United States District Court, D. Arizona
James A. Teilborg Senior United States District Judge
Pending before the Court is Plaintiff Teresa Lyn Remmers’ appeal from the Social Security Commissioner’s denial of her application for disability insurance benefits and supplemental security income under the Social Security Act. Plaintiff argues that the administrative law judge (“ALJ”) erred by determining that Plaintiff was not credible, by inadequately explaining her residual functional capacity (“RFC”) assessment, and by failing to support her finding that Plaintiff could perform a significant number of jobs existing in the national economy. The Court now rules on Plaintiff’s appeal.
A. Procedural Background
On May 21, 2010, Plaintiff filed an application for disability insurance benefits and supplemental security income, alleging that she suffered from panic and anxiety attacks and had been unable to work since April 1, 2010. (Tr. 33). Plaintiff’s claims were initially denied on October 22, 2010, and upon reconsideration on March 7, 2011. (Id.) Thereafter, Plaintiff timely requested a hearing, which was conducted by ALJ Joan G. Knight on June 20, 2012 in Phoenix, Arizona. (Id.) On December 13, 2012, the ALJ issued an unfavorable decision. (Id.) After Plaintiff’s request for review by the Social Security Administration Appeals Council was denied on March 4, 2014, she commenced this action in federal court on May 13, 2014. (Doc. 1).
B. Plaintiff’s Background
Plaintiff was born on November 1, 1960 and lives with her husband and their two dogs. (Tr. 52, 62, 229-30). Plaintiff completed nineteen years of education (Doc. 3 at 4), earned bachelor’s degrees in Biochemistry and Medical Technology with a minor in Physics (Tr. 53), took course work towards a master’s degree (Tr. 57),  and self-reports fluency in both English and German (Tr. 343). Plaintiff also spent a considerable amount of time in vocational training throughout her professional career. (Tr. 53, 57). Plaintiff worked the majority of her adult life and by all appearances was a self-reliant, competent employee who “built [her] own cliental” and once earned over $52, 000 in a year. (Tr. 59, 215). Currently, Plaintiff’s primary source of income comes from monthly unemployment benefits. (Tr. 216-17). She does drink alcohol and smokes cigarettes. (Tr. 291, 307, 343).
On June 20, 2012, Plaintiff appeared before the ALJ regarding her alleged disability of anxiety, depression, and panic attacks. (Tr. 50-75). Plaintiff testified that she takes two prescription medications, Xanax and Paxil, to alleviate the symptoms of her anxiety. (Tr. 64). She further stated that she has taken Paxil for three years. (Id.) Plaintiff attested, however, that Xanax sometimes makes her feel “goofy” and Paxil occasionally gives her a “tingling” sensation. (Tr. 64, 69). Due to these side effects, Plaintiff noted that her doctor is shifting her from Paxil to Lintemint. (Id.)
Plaintiff also testified that she has difficulty sleeping and is “scared to sleep.” (Tr. 62). Nonetheless, Plaintiff explained that after a panic attack she gets “four solid hours of good hard sleep[, ] . . . wake[s] up[, ] . . . eat[s, ] then go[es] back to sleep maybe for another hour or so.” (Id.) Previously, Plaintiff told evaluating physician Marcel Van Eerd, Ph.D., that she sleeps at least five straight hours per night, wakes up, sleeps more in the early morning, and then naps throughout the day. (Tr. 343). As for her daily routine, Plaintiff “wake[s] up in the morning” before her husband, cooks simple meals, washes the dishes, feeds and walks her two dogs, showers, dresses herself, watches television, and completes crosswords. (Tr. 62-63, 342). Plaintiff can also manage her own medications and hygiene, use the computer, pay bills, make telephone calls, do laundry, and read. (Tr. 342). As for her public endeavors, Plaintiff visits her husband’s parents three times per week (Tr. 83, 332), goes on mall outings (Tr. 406), uses public transportation to run errands (Tr. 67), rides bicycles (Tr. 376), shops (Tr. 342), and attends church regularly (Tr. 322).
C. Medical Background
Plaintiff claims that anxiety and panic attacks have plagued her since she was a child but only became disabling on April 1, 2010. (Tr. 63). As her method of managing these issues in the past, Plaintiff explains that she “isolated” herself. (Id.) This isolation is apparently why Plaintiff married “later in life, ” never had children, does not have friends, keeps her family distant, and worked as a salesperson. (Id.) Plaintiff, however, never sought clinical assistance until months after her alleged disability onset date. See (Tr. 364).
Two and a half months after Plaintiff filed her application for benefits with the Social Security Administration, she contacted Jewish Family and Children Services (“JFCS”) for intake and evaluation. (Id.) Based on a preliminary psychiatric evaluation on August 10, 2010, the clinician observed that Plaintiff “[d]ressed appropriately”; was “casually groomed”; had an “anxious” mood; maintained “good” eye contact; had “good” memory, insight, and judgment; made “logical” associations; and presented with “no mannerisms of note.” (Tr. 314). After this initial evaluation, Plaintiff “no show[ed]” to subsequent appointments. (Tr. 316, 370). JFCS attempted to contact Plaintiff numerous times, but Plaintiff never responded. (Tr. 366-69). On December 9, 2010, without ever attending a clinical treatment session, Plaintiff was discharged for “lack of contact.” (Tr. 364).
Nearly a year after Plaintiff’s discharge from JFCS and eighteen months after Plaintiff filed her application with the Social Security Administration, Plaintiff presented to Marley House Behavioral Health (“Marley House”). (Tr. 404). Plaintiff attended six of her first eight weekly appointments. (Tr. 404-06). At these appointments, Plaintiff “appeared anxious” and used “rapid speech” but was “engaged.” (Id.) The clinician also noted that Plaintiff learned coping mechanisms and breathing techniques. (Id.) After this initial period, however, Plaintiff cancelled or failed to show up to eight of the next ten appointments. (Tr. 406-11). On March 19, 2012, Marley House advised Plaintiff that if she did not provide twenty-four hour notice before her next cancellation her file would be closed. (Tr. 410). One week later, Marley House closed Plaintiff’s file after she failed to show up to her appointment and did not provide the necessary notice. (Tr. 411).
No Appointment, M.D. (“No Appointment”) appears to be Plaintiff’s primary care facility. Since the onset of her alleged disability, Plaintiff received treatment from No Appointment several times for a variety of issues. For example, on July 26, 2011, Plaintiff was treated for a knee injury she suffered when she fell off her bicycle (Tr. 376- 77), and on November 5, 2011, Plaintiff was treated for a right arm injury resulting from a fall at a dog park (Tr. 384-85). Plaintiff’s anxiety is reported in four No Appointment records. On April 21, 2011, a No Appointment clinician noted that Plaintiff “would like Xanax” for her panic attacks. (Tr. 372). At this same appointment, Plaintiff “smell[ed] of ETOH” and reported that she “drinks 4 vodkas a day.” (Id.) On June 25, 2011 and January 3, 2012, the clinical impression of Plaintiff noted panic and anxiety. (Tr. 375, 386). Finally, at a February 1, 2012 appointment, the clinician noted that Plaintiff “misplaced [her] Xanax” and was going through “4 days of anxiety.” (Tr. 390). The clinician also wrote that Plaintiff and her husband were experiencing a foreclosure and decreasing income. (Id.) Ultimately, the clinician prescribed Effexor, although Plaintiff never filled the prescription. (Tr. 391-92).
II. Legal Standard
The ALJ’s decision to deny benefits will be overturned “only if it is not supported by substantial evidence or is based on legal error.” Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989) (quotation omitted). “Substantial evidence” means more than a mere scintilla, but less than a preponderance. Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1998).
“The inquiry here is whether the record, read as a whole, yields such evidence as would allow a reasonable mind to accept the conclusions reached by the ALJ.” Gallant v. Heckler, 753 F.2d 1450, 1453 (9th Cir. 1984) (citation omitted). In determining whether there is substantial evidence to support a decision, the Court considers the record as a whole, weighing both the evidence that supports the ALJ’s conclusions and the evidence that detracts from the ALJ’s conclusions. Reddick, 157 F.3d at 720. “Where evidence is susceptible of more than one rational interpretation, it is the ALJ’s conclusion which must be upheld; and in reaching his findings, the ALJ is entitled to draw inferences logically flowing from the evidence.” Gallant, 753 F.2d at 1453 (citations omitted); see Batson v. Comm’r of the Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). This is because “[t]he trier of fact and not the reviewing court must resolve conflicts in the evidence, and if the evidence can support either outcome, the court may not substitute its judgment for that of the ALJ.” Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992); see Young v. Sullivan, 911 F.2d 180, 184 (9th Cir. 1990).
The ALJ is responsible for resolving conflicts in medical testimony, determining credibility, and resolving ambiguities. See Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). Thus, if on the whole record before the Court, substantial evidence supports the Commissioner’s decision, the Court must affirm it. See Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989); see also 42 U.S.C. § 405(g). On the other hand, the Court “may not affirm simply by isolating a specific quantum of supporting evidence.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (quotation omitted).
Notably, the Court is not charged with reviewing the evidence and making its own judgment as to whether Plaintiff is or is not disabled. Rather, the Court’s inquiry is constrained to the reasons asserted by the ALJ and the evidence relied upon in support of those reasons. See Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003).
A. Definition of Disability
To qualify for disability benefits under the Social Security Act, a claimant must show that, among other things, she is “under a disability.” 42 U.S.C. § 423(a)(1)(E). The Social Security Act defines “disability” as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). A person is:
under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.
42 U.S.C. § 423(d)(2)(A).
B. Five-Step Evaluation Process
The Social Security regulations set forth a five-step sequential process for evaluating disability claims. 20 C.F.R. § 404.1520(a)(4); see also Reddick, 157 F.3d at 721. A finding of “not disabled” at any step in the sequential process will end the inquiry. 20 C.F.R. § 404.1520(a)(4). The claimant bears the burden of proof at the first four steps, but the burden shifts to the Commissioner at the final step. Reddick, 157 F.3d at 721. The five steps are as follows:
1. First, the ALJ determines whether the claimant is “doing substantial gainful activity.” 20 C.F.R. § ...