United States District Court, W.D. Washington, Seattle
ORDER REVERSING THE COMMISSIONER AND REMANDING FOR
A. TSUCHIDA, UNITED STATES MAGISTRATE JUDGE.
Houston appeals the ALJ's decision finding her not
disabled. The ALJ found Ms. Houston's obesity, cervical
and lumbar degenerative disc disease, osteoarthritis,
diabetes, affective disorder, anxiety, posttraumatic stress
disorder, substance abuse, left knee medical meniscus tear,
chrondromalacia, are severe impairments; that with these
impairments she has the Residual Functional Capacity (RFC) to
lift/carry 20 pounds occasionally and 10 pounds frequently,
and stand/walk and sit for six hours, with normal breaks
subject to additional physical, postural, environmental, and
non-exertional limitations; that Ms. Houston cannot perform
her past work but can perform other jobs that exist in
significant numbers in the national economy. Tr. 23-37.
Houston contends the ALJ erred in assessing the medical
opinions of her treating and examining providers. Dkt. 11 at
1. As discussed below, the Court REVERSES
the Commissioner's final decision and
REMANDS the matter for further
administrative proceedings under sentence four of 42 U.S.C.
James Czysz, Psy.D.
Czysz performed a psychological evaluation of Ms. Houston and
opined she has several moderate and marked limitations in her
ability to perform work activities. Tr. 462-68. Ms. Houston
argues, and the Court agrees, the ALJ erred by failing to
provide specific and legitimate reasons to reject Dr.
Czysz's opinion. See Lester v. Chater, 81 F.3d
821, 830-31 (9th Cir. 1996).
found Dr. Czysz's opinions lacked sufficient rationale
and support, and relied instead upon Ms. Houston's
non-credible statements. An ALJ may not reject an examining
physician's opinion by questioning the credibility of the
patient's complaints where the doctor does not discredit
those complaints and supports his ultimate opinion with his
own observations. Edlund v. Massanari, 253 F.3d
1152, 1159 (9th Cir. 2001). Dr. Czysz did not question Ms.
Houston's claims. While he considered her statements, he
also supported his conclusions by performing a clinical
examination and mental status exam, and by administering
standardized testing. Additionally, in the clinical findings
section, Dr. Czysz described Ms. Houston's symptoms,
their severity, and the impact on her ability to perform
work. Substantial evidence does not support the ALJ's
conclusion that the doctor failed to provide a rationale or
any support for his opinions.
also found the difficulties Ms. Houston displayed during Dr.
Czysz's cognitive exam were inconsistent with her
treatment record which the ALJ indicated showed she had
normal attention span, concentration and memory. Tr. 32.
Substantial evidence does not support this finding. First the
records the ALJ relies upon were created by other sources,
not a medical doctor. Many of the records the ALJ referenced
were prepared by Megan Merritt, PA-C. The ALJ rejected Ms.
Merritt's opinions about the severity of Ms.
Houston's limitations, Tr. 34. It is thus unreasonable
for the ALJ to rely on discredited Ms. Merritt's records
to reject Dr. Czyz's opinions. Second, only one record
indicated normal attention, concentration and memory. Tr.
522. The others were limited to memory only. One record
indicated intact attention and memory but also noted poor
concentration and severe anxiety. Tr. 474-75. None of the
records indicate any testing was performed and if so what the
results were. An ALJ may gave more weight to the opinion of
an “other source” who is not an “acceptable
medical source” if the other source provides better
supporting evidence and a better explanation for his or her
opinion. See SSR 06- 03p, 2006 WL 2329939, *5 (Aug.
9, 2006). But here, the other sources did not consistently
find Ms. Houston more functional in all cognitive spheres as
the ALJ found, and provided no supporting evidence or
explanation in support of their notations regarding memory,
concentration or attention. The ALJ's determination is
thus not supported by substantial evidence.
the ALJ rejected Dr. Czysz's opinion regarding depressive
symptoms as inconsistent with findings from another exam.
Substantial evidence does not support this finding because
Dr. Czysz's opinion is based upon psychological testing
he performed regarding Ms. Houston's depression, but the
exam relied upon by the ALJ to contradict the doctor's
depression opinions pertains to an appointment addressing Ms.
Houston's physical symptoms. See Tr. 544. That
it mentions “no . . . evidence of depression”
during that appointment does not constitute a meaningful
contrast to Dr. Czysz's findings.
Joanne Gartenberg, M.D., and Suzanne Oelke, M.A.
Gartenberg and Ms. Oelke co-signed a May 2015 medical source
statement rating Ms. Houston's limitations in a variety
of areas and describing her diagnoses. Tr. 599-01. The ALJ
rejected the statement on the grounds it does not cite to any
objective signs or provide a significant rational to support
the limitations found; is inconsistent with treatment records
showing “normal concentration, attention span, memory,
mood and affect”; and because the statement was
completed only a week after Ms. Houston started treatment
with the doctor and Ms. Oelke. Id. Tr. 33.
erred in rejecting the statement as inconsistent with the
treatment record. This is a conclusory statement and legal
error. See Regennitter v. Comm'r Soc. Sec.
Admin., 166 F.3d 1294, 1299 (9th Cir.1999) (Conclusory
reasons will not justify an ALJ's rejection of a medical
may give less weight to a doctor's opinion that is brief,
conclusory, and inadequately supported by medical records.
Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir.
2005). The Court cannot say it was unreasonable for the ALJ
to discount the statement on the grounds it lacks
“significant rationale.” The statement states Ms.
Houston's diagnoses, how “she has trouble
functioning, ” and how she has been homeless five
years. Tr. 601. But there is no explanation for how these
statements support a finding that Ms. Houston is markedly and
moderately impaired in virtually every functional category.
The marked and moderate limitations are thus essentially
the ALJ reasonably found the statement should be discounted
because it lacks significant rationale, Ms. Houston argues,
the ALJ erred because Dr. Gartenberg's treatment notes
support the findings contained in the statement. Dkt. 11 at
4-5. However, at the time Dr. Gartenberg signed the
statement, she had examined Ms. Houston once; her treatment
notes from that examination does not contain findings
indicating Ms. Houston has multiple marked and moderate
cognitive or social functional limitations. See Tr.
686-87. After completing the statement, Dr. Gartenberg
examined Ms. Houston a number of times. But most of the
mental status examination findings are within normal limits.
See Tr. 677-87. The doctor noted Ms. Houston had
depressed and anxious mood but those notes provides no more
information than the statement which also indicated Ms.
Houston suffered from depression and PTSD. Some of the
doctor's post-statement examination findings are also
inconsistent with the statement. For example, Dr. Gartenberg
found Ms. Houston's memory was intact after signing the
statement, in contrast to the statements findings that Ms.
Houston has moderate and marked limitations in her ability to
remember instructions. Compare Tr. 599-600