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Benavidez v. Colvin

United States District Court, D. Arizona

September 29, 2016

Arthur Benavidez, Plaintiff,
Carolyn W. Colvin, Defendant.


          Honorable G. Murray Snow United States District Judge

         Pending before the Court is Claimant Arthur Benavidez's appeal of the Social Security Administration's decision to deny benefits. (Doc. 1.) For the reasons set forth below, the Court remands for further proceedings.


         For a week in October 2010 and then for about a month thereafter during most of November 2010 and part of December 2010, Mr. Benavidez was hospitalized for unexplained fainting episodes. Those episodes were eventually diagnosed as being caused by orthostatic hypotension - a drop in blood pressure when standing-that was secondary to autonomic dysfunction caused by Mr. Benavidez's diabetes mellitus. See, e.g., (R. at 584) (10/27/10 discharge summary noting a discharge diagnosis of “orthostatic hypotension with autonomic insufficiency, likely diabetic.”), (R. at 535) (12/16/10 Discharge summary diagnosing “profound refractory orthostatic hypotension presumably secondary to diabetic autonomic neuropathy”) (R. at 530) (consult noting “he has refractory orthostatic hypotension felt due to autonomic dysfunction with his diabetes”), (R. at 511) “So far, the working diagnosis has been autonomic dysfunction secondary to his diabetes mellitus.” (R. at 529) “been felt by the Neurology Service to have autonomic dysfunction related to diabetes with his profound refractory OH.” R. at 530 (Mr. Benavidez “has refractory [OH] felt due to autonomic dysfunction with his diabetes.”).

         As a result, as Mr. Benavidez acknowledges, his treatment plan was to receive continued high dose medications-apparently those medications being for diabetes and sinus tachycardia. Doc. 15 at 6, R. at 530, 536.

         In May 2011, Mr. Benavidez applied for disability insurance benefits and supplemental security income, alleging a disability onset date of November 1, 2010. (R. 25.) He claimed that his disabling conditions were his orthostatic hypotension, his diabetes, his agoraphobia and his bipolar disorder. During the course of his claim evaluation, he had appointments in September 2011 with both Dr. Steingard and Dr. Fruchtman. He acknowledged in his appointment with Dr. Steingard that he had not been taking his medications for depression for seven months prior to their visit.

         Thereafter, in October 2011, Mr. Benavidez began seeing treating physician Dr. Ravi Galholtra. He acknowledged to Dr. Galholtra that he had not been taking his diabetes medications for the past year.

         Mr. Benavidez's claim was reviewed by physicians at the administration and denied both initially and upon reconsideration leading Claimant to appeal to an Administrative Law Judge (“ALJ”).

         The ALJ conducted a hearing on the matter on December 13, 2013. (R. 43-68.). By the time of the administrative hearing, Mr. Benavidez's orthostatic hypotension had improved so that he apparently no longer had need of assistance to ambulate.[1] But as it pertained to his qualification for disability, his counsel noted that, even though then improved, his orthostatic hypotension “had certainly lasted over a year” from the time it began. He further claimed that Mr. Benavidez's lack of insurance had resulted in his recent inability to afford medications so that, despite its amelioration, his orthostatic hypotension had worsened some recently. (R. at 46).

         More significantly, at hearing Mr. Benavidez based his disability claim on newly developed emotional impairments which included “auditory, visual and olfactory hallucinations, as well as significant depression, and probably most significantly anxiety and agoraphobia with panic disorder.” Mr. Benavidez's attorney noted at hearing that “while we recognize that at least initially the emotional impairments weren't as significant, the orthostatic hypotension was certainly disabling and, and the improvement, I don't believe has restored the ability to work in that regard. But it-even if it has, Judge, the emotional impairments are independently disabling at this point, so a combination of impairments leading to a step 5argument, Your Honor.” (R. at 47). Consistently with his attorney's summary, at hearing, Mr. Benavidez consistently testified that he initially left work due to the orthostatic hypotension, but presently the biggest problem in his inability to work was his inability to be out in public (agoraphobia). Id. at 48. The claimant also testified that he didn't get out of bed much mainly due to his depression, but also due to his orthostatic hypotension which still caused him to get dizzy and often faint when he lifted his arms above his shoulders. R. at 53. He did testify, however, that while he had not been on his medication for depression when he met with Dr. Steingard, he had, in the interim, qualified for mental health care benefits and was on his medication for depression which was of some help. R. at 50-51.

         In evaluating whether the Claimant was disabled, the ALJ undertook the five-step sequential evaluation for determining disability.[2] (R. 25-36.) At step one the ALJ determined that the Claimant had not engaged in substantial gainful activity since the alleged onset date. (R. 27.) At step two, the ALJ determined that the Claimant suffered from the following severe impairments: orthostatic hypotension (“OH”), sinus tachycardia (“ST”), and bipolar disorder with agoraphobia. (R. 27.) At step three, the ALJ determined that none of those impairments, either alone or in combination, met or equaled any of the Social Security Administration's listed impairments. (R. 28.)

         At that point, the ALJ made a determination of the Claimant's residual functional capacity (“RFC”), [3] concluding that the Claimant could perform sedentary work as defined in 20 CFR § 404.1567(a). (R. 29.) The ALJ concluded that the Claimant was unable to perform any past relevant work, (R. 34), thus, the ALJ reached step five and determined that Claimant could perform jobs that exist in significant numbers in the national economy that met his RFC limitations. (R. 35.) Given this analysis, the ALJ concluded that Claimant was not disabled. (R. 36.)

         The Appeals Council declined to review the decision. (R. 1-6.) The Council accepted the ALJ's statements of the law, the issues in the case, and the evidentiary facts, as well as the ALJ's findings and ultimate conclusions regarding whether Claimant was disabled. (R. 1-5.) Claimant filed the complaint on September 3, 2015.[4] (Doc. 1.) The matter is now fully briefed. (Docs. 14, 15, 19.)


         I. Legal Standard

         A reviewing federal court will only address the issues raised by the claimant in the appeal from the ALJ's decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). A federal court may set aside a denial of disability benefits only if that denial is either unsupported by substantial evidence or based on legal error. Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006). Substantial evidence is “more than a scintilla but less than a preponderance.” Id. (quotation omitted). “Substantial evidence is relevant evidence which, considering the record as a whole, a reasonable person might accept as adequate to support a conclusion.” Id. (quotation omitted).

         However, the ALJ is responsible for resolving conflicts in testimony, determining credibility, and resolving ambiguities. See Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). “When the evidence before the ALJ is subject to more than one rational interpretation, we must defer to the ALJ's conclusion.” Batson v. Comm'r Soc. Sec. Admin., 359 F.3d 1190, 1198 (9th Cir. 2004). This is so because “[t]he [ALJ] and not the reviewing court must resolve conflicts in 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) (citations omitted). At the same time, the Court “must consider the entire record as a whole and may not affirm simply by isolating a ‘specific quantum of supporting evidence.'” Id. (citing Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989)). The Court also may not “affirm the ALJ's . . . decision based on evidence that the ALJ did not discuss.” Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003); see also SEC v. Chenery Corp., 332 U.S. 194, 196 (1947) (emphasizing the fundamental rule of administrative law that a reviewing court “must judge the propriety of [administrative] action solely by the grounds invoked by the agency” and stating that if “those grounds are inadequate or improper, the court is powerless to affirm the administrative action”). Even if the ALJ erred, however, “[a] decision of the ALJ will not be reversed for errors that are harmless.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005).

         II. Analysis

         On appeal Mr. Benavidez bases his claim for benefits on his physical impairments only. He no longer asserts, as he did at hearing that his principal disabling ailments were either his depression or his agoraphobia. See, e.g., (Doc. 15 at 4) (“this appeal will focus on the effects of Benavidez's physical impairments on his ability to perform sustained work activity.”). Mr. Benavidez's claim thus centers on his orthostatic hypotension (OH).[5]

         Mr. Benavidez asserts that the ALJ erred in two ways in denying his benefits: first, by improperly rejecting the medical assessment of Mr. Benavidez's treating physician, Ravi Galholtra, M.D.; second, by improperly rejecting Mr. Benavidez's subjective symptom testimony. (Doc. 15 at 1.)

         A. Treating Physician Dr. Galholtra's Medical Opinion

         Dr. Galholtra became Mr. Benavidez's PCP five months after Mr. Benavidez filed his instant application for benefits. Three months after Dr. Golholtra began treating him, on January 23, 2012, Dr. Galholtra filled out three check box questionnaires related to Mr. Benavidez's disability. In the first check-box questionnaire-- a Peripheral Neuropathy Residual Functional Capacity Questionnaire, (R. at 375-76)-- Dr. Galholtra noted that Mr. Benavidez has peripheral neuropathy which caused him limitations including postural hypotension. He also noted that Mr. Benavidez has a separate ...

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