Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_18-cv-00389/USCOURTS-cand-3_18-cv-00389-3/pdf.json

Parties Involved:
Nancy A. Berryhill
Defendant
Michael Kroeger
Plaintiff

Document Text:

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

United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

MICHAEL KROEGER,

Plaintiff,

v.

ANDREW SAUL,

1

Defendant.

Case No. 18-cv-00389-SI 

ORDER RE: CROSS-MOTIONS FOR 

SUMMARY JUDGMENT

Re: Dkt. Nos. 24, 27

This case is now before the Court for a second time, after having been remanded to the Social 

Security Administration (“SSA”) in May 2015. Plaintiff Michael Kroeger now seeks review of the 

January 2017 decision the administrative law judge (“ALJ”) issued after remand, in which the ALJ 

denied disability insurance benefits (“DIB”). In his motion for summary judgment, plaintiff asks 

the Court to reverse the denial of DIB and award him benefits or, in the alternative, to remand the 

case for further proceedings. Dkt. No. 24. The Commissioner of Social Security has filed a crossmotion to affirm the denial of DIB. Dkt. No. 27. 

Having considered the parties’ papers and the administrative record, the Court hereby 

GRANTS plaintiff’s motion for summary judgment and DENIES defendant’s cross-motion for 

summary judgment. The matter is REMANDED for immediate payment of benefits.

BACKGROUND

I. Procedural Background

In January of 2010, plaintiff filed an application for DIB under Title II of the Social Security 

 

1 Andrew Saul, Commissioner of Social Security, is substituted for his predecessor, Nancy 

A. Berryhill, pursuant to Federal Rule of Civil Procedure 25(d).

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 1 of 34
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

United States District Court

Northern District of California

Act. Administrative Record (“AR”) at 14, 1619. In July 2010, plaintiff filed an application for 

supplemental security income (“SSI”) under Title XVI of the Social Security Act. Id. at 14. The 

applications were denied initially and on reconsideration. Id. at 40, 45. Plaintiff requested a hearing, 

which ALJ Phillip C. Lyman conducted on May 25, 2012. Id. at 1323. At the hearing, plaintiff, 

who was represented by counsel, argued for a disability onset date of June 29, 2011.2 Id. at 14. At 

the time, plaintiff’s counsel believed that his Date Last Insured was March 31, 1998, and that a claim 

for DIB would be futile, although the ALJ informed plaintiff at the hearing that the correct Date 

Last Insured was December 31, 2010.

3

 See id. at 30, 1333. Counsel thus waived plaintiff’s claim 

to Title II benefits (DIB). Id. at 1334. After the hearing, plaintiff’s counsel realized the error in the 

calculation of the Date Last Insured and sought to rescind plaintiff’s waiver of his claim to DIB; 

plaintiff then amended the alleged onset date to December 31, 2010, in order to pursue his DIB 

claim. Id. at 14, 30. 

On June 14, 2012, the ALJ issued a decision. The ALJ’s decision acknowledged that 

plaintiff amended the alleged onset date to December 31, 2010. Id. at 14. The ALJ granted

plaintiff’s SSI application, finding he had been disabled since June 29, 2011. Id. at 26. However, 

the ALJ denied the DIB application based on a finding that plaintiff was not disabled prior to or on 

December 31, 2010, the last date he was insured. Id. The Appeals Council denied review, id. at 4, 

and plaintiff filed an appeal in the district court that was assigned to the undersigned Judge. See

Kroeger v. Colvin, No. 13-cv-05254-SI (filed Nov. 12, 2013). In the appeal, plaintiff argued that 

he was disabled on December 31, 2010, the last date he was insured, thereby making him eligible 

for DIB.

On May 19, 2015, this Court issued a decision reversing and remanding the case for further 

 

2 Throughout these proceedings, plaintiff has been represented by several different certified 

law students, under the supervision of the same attorney.

3 To qualify for DIB (Title II benefits), a claimant must be “fully insured,” as defined at 42 

U.S.C. § 414(a), and have sufficient quarters of coverage. See 42 U.S.C. § 423; 20 C.F.R. 

§ 404.130(b). The claimant has the burden of proof to demonstrate that he or she was disabled prior 

to the date on which his disability insured status expired, referred to here as the “Date Last Insured.” 

See Armstrong v. Comm’r of Soc. Sec. Admin., 160 F.3d 587, 589 (9th Cir. 1998) (citing 42 U.S.C. 

§ 423(c)).

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 2 of 34
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

United States District Court

Northern District of California

proceedings. Kroeger v. Colvin, No. 13-cv-05254-SI, Dkt. No. 23 (“Prior Order”). The Court 

ordered that on remand: 

The ALJ should determine the severity of plaintiff’s symptoms on December 31, 

2010, without attempting to separate out the symptoms related to plaintiff’s 

substance use. If the ALJ finds that plaintiff’s symptoms are severe enough to be 

disabling after completing the five-step disability [inquiry], then the ALJ should 

assess the materiality of plaintiff’s substance use on December 31, 2010. If the ALJ 

finds that plaintiff’s substance use was material to a finding of disability on 

December 31, 2010, then plaintiff was not disabled as of December 31, 2010, the last 

date insured, and does not qualify for DIB. If the ALJ determines that plaintiff’s 

mental impairments as of December 31, 2010 would remain disabling if plaintiff 

stopped his substance use, then plaintiff will be found to have been disabled on 

December 31, 2010, thereby qualifying for DIB.

Id. at 20. The Court further explained that, in determining whether plaintiff’s substance use was 

material to a finding of disability on December 31, 2010:

[t]he ALJ should evaluate the opinions of Dr. Bilik and Dr. Anderson in light of 

plaintiff’s ongoing disabling mental impairments despite maintaining sobriety on 

June 29, 2011. The ALJ should also evaluate the plaintiff’s treatment records 

between December 2010 and June 29, 2011, including the medical records during 

plaintiff’s inpatient stay at the VA from January to February 2011 and treatment 

records from plaintiff’s clinical social worker Omar Geray, to determine whether 

plaintiff’s mental impairments would have remained in the absence of his substance 

use. As the “materiality” determination is critical to whether December 31, 2010 

was the onset date, if the record seems ambiguous as to whether plaintiff’s substance 

use was material to a finding of disability on December 31, 2010, then the ALJ should 

consult a medical expert to make the determination. 

Id. at 19. The Court did not disturb that portion of the ALJ’s decision finding plaintiff entitled to 

SSI benefits.

The Appeals Council vacated the prior decision of the ALJ and remanded the case to the 

ALJ. AR at 1524. On remand, plaintiff amended his alleged disability onset date to January 7, 

2010. Id. at 1356. On October 17, 2016, ALJ Lyman held a new administrative hearing that lasted 

three hours. Plaintiff appeared and testified, as did plaintiff’s wife, Mary Kroeger. Richard Cohen, 

MD, testified as an impartial medical expert, and Ronald Morrell testified as an impartial vocational 

expert. Id. 

On January 19, 2017, the ALJ issued a partially favorable decision, again finding that 

plaintiff was disabled beginning on June 29, 2011, and was therefore eligible for SSI, which is not 

dependent on a claimant’s insured status, but was ineligible for DIB, which requires a claimant to 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 3 of 34
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

United States District Court

Northern District of California

have been disabled on or before the Date Last Insured. See id. at 3057-58.

4

 After the timeframe 

had passed within which to submit exceptions to the ALJ’s decision, plaintiff, through his counsel, 

offered exceptions to the Appeals Council. Id. at 1343. On May 25, 2017, the Appeals Council 

notified plaintiff of the untimeliness of the submission and requested plaintiff provide evidence that 

he had timely submitted the exceptions. Id. After plaintiff did not respond, on November 13, 2017, 

the ALJ’s decision became the final decision of the Commissioner after remand. Id.

On January 17, 2018, plaintiff filed this action for judicial review pursuant to 42 U.S.C. 

§ 405(g). Dkt. No.1. Plaintiff moved for summary judgment, and defendant opposed and crossmoved for summary judgment. Dkt. Nos. 24 (“Pl.’s Mot.”), 27 (“Def.’s Cross-Mot.”). Plaintiff also 

filed a reply brief. Dkt. No. 28 (“Pl.’s Reply”).

II. Medical History

At the time of the most recent administrative hearing on October 17, 2016, plaintiff was a 

fifty-five-year-old veteran with a long history of bipolar disorder, mood disorder, episodic anxiety, 

depression, and substance abuse.5See AR at 14, 142, 2888. After dropping out of high school, 

plaintiff enlisted in the Navy and served in aviation maintenance. Id. at 142. Plaintiff left the service 

in 1985 and worked as a carpenter. Id. During the early 1990s, plaintiff’s mental health declined, 

and at some point plaintiff began self-medicating with drugs. Id. Due to his worsening psychiatric 

symptoms, plaintiff was unable to work in 1994 and has not worked since. Id. Plaintiff has also 

suffered from various physical ailments such as foot deformities, a broken leg in April 2010, 

diagnosis of Hepatitis C in 2010, and prostate cancer in 2011, but he does not make these the focus 

of his appeal. See id. at 143-44, 274, 367, 926, 1258. Plaintiff previously received SSI, but on a 

continuing disability review, the SSA terminated his benefits after finding that he was no longer 

 

4 The administrative record that the SSA originally filed in this case was missing the final 

page of the ALJ’s January 19, 2017 decision. The SSA later provided this page in a supplemental 

transcript at the request of the Court. See Dkt. Nos. 32, 36.

5 Plaintiff was forty-eight years of age at the time of his alleged onset date of disability, 

January 7, 2010, and was forty-nine at the time of his Date Last Insured, December 31, 2010. See

AR at 2888-90. 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 4 of 34
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

United States District Court

Northern District of California

disabled as of August 2007. Id. at 68. 

In 2008 and 2009, plaintiff was treated at Kaiser Permanente for his bipolar and mood 

disorders and for his substance dependency. Id. at 152-201. On January 7, 2010, plaintiff was 

voluntarily hospitalized through the Veterans’ Administration (“VA”) medical system and treated 

for bipolar disorder, depression, anxiety, suicidal ideation, opioid dependence, and amphetamine 

abuse. Id. at 433-481. After being discharged on January 26, 2010, plaintiff sought outpatient 

treatment for his mental health symptoms and substance dependency. Id. at 419. Throughout March 

and April of 2010, plaintiff received therapy and medication for his depression and anxiety (id. at 

368, 371, 376, 378, 381, 387), and plaintiff was also admitted to the VA emergency room in between 

psychiatric appointments due to his increasing anxiety (id. at 364, 366, 385).

Sometime in mid-2010, plaintiff relapsed into methamphetamine and opiate use and was not 

treated at the VA for several months. Id. at 361-64. On November 5, 2010, plaintiff was seen at 

the VA by psychiatrist Dr. Rukhsana Khan, MD, and was assessed with having “[p]olysubstance 

abuse and dependence [and] [m]ood disorder secondary to active substance abuse.” Id. at 362-63. 

On the same day, plaintiff began seeing a mental health clinical social worker Omar Geray, LCSW,

and expressed interest in the VA’s detoxification and rehabilitation programs. Id. at 360-61. On 

December 20, 2010, while waiting for an opening in one of the VA’s residential treatment programs, 

plaintiff was seen by psychiatrist Dr. Vanessa de la Cruz, MD, and was diagnosed with amphetamine 

abuse, opioid dependence, mood disorder, and substance-induced bipolar with rapid cycling. Id. at 

356-58. December 31, 2010, was the last date plaintiff was insured. Id. at 99. 

On January 5, 2011, plaintiff was admitted into the VA’s Foundations of Recovery addiction 

treatment program. Id. at 343. His psychiatric intake evaluation lists multiple mood disorder 

symptoms, including suicidal ideation and depressive episodes. Id. at 313-14, 1129-39. During his 

hospitalization, plaintiff was treated for substance dependency, bipolar disorder, mood disorder, 

depression, and suicidal ideation. Id. at 1028-29, 1035-36, 1041-42, 1080, 1130. Upon his 

discharge on February 4, 2011, plaintiff was placed on the waitlist for the long-term inpatient 

Homeless Veterans Rehabilitation Program (“HVRP”). Id. at 1080. While waiting for an opening 

at HVRP, plaintiff continued to receive outpatient treatment through the VA for his substance 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 5 of 34
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

United States District Court

Northern District of California

dependency and his ongoing mental health symptoms, and plaintiff was prescribed Effexor for his 

depression. Id. at 1010-12. 

On June 29, 2011, plaintiff entered the VA’s First Step Program for relapse prevention 

training, and on September 1, 2011, plaintiff was discharged and directly transferred to HVRP. Id. 

at 673, 721. During his time as an inpatient at First Step Program and HVRP, plaintiff abstained 

from all substances, received training for relapse prevention and life skills, and was treated for his 

mental health symptoms. Id. at 673, 722, 989-90, 992. Plaintiff was discharged on March 15, 2012, 

and received outpatient care throughout 2012. Id. at 760, 736-58. 

III. Medical Evidence

In addition to reviewing treatment records, the ALJ considered the opinions of various nontreating mental health professionals. These include: (1) Dr. Scaramozzino, a consultative

psychologist who examined plaintiff on September 4, 2010; (2) Dr. Bilik, a non-examining 

consultative psychologist who reviewed plaintiff’s records and submitted a report on October 6, 

2010; (3) Dr. Anderson, a non-examining psychiatrist who testified at plaintiff’s first hearing on 

May 25, 2012; and (4) Dr. Cohen, a non-examining psychiatrist who testified at plaintiff’s second 

hearing on October 17, 2016.

A. Dr. Scaramozzino, PhD

On September 4, 2010, examining psychologist Dr. James Scaramozzino, PhD, conducted a 

consultative psychiatric evaluation on behalf of the SSA. Id. at 202. Dr. Scaramozzino examined 

plaintiff and reviewed plaintiff’s medical records from his treatment at Kaiser Permanente in 2008. 

Id. Dr. Scaramozzino noted that the severity of plaintiff’s psychiatric symptoms was in the 

“moderate to severe range as regards to his ongoing use of illicit drugs” and indicated that the 

likelihood of the claimant’s mental condition improving in the next 12 months was “poor.” Id. at 

207. He also stated that “[t]he diagnosis of bipolar did not seem to be appropriate” and that “there 

does not appear to be any sustainable period of time where a more clear diagnosis could be made 

because of the ongoing consistent use of illicit drugs.” Id. 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 6 of 34
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

United States District Court

Northern District of California

He diagnosed plaintiff with amphetamine dependence and opined that, due to ongoing 

substance use, plaintiff had moderate to marked impairments in the following work-related 

functioning: ability to accept instructions from a supervisor and respond appropriately, ability to 

complete a normal workday and workweek without interruptions at a consistent pace, and ability to 

deal with various changes in the work setting. Id. at 207-08. He also opined that, due to ongoing 

substance use, plaintiff had moderate impairment in his ability to understand and remember very 

short and simple instructions, ability to maintain concentration and attention, and ability to interact 

with co-workers. Id. He stated that plaintiff would have a fair to high likelihood of emotionally 

deteriorating in a work environment. Id.

B. Dr. Bilik, PsyD

On October 6, 2010, non-examining SSA consultative psychologist Dr. Harvey Bilik, PsyD,

reviewed plaintiff’s records from Kaiser Permanente for 2008 and 2009, records from the VA

hospital,6and the consultative examination conducted by Dr. Scaramozzino. Id. at 209, 222. Dr. 

Bilik interviewed plaintiff mainly over the phone but did not examine plaintiff.7 Id. On the basis 

of his review, Dr. Bilik noted the following medically determinable impairments: mood disorder not 

otherwise specified8and amphetamine abuse/dependence. Id. at 215, 218. He opined that plaintiff 

had mild limitations in activities of daily living and moderate limitations in maintaining social 

functioning and in maintaining concentration, persistence, or pace. Id. at 220. He also noted 

 

6 While Dr. Bilik indicates that he reviewed records from the VA hospital (AR at 209), the 

“Consultant’s Notes” only mention the treatment records from Kaiser and Dr. Scaramozzino’s 

consultative examination (see id. at 222).

7 Dr. Bilik’s notes indicate that plaintiff “came into the office to sign the SSA-827. He was 

casually dressed and fairly pleasant.” AR at 209. The notes do not indicate that any in-person 

examination took place. 

8 The exact diagnosis was identified as “MOOD ORDER NOS; r/o BIOPOLAR 

DISORDER,” which translates to “mood disorder not otherwise specified; rule out bipolar 

disorder.” See AR at 215.

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 7 of 34
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

United States District Court

Northern District of California

moderate limitations in workplace functioning in areas related to sustained concentration and 

persistence, social interaction, and adaptation. Id. at 223-24. Then, he determined that plaintiff only 

had moderate functional limitations in any domain, including limitations related to substance use, 

and that if plaintiff manifested any ongoing marked functional limitations, then “[plaintiff’s 

substance use] would likely be seen as a primary factor.” Id. at 225. 

C. Dr. Anderson, MD

Dr. David Anderson, MD, a non-examining psychiatrist, reviewed plaintiff’s records and

testified as the medical expert at plaintiff’s hearing on May 25, 2012. Id. at 1328, 1332, 1335. 

Because at the time of the hearing plaintiff was alleging a disability onset date of June 29, 2011, Dr. 

Anderson was only asked to consider plaintiff’s condition as of that date. Id. at 1335-38. Dr. 

Anderson testified that beginning on June 29, 2011, the day that plaintiff entered long-term 

treatment at the VA, plaintiff suffered ongoing mental health symptoms despite maintaining 

sustained sobriety. Based on this fact, Dr. Anderson opined that there was “compelling evidence” 

that plaintiff’s underlying mental conditions, independent of plaintiff’s substance use, met or 

equaled one of the listings of severe impairments (listings 12.02 and 12.04) beginning on June 29, 

2011. Id. at 1336-37. However, he testified that “from 2008 through 2010, it was clear . . . that 

[plaintiff’s] methamphetamine use was highly material” and that plaintiff’s mental conditions were 

not disabling independent of plaintiff’s substance use. Id. at 1337. 

D. Dr. Cohen, MD

Dr. Richard W. Cohen, MD, was a non-examining psychiatrist who testified as an impartial 

medical expert at plaintiff’s second administrative hearing, held on October 17, 2016. The ALJ 

presented Dr. Cohen with four different hypotheticals, and Dr. Cohen opined that under each one 

the hypotheticals, claimant would have restrictions ranging from mild to moderate for the “B” 

criteria of Listing 12.09 (substance addiction disorder).9 Id. at 2895-2907. Dr. Cohen also opined 

 

9 Effective January 17, 2017, the Social Security Administration removed listing 12.09 

“because we cannot use listing 12.09 alone to meet our definition of disability.” Revised Medical 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 8 of 34
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

United States District Court

Northern District of California

about whether the claimant’s drug use was present and material under each hypothetical and whether 

the claimant could perform simple, detailed, or complex work. See id.

LEGAL STANDARD

I. Standard of Review

The Social Security Act authorizes judicial review of final decisions made by the 

Commissioner. 42 U.S.C. § 405(g). A court’s review of a disability determination is limited, and 

a final administrative decision may be altered “only if it is based on legal error or if the fact findings 

are not supported by substantial evidence.” Sprague v. Bowen, 812 F.2d 1226, 1229 (9th Cir. 1987). 

Substantial evidence is the relevant evidence in the entire record “which a reasonable person might 

accept as adequate to support a conclusion.” Vertigan v. Halter, 260 F.3d 1044, 1049 (9th Cir. 

2001). Substantial evidence consists of “more than a mere scintilla but less than a preponderance.” 

Young v. Sullivan, 911 F.2d 181, 183 (9th Cir. 1990). Courts “must consider the entire record as a 

whole, weighing both the evidence that supports and the evidence that detracts from the 

Commissioner’s conclusion, and may not affirm simply by isolating a specific quantum of 

supporting evidence.” Garrison v. Colvin, 759 F.3d 995, 1009 (9th Cir. 2014) (quoting Lingenfelter 

v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007)). “Where evidence is susceptible to more than one 

rational interpretation,” the ALJ’s decision should be upheld. Burch v. Barnhart, 400 F.3d 676, 679 

(9th Cir. 2005). The substantial evidence standard is a deferential standard of review. See Biestek 

v. Berryhill, 139 S. Ct. 1148, 1154 (2019).

A district court may enter a judgment affirming, modifying, or reversing the decision of the 

Commissioner, with or without remanding the cause for a rehearing. 42 U.S.C. § 405(g). If 

additional proceedings can remedy defects in the original administrative proceedings, a Social 

Security case should be remanded. See Lewin v. Schweiker, 654 F.2d 631, 635 (9th Cir. 1981). A 

decision of the ALJ will not be reversed for errors that are harmless. Burch, 400 F.3d at 679 (citing 

Curry v. Sullivan, 925 F.2d 1127, 1131 (9th Cir. 1991)). 

 

Criteria for Evaluating Mental Disorders, 81 Fed. Reg. 66138, 66152 (Sept. 26, 2016).

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 9 of 34
10

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

United States District Court

Northern District of California

II. The Five-Step Disability Inquiry

A claimant is “disabled” under the Social Security Act if: (1) the claimant “is unable 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 twelve months,” and (2) the impairment is “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. § 1382c(a)(3)(A)-(B). The SSA regulations provide a five-step 

sequential evaluation process for determining whether a claimant is disabled. 20 C.F.R. 

§ 416.920(a)(4). The claimant has the burden of proof for steps one through four and the 

Commissioner has the burden of proof for step five. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 

1999). 

The five steps of the inquiry are:

1. Is claimant presently working in a substantially gainful activity? If 

so, then the claimant is not disabled within the meaning of the Social 

Security Act. If not, proceed to step two. See 20 C.F.R. 

§§ 404.1520(b), 416.920(b). 

2. Is the claimant’s impairment severe? If so, proceed to step three. 

If not, then the claimant is not disabled. See 20 C.F.R. 

§§ 404.1520(c), 416.920(c). 

3. Does the impairment “meet or equal” one of a list of specific 

impairments described in 20 C.F.R. Part 220, Appendix 1? If so, then 

the claimant is disabled. If not, proceed to step four. See 20 C.F.R. 

§§ 404.1520(d), 416.920(d). 

4. Is the claimant able to do any work that he or she has done in the 

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

five. See 20 C.F.R. §§ 404.1520(e), 416.920(e). 

5. Is the claimant able to do any other work? If so, then the claimant 

is not disabled. If not, then the claimant is disabled. See 20 C.F.R. 

§§ 404.1520(f), 416.920(f). 

Bustamante v. Massanari, 262 F.3d 949, 954 (9th Cir. 2001). The ALJ has an affirmative duty to 

assist the claimant in developing the record at every step of the inquiry. Tackett, 180 F.3d at 1098 

n.3. 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 10 of 34
11

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

United States District Court

Northern District of California

In between the third and fourth steps, the ALJ must determine the claimant’s Residual 

Functional Capacity (“RFC”). 20 C.F.R. §§ 404.1520(a)(4), (e), 416.945(a)(5)(1). To determine

the RFC, the ALJ considers the impact of the claimant’s symptoms on his or her ability to meet the 

physical, mental, sensory, and other requirements of work. Id. §§ 404.1545(a)(4), 416.945(e). The 

ALJ will evaluate all the claimant’s symptoms and the extent to which these symptoms are 

consistent with evidence in the record. Id. The evidence can include the claimant’s own statements 

about his or her symptoms, but such statements must be adequately supported by the record in order 

to establish a disability. Id. In order to determine whether the claimant’s statements are adequately 

supported, the ALJ must first determine whether the claimant has a medical impairment that could 

reasonably be expected to produce his or her symptoms, and then must evaluate the intensity and 

persistence of the claimant’s symptoms. Id. When evaluating intensity and persistence, the ALJ 

must consider all of the available evidence, including the claimant’s medical history, objective 

medical evidence, and statements about how the claimant’s symptoms affect him or her. Id. The 

ALJ cannot reject statements about the intensity and persistence of symptoms solely because no 

objective medical evidence substantiates the statements. Id. §§ 404.1529(c)(2), 416.929(c)(2). The 

ALJ must also consider factors relevant to the claimant’s symptoms, such as the claimant’s daily 

activities, the claimant’s medications and treatment, any other measures the claimant uses to 

alleviate symptoms, precipitating and aggravating factors, and any other factors relevant to the 

claimant’s limited capacity for work due to his or her symptoms. Id. § 416.929(c)(3)(i)-(vii). After 

determining the RFC, the ALJ proceeds to steps four and five of the disability inquiry.

III. Drug Addiction and Alcoholism

If, considering all of the claimant’s medically determinable impairments, there is a 

determination that the claimant is disabled, and there is medical evidence showing drug addiction 

and alcoholism (“DAA”), then the ALJ must determine whether the DAA is “material” to the finding 

that the claimant is disabled. 20 C.F.R. §§ 404.1535, 416.935. The Social Security Act provides 

that a claimant “shall not be considered to be disabled . . . if alcoholism or drug addiction would . . . 

be a contributing factor material to the . . . determination that the individual is disabled.” 42 U.S.C. 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 11 of 34
12

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

United States District Court

Northern District of California

§ 423(d)(2)(C). In determining whether a claimant’s DAA is material, the test is whether an 

individual would still be found disabled if he or she stopped using drugs or alcohol. See 20 C.F.R. 

§§ 404.1535(b), 416.935(b); Parra v. Astrue, 481 F.3d 742, 746-47 (9th Cir. 2007); Sousa v.

Callahan, 143 F.3d 1240, 1245 (9th Cir. 1998). The ALJ must “evaluate which of [the claimant’s] 

current physical and mental limitations . . . would remain if [the claimant] stopped using drugs or 

alcohol and then determine whether any or all of [the claimant’s] remaining limitations would be 

disabling.” 20 C.F.R. §§ 404.1535(b)(2), 416.935(b)(2). If the ALJ determines that the claimant’s 

remaining limitations are disabling, then the claimant’s DAA is not a material contributing factor to 

the determination of disability, and the claimant is disabled, independent of his or her DAA. See id.

§§ 404.1535(b)(2)(ii), 416.935(b)(2)(ii). The claimant bears the burden of proving that his 

substance use is not a material contributing factor to his disability. Parra, 481 F.3d at 745.

The Ninth Circuit has ruled that when a claimant has a history of drug or alcohol use, the 

ALJ must first determine the severity of the claimant’s symptoms without attempting to filter out 

which impairments are related to the claimant’s drug or alcohol use. Bustamante, 262 F.3d at 955. 

If the ALJ determines that the claimant’s impairments, including the impairments related to drug or 

alcohol use, are severe enough to be disabling, then the ALJ proceeds in assessing the materiality 

of the claimant’s DAA, i.e., whether the claimant would still be found disabled if he or she stopped 

using drugs or alcohol. Id. (interpreting 20 C.F.R. §§ 404.1535, 416.935); see also SSR 13-2p, 78 

Fed. Reg. 11939, 11941 (Feb. 20, 2013).10

ALJ’S DECISION

In the decision dated January 19, 2017, following the rehearing directed by this Court, the 

ALJ found that plaintiff’s Date Last Insured, or the last date of plaintiff’s insured status, was 

 

10 Social Security Rulings in the Federal Register are published by the Commissioner of 

Social Security and are binding on all components of the Social Security Administration, including 

ALJs, although they “do not carry the “‘force of law.’” 20 C.F.R. § 402.35(b)(1); Molina v. Astrue, 

674 F.3d 1104, 1113 n.5 (9th Cir. 2012) (quoting Bray v. Comm’r Soc. Sec. Admin., 554 F.3d 1219, 

1224 (9th Cir. 2009)).

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 12 of 34
13

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

United States District Court

Northern District of California

December 31, 2010. AR at 1359. The ALJ then applied the five-step disability inquiry described 

in 20 C.F.R. §§ 404.1520, 416.920. At step one, the ALJ found that plaintiff had not engaged in

substantial gainful activity since the amended alleged disability onset date of January 7, 2010. Id. 

at 1356, 1359. At step two, the ALJ found that since the alleged onset date of January 7, 2010,

plaintiff’s severe impairment was polysubstance use disorder. Id. at 1359. The ALJ found that 

beginning on June 29, 2011, plaintiff’s severe impairments were: “organic mental disorder with 

cognitive, emotional, and behavioral changes as a result of his acknowledged long-standing history 

of heavy substance abuse since age 8-10; and polysubstance use, in full sustained remission.” Id. 

The ALJ examined treatment records from February 2008 through June 29, 2011, and explained 

that:

[a]lthough impairments such as a depressive disorder, a mood disorder, and anxiety 

disorder, or a bipolar disorder are occasionally mentioned among the claimant’s 

diagnoses prior to the established onset date of June 29, 2011; the undersigned notes 

that these diagnoses were always based exclusively on the claimant’s subjectively 

reported history of long-standing anxiety, depression, and bipolar symptomatology, 

rather than as a result of clinical abnormalities during mental status examinations or 

longitudinal mental health treatment. . . . 

Although the claimant was occasionally provisionally diagnosed with mental 

impairment aside from polysubstance use, these diagnoses were provisional and 

based exclusively on the claimant’s subjective reported history of long-standing 

depression and bipolar symptomatology and his occasional description of his 

substance abuse as “self-medicating” these underlying impairments. Additionally, 

despite occasional mention of a possible anxiety disorder, mood disorder, or bipolar 

disorder by attending physicians and clinicians; subsequent treating and attending 

physicians repeatedly diagnosed the claimant only with a polysubstance use disorder 

and reported that the claimant’s acknowledged heavy substance abuse since age 8-

10 – and with virtually no significant periods of sobriety between the claimant’s 

childhood and the established onset date of June 29, 2011 – effectively preclude[ed]

solid diagnosis and render[ed] impossible effective evaluation of any potential 

underlying mental impairments.

Id. at 1359-60.

The ALJ gave substantial weight to the opinions of the non-examining medical experts who 

testified, Dr. Anderson and Dr. Cohen. Id. at 1366. In explaining his finding at step two, the ALJ 

explained that each testifying expert found, “(indirectly in the case of [Dr. Anderson] and 

specifically in the case of [Dr. Cohen])[,] that the claimant’s acknowledged long-standing heavy 

polysubstance abuse since age 8-10 with only one brief period of institutional sobriety in 2007 prior 

to the claimant’s sustained sobriety beginning June 29, 2011 and continuing, was claimant’s only 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 13 of 34
14

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

United States District Court

Northern District of California

established and documented medically determinable impairment.” Id. at 1365-66. 

At step three, the ALJ found that prior to June 29, 2011, plaintiff did not have an impairment 

or combination of impairments that met or medically equaled the severity of one of the listed 

impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. at 1367. The ALJ found that plaintiff 

had “mild restriction in activities of daily living, moderate difficulties in maintaining social 

functioning, moderate difficulties in maintaining concentration, persistence or pace, and one to two

episodes of decompensation, each of extended duration.” Id. The ALJ found that prior to June 29, 

2011, plaintiff “did not satisfy the paragraph ‘C’ criteria of the applicable mental disorder listing(s).” 

Id. at 1369.

Before proceeding to step four, the ALJ determined plaintiff’s residual functional capacity. 

The ALJ found that prior to June 29, 2011, plaintiff

had the residual functional capacity to perform a full range of work at all exertional 

levels but with the following nonexertional limitations: the claimant is precluded 

from climbing ladders, ropes, or scaffolds and from working around work hazards 

such as unprotected heights or dangerous moving machinery. The claimant must 

avoid frequent or concentrated exposure to respiratory irritants. The claimant would 

be incapable of performing detailed tasks during only less than 10% of an 8-hour 

workday; and would be incapable of interact[ing] appropriately with the public only 

less than 10% of an 8-hour workday. The claimant would be forced to miss less than 

one workday per month. . . .

Id. at 1369-70. 

In so finding, the ALJ determined that the testimony of plaintiff and of his wife regarding 

the severity of plaintiff’s symptoms were not fully credible because they were “not entirely 

consistent with the medical evidence and other evidence of record,” namely the “presence of 

acknowledged daily activities.” Id. at 1371. The ALJ gave the “greatest weight” to the opinion of 

Dr. Cohen, whom testified, according to the ALJ, “that in his medical opinion the objective medical 

evidence of record did not support the existence of any medically determinable mental impairment 

aside from the claimant’s acknowledged long-term and heavy polysubstance use at any time prior to 

the established onset date of June 29, 2011.” Id. at 1377-78. The ALJ gave “significant weight” to 

the opinions of state agency medical consultants Dr. Cox and Dr. Bilick. Id. at 1378. The ALJ gave 

“less weight” to the opinion of Dr. Anderson, who testified at the May 2012 administrative hearing, 

“because Dr. Anderson expressly testified only to the claimant’s functional level during the period 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 14 of 34
15

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

United States District Court

Northern District of California

beginning June 29, 2011 and continuing.”11 Id. The ALJ accorded “little weight” to the opinion of 

examining psychologist Dr. Scaramozzino regarding plaintiff’s functional level before June 29, 

2011, and accorded “no significant weight” to the opinion of plaintiff’s treating social worker Mr. 

Geray, for reasons discussed in greater detail below. See id. at 1379. The ALJ accorded “little 

weight” to the testimony and third-party statements of plaintiff’s wife. Id. 

Proceeding to step four, the ALJ found that plaintiff had no past relevant work. Id. at 1381. 

At step five, the ALJ found that, prior to June 29, 2011, considering plaintiff’s age, education, work 

experience, and RFC, jobs existed in significant numbers in the national economy that plaintiff could 

have performed. Id. These included jobs as custodian and dishwasher, in accordance with the 

hearing testimony of the vocational expert. Id. at 1382. As such, the ALJ found that prior to June 

29, 2011, plaintiff was not disabled; because he was not disabled at any time through December 31, 

2010, his Date Last Insured, plaintiff was not eligible for DIB. Id. at 1382-84. The ALJ continued 

to find that, beginning on June 29, 2011, claimant’s impairments met the criteria of section 12.02 of 

20 C.F.R., Part 404, Subpart P, Appendix 1, and therefore claimant was entitled to SSI. Id.

DISCUSSION

Plaintiff states that he is eligible for DIB, arguing that he was disabled as of January 7, 2010,

and that his substance use was not a material, contributing factor to his disability. Specifically, 

plaintiff contends: (1) that the Court previously held that substantial evidence did not support the 

conclusion that plaintiff was not disabled prior to June 29, 2011, and no new evidence on remand 

supports departing from the law of the case; (2) that the ALJ erred at step two by improperly 

considering the impact of plaintiff’s substance use and by failing to find that plaintiff’s mood/bipolar 

disorder was a severe impairment prior to June 29, 2011; (3) that the ALJ erred in discounting 

plaintiff’s subjective symptom testimony; and (4) that the ALJ erred by rejecting the opinion of 

licensed clinical social worker Omar Geray. Plaintiff argues that the appropriate remedy is a remand 

for a court-ordered award of benefits under the “credit as true” rule.

 

11 The ALJ noted that at the time of the May 2012 hearing, plaintiff was alleging a disability 

onset date of June 29, 2011. See AR at 1377 n.8. 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 15 of 34
16

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

United States District Court

Northern District of California

I. Law of the Case Doctrine and Weighing of Medical Opinions

In its May 2015 Order, the Court found that substantial evidence did not support the ALJ’s 

conclusion that plaintiff’s impairments were not severe enough to be disabling prior to June 29, 

2011, regardless of substance use. Prior Order at 16-17. Plaintiff argues that the only new evidence 

introduced upon remand was the October 2016 hearing testimony of Dr. Cohen, plaintiff, and 

plaintiff’s wife, and that the testimony of Dr. Cohen was insufficient to warrant departing from the 

Court’s prior ruling that the ALJ’s nondisability finding was not supported by substantial evidence. 

Defendant argues that neither the law of the case nor the rule of mandate doctrine dictates the 

outcome plaintiff advocates, arguing that new evidence was introduced on remand, that the Court 

did not order the ALJ to accept a certain opinion or find plaintiff disabled prior to June 29, 2011, 

and that the law of the case doctrine does not apply between ALJ decisions, since the Appeals 

Council vacated the first ALJ decision. Def.’s Cross-Mot. at 2-5.

In the circumstances of this case, the Court agrees with defendant that the law of the case 

doctrine does not govern. The Court’s prior order found that substantial evidence did not support 

the ALJ’s conclusion that the plaintiff was not disabled prior to June 29, 2011, because of a specific 

error: “The ALJ erred in rejecting portions of examining psychologist Dr. Scaramozzino’s report in 

favor of the opinion of non-examining psychologist Dr. Bilik.” Prior Order at 16. The Court further 

explained that “[t]he materiality of plaintiff’s substance use is not a specific and legitimate reason 

to reject Dr. Scaramozzino’s opinion because it was improper for the ALJ to consider the materiality 

of plaintiff’s substance use prior to completing the five-step disability inquiry.” Id. at 17.

Nevertheless, the Court agrees with plaintiff that the weight the ALJ assigned Dr. Cohen’s 

opinion was not supported by substantial evidence. In the January 2017 decision, the ALJ repeated 

the errors made in the first decision when he gave the opinion of examining psychologist Dr. 

Scaramozzino “little weight” (AR at 1379) while assigning the “greatest weight” to the testimony 

of non-examining psychiatrist Dr. Cohen (id. at 1378). 

An examining physician’s opinion usually should be given more weight than that of a 

physician who has not examined the claimant. Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 1198 

(9th Cir. 2008). “If a treating or examining doctor’s opinion is contradicted by another doctor’s 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 16 of 34
17

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

United States District Court

Northern District of California

opinion, an ALJ may only reject it by providing specific and legitimate reasons that are supported 

by substantial evidence.” Id. (quoting Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005)). 

This is necessary “because, even when contradicted, a treating or examining physician’s opinion is 

still owed deference and will often be ‘entitled to the greatest weight . . . even if it does not meet the 

test for controlling weight.’” Garrison, 759 F.3d at 1012 (quoting Orn v. Astrue, 495 F.3d 625, 633 

(9th Cir. 2007)). “The opinion of a nonexamining physician cannot by itself constitute substantial 

evidence that justifies the rejection of the opinion of either an examining physician or a treating 

physician.” Lester v. Chater, 81 F.3d 821, 831 (9th Cir. 1995) (citing Pitzer v. Sullivan, 908 F.2d 

502, 506 n.4 (9th Cir. 1990); Gallant v. Heckler, 753 F.2d 1450, 1456 (9th Cir. 1984)).

At step two of the disability inquiry, the ALJ assigned “substantial weight” to the opinion of 

Dr. Cohen, saying it was “well supported by the objective medical evidence present and by the other 

evidence present in the record as a whole.” AR at 1366. At the RFC stage, the ALJ assigned “the 

greatest weight” to the opinion of Dr. Cohen during the period prior to June 29, 2011, finding it to 

be “well supported by the objective medical evidence present in the record and by the other evidence 

present in the record as a whole as it applies to the claimant’s functional level during the period at 

issue . . . .” Id. at 1378. By contrast, the ALJ assigned “little weight” to the opinion of examining 

psychologist Dr. Scaramozzino, who opined in September 2010 that, due to substance abuse, 

plaintiff would have moderate to marked limitations in various areas of work-related functioning. 

The ALJ rejected this opinion in large part because it was based on the claimant’s subjectively 

reported history and subjective statements concerning his symptoms and because the ALJ found the 

opinion to be “strongly contradicted by the claimant’s acknowledged daily activities during the 

period at issue[.]” Id. at 1379. As will be discussed further below, the ALJ erred in rejecting 

plaintiff’s subjective symptom testimony and mischaracterized plaintiff’s daily activities. It follows 

that the ALJ thus failed to provide specific and legitimate reasons for rejecting the opinion of the 

only examining physician whose opinion the ALJ weighed at this stage, Dr. Scaramozzino, in favor 

of the opinion of nonexamining physician Dr. Cohen.

The weight that the ALJ assigned to the opinion of Dr. Cohen was also not supported by 

substantial evidence for two additional reasons. Most prominently, as plaintiff points out, the ALJ 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 17 of 34
18

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

United States District Court

Northern District of California

limited Dr. Cohen’s testimony at the hearing to various hypotheticals that the ALJ posed. For 

instance, the ALJ posed as “hypothetical #1” an individual who as of January 7, 2010, voluntarily 

sought psychiatric admission for heroin detox in a VA program, had been using opiates for 2.5 years 

and last used the previous Tuesday, admitted to a history of substance abuse, and was assessed by 

the VA as having polysubstance abuse and opiate dependence with a Global Assessment of Function 

score (“GAF”) of 35. Id. at 2895. The ALJ then asked Dr. Cohen, “Now, based on these facts, in 

your opinion, is drug abuse present and material as of January 7, 2010?” Id. The ALJ then 

proceeded to ask whether “such a person” could perform certain levels of work. Id. at 2897-98. 

The ALJ repeated this line of questioning for four different hypothetical individuals.

It is unclear why the ALJ questioned Dr. Cohen in the form of hypotheticals rather than 

questioning him about the plaintiff himself, particularly where Dr. Cohen had reviewed plaintiff’s 

medical records in advance of the hearing. See id. at 2894. At times during the hearing, Dr. Cohen 

seemed to be attempting to opine on what he read in the record regarding plaintiff’s medical history, 

but the ALJ prevented him from doing so and limited him to the facts presented in the 

hypotheticals.12 At other times, Dr. Cohen interjected that the ALJ’s hypothetical did not match 

what was reflected in plaintiff’s medical records. See, e.g., id. at 2901-02 (“Q. Based on the facts 

 

12 For instance, the following exchange occurred between the ALJ and Dr. Cohen: 

Q. . . . Could such a person outlined in the facts I asked you to assume in 

hypothetical #1 do simple work? 

. . .

A. If he does abuse drugs, it’s hard to do simple work. . . . 

He was using so much -- he was using $20 a day of heroin.

Q. Well, just answer -- just answer my question.

A. He’s --

Q. Sir, could such a person do simple work?

A. Yes. If they don’t have any more functional limitations, they could do simple 

work.

AR at 2897-98.

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 18 of 34
19

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

United States District Court

Northern District of California

of hypothetical 2, in your opinion, is drug abuse present and material during the period January 19, 

2010 through early September 2010? A. Well, based upon that hypothetical, no, but it’s -- it goes 

against the medical evidence because he was still using amphetamines at that time whenever he 

wanted to.”). The ALJ stated in the decision that he gave substantial weight to Dr. Cohen’s opinion 

“that the claimant’s acknowledged long-standing heavy polysubstance abuse since age 8-10 . . . was 

the claimant’s only established and documented medically determinable impairment.” Id. at 1365-

66. However, Dr. Cohen did not offer such an opinion. Dr. Cohen only responded to the 

hypothetical assumptions the ALJ posed, and the ALJ did not ask Dr. Cohen any questions outside 

of those related to four versions of a “hypothetical” claimant. See id. at 2894-2907. Dr. Cohen 

therefore provided no opinion as to plaintiff himself.

Additionally, the ALJ improperly asked Dr. Cohen to opine on whether the hypothetical 

claimant’s drug use was “material” in the situations the ALJ presented, and the ALJ then relied on 

those opinions in his decision. SSR 13-2p states that “[t]he finding about materiality is an opinion 

on an issue reserved to the Commissioner under 20 CFR 404.1527(e) and 416.927(e). Therefore, 

we will not ask a treating source, a CE [consultative exam] provider, a medical expert, or any other 

source for an opinion about whether DAA is material.” SSR 13-2p, 78 Fed. Reg. at 11943 n.19. 

“At the ALJ and Appeals Council levels . . ., the ALJ or Appeals Council determines whether DAA

is material to the determination of disability.” Id. at 11946.

The ALJ never defined the term “material” for Dr. Cohen, nor did he ask Dr. Cohen to 

elaborate on what the doctor meant when applying that term. Upon examination by plaintiff’s 

counsel, Dr. Cohen explained that he used the term “material” to mean “another psychiatric 

diagnosis. . . . I don’t have another psychiatric diagnosis. This is a whole, his -- any limitations he 

has is [sic] caused by the drugs and alcohol. He’s forwardly using it, and it’s material to any 

symptoms he has. I don’t have another psychiatric diagnosis. It’s all [Listing] 12.09 [substance 

addiction disorder] before June 2011.” AR at 2908-09. This is not consistent with how the SSA

defines materiality: “DAA is material if the claimant’s other impairment(s) would improve to the 

point that the claimant would not be disabled in the absence of DAA.” See SSR 13-2p, 78 Fed. Reg. 

at 11942. Dr. Cohen’s opinion, on which the ALJ relied, improperly resolved the question of 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 19 of 34
20

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

United States District Court

Northern District of California

materiality, which is specifically reserved to the Commissioner. See id. at 11943 n.19. 

For all of the above reasons, the ALJ erred in assigning Dr. Cohen’s testimony the greatest 

or substantial weight while assigning little weight to the opinion of Dr. Scaramozzino. Because this 

error impacted the ALJ’s decision at multiple stages of the five-step disability analysis, the error 

alone warrants reversal of the ALJ’s January 2017 decision.13

II. Materiality of Substance Use 

Plaintiff also argues that the ALJ erred in improperly analyzing the materiality of substance 

use by failing to reconcile the pre-June 29, 2011 period with the period of sobriety and continued 

mental health impairments that followed. In the Court’s May 2015 Order, the Court explained that 

“[t]he relevant inquiry in evaluating disability cases with co-occurring DAA and mental disorders 

is not whether plaintiff’s substance use contributed to the disability, but rather, whether plaintiff’s 

disability would remain after he stopped his substance use.” Prior Order at 18 (citing Sousa, 143 

F.3d at 1245). The Court found that “[t]he ALJ failed to reconcile the opinions of Dr. Bilik and Dr. 

Anderson with evidence in the record that plaintiff continued to suffer disabling mental impairments 

after maintaining sustained sobriety” and that the ALJ erred in rejecting the opinion of plaintiff’s 

mental health clinical social worker Omar Geray, who treated plaintiff beginning on November 5, 

2010. Id. On remand, the Court ordered:

 

13 Because plaintiff’s argument centers around the weight the ALJ gave Dr. Cohen’s opinion, 

the Court will not address whether the ALJ erred in weighing other non-examining physician 

opinions. However, the Court has concerns about whether substantial evidence supports the weight 

assigned to the opinions of Dr. Anderson and Dr. Cox. The reasons the ALJ credited the testimony 

of Dr. Anderson were internally inconsistent. At step two, the ALJ accorded “substantial weight” 

to Dr. Anderson’s testimony that plaintiff’s “long-term and heavy polysubstance abuse since age 8-

10 and continuing through June 29, 2011 rendered meaningful evaluation of the severity of any 

possible independently existing mental impairments impossible prior to June 29, 2011.” AR at 

1366. At the RFC stage, the ALJ accorded Dr. Anderson’s opinion “less weight during the period 

prior to June 29, 2011 because Dr. Anderson expressly testified only to the claimant’s functional 

level during the period beginning June 29, 2011 and continuing . . . [a]s a result of the claimant 

amend[ing] the alleged onset date to June 29, 2011 at the beginning of the May 2012 hearing.” Id.

at 1378 & n.11. The ALJ also gave “significant weight” to the opinion of state agency consultant 

Dr. D. Cox. See id. at 1375, 1378. Dr. Cox’s opinion is located at “Exhibit 10F.” See id. at 485, 

1375. That document consists of a single page, dated March 23, 2011, that contains only the 

following statement: “I have reviewed all the evidence in file, the most recent suggesting 

improvement/sobriety, and can affirm the determination of 10/6/10.” Id. at 485.

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 20 of 34
21

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

United States District Court

Northern District of California

The ALJ should evaluate the opinions of Dr. Bilik and Dr. Anderson in light of 

plaintiff’s ongoing disabling mental impairments despite maintaining sobriety on 

June 29, 2011. The ALJ should also evaluate the plaintiff’s treatment records 

between December 2010 and June 29, 2011, including the medical records during 

plaintiff’s inpatient stay at the VA from January to February 2011 and treatment 

records from plaintiff’s clinical social worker Omar Geray, to determine whether 

plaintiff’s mental impairments would have remained in the absence of his substance 

use.

Id. at 19.

Plaintiff argues that the ALJ failed to follow the Court’s order because on remand he 

erroneously did not reconcile the pre-June 29, 2011 period with evidence that plaintiff was disabled 

after maintaining sustained sobriety on June 29, 2011. The Court agrees. 

At the October 2016 hearing following remand, plaintiff’s counsel argued that this Court’s 

Prior Order and SSR 13-2p dictate that the ALJ should look to periods of sobriety to understand if 

the claimant is disabled during periods of drug use. Counsel argued that “the period at June 29, 

2011 through 2012 is the closest long period of sobriety, so we should actually be looking at that 

period.” AR at 2917. The ALJ responded that “if you can’t look at the evidence in the live 

period,[

14] then we need to move on.” Id. at 2918. Plaintiff’s counsel argued that the “period from 

2011 going forward is applicable to the live period because it’s the closest longstanding period of 

sobriety,” id., but the ALJ rejected this argument, stating, “you want me to take a later period and 

read it back, and I don’t think that’s appropriate under the regulations and the law. There is your 

ruling for you.” Id. at 2920.

This ruling directly contradicts the Court’s Prior Order, which instructed the ALJ to evaluate 

medical records, such as the treatment notes of Mr. Geray, that post-dated the then-alleged disability 

onset date of December 31, 2010, to determine whether plaintiff’s disability would have remained 

in the absence of his substance use. More importantly, the ALJ’s refusal to “read back” records 

from a later period of sobriety to inform whether a claimant was disabled before his Date Last 

Insured contradicts SSR 13-2p. SSR 13-2p states:

Especially in cases involving co-occurring mental disorders, the documentation of a 

period of abstinence should provide information about what, if any, medical findings 

and impairment-related limitations remained after the acute effects of drug and 

 

14 The “live period” presumably refers to the period from the alleged onset date of January 

7, 2010 to the Date Last Insured of December 31, 2010.

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 21 of 34
22

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

United States District Court

Northern District of California

alcohol use abated. Adjudicators may draw inferences from such information based 

on the length of the period(s), how recently the period(s) occurred, and whether the 

severity of the co-occurring impairment(s) increased after the period(s) of abstinence 

ended. To find that DAA is material, we must have evidence in the case record 

demonstrating that any remaining limitations were not disabling during the period.

SSR 13-2p, 78 Fed. Reg. at 11945. Nothing in SSR 13-2p states that an ALJ should only look to 

periods of abstinence that occur before the “live period” rather than after. 

In the January 2017 decision, the ALJ again failed to reconcile the period of sobriety 

beginning on June 29, 2011, and the disability that persisted even after plaintiff became sober, with 

the period that came before June 29, 2011, in evaluating the question whether plaintiff would remain 

disabled even if he stopped using substances. In this way, the ALJ repeated the error that the Court 

noted in the Prior Order. Even if the ALJ had looked to the later period of sobriety, the fact that 

plaintiff was found to be disabled even after maintaining sobriety indicates that the ALJ lacked 

“evidence in the case record demonstrating that any remaining limitations were not disabling during 

the period.” See id.

III. Severity of Impairments at Step Two

Plaintiff also challenges the ALJ’s finding at step two that plaintiff’s mood/bipolar disorder 

was not a severe impairment prior to June 29, 2011. Pl.’s Mot. at 22-23.15 Even if this were error, 

any error was harmless. “Step two is merely a threshold determination meant to screen out weak 

claims.” Buck v. Berryhill, 869 F.3d 1040, 1048 (9th Cir. 2017) (citing Bowen v. Yuckert, 482 U.S. 

137, 146-47 (1987)). “It is not meant to identify the impairments that should be taken into account 

when determining the RFC.” Id. at 1048-49. Indeed, the ALJ properly considered “all symptoms” 

at the RFC stage, including plaintiff’s allegations of bipolar disorder, depression, and anxiety. See

AR at 1370-81. Where step two is met, the five-step disability inquiry simply proceeds, as it did in 

this case. Plaintiff was not harmed by the ALJ’s failure to find plaintiff’s mood/bipolar disorder

 

15 In the ALJ’s January 2017 decision, the ALJ found at step two that since the onset date of 

January 7, 2010, and prior to June 29, 2011, plaintiff had the severe impairment of polysubstance 

use disorder. AR 1359. In contrast, in the June 2012 decision, the ALJ found at step two that since 

the alleged onset date of December 31, 2010, plaintiff’s severe impairments were polysubstance 

abuse and bipolar disorder vs. substance-induced mood disorder. Id. at 17.

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 22 of 34
23

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

United States District Court

Northern District of California

non-severe at step two.

IV. Plaintiff’s Symptom Testimony

Plaintiff challenges the ALJ’s treatment of his subjective symptom testimony. The Ninth 

Circuit has established a two-step analysis for determining how to credit a claimant’s symptom 

testimony:

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. . . . 

If the claimant satisfies the first step of this analysis, 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. This 

is not an easy requirement to meet: The clear and convincing standard is the most 

demanding required in Social Security cases.

Trevizo v. Berryhill, 871 F.3d 664, 678 (9th Cir. 2017) (quoting Garrison, 759 F.3d at 1014-15).16 

If the ALJ finds the claimant’s allegations of severity are not credible, “[t]he ALJ must state 

specifically which symptom testimony is not credible and what facts in the record lead to that 

conclusion.” Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996). “These findings, properly 

supported by the record, must be sufficiently specific to allow a reviewing court to conclude the 

adjudicator rejected the claimant’s testimony on permissible grounds and did not arbitrarily discredit 

a claimant’s testimony regarding pain.” Bunnell v. Sullivan, 947 F.2d 341, 345-46 (9th Cir. 1991)

(internal quotation marks and citation omitted).

Here, at the first step of the credibility test, the ALJ found that plaintiff’s “medically 

determinable impairment could reasonably be expected to cause the alleged symptoms[.]” AR at 

1371. The ALJ made no finding of malingering. Moving to the second step of the credibility 

analysis, the ALJ found plaintiff’s “statements concerning the intensity, persistence and limiting 

 

16 Defendant disputes that the clear and convincing reasons standard applies to review of a 

claimant’s subjective symptom testimony, though defendant acknowledges that this standard is the 

law of the Ninth Circuit. Def.’s Cross-Mot. at 12 n.4. The Ninth Circuit has repeatedly rejected 

defendant’s position in recent years, reaffirming the continued validity of the clear and convincing 

reasons standard. See Brown-Hunter v. Colvin, 806 F.3d 487, 493 (9th Cir. 2015) (citing Burrell v. 

Colvin, 775 F.3d 1133, 1136-37 (9th Cir. 2014)).

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 23 of 34
24

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

United States District Court

Northern District of California

effects of these symptoms are not fully supported prior to June 29, 2011, for the reasons explained 

in this decision.” Id. The ALJ went on to detail three categories of reasons he found plaintiff’s 

testimony not entirely consistent with the medical evidence and other evidence of record: plaintiff’s 

daily activities; “significant inconsistencies” among statements plaintiff made in his application for 

benefits, to his doctors, and during his hearing testimony; and what the ALJ deemed plaintiff’s 

“failure to consistently complain to his treating, examining, and attending physicians during the 

period at issue of the same level of disabling symptoms he testified to during the hearing and 

generally alleges.” Id. at 1371-72.

A. Daily Activities

The Court finds that plaintiff’s daily activities do not provide a clear and convincing reason 

to reject plaintiff’s symptom testimony. In examining plaintiff’s daily activities, the ALJ considered 

the function report plaintiff completed on July 23, 2010, in connection with his disability application 

and one page of VA treatment notes completed on January 26, 2010, by Dr. Maria Castelli. See id.

at 1371 (citing Ex. 4E, 8F/198). The only activities Dr. Castelli noted were: “enjoys playing musicdrummer; fishing and collecting hotwheels” and “spiritual, attends church but not on a regular 

basis.” Id. at 423. This note provides no insight into the level of daily activities plaintiff actually 

engaged in at that time. 

The function report, by contrast, paints a picture of a person who used to engage in numerous 

activities but who at the time of writing barely left home and cycled through stages of hyperactivity 

and nonactivity. Plaintiff stated that “some days” he just went to the bathroom and maybe ate and 

might not shower or change clothes for several days. Id. at 77. He further stated: 

Other[ days]: May shower, eat what is prepared, occasionally may bar b que, may 

take out some trash/compost (several times a month), may do the lawn or water, may 

do some light chores[.]

Occasionally will pick up a short grocery list or do a minor repair [or] keep a medical 

appointment[.] 

From being a productive carpenter and enjoying playing music I am just watching 

my life go by most of the time and at times thinking about ending it all[.]

Id. He reported, “There are days at a time I do nothing but sleep. There are other times that I don’t 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 24 of 34
25

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

United States District Court

Northern District of California

sleep for 3-5 days until I can no longer stay awake and fall asleep on my feet[.]” Id. at 78. He 

reported either not changing clothes and not bathing for 5+ days or that he would bathe up to two 

times a day. Id. 

The ALJ cited certain of plaintiff’s activities inaccurately or without the full context of what 

plaintiff reported. For instance, the ALJ stated that plaintiff prepared simple meals daily and 

“prepar[ed] more substantial meals on a barbecue grill 3-4 times per month[.]” Id. at 1371. But 

what plaintiff reported was that he prepared meals “sporadic[ally]. At times not for days. Bar b que 

up to 3-4x a month. At times prepare toast or sandwiches 1 or 2 times a day[.]” Id. at 79. He did 

not report preparing food daily, and instead said that he cooks “only . . . when desperate and wife is 

gone, sometimes not even then[.]” Id. The ALJ listed plaintiff as “performing household chores 

including doing the laundry, performing small repairs around the house, mowing the lawn, watering 

the yard, planting or pruning in the garden, and performing auto repairs; going outside alone daily . 

. . .” Id. at 1371. In fact, plaintiff said that he could do the listed activities “[i]f not at low” and that 

he did them “[v]ery sporadic and may take a week+ to put sink faucet together or 2 days to mow & 

rake front yard once a month[.]” Id. at 79. In response to the question “How often do you go 

outside?” plaintiff responded, “Usually daily to back yard or to ‘collect’ something” and that he 

would go away from home 1-5 times per week but sometimes not for over two weeks “because I do 

not feel good or good about self[.]” Id. at 80.

Most glaringly, the ALJ appears to have misunderstood what plaintiff meant by “collecting” 

items. The ALJ described plaintiff as “engaging in his hobby of collecting miniature cars ‘at every 

opportunity,’” and cited this among the other activities as ones the ALJ found to be “at a level 

strongly generally inconsistent with complaints of disabling symptoms . . . .” Id. at 1371. By 

contrast, plaintiff described his “collections of stuff” as one of the reasons he has “successfully 

alienated most people” and stated that he and his family “have had to move several times due to my 

‘collecting’ and inability to get rid of clutter.” Id. at 82-83. In her third party function report 

completed at the same time, plaintiff’s wife described him as “collecting to the point of losing our 

houses” and stated that “[w]e have had to move many times because of his inability to clear the 

yards from his obsessive collections.” Id. at 73, 76. Plaintiff also referred to his “hoarding” 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 25 of 34
26

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

United States District Court

Northern District of California

elsewhere in the record, stating in his disability report on appeal that “I do not even play my drums 

and cannot even access them do [sic] to all my hoarding.” Id. at 85. 

In examining the documents supporting the ALJ’s list of plaintiff’s daily activities, the Court 

finds they do not provide a clear and convincing reason to reject plaintiff’s symptom testimony. 

Moreover, this error appeared to permeate the ALJ’s decision. The ALJ recited this same list of 

plaintiff’s supposed daily activities at three different parts of the decision. See id. at 1367, 1371, 

1373. The ALJ also relied on the daily activities as a reason to reject the opinion of examining 

psychologist Dr. Scaramozzino, stating that his opinion “concerning the claimant’s functional level 

during the period at issue prior to the established onset date of June 29, 2011 . . . is strongly 

contradicted by the claimant’s acknowledged daily activities[,]” among other reasons. See id. at 

1379.

B. Inconsistencies in Statements

The ALJ also found plaintiff’s symptom testimony was inconsistent with statements plaintiff

made with his application for benefits and to his doctors. Id. at 1372. However, the only evidence

the ALJ specifically cited as inconsistent was plaintiff’s testimony at the May 2012 hearing “that 

his heavy polysubstance abuse was strictly an attempt to self-medicate underlying psychiatric 

symptoms and that his heavy polysubstance abuse did not begin until after he left the military in 

1985,” as contrasted with statements elsewhere in the record that “he had been engaged in essentially 

continuous heavy polysubstance abuse since age 8-10.” See id.

The Court does not find these statements to be inconsistent. The May 2012 hearing transcript 

shows the following exchange between the ALJ and plaintiff: 

Q. You don’t have to read very far in your record to see that there is a long 

history, I think you know, of drug abuse. How did you get started in that? Heroin, 

meth and that sort of thing.

A. It was a means of self-medicating myself because I didn’t feel right.

Q. Did it start in the military or after?

A. I think it was after.

Id. at 1339-40. The ALJ cites two portions of the record as evidence that plaintiff began heavy 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 26 of 34
27

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

United States District Court

Northern District of California

polysubstance abuse at age 8-10. See id. at 1372 (citing Ex. 1F/5, 4F/2). One record says plaintiff 

reported a “long standing history of substance use starting at age 8-10” but does not specify what 

that substance was. See id. at 156. The second record, Dr. Scaramozzino’s evaluation, states that 

plaintiff “reports that he started abusing alcohol at age 8. He reports that he stopped drinking in 

1993; however, he has consistently been using a variety of illicit drugs over the last 15-20 years.” 

Id. at 203. Because heavy use of certain substances such as alcohol since age 8-10 is not inconsistent 

with use of “heroin, meth and that sort of thing” (see id. at 1339) later in life, this was not a clear 

and convincing reason to reject plaintiff’s symptom testimony.

C. Failure to Consistently Complain of Same Level of Symptoms

Third, the ALJ rejected plaintiff’s subjective complaints because he found plaintiff failed 

“to consistently complain to his treating, examining, and attending physicians during the period at 

issue of the same level of disabling symptoms he testified to during the hearing and generally 

alleges.” Id. at 1372 (citing Ex. 1F/5-6; 2F/6; 4F/1-2; 8F/156-57, 192-99, 247, 252). The ALJ did 

not specify precisely what he found inconsistent with which complaints to physicians, and the Court 

has reviewed the exhibits the ALJ cited and is unable to discern what could be inconsistent. Some 

of the exhibits appear fully consistent with plaintiff’s reports of disabling mental impairment, such 

as a January 7, 2010 progress note from VA clinical psychologist Delilah Noronha, PsyD. See id.

at 477, 481. In it, plaintiff reported suicidal thoughts as recently as “today” and that he had a plan 

to take his life. Id. at 477. Of the above cited exhibits, the Court can find only one that may support 

the ALJ’s finding of inconsistency: a January 26, 2010 treatment plan note from Dr. Castelli at the 

VA, in which plaintiff “currently rates his mood as 10/10, with 10 being the best he could feel” and 

that he stated, “I haven’t felt this good in I don’t know how long.” See id. at 419. However, this 

note was written after plaintiff had spent nearly two weeks in inpatient care at the VA, and SSR 13-

2p cautions that “[a]s for any mental disorder, we may find that a claimant’s co-occurring mental 

disorder(s) is still disabling even if increased support or a highly structured setting reduce the overt 

symptoms and signs of the disorder.” SSR 13-2p, 78 Fed. Reg. at 11945. Moreover, the ALJ did 

not provide “specific findings” as to what testimony he found inconsistent with which records, and 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 27 of 34
28

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

United States District Court

Northern District of California

it is not this Court’s role to speculate as to why the ALJ rejected plaintiff’s allegations. See Corbin

v. Apfel, 149 F.3d 1051, 1053 (9th Cir. 1998) (citing Bunnell, 947 F.2d at 346; Murray v. Heckler, 

722 F.2d 499, 502 (9th Cir. 1983)).

In sum, the Court finds the ALJ failed to provide clear and convincing reasons for rejecting 

plaintiff’s symptom testimony. 

V. Opinion of LCSW Omar Geray

Finally, plaintiff challenges the ALJ’s assignment of “no significant weight” (see AR at 

1379) to his treating licensed clinical social worker, Omar Geray. Plaintiff argues the ALJ 

improperly failed to follow the Court’s directive on remand to consider Mr. Geray’s opinion. Pl.’s 

Mot. at 24-25.

The parties agree that a social worker is not an accepted medical source under the Social 

Security regulations. As such, an ALJ must give “germane” reasons for discounting the opinion of 

a social worker. Delegans v. Berryhill, 766 Fed. App’x 477, 480 (9th Cir. 2019) (citing Dodrill v. 

Shalala, 12 F.3d 915, 919 (9th Cir. 1993)). 

The Court finds that the reasons the ALJ gave for rejecting the opinion of Mr. Geray “as it 

applies to the period prior to June 29, 2011” were not germane. Mr. Geray first met with plaintiff 

on November 5, 2010. AR at 360-61. Plaintiff participated in therapy sessions with Mr. Geray, 

sometimes as joint therapy sessions in which plaintiff’s wife also participated. Id. at 2997-98. Mr. 

Geray appears to have been part of a larger team that coordinated plaintiff’s care, including when 

plaintiff discharged from inpatient care at the VA in March 2012. In May 2012, Mr. Geray, at the 

request of plaintiff’s counsel, completed a questionnaire. Id. at 1297-1309. Mr. Geray indicated 

that he had been seeing plaintiff since November 5, 2010, at which point plaintiff “was actively 

using substances . . ., making assessment and diagnoses difficult. Now that he is sober, his extreme 

mood swings from depressed to anxious and manic can be observed.” Id. at 1301-02. In the May 

2012 questionnaire, Mr. Geray assessed plaintiff as having bi-polar I and polysubstance dependence. 

Id. at 1301. Mr. Geray assessed plaintiff as having moderate limitations in a number of employment 

related areas. Id. at 1302-06. He stated that plaintiff had extreme limitations in his ability to perform 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 28 of 34
29

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

United States District Court

Northern District of California

activities within a schedule, maintain regular attendance, be punctual within customary tolerances, 

complete a normal workday and workweek without interruptions from psychologically based 

symptoms, and to perform at a consistent level without abnormally long rest periods. Id. at 1303-

04. 

Mr. Geray initially assessed plaintiff as having moderate limitations in the ability to: sustain 

an ordinary routine without special supervision, make simple work-related decisions, ask simple 

questions or request assistance, maintain socially appropriate behavior and adhere to basic standards 

of neatness and cleanliness, travel in unfamiliar places, use public transportation, or set realistic

goals or make plans independently of others. Id. at 1303-07. However, one day after completing 

the evaluation, Mr. Geray changed his “moderate” assessment to “extreme” in all these categories, 

indicating he made the changes after consulting “with clinicians that have recently observed Mr. 

Kroeger in various settings. Mr. Kroeger has presented as extremely anxious, with manic symptoms 

and disorganized thinking in both his home setting and during VA appointment[s]. The corrections 

made more accurately reflect Mr. . . . [text at bottom of page cut off].” Id. at 1309. Mr. Geray’s 

overall assessment of plaintiff’s employability was as follows: “At baseline, the veteran has a very 

low tolerance to stress and is prone to frustration and anxiety. The veteran would need considerable 

support/ and/or possible accommodations to maintain functionality in the workplace. When 

symptomatic, in either a manic or depressed state, the veteran could not function consistently in 

most any work setting.” Id. at 1307.

The ALJ rejected the opinion of Mr. Geray and the accompanying May 2012 evaluation. Id.

at 1379. However, there was no reason to reject Mr. Geray’s May 2012 evaluation simply because 

it occurred after the date the ALJ found to be the established disability onset date. As discussed 

above, periods of abstinence from substances “should provide information about what, if any, 

medical findings and impairment-related limitations remain after the acute effects of drug and 

alcohol use abated.” See SSR 13-2p, 78 Fed. Reg. at 11945. Nor is it a germane reason to reject 

Mr. Geray’s opinion “because Mr. Geray is not an acceptable medical source and has extremely 

limited ability to observe the claimant during the period prior to the date last insured . . . .” AR at 

1379. The regulations allow for consideration of opinion evidence from “medical sources who are 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 29 of 34
30

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

United States District Court

Northern District of California

not acceptable medical sources and from nonmedical sources,” see 20 C.F.R. § 404.1527,17 and it 

makes little sense for the ALJ to reject Mr. Geray’s opinion based on the limited times he met with 

plaintiff prior to December 31, 2010, while the ALJ simultaneously afforded greater weight to state 

agency consultants (Dr. Anderson, Dr. Cohen, Dr. Bilik, and Dr. Cox) who never examined plaintiff 

in person. There is nothing to support the ALJ’s assertion that Mr. Geray “provided no significant 

explanation, rationale, or objective support for the extreme limitations imposed aside form citing 

the claimant’s reported symptoms,” see AR at 1379; nothing in the questionnaire indicates it is not

based on Mr. Geray’s own observations from working with plaintiff since November 2010 and on 

the observations of the clinicians whom Mr. Geray consulted. Finally, the ALJ’s statement that “the 

record contains no subsequent treatment or progress notes from Mr. Geray after his initial 

examination in November 2010” (see id. at 1379) is incorrect. See, e.g., id. at 794-95 (note dated 

Feb. 10, 2012), 994 (note dated June 29, 2011). 

For all these reasons, the ALJ erred in rejecting the opinion of social worker Mr. Geray.

VI. Remedy Upon Remand

The remaining question is whether to remand this case for further administrative proceedings 

or for the immediate payment of benefits under the credit-as-true doctrine. “When the ALJ denies 

benefits and the court finds error, the court ordinarily must remand to the agency for further 

proceedings before directing an award of benefits.” Leon v. Berryhill, 880 F.3d 1041, 1045 (9th 

Cir. 2017) (citing Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1099 (9th Cir. 2014)). 

However, under the credit-as-true rule, the Court may order an immediate award of benefits if three 

conditions are met. First, the Court asks “whether the ‘ALJ failed to provide legally sufficient 

reasons for rejecting evidence, whether claimant testimony or medical opinion.’” Id. (quoting 

Garrison, 759 F.3d at 1020). Second, the Court must “determine whether there are outstanding 

issues that must be resolved before a disability determination can be made, . . . and whether further 

administrative proceedings would be useful.” Id. (citations and internal quotation marks omitted). 

 

17 This section applies to claims filed before March 27, 2017, such as plaintiff’s.

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 30 of 34
31

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

United States District Court

Northern District of California

Third, the Court then “credit[s] the discredited testimony as true for the purpose of determining 

whether, on the record taken as a whole, there is no doubt as to disability.” Id. (citing Treichler, 

775 F.3d at 1101). Even when all three criteria are met, whether to make a direct award of benefits 

or remand for further proceedings is within the district court’s discretion. Id. (citing Treichler, 775 

F.3d at 1101). In rare instances, all three credit-as-true factors may be met but the record as a whole 

still leaves doubts as to whether the claimant is actually disabled. Trevizo, 871 F.3d at 683 n.11. In 

such instances, remand for further development of the record is warranted. Id.

Here, the Court has found that the ALJ failed to provide legally sufficient reasons for 

rejecting the medical opinion of Dr. Scaramozzino, the symptom testimony of plaintiff, and the 

opinion of Mr. Geray. The Court further finds that there are no outstanding issues to resolve and 

that further administrative proceedings would not be useful. The medical record in this case is 

extensive, containing over 1000 pages of treatment notes from the VA. The record includes mental

health evaluations from examining and non-examining doctors. Defendant does not argue that the 

record requires further development nor does she identify any outstanding issues to be resolved.

Crediting the discredited testimony as true, there is no doubt as to plaintiff’s disability. 

Beginning on January 7, 2010, the alleged onset date, and through May 2012, several months after 

plaintiff discharged from inpatient care after a long period of sobriety, the record shows that 

plaintiff’s mental health disorder persisted, regardless of whether he was using substances. Even 

before he began long-term care on June 29, 2011, plaintiff experienced short periods of sobriety in 

which his mental health symptoms did not abate.

For instance, on January 7, 2010, the alleged onset date, plaintiff was voluntarily admitted 

into psychiatric inpatient care at the VA, seeking “to get off the heroin.” AR at 469. He was 

discharged on January 19, 2010, and appears to have maintained sobriety for at least several months, 

through April 2010 or perhaps later. See id. at 367, 431. Yet despite his abstaining from substances, 

he presented at the emergency room multiple times for anxiety, depression, and fears that he might 

kill himself, including just four days after his discharge. See id. at 429 (ER visit on Jan. 23, 2010). 

Although at an outpatient visit at the VA on January 26, 1010, he stated, “I haven’t felt this good in 

I don’t know how long,” he was given a diagnostic impression of mood disorder NOS, bipolar 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 31 of 34
32

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

United States District Court

Northern District of California

affective disorder (by history), opiate dependence, and methamphetamine dependence. Id. at 419, 

424. Just two days after that, on January 28, 2010, plaintiff contacted the VA stating that he was

anxious and had run out of his medications. Id. at 417. After the clinician was not able to calm him, 

and he indicated that he might “start to contemplate SI [suicidal ideation]” if he had to wait for an 

appointment the next morning, he and the clinician agreed he should have someone drive him to the 

ER that night. Id. at 418; see also id. at 385-86 (ER visit on Mar. 9, 2010, with diagnosis of anxiety 

and depression), 364-67 (ER visit on Apr. 28, 2010, with diagnosis of anxiety, depression, and 

history of substance abuse). 

Although there is a gap in the treatment notes from late April 2010 to November 2010, the 

year and a half that followed plaintiff’s January 7, 2010 admission into VA inpatient care show a 

larger pattern of plaintiff at times relapsing, attempting to access detox and mental health services, 

going to the VA for outpatient treatment, and presenting at the emergency room when he could not 

control his symptoms. He sought care at the VA in November 2010, with his first encounter with 

Mr. Geray. During a call with a VA clinician on December 17, 2010, he expressed continued interest 

in participating in the VA’s Foundations of Recovery program (a residential addiction treatment 

program), see id. at 360, 1026, which he in fact began on January 5, 2011. Id. at 343. He was 

discharged from that program on February 4, 2011, at which point he was waitlisted for the longterm Homeless Veteran Rehabilitation Program. Id. at 1026. On June 29, 2011, he entered the VA’s 

First Step residential treatment program and was discharged from there into the Homeless Veteran 

Rehabilitation Program. Id. at 673, 721-22.

Despite maintaining long-term sobriety from June 29, 2011, plaintiff’s mental impairments 

persisted. This is evidenced in the various extreme limitations that Mr. Geray noted in his May 

2012 evaluation, which the Court found above the ALJ wrongly discredited. It is also echoed in the 

findings of Dr. Anderson, who testified at the May 2012 hearing that after June 29, 2011 (the only 

time period on which Dr. Anderson was asked to opine), plaintiff met Listings 12.02 (neurocognitive 

disorders) and 12.04 (depressive, bipolar and related disorders) and potentially 12.06 (anxiety and 

obsessive-compulsive disorders). See id. at 1335-37. In the ALJ’s January 2017 decision, he 

correctly read this Court’s prior order as not disturbing his finding that plaintiff was disabled as of 

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 32 of 34
33

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

United States District Court

Northern District of California

June 29, 2011, and was thus entitled to SSI. The ALJ again found that as of June 29, 2011, plaintiff 

was disabled on the basis of meeting Listings 12.02 and 12.04. Id. at 1382. The ALJ noted that Dr. 

Anderson testified at the first hearing that “essentially permanent organic brain dysfunction caused 

by the cumulative effect of the claimant’s long-standing heavy polysubstance abuse through June 

29, 2011 was the driving force behind the claimant’s disability.” Id. Elsewhere, the ALJ reiterated 

that the opinions of Dr. Anderson and Dr. Cohen “strongly support the conclusion that the onset of 

disabling mental impairment did not occur prior to June 29, 2011, but was instead the result of 

organic brain dysfunction caused by the cumulative effect of the claimant’s long-standing heavy 

polysubstance use.” Id. at 1380-81. As plaintiff noted at the October 2016 hearing, no one 

questioned Dr. Anderson about whether those impairments would have existed one day prior or 

even earlier. See id. at 3013 (arguing, “There is no evidence to support that he didn’t meet those 

[listings] on June 28, the day before he walked into the rehabilitation center”). Nothing in the record 

indicates that plaintiff’s disabling mental impairment began abruptly on June 29, 2011, rather than 

earlier, particularly where the impairment was “caused by the cumulative effect” of long-standing 

substance abuse. See id. at 1382.

The Court acknowledges the procedural oddities of this case. As the ALJ noted, it was not 

until after the ALJ issued the June 2012 decision that the SSA published SSR 13-2p, governing 

evaluation of cases involving DAA.18 See id. at 2880, 2925. Moreover, at the first administrative 

hearing in May 2012, plaintiff’s counsel amended the alleged disability onset date to June 29, 2011, 

despite the ALJ alerting him that this would disqualify plaintiff from DIB because his Date Last 

Insured was December 31, 2010. Only after the hearing did plaintiff’s counsel seek to withdraw the 

amended disability onset date, stating that counsel made an error in the calculation of the Date Last 

Insured. See id. at 30. Thus, the initial administrative hearing was conducted without the ALJ or 

the impartial medical expert knowing that plaintiff would ultimately argue for an earlier disability 

onset date and seek to obtain DIB. Had plaintiff been seeking DIB at the time of the May 2012 

 

18 The Ninth Circuit, however, has stated in an unpublished memorandum that SSR 13-2p 

“simply codified policies that were already in existence.” Robinson v. Berryhill, 690 Fed. App’x 

520, 522 n.2 (9th Cir. 2017).

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 33 of 34
34

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

United States District Court

Northern District of California

administrative hearing, the outcome of that hearing may have been different, perhaps avoiding some 

of this case’s subsequent and lengthy procedural history.

Nevertheless, the Court finds that plaintiff has met his burden of showing he was disabled 

prior to December 31, 2010, and that his DAA was not material to his disability. See SSR 13-2, 78 

Fed. Reg. at 11944 (“We will find that DAA is not material to the determination of disability and 

allow the claim if the record is fully developed and the evidence does not establish that the 

claimant’s co-occurring mental disorder(s) would improve to the point of nondisability in the 

absence of DAA.”). Crediting the discredited testimony as true, plaintiff would have to be found 

disabled under Title II of the Social Security Act, and thus an award of DIB is appropriate. 

Moreover, remand for benefits is appropriate here where Plaintiff first applied for benefits over nine 

years ago and has already experienced lengthy, burdensome litigation, including a remand to the 

SSA from this Court in May 2015. See Vertigan v. Halter, 260 F.3d 1044, 1053 (9th Cir. 2001).

The Court echoes the ALJ’s recommendation “that a determination be made concerning the 

appointment of a representative payee who can manage payments in the claimant’s interest.” See

AR at 1383. 

Nothing in this Order shall disturb the ALJ’s ruling that plaintiff was disabled under Title 

XVI of the Social Security Act and is thus entitled to SSI. 

CONCLUSION

For the foregoing reasons, the Court GRANTS plaintiff’s motion for summary judgment and 

DENIES defendant’s cross-motion for summary judgment. The Court REMANDS this case 

pursuant to sentence four of 42 U.S.C. § 405(g) for an immediate payment of benefits.

IT IS SO ORDERED.

Dated: September 17, 2019

______________________________________

SUSAN ILLSTON

United States District Judge

Case 3:18-cv-00389-SI Document 37 Filed 09/17/19 Page 34 of 34