United States District Court, W.D. Washington, Tacoma
ORDER REVERSING AND REMANDING DEFENDANT'S
DECISION TO DENY BENEFITS
W. CHRISTEL UNITED STATES MAGISTRATE JUDGE
Elisabeth Olivieri filed this action, pursuant to 42 U.S.C.
§ 405(g), for judicial review of Defendant's denial
of Plaintiff's applications for supplemental security
income (“SSI”) and disability insurance benefits
(“DIB”). Pursuant to 28 U.S.C. § 636(c),
Federal Rule of Civil Procedure 73 and Local Rule MJR 13, the
parties have consented to have this matter heard by the
undersigned Magistrate Judge. See Dkt. 5.
considering the record, the Court concludes the
Administrative Law Judge (“ALJ”) erred when she
failed to properly discount medical opinion evidence from Dr.
Mark Magdaleno, M.D. Had the ALJ properly considered Dr.
Magdaleno's opinion, the residual functional capacity
(“RFC”) may have included additional limitations.
The ALJ may have also changed the weight she gave to medical
opinion evidence from Dr. Albert Hattem, M.D., with proper
consideration of Dr. Magdaleno's opinion. The ALJ's
error is therefore not harmless, and this matter is reversed
and remanded pursuant to sentence four of 42 U.S.C. §
405(g) to the Deputy Commissioner of Social Security
(“Commissioner”) for further proceedings
consistent with this Order.
AND PROCEDURAL HISTORY
March 21, 2014, Plaintiff filed applications for SSI and DIB,
alleging disability as of June 21, 2011. See Dkt. 8,
Administrative Record (“AR”) 18. The applications
were denied upon initial administrative review and on
reconsideration. See AR 18. ALJ Stephanie Martz held
a hearing on December 15, 2015. AR 38-79. In a decision dated
April 21, 2016, the ALJ found Plaintiff to be not disabled.
AR 15-37. The Appeals Council denied Plaintiff's request
for review of the ALJ's decision, making the ALJ's
decision the final decision of the Commissioner. See
AR 1-6; 20 C.F.R. § 404.981, § 416.1481.
Plaintiff's Opening Brief, Plaintiff maintains the ALJ
erred by: (1) improperly assessing medical opinion evidence,
thereby resulting in an inaccurate RFC; and (2) finding
Plaintiff had a severe impairment of substance abuse disorder
at Step Two of the sequential evaluation process. Dkt. 10,
pp. 3-11. Plaintiff requests the Court remand for an award of
benefits as a result of these errors. Id. at 11.
to 42 U.S.C. § 405(g), this Court may set aside the
Commissioner's denial of social security benefits if the
ALJ's findings are based on legal error or not supported
by substantial evidence in the record as a whole. Bayliss
v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir. 2005)
(citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th
Whether the ALJ properly assessed the medical opinion
argues the ALJ improperly assessed her RFC in light of
medical opinion evidence from Drs. Wayne Dees, Psy.D., Xandra
Rarden, M.D., Mark Magdaleno, M.D., and Albert Hattem, M.D.
Dkt. 10, pp. 5-11.
must provide “clear and convincing” reasons for
rejecting the uncontradicted opinion of either a treating or
examining physician. Lester v. Chater, 81 F.3d 821,
830 (9th Cir. 1995) (citing Pitzer v. Sullivan, 908
F.2d 502, 506 (9th Cir. 1990)); Embrey v. Bowen, 849
F.2d 418, 422 (9th Cir. 1988)). When a treating or examining
physician's opinion is contradicted, the opinion can be
rejected “for specific and legitimate reasons that are
supported by substantial evidence in the record.”
Lester, 81 F.3d at 830-31 (citing Andrews v.
Shalala, 53 F.3d 1035, 1043 (9th Cir. 1995); Murray
v. Heckler, 722 F.2d 499, 502 (9th Cir. 1983)). The ALJ
can accomplish this by “setting out a detailed and
thorough summary of the facts and conflicting clinical
evidence, stating his interpretation thereof, and making
findings.” Reddick v. Chater, 157 F.3d 715,
725 (9th Cir. 1998) (citing Magallanes v. Bowen, 881
F.2d 747, 751 (9th Cir. 1989)).
first argues the RFC should contain greater mental
limitations due to opinion evidence from Drs. Dees and
Rarden. Dkt. 10, pp. 5-9.
January 8, 2014, Dr. Dees conducted a
psychological/psychiatric evaluation of Plaintiff. AR 387-96.
As part of his evaluation, Dr. Dees conducted a clinical
interview and mental status examination of Plaintiff. AR
387-88, 390-91. Dr. Dees found Plaintiff moderately limited
in her ability to adapt to changes in a routine work setting,
communicate and perform effectively in a work setting, and
set realistic goals and plan independently. AR 389-90. In
addition, Dr. Dees opined Plaintiff was markedly limited in
her ability to perform activities within a schedule, maintain
regular attendance, and be punctual within customary
tolerances without special supervision. AR 389. Dr. Dees also
determined Plaintiff had a marked limitation in her ability
to maintain appropriate behavior in a work setting. AR 390.
Lastly, Dr. Dees found Plaintiff severely limited in her
ability to complete a normal work day and work week without
interruptions from psychologically based symptoms. AR 390.
discussed Dr. Dees' findings and gave his opinion
“little weight, ” stating:
Such extreme limitations are not supported by the record or
Dr. Dee's [sic] own mental status examinations. Indeed,
during such an examination, the claimant's appearance was
within normal limits, her thoughts were logical and linear,
she was friendly and cooperative, and she was fully oriented
with memory within normal limits. Dr. Dees did note that the
claimant was depressed, but this observation alone does not
explain the ratings he assessed, especially given all of his
AR 29 (internal citations omitted).
reason the ALJ gave for discounting Dr. Dees' opinion was
because Dr. Dees' “extreme limitations” were
not supported by his own mental status examination. AR 29. An
ALJ may reject an opinion that is “inadequately
supported by clinical findings.” Bayliss, 427
F.3d at 1216 (citing Tonapetyan v. Halter, 242 F.3d
1144, 1149 (9th Cir. 2001)). Here, the ALJ accurately
summarized the findings from the mental status examination
and explained how these findings - which were largely normal
- did not support Dr. Dees' opined limitations.
See AR 29; see also AR 390-91 (mental
status examination). As such, the ALJ reasonably determined
Dr. Dees' opinion was not supported by his own mental
status examination, and this was a specific, legitimate
reason to discount this opinion. See Bayliss, 427
F.3d at 1216 (upholding an ALJ's rejection of a
physician's findings where the physician's
“other recorded observations and opinions”
contradicted his opinion about Plaintiff's abilities);
see also Allen v. Heckler, 749 F.2d 577, 579 (9th
Cir. 1984) (citation omitted) (“If the evidence admits
of more than one rational interpretation, ” the court
must uphold the ALJ's decision).
the ALJ also discounted Dr. Dees' opinion for being
unsupported by the medical record as a whole, the Court need
not assess whether this reason was proper, as any error would
be harmless. See Presley-Carrillo v. Berryhill, 692
Fed.Appx. 941, 944-45 (9th Cir. 2017) (citing Carmickle
v. Comm'r of Soc. Sec. Admin., 533 F.3d 1155, 1162)
(noting that although an ALJ erred with regard to one reason
he gave to discount a medical opinion, “this error was
harmless because the ALJ gave a reason supported by the
record” to discount the opinion). Accordingly, the ALJ
need not re-evaluate Dr. Dees' opinion on remand.