Jason Gregory County v. Carolyn W Colvin

Filing 25

MEMORANDUM DECISION AND ORDER by Magistrate Judge Suzanne H. Segal. IT IS ORDERED that Judgment be entered REVERSING the decision of the Commissioner and REMANDING this matter for further proceedings consistent with this decision. (See document for further details). (mr)

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UNITED STATES DISTRICT COURT

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CENTRAL DISTRICT OF CALIFORNIA

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JASON GREGORY COUNTY,

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No. CV 16-3592 SS

Plaintiff,

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v.

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MEMORANDUM DECISION AND ORDER

NANCY A. BERRYHILL,1
Acting Commissioner of the
Social Security Administration,

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Defendant.

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I.

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INTRODUCTION

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Jason Gregory County (“Plaintiff”) seeks review of the final

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decision of the Commissioner of the Social Security Administration

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(the “Commissioner” or the “Agency”) denying his application for

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social security benefits.

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The parties consented, pursuant to

Nancy A. Berryhill is now the Acting Commissioner of Social
Security and is substituted for former Acting Commissioner Carolyn
W. Colvin in this case. See Fed. R. Civ. P. 25(d).
1

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28 U.S.C. § 636(c), to the jurisdiction of the undersigned United

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States

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decision of the Commissioner is REVERSED and this case is REMANDED

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for

5

decision.

Magistrate

further

Judge.

For

administrative

the

reasons

proceedings

stated

consistent

below,

the

with

this

claimant

must

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II.

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THE FIVE-STEP SEQUENTIAL EVALUATION PROCESS

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To

qualify

for

disability

benefits,

a

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demonstrate a medically determinable physical or mental impairment

12

that prevents him from engaging in substantial gainful activity

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and that is expected to result in death or to last for a continuous

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period of at least twelve months.

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721

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impairment must render the claimant incapable of performing the

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work he previously performed and incapable of performing any other

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substantial gainful employment that exists in the national economy.

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Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999) (citing

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42 U.S.C. § 423(d)(2)(A)).

(9th

Cir.

1998)

(citing

42

Reddick v. Chater, 157 F.3d 715,
U.S.C.

§ 423(d)(1)(A)).

The

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To decide if a claimant is entitled to benefits, an ALJ

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conducts a five-step inquiry.

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steps are:

20 C.F.R. §§ 404.1520, 416.920.

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(1)

Is the claimant presently engaged in substantial

27

gainful activity?

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disabled.

If so, the claimant is found not

If not, proceed to step two.
2

The

1

(2)

Is the claimant’s impairment severe?

2

claimant is found not disabled.

3

If not, the

step three.

4

(3)

If so, proceed to

Does the claimant’s impairment meet or equal one of

5

the specific impairments described in 20 C.F.R.

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Part 404, Subpart P, Appendix 1?

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claimant is found disabled.

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step four.

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(4)

If so, the

If not, proceed to

Is the claimant capable of performing his past

10

work?

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If not, proceed to step five.

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(5)

If so, the claimant is found not disabled.

Is the claimant able to do any other work?

If not,

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the claimant is found disabled. If so, the claimant

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is found not disabled.

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Tackett, 180 F.3d at 1098-99; see also Bustamante v. Massanari,

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262 F.3d 949, 953-54 (9th Cir. 2001) (citations omitted); 20 C.F.R.

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§§ 404.1520(b)-(g)(1) & 416.920(b)-(g)(1).

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The claimant has the burden of proof at steps one through

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four, and the Commissioner has the burden of proof at step five.

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Bustamante, 262 F.3d at 953-54.

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affirmative duty to assist the claimant in developing the record

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at every step of the inquiry.

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claimant meets his burden of establishing an inability to perform

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past work, the Commissioner must show that the claimant can perform

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some

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national economy, taking into account the claimant’s residual

other

work

that

exists

Additionally, the ALJ has an

Id. at 954.

in

3

If, at step four, the

“significant

numbers”

in

the

1

functional capacity (“RFC”), age, education, and work experience.

2

Tackett, 180 F.3d at 1098, 1100; Reddick, 157 F.3d at 721; 20

3

C.F.R. §§ 404.1520(g)(1), 416.920(g)(1).

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so by the testimony of a vocational expert or by reference to the

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Medical-Vocational Guidelines appearing in 20 C.F.R. Part 404,

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Subpart P, Appendix 2 (commonly known as “the Grids”).

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v. Apfel, 240 F.3d 1157, 1162 (9th Cir. 2001).

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has

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limitations, the Grids are inapplicable and the ALJ must take the

both

exertional

The Commissioner may do

(strength-related)

Osenbrock

When a claimant

and

non-exertional

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testimony of a vocational expert.

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869 (9th Cir. 2000) (citing Burkhart v. Bowen, 856 F.2d 1335, 1340

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(9th Cir. 1988)).

Moore v. Apfel, 216 F.3d 864,

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III.

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THE ALJ’S DECISION

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The ALJ employed the five-step sequential evaluation process

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in evaluating Plaintiff’s case.

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Plaintiff met the insured status requirements of the Act through

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December 31, 2015, and had not engaged in substantial gainful

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activity since June 8, 2010, his alleged onset date.

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Administrative Record (“AR”) 30).

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Plaintiff

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herpetic

meningoencephalitis;

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disorder

due

26

associated with general medical condition.

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that Plaintiff’s medically determinable impairment of “abdominal

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pain and problems” was nonsevere.

had

the

to

following

general

At step one, the ALJ found that

At step two, the ALJ found that

severe

impairments:

vascular

medical

4

(Certified

headache

condition;

(AR 31).

history

syndrome;

and

(AR 30).

pain

of

mood

disorder

The ALJ ruled

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At step three, the ALJ found that Plaintiff did not have an

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impairment or combination of impairments that met or medically

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equaled one of the listed impairments in 20 C.F.R. Part 404, Subpart

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P, Appendix 1. (AR 31-32).

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At step four, the ALJ determined that Plaintiff had the RFC

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to perform light work with the following limitations: lift and

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carry 20 pounds occasionally and 10 pounds frequently; stand, walk,

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and/or sit for six hours in an eight-hour workday; occasionally

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climb ladders, ropes, and scaffolds; frequently climb ramps and

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stairs; “should avoid” concentrated exposure to hazards; limited

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to work involving simple repetitive tasks, no more than occasional

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contact with coworkers, and no public contact.

(AR 32).

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In determining Plaintiff’s RFC, the ALJ partially rejected

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the

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Wendel, Ph.D. as inconsistent with Dr. Wendel’s own notes and with

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other medical evidence.

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written by Plaintiff’s treating neurologist, Dr. Pari Young, M.D.,

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but the ALJ did not assign this letter any particular weight.

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36).

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agency medical consultants, but he rejected a 2011 State agency

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assessment on an earlier disability application as “overstat[ing]”

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Plaintiff’s condition.

opinion

of

psychiatric

consultative

(AR 36).

examiner

Dr.

Isadore

The ALJ also discussed a letter

(AR

The ALJ assigned “great weight” to the opinions of State

(AR 37).

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At step four, the ALJ determined that Plaintiff could not

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perform his past relevant work.

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considered Plaintiff’s age, education, work experience, and RFC

(AR 37).

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At step five, the ALJ

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and

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significant numbers in the national economy, including small parts

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assembler, garment folder, and textile assembler.

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Accordingly, the ALJ concluded that Plaintiff was not disabled

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under the Agency’s rules.

concluded

that

Plaintiff

could

perform

jobs

available

in

(AR 37-38).

(AR 39).

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IV.

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STANDARD OF REVIEW

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Under 42 U.S.C. § 405(g), a district court may review the

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Commissioner’s decision to deny benefits.

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the Commissioner’s decision when the ALJ’s findings are based on

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legal error or are not supported by “substantial evidence” in the

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record as a whole.

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(9th Cir. 2001) (citing Tackett, 180 F.3d at 1097); Smolen v.

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Chater, 80 F.3d 1273, 1279 (9th Cir. 1996) (citing Fair v. Bowen,

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885 F.2d 597, 601 (9th Cir. 1989)).

The court may set aside

Aukland v. Massanari, 257 F.3d 1033, 1035

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“Substantial evidence is more than a scintilla, but less than

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a preponderance.”

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Chater, 112 F.3d 1064, 1066 (9th Cir. 1997)).

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evidence which a reasonable person might accept as adequate to

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support a conclusion.” Id. (citing Jamerson, 112 F.3d at 1066;

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Smolen,

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evidence supports a finding, the court must “‘consider the record

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as a whole, weighing both evidence that supports and evidence that

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detracts from the [Commissioner’s] conclusion.’” Aukland, 257 F.3d

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at 1035 (quoting Penny v. Sullivan, 2 F.3d 953, 956 (9th Cir.

80

F.3d

Reddick, 157 F.3d at 720 (citing Jamerson v.

at

1279).

To

6

determine

It is “relevant

whether

substantial

1

1993)).

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or reversing that conclusion, the court may not substitute its

3

judgment for that of the Commissioner.

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21 (citing Flaten v. Sec’y, 44 F.3d 1453, 1457 (9th Cir. 1995)).

If the evidence can reasonably support either affirming

Reddick, 157 F.3d at 720-

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V.

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DISCUSSION

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Plaintiff alleges that the ALJ erred in three ways.

First,

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Plaintiff contends that the ALJ improperly rejected his subjective

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complaints as not entirely credible.

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Points and Authorities (“Plaintiff’s Memo”) at 3-6).

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Plaintiff contends that the ALJ erred in assessing an RFC that did

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not

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irritable bowel syndrome (“IBS”).

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contends that the ALJ improperly analyzed medical evidence from

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Dr. Wendel and Dr. Young, as well as the findings of the State

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agency consultants.

include

limitations

related

to

(Plaintiff’s Memorandum of

Plaintiff’s

(Id. at 6-8).

Second,

headaches

and

Third, Plaintiff

(Id. at 8-11).

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For

the

reasons

discussed

below,

the

Court

agrees

with

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Plaintiff that this case should be remanded to permit the ALJ to

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properly evaluate the medical evidence from Dr. Young and the State

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agency consultants and assess an RFC that properly accounts for

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Plaintiff’s headaches and IBS.2

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Because the Court remands on these grounds, it is unnecessary to
address Plaintiff’s arguments regarding the ALJ’s rejection of
Plaintiff’s subjective complaints.
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1

The

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Impairments Supported By The Record, And The ALJ Did Not

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Properly Evaluate The Medical Evidence

ALJ’s

RFC

Failed

To

Include

Limitations

For

All

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5

A.

Legal Standards

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During step four of the five-step process, the ALJ must make

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a threshold determination as to the claimant’s residual function.

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This determination is an administrative finding reached after

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consideration

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diagnoses,

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Plaintiff’s own subjective symptoms. See generally Social Security

13

Ruling (“SSR”) 96-5p, 1996 WL 374183 (SSA 1996).

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a claimant can still do despite existing limitations.

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C.F.R. § 404.1545(a)(1); see also SSR 96-8p, 1996 WL 374184, at

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*1-*2 (SSA 1996) (“RFC is an assessment of an individual’s ability

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to do sustained work-related physical and mental activities in a

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work setting on a regular and continuing basis. A ‘regular and

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continuing basis’ means 8 hours a day, for 5 days a week, or an

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equivalent work schedule.”); Cooper v. Sullivan, 880 F.2d 1152,

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1155 n.5 (9th Cir. 1989). In evaluating RFC, the ALJ must “consider

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subjective symptoms such as fatigue and pain.”

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1291.

of

all

treatment,

the

relevant

observations,

evidence,
medical

including

records,

and

the
the

The RFC is what
See 20

Smolen, 80 F.3d at

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25

In evaluating a claimant’s RFC, an ALJ must properly analyze

26

the medical evidence.

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(9th Cir. 2012).

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social security cases:

See Hill v. Astrue, 698 F.3d 1153, 1159-60

There are three types of medical opinions in
the opinions of (1) treating physicians
8

1

who examine and treat, (2) examining physicians who examine but do

2

not treat, and (3) non-examining physicians who neither examine

3

nor treat.

4

Opinions of treating physicians are given the greatest weight

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because treating physicians are “employed to cure and [have] a

6

greater

7

individual.”

8

1989); Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003).

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Accordingly, where a treating physician’s opinion is refuted by

Valentine v. Comm’r, 574 F.3d 685, 692 (9th Cir. 2009).

opportunity

to

know

and

observe

the

patient

as

an

Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir.

10

another

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providing specific and legitimate reasons supported by substantial

12

evidence in the record.

13

Cir. 1996) (ALJ must provide clear and convincing reasons for

14

rejecting an unrefuted treating physician’s opinions); see also

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Ryan v. Comm’r, 528 F.3d 1194, 1198 (9th Cir. 2008).

doctor,

the

ALJ

may

not

reject

this

opinion

without

Lester v. Chater, 81 F.3d 821, 830-31 (9th

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17

B.

Analysis

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At step four, the ALJ determined that Plaintiff had the RFC

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to perform light work with the following limitations: lift and

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carry 20 pounds occasionally and 10 pounds frequently; stand, walk,

22

and/or sit for six hours in an eight-hour workday; occasionally

23

climb ladders, ropes, and scaffolds; frequently climb ramps and

24

stairs; “should avoid” concentrated exposure to hazards; limited

25

to work involving simple repetitive tasks, no more than occasional

26

contact with coworkers, and no public contact.

27
28
9

(AR 32).

1

The Court agrees with Plaintiff that the medical evidence is

2

not

3

acknowledged, the record documents extensively that Plaintiff “has

4

had chronic, severe headaches.” (AR 35). However, the RFC assessed

5

does not appear to account for this condition.

6

stated that he did not find the “persistent headaches problem”

7

itself to be “disabling,” (AR 35), and noted that the headaches

8

were “treated with medications,” (AR 35), he did not satisfactorily

9

explain why chronic, severe headaches would have no impact on

10

adequately

reflected

in

the

RFC.

First,

as

the

ALJ

Although the ALJ

Plaintiff’s ability to work.

11
12

This

is

particularly

troubling

given

the

ALJ’s

somewhat

13

selective characterization of the record.

14

stated

15

[Plaintiff] had a dramatic improvement of his migraine severity

16

and frequency, he had become dramatically less photophobic, and he

17

is [sic] continuing not to take any medications and no narcotics.”

18

(AR

19

“continued” and he was placed “back on medications in November

20

2012.”

21

Plaintiff had discontinued narcotics and “over-the-counter” and

22

“p.r.n.” medications, but he was taking Depakote twice daily.

23

538).

24

improvement” after starting Depakote, (AR 538), Plaintiff developed

25

a tremor and elevated liver function test results and had to be

26

“weaned off” Depakote as a result.

27

after being “weaned off” Depakote, Plaintiff reported that he was

28

suffering from “severe and unrelenting” daily headaches and was

that

35).

“[t]he

The

(AR 36).

ALJ

progress

later

notes

noted

in

that

For example, the ALJ

July

2012

showed

Plaintiff’s

that

headaches

The July 2012 progress note actually states that

(AR

More significantly, although Plaintiff reported “dramatic

10

(AR 539).

By November 2012,

1

“extremely photophobic.”

(AR 541).

2

the

omits

3

Plaintiff’s improvement was greater and more sustained, and his

4

headaches less severe on an ongoing basis, than the underlying

5

evidence demonstrates.

6

improperly ignored or discounted significant and probative evidence

7

in the record favorable to Hill’s position . . . and thereby

8

provided an incomplete [RFC] determination.”); Attmore v. Colvin,

9

827 F.3d 872, 877 (9th Cir. 2016) (ALJ may not focus on isolated

evidence

improperly

The ALJ’s characterization of

this

context

and

suggests

that

See Hill, 698 F.3d at 1161 (“[T]he ALJ

10

periods

11

claimant’s condition); Garrison v. Colvin, 759 F.3d 995, 1018 (9th

12

Cir. 2014) (ALJ was not permitted to “cherry-pick” from mixed

13

results to support a denial of benefits).

of

improvement

without

examining

broader

context

of

14
15

Plaintiff’s history of headaches was substantiated in part by

16

a letter and treatment records from Dr. Pari Young, M.D.

17

February 2012 note, Dr. Young stated that, in 2010, Plaintiff had

18

been diagnosed with and treated for herpes simplex encephalitis

19

and had suffered from “severe migraines and headaches” following

20

that diagnosis. (AR 531). At that time, Plaintiff reported chronic

21

daily headaches with severe headaches occurring six or seven times

22

every month.

23

and began to treat his headaches regularly after that with a variety

24

of prescription medications.

(See AR 535-37 (March 2012 progress

25

note

and

26

progress note (“weaning off” Depakote due to high liver function

27

test and development of tremor)), 541-43 (November 2012 progress

28

note (prescribing Topamax)), 544-46 (December 2012 progress note

(AR 531).

(prescribing

In a

Dr. Young reviewed Plaintiff’s records

Depakote

11

Imitrex)),

538-40

(July

2012

1

(Plaintiff

2

Topamax)), 559-61 (May 2013 progress note (Plaintiff reporting

3

“much worsening” of bad headache days since March 2013 bout of

4

pneumonia; increasing Topamax to “seizure doses”)), 567-69 (August

5

2013 progress note (Plaintiff discontinued Topamax after developing

6

kidney

7

(December 2013 progress note (prescribing propranolol))).

reported

stones;

“somewhat

prescribing

manageable

pain”

amitriptyline

and

since

starting

Keppra)),

570-72

8
9

In a January 29, 2014 letter, Dr. Young stated that she had

10

treated Plaintiff since February 2012.

11

reported that Plaintiff had “severe, daily headaches that are

12

refractory to medical treatment,” which caused “severe headache

13

pain on a daily basis.”

14

Plaintiff

15

medications and others had been ineffective, but she was “pursuing

16

a referral to the Headache and Facial Pain center at UCLA.”

17

583).

had

had

(AR 583).

“severe

side

(AR 583).

Dr. Young

Dr. Young further reported that
effects”

from

some

headache

(AR

18
19

The ALJ did not assign the letter any particular weight, but

20

the ALJ appeared to conclude that the letter and Dr. Young’s

21

treatment records were either irrelevant to Plaintiff’s allegations

22

of disability or not credible because Dr. Young never explicitly

23

recommended any restrictions on Plaintiff’s ability to work.

24

36).

25

restrictions, it is error to conclude that severe, daily headaches

26

would have no impact on Plaintiff’s ability to work, as would be

27

required to properly exclude them from consideration for an RFC.

28

At most, Dr. Young’s records were ambiguous on this issue, and it

Although

Dr.

Young

never

12

explicitly

assigned

any

(AR
work

1

was the ALJ’s duty to develop the record further, Tonapetyan v.

2

Halter, 242 F.3d 1144, 1150 (9th Cir. 2001) (ambiguous evidence

3

relevant to a finding of disability triggers the ALJ’s duty to

4

develop the record), particularly considering that Plaintiff was

5

unrepresented by counsel during the hearing before the ALJ.

6

AR 47-49); see also Higbee v. Sullivan, 975 F.2d 558, 561 (9th Cir.

7

1992) (where claimant is not represented, ALJ must “scrupulously

8

and conscientiously probe into, inquire of, and explore for all

9

the relevant facts” and “be especially diligent in ensuring that

(See

10

favorable

11

elicited”).

12

or sought clarification from Dr. Young on this issue, but the ALJ

13

did not do so. Therefore, the ALJ’s analysis of Dr. Young’s opinion

14

was

15

including in the RFC limitations related to Plaintiff’s severe,

16

chronic headaches.

as

well

as

unfavorable

facts

and

circumstances

are

The ALJ could have called a medical expert to testify

inadequate,

and

he

provided

insufficient

reasons

for

not

17
18

The ALJ also did not provide adequate reasons for excluding

19

from the RFC a restriction that Plaintiff required access to a

20

restroom due to IBS.

21

disability application, State agency medical consultant Dr. L.

22

Bobba, M.D., reported that, “considering pain due to headaches,” a

23

sedentary RFC “w hazardous precautions [was] appropriate,” and Dr.

24

Bobba further noted that Plaintiff needed “easy access to rest room

25

facilities due to diarrhea due to IBS.”

26

agency

27

Plaintiff’s RFC was “LIGHT . . . with some limits,” then similarly

28

noted that Plaintiff would require “[b]ath room access for IBS.”

medical

In 2011, in the course of evaluating a prior

consultant

Keith

13

(AR 91).

Quint,

M.D.,

In 2012, State
stated

that

1

(AR 109-10, 128, 133).

2

also documented throughout the medical evidence by a variety of

3

doctors.

4

03).

Plaintiff’s chronic diarrhea and IBS were

(AR 418, 447-50, 453, 456, 481-85, 491-92, 496-97, 502-

5
6

The RFC omits without meaningful explanation any limitations

7

related to Plaintiff’s IBS.

8

impairments, the ALJ found that Plaintiff’s “abdominal pain and

9

problems” were medically determinable but nonsevere because his

10

conditions were being “managed medically,” with no “aggressive

11

treatment” recommended, and the condition would be “amenable to

12

proper control by adherence to recommended medical management and

13

medication compliance.”

14

rejected

15

previously recommended a base RFC of “sedentary” as “overstat[ing]”

16

Plaintiff’s condition.

17

recent assessment is consistent with the current evidence.”

18

37).

the

opinions

In evaluating Plaintiff’s severe

(AR 31).
of

the

(AR 37).

Additionally, the ALJ later

State

agency

consultants

who

The ALJ ruled that “the more
(AR

19
20

Preliminarily, it is unclear whether the ALJ’s finding that

21

Plaintiff’s “abdominal pain and problems” can be managed medically

22

with no aggressive treatment obviates a finding that Plaintiff may

23

require frequent access to a bathroom during work hours.

24

event, the failure to find “abdominal pain and problems” severe at

25

step

26

limitations at step four, as an ALJ formulating an RFC “must

27

consider

28

individual’s impairments, even those that are ‘not severe.’” SSR

two

does

not

limitations

prevent

and

the

ALJ

restrictions

14

from

considering

imposed

by

all

In any

these

of

an

1

96–8p, 1996 WL 374184, at *5 (“While a ‘not severe’ impairment[]

2

standing alone may not significantly limit an individual’s ability

3

to do basic work activities, it may

4

limitations or restrictions due to other impairments -- be critical

5

to the outcome of a claim.”).

6

the earlier opinions of State agency medical consultants because

7

more recent opinions were “consistent with the current evidence,”

8

this finding is vague.

9

Cir. 1988) (“To say that medical opinions [of treating physicians]

10

are not supported by sufficient objective findings or are contrary

11

to the preponderant conclusions mandated by the objective findings

12

does not achieve the level of specificity our prior cases have

13

required.”).

14

earlier

15

recommendation regarding Plaintiff’s ability to access a bathroom.

16

Therefore, the ALJ’s analysis of the State agency consultants’

17

opinions was inadequate, and he provided insufficient reasons for

18

not including in the RFC limitations related to Plaintiff’s IBS.

-- when considered with

To the extent that the ALJ rejected

Cf. Embrey v. Bowen, 849 F.2d 418, 421 (9th

Moreover, even if the ALJ had properly rejected the

assessment

by

Dr.

Bobba,

Dr.

Quint

made

the

same

19
20

For the foregoing reasons, the matter is remanded for further

21

proceedings.

22

and the medical evidence consistent with this Order.

On remand, the ALJ should reassess Plaintiff’s RFC

23
24
25
26
27
28
15

1

VI.

2

CONCLUSION

3
4

Accordingly, IT IS ORDERED that Judgment be entered REVERSING

5

the decision of the Commissioner and REMANDING this matter for

6

further proceedings consistent with this decision.

7

ORDERED that the Clerk of the Court serve copies of this Order and

8

the Judgment on counsel for both parties.

IT IS FURTHER

9
10

DATED:

June 9, 2017

11
12
13

/S/
SUZANNE H. SEGAL
UNITED STATES MAGISTRATE JUDGE

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THIS DECISION IS NOT INTENDED FOR PUBLICATION IN LEXIS/NEXIS,
WESTLAW OR ANY OTHER LEGAL DATABASE.

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