(SS) Coats v. Commissioner of Social Security ( 2020 )

1 2 3 4 5 6 7 UNITED STATES DISTRICT COURT 8 FOR THE EASTERN DISTRICT OF CALIFORNIA 9 10 JIMMY E. COATS, No. 2:18-cv-2298-EFB 11 Plaintiff, 12 v. ORDER 13 ANDREW SAUL, Commissioner of Social Security 14 Defendant. 15 16 17 Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 18 (“Commissioner”) denying his application for a period of disability and Disability Insurance 19 Benefits (“DIB”) under Title II of the Social Security Act. The parties have filed cross-motions 20 for summary judgment. ECF Nos. 15 & 22. For the reasons discussed below, plaintiff’s motion 21 for summary judgment is granted, the Commissioner’s motion is denied, and the matter is 22 remanded for further proceedings. 23 I. Background 24 Plaintiff alleges in his application that he had been disabled since July 27, 2011. 25 Administrative Record (“AR”) at 167-75. His application was denied initially and upon 26 reconsideration. Id. at 110-13, 116-20. A hearing was subsequently held before administrative 27 law judge (“ALJ”) Mary M. French. Id. at 38-64. 28 ///// 1 On February 24, 2017, the ALJ issued a decision finding that plaintiff was not disabled 2 under sections 216(i) and 223(d) of the Act.1 Id. at 21-33. The ALJ made the following specific 3 findings: 4 1. The claimant last met the insured status requirements of the Social Security Act on 5 December 31, 2016. 6 2. The claimant did not engage in substantial gainful activity during the period from his alleged onset date of July 27, 2011 through his date last insured of December 31, 2016 (20 7 CFR 404.1571 et seq.). 8 * * * 9 10 11 1 Disability Insurance Benefits are paid to disabled persons who have contributed to the Social Security program, 42 U.S.C. §§ 401 et seq. Supplemental Security Income (“SSI”) is paid 12 to disabled persons with low income. 42 U.S.C. §§ 1382 et seq. Under both provisions, disability is defined, in part, as an “inability to engage in any substantial gainful activity” due to 13 “a medically determinable physical or mental impairment.” 42 U.S.C. §§ 423(d)(1)(a) & 1382c(a)(3)(A). A five-step sequential evaluation governs eligibility for benefits. See 20 C.F.R. 14 §§ 423(d)(1)(a), 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987). The 15 following summarizes the sequential evaluation: 16 Step one: Is the claimant engaging in substantial gainful activity? If so, the claimant is found not disabled. If not, proceed 17 to step two. Step two: Does the claimant have a “severe” impairment? 18 If so, proceed to step three. If not, then a finding of not disabled is 19 appropriate. Step three: Does the claimant’s impairment or combination 20 of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P, App.1? If so, the claimant is automatically 21 determined disabled. If not, proceed to step four. Step four: Is the claimant capable of performing his past 22 work? If so, the claimant is not disabled. If not, proceed to step 23 five. Step five: Does the claimant have the residual functional 24 capacity to perform any other work? If so, the claimant is not disabled. If not, the claimant is disabled. 25 26 Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 27 The claimant bears the burden of proof in the first four steps of the sequential evaluation process. Yuckert, 482 U.S. at 146 n.5. The Commissioner bears the burden if the sequential 28 evaluation process proceeds to step five. Id. 1 3. Through the date last insured, the claimant had the following severe impairments: shoulder arthralgia, HIV positive, thoracic bone lesion, hip arthralgia, cervical spine disc 2 disease, bursitis, sleep apnea, anxiety, bipolar disorder, PTSD, anxiety state NOS (20 CFR 3 404.1520(c)). 4 * * * 5 4. Through the date last insured, the claimant did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 6 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526). 7 * * * 8 5. After careful consideration of the entire record, the undersigned finds that, through the 9 date last insured, the claimant had the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b). He was able to lift, carry, push, and pull 20 pounds 10 occasionally and 10 pounds frequently. He could sit for 6 hours of an 8-hour workday. He could stand and walk for 6 hours of an 8-hour workday. He could occasionally climb 11 ramps/stairs, balance, stoop, kneel, crouch, and crawl. He could never climb ladders, ropes, and scaffolds. He needed to avoid concentrated exposure to extreme cold, extreme 12 heat, vibration, fumes odors [sic], dusts, gases, poor ventilation, and hazards (unprotected 13 heights, moving machinery, etc.). Mentally he was able to understand, remember, and carry out simple tasks and instructions. He needed to be in a workplace with few changes. 14 * * * 15 6. Through the date last insured, the claimant was unable to perform any past relevant work 16 (20 CFR 404.1565). 17 * * * 18 7. The claimant was born [in] 1975 and was 41 years old, which is defined as a younger 19 individual age 18-49, on the alleged disability onset date (20 CFR 404.1563). 20 8. The claimant has at least a high school education and is able to communicate in English (20 CFR 404.1564). 21 * * * 22 9. Transferability of job skills is not material to the determination of disability because using 23 the Medical-Vocational Rules as a framework supports a finding that the claimant is “not 24 disabled,” whether or not the claimant has transferable job skills (See SSR 82-41 and 20 CFR Part 404, Subpart P, Appendix 2). 25 10. Through the dated [sic] last insured, considering the claimant’s age, education, work 26 experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that the claimant could have perform (20 CFR 404.1569 27 and 404.1569(a)). 28 1 * * * 2 11. The claimant was not under a disability, as defined in the Social Security Act, at any time from July 27, 2011, the alleged onset date, through December 31, 2016, the date last 3 insured (20 CFR 404.1520(g)). 4 5 Id. at 23-32. 6 Plaintiff’s request for Appeals Council review was denied on April 6, 2018, leaving the 7 ALJ’s decision as the final decision of the Commissioner. Id. at 7-12. 8 II. Legal Standards 9 The Commissioner’s decision that a claimant is not disabled will be upheld if the findings 10 of fact are supported by substantial evidence in the record and the proper legal standards were 11 applied. Schneider v. Comm’r of the Soc. Sec. Admin., 223 F.3d 968, 973 (9th Cir. 2000); 12 Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Tackett v. Apfel, 13 180 F.3d 1094, 1097 (9th Cir. 1999). 14 The findings of the Commissioner as to any fact, if supported by substantial evidence, are 15 conclusive. See Miller v. Heckler, 770 F.2d 845, 847 (9th Cir. 1985). Substantial evidence is 16 more than a mere scintilla, but less than a preponderance. Saelee v. Chater, 94 F.3d 520, 521 (9th 17 Cir. 1996). “‘It means such evidence as a reasonable mind might accept as adequate to support a 18 conclusion.’” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. 19 N.L.R.B., 305 U.S. 197, 229 (1938)). 20 “The ALJ is responsible for determining credibility, resolving conflicts in medical 21 testimony, and resolving ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 22 2001) (citations omitted). “Where the evidence is susceptible to more than one rational 23 interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be upheld.” 24 Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). 25 III. Analysis 26 Plaintiff argues that the ALJ committed four errors. First, he argues the ALJ erred in 27 rejecting opinions from treating and examining physicians without providing legally sufficient 28 reasons. Second, he contends that the ALJ failed to properly evaluate a disability rating issued by 1 the Department of Veterans Affairs (“VA”). Third, he argues the ALJ failed to provide clear and 2 convincing reasons for rejecting his subjective complaints. Fourth, he argues that the ALJ erred 3 by rejecting lay witness testimony without sufficient explanation. As explained below, the court 4 finds plaintiff’s second argument persuasive and remands the case for further proceedings on that 5 basis. The court declines to address plaintiff’s remaining arguments. 6 Generally, an ALJ is required to consider a VA rating. McCartey v. Massanari, 298 F.3d 7 1072, 1075 (9th Cir. 2002). “While a VA disability decision does not necessarily compel the 8 SSA to reach an identical result, the ALJ must consider the VA’s finding in reaching his decision, 9 because of the similarities between the VA disability program and the Social Security disability 10 program.” Hiler v. Astrue, 687 F.3d 1208, 1211 (9th Cir. 2012). “However, [b]ecause the 11 standards for evaluating disability under the two programs is not identical, . . . the ALJ may give 12 less weight to a VA disability rating if he gives persuasive, specific, valid reasons for doing so 13 that are supported by the record.” McCartey, 298 F.3d at 1075; see also Valentine v. Comm’r 14 Soc. Sec. Admin., 574 F.3d 685, 695 (9th Cir. 2009). 15 In March 2015, the VA issued a decision finding that plaintiff’s overall disability rating 16 was 90 percent as of January 26, 2015 due to his HIV and bipolar disorder. AR 267-78. As 17 noted, that decision and, importantly the basis for it, is relevant to the evaluation of plaintiff’s 18 condition and ability to work as they relate to his claim for Social Security disability and to 19 discount it requires “persuasive, specific, valid reasons for doing so that are supported by the 20 record.” McCartey, 298 F.3d at 1075. 21 In her decision, the ALJ provided the following discussion regarding the VA’s disability 22 determination: 23 The undersigned accords little evidentiary weight to the V.A. disability ratings. The Social Security Administration uses a 24 completely different system than the V.A. to evaluate disability. The V.A. rating is designed to assess the amount of compensation to give 25 a veteran for service connected ailments. The V.A. is guided by a principle that views disability compensation as owed to veterans for 26 injuries that were incurred or aggravated by their service. But social security benefits are granted solely on medical grounds and other 27 noneconomic factors are not considered. Eligibility requirements are more stringent for social security disability. Furthermore, because 28 the ultimate responsibility for determining whether an individual is 1 disabled under Social Security law rests with the Commissioner, we are not bound by disability decisions by other governmental and 2 nongovernmental agencies. In addition, because other agencies apply different rules and standards than we do for determining 3 whether an individual is disabled, this may limit the relevance of a determination of disability made by another agency. Although this 4 decision finds that the claimant has severe impairments that cause some limitations in his ability to perform activities, the regulations at 5 20 C.F.R. 404. 1504 provide that disability decisions by another agency are based on that agency’s rules and are not binding on SSA. 6 7 AR 29. 8 While that discussion states a conclusion in the first sentence and simply recites the 9 principle that the two programs apply different standards, it does not identify what medical or 10 other evidence in the record substantiates discounting the decision made by the VA. Stated 11 differently, and more succinctly, the ALJ accorded little weight to the VA disability 12 determination because the VA utilizes different rules and standards than the SSA. This is not a 13 “persuasive, specific, valid” reason that is “supported by the record.” McCartey, 298 F.3d at 14 1075 (emphasis added). As the U.S. Court of Appeals for the Ninth Circuit has explained in the 15 context of rejecting a treating physician’s opinion, the burden of providing valid reasons includes 16 a properly explained decision that is supported by the record. Typically, this includes “setting out 17 a detailed and thorough summary of the facts and conflicting clinical evidence, stating his 18 interpretation thereof, and making findings.” Embrey v. Bowen, 849 F.2d 418, 421 (1988). Here, 19 the context is rejecting a VA disability determination, not rejecting the opinion of a treating 20 doctor. But the ALJ nonetheless was required to provide “persuasive, specific, valid” reasons for 21 giving less weight to the VA’s determination, McCartey, 298 F.3d at 1075, and this standard 22 requires at least some explanation in the context of the medical record. 23 Accordingly, the ALJ’s conclusory dismissal of the VA’s determination did not constitute 24 a persuasive, specific, valid reason for giving it less weight. The matter is therefore remanded for 25 further consideration. Dominguez v. Colvin, 808 F.3d 403, 407 (9th Cir. 2015) (“A district court 26 may reverse the decision of the Commissioner of Social Security, with or without remanding the 27 case for a rehearing, but the proper course, except in rare circumstances, is to remand to the 28 agency for additional investigation or explanation.”) (internal quotes and citations omitted). 1 IV. Conclusion 2 Based on the foregoing, it is hereby ORDERED that: 3 1. Plaintiff’s motion for summary judgment is granted; 4 2. The Commissioner’s cross-motion for summary judgment is denied; 5 3. The matter is remanded for further proceedings consistent with this order; and 6 4. The Clerk of Court is directed to enter judgment in plaintiffs favor and close the case. 7 || DATED: March 20, 2020. 8 tid, PDEA EDMUND F. BRENNAN 9 UNITED STATES MAGISTRATE JUDGE 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28