Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_18-cv-02174/USCOURTS-caed-2_18-cv-02174-1/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:416 Denial of Social Security Benefits

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UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

WILLIE MACK WILSON,

Plaintiff,

v.

ANDREW SAUL, Commissioner of Social 

Security,

Defendant.

No. 2:18-cv-02174 CKD

ORDER

Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 

(“Commissioner”) denying an application for Supplemental Security Income (“SSI”) under Title 

XVI of the Social Security Act (“Act”). The parties have consented to Magistrate Judge 

jurisdiction to conduct all proceedings in the case, including the entry of final judgment. For the 

reasons discussed below, the court will deny plaintiff’s motion for summary judgment and grant

the Commissioner’s cross-motion for summary judgment.

BACKGROUND

Plaintiff, born in 1950, applied on June 30, 2013 for SSI, alleging disability beginning 

January 1, 2005.

1

 Administrative Transcript (“AT”) 16, 18, 27. Plaintiff alleged he was unable to 

 

1 Plaintiff previously filed an application for SSI in 2008, which was denied in 2009 in a decision 

that became final and binding in 2011. AT 16. 

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work due to mental instability, paranoia, depression, hepatitis C, neck and back pain, muscle 

spasms, and arthritis. AT 393. In a decision dated February 14, 2018, the ALJ determined that 

plaintiff was not disabled.2 3 AT 15-29. The ALJ made the following findings (citations to 20 

C.F.R. omitted):

1. The claimant has not engaged in substantial gainful activity since 

June 30, 2013, the application date.

 

2 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 is paid to 

disabled persons with low income. 42 U.S.C. § 1382 et seq. Both provisions define disability, in 

part, as an “inability to engage in any substantial gainful activity” due to “a medically 

determinable physical or mental impairment. . . .” 42 U.S.C. §§ 423(d)(1)(a) & 1382c(a)(3)(A). 

A parallel five-step sequential evaluation governs eligibility for benefits under both programs. 

See 20 C.F.R. §§ 404.1520, 404.1571-76, 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 

137, 140-142, 107 S. Ct. 2287 (1987). The following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful 

activity? If so, the claimant is found not disabled. If not, proceed to 

step two. 

Step two: Does the claimant have a “severe” impairment? If 

so, proceed to step three. If not, then a finding of not disabled is 

appropriate. 

Step three: Does the claimant’s impairment or combination 

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 determined 

disabled. If not, proceed to step four. 

Step four: Is the claimant capable of performing his past 

work? If so, the claimant is not disabled. If not, proceed to step five. 

Step five: Does the claimant have the residual functional 

capacity to perform any other work? If so, the claimant is not 

disabled. If not, the claimant is disabled.

 

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 

The claimant bears the burden of proof in the first four steps of the sequential evaluation 

process. Bowen, 482 U.S. at 146 n.5, 107 S. Ct. at 2294 n.5. The Commissioner bears the 

burden if the sequential evaluation process proceeds to step five. Id.

3 The ALJ considered this case on remand from the Appeals Council. AT 15. The ALJ 

considered the prior finding of non-disability dated October 14, 2011, and the applicability of 

Acquiescence Ruling 97-4(9); Chavez v. Bowen, 844 F.2d 691 (9th Cir. 1988). The ALJ found 

that plaintiff rebutted the presumption of continued non-disability and res judicata did not apply 

to this case, as reflected in the February 14, 2018 hearing decision. AT 15-16.

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2. The claimant has the following severe impairments: cervical 

degenerative disc disease, depressive disorder, personality disorder, 

lumbar strain, and polysubstance abuse (cocaine and opioids).

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. After careful consideration of the entire record, the undersigned 

finds that the claimant has the residual functional capacity to perform

medium work [with certain exertional limitations]. He is able to 

understand, remember and carry out and maintain the concentration, 

persistence and pace to perform simple unskilled work that has no 

public contact. He is able to have frequent fellow employee contact, 

but not as part of a team and is able to appropriately interact with 

supervisors.

5. The claimant has no past relevant work.

6. The claimant was born on xx/xx/1950 and was 62 years old, which 

is defined as an individual closely approaching retirement age, on the 

date the application was filed.

7. The claimant has at least a high-school education and is able to 

communicate in English.

8. Transferability of job skills is not an issue because the claimant 

does not have past relevant work.

9. Considering the claimant’s age, education, work experience, and 

residual functional capacity, there are jobs that exist in significant 

numbers in the national economy that the claimant can perform.

10. The claimant has not been under a disability, as defined in the 

Social Security Act, since June 13, 2013, the date the application was 

filed.

AT 18-29.

ISSUES PRESENTED

Plaintiff argues that the ALJ committed the following error in finding plaintiff not 

disabled: The ALJ failed to properly assess the Department of Veterans Affairs (VA) disability 

rating under Ninth Circuit law. 

LEGAL STANDARDS

The court reviews the Commissioner’s decision to determine whether (1) it is based on 

proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in the record 

as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial 

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evidence is more than a mere scintilla, but less than a preponderance. Connett v. Barnhart, 340 

F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d 625, 630 (9th 

Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is 

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

ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations omitted). 

“The court will uphold the ALJ’s conclusion when the evidence is susceptible to more than one 

rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008).

The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th 

Cir. 1986), and both the evidence that supports and the evidence that detracts from the ALJ’s 

conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not 

affirm the ALJ’s decision simply by isolating a specific quantum of supporting evidence. Id.; see 

also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports the 

administrative findings, or if there is conflicting evidence supporting a finding of either disability 

or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d 1226, 

1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was applied in 

weighing the evidence. See Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988).

ANALYSIS

Plaintiff’s challenge to the ALJ’s decision relates to his alleged mental limitations. He 

argues that the ALJ misapplied Ninth Circuit law in assigning “no weight” to a VA finding that 

plaintiff was “permanently disabled” due to depression for a portion of alleged disability period.

4

 

In January 2015, the VA issued a Rating Decision finding that, as of November 2013, 

plaintiff was “permanently disabled due to your Major Depressive Disorder, severe, with 

psychotic features. We also determine that you are unable to secure and maintain substantially 

gainful employment due to your disability.” AT 629. The VA “assigned 100 percent evaluation 

 

4 The VA rating concerned the period of November 2013 to January 2015, while plaintiff’s Social 

Security claim alleged disability for the substantially longer period of June 2013 through the 

ALJ’s 2018 decision.

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for your Major Depressive Disorder with Psychotic Features” based on the following listed 

factors: grossly inappropriate behavior; total occupational and social impairment; persistent 

hallucinations; persistent delusions; difficulty in adapting to work; difficulty in adapting to 

stressful circumstances; suicidal ideation; difficulty in adapting to a work-like setting; impaired 

abstract thinking; disturbances of motivation and mood; flattened affect; mild memory loss; 

depressed mood; chronic sleep impairment; anxiety; and suspiciousness. AT 630.

In the section of the decision evaluating the medical opinions in the record, the ALJ 

wrote: 

Effective November 2013, the Department of Veterans Affairs 

awarded the claimant disability pension benefits for his major 

depressive disorder, not related to his military service.5 The 

undersigned notes that the standards used by the Department of 

Veterans Affairs in determining disability are completely different 

than those used by the Social Security Administration; therefore, the 

undersigned is not bound by the findings set forth in the claimant’s 

Rating Decision. Furthermore, the undersigned notes that an opinion 

on whether an individual is disabled goes to an issue reserved to the 

Commissioner and therefore cannot be given special significance; 

however, such opinions could be considered in the assessment of the 

claimant’s residual functional capacity. With this in mind, the 

undersigned has fully considered the findings contained within the 

Ratings Decision, including the determination of the claimant’s 100 

percent disability rating.

. . . 

The VA rating decisions [cited above] were reviewed and the 

undersigned notes benefits were awarded based upon major 

depressive disorder with psychotic features. However, no weight 

was assigned to these decisions as they are contrary to the medical 

evidence of record which shows normal mental status examinations 

at the VA. Moreover, the rating decision does not address any 

substance abuse and the effect of substance abuse on his functioning. 

A January 2015 evaluation notes both major depressive disorder and 

cocaine and opioid use, which resulted in total occupational and 

social impairment. The provider noted it was difficult to assess the 

degree of abuse and use due to questionable veracity of the claimant. 

It was also noted that substance use was a method of self-medicating 

and not in itself a significant factor. However, this directly 

contradicts the previous notations that it was unclear the degree of 

abuse given his questionable veracity, so little weight was assigned 

to this conclusion. The undersigned also notes that no thorough 

mental status examination was conducted before this assessment was 

rendered. The claimant has presented with no deficits in cognition, 

 

5 Citing AT 628-631.

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contrary to that reported in the ratings decisions. Given history of 

substance usage and personality disorder, it is agreed that contact 

with others is to be limited.

AT 26-27 (some citations omitted). 

An Eastern District of California court recently set forth the legal standard for evaluating 

an ALJ’s decision as to VA ratings, which the undersigned adopts here.6 “[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 [her] decision.” McCartey v. 

Massanari, 298 F.3d 1072, 1076 (9th Cir. 2002). A VA rating is not conclusive, however. 

McLeod v. Astrue, 640 F.3d 881, 885 (9th Cir. 2011). Ordinarily, an ALJ must give great weight 

to a VA disability determination, but she may give less weight if she “gives persuasive, specific, 

valid reasons for doing so that are supported be the record.” McCartey, 298 F.3d at 1076.

In both McCartey and McLeod the ALJ failed even to mention the claimants’ VA 

disability ratings. Accordingly, the Ninth Circuit reversed the district court decision affirming the 

denial of Social Security benefits in each of these cases. However, “[s]imply mentioning the 

existence of a VA rating is not enough.” Luther v. Berryhill, 891 F.3d 872, 877 (9th Cir. 2018). 

In Luther, “[t]he ALJ erred because she did not give great weight to the VA disability rating and 

did not provide any persuasive, specific, and valid reasons for rejecting it.” Id.

An ALJ may not reject a VA rating based on a general finding that the VA and SSA 

disability inquiries differ. Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685, 695 (9th Cir. 

2009). Simply observing that differences exist between the rules governing VA and SSA does 

not constitute a persuasive, specific, and valid reason for the Commissioner to disregard the VA 

rating. Id. An ALJ can only meet the standard of rejecting the VA rating by articulating 

persuasive, specific and valid reasons that are supported by the record as a whole and based on 

evidence not available in the VA’s disability determination. Id. In other words, “the acquisition 

of new evidence or a properly justified reevaluation of old evidence constitutes a ‘persuasive, 

specific, and valid reason ... supported by the record.’” Id. (quoting McCartey, 298 F.3d at 1076). 

For example, an ALJ had sufficient basis to reject a VA disability rating when he explicitly stated 

 

6 Ferrer v. Saul, 2019 WL 4942463 (E.D. Cal. Oct. 8, 2019).

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his reliance on later medical reports and the testimony of the claimant and the vocational expert. 

Atwood v. Astrue, 742 F.Supp.2d 1146, 1154 (D. Or. 2010). See also Carinio v. Berryhill, 736 

Fed. Appx. 670, 673 (9th Cir. 2018) (holding that the ALJ appropriately relied on evidence 

subsequent to the VA determination).

If the hearing decision fails “to articulate an acceptable reason for affording the ALJ’s 

determination little weight,” courts may not speculate on reasoning sufficient to justify rejection 

of the VA rating. Taylor v. Colvin, 196 F.Supp.3d 1120, 1127 (N.D. Cal. 2016). In the absence 

of a detailed explanation of the ALJ’s reasoning, a court must be “wary of speculating about the 

basis of the ALJ’s conclusion—especially when his opinion indicates that the conclusion may 

have been based exclusively upon an improper reason.” See Valentine, 574 F.3d at 695 (quoting 

Gonzalez v. Sullivan, 914 F.2d 1197, 1201 (9th Cir. 1990)).

Here, the ALJ’s observation that “the standards used by the [VA] in determining disability 

are completely different than those used by the [SSA]” is not, by itself, a sufficient reason to 

reject the VA rating. AT 26. However, the ALJ added that she “fully considered the findings 

contained within the Rating Decision, including the determination of the claimant’s 100 percent 

disability rating.” AT 26. Because the ALJ made clear that she did not categorically reject the 

VA rating, the question is whether she supplied other “specific and valid” reasons for assigning it 

no weight.

First, the ALJ found that the rating was “contrary to the medical evidence of record which 

shows normal mental status examinations at the VA.” AT 26; see AT 22-24 (ALJ’s decision 

notes plaintiff’s “largely normal mental functioning on examinations” in 2011; 2012 “mental 

status examinations showed good attention, concentration, and orientation and his memory was 

intact”; 2013 mental status examination “showed good eye contact, neutral mood, logical 

thoughts, and that he was oriented”; 2015 mental status exam “showed organized thoughts, no 

evidence of psychosis and intact memory and concentration”); see also AT 564, 573-576. “The 

claimant has presented with no deficits in cognition, contrary to that reported in the ratings 

decisions,” the ALJ stated. AT 27. While examining physician Dr. Richard Hicks found plaintiff 

to have “very, very limited” mental functioning, the ALJ rejected Dr. Hicks’ opinion as 

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inconsistent “with claimant’s college education or VA records that indicate normal cognition” in 

an unchallenged finding. AT 25, 26.

Second, the ALJ pointed out that the VA’s decision did not “address any substance abuse 

and the effect of substance abuse on [plaintiff’s] functioning.” AT 26; see AT 23-24 (noting July 

2013 positive tests for cocaine and opiates and plaintiff’s admission that he was “taking Norco, 

OxyContin and Vicodin given to him by friends”; plaintiff’s January 2015 admission of cocaine 

and heroin use), AT 25 (noting October 2013 psychological evaluation by Dr. Kimberly Stearns, 

who found recent drug use and “a history of substance abuse and noncompliance with mental 

health treatment”). Ample record evidence, including toxicology reports and plaintiff’s 

admissions, showed that he had used cocaine, marijuana, and opiates. See, e.g., AT 56, 58, 80, 

536, 540, 611, 614, 636, 657, 671, 681, 694, 709, 711. The ALJ pointed out a January 2015 

report which noted “both major depressive disorder and cocaine and opioid use, which resulted in 

total occupational and social impairment.” AT 26-27, citing AT 677-679. The extent to which 

plaintiff’s long-term drug use caused his mental impairment was a valid consideration for the 

ALJ. See Parra v. Astrue, 481 F.3d 742, 744 (9th Cir. 2007) (claimant has burden to establish 

that alcohol or drug addiction is not a contributing factor material to disability determination, 

once evidence of addiction is presented); 42 U.S.C.A. § 423(d)(2)(C).

Moreover, because the January 2015 VA rating accounted for only a portion of the multiyear period of alleged disability, the ALJ based her assessment on evidence not available in the 

VA’s disability determination, including subsequent statements by plaintiff, clinical findings, and 

medical opinions. The undersigned concludes that the ALJ provided specific and valid reasons, 

supported by the record as a whole, for considering but ultimately rejecting the VA rating. 

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CONCLUSION

For the reasons stated herein, IT IS HEREBY ORDERED that:

1. Plaintiff’s motion for summary judgment (ECF No. 17) is denied; and

2. Judgment is entered for the Commissioner.

Dated: February 4, 2020

2/wilson2174.ssi.ckd

_____________________________________

CAROLYN K. DELANEY

UNITED STATES MAGISTRATE JUDGE

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