MARCO A. HERNANDEZ, District Judge.
Plaintiff Fred Kelly brings this action seeking judicial review of the Commissioner's final decision to deny supplemental security income (SSI). This Court has jurisdiction pursuant to 42 U.S.C. § 405(g) (incorporated by 42 U.S.C. § 1383(c)(3)). I affirm the Commissioner's decision.
Plaintiff applied for SSI on February 3, 2011, alleging an onset date of August 1, 2010. Tr. 17, 197-205. His application was denied initially and on reconsideration. Tr. 84-97, 98-111.
On December 28, 2012, Plaintiff appeared, with counsel, for a hearing before an Administrative Law Judge (ALJ). Tr. 37-83. On March 1, 2013, the ALJ found Plaintiff not disabled. Tr. 14-36. The Appeals Council denied review. Tr. 1-4.
Plaintiff alleges disability based on L5-S1 disc desiccation, Hepatitis C, rheumatoid arthritis, bipolar disorder, and post-traumatic stress disorder. Tr. 235. At the time of the hearing, he was forty-five years old. Tr. 43. He has a GED. Tr. 45. He has past relevant work experience as a house painter and construction painter. Tr. 30. Because the parties are familiar with the medical and other evidence of record, I refer to any additional relevant facts necessary to my decision in the discussion section below.
A claimant is disabled if 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), 1382c(3)(a).
Disability claims are evaluated according to a five-step procedure.
In the first step, the Commissioner determines whether a claimant is engaged in "substantial gainful activity." If so, the claimant is not disabled.
In step three, the Commissioner determines whether plaintiff's impairments, singly or in combination, meet or equal "one of a number of listed impairments that the [Commissioner] acknowledges are so severe as to preclude substantial gainful activity."
In step four, the Commissioner determines whether the claimant, despite any impairment(s), has the residual functional capacity (RFC) to perform "past relevant work." 20 C.F.R. §§ 404.1520(e), 416.920(e). If the claimant can, the claimant is not disabled. If the claimant cannot perform past relevant work, the burden shifts to the Commissioner. In step five, the Commissioner must establish that the claimant can perform other work.
At step one, the ALJ determined that Plaintiff had not engaged in substantial gainful activity since his February 3, 2011 application date. Tr. 19. Next, at step two, the ALJ determined that Plaintiff has severe impairments of degenerative disc disease, depressive disorder not otherwise specified, Hepatitis C, osteoarthritis, and alcohol abuse. Tr. 19. However, at step three, the ALJ determined that Plaintiff's impairments did not meet or equal, either singly or in combination, a listed impairment. Tr. 20-21.
At step four, the ALJ concluded that Plaintiff has the residual functional capacity (RFC) to perform light work as defined in 20 C.F.R. § 416.967(b) except he can lift less than ten pounds frequently. Tr. 21. He can stand and walk for up to six hours in an eight-hour workday.
With this RFC, the ALJ determined that Plaintiff is unable to perform any of his past relevant work. Tr. 29-30. However, at step five, the ALJ determined that Plaintiff is able to perform jobs that exist in significant numbers in the economy such as small products assembler, bottling line attendant, and marker II. Tr. 30-31. Thus, the ALJ determined that Plaintiff is not disabled. Tr. 31.
A court may set aside the Commissioner's denial of benefits only when the Commissioner's findings are based on legal error or are not supported by substantial evidence in the record as a whole.
Plaintiff contends that the ALJ erred by not performing a drug and alcohol addiction (DAA) analysis, by not further developing the record as to listed impairment 12.05C, and by improperly rejecting lay witness testimony.
Plaintiff argues that the ALJ erred by failing to conduct a DAA analysis when the ALJ herself determined that alcohol abuse was one of Plaintiff's severe impairments. The ALJ remarked on the evidence of Plaintiff's alcohol use throughout her decision but the ALJ never addressed what Plaintiff contends is the unresolved issue of the materiality of Plaintiff's alcohol use.
Plaintiff focuses his argument on the ALJ's treatment of the June 2012 evaluation of Plaintiff by Heather Bee, Psy. D. Tr. 727-41. Dr. Bee conducted a structured clinical interview, reviewed some prior records, and administered two tests.
Dr. Bee made several behavioral observations, including that when Plaintiff entered the room for the evaluation, a strong smell of alcohol was present. Tr. 735. Plaintiff appeared immediately antsy and impatient, asking repeatedly why the evaluation had to last four hours.
Additionally, his performance on the WAIS-IV seemed hindered by his level of agitation and distractability and poor effort. Tr. 736. Dr. Bee stated that Plaintiff's performance on the WAIS-IV was invalid.
On testing, Plaintiff's scores on all of the WAIS-IV Indexes fell within the extremely low range, including his full-scale IQ score of 53.
The PAI showed that Plaintiff experiences significant distress with particular concerns about his physical functioning.
Dr. Bee's diagnostic impressions included: (1) adjustment disorder with mixed anxiety and depressed mood, chronic; (2) bipolar disorder not otherwise specified; and (3) polysubstance dependence, in sustained full remission by client report. Tr. 739. She rated his current Global Assessment of Functioning score at 65.
Tr. 739-40. In addition to her narrative report, Dr. Bee also completed a Mental Residual Functional Capacity Assessment and a Rating of Impairment Severity Report. Tr. 727-30.
In her decision, the ALJ summarized Dr. Bee's report and assessments. Tr. 25, 28. The ALJ specifically noted Dr. Bee's opinions that Plaintiff's conditions seriously interfere with his ability to (1) remember locations and work-like procedures; (2) understand, remember, and carry out very short and simple instructions; (3) sustain an ordinary routine without special supervision; (4) interact appropriately with the general public; (5) maintain socially appropriate behavior and adhere to basic standards of neatness and cleanliness; (6) respond appropriately to changes in the work setting; and (7) be aware of normal hazards and take appropriate precautions. Tr. 28. The ALJ also noted Dr. Bee's opinions that Plaintiff lacked the capacity to (1) understand, remember, and carry out detailed instructions; (2) maintain attention and concentration for extended periods; (3) perform activities within a schedule; (4) maintain regular attendance; and (5) be punctual within customary tolerances.
The ALJ gave Dr. Bee's opinion "some weight" because it was generally consistent with the record. Tr. 28. "Accordingly, the claimant is limited to simple work. He must have the option to stand or stand."
Under the Social Security Act, "[a]n individual shall not be considered disabled . . . if alcoholism or drug addiction would . . . be a contributing factor material to the Commissioner's determination that the individual is disabled." 42 U.S.C. §§ 423(d)(2)(C), 1382c(a)(3)(J). If the Commissioner "find[s] that [a claimant is] disabled and [the Commissioner] [has] medical evidence of [the claimant's] drug addiction or alcoholism, [the Commissioner] must determine whether [the claimant's] drug addiction or alcoholism is a contributing factor material to the determination of disability." 20 C.F.R. §§ 404.1535(a), 416.935(a).
Where the claimant has alcohol or drug addiction issues, the ALJ should first conduct the required five-step sequential evaluation "without separating out the impact of alcoholism or drug addiction."
Plaintiff argues that the ALJ erred by not engaging in the DAA analysis. Plaintiff contends that because there was evidence of alcohol addiction, the ALJ was obligated to determine if Plaintiff's alcohol use is material to his disability. Plaintiff then argues that the ALJ's error was not harmless. He contends that the harmful nature of the ALJ's error is demonstrated by the ALJ's treatment of Dr. Bee's opinion.
Plaintiff notes that if Dr. Bee's opinion were fully credited, the marked limitations in various functions and abilities would compel a finding that Plaintiff is disabled as a matter of law under Listing 12.04. According to Plaintiff, under a proper DAA analysis, the ALJ would have determined if alcohol was a material factor with respect to Dr. Bee's findings by first assessing the issue of disability with alcohol use accounted for. Plaintiff argues that if the ALJ accounted for Plaintiff's alcohol use, the ALJ would have found Plaintiff disabled under this listing.
Plaintiff then contends that under the next part of the DAA analysis, the ALJ would have considered whether Plaintiff was disabled absent evidence of alcohol use. Plaintiff states that the resolution of that issue is unclear because the ALJ simply rejected Dr. Bee's findings without considering whether Plaintiff might have been just as impaired without any alcohol use. Accordingly, Plaintiff argues, the record is unclear that the ALJ's error was inconsequential. Additionally, Plaintiff argues that the ALJ's error was prejudicial because a proper DAA analysis would have required the ALJ to develop the record regarding Plaintiff's intellectual functioning absent the use of alcohol which could have established his disability under Listing 12.05C.
Defendant responds that the ALJ was not required to conduct the DAA analysis because she did not find Plaintiff disabled even considering the effects of his alcohol abuse. Defendant notes that the DAA analysis is required only if the ALJ first finds the claimant disabled while accounting for the limitations from drug or alcohol addiction. Because, Defendant argues, the ALJ did not find the condition precedent, meaning that Plaintiff was disabled under the five-step inquiry even while considering the effects of alcohol abuse, the ALJ was under no obligation to further consider Plaintiff's limitations absent alcohol abuse.
Defendant further argues that the ALJ provided legally sufficient reasons to reject Plaintiff's credibility and reasonably weighed the medical opinions. Plaintiff does not challenge the ALJ's credibility finding and does not challenge the ALJ's assessment of the medical evidence, other than his arguments about the ALJ's treatment of Dr. Bee's opinions.
The ALJ's references to Plaintiff's history of alcohol use and her citation to the part of Dr. Bee's report in which Dr. Bee suspects Plaintiff may have been under the influence of alcohol during the June 2012 evaluation, show that the ALJ was aware of Plaintiff's alcohol use. However, I agree with Defendant that the ALJ's failure to conduct the DAA analysis in this case was not error.
While Plaintiff does not directly challenge the weight the ALJ assigned to Dr. Bee's assessments, his argument that the ALJ's failure to conduct the DAA analysis is not harmless is premised on a contention that the ALJ erred in finding Dr. Bee's opinion "not fully persuasive[.]" Plaintiff contends that the ALJ should have determined whether Plaintiff was as impaired as Dr. Bee found in her assessments in the absence of alcohol. Because the ALJ failed to do that, the ALJ erred in rejecting Dr. Bee's opinion based on the fact that Plaintiff may have been under the influence of alcohol. In other words, the ALJ was wrong to reject Dr. Bee's opinion based on the Plaintiff's possibly being under the influence of alcohol, without considering whether alcohol was material to Dr. Bee's opinion.
The problem with Plaintiff's argument is, as Defendant notes, that the ALJ rejected the full weight of Dr. Bee's opinion for an entirely independent reason: "Dr. Bee seems to rely on subjective complaints, the truthfulness of which is brought into question by the claimant's lack of credibility." Tr. 28. As the ALJ noted, Dr. Bee's report expressly indicates that she relied on Plaintiff's subjective reports in making certain assessments.
An ALJ may reject an examining physician's opinion which is based on subjective complaints by a non-credible claimant.
The ALJ properly rejected Dr. Bee's opinion for reasons entirely unrelated to Plaintiff's alcohol use. Then, the ALJ conducted the full five-step sequential analysis based on other evidence in the record, concluding that Plaintiff was not disabled. Thus, under the Social Security Act, the obligation to conduct the DAA analysis was not triggered. The ALJ did not err.
Plaintiff alternatively argues that the ALJ erred by failing to consider whether Plaintiff was disabled under Listing 12.05C which addresses intellectual disabilities. Under Listing 12.05, a claimant must have "significantly subaverage general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e. the evidence demonstrates or supports onset of the impairment before age 22." 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.05. The requisite level of severity is met by satisfying the requirements of subsections A, B, C, or D.
Plaintiff argues that the evidence in the record required the ALJ to further develop the record to assess whether Listing 12.05C was satisfied, including ordering a consultative examination to ascertain valid IQ scores. Plaintiff contends that the record established a "prima facie" case of intellectual disability but for valid IQ scores. Plaintiff argues that because the ALJ was faced with a plausible 12.05 Listing, and because the record was ambiguous, the ALJ was required to further develop the record.
I disagree. The burden is on the claimant to establish that he or she has an impairment that meets a listed impairment.
The Ninth Circuit rejected a similar request to more fully develop the record in
In
Similarly here, Plaintiff's 12.05C argument acknowledges that there is no valid evidence in the record establishing the required low IQ score. Plaintiff's position, like the claimant's in
Given the lack of other IQ testing evidence in the record, the ALJ's appropriate disregard of Dr. Bee's IQ testing, and no other evidence establishing the requisite IQ score or an equivalent extremely low intellectual functioning, the record was not ambiguous or inadequate and did not require the ALJ to send Plaintiff for a consultative examination.
The ALJ discussed the written testimony of Plaintiff's mother Kathleen Kelly, including the mother's observation of pain in Plaintiff's legs and back to the point where he cannot walk but very short distances of one-quarter block. Tr. 29. She also indicated that sitting or standing could become painful and that Plaintiff moves around a lot to try and get comfortable.
The ALJ gave Plaintiff's mother's statement some weight because it was generally consistent with the record.
Plaintiff argues that the ALJ erred because she did not account for all material limitations related by Plaintiff's mother or explain why they were rejected. He points to his mother's statements regarding his limitations in walking and his inability to sit in a bathtub because he cannot get back up. He argues that these limitations are inconsistent with the RFC providing that Plaintiff can walk six hours out of an eight-hour day and that he has only mild limitations in activities of daily living.
"Lay testimony as to a claimant's symptoms or how an impairment affects the claimant's ability to work is competent evidence that the ALJ must take into account."
Plaintiff himself testified that he could walk only a few blocks and needed help bathing. Tr. 49, 62. The ALJ discussed this testimony. Tr. 22. Assuming that the ALJ's failure to expressly reject Plaintiff's mother's testimony regarding his limitations in walking and bathing was error, the error was harmless. Plaintiff does not challenge that the ALJ gave legally sufficient reasons to reject his testimony. If the ALJ had referred to those reasons to reject the mother's testimony, which did not differ significantly from Plaintiff's testimony, the ALJ would have given germane reasons to reject the mother's testimony. Consequently, the error is harmless.
The Commissioner's decision is affirmed.
IT IS SO ORDERED.