Cuauhtemoc Florentino Ayala v. Carolyn W. Colvin
Filing
19
MEMORANDUM DECISION AND ORDER by Magistrate Judge Frederick F. Mumm: The judgement of the Commissioner is reversed and this matter is remanded for further proceedings consistent with this opinion. (see document for further details) (klg)
1
2
3
4
5
6
7
8
UNITED STATES DISTRICT COURT
9
CENTRAL DISTRICT OF CALIFORNIA
10
CUAUHTEMOC FLORENTINO
AYALA,
11
12
13
14
Plaintiff,
v.
NANCY A. BERRYHILL, Acting
Commissioner of Social Security,
Defendant.
15
)
)
)
)
)
)
)
)
)
)
)
)
No. CV 16-1506 FFM
MEMORANDUM DECISION AND
ORDER
16
17
Plaintiff brings this action seeking to overturn the decision of the Commissioner
18
of the Social Security Administration1 denying his application for disability insurance
19
benefits. Plaintiff and defendant consented to the jurisdiction of the undersigned United
20
States Magistrate Judge pursuant to 28 U.S.C. § 636(c). Pursuant to the August 22,
21
2016, Case Management Order, on May 8, 2017, the parties filed a Joint Stipulation
22
(“JS”) detailing each party’s arguments and authorities. The Court has reviewed the
23
administrative record (the “AR”), filed on January 17, 2017, and the Joint Stipulation.
24
For the reasons stated below, the decision of the Commissioner is reversed and this
25
matter is remanded for further proceedings.
26
1
27
28
Nancy A. Berryhill became Acting Commissioner of the Social Security
Administration on January 23, 2017, and is hereby substituted as defendant pursuant
to Federal Rule of Civil Procedure 25(d).
1
PRIOR PROCEEDINGS
2
On or about June 14, 2013, plaintiff applied for disability insurance benefits,
3
alleging disability as of January 1, 2008. After his application was denied initially and
4
on reconsideration, plaintiff requested a hearing before an administrative law judge
5
(“ALJ”). On December 18, 2014, ALJ Christine Long held a hearing. (AR 28-54.)
6
Plaintiff was present with counsel and testified at the hearing.
7
On March 3, 2015, the ALJ denied plaintiff benefits in a written decision. (AR
8
12-27.) Therein, the ALJ reported that in 2003 plaintiff had been involved in a boating
9
accident that resulted in the amputation of his left leg below the knee, for which
10
plaintiff received a prosthesis. Additionally, the ALJ accurately noted that the record in
11
this case contains virtually no medical records documenting the treatment plaintiff
12
presumably received for his leg injury. Based on her review of the scant evidence in the
13
record, the ALJ determined that plaintiff possesses the residual functional capacity
14
(“RFC”) to perform “light work” subject to numerous accompanying limitations. (AR
15
20.) In determining plaintiff’s RFC, the ALJ assigned little weight to certain opinions
16
of Dr. Ibrahim Yashruti, an examining physician and the only physician to render an
17
opinion about plaintiff’s physical limitations. (AR 21.) Ultimately, the ALJ found that
18
plaintiff is able to perform his past relevant work and, therefore, is not disabled.
19
20
On June 13, 2016, the Appeals Council denied review of the ALJ’s decision.
Thereafter, plaintiff initiated this action.
CONTENTIONS
21
22
Plaintiff raises the following contention in this action:
23
1.
24
25
Whether the ALJ failed to properly consider the opinions of Dr. Ibrahim
Yashruti, an examining physician.
STANDARD OF REVIEW
26
Under 42 U.S.C. § 405(g), this Court reviews the Administration’s decisions to
27
determine if: (1) the Administration’s findings are supported by substantial evidence;
28
and (2) the Administration used proper legal standards. Smolen v. Chater, 80 F.3d
2
1
1273, 1279 (9th Cir. 1996) (citations omitted). “Substantial evidence is more than a
2
scintilla, but less than a preponderance.” Reddick v. Chater, 157 F.3d 715, 720 (9th Cir.
3
1998) (citation omitted). To determine whether substantial evidence supports a finding,
4
“a court must consider the record as a whole, weighing both evidence that supports and
5
evidence that detracts from the [Commissioner’s] conclusion.” Auckland v. Massanari,
6
257 F.3d 1033, 1035 (9th Cir. 2001) (internal quotation marks omitted).
If the evidence in the record can reasonably support either affirming or reversing
7
8
the ALJ’s conclusion, the Court may not substitute its judgment for that of the ALJ.
9
Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006) (citing Flaten v. Sec’y of
10
Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995). However, even if
11
substantial evidence exists to support the Commissioner’s decision, the decision must
12
be reversed if the proper legal standard was not applied. Howard ex rel. Wolff v.
13
Barnhart, 341 F.3d 1006, 1014-15 (9th Cir. 2003); see also Smolen, 80 F.3d at 1279.
DISCUSSION
14
15
Plaintiff was examined by Dr. Yashruti on September 30, 2013. (AR 333-36.)
16
Based on the examination, Dr. Yashruti concluded, among other things, that plaintiff
17
can stand or walk for only two hours each work-day and can not kneel, crouch, or crawl.
18
(AR 336.) In her decision denying benefits, the ALJ rejected Dr. Yashruti’s opinions
19
based on the following:
20
[The limitations assigned by Dr. Yashruti] are inconsistent with
21
[plaintiff’s] failure to seek treatment, as discussed above.
22
Further, in testimony and a disability report, [plaintiff] admitted
23
he did heavy work for several years after the amputation, which
24
indicates he had a greater functional capacity than Dr. Yashruti
25
determined.
26
(AR 21.) Plaintiff contends that the ALJ impermissibly rejected the opinions of Dr.
27
Yashruti.
28
///
3
1
The Court agrees with plaintiff that the ALJ did not permissibly reject any of Dr.
2
Yashruti’s opinions. Because Dr. Yashruti was the only physician to offer an opinion
3
about plaintiff’s physical limitations, the ALJ was required to offer clear and convincing
4
reasons, supported by substantial evidence, for rejecting Dr. Yashruti’s opinions. See
5
Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1164 (9th Cir. 2008) (citations
6
omitted). Neither reason provided by the ALJ satisfies that standard.
7
The ALJ’s first reason for discrediting Dr. Yashruti’s opinions — plaintiff’s
8
failure to seek treatment — is improper for several reasons. First, plaintiff explained at
9
the hearing that he was unable to afford medical treatment.2 (AR 40.) The ALJ was not
10
permitted to penalize plaintiff for his financial inability to create a medical record that
11
supports Dr. Yashruti’s findings. See Gamble v. Chater, 68 F.3d 319, 321 (9th Cir.
12
1995) (“Disability benefits may not be denied because of the claimant’s failure to obtain
13
treatment he cannot obtain for lack of funds.”).3 Second, because Dr. Yashruti’s
14
opinions are adequately supported by his observations of plaintiff during the
15
examination, plaintiff’s failure to seek treatment prior to the examination would seem
16
irrelevant to Dr. Yashruti’s conclusions. See Orn v. Astrue, 495 F.3d 625, 632 (9th Cir.
17
2007) (“[W]hen an examining physician provides independent clinical findings . . . such
18
findings are substantial evidence.” (internal quotation marks omitted)). Based on the
19
foregoing, the Court concludes that plaintiff’s failure to seek treatment was not a clear
20
and convincing reason for rejecting Dr. Yashruti’s opinions.
21
The ALJ’s second reason for rejecting Dr. Yashruti’s opinions — that plaintiff
22
performed heavy work for several years after his injury — is also not clear and
23
convincing. The ALJ’s determination in this regard necessarily assumes that plaintiff
24
25
26
27
28
2
The ALJ faulted plaintiff for failing to find free medical treatment.
3
Ordinarily, a claimant’s inability to afford treatment has been applied to reject
an ALJ’s finding that a claimant is not credible. However, because the ALJ relied on
plaintiff’s failure to seek treatment to discredit the examining physician’s opinion, the
reasoning in Gamble is applicable to these circumstances.
4
1
would not have been able to perform heavy work from 2003 to 2008 if he were as limited
2
as Dr. Yashruti found. However, plaintiff testified the use of the prosthesis in
3
combination with the heavy work required by his job worsened his condition. (AR 36,
4
42-43.) Accordingly, the Court rejects the ALJ’s conclusion that plaintiff’s ability to
5
perform heavy work five years prior to Dr. Yashruti’s examination suggests that plaintiff
6
is not as limited as Dr. Yashruti described.
Notwithstanding the Court’s determination that the ALJ incorrectly rejected Dr.
7
8
Yashruti’s opinions, the Court declines to find that plaintiff is disabled. Even assuming
9
that fully crediting Dr. Yashruti’s opinions would render plaintiff unable to perform any
10
work, the record is insufficient to establish that plaintiff was disabled prior to December
11
31, 2012, plaintiff’s date last insured.4 Additionally, even if plaintiff were disabled prior
12
to the date last insured, it is unclear exactly when he became so, a necessary
13
determination for any retroactive calculation of benefits. See Aranda v. Comm’r Soc.
14
Sec. Admin., 405 F. App’x 139, 141 n.2 (9th Cir. 2010). Dr. Yashruti’s opinions are not
15
very helpful in either regard, as they were rendered after plaintiff’s date last insured and
16
approximately five years after the alleged onset date. Accordingly, if the ALJ
17
determines on remand that plaintiff’s limitations, as described by Dr. Yashruti, preclude
18
all work, the ALJ must call a medical expert to testify about plaintiff’s onset date.
19
Armstrong v. Comm’r of Soc. Sec. Admin., 160 F.3d 587, 590 (9th Cir. 1998) (requiring
20
ALJs to seek testimony of medical expert to determine disability onset date where the
21
medical evidence is not conclusive as to the onset date). Additionally, the
22
ALJ should seek any other evidence about plaintiff’s medical history that might help the
23
medical expert make a determination about plaintiff’s onset date.
24
///
25
///
26
27
28
4
A claimant is ineligible to receive disability insurance benefits if he cannot
prove that he was disabled during the period that he was “insured,” i.e. prior to the
date last insured. See 42 U.S.C. § 423(c).
5
CONCLUSION
1
2
3
4
For the foregoing reasons, the judgement of the Commissioner is reversed and this
matter is remanded for further proceedings consistent with this opinion.
IT IS SO ORDERED.
5
6
DATED: November 9, 2017
/S/FREDERICK F. MUMM
FREDERICK F. MUMM
United States Magistrate Judge
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
6
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?