Wingo v. Colvin

Filing 20


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1 2 3 4 5 6 7 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT TACOMA 8 9 10 JENNIFER G. WINGO, 11 12 13 Plaintiff, v. NANCY A. BERRYHILL, Acting Commissioner of Social Security, CASE NO. 3:16-CV-05619-DWC ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS 14 Defendant. 15 16 Plaintiff Jennifer G. Wingo filed this action, pursuant to 42 U.S.C. § 405(g), for judicial 17 review of Defendant’s denial of Plaintiff’s applications for supplemental security income (“SSI”) 18 and disability insurance benefits (“DIB”). Pursuant to 28 U.S.C. § 636(c), Federal Rule of Civil 19 Procedure 73 and Local Rule MJR 13, the parties have consented to have this matter heard by 20 the undersigned Magistrate Judge. See Dkt. 6. 21 After reviewing the record, the Court concludes the Administrative Law Judge (“ALJ”) 22 erred when he failed to discuss significant, probative evidence showing Plaintiff’s back 23 impairment to be severe. The ALJ further erred when he failed to provide specific and legitimate 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 1 1 reasons supported by substantial evidence in support of his decision to give only minimal 2 weight to Dr. Brown’s medical opinion. Had the ALJ properly considered pertinent evidence 3 regarding Plaintiff’s back impairment and properly considered the medical opinion evidence, the 4 residual functional capacity may have included additional limitations. The ALJ’s error is 5 therefore harmful, and this matter is reversed and remanded pursuant to sentence four of 42 6 U.S.C. § 405(g) to the Acting Commissioner of Social Security (“Commissioner”) for further 7 proceedings consistent with this Order. 8 9 FACTUAL AND PROCEDURAL HISTORY On June 23, 2008, Plaintiff filed an application for SSI and DIB, alleging disability as of 10 July 1, 2006. See Dkt. 13, Administrative Record (“AR”) 125-132, 632. The application was 11 denied upon initial administrative review and on reconsideration. See AR 66-69, 70-74, 632. On 12 January 6, 2011, ALJ Marguerite Schellentrager found Plaintiff not disabled. AR 17-26, 632. 13 The Appeals Council denied Plaintiff’s administrative appeal. See AR 1-5, 632. Plaintiff 14 appealed to the United States District Court for the Western District of Washington, which 15 remanded the case for further proceedings. See AR 724-735; Wingo v. Colvin, 3:12-CV-0558216 BHS-KLS (W.D. Wash.). 17 On remand, Plaintiff received a second hearing before ALJ Robert P. Kingsley, who 18 again found Plaintiff not disabled. AR 629-647. Plaintiff’s request for review of the ALJ’s 19 decision was denied by the Appeals Council, making ALJ Kingsley’s decision the final decision 20 of the Commissioner. See AR 622-624; 20 C.F.R. § 404.981, § 416.1481. Plaintiff now appeals 21 ALJ Kingsley’s decision finding Plaintiff not disabled. 1 22 23 1 When stating “the ALJ” or “the ALJ’s decision” throughout this Order, the Court is referring to ALJ 24 Kingsley and his July 7, 2015 decision. ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 2 1 In Plaintiff’s Opening Brief, Plaintiff maintains the ALJ erred by: (1) finding Plaintiff’s 2 back condition and hepatitis C were not severe impairments at Step Two; (2) providing legally 3 insufficient reasons for rejecting medical source opinions; (3) failing to provide clear and 4 convincing reasons for finding Plaintiff not entirely credible; (4) failing to provide germane 5 reasons for rejecting lay testimony; (5) finding Plaintiff capable of performing her past relevant 6 work at Step Four; and (6) basing his Step Five finding on his erroneous residual functional 7 capacity (RFC) assessment. Dkt. 16, p. 2. 8 STANDARD OF REVIEW 9 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 10 social security benefits if the ALJ’s findings are based on legal error or not supported by 11 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 12 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). 13 14 DISCUSSION I. Whether the ALJ erred by finding Plaintiff’s back impairment and hepatitis C did not constitute severe impairments at Step Two. 15 Plaintiff asserts the ALJ erred in failing to find Plaintiff’s (A) back pain associated with 16 multilevel degenerative disc disease, spondylosis, and herniated disc, and (B) hepatitis C were 17 severe impairments at Step Two. Dkt. 16, pp. 15-16. 18 Step Two of the administration’s evaluation process requires the ALJ to determine 19 whether the claimant “has a medically severe impairment or combination of impairments.” 20 Smolen v. Chater, 80 F.3d 1273, 1290 (9th Cir. 1996) (citation omitted); 20 C.F.R. §§ 21 404.1520(a)(4)(ii), 416.920(a)(4)(ii) (1996). An impairment is “not severe” if it does not 22 “significantly limit” the ability to conduct basic work activities. 20 C.F.R. §§ 404.1521(a), 23 416.921(a). “Basic work activities are ‘abilities and aptitudes necessary to do most jobs, 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 3 1 including, for example, walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or 2 handling.’” Smolen, 80 F.3d at 1290 (quoting 20 C.F.R. §140.1521(b)). “An impairment or 3 combination of impairments can be found ‘not severe’ only if the evidence establishes a slight 4 abnormality having ‘no more than a minimal effect on an individual[’]s ability to work.’” Id. 5 (quoting Yuckert v. Bowen, 841 F.2d 303, 306 (9th Cir. 1988) (adopting Social Security Ruling 6 “SSR” 85-28)). 7 A. Back Impairment 8 The ALJ found Plaintiff’s multilevel degenerative disc disease, spondylosis, and 9 herniated disc were not severe impairments at Step Two because the record showed minimally 10 related treatment and complaints from Plaintiff to medical providers related to these conditions. 11 AR 635. The ALJ cited Plaintiff’s treatment records indicating lack of symptoms associated with 12 her conditions including lack of tenderness, full range of motion, full strength, intact sensation, 13 and stable and normal gait. AR 635 (citing AR. 882, 886, 888, 1072, 1074, 1077, 1085). The 14 ALJ further found the record, including Plaintiff’s testimony and functional report, failed to 15 establish Plaintiff’s back conditions have more than a minimal effect on her ability to perform 16 basic work activities. AR 635. 17 However, the ALJ failed to discuss objective medical evidence showing Plaintiff was 18 diagnosed with and treated for chronic back pain associated with degenerative disc disease, 19 spondylosis and herniated disc. See AR 1070-77, 1081-88. These diagnoses are supported by 20 objective findings in Plaintiff’s July 2014 CT scan which showed, 21 22 disc bulge with superimposed right paracentral and central disc protrusion causing moderate anterior thecal sac effacement at L4… compression of the L5 nerve root, left paracentral disc herniation at T12-L1, causing mild effacement of the lateral recess affecting L1 nerve root, NFN L4-5, L2-3, L5-S1. 23 AR 1085. 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 4 1 The ALJ further failed to discuss evidence demonstrating Plaintiff’s symptoms associated 2 with her back impairment significantly limit her ability to conduct basic work activities such as 3 walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling. Smolen, 80 4 F.3d at 1290 (quoting 20 C.F.R. §140.1521(b)). For example, a complete review of Plaintiff’s 5 medical records indicates that as early as 2011, Plaintiff complained of back pain. AR 160. 6 Specifically, Plaintiff noted it was difficult for her to lift and carry due to a “long history of 7 [domestic violence], many battering (sic), broken bones and broken ribs.” Id. Plaintiff’s records 8 further indicate that more recently in 2014 she persistently complained of increasing right leg, 9 tailbone, and chronic back pain. AR 1070-77. Several nurse practitioners corroborated on several 10 occasions that Plaintiff demonstrated an antalgic, painful gait. See AR 1074, 1084-97. These 11 symptoms led to several visits to the emergency room, steroid injections and unsuccessful 12 physical therapy sessions for pain management. Id. Plaintiff has described her back pain as 13 “numbness and tingling in her arms and [legs] from the elbow [down to] the hands and the knees 14 to the feet… radiat[ing] up to her upper back.” AR 1075. 15 In November 2014 after several failed physical therapy sessions and injection treatments, 16 Plaintiff was referred to a pain specialist for her continued pain. AR 1081-1088. Medical records 17 from Seattle Pain Center indicate Plaintiff’s 18 19 20 21 [p]ain is constant, [and] tends to be worse at the beginning of the day and began 2-3 years ago. It is described as a dull, sharp, stabbing, numbness, pins and needles, pounding and aching sensation. On the average, her pain is rated 7/10… She rates her pain 10/10 at worst and 4/10 at best. Her pain is increased with activity, standing, sitting twisting, lifting, reaching, rising from a chair, walking down stairs, walking up stairs, coughing, sneezing, defecating and intercourse. 22 23 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 5 1 AR 1082. While steroid injunctions reduced her coccyx pain, Plaintiff still describes her chronic 2 pain as “throbbing that is worse with sitting.” AR 1085. Plaintiff’s symptoms therefore require 3 opioid therapy for pain management. AR 1086-87. 4 In summary, the objective medical evidence shows Plaintiff suffers from degenerative 5 disc disease, spondylosis, and a herniated disc. As a result of these conditions, the record shows 6 Plaintiff has an antalgic gait and pain when standing, sitting twisting, lifting, reaching, rising 7 from a chair, walking up and down stairs, and with increased activity. The ALJ failed to discuss 8 this evidence when he determined Plaintiff’s back impairment was not severe. As the ALJ failed 9 to discuss significant, probative evidence regarding Plaintiff’s back impairment, he erred in 10 finding this condition was “not severe” at Step Two. See Flores v. Shalala, 49 F.3d 562, 570-71 11 (9th Cir. 1995) (an ALJ “may not reject significant probative evidence without explanation”). 12 “[H]armless error principles apply in the Social Security context.” Molina v. Astrue, 674 13 F.3d 1104, 1115 (9th Cir. 2012). An error is harmless, however, only if it is not prejudicial to the 14 claimant or “inconsequential” to the ALJ’s “ultimate nondisability determination.” Stout v. 15 Commissioner, Social Security Admin., 454 F.3d 1050, 1055 (9th Cir. 2006); see Molina, 674 16 F.3d at 1115. The determination as to whether an error is harmless requires a “case-specific 17 application of judgment” by the reviewing court, based on an examination of the record made 18 “‘without regard to errors’ that do not affect the parties’ ‘substantial rights.’” Molina, 674 F.3d at 19 1118-1119 (quoting Shinseki v. Sanders, 556 U.S. 396, 407 (2009) (quoting 28 U.S.C. § 2111)). 20 If the ALJ accounts for all Plaintiff’s limitations in assessing the residual functional capacity 21 (“RFC”), the Step Two error is harmless. See Lewis v. Astrue, 498 F.3d 909, 911 (9th Cir. 2007). 22 Not only did the ALJ fail to consider probative evidence showing Plaintiff suffers from a 23 severe impairment, the ALJ did not consider Plaintiff’s degenerative disc disease, spondylosis, 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 6 1 herniated disc or the limitations caused by these conditions when considering the remaining steps 2 of the sequential evaluation process. For example, the ALJ did not include any physical 3 limitations in the RFC. See AR 637. Evidence in the record indicates Plaintiff suffers from back 4 pain increasing in severity during activity such as standing, sitting twisting, lifting, reaching, 5 rising from a chair, and walking up and down stairs. The record further demonstrates Plaintiff’s 6 chronic pain is only manageable through an opioid regimen. Had the ALJ properly considered 7 Plaintiff’s back impairment at Step Two, he may have included physical limitations in RFC 8 hypothetical question posed to the vocational expert. As the ALJ’s failure to properly consider 9 Plaintiff’s degenerative disc disease, spondylosis and herniated disc at Step Two and throughout 10 the remaining sequential evaluation process impacts the ultimate disability decision, it is not 11 harmless. 12 B. Hepatitis C 13 At Step Two, the ALJ also found Plaintiff’s hepatitis C “not severe” because the record 14 demonstrated “minimal related complaints to treatment providers or treatment” of Plaintiff’s 15 alleged symptoms associated with this condition. AR 635. In support of his finding, the ALJ 16 relied on Plaintiff’s own statements to various treatment providers from October 2009 through 17 August 2011 demonstrating she was negative for related symptoms. AR 635 (citing AR 88018 905). 19 While Plaintiff was diagnosed with hepatitis C, Plaintiff does not cite to any records or 20 relevant testimony showing this condition caused more than “slight abnormality having more 21 than a minimal” impact on her ability to work. See Smolen, 80 F.3d at 1290; Dkt. 16, pp. 15-16. 22 For example, Plaintiff’s family practitioner noted that her last evaluation with a 23 gastroenterologist showed, “her liver biopsy was good and that no treatment [for history of 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 7 1 hepatitis C] w[a]s indicated at that time.” AR 895. Additionally, as cited by the ALJ, Plaintiff 2 either affirmatively reported she did not have hepatitis C symptoms or altogether failed to report 3 any symptoms during unremarkable examinations from October 2009 through August 2011. AR 4 880-905. As Plaintiff has not shown hepatitis C has caused functional limitations on her ability to 5 work, the Court finds the ALJ did not err when he found Plaintiff’s hepatitis C was not a severe 6 impairment. However, for the reasons stated above, the ALJ committed harmful error with 7 regard to Plaintiff’s degenerated disc disease, spondylosis and herniated disc. As such this matter 8 is remanded for reconsideration of Step Two. 9 10 II. Whether the ALJ properly weighed the medical opinions. Plaintiff also contends the ALJ erred when he assigned minimal weight to the medical 11 opinions of treating physicians, Drs. Brown, Ph.D, Lewis, Ph.D., Arrienda, M.D., and Burdge, 12 Ph.D. Dkt. 16, pp. 3-13. The Court has already concluded the ALJ erred at Step Two and thus 13 this matter should be reversed and remanded for further consideration, see Section I(A), supra. 14 Because these errors may impact the weight given to the medical opinion evidence, the Court 15 directs the ALJ to reconsider all medical opinions on remand. When re-evaluating this entire 16 matter on remand, the ALJ is further specifically directed to correct the errors included in his 17 evaluation of Dr. Brown’s opinion. 18 The ALJ must provide “clear and convincing” reasons for rejecting the uncontradicted 19 opinion of either a treating or examining physician. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 20 1996) (citing Embrey v. Bowen, 849 F.2d 418, 422 (9th Cir. 1988); Pitzer v. Sullivan, 908 F.2d 21 502, 506 (9th Cir. 1990)). When a treating or examining physician’s opinion is contradicted, the 22 opinion can be rejected “for specific and legitimate reasons that are supported by substantial 23 evidence in the record.” Lester, 81 F.3d at 830-31 (citing Andrews v. Shalala, 53 F.3d 1035, 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 8 1 1043 (9th Cir. 1995); Murray v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)). The ALJ can 2 accomplish this by “setting out a detailed and thorough summary of the facts and conflicting 3 clinical evidence, stating his interpretation thereof, and making findings.” Reddick v. Chater, 157 4 F.3d 715, 725 (9th Cir. 1998) (citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)). 5 The ALJ “may reject the opinion of a non-examining physician by reference to specific 6 evidence in the medical record.” Sousa v. Callahan, 143 F.3d 1240, 1244 (9th Cir. 1998) (citing 7 Gomez v. Chater, 74 F.3d 967, 972 (9th Cir. 1996)); Andrews, 53 F.3d at 1041). However, all of 8 the determinative findings by the ALJ must be supported by substantial evidence. See Bayliss, 9 427 F.3d at 1214 n.1 (citing Tidwell, 161 F.3d at 601); see also Magallanes, 881 F.2d at 750 10 (“Substantial evidence” is more than a scintilla, less than a preponderance, and is such “relevant 11 evidence as a reasonable mind might accept as adequate to support a conclusion”). 12 A. Dr. Brown, Ph.D. 13 Examining psychologist Dr. Michael L. Brown, Ph.D. conducted a psychological 14 evaluation of Plaintiff on March 2, 2012. AR. 872-875. Following a full clinical examination 15 of Plaintiff, Dr. Brown opined in relevant part, “Given the nature and severity of her current 16 psychiatric symptoms, it is doubtful that she would be able to complete work at a competitive 17 rate at this time.” AR 874. 18 The ALJ gave little weight to this portion of Dr. Brown’s opinion because the opinion 19 was 1) inconsistent with his clinical findings, and 2) heavily reliant on Plaintiff’s subjective 20 report of symptoms and limitations. AR 644. The Court concludes the ALJ erred. 21 First, the ALJ assigned only partial weight to Dr. Brown’s opinion because, “it is 22 inconsistent with the doctor’s clinical findings.” AR 644. However, the ALJ failed to provide 23 anything more than a conclusory statement in support of his rejection of Dr. Brown’s opinion 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 9 1 on this basis. See Regennitter v. Comm'r of Soc. Sec. Admin, 166 F.3d 1294, 1299 (9th Cir. 2 1999)(quoting Embrey v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988))(“To say medical 3 opinions…are contrary to the preponderant conclusions mandated by the objective findings 4 does not achieve the level of specificity that our prior cases have required . . . The ALJ must do 5 more than offer his own conclusions. He must set forth his own interpretations and explain 6 why they, rather than the doctor's, are correct."). For example, the ALJ failed to cite 7 specifically which of Dr. Brown’s clinical findings he found inconsistent with Dr. Brown’s 8 ultimate conclusion. The ALJ further failed to provide any analysis, explanation, or additional 9 reasoning in support of his finding. Accordingly, the ALJ failed to provide a specific and 10 legitimate reason for assigning only partial weight to Dr. Brown’s opinion. 11 Second, the ALJ assigned little weight to Dr. Brown’s opinion contending Dr. Brown 12 “relied heavily on the claimant’s subjective report of symptoms and limitations.” AR 644. The 13 Ninth Circuit holds “when an [medical] opinion is not more heavily based on a patient’s self14 reports than on clinical observations, there is no evidentiary basis for rejecting the opinion.” 15 Ghanim v. Colvin, 763 F.3d 1154, 1162 (9th Cir. 2014) (citing Ryan v. Comm’r of Soc. Sec. 16 Admin., 528 F.3d 1194, 1199-1200 (9th Cir. 2008). 17 Dr. Brown conducted a psychological evaluation of Plaintiff on March 2, 2012. AR. 18 872. Following his examination of Plaintiff, Dr. Brown diagnosed Plaintiff with mood 19 disorder, PTSD, anxiety disorder, and polysubstance abuse in full remission. AR. 873. Dr. 20 Brown further concluded that while Plaintiff is able to remember and execute simple 21 instructions and sustain concentration on simple repetitive tasks, “it is doubtful that she would 22 be able to complete work at a competitive rate at this time [due to the nature and severity of her 23 current psychiatric symptoms].” AR 876. In reaching these conclusions Dr. Brown conducted a 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 10 1 clinical interview with Plaintiff (AR 874-75), reviewed her medical and psychosocial history 2 (AR 874), conducted a mental status examination (AR 975), and affirmatively marked “yes” 3 when asked whether he personally observed the symptoms he reported (AR 872-73). While 4 conducting his assessment, Dr. Brown did not discredit Plaintiff’s subjective reports, and 5 supported his ultimate opinions with his own observations and diagnoses based on the mental 6 examination results. AR 875. 7 Dr. Brown based his opinions of Plaintiff’s limitations on a combination of personal 8 observations, mental examinations, and Plaintiff’s mental health history and subjective reports. 9 Therefore, the Court concludes the ALJ’s finding that Dr. Brown’s opinions were based 10 primarily upon Plaintiff’s subjective complaints is not a specific and legitimate reason 11 supported by substantial evidence. 12 III. Whether the ALJ erred in assessing Plaintiff’s credibility, lay witness evidence, Plaintiff’s RFC, and Step Five of the sequential evaluation process. 13 Plaintiff contends the ALJ erred when he discounted the testimony of Plaintiff, Plaintiff’s 14 friend Sharon Larson, and Plaintiff’s fiancé Edward Fischer, in determining whether the claimant 15 is able to perform the requirement of her past relevant work at Step Four and capable of 16 performing work existing in significant numbers in the national economy at Step Five of the 17 sequential evaluation process. Dkt. 16, pp. 16-20. The Court has already concluded the ALJ 18 committed harmful error at Step Two and in assessing the medical opinion evidence. See Section 19 I & II, supra. Because the ALJ’s reconsideration of Step Two and the medical opinion evidence 20 may impact her assessment of Plaintiff’s subjective testimony, lay witness testimony, and the 21 RFC, the ALJ must reconsider all of these things on remand. As the ALJ must reassess Plaintiff’s 22 RFC on remand, he must also re-evaluate the findings at Step Five to determine if there are jobs 23 existing in significant numbers in the national economy Plaintiff can perform in light of the RFC. 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 11 1 See Watson v. Astrue, 2010 WL 4269545, *5 (C.D. Cal. Oct. 22, 2010) (finding the ALJ’s RFC 2 determination and hypothetical questions posed to the vocational expert defective when the ALJ 3 did not properly consider a doctor’s findings). 4 5 IV. Whether the case should be remanded for an award of benefits. Plaintiff argues this case should be remanded for an award of benefits. Dkt. 16, p. 20. The 6 Court may remand a case “either for additional evidence and findings or to award benefits.” 7 Smolen, 80 F.3d at 1292. Generally, when the Court reverses an ALJ’s decision, “the proper 8 course, except in rare circumstances, is to remand to the agency for additional investigation or 9 explanation.” Benecke v. Barnhart, 379 F.3d 587, 595 (9th Cir. 2004) (citations omitted). 10 However, the Ninth Circuit created a “test for determining when evidence should be credited and 11 an immediate award of benefits directed[.]” Harman v. Apfel, 211 F.3d 1172, 1178 (9th Cir. 12 2000). Specifically, benefits should be awarded where: 13 14 15 (1) the ALJ has failed to provide legally sufficient reasons for rejecting [the claimant’s] evidence, (2) there are no outstanding issues that must be resolved before a determination of disability can be made, and (3) it is clear from the record that the ALJ would be required to find the claimant disabled were such evidence credited. 16 Smolen, 80 F.3d 1273 at 1292; McCartey v. Massanari, 298 F.3d 1072, 1076-77 (9th Cir. 2002). 17 The Court has determined, based on the above identified errors, issues remain which 18 must be resolved concerning Plaintiff’s severe impairments and the medical opinion evidence 19 and its impact on the weight given to other testimony and evidence by the ALJ. Therefore, 20 remand for further administrative proceedings is appropriate. 21 22 CONCLUSION Based on the foregoing reasons, the Court hereby finds the ALJ improperly concluded 23 Plaintiff was not disabled. Accordingly, Defendant’s decision to deny benefits is reversed and 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 12 1 this matter is remanded for further administrative proceedings in accordance with the findings 2 contained herein. 3 Dated this 21st day of April, 2016. A 4 5 David W. Christel United States Magistrate Judge 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 ORDER REVERSING AND REMANDING DEFENDANT’S DECISION TO DENY BENEFITS- 13

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