Sapinsky v. Colvin

Filing 26

ORDER REVERSING AND REMANDING by Judge Benjamin H. Settle. (TG)

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1 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT TACOMA 2 3 4 5 JOSEPH S. SAPINSKY, CASE NO. C14-5627 BHS Plaintiff, 6 ORDER REVERSING AND REMANDING v. 7 CAROLYN COLVIN, Acting 8 Commissioner of Social Security, 9 Defendant. 10 I. BASIC DATA 11 12 Type of Benefits Sought: 13 ( X ) Disability Insurance 14 ( ) Supplemental Security Income 15 Plaintiff’s: 16 Sex: Male 17 Age: 33 at alleged onset date. 18 Principal Disabilities Alleged by Plaintiff: Major Depressive Disorder, recurrent, moderate to severe; Generalized Anxiety Disorder; Specific Phobia; Schizoid Personality 19 Disorder 20 Disability Allegedly Began: January 1, 2001 21 Principal Previous Work Experience: Air Force Pilot 22 Education Level Achieved by Plaintiff: Graduate from Air Force Academy ORDER - 1 1 II. PROCEDURAL HISTORY—ADMINISTRATIVE 2 Before ALJ : 3 Date of Hearing: August 28, 2012 4 Date of Decision: September 7, 2012 5 Appears in Record at: AR 106–120 6 Summary of Decision: 7 Claimant last met the insured status requirement of the Social Security Act on December 31, 2004. Claimant did not engage in substantial gainful activity during the period from his alleged onset date of January 1, 2001 through his date last insured of December 31, 2004. Through the date last insured there were no medical signs or laboratory findings to substantiate the existence of a medically determinable impairment. 8 9 10 11 12 Before Appeals Council: 13 Date of Decision: June 17, 2014 14 Appears in Record at: AR 1–6 15 Summary of Decision: Declined review III. PROCEDURAL HISTORY—THIS COURT 16 17 Jurisdiction based upon: 42 U.S.C. § 405(g) 18 Brief on Merits Submitted by ( X ) Plaintiff ( X ) Commissioner 19 IV. STANDARD OF REVIEW 20 Pursuant to 42 U.S.C. § 405(g), the Court may set aside the Commissioner’s 21 denial of Social Security benefits when the ALJ’s findings are based on legal error or not 22 supported by substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d ORDER - 2 1 1211, 1214 n.1 (9th Cir. 2005). “Substantial evidence” is more than a scintilla, less than 2 a preponderance, and is such relevant evidence as a reasonable mind might accept as 3 adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971); 4 Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989). The ALJ is responsible for 5 determining credibility, resolving conflicts in medical testimony, and resolving any other 6 ambiguities that might exist. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). 7 While the Court is required to examine the record as a whole, it may neither reweigh the 8 evidence nor substitute its judgment for that of the ALJ. See Thomas v. Barnhart, 278 9 F.3d 947, 954 (9th Cir. 2002). “Where the evidence is susceptible to more than one 10 rational interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion 11 must be upheld.” Id. 12 13 V. EVALUATING DISABILITY The claimant, Joseph Sapinsky (“Sapinsky”), bears the burden of proving he is 14 disabled within the meaning of the Social Security Act (“Act”). Meanel v. Apfel, 172 15 F.3d 1111, 1113 (9th Cir. 1999). The Act defines disability as the “inability to engage in 16 any substantial gainful activity” due to a physical or mental impairment which has lasted, 17 or is expected to last, for a continuous period of not less than twelve months. 42 U.S.C. 18 §§ 423(d)(1)(A), 1382c(3)(A). A claimant is disabled under the Act only if her 19 impairments are of such severity that she is unable to do her previous work, and cannot, 20 considering her age, education, and work experience, engage in any other substantial 21 gainful activity existing in the national economy. 42 U.S.C. §§ 423(d)(2)(A); see also 22 Tackett v. Apfel, 180 F.3d 1094, 1098–99 (9th Cir. 1999). ORDER - 3 1 The Commissioner has established a five-step sequential evaluation process for 2 determining whether a claimant is disabled within the meaning of the Act. See 20 C.F.R. 3 §§ 404.1520, 416.920. The claimant bears the burden of proof during steps one through 4 four. Valentine v. Comm’r of Soc. Sec. Admin., 574 F.3d 685, 689 (9th Cir. 2009). At 5 step five, the burden shifts to the Commissioner. Id. 6 7 VI. ISSUES ON APPEAL 1. Did the ALJ error in failing to determine whether Sapinsky has a medically determinable impairment? 2. Was the error harmful? 3. Should the Court remand for further proceedings or for a calculation of benefits? 8 9 10 VII. DISCUSSION 11 12 13 14 15 16 17 18 19 20 21 “The claimant has the burden of proving that he became disabled prior to the expiration of his disability insured status.” Macri v. Chater, 93 F.3d 540, 543 (9th Cir. 1996) (citing Flaten v. Secretary of Health & Human Serv., 44 F.3d 1453, 1457 (9th Cir. 1995)). The Ninth Circuit has held that if the “medical evidence is not definite concerning the onset date and medical inferences need to be made, SSR 83-20 requires the ALJ to call upon the services of a medical advisor and to obtain all evidence which is available to make the determination.” DeLorme v. Sullivan, 924 F.2d 841, 848 (9th Cir. 1991); see also Armstrong v. Commissioner of Soc. Sec. Admin., 160 F.3d 587, 590 (9th Cir. 1998) (“where a record is ambiguous as to the onset date of disability, the ALJ must call a medical expert to assist in determining the onset date”); Morgan v. Sullivan, 945 22 ORDER - 4 1 F.2d 1079, 1083 (9th Cir. 1991) (inferring a disability onset date “is not possible without 2 the assistance of a medical expert”). 3 In this case, the ALJ concluded that Sapinsky failed to show the “existence of a 4 medically determinable impairment through the date of last insured.” AR 115. It is 5 undisputed that the date of last insured was December 31, 2004. The parties, however, 6 dispute whether the ALJ must first assess whether Sapinsky is disabled and then 7 determine the onset date of the disability. On this issue, the Court agrees with Sapinsky. 8 While the parties fail to cite, and the Court is unaware of, any Ninth Circuit authority that 9 directly addresses this issue, one can infer from cases addressing similar issues that a 10 determination of a disability must precede a determination of the onset date. For 11 example, in Sam v. Astrue, 550 F.3d 808 (9th Cir. 2008), the Ninth Circuit states that 12 “[b]ecause the ALJ found that Sam was not disabled ‘at any time through the date of [the] 13 decision’ (emphasis added), the question of when he became disabled did not arise . . . .” 14 Id. at 810 (citing Scheck v. Barnhart, 357 F.3d 697, 701 (7th Cir. 2004)). Moreover, in 15 Scheck, the Seventh Circuit first addressed whether the claimant was disabled and then 16 addressed whether the ALJ correctly assessed the onset date. Id. at 700–701. Therefore, 17 the Court concludes that the ALJ erred by failing to assess whether Sapinsky has a 18 medically determinable impairment. 19 The next issue is whether the error was harmful. Although the Commissioner 20 makes passing references to harmful error, she fails to provide any argument that the 21 error was harmless. Moreover, the ALJ’s error occurred at step two of the process and 22 ORDER - 5 1 could have undermined the ultimate conclusion. Therefore, the Court finds that the error 2 was harmful. 3 The final issue is whether the Court should remand for further proceedings or 4 whether, as Sapinsky requests, the Court should remand for calculation and payment of 5 benefits. Based on the record, the Court is unable to assess Sapinsky on the final three 6 steps of the sequential process. Therefore, the Court remands the matter for further 7 proceedings consistent with this order. 8 9 VIII. ORDER Therefore, it is hereby ORDERED that the Commissioner’s final decision 10 denying Sapinsky disability benefits is REVERSED and the matter is REMANDED for 11 further proceedings. 12 Dated this 4th day of March, 2015. A 13 14 BENJAMIN H. SETTLE United States District Judge 15 16 17 18 19 20 21 22 ORDER - 6

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