United States District Court, W.D. Washington, Seattle
REPORT AND RECOMMENDATION
BRIAN A. TSUCHIDA, Magistrate Judge.
Jacquelyn McCarten appeals the denial of her Disability Insurance Benefits application, seeking remand for an award of benefits. She contends the ALJ erred by misevaluating the medical evidence and erroneously rejecting the Global Assessment of Functioning ("GAF") scores in the record. Dkt. 15 at 1. As discussed below, the Court recommends the case be REVERSED and REMANDED for further administrative proceedings.
Following a hearing, the ALJ issued a final decision finding that since Ms. McCarten's alleged onset date of October 7, 2010, she was not disabled. Utilizing the five-step disability evaluation process, the ALJ found that bipolar disorder and alcohol abuse in remission were severe impairments that did not meet or equal the requirements of a listed impairment. See 20 C.F.R. § 404.1520; 20 C.F.R. Pt. 404, Subpt. P, App. 1. The ALJ also found that Ms. McCarten had the residual functional capacity ("RFC") to perform a full range of work at all exertional levels but could only understand, remember, and carry out simple instructions; have occasional interaction with coworkers and the public; and needed a routine and predictable work environment. Tr. 30. Based on this RFC, the ALJ found Ms. McCarten could perform jobs existing in the national economy and therefore was not disabled. Tr. 35.
A. Medical Opinion Evidence
In general, more weight should be given to the opinion of a treating physician than to a non-treating physician, and more weight to the opinion of an examining physician than to a non-examining physician. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1996). Where contradicted, a treating or examining physician's opinion may not be rejected without "specific and legitimate reasons supported by substantial evidence in the record for so doing." Id. at 830-31 (quotation and citation omitted).
1. Dr. Tawnya Christiansen, treating psychiatrist
In March 2011, Dr. Christiansen opined Ms. McCarten had severe and marked limitations in her cognitive and social abilities. Tr. 480-81. The ALJ gave Dr. Christiansen's opinion "little weight" for several reasons. Tr. 33. Plaintiff argues these reasons are either legally insufficient or lack the support of substantial evidence.
First, the ALJ found that "Dr. Christiansen stated that medications had proved ineffective, " but that this assessment was inconsistent with Ms. McCarten's "reports of improvement with medication." Tr. 33. Substantial evidence does not support this finding. The ALJ misrepresents Dr. Christiansen's opinion, which stated: "[T]hough [Ms. McCarten] has derived some benefit from current treatments, her progress continues to be limited, with frequent resurgence of symptoms - thus, improvement is irregular, unpredictable." Tr. 481. This opinion is not inconsistent with Ms. McCarten's report-prior to her alleged onset date-that "her mood symptoms had been fairly well-controlled with lithium, " Tr. 312, or with Dr. Christiansen's treatment notes, which establish that Ms. McCarten continued to have difficulties despite some improvement with medication, see Tr. 368-87.
Second, the ALJ found that Dr. Christiansen's opinion was inconsistent with her own statement that Ms. McCarten had the ability to "attend to her personal needs, such as food, clothing and hygiene" and "read and manage her own money." Tr. 33 (citing Tr. 477-82 (Dr. Christiansen's opinion)). The ALJ fails to explain this finding, and the Court can discern no inconsistency between Dr. Christiansen's opinion that Ms. McCarten would have limitations in her ability to perform on a normal day-to-day work basis and her opinion that Ms. McCarten can attend to basic personal needs. As such, the ALJ's second reason for rejecting Dr. Christiansen's opinion is not supported by substantial evidence.
Third, the ALJ found that the medical evidence did not support Dr. Christiansen's findings. Tr. 33. Specifically, the ALJ found that Dr. Christiansen described Ms. McCarten as late for appointments, but the medical evidence showed only one missed appointment and several late arrivals. Id. As the ALJ noted, Dr. Christiansen found plaintiff had a "remarkable difficulty remembering appointments." Tr. 479. However, Dr. Christiansen did not cite this difficulty as the basis for any of the functional limitations she assessed. See Tr. 480-81. Accordingly, the Court does not find this inconsistency to be a specific and legitimate reason to reject Dr. Christiansen's opinion.
The ALJ also found that the medical evidence did not support Dr. Christiansen's opinion because "on February 16, 2011, Dr. Christiansen stated in her treatment notes that medication provided fair stability' and that the claimant's hospitalization seemed more of [an] effort to engage in a lower-stimulating environment' than truly fearing self-harm or suicide. She did not feel that the claimant met the admission criteria based on her reported symptoms." Tr. 33. In finding that medications provided Ms. McCarten "fair stability, " ALJ selectively quotes from Dr. Christiansen's treatment note, which stated that "lithium and lamotrigine seem to have provided fair stability though symptomatic relief was not optimal w/them. ... She continues to struggle with mood lability, irritability, feelings of despair at times...." Tr. 372 (emphasis added). Viewing Dr. Christiansen's chart note as a whole, the Court finds that is not inconsistent with her opinion. See Edlund v. Massanari, 253 F.3d 1152, 1159 (9th Cir. 2001) (an ALJ may not selectively focus on aspects of the record that tend to suggest non-disability while disregarding the remainder of the medical evidence).
The ALJ's discussion of hospitalization also reflects a misinterpretation of the record. Dr. Christiansen's February 16, 2011 treatment notes indicates that Ms. McCarten was considering checking herself into a hospital, not that Ms. McCarten had been hospitalized. See Tr. 372. Furthermore, the fact that Dr. Christiansen did not believe Ms. McCarten met the criteria for hospitalization at that time does not undermine her opinion as to Ms. McCarten's functional limitations. As such, ...