Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_12-cv-00328/USCOURTS-casd-3_12-cv-00328-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

---

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF CALIFORNIA

Diane R. Humphreys,

Plaintiff,

v.

Carolyn L. Colvin, 

Acting Commissioner of Social

Security,

Defendant.

CASE NO. 12cv328 W (PCL)

REPORT AND

RECOMMENDATION OF U.S.

MAGISTRATE JUDGE: 

GRANTING in part

PLAINTIFF’S MOTION FOR

SUMMARY JUDGMENT 

(Doc. 15); and

DENYING DEFENDANT’S

CROSS MOTION FOR

SUMMARY JUDGMENT (Doc.

16.)

I.

INTRODUCTION

On February 8, 2012, Plaintiff filed this action pursuant to the Social Security

Act, 42 U.S.C. § 405(g). (Doc. 1.) Plaintiff seeks judicial review of Acting

Commissioner of Social Security’s final decision denying Plaintiff’s application

for disability insurance benefits. (Doc. 1.) Plaintiff filed a Motion for Summary

Judgment (Doc. 15), and Defendant filed a Cross-Motion for Summary Judgment

(Doc. 16). The Honorable Thomas J. Whelan referred the matter to undersigned

judge for Report and Recommendation pursuant to 28 U.S.C. § 636(b)(1)(B). After

12cv328 W (PCL)

1

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 1 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

a thorough review of all pleadings and the entire record submitted in this matter,

this Court recommends that Plaintiff’s Motion for Summary Judgment be

GRANTED IN PART and that Defendant’s Cross-Motion for Summary Judgment

be DENIED. 

II.

BACKGROUND

A. Procedural Background

Plaintiff Diane R. Humphreys filed an application for Disability Insurance

Benefits and Supplemental Security Income on October 6, 2006, alleging an

inability to work beginning February 1, 2003. (A.R. 16-18, 136.) The matter was

initially heard by the ALJ on April 23, 2008 (A.R. 104-130), resulting in an

unfavorable decision on February 2, 2009 (A.R. 133-140). Plaintiff appealed the

decision, and the Appeals Council issued an Order Remanding Case on June 18,

2009. (A.R. 141-144.) 

A second hearing was held by the same ALJ on July 9, 2010 (A.R. 85-103),

and the remanded claim was denied on July 19, 2010 (A.R. 145-160). The denial

was appealed, and the Appeals Council again remanded the case and directed that a

different ALJ hear the case. (A.R. 161-164.) Plaintiff appeared and testified at this

hearing held on April 28, 2011 before ALJ Norman R. Buls. On June 21, 2011,

ALJ Buls issued an unfavorable decision. (A.R. 13-30.) In his decision, the ALJ

made the following findings: 

1. The claimant has not engaged in substantial gainful activity since October 6, 2006, the application date.

2. The claimant has the following severe impairments: bipolar disorder and methamphetamine dependence, in remission. 

3. The claimant does not have an impairment or combination of impairments that meets or medically equals one of the listed

impairments in 20 CFR Part 404, Subpart P, Appendix 1.

4. The claimant has the residual functional capacity to perform a full range of work at all exertional levels but with the following

nonexertional limitations: claimant is unable to sustain

concentration or attention for prolonged periods, maintain a

12cv328 W (PCL)

2

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 2 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

normal schedule of attendance, sustain an ordinary work routine,

work in conjunction with others, interact with co-workers,

supervisors or the public, or respond appropriately to changes in work routine.

5. The claimant is unable to perform any past relevant work. 

6. The claimant’s acquired job skills do not transfer to other occupations within the residual functional capacity defined above.

7. Considering the claimant’s age, education, work experience, and residual functional capacity based on all the impairments, including the substance use disorder, there are no jobs that exist in significant numbers in the national economy that claimant can

perform. 

8. If the claimant stopped the substance abuse, the remaining limitations would not cause more than a minimal impact on the

claimant’s ability to perform basic work activities; therefore, the

claimant would not have a severe impairment or combination of

impairments. 

9. Because the claimant would not be disabled if she stopped the substance use, the claimant’s substance use disorder is a

contributing factor material to the determination of disability.

Thus, the claimant has not been under a disability, as defined in

the Social Security Act, from October 6, 2006, through the date of

this decision.

(A.R. 16-26.) 

Plaintiff appealed, but the Appeals Council issued an unfavorable decision on

December 14, 2011, making the ALJ’s June 2011 decision the final determination

of the Commissioner of Social Security for purposes of judicial review. (A.R. 1-5.)

Plaintiff then filed this action on February 8, 2012. (Doc. 1.) Defendant answered

on May 21, 2013. (Doc. 10.) On October 21, 2013, Plaintiff filed a Motion for

Summary Judgment (Doc. 15), and Defendant filed a Cross-Motion for Summary

Judgment in Opposition to Plaintiff’s Motion for Summary Judgment (Doc. 21). 

This Report and Recommendation addresses both motions pending before this

Court. 

III.

ADMINISTRATIVE RECORD

Plaintiff is a 48-year old female with the following alleged impairments:

bipolar disorder, depression, and stress. (A.R. 590.) She was 40 years old at the

12cv328 W (PCL)

3

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 3 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

onset date of her alleged disability. (A.R. 22.) She is five feet, four inches tall and

weighs 156 pounds. (A.R. 598.) She previously worked for a group home as a

certified nursing assistant in 2001 and for a construction cleaning business as a

part-time cleaner in 2007. (A.R. 109-110.) 

A. Medical Evidence

1. Treating Physician Dr. Bushra Ahmad, MD

Plaintiff has received regular treatment from Dr. Bushra Ahmad, a psychiatrist

at the Imperial County Behavioral Health Services clinic since 2006. (A.R. 560.)

Dr. Ahmad diagnosed her with major depressive disorder that is recurrent and

severe, but without psychotic features, and she was placed on an antidepressant.

(A.R. 560.) At first, Dr. Ahmad described her as being angry and irritable,

hyperactive, talkative, and hypersexual. (A.R. 560.) A few months later, Dr.

Ahmad described her as being “mildly depressed but peaceful.” (A.R. 592, 606.)

Dr. Ahmad stated that she had been sober for more than a year but that she is

unable to work due to her depression. (A.R. 592.) Plaintiff’s prescriptions included

Wellbutrin, an antidepressant, and Rozerem, which enables Plaintiff to “sleep

better.” (A.R. 606.) Dr. Ahmad remarked that Plaintiff had “ok” compliance with

the prescribed treatment but that she had a tendency to stop the medication due to

their side effects. (A.R. 606.) On January 12, 2007, Dr. Ahmad described her as

being depressed, easily stressed out, very anxious around other people and in

crowds, and having poor sleep, memory, and concentration. (A.R. 607.) Dr. Ahmad

added Prozac to her prescribed medications and stated that she again had “ok”

compliance with her drug treatment regimen. (A.R. 607.) Her prognosis did not

change at the January 31, 2007 evaluation. (A.R. 608.) On February 28, 2007,

Plaintiff reported being very depressed, sleeping all day, having poor

concentration, crying, and having a poor appetite. (A.R. 609.) She reported that she

forgot to take her Prozac for a week because she did not eat on time. (A.R. 609.) In

a March 22, 2007 evaluation, Plaintiff was listed as having major depression and

12cv328 W (PCL)

4

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 4 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

bipolar disorder and being unable to work a regular job. (A.R. 617-619.) 

Her condition did not change at the March 27, 2007 check-up, with Dr. Ahmad

adding Neurontin, a mood stabilizer, to Plaintiff’s drug regimen. (A.R. 610.)

Plaintiff met again with Dr. Ahmad on April 24, 2007 and June 4, 2007, without a

change in her condition. (A.R. 611, 612.) During this time, Plaintiff stated that she

did not comply with her Prozac dosages very well as she forgot to take it. (A.R.

611, 612.) On Plaintiff’s February 25, 2008 progress report, Dr. Ahmad noted that

Plaintiff had not been compliant with her medical appointments or her medications

as she had not come in for a check-up since September 2007. (A.R. 614.) Plaintiff

complained that the medications were making her feel even worse, that she felt

depressed, and had no appetite. (A.R. 614.) Based on this evaluation, Dr. Ahmad

discontinued her previous drug regimen and instead added Lexapro for her

depression. (A.R. 614.) However, at her April 28, 2008 evaluation, Plaintiff was

still not doing well and was not compliant with her medications. (A.R. 614.)

According to Dr. Ahmad, Plaintiff still remained sober from abusing drugs such as

methamphetamine during the times he treated her from 2006 to 2008. (A.R. 613.) 

 After a period of absence from seeing Dr. Ahmad at the Imperial County

Behavioral Health Services clinic, Plaintiff was readmitted on February 25, 2010.

(A.R. 628.) Dr. Ahmad noted that Plaintiff stopped coming because she was still

using meth and that her medications were not working well. (A.R. 628.) Dr.

Ahmad noted that her last reported use of meth was on September 7, 2009. (A.R.

628.) Plaintiff reported having severe mood swings and being depressed. (A.R.

628.) She was placed on Fluoxetine, an antidepressant, and Geodon, a medication

used to treat the manic symptoms of bipolar disorder. (A.R. 628.) On March 28,

2010, Plaintiff reported that she did not take the prescribed medications. (A.R.

636.) In addition to her depression and mood swings, she reported that she had

been hitting and punching things. (A.R. 636.) On March 25, 2010, she still had the

same up and down mood with poor medication compliance. (A.R. 640.) She

12cv328 W (PCL)

5

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 5 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

reported fair medication compliance with Geodon at her April 1, 2010 evaluation

but still reported the same symptoms of depression and mood swings. (A.R. 644.)

On June 3, 2010, Plaintiff reported restlessness, anxiety, sleeplessness, poor

concentration but better control of her mood swings and no anger or irritability.

(A.R. 653.) She was continued on Geodon for treating her bipolar disorder and was

prescribed Propranolol for her anxiety. (A.R. 653.) On June 17, 2010, Plaintiff

reported not liking Propranolol as it caused more anxiety. (A.R. 658.) Reporting

fair compliance with Geodon, she nevertheless continued to have the following

impairments: poor socialization, isolation, irritability, depression, mood swings,

and occupational problems. (A.R. 658.) Finally, in a mental impairment

questionnaire dated March 21, 2011, Dr. Ahmad reported that she had Bipolar I

disorder, that she was sober since September 2009, and that her constant worries,

poor attention and concentration, her tiredness, and functional impairments would

make it difficult for her to maintain a regular job. (A.R. 663.) 

2. Treating psychologist Stephen Papaleo

Plaintiff began seeing psychologist Stephen Papaleo in early 2010. (A.R. 630.)

Dr. Papaleo noted that Plaintiff received scores on the administered psychological

tests that were consistent with severe depression and bipolar disorder. (A.R. 630.) 

On March 9, 2010, Dr. Papaleo noted that Plaintiff was highly motivated and

compliant with treatment despite her depression. (A.R. 632.) On March 16, 2010,

Plaintiff reported she was in crisis mode with increased depression, agitation, and

irritability. (A.R. 634, 635.) Two days later, Plaintiff reported that she had been

hitting and punching things, had poor sleep, poor concentration, anxiety, and

depression. (A.R. 636.) Dr. Papaleo noted that she had poor compliance with her

medications. (A.R. 636.) Dr. Papaleo noted that Plaintiff had a recent medication

change as she discontinued using Prozac and Geodon and started using Divalproex

to treat her bipolar disorder. (A.R. 638.) On March 25, 2010, Dr. Papaleo noted

that Plaintiff had to discontinue using Divalproex and she resumed Geodon and

12cv328 W (PCL)

6

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 6 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Hydroxyzine for her anxiety. (A.R. 642.) She reported an improved status with her

depression from the last session, with increases in energy, interaction, animation,

and affective range/intensity. (A.R. 642.) This improved pattern continued in her

April 13, April 20, and June 1, 2010 progress reports. (A.R. 646, 647, 650.) On

June 8, 2010, Dr. Papaleo summarized her mental status as follows: “While patient

has made clear progress, she remains fragile and at significant risk for

relapse/decompensation.” (A.R. 655.) 

3. Consultive Psychologist C. Valette, Ph.D.

On September 26, 2009, Dr. Valettek, a clinical psychologist, evaluated

Plaintiff for the Department of Social Services, Disability Evaluation Department.

(A.R. 620.) Dr. Valette noted that Plaintiff received “outpatient treatment with Dr.

Ahmad two years ago ‘or so’” but that she was not currently in treatment. (A.R.

620.) Plaintiff told Dr. Valette that she had last used methamphetamine five

months ago and that she was not currently taking medications. (A.R. 620.) 

Dr. Valette pointed out that “claimant was not putting forth good effort into

our evaluation. Her very poor scores are inconsistent with her adequate

presentation and reported functional abilities.” (A.R. 620.) Dr. Valette noted

organized thought processes, no psychotic behavior, normal speech, good memory

of her personal history, and adequate focus and concentration. (A.R. 621.) Plaintiff

reported “that she is able to wash dishes, vacuum, sweep, do laundry, cook, and

shop [but that] she cannot do these things for any length of time as she cannot

stand or sit for very long.” (A.R. 621.) 

On the Folstein Mental Status Examination, the Bender Gestalt II, the

Wechsler Adult Intelligence Scale-III, and the Wechsler Memory Scale III, 

Plaintiff’s scores were determined to be invalid due to poor effort on her part.

(A.R. 621.) Her diagnosis was the following: “Rule out malingering. In light of her

adequate presentation and reported functional abilities, it is highly likely that she is

intellectually functioning in the average range. It is highly likely that her memory

12cv328 W (PCL)

7

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 7 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

is functioning consistent with intellectual functioning, average range. It is highly

likely that there are no mental restrictions regarding this claimant and that she is

capable of handling her own finances.” (A.R. 622.) 

B. Administrative Hearings

April 23, 2008 Hearing

Before ALJ Lauren R. Mathon on April 23, 2008, Plaintiff testified regarding

her work history, medical conditions, and consequent limitations. (A.R. 109-130.)

Plaintiff stated that she was licensed as a certified nursing assistant, with her last

employment in that field in 2001. (A.R. 109.) She then worked part-time for a

commercial building cleaning business until March of 2007. (A.R. 110-111.)

Finally, she worked seven or eight days in January of 2008. (A.R. 112.) At that

point, Plaintiff testified that she could not find a job and that she felt stressed,

depressed, and couldn’t focus. (A.R. 113.) 

Plaintiff testified that she had been clean and sober from methamphetamine

usage for about eight months at the time of the hearing. (A.R. 115.) She stated that

she used meth a couple of times in 2007, which was a relapse as she had been free

from substance abuse starting in January of 2006. (A.R. 116, 126.) She stated that

she stopped seeing her psychiatrist in June of 2007 and discontinued using her

medications. (A.R. 124.) Realizing that she was making herself feel worse, she

started receiving psychiatric treatment again in March of 2008. (A.R. 124.) 

July 9, 2010 Hearing

Before ALJ Lauren R. Mathon on July 9, 2010, Plaintiff testified regarding her

work history, medical conditions, and consequent limitations. (A.R. 85-103.)

Plaintiff testified that she had another brief drug relapse in late 2008 or early 2009.

(A.R. 93-94.) She stated that she had been living in a women’s shelter, where she

had to do chores such as cleaning the kitchen and watering the yard. (A.R. 95.) She

described the severe depression she daily faced, including the occasional thoughts

of suicide. (A.R. 95.) She stated that she had been clean and sober since September

12cv328 W (PCL)

8

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 8 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

2009 and that she started receiving psychiatric treatment again and taking

medications for her symptoms in September 2010. (A.R. 97-98.) She stated that

she drinks alcohol infrequently. (A.R. 98.) She explained that the medications she

is taking help her to some extent but that they make her feel drowsy. (A.R. 99-

100.) 

April 28, 2011 Hearing

Before ALJ Norman R. Buls on April 28, 2011, Plaintiff testified regarding her

work history, medical conditions, and consequent limitations. (A.R. 31-48.) She

testified that she last used methamphetamine on September 9, 2009. (A.R. 41.) She

could not remember why she had previously told her psychiatrist two weeks after

September 9, 2009 that her last previous use was five months ago. (A.R. 41-42.)

She testified that she last worked in 2007. (A.R. 39.) Her reasons why she could

not work were her inability to focus and concentrate stemming from her

uncontrollable anxiety and her bipolar disorder. (A.R. 42.) She stated that she

usually gets up at 1:00 in the afternoon as she does not want to face the world.

(A.R. 44.) During the day, Plaintiff explained that she sits in front of the television

and spaces out, eats maybe once a day, occasionally cleans her house, does not

have any hobbies, smokes cigarettes regularly, and prefers to isolate herself from

the rest of the world. (A.R. 44-45.) 

C. ALJ Decision

The ALJ sought to determine whether Plaintiff was disabled under section

1614(a)(3)(A) of the Act. (A.R. 16.) The ALJ concluded that Plaintiff was under a

disability, but that a substance abuse disorder was a contributing factor material to

the determination of disability. (A.R. 17.) As such, the ALJ determined that

Plaintiff was not disabled at any time from the date of application through the date

of his decision. (Id.) 

The ALJ found that Plaintiff had not engaged in substantial gainful activity

since October 6, 2006, the application date. (A.R. 19.) The ALJ determined that

12cv328 W (PCL)

9

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 9 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Plaintiff had bipolar disorder and methamphetamine dependence, in remission.

(A.R. 19.) Based on her impairments including the substance use disorder, the ALJ

found that Plaintiff had the residual functional capacity to perform a full range of

work at all exertional levels but with the following nonexertional limitations:

inabilities in sustaining concentration or attention for prolonged periods,

maintaining a normal schedule of attendance, sustaining an ordinary work routine,

working in conjunction with others, interacting with co-workers, supervisors, or

the public, and responding appropriately to changes in the work routine. (A.R. 20.)

The ALJ found that after Plaintiff used methamphetamine continuously from 2001

until 2006, Plaintiff entered rehabilitation and was then diagnosed with major

depressive disorder and methamphetamine dependence, in early remission. (A.R.

20.) The ALJ noted that Plaintiff was prescribed a number of different medications

but that Plaintiff had difficulties managing their side effects and did not report

significant progress with her symptoms. (A.R. 21.) The ALJ pointed out that

Plaintiff used meth “during 2007” and discontinued treatment in June 2007, and

with the exception of attending treatment for two months in 2008, did not continue

with receiving psychiatric treatment until 2010. (A.R. 21.) The ALJ stated that

Plaintiff reported a sharp increase in her symptoms when she was out of treatment

and a noticeable improvement in her symptoms when she was not using meth and

complying with her treatments. (A.R. 21.)

The ALJ gave considerable weight to Plaintiff’s psychiatrist Dr. Ahmad’s

2007 medical opinion that Plaintiff was impaired to the extent that she could not

work. (A.R. 21.) However, the ALJ stated the following: Dr. Ahmad’s 2007

opinion “reflects claimant’s level of impairment during a time that she was

admittedly still using methampetamine. Although Dr. Ahmad does not directly

separate the two issues, claimant’s functional limitations at that time cannot be

separated from her substance abuse.” (A.R. 21.) The ALJ similarly noted that “[i]n

May 2010 and March 2011, Dr. Ahmad opined claimant’s limitations were more or

12cv328 W (PCL)

10

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 10 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

less as they had been in 2007.” (A.R. 21.) However, the ALJ did not give

considerable weight to the May 2010 and March 2011 evaluations because they

reflected “only several months of sustained sobriety and compliance with

treatment.” (A.R. 21.) The ALJ found that the limitations were not corroborated by

the record “absent substance abuse.” (A.R. 22.) The ALJ concluded, “Dr. Ahmad’s

2011 opinion is given limited weight as claimant’s last documented treatment was

in June 2006 and there is therefore no way to evaluate whether the March 2011

opinion is a current assessment or simply based on prior opinions given.” (A.R.

22.) “[T]hese opinions are limited in their usefulness as the 2010 opinion was

offered very soon after claimant stopped regular methamphetamine use and may

still reflect the after affects of her drug use and the 2011 opinion is not

accompanied by any co-occurring treatment records.” (A.R. 24.) 

Although Plaintiff was deemed unable to perform any past relevant work or

any other job in the national economy, the ALJ determined that if Plaintiff

“stopped the substance use, the remaining limitations would not cause more than a

minimal impact on the claimant’s ability to perform basic work activities [and she]

would not have a severe impairment or combination of impairments.” (A.R. 23.)

He based his conclusion on the evidentiary record as a whole and on the opinion of

Dr. C. Valette, Ph.D., the consultive psychologist. (A.R. 24-25.) Dr. Valette

evaluated Plaintiff in September 2009. (A.R. 24.) The ALJ pointed out that

Plaintiff reported to Dr. Valette that her last usage of meth was in April 2009,

which is inconsistent with her later treatment records showing that she attained

sobriety in September 2009. (A.R. 24.) The ALJ also pointed out that Dr. Valette

“was of the opinion that the psychometric testing performed during the exam was

likely invalid due to malingering and that claimant’s reported level of functional

abilities and adequate presentation was more indicative of an average range of

intellectual functioning.” (A.R. 24.) The ALJ further stated that “Dr. Valette did

not offer a diagnosis and opined that claimant was not functionally limited by any

12cv328 W (PCL)

11

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 11 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

mental health impairment.” (A.R. 24.) The ALJ qualified the opinion as in contrast

to the record showing Plaintiff’s impairments and noted that Dr. Valette’s “failure

to offer a diagnosis is likely due to her assessment that claimant was malingering

and claimant’s lack of treatment or medication at the time of the interview.” (A.R.

24.) Based on this evidence, and Plaintiff’s lack of credibility due to her ability “to

maintain employment for several months while using methamphetamine and not

receiving methal health treatment,” the ALJ concluded that “[b]ecause the claimant

would not be disabled if she stopped the substance use, the claimant’s substance

use disorder is a contributing factor material to the determination of disability” and

she is not disabled as defined by the Social Security Act. (A.R. 26.) 

IV. 

STANDARD OF REVIEW

To qualify for disability benefits under the Social Security Act, an applicant

must show that: (1) she suffers from a medically determinable impairment that can

be expected to result in death or that has lasted or can be expected to last for a

continuous period of twelve months or more, and (2) the impairment renders the

applicant incapable of performing the work that she previously performed or any

other substantially gainful employment that exists in the national economy. See 42

U.S.C.A. § 423 (d)(1)(A), (2)(A) (West 2004). An applicant must meet both

requirements to be “disabled.” Id.

A. Sequential Evaluation of Impairments

The Social Security Regulations outline a five-step process to determine

whether an applicant is “disabled.” The five steps are as follows: (1) Whether the

claimant is presently working in any substantial gainful activity. If so, the claimant

is not disabled. If not, the evaluation proceeds to step two. (2) Whether the

claimant’s impairment is severe. If not, the claimant is not disabled. If so, the

evaluation proceeds to step three. (3) Whether the impairment meets or equals a

specific impairment listed in the Listing of Impairments. If so, the claimant is

12cv328 W (PCL)

12

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 12 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

disabled. If not, the evaluation proceeds to step four. (4) Whether the claimant is

able to do any work she has done in the past. If so, the claimant is not disabled. If

not, the evaluation proceeds to step five. (5) Whether the claimant is able to do any

other work. If not, the claimant is disabled. Conversely, if the Commissioner can

establish there are significant number of jobs in the national economy that the

claimant can do, the claimant is not disabled. 20 CFR § 404.1520; see also Tackett

v. Apfel, 180 F.3d 1094, 1098-99 (9th Cir. 1999). 

B. Judicial Review

Sections 206(g) and 1631(c)(3) of the Social Security Act allow unsuccessful

applicants to seek judicial review of the Commissioner’s final agency decision. 42

U.S.C.A. §§ 405(g), 1383(c)(3). The scope of judicial review is limited. The

Commissioner’s final decision should not be disturbed unless: (1) the ALJ’s

findings are based on legal error or (2) are not supported by substantial evidence in

the record as a whole. Schneider v. Comm’r of Soc. Sec. Admin., 223 F.3d 968,

973 (9th Cir. 2000). Substantial evidence means “more than a mere scintilla but

less than a preponderance; it is such relevant evidence as a reasonable mind might

accept as adequate to support a conclusion.” Andrews v. Shalala, 53 F.3d 1035,

1039 (9th Cir. 1995). The Court must consider the record as a whole, weighing

both the evidence that supports and detracts from the ALJ’s conclusion. See Mayes

v. Massanari, 276 F.3d 453, 459 (9th Cir. 2001); Desrosiers v. Sec’y of Health &

Human Servs., 846 F.2d 573, 576 (9th Cir. 1988). “The ALJ is responsible for

determining credibility, resolving conflicts in medical testimony, and for resolving

ambiguities.” Vasquez v. Astrue, 547 F.3d 1101, 1104 (9th Cir. 2008) (quoting

Andrews, 53 F.3d at 1039). Where the evidence is susceptible to more than one

rational interpretation, the ALJ’s decision must be affirmed. Id. (citation and

quotations omitted). 

Section 405(g) permits this Court to enter a judgment affirming, modifying, or

reversing the Commissioner’s decision. 42 U.S.C.A. § 405(g). This matter may

12cv328 W (PCL)

13

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 13 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

also be remanded to the Social Security Administration for further proceedings. Id.

Furthermore, “[a] decision of the ALJ will not be reversed for errors that are

harmless.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). 

V.

DISCUSSION

Plaintiff challenges the ALJ’s determination that Plaintiff’s substance use

disorder is a contributing factor material to the determination of disability. (Doc.

15, at 8.) Plaintiff argues that the ALJ failed to give the proper weight to his

treating physician Dr. Ahmad’s medical opinion describing Plaintiff’s level of

functionality and disability. (Doc. 15, at 9.) Plaintiff argues that the ALJ’s

conclusion that Plaintiff would not be disabled if she stopped the substance use is

not based on substantial evidence and constitutes legal error. (Doc. 15, at 8-10.)

Defendant, on the other hand, argues that the ALJ properly analyzed the materiality

of Plaintiff’s methamphetamine dependence in accordance with the Social Security

regulations in concluding that Plaintiff’s meth use was a material factor

contributing to her mental dysfunction. (Doc. 16, at 3, 5.) Defendant further argues

that the ALJ provided a well-supported explanation using the record as a whole for

his decision to reject the medical source statement of Plaintiff’s treating

psychiatrist, Dr. Ahmad, who indicated that Plaintiff was disabled. (Doc. 16, at 6.) 

In determining whether a claimant’s drug addiction is a contributing factor

material to the determination of a disability, the “key factor” an ALJ must examine

is whether the claimant would still be disabled if she stopped using illegal drugs.

20 C.F.R. § 416.935(b)(1). In making this determination, an ALJ must evaluate

which of the claimant’s limitations would remain if she stopped using illegal drugs,

and whether any or all of those remaining limitations would be disabling. 20

C.F.R. § 416.935(b)(2). If the ALJ determines that the claimant’s remaining

limitations would not be disabling, the ALJ “will find that [the claimant’s] drug

addiction ... is a contributing factor material to the determination of disability.” 20

12cv328 W (PCL)

14

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 14 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

C.F.R. § 416.935(b)(2)(i). The burden of proving that drug addiction was not a

contributing factor material to the disability determination falls on the claimant,

Parra v. Astrue, 481 F.3d 742, 748 (9th Cir. 2007), but “the ALJ retains the

responsibility of developing a full and fair record in the non-adversarial

administrative proceeding.” Brueggemann v. Barnhart, 348 F.3d 689, 693 (8th Cir.

2003) (citation omitted). 

In certain cases, a claimant’s substance use and impairment may be closely

related. See, e.g., Salazar v. Barnhart, 468 F.3d 615, 623 (10th Cir. 2006)

(claimant’s mental illness may account for that claimant’s substance abuse);

Kangail v. Barnhart, 454 F.3d 627, 629 (7th Cir. 2006) (claimant’s mental illness

can precipitate substance abuse as a means by which the claimant tries to selfmedicate). Notably, the mere fact that substance abuse aggravates rather than

medicates mental illness does not establish that the mental illness itself is not

disabling. See Kangail, 454 F.3d at 629. Due to the difficulty inherent in separating

the effect of mental illness on a claimant’s functioning from the effect of substance

use on that same claimant’s functioning, courts have held that if the effect of a

claimant’s mental illness cannot be separated from the effects of substance abuse,

the substance abuse is not a contributing factor material to the disability

determination. See, e.g., Kluesner v. Astrue, 607 F.3d 533, 537 (8th Cir. 2010) (“In

other words, on the materiality of his marijuana use, a tie would go to

[claimant].”); Salazar, 468 F.3d at 622-24. If, however, the claimant’s physician

concludes that the claimant’s mental illness is secondary to the primary problem of

substance abuse, the record supports a finding that the claimant is not disabled.

See, e.g., Vester v. Barnhart, 416 F.3d 886, 891 (8th Cir. 2005) (“After considering

all of the evidence under the substantial evidence standard, we are satisfied that the

ALJ [ ] untangled [claimant’s] history of alcoholism and mental illness with

sufficient clarity and detail to support the finding that she is not disabled apart

from her alcoholism.”). The Ninth Circuit has stressed that courts must not “fail[ ]

12cv328 W (PCL)

15

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 15 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

to distinguish between substance abuse contributing to the disability and the

disability remaining after the claimant stopped using drugs or alcohol.” Sousa v.

Callahan, 143 F.3d 1240, 1245 (9th Cir. 1998). That is, “[j]ust because substance

abuse contributes to a disability does not mean that when the substance abuse ends,

the disability will too.” Id.

Here, the ALJ did not support his finding that a substance abuse disorder was a

contributing factor material to the determination of disability with substantial

evidence. None of Plaintiff’s treating physicians opined that Plaintiff’s depression

or bipolar disorder was secondary to Plaintiff’s methamphetamine use disorder. In

an attempt to untangle Plaintiff’s substance use disorder from her mental illness,

the ALJ mischaracterized the record in a number of ways. First, the ALJ stated that

because Plaintiff used meth “during 2007,” discontinued treatment in June 2007,

and did not return to see her doctor until April of 2008, Dr. Ahmad’s 2007 opinion

“reflects claimant’s level of impairment during a time that she was admittedly still

using methampetamine. Although Dr. Ahmad does not directly separate the two

issues, claimant’s functional limitations at that time cannot be separated from her

substance abuse.” (A.R. 21.) However, according to her treating physician Dr.

Ahmad, Plaintiff remained sober from abusing drugs such as methamphetamine

during the times he treated her in 2006 and 2007. (A.R. 613.) Plaintiff did testify

that she used meth a couple of times in 2007, which was a relapse as she had been

sober since January of 2006. (A.R. 116, 126.) But there was no evidence in the

record to suggest that the seven recorded times between December 2006 and June

2007 that Plaintiff was seen by Dr. Ahmad that Plaintiff was abusing drugs. As

such, the treatment notes from late 2006 and the first half of 2007 and Dr. Ahmad’s

March 22, 2007 mental impairment opinion reflected a period in which Plaintiff

was sober from drugs for more than a year.1/

 (A.R. 606-612.) Secondly, the ALJ

1. See DrugFacts: Methamphetamines, National Institute of Drug Abuse, available at

http://www.drugabuse.gov/publications/drugfacts/methamphetamine (“Chronic methamphetamine abuse

significantly changes how the brain functions ... Some of these changes persist long after methamphetamine abuse is

12cv328 W (PCL)

16

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 16 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

misstated the record when he stated the following: “Dr. Ahmad’s 2011 opinion is

given limited weight as claimant’s last documented treatment was in June 2006 and

there is therefore no way to evaluate whether the March 2011 opinion is a current

assessment or simply based on prior opinions given.” (A.R. 22.) Rather, as stated

before, Plaintiff received treatment from Dr. Ahmad in late 2006 through mid

2007, was treated at least twice by him in 2008, and resumed consistent treatment

with him from February 2010 through at least June 2010. Thus, although the record

was presumably incomplete, both Dr. Ahmad’s 2010 and 2011 medical opinions

detailing Plaintiff’s disabilities due to her mental illness should have been given

their proper weight as there were some treatment notes supporting the opinions and

there wasn’t evidence contradicting Dr. Ahmad’s diagnoses. Finally, the ALJ

mistakenly pointed out that the consultant psychologist Dr. Valette “was of the

opinion that the psychometric testing performed during the exam was likely invalid

due to malingering and that claimant’s reported level of functional abilities and

adequate presentation was more indicative of an average range of intellectual

functioning.” (A.R. 24.) However, Dr. Valette did not state that she was

malingering but that more testing would have needed to be done to “rule out

malingering.” (A.R. 622.) Dr. Valette did not separate the limitations caused by

Plaintiff’s drug use from the limitations caused by Plaintiff’s other medical issues;

he simply concluded that Plaintiff had no mental health issues based on his

inconclusive test results. Further testing by Dr. Valette was not done, and the

inconclusive test results from Dr. Valette in September 2009 became the main

basis by which the ALJ concluded that Plaintiff would not be disabled if she

stopped the substance abuse. Thus, after accounting for these errors, the ALJ had

little basis to conclude that the functional limitations due to her mental illness were

mainly due to her substance abuse disorder. Plaintiff’s brief drug relapses in 2007

stopped. Reversal of some of the changes, however, may be observed after sustained periods of abstinence (e.g.,

more than one year)”). 

12cv328 W (PCL)

17

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 17 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

(a couple times), in late 2008 to early 2009, and in September 2009 (her last

documented use) should have been treated as secondary to Plaintiff’s primary

problem of depression and bipolar disorder, as Dr. Ahmad and Stephen Papaleo,

her psychologist, had done in their progress reports.2/

Accordingly, this Court finds that when the record as a whole is reviewed,

substantial evidence does not support the ALJ’s decision that Plaintiff’s

methamphetamine use was a contributing factor material to her disability. The ALJ

committed legal error by failing to provide specific and legitimate reasons, based

upon substantial evidence, in rejecting the opinions of Plaintiff’s treating doctors,

who indicated that Plaintiff was disabled at the time of the application date of

October 6, 2006. 

VI. 

CONCLUSION

For the reasons set forth above, this Court finds that because the ALJ’s

decision was not supported by substantial evidence, the case should be remanded

for a new decision consistent with this Report and Recommendation. The Court

recommends GRANTING in part Plaintiff’s Motion for Summary Judgment and

2. The instant case is similar to cases in which courts have found a lack of

substantial evidence in the record to support the ALJ’s finding that drug or alcohol

use is a contributing factor material to disability. See, e.g., Salazar v. Barnhart, 468

F.3d 615, 622-26 (10th Cir. 2006) (holding ALJ’s determination that claimant’s

drug and alcohol addiction was contributing factor material to her mentalimpairment disability was not supported by substantial evidence where physicians

cited by government never assessed whether claimant’s mental disorders were

disabling in absence of her addictions); McGoffin v. Barnhart, 288 F.3d 1248,

1252-53 (10th Cir. 2002) (holding non-treating physician’s assessment that

claimant’s mental disorders were not disabling absent her substance abuse did not

constitute substantial evidence because physician examined claimant only once,

over a year prior to administrative hearing, and did not express an opinion on

nature of claimant’s cognitive abilities were she to be in an independent work

environment). 

12cv328 W (PCL)

18

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 18 of 19
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

DENYING Defendant’s Cross-Motion for Summary Judgment.

This Report and Recommendation is submitted to the Honorable Thomas

Whelan, United States District Judge, pursuant to 28 U.S.C. § 636(b)(1). Any party

may file written objections with the Court and serve a copy on all parties on or

before March 21, 2014. The document should be captioned “Objections to Report

and Recommendation.” Any reply to the Objections shall be served and filed on or

before March 28, 2014. The parties are advised that failure to file objections

within the specific time may waive the right to appeal the district court’s order.

Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991).

IT IS SO ORDERED.

DATE: March 7, 2014

 

Peter C. Lewis

U.S. Magistrate Judge

United States District Court

12cv328 W (PCL)

19

Case 3:12-cv-00328-W-PCL Document 18 Filed 03/07/14 Page 19 of 19