JAMES P. DONOHUE, Magistrate Judge.
Plaintiff Richard Lyle Averette appeals the final decision of the Commissioner of the Social Security Administration ("Commissioner") that denied his applications for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI") under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401-33 and 1381-83f, after a hearing before an administrative law judge ("ALJ"). For the reasons set forth below, the Court AFFIRMS the Commissioner's decision.
Plaintiff is a 51-year-old man with a 9th-grade education. Administrative Record ("AR") at 45. His past work experience includes employment as a cashier, donation attendant, and laborer. AR at 154. Plaintiff was last gainfully employed in October 2008. AR at 153.
Plaintiff filed for DIB and SSI in March 2012 and October 2012, respectively, alleging an onset date of October 1, 2008. AR at 130-37. Plaintiff asserts that he is disabled due to hearing and vision loss. AR at 153.
The Commissioner denied Plaintiff's applications initially and on reconsideration. AR at 77-79, 81-82. Plaintiff requested a hearing, which took place on September 23, 2013. AR at 31-58. On January 17, 2014, the ALJ issued a decision finding Plaintiff not disabled and denied benefits based on his finding that if Plaintiff stopped substance abuse, he could perform a specific job existing in significant numbers in the national economy. AR at 14-26. Plaintiff's administrative appeal of the ALJ's decision was denied by the Appeals Council, AR at 1-6, making the ALJ's ruling the "final decision" of the Commissioner as that term is defined by 42 U.S.C. § 405(g).
Plaintiff sought judicial review, and the U.S. District Court for the Western District of Washington reversed the ALJ's decision and remanded for further administrative proceedings. AR at 688-700. A different ALJ held another hearing on November 8, 2016 (AR at 624-58), and subsequently found Plaintiff not disabled. AR at 595-614. On September 1, 2017, Plaintiff timely filed the present action challenging the Commissioner's decision. Dkt. 1.
Jurisdiction to review the Commissioner's decision exists pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3).
Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner's denial of social security benefits when the ALJ's findings are based on legal error or not supported by substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 (9th Cir. 2005). "Substantial evidence" is more than a scintilla, less than a preponderance, and is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971); Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989). The ALJ is responsible for determining credibility, resolving conflicts in medical testimony, and resolving any other ambiguities that might exist. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). While the Court is required to examine the record as a whole, it may neither reweigh the evidence nor substitute its judgment for that of the Commissioner. Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). When the evidence is susceptible to more than one rational interpretation, it is the Commissioner's conclusion that must be upheld. Id.
As the claimant, Mr. Averette bears the burden of proving that he is disabled within the meaning of the Social Security Act (the "Act"). Meanel v. Apfel, 172 F.3d 1111, 1113 (9th Cir. 1999) (internal citations omitted). The Act defines disability as the "inability to engage in any substantial gainful activity" due to a physical or mental impairment which has lasted, or is expected to last, for a continuous period of not less than twelve months. 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A claimant is disabled under the Act only if his impairments are of such severity that he is unable to do his previous work, and cannot, considering his age, education, and work experience, engage in any other substantial gainful activity existing in the national economy. 42 U.S.C. §§ 423(d)(2)(A); see also Tackett v. Apfel, 180 F.3d 1094, 1098-99 (9th Cir. 1999).
The Commissioner has established a five step sequential evaluation process for determining whether a claimant is disabled within the meaning of the Act. See 20 C.F.R. §§ 404.1520, 416.920. The claimant bears the burden of proof during steps one through four. At step five, the burden shifts to the Commissioner. Id. If a claimant is found to be disabled at any step in the sequence, the inquiry ends without the need to consider subsequent steps. Step one asks whether the claimant is presently engaged in "substantial gainful activity." 20 C.F.R. §§ 404.1520(b), 416.920(b).
When the claimant's impairment neither meets nor equals one of the impairments listed in the regulations, the Commissioner must proceed to step four and evaluate the claimant's residual functional capacity ("RFC"). 20 C.F.R. §§ 404.1520(e), 416.920(e). Here, the Commissioner evaluates the physical and mental demands of the claimant's past relevant work to determine whether he can still perform that work. 20 C.F.R. §§ 404.1520(f), 416.920(f). If the claimant is able to perform his past relevant work, he is not disabled; if the opposite is true, then the burden shifts to the Commissioner at step five to show that the claimant can perform other work that exists in significant numbers in the national economy, taking into consideration the claimant's RFC, age, education, and work experience. 20 C.F.R. §§ 404.1520(g), 416.920(g); Tackett, 180 F.3d at 1099, 1100. If the Commissioner finds the claimant is unable to perform other work, then the claimant is found disabled and benefits may be awarded.
On June 30, 2017, the ALJ issued a decision finding the following:
AR at 598-613.
VI. ISSUE ON APPEAL
The issue on appeal is whether the ALJ erred in assessing certain medical opinions. Dkt. 8 at 1.
Dr. Kivowitz testified at Plaintiff's 2016 hearing, and indicated that Plaintiff's impairments included alcohol dependence, major depressive disorder, and panic disorder, and that these impairments met Listings 12.04 and 12.09. AR at 631-32. Dr. Kivowitz further testified that he expects to see drug and alcohol use impact a person's functioning for three months after sobriety begins, but not after that period, even though other professionals in his field believe drugs and alcohol impact a person's functioning for up to a year after use. AR at 632-33.
The ALJ assigned little weight to Dr. Kivowitz's testimony, finding it inconsistent with the record. Specifically, the ALJ cited Plaintiff's struggles with addiction and withdrawal for longer than three months after his date of sobriety, but noted that he started to show significant improvement ten months after sobriety. AR at 609. The ALJ also found Dr. Kivowitz's testimony to be contradicted by the testimony of Plaintiff's stepfather, Earl Fettit: Mr. Fettit testified that Plaintiff became anxious and upset when drinking, which the ALJ interpreted to be inconsistent with Dr. Kivowitz's "opinion that the claimant's alcohol use did not affect his functioning[.]" AR at 609. Plaintiff argues that the ALJ's reasons for discounting Dr. Kivowitz's testimony are not legally sufficient.
As a matter of law, more weight is given to a treating physician's opinion than to that of a non-treating physician because a treating physician "is employed to cure and has a greater opportunity to know and observe the patient as an individual." Magallanes, 881 F.2d at 751; see also Orn v. Astrue, 495 F.3d 625, 631 (9th Cir. 2007). A treating physician's opinion, however, is not necessarily conclusive as to either a physical condition or the ultimate issue of disability, and can be rejected, whether or not that opinion is contradicted. Magallanes, 881 F.2d at 751. If an ALJ rejects the opinion of a treating or examining physician, the ALJ must give clear and convincing reasons for doing so if the opinion is not contradicted by other evidence, and specific and legitimate reasons if it is. Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1988). "This can be done by setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings." Id. (citing Magallanes, 881 F.2d at 751). The ALJ must do more than merely state his/her conclusions. "He must set forth his own interpretations and explain why they, rather than the doctors', are correct." Id. (citing Embrey v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988)). Such conclusions must at all times be supported by substantial evidence. Reddick, 157 F.3d at 725.
The opinions of examining physicians are to be given more weight than non-examining physicians. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). Like treating physicians, the uncontradicted opinions of examining physicians may not be rejected without clear and convincing evidence. Id. An ALJ may reject the controverted opinions of an examining physician only by providing specific and legitimate reasons that are supported by the record. Bayliss, 427 F.3d at 1216.
Opinions from non-examining medical sources are to be given less weight than treating or examining doctors. Lester, 81 F.3d at 831. However, an ALJ must always evaluate the opinions from such sources and may not simply ignore them. In other words, an ALJ must evaluate the opinion of a non-examining source and explain the weight given to it. Social Security Ruling ("SSR") 96-6p, 1996 WL 374180, at *2. Although an ALJ generally gives more weight to an examining doctor's opinion than to a non-examining doctor's opinion, a non-examining doctor's opinion may nonetheless constitute substantial evidence if it is consistent with other independent evidence in the record. Thomas, 278 F.3d at 957; Orn, 495 F.3d at 632-33.
Plaintiff argues that the ALJ cherry-picked from records to find that his functioning started to improve nine or ten months after his sobriety. Dkt. 8 at 3-4. Plaintiff notes that records from this same time period continue to document some functional problems. Id. Plaintiff appears to misunderstand the purpose for which the ALJ cited the longitudinal record: the ALJ indicated that, contrary to Dr. Kivowitz's testimony, Plaintiff's functionality did not begin to improve after only three months of sobriety, but instead did not start to improve until nine or ten months after sobriety. See AR at 609. Plaintiff's citation to records indicating that his symptoms were not entirely improved within 10 months of his sobriety date does not suggest error in the ALJ's interpretation of Dr. Kivowitz's testimony. The ALJ cited numerous records indicating that Plaintiff's functionality did begin to improve in early 2013, and Plaintiff has not shown that the ALJ's inference is not supported by substantial evidence. See AR at 605-06. The ALJ did not err in considering the extent to which Dr. Kivowitz's testimony was consistent with the longitudinal medical record. See Sousa v. Callahan, 143 F.3d 1240, 1244 (9th Cir. 1998) ("The Commissioner may reject the opinion of a non-examining physician by reference to specific evidence in the medical record.").
The ALJ also cited Mr. Fettit's contrary testimony as a reason to discount Dr. Kivowitz's testimony, because Mr. Fettit described functional impacts of Plaintiff's alcohol use and the ALJ interpreted Dr. Kivowitz's testimony to suggest that Plaintiff's alcohol use did not impact his functioning. AR at 609-10.
Mr. Fettit did not describe any particular functional limitations that he observed Plaintiff currently experiencing, but he indicated that when Plaintiff was previously using alcohol, he had been anxious and upset. See AR at 645. The ALJ contrasted this testimony with Dr. Kivowitz's testimony that Plaintiff's functional limitations as expressed in Global Assessment of Functioning ("GAF") scores did not reflect any impact from alcohol use when Plaintiff was sober. AR at 609 (referencing AR at 632).
Plaintiff argues that there is no inconsistency between Mr. Fettit's testimony and Dr. Kivowitz's testimony (Dkt. 8 at 4), but he does not acknowledge the ALJ's purpose in citing Mr. Fettit's testimony: Mr. Fettit's testimony is consistent with Plaintiff's functional improvement with longer sobriety, because Mr. Fettit did not describe any functional limitations during the period that Plaintiff had been living with him while sober. This testimony is arguably inconsistent with Dr. Kivowitz's suggestion that Plaintiff's low GAF scores did not reflect any impact from alcohol use. See AR at 632. The ALJ reasonably found Dr. Kivowitz's testimony to be inconsistent with Mr. Fettit's testimony, and did not err in discounting Dr. Kivowitz's testimony on that basis.
Because the ALJ provided multiple specific, legitimate reasons to discount Dr. Kivowitz's testimony, the ALJ did not err in discounting that testimony.
Dr. Zolnikov examined Plaintiff in January 2015 and completed a DSHS form opinion describing his symptoms and limitations. AR at 873-83. Dr. Zolnikov indicated that, inter alia, Plaintiff had several marked functional limitations and described mostly normal findings on mental status examination. AR at 875-77.
The ALJ found Dr. Zolnikov's opinion to be inconsistent with his own findings, Plaintiff's treatment notes, and Plaintiff's activity level, and thereby assigned it little weight. AR at 611. The ALJ specifically found Plaintiff's ability to babysit his young nieces and nephews to be inconsistent with Dr. Zolnikov's opinion that he could not perform routine tasks without special supervision, and that Plaintiff's ability to complete yardwork and household chores was inconsistent with Dr. Zolnikov's opinion that he could not complete a normal workday without interruptions from his symptoms. Id. The ALJ also cited Plaintiff's medical record as demonstrating "steady improvement" with sobriety and compliance with treatment, and highlighted Dr. Zolnikov's many normal objective findings, some of which reflected improvement since an April 2012 examination. Id. The ALJ suggested that Dr. Zolnikov relied on Plaintiff's self-report, which the ALJ did not find to be consistent with the record. Id. Plaintiff contends that the ALJ's reasons to discount Dr. Zolnikov's opinion are not legally sufficient, and the Court will address them in turn.
Plaintiff argues that not all of Dr. Zolnikov's findings were normal, and suggests that the abnormal findings could have supported his opinion as to the marked functional limitations. Dkt. 8 at 5. Plaintiff's alternative view of the evidence does not establish error in the ALJ's decision, however. None of the abnormal findings cited by Plaintiff — specifically his poor eye contact, articulation difficulty, labile affect, and sad and anxious affect (Dkt. 8 at 5 (citing AR at 880)) — pertain to his ability to perform routine tasks without special supervision, to perform activities within a schedule, to maintain regular attendance, or to be punctual without special supervision, for example. Dr. Zolnikov did not cite any particular evidence as support for his opinion regarding Plaintiff's functional limitations, and the ALJ reasonably found that opinion to be inconsistent with the largely normal objective examination findings.
The ALJ characterized Plaintiff's medical records as demonstrating steady improvement with sobriety and treatment, and construed that record to be inconsistent with the marked limitations described by Dr. Zolnikov. Plaintiff argues that the ALJ erred in failing to identify which records demonstrate steady improvement (Dkt. 8 at 5), but the ALJ's decision highlights these records in great detail earlier in the decision. See AR at 605-07. That Dr. Kivowitz did not appear to concur with the ALJ's interpretation of the record does not indicate that the ALJ's interpretation is unreasonable or erroneous: Dr. Kivowitz did not discuss most of the record in detail and was not asked to express an opinion about whether the record demonstrated improvement with sobriety and treatment. The ALJ did not err in finding Dr. Zolnikov's opinion to be inconsistent with the longitudinal record.
Plaintiff contends that the ALJ erred in finding his babysitting, yardwork, and household chores to be inconsistent with Dr. Zolnikov's opinion, because he did not perform these activities in a workplace environment. Dkt. 8 at 6. But activities need not be performed in a workplace environment in order to be found inconsistent with a doctor's opinion on functional limitations. See, e.g., Morgan v. Comm'r of Social Sec. Admin., 169 F.3d 595, 601-02 (9th Cir. 1999) (affirming an ALJ's rejecting a physician's opinion that a claimant's mental impairments were disabling, in light of evidence that the claimant was able to maintain a oneacre garden and assisted with the restoration of an old house). The ALJ explained why he found specific activities to be inconsistent with Dr. Zolnikov's opinion in specific respects, and the ALJ's interpretation is reasonable.
Plaintiff argues that there is no indication that Dr. Zolnikov overly relied on his selfreport in reaching his conclusions. Dkt. 8 at 6. But the majority of Dr. Zolnikov's evaluation notes consist of a record of Plaintiff's own statements. AR at 873-74. The ALJ provided many reasons to discount Plaintiff's self-report, all of which are unchallenged. AR at 607-09. The ALJ did not err in discounting Dr. Zolnikov's opinion to the extent he relied on Plaintiff's self-report. See Bray v. Comm'r of Social Sec. Admin., 554 F.3d 1219, 1228 (9th Cir. 2009) ("As the district court noted, however, the treating physician's prescribed work restrictions were based on Bray's subjective characterization of her symptoms. As the ALJ determined that Bray's description of her limitations was not entirely credible, it is reasonable to discount a physician's prescription that was based on those less than credible statements.").
Because the ALJ provided multiple specific, legitimate reasons to discount Dr. Zolnikov's opinion, the ALJ did not err in discounting that opinion.
The role of this Court is limited. As noted above, the ALJ is responsible for determining credibility, resolving conflicts in medical testimony, and resolving any other ambiguities that might exist. Andrews, 53 F.3d at 1039. When the evidence is susceptible to more than one rational interpretation, it is the Commissioner's conclusion that must be upheld. Thomas, 278 F.3d at 954. While it may be possible to evaluate the evidence as Plaintiff suggests, it is not possible to conclude that Plaintiff's interpretation is the only rational interpretation.
For the foregoing reasons, the Court AFFIRMS the Commissioner's decision.
