JON S. TIGAR, District Judge.
Plaintiff Jennifer Piracha seeks judicial review of the Social Security Administration Commissioner's
Piracha claims that her disability and inability to work began on July 29, 2012 when she fractured her left ankle. AR 155. Piracha was then 50-years old and had been working as a preschool teacher, sales attendant, and caretaker. AR 74, 80.
Piracha attributes the majority of her disability to the osteoarthritis in her left ankle. On July 31, 2012, Piracha underwent ankle surgery, and on May 6, 2013, she had the related hardware removed. AR 231, 330. The record indicates that in January 2013 her ankle's "range of motion [was] within normal limits;" in February 2013 she had "5/5 strength in all ankle quadrants bilaterally;" in June 2013 her fractures were "[h]ealing or healed;" and after August 2013 she rarely sought treatment for her ankle. AR 309, 318, 334, 348-372. The record indicates, however, that Piracha nonetheless consistently reported pain to her physicians from November 2012 to December 2013.
Piracha also claims disability based on a knee injury. Shortly after her ankle surgery, Piracha's doctor advised her to try therapeutic exercises including wall squats and leg lifts against a wall. AR 258. On December 5, 2012, Piracha notified her doctor that she heard a crack in her knee when doing the leg exercises and started experiencing pain. AR 276-277. Piracha continually reported knee pain to physicians from December 2012 to April 2013.
The record indicates that Piracha's daily activities during this time included yard work, simple cooking, shopping, taking walks, visiting friends, using a computer, driving, reading, and paying bills. AR 323, 56-59.
Piracha applied for SSDI on June 11, 2013. AR 74. The Commissioner denied her applications both initially and upon reconsideration. AR 92, 101. Piracha timely requested a hearing before an Administrative Law Judge (ALJ) and hired an attorney to appear at the hearing by video. AR 106, 38.
After the March 3, 2015 hearing, the ALJ conducted the five-step evaluation process to determine if Piracha was disabled and entitled to benefits.
The ALJ denied Piracha benefits on June 22, 2015 and Piracha timely appealed to the Appeals Council on December 15, 2016. AR 32, 1. Piracha submitted new medical evidence to the Appeals Council, but the Appeals Council denied Piracha's appeal in part because the new evidence was dated two months after the ALJ's decision. AR 2. Having exhausted all administrative remedies, Piracha filed this action seeking judicial review of the Commissioner's decision. ECF No. 1 at 1.
The Court has jurisdiction to review final decisions of the Social Security Administration Commissioner. 42 U.S.C. § 405(g).
A reviewing court can set aside the Commissioner's decision only if the decision is "not supported by substantial evidence in the record or if it is based on legal error."
Piracha files a motion for summary judgment with remand for another hearing with claims that (1) the ALJ failed to develop the record, (2) the ALJ erroneously discredited Piracha's testimony, and (3) the Appeals Council erroneously rejected new evidence. ECF No. 14 at 4-9. The Commissioner filed a cross-motion for summary judgment and in opposition to Piracha's motion for remand. ECF No. 17 at 1.
The ALJ "has an independent `duty to fully and fairly develop the record. . . .'"
Piracha argues that the record is ambiguous because it includes a benefits determination from the California Public Employees' Retirement System ("CalPERS"), but does not include the record CalPERS reviewed to make that determination. ECF No. 14 at 4-5. Plaintiff argues that the medical reports CalPERS relied on "likely contain facts that are needed for a complete evaluation of" Piracha's eligibility for benefits. Because Piracha has not obtained these records and placed them before the Court, her argument is speculative. Moreover, "it is only where the record contains ambiguous evidence or the ALJ himself has found the record is inadequate to allow for proper evaluation of the evidence that the ALJ's duty to "conduct an appropriate inquiry" is triggered.
Also, the ALJ actively sought whatever information Piracha thought might be helpful. When the ALJ admitted the record into evidence, the ALJ asked Piracha's counsel "[i]s there anything additional?" and Piracha's counsel responded "[n]o, Your Honor." AR 39. On these facts, the Court cannot find that the ALJ failed to comply with the duty to develop the record.
Therefore, the Court denies Piracha's motion for summary judgment on her claim that the ALJ failed to develop the record. The Commissioner's cross motion for summary judgment is granted.
To evaluate subjective pain and symptoms, an ALJ must find objective medical evidence of an underlying impairment "which could reasonably be expected to produce the pain or other symptoms alleged."
The reviewing court must determine whether the ALJ met the specific, clear, and convincing standard.
Here, the ALJ found objective medical evidence of an underlying impairment and did not conclude that there was evidence of malingering. AR 29. Then, the ALJ rejected Piracha's testimony about the severity of her symptoms based on (1) the ALJ's observations during the hearing, (2) Piracha's daily activities, (3) Piracha's inconsistent statements, (4) objective medical evidence, (5) Piracha's medication use, and (6) Piracha's minimal treatment. AR 28-30. Piracha claims that the reasons for discrediting her testimony were not specific, clear, or convincing. ECF No. 14 at 6-8.
The ALJ may point to personally observed "symptoms that were inconsistent both with the medical evidence and with other behavior [] exhibited at the hearing."
The ALJ observed that Piracha "had one crutch at the hearing but did not seem to use it much. She was observed to be able to open the door on her own and held her coat in her other arm. She did not appear to have a complete inability to ambulate effectively. . . ." AR 29. However, the ALJ did not explain how these observations were inconsistent with the medical evidence nor other symptoms observed at the hearing. Instead, the ALJ seemed to rely on these observations as if to prove that Piracha did not exhibit manifestations of pain at the hearing. These types of observations are not specific, clear, and convincing reasons for making an adverse credibility determination. Therefore, the ALJ erred when providing personal observations as a reason for discrediting Piracha's pain testimony.
An ALJ may assess the claimant's daily activities but "must make specific findings relating to [the daily] activities and their transferability to conclude that a claimant's daily activities warrant an adverse credibility determination."
Piracha primarily argues that the ALJ erroneously discredited her testimony based on her history of doing leg presses. ECF No. 14 at 7-8. There is no support for this argument because there is no indication that the ALJ considered this observation in her credibility assessment.
However, the ALJ did assess Piracha's daily activities and how they could transfer to a workplace setting. The ALJ found that daily activities such as simple cooking, shopping, taking walks, using a computer, driving, and paying bills "do not comport with the claimant's assertions that she has disabling pain, limitation in walking and standing." AR 29. She also found that these "activities are generally consistent with the assigned light residual functional capacity (RFC) I have found in this case."
An ALJ may assess general credibility by considering prior inconsistent statements.
"While subjective pain testimony cannot be rejected on the sole ground that it is not fully corroborated by objective medical evidence, the medical evidence is still a relevant factor in determining the severity of the claimant's pain and its disabling effects."
When discussing Piracha's medical history, the ALJ concluded that Piracha "testified that she cannot walk on her left foot, but the medical evidence does not show that such a limitation lasted for a year or more." AR 28. The ALJ then thoroughly summarized Piracha's medical history from her ankle surgery in July 2012, to her x-ray examination in June 2013 that showed "the fracture had healed." AR 29. The ALJ identified specific medical testimony that conflicted with specific parts of Piracha's testimony and did not commit legal error.
The ALJ may consider "[t]he type, dosage, effectiveness, and side effects of any medication you take or have taken to alleviate your pain or other symptoms." 20 C.F.R. § 404.1529(c)(3)(iv) (2015).
ALJ's are encouraged to consider "[t]reatment, other than medication, you receive or have received for relief of your pain or other symptoms." 20 C.F.R. § 404.1529(c)(3)(v) (2015). That a claimant's pain was "not severe enough to motivate her to seek [certain] forms of treatment, even if she sought some treatment, is powerful evidence regarding the extent to which she was in pain."
The ALJ found that "[t]here has been minimal medical treatment since August 2013 [], and this indicates that the claimant's ankle fracture has healed completely and she has not had pain and symptoms severe enough to seek further, ongoing and regular treatment." AR 29. The ALJ accurately points to a five month period where Piracha did not seek surgery, physical therapy, nor regular medical treatment.
The ALJ did not meet the applicable standard when assessing Piracha's behavior during the hearing. However, she properly assessed Piracha's daily activities, inconsistent statements, objective medical evidence, medication use, and minimal treatment. Because she gave five specific, clear, and convincing reasons for discrediting Piracha's pain testimony, her single erroneous finding is harmless and does not warrant reversal.
"When a claimant submits evidence for the first time to the Appeals Council, which considers that evidence in denying review of the ALJ's decision, the new evidence is part of the administrative record, which the district court must consider in determining whether the Commissioner's decision is supported by substantial evidence."
Here, the claimant submitted an August 25, 2015 doctor's letter with bone density exam results to the Appeals Council. AR 225. The Appeals Council stated that the new evidence did not affect the ALJ's decision because the "new information [wa]s about a later time." AR 2. However, osteoarthritis does not suddenly develop. While this report is dated two months after the hearing decision, it relates to the time period before the hearing decision.
The Court would therefore be required to consider this new evidence if it could, but it does not appear in the record and Piracha has supplied it.
The Court concludes that the ALJ did not err in developing the record. The ALJ made one harmless error when making the adverse credibility determination, but her ultimate credibility determination is still valid. The Court also concludes that while the Appeals Council should not have rejected the new evidence offered by Piracha, the ALJ's decision is supported by substantial evidence. The Court therefore DENIES Piracha's motion for summary judgment and GRANTS the Commissioner's cross-motion for summary judgment.