Sawyer v. Commissioner of Social Security

CourtDistrict Court, W.D. Washington
DecidedJanuary 14, 2020
Docket3:19-cv-05576
StatusUnknown

This text of Sawyer v. Commissioner of Social Security (Sawyer v. Commissioner of Social Security) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sawyer v. Commissioner of Social Security, (W.D. Wash. 2020).

Opinion

1 2 3 4 5 UNITED STATES DISTRICT COURT 6 WESTERN DISTRICT OF WASHINGTON AT SEATTLE 7 8 HEATHER LEE S., 9 Plaintiff, Case No. C19-5576 MLP 10 v. ORDER 11 COMMISSIONER OF SOCIAL SECURITY, 12 Defendant. 13 INTRODUCTION 14 Plaintiff seeks review of the denial of her application for Disability Insurance Benefits. 15 Plaintiff contends the administrative law judge (“ALJ”) erred by excluding and not considering 16 1,003 pages of medical records. (Dkt. # 14 at 2.) According to Plaintiff, the entire five-step 17 analysis is fundamentally flawed because the ALJ failed to consider these records. (Id.) In the 18 alternative, Plaintiff argues that – even without consideration of the excluded records – the ALJ 19 erred in evaluating the Residual Functioning Capacity (“RFC”) and her finding that Plaintiff can 20 perform a significant number of jobs in the national economy. (Id.) As discussed below, the 21 Court AFFIRMS the Commissioner’s final decision and DISMISSES the case with prejudice. 22 23 1 BACKGROUND 2 Plaintiff filed her Title II application for disability on November 12, 2015, claiming that 3 her disability onset date was July 15, 2014. (Dkt. # 14 at 2.) The claim was initially denied on 4 March 1, 2016, and again upon reconsideration on June 9, 2016. (Id.) Plaintiff’s hearing before 5 the ALJ was on February 20, 2018. AR at 15. The ALJ denied Plaintiff’s claim on June 18, 2018.

6 Id. As the Appeals Council denied Plaintiff’s request for review, the ALJ’s decision is the 7 Commissioner’s final decision. Id. at 1. Plaintiff appealed the final decision of the Commissioner 8 to this Court. 9 LEGAL STANDARDS 10 Under 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of social 11 security benefits when the ALJ’s findings are based on legal error or not supported by substantial 12 evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 (9th Cir. 2005). As a 13 general principle, an ALJ’s error may be deemed harmless where it is “inconsequential to the 14 ultimate nondisability determination.” Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012)

15 (cited sources omitted). The Court looks to “the record as a whole to determine whether the error 16 alters the outcome of the case.” Id. 17 “Substantial evidence” is more than a scintilla, less than a preponderance, and is such 18 relevant evidence as a reasonable mind might accept as adequate to support a conclusion. 19 Richardson v. Perales, 402 U.S. 389, 401 (1971); Magallanes v. Bowen, 881 F.2d 747, 750 (9th 20 Cir. 1989). The ALJ is responsible for determining credibility, resolving conflicts in medical 21 testimony, and resolving any other ambiguities that might exist. Andrews v. Shalala, 53 F.3d 22 1035, 1039 (9th Cir. 1995). While the Court is required to examine the record as a whole, it may 23 neither reweigh the evidence nor substitute its judgment for that of the Commissioner. Thomas v. 1 Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). When the evidence is susceptible to more than one 2 rational interpretation, it is the Commissioner’s conclusion that must be upheld. Id. 3 The ALJ “has an independent duty to fully and fairly develop the record.” Tonapetyan v. 4 Halter, 242 F.3d 1144, 1150 (9th Cir. 2001) (internal citations and quotations omitted). This duty 5 exists even when the claimant is represented. Brown v. Heckler, 713 F.2d 411, 443 (9th Cir.

6 1983). “An ALJ’s duty to develop the record further is triggered only when there is ambiguous 7 evidence or when the record is inadequate to allow for proper evaluation of the evidence.” Mayes 8 v. Massanari, 276 F.3d 453, 460 (9th Cir. 2001). For example, where an ALJ relies on a medical 9 expert who indicates the record is insufficient to render a diagnosis, the ALJ must develop the 10 record further. See Tonapetyan, 242 F.3d at 1150. 11 DISCUSSION 12 A. The ALJ Erred by Failing to Fully Develop the Record 13 Plaintiff’s primary allegation of error relates to the ALJ’s decision to decline to admit or 14 even consider the 1,003 pages of late-submitted evidence from Franciscan Health of Enumclaw.

15 AR at 16. The ALJ’s decision was based on the representative’s failure to notify the ALJ of 16 additional evidence no later than five business days before the date of the scheduled hearing. Id. 17 at 15 (citing 20 C.F.R. 404.935(a)). The representative notified the ALJ only two business days 18 prior to the hearing and acknowledged that he had missed the five-day requirement. Id. at 1321. 19 The ALJ also found that the representative’s failure to timely notify the ALJ was not excusable 20 under one of the exceptions to the five-day rule. Id. at 15-16 (stating “not only did the 21 representative not timely inform the undersigned regarding outstanding evidence, he did not 22 show that, despite good faith efforts, the evidence could not be obtained”) (citing Id. at 1321 23 (representative’s letter to ALJ stating that Plaintiff had been treating at Franciscan in Enumclaw 1 but that, in an effort to keep the costs down, Plaintiff had been attempting to obtain the records 2 herself) and SSR 17-4p (regulations setting forth the five-day rule).) Plaintiff, through her 3 representative, requested that the record be held open to allow for the submission of the relevant 4 medical evidence; not that the hearing be postponed. 5 The ALJ was largely silent on Plaintiff’s role in failing to provide the evidence to the

6 ALJ, other than to say that the Plaintiff testified that she could not afford to order the medical 7 records. AR at 16. Instead, the ALJ focused almost entirely on Plaintiff’s representative’s 8 failures to timely provide the records or provide an explanation for the delay. Id. at 16 (noting 9 that it appeared that Franciscan lost the request for records but that the representative “left 10 collection of medical records to the last minute, despite obtaining a postponement of the 11 claimant’s first hearing”). The ALJ was also troubled by the fact that the representative “left it to 12 the claimant to try to remedy the matter.” Id. Plaintiff, however, was unsuccessful in obtaining 13 the records because she lacked the funds to pay for them. Id. And, Franciscan claimed to have 14 lost her first request for records. Id. The ALJ did not address Plaintiff’s conduct but found the

15 representative had not met his duties and therefore she declined to consider the additional 16 records. Id. 17 The Court finds that the ALJ correctly identified the representative’s deficiencies in the 18 case but applied the wrong remedy. “A representative’s failure to comply with his or her 19 affirmative duties . . . could result in disciplinary action.” SSR 17-4p. The Commissioner has the 20 option of referring a representative to the Office of the General Counsel (“OGC”) to determine 21 whether there was a violation of the social security administration’s rules. Id.

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