United States District Court, W.D. Washington, Tacoma
ORDER REVERSING AND REMANDING FOR AN AWARD OF
J. Pechman United States District Judge.
seeks review of the denial of her application for
Supplemental Security Income. Plaintiff contends the ALJ
erred by discounting two medical opinions, her testimony, and
her mother's lay witness statement and by failing to find
she met a listed impairment. Dkt. 9. As discussed below, the
Court REVERSES the Commissioner's final
decision and REMANDS the matter for an award
of benefits under sentence four of 42 U.S.C. § 405(g).
is currently 42 years old, has a high school education, and
has no past relevant work. Dkt. 7, Administrative Record (AR)
31-32. Plaintiff applied for benefits in July 2015, alleging
disability as of November 28, 2013. AR 132. Plaintiff's
applications were denied initially and on reconsideration. AR
141, 151. After the ALJ conducted a hearing in August 2017,
the ALJ issued a decision finding Plaintiff not disabled. AR
the five-step disability evaluation process set forth in 20
C.F.R. § 416.920, the ALJ found:
Step one: Plaintiff has not engaged in
substantial gainful activity since the application date.
Step two: Plaintiff has the following severe
impairments: psychotic disorder, non-specified; and substance
Step three: These impairments do not meet or
equal the requirements of a listed impairment as set forth in
20 C.F.R. Part 404, Subpart P, Appendix 1.
Residual Functional Capacity: Plaintiff can
perform work at all exertional levels. She can understand,
remember, and carry out simple instructions, and make
judgments commensurate with unskilled work. She can respond
appropriately to supervision but cannot work in close
coordination with coworkers where teamwork is required. She
can deal with occasional changes in the work environment. Her
work cannot require contact with the general public to
perform work tasks.
Step four: Plaintiff has no past relevant
Step five: As there are jobs that exist in
significant numbers in the national economy that Plaintiff
can perform, she is not disabled.
18-33. The Appeals Council denied Plaintiff's request for
review, making the ALJ's decision the Commissioner's
final decision. AR 1. The rest of the procedural history is
not relevant to the outcome of the case and is thus omitted.
Court may set aside the Commissioner's denial of Social
Security benefits only if the ALJ's decision is based on
legal error or not supported by substantial evidence in the
record as a whole. Trevizo v. Berryhill, 871 F.3d
664, 674 (9th Cir. 2017). Each of an ALJ's findings must
be supported by substantial evidence. Reddick v.
Chater, 157 F.3d 715, 721 (9th Cir. 1998).
“Substantial evidence” is more than a scintilla,
less than a preponderance, and is such relevant evidence as a
reasonable mind might accept as adequate to support a
conclusion. Richardson v. Perales, 402 U.S. 389, 401
(1971); Magallanes v. Bowen, 881 F.2d 747, 750 (9th
Cir. 1989). The ALJ is responsible for determining
credibility, resolving conflicts in medical testimony, and
resolving any other ambiguities that might exist. Andrews
v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). While
the Court is required to examine the record as a whole, it
may neither reweigh the evidence nor substitute its judgment
for that of the ALJ. Thomas v. Barnhart, 278 F.3d
947, 954 (9th Cir. 2002). When the evidence is susceptible to
more than one interpretation, the ALJ's interpretation
must be upheld if rational. Burch v. Barnhart, 400
F.3d 676, 680-81 (9th Cir. 2005). This Court “may not
reverse an ALJ's decision on account of an error that is
harmless.” Molina v. Astrue, 674 F.3d 1104,
1111 (9th Cir. 2012).
treating physician's opinion is generally entitled to
greater weight than an examining physician's opinion, and
an examining physician's opinion is entitled to greater
weight than a non-examining physician's opinion.
Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir.
2014). An ALJ may only reject the uncontradicted opinion of a
treating or examining doctor by giving “clear and
convincing” reasons. Revels v. Berryhill, 874
F.3d 648, 654 (9th Cir. 2017). Even if a treating or
examining doctor's opinion is contradicted by another
doctor's opinion, an ALJ may only reject it by stating
“specific and legitimate” reasons. Id.
The ALJ can meet this standard by providing “a detailed
and thorough summary of the facts and conflicting clinical
evidence, stating his interpretation thereof, and making
findings.” Id. (citation omitted). “The
ALJ must do more than offer his conclusions. He must set
forth his own interpretations and explain why they, rather
than the doctors', are correct.” Reddick,
157 F.3d at 725.
treating psychiatrist, Karin Barkin, M.D., filled out a
Medical Source Statement in May 2016. AR 407-09. Dr. Barkin
opined that Plaintiff was moderately to markedly limited in
most work-related abilities. Id. The ALJ gave Dr.
Barkin's opinions “little weight.” AR 29. The
Commissioner concedes that some of the ALJ's reasons were
erroneous. Dkt. 12 at 11. The ALJ discounted Dr. Barkin's
opinions for lack of “reference to specific treatment
encounters or more specific objective findings” but, as
the Commissioner acknowledges, Dr. Barkin's treatment
notes must be considered in connection with her opinions. AR
29; see Revels, 874 F.3d at 663. At the end of Dr.
Barkin's opinions, Plaintiff's
“care-coordinator” added a paragraph of
observations. AR 709. The ALJ stated that this
“complicat[ed] any analysis” of the opinions. AR
29. However, if the ALJ felt that the added sentences created
ambiguity, the ALJ had a duty to develop the record to
clarify the treating doctor's opinions. See Mayes v.
Massanari, 276 F.3d 453, 459-60 (9th Cir. 2001)
(“An ALJ's duty to develop the record further is
triggered only when there is ambiguous evidence or when the
record is inadequate to allow for proper evaluation of the
Commissioner maintains, however, that the ALJ permissibly
discounted Dr. Barkin's opinions because they conflicted
with treatment notes stating Plaintiff was doing
“well” or “stable” and because
Plaintiff was capable of appropriate behavior in a courtroom
for her child custody case. Dkt. 12 at 11-12; AR 29.
between a treating physician's opinions and her own
medical findings can be a “specific and legitimate
reason for rejecting” the opinions. Tommasetti v.
Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008). Here,
however, the treatment notes that the ALJ cited reference
only Plaintiff's self-reports that she was doing well.
These contrast with her husband's and mother's
accounts, her own admissions that she continued to experience
auditory hallucinations, and Dr. Barkin's consistent
conclusions that Plaintiff lacked insight into her condition.
April 23, 2015, Plaintiff reported she had been “doing
well” but Dr. Barkin concluded she was doing worse than
in the previous visit. AR 356, 358. Dr. Barkin observed that
Plaintiff continued to respond to nonexistent voices and
Plaintiff's mother reported that Plaintiff had stopped
visiting her father because “the voices” told her
not to visit him. AR 356. Dr. Barkin assessed Plaintiff's
insight into her condition as “limited.” AR 358.
At the next appointment, on May 7, 2015, Dr. Barkin concluded
Plaintiff seemed better because, for the first time that
year, she was not responding to nonexistent voices; however,
Plaintiff missed the voices. AR 359, 361. By the time
Plaintiff returned on June 11, 2015, she was hearing voices
again despite, as her husband confirmed, taking her
medication reliably every day. AR 362. Dr. Barkin concluded
that Plaintiff's insight was “impaired.” AR
364. The ALJ does not refer to the next few treatment notes,
which recount Plaintiff being reported to Child Protective
Services for physically abusing her children. AR 365-68. In
the next treatment note the ALJ cited, from August 26, 2015,
Plaintiff continued to have auditory hallucinations, although
she reported that her husband and mother felt she was
“doing well.” AR 373. On September 8, 2015,
Plaintiff reported her mood had been “stable” but
she still heard voices, although rarely, and she missed the
voices. AR 379.
self-reports that she had been doing well or was stable do
not contradict Dr. Barkin's opinions, especially in light
of Dr. Barkin's assessment that Plaintiff lacked insight
into her condition.