Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_18-cv-02750/USCOURTS-caed-2_18-cv-02750-4/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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UNITED STATES DISTRICT COURT 

FOR THE EASTERN DISTRICT OF CALIFORNIA 

SILEY RIVERA DE WILLIAMS, 

Plaintiff, 

v. 

ANDREW SAUL, Commissioner of Social 

Security, 

Defendant. 

No. 2:18-cv-2750-EFB 

ORDER 

Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 

(“Commissioner”) denying her application for Supplemental Security Income (“SSI”) under Title 

XVI of the Social Security Act. The parties have filed cross-motions for summary judgment. 

ECF Nos. 12 & 19. For the reasons discussed below, plaintiff’s motion is granted, the 

Commissioner’s motion is denied, and the matter is remanded for further proceedings. 

I. Background 

Plaintiff filed an application for SSI, alleging that she had been disabled since January 1, 

2010. Administrative Record (“AR”) at 188-93. Plaintiff’s application was denied initially and 

upon reconsideration. Id. at 114-18, 124-30. A hearing was subsequently held before 

Administrative Law Judge (“ALJ”) Christopher Knowdell. Id. at 55-84. 

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On October 18, 2017, the ALJ issued a decision finding that plaintiff was not disabled 

under section 1614(a)(3)(A) of the Act.1 Id. at 16-27. The ALJ made the following specific 

findings: 

1. The claimant has not engaged in substantial gainful activity since February 17, 2015, the 

application date (20 CFR 416.971 et seq.). 

2. The claimant has the following severe impairments: lumbar spine degenerative disc 

disease; anxiety disorder; and cognitive disorder (20 CFR 416.920(c)). 

* * * 

3. The claimant does not have an impairment or combination of impairments that meets or 

medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart 

1

 Disability Insurance Benefits are paid to disabled persons who have contributed to the 

Social Security program, 42 U.S.C. §§ 401 et seq. Supplemental Security Income (“SSI”) is paid 

to disabled persons with low income. 42 U.S.C. §§ 1382 et seq. Under both provisions, 

disability is defined, in part, as an “inability to engage in any substantial gainful activity” due to 

“a medically determinable physical or mental impairment.” 42 U.S.C. §§ 423(d)(1)(a) & 

1382c(a)(3)(A). A five-step sequential evaluation governs eligibility for benefits. See 20 C.F.R. 

§§ 423(d)(1)(a), 416.920 & 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987). The 

following summarizes the sequential evaluation: 

Step one: Is the claimant engaging in substantial gainful 

activity? If so, the claimant is found not disabled. If not, proceed 

to step two. 

Step two: Does the claimant have a “severe” impairment? 

If so, proceed to step three. If not, then a finding of not disabled is 

appropriate. 

Step three: Does the claimant’s impairment or combination 

of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 

404, Subpt. P, App.1? If so, the claimant is automatically 

determined disabled. If not, proceed to step four. 

Step four: Is the claimant capable of performing his past 

work? If so, the claimant is not disabled. If not, proceed to step 

five. 

Step five: Does the claimant have the residual functional 

capacity to perform any other work? If so, the claimant is not 

disabled. If not, the claimant is disabled. 

Lester v. Chater, 81 F.3d 821, 828 n.5 (9th Cir. 1995). 

 

The claimant bears the burden of proof in the first four steps of the sequential evaluation 

process. Yuckert, 482 U.S. at 146 n.5. The Commissioner bears the burden if the sequential 

evaluation process proceeds to step five. Id.

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P, Appendix 1 (20 CFR 416.920(d), 416.925 and 416.926). 

* * * 

4. After careful consideration of the entire record, the undersigned finds that the claimant has 

the residual functional capacity to perform light work as defined in 20 CFR 416.967(b) 

except: can perform postural activities on an occasional basis; capable of simple and 

detailed tasks but not complex tasks. 

* * * 

5. The claimant is capable of performing past relevant work as a Title Clerk. This work does 

not require the performance of work-related activities precluded by the claimant’s residual 

functional capacity (20 CFR 416.965). 

* * * 

6. The claimant has not been under a disability, as defined by the Social Security Act, since 

February 17, 2015, the date the application was filed (20 CFR 416.920(f)). 

Id. at 18-26. 

Plaintiff’s request for Appeals Council’s review was denied on December 14, 2017, 

leaving the ALJ’s decision as the final decision of the Commissioner. Id. at 1-6. 

II. Legal Standards 

The Commissioner’s decision that a claimant is not disabled will be upheld if the findings 

of fact are supported by substantial evidence in the record and the proper legal standards were 

applied. Schneider v. Comm’r of the Soc. Sec. Admin., 223 F.3d 968, 973 (9th Cir. 2000); 

Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Tackett v. Apfel, 

180 F.3d 1094, 1097 (9th Cir. 1999). 

 The findings of the Commissioner as to any fact, if supported by substantial evidence, are 

conclusive. See Miller v. Heckler, 770 F.2d 845, 847 (9th Cir. 1985). Substantial evidence is 

more than a mere scintilla, but less than a preponderance. Saelee v. Chater, 94 F.3d 520, 521 (9th 

Cir. 1996). “‘It means such evidence as a reasonable mind might accept as adequate to support a 

conclusion.’” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. 

N.L.R.B., 305 U.S. 197, 229 (1938)). 

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 “The ALJ is responsible for determining credibility, resolving conflicts in medical 

testimony, and resolving ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 

2001) (citations omitted). “Where 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). 

III. Analysis 

 Plaintiff raises two principal arguments. First, she argues that the ALJ’s finding that she 

can perform light work is not based on substantial evidence. Second, she argues that the ALJ 

erred in finding that she was able to perform simple and detailed tasks. As discussed below, 

remand is warranted based on the first argument. Accordingly, the court declines to reach 

plaintiff’s remaining argument. 

 In between the third and fourth steps of the sequential evaluation, the ALJ must assess the 

claimant’s residual functional capacity (“RFC”). 20 C.F.R. § 416.920(a)(4). The RFC is the 

most the claimant can do despite her physical and mental limitations. 20 C.F.R. § 416.945(a)(1). 

In assessing a claimant’s RFC, the ALJ is required to consider all relevant evidence, including 

plaintiff’s testimony and opinions from medical sources. Carmickle v. Comm’r Soc. Sec. Admin., 

533 F.3d 1155, 1164 (9th Cir. 2008); Robbins v. Soc. Sec. Admin., 466 F.3d 880, 883 (9th Cir. 

2006) (“In determining a claimant’s RFC, an ALJ must consider all relevant evidence in the 

record, including, inter alia, medical records, lay evidence, and the effects of symptoms, 

including pain, that are reasonably attributed to a medically determinable impairment.”) (internal 

quotations omitted). The ALJ, and not a physician, is responsible for determining a claimant’s 

RFC. Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 2001). Here, as discussed below, three 

different physicians rendered opinions as to the plaintiff’s RFC, but it appears that the ALJ 

reviewed a subsequent MRI and arrived at his own medical opinion on the matter. 

 In May 2015, plaintiff underwent a comprehensive internal medicine evaluation, which 

was performed by Dr. Jonathan Schwartz. AR 671-74. Based on an examination, Dr. Schwartz 

opined that plaintiff could perform medium work with frequent, but not constant, stooping and 

crouching. Id. at 674. In the following months two non-examining physicians, Dr. Amon and Dr. 

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Acinas, reviewed plaintiff’s medical records, including Dr. Schwartz’s report. Id. at 94-95, 110-

11. Based on their review, both physicians opined that plaintiff could perform medium work with 

only occasional postural activities. Id. 

 In assessing plaintiff’s RFC, the ALJ afforded some, but not full, weight to the opinions of 

Dr. Schwartz, Dr. Acinas, and Dr. Amon. Id. at 23. All three rendered their opinions in 2015. 

For that reasons, the ALJ noted, none of these physicians were able to review the results of a 

2017 MRI “when determining the claimant’s residual functional capacity.” Id. That MRI 

showed a left paracentral disc herniation at L4-5, which was displacing and compressing the left 

L5 nerve. Id. at 824. In light of this new medical evidence, the ALJ concluded that “the opinions 

of these three physicians is [sic] only partially consistent with the full medical evidence of 

record.”2 Id. at 23. 

Ultimately, the ALJ concluded that plaintiff had the RFC to perform light work with 

occasional postural activities. But the ALJ’s decision does not identify the specific evidence that 

supported that determination. For instance, the ALJ did not specifically find that plaintiff’s daily 

activities demonstrate an ability to perform light work on a sustained basis. The only logical 

inference is that the ALJ concluded that the 2017 MRI reflected that plaintiff was more limited in 

2017 than she was at the time Dr. Schwartz, Dr. Acinas, and Dr. Amon provided their opinions. 

Thus, it appears the ALJ limited plaintiff to light, rather than medium, work based on the 2017 

MRI results. 

There was nothing inappropriate in noting that the 2017 MRI might alter medical opinions 

that were not informed by the MRI. But the ALJ went beyond that. His approach was to use the 

2017 MRI to find that the plaintiff’s RFC is more limited than the opinions expressed by the three 

physicians in 2017, but not so limited as to preclude light work, and on that basis, find plaintiff 

not disabled. The problem with that approach is that the ALJ is not a medical expert and is 

2

 The record also contains a June 2017 opinion from plaintiff’s treating physician, Dr. 

Hopkins, who opined that plaintiff was not able to work due back and neck pain. AR 858. Dr. 

Hopkins further stated that he expected resolution of plaintiff’s back and neck problems by 

November 2017 Id. The ALJ rejected this opinion because it lacked a description of plaintiff’s 

specific functional limitations and failed to establish a disability expected to last more than 12 

months. Plaintiff has not challenged the ALJ’s rejection of this opinion. 

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“simply not qualified to interpret raw medical data in functional terms . . . . ” Nguyen v. Chater, 

172 F.3d 31, 35 (1st Cir. 1999); see Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975) 

(ALJ should not make his “own exploration and assessment as to claimant’s physical 

condition.”); Rohan v. Chater, 98 F.3d 966, 970 (7th Cir. 1996) (“ALJs must not succumb to the 

temptation to play doctor and make their own independent medical findings.”); cf. Tawnya T. v. 

Saul, 2019 WL 4422680, at *2 (C.D. Cal. July 9, 2019) (“It appears that, having rejected all the 

medical opinions, the ALJ formulated his own opinion as to the impact of Plaintiff’s medical 

condition on her ability to function. Although an ALJ need not adopt the RFC opined by any 

particular physician, he must base his finding on some competent evidence. Here, the ALJ 

impermissibly substituted his own opinion for that of the physicians.”) (citation omitted). The 

harm here is that record is not supported by a competent medical opinion as to the plaintiff’s RFC 

in light of the 2017 MRI. The ALJ was not permitted to formulate his opinion as to how 

plaintiff’s herniated disc and compressed nerve impacted her ability to function. Instead, he was 

required to retain a medical expert to evaluate the MRI results. 

Furthermore, the court cannot find that the ALJ’s error was harmless. See Lockwood v. 

Comm’r Soc. Sec., 616 F.3d 1068, 1071 (9th Cir. 2010) (“[E]ven if the ALJ erred, we will uphold 

the decision so long as the error was harmless.”). The ALJ’s decision does not identify any 

evidence in the record showing that plaintiff remained able to perform light work despite her 

herniated disc and compressed nerve. For example, the ALJ did not find that plaintiff’s daily 

activities demonstrated an ability to perform light work. Instead, the ALJ concluded that the 2017 

MRI reflected a worsening in plaintiff’s functional abilities, but that plaintiff still maintained the 

ability to perform light work. The ALJ, however, failed to identify any evidence in the record 

supporting that conclusion. Accordingly, the court cannot find that the ALJ’s RFC determination 

is supported by substantial evidence. 

 Accordingly, the matter must be remanded for proper consideration of the medical 

evidence. Dominguez v. Colvin, 808 F.3d 403, 407 (9th Cir. 2015) (“A district court may reverse 

the decision of the Commissioner of Social Security, with or without remanding the cause for a 

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rehearing, but the proper course, except in rare circumstances, is to remand to the agency for 

additional investigation or explanation.”) (internal quotes and citations omitted). 

IV. Conclusion 

 Accordingly, it is hereby ORDERED that: 

 1. Plaintiff’s motion for summary judgment is granted; 

 2. The Commissioner’s cross-motion for summary judgment is denied; 

 3. The matter is remanded for further proceedings consistent with this order; and 

 4. The Clerk is directed to enter judgment in plaintiff’s favor and close the case. 

DATED: April 7, 2020. 

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