Sheppard v. Berryhill

Filing 32

ORDER by Magistrate Judge Jacqueline Scott Corley granting 19 Plaintiff's Motion for Summary Judgment; denying 26 Defendant's Motion for Summary Judgment. (ahm, COURT STAFF) (Filed on 5/11/2018)

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1 2 3 4 5 6 UNITED STATES DISTRICT COURT 7 NORTHERN DISTRICT OF CALIFORNIA 8 ANTHONY SHEPPARD, 9 Plaintiff, 10 v. 11 United States District Court Northern District of California Case No.17-cv-01332-JSC NANCY A. BERRYHILL, 12 Defendant. 13 ORDER RE: PLAINTIFF AND DEFENDANT’S CROSS-MOTIONS FOR SUMMARY JUDGMENT Re: Dkt. Nos. 19, 26 Plaintiff Anthony Sheppard seeks social security benefits for impairments including: 14 15 depression, posttraumatic stress disorder, and back pain. (Administrative Record (“AR”) 58.) 16 Pursuant to 42 U.S.C. § 405(g), Plaintiff filed this lawsuit for judicial review of the final decision 17 by the Commissioner of Social Security denying his benefits claim. Now before the Court are 18 Plaintiff and Defendant’s Motions for Summary Judgment.1 (Dkt. Nos. 19 & 26.) Because the 19 Administrative Law Judge (“ALJ”) improperly weighed the medical opinion evidence and erred 20 with respect to the adverse credibility finding, the Court GRANTS Plaintiff’s motion, DENIES 21 Defendant’s cross-motion, and REMANDS for further proceedings. LEGAL STANDARD 22 A claimant is considered “disabled” under the Social Security Act if he meets two 23 24 requirements. See 42 U.S.C. § 423(d); Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). 25 First, the claimant must demonstrate “an inability to engage in any substantial gainful activity by 26 reason of any medically determinable physical or mental impairment which can be expected to 27 1 28 Both parties have consented to the jurisdiction of a magistrate judge pursuant to 28 U.S.C. § 636(c). (Dkt. Nos. 7 & 10.) result in death or which has lasted or can be expected to last for a continuous period of not less 2 than 12 months.” 42 U.S.C. § 423(d)(1)(A). Second, the impairment or impairments must be 3 severe enough that he is unable to do his previous work and cannot, based on his age, education, 4 and work experience “engage in any other kind of substantial gainful work which exists in the 5 national economy.” 42 U.S.C. § 423(d)(2)(A). To determine whether a claimant is disabled, an 6 ALJ is required to employ a five-step sequential analysis, examining: (1) whether the claimant is 7 “doing substantial gainful activity”; (2) whether the claimant has a “severe medically determinable 8 physical or mental impairment” or combination of impairments that has lasted for more than 12 9 months; (3) whether the impairment “meets or equals” one of the listings in the regulations; (4) 10 whether, given the claimant’s “residual functional capacity,” the claimant can still do his “past 11 United States District Court Northern District of California 1 relevant work”; and (5) whether the claimant “can make an adjustment to other work.” Molina v. 12 Astrue, 674 F.3d 1104, 1110 (9th Cir. 2012); see 20 C.F.R. §§ 404.1520(a), 416.920(a). 13 When the claimant has drug or alcohol addiction (DAA), the ALJ must first determine 14 whether the claimant is disabled “without separating out the impact of alcoholism or drug 15 addiction. If the ALJ finds that the claimant is not disabled under the five-step inquiry, then the 16 claimant is not entitled to benefits and there is no need to proceed with the analysis under 20 17 C.F.R. §§ 404.1535 or 416.935.” Bustamante v. Massanari, 262 F.3d 949, 955 (9th Cir. 2001). If 18 the claimant is disabled without separating the DAA impact, then the ALJ “should proceed under 19 §§ 404.1535 or 416.935 to determine if the claimant would still be found disabled if he or she 20 stopped using alcohol or drugs.” Id. (citations omitted). Specifically, the ALJ must determine 21 “which of the claimant’s disabling limitations would remain if the claimant stopped using drugs or 22 alcohol.” Parra v. Astrue, 481 F.3d 742, 747 (9th Cir. 2007); 20 C.F.R. § 404.1535(b). “If the 23 remaining limitations would still be disabling, then the claimant’s drug addiction or alcoholism is 24 not a contributing factor material to his disability. If the remaining limitations would not be 25 disabling, then the claimant’s substance abuse is material and benefits must be denied.” Parra, 26 481 F.3d at 747. Through this process, the claimant has the burden of proving that he is disabled. 27 Social Security Ruling (“SSR”) 13-2P, 2013 WL 621536, at *4 (2013). 28 The evidence used in the materiality analysis differs depending on whether the claimant’s 2 1 disabilities are physical or mental. Id. at *7. If mental, the ALJ “must have evidence in the case 2 record that establishes that a claimant with a co-occurring mental disorder(s) would not be 3 disabled in the absence of DAA. Unlike cases involving physical impairments, we do not permit 4 adjudicators to rely exclusively on medical expertise and the nature of a claimant’s mental 5 disorder.” Id. at *9. 6 In addition to the SSR 13-2P DAA materiality analysis, when the impairment is mental, a 7 failure to meet a listed impairment under Appendix 1 does not end the ALJ’s analysis. SSR 85-15, 8 1985 WL 56857, *4 (1985). “[T]he final consideration is whether the person can be expected to 9 perform unskilled work.” Id. Further, the ALJ “must not assume that failure to meet or equal a listed mental impairment equates with capacity to do at least unskilled work.” Id. Unskilled work 11 United States District Court Northern District of California 10 requires the sustained ability to: “understand, carry out, and remember simple instructions; to 12 respond appropriately to supervision, coworkers, and usual work situations; and to deal with 13 changes in a routine work setting. Id. “A substantial loss of ability to meet any of these basic 14 work-related activities would . . . justify a finding of disability.” Id. PROCEDURAL HISTORY 15 16 On October 29, 2012, Plaintiff filed for Supplemental Security Income (“SSI”) under Title 17 XVI of the Social Security Act, alleging disability beginning October 1, 2012 caused by 18 depression, posttraumatic stress disorder, and back pain. (AR 58.) His initial application and 19 request for reconsideration were denied. (AR 80-84, 89-94.) Plaintiff requested a hearing before 20 an ALJ. (AR 95-98.) On August 20, 2014, ALJ Philip Callis conducted the initial hearing. (AR 21 673-94.) The ALJ held a subsequent hearing on March 4, 2015 to allow Plaintiff’s counsel an 22 opportunity to cross-examine the non-examining physicians. (AR 37-49.) In a written decision, 23 the ALJ found that Plaintiff was not disabled within the meaning of the Social Security Act and its 24 regulations and, therefore, was not entitled to SSI benefits. (AR 16-36.) Plaintiff requested an 25 Appeals Council review, but was denied on July 19, 2016. (AR 10-15.) On February 6, 2017, 26 Plaintiff requested and received an extension of time to file a civil action. (AR 1.) Plaintiff 27 commenced this action for judicial review on March 13, 2017 pursuant to 42 U.S.C. §§ 405(g), 28 1383(c)(3). (Dkt. No. 1.) 3 ADMINISTRATIVE RECORD 1 2 I. Medical Evidence A. 4 Plaintiff has a history of mental health problems. Growing up, Plaintiff was exposed to 5 violence, alcohol, and substance abuse. (Id.) When he was 17, he began using marijuana on a 6 daily basis to cope with symptoms of depression and then other illegal drugs as well. (AR 606-7.) 7 Today, he uses marijuana daily and is on a continued methadone treatment. (AR 648.) 8 Physically, Plaintiff has asthma and problems with back and neck pain from a sports injury, but he 9 does not contend that either is disabling. (AR 631, 60.) In 2013, Plaintiff was hit by a car while 10 riding a bicycle and sustained a head injury, but he had no permanent impairment. (AR 562-69, 11 United States District Court Northern District of California 3 631, 50, 60.) B. 12 Medical History Medical Opinions 1. 13 Examining Psychologist Lesleigh Franklin On August 8, 2013, Dr. Lesleigh Franklin examined Plaintiff, conducting a clinical 14 15 interview and a range of psychological exams. (AR 604.) Dr. Franklin diagnosed Plaintiff with 16 Major Depressive Disorder, Severe with Psychotic Features; Opioid Dependence, On Agonist 17 Therapy2; and head trauma. (AR 611.) She reported that Plaintiff was severely impaired in 18 attention, concentration, short-term memory, and visuospatial organization and moderately 19 impaired in social functioning, executive functioning, long-term memory, and judgment. (AR 20 615.) Dr. Franklin observed that Plaintiff demonstrated linear thought processes, but with slowed 21 22 speech and depressed mood and affect. (AR 608.) In many stages of testing he performed 23 average, but fell significantly short of average on memory and emotional regulation. (See id.) On 24 the Mini Mental Status Exam, where extensive neuropsychological illnesses from trauma usually 25 reflects moderate to severe impairment, Plaintiff “demonstrated considerable difficulties.” (AR 26 609-10.) Specifically, his attention was in the extreme low range and his working memory, 27 28 2 Agonist therapy is the use of a drug (the agonist) that mirrors the effects of an addictive drug. 4 1 delayed memory, and impulse control were impaired causing difficulties in task completion, 2 attention, planning, problem solving, and organizing. (AR 609-611.) Plaintiff had significant 3 difficulties in executive functioning such as impulse control and immediate memory as well as 4 moderate difficulties in behavioral and emotional regulation. (AR 610-11.) 5 In another psychological exam studying emotions, Plaintiff demonstrated ongoing severe 6 depression and psychosis, symptoms of anxiety as well as auditory hallucinations, thought 7 disorganization, and persecutory ideation. (AR 611-12.) Testing results indicated that he 8 “struggles with controlling his behavior and often externalizes his emotional difficulties through 9 aggressive behavior,” and fears he will lose control. (AR 612.) “He generally disliked being around a lot of people,” having specific difficulties with authorities, but he sometimes seeks out 11 United States District Court Northern District of California 10 social interactions. (Id.) Dr. Franklin noted that the validity indicators on this test suggested the 12 need to interpret the results with extreme caution as there was a tendency to “over-report and 13 endorse atypical items.” (AR 611.) 14 In the interview, Plaintiff reported socializing at school with many friends. (AR 605.) He 15 also had an intimate relationship for the last five years, but few other long-term relationships. (AR 16 606.) Plaintiff has a daughter whom he sees frequently and friends he sees occasionally. (Id.) 17 Two months prior to the interview, he was hit by a car while riding his bicycle without a 18 helmet. (AR 606.) Since then, he has had frequent headaches and dizzy spells. (Id.) He also 19 reported some neck pain from an old football injury. (Id.) Plaintiff had a history of drug use, was 20 currently on a methadone treatment, and smoked marijuana a few times a week. (AR 606-7.) 21 Dr. Franklin reported that since childhood Plaintiff experienced depression: twice 22 attempting suicide and self-harmed, but he did not presently have suicidal ideation. (AR. 607.) 23 During periods of severe depression, he experienced auditory hallucinations with voices different 24 from his own consciousness that tried to “persuade him to do things he does not want to do.” (Id.) 25 In 2003, he was assaultive toward his family. (Id.) In adolescence, Plaintiff attended therapy at a 26 group home, but he had not received therapy as an adult. (AR 605, 7.) In 2012, he was prescribed 27 Remeron, which “seemed to help with his mood,” but he did not refill his prescription. (AR 607.) 28 5 1 Plaintiff complained of difficulties with motivation, memory, concentration (frequently missing 2 appointments), and finding pleasure in activities. (Id.) 2. 3 Counselor Haruka Kelley 4 Also in August 2013, counselor Haruka Kelley, at Humanistic Alternatives to Addiction 5 Research & Treatment, Inc., a methadone program, provided a statement of her six-month long 6 addiction treatment of Plaintiff. (AR 619.) She reported he was in good standing, but noted that 7 Plaintiff had “been dismissed from multiple social service programs due to inability to keep 8 appointments and poor attendance compliance. . . . despite his intentions. (Id.) She opined that 9 his general mental emotional state and his head injury (the bicycle-car accident) affected his 10 ability to complete tasks. (Id.) 3. United States District Court Northern District of California 11 12 Non-examining Psychologist Peter Bradley On September 24, 2013, Dr. Peter Bradley submitted a “Disability Determination 13 Explanation” finding Plaintiff not disabled from a review of medical records, including Dr. 14 Franklin and counselor Kelly’s reports. (AR 58-72.) Dr. Bradley found that Plaintiff did not meet 15 a listed impairment and that a drug and alcohol addiction materiality determination was not 16 required. (AR 72.) However, Dr. Bradley also found that Plaintiff was severely impaired by 17 substance addiction disorder, anxiety disorders, and affective disorders. (AR 65.) He found 18 moderate limitation in social functioning; maintaining concentration, persistence and pace; 19 understanding, remembering, and carrying out detailed instructions; performing scheduled 20 activities; maintaining attendance; working in coordination or close proximity with others; 21 interacting with the general public; and responding appropriately to work setting changes. (AR 22 65, 68-69.) 23 In making his report, Dr. Bradley gave less weight to Dr. Franklin’s evaluation because it 24 was not consistent with her own exam or the record. (AR 68-69.) He noted that Dr. Franklin’s 25 examination was a one-time appointment, that she relied heavily on Plaintiff’s reports, and that 26 there was no indication she reviewed Plaintiff’s current records. (AR 67.) 27 28 6 4. 1 2 Examining Psychiatrist Rene Thomas On October 16, 2013, Dr. Rene Thomas examined Plaintiff, with a follow-up examination 3 on January 22, 2014. (AR 630, 634, 640.) She diagnosed him with: major depressive disorder, 4 single episode and polysubstance abuse, in recovery. (AR 634.) She noted Plaintiff’s history of 5 suicide attempts and self-mutilation. (Id.) She also noted that he was hit by a car while riding a 6 bicycle in May of 2013. (Id.) Plaintiff had a chronically moderate-to-severe depressed mood with 7 a mildly depressed affect. She prescribed Zoloft for depression and a follow-up visit. (AR 635.) 8 In the follow-up, Plaintiff reported that his mood improved “some” with Zoloft; however, 9 he continued to feel depressed and frustrated with a mildly depressed affect. (AR 640.) She again diagnosed him with major depressive disorder, single episode and polysubstance abuse, in 11 United States District Court Northern District of California 10 recovery. (Id.) Dr. Thomas increased his dosage of Zoloft and provided 17 minutes of 12 psychotherapy. (Id.) 5. 13 14 Examining Psychologist Deepa Abraham In July 2014, Dr. Deepa Abraham examined Plaintiff twice at Plaintiff’s request. (AR 15 646.) She performed a clinical interview, administered psychological tests, and examined records 16 from Drs. Thomas and Franklin, counselor Kelley, and the Sausal Creek Outpatient Stabilization 17 Clinic. (Id.) 18 Dr. Abraham diagnosed Plaintiff with: Depressive Disorder Not Otherwise Specified; 19 Cannabis Dependence; and Opioid Dependence, Sustained Full Remission, on Agonist Therapy. 20 (AR 655-56.) She opined that his “depressive symptoms . . . may reflect the dulling effect of 21 marijuana and contribute to a sense of lethargy and fatigue,” and that his marijuana use “sustained 22 his Depressive Disorder.” (AR 657). Dr. Abraham concluded that Plaintiff’s Depressive Disorder 23 “can be managed with psychotropic medications.” (AR 656-57.) 24 Plaintiff was markedly impaired in his “mental abilities to attend, sustain effort, 25 comprehend or remember” and moderately impaired in social interactions and adaptation. (AR 26 658-659.) Dr. Abraham opined that Plaintiff may be considered to have a permanent psychiatric 27 disability maintained by “persistent negative mood states; continued cannabis dependence; [and] 28 hypothesized drug exposure during gestation,” but various forms of therapy and treatment would 7 1 “decrease to an extent the observed disability.” (Id.) Dr. Abraham noted that Plaintiff would have 2 difficulty competing for jobs due to his Depressive Disorder symptoms. (AR 658.) 3 In testing, Dr. Abraham noted that Plaintiff’s short-term memory was significantly 4 compromised, but qualified that his inattentiveness could have affected the results. (AR 651.) He 5 had no difficulty with long-term memory. (Id.) Dr. Abraham also opined his “poor concentration 6 and attention” was due to his drowsiness. (Id.) 7 Dr. Abraham noted that Plaintiff “behaved in a socially acceptable and polite manner, but 8 came across as fatigued” falling asleep throughout the session. (AR 649.) He was over an hour 9 late to his first session. (Id.) At the second session, Plaintiff arrived timely, but “[h]e struggled to maintain eye contact . . .” and “he failed to exert effort when participating in the assessment.” 11 United States District Court Northern District of California 10 (Id.) Thus, Dr. Abraham opined that the “scores may not accurately reflect [Plaintiff’s] true 12 functioning.” (Id.) He had a mildly depressed mood and affect. (AR 650-51.) He was generally 13 “lethargic and melancholic as well as self-deprecating.” (AR 651.) On one test, negative mood 14 states mildly compromised Plaintiff’s performance. (AR 654.) 15 Plaintiff’s IQ was low borderline average, but again his inattention altered the results from 16 his true cognitive functioning, and so Dr. Abraham noted the inconsistency between her results 17 and Dr. Franklin’s. (AR 653.) On perceptual reasoning and verbal perception he was in average 18 ranges. (Id.) His working memory was borderline average, suggesting mild impairment of 19 immediate recall, limited concentration and attention, and struggles with complexity and 20 processing speed. (Id.) 21 In the clinical interview, Plaintiff reported “a history of symptoms consistent with 22 depression,” and memory deficits from his head injury. (AR 647.) 23 and he demonstrated poor word-finding skills.” (AR 649.) Plaintiff reported that the Zoloft 24 treatment made him “more calm. Nothing was bothering [him]. [He] could tell it was working, 25 but it made [him] feel like a zombie.” (AR 648.) 26 hobbies or socialize with friends, just his girlfriend and family. (AR 652.) 27 28 8 “His speech sounded slurred Plaintiff reported that he does not have 6. 1 Non-examining Physician Minh Vu 2 Dr. Minh Vu provided a “Medical Interrogatory Physical Impairment(s)” for Plaintiff on 3 December 14, 2014. (AR 660-62.) In the interrogatory, Dr. Vu noted Plaintiff’s traumatic brain 4 injury and the moderate swelling on a CT impression, but reported that no acute intracranial 5 abnormality was seen. (AR 660.) She assessed Plaintiff’s records and did not find that he met a 6 listed impairment for physical disabilities, but did not provide an opinion on psychological 7 impairments. (See AR 660-61.) 8 9 7. Non-examining Psychologist Michael Lace On December 15, 2014, Dr. Michael Lace provided a “Medical Source Statement of Ability to Do Work-related Activities (Mental)” and a “Medical Interrogatory-Mental 11 United States District Court Northern District of California 10 Impairment(s)” for Plaintiff. (AR 663-71.) Dr. Lace opined that Plaintiff was markedly impaired 12 in understanding, remembering, carrying out, and making judgments on complex instructions and 13 work-related decisions. (AR 663.) Dr. Lace also opined Plaintiff was moderately impaired to 14 perform these tasks on simple instructions and work-related decisions. (Id.) Plaintiff was 15 impaired in his ability to interact appropriately. (AR 664.) Specifically, Dr. Lace opined that 16 Plaintiff was moderately to markedly impaired in interactions with the public, supervisors, and co- 17 workers. (Id.) He also found that Plaintiff was markedly impaired in his ability to respond 18 appropriately to usual work situations and to changes in a routine work setting. (Id.) 19 Dr. Lace based these opinions on the four diagnosed conditions: depression, major 20 depressive disorder with psychotic features, opioid dependence, and cannabis dependence. (AR 21 663.) He further noted that Dr. Franklin’s report did not take into account Plaintiff’s cannabis 22 dependence, but does not opine on how or if that should alter the finding of impairment. (See AR 23 663, 67.) Dr. Lace reported under Plaintiff’s interaction impairments that the impairment met a 24 combination of 12.04 and 12.09 listings, but not an individual listing. (AR 664.) However, Dr. 25 Lace also reported this combination of listings generally, implying that the combination of 26 impairments may be based solely on interaction impairments. (AR 669.) Finally, Dr. Lace wrote 27 that his answers would not change if Plaintiff abstained from cannabis. (Id.) 28 9 Regarding Plaintiff’s functional limitations, Dr. Lace found him markedly impaired in 1 2 maintaining social functioning, concentration, persistence or pace, and further, Dr. Lace found him 3 moderately impaired in activities of daily living. (AR 668.) 4 II. The ALJ Hearing 5 On August 20, 2014, Plaintiff appeared with his counsel at his scheduled hearing before 6 ALJ Philip Callis in Oakland, California. (AR 673-94.) Plaintiff and Vocational Expert (“VE”) 7 Malcolm Bordzinsky testified at the hearing. (Id.) A supplemental hearing was conducted on 8 March, 4, 2015 so Plaintiff could cross examine Medical Experts (“MEs”) Dr. Michael Lace, and 9 Dr. Minh Vu3. (AR 40-49.) Plaintiff’s Testimony A. 11 United States District Court Northern District of California 10 Plaintiff testified that in 2013 he worked as a washer in a bakery for a few weeks. (AR 12 678.) He left the position after a co-worker would not stop spraying him with hot pressurized 13 water. (AR 678.) Prior to that job, Plaintiff worked in a warehouse. (AR 680.) When he was a 14 teenager, Plaintiff worked in retail customer service. (AR 681.) Currently, Plaintiff works a few 15 hours a day in his friend’s barbershop, sweeping when necessary. (AR 685.) He previously lived at a homeless shelter, but because he distrusted the people and got into 16 17 altercations, he left. (AR 686.) Plaintiff has neck and back pains. (Id.) He sees a doctor to treat his pain, but he has to be 18 19 reminded the morning of appointments or he will forget to appear. (AR 684.) He has seen a 20 psychologist twice for his mental health issues, but he has difficulties remembering the 21 appointments and has to reschedule. (Id.) He is currently attending a methadone clinic once a 22 week to help stay clean. (AR 678.) While at the clinic, the staff remind him to take his 23 medication, so he does not forget. (Id.) He also attends domestic violence classes each week. 24 (AR 688.) He has had difficulties remembering to attend these appointments, but they have been 25 understanding of his situation and have allowed him to exceed the allowable absences. (Id.) 26 27 3 28 Dr. Vu’s testimony is not material to this analysis, as she only testified on exposure to respiratory irritants. (AR 46.) 10 1 Plaintiff was hit by a car while riding his bike and injured his head, requiring around a 2 dozen stitches. (Id.) After the accident he experienced dizziness and memory problems. (AR 3 689.) He continues to have difficulty focusing on a task. (Id.) 4 Plaintiff testified that he currently smokes marijuana, but there have been periods in the 5 past where he did not smoke marijuana. (AR 48, 683.) During those periods of abstinence, his 6 depression symptoms did not improve but stayed the same. (AR 48.) Dr. Lace’s Testimony 7 B. 8 At the ALJ’s request, Dr. Michael Lace testified regarding his interrogatory answers on 9 Plaintiff’s disability. (AR 40-46.) Dr. Lace opined that if Plaintiff ceased using marijuana his depression would improve to the point of non-disability. (AR 41.) Dr. Lace based this opinion on 11 United States District Court Northern District of California 10 his experience and Plaintiff’s poor attendance and poor compliance as consistent with marijuana 12 use. (Id.) He also opined that neither Dr. Franklin nor Dr. Abraham adequately addressed 13 marijuana use as a contributing factor. (AR 42.) Dr. Lace also testified that Plaintiff’s depression 14 could be caused by other factors including: the violence Plaintiff experienced and witnessed 15 growing up, seeing his mother abuse alcohol and drugs, being incarcerated multiple times, and 16 having a stillborn child in 2010. (AR 44.) He also found that Plaintiff’s exposure to violence and 17 drugs in his childhood could have caused posttraumatic stress disorder. (AR 44.) Vocational Expert’s Testimony 18 C. 19 At the ALJ’s request, VE Malcolm Brodzinsky, who was present for Plaintiff’s testimony, 20 testified regarding Plaintiff’s ability to perform work. (AR 691-693.) The ALJ first proposed a 21 hypothetical individual limited to jobs avoiding concentrated exposure to respiratory irritants and 22 also “limited to simple, unskilled work with minimal co-worker and public contact.” (AR 691.) 23 The VE found that there were jobs in the national economy and named three for the ALJ: Hand 24 packager (DOT 920.587-018), medium exertion, unskilled with and SVP of 2; (2) Kitchen Helper 25 (DOT 318.687-010), medium exertion, unskilled with an SVP of 2; and (3) Bench Assembler 26 (DOT 739.687-030), light exertion, unskilled with and SVP of 2. (AR 691.) 27 The ALJ limited the hypothetical in a series of ways including: (1) the individual could not 28 consistently work an eight-hour workday; (2) the individual has two to three absences a month; (3) 11 1 the individual is off-task 25 percent of the time; (4) the individual consistently leaves work 2 suddenly without returning or informing a supervisor; and (5) the individual has regular disputes 3 with co-workers, the public, and supervisors. (AR 692-93.) The VE opined that each of these 4 limitations would preclude employment. (Id.) 5 III. 6 The ALJ’s Findings In a March 2015 written decision, the ALJ found Plaintiff not disabled under section 7 1614(a)(3)(A) of the Social Security Act, taking into consideration the testimony and evidence, 8 and using the SSA’s five-step sequential evaluation process for determining disability. (AR 16- 9 30); see 20 C.F.R. § 416.920(g). Under the first step, the ALJ found that Plaintiff had not engaged in a substantially gainful 11 United States District Court Northern District of California 10 activity since October 29, 2012. (AR 21.) Under the second step, the ALJ found that Plaintiff had 12 the following severe impairments: Depressive Disorder NOS; Cannabis Dependence; and Opioid 13 Dependence, in sustained full remission, on agonist therapy. (Id.) At the third step, the ALJ 14 found that Plaintiff’s impairments medically equaled sections 12.04 and 12.09 of CRF Part 404, 15 Subpart P, Appendix 1. (AR 22.) Given this finding, the ALJ did not proceed to steps four or 16 five. (See id.) As this finding included Plaintiff’s substance use disorders, the ALJ then went onto 17 to assess whether Plaintiff would have a medically determinable impairment if he stopped 18 cannabis abuse. (AR 22-30.) 19 20 First, the ALJ found that Plaintiff’s remaining limitations would cause him to have a severe impairment or combination of impairments. (AR 22.) 21 Second, the ALJ found that Plaintiff’s remaining impairments would not medically equal 22 or exceed an impairment or combinations of impairments listed in 20 C.F.R. Part 404, Subpart P, 23 Appendix 1. (Id.) The ALJ considered sections 3.03, 12.04, and 12.09. (AR 22-23.) 24 Specifically, the ALJ found the Plaintiff would have moderate difficulties in social functioning, 25 concentration, persistence, and pace, and mild restrictions in daily living activities. (AR 23.) 26 However, the ALJ did not find these restrictions met either paragraphs B or C criteria in the 27 listings. (Id.); see 20 C.F.R. Pt. 404, Subpt. P, App. 1 § 12.04(B), (C). Third, the ALJ found that 28 Plaintiff would have the RFC to perform a full range of work at all exertional levels, limited to: 12 1 avoiding concentrated exposure to respiratory irritants, simple unskilled work, and minimal 2 contact with co-workers and the general public. (Id.) In making this RFC determination, the ALJ 3 first found that Plaintiff’s medically determinable impairments could produce his alleged 4 symptoms, but the ALJ did not consider Plaintiff’s statements concerning intensity, persistence, 5 and limiting effect of his symptoms to be credible because they were inconsistent with the RFC 6 assessment. (AR 24.) 7 To make the RFC determination, the ALJ relied on the assessments of Drs. Bradley and 8 Lace, according them great weight because of their consistency with the record. (AR 27.) He also 9 found Dr. Bradley’s assessment consistent with Dr. Thomas’ treatment notes. (Id.) Moreover, the ALJ determined that Dr. Lace was the only medical professional to review the entire record and 11 United States District Court Northern District of California 10 opine on the cannabis’ impact on Plaintiff’s mental functioning. (Id.) 12 The ALJ accorded Dr. Franklin’s opinion little weight because she evaluated the claimant 13 once, and “appeared to have relied, at least in part, on [Plaintiff’s] subjective complaints in 14 reaching her conclusion.” (Id.) He also accorded her little weight as she did not opine on 15 Plaintiff’s cannabis use. (Id.) 16 The ALJ accorded counselor Kelly’s opinion less weight, specifically determining that the 17 statement —“a history of emotional problems, which ‘she understands predate and exist 18 independently from his substance abuse’”—was “less than unequivocal” and suggested reliance on 19 someone else’s conclusions. (Id.) Further, he accorded her opinion less weight because she did 20 not note Plaintiff’s cannabis use. (Id.) 21 Finally, the ALJ accorded Dr. Abraham’s opinion less weight as he also found her 22 functional assessment “at best equivocal.” (Id.) He noted that while Dr. Abraham opined that 23 cannabis dependence “may have contributed to the dulling effect associated with” Plaintiff’s 24 depression, fatigue, and lethargy, Dr. Abraham did not address cannabis’ impact on Plaintiff’s 25 mental functioning. (Id.) 26 The ALJ did not find Plaintiff’s own allegations credible, determining (1) his “fairly 27 extensive activities of daily living;” and (2) his medication were “somewhat effective . . . as 28 evidenced by a lack of more aggressive mental treatment . . . .” (Id.) 13 Returning to the fourth step in the disability determination analysis, the ALJ determined 1 2 that Plaintiff had no past relevant work. (AR 29.) At the fifth step, the ALJ determined that there 3 would be a significant number of jobs in the national economy if Plaintiff stopped his cannabis 4 use. (Id.) Specifically, Plaintiff would be able to perform as: (1) a Hand Packager (DOT 920.587- 5 018), medium exertion, unskilled with and SVP of 2; (2) a Kitchen Helper (DOT 318.687-010), 6 medium exertion, unskilled with an SVP of 2; and (3) Bench Assembler (DOT 739.687-030), light 7 exertion, unskilled with and SVP of 2. (AR 30.) These positions were non-exclusive examples of 8 available jobs. (See id.) Each of these jobs had several hundred thousand jobs available in the 9 national economy. (Id.) Finally, the ALJ determined that Plaintiff’s cannabis addiction was material to the 11 United States District Court Northern District of California 10 disability determination, as he would not be disabled if he stopped cannabis use. (Id.) Therefore, 12 the ALJ concluded that Plaintiff would not be disabled if he stopped cannabis use. (AR 30.) 13 DISCUSSION 14 Plaintiff argues that the ALJ committed numerous errors. First, that the ALJ erred by 15 failing to analyze whether Plaintiff could perform unskilled work under SSR 85-15. Second, that 16 the ALJ erred with respect to the materiality of drug use analysis. Third, that the ALJ erred in 17 evaluating the medical opinions. Fourth, that the RFC determination was not based on substantial 18 evidence. Fifth, that the adverse credibility finding was likewise not based on substantial 19 evidence. Finally, Plaintiff insists that the ALJ erred in failing to find that Plaintiff met Listing 20 21 12.04. Because the ALJ’s weighing of the medical opinion evidence and adverse credibility determination formed the predicate basis for his other findings, the Court’s analysis begins there. 22 23 24 25 26 27 28 I. The ALJ’s Consideration of Medical Opinion Evidence A. Legal Standard In the Ninth Circuit, courts must “distinguish among the opinions of three types of physicians: (1) those who treat the claimant (treating physicians); (2) those who examine but do not treat the claimant (examining physicians); and (3) those who neither examine nor treat the claimant (nonexamining physicians).” Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995) (as 14 1 amended (Apr. 9, 1996)). A treating physician’s opinion is entitled to more weight than that of an 2 examining physician, and an examining physician’s opinion is entitled to more weight than that of 3 a nonexamining physician. Orn v. Astrue, 495 F.3d 625, 631 (9th Cir. 2007). A medical expert’s 4 opinion is weighed the same as a nonexamining physician’s. See SSR 96-6P, 1996 WL 374180, 5 *2 (1996). “The opinion of an examining doctor, even if contradicted by another doctor, can only 6 be rejected for specific and legitimate reasons that are supported by substantial evidence in the 7 record,” and the ALJ “must provide “clear and convincing” reasons for rejecting an uncontradicted 8 opinion of an examining physician. Lester, 81 F.3d at 830-31. 9 “The ALJ can meet this burden by setting out a detailed and thorough summary of the facts and conflicting medical evidence, stating his interpretation thereof, and making findings.” Cotton 11 United States District Court Northern District of California 10 v. Bowen, 799 F.2d 1403, 1407 (9th Cir. 1986), superseded on other grounds by statute, 42 U.S.C. 12 § 423(d)(5)(A), as recognized in Bunnell v. Sullivan, 912 F.2d 1149, 1154 (9th Cir. 1990). 13 Ultimately, “the ALJ must do more than offer his conclusions. He must set forth his own 14 interpretations and explain why they, rather than the doctors’, are correct.” Embrey v. Bowen, 849 15 F.2d 418, 421-22 (9th Cir. 1988). 16 “When an ALJ does not explicitly reject a medical opinion or set forth specific, legitimate 17 reasons for crediting one medical opinion over another, he errs. In other words, an ALJ errs when 18 he rejects a medical opinion or assigns it little weight while doing nothing more than ignoring it, 19 asserting without explanation that another medical opinion is more persuasive, or criticizing it 20 with boilerplate language that fails to offer a substantive basis for his conclusion.” Garrison v. 21 Colvin, 759 F.3d 995, 1012-13 (9th Cir. 2014) (internal citation omitted). In weighing medical 22 opinions, the ALJ may consider (1) the examining relationship, (2) the treatment relationship, (3) 23 the supportability, (4) the consistency, (5) the specialization, and (6) other factors brought to the 24 ALJ’s attention. 20 C.F.R. § 416.927(c)(5). In conducting his review, the ALJ “must consider the 25 entire record as a whole and may not affirm simply by isolating a ‘specific quantum of supporting 26 evidence.’” Hill v. Astrue, 388 F.3d 1144, 1159 (9th Cir. 2012) (internal citations omitted). 27 “Particularly in a case where the medical opinions of the physicians differ so markedly from the 28 ALJ’s[,]” “it is incumbent on the ALJ to provide detailed, reasoned, and legitimate rationales for 15 1 disregarding the physicians’ findings.” Embrey, 849 F.2d at 422. 2 B. 3 The ALJ gave great weight to the opinions of medical expert Dr. Lace and nonexamining 4 physician Dr. Bradley while only according “little” weight to the opinion of examining physician 5 Dr. Franklin and “less” weight to the opinion of examining physician Dr. Abraham. (AR 27-28.) Analysis 6 1. 7 The ALJ accorded Dr. Franklin’s opinion little weight for three reasons: (1) she evaluated 8 Plaintiff only once; (2) she relied in part on Plaintiff’s own reporting as to his symptoms; and (3) 9 she did not directly address the effects of cannabis or diagnose cannabis dependence. (AR 27.) 10 Dr. Franklin First, that Dr. Franklin only examined Plaintiff once is not a legitimate reason for rejecting United States District Court Northern District of California 11 her medical opinion because “[b]y definition an examining opinion is a one-time examination.” 12 See Smith v. Colvin, No. 14-cv-05082-HSG, 2015 WL 9023486, at *7 (N.D. Cal. Dec. 16, 2015) 13 see also Raven-Jones v. Berryhill, No. 3:16-CV-03766-LB, 2017 WL 1477128, at *15 (N.D. Cal. 14 Apr. 25, 2017) (collecting cases re: same). “Adoption of the ALJ’s reasoning would result in the 15 rejection of virtually all examining opinions.” Smith, 2015 WL 9023486 at *7 (internal citation 16 and quotation marks omitted). The regulations provide a mechanism for according nonexamining 17 and examining physicians less weight than treating physicians who see claimants multiple times. 18 See 20 C.F.R. § 416.927(c). But all things being equal, examining physicians are still entitled to 19 greater weight than physicians who have never examined the claimant. 20 Second, according little weight based on Dr. Franklin’s partial reliance on Plaintiff’s self- 21 reports regarding his symptoms is also not a legitimate basis for rejecting her opinion, as this was 22 far from the sole basis for Dr. Franklin’s assessment. Rather, Dr. Franklin also conducted a 23 clinical interview and a series of psychological tests. (AR 604 (listing eight different assessments 24 performed during the clinical interview).) See Buck v. Berryhill, 869 F.3d 1040, 1049 (9th Cir. 25 2017) (holding that an opinion could not be rejected when based in part on self-report when the 26 opinion was also based on a clinical interview and a mental status evaluation). As “[d]iagnoses 27 will always depend in part on the patient’s self-report” the test is not whether the physician relied 28 on self-reports but whether her “opinion of disability premised to a large extent upon the 16 1 claimant’s own accounts of his symptoms and limitations.” Id. (emphasis added) (citations 2 omitted). Given the multitude of assessments Dr. Franklin performed here, the fact that she also 3 reviewed Plaintiff’s mental health records and conducted a clinical interview, the ALJ erred in 4 rejecting her opinion because she also relied on Plaintiff’s self-reporting of symptoms. 5 However, the ALJ’s rejection of Dr. Franklin’s opinion because she did not “directly 6 address the effects from the claimant’s continued and extensive history of marijuana use and 7 dependence” (AR 27) is a specific and legitimate reason for rejecting her opinion. While Dr. 8 Franklin did note Plaintiff’s cannabis use (AR 606-607 (noting that Plaintiff reported he smoked a 9 few times a week) she did not engage in any analysis as to whether that chronic use contributed to his limitations. As the ALJ noted, “[e]ven Dr. Abraham, who diagnosed the claimant with 11 United States District Court Northern District of California 10 cannabis dependence, similarly suggested consistent with the opinion of Dr. Lace that it can be 12 hypothesized the claimant’s depressive symptoms may reflect the dulling effect of marijuana and 13 contribute to a sense of lethargy and fatigue.” (AR 27-28.) Assuming that Dr. Franklin implicitly, 14 and without explanation, concluded that Plaintiff’s ongoing marijuana use had no effect, the ALJ 15 was entitled to resolve the conflict in the record. See Lewis v. Astrue, 498 F.3d 909, 911 (9th Cir. 16 2007). Thus, the ALJ did not err in according examining physician Dr. Franklin little weight. 17 2. Dr. Abraham 18 The ALJ accorded Dr. Abraham’s opinion less weight because while Dr. Abraham 19 diagnosed Plaintiff with cannabis dependence, her “functional assessment was at best equivocal.” 20 (AR 28.) In other words, while Dr. Abraham speculated that Plaintiff’s lethargy, fatigue and 21 depressive symptoms may be caused by marijuana, he did not opine on whether the marijuana use 22 did in fact cause or contribute to his limitations. Similarly, Dr. Abraham did not address 23 Plaintiff’s chronic marijuana use on his mental functioning. Dr. Lace, however, did. Further, as 24 the ALJ noted, these findings are consistent with those of the medical expert Dr. Lace. (Compare 25 AR 658-59 (Dr. Abraham noting marked impairment in social interactions and ability to attend, 26 sustain effort, comprehend, and remember) with AR 663-64 (Dr. Lace noting marked limitations 27 (1) interacting with public, coworkers, and supervisors; and (2) ability to understand, remember, 28 carry out, and make judgments on complex work-related decisions).) The ALJ chose to give more 17 1 weight to Dr. Lace than to Dr. Abraham because Dr. Lace, unlike Dr. Abraham, explained whether 2 and how Plaintiff’s marijuana use affected those limitations. The ALJ did not err in doing so. 3 3. Dr. Lace 4 The ALJ afforded great weight to the opinion of nonexamining medical expert Dr. Lace. 5 The ALJ cited the following reasons for doing so: (1) he was the only physician to review the 6 entire mental health record; (2) he was the only physician to opine on cannabis’s impact on 7 Plaintiff’s mental health; and (3) his opinion was consistent with the record. The ALJ’s reliance 8 on Dr. Lace’s opinion is particularly critical here because the issue of whether Plaintiff would be 9 disabled even without his cannabis use is the dispositive question. Under the DAA analysis the ALJ is required to assess whether Plaintiff is disabled absent drug abuse. If so, then DAA is 11 United States District Court Northern District of California 10 material, and the Plaintiff is disabled for Social Security purposes. See Parra, 481 F.3d at 747 12 Although the ALJ relied on Dr. Lace’s opinion that Plaintiff would not be disabled absent 13 his cannabis use, the ALJ failed to resolve a conflict between Dr. Lace’s interrogatory response 14 and his testimony. In his interrogatory response, Dr. Lace hand wrote that there would be “no 15 changes” to his impairment report if Plaintiff abstained from drugs. (AR 664.) During his 16 testimony, Dr. Lace twice affirmed that his interrogatory response correctly stated his 17 “conclusions concerning the medical determinable impairments and limitations.” (AR 40, see also 18 AR 45 (noting a change to Plaintiff’s age, but otherwise affirming his impressions and 19 conclusions).) However, he also testified that in his opinion Plaintiff’s depression would improve 20 to the point of non-disability if he were to cease using marijuana. (AR 40-41.) 21 The Commissioner insists that the interrogatory response was nothing more than a 22 scrivener’s error, and even if not, that the ALJ is not required to accord every aspect of a 23 physician’s opinion great weight. While this statement is true, the ALJ here failed to even 24 acknowledge the conflict between the testimony and the interrogatory response. See Hamblin v. 25 Soc. Sec. Admin., 123 Fed. Appx. 274, 276 (9th Cir. 2005) (an inconsistency in a physician’s 26 report “triggered the ALJ’s duty to conduct an appropriate inquiry and develop the record fully 27 and fairly”); Korenica v. Astrue, 346 Fed. Appx. 141, 142 (9th Cir. 2009) (holding an ALJ may 28 weigh a physician’s inconsistent reports if he or she provides specific and legitimate reasons to 18 1 reject an inconsistent portion of the opinion). The ALJ’s failure to investigate or even weigh this 2 inconsistency is especially problematic, where, as here, the opinion in question forms the basis of 3 the ALJ’s RFC and finding of non-disability. 4 The Court cannot assume—as the Commissioner insists—that Dr. Lace’s interrogatory 5 response stating that without substance abuse there would be no changes was simply an error. 6 See Delgado v. Heckler, 722 F.2d 570, 574 (9th Cir. 1983) (holding that the court cannot rule on 7 assumptions that the Secretary requests the court to accept). Indeed, that the response was 8 handwritten—Dr. Lace wrote the words “no changes”—is inconsistent with a mere scrivener’s 9 error. And, in any event, the ALJ did not even acknowledge the inconsistency let alone decide 10 United States District Court Northern District of California 11 that the interrogatory response was an inadvertent mistake. Further, Dr. Lace’s interrogatory response stated that Plaintiff would have marked 12 limitations interacting with the public, supervisors, and coworkers; responding appropriately to 13 usual work situations and changes in routine work setting; and understanding, carrying out, and 14 making judgments on complex work-related decisions. (AR 663-64.) In his testimony, when he 15 stated that Plaintiff’s depression would improve to the point of non-disability if he were to cease 16 smoking marijuana, the only characteristic that Dr. Lace identified as being linked to marijuana 17 use was “poor attendance, poor compliance . . . the treatment and not showing up for things.” (AR 18 41.) Dr. Lace did not testify that ceasing marijuana use would have an effect on the other areas in 19 which he previously identified Plaintiff as markedly limited. The ALJ nonetheless ignored these 20 other areas of limitation while at the same time stating that he gave great weight to the opinion of 21 Dr. Lace in formulating his RFC. Given this conflicting and muddy record, the ALJ’s conclusions 22 regarding Dr. Lace are not supported by substantial evidence. 23 24 * * * Given the unresolved conflict in Dr. Lace’s opinion—on whom the ALJ relied in 25 formatting this RFC and in finding Plaintiff not disabled—the ALJ’s overall weighing of the 26 medical evidence and RFC finding are not supported by substantial evidence. 27 28 19 1 II. The ALJ’s Credibility Determination 2 A. Standard for Assessing Credibility 3 To “determine whether a claimant’s testimony regarding subjective pain or symptoms is 4 credible,” an ALJ must use a “two-step analysis.” Garrison, 759 F.3d at 1014. “First, the ALJ 5 must determine whether the claimant has presented objective medical evidence of an underlying 6 impairment which could reasonably be expected to produce the pain or other symptoms alleged.” 7 Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007) (citations omitted). “Second, if the 8 claimant meets the first test, and there is no evidence of malingering, the ALJ can reject the 9 claimant’s testimony about the severity of [his] symptoms only by offering specific, clear and convincing reasons for doing so.” Id. (citations omitted). The clear and convincing standard is 11 United States District Court Northern District of California 10 “the most demanding required in Social Security cases.” Moore v. Comm’r of the Soc. Sec. 12 Admin., 278 F.3d 920, 924 (9th Cir. 2002). 13 B. Analysis 14 The ALJ found that Plaintiff’s “medically determinable impairments could reasonably be 15 expected to cause the type of alleged symptoms,” but he determined that Plaintiff’s testimony 16 “concerning the intensity, persistence and limiting effects of these symptoms” was not credible for 17 two reasons: (1) Plaintiff’s extensive activities of daily living and (2) Plaintiff’s symptoms’ partial 18 improvement through medication. (AR 24, 29.) Since Plaintiff met the first part of the test, the 19 ALJ could only reject Plaintiff’s testimony regarding his symptoms’ limiting effects due to 20 evidence of malingering or by offering specific, clear and convincing reasons for doing so. See 21 Lingenfelter, 504 F.3d at 1036. The ALJ failed to do so. 22 First, the ALJ determined that Plaintiff’s statements were incredible because of his “fairly 23 extensive activities of daily living.” (AR 29.) Specifically, the ALJ looked at Plaintiff’s care for 24 his niece, barbershop work, and residence search. (Id.) These instances are not clear and 25 convincing reasons to discredit Plaintiff’s testimony. Plaintiff must be “able to spend a substantial 26 part of [his] day engaged in pursuits involving the performance of physical functions that are 27 transferable to a work setting.” Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 2001) (emphasis 28 in original) (citations omitted). Plaintiff cared for his niece occasionally. (AR 652.) He worked in 20 1 his friend’s barbershop for a few hours a day, sweeping hair periodically. (AR 685 (“. . . I’d just 2 sit there until I see enough hair and then I’ll sweep it up and that’s all I do for extra change.”).) 3 Finally, while Plaintiff did indeed search for a permanent residence there is no evidence in the 4 record regarding what the search involved such that the ALJ could conclude that his search was a 5 transferable job skill. (AR 652 (“I try to find somewhere to stay permanently because I’m 6 homeless.”).) None of these activities consume a substantial part of Plaintiff’s day, and they are 7 therefore inapplicable to discredit Plaintiff’s testimony regarding the limiting effects of his 8 symptoms. See Vertigan, 260 F.3d at 1049. The ALJ thus erred in using Plaintiff’s daily activities 9 to discredit his testimony. 10 Second, the ALJ discredited Plaintiff’s testimony because his medication was “somewhat United States District Court Northern District of California 11 effective,” as evidenced by Plaintiff’s own report and the “lack of more aggressive mental 12 treatment.” (AR 29.) However, “while discussing mental health issues, it is error to reject a 13 claimant’s testimony merely because symptoms wax and wane in the course of treatment.” 14 Garrison, 759 F.3d at 1017. “Reports of ‘improvement’ in the context of mental health issues 15 must be interpreted with an understanding of the patient’s overall well-being and the nature of 16 [his] symptoms.” Id. While Plaintiff reported “some” improvement with Zoloft at an examination 17 with Dr. Thomas, he was diagnosed in that same visit with Major Depressive Disorder. (AR 640.) 18 Six months later at an examination by Dr. Abraham, Plaintiff was again diagnosed with 19 Depressive Disorder. (AR 655.) This demonstrates the wax and wane of symptoms that the 20 Garrison court was concerned with. See Garrison, 759 F.3d at 1017. Experiencing “some 21 improvement does not mean that the [Plaintiff’s] impairments no longer seriously affect [his] 22 ability to function in a workplace.” See id. It was an error for the ALJ to rely on the “somewhat 23 effective[ness]” of Plaintiff’s medication regimen to discredit his testimony. 24 25 26 27 28 The ALJ’s adverse credibility finding was thus not based on clear and convincing evidence. * * * Given the Court’s conclusion that the ALJ’s evaluation of Dr. Lace’s opinion and the adverse credibility finding were in error and both of these formed the basis for the RFC and the 21 1 finding of non-disability, the Court declines to consider Plaintiff’s additional arguments. The 2 ALJ’s errors here were not harmless and thus the ALJ’s decision must be reversed. See Molina v. 3 Astrue, 674 F.3d 1104, 1122 (9th Cir. 2012) (an error is harmless if it is “inconsequential to the 4 ultimate nondisability determination”). 5 III. 6 Remand Plaintiff asks the Court to remand for immediate benefits under the credit-as-true rule. 7 Generally, when the Court reverses an ALJ’s decision, “the proper course, except in rare 8 circumstances, is to remand to the agency for additional investigation or explanation.” Benecke v. 9 Barnhart, 379 F.3d 587, 595 (9th Cir. 2004). However, a court may remand for an immediate award of benefits where “(1) the record has been fully developed and further administrative 11 United States District Court Northern District of California 10 proceedings would serve no useful purpose; (2) the ALJ has failed to provide legally sufficient 12 reasons for rejecting evidence, whether claimant testimony or medical opinion; and (3) if the 13 improperly discredited evidence were credited as true, the ALJ would be required to find the 14 claimant disabled on remand.” Garrison, 759 F.3d at 1020. Each part of this three-part standard 15 must be satisfied for the court to remand for an award of benefits, id., and “[i]t is the ‘unusual 16 case’ that meets this standard.” Williams v. Colvin, No. 12–CV6179, 2014 WL 957025, at *14 17 (N.D. Cal. Mar. 6, 2014) (quoting Benecke, 379 F.3d at 595); Leon v. Berryhill, 880 F.3d 1041, 18 1045 (9th Cir. 2017) (“where [...] an ALJ makes a legal error, but the record is uncertain and 19 ambiguous, the proper approach is to remand the case to the agency”) (citing Treichler v. Comm’r 20 of Soc. Sec. Admin., 775 F.3d 1090, 1105 (9th Cir. 2014)). It is only “rare circumstances that result 21 in a direct award of benefits” and “only when the record clearly contradicted an ALJ’s conclusory 22 findings and no substantial evidence within the record supported the reasons provided by the ALJ 23 for denial of benefits.” Leon, 880 F.3d at 1047. 24 In this case, there are outstanding issues that must be resolved before a final determination 25 can be made. In particular, the ALJ must further develop the record regarding Plaintiff’s disability 26 status without cannabis use. On remand, the ALJ must resolve the conflict between Dr. Lace’s 27 interrogatory response and his testimony. The ALJ shall also reassess the medical opinion 28 evidence as a whole, explain the weight afforded to each opinion, and provide legally adequate 22 1 reasons for any portion of an opinion that the ALJ discounts or rejects, including a legally 2 sufficient explanation for crediting one doctor’s opinion over any of the others. The ALJ shall 3 also make a determination regarding the materiality of plaintiff’s substance use in accordance with 4 SSR 13–2p. Bustamante, 262 F.3d at 955; see 20 C.F.R. §§ 404.1535, 416.935; SSR 13–2p. If 5 necessary, the ALJ shall reassess Plaintiff’s RFC and proceed with the remainder of the disability 6 analysis. CONCLUSION 7 8 9 For the reasons stated above, the Court GRANTS Plaintiff’s motion for summary judgment, DENIES Defendant’s motion, and REMANDS for a new hearing consistent with Order. This Order disposes of Docket Nos. 19 & 26. 11 United States District Court Northern District of California 10 IT IS SO ORDERED. 12 Dated: May 11, 2018 13 14 JACQUELINE SCOTT CORLEY United States Magistrate Judge 15 16 17 18 19 20 21 22 23 24 25 26 27 28 23

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