Norris v. Colvin
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Opinion
1 2 3 UNITED STATES DISTRICT COURT 4 NORTHERN DISTRICT OF CALIFORNIA 5 SAN JOSE DIVISION 6 7 MICHAEL NORRIS, Case No. 5:24-cv-09196-BLF
8 Plaintiff, ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY 9 v. JUDGMENT
10 FRANK BISIGNANO, Commissioner of [Re: ECF No. 16, 18, 23] Social Security, 11 Defendant. 12
13 Plaintiff Michael Norris (“Norris”) appeals a final decision of Defendant Commissioner of 14 Social Security Administration (“Commissioner”) denying his application for Title XVI 15 supplemental security income (“SSI”). ECF 1. Norris filed a motion for summary judgment. See 16 ECF 16 (“Mot.”). In his motion, Norris asks the Court to reverse the Commissioner’s decision and 17 remand for payment of benefits or, alternatively, to remand for further administrative proceedings. 18 Id. at 25. The Commissioner filed an opposition. See ECF 18 (“Opp.”). Norris filed a reply. See ECF 19 23 (“Reply”). 20 For the reasons discussed below, the Court GRANTS Norris’s motion. The Court hereby 21 VACATES the Commissioner’s decision denying benefits and REMANDS this action for further 22 administrative proceedings. 23 I. BACKGROUND 24 Norris was born on November 6, 1992, and was twenty-eight at the time of his alleged onset 25 date. Administrative Record (“AR”) 17, 97. Norris graduated from high school from a continuation 26 school. AR 2135. Norris has no relevant past work. AR 26. On September 27, 2021, Norris filed his 27 Title XVI application for supplemental security income (“SSI”) benefits. AR 17. He claimed 1 depressive disorder, unspecified anxiety disorder, schizophrenia, PTSD, alcohol use disorder, and 2 polysubstance abuse. AR 20, 37-38, 64. Norris claimed that he had not engaged in substantial gainful 3 activity since July 16, 2021. AR 20. 4 Norris’s application was initially denied on May 27, 2022, and was again denied on 5 reconsideration on November 9, 2022. AR 62-96. On April 2, 2024, an Administrative Law Judge 6 (“ALJ”) held a hearing, at which Norris and a vocational expert testified. AR 33. 7 The ALJ issued an unfavorable decision on July 26, 2024. AR 14. The ALJ found that Norris was under a disability, but Norris’s substance use disorder was a contributing factor material to the 8 determination of disability. AR 18. Accordingly, the ALJ found that Norris was not disabled under 9 the Social Security Act and denied benefits. AR 18. On November 5, 2024, the Appeals Council 10 denied Norris’s request to review the ALJ’s decision. AR 1. On December 18, 2024, Norris sought 11 review of the ALJ’s decision in this Court pursuant to 42 U.S.C. § 405(g). See ECF 1. 12 II. LEGAL STANDARD 13 A. Standard of Review 14 Pursuant to 42 U.S.C. § 405(g), district courts have the authority to review a decision by the 15 Commissioner denying a claimant disability benefits. “This court may set aside the Commissioner's 16 denial of disability insurance benefits when the ALJ’s findings are based on legal error or are not 17 supported by substantial evidence in the record as a whole.” Tackett v. Apfel, 180 F.3d 1094, 1097 18 (9th Cir. 1999) (citations omitted). Substantial evidence is evidence within the record that could lead 19 a reasonable mind to accept a conclusion regarding disability status. See Richardson v. Perales, 402 20 U.S. 389, 401 (1971). It is more than a mere scintilla, but less than a preponderance. See Saelee v. 21 Chater, 94 F.3d 520, 522 (9th Cir. 1996) (internal citation omitted). When performing this analysis, 22 the court must “consider the entire record as a whole and may not affirm simply by isolating a 23 specific quantum of supporting evidence.” Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 24 2006) (citation and quotation marks omitted). If the evidence is susceptible to more than one rational 25 interpretation, the court may not substitute its judgment for that of the Commissioner. Tackett, 180 26 F.3d at 1097; Morgan v. Commissioner, 169 F.3d 595, 599 (9th Cir. 1999). 27 The ALJ is responsible for determining credibility, resolving conflicts in medical testimony, 1 and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). The ALJ's 2 determinations of law are reviewed de novo, although deference is owed to a reasonable construction 3 of the applicable statutes. McNatt v. Apfel, 201 F.3d 1084, 1087 (9th Cir. 2000). 4 Finally, even when the ALJ commits legal error, the ALJ’s decision will be upheld so long 5 as the error is harmless. See Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015). However, 6 “[a] reviewing court may not make independent findings based on the evidence before the ALJ to 7 conclude that the ALJ’s error was harmless.” Id. The court is “constrained to review the reasons the ALJ asserts.” Id. (internal quotation marks and citation omitted). 8 B. Standard for Determining Disability 9 A claimant seeking SSI under Title XVI must establish disability between the date of the 10 application for benefits and the date of the ALJ's decision. Deckard, 2020 WL 1157026, at *2; see 11 Sophie Jean P. v. Comm'r of Soc. Sec., 2019 WL 6749415, at *2 (D. Or. Dec. 11, 2019). 12 “To determine whether a claimant is disabled, an ALJ is required to employ a five-step 13 sequential analysis, determining: (1) whether the claimant is doing substantial gainful activity; (2) 14 whether the claimant has a severe medically determinable physical or mental impairment or 15 combination of impairments that has lasted for more than 12 months; (3) whether the impairment 16 meets or equals one of the listings in the regulations; (4) whether, given the claimant’s residual 17 functional capacity, the claimant can still do his or her past relevant work; and (5) whether the 18 claimant can make an adjustment to other work.” Ghanim v. Colvin, 763 F.3d 1154, 1160 (9th Cir. 19 2014) (internal quotation marks and citations omitted). The residual functional capacity (“RFC”) 20 referenced at step four is what a claimant can still do despite his or her limitations. Id. at 1160 n.5. 21 “The burden of proof is on the claimant at steps one through four, but shifts to the Commissioner at 22 step five.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009). 23 C. Drug Addiction and Alcoholism (“DAA”) Analysis 24 “An individual shall not be considered to be disabled . . . if alcoholism or drug addiction 25 would . . . be a contributing factor material to the Commissioner's determination that the individual 26 is disabled.” 42 U.S.C. § 423(d)(2)(C). In cases involving DAA, an ALJ must apply the five-step 27 sequential disability analysis twice. See Social Security Ruling 13-2p.; Titles II and XVI: Evaluating 1 Cases Involving Drug Addiction and Alcoholism (DAA), 2013 WL 621536, at *6 (Feb. 20, 2013) 2 (“SSR 13-2p”); Bustamante v.
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1 2 3 UNITED STATES DISTRICT COURT 4 NORTHERN DISTRICT OF CALIFORNIA 5 SAN JOSE DIVISION 6 7 MICHAEL NORRIS, Case No. 5:24-cv-09196-BLF
8 Plaintiff, ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY 9 v. JUDGMENT
10 FRANK BISIGNANO, Commissioner of [Re: ECF No. 16, 18, 23] Social Security, 11 Defendant. 12
13 Plaintiff Michael Norris (“Norris”) appeals a final decision of Defendant Commissioner of 14 Social Security Administration (“Commissioner”) denying his application for Title XVI 15 supplemental security income (“SSI”). ECF 1. Norris filed a motion for summary judgment. See 16 ECF 16 (“Mot.”). In his motion, Norris asks the Court to reverse the Commissioner’s decision and 17 remand for payment of benefits or, alternatively, to remand for further administrative proceedings. 18 Id. at 25. The Commissioner filed an opposition. See ECF 18 (“Opp.”). Norris filed a reply. See ECF 19 23 (“Reply”). 20 For the reasons discussed below, the Court GRANTS Norris’s motion. The Court hereby 21 VACATES the Commissioner’s decision denying benefits and REMANDS this action for further 22 administrative proceedings. 23 I. BACKGROUND 24 Norris was born on November 6, 1992, and was twenty-eight at the time of his alleged onset 25 date. Administrative Record (“AR”) 17, 97. Norris graduated from high school from a continuation 26 school. AR 2135. Norris has no relevant past work. AR 26. On September 27, 2021, Norris filed his 27 Title XVI application for supplemental security income (“SSI”) benefits. AR 17. He claimed 1 depressive disorder, unspecified anxiety disorder, schizophrenia, PTSD, alcohol use disorder, and 2 polysubstance abuse. AR 20, 37-38, 64. Norris claimed that he had not engaged in substantial gainful 3 activity since July 16, 2021. AR 20. 4 Norris’s application was initially denied on May 27, 2022, and was again denied on 5 reconsideration on November 9, 2022. AR 62-96. On April 2, 2024, an Administrative Law Judge 6 (“ALJ”) held a hearing, at which Norris and a vocational expert testified. AR 33. 7 The ALJ issued an unfavorable decision on July 26, 2024. AR 14. The ALJ found that Norris was under a disability, but Norris’s substance use disorder was a contributing factor material to the 8 determination of disability. AR 18. Accordingly, the ALJ found that Norris was not disabled under 9 the Social Security Act and denied benefits. AR 18. On November 5, 2024, the Appeals Council 10 denied Norris’s request to review the ALJ’s decision. AR 1. On December 18, 2024, Norris sought 11 review of the ALJ’s decision in this Court pursuant to 42 U.S.C. § 405(g). See ECF 1. 12 II. LEGAL STANDARD 13 A. Standard of Review 14 Pursuant to 42 U.S.C. § 405(g), district courts have the authority to review a decision by the 15 Commissioner denying a claimant disability benefits. “This court may set aside the Commissioner's 16 denial of disability insurance benefits when the ALJ’s findings are based on legal error or are not 17 supported by substantial evidence in the record as a whole.” Tackett v. Apfel, 180 F.3d 1094, 1097 18 (9th Cir. 1999) (citations omitted). Substantial evidence is evidence within the record that could lead 19 a reasonable mind to accept a conclusion regarding disability status. See Richardson v. Perales, 402 20 U.S. 389, 401 (1971). It is more than a mere scintilla, but less than a preponderance. See Saelee v. 21 Chater, 94 F.3d 520, 522 (9th Cir. 1996) (internal citation omitted). When performing this analysis, 22 the court must “consider the entire record as a whole and may not affirm simply by isolating a 23 specific quantum of supporting evidence.” Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 24 2006) (citation and quotation marks omitted). If the evidence is susceptible to more than one rational 25 interpretation, the court may not substitute its judgment for that of the Commissioner. Tackett, 180 26 F.3d at 1097; Morgan v. Commissioner, 169 F.3d 595, 599 (9th Cir. 1999). 27 The ALJ is responsible for determining credibility, resolving conflicts in medical testimony, 1 and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). The ALJ's 2 determinations of law are reviewed de novo, although deference is owed to a reasonable construction 3 of the applicable statutes. McNatt v. Apfel, 201 F.3d 1084, 1087 (9th Cir. 2000). 4 Finally, even when the ALJ commits legal error, the ALJ’s decision will be upheld so long 5 as the error is harmless. See Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015). However, 6 “[a] reviewing court may not make independent findings based on the evidence before the ALJ to 7 conclude that the ALJ’s error was harmless.” Id. The court is “constrained to review the reasons the ALJ asserts.” Id. (internal quotation marks and citation omitted). 8 B. Standard for Determining Disability 9 A claimant seeking SSI under Title XVI must establish disability between the date of the 10 application for benefits and the date of the ALJ's decision. Deckard, 2020 WL 1157026, at *2; see 11 Sophie Jean P. v. Comm'r of Soc. Sec., 2019 WL 6749415, at *2 (D. Or. Dec. 11, 2019). 12 “To determine whether a claimant is disabled, an ALJ is required to employ a five-step 13 sequential analysis, determining: (1) whether the claimant is doing substantial gainful activity; (2) 14 whether the claimant has a severe medically determinable physical or mental impairment or 15 combination of impairments that has lasted for more than 12 months; (3) whether the impairment 16 meets or equals one of the listings in the regulations; (4) whether, given the claimant’s residual 17 functional capacity, the claimant can still do his or her past relevant work; and (5) whether the 18 claimant can make an adjustment to other work.” Ghanim v. Colvin, 763 F.3d 1154, 1160 (9th Cir. 19 2014) (internal quotation marks and citations omitted). The residual functional capacity (“RFC”) 20 referenced at step four is what a claimant can still do despite his or her limitations. Id. at 1160 n.5. 21 “The burden of proof is on the claimant at steps one through four, but shifts to the Commissioner at 22 step five.” Bray v. Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009). 23 C. Drug Addiction and Alcoholism (“DAA”) Analysis 24 “An individual shall not be considered to be disabled . . . if alcoholism or drug addiction 25 would . . . be a contributing factor material to the Commissioner's determination that the individual 26 is disabled.” 42 U.S.C. § 423(d)(2)(C). In cases involving DAA, an ALJ must apply the five-step 27 sequential disability analysis twice. See Social Security Ruling 13-2p.; Titles II and XVI: Evaluating 1 Cases Involving Drug Addiction and Alcoholism (DAA), 2013 WL 621536, at *6 (Feb. 20, 2013) 2 (“SSR 13-2p”); Bustamante v. Massanari, 262 F.3d 949, 955 (9th Cir. 2001). 3 At first stage of the DAA analysis, the ALJ conducts the five-step sequential analysis and 4 determines whether the claimant is disabled based on all of the claimant’s medically determinable 5 impairments, including DAA. Bustamante, 262 F.3d at 955; SSR 13-2p, 2013 WL 621536, at *6. If 6 the ALJ determines that the claimant’s impairments, including DAA, are not disabling, then the 7 inquiry ends. Bustamante, 262 F.3d at 955; SSR 13-2p, 2013 WL 621536, at *5-6. If the ALJ finds that the claimant is disabled and there is medical evidence of DAA, the ALJ proceeds to the second 8 stage of the DAA analysis. 9 At the second stage, the ALJ applies the five-step sequential inquiry a second time to 10 determine whether DAA is “material” to the disability determination. SSR 13-2p, 2013 WL 621536, 11 at *4. “ ‘Materiality’ is the degree to which an individual would still be found disabled if they 12 stopped using drugs or alcohol.” Jessie L. v. Kijakazi, No. 20-cv-09305-DMR, 2022 WL 2222964, 13 at *2 (N.D. Cal. June 21, 2022); 20 C.F.R. § 416.935(b). At this stage, the ALJ “evaluate[s] which 14 of [the claimant’s] current physical and mental limitations . . . would remain if [the claimant] stopped 15 using drugs or alcohol and then determine[s] whether any or all of [the claimant’s] remaining 16 limitations would be disabling.” 20 C.F.R. §§ 404.1535(b)(2), 416.935(b)(2). If the ALJ determines 17 that the claimant’s “remaining limitations are disabling . . . independent of [the claimant's] drug 18 addiction or alcoholism,” then the ALJ “will find [DAA] is not a contributing factor material to the 19 determination of disability,” and the claimant is deemed disabled. 20 C.F.R. §§ 404.1535(b)(2)(ii), 20 416.935(b)(2)(ii). By contrast, if, absent the DAA, the claimant’s “remaining limitations would not 21 be disabling,” the ALJ will determine that DAA “is a contributing factor material to the 22 determination of disability,” and will find the claimant not disabled. 20 C.F.R. §§ 404.1535(b)(2)(i), 23 416.935(b)(2)(i). 24 “[W]hen evidence exists of a claimant’s drug or alcohol abuse, the claimant bears the burden 25 of proving that his substance abuse is not a material contributing factor to his disability.” Parra v. 26 Astrue, 481 F.3d 742, 744-745 (9th Cir. 2007); see also id. at 748. Unlike physical impairments, the 27 SSA has indicated that there is no research data that can reliably predict how a mental disorder will 1 be affected if DAA ceases and, accordingly, does not permit adjudicators to “rely exclusively on 2 medical expertise and the nature of a claimant’s mental disorder” in finding DAA is material. SSR 3 13-2p, 2013 WL 621536, at *9. “All adjudicators must provide sufficient information in their 4 determination or decision that explains the rationale supporting their determination of the materiality 5 of DAA so that a subsequent reviewer considering all of the evidence in the case record is able to 6 understand the basis for the materiality finding and the determination of whether the claimant is 7 disabled.” SSR 13-2p, 2013 WL 621536, at *2. 8 III. DISCUSSION 9 The Court first summarizes the ALJ’s decision denying benefits. The Court then addresses 10 Norris’s challenges to the ALJ’s decision and the Commissioner’s response thereto. 11 A. ALJ’s Determinations 12 The ALJ determined that Norris was under a disability, but Norris’s substance use disorder 13 was a contributing factor material to the determination of disability. AR 18. Therefore, the ALJ 14 found that Norris was not disabled under the Social Security Act at any time from the amended 15 alleged onset date through the date of the decision. AR 18. 16 At step one, the ALJ determined that Norris had not engaged in substantial gainful activity 17 since the alleged onset date, July 16, 2021. AR 20. 18 At step two, the ALJ found that Norris had the following severe impairments: unspecified 19 depressive disorder; unspecified anxiety disorder; schizophrenia; PTSD; alcohol use disorder; and 20 polysubstance use disorder. AR 20. 21 At step three, the ALJ found that including substance use, the severity of Norris’s 22 impairments met the criteria of section 12.03 of 20 CFR Part 404, Subpart P, Appendix 1. AR 20. 23 In doing so, the ALJ followed a two-step process: first, the ALJ determined whether there was an 24 underlying medically determinable physical or mental impairment; and, second, the ALJ evaluated 25 the intensity, persistence, and limiting effects of Norris’s symptoms to determine the extent to which 26 they limited Norris’s ability to function. AR 20. The ALJ found that the Paragraph A criteria were 27 satisfied because the Norris had “hallucinations, disorganized thinking (speech), and grossly 1 because Norris’s impairments “caused a mild limitation in understanding, remembering, or applying 2 information, a marked limitation in interacting with others, a marked limitation in concentrating, 3 persisting, or maintaining pace, and a marked limitation in adapting or managing oneself.” AR 20. 4 As required in cases involving DAA, the ALJ conducted a second sequential analysis at step 5 three and found that if Norris stopped substance use, Norris would not have an impairment that met 6 or medically equaled the severity of one of the impairments listed in 20 CFR 416.994(b)(5)(i). AR 7 21. The ALJ determined that, if Norris stopped the substance use, his mental impairments would 8 not satisfy the Paragraph B criteria. AR 22. Specifically, the ALJ evaluated the evidence in the light 9 most favorable to Norris and found that, when Norris was clean and sober, there were no reported 10 incidents or difficulty that would meet or cause at least two marked limitations or one extreme 11 limitations in the areas of: (1) understanding, remembering, or applying information; (2) interacting 12 with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or managing 13 oneself. AR 21-22. The ALJ also found that the evidence failed to show the presence of the 14 Paragraph C criteria when Norris stopped substance use. AR 22. 15 Before considering step four, the ALJ found that if Norris stopped substance use, Norris 16 would have the residual functional capacity to perform a full range of work at all exertional levels 17 with the nonexertional limitations of performing simple routine tasks. AR 22. The ALJ also found 18 that Norris was able to work independently. AR 22. The ALJ found that Norris’s medically 19 determinable impairments could reasonably be expected to produce the alleged symptoms, but the 20 intensity, persistence, and limiting effects of these symptoms were inconsistent with other evidence 21 in the record. AR 23. The ALJ found that the medical evidence showed Norris’s mental symptoms 22 were exacerbated by polysubstance abuse, but the mental symptoms were “greatly diminished” 23 when he was clean and sober. AR 23. 24 At step four, the ALJ found that Norris had the residual functional capacity to perform past 25 relevant work. AR 25. 26 At step five, the ALJ considered Norris’s age, education, work experience, and residual 27 functional capacity and found that there had been jobs that exist in significant numbers in the 1 use, his ability to work at all exertional levels had been compromised by nonexertional limitations. 2 AR 26. Nonetheless, the ALJ credited a vocational expert’s testimony and found that, if Norris 3 stopped substance use, Norris would be able to perform requirements of occupations such as cleaner, 4 routing clerk, and compression molding machine tender. AR 26. Accordingly, the ALJ found that 5 Norris was not disabled within the meaning of the Social Security Act because the substance use 6 disorder was a contributing factor material to the determination of disability. AR 26. 7 B. Norris’s Challenges to the ALJ’s Determinations 8 The parties do not dispute the ALJ’s determinations at step one and step two. See generally 9 Mot.; Opp. The parties also do not dispute the ALJ's first sequential analysis finding Norris disabled 10 at step three when substance use was included. The parties dispute the ALJ’s finding at step three 11 of the second sequential analysis where the ALJ found that Norris’s impairments would no longer 12 meet listing 12.03 absent substance use and that Norris’s substance use was material to his 13 impairment. See generally Mot.; Opp. 14 Norris argues that the ALJ’s determinations should be reversed for five reasons. Mot. at 1. 15 First, Norris argues that the ALJ’s finding that substance use is material to Norris’s disability is not 16 based on substantial evidence. Id. at 4-16. Second, Norris argues that the ALJ erred in substituting 17 his own lay opinion in place of the opinions of Norris’s medical providers. Id. at 16-17. Third, Norris 18 argues that the ALJ failed to articulate factors of supportability and consistency when evaluating the 19 medical opinion evidence. Id. at 17-22. Fourth, Norris argues that the ALJ’s “Paragraph C” findings 20 are not based on substantial evidence. Id. at 22-23. Fifth, Norris argues that the ALJ erred in 21 determining that Norris’s statements concerning the intensity, persistence, and limiting effects of 22 his symptoms are not consistent with the medical evidence. Id. at 23-24. 23 In response, the Commissioner argues that the ALJ’s decision should be affirmed. Opp. at 24 15. The Commissioner argues that the ALJ reasonably determined that DAA was material to 25 Norris’s disability, and that, without DAA, Norris’s mental impairments improved and did not meet 26 Listing 12.03. Id. at 2-7. Second, the Commissioner argues that the ALJ reasonably found that, 27 absent DAA, Norris’s symptom allegations were not all consistent with the evidence in the record. 1 consistency factors in evaluating the medical opinion. Id. at 11-14. Finally, the Commissioner argues 2 that substantial evidence supports the ALJ’s residual functioning capacity finding. Id. at 14-15. 3 The Court addresses the parties’ arguments in turn. 4 1. The ALJ’s DAA Materiality Finding is Not Supported by Substantial Evidence. 5 Norris argues that substantial evidence in the record does not support the ALJ’s finding that 6 drug and alcohol addiction (“DAA”) is material to Norris’s disability. Mot. at 7-15. First, Norris 7 argues that the ALJ improperly evaluated the severity of Norris’s mental impairments without DAA 8 by mistakenly relying on evidence when Norris was not sober. Id. at 7-8. Second, Norris argues that 9 the ALJ overlooked evidence of severe functional impairments while Norris was sober. Id. at 8-10. 10 Third, Norris argues that the ALJ erred in relying on mental status examinations (“MSE”) because 11 they are of limited evidentiary value. Id. at 10-11. Fourth, Norris argues that improvement in 12 Norris’s mental health symptoms in highly structured environments does not establish the 13 materiality of DAA. Id. at 11-12. Fifth, Norris argues that the ALJ’s finding that the Paragraph B 14 criteria are not satisfied absent DAA are tenuous. Id. at 12. Sixth, Norris argues that his medical 15 providers determined DAA was not material to his disability. Id. at 15. 16 The Commissioner argues that the ALJ reasonably determined that drug and alcohol 17 addiction is material to Norris’s disability. Opp. at 2-7. First, the Commissioner asserts that the ALJ 18 properly applied the DAA analysis. Id. at 2-4. Second, the Commissioner asserts that the ALJ 19 reasonably determined that without DAA, Norris’s impairments did not meet Listing 12.03 of the 20 Social Security Act because the ALJ’s finding is supported by substantial evidence. Id. at 4-7. 21 a. The ALJ erred in analyzing evidence showing Norris had functional 22 impairments while under a period of sobriety. 23 Norris argues that the ALJ failed to address evidence that showed Norris had functional 24 impairments when he was under a period of sobriety. Mot. at 8-10. The Commissioner has not 25 expressly responded to evidence pointed out by Norris. See generally Opp.; Reply at 1-2. 26 DAA is not material to the determination of disability if the claimant has other impairments 27 that result in disability and DAA “is not causing or does not affect the other impairment(s) to the 1 2p, 2013 WL 621536 at *7. 2 Here, the ALJ found Norris “would not have an impairment” that meets the criteria of listings 3 12.03, 12.04, 12.06 and 12.15 if he stopped substance use. AR 21. The Court notes that the ALJ 4 relied exclusively on evidence from Norris’s incarceration and treatment at the CURA and excluded 5 as not persuasive all opinions from Norris’s medical providers. See AR 23 (citing AR 491, 1000- 6 02); AR 24 (citing AR 1256-1417, 1503, 1534, 1539, 1561, 1571); AR 25. SSR 13-2p provides that 7 “[i]mprovement in a co-occurring mental disorder in a highly structured treatment setting ... may be 8 due ... to treatment for the co-occurring mental disorder, not (or not entirely) the cessation of 9 substance use.” 2013 WL 621536, at *12. “[A] record of multiple hospitalizations, emergency 10 department visits, or other treatment for the co-occurring mental disorder—with or without 11 treatment for DAA—is an indication that DAA may not be material even if the claimant is 12 discharged in improved condition after each intervention.” Id. at *13. Here, as discussed further 13 below, the ALJ erred in relying only on medical evidence from highly structured settings while 14 finding all the medical opinions from Norris’s providers unpersuasive. See, e.g., Albert B. v. 15 Kijakazi, No. 5:22-CV-00865-EJD, 2023 WL 6462856, at *5 (N.D. Cal. Sept. 29, 2023) (“[A] 16 mental disorder may still be disabling even when symptoms are reduced during times of structure 17 and support.”); L.S. v. King, No. 23-CV-02862-VKD, 2025 WL 588998, at *8 (N.D. Cal. Feb. 23, 18 2025) (finding “materiality is not shown where the evidence does not separate the effects of the 19 structured environment and the purported sobriety.”). On this basis alone, the Court finds that the 20 ALJ failed to apply the standards provided under SSR 13-2p and his finding is unsupported by 21 substantial evidence. See SSR 13-2p, 2013 WL 621536, at *13 (DAA materiality finding “need 22 evidence from outside of such highly structured treatment settings demonstrating that the claimant’s 23 co-occurring mental disorder(s) has improved, or would improve, with abstinence.”). 24 The Court also notes that the ALJ has failed to address incidents and reports from Norris’s 25 incarceration and treatment in medical facilities. For example, the ALJ considered Norris’s 26 admission to a 5250 hold from July 16, 2021, until August 13, 2021 as a period of sobriety and 27 found medical evaluations from that period showed Norris’s impairment improved absent substance 1 thought process was “disorganized and illogical,” his thought content was notable for bizarre and 2 paranoid ideas, and he had poor insight and recent judgment. AR 806. The ALJ also found that the 3 provider’s report showed that Norris “[was] generally normal” during that time without addressing 4 this evidence. AR 24 (citing AR 1470, 1480). But the record shows that on June 10, 2022, after 5 being incarcerated at Santa Rita for one month, a medical provider reported that Norris “started 6 feeling angry and hopeless,” and that “[Norris] began tearing up books and was seen banging his 7 head a couple times on the wall.” AR 1471. The record further shows that on July 7, 2022, Norris 8 reported increased anxiety, sad mood, mood swings, increased irritability, high energy level with 9 poor sleep, nightmares, mind racing and increased restlessness. AR 1479. Furthermore, the ALJ 10 found that providers’ reports between 2022 and 2024 were generally normal when Norris was 11 presumed to be sober and clean during periods of incarceration. AR 24 (citing AR 1503, 1534, 1539, 12 1561, 1571, AR 2205-30, 2231-74). However, the record shows that Norris displayed symptoms of 13 anxiety and depressed mood during that period. See AR 1503, 1534, 1539, 1561-62, 1571, 1573, 14 2240, 2246, 2250, 2252-53, 2272). The Court finds that the ALJ has failed to address this evidence 15 in his decision. 16 The Court is not persuaded by the Commissioner's argument that Norris’s symptoms were 17 largely controlled with antipsychotic medication. Opp. at 9-10 (citing AR 23, 491-92, 1000-01). 18 Rather, the ALJ erred in picking out a few instances of improvement and treating them as basis for 19 rejecting benefits. Garrison v. Colvin, 759 F.3d 995, 1017 (9th Cir. 2014) (“[I]t is error to reject a 20 claimant's testimony merely because symptoms wax and wane in the course of treatment.”). 21 Accordingly, the Court finds that substantial evidence does not support the ALJ’s finding 22 that Norris’s impairments improved during periods of sobriety. 23 b. The ALJ’s Evaluation of Norris’s Mental Status Examinations 24 Norris argues that the ALJ erred in relying on mental status examinations because they “are 25 of limited evidentiary value.” Mot. at 10. Norris argues that the mental status examinations 26 considered by the ALJ “were often at odds with the broader context of medical treatment that 27 showed Plaintiff had functional impairments while inside jail.” Id. at 11. In response, the 1 during periods when Plaintiff was incarcerated that showed Norris was normal. Opp. at 5-6. 2 “It is error for an ALJ to pick out a few isolated instances of improvement over a period of 3 months . . . and to treat them as a basis for concluding a claimant is capable of working.” Garrison, 4 759 F.3d at 1017; see Jones v. Kijakazi, No. 21-16950, 2022 WL 4285597, at *1–2 (9th Cir. 2022) 5 (holding that an ALJ failed to provide clear and convincing reasons where the ALJ 6 “mischaracterized the contents of a function report ... and a psychological evaluation”). A “ ‘normal’ 7 designation of Plaintiff's ‘mental status’ is not only ambiguous but is also not dispositive of 8 Plaintiff's mental health as a whole . . . Plaintiff having a composed and ‘normal’ demeanor during 9 doctor visits does not preclude her from experiencing anxiety and depression in other contexts.” 10 Moody v. Berryhill, No. 16-cv-3646-JSC, 2017 WL 3215353, at *10 (N.D. Cal. July 28, 2017) 11 (internal citations and quotation marks omitted). 12 The Court finds that the ALJ relied heavily on parts of mental status examinations in which 13 a medical provider recorded Norris’s mental status during his incarceration. See AR 22-25. As 14 discussed above, the ALJ's selective citations to these portions of the record mischaracterize the 15 medical record as a whole. Furthermore, even if Plaintiff were normal on the days he was examined 16 or treated by mental health professionals, this notation alone was insufficient reason to find his 17 impairments improved absent substance use. Garrison, 759 F.3d at 1017 (“Cycles of improvement 18 and debilitating symptoms are a common occurrence, and in such circumstances, it is error for an 19 ALJ to pick out a few isolated instances of improvement over a period of months or years and to 20 treat them as a basis for concluding a claimant is capable of working.”). 21 Accordingly, the Court finds the ALJ erred in making his finding based heavily on selected 22 mental status examinations in jail. 23 c. The ALJ failed to apply the standards provided under SSR 13-2p by relying 24 only on improvements in highly structured settings in his decision. 25 Norris argues that the ALJ’s materiality findings are not supported by substantial evidence 26 because “evidence of any improvement was attributable to treatment for his mental health symptoms 27 in a highly structured environment.” Mot. at 12. In response, the Commissioner argues that the ALJ 1 functioning when absent DAA.” Opp. at 7. 2 SSR 13-2p acknowledges that “[i]mprovement in a co-occurring mental disorder in a highly 3 structured treatment setting, such as a hospital or substance abuse rehabilitation center, may be due 4 at least in part to treatment for the co-occurring mental disorder, not (or not entirely) the cessation 5 of substance use.” SSR 13-2p, 2013 WL 621536, at *12. Accordingly, the DAA materiality 6 determination requires “evidence from outside of such highly structured treatment settings 7 demonstrating that the claimant's co-occurring mental disorder(s) has improved, or would improve, 8 with abstinence.” Id. at *13 (emphasis added). 9 As acknowledged in the ALJ’s decision, much of Norris’s documented improvement 10 occurred when he was in a structured environment. For example, the ALJ found that, after being 11 placed on a 5250 hold for about a month in 2021 for acute psychosis due to polysubstance abuse, 12 Norris’s condition at discharge was “improved, stable, with no suicidal ideation or acute psychotic 13 symptoms.” AR 23 (citing AR 491, 1000-02). Additionally, the ALJ considered periods of 14 incarceration in 2022 and 2023 and found Norris’s mental status examination conducted in jail 15 “were also generally normal.” AR 24. The ALJ also based his decision on psychiatric evaluations 16 from Norris’s treatment at the CURA residential treatment center in 2024. AR 24 (citing AR 2162, 17 2174, 2190, 2196). 18 Jails and hospitals are structured settings under the regulations. See SSR 13-2p, 2013 WL 19 621536, at *12; Moore v. Colvin, No. 5:12-CV-120-C, 2013 WL 3156505, at *5 (N.D. Tex. June 20 21, 2013) (finding “highly supportive living arrangements” include jail). While Norris presumably 21 was abstinent during his periods of incarceration and treatment at CURA and experienced some 22 improvements in his mental health symptoms during those periods, that evidence from “highly 23 structured settings” is insufficient to show that his improvements were results of “cessation of 24 substance use” under the regulation. SSR 13-2p, 2013 WL 621536, at *12. The Court notes that the 25 ALJ has failed to point to any “evidence from outside of” highly structured settings in making his 26 decision. See AR 23-25; SSR 13-2p, 2013 WL 621536, at *13. Accordingly, the ALJ erred in finding 27 that Norris’s “mental symptoms are greatly diminished” absent substance use without first 1 considering evidence outside of structured settings. AR 23; see Albert B., No. 5:22-CV-00865-EJD, 2 2023 WL 6462856, at *5; L.S., No. 23-CV-02862-VKD, 2025 WL 588998, at *8; Clark v. Berryhill, 3 No. 17-cv-00371-JCS, 2018 WL 3659052, at *29 (N.D. Cal. Aug. 2, 2018) (“Intermittent 4 improvement ... limited to structured settings is particularly suspect as evidence that a claimant can 5 work outside of such settings.”). 6 d. The ALJ’s finding that Norris does not meet Criteria B absent DAA is not 7 supported by substantial evidence. 8 Norris argues that the ALJ’s Paragraph B findings are not supported by substantial evidence. 9 Mot. at 7, 12-15. Norris argues that the ALJ improperly relied on cherry-picked evidence in his 10 Paragraph B decision that do not reasonably show Norris’s overall mental health condition. Id. at 7 11 (citing Holohan v. Massanari, 246 F.3d 1195, 1207-1208 (9th Cir. 2001)). 12 In response, the Commissioner argues that the ALJ reasonably found that Norris’s mental 13 impairments did not cause extreme or marked limitations in the “B Criteria” and that his 14 impairments therefore did not rise to Listings-level severity under 12.03(B). Opp. at 5-6. 15 If the ALJ finds a medically determinable mental impairment, the ALJ then must assess the 16 degree of functional limitations resulting from the claimant's mental impairment with respect to the 17 following functional areas: (1) the claimant's ability to understand, remember, or apply information; 18 (2) the claimant's ability to interact with others; (3) the claimant's ability to concentrate, persist, or 19 maintain pace; and (4) the claimant's ability to adapt or manage oneself. 20 C.F.R. §§ 20 404.1520a(b)(2), (c)(3). These four factors are known as the “Paragraph B” criteria. Id. 21 Under Paragraph B criteria, a claimant's mental disorder renders him disabled if it “result[s] 22 in ‘extreme’ limitation of one, or ‘marked’ limitation of two, of the four areas of mental 23 functioning.” 20 C.F.R. § Pt. 404, Subpt. P, App. 1, 12.00(A)(2)(b). A claimant has a “marked” 24 limitation if the claimant's “functioning in this area independently, appropriately, effectively, and 25 on a sustained basis is seriously limited.” 20 C.F.R. § Pt. 404, Subpt. P, App. 1, 12.00(F)(2)(d). By 26 contrast, a claimant has an “extreme” limitation if he is “not able to function in this area 27 independently, appropriately, effectively, and on a sustained basis.” 20 C.F.R. § Pt. 404, Subpt. P, 1 The Court addresses each functional area under Paragraph B criteria in turn. 2 i. Understanding, remembering and applying information 3 Norris argues that the ALJ erred in finding that Norris had a mild limitation in understanding, 4 remembering, or applying information irrespective of substance use. Mot. at 12-13. In response, the 5 Commissioner argues that the ALJ’s finding is supported by substantial evidence. Opp. at 5. 6 As to this functional area, the ALJ found that Norris had a mild limitation when engaged in 7 substance use. AR 20 (citing 439-508, 1039-1190). The ALJ further found that there was little 8 evidence of any limitation from periods of incarceration and beginning in late 2023 when Norris 9 was clean and sober. AR 21. Consequently, the ALJ found that when Norris was not engaged in 10 substance use, he had a mild limitation in this area. AR 21. 11 The Court finds that the ALJ’s finding that Norris would have a mild limitation in 12 understanding, remembering, and applying information irrespective of substance use is not 13 supported by substantial evidence. For example, on August 12, 2021, after Norris had been under a 14 5250 hold for one month, his thought process was still “disorganized and illogical.” AR 806. The 15 ALJ has failed to address this evidence. Additionally, as discussed below, the ALJ erred in rejecting 16 the medical opinions from Norris’s medical providers. AR 25. For example, Dr. Wiebe opined that 17 Norris had marked limitations in every category of mental abilities needed to do unskilled work 18 including understanding, remembering, and carrying out both “very short and simple” and detailed 19 instructions. AR 2158. Additionally, Mr. Neulight opined that Norris would have marked limitations 20 in the area of understanding, remembering, and applying information and that he would not expect 21 Norris’s impairments to significantly improve in the absence of substance use. AR 1617, 1619. The 22 Court finds that the ALJ failed to address how this evidence affected the ALJ’s finding that Norris 23 has a mild limitation in this area irrespective of substance use. 24 Accordingly, the Court finds that the ALJ erred in rejecting the medical opinions and failing 25 to address evidence of Norris’s impairments to support the finding that Norris had a mild limitation 26 in this area irrespective of substance use. 27 ii. Interaction with others 1 with others when not engaged in substance use. Mot. at 13. In response, the Commissioner argues 2 that the ALJ’s finding is supported by substantial evidence. Opp. at 5. 3 As to this functional area, the ALJ considered that there was no reported difficulty with 4 interaction in the record when Norris stopped substance use and that Norris testified that socializing 5 causes his heart to race and he has anxiety. AR 21. The ALJ found that when Norris was not engaged 6 in substance use, he had a mild limitation in this area. AR 21. 7 The Court finds that the ALJ’s finding that Norris would have a mild limitation in interacting 8 with others when not engaged in substance use is not supported by substantial evidence. The ALJ 9 explained that “[t]here is no reported violent or difficulty with interaction in the record when the 10 claimant stopped substance use.” AR 21. But the medical opinions show otherwise. First, Mr. 11 Neulight opined that Norris would have a marked limitation in the area of interacting with others. 12 AR 1617. Mr. Neulight noted that he would not expect Norris’s impairments to significantly 13 improve in the absence of substance use. AR 1619. Additionally, Dr. Wiebe opined that Norris had 14 marked limitations in every category of mental abilities needed to do unskilled work including: 15 getting along with others without excessive irritability, sensitivity, argumentativeness, or 16 suspiciousness; interacting appropriately with the general public; accepting instructions and 17 responding appropriately to criticism from supervisors. AR 2158. Dr. Wiebe also opined that Norris 18 “is socially alienated and would have difficulties being able to relate and communicate effectively 19 with supervisors, co-workers, and the public in a work environment.” AR 2153. Dr. Wiebe further 20 opined that Norris would have difficulty maintaining a regular job even if he were able to no longer 21 use any substance in the future. AR 2154. The ALJ failed to address this evidence. 22 The ALJ also overlooked Norris’s behavior when he was incarcerated. For example, on June 23 10, 2022, after Norris had been incarcerated at Santa Rita for one month, Norris was seen “acting 24 bizarrely” and deputies had to use force due to his behavior. AR 1473. The Court is also unpersuaded 25 by the Commissioner’s argument that Norris presented with normal mood and affect when 26 interacting with clinicians when incarcerated. Opp. at 5 (citing AR 1424, 1458, 1468, 2174). As 27 discussed, treatments that occurred when Norris was in highly structured institutions are insufficient 1 Accordingly, the Court finds that the ALJ erred in rejecting the medical opinion evidence 2 and failing to address evidence of Norris’s impairments to support the finding that Norris had a mild 3 limitation in the area of interacting with others when not engaging in substance use. 4 iii. Concentration, persisting, or maintaining pace 5 Norris argues that the ALJ erred in finding that Norris had a moderate limitation in 6 concentrating, persisting, or maintaining pace when not engaged in substance use. Mot. at 14. In 7 response, the Commissioner argues that the ALJ’s finding is supported by substantial evidence. 8 Opp. at 5-6. 9 As to this functional area, the ALJ considered Norris’s testimony that he has difficulty with 10 focus and concentration when sober and that he has constant auditory hallucinations. AR 21-22. The 11 ALJ further determined that there were no reported incidents during periods when Norris was clean 12 and sober. AR 22. Specifically, the ALJ noted that in February of 2024, when Norris had been sober 13 for approximately 120 days, Norris’s auditory hallucinations were not “command in nature” and 14 were described as Norris’s internal thoughts. AR 22 (citing AR 2162). Based on this evidence, the 15 ALJ found that Norris had a moderate limitation in the area of concentrating, persisting, or 16 maintaining pace. AR 21-22. 17 The Court finds that the ALJ’s finding is not supported by substantial evidence. Here, Mr. 18 Neulight opined that Norris would have a marked limitation in the area of concentrating, persisting, 19 or maintaining pace and that he did not expect these limitations to significantly improve in the 20 absence of substance use. AR 1618-19. Additionally, Dr. Wiebe assessed Norris when he was clean 21 and sober, AR 2140-41, and opined that Norris had marked limitations in every category of mental 22 abilities needed to do unskilled work including: maintaining focus, attention, and concentration for 23 two-hour segments; and performing at a consistent pace without an unreasonable number and length 24 of rest periods. AR 2158. Considering the medical opinions, the Court finds that substantial evidence 25 in the record does not support the determination that Norris had a moderate limitation in this area. 26 Accordingly, the Court finds that the ALJ’s finding that Norris had a moderate limitation in 27 concentrating, persisting, or maintaining pace when not engaged in substance use is not supported 1 iv. Adapt and manage oneself 2 Norris argues that the ALJ erred in finding that Norris had a moderate limitation in adapting 3 or managing oneself when not engaged in substance use. Mot. at 14-15. In response, the 4 Commissioner argues that the ALJ’s finding is supported by substantial evidence. Opp. at 6. 5 As to this functional area, the ALJ found that there was no reported difficulty in the record 6 when Norris was clean and sober. AR 22. The ALJ viewed “the record in the light most favorable 7 to the claimant” and found that Norris had a moderate limitation in this area when Norris was not 8 engaged in substance use. AR 22. 9 The Court finds that the ALJ’s finding is not supported by substantial evidence. Mr. Neulight 10 opined that Norris had a marked limitation in the area of adapting or managing oneself and that he 11 did not expect this limitation to significantly improve in the absence of substance use. AR 1618-19. 12 Additionally, Dr. Wiebe opined that Norris had marked limitations in every category of mental 13 abilities needed to do unskilled work including: responding appropriately to changes in a routine 14 work setting and dealing with normal work stressors; completing a normal workday and workweek 15 without interruptions from psychologically based symptoms; and maintaining regular attendance 16 and being punctual within customary usually strict tolerances. AR 2158. The Court finds that the 17 ALJ erred in finding that Norris had a moderate limitation in this functional area by failing to 18 consider this evidence. 19 The Court is also not persuaded by the Commissioner’s argument that the ALJ’s finding is 20 supported by the evidence that, when incarcerated, Norris had good hygiene, intact impulse control, 21 and good judgment. Opp. at 6 (citing AR 24, 1424). As discussed, the Court finds that the ALJ failed 22 to address reported anger and behavior incidents from Norris’s incarceration. See AR 1473, 1471. 23 Accordingly, the Court finds that the ALJ’s finding that Norris has a moderate limitation in 24 this area is not supported by substantial evidence. 25 *** 26 For the above reasons, the Court finds that the ALJ’s Paragraph B findings are not supported 27 by substantive evidence. 1 e. Acceptable medical sources all opined that Norris’s mental illness would not 2 substantially improve in the absence of DAA. 3 Norris argues that no acceptable medical opinions show that Norris’s mental illness “would 4 substantially improve in the absence of DAA.” Mot. at 15-16. In response, the Commissioner argues 5 that the ALJ reasonably considered the medical opinions in the record. Opp. at 11-14. 6 As discussed more in detail below, the Court finds that the ALJ erred in finding the opinions 7 from Norris’s medical providers were, across the board, unpersuasive. Additionally, all of Norris’s 8 medical providers opined that substance use is not material to his disability. See AR 1619, 2154, 9 1055, 1215, 445. While the ALJ relied on opinions from medical providers in jail and CURA in his 10 decision, AR 25, as discussed above, those opinions are from highly structured settings and the 11 regulation requires “evidence from outside such highly structured treatment settings” to demonstrate 12 that Norris’s “co-occurring mental disorder(s) has improved, or would improve, with abstinence.” 13 SSR 13-2p, 2013 WL 621536, at *13; see Albert B., No. 5:22-CV-00865-EJD, 2023 WL 6462856, 14 at *5; L.S., No. 23-CV-02862-VKD, 2025 WL 588998, at *8. Accordingly, the Court finds that the 15 ALJ’s rejection of the medical opinions is not supported by clear and convincing evidence. Longoria 16 v. Berryhill, No. 1:18-CV-00409-SKO, 2019 WL 427295, at *6 (E.D. Cal. Feb. 4, 2019) (“An ALJ 17 may reject an uncontradicted opinion of a treating or examining medical professional only for ‘clear 18 and convincing’ reasons.”). 19 *** 20 For the above reasons, the Court finds that the ALJ erred at step three of the materiality 21 analysis and in finding Norris’s substance use material. 22 2. The ALJ Erred in Evaluating the Medical Opinions from Norris’s Providers. 23 Norris argues that the ALJ erred in finding that the medical opinions of Dr. Wiebe, Dr. 24 Catlin, and Mr. Neulight were not persuasive. Mot. at 16-22. Norris argues that the ALJ substituted 25 his own lay opinion in place of the medical opinions from Norris’s medical providers. Id. at 16. 26 Norris further argues that the ALJ failed to properly consider supportability and consistency in 27 evaluating the persuasiveness of medical evidence. Id. at 17-21. 1 supported by substantial evidence. Opp. at 11-14. 2 a. The ALJ erred in evaluating the supportability and consistency of the 3 medical opinions. 4 The ALJ must consider all medical opinions and “evaluate their persuasiveness” based on 5 the following factors: 1) supportability; 2) consistency; 3) relationship with the claimant; 4) 6 specialization; and 5) “other factors.” 20 C.F.R. § 416.920c(a)-(c); see also Woods v. Kijakazi, 32 7 F.4th 785, 787 (9th Cir. 2022) (“For claims subject to the new regulations, the former hierarchy of 8 medical opinions—in which we assign presumptive weight based on the extent of the doctor's 9 relationship with the claimant—no longer applies.”). The ALJ's persuasiveness explanation must be 10 supported by substantial evidence. See Woods, 32 F.4th at 787. 11 Supportability and consistency are the two most important factors, and the ALJ is required 12 to explicitly address them in his or her decision. 20 C.F.R. § 404.1520c(b)(2); see Woods, 32 F.4th 13 at 792. “Supportability means the extent to which a medical source supports the medical opinion by 14 explaining the relevant objective medical evidence.” Woods, 32 F.4th at 791-92 (cleaned up; 15 quotations and citation omitted). “The more relevant the objective medical evidence and supporting 16 explanations presented by a medical source are to support his or her medical opinion(s) or prior 17 administrative medical finding(s), the more persuasive the medical opinions or prior administrative 18 medical finding(s) will be.” 20 C.F.R. § 416.920c(c)(1). “Consistency means the extent to which a 19 medical opinion is consistent with the evidence from other medical sources and nonmedical sources 20 in the claim.” Woods, 32 F.4th at 792 (cleaned up; quotations and citation omitted). “The more 21 consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from 22 other medical sources and nonmedical sources in the claim, the more persuasive the medical 23 opinion(s) or prior administrative medical finding(s) will be.” 20 C.F.R. § 416.920c(c)(2). The ALJ 24 “may, but [is] not required to,” explain how he or she considered the remaining three factors listed 25 in the regulations. Id. § 416.920c(b)(2). However, where two or more distinct medical opinions are 26 equally supported and consistent, the ALJ should articulate how they considered factors other than 27 supportability and consistency, including the treatment relationship, the extent of specialization, and 1 at 792 (discussing 20 C.F.R. § 404.1520c(b)(3)) (“In that case, the ALJ ‘will articulate how [the 2 agency] considered the other most persuasive factors.’”). 3 The record provides the opinions of three medical providers who all expressly state that 4 DAA is not material to Norris’s disability. The Court addresses each opinion in turn. 5 i. Dr. Wiebe 6 On March 13, 2024, Dr. Katherine Wiebe, Ph.D., conducted a tele-video psychological 7 evaluation of Norris. AR 2131. At the evaluation, Norris reported his last use of any substance, 8 including methamphetamine, alcohol, and marijuana, was on November 8, 2023. AR 2140-41. Dr. 9 Wiebe noted that “the reliability of Mr. Norris’s reporting is considered limited due to his psychiatric 10 and cognitive disorder symptoms.” AR 2133. 11 Dr. Wiebe opined that “Mr. Norris has moderate to severe impairment in immediate and 12 delayed memory; and in attention/concentration/pace.” AR 2153. Dr. Wiebe found that Norris had 13 “mild to moderate impairment in executive; language; and sensorimotor functioning.” AR 2153. Dr. 14 Wiebe further opined that Norris had “mildly impaired overall intellectual functioning” and “his 15 psychiatrist and [p]ersonality disorder symptoms affect[ed] his cognitive functioning abilities.” AR 16 2153. Additionally, Dr. Wiebe opined that Norris had marked limitations in every category of 17 “[mental abilities and aptitudes needed to do unskilled work].” AR 2158. This included marked 18 limitations in the areas of understanding, remembering, and carrying out short and simple 19 instructions; maintaining focus, attention, and concentration for two-hour segments; interacting 20 appropriately with the general public; responding appropriately to changes in a routine work setting 21 and dealing with normal work stressors; and completing a normal workday and workweek without 22 interruptions from psychologically based symptoms. AR 2158. 23 The Court finds that the ALJ has failed to expressly address the supportability and 24 consistency of Dr. Wiebe's opinion. First, the ALJ concluded Dr. Wiebe’s noted limitations were 25 inconsistent with her conclusion that Norris “was markedly limited in his mental functioning.” AR 26 25. But the ALJ failed to acknowledge that Dr. Wiebe explained in her report that the evaluation 27 results were valid “due to general congruency of Mr. Norris’[s] presentation, results of testing, and 1 various reports and examinations from Norris’s incarceration that showed “consistent improvement” 2 in Norris’s mental condition when clean and sober. AR 25. As discussed above, the ALJ’s DAA 3 materiality determination is based on selected mental status examinations from Norris’s 4 incarceration in highly structured settings. The DAA materiality determination requires “evidence 5 from outside of such highly structured treatment settings demonstrating that the claimant's 6 cooccurring mental disorder(s) has improved, or would improve, with abstinence.” SSR 13-2p, 2013 7 WL 621536, at *13 (emphasis added). To the extent the ALJ found Dr. Wiebe's opinion is 8 unpersuasive because her opinion was solicitated from an attorney referral, AR 25, the Court finds 9 that it “is not a legitimate basis on which to discount” Dr. Wiebe’s opinion. See Nguyen v. Chater, 10 100 F.3d 1462, 1464 (9th Cir. 1996) (finding discounting a medical opinion on the basis that the 11 opinion was provided at the request of the claimant’s attorney is not “legitimate”). 12 Accordingly, for all the above reasons, the Court finds the ALJ erred in finding Dr. Wiebe’s 13 opinion unpersuasive. 14 ii. Mr. Neulight 15 Mr. Ari Neulight, LCSW, evaluated Norris on November 8, 2023. AR 1620. Mr. Neulight 16 noted he worked with Norris on and off for over five years. AR 1615. Mr. Neulight opined that 17 Norris has marked limitations in: (1) understanding, remembering, and applying information; (2) 18 interacting with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or 19 managing oneself. AR 1617-18. Mr. Neulight noted that Norris has repeated history of 20 decompensation and “has struggled in settings without lots of structure to follow through on 21 appointments, [and medication] compliance.” AR 1619. Additionally, Mr. Neulight opined that 22 Norris’s impairments would not be expected to significantly improve in the absence of substance 23 use. AR 1619. Mr. Neulight noted that Norris has a “long history of substance use to cope with long- 24 standing trauma, anxiety, and depression.” AR 1619. Mr. Nuelight also opined that Norris would be 25 absent from work four or more days per month and would be off-task more than 30% of the time. 26 AR 1619-20. Mr. Neulight noted that Norris’s symptoms and limitations cause him to have difficulty 27 with attending appointments, regularly taking medications, and consistently engaging with 1 Norris was not expected to fluctuate over time. Id. 2 The Court finds that the ALJ has failed to expressly address the supportability and 3 consistency of Mr. Neulight’s opinion. First, the ALJ found that Mr. Neulight’s report was not 4 persuasive because he failed to address the impact of Norris’s polysubstance use and its effects on 5 his mental functioning. AR 25. But the records shows that Mr. Neulight considered Norris’s 6 substance use in his report. See AR 1619. Additionally, the ALJ found that Mr. Neulight, a social 7 worker, lacked the medical expertise to opine on Norris’s medical issue. AR 25. But Mr. Neulight 8 had worked with Norris “on [and] off, at times intensively for over 5 years.” AR 1615. Mr. Neulight 9 observed that Norris had symptoms consistent with depression, anxiety, complex trauma and PTSD. 10 AR 1615. Considering the relationship between Mr. Neulight and Norris and Mr. Neulight’s 11 observation, the Court finds that the ALJ has not provided legally sufficient reasons to reject Mr. 12 Neulight’s opinion. 13 Accordingly, for all the above reasons, the Court finds the ALJ erred in finding Dr. 14 Neulight's opinion unpersuasive. 15 iii. Dr. Catlin 16 On November 12, 2021, Dr. Laura Catlin, Psy.D., completed a psychological disability 17 evaluation of Norris over the phone. AR 440-41. The evaluation took place after Norris “was 18 recently released from a residential mental health facility . . . after having a psychotic break.” AR 19 444. Dr. Catlin noted that Norris was “difficult to evaluate as he was unable to provide much 20 information,” and was vague when answering questions about himself. AR 444. Dr. Catlin opined 21 that Norris’s “attention, concentration, and memory all seem to be impaired.” AR 444. 22 The ALJ found Dr. Catlin’s report not persuasive because “Dr. Catlin herself noted the 23 claimant was an unreliable historian.” AR 25. The ALJ also emphasized that Dr. Catlin’s 24 examination was solicitated through attorney referral for “generating supportive evidence.” AR 25. 25 The Court finds that the ALJ has failed to expressly address the supportability and 26 consistency of Dr. Catlin’s opinion. The Court notes that the ALJ erred by finding Dr. Catlin’s 27 opinion “not persuasive” because her objective finding that Norris “was an unreliable historian” did 1 opinion when Norris was using substances. See AR 21-22, 25, 444. Additionally, the Court finds 2 that the ALJ has failed to address the supportability and credibility of Dr. Catlin’s opinion when she 3 found Norris “was very difficult to evaluate” and Norris’s “substance use clouds the diagnostic 4 picture.” AR 444-45. To the extent the ALJ found Dr. Catlin’s opinion is unpersuasive because her 5 opinion was solicitated from an attorney referral, AR 25, the Court finds that it “is not a legitimate 6 basis on which to discount” Dr. Catlin’s opinion. See Nguyen, 100 F.3d at 1464. 7 Accordingly, for all the above reasons, the Court finds the ALJ erred in finding Dr. Catlin’s 8 opinion unpersuasive. 9 *** 10 For the above reasons, the Court finds that the ALJ erred in evaluating the medical opinions 11 provided by Dr. Wiebe, Mr. Neulight, and Dr. Catlin because the ALJ failed to expressly address 12 the supportability and consistency of those opinions. Woods, 32 F.4th at 792. While the Court 13 recognizes that it must defer to the ALJ where there are alternative and reasonable interpretations 14 of the evidence. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004) (“[I]f 15 evidence exists to support more than one rational interpretation, [the Court] must defer to the 16 Commissioner's decision.”). Nonetheless, the ALJ here erred in rejecting the medical opinions in 17 the record without providing adequate explanation as required by the regulation. Woods, 32 F.4th at 18 792. 19 b. The ALJ erred in substituting his own lay opinion in place of the medical 20 opinions for the RFC findings. 21 Norris argues that the ALJ erred in finding the opinions of all providers unpersuasive as to 22 Norris’s disability when he was abstinent. Mot. at 16. Norris argues that the ALJ erred in 23 constructing a residual functional capacity (“RFC”) assessment of a “hypothetically sober Plaintiff” 24 and relying on the RFC assessment in the ALJ’s questions to the vocational expert. Id. at 16-17 25 (citing AR 26, 57). In response, the Commissioner argues that the ALJ reasonably rejected medical 26 opinions that he found unpersuasive in his RFC findings. Opp. at 14-15. 27 To evaluate whether an ALJ properly rejected a medical opinion, in addition to considering 1 clinical findings that support the opinions. See Longoria v. Berryhill, No. 1:18-CV-00409-SKO, 2 2019 WL 427295, at *6 (E.D. Cal. Feb. 4, 2019). An ALJ cannot reject a medical opinion “as 3 unsupported or inconsistent without providing an explanation supported by substantial evidence.” 4 Woods, 32 F.4th at 792. 5 The Court finds that the ALJ erred in advancing his own opinion to conclude that DAA is 6 material by relying solely on records and examinations when Norris was in highly structured 7 settings. As discussed above, the ALJ cannot base his findings only on evidence of improvement in 8 highly structured settings because the improvement “may be due at least in part to treatment for the 9 co-occurring mental disorder, not entirely the cessation of substance use.” SSR 13-2p, 2013 WL 10 621536, at *12. Additionally, the ALJ erred in finding none of the opinions from Norris’s medical 11 providers persuasive. Thus, Court finds that the ALJ’s rejection of the medical opinions is not based 12 on “clear and convincing” evidence. Longoria, 2019 WL 427295, at *6. 13 After the ALJ rejected the medical opinions in the record, the ALJ made RFC findings based 14 on his interpretation of the record. AR 22-25. The Court finds that the ALJ impermissibly substituted 15 his own medical judgment for that of the medical opinions from Norris’s providers. See Tacket v. 16 Apfel, 180 F.3d 1094, 1102–03 (9th Cir. 1999); Banks v. Barnhart, 434 F.Supp.2d 800, 805 (C.D. 17 Cal. 2006) (explaining that an ALJ “cannot arbitrarily substitute his or her own judgment for 18 competent medical opinion,” and must not “succumb to the temptation to play doctor and make [his 19 or her] own independent medical findings”). The Court finds that the ALJ erred in effectively 20 ignoring the medical opinions from Dr. Wiebe, Mr. Neulight, and Dr. Catlin in his RFC finding. 21 3. The ALJ’s “Paragraph C” Findings Are Not Supported by Substantial 22 Evidence. 23 Norris argues that the ALJ’s determination that the ALJ’s “Paragraph C” criteria findings 24 are not supported by substantive evidence because the ALJ provides no explanation in support of 25 his findings. Mot. at 22. 26 In response, the Commissioner argues that the ALJ “accurately pointed out that the record 27 did not show any of [the] requisite elements [under Paragraph C] during periods of sobriety.” Opp. 1 interpretation of the evidence.” Opp. at 7. 2 In his decision, the ALJ considered the “Paragraph C” criteria and found the criteria was not 3 met if Norris “stopped substance use.” AR 22. The Court notes that the ALJ failed to provide any 4 explanation as to his conclusion. See SSR 13-2p, 2013 WL 621536, at *4 (stating that “[i]f the 5 claimant has [an] ... impairment[ ] that results in disability and DAA is not causing or does not affect 6 the other impairment[ ] to the point where the other impairment[ ] could be found nondisabling in 7 the absence of DAA, DAA is not material to the determination of disability.”). The ALJ's failure to 8 provide that explanation leaves the Court “[un]able to understand the basis for the materiality 9 finding and the determination of whether the [Plaintiff] is disabled.” SSR 13-2p(b), 2013 WL 10 621536, at *2. The Court finds that the ALJ’s failure to provide an explanation for the “paragraph 11 C” analysis was erroneous under SSR 13-2p. Albert B. v. Kijakazi, No. 5:22-CV-00865-EJD, 2023 12 WL 6462856, at *4 (N.D. Cal. Sept. 29, 2023) (holding the ALJ’s failure to provide a sufficient 13 explanation for his DAA materiality determination was an error under SSR 13-2p). Accordingly, 14 the Court need not reach Norris’s remaining arguments as to the ALJ’s “Paragraph C” analysis. 15 The Court hereby VACATES the ALJ’s determination that Norris failed to satisfy the 16 “Paragraph C” criteria absent substance use, and REMANDS for further proceedings. 17 4. The ALJ Erred in Rejecting Norris’s Symptom Testimony. 18 Norris argues that the ALJ erred in finding Norris’s statements were inconsistent and failed 19 to provide clear and convincing reasons for rejecting his testimony. Mot. at 23. Norris argues that 20 his testimony is consistent with the medical opinions and that the ALJ incorrectly rejected the 21 testimony in light of the jail records. Id. at 23-24. In response, the Commissioner argues that the 22 ALJ reasonably found that the Norris’s statements concerning his symptoms was not consistent with 23 the record evidence. Opp. at 8. 24 In general, credibility determinations are the province of the ALJ. “It is the ALJ's role to 25 resolve evidentiary conflicts. If there is more than one rational interpretation of the evidence, the 26 ALJ's conclusion must be upheld.” Allen v. Sec'y of Health & Human Servs., 726 F.2d 1470, 1473 27 (9th Cir. 1984) (citations omitted). The Ninth Circuit has “established a two-step analysis for 1 Berryhill, 871 F.3d 664, 678 (9th Cir. 2017). First, “the claimant ‘must produce objective medical 2 evidence of an underlying impairment’ or impairments that could reasonably be expected to produce 3 some degree of symptom.” Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008) (quoting 4 Smolen v. Chater, 80 F.3d 1273, 1281–82 (9th Cir. 1996)). Second, if the claimant does so and there 5 is no affirmative evidence of malingering, the ALJ can reject the claimant’s testimony as to the 6 severity of the symptoms “‘only by offering specific, clear and convincing reasons for doing so.’” 7 Tommasetti, 533 F.3d at 1309 (quoting Smolen, 80 F.3d at 1281); see also Garrison, 759 F.3d at 8 1014. 9 The ALJ’s reasons for discounting Norris’s symptom testimony do not comport with the 10 “clear and convincing” standard. The ALJ found Norris’s statements about “the intensity, 11 persistence, and limiting effects” of his impairments were “inconsistent” with the evidence that 12 Norris’s mental symptoms greatly diminished when he was clean and sober. AR 23. But, as 13 discussed above, the ALJ’s improperly relied on selected mental health evaluations from highly 14 structured settings, and the evidence is insufficient to support the ALJ’s materiality findings. The 15 ALJ also improperly found the medical opinions unpersuasive. Here, Norris testified that he had 16 mental breakdowns and behaved erratically when he was hospitalized and incarcerated. See e.g., 17 AR 49. The Court finds that Norris’s testimony is consistent with the medical opinions from Dr. 18 Wiebe, Mr. Neulight, Ms. Adeniji and SAGE that Norris’s substance use is not material to his 19 impairments. See AR 1055, 1215, 1619, 2154. Indeed, the Court notes that the ALJ did not expressly 20 address Ms. Adeniji and SAGE’s opinions in his decision. See AR 22-25. Accordingly, the ALJ 21 erred in rejecting Norris’s testimony without providing specific, clear, or convincing reasons to do 22 so. 23 C. Remedy 24 In reviewing a commissioner’s decision, a court may remand the case “either for additional 25 evidence and findings or to award benefits.” Smolen v. Chater, 80 F.3d 1273, 1292 (9th Cir. 1996). 26 When a court reverses an ALJ's decision, “the proper course, except in rare circumstances, is to 27 remand to the agency for additional investigation or explanation.” Benecke v. Barnhart, 379 F.3d 1 benefits “if (1) the ALJ failed to provide legally sufficient reasons for rejecting the evidence; (2) 2 || there are no outstanding issues that must be resolved before a determination of disability can be 3 made; and (3) it is clear from the record that the ALJ would be required to find the claimant disabled 4 were such evidence credited.” Jd. at 593 (citing Harman y. Apfel, 211 F.3d 1172, 1174, 1178 (9th 5 || Cir. 2000)). 6 Here, as to step one of the Harman test, the ALJ failed to provide legally sufficient reasons 7 || for rejecting the medical opinion evidence. As to step two of the Harman test, as discussed above, 8 || the ALJ failed to make adequate findings in denying Norris’s requested benefits, and the record 9 shows “serious doubt” as to whether Norris was “in fact disabled” absent DAA. Leon □□□ Berryhill, 10 880 F.3d 1041, 1045 (9th Cir. 2017). As to the step three of the Harman test, the Court cannot 11 conclude that the ALJ would be required to find Norris disabled if the ALJ properly credited the 12 || evidence. Thus, because the record is “uncertain and ambiguous, the proper approach is to remand 5 13 the case to the agency.” Jd. (quoting Treichler v. Comm'r of Soc. Sec. Admin., 775 F.3d 1090, 1105 14 || (9th Cir. 2014)). Because “additional proceedings can remedy defects in the original administrative 3 15 proceedings,” this case is remanded to the ALJ for further consideration.” Lewin v. Schweiker, 654 a 16 || F.2d 631, 635 (9th Cir. 1981). 2 17 IV. ORDER Z 18 For the foregoing reasons, IT IS HEREBY ORDERED that Norris’s motion for summary 19 || judgment is GRANTED. The Court hereby VACATES the Commissioner’s decision denying 20 || benefits and REMANDS this action for further administrative proceedings consistent with this 21 order. 22 23 Dated: August 14, 2025
BETH LABSON FREEMAN 25 United States District Judge 26 27 28
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Cite This Page — Counsel Stack
Norris v. Colvin, Counsel Stack Legal Research, https://law.counselstack.com/opinion/norris-v-colvin-cand-2025.