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5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 ELIZABETH T., CASE NO. 2:25-CV-577-DWC 11 Plaintiff, v. ORDER RE: SOCIAL SECURITY 12 DISABILITY APPEAL COMMISSIONER OF SOCIAL 13 SECURITY, 14 Defendant.
15 Plaintiff filed this action, pursuant to 42 U.S.C. § 405(g), for judicial review of the denial 16 of her applications for Supplemental Security Income (SSI) benefits and Disability Insurance 17 Benefits (DIB). Pursuant to 28 U.S.C. § 636(c), Fed. R. Civ. P. 73, and Local Rule MJR 13, the 18 parties have consented to proceed before the undersigned. After considering the record, the Court 19 concludes that this matter must be reversed and remanded pursuant to sentence four of 42 U.S.C. 20 § 405(g) for further proceedings consistent with this Order. 21 I. BACKGROUND 22 Plaintiff applied for DIB on June 20, 2022, and for SSI on September 1, 2022. 23 Administrative Record (AR) 17. Her alleged date of disability onset is February 1, 2022. Id. Her 24 1 requested hearing was held before an Administrative Law Judge (ALJ) on November 7, 2024. 2 AR 38–74. On December 6, 2024, the ALJ issued a written decision finding Plaintiff not 3 disabled. AR 14–37. The Appeals Council declined Plaintiff’s timely request for review, making 4 the ALJ’s decision the final agency action subject to judicial review. AR 1–6. On April 4, 2024,
5 Plaintiff filed a Complaint in this Court seeking judicial review of the ALJ’s decision. Dkt. 5. 6 II. STANDARD 7 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 8 benefits if, and only if, the ALJ’s findings are based on legal error or not supported by 9 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 10 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). 11 III. DISCUSSION 12 In her opening brief, Plaintiff argues the ALJ erroneously assessed the medical opinions 13 of Pamela Kahn, LICSW; Rebecca McClinton, LMHC; and Douglas Uhl, PsyD; as well as her 14 subjective symptom testimony regarding her mental symptoms. Dkt. 11.1
15 For applications, like Plaintiff’s, filed after March 27, 2017, ALJs need not “defer or give 16 any specific evidentiary weight, including controlling weight, to” particular medical opinions, 17 including those of treating or examining sources. See 20 C.F.R. §§ 404.1520c(a), 416.920c(a). 18 Rather, ALJs must consider every medical opinion in the record and evaluate each opinion’s 19 persuasiveness, considering each opinion’s “supportability” and “consistency,” and, under some 20 circumstances, other factors. Woods v. Kijakazi, 32 F.4th 785, 791 (9th Cir. 2022); 20 C.F.R. §§ 21
22 1 Plaintiff also contends the ALJ’s RFC assessment was erroneous because it did not include limitations supported by the evidence she contends was improperly evaluated, but the Court addresses this argument by considering 23 whether the evidence was improperly discredited and, if so, whether that improper assessment rendered the RFC incomplete. See Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1175–76 (9th Cir. 2008) (RFC inadequacy based only 24 on other arguments not independent basis for remand). 1 404.1520c(b)–(c), 416.920c(b)–(c). Supportability concerns how a medical source supports a 2 medical opinion with relevant evidence, while consistency concerns how a medical opinion is 3 consistent with other evidence from medical and nonmedical sources. 20 C.F.R. §§ 4 404.1520c(c)(1), (c)(2); 416.920c(c)(1), (c)(2).
5 Ms. Kahn, Plaintiff’s treating provider, completed an opinion in October 2024. AR 2075– 6 82. She opined Plaintiff was unable to meet competitive standards in several mental abilities 7 needed to do unskilled work, including completing a normal workday or workweek without 8 interruptions, performing at a consistent pace, accepting instructions and responding 9 appropriately to criticism, getting along with co-workers, dealing with normal work stress, and 10 setting realistic goals. AR 2075–77. 11 The ALJ found Ms. Kahn’s opinion unpersuasive. AR 28–29. The ALJ found the opinion 12 unsupported because she “cited to symptoms” of Plaintiff’s impairments but “did not cite to any 13 objective findings.” AR 29. However, Ms. Kahn provided a two-and-a-half-page explanation of 14 her opinion, and her explanation included reference to her observations of Plaintiff. AR 2080–82.
15 Defendant argues the ALJ’s finding was nonetheless a proper supportability finding because Ms. 16 Kahn did not tie her description of Plaintiff’s symptoms into her opined work-related limitations. 17 Dkt. 13 at 14. 18 The Court disagrees. Ms. Kahn stated she “witnessed [Plaintiff’s] lack of focus,” 19 observed she requires “standby company” to feel motivated, and wrote Plaintiff “suffers [from] 20 lack of follow through” and goes through periods of “isolating for 3-7 day periods.” AR 2080. 21 She also explained: 22 I have witnessed the cycle of manic behavior (witnessed by pressured speech, elevated mood, flight of ideas, poor attention and easily distracted)[,] [and] [m]anic 23 behaviors followed by depressive episodes (Witnessed by isolating, loss of hope 24 1 and loss of interest in usually joyful activities), at least bimonthly cycles, during our work together this past year. 2 Id. After describing symptoms of Plaintiff’s Bipolar Disorder, she explained that “as an 3 employee [Plaintiff’s] behaviors[] would reasonabl[y] be predictive of poor outcomes” and she 4 “could reasonably be expected to generate negative work relationships.” AR 2081. Similarly, she 5 wrote Plaintiff’s “depressive symptoms are likely to impede consistent attendance.” Id. 6 Ms. Kahn’s explanation, therefore, did describe how the mentioned symptoms would 7 affect Plaintiff’s work abilities. Further, her reference to her own observations of Plaintiff’s 8 psychological functioning did provide objective medical evidence supporting her opinion. See 20 9 C.F.R. §§ 404.1513(a)(1) (“objective medical evidence is medical signs, laboratory findings, or 10 both”), 404.1502(g) (“signs” include “psychological abnormalities that can be observed”); see 11 also Buck v. Berryhill, 869 F.3d 1040, 1049 (9th Cir. 2017) (“Dr. Kenderdine also conducted a 12 clinical interview and a mental status evaluation. These are objective measures and cannot be 13 discounted as a ‘self-report.’”). The ALJ therefore erred in finding Ms. Kahn’s opinion 14 unsupported.
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5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 ELIZABETH T., CASE NO. 2:25-CV-577-DWC 11 Plaintiff, v. ORDER RE: SOCIAL SECURITY 12 DISABILITY APPEAL COMMISSIONER OF SOCIAL 13 SECURITY, 14 Defendant.
15 Plaintiff filed this action, pursuant to 42 U.S.C. § 405(g), for judicial review of the denial 16 of her applications for Supplemental Security Income (SSI) benefits and Disability Insurance 17 Benefits (DIB). Pursuant to 28 U.S.C. § 636(c), Fed. R. Civ. P. 73, and Local Rule MJR 13, the 18 parties have consented to proceed before the undersigned. After considering the record, the Court 19 concludes that this matter must be reversed and remanded pursuant to sentence four of 42 U.S.C. 20 § 405(g) for further proceedings consistent with this Order. 21 I. BACKGROUND 22 Plaintiff applied for DIB on June 20, 2022, and for SSI on September 1, 2022. 23 Administrative Record (AR) 17. Her alleged date of disability onset is February 1, 2022. Id. Her 24 1 requested hearing was held before an Administrative Law Judge (ALJ) on November 7, 2024. 2 AR 38–74. On December 6, 2024, the ALJ issued a written decision finding Plaintiff not 3 disabled. AR 14–37. The Appeals Council declined Plaintiff’s timely request for review, making 4 the ALJ’s decision the final agency action subject to judicial review. AR 1–6. On April 4, 2024,
5 Plaintiff filed a Complaint in this Court seeking judicial review of the ALJ’s decision. Dkt. 5. 6 II. STANDARD 7 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 8 benefits if, and only if, the ALJ’s findings are based on legal error or not supported by 9 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 10 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). 11 III. DISCUSSION 12 In her opening brief, Plaintiff argues the ALJ erroneously assessed the medical opinions 13 of Pamela Kahn, LICSW; Rebecca McClinton, LMHC; and Douglas Uhl, PsyD; as well as her 14 subjective symptom testimony regarding her mental symptoms. Dkt. 11.1
15 For applications, like Plaintiff’s, filed after March 27, 2017, ALJs need not “defer or give 16 any specific evidentiary weight, including controlling weight, to” particular medical opinions, 17 including those of treating or examining sources. See 20 C.F.R. §§ 404.1520c(a), 416.920c(a). 18 Rather, ALJs must consider every medical opinion in the record and evaluate each opinion’s 19 persuasiveness, considering each opinion’s “supportability” and “consistency,” and, under some 20 circumstances, other factors. Woods v. Kijakazi, 32 F.4th 785, 791 (9th Cir. 2022); 20 C.F.R. §§ 21
22 1 Plaintiff also contends the ALJ’s RFC assessment was erroneous because it did not include limitations supported by the evidence she contends was improperly evaluated, but the Court addresses this argument by considering 23 whether the evidence was improperly discredited and, if so, whether that improper assessment rendered the RFC incomplete. See Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1175–76 (9th Cir. 2008) (RFC inadequacy based only 24 on other arguments not independent basis for remand). 1 404.1520c(b)–(c), 416.920c(b)–(c). Supportability concerns how a medical source supports a 2 medical opinion with relevant evidence, while consistency concerns how a medical opinion is 3 consistent with other evidence from medical and nonmedical sources. 20 C.F.R. §§ 4 404.1520c(c)(1), (c)(2); 416.920c(c)(1), (c)(2).
5 Ms. Kahn, Plaintiff’s treating provider, completed an opinion in October 2024. AR 2075– 6 82. She opined Plaintiff was unable to meet competitive standards in several mental abilities 7 needed to do unskilled work, including completing a normal workday or workweek without 8 interruptions, performing at a consistent pace, accepting instructions and responding 9 appropriately to criticism, getting along with co-workers, dealing with normal work stress, and 10 setting realistic goals. AR 2075–77. 11 The ALJ found Ms. Kahn’s opinion unpersuasive. AR 28–29. The ALJ found the opinion 12 unsupported because she “cited to symptoms” of Plaintiff’s impairments but “did not cite to any 13 objective findings.” AR 29. However, Ms. Kahn provided a two-and-a-half-page explanation of 14 her opinion, and her explanation included reference to her observations of Plaintiff. AR 2080–82.
15 Defendant argues the ALJ’s finding was nonetheless a proper supportability finding because Ms. 16 Kahn did not tie her description of Plaintiff’s symptoms into her opined work-related limitations. 17 Dkt. 13 at 14. 18 The Court disagrees. Ms. Kahn stated she “witnessed [Plaintiff’s] lack of focus,” 19 observed she requires “standby company” to feel motivated, and wrote Plaintiff “suffers [from] 20 lack of follow through” and goes through periods of “isolating for 3-7 day periods.” AR 2080. 21 She also explained: 22 I have witnessed the cycle of manic behavior (witnessed by pressured speech, elevated mood, flight of ideas, poor attention and easily distracted)[,] [and] [m]anic 23 behaviors followed by depressive episodes (Witnessed by isolating, loss of hope 24 1 and loss of interest in usually joyful activities), at least bimonthly cycles, during our work together this past year. 2 Id. After describing symptoms of Plaintiff’s Bipolar Disorder, she explained that “as an 3 employee [Plaintiff’s] behaviors[] would reasonabl[y] be predictive of poor outcomes” and she 4 “could reasonably be expected to generate negative work relationships.” AR 2081. Similarly, she 5 wrote Plaintiff’s “depressive symptoms are likely to impede consistent attendance.” Id. 6 Ms. Kahn’s explanation, therefore, did describe how the mentioned symptoms would 7 affect Plaintiff’s work abilities. Further, her reference to her own observations of Plaintiff’s 8 psychological functioning did provide objective medical evidence supporting her opinion. See 20 9 C.F.R. §§ 404.1513(a)(1) (“objective medical evidence is medical signs, laboratory findings, or 10 both”), 404.1502(g) (“signs” include “psychological abnormalities that can be observed”); see 11 also Buck v. Berryhill, 869 F.3d 1040, 1049 (9th Cir. 2017) (“Dr. Kenderdine also conducted a 12 clinical interview and a mental status evaluation. These are objective measures and cannot be 13 discounted as a ‘self-report.’”). The ALJ therefore erred in finding Ms. Kahn’s opinion 14 unsupported. 15 With respect to consistency, the ALJ wrote the “opinion overstates the claimant’s 16 limitations” and that the evidence of record was “more consistent” with the limitations in the 17 RFC. AR 29. Defendant clarifies this was a reference to examination results, some referenced 18 elsewhere in the ALJ’s decision, revealing Plaintiff had normal memory and concentration, as 19 well as treatment notes describing Plaintiff as “stable” in group therapy sessions and stating she 20 found such sessions “very helpful.” Dkt. 13 at 14–15. 21 But such evidence does not undermine most of Ms. Kahn’s opinion. Ms. Kahn indicated 22 much of her assessment of Plaintiff’s symptoms was based on cyclical symptoms, so such one- 23 time observations where Plaintiff was doing well are not necessarily substantial evidence to 24 1 reject the opinion. Garrison v. Colvin, 759 F.3d 995, 1017 (9th Cir. 2014) (“Cycles of 2 improvement and debilitating symptoms are a common occurrence, and in such circumstances, it 3 is error for an ALJ to pick out a few isolated instances of improvement over a period of months 4 or years and to treat them as a basis for concluding a claimant is capable of working.”).
5 Further, the evidence cited by the ALJ is not probative as to many of the limitations 6 opined by Ms. Kahn. Ms. Kahn assessed, for instance, an absenteeism limitation based on 7 Plaintiff’s depressive symptoms. See AR 2081. This is not undermined by the evidence cited by 8 Defendant. Similarly, the Court cannot discern how the evidence cited by the ALJ suggests 9 Plaintiff can set goals, respond to criticism, or deal with stress. 10 Evidence showing Plaintiff found group therapy sessions “helpful,” at best, shows she 11 experienced some improvement in her condition; it does not show improvement in any of the 12 specific areas Ms. Kahn identified or that her conditions no longer had a significant impact on 13 her work-related abilities. See Holohan v. Massanari, 246 F.3d 1195, 1205 (9th Cir. 2001) 14 (“some improvement” in a person’s symptoms “does not mean that the person’s impairments no
15 longer seriously affect her ability to function in a workplace”). Nor do notations that Plaintiff 16 was “stable” necessarily mean Plaintiff’s symptoms improved such that they were no longer 17 disabling. See Martinez v. Comm’r of Soc. Sec., No. 1:20-CV-00439, 2021 WL 2915018, at *6 18 (E.D. Cal. July 12, 2021) (“‘[F]airly stable’ and ‘doing well’ are relative terms.”) (citation 19 omitted). 20 In sum, the ALJ failed to provide proper reasons supported by substantial evidence for 21 rejecting Ms. Kahn’s opinion. Defendant does not contend such an error was harmless, so the 22 Court reverses. See Ferguson v. O’Malley, 95 F.4th 1194, 1204 (9th Cir. 2024) (“The 23
24 1 Commissioner does not contend that the ALJ’s error was harmless. Consequently, we reverse the 2 judgment …”). 3 Having found reversible error, the Court need not consider Plaintiff’s other contentions. 4 Plaintiff contends the case should be remanded for an award of benefits (Dkt. 11 at 17), but the
5 Court finds the record is not free from ambiguities, conflicts, and gaps, and therefore remands for 6 further proceedings. See Leon v. Berryhill, 880 F.3d 1041, 1045 (9th Cir. 2017). On remand, the 7 ALJ should reassess the medical evidence and, if appropriate, reassess his RFC finding and his 8 finding at step five of the sequential evaluation process. 9 IV. CONCLUSION 10 For the foregoing reasons, the Court REVERSES and REMANDS the decision pursuant 11 to sentence four of 42 U.S.C. § 405(g) for further administrative proceedings consistent with this 12 Order. 13 Dated this 30th day of September, 2025. 14 A 15 David W. Christel United States Magistrate Judge 16 17 18 19 20 21 22 23 24