Opinion ID: 3047861
Heading Depth: 3
Heading Rank: 2

Heading: The DAA Analysis

Text: Appellant next argues that the ALJ erred in finding Parra ineligible for benefits because his alcoholism was a contributing factor material to his disability under 42 U.S.C. § 423(d)(2)(C). Once medical evidence of Parra’s alcoholism surfaced, the ALJ placed the burden of proof upon the claimant to establish that Parra’s alcoholism was not a contributing factor material to his disability, by showing he would have remained disabled had he stopped drinking in 1995. Appellant asserts that this holding was erroneous. Once a claimant satisfies the five-step analysis, she argues, the Commissioner should bear the burden of proving that benefits should be denied. Appellant analogizes to cases involving termination of benefits, wherein the Commissioner must prove that a claimant previously adjudged disabled has recovered sufficiently to 2 The finding that Parra had no “severe physical impairment” prior to December 31, 1995 appears in the section of the decision addressing his bursitis claim, before the ALJ discusses the effects of his alcoholism. In context, this statement is better understood as merely a recognition that Parra’s non-alcohol-related impairments did not constitute a disability—a finding supported by the record and seemingly not challenged on appeal. PARRA v. ASTRUE 3443 return to work. See, e.g., Bellamy v. Sec’y of Health & Human Servs., 755 F.2d 1380, 1381 (9th Cir. 1985). [4] Our prior opinions have explicitly left open the issue of which party bears the burden of proof under 42 U.S.C. § 423(d)(2)(C). We placed the burden upon the claimant in Ball, 254 F.3d at 821, although a later opinion correctly described this language as dicta. See Bustamante, 262 F.3d at 955 n.1. We note that each circuit to have considered the issue has placed the burden squarely upon the claimant. See, e.g., Doughty v. Apfel, 245 F.3d 1274, 1276 (11th Cir. 2001); Mittlestedt v. Apfel, 204 F.3d 847, 852 (8th Cir. 2000); Brown v. Apfel, 192 F.3d 492, 498 (5th Cir. 1999). Our own case law has suggested the same. See Sousa v. Callahan, 143 F.3d 1240, 1245 (9th Cir. 1998) (remanding to allow claimant “an opportunity to present evidence as to whether claimant’s disability would have continued if she stopped using drugs or alcohol”). This approach is consistent with the general rule that “[a]t all times, the burden is on the claimant to establish [his] entitlement to disability insurance benefits.” Tidwell, 161 F.3d at 601. Moreover, placing the burden on the claimant is practical because the claimant “is the party best suited to demonstrate whether [he] would still be disabled in the absence of drug or alcohol addiction.” Brown, 192 F.3d at 498. [5] Appellant’s reliance on cases involving the termination of benefits is misplaced. As Bellamy makes clear, the Commissioner’s burden in termination cases stems from the notion that “[o]nce a claimant has been found to be disabled [ ] a presumption of continuing disability arises in [his] favor.” Bellamy, 755 F.2d at 1381 (emphasis added). But the CAAA amended the definition of “disability” under the Social Security Act, such that an individual “shall not be considered disabled” if drug or alcohol use is material to his disability. In other words, the presumption driving Bellamy has not yet attached when the DAA Analysis is performed because the agency has yet to determine whether the claimant is disabled. 3444 PARRA v. ASTRUE “Unquestionably, proving disability is [claimant’s] burden, and any amendment to the definition of disability logically impacts [his] burden.” Brown, 192 F.3d at 498; see also Bellamy, 755 F.2d at 1381 (“Social Security disability benefits claimants have the burden of proving disability.”). We thus make explicit what was intimated by our earlier cases, that the claimant bears the burden of proving that drug or alcohol addiction is not a contributing factor material to his disability. [6] Appellant failed to carry this burden. The record offers no evidence supporting the notion that the disabling effects of Parra’s cirrhosis would have remained had he stopped drinking before December 31, 1995. Dr. Marmorstein testified that cirrhosis, caused by alcohol abuse, is generally reversible and that the medical records support a finding that Parra’s cirrhosis was irreversible only after July 1, 1999. Dr. Marmorstein explained that he had no reason to believe that Parra’s condition would not have improved had Parra quit drinking in 1995. When pressed by Parra’s counsel, he reiterated several times that “there is no way for me to know” whether Parra’s cirrhosis was irreversible in 1994 or 1995 because the record was insufficient to support a conclusion either way.3 Appellant argues that Dr. Marmorstein’s testimony was inconclusive on this point, and that inconclusive testimony is sufficient to satisfy the claimant’s burden of proof under the 3 The ALJ also cited the 1994 report of psychologist Dr. Nancy McCarthy. Dr. McCarthy documented many of the mental impairments later cited by Parra and his daughter at the disability hearings. Without discussing Parra’s liver damage, Dr. McCarthy wrote that these mental impairments were likely caused by excessive alcohol consumption and intimated that they would resolve if Parra stopped drinking. As appellant notes, Dr. McCarthy’s report does not state that Parra’s cirrhosis would have resolved with abstinence. But it does constitute substantial evidence to support a finding that his disabling mental limitations, which Dr. Marmorstein testified may have been caused by cirrhosis, would have resolved with abstinence. See Tackett, 180 F.3d at 1097 (court reviews whether ALJ’s conclusions are “supported by substantial evidence in the record as a whole” (emphasis added)). PARRA v. ASTRUE 3445 statute. To support this claim, she relies upon two internal agency documents, HALLEX I-5-3-14A4 and Emergency Teletype No. EM-96-94.5 These documents, she argues, preclude a finding of materiality unless the medical evidence affirmatively shows that a disability will resolve with abstinence. We reject this argument, which effectively shifts the burden to the Commissioner to prove materiality. Assuming without deciding that the HALLEX and Teletype provisions apply to this situation, we have previously explained that internal agency documents such as these do not carry the force of law and are not binding upon the agency. See, e.g., Lowry v. Barnhart, 329 F.3d 1019, 1023 (9th Cir. 2003); Moore v. Apfel, 216 F.3d 864, 868-69 (9th Cir. 2000). Therefore, they do not create judicially enforceable duties, and we will not review allegations of noncompliance with their provisions. See Moore, 216 F.3d at 869. At most, these sources may represent the agency’s unpromulgated interpretation of the statute’s phrase “contributing factor material to the determination of disability.” Such an interpretation is “ ‘entitled to respect’ ” but only to the extent that it has the “ ‘power to persuade.’ ” Christensen v. Harris County, 529 U.S. 576, 587 (2000) (quoting Skidmore v. Swift 4 HALLEX is the Hearing, Appeals, and Litigation Law Manual, an internal agency guidebook. HALLEX I-5-3-14A states that a finding that DAA is material is appropriate “only when . . . there is sufficient and appropriate medical evidence to establish . . . the individual would not be considered to be disabled if he/she stopped using drugs and/or alcohol.” 5 On August 30, 1996, the SSA’s Office of Disability sent this teletype to all hearing offices, responding to initial questions posed by the adoption of the CAAA. The relevant portion of the teletype explains that “a finding that DAA is material will be made only when the evidence establishes that the individual would not be disabled if he/she stopped using drugs/ alcohol.” Therefore in “cases in which the evidence demonstrates multiple impairments, especially cases involving multiple mental impairments, where the MC/PC cannot project what limitations would remain if the individuals stopped using drugs/alcohol,” the MC/PC “should record his/ her findings to that effect” and “the DE will find that DAA is not a contributing material factor to the determination of disability.” 3446 PARRA v. ASTRUE & Co., 323 U.S. 134, 140 (1944)). In this case, such an interpretation is unpersuasive because it contradicts the purpose of the statute. As noted above, Congress sought through the CAAA “to discourage alcohol and drug abuse, or at least not to encourage it with a permanent government subsidy.” Ball, 254 F.3d at 824.6 Appellant’s proposed rule provides the opposite incentive. An alcoholic claimant who presents inconclusive evidence of materiality has no incentive to stop drinking, because abstinence may resolve his disabling limitations and cause his claim to be rejected or his benefits terminated. His claim would be guaranteed only as long as his substance abuse continues—a scheme that effectively subsidizes substance abuse in contravention of the statute’s purpose.7 [7] In sum, we find that Parra bore the burden of proving that his alcoholism was not a contributing factor material to his cirrhosis-related disability. Dr. Marmorstein testified that abstinence generally ameliorates the effects of cirrhosis and that the record fails to show that Parra’s cirrhosis was irreversible when his disability insurance lapsed. Therefore we conclude that the ALJ’s denial of benefits under 42 U.S.C. § 423(d)(2)(C) was supported by substantial evidence and free of material error.