STANLEY A. BOONE, Magistrate Judge.
Plaintiff Nantha Vongphachanh ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner" or "Defendant") denying her application for disability benefits pursuant to the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to Magistrate Judge Stanley A. Boone.
Plaintiff suffers from major depressive disorder, posttraumatic stress disorder, diabetes, hypertension, and allergies. For the reasons set forth below, Plaintiff's Social Security appeal shall be denied.
Plaintiff filed applications for a period of disability, disability insurance benefits, and supplemental security income on August 24, 2012, alleging disability beginning June 25, 2011. (AR 214-215.) Plaintiff's applications were initially denied on April 12, 2013, and denied upon reconsideration on October 24, 2013. (AR 103-107, 114-124.) Plaintiff requested and received a hearing before Administrative Law Judge Sharon Madsen ("the ALJ"). Plaintiff appeared for a hearing on March 5, 2015, but that hearing was postponed because the interpreter scheduled did not speak Plaintiff's language. (AR 50-54.) Plaintiff then appeared for a hearing on June 16, 2015. (AR 29-49.) On June 25, 2015, the ALJ found that Plaintiff was not disabled. (AR 8-22.) The Appeals Council denied Plaintiff's request for review on December 30, 2016. (AR 1-4.)
Plaintiff testified at the hearing on June 16, 2015, with the assistance of a Laotian interpreter.
She does not need any help showering or getting dressed. (AR 35.) She does some chores and her children do other chores. (AR 35.) She microwaves food. (AR 35.) She goes with her friend to shop sometimes. (AR 35.) On the weekend, she goes to church, and during the week, she goes to an adult care center three days a week. (AR 35-36.) During a typical day, she goes to the adult care center where she eats, does some exercise, and eats again. (AR 36.) She stays home on days she is not going to the adult care center. (AR 36.) She watches TV and visits with her mother. (AR 36.) She regularly takes her diabetes medication. (AR 38.) She remembers to take it, but her children help administer her medication. (AR 38.)
She has seen Dr. Maximo Parayno and others for depression. (AR 40.) The takes medication she takes helps. (AR 40-41.) Sometimes, she feels very sad, wants to cry, gets angry, and wants to kill herself. (AR 40.) She talks to counselors once a month at an adult program. (AR 40.) She meets with two people who work at the social program. (AR 41.)
She can somewhat pay attention to the TV. (AR 41.) The man that was living with her helped her pay her bills. (AR 41.) She does not have a problem getting along with other people, but she sometimes has a problem getting along with her mother. (AR 41.) She cannot fall asleep due to her brain doing too much thinking. (AR 41-42.) She has nightmares two or three times a week. (AR 42.) She is unable to finish projects that she starts. (AR 42.)
A vocational expert ("VE") Judith Najarian, also testified at the hearing. (AR 42-48.) The first hypothetical that the ALJ asked the VE was for an individual with the same age, education, and work background as Plaintiff and who had "just a little bit of English" for language. (AR 43-44.) This person could lift and carry 50 lbs occasionally and 25 lbs frequently; sit, stand, or walk 6 to 8 hours a day; frequently climb ladders, ropes, or scaffolds; and frequently perform gross handling. (AR 44.) This individual could not do Plaintiff's past relevant work as poultry dressing, but could do the grader for dress poultry position. (AR 43-44.)
The second hypothetical is based on the first hypothetical with the additional limitation of simple routine work. (AR 44.) This person has some English and can at least do demo jobs. (AR 44-45.) The individual could be a rack loader, which is medium, SVP 1, and frequent handling. (AR 45.) The VE did a 25% reduction of the number of jobs because of continuous hand activity. (AR 45.) The individual could also be a carton forming machine operator, which is medium and SVP 2, and the VE reduced the number of jobs by 50% because of continuous hand activity. (AR 45.) The individual could also be a package sealer machine operator, which is medium and SVP 2, and the VE reduced the number of jobs by 20% because of continuous hand activity. (AR 46.)
(AR 11-23.)
To qualify for disability insurance benefits under the Social Security Act, the claimant must show that she is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment 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. § 423(d)(1)(A). The Social Security Regulations set out a five step sequential evaluation process to be used in determining if a claimant is disabled. 20 C.F.R. § 404.1520;
Congress has provided that an individual may obtain judicial review of any final decision of the Commissioner of Social Security regarding entitlement to benefits. 42 U.S.C. § 405(g). In reviewing findings of fact in respect to the denial of benefits, this court "reviews the Commissioner's final decision for substantial evidence, and the Commissioner's decision will be disturbed only if it is not supported by substantial evidence or is based on legal error."
"[A] reviewing court must consider the entire record as a whole and may not affirm simply by isolating a specific quantum of supporting evidence."
Plaintiff raises two main issues in this appeal. First, Plaintiff argues that the ALJ erred by finding that she could communicate in English. Second, Plaintiff argues that the ALJ erred in evaluating her mental impairments, and specifically, by rejecting Dr. Parayno's opinions and not addressing the GAF scores rendered by Dr. Manolito Castillo and Dr. Asher Gorelik.
Defendant counters that substantial evidence supports the ALJ's finding that Plaintiff was able to communicate in English and the ALJ's rejection of Dr. Parayno's opinions. Defendant contends that an ALJ is not required to specifically address GAF scores.
Plaintiff argues that the ALJ erred in finding that she was literate in English. Plaintiff asserts that the evidence of her literacy is vague and somewhat confusing. Defendant responds that the ALJ considered Plaintiff's literacy in her decision and the finding that Plaintiff was able to communicate in English is supported by substantial evidence.
"The Commissioner has the burden to show that the claimant can perform other work existing in the national economy, `given his residual functional capacity, age, education, and work experience.'"
The Social Security regulations define illiteracy as an inability to read and write. 20 C.F.R. § 416.964(a)(1). The Ninth Circuit has held "only literacy in English is considered, since literacy in other languages has little effect on the number of jobs in the national economy available to the claimant. 20 C.F.R. § 416.964(b)(5). `Illiterate' therefore means illiterate in English.
Here, the ALJ found:
(AR 21.)
Plaintiff believes that the record needs to be further developed regarding her ability to speak, read, write, and understand English because she was not asked these questions at the hearing. The ALJ has an independent "duty to fully and fairly develop the record and to assure that the claimant's interests are considered."
Viewing the record as a whole, the Court finds that the ALJ did not err by not further developing the record regarding Plaintiff's ability to communicate in English. Plaintiff does not cite to any authority to support her argument that an ALJ must specifically ask a plaintiff during a hearing to what extent she understands, speaks, reads, and writes English. The relevant question on review is whether there is substantial evidence supporting the ALJ's finding. While an ALJ may meet her burden for determining a plaintiff's ability to communicate in English by asking a plaintiff about her abilities to communicate in English, it is not the only way. The evidence in the record of a plaintiff's ability to communicate in English, such as reports or doctors' visits, may provide substantial evidence for the ALJ's finding.
Here, the ALJ considered Plaintiff's ability to testify in English at the hearing. (AR 21.) The ALJ discussed how Plaintiff answered some questions with a mixture of Laotian and English words, and in fact, was able to fully answer some of the ALJ's questions in English. (AR 21.) Plaintiff does not argue that this is inaccurate. Although Plaintiff argues that it is unclear whether she is able to communicate in English, her ability to understand and speak English at the hearing is evidence that she has the ability to communicate in English. Further, Plaintiff testified during the hearing that she understood a little bit of English and that she had taken adult classes in the United States. (AR 21, 35.)
The ALJ discussed Plaintiff's ability to speak English during her involuntary psychiatric hospitalization in February 2014. (AR 393.) Dr. Castillo noted that Plaintiff spoke English. (AR 393.) The history of present illness section of that psychiatry encounter report includes a detailed history. (AR 393.) Plaintiff's ability to say a detailed accounting of her family problems and life difficulties in English is evidence of her ability to speak English.
The ALJ relied on Plaintiff's statement in her disability report that she preferred to speak and understand Laotian, but she could read and understand English and write more than her name in English. (AR 21, 248.) While Plaintiff contends that the ALJ did not ask Plaintiff how much more than her name she could write in English, there is other evidence in the record that reflects Plaintiff's ability to write in English.
The ALJ considered that Plaintiff completed her Adult Function Report in English. (AR 21, 282-290.) Plaintiff argues that Plaintiff's function report appears to have been written by someone else because the handwriting is different than the signatures on Plaintiff's request for hearing by administrative law judge, appointment of representative, and acknowledgment of receipt forms. Plaintiff's signature on these forms is different from her printed name on her function report. However, Plaintiff did not sign the function report. (AR 282-290.) She printed her name and the printed name is consistent with the handwriting used in the other sections of the form. (AR 282-290.) The forms Plaintiff cites to do not call into question whether Plaintiff wrote her disability report. While Plaintiff's printed name on her function report is different from her signature on other documents, this does not meant that she did not write the function report. It is a rational interpretation that Plaintiff's printed name and cursive signature are different. In addition, Plaintiff's function report is written in the first person and when there are mistakes crossed out, Plaintiff initialed these mistakes. (AR 282-289.) Therefore, the fact that Plaintiff completed her adult function report in English supports the ALJ's finding that Plaintiff can communicate in English.
Thus, the Court finds that there is substantial evidence in the record to support the ALJ's finding that Plaintiff is literate in English.
Plaintiff argues that the ALJ erred in evaluating her mental impairments because she rejected the opinions of Dr. Parayno, Dr. Castillo, and Dr. Gorelik. Plaintiff also asserts that the ALJ erred because she impermissibly substituted her own lay opinion when formulating Plaintiff's mental RFC. Defendant responds that the ALJ provided good reasons explaining why she rejected the opinions of Dr. Parayno.
The weight to be given to medical opinions depends upon whether the opinion is proffered by a treating, examining, or non-examining professional.
Where the treating physician's opinion is contradicted by the opinion of an examining physician who based the opinion upon independent clinical findings that differ from those of the treating physician, the nontreating source itself may be substantial evidence, and the ALJ is to resolve the conflict.
The contrary opinion of a non-examining expert is not sufficient by itself to constitute a specific, legitimate reason for rejecting a treating or examining physician's opinion, however, "it may constitute substantial evidence when it is consistent with other independent evidence in the record."
Plaintiff argues that the ALJ erred by rejecting the opinions of her treating psychiatrist, Dr. Parayno. Dr. Parayno provided three opinions. His January 2013 opinion was on an immigration form entitled Medical Certification for Disability Exceptions. (3F.) In July 2014,
Dr. Parayno diagnosed Plaintiff with recurrent and severe major depressive disorder without psychotic features and chronic PTSD as part of the January 14, 2013 immigration form.
The ALJ gave the January 2013 opinion little weight. (AR 17.) The ALJ found:
(AR 17.)
The fact that Dr. Parayno's opinion is on a matter reserved for the Commissioner is in itself not a specific and legitimate reason to reject the opinion.
The ALJ found that Dr. Parayno's use of "he" and "she" indicated inattentiveness or use of standardized answers. (AR 17.) Dr. Parayno stated in response to question 8, "[f]rom the trauma of war in Laos,
At the hearing, Plaintiff was able to state her address, phone number, and date of birth. (AR 33.) In fact, when asked if her phone number was what was on file, she indicated that it had changed and she provided the new number. (AR 33.) This contradicts Dr. Parayno's testing that allegedly showed that Plaintiff was disoriented and did not know the date, her home address, or her own phone number. (AR 364.) Further, the ALJ noted that Plaintiff was able to testify at times during the hearing in English. (AR 17.) Plaintiff also testified that she could understand a little bit of English. (AR 35.)
The ALJ also pointed out that Dr. Parayno's statement that Plaintiff had a disability or impairment was vague. (AR 17.) Dr. Parayno did not provide any functional limitations. (AR 361-365.)
Although Plaintiff offers a different interpretation of the evidence, where the ALJ's interpretation is rational, it is not this Court's function to second guess the ALJ's conclusions and substitute the Court's judgment for the ALJ's.
Dr. Parayno next provided an opinion in July 2014. (AR 390-391.) He found that Plaintiff was unable to work. (AR 390.) He opined that she needed significant, frequent assistance with her daily activities, she was unable to interact appropriately and communicate effectively with coworkers, instructors, and members of the public, she was unable to complete everyday tasks, and she was unable to adapt to stress related to work-like situations. (AR 391.)
The ALJ found:
(AR 17-18.)
Plaintiff contends that it was error to reject Dr. Parayno's July 2014 opinion because of Plaintiff's activities. She argues that a "holistic view of the record" does not reveal any substantive contradictions between Dr. Parayno's opinion and Plaintiff's activities. Plaintiff also asserts that the ALJ did not provide specific reasons for rejecting Dr. Parayno's opinion that Plaintiff has a poor stress tolerance and she was unable to complete everyday workplace routines. Defendant argues that the ALJ properly found that Dr. Parayno's opinion was inconsistent with other evidence, including Plaintiff's daily activities and examination findings by other physicians.
Dr. Parayno stated that Plaintiff needed significant, frequent assistance in daily activities. (AR 391.) However, Plaintiff told consultative examiner, Dr. Roger Wagner, that she could perform her own activities of daily living without assistance. (AR 17, 380.) Dr. Parayno's statement that Plaintiff could not perform everyday tasks is contradicted by Plaintiff's statement to Dr. Lewis that she cooked, washed dishes, did laundry, and paid her bills without any reminders. (AR 17, 374.) Plaintiff is correct that she stated during the hearing that her children helped with chores, her friend helped her pay her bills, and she microwaved her food. (AR 35, 41.) While Plaintiff stated at the hearing that her children do chores, she testified that she did chores and they did other chores. (AR 35.) Plaintiff also stated multiple times in the record that she cleans, does chores, and cooks. (AR 283-284, 374, 380.) Ms. Melissa Somtakoune indicated in the third party function report that Plaintiff prepared meals if she wants and if she feels okay. (AR 270.) Plaintiff also told Dr. Wagner that she drives and shops. (AR 380.) However, Plaintiff stated in her function report that an Asian store helps her pay her bills and that most of the time her friends help. (AR 285.)
When the Court reviews the record as a whole, the Court finds that there is substantial evidence supporting the finding that Plaintiff's daily activities contradict Dr. Parayno's opinion. Plaintiff is attempting to proffer an alternative reading of the record. Where the ALJ's interpretation is rational and reasonable, it is not this Court's function to second guess the ALJ's conclusions and substitute the Court's judgment for the ALJ's.
Dr. Parayno stated that Plaintiff was unable to interact appropriately or effectively with coworkers and members of the public. (AR 391.) However, the ALJ found this was inconsistent with Plaintiff having friends, going to temple, and spending time with her mother, her children, and a male friend. (AR 17, 35, 41, 374.) Plaintiff contends that she can only occasionally socialize and that occasional socializing does not contradict Dr. Parayno's opinion.
In
The ALJ also rejected Dr. Parayno's July 2014 opinion because the clinic notes from Dr. Dhillon showed normal psychiatric behavior. (AR 17-18.) Plaintiff asserts that the examination was actually performed by a nurse practitioner at the beginning of Plaintiff's hospitalization in February 2014. Plaintiff contends that the examination was not to assess Plaintiff's mental functioning, but rather to determine whether Plaintiff was medically stable.
The February 19, 2014 examination was conducted by Nurse Practitioner ("NP") Cecil Litiema. (AR 385-386.) However, the Court notes that Dr. Dhillon cosigned the patient note. (AR 385-386.) NP Litiema noted that Plaintiff was admitted on 5150 because she was a danger to herself. (AR 385.) During the review of Plaintiff's systems, Plaintiff stated that she had an altered mental status, depression, hallucinations, and suicidal ideas. (AR 385.) During the psychiatric portion of the physical examination, NP Litiema found that Plaintiff's behavior was normal. (AR 386.) NP Litiema stated in the plan section that Plaintiff was medically stable and that she would have therapy per psychiatry. (AR 386.) Although NP Litiema is not a psychiatrist and is not a doctor, she is able to comment on Plaintiff's psychiatric behavior during an examination that she conducted. Therefore, NP Litiema's observation that Plaintiff had normal psychiatric behavior may be considered by the ALJ when determining what weight to give medical opinions. The Court finds that the NP Litiema's observation that Plaintiff had normal psychiatric behavior is a specific and legitimate reason to reject Dr. Parayno's July 2014 opinion.
Although Plaintiff asserts that the ALJ did not address Dr. Parayno's opinion that Plaintiff was unable to complete everyday tasks and unable to adapt to stress from work-like situations, the ALJ provided specific and legitimate reasons supported by substantial evidence for giving little weight to the July 2014 opinion. Thus, the Court finds that the ALJ did not err in giving little weight to Dr. Parayno's July 2014 opinion.
In February 2015, Dr. Parayno conducted a psychiatric evaluation of Plaintiff. (AR 402-405.) During the mental status examination, Plaintiff was alert, pleasant, and cooperative, had fair grooming, and was tentatively oriented. (AR 404.) She had impaired concentration and attention span, impaired remote memory, and impaired recent memory. (AR 404.) She did not give an appropriate abstract answer to a question and she had impaired social judgment. (AR 404.) Her mood was "definitely depressed," her affect was blunted, and her judgment and insight were minimal. (AR 404-405.) He opined that she appears to have restricted activities of daily living and that she seems to have a constricted social life. (AR 405.) He stated that "[s]he has never been involved in any substantial gainful activities and with his multiple medical problems and mental disabilities, it is apparent she is unable to work." (AR 405.)
The ALJ found:
(AR 18.)
Plaintiff argues that this opinion was not vague, that the mistake regarding Plaintiff's substantial activities is only a mistake about Plaintiff's background, and that the fact the opinion was on an issue reserved to the Commissioner is not a proper reason to reject it. Defendant asserts that the ALJ properly gave the opinion little weight as it was inconsistent with the other evidence.
Plaintiff is correct that the fact that Dr. Parayno's opinion is on a matter reserved for the Commissioner is in itself not a specific and legitimate reason to reject the opinion.
In Dr. Parayno's opinion, he used "appears" and "seems," which indicate a lack of certainty regarding Plaintiff's activities of daily living and social life. (AR 405.) Plaintiff contends that the ALJ failed to mention that Dr. Parayno also opined that it was apparent that Plaintiff could not work. However, the fact that Dr. Parayno opined that it is apparent that Plaintiff is unable to work does not change the vagueness of the statements regarding activities of daily living and social life. These two statements regarding Plaintiff's activities of daily living and social life are vague and suggest a lack of certainty, as the ALJ found. Plaintiff contends that any vagueness is compensated for because the statements are consistent with Dr. Parayno's prior opinions and the Global Assessment of Functioning ("GAF") scores by Dr. Gorelik and Dr. Castillo. As the ALJ found, Dr. Parayno's prior opinions were not consistent with the medical records or were refuted by other evidence. (AR 18.) As discussed above, the ALJ gave specific and legitimate reasons supported by substantial evidence for giving little weight to Dr. Parayno's January 2013 and July 2014 opinions. Even if GAF scores by other doctors are consistent with this February 2015 opinion, it does not change the fact that the opinion is vague and the opinion itself indicates a lack of certainty. The ALJ's finding that Dr. Parayno's statements regarding Plaintiff's activities of daily living and social life are vague is a specific and legitimate reason to reject the opinion.
Plaintiff asserts that Dr. Parayno made a mistake of fact regarding Plaintiff's background when he said that Plaintiff had never engaged in any substantial activities. Plaintiff contends that this does not contradict Dr. Parayno's actual observations and the opinion. However, as the ALJ pointed out, this contradiction suggests that Dr. Parayno was misinformed or inattentive. (AR 18.) Dr. Parayno's statement that it is apparent Plaintiff is unable to work is connected to his statement that Plaintiff has never been involved in any substantial gainful activities. (AR 405.) If Dr. Parayno was aware that Plaintiff had performed substantial gainful activities for a number of years, he could change his opinion of her ability to work. The fact that Dr. Parayno was misinformed or inattentive regarding Plaintiff's substantial gainful activity calls into question his opinion. Therefore, the Court finds the fact that Dr. Parayno was misinformed or inattentive is a specific and legitimate reason for giving his opinion little weight. Accordingly, the Court finds that the ALJ did not err in giving little weight to Dr. Parayno's February 2015 opinion.
Plaintiff asserts that Dr. Castillo and Dr. Gorelik's GAF scores are opinions that the ALJ was required to accept or reject. "A Global Assessment of Functioning ("GAF") score is the clinician's judgment of the individual's overall level of functioning. It is rated with respect only to psychological, social, and occupational functioning, without regard to impairments in functioning due to physical or environmental limitations."
Both Dr. Castillo and Dr. Gorelik assessed Plaintiff with a GAF score of 50. GAF scores between 41 and 50 indicate serious symptoms or any serious impairment in social, occupational, or school functioning.
Plaintiff points to an Administrative message that "[W]e consider a GAF rating as opinion evidence." SSA Administrative Message 13066 (effective July 22, 2013). Plaintiff also cites to an unpublished Ninth Circuit opinion,
In fact, the Ninth Circuit has stated in other unpublished opinions that an ALJ did not err by failing to address a doctor's GAF score.
Therefore, while an ALJ may consider a GAF score in considering a claimant's abilities, an ALJ does not need to accept or reject a GAF score. Thus, the Court finds that the ALJ did not err by not accepting or rejecting the GAF scores rendered by Dr. Castillo and Dr. Gorelik.
Plaintiff asserts that the ALJ's finding that Plaintiff had the RFC to perform simple routine tasks is unsupported by any psychiatric opinion of record. Plaintiff contends that the ALJ impermissibly provided a lay interpretation of the evidence. Defendant counters that the ALJ properly performed her function as factfinder.
It is error for the ALJ to define her own limitations for a plaintiff.
Plaintiff is correct that no doctor specifically opined that she is limited to simple, routine tasks. However, three doctors opined that she does not have a severe mental impairment, which is less restrictive than the RFC that the ALJ found. (AR 19, 61, 72, 83-85, 95-96, 370-375.) Dr. Lewis stated that Plaintiff did not appear to be suffering from a major mental disorder and she appeared to be functioning adequately. (AR 19.) Dr. Cory Brown, PsyD, an agency reviewing physician, opined that Plaintiff's mental impairment is not severe. (AR 61, 72.) Another agency reviewing physician, Dr. Richard Kaspar, PhD, affirmed Dr. Brown's opinion. (AR 85, 96.)
The ALJ gave limited weight to Dr. Lewis's opinion because her GAF score of 60 suggested some moderate limitations and she did not explain the discrepancy between the GAF score and her opinion that Plaintiff had no significant mental limitation. (AR 19.) The ALJ gave the opinions of Dr. Brown and Dr. Kaspar little weight because they overly relied on Dr. Lewis's opinion. (AR 19.) The ALJ also found that "the records showing [Plaintiff] had some mental health treatment and at least two involuntary psychiatric hospitalizations support limiting [Plaintiff] to simple routine tasks." (AR 19.)
Therefore, the ALJ considered the medical evidence and the opinions in the record when deciding Plaintiff's RFC. The ALJ determined that the opinions of Dr. Lewis, Dr. Kaspar, and Dr. Brown were not restrictive enough and based on Plaintiff's mental health treatment and two involuntary psychiatric hospitalizations, the ALJ restricted Plaintiff to simple routine tasks. This is not a situation where the ALJ found an RFC that is less restrictive than all of the doctors' opinions. The ALJ did not impermissibly substitute her lay opinion. Thus, the Court finds that the ALJ did not err in formulating Plaintiff's RFC for her mental impairments.
Based on the foregoing, the Court finds that the ALJ did not err in finding that Plaintiff can communicate in English and in her evaluation of Plaintiff's mental impairments.
Accordingly, IT IS HEREBY ORDERED that Plaintiff's appeal from the decision of the Commissioner of Social Security is DENIED. It is FURTHER ORDERED that judgment be entered in favor of Defendant Commissioner of Social Security and against Plaintiff Nantha Vongphachanh. The Clerk of the Court is directed to CLOSE this action.
IT IS SO ORDERED.