Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_13-cv-02235/USCOURTS-azd-2_13-cv-02235-0/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 (SSID)

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Gary Waddle, 

Plaintiff, 

vs.

Carolyn W. Colvin, Commissioner of the

Social Security Administration, 

Defendant. 

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CIV 13-2235-PHX-MHB

ORDER

Pending before the Court is Plaintiff Gary Waddle’s appeal from the Social Security

Administration’s final decision to deny his claim for disability insurance benefits. After

reviewing the administrative record and the arguments of the parties, the Court now issues

the following ruling.

I. PROCEDURAL HISTORY

In January 2011, Plaintiff filed an application for disability insurance benefits alleging

disability beginning October 2010. (Transcript of Administrative Record (“Tr.”) at 13, 153-

59.) His application was denied initially and on reconsideration. (Tr. at 67-92.) Thereafter,

Plaintiff requested a hearing before an administrative law judge. (Tr. at 104.) A hearing was

held on July 25, 2012, (Tr. at 26-66), and the ALJ issued a decision finding that Plaintiff was

not disabled (Tr. at 10-25). The Appeals Council denied Plaintiff’s request for review (Tr.

at 1-6), making the ALJ’s decision the final decision of the Commissioner. Plaintiff then

sought judicial review of the ALJ’s decision pursuant to 42 U.S.C. § 405(g).

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II. STANDARD OF REVIEW

The Court must affirm the ALJ’s findings if the findings are supported by substantial

evidence and are free from reversible legal error. See Reddick v. Chater, 157 F.3d 715, 720

(9th Cir. 1998); Marcia v. Sullivan, 900 F.2d 172, 174 (9th Cir. 1990). Substantial evidence

means “more than a mere scintilla” and “such relevant evidence as a reasonable mind might

accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401

(1971); see Reddick, 157 F.3d at 720.

In determining whether substantial evidence supports a decision, the Court considers

the administrative record as a whole, weighing both the evidence that supports and the

evidence that detracts from the ALJ’s conclusion. See Reddick, 157 F.3d at 720. “The ALJ

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

resolving ambiguities.” Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); see

Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989). “If the evidence can reasonably

support either affirming or reversing the [Commissioner’s] conclusion, the court may not

substitute its judgment for that of the [Commissioner].” Reddick, 157 F.3d at 720-21.

III. THE ALJ’S FINDINGS

In order to be eligible for disability or social security benefits, a claimant must

demonstrate an “inability to engage in any substantial gainful activity by reason of any

medically determinable physical or mental impairment which can be expected to result in

death or which has lasted or can be expected to last for a continuous period of not less than

12 months.” 42 U.S.C. § 423(d)(1)(A). An ALJ determines a claimant’s eligibility for

benefits by following a five-step sequential evaluation:

(1) determine whether the applicant is engaged in “substantial gainful activity”;

(2) determine whether the applicant has a medically severe impairment or

combination of impairments;

(3) determine whether the applicant’s impairment equals one of a number of listed

impairments that the Commissioner acknowledges as so severe as to preclude the

applicant from engaging in substantial gainful activity;

Case 2:13-cv-02235-MHB Document 31 Filed 02/18/15 Page 2 of 7
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 “Residual functional capacity” is defined as the most a claimant can do after

considering the effects of physical and/or mental limitations that affect the ability to perform

work-related tasks.

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(4) if the applicant’s impairment does not equal one of the listed impairments,

determine whether the applicant is capable of performing his or her past relevant

work;

(5) if the applicant is not capable of performing his or her past relevant work,

determine whether the applicant is able to perform other work in the national

economy in view of his age, education, and work experience.

See Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987) (citing 20 C.F.R. §§ 404.1520,

416.920). At the fifth stage, the burden of proof shifts to the Commissioner to show that the

claimant can perform other substantial gainful work. See Penny v. Sullivan, 2 F.3d 953, 956

(9th Cir. 1993).

At step one, the ALJ determined that Plaintiff had not engaged in substantial gainful

activity since October 4, 2010 – the alleged onset date. (Tr. at 15.) At step two, she found

that Plaintiff had the following severe impairments: s/p cervical fusion (X2); s/p

mastoidectomy (deafness in left ear); and obesity. (Tr. at 15.) At step three, the ALJ stated

that Plaintiff did not have an impairment or combination of impairments that met or

medically equaled an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 of the

Commissioner’s regulations. (Tr. at 15-16.) After consideration of the entire record, the ALJ

found that Plaintiff retained “the residual functional capacity to perform light work as defined

in 20 CFR 404.1567(b) except he can never climb ladders, ropes, or scaffolds. He can

frequently climb ramps and stairs, frequently balance, frequently stoop, frequently crouch,

and frequently kneel. He can occasionally crawl. He should avoid concentrated exposure

to non-weather related extreme cold or heat as well as concentrated exposure to excessive

vibration. He should also avoid concentrated exposure to dangerous machinery with moving

mechanical parts as well as concentrated exposure to unprotected heights.”1

 (Tr. at 16-19.)

The ALJ determined that Plaintiff was capable of performing past relevant work as a health

educator, hospital services director, clinical nurse (emergency services) and clinical nurse

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manager. (Tr. at 20.) Therefore, the ALJ concluded that Plaintiff has not been under a

disability from October 4, 2010, through the date of her decision. (Tr. at 20.)

IV. DISCUSSION

In his brief, Plaintiff contends that the ALJ erred by: (1) failing to properly weigh

medical source opinion evidence; (2) failing to properly consider his subjective complaints;

and (3) failing to properly consider lay witness or third-party statements. Plaintiff requests

that the Court remand for determination of benefits.

Plaintiff first contends that the ALJ erred by failing to properly weigh medical source

opinion evidence. Specifically, Plaintiff argues that the ALJ improperly rejected the opinions

of treating physician, Jesse Babbitz, M.D., and examining physician, Atul Patel, M.D.,

relying instead upon the reports of reviewing and consultative examiners.

“The ALJ is responsible for resolving conflicts in the medical record.” Carmickle v.

Comm’r, Soc. Sec. Admin., 533 F.3d at 1164. Such conflicts may arise between a treating

physician’s medical opinion and other evidence in the claimant’s record. In weighing

medical source opinions in Social Security cases, the Ninth Circuit distinguishes among three

types of physicians: (1) treating physicians, who actually treat the claimant; (2) examining

physicians, who examine but do not treat the claimant; and (3) non-examining physicians,

who neither treat nor examine the claimant. See Lester v. Chater, 81 F.3d 821, 830 (9th Cir.

1995). The Ninth Circuit has held that a treating physician’s opinion is entitled to

“substantial weight.” Bray v. Comm’r, Soc. Sec. Admin., 554 F.3d 1219, 1228 (9th Cir.

2009) (quoting Embrey v. Bowen, 849 F.2d 418, 422 (9th Cir. 1988)). A treating physician’s

opinion is given controlling weight when it is “well-supported by medically accepted clinical

and laboratory diagnostic techniques and is not inconsistent with the other substantial

evidence in [the claimant’s] case record.” 20 C.F.R. § 404.1527(d)(2). On the other hand,

if a treating physician’s opinion “is not well-supported” or “is inconsistent with other

substantial evidence in the record,” then it should not be given controlling weight. Orn v.

Astrue, 495 F.3d 624, 631 (9th Cir. 2007).

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If a treating physician’s opinion is not contradicted by the opinion of another

physician, then the ALJ may discount the treating physician’s opinion only for “clear and

convincing” reasons. See Carmickle, 533 F.3d at 1164 (quoting Lester, 81 F.3d at 830). If

a treating physician’s opinion is contradicted by another physician’s opinion, then the ALJ

may reject the treating physician’s opinion if there are “specific and legitimate reasons that

are supported by substantial evidence in the record.” Id. (quoting Lester, 81 F.3d at 830).

The Court having reviewed the ALJ’s evaluation of the objective medical evidence

finds that the ALJ did not even mention the opinions or treatment record of Dr. Babbitz. (Tr.

at 18-19.) As such, the ALJ necessarily failed to substantiate her implicit rejection of Dr.

Babbitz’s opinion regarding Plaintiff’s limitations and ability to perform work. Because Dr.

Babbitz was a treating physician, the ALJ owed his opinion special deference, and the ALJ’s

failure to set forth specific and legitimate reasons for rejecting Dr. Babbitz’s opinion was

error. See Salvador v. Sullivan, 917 F.2d 13, 15 (9th Cir. 1990) (finding that ALJ’s implicitly

rejected treating physician’s opinion by concluding that claimant could perform light work,

and ALJ’s failure to evaluate the treating physician’s findings or conclusions was error);

Kreisher v. Astrue, 2011 WL 837147, at * 4 (E.D. Cal., March 9, 2011) (finding that ALJ

erred in failing to address claimant’s treating physician’s medical opinion and remanding for

further proceedings); see also Lingenfelter v. Astrue, 504 F.3d 1028, 1038 n.10 (9th Cir.

2007) (holding that “[i]t was also legal error for the ALJ to discount the opinions of [the

plaintiff’s] treating physicians without providing specific and legitimate reasons for doing

so”); Ghokassian v. Shalala, 41 F.3d 1300, 1303 (9th Cir. 1994) (holding “that the ALJ

committed a legal error when he failed to grant deference to the conclusions of [plaintiff’s]

treating physician”). Moreover, the ALJ’s error in this regard does not constitute harmless

error. See Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012) (“[A]n ALJ’s error is

harmless where it is ‘inconsequential to the ultimate nondisability determination.’”) (citations

omitted). Additionally, since the ALJ utilized and relied upon the objective medical evidence

in this case, in part, for discounting Plaintiff’s statements regarding his pain and limitations,

(Tr. at 16-18), the Court declines to reach Plaintiff's remaining arguments.

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Therefore, in light of the fact that the Court finds that the ALJ failed to provide

specific, legitimate reasons based on substantial evidence in the record for rejecting Dr.

Babbitz’s opinion, and the fact that the ALJ relied upon an erroneous evaluation of the

objective medical evidence, in part, to discount Plaintiff’s credibility, the Court will order

that the decision of the ALJ be vacated and the case be remanded.

“[R]emand for further proceedings is appropriate where there are outstanding issues

that must be resolved before a determination can be made, and it is not clear from the record

that the ALJ would be required to find claimant disabled if all the evidence were properly

evaluated.” Hill v. Astrue, 698 F.3d 1153, 1162 (9th Cir. 2012) (citing Vasquez v. Astrue,

572 F.3d 586, 593 (9th Cir. 2009)). “[T]he proper course, except in rare circumstances, is

remand to the agency for additional investigation or explanation.” INS v. Ventura, 537 U.S.

12, 16 (2002) (per curiam). The Ninth Circuit has held that when “additional proceedings

can remedy defects in the original administrative proceeding, a social security case should

be remanded.” Marcia v. Sullivan, 900 F.2d 172, 176 (9th Cir. 1990) (remanding “to the

Secretary for proper consideration of step three equivalence”). Here, the record contains

evidentiary conflicts that make an award of benefits inappropriate and require further

evaluation on remand. Specifically, remand is appropriate for a renewed residual functional

capacity assessment, which explicitly considers the opinions and treatment record of Dr.

Babbitz in the ALJ’s examination of the objective medical evidence and Plaintiff’s subjective

complaints.

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V. CONCLUSION

For the reasons discussed in this Order, the Commissioner’s decision will be vacated

and this matter will be remanded for further administrative proceedings consistent with this

Order.

Accordingly,

IT IS ORDERED that the Commissioner’s decision is VACATED and this matter

is REMANDED to the Commissioner for further administrative proceedings as set forth in

this Order;

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

accordingly.

DATED this 18th day of February, 2015.

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