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Audra H. v. Berryhill

United States District Court, D. Arizona

April 16, 2019

Audra H., Plaintiff,
Nancy A. Berryhill, Acting Commissioner of Social Security Administration, Defendant.


          David G. Campbell, Senior United States District Judge.

         Plaintiff Audra H. seeks review under 42 U.S.C. § 405(g) of the final decision of the Commissioner of Social Security which denied her disability insurance benefits under sections 216(i), 223(d), and 1614(a)(3)(A) of the Social Security Act. For the following reasons, the Court will reverse the decision of the Administrative Law Judge (“ALJ”), and remand for additional proceedings.

         I. Background.

         Plaintiff is a 61-year-old woman with a high-school education, and she previously worked as a front-desk clerk, phone operator, and caregiver. A.R. 44, 46-48. Plaintiff applied for disability benefits on December 6, 2013, alleging disability beginning October 23, 2013. A.R. 11. Plaintiff and a vocational expert appeared and testified at a hearing before the ALJ. A.R. 40-84. On March 15, 2017, the ALJ issued an unfavorable decision, finding Plaintiff was not disabled. A.R. 11-21. The ALJ's decision became the Commissioner's final decision when the Appeals Council denied Plaintiff's request for review on April 19, 2018. A.R. 1-4.

         II. Legal Standard.

         The Court reviews only those issues raised by the party challenging the ALJ's 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, less than a preponderance, and relevant evidence that a reasonable person might accept as adequate to support a conclusion considering the record as a whole. Id. In determining 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. (internal citations and quotation marks omitted). 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). The ALJ is responsible for resolving conflicts in medical testimony, determining credibility, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). In reviewing the ALJ's reasoning, the Court is “not deprived of [its] faculties for drawing specific and legitimate inferences from the ALJ's opinion.” Magallanes v. Bowen, 881 F.2d 747, 755 (9th Cir. 1989).

         III. The ALJ's Five-Step Evaluation Process.

         To determine whether a claimant is disabled for purposes of the Social Security 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, and 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 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. § 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. Pt. 404. § 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. Id. If not, the ALJ proceeds to step four. At step four, the ALJ assesses the claimant's residual functional capacity (“RFC”) and determines whether the claimant is still capable of performing past relevant work. § 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 to determine whether the claimant can perform any other work based on the claimant's RFC, age, education, and work experience. § 404.1520(a)(4)(v). If so, the claimant is not disabled. If not, the claimant is disabled. Id.

         At step one, the ALJ found that Plaintiff met the insured status requirements of the Social Security Act through September 30, 2016, and that she had not engaged in substantial gainful activity since October 23, 2013. A.R. 13. At step two, the ALJ found that Plaintiff had the following severe impairments: vision loss in the right eye; peripheral neuropathy; osteoarthritis of the right foot and bilateral wrists; bilateral carpal tunnel syndrome, status post release on the left; bilateral cubital tunnel syndrome; left ring finger trigger finger, status post release; and lumbar degenerative disc disease. A.R. 13. At step three, the ALJ determined that Plaintiff did not have an impairment or combination of impairments that meets or medically equals a listed impairment. A.R 16.[1] At step four, the ALJ found that Plaintiff had the RFC to perform light work, and was capable of performing past relevant work as a personal attendant, front desk clerk, and casino reservation clerk. A.R. 16, 21.

         IV. Analysis.

         Plaintiff argues the ALJ's decision is defective for two reasons: (1) the ALJ erred in rejecting the opinion of Plaintiff's treating physician; and (2) the ALJ rejected Plaintiff's symptom testimony without specific, clear, and convincing reasons, supported by substantial evidence. Doc. 12 at 1-2.

         A. Medical Opinion Evidence.

         1. Legal Standard.

         A physician's opinion may be a treating source, examining source, or non-examining source. See 20 C.F.R. § 404.1527 (evaluating opinion evidence for claims filed before March 2017); Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). A treating physician is one who provides or has provided the claimant with medical treatment or evaluation, or who has an ongoing treatment relationship with the claimant. Id. at § 404.1527(a)(2). Generally, an ALJ should give greatest weight to a treating physician's opinion and more weight to the opinion of an examining physician than a non-examining physician. See Andrews, 53 F.3d at 1040-41; see also 20 C.F.R. § 404.1527(c)(2)-(6). “The ALJ must do more than offer his conclusions. He must set forth his own interpretations and explain why they, rather than the doctors', are correct.” Embrey v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988). The Commissioner is responsible for determining whether a claimant meets the statutory definition of disability and does not give significance to a statement by a medical source that the claimant is “disabled” or “unable to work.” 20 C.F.R. § 416.927(d).

         2. Dr. Janikowski.

         The ALJ gave limited weight to the assessment by treating physician, Dr. Mary Janikowski. A.R. 20. Because Dr. Janikowksi is a treating source whose opinion was contradicted by consultative examining physician Dr. Tromp, the ALJ could discount her opinion only for specific and legitimate reasons supported by substantial evidence in the record. Lester, 81 F.3d at 830-31.

         On July 19, 2016, Dr. Janikowski opined that Plaintiff could continuously sit for thirty minutes to an hour, and sit for three hours per day; stand and walk for thirty minutes to an hour at a time, and for two hours or less per day; frequently lift and carry five pounds, occasionally lift and carry ten pounds, and rarely lift and carry more than ten pounds; occasionally reach, and rarely stoop, squat, crawl, or climb; frequently handle, grip, or grasp; rarely push or pull controls; frequently do fingering or fine manipulation; use either foot for repetitive movements, but not both; has a moderate restriction for occupational driving, but no restrictions for unprotected heights, moving machinery, exposure to dust, fumes, gases, or marked changes in temperature and humidity; and has moderately severe limitations from pain and fatigue. Dr. Janikowski based her opinion on Plaintiff's medical records, clinical observations, lab and other diagnostics, and her knowledge of Plaintiff's presenting diseases and disorders. A.R. 1324-1326.[2]

         Discrediting Dr. Janikowski's opinion, the ALJ stated:

While I accepted the assessment that the claimant's impairments resulted in more than minimal limitations with her ability to perform work related activities[, ] the limitations assessed by Dr. Janikowski appeared to rely heavily on the claimant's subjective allegations and were inconsistent with available physical examination results and review of systems, which, as discussed in this decision, routinely showed ...

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