Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_11-cv-00954/USCOURTS-azd-2_11-cv-00954-0/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)

---

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 

Jane Marie Behling, 

Plaintiff, 

v. 

Michael J. Astrue, Commissioner of Social 

Security Administration, 

Defendant.

No. CV11-954-PHX-JAT

ORDER 

 Plaintiff Jane Behling appeals the Commissioner of Social Security’s (the 

“Commissioner”) denial of disability benefits. The Court now rules on her appeal (Doc. 

23.) 

I. BACKGROUND

A. Procedural History 

 Plaintiff filed for disability insurance pursuant to Title II of the Act on April 17, 

2007. She alleged disability since October 28, 2006. Plaintiff’s application was denied 

initially and on reconsideration. Administrative Law Judge (the “ALJ”) Ronald 

Dickinson held a hearing on August 7, 2009, which Plaintiff and a vocational expert 

attended. The ALJ issued a decision denying Plaintiff’s application for benefits on 

November 24, 2009. Plaintiff filed her appeal with this Court on May 12, 2011. 

B. Medical Background

 The following is only a summary of the medical evidence found in the 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 1 of 9
- 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 

administrative record.1 Plaintiff’s impairments include: cognitive disorder, as a result of 

brain aneurysms and aneurysm clipping surgeries; anxiety disorder; and 

depression/dysthymic disorder. Plaintiff also has a history of alcohol abuse in partial 

remission, but the ALJ did not find alcohol abuse material to the disability determination. 

 In April 2004, Plaintiff underwent aneurysm clipping surgery for two or three 

acute brain aneurysms. In 2005, she had a second aneurysm clipping surgery for two 

acute brain aneurysms. In November 2006, she had aortic valve replacement surgery to 

address heart disease. After her aortic valve replacement surgery, Plaintiff required 

surgery for placement of a dual chamber permanent pacemaker. 

 On August 24, 2007, Elizabeth Ottney, D.O., examined Plaintiff at the request of 

the state agency. Plaintiff complained of depression and anxiety. She reported her daily 

activities as: reading; watching television; and taking care of her 13-year-old daughter. 

Plaintiff complained of short-term memory loss and claimed she had to write things down 

to remember them. Dr. Ottney found Plaintiff had good hygiene and was not anxious 

during the examination. She determined that Plaintiff was alert and oriented times four 

with normal speech, cognition, hearing, affect mood, judgment, and intact memory. Dr. 

Ottney found that Plaintiff had no physical restrictions and did not appear to have any 

short-term memory loss because she could relate the details of her medical history with 

good accuracy. 

 Plaintiff presented to John Hopkins, M.D., on September 20, 2007 with complaints 

of stress, difficulty adjusting to her new environment, and fatigue. Dr. Hopkins 

diagnosed brain aneurysm, benign hypertension, hyperlipidemia, and major depression. 

On February 1, 2008, Plaintiff told Dr. Hopkins she was “quite anxious.” Dr. Hopkins 

found Plaintiff alert, cooperative, and not in any acute distress. Dr. Hopkins adjusted 

Plaintiff’s medications after noting she had ongoing anxiety that her medication was not 

helping. On March 11, 2008, Dr. Hopkins found Plaintiff alert and cooperative without 

 

1

 The summary focuses on Plaintiff’s cognitive deficits and mental impairments because she claims those are her disabling limitations. 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 2 of 9
- 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 

acute distress, but she had slurred speech and hesitant thought processing. 

 Brent Geary, Ph.D., examined Plaintiff on March 14, 2008 at the request of the 

state agency. Dr. Geary found Plaintiff had satisfactory eye contact and attention span 

with normal motor functioning. She denied any abnormalities of thought or perception. 

Plaintiff described her mood as good and bad. Dr. Geary noted that Plaintiff was hesitant 

to admit she was depressed, saying she was more frustrated than depressed, but she did 

acknowledge that she had reduced energy, was withdrawn and unmotivated at times, blue 

in mood, and restricted in her range of activities. Dr. Geary found Plaintiff had some 

difficulty in executing functioning, most notably when she left her home. Dr. Geary 

diagnosed Plaintiff with mild to moderate dysthymic disorder of late onset; possible 

cognitive disorder not otherwise specified due to aneurysm with impairment of attention 

and concentration and executive functioning; and alcohol dependence in full sustained 

reported remission. 

 Dr. Geary completed a “Psychological/Psychiatric Medical Source Statement,” 

wherein he opined that Plaintiff’s impairments imposed limitations for twelve months. 

He found that Plaintiff had no limitations in understanding, mild limitations in memory 

and social interaction, and moderate limitations in holding her attention since her brain 

aneurysm (flustered and anxious outside her home with diminished concentration and 

task orientation) and focusing. 

 On March 25, 2008, Plaintiff presented to Charles Stout, M.D., her treating 

cardiologist. Dr. Stout found Plaintiff’s pacemaker was functioning normally and that 

she had regular heart rate and rhythm. Dr. Stout completed a “Cardiac Residual 

Functional Capacity Questionnaire,” in which he stated that Plaintiff had palpitations. 

Dr. Stout found that Plaintiff’s physical limitations and symptoms caused emotional 

difficulties such as depression and chronic anxiety. He opined that emotional factors 

contributed to the severity of her symptoms and limitations and that she often 

experienced symptoms severe enough to interfere with attention and concentration. 

 Brady Dalton, Psy.D., a state agency psychologist, reviewed the evidence and 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 3 of 9
- 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 

completed a “Psychiatric Review Technique” form. He opined Plaintiff had mild 

restriction of her daily living activities; mild difficulties in maintaining social 

functioning; moderate difficulties in maintaining concentration, persistence, and pace; 

and had no episodes of decompensation. He completed a “Mental Residual Functional 

Capacity Assessment” wherein he assigned moderate limitations on Plaintiff’s abilities to 

understand, remember, and carry out detailed instructions, maintain attention, complete a 

normal workday and workweek, respond appropriately to changes in a work setting, and 

set realistic goals or make plans independently of others. He concluded Plaintiff had the 

mental residual functional capacity for simple work. 

 On April 28, 2008, Plaintiff presented to Marc Wasserman, M.D., her neurologist, 

because she was having difficulty concentrating. He referred her for psychiatric followup because she suffered from depression and anxiety. On July 14, 2008, Dr. Wasserman 

found Plaintiff had normal neurological functioning and that she seemed less anxious. 

Plaintiff told him was feeling calmer. 

 Plaintiff underwent emergency room treatment for acute alcohol poisoning on 

June 29, 2008. Plaintiff was hospitalized on July 6, 2008 after inadvertently taking 

approximately eleven Xanax tablets. 

 Will Schultz, Ph.D., examined Plaintiff on October 9, 2008 at the request of Dr. 

Wasserman. Dr. Schultz conducted a neurobehavioral status examination and 

administered a battery of standardized neuropsychological tests. He found Plaintiff was 

alert, generally oriented, appropriately groomed, and appeared to have a right facial 

droop. She had normal speech; linear, logical, and coherent thought processes; fair 

judgment and insight; full affect (although she seemed to have difficulty recognizing 

social cues); and mild impulsivity. Dr. Schultz administered the Wechsler Adult 

Intelligence Scale and Wechsler Memory Scale. Plaintiff’s test performance revealed 

impairment in executive functioning, visuospacial skills, and bilateral fine motor speed 

consistent with ruptured aneurysm and multiple aneurysm clippings. Dr. Schultz found 

that Plaintiff’s test results, depression, difficulty in regulating emotional responses, and 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 4 of 9
- 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 

variability in memory and speed of information processing would likely present 

significant challenges to maintaining gainful employment. He recommended that 

Plaintiff seek occupational or vocational rehabilitation if she were interested in working. 

II. LEGAL STANDARD

 A district court: 

may set aside a denial of disability benefits only if it is not 

supported by substantial evidence or if it is based on legal 

error. Substantial evidence means more than a mere scintilla 

but less than a preponderance. Substantial evidence is 

relevant evidence, which considering the record as a whole, a 

reasonable person might accept as adequate to support a 

conclusion. Where the evidence is susceptible to more than 

one rational interpretation, one of which supports the ALJ’s 

decision, the ALJ’s decision must be upheld. 

Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (internal citation and quotation 

omitted). This is because “[t]he trier of fact and not the reviewing court must resolve 

conflicts in the evidence, and if the evidence can support either outcome, the court may 

not substitute its judgment for that of the ALJ.” Matney v. Sullivan, 981 F.2d 1016, 1019 

(9th Cir. 1992). Also under this standard, the Court will uphold the ALJ’s findings if 

supported by inferences reasonably drawn from the record. Batson v. Comm’r of the Soc. 

Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). However, the Court must consider the 

entire record as a whole and cannot affirm simply by isolating a “specific quantum of 

supporting evidence.” Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007)(internal 

quotation omitted). 

III. DISCUSSION 

 To qualify for disability benefits under the Social Security Act a claimant must 

show, among other things, that she is “under a disability.” 42 U.S.C. §423(a)(1)(E). The 

Act defines “disability” as the “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). A person is: 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 5 of 9
- 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 

under a disability only if his physical or mental impairment or 

impairments are of such severity that he is not only unable to 

do his previous work but cannot, considering his age, 

education, and work experience, engage in any other kind of 

substantial gainful work which exists in the national 

economy. 

42 U.S.C. §423(d)(2)(A). 

 A. Five-Step Sequential Process 

 The Social Security regulations set forth a five-step sequential process for 

evaluating disability claims. 20 C.F.R. §404.1520; see also Reddick v. Chater, 157 F.3d 

715, 721 (9th Cir. 1998). A finding of “not disabled” at any step in the sequential process 

will end the inquiry. 20 C.F.R. §404.1520(a)(4). The claimant bears the burden of proof 

at the first four steps, but the burden shifts to the Commissioner at the final step. 

Reddick, 157 F.3d at 721. The five steps are as follows: 

 1. First, the ALJ determines whether the claimant is “doing substantial gainful 

activity.” 20 C.F.R. §404.1520(a)(4)(i). If so, the claimant is not disabled. 

 2. If the claimant is not gainfully employed, the ALJ next determines whether the 

claimant has a “severe medically determinable physical or mental impairment.” 20 

C.F.R. §404.1520(a)(4)(ii). To be considered severe, the impairment must “significantly 

limit[] [the claimant's] physical or mental ability to do basic work activities.” 20 C.F.R. 

§404.1520(c). Basic work activities are the “abilities and aptitudes to do most jobs,” for 

example: lifting; carrying; reaching; understanding, carrying out and remembering simple 

instructions; responding appropriately to co-workers; and dealing with changes in 

routine. 20 C.F.R. §404.1521(b). Further, the impairment must either be expected “to 

result in death” or “to last for a continuous period of twelve months.” 20 C.F.R. 

§404.1509 (incorporated by reference in 20 C.F.R. §404.1520(a)(4)(ii)). The “step-two 

inquiry is a de minimis screening device to dispose of groundless claims.” Smolen v. 

Chater, 80 F.3d 1273, 1290 (9th Cir. 1996). If the claimant does not have a severe 

impairment, the claimant is not disabled. 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 6 of 9
- 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 

 3. Having found a severe impairment, the ALJ next determines whether the 

impairment “meets or equals” one of the impairments listed in the regulations. 20 C.F.R. 

§404.1520(a)(4)(iii). If so, the claimant is found disabled without further inquiry. If not, 

before proceeding to the next step, the ALJ will make a finding regarding the claimant’s 

“residual functional capacity based on all the relevant medical and other evidence in [the] 

record.” 20 C.F.R. §404.1520(e). A claimant’s “residual functional capacity” (the 

“RFC”) is the most she can do despite all her impairments, including those that are not 

severe, and any related symptoms. 20 C.F.R. §404.1545(a)(1). 

 4. At step four, the ALJ determines whether, despite the impairments, the 

claimant can still perform “past relevant work.” 20 C.F.R. §404.1520(a)(4)(iv). To make 

this determination, the ALJ compares its “residual functional capacity assessment . . . 

with the physical and mental demands of [the claimant’s] past relevant work.” 20 C.F.R. 

§404.1520(f). If the claimant can still perform the kind of work she previously did, the 

claimant is not disabled. Otherwise, the ALJ proceeds to the final step. 

 5. At the final step, the ALJ determines whether the claimant “can make an 

adjustment to other work” that exists in the national economy. 20 C.F.R. 

§404.1520(a)(4)(v). In making this determination, the ALJ considers the claimant’s 

“residual functional capacity” and her “age, education, and work experience.” 20 C.F.R. 

§404.1520(g)(1). If the claimant can perform other work, she is not disabled. If the 

claimant cannot perform other work, she will be found disabled. As previously noted, the 

Commissioner has the burden of proving the claimant can perform other work. Reddick, 

157 F.3d at 721. 

 In this case, the ALJ concluded at step five of the sequential process that Plaintiff 

was not disabled. The ALJ found that Plaintiff could not perform any of her past relevant 

work as a secretary, store manager, or office manager because it was all skilled labor, but 

that Plaintiff had the residual functional capacity to work as an office helper, a 

receptionist, and an assembly production worker. The ALJ determined that the Plaintiff 

would be limited to light, unskilled work. 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 7 of 9
- 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 

B. Mental Functional Capacity Determination 

 Plaintiff makes several arguments for reversing the Commissioner’s denial of 

benefits, including arguing that the ALJ failed to perform a function-by-function 

assessment of Plaintiff’s residual functional capacity. Because the Court is reversing and 

remanding for a new hearing on that basis, the Court will not address the remaining 

arguments Plaintiff makes on appeal. A new hearing may cure the other alleged errors 

listed by Plaintiff. 

 The ALJ found Plaintiff has the ability to perform “unskilled work,” but did not do 

a function-by-function residual capacity determination. Social Security Ruling 96-8p 

provides that a RFC assessment must first identify an individual’s functional limitations 

or restrictions and assess her work-related abilities on a function-by-function basis, 

including the functions in paragraphs (b), (c), and (d) of 20 C.F.R. §§404.1545 & 

416.945. “Only after that may RFC be expressed in terms of the exertional levels of 

work, sedentary, light, medium, heavy and very heavy.” SSR 96-8p. 

And Social Security Ruling 85-15 provides that an ALJ “must not assume failure to meet 

or equal a listed mental impairment equates with capacity to do at least unskilled work. 

The decision requires careful consideration of the assessment of RFC.” 

 The ALJ did not perform a function-by-function assessment of Plaintiff’s mental 

residual functional capacity as required by the Social Security Rulings. The 

Commissioner argues that the ALJ did not err because implicit in the ALJ’s finding that 

Plaintiff could perform unskilled work were certain findings regarding Plaintiff’s residual 

functional capabilities. But the Court finds that the ALJ must make the explicit findings 

required by the Social Security Rulings regarding Plaintiff’s RFC. Because the ALJ did 

not do so, the Court will reverse and remand for a new hearing on Plaintiff’s entitlement 

to benefits. 

/// 

/// 

/// 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 8 of 9
- 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 

 Accordingly, 

IT IS ORDERED reversing the Commissioner’s denial of benefits and remanding 

for a new hearing. 

 Dated this 30th day of July, 2012. 

Case 2:11-cv-00954-JAT Document 31 Filed 07/30/12 Page 9 of 9