Sides-Allen v. Bisignano

• Court: District Court, E.D. Washington
• Decided: June 9, 2025
• Docket: 2:24-cv-00315
• Status: Unknown

Opinion

1 2 FILED IN THE U.S. DISTRICT COURT 3 EASTERN DISTRICT OF WASHINGTON Jun 09, 2025 4 SEAN F. MCAVOY, CLERK 5 6 UNITED STATES DISTRICT COURT 7 EASTERN DISTRICT OF WASHINGTON 8 9 10 TREY ANDREW S., No. 2:24-CV-00315-SAB 11 Plaintiff, 12 v. 13 COMMISSIONER OF SOCIAL ORDER REVERSING DECISION OF 14 SECURITY ADMINISTRATION, COMMISSIONER 15 Defendant. 16 17 Plaintiff brings this action seeking juridical review of the Commissioner of 18 Social Security’s final decision denying his application for social security benefits. 19 Plaintiff is represented by Maren Ann Miller Bam. The Commissioner is 20 represented by Jacob Peter Phillips, David Burdett, and Brian M. Donovan. 21 Pending before the Court is Plaintiff’s Opening Brief, ECF No. 7, the 22 Commissioner’s Brief, ECF No. 14, and Plaintiff’s Reply Brief, ECF No. 15. 23 After reviewing the administrative record and briefs filed by the parties, the 24 Court is now fully informed. For the reasons set forth below, the Court reverses the 25 Commissioner’s decision. 26 // 27 // 28 // 1 I. Jurisdiction 2 On October 4, 2018, Plaintiff filed an application for supplemental security 3 income, alleging disability beginning November 1, 2012.1 Plaintiff’s application 4 was denied initially and on reconsideration. Plaintiff appealed the denial to this 5 Court, which remanded the denial, finding the ALJ erred in discounting Pliantiff’s 6 chronic abdominal pain. The ALJ held a second hearing on August 18, 2022, and 7 again denied Plaintiff’s application for benefit, and Plaintiff appealed. The parties 8 stipulated to a remand. 9 On July 11, 2024, ALJ held a hearing in Spokane, Washington. Plaintiff 10 appeared and was represented by counsel, Maren Miller Bam. Thomas Polsin, a 11 vocational expert appeared and testified as well. The next day the ALJ issued a 12 partially favorable decision, finding Plaintiff disabled from October 4, 2018 13 through April 13, 2020, with medical improvement commencing on April 14, 14 2020. Plaintiff filed a timely appeal with the United States District Court for the 15 Eastern District of Washington on February 13, 2023. ECF No. 1. The matter is 16 before this Court pursuant to 42 U.S.C. §§ 405(g), 1383(c)(1)(3). 17 II. Five-Step Sequential Evaluation Process 18 The Social Security Act defines disability as the “inability to engage in any 19 substantial gainful activity by reason of any medically determinable physical or 20 mental impairment which can be expected to result in death or which has lasted or 21 can be expected to last for a continuous period of not less than twelve months.” 42 22 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A claimant shall be determined to be 23 under a disability only if their impairments are of such severity that the claimant is 24 not only unable to do their previous work, but cannot, considering claimant’s age, 25 education, and work experiences, engage in any other substantial gainful work that 26

27 1 At the 2024 hearing, Plaintiff amended his alleged onset date to the protected 28 filing date of October 4, 2018. 1 exists in the national economy. 42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B). The 2 Commissioner has established a five-step sequential evaluation process to 3 determine whether a person is disabled in the statute. See 20 C.F.R. §§ 4 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v). 5 Step One: Is the claimant engaged in substantial gainful activities? 20 6 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). Substantial gainful activity is work 7 done for pay and requires compensation above the statutory minimum. Keyes v. 8 Sullivan, 894 F.2d 1053, 1057 (9th Cir. 1990). If the claimant is engaged in 9 substantial activity, benefits are denied. 20 C.F.R. § 404.1520(b), 416.920(b). If 10 the claimant is not, the ALJ proceeds to step two. 11 Step Two: Does the claimant have a medically-severe impairment or 12 combination of impairments? 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). A 13 severe impairment is one that lasted or must be expected to last for at least 12 14 months and must be proven through objective medical evidence. Id. §§ 404.1509, 15 416.909. If the claimant does not have a severe impairment or combination of 16 impairments, the disability claim is denied. Id. § 404.1520(a)(4)(ii), 17 416.920(a)(4)(ii). If the impairment is severe, the evaluation proceeds to the third 18 step. 19 Step Three: Does the claimant’s impairment meet or equal one of the listed 20 impairments acknowledged by the Commissioner to be so severe as to preclude 21 substantial gainful activity? 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If 22 the impairment meets or equals one of the listed impairments, the claimant is 23 conclusively presumed to be disabled. 20 C.F.R. §§ 404.1520(d), 416.920(d). If the 24 impairment is not one conclusively presumed to be disabling, the evaluation 25 proceeds to the fourth step. 26 Before considering to the fourth step, the ALJ must first determine the 27 claimant’s residual functional capacity. An individual’s residual functional 28 capacity is their ability to do physical and mental work activities on a sustained 1 basis despite limitations from their impairments. 20 C.F.R. §§ 404.1545(a)(1), 2 416.945(a)(1). The residual functional capacity is relevant to both the fourth and 3 fifth steps of the analysis. 4 Step Four: Does the impairment prevent the claimant from performing work 5 they have performed in the past? 20 C.F.R. §§ 404.1520(a)(4)(iv), 6 416.920(a)(4)(iv). If the claimant is able to perform their previous work, they are 7 not disabled. 20 C.F.R. §§ 404.1520(f), 416.920(f). If the claimant cannot perform 8 this work, the evaluation proceeds to the fifth and final step. 9 Step Five: Is the claimant able to perform other work in the national 10 economy in view of their age, education, and work experience? 20 C.F.R. §§ 11 404.1520(a)(4)(v), 416.920(a)(4)(v). The initial burden of proof rests upon the 12 claimant to establish a prima facie case of entitlement to disability benefits. Tackett 13 v. Apfel, 108 F.3d 1094, 1098 (9th Cir. 1999). This burden is met once a claimant 14 establishes that a physical or mental impairment prevents him from engaging in her 15 previous occupation. Id. At step five, the burden shifts to the Commissioner to 16 show that the claimant can perform other substantial gainful activity. Id. 17 III. Standard of Review 18 The Commissioner’s determination will be set aside only when the ALJ’s 19 findings are based on legal error or are not supported by substantial evidence in the 20 record as a whole. Matney v. Sullivan, 981 F.2d 1016, 1018 (9th Cir. 1992) (citing 21 42 U.S.C. § 405(g)). Substantial evidence is “more than a mere scintilla,” 22 Richardson v. Perales, 402 U.S. 389, 401 (1971), but “less than a preponderance,” 23 Sorenson v. Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975). Substantial 24 evidence is “such relevant evidence as a reasonable mind might accept as adequate 25 to support a conclusion.” Richardson, 402 U.S. at 401. 26 A decision supported by substantial evidence will be set aside if the proper 27 legal standards were not applied in weighing the evidence and making the decision. 28 Brawner v. Secr’y of Health & Human Servs., 839 F.2d 432, 433 (9th Cir. 1988). 1 An ALJ is allowed “inconsequential” errors as long as they are immaterial to the 2 ultimate nondisability determination. Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 3 1050, 1055 (9th Cir. 2006). The Court must uphold the ALJ’s denial of benefits if 4 the evidence is susceptible to more than one rational interpretation, one of which 5 supports the decision of the administrative law judge. Batson v. Barnhart, 359 F.3d 6 1190, 1193 (9th Cir. 2004). It “must consider the entire record as a whole, 7 weighing both the evidence that supports and the evidence that detracts from the 8 Commissioner’s conclusion, and may not affirm simply by isolating a specific 9 quantum of supporting evidence.” Revels v. Berryhill, 874 F.3d 648, 654 (9th Cir. 10 2017) (quotation omitted). “If the evidence can support either outcome, the court 11 may not substitute its judgment for that of the ALJ.” Matney, 981 F.2d at 1019. 12 IV. Statement of Facts 13 The facts have been presented in the administrative record, the ALJ’s 14 decision, and the briefs to this Court. Only the most relevant facts are summarized 15 herein. 16 At the July 11, 2024 hearing, Plaintiff testified that typically he has minor 17 pain in his stomach that comes in waves throughout the whole day. Usually, 18 toward the later of the day, it starts to get a little worse, and then if he lays down, 19 the pain significantly goes up. He maintains a strict diet. If he eats the wrong food, 20 the pain starts and he experiences a flare-up, which includes diarrhea and 21 cramping. Sometimes it gets so bad, it is hard to breath and talk. Major flareups 22 happen about once a month, minor flareups about once a week, which causes him 23 to feel like crap and it is hard to move. He takes about two or three showers a day 24 once the pain starts getting severe. He takes medication and marijuana, which 25 helps relieve the pain instead of hydrocodone. He explained that if he starts having 26 a flareup, he will need to go to the bathroom about 10 or 12 times a day, lasting 27 between 3 – 30 minutes. 28 // 1 V. The ALJ’s Findings 2 The ALJ issued an opinion affirming denial of benefits. AR 2815-2834. 3 At step one, the ALJ found that Plaintiff has not engaged in substantial 4 gainful activity since October 4, 2018, the alleged amended onset date. AR 2823. 5 At step two, the ALJ identified the following severe impairments that 6 existed from October 4, 2018 through April 13, 2020: obesity, Crohn’s disease, 7 ulcerative colitis, and asthma. AR 2824. 8 At step three, the ALJ found that Plaintiff did not have an impairment or 9 combination of impairments that meets or medically equals the severity of one of 10 the listed impairments. AR 2824-25. Ultimately, the ALJ concluded that Plaintiff 11 has a residual functional capacity (“RFC”) to perform:

12 a full range of light as defined in 20 CFR 416.967(b) except: he could 13 frequently balance, stoop, kneel, crouch, and crawl; he could occasionally climb ramps or stairs; he could never climb ladders, 14 ropes, or scaffolds; he could not have concentrated exposure to 15 extreme cold, vibration or pulmonary irritants; he could not have exposure to hazards, (e.g., unprotected heights, moving mechanical 16 parts); he could have no exposure to hazards (e.g. unprotected heights, 17 moving mechanical parts); he would need ready access to a restroom and an allow to take a three-to-five-minute break every hour to use the 18 restroom; he could perform simple and detailed, but not complex, 19 tasks; he would be capable of simple decision-making; and he would be absent from work approximately two times per month on an 20 unpredictable, unscheduled basis. 21 AR 20. 22 At step four, the ALJ found that Plaintiff was no past relevant work. AR 23 2829. 24 The ALJ found Plaintiff was under disability, as defined by the social 25 Security Act, from October 4, 2018 through April 13, 2020. AR 2829. 26 The ALJ then found that Plaintiff was not disabled beginning April 14, 2020 27 because medical improvement occurred. AR 2830. The ALJ concluded that as of 28 1 April 14, 2020, Plaintiff’s functional capacity for basic work activities increased so 2 that he now has the residual functional capacity to perform: 3 A full range of light work as defined in 20 CFR 416.967(b) except: he 4 could frequently balance, stoop, kneel crouch, and crawl; he could 5 occasionally climb ramps or stairs; he could never climb ladders, ropes, or scaffolds; he could not have concentrated exposure to 6 extreme cold, vibration, or pulmonary irritants; he could have no 7 exposure to hazards (e.g. unprotected heights, moving mechanical parts); he could need ready access to a restroom and an allowance to 8 take a three- or five-minute break every hour to use the restroom; he 9 could perform simple and detailed, but not complex tasks; and he would be capable of simple decision-making. 10 AR 2830-31. 11 The ALJ found there were other jobs that existed in significant numbers in 12 the national economy that Plaintiff could also perform, including Housekeeping, 13 Cleaner Attendant, Cafeteria Attendant, and Assembler, Small Products. 14 Consequently, the ALJ found that Plaintiff was not disabled. AR 2834. 15 VI. Issues on Appeal 16 1. Whether the ALJ properly rejected Plaintiff’s subjective complaints from 17 April 13, 2020, onward. 18 2. Whether substantial evidence supports the ALJ’s finding of medical 19 improvement. 20 VII. Discussion 21 The ALJ found that Plaintiff’s statements concerning the intensity, 22 persistence and limiting effects of his symptoms were not entirely consistent with 23 the medical evidence and other evidence in the record. It concluded there was no 24 evidence suggesting that Plaintiff had marked side effects from his painkillers, and 25 the frequency and dosage of his pain medication had been relatively low. The ALJ 26 noted Plaintiff did not make any complaints after April 2020 about experiencing 27 significant pain. The ALJ speculated that because Plaintiff did not require more 28 1 aggressive treatment this suggests Plaintiff did not feel the need for such treatment, 2 which in turn, seemingly indicates his symptoms are not as problematic as he 3 alleges. He found that after April 2020, Plaintiff would not be absent from work 4 multiple days per month. Notably, Plaintiff has not required any emergency 5 department visits for colitis or other emergent treatment for flares since October 6 2019. 7 In determining whether a claimant’s testimony regarding subjective pain or 8 symptoms is credible, the ALJ engages in a two-step analysis. Garrison v. Colvin, 9 759 F.3d 995, 1014 (9th Cir. 2014). “First, the ALJ must determine whether the 10 claimant has presented objective medical evidence of an underlying impairment 11 which could reasonably be expected to produce the pain or other symptoms 12 alleged.” Id. (citation and quotation omitted). If the claimant satisfies the first step 13 of the analysis, and there is no evidence of malingering, the ALJ can reject the 14 claimant’s testimony about the severity of their symptoms “only by offering 15 specific, clear and convincing reasons for doing so.” Id. (citation and quotation 16 omitted). “This is not an easy requirement to meet: The clear and convincing 17 standard is the most demanding required in Social Security cases.” Id. (citation and 18 quotation omitted). That said, if the ALJ’s credibility finding is supported by 19 substantial evidence in the record, the Court may not engage in second-guessing. 20 Thomas v. Barnhart, 278 F.3d 947, 959 (9th Cir. 2002). 21 The ALJ’s decision that Plaintiff is no longer disabled as of April 13, 2020 is 22 not supported by substantial evidence. The record does not demonstrate that 23 medical improvement occurred to the extent found by the ALJ. It failed to properly 24 consider the combined effects of Plaintiff’s impairments. Instead, the record is 25 clear that Plaintiff is not able to sustain competitive employment, given the 26 documented need for hourly restroom breaks, the impact of fatigue and the 27 likelihood of absenteeism due to Plaintiff’s chronic pain. 28 The record shows that although Plaintiff had improvements with 1 medications, he continued to report aching pain in the areas of the sigmoid colon, 2 and generally reported an average pain level of 6 or 7/10 through at least July 22, 3 2022. The ALJ frequently relied upon examination findings that were unrelated to 4 Plaintiff’s reported pain as a basis to discredit Plaintiff’s subjective complaints. 5 Also, the ALJ selectively relied on isolated periods of symptom stability to 6 discredit Plaintiff’s allegations. Whereas treatment notes one month would indicate 7 an improvement in abdominal pain and bowel urgency, by the next month, 8 Plaintiff’s symptoms worsened. The record demonstrates that Plaintiff’s symptoms 9 fluctuate to include periods of manageability as well as disruptive flareups. The 10 fact that Plaintiff did not experience hospitalizations in no way detracts from his 11 chronic symptoms that prevent him from engaging in full-time employment. 12 The ALJ failed to provide clear and convincing reasons for rejecting 13 Plaintiff’s testimony that he cannot engage in full time work and in turn, erred in 14 finding that medical improvement occurred after April 2020. The record 15 demonstrates ongoing chronic pain despite treatment at least two years after the 16 time that the ALJ considered Plaintiff’s medical situation to be improved. Plaintiff 17 maintained pain management care from July 2020 to July 2022 for constant pain 18 with intermittent flares. He was treated with opioid therapy. 19 Additionally, the ALJ failed to include in the RFC the need for hourly 20 restroom breaks, which could last up to 30 minutes. According to the VE, this 21 would make it impossible for Plaintiff to meet the demands of competitive 22 employment. 23 Finally, the ALJ failed to address Plaintiff’s chronic fatigue, which causes 24 Plaintiff to have to take rests multiple times per day, would preclude full-time 25 employment, and failed to address Plaintiff’s daily use of marijuana to manage his 26 pain. As such, the ALJ’s conclusion that Plaintiff is not disabled from April 2020 27 is not supported by substantial evidence. 28 // 1 VII. Conclusion Here, the record is fully developed, and further proceedings would not serve 3|| any useful purpose. Garrison, 759 F.3d at 1020. The ALJ failed to provide legally sufficient reasons to reject Plaintiff's testimony. Instead, the record fully supports 5|| Plaintiff's statements that he is unable to sustain full-time employment, even after April 20, 2020. As such, it is proper to remand for an award of immediate benefits. Td. 8 Accordingly, IT IS HEREBY ORDERED: 9 l. For court management purposes, Plaintiff's Opening Brief, ECF No. 7, and Reply Brief, ECF No. 15, are GRANTED. 11 2. For court management purposes, the Commissioner’s Brief, ECF No. 14, is DENIED. 13 3. The decision of the Commissioner is reversed and remanded for an immediate award of benefits. 15 4. Judgment shall be entered in favor of Plaintiff and against Defendant. 16 IT IS SO ORDERED. The District Court Executive is hereby directed to 17\| file this Order, provide copies to counsel, and close the file. 18 DATED this 9th day of June 2025. I 9 on

21 wast ) iv Ta 22 Stan Bastian Chief United States District Judge 23 24 25 26 27 28 ORDER REVERSING DECISION OF COMMISSIONER ~ 10