United States District Court, W.D. Washington, Seattle
ORDER AFFIRMING AND DISMISSING WITH
A. TSUCHIDA, CHIEF UNITED STATES MAGISTRATE JUDGE
Biklen appeals the decision of the Administrative Law Judge
(ALJ) finding him not disabled. Plaintiff contends the ALJ
erred in failing to consider limitations arising from
Klinefelter's Syndrome and that this error impacted the
weight given to the medical opinion evidence and to
Plaintiff's allegations concerning the severity of his
impairments. Dkt. 10. Plaintiff seeks remand for further
proceedings. Id. As discussed below, the ALJ did not
err and her decision is supported by substantial evidence.
Accordingly, the Court AFFIRMS the decision
and DISMISSES the case with prejudice.
November 30, 2012, Plaintiff protectively filed an
application for Supplemental Security Income, alleging
disability beginning June 2, 1980. Tr. 200-01. The claim was
denied initially on May 17, 2013 and upon reconsideration on
January 22, 2014. Tr. 140-42, 147-48. Plaintiff testified at
an initial hearing on August 26, 2015. The hearing was
continued to allow Plaintiff to obtain representation and
additional medical documentation. Plaintiff appeared with a
non-attorney representative and testified at a supplemental
hearing on June 23, 2016. Patricia B. Ayerza, a vocational
expert, also testified. Tr. 58-108. On September 28, 2016,
the ALJ issued a decision finding that Plaintiff was not
disabled. Tr. 17-34. On October 26, 2017, the Appeals Council
denied review. Tr. 1-4.
the five-step disability evaluation process (20 C.F.R.
§§ 404.1520, 416.920), the ALJ found, at steps one
through three, that Plaintiff has not engaged in substantial
gainful activity since November 30, 2012 and Plaintiff has
the severe impairment of bipolar disorder. Tr. 22. The ALJ
acknowledged Plaintiff was born with Klinefelter syndrome,
determined the condition does not constitute a severe
medically determinable impairment. Id. The ALJ
concluded Plaintiff does not have an impairment or
combination of impairments that meets or medically equals the
severity of one of the listed impairments (20 C.F.R. Part
404, Subpart P. Appendix 1). Id.
to completing step four, the ALJ found Plaintiff had the
residual functional capacity (RFC) to perform a full range of
work at all exertional levels with the following
non-exertional limitations: he is able to remember,
understand and carry out tasks or instructions consistent
with a specific vocational preparation (SVP) rating of 1 or
2; he would do best only having occasional interaction with
the general public, such as brief meetings, but not in depth
conversations such as mediations or negotiation type tasks;
and he may interact with coworkers, but he should not perform
tasks requiring teamwork. Tr. 24. As Plaintiff has no past
relevant work, the ALJ proceeded to step five, where he
relied on the testimony of the vocational expert, in
concluding Plaintiff would be able to perform the
requirements of occupations such as janitor, hand packager,
and laundry worker. Tr. 33.
The ALJ Did Not Err At Step Two
asserts that the ALJ erred in finding that his Klinefelter
syndrome was not a severe impairment (Dkt. 10 at 2-4), but
concedes that the error was “not, in itself
harmful.” Id. at 4. Rather, Plaintiff contends
that the harm occurred when the ALJ failed to consider the
effect of symptoms attributable to his Klinefelter's
syndrome - particularly the psychological or cognitive
symptoms - when she evaluated the medical evidence,
Plaintiff's testimony, and lay witness testimony. Dkts.
10 and 16. Accordingly, no harmful error occurred at step
The ALJ Did Not Err in Weighing the Medical Evidence
reject the uncontroverted opinion of a treating or examining
physician, an ALJ must articulate “clear and
convincing” reasons for so doing. Bayliss v.
Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005) (citing
Lester v. Chater, 81 F.3d 821, 830-831 (9th Cir.
1995)). If a treating or examining physician's opinion is
in conflict with substantial medical evidence or with another
physician's opinion, however, it may be rejected for
merely “specific and legitimate reasons.”
Lawrence Moore, Ph.D., Examining Psychologist
contends the ALJ erred when she discounted the opinion of Dr.
Moore as Dr. Moore was the only medical provider who
considered the impact of his Klinefelter's syndrome on
his cognitive functioning. In May 2016, Dr. Moore diagnosed
Plaintiff with major neurocognitive disorder with features of
executive dysfunction and bipolar disorder most recent
episode manic. Dr. Moore interviewed Plaintiff and
administered psychological testing on which Plaintiff
generally scored in the average to low-average range. Tr.
825-826. Dr. Moore acknowledged that this objective testing
generally failed to reveal cognitive or psychological
functioning deficits, but suggested his observations during
the examination along with Plaintiff's history revealed a
“clear picture of executive dysfunction that is
manifested through cognitive, behavioral, and social
deficits” that undermined Plaintiff's employment
prospects. Tr. 827, 831. Dr. Moore did not articulate
specific limitations or offer an opinion as to what Plaintiff
was capable of doing despite any limitations. Tr. 815-31.
on his observations of Plaintiff during his examination, Dr.
Moore opined that Plaintiff's primary cognitive
difficulties are linked to a significant executive
dysfunction. From a cognitive standpoint, he noted Plaintiff
was notably disorganized, showed deficits in decision making
and demonstrated an extremely slow pace. From a behavioral
standpoint, he noted Plaintiff exhibited prominent
disinhibition, did not manage well with lack of structure,
and demonstrated inappropriate behaviors. From a social
standpoint, he noted Plaintiff was socially immature and had
a profound lack of insight regarding his deficits. Dr. Moore
opined that even with a strong treatment team and regular
psychotherapy and taking psychoactive medications, Plaintiff
may continue to demonstrate underlying executive dysfunction
that interferes with his ability to maintain a fully
independent lifestyle and be competitive in the work
environment and suggested Plaintiff consider disability
compensation and/or vocational rehabilitation services. Tr.
Moore opined that Plaintiff's significant executive
dysfunction is “possibly related to
Klinefelter syndrome, ” as some research suggests that
executive dysfunction and learning disabilities are
potentially linked to this condition. Tr. 827 (emphasis
added). However, he also noted that Plaintiff has a history
of repeated head injuries and Vitamin D deficiency that could
clearly exacerbate, lower the threshold for the expression of
cognitive deficits, or contribute to his cognitive
difficulties. Id. Another area identified by Dr.
Moore as being possibly related to Plaintiff's
Klinefelter syndrome is Plaintiff's fluctuating
testosterone levels, which have also been correlated with
mood difficulties. However, Dr. Moore also notes
“psychiatric functioning has also emerged as a
significant factor in this individual's overall situation
even separate from testosterone fluctuations and substance
abuse” and while ...