Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_14-cv-02411/USCOURTS-azd-4_14-cv-02411-1/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 (DIWC)

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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Inga K. McCord, 

Plaintiff, 

vs.

Carolyn W. Colvin, 

Defendant.

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CV-14-2411-TUC-DCB

ORDER

Pending before this Court is the Report and Recommendation (R&R) of

Magistrate Judge Markovich, Plaintiff’s Objections and Defendant’s

Response to Objections. After conducting a de novo review of the record,

this Court will: adopt the Report and Recommendation, reverse the ruling

of the Commissioner, and remand for an award of benefits.

The Court will adopt in its entirety the Magistrate Judge’s

thoroughly documented recitation of the procedural and factual history.

(Doc. 20, 1- 34.)

STANDARD OF REVIEW

When objection is made to the findings and recommendation of a

magistrate judge, the district court must conduct a de novo review.

United States v. Reyna-Tapia, 328 F.3d 1114, 1121 (9th Cir. 2003). 

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OBJECTIONS

A. Defendant objects to the R&R’s re-weighing of conflicting evidence

and the substitution of his judgment for that of the Commissioner

Defendant objects to the R&R’s contravention of this limited scope

of review and the substitution of his judgment for that of the

Commissioner. The R&R reweighed the evidence by noting the medical

opinions in this case “somewhat contradict” the opinion of a treating

physician, Dr. Bupp, but the opinions are “not entirely inconsistent”

with that opinion. (Doc. 20 at 39.) The R&R also found fault with the

Administrative Law Judge’s (ALJ’s) apparent failure “to acknowledge Dr.

Bupp’s OCD diagnosis,” despite Plaintiff never having alleged her OCD was

a severe impairment in the first place. (Doc. 29 at 40.) This

“independent review” involves an improper substitution of judgment.

Defendant objects to the R&R’s determination that the ALJ “summarily

dismissed” Dr. Bupp’s opinion as “too restrictive and not supported by

the objective evidence” because Plaintiff received “only modest treatment

for depressed mood.” (Doc. 20 at 39.) The ALJ did not summarily dismiss

Dr. Bupp’s opinion. Defendant objects to the R&R’s claim that the “ALJ

failed to consider any of the factors outlined in 20 C.F.R.

§404.1527(c).” (Doc. 20 at 42.) To the contrary, the ALJ specifically

stated in the hearing decision that “I have also considered opinion

evidence in accordance with the requirements of 20 C.F.R. §404.1527 and

SSRs 96-2p, 96-5p, 96-6p and 06-3p.” (Tr. 22.) Defendant objects to the

R&R’s determination that the ALJ’s adverse credibility finding was

erroneous. Here, the ALJ’s interpretation of the evidence was reasonable

and consistent with the regulations and circuit authority. Defendant

objects to the R&R second-guessing of the ALJ’s rationale.

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Plaintiff responds that the Magistrate Judge was well-aware of the

substantial-evidence standard of review, including elements of that

standard the Commissioner alleges that he did not apply. (Doc. 20 at 35-

36 (citing 42 U.S.C. § 405(g) and numerous Ninth Circuit cases explaining

and applying the substantial-evidence standard of review).) Contrary to

the Commissioner’s view that he did not understand § 405(g), the

Magistrate Judge understood that on substantial-evidence review a “‘court

must consider the record as a whole, weighing both evidence that supports

and evidence that detracts from the Secretary’s conclusion.’” (Doc. 20

at 35 (quoting Aukland v. Massanari, 257 F.3d 1033, 1035 (9th Cir.

2001)).) Further, the Magistrate Judge’s reference to his “independent

review” is a reference to his very responsibility to prepare a report and

recommendation. 

In August 2009, treating psychiatrist Dr. Bupp opined that Plaintiff

was much more limited than the ALJ found. (AR. 405-06.) The Magistrate

Judge correctly recommended that the Court hold that the ALJ “erred in

failing to provide legally sufficient reasons for rejecting Dr. Bupp’s

opinion.” (Doc. 20 at 37.) The case at bar concerns a treating

specialist’s opinion that the regulations expressly require giving “good

reasons” for rejecting, see 20 C.F.R. § 404.1527(c)(2) (201), and that

longstanding Circuit law requires clear-and-convincing (or specific-andlegitimate) reasons for rejecting, see Garrison v. Colvin, 759 F.3d 995,

1012-13 & nn.10-11 (9th Cir. 2014). The Magistrate Judge relied on

Circuit treating-physician law and the regulations. (Doc. 20 at 37-39

(applying, e.g., Garrison, 759 F.3d at 1012).) The Magistrate Judge

correctly recommended rejecting the Commissioner’s baseless waiver

argument the ALJ failed to mention other physicians when rejecting Dr.

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Bupp’s opinions. (Doc. 20 at 39; Doc. 24 at 3-4.) The Magistrate Judge

explained why the ALJ did not provide the required clear-and-convincing

reasons to find Plaintiff not credible. (Doc. 20 at 42-49.)

The R&R correctly reasons that if the ALJ believed that Dr. Bupp’s

opinion was contradicted by the examining and consulting physician

opinions, then the ALJ was required to give specific and legitimate

reasons supported by substantial evidence for rejecting Dr. Bupp’s

opinion. The ALJ failed to meet this burden when she summarily rejected

Dr. Bupp’s opinion as “too restrictive and not supported by the objective

evidence” and noted that “received only modest treatment for depressed

mood.” (AR 21); see Garrison, 759 F.3d at 1012 (“The ALJ must do more

than state conclusions. He must set forth his own interpretations and

explain why they, rather than the doctors’, are correct.”). Further,

in noting that she accorded “less weight” to Dr. Bupp’s opinion because

it was too restrictive, the ALJ failed to address the factors set out in

20 C.F.R. 404.1527(c). Finally, the ALJ erred in failing to consider Dr.

Bupp’s OCD diagnosis.

In sum, the ALJ’s conclusory dismissal of Dr. Bupp’s opinion as “too

restrictive and not supported by the objective evidence” is wholly

inadequate to meet the required standards of either clear and convincing

reasons or specific and legitimate reasons supported by substantial

evidence. (AR 21). In addition, the ALJ failed to consider any of the

factors outlined in 20 C.F.R. 404.1527(c). The R&R properly found that

the ALJ erred in rejecting Dr. Bupp’s opinion and the ALJ failed to

provide “legally sufficient reasons for rejecting” Dr. Gray’s opinion.

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B. Defendant objects to the improper application of the credit-as-true

rule to award benefits

Defendant argues that multiple inconsistencies in the record

preclude an immediate award of benefits. These different opinions

underscore that the record is disputed in this case and remand is

required to resolve these issues. Moreover, the R&R’s conclusion that the

ALJ’s findings were inadequate or not sufficiently specific amounts to

a concession that remand is the appropriate remedy. In light of the

inconsistencies and conflicts in the record that require further

administrative proceedings, this Court cannot proceed to the next

question, whether the ALJ would be required to find Plaintiff disabled

if Dr. Bupp’s opinion and Plaintiff’s testimony were credited as true.

In response, Plaintiff argues that an ALJ’s failure to provide

legally sufficient reasons for rejecting evidence does not automatically

require a remand for readjudication, but instead is a condition precedent

to finding the plaintiff disabled on the existing record. The

Commissioner incorrectly argued that because the ALJ rendered an adverse

credibility finding, a remand for readjudication is appropriate. (Doc.

24 at 7.) Just because an ALJ found a claimant not credible does not

somehow mean that a remand for readjudication is required or warranted.

The credit-as-true doctrine applies when a court holds that an ALJ does

not provide clear-and-convincing reasons for finding a claimant not

credible. While the Commissioner maintained that there are inconsistent

medical opinions, the Commissioner did not present an argument that

specific medical opinions provide clear-and-convincing reasons (or

specific-and-legitimate reasons) for rejecting Dr. Bupp’s opinions. (Doc.

24 at 6.) This is not a case when additional vocational-expert testimony

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is needed to ascertain whether Plaintiff was disabled. The Magistrate

Judge recommends finding that Plaintiff was disabled because (1) the ALJ

did not provide clear-and-convincing reasons for rejecting the opinions

of a treating specialist and Plaintiff’s statements and (2) after

applying the Circuit’s test for the choice of judicial remedy in such

instance. In other words, those expert medical opinions improperly

rejected may be credited as true and may be the basis for a finding of

disability.

The Ninth Circuit recently reaffirmed the legal framework for a

finding of disability based on the credit-as-true rule. Dominguez v.

Colvin, 808 F.3d 403, 407-408 (9th Cir. 2015). Before a court can impose

such a remedy, there must be a determination of whether certain

prerequisites have been met. Burrell v. Colvin, 775 F.3d 1133, 1141 (9th

Cir. 2014) (discussing Garrison v. Colvin, 759 F.3d 995(9th Cir. 2014)).

First, the court must first determine that the ALJ made a legal error,

such as failing to provide legally sufficient reasons for rejecting

evidence. Dominguez, 808 F.3d at 407. This threshold requirement is met

in this case if the conclusion is that the ALJ improperly rejected Dr.

Bupp’s and Plaintiff’s testimony. The court must then “assess whether

there are outstanding issues requiring resolution before considering

whether to hold that the claimant's testimony is credible as a matter of

law.” Treichler, 775 F.3d at 1105. If such outstanding issues do exist,

the court cannot deem the erroneously disregarded testimony to be true;

rather, the court must remand for further proceedings. Id. at 1105–06.

This Court agrees with the R&R that the opinions of treating medical

experts were improperly disregarded and will credit them as true in this

instance. Two treating physicians opined, without contradiction and

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after numerous objective clinical and diagnostic testing, that Plaintiff

could not sustain work on a regular basis.

Dr. Gray

Plaintiff began treatment with Dr. Michael Gray in 2009 for

evaluation and treatment of alleged mold exposure.

On November 17, 2009 Plaintiff saw Dr. Gray and stated she

could not exercise 2 days in a row without having significant

fallout, and the same thing happens if she cleans her house 2

days in a row. (AR 512). She is unable to maintain a regular

40 hour work week without having significant increased

sickness, and Dr. Gray noted her absences were consistent with

her chronic fatigue immune dysfunction syndrome. Plaintiff

stated she had joint pain in her hands, knees, and hips on an

almost daily basis, and that is was not too severe and lasted

2–4 hours. Dr. Gray assessed: 1) fatigue; 2) restless leg

syndrome; 3) insomnia; and 4) asthma, unspecified. (AR 514).

On January 19, 2010 Dr. Gray saw Plaintiff and noted that she

continued to be significantly impaired and had hired a

housekeeper so she could get some exercise and not be fatigued

all the time. (AR 509). Dr. Gray assessed toxic effect of

nonmedicinal substance, and noted that she Plaintiff needed to

return to the lab because they did not complete all of the

tests. (AR 511).

(Doc. 20 at 6.)

On March 29, 2011 Plaintiff saw Dr. Gray and reported she

continued to be significantly impaired in her ability to

engage in gainful employment, household chores, and other

activities of daily living. (AR 487). She tried to take a

college course but had to drop out because of her illness. She

had been sick every other week recently and had taken several

courses of antibiotics, and stopped taking her sequestering

agents. She experienced moderate pain almost daily for 5–8

hours, had been sick 4 times in the last 2 months, and felt as

though she was doing a lot worse. (AR 488). Dr. Gray noted

that her labs from January showed her C4a level was in the

normal range, but because of the break in treatment he would

need to repeat labs because “these indirect markers of toxic

load may well have increased.” (AR 489). Dr. Gray made the

same assessment as at the February 28, 2011 appointment, with

the addition of toxic reaction.

(Doc. 20 at 8.)In a letter dated May 11, 2010 Dr. Gray noted that he was

Plaintiff’s treating physician for problems associated with excessive

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fatigue, asthma, mycotoxicosis, recurrent and frequent urinary tract

infections, insomnia, restless legs syndrome, arthritis, and headaches.

(AR 446). He opined that she was “unable to engage in gainful employment

as a result of the symptoms including excessive fatigue associated with

her clinical condition.” Dr. Gray further stated that Given the severity

of her clinical condition, understanding that her condition does

fluctuate at times but is also extremely unpredictable in terms of the

onset of exacerbation of her symptoms, it is a reasonable medical

certainty that Inga K Plaintiff is unable to engage in gainful employment

and should be considered permanently impaired and totally disabled. On

a Fatigue RFC Questionnaire, Dr. Gray reported that Plaintiff suffered

from moderately severe fatigue (seriously affecting ability to function),

and that her fatigue frequently interfered with her attention and

concentration. (AR 664). Dr. Gray stated that Plaintiff experienced

deficiencies of concentration, persistence, or pace often, and that she

could not sustain work on a regular and continuing basis.

Dr. Bupp

Dr. Bupp has been Plaintiff’s treating psychiatrist since January

1996. (AR 290).Dr. Bupp assessed major depressive disorder, recurrent,

in partial remission; restless leg syndrome, moderate/severe; and

obsessive compulsive disorder, moderate. Plaintiff saw Dr. Bupp on May

12, 2010 and reported she was only “ok” and had a series of depressions.

(AR 480). He observed that she was alert and oriented, mood was only

fair, affect was ok, and memory was intact. He assessed major depressive

disorder, recurrent, in partial remission; restless leg syndrome,

moderate; and mold titers increased. Dr. Bupp noted that depression,

OCD, and aspergillosis had a combined effect on Plaintiff’s functional

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In addition, the ALJ improperly failed to even mention the lay

witness statement by Plaintiff’s husband, which substantiates her

testimony.

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capacity, and that her limitations could be expected to last for 12

months or longer.

In addition, the testimony of Plaintiff was improperly discounted

and will be credited as true, to substantiate the Court’s finding of

disability here.1

Plaintiff testified at her hearing before the ALJ on July 18,

2011. She stated that she tries to walk her dog on a regular

basis for exercise, and that she drives to town twice a week

for grocery shopping. (AR 78). She traveled to Idaho to visit

her brother several times after his wife died. (AR 78, 86).

Plaintiff takes prescription medications for depression,

anxiety, sleep, acid reflux, and asthma, plus a lot of

vitamins and minerals, and Tylenol for restless legs and Advil

for headaches. (AR 79). On examination by her attorney,

Plaintiff stated that she forgets things more frequently than

she did in the past, and that she had a “lack of ability to

concentrate much diminished.” (AR 89). She reported that if

she tried to work as a programmer for several hours a day, she

“would run out of mental capabilities in about 50 percent the

time that I did ten years ago.” Plaintiff stated that she took

a lot of time off of work in 2007 because she was ill so

frequently, and used up all of her sick and vacation time. If

she tries to do housework for half a day, the next day she is

mentally drained and feels incapable of balancing her

checkbook, and her muscles ache badly. (AR 92–93). Plaintiff

testified that some days she can do the household finances,

but she doesn’t attempt to on days when she is very fatigued.

(AR 94). She was laid off of her job because she could not

work a 40-hour week, and then she got a new job but could not

work a full week because: “By about Wednesday I lost my

ability to solve problems anymore. By Thursday I would be

there, but I would really, really wish I could crawl under my

desk and lie down so I lost all productivity at that point.

Friday was typically just a nothing day.” (AR 94–95).

(Doc. 20 at 27.)

The Court finds no outstanding material issues precluding resolution

of disability at this time.

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CONCLUSION

After correctly concluding that the ALJ did not provide clear-andconvincing reasons or specific-and-legitimate reasons for rejecting

treating medical opinions and after concluding that the ALJ did not

provide clear-and-convincing reasons for finding Plaintiff not credible,

the Magistrate Judge reviewed Circuit law and correctly recommended that

under that law, the proper judicial remedy in this case is a finding of

disability and an award of benefits. (Doc. 20 at 49-51.) 

Accordingly, after conducting a de novo review of the record, 

IT IS ORDERED that the Report and Recommendation of Magistrate Judge

Markovich is ADOPTED in its entirety.

IT IS FURTHER ORDERED that the ruling of the Commissioner is

REVERSED and this matter is REMANDED for an award of benefits to the

Plaintiff.

IT IS FURTHER ORDERED that this action is DISMISSED and closed. The

Clerk of this Court shall enter final judgment accordingly.

DATED this 19th day of May, 2016.

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