STACIE F. BECKERMAN, Magistrate Judge.
Kimberly B. ("Plaintiff") brings this appeal challenging the Commissioner of the Social Security Administration's ("Commissioner") denial of her application for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act. The only issue in dispute on appeal is whether the Court should remand this case for further proceedings or an award of benefits. The Court has jurisdiction to hear this appeal pursuant to 42 U.S.C. § 405(g). For the reasons explained below, the Court reverses the Commissioner's decision and remands for an award of benefits.
The district court may set aside a denial of benefits only if the Commissioner's findings are "`not supported by substantial evidence or [are] based on legal error.'" Bray v. Comm'r Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009) (quoting Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006)). Substantial evidence is defined as "`more than a mere scintilla [of evidence] but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Id. (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)).
The district court "cannot affirm the Commissioner's decision `simply by isolating a specific quantum of supporting evidence.'" Holohan v. Massanari, 246 F.3d 1195, 1201 (9th Cir. 2001) (quoting Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999)). Instead, the district court must consider the entire record, weighing the evidence that both supports and detracts from the Commissioner's conclusions. Id. Where the record as a whole can support either a grant or a denial of Social Security benefits, the district court "`may not substitute [its] judgment for the [Commissioner's].'" Bray, 554 F.3d at 1222 (quoting Massachi v. Astrue, 486 F.3d 1149, 1152 (9th Cir. 2007)).
Plaintiff was born in January 1969, making her forty-one years old on May 25, 2010, the alleged disability onset date. (Tr. 73, 88.) Plaintiff has an associate's degree and past relevant work experience as a certified veterinary technician. (Tr. 22, 188, 264.) In her DIB application, Plaintiff alleges disability due to post-traumatic stress disorder ("PTSD"), depression, suicidal ideation, fibromyalgia, obsessive compulsive disorder ("OCD"), and a learning disability.
The Commissioner denied Plaintiff's DIB application initially and upon reconsideration, and on May 10, 2017, Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). (Tr. 13.) Plaintiff and a vocational expert ("VE") appeared and testified at a hearing held on September 18, 2017. (Tr. 30-66.) On December 6, 2017, the ALJ issued a written decision denying Plaintiff's DIB application. (Tr. 13-23.) Plaintiff now seeks judicial review of that decision.
A claimant is considered disabled if he or she is unable to "engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment 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). "Social Security Regulations set out a five-step sequential process for determining whether an applicant is disabled within the meaning of the Social Security Act." Keyser v. Comm'r Soc. Sec. Admin., 648 F.3d 721, 724 (9th Cir. 2011). Those five steps are: (1) whether the claimant is currently engaged in any substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the impairment meets or equals a listed impairment; (4) whether the claimant can return to any past relevant work; and (5) whether the claimant is capable of performing other work that exists in significant numbers in the national economy. Id. at 724-25. The claimant bears the burden of proof for the first four steps. Bustamante v. Massanari, 262 F.3d 949, 953-54 (9th Cir. 2001). If the claimant fails to meet the burden at any of those steps, the claimant is not disabled. Id.; Bowen v. Yuckert, 482 U.S. 137, 140-41 (1987).
The Commissioner bears the burden of proof at step five of the sequential analysis, where the Commissioner must show the claimant can perform other work that exists in significant numbers in the national economy, "taking into consideration the claimant's residual functional capacity, age, education, and work experience." Tackett, 180 F.3d at 1100. If the Commissioner fails to meet this burden, the claimant is disabled. Bustamante, 262 F.3d at 954 (citations omitted).
The ALJ applied the five-step sequential evaluation process to determine if Plaintiff is disabled. (Tr. 13-23.) At step one, the ALJ determined that Plaintiff had not engaged in substantial gainful activity since May 25, 2010, the alleged disability onset date. (Tr. 15.) At step two, the ALJ determined that Plaintiff suffered from four severe impairments: (1) affective disorder, (2) anxiety disorder, (3) personality disorder, and (4) "shoulder/rotator cuff status postsurgery." (Tr. 15.) At step three, the ALJ concluded that Plaintiff did not have an impairment that meets or equals a listed impairment. (Tr. 16.) The ALJ then concluded that Plaintiff had the residual functional capacity ("RFC") to perform light work, subject to the following limitations: (1) Plaintiff needs to be limited to occasional "reach[ing] overhead with [her] right dominant upper extremity," (2) Plaintiff needs to be limited to "simple, routine tasks," (3) Plaintiff needs to be limited to "occasional contact with coworkers," and (4) Plaintiff cannot have "contact with the public." (Tr. 17.) At step four, the ALJ concluded that Plaintiff was unable to perform her past relevant work. (Tr. 22.) At step five, the ALJ concluded that Plaintiff was not disabled because a significant number of jobs existed in the national economy that she could perform, including work as a production assembler, a bottle packer, and an "electrical access" assembler. (Tr. 23.)
As discussed above, the only issue in dispute on appeal is whether the Court should remand this case for further administrative proceedings or an award of benefits. As explained below, Plaintiff satisfies the credit-as-true standard, and the Court does not have any serious doubt about whether Plaintiff is disabled. Accordingly, the Court remands this case for an award of benefits.
"Generally when a court of appeals reverses an administrative determination, `the proper course, except in rare circumstances, is to remand to the agency for additional investigation or explanation.'" Benecke v. Barnhart, 379 F.3d 587, 595 (9th Cir. 2004) (citation omitted). In a number of cases, however, the Ninth Circuit has "stated or implied that it would be an abuse of discretion for a district court not to remand for an award of benefits when [the three-part creditas-true standard is] met." Garrison v. Colvin, 759 F.3d 995, 1021 (9th Cir. 2014). The credit-astrue standard is met if the following conditions are satisfied: (1) "the ALJ has failed to provide legally sufficient reasons for rejecting evidence, whether claimant testimony or medical opinion," (2) "if the improperly discredited evidence were credited as true, the ALJ would be required to find the claimant disabled on remand," and (3) "the record has been fully developed and further administrative proceedings would serve no useful purpose." Id. at 1020 (citations omitted).
In this appeal, Plaintiff argues that the ALJ erred by failing to provide: (1) clear and convincing reasons for discounting Plaintiff's testimony, (2) germane reasons for discounting the opinion of Plaintiff's treating mental health therapist, Debbie Hrycyk ("Hrycyk"), and (3) legally sufficient reasons for discounting the opinion of Plaintiff's examining psychologist, Claudia Lake, Psy.D. ("Dr. Lake"). (Pl.'s Opening Br. at 6, 17-18.) The Commissioner "concedes" that the ALJ "harmfully erred" and does not dispute any of Plaintiff's assignments of error. (See Def.'s Br. Requesting Remand at 1-7.) Thus, Plaintiff satisfies part one of the credit-as-true standard. See Lara M. v. Saul, No. 6:18-cv-00880-SB, 2019 WL 6045585, at *3 (D. Or. Nov. 15, 2019) (holding that the plaintiff met part one of the credit-as-true standard because there was "no dispute that the ALJ failed to provide legally sufficient reasons for rejecting significant, probative evidence").
The Court must next address whether the ALJ would be required to find Plaintiff disabled on remand, if the improperly discredited evidence were credited as true. See Garrison, 759 F.3d at 1020. As explained below, if the improperly discredited evidence (Plaintiff's testimony and Dr. Lake's and Hrycyk's opinions) were credited as true, the ALJ would be required to find Plaintiff disabled.
Hrycyk's opinion alone would compel a finding of disability. In her questionnaire and medical source statement, Hrycyk stated that Plaintiff suffers from major depressive disorder, severe PTSD and anxiety, chronic suicidal ideation, "clinically significant distress [and] impairment in occupational functioning," and difficulty functioning in "all areas of her life," including "getting restful sleep, [activities of daily living], socializing, shopping, education, [and] working." (Tr. 874-79.) Hrycyk added that Plaintiff's impairments are related to past trauma and result in symptoms such as crying spells, hypervigilance, irritability or outbursts of anger, self-destructive behavior, isolating and avoiding others, and stress intolerance.
(Tr. 875-76; cf. Tr. 61-64, reflecting that the VE testified that if a hypothetical worker missed "more than two days of work" on a regular, ongoing basis, it "would rule out all work at all skill levels").
Hrycyk also opined that Plaintiff suffers from marked limitations (i.e., a substantial loss in the ability to effectively function) in her ability to, among other things, interact appropriately with supervisors. (Tr. 878.) In support of this finding, Hrycyk noted that Plaintiff's "current retriggering for [t]rauma (PTSD) has been significant" and that Plaintiff is "hypervigilant and becomes easily irritated [and] demonstrates self-destructive behavior or angry verbal outbursts." (Tr. 878-79; cf. Tr. 61-64, showing that the VE testified that a hypothetical worker could not sustain gainful employment if she responded inappropriately to a supervisor on four or more occasions).
Based on the foregoing, it is clear that if Hrycyk's opinion were credited as true, the ALJ would be required to find Plaintiff disabled on remand. See Burget v. Comm'r of Soc. Sec., No. 17-cv-01836, 2018 WL 4204057, at *9 (W.D. Wash. Sept. 4, 2018) ("[I]f the improperly discredited evidence is credited as true, the ALJ would be required to find the claimant disabled because his mental limitations prevent him from sustaining and persisting in full-time employment.").
Dr. Lake's opinion and Plaintiff's testimony, if credited as true, also establish that Plaintiff is disabled. Dr. Lake, an examining psychologist, conducted a clinical interview, administered tests, and reviewed some of Plaintiff's mental health records. (Tr. 882-86.) Dr. Lake opined that Plaintiff (1) cannot "complete a normal workday/workweek without interruptions from a psychiatric condition," given her "chronic emotional instability," and (2) cannot "deal with the usual stress encountered in the workplace . . ., which will only increase her instability." (Tr. 886.) Along similar lines, Plaintiff testified that (1) she suffers from panic attacks "[m]ultiple times a day," (2) she was not able to complete the schooling necessary to become a medical assistant, (3) she called in sick four times during a six- to eight-week externship at a medical clinic, and (4) she "was calling out between probably two to four days a month" prior to her termination in 2010. (Tr. 40, 49-54, 65.) This evidence, if credited as true, establishes that Plaintiff is disabled. (See Tr. 60-64, reflecting that the VE testified that "20% off-PAGE task behavior would rule out all work at all skill levels," and that if a hypothetical worker missed "more than two days of work" on a regular, ongoing basis, it "would rule out all work at all skill levels").
For these reasons, the Court concludes that Plaintiff satisfies part two of the credit-as-true standard.
The third and final part of the credit-as-true standard asks whether the record has been fully developed and whether further administrative proceedings would serve a useful purpose. Garrison, 759 F.3d at 1020. The Court finds that the third part of the credit-as-true standard is satisfied here.
The Commissioner argues that further proceedings would serve a useful purpose because "[t]he ALJ should have the opportunity to resolve the conflict between his finding[] . . . that Ms. Hrycyk did not treat Plaintiff during the relevant period . . . and the treatment record showing that she did." (Def.'s Br. Requesting Remand at 4.) In support of this argument, the Commissioner notes that (1) "Congress authorized the Commissioner, not court, to make findings of fact in Social Security claims," and (2) "[g]iven the ALJ's misunderstanding of the record, the agency should have the opportunity to properly weigh Ms. Hrycyk's opinion and the treatment record, and to evaluate the effect of those records on the rest of the analysis, including other medical opinions and Plaintiff's credibility." (Id.) (citation omitted).
The Court finds that the Commissioner's argument fails for two reasons. First, there is no factual conflict to resolve with respect to whether Hrycyk treated Plaintiff during the alleged period of disability. In discounting Hrycyk's opinion, the ALJ made a finding that Hrycyk did not treat Plaintiff during the alleged period of disability. (Tr. 21.) However, the Commissioner concedes that substantial evidence does not support the ALJ's finding. (See Def.'s Br. Requesting Remand at 2, noting that the ALJ discounted Hrycyk's opinion because she "was not treating the claimant during the time period at issue," and acknowledging that "[t]he record contradicts that finding"). Accordingly, because it is undisputed that Hrycyk treated Plaintiff during the alleged period of disability, the ALJ need not resolve any conflict, and the Court need not make a factual finding, about this issue.
Second, the Commissioner argues that in light of the ALJ's "misunderstanding" about whether Hrycyk treated Plaintiff during the alleged period of disability, the ALJ should be given the opportunity to "evaluate the effect" that Hrycyk's treatment records have "on the rest of the [ALJ's] analysis, including other medical opinions and Plaintiff's credibility." (Def.'s Br. Request Remand at 4.) In other words, the Commissioner argues that the Court should remand this case for further proceedings so the ALJ can "reevaluate the medical source opinions and Plaintiff's subjective allegations[.]" (Def.'s Br. Requesting Remand at 3) (emphasis added). Ninth Circuit precedent and the objectives of the credit-as-true standard, however, foreclose such an argument:
Garrison, 759 F.3d at 1021; see also Benecke, 379 F.3d at 595 ("Allowing the Commissioner to decide the issue again would create an unfair `heads we win; tails, let's play again' system of disability benefits adjudication."); Moisa v. Barnhart, 367 F.3d 882, 887 (9th Cir. 2004) ("The Commissioner, having lost this appeal, should not have another opportunity to show that [the claimant] is not credible any more than [the claimant], had he lost, should have an opportunity for remand and further proceedings to establish his credibility."); Lara M., 2019 WL 6045585, at *6 ("The Commissioner's request to allow the ALJ to . . . reevaluate the medical evidence, reevaluate Plaintiff's symptoms, reevaluate Plaintiff's RFC, and issue a new opinion, is exactly the `heads we win; tails, let's play again' scenario that the Ninth Circuit instructs courts to avoid.").
In sum, the Commissioner has not identified a useful purpose that further proceedings would serve, and therefore the Court finds that Plaintiff has satisfied the third part of the creditas-true standard.
Finally, the Commissioner argues that the Court should remand for further proceedings because the record creates serious doubt about whether Plaintiff is disabled. See generally Burrell v. Colvin, 775 F.3d 1133, 1141 (9th Cir. 2014) (explaining that even if the credit-as-true standard is met, the court "may remand on an open record for further proceedings `when the record as a whole creates serious doubt as to whether the claimant is, in fact, disabled'") (citation omitted). In support of his argument, the Commissioner notes that (1) Plaintiff's depression and anxiety were "largely controlled with medication" during the relevant time period, (2) there were "significant gaps in treatment," in particular between January 2013 and August 2014, and (3) Plaintiff's "work history calls her claim of disability into question." (Def.'s Br. Requesting Remand at 4-5.)
The Court does not have serious doubt about whether Plaintiff is disabled. Contrary to the Commissioner's argument, the record fails to reflect that Plaintiff's mental health symptoms were largely controlled with medication. Instead, the record reflects that Plaintiff's symptoms waxed and waned and that Plaintiff's condition worsened over time. See generally Garrison, 759 F.3d at 1017 ("Cycles of improvement and debilitating symptoms are a common occurrence, and in such circumstances 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."). To be sure, the following record evidence demonstrates that Plaintiff's condition worsened, and that Plaintiff's symptoms were not adequately controlled with medication:
In conclusion, contrary the Commissioner's argument, the evidence above demonstrates that medication did not control Plaintiff's symptoms.
The Commissioner also relies on gaps in treatment, in particular a gap between January 2013 and August 2014, in arguing that the record creates serious doubt about whether Plaintiff is disabled.
Finally, the Commissioner argues that Plaintiff's pre-onset work history creates serious doubt about whether Plaintiff is disabled. The Court disagrees. As discussed above, the record demonstrates that Plaintiff's condition has worsened. Accordingly, the Court concludes that Plaintiff's pre-onset work history does not create serious doubt about whether she is disabled. See Thom v. Berryhill, No. 6:16-cv-01840-SB, 2017 WL 6329559, at *8-9 (D. Or. Nov. 9, 2017) (explaining that courts have found "reliance on the claimant's pre-onset work history misplaced when the claimant's condition has worsened," and holding that the ALJ erred in discounting a medical provider's opinion because the record suggested that the claimant's "condition had worsened").
In sum, the Court does not have any serious doubt about whether Plaintiff suffered from debilitating mental health symptoms during the relevant time period, and therefore the Court remands this case for an award of benefits.
For the reasons stated, the Court REVERSES the Commissioner's decision and REMANDS for an award of benefits.
