1 2 3 4
5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 HOLLY T., CASE NO. 3:23-CV-5295-DWC 11 Plaintiff, ORDER REVERSING AND 12 v. REMANDING DEFENDANT’S DECISION TO DENY BENEFITS 13 COMMISSIONER OF SOCIAL SECURITY, 14 Defendant. 15
16 Plaintiff filed this action under 42 U.S.C. § 405(g) for judicial review of Defendant’s 17 denial of her application for disability insurance benefits (“DIB”) and supplemental security 18 income benefits (“SSI”). 1 After considering the record, the Court concludes the Administrative 19 Law Judge (“ALJ”) erred when he failed to provide legally sufficient reasons for finding the 20 opinion of Neal F. Moody, Jr., PA-C, unpersuasive. Had the ALJ properly considered this 21 opinion, Plaintiff’s residual functional capacity (“RFC”) may have included additional 22
23 1 Pursuant to 28 U.S.C. § 636(c), Federal Rule of Civil Procedure 73, and Local Rule MJR 13, the parties 24 have consented to have this matter heard by the undersigned Magistrate Judge. See Dkt. 3. 1 limitations. The ALJ’s error is, therefore, not harmless, and this matter is reversed and remanded 2 pursuant to sentence four of 42 U.S.C. § 405(g) to the Commissioner of Social Security 3 (“Commissioner”) for further proceedings consistent with this Order. 4 I. Factual and Procedural History
5 On January 25, 2021, Plaintiff protectively filed applications for DIB and SSI, alleging 6 disability beginning January 22, 2021. Dkt. 5, Administrative Record (“AR”) 15, 296–309. After 7 her applications were denied at the initial level and on reconsideration, Plaintiff requested a 8 hearing before an ALJ. AR 15, 154–55, 186, 197, 224–26. Plaintiff was represented by counsel 9 at the hearing, which took place on February 22, 2022. AR 15, 81. The ALJ issued an 10 unfavorable decision on April 21, 2022. AR 12–28. The Appeals Council denied Plaintiff’s 11 request for review. AR 1. Plaintiff then appealed to this court. Dkt. 1. 12 II. Standard of Review 13 When reviewing the Commissioner’s final decision under 42 U.S.C. § 405(g), this Court 14 may set aside the denial of social security benefits if the ALJ’s findings are based on legal error
15 or are not supported by substantial evidence in the record. Bayliss v. Barnhart, 427 F.3d 1211, 16 1214 n.1 (9th Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). Substantial 17 evidence “is a highly deferential standard of review.” Valentine v. Comm’r of Soc. Sec. Admin., 18 574 F.3d 685, 690 (9th Cir. 2009). Evidence is “substantial” when it is “more than a mere 19 scintilla.” Biestek v. Berryhill, 139 S. Ct. 1148, 1153 (2019). “It means—and means only—‘such 20 relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’” Id. 21 (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). 22 “[T]he ALJ ‘is responsible for determining credibility, resolving conflicts in medical 23 testimony, and for resolving ambiguities.’” Ford v. Saul, 950 F.3d 1141, 1149 (9th Cir. 2020)
24 1 (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). Accordingly, “[e]ven if the 2 evidence is ‘susceptible to more than one rational interpretation, it is the ALJ's conclusion that 3 must be upheld.’” Farlow v. Kijakazi, 53 F.4th 485, 488 (9th Cir. 2022) (quoting Burch v. 4 Barnhart, 400 F.3d 676, 679 (9th Cir. 2005)). However, ALJs must “set forth the reasoning
5 behind [their] decisions in a way that allows for meaningful review.” Brown-Hunter v. Colvin, 6 806 F.3d 487, 492 (9th Cir. 2015). “A clear statement of the agency’s reasoning is necessary 7 because [the Court] can affirm the agency’s decision to deny benefits only on the grounds 8 invoked by the agency.” Id. 9 “[H]armless error principles apply in the Social Security Act context.” Molina v. Astrue, 10 674 F.3d 1104, 1115 (9th Cir. 2012), superseded on other grounds by 20 C.F.R. § 404.1502(a). 11 Generally, an error is harmless if it is not prejudicial to the claimant and is “inconsequential to 12 the ultimate nondisability determination.” Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 13 1055 (9th Cir. 2006); see also Molina, 674 F.3d at 1115. 14 III. Discussion
15 Plaintiff argues that the ALJ did not properly consider certain medical opinion evidence 16 and failed to support his findings with substantial evidence. See Dkt. 7. 17 A. Medical Opinion Evidence Standard 18 The regulations regarding the evaluation of medical opinion evidence have been amended 19 for claims filed on or after March 27, 2017. See Revisions to Rules Regarding the Evaluation of 20 Medical Evidence, 82 Fed. Reg. 5844, 5867–68, 5878–79 (Jan. 18, 2017). Because Plaintiff filed 21 her claim after that date, the new regulations apply. See 20 C.F.R. §§ 404.1520c, 416.920c. 22 Under the revised regulations, ALJs “will not defer or give any specific evidentiary weight, 23 including controlling weight, to any medical opinion(s) or prior administrative medical
24 1 finding(s). . . .” Id. §§ 404.1520c(a), 416.920c(a). Instead, ALJs must consider every medical 2 opinion or prior administrative medical finding in the record and evaluate the persuasiveness of 3 each one using specific factors. Id. §§ 404.1520c(a), 416.920c(a). 4 The two most important factors affecting an ALJ’s determination of persuasiveness are
5 the “supportability” and “consistency” of each opinion. Id. §§ 404.1520c(a), 416.920c(a). 6 “Supportability means the extent to which a medical source supports the medical opinion by 7 explaining the ‘relevant . . . objective medical evidence.’” Woods v. Kijakazi, 32 F.4th 785, 791– 8 92 (9th Cir. 2022) (quoting 20 C.F.R. § 404.1520c(c)(1)); see also 20 C.F.R. § 416.920c(c)(1). 9 An opinion is more “supportable,” and thus more persuasive, when the source provides more 10 relevant “objective medical evidence and supporting explanations” for their opinion.
Free access — add to your briefcase to read the full text and ask questions with AI
1 2 3 4
5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 HOLLY T., CASE NO. 3:23-CV-5295-DWC 11 Plaintiff, ORDER REVERSING AND 12 v. REMANDING DEFENDANT’S DECISION TO DENY BENEFITS 13 COMMISSIONER OF SOCIAL SECURITY, 14 Defendant. 15
16 Plaintiff filed this action under 42 U.S.C. § 405(g) for judicial review of Defendant’s 17 denial of her application for disability insurance benefits (“DIB”) and supplemental security 18 income benefits (“SSI”). 1 After considering the record, the Court concludes the Administrative 19 Law Judge (“ALJ”) erred when he failed to provide legally sufficient reasons for finding the 20 opinion of Neal F. Moody, Jr., PA-C, unpersuasive. Had the ALJ properly considered this 21 opinion, Plaintiff’s residual functional capacity (“RFC”) may have included additional 22
23 1 Pursuant to 28 U.S.C. § 636(c), Federal Rule of Civil Procedure 73, and Local Rule MJR 13, the parties 24 have consented to have this matter heard by the undersigned Magistrate Judge. See Dkt. 3. 1 limitations. The ALJ’s error is, therefore, not harmless, and this matter is reversed and remanded 2 pursuant to sentence four of 42 U.S.C. § 405(g) to the Commissioner of Social Security 3 (“Commissioner”) for further proceedings consistent with this Order. 4 I. Factual and Procedural History
5 On January 25, 2021, Plaintiff protectively filed applications for DIB and SSI, alleging 6 disability beginning January 22, 2021. Dkt. 5, Administrative Record (“AR”) 15, 296–309. After 7 her applications were denied at the initial level and on reconsideration, Plaintiff requested a 8 hearing before an ALJ. AR 15, 154–55, 186, 197, 224–26. Plaintiff was represented by counsel 9 at the hearing, which took place on February 22, 2022. AR 15, 81. The ALJ issued an 10 unfavorable decision on April 21, 2022. AR 12–28. The Appeals Council denied Plaintiff’s 11 request for review. AR 1. Plaintiff then appealed to this court. Dkt. 1. 12 II. Standard of Review 13 When reviewing the Commissioner’s final decision under 42 U.S.C. § 405(g), this Court 14 may set aside the denial of social security benefits if the ALJ’s findings are based on legal error
15 or are not supported by substantial evidence in the record. Bayliss v. Barnhart, 427 F.3d 1211, 16 1214 n.1 (9th Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). Substantial 17 evidence “is a highly deferential standard of review.” Valentine v. Comm’r of Soc. Sec. Admin., 18 574 F.3d 685, 690 (9th Cir. 2009). Evidence is “substantial” when it is “more than a mere 19 scintilla.” Biestek v. Berryhill, 139 S. Ct. 1148, 1153 (2019). “It means—and means only—‘such 20 relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’” Id. 21 (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). 22 “[T]he ALJ ‘is responsible for determining credibility, resolving conflicts in medical 23 testimony, and for resolving ambiguities.’” Ford v. Saul, 950 F.3d 1141, 1149 (9th Cir. 2020)
24 1 (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). Accordingly, “[e]ven if the 2 evidence is ‘susceptible to more than one rational interpretation, it is the ALJ's conclusion that 3 must be upheld.’” Farlow v. Kijakazi, 53 F.4th 485, 488 (9th Cir. 2022) (quoting Burch v. 4 Barnhart, 400 F.3d 676, 679 (9th Cir. 2005)). However, ALJs must “set forth the reasoning
5 behind [their] decisions in a way that allows for meaningful review.” Brown-Hunter v. Colvin, 6 806 F.3d 487, 492 (9th Cir. 2015). “A clear statement of the agency’s reasoning is necessary 7 because [the Court] can affirm the agency’s decision to deny benefits only on the grounds 8 invoked by the agency.” Id. 9 “[H]armless error principles apply in the Social Security Act context.” Molina v. Astrue, 10 674 F.3d 1104, 1115 (9th Cir. 2012), superseded on other grounds by 20 C.F.R. § 404.1502(a). 11 Generally, an error is harmless if it is not prejudicial to the claimant and is “inconsequential to 12 the ultimate nondisability determination.” Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 13 1055 (9th Cir. 2006); see also Molina, 674 F.3d at 1115. 14 III. Discussion
15 Plaintiff argues that the ALJ did not properly consider certain medical opinion evidence 16 and failed to support his findings with substantial evidence. See Dkt. 7. 17 A. Medical Opinion Evidence Standard 18 The regulations regarding the evaluation of medical opinion evidence have been amended 19 for claims filed on or after March 27, 2017. See Revisions to Rules Regarding the Evaluation of 20 Medical Evidence, 82 Fed. Reg. 5844, 5867–68, 5878–79 (Jan. 18, 2017). Because Plaintiff filed 21 her claim after that date, the new regulations apply. See 20 C.F.R. §§ 404.1520c, 416.920c. 22 Under the revised regulations, ALJs “will not defer or give any specific evidentiary weight, 23 including controlling weight, to any medical opinion(s) or prior administrative medical
24 1 finding(s). . . .” Id. §§ 404.1520c(a), 416.920c(a). Instead, ALJs must consider every medical 2 opinion or prior administrative medical finding in the record and evaluate the persuasiveness of 3 each one using specific factors. Id. §§ 404.1520c(a), 416.920c(a). 4 The two most important factors affecting an ALJ’s determination of persuasiveness are
5 the “supportability” and “consistency” of each opinion. Id. §§ 404.1520c(a), 416.920c(a). 6 “Supportability means the extent to which a medical source supports the medical opinion by 7 explaining the ‘relevant . . . objective medical evidence.’” Woods v. Kijakazi, 32 F.4th 785, 791– 8 92 (9th Cir. 2022) (quoting 20 C.F.R. § 404.1520c(c)(1)); see also 20 C.F.R. § 416.920c(c)(1). 9 An opinion is more “supportable,” and thus more persuasive, when the source provides more 10 relevant “objective medical evidence and supporting explanations” for their opinion. 20 C.F.R. 11 §§ 404.1520c(c)(1), 416.920c(c)(1). “Consistency means the extent to which a medical opinion 12 is ‘consistent . . . with the evidence from other medical sources and nonmedical sources in the 13 claim.’” Woods, 32 F.4th 785 at 792 (quoting 20 C.F.R. § 404.1520c(c)(2)); see also 20 C.F.R. § 14 416.920c(c)(2). ALJs must articulate “how [they] considered the supportability and consistency
15 factors for a medical source’s medical opinions” when making their decision. 20 C.F.R. §§ 16 404.1520c(b)(2), 416.920c(b)(2). 17 B. Neal F. Moody, Jr., PA-C 18 On July 26, 2021, rheumatology physician assistant Neal F. Moody, Jr., completed an 19 “arthritis medical source statement” regarding Plaintiff. AR 1324. He indicated that he had seen 20 Plaintiff every three months since August 24, 2015, most recently on May 3, 2021. Id. His list of 21 Plaintiff’s diagnoses included non-radiographic axial spondyloarthropathy and fibromyalgia, 22 among others. Id. Mr. Moody wrote that Plaintiff complained of symptoms including fatigue, 23 widespread muscle pain, throbbing pain of axial skeleton, stiffness, and pain of peripheral joints,
24 1 which she had rated as nine out of ten at her most recent visit. Id. He checked boxes 2 corresponding to the following “positive objective signs:” reduced range of motion in Plaintiff’s 3 lumbar and cervical spine, myofascial trigger points, fibromyalgia tender points, impaired sleep, 4 tenderness, reduced grip strength, and abnormal gait. Id.
5 Based on these impairments, Mr. Moody indicated that Plaintiff would have various 6 functional limitations if placed in a competitive work situation. AR 1325–27. These restrictions 7 included significant limitations with reaching, handling, or fingering objects. AR 1326. Mr. 8 Moody estimated that, during an eight-hour working day, Plaintiff could only grasp, turn, or 9 twist objects fifteen percent of the time, perform fine manipulations twenty percent of the time, 10 and reach in front of her body or overhead ten percent of the time. AR 1327. 11 The ALJ found this opinion unpersuasive. AR 25. He wrote that Mr. Moody’s statements 12 were “inconsistent with the record, unexplained, inadequately supported, brief, and conclusory.” 13 Id. The ALJ stated that the “check-box form” completed by Mr. Moody contained “insufficient 14 explanation for the severe limitations, such as manipulative limitations that are unexplained.” Id.
15 He also found that the limitations were inconsistent with Plaintiff’s “physical examinations 16 throughout the period at issue, which show intact upper and lower extremity strength, no focal 17 motor deficits, and normal gait,” as well as with Plaintiff’s recent work activity as a part-time 18 cashier and stocker. Id. 19 Plaintiff contends that the ALJ erred in his consideration of Mr. Moody’s opinion. Dkt. 7 20 at 2. Among other arguments, she points out that, although the ALJ found inadequate support for 21 the opined severe manipulative limitations, the ALJ appeared to adopt some limitations based on 22 Plaintiff’s spondylarthritis. Id. at 3. The ALJ’s decision contains an internal inconsistency on this 23 point. When summarizing Plaintiff’s musculoskeletal impairments, the ALJ stated that Plaintiff’s
24 1 “spondylarthritis is accommodated with limited handling and fingering[.]” AR 24. However, in 2 the RFC, the ALJ wrote that Plaintiff “can perform frequent bilateral handling and fingering.” 3 AR 21. The decision does not include any explanation of this discrepancy. 4 The Court reviews the ALJ’s decision in its entirety to determine whether the ALJ has
5 adequately explained their conclusions. See Kaufmann v. Kijakazi, 32 F.4th 843, 851 (9th Cir. 6 2022). Because the ALJ’s decision contains contradictory statements without explaining the 7 basis for the contradiction, the Court cannot assess whether the ALJ properly evaluated Mr. 8 Moody’s opinion on Plaintiff’s manipulative limitations. Accordingly, the ALJ erred. This error 9 was not harmless because, had the ALJ been persuaded by Mr. Moody’s opined severe 10 limitations, the RFC may have included additional limitations regarding Plaintiff’s capabilities in 11 a work setting. 12 IV. Conclusion 13 Based on the foregoing reasons, the Court hereby finds the ALJ improperly concluded 14 Plaintiff was not disabled. Accordingly, the Commissioner’s decision to deny benefits is reversed
15 and this matter is remanded for further administrative proceedings in accordance with the 16 findings contained herein. 17 Dated this 16th day of November, 2023. 18 A 19 David W. Christel Chief United States Magistrate Judge 20 21 22 23 24