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Corthion v. Colvin

United States District Court, D. Arizona

January 6, 2017

Brenda Corthion, Plaintiff,
Carolyn W. Colvin, Defendant.


          Honorable G. Murray Snow United States District Judge

         Pending before the Court is Plaintiff Brenda Corthion's appeal of the Social Security Administration's decision to deny her benefits. (Doc. 1.) For the reasons set forth below, the Court affirms the decision.


         On September 28, 2011, Brenda Corthion filed applications for disability insurance benefits and supplemental security income, alleging various physical and mental health problems with a disability onset date of September 9, 2011. (Tr. 214-28.) On July 10, 2013, Corthion testified at a hearing before Administrative Law Judge (“ALJ”) Ted W. Armbruster. (Tr. 90-130.) On October 29, 2013, the ALJ issued a decision finding Corthion not disabled. (Tr. 69-89.)

         In evaluating whether Corthion was disabled, the ALJ undertook the five-step sequential evaluation for determining disability.[1] (Id.) At step one, the ALJ determined that Corthion had not engaged in substantial gainful activity since her alleged onset date. (Tr. 74.) At step two, the ALJ determined that Corthion suffered from severe impairments of “psychotic disorder, NOS; anxiety disorder, mood disorder, NOS; major depressive disorder; and right ankle degenerative joint disease, status-post reconstructive surgery.” (Tr. 75.) At step three, the ALJ determined that none of these impairments, either alone or in combination, met or equaled any of the Social Security Administration's listed impairments. (Tr. 77.)

         At that point, the ALJ made a determination of Corthion's residual functional capacity (“RFC”), [2] concluding that Corthion could “perform light work as defined in 20 CFR § 404.1567(b) and § 419.967(b), but with the following limitations: occasional pushing and pulling with the lower extremities; frequent climbing of ramps or stairs; never climbing ladders, ropes, or scaffolds; frequent balancing and stooping; occasional kneeling, crouching, or crawling” as well as avoiding environments with loud noise intensity and hazardous environments, not taking jobs requiring driving, and “limited to simple unskilled work with only occasional changes in the workplace and occasional interaction with the public.” (Tr. 79.) The ALJ thus determined at step four that Corthion retained the RFC to perform her past relevant work as a companion. (Tr. 82.) The ALJ reached step five, concluding that Corthion could perform a significant number of other jobs in the national economy despite her limitations. (Id.)

         On March 11, 2015, the Appeals Council declined to review the decision. (Tr. 1- 7.) Corthion filed the complaint underlying this action on May 8, 2015, seeking this Court's review of the ALJ's denial of benefits. (Doc. 1.) The matter is now fully briefed before this Court. (Docs. 17, 19, 20.)


         I. Standard of Review

         A reviewing federal court need 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. Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). 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).

         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 of 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).

         II. Analysis

         On appeal, Corthion challenges the ALJ's determination only as to her mental impairments and not as to her physical impairments. (Doc. 1 at 1 n.1.) Corthion argues that the ALJ erred by: (A) improperly giving little weight to the opinion of treating psychiatrist Dr. England; (B) improperly giving significant weight to the opinions of state agency psychological consultative examiner Dr. Geary and state agency non-examining physicians Dr. Starace and Dr. Santulli; (C) failing to discuss Corthion's SMI determination; (D) improperly considering only part of the opinion of state agency non-examining physician Dr. Cox; and (E) improperly rejecting Corthion's symptom testimony.

         A. Treating Source Opinion

         When evaluating opinion evidence, ALJs “evaluate every medical opinion” received but generally “give more weight to opinions from . . . treating sources” because treating medical professionals can “provide a detailed, longitudinal picture of [the claimant's] medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from [non-treating sources].” 20 C.F.R. § 416.927(c)(2). “If . . . a treating source's opinion on the issue(s) of the nature and severity of [the claimant's] impairment(s) is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record, ” an ALJ “will give it controlling weight.” Id. However, if the treating physician's opinion is contradicted, the ALJ must either determine how much weight to afford it through the imposition of certain factors provided in 20 C.F.R. § 404.1527(c)(2)-(6), or, the ALJ may reject the opinion if he provides “specific and legitimate reasons that are supported by substantial evidence” for doing so. Ryan v. Comm'r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008); see Ghanim v. Colvin, 763 F.3d 1154, 1161 (9th Cir. 2014).

         Here, citing SSR 96-2p, [3] the ALJ found that the opinion of the treating physician was “unsupported by substantial evidence” and accordingly gave it “little weight.” (Tr. 81-82.) The ALJ gave four reasons for so finding: (1) Corthion “has been treated on an outpatient basis since her September 2011 admission, ” (2) Corthion's “medical records disclose no debilitating side effects from medication, ” (3) Corthion's “mental status findings were generally intact, ” and (4) Corthion's “self-admitted activities, including [several part-time jobs, ] suggest that her capacities are greater than Dr. England contends.” (Id.)

         1. Generally Intact Mental Status

         The ALJ found Corthion's “generally intact” mental status as a reason to give less weight to Dr. England's opinion. Corthion contends that the ALJ failed to support this finding with any citations to the record. But this contention is based on a misreading of the ALJ's opinion. Initially, in his step two analysis, the ALJ cited numerous specific portions of the record referring to Corthion's mental status. (See Tr. 75-77.) Then, in assessing Corthion's own credibility, the ALJ wrote that Corthion's “[m]ental status examinations since her September 2011 admission, as summarized above, have generally revealed intact mental status, with good concentration and an intact memory.” (Tr. 80.) Finally, in giving little weight to Dr. England's opinion, the ALJ wrote that “mental status findings were generally intact.” (Tr. 82.) To be sure, the ALJ did not again set out all of the mental status findings he initially cited, but it is clear that the later finding refers back to the initial summary.

         That summary cites substantial evidence in the record supporting the ALJ's finding that Corthion's mental status was generally intact. Corthion was hospitalized with paranoia, homicidal ideation, and suicidal ideation in September of 2011. (Tr. 453.) Near the end of her hospitalization, she was less disturbed by paranoia, and had no homicidal or suicidal ideation. (Tr. 439.) Upon discharge, she appeared “mildly depressed” and had “impaired” judgment and insight but was fully oriented and had “satisfactory” attention span and memory. (Tr. 467.) On follow up soon after her discharge, she was fully oriented and demonstrated appropriate mood and affect, even though she had been non-compliant with her medication. (Tr. 588-90.) Three months later, in December, 2011, although Corthion was still depressed and had a “dysphoric” and “agitated” mood, she had an appropriate affect, intact memory, fair concentration, normal speech, logical and non-psychotic thought processes, and good insight and judgment. (Tr. 615-16.) Again, in February, 2012, Corthion was depressed, but also pleasant and cooperative with a logical and coherent thought process, being able to concentrate and remain on task. (Tr. 625.) That same month, she did report hearing voices and appeared irritable, but her thoughts were “logical” and “non-psychotic, ” her concentration and intellect “good, ” and her insight and judgment “fair.” (Tr. 756-57.) In July, 2012, Corthion was examined by a state agency physician, who found her attention span and concentration satisfactory, her associations logical, and her insight “mildly limited but essentially intact.” (Tr. 704.) Treatment records throughout 2013 indicate, similarly, that though Corthion was chronically depressed (Tr. 865), she was “doing well, ” (Tr. 833), fully oriented with appropriate mood and affect, (Tr. 871), with good concentration and intact memory, albeit with limited insight and judgment. (Tr. 840.)

         Corthion argues that the Garrison v. Colvin, 759 F.3d 995 (9th Cir. 2014), precludes the ALJ's finding, because “it is error for an ALJ to pick out a few isolated instances of improvement over a period of months or years and to treat them as a basis for concluding a claimant is capable of working.” Id. at 1017. Corthion makes a number of citations to the record, purporting to demonstrate that the ALJ's record citations were merely isolated instances of improvement, inconsistent with the generally severe nature of Corthion's symptoms. (Doc. 17 at 16.) But the majority of the reports Corthion cites are not inconsistent with those the ALJ cited-in many cases they are actually the same reports-and they do not demonstrate any kind of “cherry-picking” by the ALJ.

         For example, Corthion cites a December, 2011 report as indicating that Corthion's condition was “largely unchanged” from her earlier episodes of psychosis and paranoia. (Doc. 17 at 16.) But that report indicated that though Corthion was depressed and still suffered from auditory hallucinations, her thoughts were logical and non-psychotic, her concentration, intellect, judgment and insight good, and her attitude cooperative and friendly. (Tr. 760-61.) The reports Corthion cites from 2012-including a report that the ALJ also cited-show generally the same findings, although on two occasions Corthion's judgment and insight are listed as “fair” instead of “good.” (See Tr. 740-43, 753-54, 756-58.) A December, 2012 report reported that Corthion's mood was angry and dysphoric and her affect blunted and constricted. (Tr. 846-48.) This is consistent with the December, 2011 report the ALJ cited. (Tr. 615-16.) So too with the reports Corthion cites from 2013-which, again, include reports cited to by the ALJ-with the main variations being several findings of judgment and insight as being “limited.” (See Tr. 839-40, 843-45, 856-65.)

         Corthion does cite two reports that seem more at odds with the substantial evidence the ALJ cited indicating that Corthion's mental status was generally intact. These reports came soon after her hospitalization in 2011, one from October and one from November, describing her as “acutely psychotic, ” (Tr. 537-40), and “extremely paranoid with auditory hallucinations.” (Tr. 508.) But two reports from the period immediately following Corthion's hospitalization do not invalidate the generally consistent reports over two years that the ALJ cited. And importantly, both reports indicate that the more severe symptoms they describe may have been related to Corthion's non-compliance with her medication. (Tr. 508, 537.) They thus do not directly contradict the ALJ's finding that Corthion's mental status was “generally intact.” At the very least, there is still substantial evidence in the record supporting the ALJ's finding.

         2. Conservative Treatment and ...

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