Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_14-cv-00731/USCOURTS-azd-2_14-cv-00731-0/pdf.json

Nature of Suit Code: 865
Nature of Suit: Social Security - RSI (405(g))
Cause of Action: 42:405 Review of HHS Decision (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Sherry Renee Espinoza, 

Plaintiff, 

v. 

Carolyn W. Colvin 

Defendant.

No. CV-14-00731-PHX DGC

ORDER 

Plaintiff Sherry Renee Espinoza seeks review under 42 U.S.C. § 405(g) of the 

final decision of the Commissioner of Social Security (“Defendant”), which denied her 

disability insurance benefits and supplemental security income under §§ 216(i), 223(d), 

and 1614(a)(3)(A) of the Social Security Act. Defendant’s decision will be vacated and 

the matter remanded for an award of benefits. 

I. Background. 

Plaintiff applied for disability insurance benefits and supplemental security 

income, alleging her disability began on August 9, 2006. Doc. 15 at 1. Since making her 

application, Plaintiff has had three hearings before Administrative Law Judges. Id. The 

Appeal Council has twice remanded the ALJ’s decision denying benefits. Id. Plaintiff’s 

most recent hearing occurred on May 7, 2013. Plaintiff appeared with her attorney and 

testified. Id.; A.R. 38-59. A vocational expert also testified. A.R. 59-68. On June 26, 

2013, the ALJ issued a decision that Plaintiff is not disabled within the meaning of the 

Social Security Act. Id. at 13-32. The Appeals Council denied Plaintiff’s request for 

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review, making the ALJ’s decision the Commissioner’s final decision. Id. at 1-6. 

Defendants now concede that this third decision also included several legal errors. 

II. Legal Standard. 

The Court may set aside the Commissioner’s disability determination only if it 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, less than a 

preponderance, and relevant evidence that a reasonable person might accept as adequate 

to support a conclusion. Id. In determining whether substantial evidence supports a 

decision, the court must consider the record as a whole and may not affirm simply by 

isolating a “specific quantum of supporting evidence.” Id. As a general rule, “[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). 

III. The ALJ’s Five-Step Evaluation Process. 

 To determine whether a claimant is disabled for purposes of the Social Security 

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 step one, the ALJ determines whether the claimant is 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. § 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. Pt. 404. 

§ 404.1520(a)(4)(iii). If so, the claimant is automatically found to be disabled. Id. If 

not, the ALJ proceeds to step four. At step four, the ALJ assesses the claimant’s residual 

functional capacity (“RFC”) and determines whether the claimant is still capable of 

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performing past relevant work. § 404.1520(a)(4)(iv). If so, the claimant is not disabled 

and the inquiry ends. Id. If not, the ALJ proceeds to step five, where he determines 

whether the claimant can perform any other work based on the claimant’s RFC, age, 

education, and work experience. § 404.1520(a)(4)(v). If so, the claimant is not disabled. 

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

At step one, the ALJ found that Plaintiff meets the insured status requirements of 

the Social Security Act through December 31, 2011, and that she has not engaged in 

substantial gainful activity since August 9, 2006. A.R. at 18. At step two, the ALJ found 

that Plaintiff has the following severe impairments: left tarsal tunnel syndrome/neuritis, 

diabetes mellitus, fibromyalgia, and obesity. Id. At step three, the ALJ determined that 

Plaintiff does not have an impairment or combination of impairments that meets or 

medically equals an impairment listed in Appendix 1 to Subpart P of 20 C.F.R. Pt. 404. 

Id. at 20. At step four, the ALJ found: 

[Plaintiff] had the [RFC] to perform sedentary work as 

defined in 20 CFR 404.1567(a) subject to the following. She 

could lift and carry up 20 lbs occasionally, and 10 lbs 

frequently; she could sit at least 6-hours, and stand or walk up 

to 2-hours in a standard 8 hour workday with normal breaks; 

she has no limits on pushing or pulling within the above 

weight restrictions; she could occasionally climb ramps or 

stairs, but should have avoided climbing ladders, rope, or 

scaffolds; she could occasionally balance, stoop, kneel, 

crouch, or crawl; and she should have avoided concentrated 

exposure to hazards such as unprotected heights and 

dangerous moving machinery. 

Id. at 20. The ALJ further found that Plaintiff is unable to perform any of her past 

relevant work. Id. at 24. At step five, the ALJ found that, based on the testimony of the 

vocational expert, jobs exist in significant numbers in the national economy that Plaintiff 

could perform. Id. at 25. Given that finding, the ALJ concluded that Plaintiff is not 

“under a disability as defined by the Social Security Act.” Id. at 26. 

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IV. Medical Source Evidence. 

Plaintiff argues that the ALJ improperly weighed the medical opinions of the 

following medical sources: Dan Bangart, D.P.M; Jeff Alvarez, M.D.; John Prieve, D.O.; 

and Jeanette Jicha, F.N.P. Doc. 15 at 13-18. Defendant concedes the ALJ erred in 

considering the opinions of Dr. Bangart,1

 Dr. Prieve,2 and Ms. Jicha,3 and asks the Court 

to remand for further proceedings to correct these errors. Doc. 20 at 5-6. The Court will 

accept Defendant’s concession of error with respect to Dr. Bangart, Dr. Prieve, and Ms. 

Jicha, and address the ALJ’s treatment of the opinion of Dr. Alvarez. 

 A. Legal Standard. 

The Ninth Circuit distinguishes between the opinions of treating physicians, 

examining physicians, and non-examining physicians. See Lester v. Chater, 

81 F.3d 821, 830 (9th Cir. 1995). Generally, an ALJ should give greatest weight to a 

treating physician’s opinion and more weight to the opinion of an examining physician 

than to one of a non-examining physician. See Andrews v. Shalala, 53 F.3d 1035, 1040-

41 (9th Cir. 1995); see also 20 C.F.R. § 404.1527(c)(2)-(6). If it is not contradicted by 

another doctor’s opinion, the opinion of a treating or examining physician can be rejected 

only for “clear and convincing” reasons. Lester, 81 F.3d at 830 (citing Embrey v. Bowen, 

849 F.2d 418, 422 (9th Cir. 1988)). 

 1

 The ALJ discounted a portion of Dr. Bangart’s medical opinions because they 

were contradicted by a treatment note from February 8, 2011. A.R. at 23. Defendant 

concedes the ALJ misconstrued the treatment note as claiming Plaintiff received 100% 

relief from a nerve block procedure, when in fact the note merely predicts that the 

procedure “should get [Plaintiff] to 100%.” Doc. 20 at 6. 

2

 The ALJ gave no weight to the medical opinions of Dr. Prieve because he was 

unlicensed at the time of the examination. A.R. at 24. Defendant concedes that the 

record does not contain evidence for this finding. Doc. 20 at 5. 

3

 The ALJ does not explain the weight given to Ms. Jicha’s medical opinions. 

A.R. 960-65. Defendant concedes this is error. Id. at 5-6. 

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 B. Jeff Alvarez, M.D. 

Dr. Alvarez began treating Plaintiff in 2006. A.R. at 648. In June 2008, Dr. 

Alvarez completed a form titled “Medical Assessment of Ability to do Work-Related 

Activities (Mental),” and found that while Plaintiff can manage benefits in her own 

interest, she has no useful ability to function in 10 of 15 work-related mental function 

areas. Id. at 648-50. In a letter dated May 7, 2009, Dr. Alvarez stated that Plaintiff’s 

medical problems affect her to the point she needs a caregiver to assist her with 

medication and some daily living activities. Id. at 777. 

The ALJ gave “little weight” to Dr. Alvarez’s opinions based primarily on three 

reasons: (1) Dr. Alvarez’s statements are “wholly unsupported by any objective clinical 

finding, cognitive testing, or other psychometric testing”; (2) Plaintiff does not claim to 

be as impaired as Dr. Alvarez states; and (3) “Dr. Alvarez is not a specialist in psychiatry, 

psychology, or other field of mental or behavioral health.” Id. at 24. The ALJ identified 

no contradicting physician testimony or clinical findings. See id. 

The ALJ erred in discounting Dr. Alvarez’s opinion on the ground that he is not a 

psychologist or psychiatrist. The Ninth Circuit has recognized that a treating physician 

may properly opine on his patient’s mental condition, particularly when the opinion is 

based on observation of the patient over a period of time. Sprague v. Bowen, 812 F.2d 

1226, 1231-32 (9th Cir. 1987) (treating physician qualified to give opinion on how 

patient’s mental state impacted on her physical disability even though physician was not 

psychiatrist). 

The ALJ also erred in concluding that Dr. Alvarez’s opinion was not support by 

clinical findings. Treating sources have identified and diagnosed Plaintiff’s depression 

and anxiety. Tr. 518, 542, 648-50, 654-55, 785-86, 800, 842-44, 896-99, 960-65. The 

ALJ seemed particularly concerned about Dr. Alvarez’s opinion that Plaintiff needed 

caregiver support in daily living. Tr. 24. His opinion, however, was that she needed help 

with her medication due to memory issues and some help with daily living. Tr. 777. 

This opinion was consistent with the testimony of Plaintiff and her husband that she has 

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memory issues and needs help from her daughters and husband in maintaining the house, 

preparing meals, etc. Tr. 55-59. Dr. Alvarez did not opine that Plaintiff was so impaired 

as to require psychiatric hospitalization as the ALJ suggested. Tr. 24. 

With these two reasons rejected, the Court does not find that the ALJ’s third 

reason satisfies the clear and convincing reasons standard. The ALJ asserted that even 

Plaintiff did not claim to be as mentally impaired as Dr. Alvarez found, but Plaintiff’s 

testimony concerned her functioning at home while Dr. Alvarez opined about her ability 

to function at work, two significantly different environments. Id. at 648-50. Dr. Alvarez 

found that while Plaintiff can manage matters in her own interest, she has no useful 

ability to function in 10 of 15 work-related mental function areas. The fact that Plaintiff 

can, from a mental health perspective, function better at home than in a work 

environment does not constitute a clear and convincing reason to discount Dr. Alvarez’s 

opinion regarding her ability to work. 

The ALJ did not consider the other factors listed in 20 C.F.R. § 404.1527(c)(2)-

(6), nor did she “[set] out a detailed and thorough summary of the facts and conflicting 

clinical evidence” or “do more than offer [her] conclusions.” Cotton, 799 F.2d at 1408; 

Embrey, 849 F.2d at 421-22. The Court concludes that the ALJ improperly rejected the 

opinions of Dr. Alvarez.4

 

V. Remand. 

Where an ALJ fails to provide adequate reasons for rejecting the opinion of a 

physician, a court in this circuit must credit that opinion as true. Lester, 81 F.3d at 834. 

An action should be remanded for an immediate award of benefits when the following 

three factors are satisfied: (1) the record has been fully developed and further 

administrative proceedings would serve no useful purpose; (2) the ALJ has failed to 

provide legally sufficient reasons for rejecting evidence, whether claimant testimony or 

 4

 In light of this conclusion and Defendant’s concession of error with respect to 

other medical opinions, the Court need not address Plaintiff’s argument that the ALJ 

erred in rejecting her testimony. 

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medical opinion; and (3) if the improperly discredited evidence were credited as true, the 

ALJ would be required to find the claimant disabled on remand. Garrison v. Colvin, 759 

F.3d 995, 1020 (9th Cir. 2014) (citing Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 1202 

(9th Cir. 2008), Lingenfelter v. Astrue, 504 F.3d 1028, 1041 (9th Cir. 2007), Orn, 495 

F.3d at 640, Benecke v. Barnhart, 379 F.3d 587, 595 (9th Cir. 2004), and Smolen v. 

Chater, 80 F.3d 1273, 1292 (9th Cir. 1996)). 

The Court agrees with both parties that the ALJ’s decision contains error regarding 

the weight given to the medical opinions of Dr. Bangart, Dr. Prieve, and Ms. Jicha. 

Doc. 15 at 18; Doc. 20 at 5-6. The Court also finds that the ALJ erred in affording little 

weight to the medical opinion of Dr. Alvarez. 

When these opinions are credited as true, the following facts are established: 

Plaintiff cannot stand or walk for more than five minutes at a time, can stand or walk less 

than two hours in an eight-hour workday, must elevate her foot to heart level for 50% of 

the workday, and would be compromised in her ability to pay attention and concentrate 

for up to 50% of the workday due to pain. Tr. 23, 494-96, 641-46, 772. In addition, 

Plaintiff has no useful ability to function in 10 of 15 work-related mental function areas. 

Tr. 648-50. She cannot follow work rules, function independently, maintain attention and 

concentration, or understand, remember, and carry out simple job instructions. Tr. 648-

49. Given these restrictions and the testimony of the vocational experts at Plaintiff’s 

three hearings (Tr. 61-65, 100-102, 134-36), Plaintiff does not have the ability to work. 

Thus, when the improperly discredited evidence is credited as true, the ALJ would be 

required to find the claimant disabled on remand. Garrison, 759 F.3d at 1020. 

The Court notes that the Court of Appeals has adopted the credit-as-true rule in 

part to prevent repeated remands and hearings, resulting in lengthy delays in decisions for 

disabled applicants. That purpose seems particularly relevant here. Plaintiff has had 

three different hearings before ALJs, every one resulting in error and remand. 

IT IS ORDERED that Defendant’s motion to remand (Doc. 20) is granted, the 

final decision of the Commissioner of Social Security is vacated, and this case is 

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remanded for an award of benefits. The Clerk shall enter judgment accordingly and 

terminate this case. 

Dated this 25th day of November, 2014. 

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