BERNARDO P. VELASCO, District Judge.
Plaintiff's mother filed this action for review of the final decision of the Commissioner of Social Security pursuant to 42 U.S.C. § 405(g). The United States Magistrate Judge presides over this case pursuant to 28 U.S.C. § 636 (c) and Fed.R.Civ.P. 73, having received the written consent of both parties.
Plaintiff's mother protectively filed an application for Supplemental Security Income ("SSI") on January 11, 2008, alleging an onset of disability beginning January 11, 2008 due to mental problems: learning difficulties; behavioral impairments; difficulty taking care of personal needs; and difficulty paying attention and sticking to a task. Transcript/Administrative Record ("Tr.") 106-12, 113, 117-128. The application was denied initially and on reconsideration. Tr. 69-71, 72-74. A hearing before an Administrative Law Judge ("ALJ") was held on January 22, 2010. Tr. 57-68. The ALJ issued a decision on June 4, 2010, finding Plaintiff, 9 years old on the date of the ALJ's decision, had severe impairments of attention deficit hyperactivity disorder (ADHD; learning disorder; and explosive disorder, but was not disabled within the meaning of the Social Security Act. Tr. 18-38. This decision became the Commissioner's final decision when the Appeals Council denied review. Tr. 1-4.
Plaintiff's mother then commenced this action for judicial review pursuant to 42 U.S.C. § 405(g). (Doc. 1) For reasons that follow, the Court reverses the decision of the Commissioner and remands for an immediate award of benefits.
A person under the age of 18 will be considered disabled and eligible for Supplemental Security Income (SSI) if he has a "medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 1382c(a)(3)(C)(i). The Commissioner employs a three-step sequential process to evaluate SSI claims for minors. First, if the claimant is engaged in substantial gainful activity, he is not disabled. 20 C.F.R. § 416.924(b). Second, if the claimant does not have a medically determinable severe impairment(s), in that the impairment does not cause more than minimal functional limitations, he is not disabled. 20 C.F.R. § 426.924(c). Third, if the claimant's impairment does not meet, medically equal, or functionally equal an impairment in the listings, he is not disabled. 20 C.F.R. § 924(d). There are six areas the Commissioner assesses for functional equivalence: acquiring and using information; attending and completing tasks; interacting and relating with others; moving about and manipulating objects; caring for yourself; and health and physical wellbeing. 20 C.F.R. § 416.926a(b).
The findings of the Commissioner are meant to be conclusive if supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is "more than a mere scintilla but less than a preponderance." Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999) (quoting Matney v. Sullivan, 981 F.2d 1016, 1018 (9th Cir. 1992)). The court may overturn the decision to deny benefits only "when the ALJ's findings are based on legal error or are not supported by substantial evidence in the record as a whole." Aukland v. Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001). This is so because the ALJ "and not the reviewing court must resolve conflicts in the evidence, and if the evidence can support either outcome, the court may not substitute its judgment for that of the ALJ." Matney, 981 F.2d at 1019 (quoting Richardson v. Perales, 402 U.S. 389, 400 (1971)); Batson v. Comm'r of Soc. Sec. Admin., 359 F.3d 1190, 1198 (9th Cir. 2004). The Commissioner's decision, however, "cannot be affirmed simply by isolating a specific quantum of supporting evidence." Sousa v. Callahan, 143 F.3d 1240, 1243 (9th Cir. 1998) (citing Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989)). Reviewing courts must consider the evidence that supports as well as detracts from the Commissioner's conclusion. Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975).
Plaintiff argues that the ALJ failed to give controlling weight to his treating psychiatrist's opinion. In May, 2006, Plaintiff underwent a psychiatric intake evaluation with psychiatric nurse practitioner Karen Van Wie of Providence Service Corp., because of worsening temper tantrums and aggressive behavior towards others. Tr. 355. Ms. Van Wie assessed generalized anxiety disorder and post-traumatic stress disorder, as well as victim of neglect and rule out attention deficit hyperactivity disorder (ADHD). Ms. Van Wie assigned Plaintiff a GAF score of 45 to 50.
In November 2006, Plaintiff's care was transferred to treating psychiatrist Michael Mardis, M.D., at Providence, who conducted an initial exam of Plaintiff and diagnosed him with ADHD, Intermittent Explosive Disorder, and Anxiety Disorder, and considered a diagnosis of Pervasive Developmental Disorder Syndrome. Tr. 393. The administrative record contains medical records from Dr. Mardis dated from the initial evaluation through October 2009. Tr. 345-47, 361-64, 367-80, 383-86, 388-89, 391-95, 407-21, 423, 454-59, 462, 482-84. During the course of treatment, Dr. Mardis prescribed numerous medications for Plaintiff's various symptoms, summarized in Dr. Mardis's psychiatric update containing a detailed medication report and description of each medication's efficacy, dated October 30, 2009.
Tr. 482, 484. Dr. Mardis completed a Childhood Disability Evaluation Form and opined that Plaintiff had marked limitations in acquiring and using information, with "some difficulties with learning disabilities — with reading and math, as well as writing"; marked limitations with attending and completing tasks, with "significant difficulties with sustaining his attention in tasks, and in focusing on relevant stimuli, leading to difficulties in school and poor follow through at home"' extreme limitations in interacting and relating with others, with "frequent episodes of aggression to family members, leading to extreme disruption at home"; marked limitations in health and physical well-being, "due to aggressive incidents, anger, and significant anxiety over timing of events, contamination fears." Tr. 485-86.
The ALJ acknowledged Dr. Mardis as Plaintiff's treating psychiatrist but gave Dr. Mardis's opinion minimal weight, finding the opinion and evaluation over-restrictive based on Dr. Mardis's own treatment notes and other evidence of record. Tr. 26. The ALJ further discounted Dr. Mardis's opinion because of the possibility that Dr. Mardis submitted his opinion in an effort to assist Plaintiff because Dr. Mardis sympathized with the Plaintiff. Tr. 26. The ALJ gave great weight to the opinions of reviewing State Agency psychologist Jocelyn Fuller, Ph.D., and the other State Agency reviewing physicians who affirmed Dr. Fuller's assessment.
Where a treating doctor's ultimate conclusion is contradicted, as in this case by Dr. Fuller, it may be rejected only for specific and legitimate reasons that are supported by substantial evidence in the record. Carmickle v. Comm'r Soc.Sec. Admin., 533 F.3d 1155, 1164 (9
As a non-examining physician, Dr. Fuller's opinion, cannot, by itself "constitute substantial evidence that justifies the rejection of the opinion of either an examining physician or a treating physician." Lester v. Chater, 81 F.3d 821, 831 (9
The ALJ's finding that "Dr. Mardis's opinion and evaluation of the claimant's limitations in each domain is over-restrictive based on Dr. Mardis's own treatment notes and other evidence of record" (Tr. 26) does not set forth the specific detail necessary, nor does it achieve the level of specificity required to reject a treating physician's conclusion. See Embrey, 849 at 421-422 ("To say that medical opinions are not supported by sufficient objective findings or are contrary to the preponderant conclusions mandated by the objective findings does not achieve the level of specificity our prior cases have required....") The ALJ states that, "
Finally, the ALJ errs by speculating, without introducing evidence of any actual improprieties, that Dr. Mardis fabricated his opinion in order to assist Plaintiff to collect disability benefits. Lester, 81 F.3d at 832.
The court has the discretion to make a determination to remand for further proceedings or to simply award benefits. Lewin v. Schweiker, 654 F.2d 631, 635 (9
Plaintiff requests that the Court award benefits. Defendant requests that the Court deny relief or, if the Court concludes there was reversible error, remand for further proceedings. A federal court may affirm, modify, reverse, or remand a social security case. 42 U.S.C. § 405(g). "`[T]he decision whether to remand the case for additional evidence or simply to award benefits is within the discretion of the court.'" Rodriguez v. Bowen, 876 F.2d 759, 763 (9
Id. (citations omitted) Where the test is met, "we will not remand solely to allow the ALJ to make specific findings ... Rather we take the relevant testimony to be established as true and remand for an award of benefits." Benecke, 379 F.3d at 593 (citations omitted); see also Lester, 81 F.3d at 834 (same).
"Where the Commissioner fails to provide adequate reasons for rejecting the opinion of a treating or examining physician, we credit that opinion `as a matter of law.'" Lester, 81 F.3d at 834 (quoting Hammock, 879 F.2d at 502); Benecke, 379 F.3d at 594 ("Because the ALJ failed to provide legally sufficient reasons for rejecting Benecke's testimony and her treating physicians' opinions, we credit the evidence as true."). The ALJ failed to provide legally sufficient reasons to reject Dr. Mardis's opinion. Dr. Mardis's opinion established marked limitations in three functional domains, and extreme limitations in one functional domain of the six areas the Commissioner assesses for functional equivalence. Adopting Dr. Mardis's opinion as true results in the conclusion that Plaintiff's impairment functionally equaled the listings. Under these circumstances, it is evident from the record that no outstanding issues must be resolved, and if Dr. Mardis's opinion is credited as true, the ALJ would be required to find the Plaintiff disabled. See Benecke, 379 F.3d at 593-595 (remanding for an award of benefits where no outstanding issues remain and ALJ would be required to find claimant disabled if evidence is credited); Regennitter v. Comm'r Soc. Sec. Admin., 166 F.3d 1294, 1300 (9
IT IS THEREFORE ORDERED that the Commissioner's final decision in this matter is REVERSED.
IT IS FURTHER ORDERED that Plaintiff's claim for benefits is REMANDED to the Commissioner of Social Security Administration for an immediate payment of benefits.
The Clerk of Court is instructed to enter judgment accordingly and close this case.