Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_14-cv-08177/USCOURTS-azd-3_14-cv-08177-0/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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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Roshini Szarka, 

Plaintiff, 

vs.

Carolyn W. Colvin, Commissioner of the

Social Security Administration, 

Defendant. 

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CIV 14-8177-PCT-MHB

ORDER

Pending before the Court is Plaintiff Roshini Szarka’s appeal from the Social Security

Administration’s final decision to deny her claim for disability insurance benefits and

supplemental security income. After reviewing the administrative record and the arguments

of the parties, the Court now issues the following ruling.

I. PROCEDURAL HISTORY

Plaintiff filed applications for disability insurance benefits and supplemental security

income alleging disability beginning June 1, 2007. (Transcript of Administrative Record

(“Tr.”) at 16.) Her applications were denied initially and on reconsideration. (Tr. at 16.)

Thereafter, Plaintiff requested a hearing before an administrative law judge. (Tr. at 16.) A

hearing was held on September 20, 2012, (Tr. at 29-49), and the ALJ issued a decision

finding that Plaintiff was not disabled (Tr. at 13-28). 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;

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1

 “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 June 1, 2007 – the alleged onset date. (Tr. at 18.) At step two, he found that

Plaintiff had the following severe impairment: interstitial cystitis. (Tr. at 19.) 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 19.) After consideration of the entire record,

the ALJ found that Plaintiff retained “the residual functional capacity to perform the full

range of light work as defined in 20 CFR 404.1567(b) and 416.967(b). With the residual

functional capacity to perform light work, the claimant is also able to perform the full range

of sedentary work (20 CFR 404.1567(a) and 416.967(a)).”1

 (Tr. at 19-22.) The ALJ

determined that Plaintiff was able to perform past relevant work as a filing clerk, information

coordinator, medical billing clerk, receptionist, and library clerk. (Tr. at 23.) Therefore, the

ALJ concluded that Plaintiff has not been under a disability from June 1, 2007, through the

date of his decision. (Tr. at 23.)

IV. DISCUSSION

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

her subjective complaints; (2) failing to properly weigh medical source opinion evidence; and

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2

 With respect to the claimant’s daily activities, the ALJ may reject a claimant’s

symptom testimony if the claimant is able to spend a substantial part of her day performing

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

the Court remand for determination of benefits.

Plaintiff first argues that the ALJ erred in rejecting her subjective complaints in the

absence of clear and convincing reasons for doing so.

To determine whether a claimant’s testimony regarding subjective pain or symptoms

is credible, the ALJ must engage in a two-step analysis. “First, the ALJ must determine

whether the claimant has presented objective medical evidence of an underlying impairment

‘which could reasonably be expected to produce the pain or other symptoms alleged.’ The

claimant, however, ‘need not show that her impairment could reasonably be expected to

cause the severity of the symptom she has alleged; she need only show that it could

reasonably have caused some degree of the symptom.’” Lingenfelter v. Astrue, 504 F.3d

1028, 1036-37 (9th Cir. 2007) (citations omitted). “Second, if the claimant meets this first

test, and there is no evidence of malingering, ‘the ALJ can reject the claimant’s testimony

about the severity of her symptoms only by offering specific, clear and convincing reasons

for doing so.’” Id. at 1037 (citations omitted). General assertions that the claimant’s

testimony is not credible are insufficient. See Parra v. Astrue, 481 F.3d 742, 750 (9th Cir.

2007). The ALJ must identify “what testimony is not credible and what evidence undermines

the claimant’s complaints.” Id. (quoting Lester v. Chater, 81 F.3d 821, 834 (9th Cir. 1995).

In weighing a claimant’s credibility, the ALJ may consider many factors, including,

“(1) ordinary techniques of credibility evaluation, such as the claimant’s reputation for lying,

prior inconsistent statements concerning the symptoms, and other testimony by the claimant

that appears less than candid; (2) unexplained or inadequately explained failure to seek

treatment or to follow a prescribed course of treatment; and (3) the claimant’s daily

activities.” Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996); see Orn v. Astrue, 495

F.3d 624, 637-39 (9th Cir. 2007).2

 The ALJ also considers “the claimant’s work record and

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household chores or other activities that are transferable to a work setting. See Fair v.

Bowen, 885 F.2d 597, 603 (9th Cir. 1989). The Social Security Act, however, does not

require that claimants be utterly incapacitated to be eligible for benefits, and many home

activities may not be easily transferable to a work environment where it might be impossible

to rest periodically or take medication. See id.

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observations of treating and examining physicians and other third parties regarding, among

other matters, the nature, onset, duration, and frequency of the claimant’s symptom;

precipitating and aggravating factors; [and] functional restrictions caused by the symptoms

... .” Smolen, 80 F.3d at 1284 (citation omitted).

Plaintiff was 32 years old at the time of the ALJ hearing. (Tr. at 35.) She has a high

school education. (Tr. at 36.) Her past relevant work consists of sedentary semiskilled jobs

(medical billing clerk, receptionist) and light semiskilled jobs (library clerk, filing clerk,

information coordinator). (Tr. at 46, 23.)

Plaintiff testified that she stopped working in 2008 when she was fired because of

absenteeism due to bladder surgery. (Tr. at 36.) Plaintiff was limited to standing, walking,

or sitting for no more than an hour. (Tr. at 38.) She suffered pain in her bladder, going into

her lower back and legs, plus “[f]requency, urine, all through the night, all day long. Urge

to urine. And it hurts when I urine. I sometimes have to sit there for a while and squeeze it

all out. ... Every 30 minutes to an hour. At nighttime, it’s sometimes every 15 minutes. It

depends.” (Tr. at 40-41.)

The vocational expert testified, “Based on her testimony, I believe she would need to

have accommodated jobs, so there wouldn’t be competitive work.” (Tr. at 47.) Even

assuming the exertional limitations Plaintiff described, regarding sitting or standing, the

vocational expert testified that an hourly bathroom break, lasting five to ten minutes, would

preclude sustained employment: “It’s been my experience in contacting employers and

placing people at jobs, that employers typically want you to be able to stay on task for

two-hour increments and then get a ten to 15-minute break. If it’s less than two hours, that

individual is going to need to be given a specially accommodated job, and it wouldn’t fit

under the standards of Social Security.” (Tr. at 48.)

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Having reviewed the record along with the ALJ’s credibility analysis, the Court finds

that the ALJ failed to make sufficient credibility findings. The ALJ recognized that

Plaintiff’s medically determinable impairments could reasonably be expected to cause the

alleged symptoms, but concluded that Plaintiff’s statements concerning the intensity,

persistence, and limiting effects of the symptoms were not fully credible. (Tr. at 19-22.) The

ALJ then proceeded with a general discussion of the medical evidence, but provided no

explanation as to how the medical evidence detracted from Plaintiff’s credibility.

First, the ALJ mischaracterized the treating physicians’ statements. Although the ALJ

noted that treating physician Sharon Li, M.D., was unable to provide a medical opinion with

regard to Plaintiff’s ability to do work related activity, the ALJ stated that Dr. Li “opined that

the claimant does not have any condition that would limit her ability to do basic work

functions.” Similarly, with regard to treating physician Paul A. Ostergaard, M.D.’s opinion,

the ALJ stated, “Dr. Ostergaard completed a medical source statement concurring with Dr.

Li’s opinions that the claimant’s diagnosis does not impede her from performing work

activity.” (Emphasis added.) However, a close review of the treating physicians’ statements

reveals a different assessment.

Dr. Li’s records reveal a diagnosis of chronic interstitial cystitis, with “chronic pain,”

and treatments including hydrodistension and bladder biopsies. Dr. Li checked “no” in

response to the question, “Can you provide, based on your medical findings, your medical

opinion regarding your patient’s ability to do work related activities?” Then, in answering

an open-ended question, “Are there any other conditions that limit this individual’s ability

to do work related activities,” Dr. Li checked “no” – meaning there were no conditions other

than interstitial cystitis. The fact that Dr. Li opined that no other condition would limit work

activity, is not an affirmative opinion on whether the chronic interstitial cystitis would cause

work related limits.

Like Dr. Li, Dr. Ostergaard completed the same form, and also answered “no” in

response to the question, “Can you provide, based on your medical findings, your medical

opinion regarding your patient’s ability to do work related activities?” He also checked “no”

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– again meaning there were no conditions other than interstitial cystitis – in answering the

question, “Are there any other conditions that limit this individual’s ability to do work related

activities?”

Dr. Li never opined chronic interstitial cystitis would not cause any work related

limitations; he only declined to rate exertional work capacities. Thus, contrary to the ALJ’s

findings, there was nothing for Dr. Ostergaard to “concur” with despite the ALJ’s assertion

that Dr. Ostergaard agreed with Dr. Li.

Lastly, with regard to the medical evidence relied upon by the ALJ to detract from

Plaintiff’s credibility, the ALJ asserted that treating physician Anthony Lemanski, M.D.,

opined that Plaintiff “had no physical disability.” A review of the cited record reveals that

Dr. Lemanski made that statement under the “Social History” section of Plaintiff’s records

– not in the context of any functional assessment or medical opinion as the ALJ implies.

After reciting two pages of medical evidence, the ALJ found that based on his “review

of the overall record,” Plaintiff’s testimony was “not fully credible with regard to the severity

and extent of her symptoms.” The ALJ then listed Plaintiff’s various routine activities, such

as attending to personal care, preparing meals, household chores, shopping, driving, and

handling finances. However, the ALJ gave no indication as to what activities were at odds

with Plaintiff’s reported symptoms. The ALJ did not find – and the record does not

demonstrate – that a substantial part of a typical day was spent engaged in activities

inconsistent with Plaintiff’s specific disabling limitations.

The ALJ then listed Plaintiff’s exertional capacities for standing, walking, and sitting,

etc., and concluded that the “ability to perform such activities is inconsistent with the

claimant’s allegations of disability.” But, Plaintiff’s claim is not founded on exertional, or

strength-related limitations, but rather on nonexertional limitations of pain and frequent

interruptions due to urgent needs to use the bathroom. And, as noted by the vocational

expert, the need for such urgent and frequent bathroom breaks would not be tolerated in the

workplace.

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The ALJ found, “The claimant’s testimony that she has to use the bathroom every 30

minutes to an hour is not supported by the medical evidence overall. The claimant’s physical

disorder can be accommodated by normal breaks.” The ALJ, however, failed to give any

indication of what “medical evidence overall” was at odds with Plaintiff’s need for frequent

bathroom breaks. As such, this rationale fails for lack of specificity. See Embrey v. Bowen,

849 F.2d 418, 421-22 (9th Cir. 1988) (“To say that medical opinions are not supported by

sufficient objective findings does not achieve the level of specificity our prior cases have

required ... The ALJ must do more than offer his own conclusions. He must set forth his own

interpretations and explain why they, rather than the doctors’, are correct.”). Furthermore,

it is error to discount the severity of a claimant’s symptoms based on lack of objective

medical evidence alone. See Lester, 81 F.3d at 834 (“Once the claimant produces medical

evidence of an underlying impairment, the Commissioner may not discredit the claimant’s

testimony as to subjective symptoms merely because they are unsupported by objective

evidence.”).

In sum, the Court finds that in rejecting Plaintiff’s subjective complaints the ALJ

failed to support his decision to discredit Plaintiff’s allegations with specific, clear and

convincing reasons and, therefore, the Court finds error. The Ninth Circuit has held that

evidence should be credited as true, and an action remanded for an award of benefits, where

(1) the ALJ has failed to provide legally sufficient reasons for rejecting evidence, (2) no

outstanding issues remain that must be resolved before a determination of disability can be

made, and (3) it is clear from the record that the ALJ would be required to find the claimant

disabled were the rejected evidence credited as true. See, e.g., Varney v. Sec’y of HHS, 859

F.2d 1396, 1400 (9th Cir. 1988); Benecke v. Barnhart, 379 F.3d 587, 593 (9th Cir. 2004); Orn,

495 F.3d 625, 640 (9th Cir. 2007). The Court has considered Plaintiff’s testimony coupled

with the testimony of the vocational expert in this matter. After applying the credit-as-true

rule to the improperly discredited evidence, no outstanding issue remains to be resolved

before determining that Plaintiff is entitled to benefits. Because it is clear that the ALJ would

be required to find Plaintiff disabled, see Benecke, 379 F.3d at 593-95, the Court will remand

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the case for an award of benefits. See Orn, 495 F.3d at 640 (remanding for an award of

benefits where it was “‘clear from the record that the ALJ would be required to determine

the claimant disabled’”) (citation omitted). Given this ruling, the Court declines to reach

Plaintiff’s remaining arguments.

V. CONCLUSION

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

and this matter will be remanded for an award of benefits.

Accordingly,

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

is REMANDED to the Commissioner for an award of benefits as set forth in this Order;

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

accordingly. The judgment will serve as the mandate of this Court.

DATED this 1st day of February, 2016.

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