Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_11-cv-00196/USCOURTS-azd-4_11-cv-00196-0/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)

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

CLIFFORD B. GUILLORY,

Plaintiff, 

vs.

MICHAEL J. ASTRUE,

Commissioner of Social Security,

Defendant. 

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No. CV-11-196-TUC-BGM

ORDER

Currently pending before the Court is Plaintiff’s Motion for Summary Judgment [Doc.

20]. A response and reply have been filed. Plaintiff brings this cause of action for review

of the final decision of the Commissioner for Social Security pursuant to 42 U.S.C. § 405(g).

The United States Magistrate Judge has received the written consent of both parties, and

presides over this case pursuant to 28 U.S.C. § 636(c) and Rule 73, Federal Rules of Civil

Procedure.

I. BACKGROUND

On June 25, 2007, Plaintiff filed an initial application for Social Security Disability

Insurance Benefits (“SSDIB”) due to a disabling condition that arose on January 18, 2007.

See Administrative Record (“A.R.”) at 92-99. The Social Security Administration (“SSA”)

denied this application on September 10, 2007. Id. at 70. On February 28, 2008, Plaintiff

filed a second application for SSDIB, again due to a disabling condition that arose on January

18, 2007. See id. at 100-4. On May 8, 2008, SSA denied Plaintiff’s second application for

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benefits. Id. at 74. Plaintiff was unrepresented at the time of filing his initial applications.

Id. at 92, 100. On June 26, 2008, Plaintiff retained counsel and filed his request for

reconsideration. A.R. at 78-80. On November 26, 2008, upon reconsideration, SSA again

denied benefits. Id. at 81. Plaintiff filed his request for hearing on December 12, 2008. Id.

at 84. On October 14, 2009, a hearing was held before Administrative Law Judge (“ALJ”)

Norman R. Buls. Id. at 31. The ALJ issued an unfavorable decision on April 6, 2010. Id.

at 12-23. On April 29, 2010, Plaintiff requested review of the ALJ’s decision by the Appeals

Council. A.R. at 11. On March 16, 2011, Plaintiff’s appeal was denied. A.R. at 1. Plaintiff

filed this cause of action on April 1, 2011. Compl. [Doc. 1].

Plaintiff began serving in the United States Navy in August, 1983. A.R. at 184.

Twenty (20) years later, on or about September, 2003, he was honorably discharged. Id. at

1174. The administrative record contains Plaintiff’s medical records regarding his physical

health, prior to discharge, beginning on May 7, 2003. Id. at 1196. On May 9, 2003, Plaintiff

received a general psychiatric examination. Id. at 1212. Subsequent to retirement from the

U.S. Navy, Plaintiff has consistently sought treatment at the Southern Arizona Veterans’

Association (“VA”) Health Care System (“HCS”). Id. at 277-365, 380-1112, 1139-1495.

On July 17, 2007, the VA issued its Rating Decision to Plaintiff finding an entitlement to

individual unemployability effective February 9, 2007. A.R. at 1173. The VA found

Plaintiff to have a “a combined evaluation of 80 percent . . . [thereby] meet[ing] the schedular

requirements for individual unemployability” and based its findings upon “[s]ervice

connected disabilities currently evaluated as 50 percent for obstructive sleep apnea; 50

percent for bipolar disorder; 10 percent for post traumatic vertigo; 10 percent for tinnitus; 10

percent for cystic acne; 0 percent for GERD; 0 percent for status post removal of nevi, chest

and back and 0 percent for herpes simplex virus.” Id. at 1174; see also A.R. at 122.

Pursuant to request by the Commissioner, Plaintiff was examined by Randy SooHoo,

M.D., MPH, FACOEM. A.R. at 366-71. Prior to examination, Dr. SooHoo reviewed

Plaintiff’s medical records. Id. at 366. Dr. SooHoo stated the reason for the evaluation as

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“an internal medicine consultation to address is [sic] allegations of ‘sleep apnea, lumbar

spine bulging disc and degeneration, torn tendon in right biceps, posttraumatic vertigo,

tinnitus and carpal tunnel syndrome[.]’” Id. Plaintiff’s medical records were reviewed by

Robert S. Hirsch, M.D. and Randall J. Garland, Ph.D. A.R. at 1113-20; 1121-38. These

findings were affirmed upon reconsideration. Id. at 1330, 1331.

II. STANDARD OF REVIEW

The factual findings of the Commissioner shall be conclusive so long as they are

based upon substantial evidence and there is no legal error. 42 U.S.C. §§ 405(g), 1383(c)(3);

Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). This Court may “set aside the

Commissioner’s denial of disability insurance benefits when the ALJ’s findings are based

on legal error or are not supported by substantial evidence in the record as a whole.” Tackett

v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999) (citations omitted). 

Substantial evidence is “more than a mere scintilla, but not necessarily a

preponderance.” Tommasetti, 533 F.3d at 1038 (quoting Connett v. Barnhart, 340 F.3d 871,

873 (9th Cir. 2003)); see also Tackett, 180 F.3d at 1098. Further, substantial evidence is

“such relevant evidence as a reasonable mind might accept as adequate to support a

conclusion.” Parra v. Astrue, 481 F.3d 742, 746 (9th Cir. 2007). Where “the evidence can

support either outcome, the court may not substitute its judgment for that of the ALJ.”

Tackett, 180 F.3d at 1098 (citing Matney, 981 F.2d at 1019); see also Massachi v. Astrue,

486 F.3d 1149, 1152 (9th Cir. 2007). Moreover, the court may not focus on an isolated piece

of supporting evidence, rather it must consider the entirety of the record weighing both

evidence that supports as well as that which detracts from the Secretary’s conclusion.

Tackett, 180 F.3d at 1098 (citations omitted).

 . . .

 . . .

 . . .

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III. ANALYSIS

The Commissioner follows a five-step sequential evaluation process to assess whether

a claimant is disabled. 20 C.F.R. § 404.1520(a)(4). This process is defined as follows:

Step One asks is the claimant “doing substantial gainful activity[?]” If yes, the claimant is

not disabled; Step Two considers if the claimant has a “severe medically determinable

physical or mental impairment[.]” If not, the claimant is not disabled; Step Three determines

whether the claimant’s impairments or combination thereof meet or equal an impairment

listed in 20 C.F.R., Pt. 404, Subpt. P, App. 1. If not, the claimant is not disabled; Step Four

considers the claimant’s residual functional capacity and past relevant work. If claimant can

still do past relevant work, then he or she is not disabled; Step Five assesses the claimant’s

residual functional capacity, age, education, and work experience. If it is determined that the

claimant can make an adjustment to other work, then he or she is not disabled. 20 C.F.R. §

404.1520(a)(4)(i)-(v). In the instant case, the ALJ found that Plaintiff was not engaged in

substantial gainful activity since January 18, 2007. A.R. at 17. Plaintiff was determined to

have the following severe impairments: “peripheral vascular disease; a history of right biceps

tendon rupture; a history of a bipolar disorder; posttraumatic stress disorder; and drug abuse.”

Id. The ALJ further found that Plaintiff “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.” Id. at 18. Plaintiff asserts that the Commissioner “failed to

apply the proper legal standards in evaluating the Veterans’ Affairs Adjudicated Findings.”

Pl.’s Mot. for Summ. J. [Doc. 20-1] at 6. Plaintiff further avers that the Commissioner erred

in applying “the Medical Vocational Guidelines (“Grid”) in spite of [Claimant’s] significant

non-exertional impairments.” Id. at 7.

A. Veterans’ Affairs Disability Rating

“[A]lthough a VA rating of disability does not necessarily compel the SSA to reach

an identical result, 20 C.F.R. § 404.1504, the ALJ must consider the VA’s finding in reaching

his decision.” McCartey v. Massanari, 298 F.3d 1072, 1076 (9th Cir. 2002). Furthermore,

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“[b]ecause social security disability and VA disability programs ‘serve the same

governmental purpose – providing benefits to those unable to work because of a serious

disability,’ the ALJ must give ‘great weight to a VA determination of disability.’” Turner v.

Comm’r of Soc. Sec. Admin., 613 F.3d 1217, 1225 (9th Cir. 2010) (quoting McCartey, 298

F.3d at 1076). “Nevertheless, ‘[b]ecause the VA and SSA criteria for determining disability

are not identical,’ [the Ninth Circuit Court of Appeals has] allowed an ALJ to ‘give less

weight to a VA disability rating if he gives persuasive, specific, valid reasons for doing so

that are supported by the record.’” Valentine v. Comm’r of Soc. Sec. Admin., 574 F.3d 685,

695 (9th Cir. 2009) (quoting McCartey, 298 F.3d at 1076). Noting “that the SSA is not

bound by the VA’s determination[, however,] is not a ‘persuasive, specific, valid reason[ ]’

for discounting the VA determination.” Berry v. Astrue, 522 F.3d 1228, 1236 (9th Cir.

2010).

Here, the ALJ apparently did not give any weight to the VA’s finding of disability.

The record reflects a passing reference to the VA’s findings, and then the ALJ went on to

perform his own analysis. His decision states, in relevant part:

The medical evidence consists of voluminous progress notes and other treating

records from the Veterans Administration (VA) Medical Center (Exhibits 5F,

8F, 12F, 13F, 14F, and 17F). The undersigned notes at the outset that the

claimant was awarded service-connected disability benefits from the VA

effective February 2007 due to obstructive sleep apnea, a bipolar disorder,

posttraumatic vertigo, tinnitus, and cystic acne (Exhibit 12F, pp. 35-39 and

Exhibit 4E). However, it is emphasized that the Social Security

Administration is not bound by disability determinations made by other

governmental agencies (20 CFR 404.1504). Additionally, the medical

evidence in this case shows that while the claimant has numerous severe and

non-severe physical and mental conditions, his treatment has largely been of

a conservative and symptomatic nature.

A.R. at 19. The ALJ goes on to provide a brief summary of the medical care received by

Plaintiff, concluding “[n]otably, the claimant was not awarded any disability benefits by the

VA for a mental condition.” Id. This last statement is unsupported by the record.

The VA found Plaintiff to have a “a combined evaluation of 80 percent . . . [thereby]

meet[ing] the schedular requirements for individual unemployability” and based its findings

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upon “[s]ervice connected disabilities currently evaluated as 50 percent for obstructive sleep

apnea; 50 percent for bipolar disorder; 10 percent for post traumatic vertigo; 10 percent for

tinnitus; 10 percent for cystic acne; 0 percent for GERD; 0 percent for status post removal

of nevi, chest and back and 0 percent for herpes simplex virus.” A.R. at 1174; see also A.R.

at 122. An evaluation of 50 percent in the General Rating Formula for Mental Disorders is

assigned to “[o]ccupational and social impairment with reduced reliability and productivity

due to such symptoms as: flattened affect; circumstantial, circumlocutory, or sterotyped

speech; panic attacks more than once a week; difficulty in understanding complex

commands; impairment of short and long-term memory (e.g., retention of only highly learned

material, forgetting to complete tasks); impaired judgment; impaired abstract thinking;

disturbances of motivation and mood; difficulty in establishing and maintaining effective

work and social relationships.” 38 C.F.R. § 4.130. As such, the record reflects that the VA’s

disability finding was based in part on Plaintiff’s bipolar disorder, a mental condition.

The Commissioner argues that the ALJ correctly found that “[d]espite ongoing care

there have been no significant abnormalities or complications from any of the claimant’s

conditions. Many of the progress records merely reflect medication management and basic

health-maintenance.” A.R. at 20. The Commissioner urges that these observations in

addition to “[t]he fact that Plaintiff’s physical and mental conditions proved amenable to

primarily conservative treatment” are sufficient reasons to give less weight to the VA

determination. Def.’s Resp. to Mot. for Summ. J. [Doc. 21] at 8. The Commissioner further

asserts that the ALJ properly relied on Dr. SooHoo’s examination of Plaintiff as undermining

the VA determination and a finding of disability in the Social Security context. Id.

As an initial matter, Dr. SooHoo described his examination of Plaintiff as “an internal

medicine consultation to address is [sic] allegations of ‘sleep apnea, lumbar spine bulging

disc and degeneration, torn tendon in right biceps, posttraumatic vertigo, tinnitus and carpal

tunnel syndrome[.]’” A.R. at 366. Dr. SooHoo did not address any of Plaintiff’s mental

disorders. As such, his findings fail to address the totality of the Plaintiff’s conditions as

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addressed by the VA. Furthermore, the ALJ makes no suggestion as to what other type of

treatment Plaintiff should have sought or received. See Lapeirre-Gutt v. Astrue, 2010 WL

2317918, *1 (9th Cir. June 9, 2010) (“A claimant cannot be discredited for failing to pursue

non-conservative treatment options where none exist.”) (pursuant to Ninth Circuit Rule 36-3,

cited for persuasive value). Plaintiff’s medication list contains ongoing prescriptions targeted

for depression, anxiety, muscle spasms and tremors. A.R. 1343-67. Additionally, the VA’s

finding of disability occurred eight months prior to Plaintiff’s hospitalization for a major

depressive episode. A.R. 458-71; 1174. As such, the Court finds that the ALJ failed to give

persuasive, specific, valid reasons for disregarding the VA disability rating.

B. Determination of Benefits

“‘[T]he decision whether to remand the case for additional evidence or simply to

award benefits is within the discretion of the court.’” Rodriguez v. Bowen, 876 F.2d 759, 763

(9th Cir. 1989) (quoting Stone v. Heckler, 761 F.2d 530, 533 (9th Cir. 1985)). “Remand for

further administrative proceedings is appropriate if enhancement of the record would be

useful.” Benecke v. Barnhart, 379 F.3d 587, 593, (9th Cir. 2004) (citing Harman v. Apfel,

211 F.3d 1172, 1178 (9th Cir. 2000)). Conversely, remand for an award of benefits is

appropriate where:

(1) the ALJ failed to provide legally sufficient reasons for rejecting the

evidence; (2) there are no outstanding issues that must be resolved before a

determination of disability can be made; and (3) it is clear from the record that

the ALJ would be required to find the claimant disabled were such evidence

credited.

Benecke, 379 F.3d at 593 (citations omitted). Where the test is met, “we will not remand

solely to allow the ALJ to make specific findings. . . . Rather, we take the relevant testimony

to be established as true and remand for an award of benefits." Id. (citations omitted); see

also Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995).

Here, the ALJ failed to heed Ninth Circuit precedent and give the VA disability rating

great weight. See McCartey, 298 F.3d at 1076; A.R. at 19. The record before the Court is

expansive and fully developed. Properly crediting the disability evaluation of the VA, the

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ALJ would be required to find Plaintiff is disabled. See Davis v. Astrue, 2009 WL 1227870,

*3 (D. Or. 2009). Accordingly, the final decision of the Commissioner denying Plaintiff’s

application for benefits is reversed and remanded for an award of benefits.

C. ALJ’s Reliance on the Medical Vocational Guidelines

In light of this Court’s finding that this matter shall be remanded to the ALJ for an

award of benefits based upon his failure to give proper weight to the VA disability

determination, the Court declines to address whether his reliance on the Medical Vocational

Guidelines was appropriate in this case.

Accordingly, IT IS HEREBY ORDERED that:

1) Plaintiff’s Motion for Summary Judgment [Doc. 20] is GRANTED;

2) The Commissioner’s decision is REVERSED and REMANDED for calculation

and award of benefits. 42 U.S.C. § 405(g).

3) The Clerk of the Court shall enter judgment, and close its file in this matter.

DATED this 13th day of September, 2012.

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