Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_22-cv-00812/USCOURTS-azd-2_22-cv-00812-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

---

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

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Shauna Deann Holt,

Plaintiff,

v. 

Commissioner of Social Security 

Administration,

Defendant.

No. CV-22-00812-PHX-JJT

ORDER 

At issue is the denial of Plaintiff Shauna Deann Holt’s Application for Disability 

Insurance Benefits by the Social Security Administration under the Social Security Act. 

Plaintiff filed a Complaint (Doc. 1) with this Court seeking judicial review of that denial, 

and the Court now addresses Plaintiff’s Opening Brief (Doc. 13, Pl. Br.), Defendant Social 

Security Administration Commissioner’s Response Brief (Doc. 16, Def. Br.), and 

Plaintiff’s Reply (Doc. 19, Reply). The Court has reviewed the briefs and Administrative 

Record (Doc. 12, R.) and now reverses the Administrative Law Judge’s (ALJ) decision 

(R. at 13–22) as upheld by the Appeals Council (R. at 1–3).

I. BACKGROUND

Plaintiff filed an application for Disability Insurance Benefits on June 30, 2019, for 

a period of disability beginning on October 5, 2017. (R. at 13.) Her claim was denied 

initially on November 6, 2019, and upon reconsideration on October 19, 2020. (R. at 13.) 

On May 11, 2021, Plaintiff appeared before the ALJ for a hearing regarding her claim. 

(R. at 28.) On June 14, 2021, the ALJ denied Plaintiff’s claim. (R. at 13–22.) On March 30, 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 1 of 10
- 2 -

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

2022, the Appeals Council denied Plaintiff’s Request for Review of the ALJ’s decision. 

(R. at 1–3.) 

The Court has reviewed the record and will discuss the pertinent medical evidence 

in addressing the issues raised by the parties. Upon considering the medical records and 

opinions, the ALJ evaluated Plaintiff’s disability based on the severe impairments of 

bipolar disorder, depressive disorder, anxiety disorder, and attention deficit/hyperactivity 

disorder (ADHD). (R. at 15.) 

Ultimately, the ALJ evaluated the medical evidence and testimony and concluded 

that Plaintiff is not disabled. (R. at 22.) In so doing, the ALJ determined that Plaintiff “does 

not have an impairment or combination of impairments that meets or medically equals the 

severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1.” 

(R. at 16.) The ALJ found that Plaintiff has the Residual Functional Capacity (RFC) to 

perform work at all exertional levels with some non-exertional limitations, including that 

Plaintiff is limited to performing simple, routine tasks and making simple, work-related 

decisions with occasional interaction with the public, supervisors, and co-workers. (R. at 

17.) Accordingly, the ALJ found that Plaintiff can perform work in the national economy, 

including as a hand packager inspector, routing clerk, or small parts assembler, such that 

Plaintiff is not under a disability as defined in the Social Security Act. (R. at 21.)

II. LEGAL STANDARD

In determining whether to reverse an ALJ’s decision, the district court reviews only 

those issues raised by the party challenging the decision. See Lewis v. Apfel, 236 F.3d 503, 

517 n.13 (9th Cir. 2001). The Court may set aside the Commissioner’s disability 

determination only if the determination is not supported by substantial evidence or is based 

on legal error. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). Substantial evidence is 

more than a scintilla, but less than a preponderance; it is relevant evidence that a reasonable 

person might accept as adequate to support a conclusion considering the record as a whole. 

Id.; see also Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). To determine whether 

substantial evidence supports a decision, the Court must consider the record as a whole and 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 2 of 10
- 3 -

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

may not affirm simply by isolating a “specific quantum of supporting evidence.” Id.

Generally, “[w]here the evidence is susceptible to more than one rational interpretation, 

one of which supports the ALJ’s decision, the ALJ’s conclusion must be upheld.” Thomas 

v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (citations omitted). 

To determine whether a claimant is disabled for purposes of the Act, the ALJ 

follows a five-step process. 20 C.F.R. § 404.1520(a). The claimant bears the burden of 

proof on the first four steps, but the burden shifts to the Commissioner at step five. Tackett 

v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). At the first step, the ALJ determines whether 

the claimant is presently engaging in substantial gainful activity. 20 C.F.R. 

§ 404.1520(a)(4)(i). If so, the claimant is not disabled, and the inquiry ends. Id. At step 

two, the ALJ determines whether the claimant has a “severe” medically determinable 

physical or mental impairment. 20 C.F.R. § 404.1520(a)(4)(ii). If not, the claimant is not 

disabled, and the inquiry ends. Id. At step three, the ALJ considers whether the claimant’s 

impairment or combination of impairments meets or medically equals an impairment listed 

in Appendix 1 to Subpart P of 20 C.F.R. Part 404. 20 C.F.R. § 404.1520(a)(4)(iii). If so, 

the claimant is automatically found to be disabled. Id. If not, the ALJ proceeds to step four. 

Id. At step four, the ALJ assesses the claimant’s residual functional capacity and 

determines whether the claimant is still capable of performing past relevant work. 

20 C.F.R. § 404.1520(a)(4)(iv). If so, the claimant is not disabled, and the inquiry ends. Id.

If not, the ALJ proceeds to the fifth and final step, where she determines whether the 

claimant can perform any other work in the national economy based on the claimant’s RFC, 

age, education, and work experience. 20 C.F.R. § 404.1520(a)(4)(v). If so, the claimant is 

not disabled. Id. If not, the claimant is disabled. Id. 

III. ANALYSIS

Plaintiff raises two arguments for the Court’s consideration, namely, (1) the ALJ’s 

reliance on the assessment of examining psychologist Kari Coelho, Psy.D., and reasons for 

discounting the opinions of treating psychiatrist Marc Schwartz, D.O., were neither

sufficiently explained nor supported by substantial evidence in the record, and (2) the ALJ 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 3 of 10
- 4 -

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

erred in evaluating Plaintiff’s symptom testimony. (Pl. Br. at 1.) The Court examines these 

arguments in turn.

A. Examining Psychologist Kari Coelho, Psy.D.

Dr. Coelho examined and evaluated Plaintiff on October 7, 2019. (R. at 958–64.) 

Plaintiff first contends that the ALJ erred in his interpretation and application of 

Dr. Coelho’s assessment in the disability determination. 

The Ninth Circuit no longer accords special deference to a treating or examining

physician. Woods v. Kijakazi, 32 F. 4th 785, 792 (9th Cir. 2022). In 2017, the Social 

Security Administration amended the regulations for evaluating medical evidence. See

Revisions to Rules Regarding Evaluation of Medical Evidence, 82 Fed. Reg. 5844, 5844 

(Jan. 18, 2017). The 2017 regulations provide that “[w]e will not defer or give any specific 

evidentiary weight, including controlling weight, to any medical opinion . . . . The most 

important factors we consider when we evaluate the persuasiveness of medical opinions 

. . . are supportability . . . and consistency.” 20 C.F.R. § 404.1520c(a). Other factors, which 

an ALJ “may, but [is] not required to[ ] explain” when evaluating the persuasiveness of a 

medical opinion, are the medical source’s “relationship with the claimant,” 

“specialization,” “familiarity with the other evidence in the claim,” and “understanding of 

our disability program’s policies and evidentiary requirements.” Id. § 404.1520c(b)(2), (c).

Moreover, the Ninth Circuit held its requirement that ALJs provide “specific and 

legitimate reasons” for rejecting a treating or examining doctor’s opinion is incompatible 

with the revised regulations. Woods, 32 F. 4th at 790. Nonetheless, in rejecting a treating 

or examining doctor’s opinion as unsupported or inconsistent, an ALJ must provide an 

explanation—that is, reasons—supported by substantial evidence. Id. This means that the 

ALJ “must ‘articulate . . . how persuasive’ it finds ‘all of the medical opinions’ from each 

doctor or other source, and ‘explain how it considered the supportability and consistency 

factors’ in reaching these findings.” Id. (citing 20 C.F.R. §§ 404.1520c(b), 404.1520(b)(2)).

In her evaluation, Dr. Coelho noted that Plaintiff reported she “has struggled to find 

medications that she can tolerate that alleviate her mental health complaints and do not lead 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 4 of 10
- 5 -

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 significant side effects,” that she stopped working 2–3 years ago “due to mood 

instability, feelings of being overwhelmed and lack of appropriate coping skills,” and 

“doctors have not been able to stabilize her psychologically speaking.” (R. at 962.)

Based on Plaintiff’s reports and an examination, Dr. Coelho offered some

observations with respect to Plaintiff’s ability to perform substantial work activity on a 

regular and continuing basis. (R. at 963–64.) Dr. Coelho observed Plaintiff did not appear 

to suffer significant problems in understanding and memory during the evaluation but 

reported intermittent memory problems. (R. at 963.) Plaintiff “demonstrated fair attention 

and concentration” and was “able to carry out simple instructions” but reported no energy 

or motivation and an inability to leave the house due to anxiety and depression. (R. at 963.) 

With regard to social interaction, Dr. Coelho stated Plaintiff “demonstrate[d] depression 

and some intermittent crying during the evaluation” that she appears “capable of 

controlling.” (R. at 963.) She also stated Plaintiff reported that in her last job, she 

demonstrated agitation and irritability and was verbally confrontational. (R. at 963.) In 

adapting to change, Dr. Coelho observed that Plaintiff “appears to lack impulse control” 

and may “cry or be verbally aggressive or throw things or become overwhelmed to the 

extent that she has become dependent upon other people to help her.” (R. at 964.)

The ALJ found Dr. Coelho’s evaluation “persuasive” and incorporated her 

observations by “limiting [Plaintiff] to simple routine tasks with occasional interaction with 

supervisors, coworkers and the public.” (R. at 20.) The ALJ adequately considered the 

supportability and consistency factors in giving weight to Dr. Coelho’s opinion by 

considering that Dr. Coelho examined and assessed Plaintiff in person, including by noting 

Plaintiff scored 30 out of 30 on a mini-mental status examination, and by citing specific, 

substantial portions of the medical record that were consistent with Dr. Coelho’s 

evaluation. (R. at 18–20.) The ALJ also considered Dr. Coelho’s expertise in psychology 

and knowledge of Social Security disability programs. (R. at 20.)

Plaintiff essentially argues that the ALJ should have given more weight to certain 

aspects of Dr. Coelho’s opinion. Specifically, Plaintiff argues that the ALJ’s assessment 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 5 of 10
- 6 -

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

failed to incorporate Dr. Coelho’s opinion that Plaintiff “lacked impulse control, became 

overwhelmed, and was incapable of handling stress.” (Pl. Br. at 16.) But a reading of 

Dr. Coelho’s opinion reveals a lack of specificity and definitiveness in its conclusions. For 

example, Dr. Coelho stated Plaintiff reported in the last 2–3 years that she has behaved 

without impulse control and was unable to handle stress, but Dr. Coelho neither 

corroborated nor refuted that report. 

The applicable Social Security Regulation’s listed mental work activities include 

“understanding; remembering; maintaining concentration, persistence, or pace; carrying 

out instructions; or responding appropriately to supervision, co-workers, or pressures in a 

work setting.” 20 C.F.R. § 404.1513(a)(2)(ii). Dr. Coelho’s inclusion of Plaintiff’s 

subjective reports in her evaluation, which she placed under the heading “adapting to 

change,” apply most aptly to the category, “responding appropriately to supervision, coworkers, or pressures in a work setting.”1

(R. at 964.) Dr. Coelho did not opine that Plaintiff 

had severe, marked or even moderate limitations in that area, but instead considered 

Plaintiff’s reports made over the last 2–3 years. (R. at 964.) Without more specificity in 

Dr. Coelho’s evaluation, the ALJ neither committed legal error nor failed to rely on

substantial evidence in the record in incorporating Dr. Coelho’s opinion into the RFC by 

limiting Plaintiff to “occasional interaction with supervisors, coworkers and the public.” 

(R. at 20.) In sum, the Court cannot conclude the ALJ erred in considering Dr. Coelho’s 

opinion.

B. Treating Psychiatrist Marc Schwartz, D.O.

Dr. Schwartz began treating Plaintiff on May 7, 2019 (R. at 979), and he evaluated 

Plaintiff’s mental work limitations on April 24, 2020 (R. at 974–77). Dr. Schwartz 

concluded that Plaintiff has severe limitations across all areas of mental work capacity, 

including understanding and memory, sustained concentration and persistence, social 

interactions, and adaptation. (R. at 974–76.) The ALJ cursorily found Dr. Schwartz’s 

1 The Court disagrees with Plaintiff that Dr. Coelho’s evaluation more aptly translates to 

restrictions in Plaintiff’s ability to perform simple routine tasks and make simple workrelated decisions. (See Pl. Br. at 16.)

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 6 of 10
- 7 -

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

evaluation “unpersuasive” based on two snippets from the medical record: (1) on July 25, 

2019, Plaintiff reported to Dr. Schwartz that she was feeling “much better” on a higher 

dose of Zoloft, and (2) on February 14, 2019, Dr. Melissa Ramirez observed on a checklist 

form that Plaintiff was appropriately dressed and adequately groomed with sad/depressed 

and anxious but congruent mood, organized thought process and intact memory. (R. at 19, 

505, 1001.)

The Court agrees with Plaintiff that the reasons the ALJ provided for discounting 

Dr. Schwartz’s evaluation of Plaintiff are wholly insufficient and constitute legal error. 

First, reading the treatment notes of Dr. Schwartz as well as the available notes of his 

predecessors in Plaintiff’s treatment, Drs. Patel and Greenman, the three doctors 

consistently observed that Plaintiff suffered from severe anxiety, depression, and suicidal 

ideation and was generally unable to leave the house. (E.g., R. at 547–50, 979–94.) The 

doctors noted Plaintiff was generally unresponsive to treatment or suffered from severe 

medical side effects from the medications she tried, including Lamictal, Pristiq, Latuda, 

Vraylar, Resperidone, Geodon, Lithium, and Zyprexa. (E.g., R. at 986–87, 994.) While she 

was able to tolerate Zoloft, Adderall, and Vistaril, she continued to suffer severe depressive 

lows and suicidal ideation. (R. at 983, 989.) Dr. Schwartz recommended Plaintiff receive 

an evaluation for electroconvulsive therapy (ECT) and opined that Plaintiff “may very well 

qualify for a [serious mental illness] designation.” (R. at 1000–1001.) The ALJ’s citation 

to a single instance in which Plaintiff reported that a higher dose of Zoloft resulted in an 

improvement is not sufficient to discount three years of treatment notes that are consistent 

with Dr. Schwartz’s evaluation of Plaintiff’s mental work capacity. See Attmore v. Colvin, 

827 F.3d 872, 877 (9th Cir. 2016) (stating the ALJ must not simply identify a few instances 

recording the plaintiff’s improvement “but must interpret reports of improvement with an 

understanding of the patient’s overall well-being and the nature of her symptoms”).

Next, Dr. Ramirez’s observations on a checklist form that Plaintiff was, for 

example, appropriately dressed and adequately groomed at the appointment (R. at 505) also 

do not constitute substantial evidence sufficient to discount the treatment notes by 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 7 of 10
- 8 -

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’s mental health care providers; indeed, the ALJ provides no explanation linking 

Dr. Ramirez’s observations regarding Plaintiff’s appearance to Dr. Schwartz’s evaluation 

of Plaintiff’s mental work capacity. Moreover, in the same appointment, Dr. Ramirez

observed Plaintiff’s continued suicidal ideation, depression, anxiety, poor concentration, 

and history of hypomanic episodes, and she diagnosed Plaintiff with bipolar II disorder, 

anxiety disorder, and ADHD, adding another antipsychotic medication to Plaintiff’s 

regimen. (R. at 505–508.)

In short, the ALJ failed to adequately describe how Dr. Schwartz’s evaluation is 

inconsistent with the medical record or to support that conclusion with substantial 

evidence. See 20 C.F.R. § 404.1520c(b)(2). And the ALJ also did not identify or evaluate 

other relevant factors with regard to weighing Dr. Schwartz’s opinion, such as that he is a 

specialist and examined and treated Plaintiff regularly for a year before providing the 

mental work capacity evaluation. See Woods, 32 F.4th at 792. The ALJ thus committed 

reversible error in finding Dr. Schwartz’s opinion unpersuasive and declining to 

incorporate it in formulating Plaintiff’s RFC.

C. Plaintiff’s Symptom Testimony

The ALJ also erred in evaluating Plaintiff’s symptom testimony for many of the 

same reasons the Court discussed above with regard to the weighing of Dr. Schwartz’s 

evaluation.

While credibility is the province of the ALJ, an adverse credibility determination 

requires the ALJ to provide “specific, clear and convincing reasons for rejecting the 

claimant’s testimony regarding the severity of the claimant’s symptoms.” Treichler v. 

Comm’r of Soc. Sec., 775 F.3d 1090, 1102 (9th Cir. 2014) (citing Smolen v. Chater, 80 

F.3d 1273, 1281 (9th Cir. 1996).)). For example, “[i]n evaluating the credibility of pain 

testimony after a claimant produces objective medical evidence of an underlying 

impairment, an ALJ may not reject a claimant’s subjective complaints based solely on a 

lack of medical evidence to fully corroborate the alleged severity of pain.” Burch v. 

Barnhart, 400 F.3d 676, 680 (9th Cir. 2005). But the ALJ may properly consider that the 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 8 of 10
- 9 -

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

medical record lacks evidence to support certain symptom testimony. Id. at 681. The ALJ 

may also properly consider inconsistencies in the claimant’s testimony, including 

inconsistencies between the claimant’s testimony of daily activities and symptom 

testimony. Id. 

As discussed above, a single report by Plaintiff that a medication dosage change 

resulted in an improvement does not support the ALJ’s opinion negating Plaintiff’s reports 

of severe anxiety and depression, much less three years of mental health treatment records 

identifying Plaintiff’s severe anxiety, depression, bipolar disorder and ADHD. Moreover, 

the ALJ did not explain—or provide specific, clear and convincing reasons—why 

Plaintiff’s daily activities were inconsistent with her specific reports of symptoms of 

depression, anxiety, panic attacks and self-isolating. See Vertigan v. Halter, 260 F.3d 1044, 

149–50 (9th Cir. 2001). The ALJ thus also erred in discounting Plaintiff’s symptom 

testimony.

D. Credit as True

The credit–as–true standard, if applied, results in a remand of Plaintiff’s case for a 

calculation and payment of benefits. Garrison v. Colvin, 759 F.3d 995, 1020 (9th Cir. 

2014). It applies if each part of a three–part standard is satisfied. Id. First, the record must 

have been fully developed and further administrative proceedings would serve no useful 

purpose. Id. Next, the ALJ must have failed to provide sufficient reasons for rejecting 

claimant’s testimony or medical opinions. Id. Finally, if the improperly discredited 

evidence were credited as true, then the ALJ would be required to find the claimant 

disabled. Id. 

The credit–as–true rule applies in this case. First, the record in this case was fully 

and extensively developed and no contradictions remain that need to be resolved. 

Specifically, Dr. Coelho’s evaluation of Plaintiff was not inconsistent was Dr. Schwartz’s 

treatment notes and assessment of Plaintiff; Dr. Coelho’s evaluation simply lacked the 

same specificity and definitiveness that could have compelled the ALJ to incorporate 

additional limitations in the RFC formulation. As a result, further proceedings would be 

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 9 of 10
- 10 -

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

unproductive. Next, as discussed above, the ALJ failed to provide legally sufficient reasons 

for rejecting the medical opinions of Dr. Schwartz, Plaintiff’s treating psychiatrist. The 

ALJ also failed to properly weigh Plaintiff’s symptom testimony. Finally, if the improperly 

discredited evidence were credited as true, then considering the whole record, including 

the testimony of the Vocational Expert (R. at 46), the ALJ would be required to find that 

Plaintiff is disabled. 

Therefore, it is unnecessary to remand for further administrative proceedings, and 

the Court will remand for a calculation and entry of benefits.

IT IS THEREFORE ORDERED reversing the June 14, 2021 decision of the 

Administrative Law Judge (R. at 13–22), as upheld by the Appeals Council on March 30, 

2022 (R. at 1–3).

IT IS FURTHER ORDERED remanding this case to the Social Security 

Administration for a calculation of benefits.

IT IS FURTHER ORDERED directing the Clerk of Court to enter judgment and 

close this case.

Dated this 21st day of September, 2023.

Honorable John J. Tuchi

United States District Judge

Case 2:22-cv-00812-JJT Document 20 Filed 09/22/23 Page 10 of 10