1 2 3 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF CALIFORNIA 7
8 SCOTT COPELAND, Case No. 1:23-cv-00378-SKO 9 Plaintiff,
10 v. ORDER ON PLAINTIFF’S SOCIAL 11 SECURITY COMPLAINT FRANK BISIGNANO, 12 Commissioner of Social Security1, 13 Defendant. (Doc. 1) _____________________________________/ 14
15 16 I. INTRODUCTION 17 18 Plaintiff Scott Copeland (“Plaintiff”) seeks judicial review of a final decision of the 19 Commissioner of Social Security (the “Commissioner” or “Defendant”) denying his applications for 20 disability insurance benefits (DIB) and Supplemental Security Income (SSI) under the Social 21 Security Act (the “Act”). (Doc. 1.) The matter is currently before the Court on the parties’ briefs, 22 which were submitted, without oral argument, to the Honorable Sheila K. Oberto, United States 23 Magistrate Judge.2 24 25
26 1 On May 6, 2025, Frank Bisignano was appointed the Commissioner of the Social Security Administration. See https://www.ssa.gov/news/press/releases/2025/#2025-05-07. He is therefore substituted as the defendant in this action. 27 See 42 U.S.C. § 405(g) (referring to the “Commissioner’s Answer”); 20 C.F.R. § 422.210(d) (“the person holding the Office of the Commissioner shall, in his official capacity, be the proper defendant”). 28 2 The parties consented to the jurisdiction of a U.S. Magistrate Judge. (See Doc. 11.) On April 13, 2026, this case 1 II. BACKGROUND 2 Plaintiff protectively filed claims for DIB and SSI payments on July 24 and 31, 2019, 3 respectively, alleging he became disabled on September 15, 2006, due to dyslexia, uncontrolled 4 diabetes, “mannose binding lectin,” ulnar nerve damage in both hands, lumbar strain, chronic 5 pneumonia, chronic sepsis, collapsed lungs, “gastronarapothy,” and asthma. (Administrative Record 6 (“AR”) 20, 98, 116, 136, 152.) 7 Plaintiff was born in 1967 and was 39 years old on the alleged disability onset date. (AR 31, 8 97, 115, 135, 151.) He has at least a high school education and previously worked as a security 9 guard and dishwasher. (AR 31, 51–52, 371.) 10 A. Administrative Proceedings 11 The Commissioner denied Plaintiff’s applications for benefits initially on January 17, 2020, 12 and again on reconsideration on July 27, 2020. (AR 20, 179–188, 195–206.) Consequently, Plaintiff 13 requested a hearing before an Administrative Law Judge (“ALJ”). (AR 112–14.) The ALJ 14 conducted a telephonic hearing on November 5, 2021. (AR 41–68.) Plaintiff appeared at the hearing 15 with his attorney and testified as to his alleged disabling conditions and work history. (AR 48–63.) 16 A Vocational Expert (“VE”) also testified at the hearing. (AR 63–67.) 17 B. The ALJ’s Decision 18 In a decision dated December 6, 2021, the ALJ found that Plaintiff was not disabled, as 19 defined by the Act. (AR 20–32.) The ALJ conducted the five-step disability analysis set forth in 20 20 C.F.R. §§ 404.1520 and 416.920. (AR 23–32.) The ALJ decided that Plaintiff met the insured status 21 requirements of the Act through December 31, 2011, and he had not engaged in substantial gainful 22 activity since September 15, 2006, the alleged onset date (step one). (AR 23.) At step two, the ALJ 23 found Plaintiff’s following impairments to be severe: diabetes mellitus; ulnar neuropathy and 24 coronary artery disease. (AR 23–24.) Plaintiff did not have an impairment or combination of 25 impairments that met or medically equaled one of the listed impairments in 20 C.F.R. Part 404, 26 Subpart P, Appendix 1 (“the Listings”) (step three). (AR 24–25.) 27 28 1 The ALJ then assessed Plaintiff’s residual functional capacity (RFC)3 and applied the 2 assessment at steps four and five. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4) (“Before we go 3 from step three to step four, we assess your residual functional capacity . . . . We use this residual 4 functional capacity assessment at both step four and step five when we evaluate your claim at these 5 steps.”). The ALJ determined that Plaintiff had the RFC: 6 to perform medium work as defined in 20 CFR [§§] 404.1567(c) and 416.967(c) except he can frequently climb ramps or stairs but can never climb ladders, ropes 7 or scaffolds. He can frequently kneel, crouch or crawl. [Plaintiff] can frequently handle and finger, bilaterally. He must avoid frequent exposure to irritants such as 8 fumes, odors, dusts, gases and poorly ventilated areas. He must avoid all exposure 9 to unprotected heights and all exposure to hazardous machinery. 10 (AR 25–30.) Although the ALJ recognized that Plaintiff’s impairments “could reasonably be 11 expected to cause the alleged symptoms[,]” the ALJ rejected Plaintiff’s subjective testimony as “not 12 entirely consistent with the medical evidence and other evidence in the record for the reasons 13 explained in this decision.” (AR 26.) 14 Based on this RFC assessment, the ALJ determined that Plaintiff could perform his past 15 relevant work as a security guard with regard to his DIB claim (step 4). (AR 30–31.) The ALJ also 16 made the alternative finding with respect to Plaintiff’s DIB and SSI claims that he could perform a 17 significant number of other jobs in the national economy (step five). (AR 31–32.) The ALJ 18 concluded Plaintiff was not disabled from September 15, 2006, through the date of the decision. 19 (AR 32.) 20 Plaintiff sought review of this decision before the Appeals Council, which denied review on 21 October 13, 2022. (AR 5–10.) Therefore, the ALJ’s decision became the final decision of the 22 Commissioner. 20 C.F.R. §§ 404.981, 416.1481. 23 24
25 3 RFC is an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis of 8 hours a day, for 5 days a week, or an equivalent work schedule. TITLES 26 II & XVI: ASSESSING RESIDUAL FUNCTIONAL CAPACITY IN INITIAL CLAIMS, Social Security Ruling (“SSR”) 96-8P (S.S.A. July 2, 1996). The RFC assessment considers only functional limitations and restrictions that result from an 27 individual’s medically determinable impairment or combination of impairments. Id. “In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record including, inter alia, medical records, lay evidence, and 28 ‘the effects of symptoms, including pain, that are reasonably attributed to a medically determinable impairment.’” 1 2 A. Applicable Law 3 An individual is considered “disabled” for purposes of disability benefits if they are unable 4 “to engage in any substantial gainful activity by reason of any medically determinable physical or 5 mental impairment which can be expected to result in death or which has lasted or can be expected 6 to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A).
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1 2 3 4 5 UNITED STATES DISTRICT COURT 6 EASTERN DISTRICT OF CALIFORNIA 7
8 SCOTT COPELAND, Case No. 1:23-cv-00378-SKO 9 Plaintiff,
10 v. ORDER ON PLAINTIFF’S SOCIAL 11 SECURITY COMPLAINT FRANK BISIGNANO, 12 Commissioner of Social Security1, 13 Defendant. (Doc. 1) _____________________________________/ 14
15 16 I. INTRODUCTION 17 18 Plaintiff Scott Copeland (“Plaintiff”) seeks judicial review of a final decision of the 19 Commissioner of Social Security (the “Commissioner” or “Defendant”) denying his applications for 20 disability insurance benefits (DIB) and Supplemental Security Income (SSI) under the Social 21 Security Act (the “Act”). (Doc. 1.) The matter is currently before the Court on the parties’ briefs, 22 which were submitted, without oral argument, to the Honorable Sheila K. Oberto, United States 23 Magistrate Judge.2 24 25
26 1 On May 6, 2025, Frank Bisignano was appointed the Commissioner of the Social Security Administration. See https://www.ssa.gov/news/press/releases/2025/#2025-05-07. He is therefore substituted as the defendant in this action. 27 See 42 U.S.C. § 405(g) (referring to the “Commissioner’s Answer”); 20 C.F.R. § 422.210(d) (“the person holding the Office of the Commissioner shall, in his official capacity, be the proper defendant”). 28 2 The parties consented to the jurisdiction of a U.S. Magistrate Judge. (See Doc. 11.) On April 13, 2026, this case 1 II. BACKGROUND 2 Plaintiff protectively filed claims for DIB and SSI payments on July 24 and 31, 2019, 3 respectively, alleging he became disabled on September 15, 2006, due to dyslexia, uncontrolled 4 diabetes, “mannose binding lectin,” ulnar nerve damage in both hands, lumbar strain, chronic 5 pneumonia, chronic sepsis, collapsed lungs, “gastronarapothy,” and asthma. (Administrative Record 6 (“AR”) 20, 98, 116, 136, 152.) 7 Plaintiff was born in 1967 and was 39 years old on the alleged disability onset date. (AR 31, 8 97, 115, 135, 151.) He has at least a high school education and previously worked as a security 9 guard and dishwasher. (AR 31, 51–52, 371.) 10 A. Administrative Proceedings 11 The Commissioner denied Plaintiff’s applications for benefits initially on January 17, 2020, 12 and again on reconsideration on July 27, 2020. (AR 20, 179–188, 195–206.) Consequently, Plaintiff 13 requested a hearing before an Administrative Law Judge (“ALJ”). (AR 112–14.) The ALJ 14 conducted a telephonic hearing on November 5, 2021. (AR 41–68.) Plaintiff appeared at the hearing 15 with his attorney and testified as to his alleged disabling conditions and work history. (AR 48–63.) 16 A Vocational Expert (“VE”) also testified at the hearing. (AR 63–67.) 17 B. The ALJ’s Decision 18 In a decision dated December 6, 2021, the ALJ found that Plaintiff was not disabled, as 19 defined by the Act. (AR 20–32.) The ALJ conducted the five-step disability analysis set forth in 20 20 C.F.R. §§ 404.1520 and 416.920. (AR 23–32.) The ALJ decided that Plaintiff met the insured status 21 requirements of the Act through December 31, 2011, and he had not engaged in substantial gainful 22 activity since September 15, 2006, the alleged onset date (step one). (AR 23.) At step two, the ALJ 23 found Plaintiff’s following impairments to be severe: diabetes mellitus; ulnar neuropathy and 24 coronary artery disease. (AR 23–24.) Plaintiff did not have an impairment or combination of 25 impairments that met or medically equaled one of the listed impairments in 20 C.F.R. Part 404, 26 Subpart P, Appendix 1 (“the Listings”) (step three). (AR 24–25.) 27 28 1 The ALJ then assessed Plaintiff’s residual functional capacity (RFC)3 and applied the 2 assessment at steps four and five. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4) (“Before we go 3 from step three to step four, we assess your residual functional capacity . . . . We use this residual 4 functional capacity assessment at both step four and step five when we evaluate your claim at these 5 steps.”). The ALJ determined that Plaintiff had the RFC: 6 to perform medium work as defined in 20 CFR [§§] 404.1567(c) and 416.967(c) except he can frequently climb ramps or stairs but can never climb ladders, ropes 7 or scaffolds. He can frequently kneel, crouch or crawl. [Plaintiff] can frequently handle and finger, bilaterally. He must avoid frequent exposure to irritants such as 8 fumes, odors, dusts, gases and poorly ventilated areas. He must avoid all exposure 9 to unprotected heights and all exposure to hazardous machinery. 10 (AR 25–30.) Although the ALJ recognized that Plaintiff’s impairments “could reasonably be 11 expected to cause the alleged symptoms[,]” the ALJ rejected Plaintiff’s subjective testimony as “not 12 entirely consistent with the medical evidence and other evidence in the record for the reasons 13 explained in this decision.” (AR 26.) 14 Based on this RFC assessment, the ALJ determined that Plaintiff could perform his past 15 relevant work as a security guard with regard to his DIB claim (step 4). (AR 30–31.) The ALJ also 16 made the alternative finding with respect to Plaintiff’s DIB and SSI claims that he could perform a 17 significant number of other jobs in the national economy (step five). (AR 31–32.) The ALJ 18 concluded Plaintiff was not disabled from September 15, 2006, through the date of the decision. 19 (AR 32.) 20 Plaintiff sought review of this decision before the Appeals Council, which denied review on 21 October 13, 2022. (AR 5–10.) Therefore, the ALJ’s decision became the final decision of the 22 Commissioner. 20 C.F.R. §§ 404.981, 416.1481. 23 24
25 3 RFC is an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis of 8 hours a day, for 5 days a week, or an equivalent work schedule. TITLES 26 II & XVI: ASSESSING RESIDUAL FUNCTIONAL CAPACITY IN INITIAL CLAIMS, Social Security Ruling (“SSR”) 96-8P (S.S.A. July 2, 1996). The RFC assessment considers only functional limitations and restrictions that result from an 27 individual’s medically determinable impairment or combination of impairments. Id. “In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record including, inter alia, medical records, lay evidence, and 28 ‘the effects of symptoms, including pain, that are reasonably attributed to a medically determinable impairment.’” 1 2 A. Applicable Law 3 An individual is considered “disabled” for purposes of disability benefits if they are unable 4 “to engage in any substantial gainful activity by reason of any medically determinable physical or 5 mental impairment which can be expected to result in death or which has lasted or can be expected 6 to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). However, 7 “[a]n individual shall be determined to be under a disability only if [their] physical or mental 8 impairment or impairments are of such severity that [they] are not only unable to do [their] previous 9 work but cannot, considering [their] age, education, and work experience, engage in any other kind 10 of substantial gainful work which exists in the national economy.” Id. § 423(d)(2)(A). 11 “The Social Security Regulations set out a five-step sequential process for determining 12 whether a claimant is disabled within the meaning of the Social Security Act.” Tackett v. Apfel, 180 13 F.3d 1094, 1098 (9th Cir. 1999) (citing 20 C.F.R. § 404.1520); see also 20 C.F.R. § 416.920. The 14 Ninth Circuit has provided the following description of the sequential evaluation analysis: 15 In step one, the ALJ determines whether a claimant is currently engaged in substantial gainful activity. If so, the claimant is not disabled. If not, the ALJ 16 proceeds to step two and evaluates whether the claimant has a medically severe 17 impairment or combination of impairments. If not, the claimant is not disabled. If so, the ALJ proceeds to step three and considers whether the impairment or 18 combination of impairments meets or equals a listed impairment under 20 C.F.R. pt. 404, subpt. P, [a]pp. 1. If so, the claimant is automatically presumed disabled. If 19 not, the ALJ proceeds to step four and assesses whether the claimant is capable of 20 performing [their] past relevant work. If so, the claimant is not disabled. If not, the ALJ proceeds to step five and examines whether the claimant has the [RFC] . . . to 21 perform any other substantial gainful activity in the national economy. If so, the claimant is not disabled. If not, the claimant is disabled. 22 23 Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005); see, e.g., 20 C.F.R. § 416.920(a)(4) (providing 24 the “five-step sequential evaluation process” for SSI claimants). “If a claimant is found to be 25 ‘disabled’ or ‘not disabled’ at any step in the sequence, there is no need to consider subsequent 26 steps.” Tackett, 180 F.3d at 1098 (citing 20 C.F.R. § 404.1520); 20 C.F.R. § 416.920. 27 “The claimant carries the initial burden of proving a disability in steps one through four of 28 the analysis.” Burch, 400 F.3d at 679 (citing Swenson v. Sullivan, 876 F.2d 683, 687 (9th Cir. 1989)). 1 “However, if a claimant establishes an inability to continue [their] past work, the burden shifts to 2 the Commissioner in step five to show that the claimant can perform other substantial gainful work.” 3 Id. (citing Swenson, 876 F.2d at 687). 4 B. Scope of Review 5 “This court may set aside the Commissioner’s denial of [social security] benefits [only] when 6 the ALJ’s findings are based on legal error or are not supported by substantial evidence in the record 7 as a whole.” Tackett, 180 F.3d at 1097 (citation omitted). “Substantial evidence . . . is ‘more than 8 a mere scintilla,’” and means only “such relevant evidence as a reasonable mind might accept as 9 adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (quoting 10 Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). See also Ford v. Saul, 950 F.3d 1141, 1154 11 (9th Cir. 2020). 12 “This is a highly deferential standard of review . . . .” Valentine v. Comm’r of Soc. Sec. 13 Admin., 574 F.3d 685, 690 (9th Cir. 2009). “The ALJ’s findings will be upheld if supported by 14 inferences reasonably drawn from the record.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 15 2008) (citation omitted). Additionally, “[t]he court will uphold the ALJ’s conclusion when the 16 evidence is susceptible to more than one rational interpretation.” Id.; see, e.g., Edlund v. Massanari, 17 253 F.3d 1152, 1156 (9th Cir. 2001) (“If the evidence is susceptible to more than one rational 18 interpretation, the court may not substitute its judgment for that of the Commissioner.” (citations 19 omitted)). 20 Nonetheless, “the Commissioner’s decision ‘cannot be affirmed simply by isolating a 21 specific quantum of supporting evidence.’” Tackett, 180 F.3d at 1098 (quoting Sousa v. Callahan, 22 143 F.3d 1240, 1243 (9th Cir. 1998)). “Rather, a court must ‘consider the record as a whole, 23 weighing both evidence that supports and evidence that detracts from the [Commissioner’s] 24 conclusion.’” Id. (quoting Penny v. Sullivan, 2 F.3d 953, 956 (9th Cir. 1993)). 25 Finally, courts “may not reverse an ALJ’s decision on account of an error that is harmless.” 26 Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (citing Stout v. Comm’r, Soc. Sec. Admin., 27 454 F.3d 1050, 1055–56 (9th Cir. 2006)). Harmless error “exists when it is clear from the record 28 that ‘the ALJ’s error was inconsequential to the ultimate nondisability determination.’” Tommasetti, 1 533 F.3d at 1038 (quoting Robbins v. Soc. Sec. Admin., 466 F.3d 880, 885 (9th Cir. 2006)). “[T]he 2 burden of showing that an error is harmful normally falls upon the party attacking the agency’s 3 determination.” Shinseki v. Sanders, 556 U.S. 396, 409 (2009) (citations omitted). 4 IV. DISCUSSION 5 Plaintiff asserts that the RFC was not supported by substantial evidence because the ALJ 6 independently interpreted medical records without the aid of a medical expert rather than further 7 developing the record; and 2) that the ALJ failed to offer clear and convincing reasons for rejecting 8 Plaintiff’s subjective symptom complaints. (Docs. 17, 20.) The Court agrees that the ALJ did not 9 fully develop the record and instead improperly interpreted medical records on their own in 10 formulating the RFC and will remand for further proceedings on that basis. 11 A. The ALJ’s Physical RFC Determination is Not Supported by Substantial Evidence 12 A claimant’s RFC is “the most [a claimant] can still do despite [their] limitations.” 20 C.F.R. 13 §§ 404.1545(a), 416.945(a); see also 20 C.F.R. Part 404, Subpart P, Appendix 2, § 200.00(c) 14 (defining an RFC as the “maximum degree to which the individual retains the capacity for sustained 15 performance of the physical-mental requirements of jobs”). In formulating the RFC, the ALJ weighs 16 medical and other source opinions, as well as the claimant’s credibility. See, e.g., Bray v. Comm’r 17 of Soc. Sec. Admin., 554 F.3d 1219, 1226 (9th Cir. 2009). As set forth above, the ALJ’s RFC finding 18 in this case stated that Plaintiff can perform medium work; frequently climb ramps and stairs, kneel 19 crouch, crawl, and handle and finger, bilaterally; never climb ladders, ropes or scaffolds; must avoid 20 frequent exposure to irritants such as fumes, odors, dusts, gases and poorly ventilated areas; and 21 must avoid all exposure to unprotected heights and all exposure to hazardous machinery. (AR 25.) 22 Medical opinions regarding the effects of Plaintiff’s physical impairments were provided by 23 the following individuals: State agency physicians Leslie Arnold, M.D., and A. Wong, M.D.; 24 treating physicians Grant Medefind, M.D. and Keith Campbell, M.D.; workers’ compensation 25 physicians Bradley Tourtlotte, M.D. and Maureen D. Miner; and consultative examiner Roger 26 Wagner, M.D. Drs. Arnold and Wong opined that Plaintiff could perform a range of light work. 27 (AR 110–12, 126–30, 145–48, 160–64.) Dr. Medefind opined that Plaintiff can sit and stand for 28 fifteen minutes at one time, for a total of 2 hours total, each; needs to shift at will; needs periods of 1 walking around every fifteen minutes for five minutes; needs unscheduled breaks every ten to fifteen 2 minutes for five minutes; must use a cane; can rarely lift ten pounds, never lift twenty, can rarely 3 perform any postural activities; can use the hands, fingers, arms 1–5% of the day; would be off-task 4 25% of the day; and would be incapable of even low stress work. (AR 2241–43.) Dr. Campbell 5 opined that Plaintiff could lift, pull, and push no more than five to 10 pounds. (AR 511–14.) Drs. 6 Tourtlotte and Miner each opined that Plaintiff could lift, pull, and push up to 30 pounds. (AR 552, 7 577.) Finally, Dr. Wagner opined that Plaintiff requires a walking stick for long distances and 8 uneven terrain due to balance problems and cannot perform manipulative activities. (AR 1980.) 9 The ALJ found each of these seven medical opinions “not persuasive” because they were 10 inconsistent with the overall medical record. (AR 29–30.) In other words, the ALJ disagreed with 11 all of medical opinions in the record concerning Plaintiff’s impairments and found that, contrary to 12 the opinions of the State agency physicians, treating physicians, workers’ compensation physicians, 13 and the consultative examiner, Plaintiff’s impairments would result in some work-related 14 restrictions. While the absence of a medical opinion is not necessarily fatal, the RFC determination 15 still must be supported by substantial evidence. See Bradford v. Comm’r of Soc. Sec. Admin., No. 16 CV-21-00232-TUC-SHR (JR), 2022 WL 4538569, at *5 (D. Ariz. Aug. 18, 2022). 17 Here, having rejected all of the medical opinion evidence in the record, the ALJ’s RFC 18 determination appears to have been based solely on their own interpretation of Plaintiff’s testimony 19 and the medical evidence. Without relying on any medical opinion regarding what work-related 20 restrictions would be appropriate, the ALJ improperly included limitations in the RFC and concluded 21 these limitations were sufficient to address Plaintiff’s impairments. It is well-settled that an ALJ 22 may not render their own medical opinion and is not empowered to independently assess clinical 23 findings. See, e.g., Tackett, 180 F.3d at 1102–03 (holding an ALJ erred in rejecting physicians’ 24 opinions and rendering his own medical opinion); Miller v. Astrue, 695 F. Supp. 2d 1042, 1048 (C.D. 25 Cal. 2010) (reasoning that it is improper for the ALJ to act as the medical expert); Banks v. Barnhart, 26 434 F. Supp. 2d 800, 805 (C.D. Cal. 2006) (“An ALJ cannot arbitrarily substitute his own judgment 27 for competent medical opinion, and he must not succumb to the temptation to play doctor and make 28 his own independent medical findings”). 1 The Commissioner contends that because ALJs—not medical professionals—are responsible 2 for determining a claimant’s RFC, the ALJ’s conclusion must be upheld. (Doc. 19 at 4.) However, 3 the ALJ in this case did not simply synthesize the medical evidence and opinions to reach an RFC 4 determination, as they are charged to do. The ALJ does not explain how, for example, Plaintiff’s 5 treatment notes, imaging results, or testimony provide sufficient indications of Plaintiff’s functional 6 limitations and are clear as to their impact on Plaintiff’s ability to work. See Howell v. Kijakazi, No. 7 20-CV-2517-BLM, 2022 WL 2759090, at *7 (S.D. Cal. July 14, 2022) (MRIs, radiological studies, 8 and X-rays “generally reflect only the findings, impressions, and medical diagnoses, which are 9 difficult for a lay person to interpret.”); Hurt v. Kijakazi, No. 3:20-CV-00481-CSD, 2022 WL 10 444355, at *9–10 (D. Nev. Feb. 14, 2022) (“When the ‘medical findings in the record merely 11 diagnose [the] claimant’s exertional impairments and do not relate those diagnoses to specific 12 residual functional capabilities . . . [the] bare medical findings are unintelligible to a lay person in 13 terms of residual functional capacity.’”) (quoting Rosado v. Sec’y of Health & Human Servs., 807 14 F.2d 292, 293 (1st Cir. 1986)). Thus, it appears the ALJ formulated an RFC based on their 15 interpretation of the medical evidence, which is improper. The ALJ was not qualified to translate 16 the evidence into functional limitations and engage in their “own exploration and assessment” of 17 Plaintiff’s impairments. See McAnally v. Berryhill, Case No.: 3:18-cv-02272-GPC-RNB, 2020 WL 18 1443734, at *7 (S.D. Cal. Mar. 25, 2020) (quoting Day v. Weinberger, 522 F.2d 1154, 1156 (9th 19 Cir. 1975)). 20 The Court agrees with Plaintiff that the ALJ had a duty to develop the record further under 21 these circumstances. See Ford, 950 F.3d at 1156 (When there is “ambiguous evidence or when the 22 record is inadequate to allow for proper evaluation of the evidence,” the ALJ has a duty to develop 23 the record) (quoting Mayes v. Massanari, 276 F.3d 453, 459–60 (9th Cir. 2001)). Indeed, Ninth 24 Circuit courts have found that “[b]arring a few exceptions, an ALJ must have a doctor’s opinion of 25 a claimant’s functional capacity in order for there to be substantial evidence supporting the 26 decisions.” Bradford, 2022 WL 4538569, at *5 (quoting Howell, 2022 WL 2759090, at *7); Walker 27 v. Comm’r of Soc. Sec., Case No. 2:22-cv-01871-EJY, 2024 WL 64784, at *6 (D. Nev. Jan. 4, 2024) 28 (“While the ALJ ‘can pick and choose between opinions expressed by the experts,’ when an ALJ 1 decides severity or residual functional capacity ‘without the support of any of the medical opinion 2 evidence,’ this is error.”) (quoting Holtan v. Kijakazi, 2:22-cv-01222-VCF, 2023 WL 2424648, at 3 *3 (D. Nev. Mar. 9, 2023)). 4 The ALJ was therefore required to obtain a medical expert’s opinion to allow for a proper 5 evaluation of Plaintiff’s physical capabilities after concluding that he suffered from several severe 6 impairments. See Mack v. Saul, No. 1:18-CV-01287-DAD-BAM, 2020 WL 2731032, at *2 (E.D. 7 Cal. May 26, 2020) (duty to develop where the ALJ improperly determined RFC after considering 8 MRIs and radiological studies absent a doctor’s opinion regarding the effect on plaintiff’s ability to 9 work on a function-by-function basis); see also Howell, 2022 WL 2759090, at *10 (“Because the 10 record was inadequate to establish Plaintiff’s current function-by-function capabilities, the ALJ had 11 a duty to further develop the record. His failure to do so was an error.”); Escudero v. Comm’r of 12 Soc. Sec., Case No. 1:18-cv-01136-EPG, 2019 WL 4917634, at *2 (E.D. Cal. October 4, 2019). The 13 ALJ did not do so here. Without a medical expert’s opinion to support the conclusion that Plaintiff 14 can perform a range of medium work as described in the RFC, the RFC lacks the support of 15 substantial evidence. See Holtan, 2023 WL 2424648, at *3 (finding that the ALJ erred primarily by 16 simply summarizing the medical evidence without making it clear how the ALJ then translated that 17 evidence into the RFC, noting that it was “particularly concerning because the ALJ did not rely on 18 any of the medical opinions, finding all of the medical opinions of record unpersuasive.”) (emphasis 19 in original); De Gutierrez v. Saul, No. 1:19-cv-00463-BAM, 2020 WL 5701019, at *6 (E.D. Cal. 20 Sept. 24, 2020) (“Without a medical opinion to support the conclusion that Plaintiff was able to 21 perform” a certain level of work, lift and carry certain weight, or sit, stand or walk for certain periods 22 of time, “the ALJ’s RFC lacks the support of substantial evidence.”) (citing Perez v. Sec’y of Health 23 & Human Servs., 958 F.2d 445, 446 (1st Cir. 1991) (“where an ALJ reaches conclusions about 24 claimant’s . . . capacity without any assessment of residual functional capacity by a physician, the 25 ALJ’s conclusions are not supported by substantial evidence”)); Shipp v. Colvin, No. CV 13–9468 26 JC, 2014 WL 4829035, at *7 (C.D. Cal. Sept. 26, 2014) (“Since . . . the record contains no assessment 27 by a treating or examining doctor regarding the effect of plaintiff’s physical impairments on her 28 ability to function, it appears that the ALJ’s physical residual functional capacity assessment was 1 erroneously based solely on the ALJ’s own, lay interpretation of plaintiff’s testimony and other raw 2 medical evidence in the record.”). 3 B. The ALJ’s Error Was Harmful 4 The Court must now consider whether the ALJ’s error was harmless. Molina, 674 F.3d at 5 1115. Courts look at the record as a whole to determine whether the error alters the outcome of the 6 case. Id.; March v. Colvin, 792 F.3d 1170, 1172 (9th Cir. 2015). 7 This Court finds this was harmful error necessitating remand. Tommasetti, 533 F.3d at 1038 8 (ALJ error is harmless if it is “inconsequential to the ultimate nondisability determination.”). While 9 the ALJ assessed an RFC restricting Plaintiff to medium work with additional limitations, it is still 10 without supporting evidence (and with less restrictive limitations than those contained in the seven 11 rejected medical opinions, cf. Lamas v. Saul, No. 1:19-cv-00852-BAM, 2020 WL 6561306, at *9 12 (E.D. Cal. Nov. 9, 2020) (holding that although ALJ erred in evaluating a claimant’s RFC without 13 support from a medical opinion, such error was harmless where the ALJ found more stringent 14 limitations than any medical opinion)). Had the ALJ included different limitations in the RFC based 15 upon a proper review of the evidence and an adequate record, the ultimate disability determination 16 may have been different.4 See Clarenda A. S. v. O’Malley, No. 1:24-CV-00127-DKG, 2024 WL 17 4851214, at *5 (D. Idaho Nov. 21, 2024) (finding harmful error where the ALJ relied on her own 18 interpretation of the medical records without any medical opinion of Plaintiff's physical functioning 19 in formulating the RFC). Moreover, because the record “[did] not support the assumptions in the 20 hypothetical[s]” posed to the VE, the hypotheticals were incomplete and therefore, the “vocational 21 expert's opinion [had] no evidentiary value.” Lewis v. Apfel, 236 F.3d 503, 517 (9th Cir. 2001). C. Remand for Further Proceedings is Appropriate 22 In a case where the ALJ’s determination is not supported by substantial evidence or is tainted 23 by legal error, the court may remand the matter for additional proceedings or an immediate award 24 of benefits. Remand for additional proceedings is proper where (1) outstanding issues must be 25 resolved, and (2) it is not clear from the record before the court that a claimant is disabled. See 26 Benecke v. Barnhart, 379 F.3d 587, 593 (9th Cir. 2004). Here, the Court finds that remand for 27
28 4 This is not to say that the disability determination will or should be different, only that the Court cannot determine 1 further proceedings is warranted. See Osborne v. Commissioner of Soc. Sec., No. 1:22-CV-01538- 2 EPG, 2024 WL 1312202, at *5 (E.D. Cal. Mar. 27, 2024) (remanding for further proceedings where 3 the ALJ relied on their own judgment in assessing the RFC without the support of any medical 4 opinion evidence). On remand, the Commissioner shall further develop the record, as outlined 5 above, to allow for proper consideration of the medical evidence. 6 D. The Court Declines to Determine Plaintiff’s Remaining Assertion of Error 7 As the Court finds that remand is appropriate for further development of the record, the 8 Court does not reach Plaintiff’s additional assertion of error directed to his subjective symptom 9 complaints, which were discounted based on an undeveloped record (see AR 26). See Hiler v. 10 Astrue, 687 F.3d 1208, 1212 (9th Cir. 2012) (“Because we remand the case to the ALJ for the 11 reasons stated, we decline to reach [plaintiff’s] alternative ground for remand.”); see also Augustine 12 ex rel. Ramirez v. Astrue, 536 F. Supp. 2d 1147, 1153 n.7 (C.D. Cal. 2008) (“[The] Court need not 13 address the other claims plaintiff raises, none of which would provide plaintiff with any further 14 relief than granted, and all of which can be addressed on remand.”). 15 V. CONCLUSION AND ORDER 16 Based on the foregoing, the Court finds that the ALJ’s decision is not supported by 17 substantial evidence and is therefore VACATED, and the case is REMANDED to the ALJ for 18 further proceedings consistent with this Order. The Clerk of this Court is DIRECTED to enter 19 judgment in favor of Plaintiff Scott Copeland and against Defendant Frank Bisignano, 20 Commissioner of Social Security. 21 IT IS SO ORDERED. 22 23 Dated: May 5, 2026 /s/ Sheila K. Oberto . UNITED STATES MAGISTRATE JUDGE 24
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