United States District Court, W.D. Washington, Seattle
RICHARD A. JONES, District Judge.
This matter comes before the court via 42 U.S.C. § 405(g) on review of the final decision of the Commissioner of the Social Security Administration ("SSA") denying Plaintiff Teresa Hall's application for disability insurance benefits and supplemental security income. The court has considered the parties' briefs and the Administrative Record ("AR"). For the reasons stated herein, the court REVERSES the Commissioner's decision and REMANDS this case for further proceedings consistent with this order. The court directs the clerk to enter judgment for Ms. Hall.
II. STANDARD OF REVIEW
In a case like this one, where the court reviews the decision of an administrative law judge ("ALJ") to deny disability benefits, the court must generally affirm the ALJ's decision where substantial evidence supports it. Bray v. Comm'r of SSA, 554 F.3d 1219, 1222 (9th Cir. 2009) ("Substantial evidence means more than a mere scintilla but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.") (citation omitted). In certain circumstances, such as when an ALJ rejects a claimant's testimony about the severity of her impairments, a higher standard applies. Greger v. Barnhart, 464 F.3d 968, 972 (9th Cir. 2006) (requiring "specific, cogent reasons" for rejecting claimant's testimony, and "clear and convincing evidence" where there is no evidence of malingering). Similarly, an ALJ can reject the uncontradicted opinions of a treating or examining medical provider only where clear and convincing evidence supports that decision. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). Even where medical evidence contradicts the opinion of a treating or examining provider, the "ALJ may only reject it by providing specific and legitimate reasons that are supported by substantial evidence." Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014). The court does not defer to the ALJ's legal conclusions. Bray, 554 F.3d at 1222.
A five-step process determines whether an applicant is disabled. See Treichler v. Comm'r of SSA, 775 F.3d 1090, 1096 n.1 (9th Cir. 2014); 20 C.F.R. §§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v). The burden of proof is on the applicant in the first four steps, which are the prerequisites of a prima facie case of disability. Treichler, 775 F.3d at 1096 n.1. In the first step, the applicant must show that she did not engage in substantial gainful activity during a relevant time period. 20 C.F.R. § 404.1520(a)(4)(i). If she did, then she is not disabled. If she did not, then the claimant must show at the second step that she has a "severe medically determinable physical or mental impairment" or combination of impairments that are collectively severe. 20 C.F.R. § 404.1520(a)(4)(ii). The severe impairment must generally last at least a year. Id.; see also 20 C.F.R. § 416.909 (setting "duration requirement" for impairment). If an applicant shows a severe impairment of sufficient duration, she must show at the third step that over the course of at least a year, her impairment "meets or equals" an impairment listed in applicable regulations. 20 C.F.R. § 404.1520(a)(4)(iii). If it does, she is disabled. If not, the ALJ must determine, between step three and step four, the applicant's RFC, which is an assessment of the applicant's "ability to work after accounting for her verifiable impairments." Bray, 554 F.3d at 1222-23. The applicant must demonstrate at step four that her RFC is such that she cannot perform her past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv) (noting that an applicant who can perform past relevant work is not disabled). If she cannot, then the burden shifts to the SSA to demonstrate that her RFC permits her to perform other jobs that exist in substantial numbers in the national economy. See Bray, 554 F.3d at 1223 (describing allocation of burdens in five-step process).
The ALJ held a hearing in September 2012. Ms. Hall and a vocational expert testified. In an October 2012 written decision following the hearing, the ALJ determined that Ms. Hall suffered from a number of severe impairments: chronic obstructive pulmonary disorder, obesity, hypertension, diabetes mellitus, complications following an October 2011 cardiovascular event (which the court will refer to as a "stroke, " for simplicity) and an affective disorder. Although Ms. Hall initially claimed a disability that onset in August 2010, she amended that date to October 27, 2011, the date of her stroke. The ALJ found that she had not engaged in substantial gainful activity over the relevant time period, that her impairments did not meet or equal a listing, and that she could not perform her past relevant work. The ALJ assessed an RFC that the court will later examine in more detail. For now, it suffices to note that the ALJ concluded that RFC left Ms. Hall able to perform jobs that exist in substantial numbers.
Ms. Hall challenges the ALJ's finding at the third step that Ms. Hall's impairments did not meet or equal a listed impairment. As to the ALJ's RFC determination, she contends that the ALJ improperly discredited her testimony at the hearing about the effects of her impairments. She contends that the ALJ improperly discounted the opinions of physicians and other medical providers who examined or treated her, relying instead on the opinions of providers who never examined her. Ms. Hall alleges that these errors and others led to errors in the ALJ's assessment of her RFC. These are the only errors to which Ms. Hall points; they are therefore the only issues the court considers in this appeal. See Carmickle v. Comm'r of SSA, 533 F.3d 1155, 1161 n.2 (9th Cir. 2008) (refusing to review ALJ's conclusion when plaintiff "failed to argue th[e] issue with any specificity in his briefing"); Lewis v. Apfel, 236 F.3d 503, 517 n. 13 (9th Cir. 2001) (limiting review to issues plaintiff raises).
The court summarizes its ruling as follows: Plaintiff does not persuade the court that the ALJ erred at step three in determining that she had no impairment that met or equaled a listed impairment. The ALJ made errors in assessing Ms. Hall's credibility and in discounting evidence from Ms. Hall's medical providers as to both her physical capacity and the impact of her mental health on her capacity to work. Because the court concludes that it is reasonably likely that an ALJ would reach a different RFC assessment but for those errors, the court remands this case for additional proceedings.
A. The ALJ Did Not Err at Step Three.
At step three of the sequential evaluation process, the ALJ must determine whether any of the claimant's impairments meet or medically equal an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. 20 C.F.R. §§ 404.1520(4)(iii), 416.920(4)(iii). The Listing of Impairments "describes for each of the major body systems impairments that we consider to be severe enough to prevent an individual from doing any gainful activity, regardless of his or her age, education, or work experience." 20 C.F.R. §§ 404.1525(a), 416.925(a). "If a claimant has an impairment or combination of impairments that meets or equals a condition outlined in the Listing of Impairments, ' then the claimant is presumed disabled at step three." Lewis, 236 F.3d at 512. At step three, the claimant bears the burden of proving that her impairment meets a Listing. See Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). The ALJ need not, as a matter of law, "state why a claimant failed to satisfy every different section of the listing of impairments." Gonzalez v. Sullivan, 914 F.2d 1197, 1201 (9th Cir. 1990).
Ms. Hall contends that her October 2011 stroke left her with severe, lasting difficulties with her right hand and lower extremities. AR 39-43. She claims that, despite her counsel's specific and repeated references at the hearing, the ALJ failed to consider whether her impairments meet Listing 11.04(B). Dkt. # 9 at 2-5. The Commissioner contends that Ms. Hall argues only that the ALJ failed to consider whether she met Listing 11.04(B) and not that her impairments rise to the Listing level. Dkt. # 10 at 10-11. The Commissioner also urges that Ms. Hall's medical records show that her impairments do not meet the severity requirements of the Listing. Id.
Listing 11.04(B) is the neurological listing for "central nervous system vascular accident, " with "[s]ignificant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station (see 11.00C), " persisting for more than three months post vascular accident. 20 C.F.R. Part 404, Subpart P, Appendix 1 § 11.04(B). "Persistent disorganization of motor function" is defined as "paresis or paralysis, tremor or other involuntary movements, ataxia and sensory disturbances (any or all of which may be due to cerebral, cerebellar, brain stem, spinal cord, or peripheral nerve dysfunction) which occur singly or in various combinations." 20 C.F.R. Part 404, Subpart P, Appendix 1 § 11.00C. Assessment of an impairment characterized by persistent disorganization of motor function "depends on the ...