Maserang v. Colvin
Filing
21
REPORT AND RECOMMENDATION re 16 MOTION for Summary Judgment filed by Zscaquline C. Maserang, 19 Cross MOTION for Summary Judgment filed by Nancy A. Berryhill. Court recommends that the case be remanded for further proceedings and the Admini strative Law Judge (ALJ) be instructed not apply the principle of the res judicata presumption of continuing nondisability. Objections to R&R due by 9/12/2017. Replies due by 9/19/2017. Signed by Magistrate Judge Mitchell D. Dembin on 8/29/2017. (jah)
1
2
3
4
5
6
7
8
UNITED STATES DISTRICT COURT
9
SOUTHERN DISTRICT OF CALIFORNIA
10
11
ZSCAQULINE C. MASERANG,
Plaintiff,
12
13
v.
14
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,
15
Defendant.
16
Case No.: 16cv2098-BAS-MDD
REPORT AND
RECOMMENDATION ON CROSS
MOTIONS FOR SUMMARY
JUDGMENT
[ECF Nos. 16, 19]
17
18
Plaintiff Zscaquline C. Maserang (“Plaintiff”) filed this action pursuant
19
to 42 U.S.C. § 405(g) for judicial review of the decision of the Commissioner of
20
the Social Security Administration (“Commissioner”) denying Plaintiff’s
21
application for disability benefits under Title II of the Social Security Act and
22
supplemental security income payments under Title XVI of the Social
23
Security Act. Plaintiff moves the Court for summary judgment reversing the
24
Commissioner and ordering an award of benefits, or, in the alternative, to
25
remand the case for further administrative proceedings. (ECF No. 16).
26
Defendant moved for summary judgment affirming the denial of benefits.
27
(ECF No. 19).
1
16cv2098-BAS-MDD
For the reasons expressed herein, the Court recommends that the case
1
2
be REMANDED to the ALJ for further proceedings.
I. BACKGROUND
3
Plaintiff alleges that she became disabled on May 17, 2011. (A.R. 176,
4
5
182).1 Plaintiff’s date of birth, November 2, 1973, categorizes her as a
6
younger person on the alleged disability onset date. 20 C.F.R. §§ 404.1563,
7
416.963; (A.R. 28).
8
A.
Procedural History
9
On January 17, 2013, Plaintiff filed an application for social security
10
disability insurance benefits, and on January 31, 2013, Plaintiff filed an
11
application for supplemental security income. (A.R. 21). Plaintiff had
12
previously filed for disability insurance benefits and supplementary security
13
income on November 5, 2008. (A.R. 62). Administrative Law Judge (“ALJ”)
14
David L. Wurzel denied those claims on May 16, 2011. (A.R. 59-73). On
15
December 13, 2011, the Appeals Council denied Plaintiff’s request for review
16
of the ALJ’s decision. (A.R. 78).
Plaintiff’s January 2013 claims were initially denied on May 17, 2013,
17
18
and denied upon reconsideration on October 3, 2013. (Id.). On September 19,
19
2014, Plaintiff appeared at a hearing in San Diego, California, before ALJ
20
Jay Levine. (A.R. 36). Plaintiff and impartial vocational expert Harlan S.
21
Stock testified. (A.R. 21).
On January 14, 2015, the ALJ issued a written decision finding Plaintiff
22
23
not disabled. (A.R. 21, 29). Plaintiff appealed, and the Appeals Council
24
declined to review the ALJ’s decision. (A.R. 1). Consequently, the ALJ’s
25
26
27
“A.R.” refers to the Administrative Record filed on November 21, 2016, and
is located at ECF No. 11.
1
2
16cv2098-BAS-MDD
1
2
decision became the final decision of the Commissioner. (Id.).
On August 18, 2016, Plaintiff filed a Complaint with this Court seeking
3
judicial review of the Commissioner’s decision. (ECF No. 1). On November
4
21, 2016, Defendant answered and lodged the administrative record with the
5
Court. (ECF Nos. 10, 11). On April 17, 2017, Plaintiff moved for summary
6
judgment. (ECF No. 16). On May 16, 2017, the Commissioner cross-moved
7
for summary judgment. (ECF No. 19). Plaintiff did not reply to the
8
Commissioner’s response.
II. DISCUSSION
9
10
11
A. Legal Standard
The supplemental security income program provides benefits to
12
disabled persons without substantial resources and with little income. 42
13
U.S.C. § 1382. To qualify, a claimant must establish an inability to engage in
14
“substantial gainful activity” because of a “medically determinable physical
15
or mental impairment” that “has lasted or can be expected to last for a
16
continuous period of not less than 12 months.” 42 U.S.C. § 1382c(a)(3)(A).
17
The disabling impairment must be so severe that, considering age, education,
18
and work experience, the claimant cannot engage in any kind of substantial
19
gainful work that exists in the national economy. 42 U.S.C. § 1382c(a)(3)(B).
20
The Commissioner makes this assessment through a process of up to
21
five steps. First, the claimant must not be engaged in substantial, gainful
22
activity. 20 C.F.R. § 416.920(b). Second, the claimant must have a “severe”
23
impairment. 20 C.F.R. § 416.920(c). Third, the medical evidence of the
24
claimant’s impairment is compared to a list of impairments that are
25
presumed severe enough to preclude work. 20 C.F.R. § 416.920(d). If the
26
claimant’s impairment meets or is equivalent to the requirements for one of
27
the listed impairments, benefits are awarded. Id. If the claimant’s
3
16cv2098-BAS-MDD
1
impairment does not meet or is not equivalent to the requirements of a listed
2
impairment, the analysis continues to a fourth and possibly fifth step and
3
considers the claimant’s residual functional capacity. At the fourth step, the
4
claimant’s relevant work history is considered with the claimant’s residual
5
functional capacity. If the claimant can perform the claimant’s past relevant
6
work, benefits are denied. 20 C.F.R. § 416.920(e). At the fifth step, if the
7
claimant is found unable to perform the claimant’s past relevant work, the
8
issue is whether the claimant can perform any other work that exists in the
9
national economy, considering the claimant’s age, education, work
10
experience, and residual functional capacity. If the claimant cannot do other
11
work that exists in the national economy, benefits are awarded. 20 C.F.R. §
12
416.920(f).
13
Sections 405(g) and 1383(c)(3) of the Social Security Act allow
14
unsuccessful applicants to seek judicial review of a final agency decision of
15
the Commissioner. 42 U.S.C. §§ 405(g), 1383(c)(3). The scope of judicial
16
review is limited and the Commissioner’s denial of benefits “will be disturbed
17
only if it is not supported by substantial evidence or is based on legal error.”
18
Brawner v. Secretary of Health & Human Services, 839 F.2d 432, 433 (9th
19
Cir. 1988) (quoting Green v. Heckler, 803 F.2d 528, 529 (9th Cir. 1986)).
20
Substantial evidence means “more than a mere scintilla” but less than a
21
preponderance. Sandqathe v. Chater, 108 F.3d 978, 980 (9th Cir. 1997). “[I]t
22
is such relevant evidence as a reasonable mind might accept as adequate to
23
support a conclusion.” Id. (quoting Andrews v. Shalala 53 F.3d 1035, 1039
24
(9th Cir. 1995)). The court must consider the record as a whole, weighing
25
both the evidence that supports and detracts from the Commissioner’s
26
conclusions. Desrosiers v. Secretary of Health & Human Services, 846 F.2d
27
573, 576 (9th Cir. 1988). If the evidence supports more than one rational
4
16cv2098-BAS-MDD
1
interpretation, the court must uphold the ALJ’s decision. Allen v. Heckler,
2
749 F.2d 577, 579 (9th Cir. 1984). When the evidence is inconclusive,
3
“questions of credibility and resolution of conflicts in the testimony are
4
functions solely of the Secretary.” Sample v. Schweiker, 694 F.2d 639, 642
5
(9th Cir. 1982).
6
The ALJ has a special duty in social security cases to fully and fairly
7
develop the record in order to make an informed decision on a claimant’s
8
entitlement to disability benefits. DeLorme v. Sullivan, 924 F.2d 841, 849
9
(9th Cir. 1991). Because disability hearings are not adversarial in nature,
10
the ALJ must “inform himself [or herself] about the facts relevant to his
11
decision,” even if the claimant is represented by counsel. Id. (quoting Heckler
12
v. Campbell, 461 U.S. 458, 471 n.1 (1983)).
13
Even if a reviewing court finds that substantial evidence supports the
14
ALJ’s conclusions, the court must set aside the decision if the ALJ failed to
15
apply the proper legal standards in weighing the evidence and reaching his or
16
her decision. Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978). Section
17
405(g) permits a court to enter a judgment affirming, modifying or reversing
18
the Commissioner’s decision. 42 U.S. C. § 405(g). The reviewing court may
19
also remand the matter to the Social Security Administration for further
20
proceedings. Id.
21
B. The ALJ’s Decision
22
The ALJ concluded Plaintiff was not disabled, as defined in the Social
23
Security Act, from May 17, 2011, through the date of the ALJ’s decision,
24
January 14, 2015. (A.R. 29). The ALJ also found Plaintiff did not show
25
changed circumstances sufficient to overcome the presumption of
26
nondisability from the previous ALJ decision on May 16, 2011. (A.R. 22).
27
The ALJ found Plaintiff has the following severe impairments:
5
16cv2098-BAS-MDD
1
polyarthralgia; arthritis; chondromalacia patellar, bilateral knees;
2
fibromyalgia; obesity; degenerative disc disease (“DDD”) and joint disease,
3
lumbar and cervical spine; and hypertension. (A.R. 24). The ALJ determined
4
that Plaintiff did not have an impairment or combination of impairments
5
meeting or medically equivalent to the severity of one of the listed
6
impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§
7
404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925 and 416.926). (A.R. 25).
8
Specifically, the ALJ found that “[n]o treating or examining physician has
9
recorded findings equivalent in severity to the criteria of any listed
10
impairment, nor does the evidence show medical findings that are the same
11
or equivalent to those of any listed impairment of the Listing of
12
Impairments.” (Id.). The ALJ considered listings 1.02, 1.03, 1.04, 4.00 and
13
14.09.
14
15
The ALJ found that Plaintiff has the residual functional capacity
(“RFC”) to:
24
[P]erform light work . . . except [Plaintiff] can lift and/or carry 20
pounds occasionally and 10 pounds frequently; [Plaintiff] can stand
and/or walk 2 hours in an 8-hour workday, in ½ hour intervals;
[Plaintiff] can sit 6 hours in an 8-hour workday; [Plaintiff] cannot
push and/or pull with either leg; [Plaintiff] cannot work around
unprotected heights, temperature extremes, and vibration;
[Plaintiff] cannot walk on uneven ground; [Plaintiff] cannot climb
ladders, but she can occasionally climb stairs and ramps; [Plaintiff]
can occasionally stoop and bend; [Plaintiff] cannot balance;
[Plaintiff] can perform frequent handling and fine fingering;
[Plaintiff] cannot perform power gripping and/or grasping with
either hand; and [Plaintiff] can occasionally lift above shoulder
level.
25
(A.R. 25). After reviewing the record and Plaintiff’s testimony, the ALJ found
26
that Plaintiff’s “medically determinable impairments could reasonably be
27
expected to cause the alleged symptoms; however, [Plaintiff’s] statements
16
17
18
19
20
21
22
23
6
16cv2098-BAS-MDD
1
concerning the intensity, persistence and limiting effects of these symptoms
2
are not entirely credible.” (A.R. 26).
3
Relying on the record and testimony of vocational expert (VE) Harlan S.
4
Stock, the ALJ found that Plaintiff is unable to perform any past relevant
5
work. (A.R. 28). The ALJ stated that the record reflects that Plaintiff
6
worked as a preschool teacher. (Id.). VE Stock testified that this position
7
requires an exertional level that Plaintiff could not perform at her current
8
functional capacity. (A.R. 55).
9
The ALJ found that there are jobs that exist in significant numbers in
10
the national economy that Plaintiff can perform. (A.R. 28). In determining
11
this, the ALJ considered Plaintiff’s RFC; that Plaintiff has a Master’s degree
12
in human services, can communicate in English, and is a “younger
13
individual;” and that transferable job skills are immaterial. (A.R. 26, 28).
14
Based on this information, VE Stock testified that Plaintiff can perform
15
occupations such as dresser, election clerk, and call out operator. (A.R. 29).
16
Accordingly, the ALJ found Plaintiff was not disabled from May 17, 2011, to
17
the date of the ALJ decision, January 14, 2015. (A.R. 29-30).
18
19
In determining that Plaintiff is not disabled, the ALJ noted the
following to be of particular relevance:
20
1.
Plaintiff’s Testimony
21
At the hearing, Plaintiff testified that she was divorced with three
22
children, ages 19, 21, and 8. (A.R. 26). Plaintiff lived with her 8-year-old
23
daughter. (Id.). Plaintiff testified that she was hospitalized due to
24
rheumatoid arthritis and swelling in her legs, and also complained of
25
worsening back and joint pain. (Id.). For insurance reasons, Plaintiff was
26
unable to get an MRI. (Id.).
27
Plaintiff testified that she could not work because it was difficult to
7
16cv2098-BAS-MDD
1
stand on her feet, and she had difficulties with daily activities like washing
2
her hair and walking around her complex. (Id.). She complained of extreme
3
joint pain and swelling and numbness in her knees and legs. (Id.). Plaintiff
4
mostly tried to walk without a cane, but sometimes used one. (Id.).
5
The ALJ found that Plaintiff’s allegations regarding the severity of her
6
symptoms and limitations are greater than expected in light of the objective
7
evidence of record. (A.R. 27).
8
2.
Plaintiff’s 2011-2014 Medical Record
9
On August 8, 2011, Plaintiff attended a rheumatology consultation with
10
Michael Keller, M.D. (A.R. 299-301). Dr. Keller evaluated Plaintiff and
11
diagnosed her with degenerative disease, osteoarthritis polyfocal, and
12
fibromyalgia. (A.R. 301). Plaintiff had negative Antinuclear Antibody2
13
(“ANA”) testing, which resulted in no diagnosis of rheumatoid arthritis. Dr.
14
Keller gave Plaintiff a trial of Lyrica and advised her on the importance of
15
diet and exercise. (Id.).
On August 31, 2012, Plaintiff complained of generalized myalgia and
16
17
arthralgia to King Chavez Health Center. (A.R. 318, 336). Plaintiff also
18
reported at that time that her rheumatologist felt Plaintiff had rheumatoid
19
arthritis. (A.R. 318).
20
On January 28, 2013, Plaintiff’s cervical spine x-ray indicated she had
21
mild DDD at C6-7 without abnormal motion. (A.R. 371). On March 3, 2013,
22
Plaintiff’s screening for rheumatoid arthritis showed elevated inflammatory
23
markers, but her ANA was negative. (A.R. 357). Plaintiff was diagnosed
24
25
26
27
ANA testing assists in screening for autoimmune disorders. Whitendale v.
Astrue, No. 1:10-cv-01561-SKO, 2012 WL 652646, at *1 n.6 (E.D. Cal. Feb. 28,
2012) (citing to https://medlineplus.gov/ency/article/003535.htm).
2
8
16cv2098-BAS-MDD
1
with “likely” rheumatoid arthritis, unspecified myalgias and myositis,
2
unspecified generalized osteoarthritis, Raynaud’s syndrome, and mild
3
degenerative joint disease in the cervical spine. (Id.). Plaintiff evidenced
4
inflammation in her joints and skin with elevated inflammation markers, but
5
negative serologies. (Id.). On August 14, 2013, Dr. Roshan, a treating
6
physician, indicated that Plaintiff continued to have inflammatory arthritis
7
with elevated inflammatory markers, but that her ANA by
8
immunofluorescence was negative. (A.R. 392). Plaintiff had less swelling in
9
her hands, but still had significant pain in her joints and had prolonged
10
morning stiffness. (Id.). Dr. Roshan treated Plaintiff with Methotrexate,
11
authorized her to try Humira, and advised Plaintiff to lose weight. (Id.).
12
On May 16, 2014, Dr. Roshan reported that Plaintiff’ continued to have
13
inflammatory arthritis, fibromyalgia, and connective tissue condition, which
14
were treated with Methotrexate and shoulder injections. (A.R. 401). Dr.
15
Roshan treated Plaintiff’s cervical stenosis with Gabapentin, treated her
16
fatigue with folate and B12, and counseled Plaintiff on weight loss and
17
exercise. (Id.).
18
3.
Dr. Close, Consultative Examiner
19
The ALJ gave great weight to consultative examiner Frederick Close,
20
M.D., a Board certified orthopedic surgeon, and found his opinion consistent
21
with the objective record. (A.R. 27-28). Dr. Close evaluated Plaintiff on April
22
30, 2013, and found that she was not precluded from performing less than
23
light exertional capacity. (A.R. 378-381). Dr. Close reported that Plaintiff
24
was 39 years old with a workers’ compensation injury four years earlier,
25
when a chair was pulled out from under her, causing pain in her joints and
26
back. (A.R. 378). Plaintiff continued to have rheumatoid disease after her
27
workers’ compensation claim closed. (Id.).
9
16cv2098-BAS-MDD
1
Dr. Close’s physical examination determined that Plaintiff had
2
polyarthralgia, rheumatoid arthritis, and chondromalacia patellae knees,
3
bilateral. (A.R. 380). He found that Plaintiff stood and walked with a normal
4
gait and used a cane for balance; had crepitus in both knees; had a negative
5
McMurray test3 and negative straight leg raise test; had generalized
6
tenderness in the rotator cuff bilaterally and wrists; and had a negative
7
Finkelstein test.4 (A.R. 379).
Dr. Close opined that Plaintiff “was able to lift and/or carry 20 pounds
8
9
occasionally and ten pounds frequently; stand and/or walk for four hours with
10
normal rest breaks; sit for six hours with normal rest breaks; use a cane for
11
balance and avoid uneven terrain and long-distance walking; frequently
12
bend, stoop, and crouch; and frequently reach, handle, feel, grasp, and
13
finger.” (A.R. 381).
14
4.
Drs. Taylor-Holmes and Kalmar, State Agency Reviewers
15
The ALJ gave less weight to State agency reviewers Dr. Taylor-Holmes
16
and Dr. Kalmar, who reviewed the record and determined Plaintiff was
17
functionally limited to sedentary work. (A.R. 28, 85-97, 113-125). The ALJ
18
noted that Plaintiff’s treatment records indicated that Plaintiff had
19
rheumatoid arthritis, but negative ANA testing, and an x-ray of Plaintiff’s
20
21
22
23
24
25
26
27
A McMurray test is a “rotation of the tibia on the femur to determine injury
to meniscal structures. . . . A positive test indicates meniscal injury.”
Rodriguez v. Astrue, No. 12-CV-4103, 2013 WL 1282363, at *7 n.45 (E.D. N.Y.
Mar. 28, 2013) (internal citations and quotations omitted).
4 The Finkelstein test is used by physicians to confirm de Quervain’s
tenosynovitis, which is a painful condition affecting the tendons on the thumb
side of the wrist. “The thumb is bent down along the palm and then covered
with the other fingers.” Herring v. Colvin, No. 3:13-CV-00004, 2014 WL
1052078, at *7 n.20 (M.D. Pa. Mar. 18, 2014) (internal citations omitted).
3
10
16cv2098-BAS-MDD
1
cervical spine showed only mild degeneration. (Id.). Accordingly, the ALJ
2
found that Plaintiff had a significant range of light residual functional
3
capacity assessment and was not limited to sedentary work. (See id.).
4
C.
Issues
5
1.
6
Plaintiff’s sole argument on appeal is that the ALJ failed to articulate
Credibility of Plaintiff’s Testimony
7
sufficient reasons to find Plaintiff not credible. (ECF No. 16-1 at 4).
8
Specifically, Plaintiff argues that the ALJ erred in using boilerplate language
9
to discredit her testimony, and in rejecting her testimony based on a lack of
10
objective evidence, which Plaintiff argues is always legally insufficient. (Id.
11
at 6-7). Conversely, Defendant argues that the ALJ offered substantial
12
evidence in finding Plaintiff not entirely credible. (ECF No. 19-1 at 3).
13
Plaintiff’s allegation of error will not be examined here. As discussed
14
below, the Court finds that the ALJ improperly applied the res judicata
15
presumption of continuing nondisability to his standard of review in this
16
case. This constituted clear error.
17
2.
Res Judicata Presumption of Nondisability
18
As noted herein, Plaintiff previously applied and was denied disability
19
benefits. (A.R. 21). Specifically, on May 16, 2011, ALJ David Wurzel ruled
20
that Plaintiff had not “been under a disability… from October 21, 2008,
21
through the date of [his] decision.” (A.R. 73).
22
Ruling on the instant (second) application for disability benefits, on
23
January 14, 2015, ALJ Jay Levine found that Plaintiff had not “been under a
24
disability…from May 17, 2011 through the date of [his] decision.” (A.R. 29).
25
In his decision, ALJ Levine noted that “the documentary evidence reflects the
26
claimant filed prior applications for Title II and Title XVI benefits…which
27
were denied at the initial level on December 18, 2008 and affirmed on May
11
16cv2098-BAS-MDD
1
16, 2011, following a review and hearing conducted by ALJ Wurzel. (A.R.
2
21). ALJ Levine cited to Chavez v. Bowen, 844 F.2d 691 (9th Cir. 1988) for
3
the proposition that “[t]he principles of res judicata apply to administrative
4
decisions. . . .” Id. at 693. He also cited to Lyle v. Secretary of Health and
5
Human Services, 700 F.2d 566 (9th Cir. 1983) for the proposition that “a
6
prior decision, which finds a claimant capable of a certain residual functional
7
capacity, creates a presumption that the claimant continues to be able to do
8
work at that level unless evidence is presented to overcome this
9
presumption.” (A.R. 21). Lastly, ALJ Levine acknowledged that for a
10
claimant to overcome the presumption of continuing nondisability a claimant
11
must prove ‘changed circumstances’ indicating a greater disability, an
12
increase in severity of her impairments or the existence of an impairment not
13
previously considered. (A.R. 21-22). See Taylor v. Heckler, 765 F.2d 872, 875
14
(9th Cir. 1985); AR 97-4(9); 20 C.F.R. 404.1563; 20 C.F.R. 416.963.
15
16
17
18
19
20
21
After citing the applicable legal standard, ALJ Levine subsequently
concluded:
In this case, the claimant has not provided any persuasive
evidence of significant “changed circumstances” that would warrant
a more restricted residual functional capacity than that described
[herein]. In fact, the evidence indicates that claimant is capable of
performing less than light exertional capacity. As such, [I find] the
claimant has not rebutted the presumption of continuing
nondisability.
22
(A.R. 22). From that conclusion, ALJ Levine proceeded to rule upon
23
Plaintiff’s second application.
24
“Normally, an ALJ’s findings that a claimant is not disabled ‘creates a
25
presumption that the claimant continued to be able to work after that date.”
26
Vasquez v. Astrue, 572 F.3d 586, 597 (9th Cir. 2009) (quoting Lester v. Chater,
27
12
16cv2098-BAS-MDD
1
81 F.3d, 821, 827 (9th Cir. 1995)). “[T]he principles of res judicata apply to
2
administrative decisions,” but, “the doctrine is applied less rigidly to
3
administrative proceedings. . . .” Id. Consequently, when a claimant files a
4
second (or subsequent) claim for benefits, the ALJ deciding the subsequent
5
application is required to consider the res judicata effect to be accorded to
6
the prior unfavorable decision. Lester v. Chater, 81 F.3d, 821, 827 (9th Cir.
7
1995). Notably, “[t]he presumption [never] applies, if there are changed
8
circumstances.” Id. (citations omitted.) Changed circumstances that can bar
9
the application of res judicata specifically include a new issue raised by the
10
Plaintiff “such as the existence of an impairment not considered in the
11
previous application.” Id. (citations omitted).
12
In Plaintiff’s first application (2011) ALJ Wurtzel specifically found:
13
17
I find that the claimant has the following medically determinable
impairments that in combination are considered severe under the
Social Security Act and regulations: Degenerative disc disease,
cervical spine, with significant disc-spur complex at C6-C7;
degenerative disc and joint disease, lumbar spine, with disc-spur
complex at L4-L5; hypertension, well controlled; patellofemoral
pain syndrome, both knees; and obesity.
18
(A.R. 64). ALJ Wurzel’s decision does not indicate that fibromyalgia was
19
presented as a basis for Plaintiff’’s claim of disability in the first application
20
or that he considered it in his findings. (A.R. 64).
14
15
16
21
In the application at issue here (2015) ALJ Levine found:
22
The claimant has the following severe impairments: polyarthralgia;
arthritis; chondromalacia patellar, bilateral knees; fibromyalgia;
obesity; degenerative disc and joint disease, lumber and cervical
spine; and hypertension.
23
24
25
26
27
(A.R. 24). Also, ALJ Levine specifically acknowledged Plaintiff’s fibromyalgia
impairment:
13
16cv2098-BAS-MDD
The objective treatment records support she has a medically
determinable and severe impairment of fibromyalgia, based on
evidence showing widespread pain; at least 11 positive tender
points on physical examination; repeated manifestations of six or
more fibromyalgia symptoms; and a determination that other
disorders could not cause these repeated manifestations of
symptoms.
1
2
3
4
5
6
(A.R. 24).
7
The record shows that the earliest date Plaintiff was given a tentative
8
diagnosis of fibromyalgia was following an exam by Dr. Soumya Rao, M.D. on
9
August 8, 2011. (A.R. 301). The date of that exam was over four months after
10
ALJ Wurzel issued his ruling on Plaintiff’s first application on May 16, 2011.
11
(A.R. 73). Thus, the Court finds that the record evidence demonstrates that
12
Plaintiff’s allegation of fibromyalgia constituted a “changed circumstance”
13
because this impairment was not addressed in the 2011 decision. 5
14
The Ninth Circuit has held that “the Commissioner may not apply res
15
judicata where the claimant raises a new issue, such as the existence of an
16
impairment not considered in the previous application.” Gregory v. Bowen,
17
844 F.2d 664, 666 (9th Cir. 1988). “[A]ll an applicant has to do to preclude
18
the application of res judicata is raise a new issue in a later proceeding.”
19
Vasquez v. Astrue, 572 F.3d 586, 598 n. 9 (9th Cir. 2009). The newly asserted
20
impairment need not be severe or disabling, res judicata is precluded based
21
only upon the assertion of new impairments. Id. Because Plaintiff raised a
22
new impairment not previously presented in her first application it was error
23
for the ALJ to apply the presumption of continuing nondisability in ruling on
24
Plaintiff’s second application.
25
26
27
: The Court was compelled to consider the issue of res judicata without input from either
party as neither addressed it in their pleadings.
5
14
16cv2098-BAS-MDD
1
3.
Remand for Further Administrative Proceedings Is
2
Appropriate
The Court recognizes the importance of administrative res
3
4
judicata, however when the doctrine is erroneously applied, remand is an
5
appropriate remedy. “[A] court has discretion to remand for further
6
proceedings when an ALJ has committed legal error in denying benefits.”
7
Harman v Apfel, 211 F.3d 1172, 1175-78 (9th Cir. 2000). Here the ALJ erred
8
by applying the res judicata presumption of continuing nondisability to
9
Plaintiff’s first application and subsequent ruling. Based on the record
10
evidence in the case, the principle of res judicata is not applicable. Plaintiff’s
11
second application for benefits was denied for her failure to overcome the
12
presumption of continuing nondisability for the period following the denial of
13
her first application. This presumption did not apply to Plaintiff because the
14
record presented shows she alleged a new disability not contained in her first
15
application for benefits.
16
In sum, the ALJ's application of the continuing presumption of
17
nondisability arising from the prior ALJ's decision was error. When error
18
exists in an administrative determination, “the proper course, except in rare
19
circumstances, is to remand to the agency for additional investigation or
20
explanation.” INS v. Ventura, 537 U.S. 12, 16, 123 S.Ct. 353, 355, 154
21
L.Ed.2d 272 (2002) (citations and quotation marks omitted); Moisa v.
22
Barnhart, 367 F.3d 882, 886 (9th Cir.2004). Accordingly, the Court
23
recommends the case be remanded so the ALJ can determine Plaintiff’s
24
residual functional capacity and entitlement to disability benefits in the first
25
instance.
26
27
III. CONCLUSION
The Court RECOMMENDS that the case be REMANDED for further
15
16cv2098-BAS-MDD
1
proceedings and the ALJ be instructed not to apply the principle of the res
2
judicata presumption of continuing nondisability. This Report and
3
Recommendation of the undersigned Magistrate Judge is submitted to the
4
United States District Judge assigned to this case, pursuant to the provisions
5
of 28 U.S.C. § 636(b)(1).
6
IT IS HEREBY ORDERED that any written objection to this report
7
must be filed with the court and served on all parties no later than
8
September 12, 2017. The document should be captioned “Objections to
9
Report and Recommendations.”
10
IT IS FURTHER ORDERED that any reply to the objections shall be
11
filed with the Court and served on all parties no later than September 19,
12
2017. The parties are advised that failure to file objections within the
13
specified time may waive the right to raise those objections on appeal of the
14
Court’s order. Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991).
15
16
Dated: August 29, 2017
17
18
19
20
21
22
23
24
25
26
27
16
16cv2098-BAS-MDD
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?