1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 11 NANTIDA YIENGYOUAV, Case No. 1:23-cv-01601-HBK 12 Plaintiff, ORDER REMANDING CASE TO COMMISSIONER OF SOCIAL SECURITY2 13 v. (Doc. Nos. 14, 16) 14 MICHELLE KING, COMMISSIONER OF SOCIAL 15 SECURITY,1 16 Defendant. 17 18 19 Nantida Yiengyouav (“Plaintiff”) seeks judicial review of a final decision of the 20 Commissioner of Social Security (“Commissioner” or “Defendant”) denying her application for 21 disability insurance benefits under the Social Security Act. (Doc. No. 1). The matter is currently 22 before the Court on the parties’ briefs, which were submitted without oral argument. (Doc. Nos. 23 14, 16). For the reasons stated, the Court orders this matter remanded for further administrative 24 proceedings. 25
26 1 The Court has substituted Michelle King, who has been appointed the Acting Commissioner of Social Security, as the defendant in this suit. See Fed. R. Civ. P. 25(d). 27 2 Both parties have consented to the jurisdiction of a magistrate judge, in accordance with 28 U.S.C. §636(c)(1). (Doc. No. 6). 28 1 I. JURISDICTION 2 Plaintiff protectively filed for disability insurance benefits on July 6, 2019, alleging an 3 onset date of May 4, 2016. (AR 340-46). Benefits were denied initially (AR 59-80, 99-103), and 4 upon reconsideration (AR 81-98, 107-13). Plaintiff appeared at a hearing before an 5 Administrative Law Judge (“ALJ”) on May 5, 2022. (AR 39-58). Plaintiff was represented by 6 counsel and testified at the hearing with an interpreter. (Id.). On May 23, 2022, the ALJ issued 7 an unfavorable decision (AR 16-38), and May 17, 2023 the Appeals Council denied review (AR 8 1-6). The matter is now before this Court pursuant to 42 U.S.C. § 1383(c)(3). 9 II. BACKGROUND 10 The facts of the case are set forth in the administrative hearing and transcripts, the ALJ’s 11 decision, and the briefs of Plaintiff and Commissioner. Only the most pertinent facts are 12 summarized here. 13 Plaintiff was 52 years old at the time of the hearing. (See AR 369). She completed tenth 14 grade. (AR 44). She lives with her husband and two children. (AR 43-44). Plaintiff has work 15 history as a machine operator. (AR 44-46, 53). Plaintiff testified that she is unable to work 16 because of hearing loss and memory problems. (AR 46). She “never [does] anything 17 independently,” she no longer drives because she gets anxious, and she has back, neck, and chest 18 pain. (AR 47-50). She can lift one pound maximum, has difficulty being around large groups of 19 people, is unable to follow the plot of a television show, and cannot get out of bed because of 20 depression almost every day. (AR 49-51). 21 III. STANDARD OF REVIEW 22 A district court’s review of a final decision of the Commissioner of Social Security is 23 governed by 42 U.S.C. § 405(g). The scope of review under § 405(g) is limited; the 24 Commissioner’s decision will be disturbed “only if it is not supported by substantial evidence or 25 is based on legal error.” Hill v. Astrue, 698 F.3d 1153, 1158 (9th Cir. 2012). “Substantial 26 evidence” means “relevant evidence that a reasonable mind might accept as adequate to support a 27 conclusion.” Id. at 1159 (quotation and citation omitted). Stated differently, substantial evidence 28 equates to “more than a mere scintilla[,] but less than a preponderance.” Id. (quotation and 1 citation omitted). In determining whether the standard has been satisfied, a reviewing court must 2 consider the entire record as a whole rather than searching for supporting evidence in isolation. 3 Id. 4 In reviewing a denial of benefits, a district court may not substitute its judgment for that of 5 the Commissioner. “The court will uphold the ALJ's conclusion when the evidence is susceptible 6 to more than one rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 7 2008). Further, a district court will not reverse an ALJ’s decision on account of an error that is 8 harmless. Id. An error is harmless where it is “inconsequential to the [ALJ’s] ultimate 9 nondisability determination.” Id. (quotation and citation omitted). The party appealing the ALJ’s 10 decision generally bears the burden of establishing that it was harmed. Shinseki v. Sanders, 556 11 U.S. 396, 409-10 (2009). 12 IV. FIVE-STEP SEQUENTIAL EVALUATION PROCESS 13 A claimant must satisfy two conditions to be considered “disabled” within the meaning of 14 the Social Security Act. First, the claimant must be “unable to engage in any substantial gainful 15 activity by reason of any medically determinable physical or mental impairment which can be 16 expected to result in death or which has lasted or can be expected to last for a continuous period 17 of not less than twelve months.” 42 U.S.C. § 423(d)(1)(A). Second, the claimant’s impairment 18 must be “of such severity that he is not only unable to do his previous work[,] but cannot, 19 considering his age, education, and work experience, engage in any other kind of substantial 20 gainful work which exists in the national economy.” 42 U.S.C. § 423(d)(2)(A). 21 The Commissioner has established a five-step sequential analysis to determine whether a 22 claimant satisfies the above criteria. See 20 C.F.R. § 404.1520(a)(4)(i)-(v). At step one, the 23 Commissioner considers the claimant’s work activity. 20 C.F.R. § 404.1520(a)(4)(i). If the 24 claimant is engaged in “substantial gainful activity,” the Commissioner must find that the 25 claimant is not disabled. 20 C.F.R. § 404.1520(b). 26 If the claimant is not engaged in substantial gainful activity, the analysis proceeds to step 27 two. At this step, the Commissioner considers the severity of the claimant’s impairment. 20 28 C.F.R. § 404.1520(a)(4)(ii). If the claimant suffers from “any impairment or combination of 1 impairments which significantly limits [his or her] physical or mental ability to do basic work 2 activities,” the analysis proceeds to step three. 20 C.F.R. § 404.1520(c). If the claimant’s 3 impairment does not satisfy this severity threshold, however, the Commissioner must find that the 4 claimant is not disabled. 20 C.F.R. § 404.1520(c). 5 At step three, the Commissioner compares the claimant’s impairment to severe 6 impairments recognized by the Commissioner to be so severe as to preclude a person from 7 engaging in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(iii). If the impairment is as 8 severe or more severe than one of the enumerated impairments, the Commissioner must find the 9 claimant disabled and award benefits. 20 C.F.R. § 404.1520(d). 10 If the severity of the claimant’s impairment does not meet or exceed the severity of the 11 enumerated impairments, the Commissioner must pause to assess the claimant’s “residual 12 functional capacity.” Residual functional capacity (RFC), defined generally as the claimant’s 13 ability to perform physical and mental work activities on a sustained basis despite his or her 14 limitations, 20 C.F.R. § 404.1545(a)(1), is relevant to both the fourth and fifth steps of the 15 analysis. 16 At step four, the Commissioner considers whether, in view of the claimant’s RFC, the 17 claimant is capable of performing work that he or she has performed in the past (past relevant 18 work). 20 C.F.R. § 404.1520(a)(4)(iv). If the claimant is capable of performing past relevant 19 work, the Commissioner must find that the claimant is not disabled. 20 C.F.R. § 404.1520(f). If 20 the claimant is incapable of performing such work, the analysis proceeds to step five. 21 At step five, the Commissioner considers whether, in view of the claimant’s RFC, the 22 claimant is capable of performing other work in the national economy. 20 C.F.R. § 23 404.1520(a)(4)(v). In making this determination, the Commissioner must also consider 24 vocational factors such as the claimant’s age, education, and past work experience. 20 C.F.R. § 25 404.1520(a)(4)(v). If the claimant is capable of adjusting to other work, the Commissioner must 26 find that the claimant is not disabled. 20 C.F.R. § 404.1520(g)(1). If the claimant is not capable 27 of adjusting to other work, analysis concludes with a finding that the claimant is disabled and is 28 therefore entitled to benefits. 20 C.F.R. § 404.1520(g)(1). 1 The claimant bears the burden of proof at steps one through four above. Tackett v. Apfel, 2 180 F.3d 1094, 1098 (9th Cir. 1999). If the analysis proceeds to step five, the burden shifts to the 3 Commissioner to establish that (1) the claimant is capable of performing other work; and (2) such 4 work “exists in significant numbers in the national economy.” 20 C.F.R. § 404.1560(c)(2); 5 Beltran v. Astrue, 700 F.3d 386, 389 (9th Cir. 2012). 6 V. ALJ’S FINDINGS 7 At step one, the ALJ found that Plaintiff did not engage in substantial gainful activity 8 during the period from her alleged onset date of May 4, 2016 through her date last insured of 9 December 31, 2021. (AR 21). At step two, the ALJ found that, through the date last insured, 10 Plaintiff had the following severe impairments: hearing loss, degenerative disc disease of the 11 lumbar spine, asthma, chronic obstructive pulmonary disorder, anxiety, depression and 12 posttraumatic stress disorder. (AR 21). At step three, the ALJ found that, through the date last 13 insured, Plaintiff did not have an impairment or combination of impairments that met or 14 medically equaled the severity of a listed impairment. (AR 22). The ALJ then found that, 15 through the date last insured, Plaintiff had the RFC to 16 perform light work as defined in 20 CFR 404.1567(b). The claimant can lift and carry 20 pounds occasionally and 10 pounds frequently, 17 stand and/or walk for 6 hours in an 8-hour workday, and sit for 6 hours in an 8-hour workday. The claimant can occasionally climb 18 ramps, stairs, ladders, ropes and scaffolds, and can occasionally balance, crawl, crouch, kneel and stoop. She should not work in 19 environments subjecting her to more than moderate levels of background noise, and any learning on the job will be required to 20 occur through demonstration. The claimant should not work in environments subjecting her to concentrated exposure to extreme 21 cold temperatures, dampness or respiratory irritants such as gases, dust, smoke and/or fumes. The claimant is capable of performing 22 jobs of a non-complex nature requiring the performance of no more than simple, routine tasks. The claimant should have no contact with 23 members of the general public. 24 (AR 23). At step four, the ALJ found that, through the date last insured, Plaintiff is unable to 25 perform any past relevant work. (AR 28). At step five, the ALJ found that, through the date last 26 insured, considering Plaintiff’s age, education, work experience, and RFC, there were jobs that 27 existed in significant numbers in the national economy that Plaintiff can perform, including: 28 marker and photocopy machine operator. (AR 29). On that basis, the ALJ concluded that 1 Plaintiff has not been under a disability, as defined in the Social Security Act, at any time from 2 May 6, 2016, the alleged onset date, through December 31, 2021, the date last insured. (AR 30). 3 VI. ISSUES 4 Plaintiff seeks judicial review of the Commissioner’s final decision denying her disability 5 insurance benefits under Title II of the Social Security Act. (Doc. No. 1). Plaintiff raises the 6 following issues for this Court’s review: 7 1. Whether the ALJ properly considered Plaintiff’s symptom claims; and 8 2. Whether the RFC was supported by substantial evidence in light of the ALJ’s 9 consideration of the medical opinion of Angela Desai, NP. 10 (Doc. No. 14 at 3-15). 11 VII. DISCUSSION 12 A. Symptom Claims 13 An ALJ engages in a two-step analysis when evaluating a claimant’s testimony regarding 14 subjective pain or symptoms. Lingenfelter v. Astrue, 504 F.3d 1028, 1035-36 (9th Cir. 2007). 15 The ALJ first must determine whether there is “objective medical evidence of an underlying 16 impairment which could reasonably be expected to produce the pain or other symptoms alleged.” 17 Id. (internal quotation marks omitted). “The claimant is not required to show that his impairment 18 could reasonably be expected to cause the severity of the symptom he has alleged; he need only 19 show that it could reasonably have caused some degree of the symptom.” Vasquez v. Astrue, 572 20 F.3d 586, 591 (9th Cir. 2009) (internal quotation marks omitted). 21 Second, “[i]f the claimant meets the first test and there is no evidence of malingering, the 22 ALJ can only reject the claimant’s testimony about the severity of the symptoms if [the ALJ] 23 gives ‘specific, clear and convincing reasons’ for the rejection.” Ghanim v. Colvin, 763 F.3d 24 1154, 1163 (9th Cir. 2014) (internal citations and quotations omitted). “General findings are 25 insufficient; rather, the ALJ must identify what testimony is not credible and what evidence 26 undermines the claimant’s complaints.” Id. (quoting Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 27 1995)); Thomas v. Barnhart, 278 F.3d 947, 958 (9th Cir. 2002) (“[T]he ALJ must make a 28 credibility determination with findings sufficiently specific to permit the court to conclude that 1 the ALJ did not arbitrarily discredit claimant’s testimony.”). “The clear and convincing 2 [evidence] standard is the most demanding required in Social Security cases.” Garrison v. 3 Colvin, 759 F.3d 995, 1015 (9th Cir. 2014) (quoting Moore v. Comm’r of Soc. Sec. Admin., 278 4 F.3d 920, 924 (9th Cir. 2002)). 5 Here, the ALJ found Plaintiff’s medically determinable impairments could reasonably be 6 expected to cause some of the alleged symptoms; however, Plaintiff’s “statements concerning the 7 intensity, persistence, and limiting effects of these symptoms are not entirely consistent with the 8 medical evidence and other evidence in the record.” (AR 24). Plaintiff argues the ALJ failed to 9 provide clear and convincing reasons for rejecting “psychological symptomology evidence.” 10 (Doc. No. 14 at 12-14). More specifically, Plaintiff argues the ALJ’s “mere ‘summary’ of the 11 medical evidence absent any dismission of this evidence in relation to specific testimony or 12 symptomology evidence, renders the ALJ’s amorphous rejection of Plaintiff’s testimony 13 unreviewable.” (Id. at 14). The Court agrees. 14 It is well-settled in the Ninth Circuit that ALJs are not required “to perform a line-by-line 15 exegesis of the claimant’s testimony, nor do they require ALJs to draft dissertations when 16 denying benefits.” See Lambert v. Saul, 980 F.3d 1266, 1277 (9th Cir. 2020); Smartt v. Kijakazi, 17 53 F. 4th 489, 499 (9th Cir. 2022) (“The standard isn’t whether our court is convinced, but instead 18 whether the ALJ’s rationale is clear enough that it has the power to convince.”)). However, “[a]n 19 ALJ does not provide specific, clear, and convincing reasons for rejecting a claimant's testimony 20 by simply reciting the medical evidence in support of his or her residual functional capacity 21 determination.” Brown-Hunter v. Colvin, 806 F.3d 487, 489 (9th Cir. 2015). Instead, “the ALJ 22 must specifically identify the testimony she or he finds not to be credible and must explain what 23 evidence undermines the testimony.” Holohan v. Massanari, 246 F.3d 1195 (9th Cir. 2001); 24 Brown-Hunter, 806 F.3d at 494 (“To ensure that our review of the ALJ’s credibility 25 determination is meaningful, and that the claimant’s testimony is not rejected arbitrarily, we 26 require the ALJ to specify which testimony she finds not credible, and then provide clear and 27 convincing reasons, supported by the evidence in the record, to support that credibility 28 determination.”). 1 Here, a plain reading of the ALJ’s decision indicates that while he identified Plaintiff’s 2 mental health claims of depression, anxiety, and difficulty being in crowds, the analysis is entirely 3 comprised of a chronological summary of the medical and opinion evidence including diagnoses 4 in May 2016 of major depressive disorder, recurrent, moderate and moderately-severe anxious 5 distress, and contemporary mental health status examination findings of good eye contact, full 6 orientation, normal gait, normal speech, blunted affect, and depressed mood; evaluation for a 7 temporary involuntary psychiatric hold in December 2016, at which time she demonstrated intact 8 memory, fair insight and judgment, coherent speech, and anxious mood and affect; positive 9 screening for positive suicidal ideation without plans or intent in June 2019; and a general 10 notation that Plaintiff attended therapy regularly throughout 2018 and 2019 and it was “noted she 11 was doing good with her medications without any side effects” with mild depression screenings 12 “throughout 2020.3 (AR 27-28, 517, 540-42, 558, 562, 613 (reporting she is “good” on current 13 meds but also reporting panic when going out sometimes and passive suicidal ideation), 619, 813- 14 14). 15 Defendant generally responds, without specific citation to the medical record, that the ALJ 16 “discussed evidence of Plaintiff’s physical and mental functioning that tended to undermine [her] 17 claims.” (Doc. No. 16 at 2). Moreover, and primarily, Defendant argues that the ALJ “pointed to 18 numerous medical opinions and findings that undermined Plaintiff’s reports about the extent of 19 her limitations.” (Id. at 2-3 (citing Carmickle v. Comm’r of Soc. Sec., 533 F.3d 1155, 1161 (9th 20 Cir. 2008)); see also Edna v. Saul, 2020 WL 1853312, at *8 (S.D. Cal. Apr. 13, 2020) (lack of 21 medical opinion finding Plaintiff disabled was a clear and convincing reason to reject Plaintiff’s 22 subjective allegations). However, the Court’s review of the record indicates that the ALJ 23 considered the persuasiveness of the medical opinion evidence only as required under 20 C.F.R. § 24 404.1520c(a) and (b). Thus, the Court is not permitted to consider this reasoning as it was not 25 offered by the ALJ in the decision as a reason to discount Plaintiff’s symptom claims. Bray v. 26 3 The ALJ also considered Plaintiff’s alleged physical impairments of hearing loss, back pain, and asthma. 27 (AR 24-26). However, as Plaintiff does not specifically challenge those findings in her opening brief the Court declines to consider them here. See Carmickle v. Comm’r of Soc. Sec. Admin., 533 F.3d 1155, 1161 28 n.2 (9th Cir. 2008). 1 Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1226 (9th Cir. 2009) (the Court “review[s] the ALJ's 2 decision based on the reasoning and factual findings offered by the ALJ—not post hoc 3 rationalizations that attempt to intuit what the adjudicator may have been thinking.”). 4 Based on the foregoing, to the extent that the ALJ found Plaintiff’s mental health 5 symptom claims were not supported by the objective medical evidence, without explanation as to 6 how the medical evidence undermined her testimony, this was not a clear and convincing reason, 7 supported by substantial evidence, to discount her mental health symptom claims. On remand, 8 the ALJ must reconsider Plaintiff’s symptom claims. 9 B. RFC/Medical Opinions 10 A claimant’s RFC is “the most [the claimant] can still do despite [his or her] limitations.” 11 20 C.F.R. § 404.1545(a); 20 C.F.R. § 416.945(a). The RFC assessment is an administrative 12 finding based on all relevant evidence in the record, not just medical evidence. Bayliss v. 13 Barnhart, 427 F.3d 1211, 1217 (9th Cir. 2005). In determining the RFC, the ALJ must consider 14 all limitations, severe and non-severe, that are credible and supported by substantial evidence in 15 the record. (Id.) (RFC determination will be affirmed if supported by substantial evidence). 16 However, an ALJ’s RFC findings need only be consistent with relevant assessed limitations and 17 not identical to them. Turner v. Comm'r of Soc. Sec., 613 F.3d 1217, 1222-23 (9th Cir. 2010). 18 Ultimately, a claimant’s RFC is a matter for the ALJ to determine. See Vertigan v. Halter, 260 19 F.3d 1044, 1049 (9th Cir. 2001) (“It is clear that it is the responsibility of the ALJ ... to determine 20 residual functional capacity.”). 21 Plaintiff argues the ALJ erred in assessing the RFC because he failed to account for 22 mental limitations assessed by her treating nurse practitioner Angela Desai. (Doc. No. 14 at 4- 23 12). For claims filed on or after March 27, 2017, new regulations apply that change the 24 framework for how an ALJ must evaluate medical opinion evidence. Revisions to Rules 25 Regarding the Evaluation of Medical Evidence, 2017 WL 168819, 82 Fed. Reg. 5844-01 (Jan. 18, 26 2017); 20 C.F.R. § 404.1520c. The new regulations provide that the ALJ will no longer “give 27 any specific evidentiary weight…to any medical opinion(s)…” Revisions to Rules, 2017 WL 28 168819, 82 Fed. Reg. 5844, at 5867-68; see 20 C.F.R. § 404.1520c(a). Instead, an ALJ must 1 consider and evaluate the persuasiveness of all medical opinions or prior administrative medical 2 findings from medical sources. 20 C.F.R. § 404.1520c(a) and (b). The factors for evaluating the 3 persuasiveness of medical opinions and prior administrative medical findings include 4 supportability, consistency, relationship with the claimant (including length of the treatment, 5 frequency of examinations, purpose of the treatment, extent of the treatment, and the existence of 6 an examination), specialization, and “other factors that tend to support or contradict a medical 7 opinion or prior administrative medical finding” (including, but not limited to, “evidence showing 8 a medical source has familiarity with the other evidence in the claim or an understanding of our 9 disability program’s policies and evidentiary requirements”). 20 C.F.R. § 404.1520c(c)(1)-(5). 10 Supportability and consistency are the most important factors, and therefore the ALJ is 11 required to explain how both factors were considered. 20 C.F.R. § 404.1520c(b)(2). 12 Supportability and consistency are explained in the regulations: 13 (1) Supportability. The more relevant the objective medical evidence and supporting explanations presented by a medical source are to support his or 14 her medical opinion(s) or prior administrative medical finding(s), the more persuasive the medical opinions or prior administrative medical finding(s) 15 will be. 16 (2) Consistency. The more consistent a medical opinion(s) or prior administrative medical finding(s) is with the evidence from other medical 17 sources and nonmedical sources in the claim, the more persuasive the medical opinion(s) or prior administrative medical finding(s) will be. 18 19 20 C.F.R. § 404.1520c(c)(1)-(2). The ALJ may, but is not required to, explain how the other 20 factors were considered. 20 C.F.R. § 404.1520c(b)(2). However, when two or more medical 21 opinions or prior administrative findings “about the same issue are both equally well-supported ... 22 and consistent with the record ... but are not exactly the same,” the ALJ is required to explain how 23 “the other most persuasive factors in paragraphs (c)(3) through (c)(5)” were considered. 20 24 C.F.R. § 404.1520c(b)(3). 25 The Ninth Circuit has additionally held that the new regulatory framework displaces the 26 longstanding case law requiring an ALJ to provide “specific and legitimate” or “clear and 27 convincing” reasons for rejecting a treating or examining doctor’s opinion. Woods v. Kijakazi, 32 28 F.4th 785 (9th Cir. 2022). Nonetheless, in rejecting an examining or treating doctor’s opinion as 1 unsupported or inconsistent, an ALJ must still provide an explanation supported by substantial 2 evidence. Id. at 792. This means that the ALJ “must ‘articulate ... how persuasive’ [he or she] 3 finds ‘all of the medical opinions’ from each doctor or other source ... and ‘explain how [he or 4 she] considered the supportability and consistency factors’ in reaching these findings.” Id. (citing 5 20 C.F.R. §§ 404.1520c(b), 404.1520(b)(2)). 6 In January 2020, Ms. Desai completed a “mental disorder questionnaire for evaluation of 7 ability to work,” and opined that Plaintiff’s posture, gait, mannerisms, or general appearance 8 impaired her ability to work; abnormalities in concentration, judgment, and social isolation would 9 impair her ability to work; her mood and affect would be “affected” to a degree that would impair 10 her ability to work; her social functioning is deficient to the point that it would impair her ability 11 to work with supervisors, co-workers, or the public; and her mental illness would impair her 12 ability to adapt to stresses common in the normal work environment. (AR 853-54). The ALJ 13 found the opinion “generally aligns with [state agency medical consultants] Dr. Leizer and Dr. 14 Sampson’s findings, in that [Plaintiff’s] impairments cause limitations socially and cognitively. 15 However, the degree of limitation is not supported by the medical evidence because her 16 medications were effective in lessening her symptoms of depression and anxiety and her 17 depression screenings were generally mild. As such, I find the State agency opinions more 18 persuasive.” (AR 28). 19 Plaintiff argues the ALJ “harmfully erred by failing to properly distinguish, discuss, or 20 specify to any extent as to how the ALJ determined how [Ms. Desai’s] own medical evidence 21 (supportability) and the record as a whole (consistency) support a finding that ‘her medications 22 were effective in lessening her symptoms of depression and anxiety and her depression screenings 23 were generally mild’ in order to properly reject [Ms. Desai’s] disabling opinions including” 24 limitations on Plaintiff’s social ability and her impaired ability to adapt to stress. (Doc. No. 14 at 25 5). Plaintiff also argues that substantial evidence does not support the ALJ’s general findings, 26 without citation to the record, that medications were effective in lessening her mental health 27 symptoms or that her depression screenings were generally mild. (Doc. No. 14 at 6-12, citing, 28 e.g., AR 548 (reporting meds are “too strong”; mental status examination (“MSE”) findings of 1 sad mood; sullen, sad and flat affect; and impaired insight and judgment), 551 (reporting 2 medication helps with sleep, but still moderate dysphoria and depression), 558-59 (reporting 3 fleeting thoughts of suicidal ideation; MSE findings of sad mood and flat and tearful affect), 608 4 (MSE findings of sad and depressed mood; helpless/hopeless, suicidal, guilt, and worthless 5 thought content; fair memory; and fair judgment and insight), 612 (Ms. Desai MSE findings of 6 helpless/hopeless thought content; depressed, anxious and irritable mood, and flat affect), 613 7 (reporting feeling “panicky” and passive suicidal ideation, requesting increase in medication from 8 Ms. Desai), 619-20 (reporting depression and panic when going out; Ms. Desai MSE findings of 9 depressed and anxious mood), 621 (Ms. Desai MSE findings of helpless/hopeless and worthless 10 thought content; depressed and anxious mood; flat and tearful affect), 623 (reporting “she would 11 be better off dead sometimes” and Ms. Desai MSE findings of helpless/hopeless and worthless 12 thought content and depressed and anxious mood), 625 (noting meds help with anxiety, and same 13 MSE findings), 762 (treated for “unresolved anxiety and phobia”), 798 (noting a “6 year history 14 of severe depression” and recommending a mental health assessment), 813 (reports feeling “fine” 15 on current meds, but “always paranoid” when alone or near strangers). 16 Defendant does not offer any evidence from the record that would support the ALJ’s 17 finding regarding improvement with medication or mild depression screenings; rather, Defendant 18 argues Plaintiff cannot demonstrate harmful error in the ALJ’s analysis of Ms. Desai’s opinion 19 because the assessed RFC accounted for the assessed social limitations by limiting Plaintiff to “no 20 contact with the general public,” and the RFC reasonably accounted for assessed limitations 21 regarding work stress because “the other part of her opinion suggest that any impairment with 22 respect to stress was not ‘significant’ because it would not prevent Plaintiff from performing 23 simple work on a full-time basis.” (Doc. No. 16 at 6). As an initial matter, Defendant’s argument 24 that any errors in considering the opinion were harmless is unavailing because (1) the general 25 argument as to “suggestions” in “other parts” of Ms. Desai’s opinion regarding Plaintiff’s ability 26 to handle work stress is speculative, and (2) while the RFC accounts for limitations on Plaintiff’s 27 contact with members of the general public, the RFC does not include any restriction on contact 28 with co-workers or supervisors as opined by Ms. Desai. See Robbins v. Soc. Sec. Admin., 466 1 F.3d 880, 886 (9th Cir. 2006) (“an ALJ is not free to disregard properly supported limitations”). 2 Moreover, when considering the medical opinion evidence, the ALJ must do more than 3 state a conclusion; rather, the ALJ must “set forth his own interpretations and explain why they, 4 rather than the doctors’, are correct.” Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998); 5 Brown-Hunter, 806 F.3d at 495 (a court “cannot substitute [the court's] conclusions for the ALJ’s, 6 or speculate as to the grounds for the ALJ's conclusions. Although the ALJ’s analysis need not be 7 extensive, the ALJ must provide some reasoning in order for [the court] to meaningfully 8 determine whether the ALJ’s conclusions were supported by substantial evidence.”). “This can 9 be done by setting out a detailed and thorough summary of the facts and conflicting clinical 10 evidence, stating his interpretation thereof, and making findings.” Reddick, 157 F.3d at 725. In 11 addition, as noted above, the Ninth Circuit recently clarified that under the new regulations for 12 considering medical evidence, “an ALJ cannot reject an examining or treating doctor’s opinion as 13 unsupported or inconsistent without providing an explanation supported by substantial evidence. 14 The agency must ‘articulate … how persuasive’ it finds ‘all of the medical opinions’ from each 15 doctor or other source, and ‘explain how [it] considered the supportability and consistency 16 factors’ in reaching these findings.” Woods, 32 F.4th at 792 (internal citations omitted). 17 The ALJ fails to explain how the specific limitations assessed by Ms. Desai “generally 18 align” with, or are less persuasive than, the limitations opined by the state agency medical 19 consultants, or how the “degree” of her assessed limitations are unsupported by the medical 20 evidence, as discussed above. Thus, the ALJ’s finding that the state agency opinions were “more 21 persuasive” than Ms. Desai’s opinion is not supported by substantial evidence. The ALJ must 22 reconsider Ms. Desai’s opinion, and reassess the RFC, on remand. 23 C. Additional Assignment of Error 24 Plaintiff also argues the ALJ failed to address the lay witness statements provided by 25 Plaintiff’s husband and niece. (Doc. No. 14 at 14-15). In light of the finding, discussed in detail 26 supra, that the RFC needs to be reassessed due to improper consideration of the medical opinion 27 evidence under the new regulations and improper evaluation of Plaintiff’s symptom claims, the 28 Court declines to address this challenge in detail here. On remand, the ALJ is instructed to 1 reconsider the medical opinion evidence and conduct a new sequential analysis, including a 2 reassessment of Plaintiff’s symptom claims, and the step five findings if necessary. 3 D. Remedy 4 Plaintiff asks the Court to remand for an immediate award of benefits. (Doc. No. 14 at 5 15). The decision whether to remand for further proceedings or reverse and award benefits is 6 within the discretion of the district court. McAllister v. Sullivan, 888 F.2d 599, 603 (9th Cir. 7 1989). An immediate award of benefits is appropriate where “no useful purpose would be served 8 by further administrative proceedings, or where the record has been thoroughly developed,” 9 Varney v. Sec'y of Health & Human Servs., 859 F.2d 1396, 1399 (9th Cir. 1988), or when the 10 delay caused by remand would be “unduly burdensome[.]” Terry v. Sullivan, 903 F.2d 1273, 11 1280 (9th Cir. 1990); see also Garrison, 759 F.3d at 1021 (noting that a district court may abuse 12 its discretion not to remand for benefits when all of these conditions are met). This policy is 13 based on the “need to expedite disability claims.” Varney, 859 F.2d at 1401. But where there are 14 outstanding issues that must be resolved before a determination can be made, and it is not clear 15 from the record that the ALJ would be required to find a claimant disabled if all the evidence 16 were properly evaluated, remand is appropriate. See Benecke v. Barnhart, 379 F.3d 587, 595-96 17 (9th Cir. 2004); Harman v. Apfel, 211 F.3d 1172, 1179-80 (9th Cir. 2000). 18 The Court finds that further administrative proceedings are appropriate. See Treichler v. 19 Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1103-04 (9th Cir. 2014) (remand for benefits is not 20 appropriate when further administrative proceedings would serve a useful purpose). Here, the 21 ALJ improperly considered Plaintiff’s symptom claims and the medical opinion evidence, which 22 calls into question whether the assessed RFC, and resulting hypothetical propounded to the 23 vocational expert, are supported by substantial evidence. “Where,” as here, “there is conflicting 24 evidence, and not all essential factual issues have been resolved, a remand for an award of 25 benefits is inappropriate.” Treichler, 775 F.3d at 1101. On remand, the ALJ should reevaluate 26 Plaintiff’s symptom claims, as well as all relevant medical evidence, including medical opinions. 27 The ALJ should order additional consultative examinations and, if appropriate, take additional 28 testimony from medical experts. The ALJ should conduct a new sequential analysis, reassess 1 | Plaintiff’s RFC and, if necessary, take additional testimony from a vocational expert which 2 | includes all of the limitations credited by the ALJ. 3 Accordingly, it is ORDERED: 4 1. Plaintiff's Motion for Summary Judgment (Doc. No. 14) is GRANTED. 5 2. Defendant’s Cross Motion for Summary Judgment (Doc. No. 16) is DENIED. 6 3. Pursuant to sentence four of 42 U.S.C.§ 405(g), the Court REVERSES the 7 Commissioner’s decision and REMANDS this case back to the Commissioner of 8 Social Security for further proceedings consistent with this Order. 9 4. An application for attorney fees may be filed by separate motion within thirty (30) 10 days. 11 5. The Clerk shall enter judgment in favor of Plaintiff, terminate any motions and 12 deadlines, and close this case. 13 Dated: _ February 21, 2025 Mihaw. Wh. foareh Zaskth 15 HELENA M. BARCH-KUCHTA 6 UNITED STATES MAGISTRATE JUDGE
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