr’y of Health & Human Servs., 839 F.2d 432, 433 (9th Cir. 1988). 25 An ALJ is allowed “inconsequential” errors as long as they are immaterial to the 26 ultimate nondisability determination. Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 27 1050, 1055 (9th Cir. 2006). The Court must uphold the ALJ’s denial of benefits if 28 the evidence is susceptible to more than one rational interpretation, one of which 1 supports the decision of the administrative law judge. Batson v. Barnhart, 359 F.3d 2 1190, 1193 (9th Cir. 2004). It “must consider the entire record as a whole, 3 weighing both the evidence that supports and the evidence that detracts from the 4 Commissioner’s conclusion, and may not affirm simply by isolating a specific 5 quantum of supporting evidence.” Revels v. Berryhill, 874 F.3d 648, 654 (9th Cir. 6 2017) (quotation omitted). “If the evidence can support either outcome, the court 7 may not substitute its judgment for that of the ALJ.” Matney, 981 F.2d at 1019. 8 IV. Statement of Facts 9 The facts have been presented in the administrative record, the ALJ’s 10 decision, and the briefs to this Court. Only the most relevant facts are summarized 11 herein. 12 At the 2025 hearing, Plaintiff testified that she earned her high school 13 diploma and attended two years of college. She explained that she used alcohol to 14 mask her mental health symptoms, but she became sober in 2018. She lives alone 15 in her apartment. She testified that she stays home a lot because it is hard to get her 16 walker down the stairs. She testified she experiences lots of pain and has trouble 17 focusing. While testifying, Plaintiff lost her train of thought numerous times. 18 V. The ALJ’s Findings 19 The ALJ issued an opinion affirming denial of benefits. AR 2187-2205. 20 At step one, the ALJ found that Plaintiff has not engaged in substantial 21 gainful activity since October 24, 2018, the alleged amended onset date. AR 2191. 22 At step two, the ALJ identified the following severe impairments: cervical 23 and lumbar degenerative disc disease; bilateral knee osteoarthritis; COPD; obesity; 24 depressive/bipolar disorder; anxiety disorder; attention deficit hyperactivity 25 disorder (ADHD); personality disorder; and PTSD. AR 2191. 26 At step three, the ALJ found that Plaintiff did not have an impairment or 27 combination of impairments that meets or medically equals the severity of one of 28 the listed impairments. AR 2192. Ultimately, the ALJ concluded that Plaintiff has a 1 residual function capacity (“RFC”) to perform:

2 light work as defined in 20 CFR 416.967(b) except she could occasionally 3 climb ramps and stairs, and could not climb ladders, ropes, or scaffolds. She could occasionally balance, stoop, and crouch. She could frequently kneel 4 and crawl. She could perform frequent bilateral reaching and frequent 5 bilateral handling and fingering. She could frequently push and/or pull with the left lower extremity. She had to avoid concentrated exposure to extreme 6 vibration. She could understand, remember, and perform simple, routine 7 tasks with simple, superficial cooperation with coworkers. She could work in job with occasional, routine workplace changes. 8 AR 2194. 9 At step four, the ALJ found Plaintiff did not have past relevant work. AR 10 2204. 11 The ALJ found there were other jobs that existed in significant numbers in 12 the national economy that Plaintiff could also perform, including housekeeper, 13 Cleaner; small products assembler; and sales attendant. AR 2205. Consequently, 14 the ALJ found that Plaintiff was not disabled from October 24, 2018 through 15 January 17, 2021. 16 VI. Issues 17 1. Whether the ALJ properly evaluated Plaintiff’s symptom testimony? 18 2. Whether the ALJ properly revaluated the medical opinions? 19 VII. Discussion 20 1. Plaintiff’s symptom testimony 21 Plaintiff argues the ALJ erred in discounting her subjective symptoms. In 22 determining whether a claimant’s testimony regarding subjective pain or symptoms 23 is credible, the ALJ engages in a two-step analysis. Garrison v. Colvin, 759 F.3d 24 995, 1014 (9th Cir. 2014). “First, the ALJ must determine whether the claimant has 25 presented objective medical evidence of an underlying impairment which could 26 reasonably be expected to produce the pain or other symptoms alleged.” Id. 27 (citation and quotation omitted). If the claimant satisfies the first step of the 28 1 analysis, and there is no evidence of malingering, the ALJ can reject the claimant’s 2 testimony about the severity of their symptoms “only by offering specific, clear 3 and convincing reasons for doing so.” Id. (citation and quotation omitted). “This is 4 not an easy requirement to meet: The clear and convincing standard is the most 5 demanding required in Social Security cases.” Id. (citation and quotation omitted). 6 That said, if the ALJ’s credibility finding is supported by substantial evidence in 7 the record, the Court may not engage in second-guessing. Thomas v. Barnhart, 278 8 F.3d 947, 959 (9th Cir. 2002). 9 The ALJ found Plaintiff’s medically determinable impairments could 10 reasonably have caused her alleged symptoms, but her statements concerning the 11 intensity, persistence, and limiting effects of the symptoms are not entirely 12 consistent with the medical evidence and other evidence in the record. 13 The ALJ failed to provide clear and convincing reasons for rejecting 14 Plaintiff’s symptom testimony. While the ALJ rejected Plaintiff’s testimony for 15 normal affect, speech and through process, this finding is inconsistent with an 16 additional finding by the ALJ that the record demonstrated abnormalities, such as 17 anxious affect, labile mood, racing or tangential thought processes, rapid speech, 18 irritability and/or poor concentration. Although the ALJ found Plaintiff had a 19 “generally unremarkable presentation,” this is not a clear and convincing reason to 20 reject her testimony because the record is replete with evidence of Plaintiff 21 presenting as labile, tearful, angry, moody, distracted, anxious, depressed, 22 emotional, agitated, unkempt, fidgety, with racing thoughts, ruminations, 23 preoccupations, and obsessions. The “normal findings” noted by the ALJ are not 24 representative of the record as a whole. The record does not show any period of 25 sustained improvement, significant control of mental health symptoms even with 26 treatment, or significant remission of symptoms with sobriety. 27 The ALJ’s rejection of Plaintiff’s testimony regarding her physical 28 limitations is also not supported by the record. The ALJ’s conclusion that Plaintiff 1 required only conservative treatment is not supported by the record. The ALJ’s 2 finding that most clinical findings were unremarkable is not supported by the 3 record. The ALJ’s reliance on Plaintiff’s daily activities is not a clear and 4 convincing reason for rejecting her symptom testimony, given that these daily 5 activities do not translate to full-time work, and the activities are such that they are 6 able to be accomplished and are consistent with the limitations testified to by 7 Plaintiff. 8 The ALJ failed to provide clear and convincing reasons for rejecting 9 Plaintiff’s symptom testimony. As such, the ALJ’s finding that Plaintiff is not 10 credible is not supported by substantial evidence in the record. 11 2. Medical Opinion Evidence 12 In evaluating medical opinion evidence, the ALJ must consider the 13 persuasiveness of each medical opinion and prior administrative medical finding 14 from medical sources. 20 C.F.R. § 416.920c(a) and (b). The ALJ is required to 15 consider multiple factors, including supportability, consistency, the source’s 16 relationship with the claimant, any specialization of the source, and other factors 17 (such as the source’s familiarity with other evidence in the file or an understanding 18 of Social Security's disability program). 20 C.F.R. § 416.920c(c)(1)-(5). 19 Supportability and consistency of an opinion are the most important factors, 20 and the ALJ must articulate how they considered those factors in determining the 21 persuasiveness of each medical opinion or prior administrative medical finding. 20 22 C.F.R. § 416.920c(b)(2). The ALJ may explain how they considered the other 23 factors, but is not required to do so, except in cases where two or more opinions 24 are equally well-supported and consistent with the record. Id. 25 Supportability and consistency are further explained in the regulations:

26 (1) Supportability. 27 The more relevant the objective medical evidence and supporting explanations presented by a medical source are to support his or her medical 28 1 opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) will be. 2

3 (2) Consistency. 4 The more consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from other medical sources and nonmedical 5 sources in the claim, the more persuasive the medical opinion(s) or prior 6 administrative medical finding(s) will be. Id. 7 8 The ALJ found certain medical opinions were unpersuasive because they 9 relied on Plaintiff’s subjective reports that were undermined by her ability to 10 perform robust daily activities, were inconsistent with the longitudinal medical 11 record and because they lacked sufficient supporting explanation. The ALJ’s 12 rejection of the medical opinions is not supported by substantial evidence in the 13 record. 14 a. Betty Borden, Ph.D 15 The ALJ found Dr. Borden’s opinion somewhat persuasive. Dr. Borden 16 found marked limitations in adapting/management herself because her rationale 17 was too generalized to support marked limitations. Dr. Borden testified at the 18 hearing and the ALJ failed to ask Dr. Borden to clarify her opinion. Moreover, as 19 set forth above, the ALJ failed to adequately consider Plaintiff’s symptom 20 testimony, and this testimony supports Dr. Borden’s conclusion. 21 b. Wint Wai, M.D. 22 The ALJ found Dr. Wai’s opinion not supported. This was in error. Dr. 23 Wai’s opinion provided a thorough explanation regarding Plaintiff’s multilevel 24 degenerative disc disease of the lumbar spine and osteoarthritic of the hip, as well 25 as her mental health impairment. Dr. Wai’s opinion is consistent and supported by 26 the record. 27 // 28 // 1 c. Steven Olmer, Ph.D 2 The ALJ rejected Dr. Olmer’s opinion because it was issued the month prior 3 to her application. This was in error. Dr. Olmer was assessing chronic mental 4 health conditions and the record does not indicate there were any acute changes in 5 her condition. Moreover, Dr. Olmer’s opinion was consistent with and supported 6 by the record. 7 d. Daniel Cole, D.O. 8 The ALJ rejected Dr. Cole’s opinion because it was provided in February 9 2021. Notably, Dr. Cole opined Plaintiff was unable to perform most basic work 10 activities and could not do even sedentary work. The ALJ’s rejection of Dr. Cole’s 11 opinion is in error. Dr. Cole’s opinion of her disabling limitations based on 12 impairments she has had throughout the time period in question is relevant to the 13 ALJ’s decision. There is nothing in the record indicating her conditions suddenly 14 worsened in January 2021. Dr. Cole’s opinion is consistent with and supported by 15 the record. 16 3. Remand 17 Because there is no need to develop the record or convene further 18 administrative proceedings, a remand for the immediate award of benefits is 19 appropriate. See Garrison v. Colvin, 759 F.3d 995, 1021 (9th Cir. 2014). If the ALJ 20 properly credited Plaintiff’s testimony and properly evaluated the medical 21 opinions, it is clear Plaintiff has been disabled from October 24, 2018, through 22 January 17, 2021. Despite multiple chances to correct its mistakes, the ALJ’s 23 decision still is not supported by substantial evidence and contains legal errors. 24 Accordingly, IT IS HEREBY ORDERED: 25 1. For court management purposes, Plaintiff’s Opening Brief, ECF No. 26 11, is GRANTED. 27 2. For court management purposes, the Commissioner’s Brief, ECF No. 28 12, is DENIED. 1 3. The decision of the Commissioner is reversed and remanded for an immediate award of benefits. 3 4. Judgment shall be entered in favor of Plaintiff and against Defendant. IT IS SO ORDERED. The District Court Executive is hereby directed to 5|| file this Order, provide copies to counsel, and close the file. DATED this 6th day of May 2026.

10 Stan Bastian 1 Chief United States District Judge 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ORDER REVERSING THE DECISION OF COMMISSIONER ~ 11