NOT FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

SOREN A. STIEHL, 

Plaintiff-Appellant, 

 v. 

NANCY A. BERRYHILL, Acting 

Commissioner Social Security, 

Defendant-Appellee.

No. 14-35718 

D.C. No. 1:13-cv-00237-AA 

MEMORANDUM*

Appeal from the United States District Court

for the District of Oregon

Ann L. Aiken, District Judge, Presiding

Submitted August 25, 2017**

Before: NELSON, TROTT, and SILVERMAN, Circuit Judges.

Soren Stiehl appeals the district court’s judgment affirming the 

Commissioner of Social Security’s denial of Stiehl’s application for supplemental 

security income under Title XVI of the Social Security Act. Stiehl alleged 

 

* This disposition is not appropriate for publication and is not precedent 

except as provided by Ninth Circuit Rule 36-3.

** The panel unanimously concludes this case is suitable for decision 

without oral argument. See Fed. R. App. P. 34(a)(2).

FILED

AUG 28 2017

MOLLY C. DWYER, CLERK

U.S. COURT OF APPEALS
2 14-35718 

disability due to various mental and physical impairments. We have jurisdiction 

under 28 U.S.C. § 1291. We review de novo, Molina v. Astrue, 674 F.3d 1104, 

1110 (9th Cir. 2012), and we reverse and remand for further proceedings.

The Administrative Law Judge (“ALJ”) erred by rejecting the contradicted 

opinion of Stiehl’s treating psychologist, Dr. Greene, without providing “specific 

and legitimate reasons supported by substantial evidence.” Orn v. Astrue, 495 F.3d 

625, 632 (9th Cir. 2007) (internal citations and quotations omitted). The ALJ gave 

no weight to the mental RFC report that Dr. Greene completed in June 2011, 

reasoning that the mental RFC report was inconsistent with Dr. Greene’s January 

2011 report which found “only moderate difficulty in social, occupational, or 

school functioning.” The ALJ also explained that Dr. Greene’s mental RFC report

failed to describe the four incidents of decompensation that Dr. Greene claimed 

Stiehl suffered. The ALJ’s reasoning is not supported by substantial evidence in 

the record as a whole.

First, Dr. Greene’s January report described results of several 

neuropsychological tests, including findings of “extremely low processing speed 

index, 0.3%ile,” “extremely low range bilaterally” on a test of fine motor speed, 

and “severely impaired executive functioning.” The ALJ’s finding of only 

moderate limitations was based entirely on a single GAF score contained in the 

January report, which the ALJ improperly relied upon to reject Dr. Greene’s 
3 14-35718 

mental RFC report. See Ghanim v. Colvin, 763 F.3d 1154, 1161-62 (9th Cir. 2014) 

(concluding that the ALJ improperly rejected a treating physician’s opinion based 

on isolated notes of improved mood and energy level when the overall diagnostic 

picture of the treatment notes was far more severe). Moreover, Dr. Greene’s 

October letter, submitted to and considered by the Appeals Council, explained that 

the GAF score was assigned for treatment purposes and was not inconsistent with 

the conclusions in the mental RFC report. See Brewes v. Comm’r of Soc. Sec. 

Admin., 682 F.3d 1157, 1160 (9th Cir. 2012) (holding that when the appeals 

council considers new evidence, that evidence becomes part of the record and this 

court must consider it “in determining whether the Commissioner’s decision is not 

supported by substantial evidence”). 

Second, Dr. Greene’s October letter clarified that her conclusions regarding 

episodes of decompensation in the mental RFC report were based on her findings 

from the January report regarding PTSD and anxiety. Based on the full record 

before this Court, substantial evidence does not support the ALJ’s reasoning that 

Dr. Greene failed to describe the source of her conclusions regarding episodes of 

decompensation. See Ghanim, 763 F.3d at 1161-62. The Commissioner contends 

that the ALJ could reject Dr. Greene’s explanation for episodes of decompensation 

because the explanation was based on Stiehl’s unreliable self-reports. This 

contention lacks merit because this Court can only review the ALJ’s decision 
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based on the reasoning and factual findings offered by the ALJ. See Bray v. 

Comm’r of Soc. Sec. Admin., 554 F.3d 1219, 1225-26 (9th Cir. 2009). Because the 

ALJ’s finding that Stiehl did not meet listing 12.06 depended on the ALJ’s 

improper rejection of Dr. Greene’s mental RFC report, the ALJ should reconsider 

this finding on remand if necessary.

The ALJ erred by giving less than full weight to Stiehl’s testimony regarding 

the intensity and limiting effects of his symptoms. Because the ALJ found that 

medically determinable impairments could reasonably be expected to cause 

Stiehl’s symptoms and no evidence of malingering, the ALJ was required to offer 

specific, clear, and convincing reasons for rejecting Stiehl’s testimony. Vasquez v. 

Astrue, 572 F.3d 586, 591 (9th Cir. 2009). The ALJ reasoned that “the medical 

evidence of record reflects on irregular treatment for the claimant’s mental 

impairments [and] no treating provider offered a functional assessment of the 

claimant’s mental residual functional capacity.” The ALJ improperly relied on 

Stiehl’s lack of treatment to reject his testimony without discussing evidence in the 

record showing that Stiehl could not afford treatment and missed medical 

appointments due to cognitive issues. See Orn, 495 F.3d at 638 (concluding that an 

ALJ must consider evidence in the record explaining lack of treatment before 

relying on lack of treatment to discredit claimant testimony).

We reverse and remand for further administrative proceedings, including 
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consideration of Dr. Greene’s opinions, Dr. Greene’s October letter submitted to 

the Appeals Council, and Stiehl’s testimony regarding the intensity and limiting 

effects of his symptoms. See Dominguez v. Colvin, 808 F.3d 403, 408-09 (9th Cir. 

2015) (remanding to the ALJ for further proceedings to resolve outstanding issues 

in the record).

REVERSED AND REMANDED.