Munguia v. Commissioner of Social Security Administration

• Court: District Court, D. Arizona
• Decided: July 29, 2025
• Docket: 2:24-cv-02534
• Status: Unknown

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8

9 Cecilia Torres Munguia, No. CV-24-02534-PHX-DGC

10 Plaintiff, ORDER 11 v. 12 Commissioner of Social Security Administration, 13 Defendant.

15 16 Plaintiff Cecilia Torres Munguia appeals from the final decision of the 17 Commissioner of Social Administration which denied her claim for disability insurance 18 benefits and supplemental security income. Defendant concedes that the decision is based 19 on reversible error, but the parties dispute whether the Court should remand for further 20 proceedings or an award of benefits. For reasons stated below, the Court will reverse the 21 decision and remand for further proceedings. 22 I. Background. 23 Plaintiff is 55 years old, has a sixth-grade education, and has worked as a 24 housekeeper at senior living facilities. Docs. 13-15, Administrative Transcript (“Tr.”) 25 86-89. Plaintiff applied for social security benefits in March 2021. Tr. 306-12. The claim 26 was denied at the initial and reconsideration levels by state agency physicians. Tr. 99-154. 27 A hearing before an Administrative Law Judge (“ALJ”) was held on July 21, 2023. 28 Tr. 80-98. The ALJ issued an unfavorable decision on November 28, 2023. Tr. 22-46. 1 The ALJ applied the requisite five-step process for determining whether Plaintiff 2 was disabled during the relevant period – from March 17, 2021, the alleged disability date, 3 to July 21, 2023, the date of the ALJ’s decision. Tr. 28-30; 42 U.S.C. § 423(d)(1)(A); 20 4 C.F.R. § 404.1509. Under the five-step process, Plaintiff must show that (1) she has not 5 engaged in substantial gainful activity since the alleged disability date, (2) she has a severe 6 impairment, and (3) the impairment meets or equals a listed impairment or (4) her residual 7 functional capacity (“RFC”) – the most she can do with her impairment – precludes her 8 from performing past work. If Plaintiff meets her burden at step three, she is presumed 9 disabled and the process ends. If the inquiry proceeds and Plaintiff meets her burden at 10 step four, then (5) Defendant must show that Plaintiff is able to perform other available 11 work given her RFC, age, education, and work experience. 20 C.F.R. §§ 404.1509, 12 404.1520(a)(4); Social Security Ruling (“SSR”) 96-8p, 1996 WL 374184 (July 2, 1996). 13 The ALJ found that Plaintiff met her burden at steps one and two because she has 14 not engaged in substantial gainful activity since the alleged disability date and has severe 15 cervical and lumbar spondylosis, myofascial pain syndrome, cardiac pacemaker, and 16 obesity. Tr. 30-32. The ALJ found at step three that Plaintiff’s impairments do not meet 17 or medically equal the severity of a listed impairment. Tr. 32. At steps four and five, the 18 ALJ determined that while Plaintiff is not able to perform her past work as a housekeeper, 19 she has the RFC to perform light work with restrictions, including the jobs of marker, 20 parking lot cashier, and toll collector. Tr. 33-40. The ALJ therefore found Plaintiff not 21 disabled within the meaning of the Social Security Act. Tr. 40. This decision became 22 Defendant’s final decision when the Appeals Council denied review. Tr. 1-9.1 23 Plaintiff seeks judicial review under 42 U.S.C. § 405(g), which provides that the 24 district court may enter “a judgment affirming, modifying, or reversing the decision of the 25

26 1 To determine the physical exertion requirements of work in the national economy, the Social Security Administration classifies jobs as sedentary, light, medium, heavy, and 27 very heavy. Light work generally involves a good deal of walking or standing, or some pushing and pulling of arm or leg controls while sitting most of the time, and lifting no 28 more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. 20 C.F.R. §§ 404.1567(b). 1 Commissioner of Social Security, with or without remanding the cause for a rehearing.” 2 Doc. 1 at 1-2. Plaintiff alleges that the ALJ erred by rejecting Dr. Patrick Knowles’ 3 opinions and Plaintiff’s symptom testimony. Id. at 3-4. Defendant does not address the 4 alleged errors in the answer to the complaint, but admits that a remand is warranted. 5 Doc. 16 at 1-2. The parties have now briefed the sole issue before the Court – whether the 6 case should be remanded for further administrative proceedings or an immediate award of 7 benefits. Docs. 19, 22, 23. 8 II. Remand Legal Standards. 9 When the ALJ denies benefits and the Court finds reversible error, the Court 10 “ordinarily must remand to the agency for further proceedings before directing an award 11 of benefits.” Leon v. Berryhill, 880 F.3d 1041, 1045 (9th Cir. 2017). Under limited 12 circumstances, however, the Court may remand for an award of benefits after applying the 13 “credit-as-true” rule. Id. “An award under this rule is a rare exception, and the rule was 14 intended to deter ALJs from providing boilerplate rejections without analysis.” Id. 15 The credit-as-true rule has three steps. First, the Court asks “whether the ‘ALJ has 16 failed to provide legally sufficient reasons for rejecting evidence, whether claimant 17 testimony or medical opinion.’” Washington v. Kijakazi, 72 F.4th 1029, 1041 (9th Cir. 18 2023) (quoting Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1100-01 (9th Cir. 19 2014)). Second, the Court determines “whether the record has been fully developed, 20 whether there are outstanding issues that must be resolved before a determination of 21 disability can be made, and whether further administrative proceedings would be useful.” 22 Id. (quoting Treichler, 775 F.3d at 1101). And third, “if no outstanding issues remain and 23 further proceedings would not be useful, only then [does the Court] have discretion to find 24 the relevant testimony credible as a matter of law.” Id. (quotation marks omitted). 25 “Where an ALJ makes a legal error, but the record is uncertain and ambiguous, the 26 proper approach is to remand the case to the agency.” Leon, 880 F.3d at 1045 (quoting 27 Treichler, 775 F.3d at 1105); see Dominguez v. Colvin, 808 F.3d 403, 407-08 (9th Cir. 28 2015) (“District courts retain flexibility in determining the appropriate remedy, and a 1 reviewing court is not required to credit claimants’ allegations regarding the extent of their 2 impairments as true merely because the ALJ made a legal error in discrediting their 3 testimony.”) (citations and quotation marks omitted); Brown-Hunter v. Colvin, 806 F.3d 4 487, 495 (9th Cir. 2015) (“[E]ven if all three requirements are met, we retain ‘flexibility’ 5 in determining the appropriate remedy. We may remand on an open record for further 6 proceedings ‘when the record as a whole creates serious doubt as to whether the claimant 7 is, in fact, disabled within the meaning of the Social Security Act.’”) (citation omitted); 8 Tinsley v. King, No. 24-1913, 2025 WL 471118, at *2 (9th Cir. Feb. 12, 2025) (“At bottom, 9 this Court can only remand for benefits if ‘the claimant is, in fact, disabled, no matter how 10 egregious the ALJ’s errors may be.’”) (quoting Strauss v. Comm’r of Soc. Sec. Admin., 635 11 F.3d 1135, 1138 (9th Cir. 2011)). 12 III. Discussion. 13 A. Discredited Evidence. 14 Because it will inform the remand analysis, the Court will briefly review the 15 discredited evidence – Dr. Knowles’ opinions and Plaintiff’s testimony. 16 1. Dr. Knowles’ Opinions. 17 Dr. Knowles completed an assessment of Plaintiff’s functional limitations and 18 ability to do work-related activities on December 1, 2022. Tr. 1418-21 (Ex. 16F). He 19 opined that Plaintiff could walk a quarter of a block; sit for twenty minutes and stand for 20 five minutes at a time; stand and walk with a cane for less than two hours in an eight-hour 21 workday; rarely lift less than ten pounds; rarely twist, stoop, and crouch; and use her arms 22 for reaching and hands for grasping and manipulating objects less than ten percent of the 23 workday. Tr. 1419-20. Dr. Knowles also opined that Plaintiff would be severely off task 24 due to attention and concentration deficits and would miss more than four days of work per 25 month. Tr. 1421. Dr. Knowles completed an updated assessment on May 2, 2023, and 26 essentially reiterated his prior opinion, although he noted that Plaintiff no longer needed a 27 cane and could perform fine manipulation during half the workday. Tr. 1422-25 (Ex. 17F). 28 1 Citing normal clinical findings and Plaintiff’s daily activities, the ALJ found Dr. 2 Knowles’ opinion that Plaintiff had extreme functional limitations “not persuasive based 3 on its inconsistency with the greater record later available at the hearing level.” Tr. 38. 4 2. Plaintiff’s Testimony. 5 Plaintiff testified at the administrative hearing that she was unable to work due to 6 neck and low back pain, numbness and stiffness in her hands and left foot, and inability to 7 lift heavy things. Tr. 89-91. Standing and walking increased her pain. Tr. 91. She sat on 8 the sofa most of the time, was not able to do household chores, and drove only to church 9 and to pick up her children at school. Tr. 89-90. She also experienced some dizziness and 10 chest pressure. Tr. 90-91. 11 In discounting this testimony, the ALJ found that Plaintiff’s “statements concerning 12 the intensity, persistence and limiting effects of [the] symptoms are not entirely consistent 13 with the medical evidence and other evidence in the record[.]” Tr. 34. The ALJ also found 14 that the “symptoms are generally consistent throughout the record, but they do not support 15 any restrictions not specifically outlined in the RFC.” Tr. 35. 16 B. Remand for Further Proceedings Is Warranted. 17 Applying the three-step credit-as-true rule, the Court concludes that it must remand 18 the case for further administrative proceedings. 19 1. First Step. 20 The first step of the rule is satisfied. Defendant concedes that the ALJ erred in two 21 respects. First, the ALJ did not address the supportability of Dr. Knowle’s opinions in a 22 manner consistent with the applicable regulations. Doc. 22 at 5-7; see Woods v. Kijakazi, 23 32 F.4th 785, 791-92 (9th Cir. 2022) (“‘The most important factors’ that the [ALJ] 24 considers when evaluating the persuasiveness of medical opinions are ‘supportability’ and 25 ‘consistency.’ Supportability means the extent to which a medical source supports the 26 medical opinion by explaining the ‘relevant . . . objective medical evidence.’ Consistency 27 means the extent to which a medical opinion is ‘consistent . . . with the evidence from other 28 medical sources and nonmedical sources in the claim.’”) (quoting 20 C.F.R. 1 § 404.1520c(a), (c)(1)-(2)). Second, the ALJ erred by discounting Plaintiff’s symptom 2 testimony based on the lack of objective medical evidence to substantiate the alleged 3 severity of her symptoms. Doc. 12 at 12; see 20 C.F.R. § 404.1529(c)(2) (“[W]e will not 4 reject your statements about the intensity and persistence of your pain or other symptoms 5 or about the effect your symptoms have on your ability to work solely because the available 6 objective medical evidence does not substantiate your statements.”); Bunnell v. Sullivan, 7 947 F.2d 341, 345 (9th Cir. 1991) (“[A]n adjudicator may not reject a claimant’s subjective 8 complaints based solely on a lack of objective medical evidence to fully corroborate the 9 alleged severity of pain.”). 10 2. Second Step. 11 Under the second step, Defendant argues that further proceedings will be useful to 12 enable the ALJ to resolve conflicts in the medical opinion evidence and address 13 inconsistencies between Plaintiff’s symptom testimony and objective medical evidence. 14 Doc. 12 at 9-13. The Court agrees. 15 The state agency physicians, Drs. Erika Wavak and Amita Hegde, opined that 16 Plaintiff’s impairments limit her to light work with restrictions. Tr. 101-10, 123-32 (Exs. 17 3A, 7A). The ALJ found these opinions somewhat persuasive to the extent they are 18 consistent with the ALJ’s RFC determination. Tr. 37.2 Dr. Keith Cunningham examined 19 Plaintiff in January 2022 and opined that she could perform a range of medium work with 20 restrictions. Tr. 1390-96 (Ex. 11F). The ALJ found this opinion less persuasive than those 21 of the state agency physicians because Dr. Cunningham appears to have overestimated 22 Plaintiff’s lifting capacity. Tr. 38. As noted, Dr. Knowles opined that Plaintiff had extreme 23 functional limitations that would preclude even sedentary work. Tr. 1418-25 (Exs. 16F, 24 17F). 25 Further proceedings will allow the ALJ to fully address these conflicts in the 26 medical opinions. See Washington v. Kijakazi, 72 F.4th 1029, 1042 (9th Cir. 2023) (“[T]he

27 2 Contrary to Plaintiff’s assertion (Doc. 23 at 6), the state agency physicians did not 28 focus solely on Plaintiff’s cardiac-related symptoms. See, e.g., Tr. 103, 113, 126, 130, 136, 140 (discussing medical records regarding Plaintiff’s spondylosis and neck and back pain). 1 district court properly identified contradictory evidence in the record appropriate for 2 remand. For instance, the district court noted the conflict between Washington’s treating 3 doctor and the consulting medical expert. While Washington’s doctor determined that 4 Washington was ‘unable to perform even sedentary work activity on a consistent basis, the 5 consulting medical expert concluded that Washington could perform work-related 6 activities with ‘certain exertional, postural, and environmental limitations.’ . . . As a result, 7 the district court did not abuse its discretion in remanding to the Commissioner to resolve 8 the contested issues.”); Baker v. Comm’r of Soc. Sec. Admin., No. CV-21-08084-PCT-SPL, 9 2022 WL 2390945, at *6 (D. Ariz. July 1, 2022) (“This Court finds that the ALJ erred by 10 1) discrediting the medical opinions of Dr. Peace and Dr. Ruzich, and 2) discounting 11 Plaintiff’s subjective symptom testimony. . . . Here, it is not clear from the record whether 12 the ALJ would be required to find Plaintiff disabled if all the evidence were properly 13 evaluated. There remain outstanding issues to be resolved given the conflicting medical 14 opinions regarding the extent of Plaintiff’s limitations.”). 15 The ALJ also found inconsistencies between Dr. Knowles’ opinions and Plaintiff’s 16 daily activities and other medical evidence in the record. Tr. 38; see Doc. 22 at 8-9. The 17 ALJ explained that while Plaintiff “does have restrictions and limitations, Dr. Knowles’ 18 assessments are excessive when considering [Plaintiff’s] reported daily activities, which 19 include caring for two minor children.” Tr. 38. The ALJ noted that Plaintiff “is able to 20 drive her car on a daily basis and perform daily activities including simple cooking and 21 light cleaning.” Id. (citing Tr. 346 (Ex. 3E/2)). The ALJ further explained that “the 22 objective clinical findings such as radiology studies of record do not support the extent of 23 limitation assessed by Dr. Knowles[,]” noting that “nerve root involvement is not shown 24 on cervical or lumbar spine studies, and Spurling’s test was negative on exam.” Id.3 These 25 inconsistencies are “exactly the sort of issues that should be remanded to the agency for 26 further proceedings.” Treichler, 775 F.3d at 1105; see Cruz v. Kijakazi, No. 20-16651,

27 3 A Spurling’s test is used to diagnose cervical radiculopathy. See Joshua W. H. v. 28 Dudek, No. CV 23-90-H-KLD, 2025 WL 850923, at *5 (D. Mont. Mar. 19, 2025) (citing Spurling’s Test, Physiopedia, https://www.physio-pedia.com/Spurling’s Test)). 1 2021 WL 5357231, at *1 (9th Cir. Nov. 17, 2021) (“Further proceedings may be useful 2 when the medical evidence is inconsistent.”) (citing Dominguez, 808 F.3d at 408-09). 3 Plaintiff does not dispute that there are inconsistencies between her subjective 4 symptom testimony and objective medical evidence. “When objective medical evidence 5 in the record is inconsistent with the claimant’s subjective testimony, the ALJ may . . . 6 weigh it as undercutting such testimony.” Smartt v. Kijakazi, 53 F.4th 489, 498 (9th Cir. 7 2022). This Circuit has “upheld ALJ decisions that do just that in many cases.” Id. 8 (citations omitted); see Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001) (“While 9 subjective pain testimony cannot be rejected on the sole ground that it is not fully 10 corroborated by objective medical evidence, the medical evidence is still a relevant factor 11 in determining the severity of the claimant’s pain and its disabling effects.”) (citing 20 12 C.F.R. § 404.1529(c)(2)); Tamera H. v. Comm’r, Soc. Sec. Admin., No. 6:20-CV-1428- 13 MO, 2024 WL 68354, at *3 (D. Or. Jan. 5, 2024) (“Plaintiff is correct, that absence of 14 corroborating objective medical evidence is not a clear and convincing reason to discount 15 subjective symptom testimony about pain; conflict with objective medical evidence is, 16 however. And here, the ALJ relied on several inconsistencies between Plaintiff’s 17 testimony and the record – all valid reasons to discount her testimony[.]”); see also SSR 18 16-3p, 2017 WL 5180304, at *5 (Oct. 25, 2017) (explaining that “objective medical 19 evidence is a useful indicator to help make reasonable conclusions about the intensity and 20 persistence of symptoms”).4 21 Plaintiff asserts that the ALJ failed to connect anything specific in the medical 22 record to a specific inconsistency with the symptom testimony. Doc. 19 at 19. Plaintiff 23 also asserts that the ALJ failed to explain how normal clinical findings invalidate the 24 symptom testimony and outweigh abnormal clinical findings, positive imaging, and course 25 of treatment that support the testimony. Id. at 19-20; Doc. 23 at 10-11. While all agree 26 that the ALJ’s decision was defective, the resolution of these issues clearly would be useful 27

28 4 Contrary to Plaintiff’s assertion (Doc. 23 at 4-9), the inconsistencies and conflicts in the record are not insignificant. 1 in determining whether Plaintiff is, in fact, disabled. See Treichler, 775 F.3d at 1105 2 (“[T]he record raises crucial questions as to the extent of Treichler’s impairment given 3 inconsistencies between his testimony and the medical evidence in the record. These are 4 exactly the sort of issues that should be remanded to the agency for further proceedings. 5 Where, as in this case, an ALJ makes a legal error, but the record is uncertain and 6 ambiguous, the proper approach is to remand the case to the agency.”) (citations omitted); 7 Brown-Hunter, 806 F.3d at 495-96 (“[A]lthough we conclude that the ALJ committed legal 8 error by failing to specify which testimony she found not credible and why, we will not 9 remand for an immediate award of benefits because we are not satisfied that ‘further 10 administrative proceedings would serve no useful purpose.’ Indeed, the record raises 11 crucial questions about the extent to which Brown-Hunter’s pain and accompanying 12 symptoms render her disabled.”) (citation omitted); Bonham v. Comm’r of Soc. Sec. 13 Admin., No. CV-23-00103-PHX-DWL, 2023 WL 6805043, at *8 (D. Ariz. Oct. 16, 2023) 14 (“The credit-as-true rule is inapplicable here. Although step one is satisfied in light of the 15 ALJ’s failure to provide legally sufficient reasons for discrediting the opinions of Dr. 16 Doust, step two is not – further administrative proceedings would be useful to enable the 17 ALJ to address the analytical deficiencies discussed above, including why the ALJ viewed 18 the largely ‘normal’ physical examination findings . . . as inconsistent with Dr. Doust’s 19 opinions.”).5 20 3. Third Step. 21 Plaintiff suggests that further proceedings are unnecessary because the ALJ would 22 be required to find her disabled if her symptom testimony and Dr. Knowles’ opinions were

23 5 Plaintiff contends that the ALJ was improperly “playing doctor” when she 24 reviewed spinal imaging and relied on normal clinical findings. Docs. 19 at 13-14, 23 at 5. This argument is without merit. See Mills v. Comm’r of Soc. Sec., No. 2:13-CV-0899-KJN, 25 2014 WL 4195012, at *4 n.8 (E.D. Cal. Aug. 22, 2014) (rejecting the argument that the ALJ attempted to “play doctor” because “it is the ALJ’s responsibility to formulate an RFC 26 that is based on the record as a whole,” and the ALJ “carefully analyzed the various medical opinions, treatment records, and plaintiff’s own testimony in formulating an RFC”); Lopez 27 v. Saul, No. 1:19-CV-00971-BAM, 2020 WL 6526197, at *8 (E.D. Cal. Nov. 5, 2020) (“Plaintiff’s additional argument that the ALJ ‘played doctor’ by interpreting the medical 28 evidence . . . is likewise without merit. Contrary to Plaintiff’s contention, it is within the ALJ’s province to synthesize the medical evidence.”) (citations omitted). 1 deemed true. Doc. 23 at 2. But this reverses the required order of analysis. As this Circuit 2 has explained, “the district court must ‘assess whether there are outstanding issues 3 requiring resolution before considering whether to hold that the claimant’s testimony is 4 credible as a matter of law.’ If such outstanding issues do exist, the district court cannot 5 deem the erroneously disregarded testimony to be true; rather, the court must remand for 6 further proceedings.” Dominguez, 808 F.3d at 409 (citing Treichler, 775 F.3d at 1105-06). 7 Here, inconsistencies and conflicts in the record raise questions about the severity of 8 Plaintiff’s impairments and symptoms which preclude the Court from reaching the third 9 step of the credit-as-true rule. See id. at 410 (“In light of the inconsistencies, conflicts, and 10 gaps in the record that require further administrative proceedings, we do not proceed to the 11 next question, whether the ALJ would be required to find Dominguez disabled if Dr. 12 Bhakta’s inconsistent reports were credited as true.”); Brown-Hunter, 806 F.3d at 495 13 (“Importantly, we are to assess whether there are outstanding issues requiring resolution 14 before considering whether to hold that the claimant’s testimony is credible as a matter of 15 law. This is because a reviewing court is not required to credit claimants’ allegations 16 regarding the extent of their impairments as true merely because the ALJ made a legal error 17 in discrediting their testimony.”) (citations and quotation marks omitted). 18 Plaintiff suggests that a remand for further proceedings would simply allow the ALJ 19 to have a “mulligan.” Doc. 23 at 8 (citing Garrison v. Colvin, 759 F.3d 995, 1021 (9th Cir. 20 2014)). The Court disagrees. As in this case, Garrison involved an ALJ’s acceptance of 21 opinions from state agency physicians while rejecting the claimant’s testimony and that of 22 her treating physician. Garrison, 759 F.3d at 1008-09. In this case, however, medical 23 records and opinions demonstrate that there is a legitimate disagreement as to the severity 24 of Plaintiff’s impairments and symptoms, which should be resolved on remand. At the 25 very least, the Court cannot say that “the record clearly contradicted an ALJ’s conclusory 26 findings and no substantial evidence within the record supported the reasons provided by 27 the ALJ for denial of benefits.” Leon, 880 F.3d at 1047; see also Meaghan M. v. Comm’r, 28 Soc. Sec. Admin., No. 1:22-CV-00916-HL, 2023 WL 3816415, at *6 (D. Or. June 5, 2023). 1|| IV. Conclusion. 2 Because further proceedings will “allow the ALJ to properly assess [Plaintiff's] || subjective symptom testimony and [Dr. Knowles’] medical opinion[s], . . . this is not the 4|| rare case in which remand for an immediate award of benefits 1s warranted.” Jones v. 5|| O'Malley, No. 23-16136, 2024 WL 3963835, at *2 (9th Cir. Aug. 28, 2024). The Court 6|| will exercise its discretion and remand to the Commissioner for further proceedings. 7 IT IS ORDERED: 8 1. The final decision of the Commissioner of Social Security to deny Plaintiff's 9|| claim for disability insurance benefits and supplemental security income (Tr. 1-9, 22-46) |} is reversed and this case is remanded for further administrative proceedings consistent 11 || with this order. 12 2. The Clerk of Court shall enter judgment accordingly and close this case. 13 Dated this 29th day of July, 2025. 14 ° 2 ard © Cour 16 . David G. Campbell Senior United States District Judge 18 19 20 21 22 23 24 25 26 27 28