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Cruz v. Commissioner of Social Security Administration

United States District Court, D. Arizona

April 17, 2018

Belia Hurtado Cruz, Plaintiff,
Commissioner of Social Security Administration, Defendant.



         At issue is the denial of Plaintiff Belia Hurtado Cruz's Application for Disability Insurance Benefits by the Social Security Administration (“SSA”) under the Social Security Act (“the Act”). Plaintiff filed a Complaint (Doc. 1) with this Court seeking judicial review of that denial, and the Court now addresses Plaintiff's Opening Brief (Doc. 27, “Pl.'s Br.”), Defendant Social Security Administration Commissioner's Opposition (Doc. 28, “Def.'s Br.”), and Plaintiff's Reply (Doc. 29, “Reply”). The Court has reviewed the briefs and Administrative Record (Doc. 23, R.) and now reverses the Administrative Law Judge's decision (R. at 32-41) as upheld by the Appeals Council (R. at 1-4).

         I. BACKGROUND

         Plaintiff filed her Application on December 5, 2011 (R. at 189-91), for a period of disability originally beginning April 9, 2011, but later amended by Plaintiff to September 1, 2011 (R. at 53-54, 189). Plaintiff's claim was denied initially on July 31, 2012 (R. at 113-16), and on reconsideration on February 26, 2013 (R. at 118-20). Plaintiff then testified at a hearing held before an Administrative Law Judge (“ALJ”) on December 17, 2014. (R. at 49-73.) On February 13, 2015, the ALJ denied Plaintiff's Application. (R. at 32-41.) On April 26, 2016, the Appeals Council upheld the ALJ's decision. (R. at 1-4.) The present appeal followed.

         The Court has reviewed the medical evidence in its entirety and finds it unnecessary to provide a complete summary here. The pertinent medical evidence will be discussed in addressing the issues raised by the parties. In short, upon considering the medical records and opinions, the ALJ found that Plaintiff has severe impairments of diabetes mellitus, degenerative disc disease (“DDD”), osteoarthritis, cervical spondylosis, fibromyalgia, left shoulder impingement, left lateral epicondylitis (“tennis elbow”), left trigger thumb, right ankle posterior tibialis tendinitis, and obesity (R. at 34), but that Plaintiff has the residual functional capacity (“RFC”) to perform skilled sedentary work with some limitations, including her past work as a customer service representative, such that Plaintiff is not disabled under the Act (R. at 40-41).


         In determining whether to reverse an ALJ's decision, the district court reviews only those issues raised by the party challenging the decision. See Lewis v. Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The court may set aside the Commissioner's disability determination only if the determination is not supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). Substantial evidence is more than a scintilla, but less than a preponderance; it is relevant evidence that a reasonable person might accept as adequate to support a conclusion considering the record as a whole. Id. To determine whether substantial evidence supports a decision, the court must consider the record as a whole and may not affirm simply by isolating a “specific quantum of supporting evidence.” Id. As a general rule, “[w]here the evidence is susceptible to more than one rational interpretation, one of which supports the ALJ's decision, the ALJ's conclusion must be upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted).

         To determine whether a claimant is disabled for purposes of the Act, the ALJ follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears the burden of proof on the first four steps, but the burden shifts to the Commissioner at step five. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). At the first step, the ALJ determines whether the claimant is presently engaging in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). If so, the claimant is not disabled and the inquiry ends. Id. At step two, the ALJ determines whether the claimant has a “severe” medically determinable physical or mental impairment. 20 C.F.R. § 404.1520(a)(4)(ii). If not, the claimant is not disabled and the inquiry ends. Id. At step three, the ALJ considers whether the claimant's impairment or combination of impairments meets or medically equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Part 404. 20 C.F.R. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. Id. If not, the ALJ proceeds to step four. Id. At step four, the ALJ assesses the claimant's RFC and determines whether the claimant is still capable of performing past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). If so, the claimant is not disabled and the inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, where he determines whether the claimant can perform any other work in the national economy based on the claimant's RFC, age, education, and work experience. 20 C.F.R. § 404.1520(a)(4)(v). If so, the claimant is not disabled. Id. If not, the claimant is disabled. Id.

         III. ANALYSIS

         Plaintiff raises two principal arguments for the Court's consideration: (1) the ALJ erred in weighing the opinions of the treating physicians and the state agency non-examining physicians; and (2) the ALJ erred in finding Plaintiff's testimony less than fully credible. (Pl.'s Br. at 9-25.)

         A. The ALJ Assigned Improper Weight to the Assessments of Plaintiff's Treating Physicians and the State Agency Physicians Considering the Record as a Whole

         Plaintiff first argues the ALJ committed reversible error by assigning inadequate weight to the assessment of two of Plaintiff's medical care providers, Dr. Ehteshami and Dr. Keller. (Pl.'s Br. at 9-22.) The Ninth Circuit has stated that an ALJ “may only reject a treating or examining physician's uncontradicted medical opinion based on ‘clear and convincing reasons.'” Carmickle v. Comm'r of Soc. Sec., 533 F.3d 1155, 1164 (9th Cir. 2008) (citing Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996)). “Where such an opinion is contradicted, however, it may be rejected for specific and legitimate reasons that are supported by substantial evidence in the record.” Id.

         In this instance, the opinions of Plaintiff's treating doctors were contradicted only by the opinions of the non-examining state agency physicians, who themselves simply relied on Plaintiff's treatment records. The Court agrees with Plaintiff (Reply at 6) that it would be difficult to consider the opinions of the non-examining state agency physicians, standing alone, to be substantial evidence sufficient to contradict the treating physicians' opinions. The medical opinions of Plaintiff's treating physicians are largely consistent, and thus the ALJ was required to provide clear and convincing reasons to reject them. But the Court finds that the ALJ failed to provide adequate reasons to reject the treating physicians' opinions under either standard-clear and convincing or specific and legitimate.

         The ALJ's reason, in its entirety, for rejecting the opinion evidence of Dr. Ehteshami, Plaintiff's treating orthopedic doctor, is that the opinions were “conclusory, with no attached narrative and unsupported by objective evidence.” (R. at 39.) The record does not bear this out. Dr. Ehteshami treated Plaintiff's multiple spinal conditions from September 2011, when Plaintiff underwent spinal surgery in the form of a two-level cervical discectomy and fusion, through at least mid-2013. He examined Plaintiff's physical condition regularly; treated her for cervical, thoracic and lumbar spinal pain and associated symptoms as well as knee pain and carpal tunnel syndrome; and referred Plaintiff to physical therapy, pain management, a rheumatologist for fibromyalgia, and an arthritis specialist-all of which treatment Plaintiff sought. (R. at 410-16, 521-24, 826-46.) Dr. Ehteshami's treatment notes were narrative and detailed- not “conclusory”-and supported by cited objective evidence in the form of MRI and x- ray images and physical examinations. (R. at 410-16, 521-24, 826-46.) As but one example, on April 10, 2012, Dr. Ehteshami's physical examination of Plaintiff revealed that she had significant difficulty sitting and standing, and he noted her continued problems including “the cervical spine with a significant degree of arthritis, her thoracic spine, her lumbar spine, as well as continued radicular symptoms and neuropathy in her hands and legs.” (R. at 522-23.) Viewed in the light of his ...

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