Pat Darwin Caudill v. Commissioner of Social Security

[7] 8 UNITED STATES DISTRICT COURT 9 EASTERN DISTRICT OF CALIFORNIA [10] 11 PAT DARWIN CAUDILL, Case No. 1:22-cv-01154-CDB (SS) 12 Plaintiff, ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT 13 v. AND REMANDING ACTION PURSUANT TO SENTENCE FOUR OF 42 U.S.C. 14 COMMISSIONER OF SOCIAL SECURITY, §405(g) 15 Defendant. (Doc. 16) [16] 17 Plaintiff Pat Darwin Caudill (“Plaintiff”) seeks judicial review of a final decision of the 18 Commissioner of Social Security (“Commissioner” or “Defendant”) denying his application for 19 disability benefits under the Social Security Act (“SSA” or “Act”). (Doc. 1). The matter is before 20 the Court on the Administrative Record (Doc. 15, hereinafter “AR”) and the parties’ briefs (Docs. 21 16, 17, 19), which were submitted without oral argument. Upon review of the record, the Court 22 finds and rules as follows.1 23 I. BACKGROUND 24 A. Administrative Proceedings and ALJ’s Decision 25 On April 18, 2019, Plaintiff filed an application for a period of disability and disability 26 insurance benefits with an alleged onset date of May 15, 2007. (AR 15). Plaintiff’s claim was 27 1 On September 14, 2022, after the parties consented to the jurisdiction of a U.S. Magistrate Judge for all further proceedings pursuant to 28 U.S.C. § 636 (c)(1), this action was reassigned to a 1 initially denied on June 26, 2019, and again upon reconsideration on October 25, 2019. Id. Plaintiff 2 requested a hearing before an Administrative Law Judge on November 12, 2019. Id. Lisa B. 3 Martin, the Administrative Law Judge (“ALJ”), held a telephone hearing on May 4, 2020, wherein 4 Plaintiff, his non-attorney representative Diana P. Wade, and impartial vocational expert Morian I. 5 Hyatt, all testifie`d . Id. The ALJ issued an unfavorable decision on May 26, 2020, finding Plaintiff 6 was not disabled. (AR 12, 17-24). The Appeals Council denied Plaintiff’s request for review on 7 July 6, 2020, rendering the ALJ’s decision as the final decision of the Commissioner. (AR 1). 8 Plaintiff subsequently filed this action seeking judicial review of the ALJ’s decision. (Doc. 1). 9 In the decision, the ALJ considered Plaintiff’s claims using the five-step sequential 10 evaluation required by 20 C.F.R. § 416.920 (a). (AR 17-24). The ALJ found that Plaintiff last met 11 the insured status requirements of the Social Security Act (“Act”) on December 31, 2013. (AR 17). 12 At step one, the ALJ found that Plaintiff had not engaged in substantial gainful activity since May 13 15, 2007, the alleged onset date, through his date last insured on December 31, 2013. (AR 18). 14 At step two, the ALJ found that Plaintiff had the following medically determinable 15 impairments (“MDIs”) through the date last insured which significantly limit the ability to perform 16 basic work activities as required by Social Security Ruling (“SSR”) 85-28: lumbar spine disorder; 17 headaches; sleep apnea; depression; anxiety; and post-traumatic stress disorder (“PTSD”). Id. 18 At step three, the ALJ found that Plaintiff did not have an impairment, or any combination 19 of impairments, that met or medically equaled the severity of one of the listed impairments in 20 20 C.F.R. Part 404, Subpart P, Appendix 1 ( 20 C.F.R. §§ 404.1520 (d), 404.1525, and 404.1526). Id. 21 The ALJ considered the severity of Plaintiff’s mental impairments, singly and in combination, 22 finding it did not meet or medically equal the criteria of listings 12.04, 12.06, and 12.15. Id. In 23 making this finding, the ALJ considered whether the four broad functional areas of mental 24 functioning listed in the “paragraph B” criteria are satisfied.2 Because Plaintiff’s mental [25] 2 The “paragraph B” criteria evaluate mental impairments in the context of four broad areas 26 of functioning: (1) understanding, remembering, or applying information; (2) interacting with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or managing oneself. [27] 20 C.F.R. § Pt. 404, Subpt. P, App. 1. The severity of the limitation a claimant has in each of the four areas of functioning is identified as either “no limitation,” “mild,” “moderate,” “marked,” or 1 impairments did not cause at least two “marked” limitations or one “extreme” limitation, the ALJ 2 found the paragraph B criteria were not satisfied. (AR 19). The ALJ also found that the evidence 3 in this case fails to establish the presence of “paragraph C” criteria.3 4 Prior to step four, the ALJ found that Plaintiff has the RFC to perform a full range of light 5 work as defined `i n 20 C.F.R. 404.1567(b) except that: [6] [Plaintiff] was limited to 4 hours of standing/walking, the rest sitting, in an eight 7 hour workday, was precluded from all climbing of ladders, ropes, and scaffolds, and was limited to performing all other postural motions occasionally. [He] was 8 limited to moderate noise work environments, and was precluded from all exposure to dangerous work hazards (such as unprotected heights and expose moving 9 machinery). [He] was limited to detailed, but not complex, work tasks, work not requiring a fast assembly quota pace as defined at hearing, and work allowing for [10] some off task behavior of up to 3% of the day due to momentary symptom 11 distractions. Finally, [he] would miss work up to one day a month on an unscheduled basis due to increased symptoms. [12] 13 (AR 19). In considering Plaintiff’s symptoms and the extent to which these symptoms can 14 reasonably be accepted as consistent with objective medical evidence and other evidence, the ALJ 15 noted she followed the two-step process as set forth in 20 C.F.R. § 404.1529 and SSR 16-3p, and [16] 20 C.F.R. § 404 .1520c. Id. The ALJ found “after careful consideration of the evidence” that 17 Plaintiff’s MDIs could reasonably be expected to cause the alleged symptoms but that his 18 statements concerning the intensity, persistence, and limiting effects of symptoms are not entirely 19 consistent with the medical evidence and other record evidence. (AR 20). Following the ALJ’s [20] in at least one of the areas of mental functioning, or a “marked” limitation in at least two of the 21 areas of mental functioning. (Id.). An “extreme” limitation is the inability to function independently, appropriately, or effectively, and on a sustained basis. (Id.). A “marked” limitation 22 is a seriously limited ability to function independently, appropriately, or effectively, and on a sustained basis. (Id.). A “moderate” degree of mental limitation means that functioning in this area [23] independently, appropriately, effectively, and on a sustained basis is “fair.” (Id.) And a “mild” 24 degree of mental limitation means that functioning in this area independently, appropriately, effectively, and on a sustained basis is “slightly limited.” (Id.); see Carlos v. Comm’r of Soc. Sec., 25 No. 1:21-cv-00517-SAB, 2023 WL 1868870 , at *4 n.7 (E.D. Cal. Feb. 9, 2023). 26 3 “Paragraph C,” subsection (1) requires a “highly structured setting that is ongoing that diminishes the signs and symptoms of [Plaintiff’s] mental disorder.” 20 C.F.R. Pt. 404, Subpt. P, 27 App. 1 § 12 .04(C)(1). “Paragraph C,” subsection (2) requires that Plaintiff “have minimal capacity to adapt to changes in [Plaintiff’s] environment or to demands that are not already part of 1 discussion of the evidence, she found that during the period in question, Plaintiff was capable of 2 performing light exertion with the additional postural, environmental, and mental restrictions as 3 specified in the RFC as noted above. (AR 22). The ALJ further found that there is no medical 4 evidence or any opinion from a treating or examining source during the relevant period showing 5 any greater limit`a tions. Id. The ALJ noted that though the opinions of disability determination 6 service medical consultants indicated Plaintiff did not have severe physical or mental impairments, 7 she found the opinions unpersuasive given VA records showed treatment for Plaintiff’s disorders 8 as described in her opinion. Id. (citing Exhibits (“Ex.”) 1A, 3A). 9 At step four, the ALJ determined that Plaintiff is unable to perform any past relevant work 10 based on his documented vocational background and the vocational expert’s testimony. (AR 22). 11 The ALJ found that Plaintiff is a younger individual on the date last insured pursuant to 20 C.F.R. 12 § 404.1563 and has at least a high school education and is able to communicate in English. Id. The 13 ALJ determined that using the Medical-Vocational Rules as a framework supports a finding that 14 Plaintiff is not disabled regardless of whether he has transferable job skills. Id. (citing SSR 82-41 15 and 20 C.F.R. Part 404, Subpart P, Appendix 2). 16 At step five, the ALJ found that there are jobs that exist in significant numbers in the 17 national economy that Plaintiff could perform. (AR 23). The ALJ cited to order clerk and 18 document specialist based on the testimony of the vocational expert. Id. The ALJ therefore 19 concluded a finding of “not disabled” was appropriate under sections 216(i) and 223(d) of the Act 20 through December 31, 2013, the last date insured. (AR 24). 21 B. Medical Record and Hearing Testimony 22 The relevant hearing testimony and medical record were reviewed by the Court and will be 23 referenced below as necessary to this Court’s decision. 24 II. LEGAL STANDARD 25 A district court’s review of a final decision of the Commissioner of Social Security is 26 governed by 42 U.S.C. § 405 (g). The scope of review under § 405(g) is limited; the 27 Commissioner’s decision will be disturbed “only if it is not supported by substantial evidence or is 1 means “relevant evidence that a reasonable mind might accept as adequate to support a 2 conclusion.” Id. at 1159 (quotation and citation omitted). Stated differently, substantial evidence 3 equates to “more than a mere scintilla[,] but less than a preponderance.” Id. (quotation and citation 4 omitted). “[I]t is such relevant evidence as a reasonable mind might accept as adequate to support 5 a conclusion.” S` andgathe v. Chater, 108 F.3d 978 , 980 (9th Cir. 1997) (quotation and citation 6 omitted). In determining whether the standard has been satisfied, a reviewing court must consider 7 the entire record as a whole rather than searching for supporting evidence in isolation. Id. 8 The court will review only the reasons provided by the ALJ in the disability determination 9 and may not affirm the ALJ on a ground upon which she did not rely. Social Security Act § 205, [10] 42 U.S.C. § 405 (g). In reviewing a denial of benefits, a district court may not substitute its 11 judgment for that of the Commissioner. “The court will uphold the ALJ’s conclusion when the 12 evidence is susceptible to more than one rational interpretation.” Tommasetti v. Astrue, 533 F.3d 13 1035, 1038 (9th Cir. 2008). Further, a district court will not reverse an ALJ’s decision on account 14 of an error that is harmless. Id. An error is harmless where it is “inconsequential to the [ALJ’s] 15 ultimate nondisability determination.” Id. (quotation and citation omitted). The party appealing 16 the ALJ’s decision generally bears the burden of establishing that it was harmed. Shinseki v. 17 Sanders, 556 U.S. 396, 409-10 (2009). 18 A claimant must satisfy two conditions to be considered “disabled” and eligible for benefits 19 within the meaning of the Social Security Act. First, the claimant must be “unable to engage in any 20 substantial gainful activity by reason of any medically determinable physical or mental impairment 21 which can be expected to result in death or which has lasted or can be expected to last for a 22 continuous period of not less than twelve months.” 42 U.S.C. § 1382c(a)(3)(A). Second, the 23 claimant’s impairment must be “of such severity that he is not only unable to do his previous 24 work[,] but cannot, considering his age, education, and work experience, engage in any other kind 25 of substantial gainful work which exists in the national economy.” 42 U.S.C. § 26 1382c(a)(3)(B). 27 The Commissioner has established a five-step sequential analysis to determine whether a 1 Commissioner considers the claimant’s work activity. 20 C.F.R. § 416.920 (a)(4)(i). If the claimant 2 is engaged in “substantial gainful activity,” the Commissioner must find that the claimant is not 3 disabled. 20 C.F.R. § 416.920 (b). 4 If the claimant is not engaged in substantial gainful activity, the analysis proceeds to step 5 two. At this step`, the Commissioner considers the severity of the claimant’s impairment. 20 C.F.R. 6 § 416.920(a)(4)(ii). If the claimant suffers from “any impairment or combination of impairments 7 which significantly limits [his or her] physical or mental ability to do basic work activities,” the 8 analysis proceeds to step three. 20 C.F.R. § 416.920 (c). If the claimant’s impairment does not 9 satisfy this severity threshold, however, the Commissioner must find that the claimant is not 10 disabled. Id. 11 At step three, the Commissioner compares the claimant’s impairment to impairments 12 recognized by the Commissioner to be so severe as to preclude a person from engaging in 13 substantial gainful activity. 20 C.F.R. § 416.920 (a)(4)(iii). If the impairment is as severe or more 14 severe than one of the enumerated impairments, the Commissioner must find the claimant disabled 15 and award benefits. 20 C.F.R. § 416.920 (d). 16 If the severity of the claimant’s impairment does not meet or exceed the severity of the 17 enumerated impairments, the Commissioner must pause to assess the claimant’s “residual 18 functional capacity,” defined generally as the claimant’s ability to perform physical and mental 19 work activities on a sustained basis despite his or her limitations ( 20 C.F.R. § 416.945 (a)(1)). 20 At step four, the Commissioner considers whether, in view of the claimant’s RFC, the 21 claimant is capable of performing work that he or she has performed in the past (past relevant 22 work). 20 C.F.R. § 416.920 (a)(4)(iv). If the claimant is capable of performing past relevant work, 23 the Commissioner must find that the claimant is not disabled. 20 C.F.R. § 416.920 (f). If the 24 claimant is incapable of performing such work, the analysis proceeds to step five. 25 At step five, the Commissioner considers whether, in view of the claimant’s RFC, the 26 claimant is capable of performing other work in the national economy. 20 C.F.R. § 27 416.920(a)(4)(v). In making this determination, the Commissioner must also consider vocational 1 capable of adjusting to other work, the Commissioner must find that the claimant is not disabled. 20 2 C.F.R. § 416.920 (g)(1). If the claimant is not capable of adjusting to other work, the analysis 3 concludes with a finding that the claimant is disabled and is therefore entitled to benefits. Id. 4 The claimant bears the burden of proof at steps one through four above. Tackett v. Apfel, [5] 180 F.3d 1094 , 1` 098 (9th Cir. 1999). If the analysis proceeds to step five, the burden shifts to the 6 Commissioner to establish that (1) the claimant is capable of performing other work; and (2) such 7 work “exists in significant numbers in the national economy.” 20 C.F.R. § 416.960 (c)(2); Beltran 8 v. Astrue, 700 F.3d 386, 389 (9th Cir. 2012). 9 III. ISSUES AND ANALYSIS 10 Plaintiff seeks judicial review of the Commissioner’s final decision denying her application 11 and raises the following issues: (1) whether the ALJ satisfied the Commissioner’s burden at step 12 five of the sequential evaluation; (2) whether the ALJ impermissibly rejected Plaintiff’s subjective 13 symptom testimony; and (3) whether Plaintiff is meets all three parts of the credit-as-true test to 14 entitle him to an order for the payment of benefits rather than a remand. See generally (Doc. 16). 15 Defendant concedes that the ALJ’s decision is not supported by substantial evidence. (Doc. 16 19 at 2). Defendant notes that on March 14, 2023, counsel for the Commissioner offered to remand 17 this matter for further proceedings, but the parties have been unable to agree to settlement. Id. 18 The Court agrees with Defendant that in light of Defendant’s concession that the ALJ failed 19 to support her decision with substantial evidence—which the Court construes as a concession that 20 the ALJ erred its burden at step five of the sequential evaluation and in impermissibly rejecting 21 Plaintiff’s subjective symptom testimony—the “only remaining issue for this Court is [the] 22 remedy”—either for a payment of benefits as Plaintiff prefers, or a remand for further proceedings. 23 Id.; see id. at 5, n. 3. 24 A. Proper Remedy 25 1. Parties’ Contentions 26 Plaintiff seeks an order for the payment of benefits or, in the alternative, for remand for the 27 correction of legal errors. (Doc. 16 at 19-20). Plaintiff contends that under the three-part credit1 did not provide any legally sufficient reasons for rejecting his testimony. Id. Second, he asserts 2 the record is “fully developed, … free from conflicts and ambiguities, and all essential factual issues 3 have been resolved.” Id. (citing Dominguez v. Colvin, 808 F.3d 403, 407 (9th Cir. 2015) (quotation 4 omitted)). Third, he argues that because there are no serious doubts from the record as a whole that 5 he is disabled, th` e Court may therefore award the immediate payment of benefits. Id. at 19-20. 6 Plaintiff argues that in the alternative, the Court should remand for the correction of legal errors. 7 Id. at 20. 8 Defendant argues that the proper remedy is to remand for further proceedings based on the 9 existing record as Plaintiff cannot satisfy the three conditions of the “credit-as-true” test. (Doc. 19 10 at 5). Defendant contends the in the Ninth Circuit, remand for payment of benefits is granted only 11 in the rare circumstances “where no useful purpose would be served by further administrative 12 proceedings and the record has been thoroughly developed.” Id. (citing Treichler v. Comm’r, 775 13 F.3d 1090, 1100 (9th Cir. 2014) (quotation omitted)). Defendant argues that here, “the benign 14 objective evidence, Plaintiff’s daily activities, and the opinion evidence show that outstanding 15 issues do exist and these issues create serious doubt that Plaintiff is disabled.” Id. at 6. Defendant 16 further argues that further proceedings could remedy factual issues raised Plaintiff’s filing, 17 including of the ALJ’s discussion of his daily activities and whether the medical evidence contracts 18 the ALJ’s analysis. Id. at 7. 19 2. Governing Authority 20 “The decision whether to remand for further proceedings or simply to award benefits is 21 within the discretion of court.” Trevizo v. Berryhill, 871 F.3d 664, 682 (9th Cir. 2017) (quoting 22 Sprague v. Bowen, 812 F.2d 1226, 1232 (9th Cir. 1987)). “Remand for further administrative 23 proceedings is appropriate if enhancement of the record would be useful.” Benecke v. Barnhart, [24] 379 F.3d 587, 593 (9th Cir. 2004) (emphasis omitted). On the other hand, if the record has been 25 fully developed such that further administrative proceedings would serve no purpose, “the district 26 court should remand for an immediate award of benefits.” Id. However, a remand for an immediate 27 award of benefits is appropriate only in rare circumstances. Brown-Hunter v. Colvin, 806 F.3d. 1 In the Ninth Circuit, a three-part credit-as-true test must be satisfied in order for a court to 2 remand to an ALJ with instructions to calculate and award benefits: (1) the record has been fully 3 developed and further administrative proceedings would serve no useful purpose; (2) the ALJ has 4 failed to provide legally sufficient reasons for rejecting evidence, whether a plaintiff’s testimony 5 or medical opini`o n; and (3) if the improperly discredited evidence were credited as true, the ALJ 6 would be required to find the plaintiff disabled on remand. See Garrison v. Colvin, 759 F.3d 995 , 7 1020 (9th Cir. 2014). 8 3. Analysis 9 Given Defendant’s concession that the ALJ failed to support her decision with substantial 10 evidence, which the Court construes as an admission that the ALJ erred on the two issues raised in 11 his motion for summary judgment, the Court finds that error is established such that the Court has 12 discretion to remand or reverse and award benefits. Morales v. Berryhill, 239 F. Supp. 3d 1211 , 13 1219-20 (E.D. Cal. 2017) (citing McAllister v. Sullivan, 888 F.2d 599, 603 (9th Cir. 1989)). “Even 14 where all the conditions for the ‘credit-as-true’ rule are met, the [C]ourt retains ‘flexibility to 15 remand for further proceedings when the record as a whole creates serious doubt as to whether 16 [plaintiff] is, in fact, disabled within the meaning of the Social Security Act.’” Id. (quoting 17 Garrison, 759 F.3d at 1021 ); see Dominguez, 808 F.3d at 407 (“Unless the district court concludes 18 that further administrative proceedings would serve no useful purpose, it may not remand with a 19 direction to provide benefits.”); Treichler, 775 F.3d at 1105 (“Where … an ALJ makes a legal error, 20 but the record is uncertain and ambiguous, the proper approach is to remand the case to the 21 agency.”). 22 Here, in applying the three-part “credit-as-true” test under Garrison, the Court finds that 23 remand for further proceedings is warranted because additional administrative proceedings may 24 remedy the deficiencies in the ALJ’s decision for lack of support by substantial evidence, and 25 because the record creates doubt as to whether Plaintiff is disabled. Morales, 239 F. Supp. 3d at 26 1219-20. 27 While the Court acknowledges that the record appears to be fully developed as it includes 1 vocational expert, (see Morales, 239 F. Supp. 3d at 1220 ), “there are outstanding issues requiring 2 resolution before considering whether to hold [Plaintiff’s] testimony is credible as a matter of 3 law[,]’” (Dominguez, 808 F.3d at 409 (citing Treichler, 775 F.3d at 1105)). See Dominguez, 808 4 F.3d at 409 (“If such outstanding issues do exist, the [Court] cannot deem the erroneously 5 disregarded testi`m ony to be true; rather, the [Court] must remand for further proceedings.”). The 6 Court finds that review of the record raises serious doubts as to whether Plaintiff is in fact disabled 7 due to her impairments. In the record, two agency physicians noted in an initial disability 8 determination explanation note that Plaintiff has “severe” migraines and “non severe” disorders of 9 back-discogenic and degenerative (“DDD”) but ultimately determined that Plaintiff is “not 10 disabled.” (AR 63, 66). In a disability determination explanation note on reconsideration, Dr. 11 Kevin Gregg noted that he does not see “objective evidence of significant functional limitation” 12 and indicated that “psych NOT severe.” (AR 74). The same note indicated Plaintiff’s impairments 13 of depressive, bipolar, and related disorders are “non severe,” assessed only environmental 14 limitations on Plaintiff, and again determined that, based on the documented findings, that Plaintiff 15 is “not disabled.” (AR 75, 77, 78). These disability determination notes raise doubt as to Plaintiff’s 16 allegations of disability and warrant further consideration to determine whether such medical 17 opinion evidence may properly be considered in determining whether Plaintiff is disabled. 18 Therefore, further administrative proceedings would be useful for the ALJ to properly 19 consider this medical opinion evidence and other evidence in the record and to further develop the 20 record as necessary to address Plaintiff’s claim of disability. See, e.g., Dominguez, 808 F.3d at 409 21 (concluding that the district court did not err in remanding for further proceedings as outstanding 22 factual issues, including inconsistencies noted within and among treatment notes, were reflected in 23 the record); Hoskins v. Comm’r of Soc. Sec., No. 1:17-cv-01520-LJO-SAB, 2019 WL 423128 , at 24 *14 (E.D. Cal. Feb. 4, 2019) (“Upon remand the ALJ shall obtain additional medical opinion 25 evidence as to Plaintiff’s physical functioning from a consultative examiner or a medical expert, 26 and further develop the record as deemed necessary.”); Boyd v. Comm’r of Soc. Sec., No. 1:17-cv27 00021-SAB, 2017 WL 5167656 , at *7 (E.D. Cal. Nov. 8, 2017) (remanding for further proceedings 1 | ALJ should have sought additional evidence to evaluate Plaintiffs functional capacity with his 2 | limitations.”). Cf Garrison, 759 F.3d at 1022 (remanding for a calculation and award of benefits 3 | where defendant failed to “point to anything in the record that the ALJ overlooked and explain how 4 | that evidence casts into serious doubt Garrison’s claim to be disabled.”). 5 | IV. CONCLUSION AND ORDER 6 For the reasons stated above, IT IS HEREBY ORDERED that: 7 1. Plaintiff's motion for summary judgment (Doc. 16) is GRANTED; 8 2. The ALJ’s decision (Doc. 15) is REVERSED; 9 3. This matter is REMANDED pursuant to sentence four of 42 U.S.C. $405(g) for further 10 proceedings consistent with this decision; and 11 4. The Clerk of the Court is DIRECTED to enter judgment in favor of Plaintiff Pat Darwin 12 Caudill and against Defendant Commissioner of Social Security. | Tris SO ORDERED. 14 | } ) Bo Dated: _ September 23, 2025 15 UNITED STATES MAGISTRATE JUDGE [28] 1]