Opinion

(SS) Stubblefield v. Commissioner of Social Security

Court
District Court, E.D. California
Filed
Feb 21, 2023
Cited by
0 cases
Authority
More cited than 18.3%

“We will not manufacture arguments for an appellant, and a bare assertion does not preserve a claim, particularly when, as here, a host of other issues are presented for review”

How later courts described this case

  • “We will not manufacture arguments for an appellant, and a bare assertion does not preserve a claim, particularly when, as here, a host of other issues are presented for review”
  • “Generally when a court . . . reverses an administrative determination, the proper 22 course, except in rare circumstances, is to remand to the agency for additional investigation or 23 explanation.”

Written by the judges who cited it.

The opinion

UNITED STATES DISTRICT COURT

2

EASTERN DISTRICT OF CALIFORNIA

3

4

MISTY STUBBLEFIELD, No. 1:21-cv-01566-GSA

5

Plaintiff,

6

v. OPINION & ORDER DIRECTING ENTRY

7 OF JUDGMENT IN FAVOR OF

KILOLO KIJAKAZI, acting PLAINTIFF AND AGAINST DEFENDANT

8 Commissioner of Social Security, COMMISSIONER OF SOCIAL SECURITY

9 (Doc. 16, 17)

Defendant.

10

11

I. Introduction

12

Plaintiff Misty Stubblefield (“Plaintiff”) seeks judicial review of a final decision of the

13

Commissioner of Social Security (“Commissioner” or “Defendant”) denying her application for

14

disability insurance benefits pursuant to Title II of the Social Security Act. The matter is before

15

the Court on the parties’ briefs which were submitted without oral argument to the United States

16

Magistrate Judge.1 Docs. 16, 17. After reviewing the record the Court finds that substantial

17

evidence and applicable law do not support the ALJ’s decision.

18

II. Factual and Procedural Background2

19

On April 1, 2020 Plaintiff applied for disability insurance benefits alleging a disability onset

20

date of March 7, 2020. The application was denied initially on June 11, 2020 and on

21

reconsideration on July 20, 2020. Plaintiff requested a hearing which was held before an

22

Administrative Law Judge (the “ALJ”) on January 5, 2021. AR 35–51. On March 8, 2021 the ALJ

23

issued a decision denying Plaintiff’s application. AR 12–28. The Appeals Council denied review

24

on September 15, 2021. AR 1–6. On October 22, 2021 Plaintiff filed a complaint in this Court.

25

26

27 1 The parties consented to the jurisdiction of a United States Magistrate Judge. See Docs. 6 and 11.

2 The Court has reviewed the relevant portions of the administrative record including the medical, opinion and

28 testimonial evidence about which the parties are well informed, which will not be exhaustively summarized. Relevant

portions will be referenced in the course of the analysis below when relevant to the parties’ arguments.

III. The Disability Standard

2 Pursuant to 42 U.S.C. §405(g), this court has the authority to review a decision by the

3 Commissioner denying a claimant disability benefits. “This court may set aside the

4 Commissioner’s denial of disability insurance benefits when the ALJ’s findings are based on legal

5 error or are not supported by substantial evidence in the record as a whole.” Tackett v. Apfel, 180

6 F.3d 1094, 1097 (9th Cir. 1999) (citations omitted). Substantial evidence is evidence within the

7 record that could lead a reasonable mind to accept a conclusion regarding disability status. See

8 Richardson v. Perales, 402 U.S. 389, 401 (1971). It is more than a scintilla, but less than a

9

preponderance. See Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1996) (internal citation omitted).

10

When performing this analysis, the court must “consider the entire record as a whole and

11

may not affirm simply by isolating a specific quantum of supporting evidence.” Robbins v. Social

12

Security Admin., 466 F.3d 880, 882 (9th Cir. 2006) (citations and quotations omitted). If the

13

evidence could reasonably support two conclusions, the court “may not substitute its judgment for

14

that of the Commissioner” and must affirm the decision. Jamerson v. Chater, 112 F.3d 1064, 1066

15

(9th Cir. 1997) (citation omitted). “[T]he court will not reverse an ALJ’s decision for harmless

16

error, which exists when it is clear from the record that the ALJ’s error was inconsequential to the

17

ultimate non-disability determination.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008).

18

To qualify for benefits under the Social Security Act, a plaintiff must establish that

19 he or she is unable to engage in substantial gainful activity due to a medically

determinable physical or mental impairment that has lasted or can be expected to

20

last for a continuous period of not less than twelve months. 42 U.S.C. §

21 1382c(a)(3)(A). An individual shall be considered to have a disability only if . . .

his physical or mental impairment or impairments are of such severity that he is not

22 only unable to do his previous work, but cannot, considering his age, education, and

work experience, engage in any other kind of substantial gainful work which exists

23 in the national economy, regardless of whether such work exists in the immediate

area in which he lives, or whether a specific job vacancy exists for him, or whether

24

he would be hired if he applied for work.

25 42 U.S.C. §1382c(a)(3)(B).

26 To achieve uniformity in the decision-making process, the Commissioner has established a

27 sequential five-step process for evaluating a claimant’s alleged disability. 20 C.F.R. §§ 416.920(a)-

28 (f). The ALJ proceeds through the steps and stops upon reaching a dispositive finding that the

claimant is or is not disabled. 20 C.F.R. §§ 416.927, 416.929.

2 Specifically, the ALJ is required to determine: (1) whether a claimant engaged in substantial

3 gainful activity during the period of alleged disability, (2) whether the claimant had medically

4 determinable “severe impairments,” (3) whether these impairments meet or are medically

5 equivalent to one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1, (4)

6 whether the claimant retained the residual functional capacity (“RFC”) to perform past relevant

7 work, and (5) whether the claimant had the ability to perform other jobs existing in significant

8 numbers at the national and regional level. 20 C.F.R. § 416.920(a)-(f). While the Plaintiff bears

9

the burden of proof at steps one through four, the burden shifts to the commissioner at step five to

10

prove that Plaintiff can perform other work in the national economy given her RFC, age, education

11

and work experience. Garrison v. Colvin, 759 F.3d 995, 1011 (9th Cir. 2014).

12

IV. The ALJ’s Decision

13

At step one the ALJ found that Plaintiff had not engaged in substantial gainful activity since

14

her amended alleged disability onset date of March 7, 2020. AR 18. At step two the ALJ found

15

that Plaintiff had the following severe impairments: bilateral carpal tunnel syndrome; lateral

16

epicondylitis; degenerative disc disease of the cervical spine; degenerative disc disease of the

17

lumbar spine with radiculopathy and neuropathy; and obesity. AR 18. At step three the ALJ found

18

that Plaintiff did not have an impairment or combination thereof that met or medically equaled the

19

severity of one of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. AR 18.

20

Prior to step four the ALJ evaluated Plaintiff’s residual functional capacity (RFC) and

21

concluded that Plaintiff had the RFC to perform sedentary work as defined in 20 C.F.R. 416.967(a)

22

with the following restrictions: after every 45 minutes of sitting stand for 2 minutes while remaining

23

on task at her work station; occasionally climb ramps and stairs; occasional perform postural

24

activities; frequently reach, handle, and finger. AR 18–22.

25

At step four the ALJ found that Plaintiff could perform her past relevant work as a

26

collections clerk. AR 22. Accordingly, the ALJ found that Plaintiff was not disabled at any time

27

since her amended alleged disability onset date of March 7, 2020. AR 22.

28

V. Issues Presented

2 Plaintiff begins the brief with the following statement:

3

The parties hereby submit this joint stipulation for resolution of the issues presented

4 in this case pursuant to the Scheduling Order filed on the docket of the District Court

on 4/1/2022

5

Br. at 1, Doc. 16.

6

The scheduling order issued on April 1, 2022 does not require the parties to submit a “joint

7

stipulation for resolution of issues presented,” nor does that requirement exist in any previous

8

scheduling order issued in this case or other social security cas es before this Court in which counsel

9

has made the same introductory statement. Doc. 14. Although the Court previously required parties

10

to exchange confidential letter briefs, the briefs were not to be shared with the Court, and that

11

requirement was eliminated prior to the issuance of the scheduling order in this case. Most

12

importantly, the document Plaintiff submitted is not a “joint stipulation for resolution of the issues

13

presented.” It is Plaintiff’s motion for summary judgment.3

14

What the scheduling order does require, among other things, is a short and separate

15

statement of each of Plaintiff’s legal claims supported by factual and legal citations. Plaintiff does

16

not clearly set forth distinct issues by way of a statement of issues presented, section headings, or

17

any internal organizational structure. The Court will attempt to identify and address the points

18

Plaintiff appears to be making.

19

20 A. Listing 1.04

21 1. Applicable Law

22 At step three of the sequential evaluation, Plaintiff has the burden to establish the existence

23

of an impairment that meets or equals the criteria of an impairment listed in Appendix 1 of the

24

regulations. See 20 C.F.R. § 404.1520(a)(4)(iii); 20 C.F.R. Part 404, Subpart P, Appendix 1.

25

The Social Security Regulations “Listing of Impairments” is comprised of impairments to

26

27

28 3 The motion contains a copied and pasted reproduction of counsel’s letter to the Appeal’s Counsel (See AR 153-58)

to which Plaintiff adds the introductory language quoted above.

fifteen categories of body systems that are severe enough to preclude a person from performing

2

gainful activity. See Young v. Sullivan, 911 F.2d 180, 183-84 (9th Cir. 1990); 20 C.F.R. §

3

404.1520(d). Conditions described in the listings are considered so severe that the presumption of

4

5 disability cannot be rebutted. 20 C.F.R. § 404.1520(d). To meet a listing or satisfy medical

6 equivalency of a listing, it is not sufficient for a claimant to have a diagnosis that matches the name

7 of a listed diagnoses; all of the elements under the listing must be met. See Key v. Heckler, 754

8 F.2d 1545, 1549-50 (9th Cir. 1985).

9

2. Analysis

10

Plaintiff questions the ALJs conclusion that Listing 1.04 (disorders of the spine) was not

11

met. Plaintiff begins by block quoting4 the ALJ’s step three finding. With no transition, Plaintiff

12

13 then offers a one paragraph summary of notes from Dr. Newton (the medical examiner in

14 connection with her worker’s compensation claim) concerning Plaintiff’s radicular back pain,

15 postural limitations, mobility limitations, exertional limitations, sensory abnormalities, gait

16

abnormalities, muscle spasms, and positive nerve root tension signs. Br. at 4 (citing Ex. 10F p. 3,

17

8).

18

Plaintiff then contends that the listing5 “may be met” because the listing discusses

19

compromise of a nerve root, and Plaintiff’s MRI report revealed moderate to severe left sided

20

21 foraminal stenosis causing impingement at the exiting L5 nerve root.

22 A claimant will be found disabled under Listing 1.04 if s/he (1) has a disorder of the spine,

23

such as “herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis,

24

degenerative disc disease, facet arthritis, [or] vertebral fracture,” (2) which results in “compromise

25

26

4 More accurately, Plaintiff appears to have taken a scanned copy of the ALJ’s decision, captured a screenshot of the

27 the relevant language, and copied and pasted the blurry image into the body of her brief, rather than highlighting the

text from an electronic copy, or typing the language out manually.

28 5 Plaintiff actually stated it was listing 2.04, but the relevant listing considered by the ALJ (disorders of the spine) is

1.04.

of a nerve root...or the spinal cord,” and (3) is accompanied by the additional requirements set forth

2

under subsections 1.04(A), 1.04(B), or 1.04(C). 20 C.F.R. 404, subpt. P, app. 1, § 1.04 (emphasis

3

added).

4

5 All agree Plaintiff has a disorder of the spine, namely degenerative disc disease. Thus, she

6 meets the first requirement. As for the second requirement, the ALJ found that the evidence of

7 record does not establish compromise of a nerve root. AR 18. According to the regulations

8 “Compromise of a nerve root, sometimes referred to as ‘nerve root impingement,’ is a phrase used

9

when a physical object, such as a tumor, herniated disc, foreign body, or arthritic spur, is pushing

10

on the nerve root as seen on imaging or during surgery.” 20 C.F.R. § Pt. 404, Subpt. P, App. 1. As

11

the ALJ acknowledged at step four, the August 2020 lumbar spine MRI showed moderate to severe

12

13 stenosis causing impingement of the L5 exiting nerve root. AR 904. Thus, it is not clear why the

14 ALJ found that there was no evidence of nerve root compromise when it appears otherwise. See

15 below.

16

In addition to a spinal disorder resulting in compromise of a nerve root, spinal cord or cauda

17

equina, a claimant must also satisfy one of the three alternatives set forth in subsections 1.04(A),

18

1.04(B), and 1.04(C).

19

Subsection 1.04(A) requires:

20

21 Evidence of nerve root compression characterized by neuro-anatomic distribution

of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle

22 weakness or muscle weakness) accompanied by sensory or reflex loss and, if there

is involvement of the lower back, positive straight-leg raising test (sitting and

23

supine).

24

Id. § 1.04(A). Subsection 1.04(B) requires:

25

Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue

26 biopsy, or by appropriate medically acceptable imaging, manifested by severe

burning or painful dysesthesia, resulting in the need for changes in position or

27

posture more than once every 2 hours

28

Id. § 1.04(B). Subsection 1.04(C) requires:

Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on

2 appropriate medically acceptable imaging, manifested by chronic nonradicular pain

and weakness, and resulting in inability to ambulate effectively, as defined in

3 1.00B2b.

4 Id. § 1.04(C).

5

The ALJ found there was no evidence of spinal arachnoiditis as specified in 1.04(B), or

6

lumbar spinal stenosis resulting in pseudoclaudication as specified in 1.04(C). Plaintiff does not

7

contend otherwise, and there do not appear to be any findings in the record that would substantiate

8

9

spinal arachnoiditis which is defined as “‘inflammation of the arachnoid membrane,’ a membrane

10 that surrounds spinal cord nerves, ‘often without involvement of the subjacent subarachnoid

11 space.’” Smith v. Colvin, 2015 WL 248281, at *4 n.3 (C.D. Cal., Jan. 20, 2015) (quoting Stedman's

12

Medical Dictionary arachnoid, arachnoiditis (27th ed. 2000)).

13

With respect to 1.04(C), Plaintiff’s MRI did show lumbar spinal stenosis, but there do not

14

appear to be any clinical findings in the record to substantiate pseudoclaudication, associated

15

weakness, or inability to ambulate effectively as required by 1.04(C). Plaintiff contends that Dr.

16

17 Newton’s examination “documents” a variety of deficiencies including “walking with a limp.” Br.

18 at 4 (citing AR 891). That is incorrect. The cited section of Dr. Newton’s report did not “document”

19 anything objectively. Rather, that section reflects “PRESENT COMPLAINTS (as reported by the

20

applicant to the historian).” AR 890 (emphasis in original). Later in his report, Dr. Newton did

21

objectively document various examination findings related to gait, but all were normal save for the

22

claimant’s complaint of heel pain when walking on heels. AR 895.

23

24 Neither Plaintiff nor the ALJ addressed subsection 1.04(A) and it’s requirements of 1)

25 neuro-anatomic distribution of pain, 2) limitation of motion of the spine, 3) motor loss (atrophy

26 with associated muscle weakness or muscle weakness), 4) accompanied by sensory or reflex loss

27

and, 5) if there is involvement of the lower back, positive straight-leg raising test (sitting and

28

supine). Plaintiff did offer a scattershot recitation of findings purportedly “documented” by Dr.

Newton such as numbness and weakness, though Plaintiff did not make any connection between

2

those findings and Listing 1.04(A). Moreover, numbness and weakness were not objectively

3

documented. As discussed above, Plaintiff relies on the portion of Dr. Newton’s report that merely

4

5 documented Plaintiff’s subjective, self-reported history to the historian. AR 890. In contrast, the

6 notes from Dr. Newton’s objective examination reflects full motor strength throughout, normal

7 sensation, and normal reflexes. AR 899–900. Thus, the examination findings do not satisfy

8 1.04(A).

9

In sum, the ALJ erred at step three in finding no nerve root compromise despite

10

acknowledging at step four that an MRI showed L5 nerve root impingement caused by moderate

11

to severe foraminal stenosis. The ALJ further erred in failing to discuss subsection 1.04(A). These

12

13 two errors, together with the analysis at step three, suggest the ALJ gave insufficient consideration

14 to the requirements of listing 1.04 and how these would apply in this case.

15 Claimants’ frequently assert that they meet Listing 1.04 based on common MRI findings of

16

disc degeneration, bulging discs, stenosis, or similar finding, which are nearly unavoidable with

17

age.6 As courts have observed, these findings do not satisfy the threshold requirement of nerve root

18

compromise. See, e.g., McKenzie v. Commissioner of Social Security, 2020 WL 916872, at *4

19

(E.D. Cal., 2020) (finding no “nerve root compromise” as required by listing 1.04 where the MRI

20

21 results showed only spinal stenosis and compression of the fat surrounding the nerve root, but no

22 compression or impingement of the nerve root itself); Schrader v. Colvin, 2015 WL 1061681, at *8

23

(C.D. Cal., 2015) (finding no nerve root compromise where MRI report described narrowing of the

24

disc space but no compression on the nerve root itself).

25

26

6 The incidence of lumbar degenerative disc disease in the general population is 30% by age 35 and 90% by age 60.

27 https://www.neurosurgery.columbia.edu/patient-care/conditions/degenerative-disc-disease

Sciatica is also quite common, with a lifetime incidence as high as 40%.

28 https://www.health.harvard.edu/pain/sciatica-of-all-the-nerve

However, MRI results in these types of cases can specify that a nerve root is in fact impinged

2

or compressed, and here the ALJ was incorrect in concluding otherwise. See, e.g. Kallenbach v.

3

Berryhill, 766 F. App'x 518 (9th Cir. 2019) (finding the ALJ erred in finding no nerve root

4

5 compromise where MRI results did specify nerve root impingement, but the error was nonetheless

6 harmless because there was no evidence of associated motor loss, reflex loss, sensory loss, and

7 positive straight leg raise as required by 1.04(A)).

8 If the ALJ’s assumption was that there is some underlying severity requirement for the

9

impingement or compression to constitute a nerve root compromise, this assumption runs contrary

10

to the plain language of the regulation:

11

Compromise of a nerve root, sometimes referred to as ‘nerve root impingement,’ is

12

a phrase used when a physical object, such as a tumor, herniated disc, foreign body,

13 or arthritic spur, is pushing on the nerve root as seen on imaging or during surgery.

It can occur when a musculoskeletal disorder produces irritation, inflammation, or

14 compression of the nerve root(s) as it exits the skeletal spine between the vertebrae.

Related symptoms must be associated with, or follow the path of, the affected nerve

15 root(s).

16

20 C.F.R. § Pt. 404, Subpt. P, App. 1 (emphasis added).

17

Thus, “Compromise” is described in such unremarkable terms (including irritation,

18

inflammation, or compression) that it suggests the threshold is quite low. What makes Listing 1.04

19

difficult to meet is that the compromise of the nerve root, cauda equina, or spinal cord must manifest

20

21 rather profoundly, as in one of the three manners specified in subsections (A) through (C), which

22 would not happen in the absence of severe compromise of a nerve root, cauda equina, or spinal

23

cord. Hence an ALJ errs when too quickly finding the threshold requirement of nerve root

24

compromise is not met, dispensing with the step three analysis and, in so doing, excusing the

25

obligation of analyzing the dense technical requirements of subsections (A) through (C), which

26

often require a detailed read through progress notes and physical examinations. Those subsections

27

28 are the real driving force behind listing 1.04.

Notwithstanding, there is no basis here to find the ALJ’s errors harmful given: 1) Plaintiff

2

fails to address the requirements of any of the three subsections quoted above, and 2) the only

3

examination Plaintiff cites (Dr. Newton’s September 28, 2020 examination) does not contain

4

5 findings that satisfy any of the three subsections (despite Plaintiff’s unverified reported symptoms

6 of weakness and gait disturbance to the historian), and 3) there do not appear to be any examination

7 findings in the record that would satisfy any of the three subsections, though the Court has no

8 obligation to scour the record in search of the same where Plaintiff made no attempt to do so.

9

Plaintiff did not identify the two errors in the ALJ’s step three analysis, did not attempt to

10

identify any errors in the ALJ’s step three analysis, and does not appear confident in the proposition

11

that listing 1.04 was in fact met when Plaintiff merely asserts that it “may” have been met given

12

13 the existence of nerve root compromise (which, again, is a fairly unremarkable threshold finding

14 that does not satisfy listing 1.04 unless one of the three subsections quoted above is met).7

15 B. Dr. Newton’s Opinion

16

1. Applicable Law

17

Before proceeding to step four, the ALJ must first determine the claimant’s residual

18

functional capacity. Nowden v. Berryhill, No. EDCV 17-00584-JEM, 2018 WL 1155971, at *2

19

20

21

7 Intermixed with Plaintiff’s discussion of Dr. Newton’s examination and opinion, and listing 1.04, Plaintiff offered

various discussion about the ALJ’s duty to identify clear and convincing reasons before rejecting a claimant’s

22

testimony. The discussion is a bit disjointed because counsel appears to have copied and pasted the paragraphs and

pages from his Appeal’s Council letter in the wrong order (the letter he repurposed for use as his motion for summary

23 judgment). In any event, the discussion does not identify 1) what specific pieces of testimony should have been credited

as true, 2) what physical or mental restrictions would result, 3) how those restrictions would differ from those identified

24 in the RFC, 4) what reasoning the ALJ offered on the subject, or 5) why that reasoning was deficient. The discussion

does not get to the type of analysis that is required to meet Plaintiff’s burden of identifying harmful error with respect

25 to the ALJ’s handling of her subjective statements. Granted, the ALJ did offer a boilerplate conclusion when stating

that “the claimant’s statements concerning the intensity, persistence and limiting effects of these symptoms are not

26 entirely consistent with the medical evidence and other evidence in the record for the reasons explained in this

decision.” But this is the same verbatim boilerplate finding set forth in virtually every ALJ decision, and simply

27 describing it as such is not a compelling or novel strategy, nor does it excuse Plaintiff from acknowledging and

discussing the remainder of the ALJ’s decision. See Greenwood v. Fed. Aviation Admin., 28 F.3d 971, 977 (9th Cir.

28 1994) (“We will not manufacture arguments for an appellant, and a bare assertion does not preserve a claim, particularly

when, as here, a host of other issues are presented for review”) (citation omitted).

(C.D. Cal. Mar. 2, 2018). The RFC is “the most [one] can still do despite [his or her] limitations”

2

and represents an assessment “based on all the relevant evidence.” 20 C.F.R. §§ 404.1545(a)(1),

3

416.945(a)(1). The RFC must consider all of the claimant’s impairments, including those that are

4

5 not severe. 20 C.F.R. §§ 416.920(e), 416.945(a)(2); Social Security Ruling (“SSR”) 96–8p.

6 A determination of residual functional capacity is not a medical opinion, but a legal decision

7 that is expressly reserved for the Commissioner. See 20 C.F.R. §§ 404.1527(d)(2) (RFC is not a

8 medical opinion), 404.1546(c) (identifying the ALJ as responsible for determining RFC). “[I]t is

9

the responsibility of the ALJ, not the claimant’s physician, to determine residual functional

10

capacity.” Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 2001). In doing so, the ALJ must

11

determine credibility, resolve conflicts in medical testimony and resolve evidentiary ambiguities.

12

13 Andrews v. Shalala, 53 F.3d 1035, 1039–40 (9th Cir. 1995).

14 “In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the record

15 such as medical records, lay evidence and the effects of symptoms, including pain, that are

16

reasonably attributed to a medically determinable impairment.” Robbins, 466 F.3d at 883. See also

17

20 C.F.R. § 404.1545(a)(3) (residual functional capacity determined based on all relevant medical

18

and other evidence). “The ALJ can meet this burden by setting out a detailed and thorough

19

summary of the facts and conflicting evidence, stating his interpretation thereof, and making

20

21 findings.” Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989) (quoting Cotton v. Bowen, 799

22 F.2d 1403, 1408 (9th Cir. 1986)). The RFC need not mirror a particular opinion; it is an assessment

23

formulated by the ALJ based on all relevant evidence. See 20 C.F.R. §§ 404.1545(a)(3).

24

For applications filed on or after March 27, 2017, the new regulations eliminate a hierarchy

25

of medical opinions, and provide that “[w]e will not defer or give any specific evidentiary weight,

26

including controlling weight, to any medical opinion(s) or prior administrative medical finding(s),

27

28 including those from your medical sources.” 20 C.F.R. § 404.1520c(a). Rather, when evaluating

any medical opinion, the regulations provide that the ALJ will consider the factors of supportability,

2

consistency, treatment relationship, specialization, and other factors. 20 C.F.R. § 404.1520c(c).

3

Supportability and consistency are the two most important factors and the agency will articulate

4

5 how the factors of supportability and consistency are considered. Id.

6 On April 22, 2022, the Ninth Circuit addressed whether the specific and legitimate

7 reasoning standard is consistent with the revised regulations, and clarified what explanatory

8 obligations still remain:

9

The revised social security regulations are clearly irreconcilable with our caselaw

10 according to special deference to the opinions of treating and examining physicians

on account of their relationship with the claimant. See 20 C.F.R. § 404.1520c(a)

11 (“We will not defer or give any specific evidentiary weight, including controlling

weight, to any medical opinion(s) ..., including those from your medical sources.”).

12

Our requirement that ALJs provide “specific and legitimate reasons” for rejecting a

13 treating or examining doctor's opinion, which stems from the special weight given

to such opinions, see Murray, 722 F.2d at 501–02, is likewise incompatible with the

14 revised regulations. Insisting that ALJs provide a more robust explanation when

discrediting evidence from certain sources necessarily favors the evidence from

15 those sources—contrary to the revised regulations.

. . .

16

Even under the new regulations, an ALJ cannot reject an examining or treating

17 doctor's opinion as unsupported or inconsistent without providing an explanation

supported by substantial evidence. The agency must “articulate ... how persuasive”

18 it finds “all of the medical opinions” from each doctor or other source, 20 C.F.R. §

404.1520c(b), and “explain how [it] considered the supportability and consistency

19 factors” in reaching these findings, id. § 404.1520c(b)(2).

20

Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022).

21

2. Analysis

22

On September 28, 2020, Dr. Newton performed a “qualified medical re-evaluation” of the

23

24 Plaintiff in connection with a workers’ compensation claim. AR 889–912. Plaintiff emphasizes

25 Dr. Newton’s opinion that Plaintiff had the following limitations due to impairments of the cervical

26 spine, lumbar spine, bilateral elbows, and bilateral wrists: lift 10 lbs; no prolonged overhead work;

27

no repetitive forceful gripping or grasping; 10 minutes rest for every 50 minutes of typing or writing

28

(but she can keyboard, grasp, push and pull 4 to 6 hours in an eight hour day); no repetitive bending,

twisting, squatting or turning (but she can forward bend and twist 1-2 hours a day); she should work

2

at an ergonomically designed workstation; she had no restrictions on standing, walking, sitting, or

3

climbing. AR 910.

4

5 The ALJ offered the following discussion of the state agency opinions, followed by Dr.

6 Newton’s opinion:

7 The opinions of the state agency physical consultants are less persuasive. In May

and July 2020, the state agency physical consultants determined that the claimant

8 can lift and/or carry 20 pounds, and frequently lift and/or carry 10 pounds; can stand,

9

sit or walk for six hours in an eight-hour workday ; and, can frequently reach

overhead, and frequently handle and finger. (1A/6-8; 3A/6-8) These opinions are

10 not consistent with the claimant’s latest imaging of her back impairment: In August

2020, imaging of the lumbar spine showed advanced neural foraminal narrowing

11 and disc osteophyte complex causing impingement of the existing nerve root.

(10F/16) Electro-diagnostic studies of the lower extremities demonstrated mild

12

innervated denervation. (10F/15) These diagnostic studies show that the claimant

13 has a more restrictive residual functional capacity.

14 On the other hand, the opinions of Dr. Peter Newton are persuasive. In July and

September 2020, Dr. Peter Newton limited the claimant from lifting more than ten

15 pounds, with no repetitive forceful gripping, and resting ten minutes, for every 50

minutes of typing. (10F/22; 9F/23) The claimant was further limited to no repetitive

16

bending, stooping, twisting, squatting or turning. Id. The claimant had no

17 restrictions on standing, walking, sitting, and climbing, but she had restrictions on

forward bending, twisting, keyboarding, grasping and pushing or pulling. (10F/23)

18 Limiting the claimant to a less-than-sedentary range of work is supported by the

record of the claimant’s diagnostic study showing severe median nerve neuropathy

19 in September 2019. (10F/16) It is consistent with the record that the claimant has

reached maximum medical improvement. (10F/17).

20

21 AR 21 (emphasis added).

22 Despite purporting to find Dr. Newton’s opinion persuasive and reciting the restrictions

23

identified therein, the ALJ did not include many of those restrictions in the RFC. The ALJ

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formulated an RFC which restricted Plaintiff to: sedentary work; after every 45 minutes of sitting

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stand for 2 minutes while remaining on task at her work station; occasionally climb ramps and

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stairs; occasional perform postural activities; frequently reach, handle, and finger. AR 18–22.

27

28 The ALJ adopted the state agency physicians’ opinions as to frequent reaching, handling,

and fingering (despite finding those opinions less persuasive) and was more restrictive in the

2

remaining respects, restricting Plaintiff to the sedentary exertional level rather than light.

3

The ALJ adopted Dr. Newton’s opinion regarding 10 pound lifting capacity (the most

4

5 required by sedentary work), and was even more restrictive than Dr. Newton’s opinion with respect

6 to standing and walking. Further, the ALJ partially but not entirely, embraced Dr. Newton’s

7 articulated restrictions regarding postural activities, finding Plaintiff could perform all postural

8 activities occasionally (defined as up to 1/3 of an 8-hour day), whereas Dr. Newton restricted

9

forward bending and twisting to 1-2 hours (which is not quite 1/3 of an 8-hour day). The ALJ

10

assessed no more than frequent handling, reaching, and fingering (i.e. up to 2/3 of an 8-hour day,

11

which would fall within the 4-6 hour window that Dr. Newton opined Plaintiff could perform the

12

13 related activities of keyboarding and grasping).

14 The ALJ did not, however, adopt Dr. Newton’s identified prohibitions on repetitive postural

15 activities and repetitive forceful gripping/grasping, or the restriction concerning a 10 minute break

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for every 50 minutes of typing, opting instead for a 2 minute break after every 45 minutes of sitting

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but while remaining on task at her work station.

18

Dr. Newton’s worker’s compensation evaluation was quite lengthy and detailed and

19

addressed matters not often addressed by the RFC questionnaires submitted in the social security

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21 context. However, an ALJ “may not disregard a physician’s medical opinion simply because it was

22 initially elicited in a state workers’ compensation proceeding, or because it is couched in the

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terminology used in such proceedings.” Booth v. Barnhart, 181 F. Supp. 2d 1099, 1103 (C.D. Cal.

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2002). Rather, the ALJ must evaluate workers’ compensation opinions just as he or she would

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evaluate any other medical opinion and must “translate” workers’ compensation terminology into

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Social Security terminology to accurately assess the implications of those opinions for the Social

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28 Security disability determination. Id.; Soria v. Berryhill, No. 1:18-CV-00089-SKO, 2019 WL

2448435, at *11 (E.D. Cal. June 12, 2019); Herlinda C. v. Saul, No. CV 19-2730 AGR, 2020 WL

2

6287716, at *4 (C.D. Cal. Oct. 27, 2020).

3

Although the ALJ did not overtly reject Dr. Newton’s opinion (and did acknowledge and

4

5 incorporate some of the restrictions identified therein), the ALJ omitted the remainder without

6 discussion. It is not reasonable to expect the ALJ to capture every subtlety and nuance in the

7 opinion. Nor must the ALJ attempt to give meaning to vague restrictions such as the prohibition

8 on “prolonged overhead work.” But the 10 minute break for every 50 minutes of typing is concrete

9

and there is no reason to conclude that it is not readily transferable to the RFC.

10

Defendant emphasizes that the RFC is not a medical opinion but an administrative finding

11

reserved the commissioner, one which need not mirror any opinion. See 20 C.F.R. §404.1545(a).

12

13 Defendant also argues that Plaintiff relies “on a highly cherry-picked view of Dr. Newton’s

14 opinion” in underscoring the restrictions he identified while ignoring his conclusion that she could

15 return to work with an ergonomic work station and had no restrictions on standing, walking or

16

sitting. Further, Defendant emphasizes that the ALJ assessed an RFC more restrictive than the

17

medical opinions in several respects.

18

The fact that the ALJ included in the RFC some restrictions more stringent than Dr.

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Newton’s (such as sitting, standing, and walking duration) does not necessarily justify the exclusion

20

21 of other restrictions if those restrictions were independently justified. Additionally, Dr. Newton’s

22 conclusion that she could return to work with the restrictions he identified8 is irrelevant if the ALJ

23

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8 The ultimate conclusion that Plaintiff could return to work is an example of the type of finding in the workers’

25 compensation context that likely cannot be mechanically applied in the social security context. It appears to be

predicated at least in part on wholly unique considerations such as the “computerized assessment of the applicant’s

26 total whole body impairment” broken down in percentages by body part, and the allocation of the claimant’s

impairments based on what caused those impairments (such as the lumbar spine impairment caused 50% by “obesity-

27 appropriate degenerative changes and normal activities of daily living” and 50% by work trauma). AR 906. Had Dr.

Newton’s Qualified Medical Re-Evaluation ultimately concluded that Plaintiff could not return to her work, the

28 Commissioner would assuredly contend (and has contended in the past) that the conclusion is inapplicable because

disability under workers’ compensation law is determined using an entirely different standard.

erroneously excluded those restrictions. Further, the fact that the ALJ stated the opinion was

2

persuasive and mirrored it in some (or even most) respects does not permit the rejection of other

3

restrictions without comment.

4

5 Here, the ALJ notably found Dr. Newton’s opinion persuasive and found the opinions of

6 the state agency physicians less so (without identifying any exceptions). The ALJ made that finding

7 particularly in light of Plaintiff’s “severe median nerve neuropathy” and her spinal pathology,

8 conditions which could just as easily justify including additional restrictions Dr. Newton identified.

9

This may suggest that the ALJ’s intention was to incorporate those restrictions into the RFC, yet

10

the ALJ did not entirely do so.

11

Hair splitting, perhaps, and this may not have impacted the conclusion that Plaintiff could

12

13 perform her past relevant work. For example, the distinction between Dr. Newton’s restriction of

14 1-2 hours of forward bending, versus the ALJ’s restriction of all postural activities to “occasional”

15 which strictly construed means up to 1/3 of an 8-hour day, or 2.67 hours.9 However, Dr. Newton

16

identified restrictions that were potentially outcome determinative such as the restriction of a 10-

17

minute break every 50 minutes of keyboarding versus the ALJ’s restriction of a 2-minute break

18

every 45 minutes of sitting but while remaining at her workstation and remaining on task. These

19

are quite different restrictions. Dr. Newton’s restriction accommodates her carpal tunnel syndrome

20

21 and associated median nerve neuropathy, whereas the ALJ’s does not. Given the importance of the

22 capacities of handling and fingering in sedentary occupations10 (and the ALJ’s own emphasis of

23

“severe median nerve neuropathy” as one of the two specific reasons for rejecting the state agency

24

opinions and crediting Dr. Newton’s), the ALJ ought to have clarified her intentions and reasoning

25

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9 But SSR 83-10 states that occasional means “from very little up to 1/3 of the time,” and later states that it equates to

27 “about 2 hours of an eight hour work day.”

10 See SSR 96-9 (“Any significant manipulative limitation of an individual's ability to handle and work with small

28 objects with both hands will result in a significant erosion of the unskilled sedentary occupational base” . . . “Most

unskilled sedentary jobs require good use of the hands and fingers for repetitive hand-finger actions.”).

vis-à-vis Dr. Newton’s identified restriction because the ALJ did not ultimately encapsulate that

2

restriction.

3

Dr. Newton’s detailed findings and associated opinions were specially tailored to each of

4

5 her body parts and associated impairments (such as carpal tunnel and associated median nerve

6 neuropathy). Those findings and opinions were uniquely relevant as to what extent and under what

7 precise set of circumstances she could return to her past relevant work as a collections clerk for

8 Kern county. The non-disability finding here was predicated on a finding that Plaintiff could return

9

to that specific job. Thus, where a physician has already given tremendous attention to that precise

10

issue, the restrictions identified in his opinion ought to have been addressed more thoroughly.

11

VI. Conclusion and Remand for Further Proceedings

12

13 In conclusion, at a minimum the ALJ ought to have identified the difference between Dr.

14 Newton’s opinion and the ultimate RFC, and clarified whether the intention was to include or

15 exclude the restrictions therein and why (including repetitive postural activities, no repetitive

16

forceful gripping, grasping; and 10 minutes rest for every 50 minutes of typing or writing), or posed

17

those restrictions to the VE in one of the ALJ’s alternative hypotheticals to ascertain whether their

18

inclusion would have affected Plaintiff’s ability to perform her past work as a collections clerk.

19

Remand is thus appropriate for the ALJ to do so. See Benecke v. Barnhart, 379 F.3d 587, 595

20

21 (9th Cir. 2004) (“Generally when a court . . . reverses an administrative determination, the proper

22 course, except in rare circumstances, is to remand to the agency for additional investigation or

23

explanation.”).

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VII. Order

25

For the reasons stated above, the Court finds that substantial evidence and applicable law

26

do not support the ALJ’s conclusion that Plaintiff was not disabled. Accordingly, Plaintiff’s appeal

27

28 from the administrative decision of the Commissioner of Social Security is granted. The Clerk of

Court is directed to enter judgment in favor of Plaintiff Misty Stubblefield and against Defendant

2

Kilolo Kijakazi, acting Commissioner of Social Security.

3

IT IS SO ORDERED.

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5 Dated: February 21, 2023 /s/ Gary S. Austin

UNITED STATES MAGISTRATE JUDGE

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This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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