JAMES P. DONOHUE, Chief Magistrate Judge.
Plaintiff Daniel L. Smith appeals the final decision of the Commissioner of the Social Security Administration ("Commissioner") which 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 Commissioner's decision is REVERSED and REMANDED for further administrative proceedings.
At the time of the administrative hearing, plaintiff was a twenty-four year old man with a high school education. Administrative Record ("AR") at 50, 151. Plaintiff testified that he was in special education courses in school. AR at 50. Plaintiff received SSI disability benefits as a child, which ceased when he turned eighteen. Dkt. 12 at 2. After high school, he enrolled with the Washington State Division of Vocational Rehabilitation ("DVR"), which placed him in three jobs: Walmart courtesy associate, shopping cart wrangler, and housekeeper. These work attempts were all ultimately unsuccessful. AR at 31. In November 2013, DVR determined that plaintiff is "unemployable in competitive employment" due to the combination of his physical impairments and intellectual limitations, including "the inability to do any standing and [his] serious limitations in reading, spelling and math[.]" AR at 420. Plaintiff was last gainfully employed in 2013 performing janitorial duties at a mall in Federal Way. AR at 51.
On October 25, 2013, plaintiff filed a claim for SSI payments and DIB, alleging an onset date of July 10, 2012. AR at 16, 294-311.
The Commissioner denied plaintiff's claim initially and on reconsideration. AR at 132, 150-52, 169. Plaintiff requested a hearing, which took place on May 20, 2015. AR at 44-91. On August 27, 2015, the ALJ issued a decision finding plaintiff not disabled and denied benefits based on his finding that plaintiff could perform a specific job existing in significant numbers in the national economy. AR at 13-33. Plaintiff's request for review was denied by the Appeals Council, AR at 1-7, making the ALJ's ruling the "final decision" of the Commissioner as that term is defined by 42 U.S.C. § 405(g). On April 26, 2017, plaintiff timely filed the present action challenging the Commissioner's decision. Dkt. 3.
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.
The Court may direct an award of benefits where "the record has been fully developed and further administrative proceedings would serve no useful purpose." McCartey v. Massanari, 298 F.3d 1072, 1076 (9th Cir. 2002) (citing Smolen v. Chater, 80 F.3d 1273, 1292 (9th Cir. 1996)). The Court may find that this occurs when:
Id. at 1076-77; see also Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir. 2000) (noting that erroneously rejected evidence may be credited when all three elements are met).
As the claimant, Mr. Smith 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 August 27, 2015, the ALJ issued a decision finding the following:
AR at 18-32.
The principal issues on appeal are:
Dkt. 12 at 1; Dkt. 13 at 1.
DVR provided vocational rehabilitation services to plaintiff from June 2010 to November 2013, including three job placements that were ultimately unsuccessful. On November 13, 2013, lead DVR vocational counselor Rickey McDonald, LMHC wrote a letter summarizing plaintiff's failed work attempts and further explaining that plaintiff's case was closed for the following reasons:
AR at 420.
The ALJ considered Mr. McDonald's "other source" statement as required by SSR 06-3p and the social security regulations,
Although the ALJ is correct that Mr. McDonald's opinion about plaintiff's employability is not binding on the ALJ, because the question of whether a claimant is disabled under the social security law is reserved to the Commissioner, that is true of any opinion issued by another governmental agency. The ALJ should explain the consideration given to these another agency's decision that a claimant is not disabled, and such consideration should consist of more than simply rejecting the decision by virtue of the fact that it is non-binding. Here, the ALJ indicated that he was affording greater weight to Dr. Washburn's opinion, who "had these [DVR] opinions to consider as well as other information, [and] noted the claimant would have difficulty finding a job on his own, but also that he had the capability to perform certain kinds of unskilled work." AR at 28.
As plaintiff argues, however, the ALJ's summary of Dr. Washburn's report to rebut the vocational evidence appears inaccurate. AR at 28. Dr. Washburn's opinion, when read in context, appears to express agreement with Mr. McDonald's conclusion that plaintiff's combination of impairments rendered him unemployable:
AR at 694-95.
The Court finds that without more, inconsistency with Dr. Washburn's medical opinion was not a germane reason for the ALJ to reject Mr. McDonald's assessment. As discussed below, the ALJ made several errors in evaluating the medical opinions evidence in this case. On remand, the ALJ should also reevaluate Mr. McDonald's assessment, and provide a valid reason for rejecting his vocational opinion, if appropriate.
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 v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989); 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.3d821, 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 v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005).
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 nonexamining doctor's opinion may nonetheless constitute substantial evidence if it is consistent with other independent evidence in the record. Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002); Orn, 495 F.3d at 632-33.
Plaintiff argues that the ALJ's decision is internally inconsistent because the ALJ's finding that plaintiff can perform light level work and therefore stand/walk 25% of the workday, AR at 23, is inconsistent with his adoption of the opinions of Dr. Carlson, Dr. Faria, and Dr. Hutchinson. The ALJ stated that he gave these medical opinions "great weight." Specifically, the ALJ noted the following with respect to each of these physicians' opinions:
AR at 27-28.
AR at 29.
AR at 30.
Despite these physicians' opinions that plaintiff is limited to sedentary work (or likely even more limited than the the definition of sedentary work as defined by the regulations because they opined he can perform only "seated work" and be on his feet for only "brief periods"), the ALJ's RFC assessment in this case only limited plaintiff to "light" work which allows for prolonged standing/walking (30 minutes at a time) for 25% of the workday. AR at 23. The ALJ did not explain why he only limited to plaintiff to light, as opposed to sedentary, work, or explain how a light work limitation is consistent with the doctors' opinions that plaintiff can only perform "seated work." Similarly, the ALJ erred by failing to discuss the opinion of a fourth doctor, Dr. Bourdeau, who also limited plaintiff to sedentary work on a permanent basis. AR at 661. See Lingenfelter v. Astrue, 504 F.3d 1028 fn.10 (9th Cir. 2007) (providing that it was error to discount a doctor's opinion by not mentioning the opinion and simply making findings contrary to it). The ALJ erred by stating that he was assigning these physicians' opinions great weight, and then adopting an inconsistent RFC.
The Commissioner asserts that even if the Court were to find that the ALJ erred in evaluating these physicians' opinions, any such error was harmless because the vocational expert and ALJ identified three sedentary type jobs plaintiff could perform. Dkt. 13 at 9. However, as noted above, it appears that these physicians may have considered plaintiff to be even more limited than the definition of "sedentary" in the regulations, because they limited him to only "seated work" and being on his feet briefly. AR at 650, 719. It is therefore not clear that the VE's testimony, which was based on the ALJ's hypothetical question, adequately took their opinions into account and that the ALJ's errors were harmless. Moreover, in light of the other errors made by the ALJ in evaluating the evidence in this case, the ALJ should reevaluate these opinions on remand.
Dr. Griffin performed a consultative examination for DHS in February 2014. AR at 668-70. Dr. Griffin diagnosed plaintiff with major depressive disorder (severe), learning disorder NOS, and rule out cognitive disorder and attention-deficit hyperactivity disorder. AR at 670. In Dr. Griffin's medical source statement, she opined as follows:
AR at 670.
The ALJ gave Dr. Griffin's opinion little weight because plaintiff "did not undergo as thorough testing during this exam as compared to other psychological exams during the timeframes relevant to this application. Dr. Griffin opined that there was a need for a full neuropsychological evaluation, indicating her opinions were not fully informed and preliminary." AR at 28. The ALJ noted that Dr. Washburn obtained "this additional evaluation. . . and his opinions and conclusions are better informed having both her examination as well as his own more extensive testing." AR at 28.
The ALJ's rationale failed to articulate what aspect of Dr. Griffin's assessment the ALJ believed to have been contradicted by Dr. Washburn's report. Moreover, although the ALJ asserted that he preferred Dr. Washburn's report because Dr. Washburn had the benefit of the neuropsychological testing, unlike Dr. Griffin, the ALJ also declined to fully adopt Dr. Washburn's opinion. For example, the ALJ rejected Dr. Washburn's conclusion that plaintiff "did not have the cognitive skills needed to find employment suited to his pattern of strengths and weaknesses," AR at 28, which seems consistent with Dr. Griffin's opinion. Accordingly, inconsistency between Dr. Griffin's opinion and Dr. Washburn's opinion was not a specific and legitimate reason for the ALJ to reject Dr. Griffin's conclusions.
As noted above, Dr. Washburn conducted a March 2014 neuropsychological evaluation that included a diagnostic interview with mental status evaluation, Wechsler Memory Scale, Wechsler Adult Intelligence Scale, and Trail Making Test. AR at 690-95. Dr. Washburn concluded,
AR at 695.
The ALJ rejected Dr. Washburn's opinion that "Mr. Smith's level of cognitive functioning is such that he does not have the cognitive skills needed to find employment suited to his pattern of strengths and weaknesses," because the ALJ found that "[t]his portion of the opinion is vague as to whether Dr. Washburn refers to the claimant's physical or mental strengths and weaknesses." AR at 28. The ALJ then stated that he gave "this opinion some weight because Dr. Washburn attached the presumption that unskilled work requires physical abilities beyond what the claimant possesses. As Dr. Washburn is a Ph.D. rather than an M.D., he is not qualified to render physical vocational opinions." AR at 28-29. The ALJ gave "more weight to the portion of this opinion that focuses on the claimant's ability to perform unskilled work because it is most consistent with the evidence as a whole including psychological testing done contemporaneously with the issuance of this opinion." AR at 29.
The ALJ's reasons for rejecting this aspect of Dr. Washburn's opinion are not specific, legitimate, or supported by substantial evidence. The ALJ seems to have adopted only the portions of Dr. Washburn's opinion that suggested plaintiff could sustain unskilled work, while ignoring his overall conclusions that took the evidence from DVR into account. Specifically, Dr. Washburn's opinion suggests that neither plaintiff's intellectual disability, nor his limitation to sedentary work, alone rendered him unable to find suitable employment. Rather, as plaintiff's work attempts at DVR demonstrates, it is the unique combination of plaintiff's impairments that rendered plaintiff unemployable. Dr. Washburn was specifically provided with the evidence from DVR by the SSA to be reviewed prior to the psychological evaluation. AR at 690-91. Thus, Dr. Washburn did not provide an opinion regarding plaintiff's physical limitations that was outside his area of expertise, but instead assessed plaintiff's degree of cognitive impairment and how it would affect his ability to perform work in the vocational circumstances described in the DVR report. On remand, the ALJ should reassess Dr. Washburn's opinion, as well as Dr. Griffin's conclusions.
Plaintiff argues that the ALJ in this case erred by failing to discuss plaintiff's IQ scores that appear to meet the intellectual criteria for Listing 12.05(C), as it existed at the time of the ALJ's decision. Specifically, plaintiff was in special education all through school, and he received an IQ score of 67 at Mt. Vernon High School (his last school IQ test). AR at 540. Specifically, the school records provide that "over the years, [plaintiff] has been evaluated several times. . . and his IQ scores ranged from Low average to Mentally retarded. His last IQ was 67 and he demonstrated commensurate delays in adaptive behavior, skills, academics, etc. There was no reason to conduct further IQ testing." AR at 540.
To satisfy Listing 12.05(C) (Intellectual Disability), a claimant must satisfy the following three requirements:
20 C.F.R. pt. 404, subpt. P, app. 1 § 12.05C; Kennedy v. Colvin, 738 F.3d 1172, 1175-76 (9th Cir. 2013).
Here, it is not clear that the ALJ was even aware that plaintiff previously received an IQ score of 67, as he did not acknowledge it in his written decision. In his discussion of Listing 12.05(C), the ALJ did acknowledge that plaintiff satisfied the final requirement of the listing because he has several other severe impairments in the form of "a foot disorder and mental impairments." AR at 23. These other severe impairments would satisfy the Listing requirement of "an additional and significant work-related limitation of function." See Fanning v. Bowen, 827 F.2d 631, 633 n.3 (9th Cir. 1986) (holding that an impairment satisfies this requirement when its impact on a claimant's ability to perform basic work activities is more than slight or minimal, and a step 2 finding of a severe impairment satisfies this test). Plaintiff's school records, which are discussed above, also show that plaintiff satisfies the third requirement. He was in special education classes throughout school, and even received SSI benefits as a minor. AR at 540. Thus, the record indicates that plaintiff has had subaverage general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., onset before age 22. With respect to plaintiff's IQ scores, the ALJ noted only that "he scored as follows on the Weschler Adult Intelligence Scale IV: full scale 72, verbal comprehension 74, perceptual reasoning 77, working memory 71, and processing speed 86." AR at 23. Thus, it appears that the only reason the ALJ concluded that plaintiff did not meet the Listing criteria is because the ALJ believed his IQ scores were too high.
On remand, the ALJ is directed to re-evaluate whether plaintiff meets or equals Listing 12.05(C), and specifically discuss plaintiff's IQ score of 67 as part of his analysis. AR at 540. Although the Commissioner contends that the ALJ "logically used the more recent testing results obtained by Dr. Washburn in March 2015," this is a post hoc argument that was not made by the ALJ. The Court can evaluate the ALJ's decision only on the grounds articulated by the ALJ. Furthermore, ignoring plaintiff's lowest IQ score in favor of his higher scores appears to be inconsistent with the social security regulations and the law of this Circuit.
The ALJ included a very limited discussion of plaintiff's credibility in this case, focused entirely upon his activities of daily living. AR at 26-27.
Because this case is being remanded for reconsideration of the medical evidence, and the Court has found that credibility determinations are inescapably linked to conclusions regarding medical evidence, 20 C.F.R. § 404.1529, the ALJ's credibility finding is also reversed and the issue remanded. Similarly, in this case the ALJ's analysis of plaintiff's father and grandmother's testimony was closely related to his analysis of the medical evidence (such as Dr. Washburn's opinion), and therefore the ALJ should also reconsider their testimony. AR at 30-31. On remand, the ALJ should reevaluate the medical evidence, plaintiff's testimony, and the lay witness evidence.
For the foregoing reasons, this case is REVERSED and REMANDED to the Commissioner for further proceedings not inconsistent with the Court's instructions.