Opinion

Ani Viramontes v. Kilolo Kijakazi

Court
District Court, C.D. California
Filed
Jul 12, 2022
Cited by
0 cases
Authority
More cited than 16.4%

“The purpose for 13 which medical reports are obtained does not provide a legitimate basis for rejecting 14 them.”

How later courts described this case

  • “The purpose for 13 which medical reports are obtained does not provide a legitimate basis for rejecting 14 them.”
  • “If a treating or examining doctor’s 17 opinion is contradicted by another doctor’s opinion, an ALJ may only reject it by 18 providing specific and legitimate reasons that are supported by substantial 19 evidence.”
  • remand for 6 award of benefits is inappropriate where “there is conflicting evidence, and not all 7 essential factual issues have been resolved”
  • “Because we remand the case to the ALJ for the reasons stated, we decline to 23 reach [plaintiff’s] alternative ground for remand.”

Written by the judges who cited it.

The opinion

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 1 of 9 Page ID #:891

1

2

3

4

5

6

7

8 UNITED STATES DISTRICT COURT

9 CENTRAL DISTRICT OF CALIFORNIA

10

ANI V.,1

11 Case No. 5:20-cv-02107-GJS

Plaintiff

12

v.

13 MEMORANDUM OPINION AND

KILOLO KIJAKAJI, Acting ORDER

14 Commissioner of Social Security,

15 Defendant.

16

17 I. PROCEDURAL HISTORY

18 Plaintiff Ani V. (“Plaintiff”) filed a complaint seeking review of the decision

19 of the Commissioner of Social Security denying her applications for Disability

20 Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”). The parties

21 filed consents to proceed before the undersigned United States Magistrate Judge

22 [Dkts. 10 and 13] and briefs [Dkt. 15 (“Pl. Br.”), Dkt. 24 (“Def. Br.”), Dkt 25

23 (“Reply”)] addressing disputed issues in the case. The matter is now ready for

24 decision. For the reasons discussed below, the Court finds that this matter should be

25

26

27 1 In the interest of privacy, this Order uses only the first name and the initial of

the last name of the non-governmental party in this case.

28

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 2 of 9 Page ID #:892

1 remanded.

2

3 II. ADMINISTRATIVE DECISION UNDER REVIEW

4 Plaintiff filed applications for DIB and SSI on March 17, 2017, alleging

5 disability beginning May 27, 2014. [Dkt. 12, Administrative Record (“AR”) 15,

6 251-75.] Plaintiff’s applications were denied at the initial level of review and on

7 reconsideration. [AR 15, 160-70, 175-80.] A hearing was held before

8 Administrative Law Judge Elizabeth Stevens Bentley (“the ALJ”) on January 8,

9 2020. [AR 15, 39-58.]

10 On January 17, 2020, the ALJ issued an unfavorable decision applying the

11 five-step sequential evaluation process for assessing disability. [AR 15-26]; see 20

12 C.F.R. §§ 404.1520(b)-(g)(1), 416.920(b)-(g)(1). [AR 15-30.] At step one, the ALJ

13 determined that Plaintiff had not engaged in substantial gainful activity (“SGA”)

14 since the alleged onset date. [AR 18.] At step two, the ALJ determined that

15 Plaintiff has the following severe impairments: degenerative disc disease of the

16 cervical and lumbar spine; carpal tunnel syndrome, right upper extremity; and

17 depression. [AR 18.] At step three, the ALJ determined that Plaintiff does not have

18 an impairment or combination of impairments that meets or medically equals the

19 severity of one of the impairments listed in Appendix I of the Regulations. [AR 18];

20 see 20 C.F.R. Pt. 404, Subpt. P, App. 1. The ALJ found that Plaintiff has the

21 residual functional capacity (“RFC”) to perform light work, as defined in 20 C.F.R.

22 §§ 404.1567(b), 416.967(b), but she requires a sit/stand option such that she can sit

23 for 15 minutes at a time before needing to stand and stand for 15 minutes at a time

24 before needing to sit. [AR 20.] The ALJ also found Plaintiff is able to:

25 occasionally climb ladders, ropes and scaffolds; frequently stoop, kneel, crouch and

26 crawl; occasionally reach overhead bilaterally; frequently handle and finger with the

27 right upper extremity; and perform simple, routine tasks. [AR 20.] At step four, the

28 ALJ determined that Plaintiff is not able to perform any past relevant work. [AR

2

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 3 of 9 Page ID #:893

1 28.] At step five, the ALJ found there are jobs that exist in significant numbers in

2 the national economy that Plaintiff can perform, including representative jobs such

3 as information clerk and assembler, small products. [AR 28-29.] Based on these

4 findings, the ALJ found Plaintiff not disabled through the date of the decision. [AR

5 29-30.]

6 The Appeals Council denied review of the ALJ’s decision on August 21,

7 2020. [AR 1-6.] This action followed.

8 Plaintiff raises the following issues challenging the ALJ’s findings and

9 determination of non-disability:

10 1. The ALJ erred in finding that there were a significant number of

11 jobs that Plaintiff could perform. [Pl. Br. at 2-3.]

12 2. The ALJ failed to properly assess and reject the opinions of

13 Plaintiff’s treatment and examining sources. [Pl. Br. at 3-12.]

14 3. The ALJ improperly evaluated Plaintiff’s RFC. [Pl. Br. at 12-23.]

15 4. The ALJ improperly rejected Plaintiff’s testimony. [Pl. Br. at 23-

16 25.]

17 The Commissioner asserts that the ALJ’s decision should be affirmed. [Def.

18 Br. at 1-18.]

19

20 III. GOVERNING STANDARD

21 Under 42 U.S.C. § 405(g), the Court reviews the Commissioner’s decision to

22 determine if: (1) the Commissioner’s findings are supported by substantial

23 evidence; and (2) the Commissioner used correct legal standards. See Carmickle v.

24 Comm’r Soc. Sec. Admin., 533 F.3d 1155, 1159 (9th Cir. 2008); Brewes v. Comm’r

25 Soc. Sec. Admin., 682 F.3d 1157, 1161 (9th Cir. 2012). “Substantial evidence is

26 more than a mere scintilla but less than a preponderance; it is such relevant evidence

27 as a reasonable mind might accept as adequate to support a conclusion.” Gutierrez

28

3

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 4 of 9 Page ID #:894

1 v. Comm’r of Soc. Sec., 740 F.3d 519, 522-23 (9th Cir. 2014) (internal quotation

2 marks and citation omitted).

3 The Court will uphold the Commissioner’s decision when “the evidence is

4 susceptible to more than one rational interpretation.” Magallanes v. Bowen, 881

5 F.2d 747, 750 (9th Cir. 1989). However, the Court may review only the reasons

6 stated by the ALJ in his decision “and may not affirm the ALJ on a ground upon

7 which he did not rely.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). The

8 Court will not reverse the Commissioner’s decision if it is based on harmless error,

9 which exists if the error is “inconsequential to the ultimate nondisability

10 determination.” Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015)

11 (internal quotation marks and citations omitted).

12

IV. DISCUSSION

13

A. The ALJ Erred in Evaluating the Medical Opinion Evidence

14

Petitioner challenges the ALJ’s evaluation of the medical opinions relating to

15

her physical and mental impairments. [Pl. Br. 3-12.] Respondent contends that the

16

ALJ reasonably evaluated the opinion evidence. [Def. Br. at 4-9.]

17

1. Legal Standards

18

The weight given to medical opinions depends in part on whether they are

19

proffered by treating, examining, or non-examining professionals. See Holohan v.

20

Massanari, 246 F.3d 1195, 1201-02 (9th Cir. 2001); Lester v. Chater, 81 F.3d 821,

21

830 (9th Cir. 1995).2 In general, opinions of treating sources are entitled to the

22

23

24

2 The regulations governing the evaluation of medical evidence were amended

25

for claims filed after March 27, 2017. See 20 C.F.R. §§ 404.1520c, 416.920c. The

26 new regulations change how the Social Security Administration considers medical

opinions and eliminate the deference to treating source medical opinions. See 20

27 C.F.R. § 404.1520c(a); see also 81 Fed. Reg. 62560, at 62573-74 (Sept. 9, 2016).

Because Petitioner’s claims were filed on March 17, 2017, the Court does not apply

28

the new regulations.

4

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 5 of 9 Page ID #:895

1 greatest weight, opinions of examining, non-treating sources are entitled to lesser

2 weight, and opinions of non-examining, non-treating sources are entitled to the least

3 weight. See Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014).

4 If a treating or examining doctor’s opinion is contradicted by another doctor’s

5 opinion, an ALJ may only reject it by providing “specific and legitimate reasons that

6 are supported by substantial evidence in the record.” Lester, 81 F.3d at 830-31. An

7 ALJ can satisfy this standard by “setting out a detailed and thorough summary of the

8 facts and conflicting evidence, stating his [or her] interpretation thereof, and making

9 findings.” Magallanes, 881 F.2d at 751 (internal quotation marks and citation

10 omitted).

11 2. The ALJ Failed to Properly Evaluate Dr. Grogan’s Opinion

12 Having carefully reviewed the record, the Court finds the ALJ erred by

13 mischaracterizing and failing to state legally sufficient reasons for rejecting the

14 opinion of an examining orthopedic surgeon, Dr. Thomas Grogan.

15 In the decision, the ALJ misstated Dr. Grogan’s opinion regarding Plaintiff’s

16 ability to sit, stand and walk. The ALJ stated: “[i]n a Physical Capacities form

17 dated February 2, 2017, Dr. Grogan opined the claimant was able to stand and/or

18 walk for zero to two hours in an eight-hour day [and] sit for zero to two hours in an

19 eight-hour day.” [AR 24.] However, a review of the Physical Capacities form

20 reflects that Dr. Grogan opined that Plaintiff was able to: stand/walk 0 to 2 hours at

21 one time, for a total of 2 to 4 hours in an 8-hour workday; and sit 0 to 2 hours at one

22 time, for a total of 4 to 6 hours in an 8-hour workday. [AR 564 (emphasis added).]

23 Thus, the ALJ erred in rejecting Dr. Grogan’s assessment of Plaintiff’s physical

24 capacities.

25 The ALJ also failed to provide specific and legitimate reasons supported by

26 substantial evidence for rejecting to Dr. Grogan’s opinion. [AR 24.] The three

27 reasons the ALJ provided for giving “little weight” to Dr. Grogan’s opinion are

28 addressed and rejected.

5

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 6 of 9 Page ID #:896

1 First, to the extent the ALJ found that “the extreme limitation[s] opined by

2 Dr. Grogan [were] not consistent with [Plaintiff’s] treatment record or imaging as

3 noted above [in the decision],” her assessment is impermissibly broad and

4 conclusory and “does not achieve the level of specificity” required to justify

5 rejection of an examining physician’s opinion. [AR 25]; Rodriguez v. Bowen, 876

6 F.2d 759, 762 (9th Cir. 1989) (“[m]erely to state that a medical opinion is not

7 supported by enough objective findings does not achieve the level of specificity our

8 prior cases have required”) (internal quotation marks and citation omitted). “The

9 ALJ must do more than offer [her] conclusions. [She] must set forth [her] own

10 interpretations and explain why they, rather than the doctors’, are correct.” Embrey

11 v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988). While Defendant argues that Dr.

12 Grogan’s opinion is inconsistent with the opinions of Plaintiff’s treating and

13 examining physicians in certain respects [Def. Br. at 7], a conflict in the medical

14 evidence merely triggers, rather than satisfies, the ALJ’s obligation of providing

15 specific and legitimate reasons supported by substantial evidence. See Bayliss v.

16 Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005) (“If a treating or examining doctor’s

17 opinion is contradicted by another doctor’s opinion, an ALJ may only reject it by

18 providing specific and legitimate reasons that are supported by substantial

19 evidence.”); Chernick v. Comm’r of Soc. Sec., No. 1:19-CV-00160-JDP, 2020 WL

20 3542287, at *2 (E.D. Cal. June 30, 2020) (“[B]ecause the ‘specific and legitimate’

21 requirement is triggered by a conflict between the opinion and the record, it would

22 make little sense if the ALJ could satisfy that standard by noting the existence of a

23 conflict.”). Moreover, Plaintiff’s imaging records appear to support Dr. Grogan’s

24 opinion that Plaintiff suffers from facet arthropathy of the lower lumbar spine. [AR

25 563-64.] X-rays revealed positive facet changes throughout the lower lumbar spine.

26 [AR 563.] In addition, MRIs of Plaintiff’s spine revealed a 2 to 3 mm disc

27 protrusion at C5-6 extending partially into the left neuroforaminal exit zone, a 1 to 2

28 mm midline disc protrusion at L1-2, disc desiccation and degeneration with a 3 to 4

6

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 7 of 9 Page ID #:897

1 mm disc protrusion at L3-4 impinging on and partially distorting the thecal sac,

2 desiccation and degeneration with a 2 to 3 mm disc protrusion at L5-S1 extending to

3 both neural foraminal exit zones, and scoliosis convex to the right. [AR 22, 583-

4 86.]

5 Second, the ALJ asserted that Dr. Grogan opined that Plaintiff was “partially

6 disabled through August 1, 2017,” using criteria for determining disability under the

7 workers’ compensation system, rather than Social Security disability terminology.

8 [AR 25.] This was not a specific and legitimate reason for rejecting Dr. Grogan’s

9 opinion. An ALJ “may not disregard a ... medical opinion simply because it was

10 initially elicited in a state workers’ compensation proceeding, or because it is

11 couched in the terminology used in such proceedings.” Booth v. Barnhart, 181 F.

12 Supp. 2d 1099, 1105 (C.D. Cal. 2002); Lester, 81 F.3d at 830 (“The purpose for

13 which medical reports are obtained does not provide a legitimate basis for rejecting

14 them.”).

15 Third, the ALJ asserted that “the determination of disability is an issue

16 reserved to the Commissioner.” [AR 25.] However, “[i]n disability benefits cases

17 ... physicians may render medical, clinical opinions, or they may render opinions on

18 the ultimate issue of disability — the claimant’s ability to perform work.” Reddick

19 v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) (citation omitted); Holohan, 246 F.3d

20 at 1202 (same). Thus, the ALJ was not entitled to reject Dr. Grogan’s opinion

21 simply because he gave an opinion that Plaintiff was “partially disabled.” [AR 25.]

22 Accordingly, the Court finds the ALJ failed to provide specific and legitimate

23 reasons for discrediting Dr. Grogan’s opinion and the ALJ’s decision denying

24 benefits is not supported by substantial evidence.

25

26 V. REMAND FOR FURTHER PROCEEDINGS

27 The Court has discretion to remand or reverse and award benefits. See

28 Trevizo v. Berryhill, 871 F.3d 664, 682 (9th Cir. 2017). “Remand for further

7

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page 8 of 9 Page ID #:898

1 proceedings is appropriate where there are outstanding issues that must be resolved

2 before a determination can be made, and it is not clear from the record that the ALJ

3 would be required to find the claimant disabled if all the evidence were properly

4 evaluated.” Hill v. Astrue, 698 F.3d 1153, 1162 (9th Cir. 2012); Treichler v.

5 Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1101 (9th Cir. 2014) (remand for

6 award of benefits is inappropriate where “there is conflicting evidence, and not all

7 essential factual issues have been resolved”). But “[w]here ‘(1) the record has been

8 fully developed and further administrative proceedings would serve no useful

9 purpose; (2) the ALJ has failed to provide legally sufficient reasons for rejecting

10 evidence, whether claimant testimony or medical opinion; and (3) if the improperly

11 discredited evidence were credited as true, the ALJ would be required to find the

12 claimant disabled on remand,’” it is appropriate to exercise this discretion to direct

13 an immediate award of benefits. Trevizo, 871 F.3d at 682-83 (quoting Garrison,

14 759 F.3d at 1020).

15 Here, remand is required because the ALJ failed to properly evaluate Dr.

16 Grogan’s opinion and there are outstanding issues that must be resolved before a

17 final determination can be made. On remand, the ALJ should reconsider Dr.

18 Grogan’s opinion, explain the weight afforded to that opinion, and provide legally

19 sufficient reasons for rejecting any portion of that opinion.

20 Having found that remand is warranted, the Court declines to address

21 Plaintiff’s remaining issues. See Hiler v. Astrue, 687 F.3d 1208, 1212 (9th Cir.

22 2012) (“Because we remand the case to the ALJ for the reasons stated, we decline to

23 reach [plaintiff’s] alternative ground for remand.”).

24

25 VI. CONCLUSION

26 For all of the foregoing reasons, IT IS ORDERED that:

27 (1) the decision of the Commissioner is REVERSED and this matter is

28 REMANDED pursuant to sentence four of 42 U.S.C. § 405(g) for further

8

Case 5:20-cv-02107-GJS Document 26 Filed 07/12/22 Page9of9 Page ID #:899

1 administrative proceedings consistent with this Memorandum Opinion and

2 Order; and

3 (2) Judgment be entered in favor of Plaintiff.

5 IT IS ORDERED.

7 || DATED: July 12, 2022

8 ;

10 UNITED STATES MAGISTRATE JUDGE

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

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.

A word about cookies

We need a few to keep you signed in and the library working. The rest help us see which pages people use and where they get stuck. They stay off unless you say yes.