Court Opinion

ID: 9915536
Source: CourtListenerOpinion
Date Created: 2024-01-05 18:00:32.15632+00
Date Added: 2024-06-11T13:15:32.052254
License: Public Domain

FOR PUBLICATION

   UNITED STATES COURT OF APPEALS
        FOR THE NINTH CIRCUIT

JUANITA L. CROSS,                          No. 23-35096

               Plaintiff-Appellant,           D.C. No.
                                           3:22-cv-05205-
 v.                                             SKV

MARTIN J. O'MALLEY,
Commissioner of Social Security,             OPINION

               Defendant-Appellee.

        Appeal from the United States District Court
           for the Western District of Washington
      Sarah Kate Vaughan, Magistrate Judge, Presiding

         Argued and Submitted December 4, 2023
                  Seattle, Washington

                   Filed January 5, 2024

Before: N. Randy Smith, Gabriel P. Sanchez, and Salvador
              Mendoza, Jr., Circuit Judges.

                Opinion by Judge Sanchez
2                       CROSS V. O’MALLEY

                          SUMMARY*

                         Social Security

    The panel affirmed the district court’s decision affirming
the Commissioner of Social Security’s denial of a claimant’s
application for supplemental security income under Title
XVI of the Social Security Act.
   Claimant      argued     that    the   Social    Security
Administration’s 2017 revised regulations for evaluating
medical opinions were partially invalid because they did not
provide a reasoned explanation for permitting an
administrative law judge to avoid articulating how he or she
accounts for the “examining relationship” or
“specialization” factors under the Social Security Act or the
Administrative Procedure Act (“APA”).
    The panel held that the 2017 medical-evidence
regulations were valid under the Social Security Act. The
Commissioner’s decision to promulgate the 2017 medical-
evidence regulations fell within his “wide latitude” to make
rules and regulations, particularly those governing the nature
and extent of the proofs and evidence to establish the right
to benefits.
    The panel joined the Eleventh Circuit in holding that the
regulations were valid under the APA. The agency’s
response to public comment and reasoned explanation for

*
 This summary constitutes no part of the opinion of the court. It has
been prepared by court staff for the convenience of the reader.
                     CROSS V. O’MALLEY                     3

the regulatory changes established that the regulations were
not arbitrary or capricious.
   The panel addressed claimant’s other claims in an
unpublished memorandum disposition filed concurrently
with this opinion.

                       COUNSEL

Eitan K. Yanich (argued), Law Office of Eitan Kassel
Yanich PLLC, Olympia, Washington, for Plaintiff-
Appellant.
David J. Burdett (argued), Special Assistant United States
Attorney; Mathew W. Pile, Associate General Counsel;
Office of the General Counsel, Office of Program Litigation,
Social Security Administration, Baltimore, Maryland;
Rebecca S. Cohen and Kerry Keefe, Assistant United States
Attorneys; Tessa M. Gorman, Acting United States
Attorney; United States Department of Justice, United States
Attorney’s Office, Seattle, Washington; for Defendant-
Appellee.
4                    CROSS V. O’MALLEY

                         OPINION

SANCHEZ, Circuit Judge:

    Claimant Juanita L. Cross appeals the district court’s
decision affirming the Commissioner of the Social Security
Administration’s denial of her application for supplemental
security income under Title XVI of the Social Security Act.
She argues that the Social Security Administration’s 2017
medical-evidence regulations are partially invalid, rendering
the administrative law judge’s (“ALJ”) application of those
regulations to her claim reversible legal error. We have
jurisdiction under 28 U.S.C. § 1291, and we affirm.1

            PROCEDURAL BACKGROUND
    On January 11, 2019, Cross filed her application for
supplemental security income based on her alleged
disability. The Social Security Administration denied her
claim on June 12, 2019 and upon reconsideration on
September 11, 2019. At Cross’s request, ALJ David
Johnson held an administrative hearing on December 9,
2020.
    In his decision on January 29, 2021, the ALJ used the
five-step sequential evaluation process to find that Cross was
not disabled. See 20 C.F.R. § 416.920. Before moving to
steps four and five, the ALJ applied the Social Security
Administration’s governing medical-evidence regulations,
considered conflicting medical opinions, and determined
that Cross would have the residual functional capacity to
perform a full range of work at all exertional levels in

1
  We address Cross’s other claims in an unpublished memorandum
disposition filed concurrently with this opinion.
                     CROSS V. O’MALLEY                      5

accordance with certain restrictions.        The ALJ then
determined that Cross was not disabled because she would
be able to perform several occupations existing in significant
numbers in the national economy.
    The Appeals Council denied Cross’s request for review,
making the ALJ’s decision the Commissioner’s final
decision. Cross sought judicial review, and the district court
affirmed the Commissioner’s decision that Cross was not
disabled on December 7, 2022. Cross timely appealed.

                LEGAL BACKGROUND
    When determining whether a claimant is eligible for
benefits, an ALJ need not take every medical opinion at
“face value.” Ford v. Saul, 950 F.3d 1141, 1155 (9th Cir.
2020). Rather, the ALJ must scrutinize the various—often
conflicting—medical opinions to determine how much
weight to afford each opinion. See id. (citing 20 C.F.R.
§ 404.1527(c)(3)). For social security disability claims filed
prior to March 27, 2017, an ALJ is required to assess medical
opinions “based on the extent of the doctor’s relationship
with the claimant.” Woods v. Kijakazi, 32 F.4th 785, 789
(9th Cir. 2022). “We categorized these relationships in a
three-tiered hierarchy”: treating physicians, examining
physicians, and non-examining physicians. Id. A treating or
examining physician’s medical opinion was afforded greater
deference due to his or her relationship to the claimant. Id.
Before an ALJ could disregard the medical opinion of a
treating physician, we required “specific and legitimate”
reasons for doing so, based upon substantial evidence in the
record. Id. (citation omitted).
    In January 2017, the Social Security Administration
issued revised regulations for evaluating medical opinions
6                       CROSS V. O’MALLEY

relating to claims filed on or after March 27, 2017. See
Revisions to Rules Regarding the Evaluation of Medical
Evidence, 82 Fed. Reg. 5844-01 (Jan. 18, 2017) (codified at
20 C.F.R. pts. 404 & 416). The regulations provide that
ALJs will no longer “defer or give any specific evidentiary
weight” to any medical opinions. 20 C.F.R. § 416.920c(a).
Instead, ALJs must explain how persuasive they find the
medical opinion by expressly considering the two most
important factors for evaluating such opinions:
“supportability” and “consistency.” Id. § 416.920c(b)(2).
The regulations define “supportability” as follows:

       The more relevant the objective medical
       evidence and supporting explanations
       presented by a medical source are to support
       his or her medical opinion(s) or prior
       administrative medical finding(s), the more
       persuasive the medical opinions or prior
       administrative medical finding(s) will be.

Id. § 416.920c(c)(1). The regulations define “consistency”
as follows:

       The more consistent a medical opinion(s) or
       prior administrative medical finding(s) is
       with the evidence from other medical sources
       and nonmedical sources in the claim, the
       more persuasive the medical opinion(s) or
       prior administrative medical finding(s) will
       be.

Id. § 416.920c(c)(2).
   An ALJ may discuss other factors, such as the medical
source’s “relationship with the claimant” or “specialization,”
                      CROSS V. O’MALLEY                        7

but generally has no obligation to do so.                 Id.
§ 416.920c(b)(2). Only if the ALJ finds two or more
contradictory medical opinions “both equally well-
supported . . . and consistent with the record” must the ALJ
then articulate how he or she considered these other factors.
Id. § 416.920c(b)(3), (c)(3)–(5).
    Thus, for social security disability claims filed on or after
March 27, 2017, these new regulations apply. In applying
these new regulations, we recently held in Woods that the
“specific and legitimate” standard was “clearly
irreconcilable” with the “intervening higher authority” of the
regulations. 32 F.4th at 790 (citation omitted). Accordingly,
these regulations “displace[d] our longstanding case law
requiring an ALJ to provide ‘specific and legitimate’ reasons
for rejecting an examining doctor’s opinion.” Id. at 787.
Even under the revised regulations, however, “an ALJ
cannot reject an examining or treating doctor’s opinion as
unsupported or inconsistent without providing an
explanation supported by substantial evidence.” Id. at 792.

   JURISDICTION AND STANDARD OF REVIEW
    The district court had subject matter jurisdiction under
42 U.S.C. § 405(g). We have jurisdiction under 28 U.S.C.
§ 1291. We review de novo “[t]he ALJ’s determinations of
law . . . , although deference is owed to a reasonable
construction of the applicable statutes.”         Edlund v.
Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001), as amended
on reh’g (Aug. 9, 2001).

                        DISCUSSION
    In Woods, we confirmed that the 2017 regulations were
irreconcilable with our prior case law, but we did not
8                    CROSS V. O’MALLEY

consider whether the regulations complied with the Social
Security Act or Administrative Procedure Act (“APA”). See
32 F.4th at 790 n.3. That issue is now squarely before us.
Cross argues that the regulations are partially invalid
because they do not provide a reasoned explanation for
permitting an ALJ to avoid articulating how he or she
accounts for the “examining relationship” or
“specialization” factors under the Social Security Act or
APA. See 42 U.S.C. § 405(b)(1) (requiring the Social
Security Commissioner to explain the basis of his decision
denying benefits); 5 U.S.C. § 557(c)(A) (requiring an ALJ
to explain the basis of his or her findings and conclusions).
We address Cross’s contention in view of the requirements
of each statute.

I. The Social Security Act
    The Social Security Act empowers the Commissioner to
“adopt reasonable and proper rules and regulations to
regulate and provide for the nature and extent of the proofs
and evidence and the method of taking and furnishing the
same . . . .” 42 U.S.C. § 405(a). This provision confers
“exceptionally broad authority [on the Commissioner] to
prescribe standards for applying certain sections of the Act.”
Bowen v. Yuckert, 482 U.S. 137, 145 (1987) (citation
omitted). Because the Social Security Act “expressly
entrusts the [Commissioner] with the responsibility for
implementing a provision by regulation, our review is
limited to determining whether the regulations promulgated
exceeded the [Commissioner’s] statutory authority and
whether they are arbitrary and capricious.” Id. (quoting
Heckler v. Campbell, 461 U.S. 458, 466 (1983)).
   The agency’s broad mandate from Congress plainly
encompasses the Commissioner’s authority to adopt
                      CROSS V. O’MALLEY                      9

regulations to govern the weighing of medical evidence. In
Woods, we observed that “[t]he Social Security Act provides
no guidance as to how the agency should evaluate medical
evidence.” 32 F.4th at 790. “The Commissioner has wide
latitude ‘to make rules and regulations and to establish
procedures . . . to carry out [the statutory] provisions,’ in
particular regulations governing ‘the nature and extent of the
proofs and evidence . . . to establish the right to benefits.’”
Id. (quoting 42 U.S.C. § 405(a) and citing Yuckert, 482 U.S.
at 145).
    It is true, as Cross contends, that 42 U.S.C. § 405(b)(1)
requires an ALJ to explain the basis for his or her decision.
But the statute does not restrict the Commissioner’s
authority to regulate the manner in which medical-evidence
factors should be analyzed and discussed. The 2017
regulations require an ALJ to discuss the supportability and
consistency of medical evidence—the factors the agency has
historically found to be the most important in evaluating
medical opinions—while allowing for discussion of other
factors listed in paragraphs (c)(3) through (c)(5), as
appropriate. 20 C.F.R. § 416.920c(a); see Revisions to
Rules Regarding the Evaluation of Medical Evidence, 82
Fed. Reg. at 5853. Indeed, the regulations mandate
discussion of these other factors when there are two or more
contradictory medical opinions both “equally well-
supported” and “consistent with the record.” See 20 C.F.R.
§ 416.920c(b)(3). The regulations thus “fill” a “gap”
“explicitly left” by Congress and are not “manifestly
contrary to the statute.” Chevron, U.S.A., Inc. v. Nat. Res.
Def. Council, Inc., 467 U.S. 837, 843–44 (1984).
     We hold that the Commissioner’s decision to promulgate
the 2017 medical-evidence regulations falls within his “wide
latitude ‘to make rules and regulations,’” particularly those
10                   CROSS V. O’MALLEY

“governing ‘the nature and extent of the proofs and evidence
. . . to establish the right to benefits.’” Woods, 32 F.4th at
790 (quoting 42 U.S.C. § 405(a)). The 2017 medical-
evidence regulations are valid under the Social Security Act.

II. The APA
     “The APA sets forth the procedures by which federal
agencies are accountable to the public and their actions
subject to review by the courts.” Dep’t of Homeland Sec. v.
Regents of the Univ. of Cal., 140 S. Ct. 1891, 1905 (2020)
(internal quotations marks and citation omitted). Agencies
must “engage in ‘reasoned decisionmaking.’” Id. (citation
omitted). We do not “substitute [our] judgment for that of
the agency” but rather “assess only whether the decision was
based on a consideration of the relevant factors and whether
there has been a clear error of judgment.” Id. (internal
quotation marks and citations omitted). Thus, we will “set
aside” the Commissioner’s rulemaking only if it was
“arbitrary or capricious.” See id. (internal quotation marks
omitted) (quoting 5 U.S.C. § 706(2)(A)). In reviewing the
agency’s decisionmaking, we are mindful that “[a]gencies
are free to change their existing policies as long as they
provide a reasoned explanation for the change.” Encino
Motorcars, LLC. v. Navarro, 579 U.S. 211, 221 (2016)
(citing Nat’l Cable & Telecomms. Ass’n v. Brand X Internet
Servs., 545 U.S. 967, 981–982 (2005); Chevron, 467 U.S. at
863–64).
    Cross challenges the validity of the regulations under the
APA because the agency did not provide a “reasoned
explanation” for their adoption. Cross’s opening brief fails
to acknowledge the agency’s published reasons for the
changes and its response to public comment from its earlier
notice of proposed rulemaking. See Revisions to Rules
                     CROSS V. O’MALLEY                    11

Regarding the Evaluation of Medical Evidence, 82 Fed. Reg.
5844-01.
    At the time, the agency explained that changes to the
healthcare system since the adoption of the prior regulations
in 1991, along with the agency’s long experience in
adjudicating disability claims, showed that “supportability”
and “consistency” were the two most important factors for
evaluating medical opinions. Id. at 5853. “Many individuals
receive health care from multiple medical sources,” the
agency explained, “such as from coordinated and managed
care organizations,” and “less frequently develop a sustained
relationship with one treating physician.” Id. Supportability
and consistency, according to the agency, are therefore
“more objective measures that will foster the fairness and
efficiency in [its] administrative process.” Id. Moreover,
the agency expressed concern that, under the former rule,
courts “focused more on whether [the agency] sufficiently
articulated the weight [it] gave treating source opinions,
rather than on whether substantial evidence support[ed]” the
agency’s “final decision.” Id. Still, the agency noted, the
regulations “retain the relationship between the medical
source and the claimant as one of the factors” to consider.
Id.
    The Eleventh Circuit recently held these regulations to
be valid under the APA based on the agency’s reasoned
explanation that the regulations “help[] to ‘eliminate
confusion about a hierarchy of medical sources’ that no
longer reflects how most claimants receive health care.”
Harner v. Soc. Sec. Admin., Comm’r, 38 F.4th 892, 897 (11th
Cir. 2022) (quoting Revisions to Rules Regarding the
Evaluation of Medical Evidence, 82 Fed. Reg. at 5853)
(evaluating 20 C.F.R. § 404.1520c). We agree. The
agency’s response to public comment and reasoned
12                   CROSS V. O’MALLEY

explanation for the regulatory changes establishes that the
regulations are not arbitrary or capricious. We join the
Eleventh Circuit in holding that the regulations are valid
under the APA.

                     CONCLUSION
    The Social Security Administration’s 2017 medical-
evidence regulations fall within the broad scope of the
Commissioner’s authority under the Social Security Act, and
the agency provided a reasoned explanation for the
regulatory changes, making the regulations neither arbitrary
nor capricious under the APA.
     AFFIRMED.