Reyes-Valle v. Colvin, No. 1:2016cv03005 - Document 19 (E.D. Wash. 2016)
Court Description: ORDER Granting 15 Plaintiff's Motion for Summary Judgment and Remand for Payment of Benefits; Denying 17 Defendant's Motion for Summary Judgment. Signed by Senior Judge Robert H. Whaley. (PL, Case Administrator)
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Reyes-Valle v. Colvin Doc. 19 1 2 3 4 5 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 6 7 DILCIA REYES-VALLE, 8 Plaintiff, 9 v. 10 11 12 13 CAROLYN W. COLVIN, Acting Commissioner of Social Security, No. 1:16-CV-03005-RHW ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS Defendant. Before the Court are the parties’ cross-motions for summary judgment, ECF 14 Nos. 15, 17. Plaintiff Dilcia Reyes-Valle brings this action seeking judicial 15 review, pursuant to 42 U.S.C. § 405(g), of the Commissioner’s final decision, 16 which denied her application for Disability Insurance Benefits under Title II of the 17 Social Security Act, 42 U.S.C §§ 401-434, and for Supplemental Security Income 18 under Title XVI of the Social Security Act, 42 U.S.C §§ 1381-1383F. After 19 reviewing the administrative record and briefs filed by the parties, the Court is now 20 ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 1 Dockets.Justia.com 1 fully informed. For the reasons set forth below, the Court GRANTS Ms. Reyes- 2 Valle’s Motion for Summary Judgment and REMANDS for payment of benefits. 3 4 I. Jurisdiction Ms. Reyes-Valle filed an application for Disability Insurance Benefits on 5 December 2, 2011, AR 236, and an application for Supplemental Security Income 6 on May 7, 2012, AR 30, alleging onset of disability on November 16, 2011. AR 7 236. The applications were denied on January 4, 2012, and March 26, 2012, AR 8 97-107, and on reconsideration on June 8, 2012, AR 112-124. On May 13, 2013, 9 Administrative Law Judge (“ALJ”) Laura Valente held a video hearing. AR 45- 10 68. On September 26, 2013, ALJ Valente issued a decision finding Ms. Reyes- 11 Valle ineligible for benefits. AR 30-39. The Appeals Council denied Ms. Reyes- 12 Valle’s request for review on April 28, 2015, AR 16-18, making the ALJ’s ruling 13 the “final decision” of the Commissioner. Ms. Reyes-Valle timely filed the 14 present action challenging the denial of benefits, and accordingly, her claims are 15 properly before this Court pursuant to 42 U.S.C. § 405(g). 16 17 II. Sequential Evaluation Process The Social Security Act defines disability as the “inability to engage in any 18 substantial gainful activity by reason of any medically determinable physical or 19 mental impairment which can be expected to result in death or which has lasted or 20 can be expected to last for a continuous period of not less than twelve months.” 42 ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 2 1 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A claimant shall be determined to be 2 under a disability only if the claimant’s impairments are of such severity that the 3 claimant is not only unable to do his previous work, but cannot, considering 4 claimant's age, education, and work experience, engage in any other substantial 5 gainful work that exists in the national economy. 42 U.S.C. §§ 423(d)(2)(A) & 6 1382c(a)(3)(B). 7 The Commissioner has established a five-step sequential evaluation process 8 for determining whether a claimant is disabled within the meaning of the Social 9 Security Act. 20 C.F.R. §§ 404.1520(a)(4) & 416.920(a)(4); Lounsburry v. 10 11 Barnhart, 468 F.3d 1111, 1114 (9th Cir. 2006). Step one inquires whether the claimant is presently engaged in “substantial 12 gainful activity.” 20 C.F.R. §§ 404.1520(b) & 416.920(b). Substantial gainful 13 activity is defined as significant physical or mental activities done or usually done 14 for profit. 20 C.F.R. §§ 404.1572 & 416.972. If the claimant is engaged in 15 substantial activity, he or she is not entitled to disability benefits. 20 C.F.R. §§ 16 404.1571 & 416.920(b). If not, the ALJ proceeds to step two. 17 Step two asks whether the claimant has a severe impairment, or combination 18 of impairments, that significantly limits the claimant’s physical or mental ability to 19 do basic work activities. 20 C.F.R. §§ 404.1520(c) & 416.920(c). A severe 20 impairment is one that has lasted or is expected to last for at least twelve months, ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 3 1 and must be proven by objective medical evidence. 20 C.F.R. §§ 404.1508-09 & 2 416.908-09. If the claimant does not have a severe impairment, or combination of 3 impairments, the disability claim is denied, and no further evaluative steps are 4 required. Otherwise, the evaluation proceeds to the third step. 5 Step three involves a determination of whether any of the claimant’s severe 6 impairments “meets or equals” one of the listed impairments acknowledged by the 7 Commissioner to be sufficiently severe as to preclude substantial gainful activity. 8 20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526 & 416.920(d), 416.925, 416.926; 9 20 C.F.R. § 404 Subpt. P. App. 1 (“the Listings”). If the impairment meets or 10 equals one of the listed impairments, the claimant is per se disabled and qualifies 11 for benefits. Id. If the claimant is not per se disabled, the evaluation proceeds to 12 the fourth step. 13 Step four examines whether the claimant’s residual functional capacity 14 enables the claimant to perform past relevant work. 20 C.F.R. §§ 404.1520(e)-(f) 15 & 416.920(e)-(f). If the claimant can still perform past relevant work, the claimant 16 is not entitled to disability benefits and the inquiry ends. Id. 17 Step five shifts the burden to the Commissioner to prove that the claimant is 18 able to perform other work in the national economy, taking into account the 19 claimant’s age, education, and work experience. See 20 C.F.R. §§ 404.1512(f), 20 404.1520(g), 404.1560(c) & 416.912(f), 416.920(g), 416.960(c). To meet this ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 4 1 burden, the Commissioner must establish that (1) the claimant is capable of 2 performing other work; and (2) such work exists in “significant numbers in the 3 national economy.” 20 C.F.R. §§ 404.1560(c)(2); 416.960(c)(2); Beltran v. Astrue, 4 676 F.3d 1203, 1206 (9th Cir. 2012). 5 6 III. Standard of Review A district court's review of a final decision of the Commissioner is governed 7 by 42 U.S.C. § 405(g). The scope of review under § 405(g) is limited, and the 8 Commissioner's decision will be disturbed “only if it is not supported by 9 substantial evidence or is based on legal error.” Hill v. Astrue, 698 F.3d 1144, 10 1158-59 (9th Cir. 2012) (citing § 405(g)). Substantial evidence means “more than 11 a mere scintilla but less than a preponderance; it is such relevant evidence as a 12 reasonable mind might accept as adequate to support a conclusion.” Sandgathe v. 13 Chater, 108 F.3d 978, 980 (9th Cir.1997) (quoting Andrews v. Shalala, 53 F.3d 14 1035, 1039 (9th Cir. 1995)) (internal quotation marks omitted). In determining 15 whether the Commissioner’s findings are supported by substantial evidence, “a 16 reviewing court must consider the entire record as a whole and may not affirm 17 simply by isolating a specific quantum of supporting evidence.” Robbins v. Soc. 18 Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006) (quoting Hammock v. Bowen, 879 19 F.2d 498, 501 (9th Cir. 1989)). 20 ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 5 1 In reviewing a denial of benefits, a district court may not substitute its 2 judgment for that of the ALJ. Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 3 1992). If the evidence in the record “is susceptible to more than one rational 4 interpretation, [the court] must uphold the ALJ's findings if they are supported by 5 inferences reasonably drawn from the record.” Molina v. Astrue, 674 F.3d 1104, 6 1111 (9th Cir. 2012); see also Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 7 2002) (if the “evidence is susceptible to more than one rational interpretation, one 8 of which supports the ALJ’s decision, the conclusion must be upheld”). Moreover, 9 a district court “may not reverse an ALJ's decision on account of an error that is 10 harmless.” Molina, 674 F.3d at 1111. An error is harmless “where it is 11 inconsequential to the [ALJ's] ultimate nondisability determination.” Id. at 1115. 12 The burden of showing that an error is harmful generally falls upon the party 13 appealing the ALJ's decision. Shinseki v. Sanders, 556 U.S. 396, 409–10 (2009). 14 15 IV. Statement of Facts The facts of the case are set forth in detail in the transcript of proceedings, 16 and accordingly, are only briefly summarized here. Ms. Reyes-Valle was 50 years 17 old on her alleged onset date. AR 29. Ms. Reyes-Valle has four years of education, 18 all of which was in Mexico, her native country. AR 56-58. Ms. Reyes-Valle’s 19 primary language is Spanish, and she required a translator for her hearing. AR 47, 20 56. She understands English, but she has limited speaking, reading, and writing ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 6 1 skills. AR 56-57. Ms. Reyes-Valle has previously been employed as a home 2 attendant, fish cleaner, fruit inspector, agricultural produce sorter, and agricultural 3 produce packer. AR 37. Ms. Reyes-Valle has a history of diabetes, obesity, urinary 4 tract infections, and depression. AR 867. She was involved in a car accident that 5 injured her left shoulder. AR 59. 6 7 8 9 V. The ALJ’s Findings The ALJ determined that Ms. Reyes-Valle was not disabled under the Social Security Act and denied her application for benefits. AR 30-39. At step one, the ALJ found that Ms. Reyes-Valle had not engaged in 10 substantial gainful activity since her alleged onset date of November 16, 2011 11 (citing 20 C.F.R. §§ 404.1571 et seq. & 416.971 et seq.). AR 32. 12 At step two, the ALJ found Ms. Reyes-Valle had the following severe 13 impairments: diabetes mellitus and obesity (citing 20 C.F.R. §§ 404.1520(c) & 14 416.920(c)). AR 32-33. 15 At step three, the ALJ found that Ms. Reyes-Valle did not have an 16 impairment or combination of impairments that meets or medically equals the 17 severity of one of the listed impairments in 20 C.F.R. §§ 404, Subpt. P, App. 1 18 (citing 20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925, & 19 416.926). AR 33. 20 ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 7 1 At step four, the ALJ found that Ms. Reyes-Valle could perform light work 2 as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), except that she could only 3 sit for an hour at a time before changing positions at the work station; continue 4 sitting in this manner fox six hours in an eight-hour workday; stand or walk for 5 four hours in an eight-hour workday; occasionally stoop, crouch, or crawl; never 6 climb ladders, ropes, or scaffolds; occasionally climb ramps or stairs; frequently 7 perform fine fingering and gross handling with her left upper extremity; 8 occasionally reach overhead with her left upper extremity; avoid concentrated 9 exposure to extreme cold and heat; and avoid all exposure to dangerous moving 10 machinery and heights. AR 33-37. 11 The ALJ found that Ms. Reyes-Valle was unable to perform any past 12 relevant work as a home attendant, fish cleaner, fruit inspector, agricultural 13 produce sorter, and agricultural produce packer. AR 37. 14 At step five, the ALJ found that, considering her age, education, work 15 experience, residual functional capacity, and acquired work skills from past 16 relevant work, in conjunction with the Medical-Vocational Guidelines and the 17 testimony of a vocational expert, there are jobs that exist in significant numbers in 18 the national economy that Ms. Reyes-Valle can perform, including semiconductor 19 bonder, hand packager, and information clerk. AR 37-38. 20 // ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 8 1 2 VI. Issues for Review Ms. Reyes-Valle argues that the Commissioner’s decision is not free of legal 3 error and not supported by substantial evidence. Specifically, she argues the ALJ 4 erred by: (1) improperly weighing the medical opinion evidence of her treating 5 physician, Dr. Rosa Martinez; (2) improperly rejecting Ms. Reyes-Valle’s 6 subjective symptom testimony; and (3) determining that Ms. Reyes-Valle was able 7 to perform light work because due to her age, she should have been found disabled 8 under the Social Security grid rules. ECF No. 15 at 1. 9 10 VII. Analysis A. The ALJ improperly rejected the opinion of treating physician Dr. Rosa 11 Martinez. 12 The Ninth Circuit has distinguished between three classes of medical 13 providers in defining the weight to be given to their opinions: (1) treating 14 providers, those who actually treat the claimant; (2) examining providers, those 15 who examine but do not treat the claimant; and (3) non-examining providers, those 16 who neither treat nor examine the claimant. Lester v. Chater, 81 F.3d 821, 830 (9th 17 Cir. 1996) (as amended). 18 A treating provider’s opinion is given the most weight, followed by an 19 examining provider, and finally a non-examining provider. Id. at 830-31. In the 20 absence of a contrary opinion, a treating or examining provider’s opinion may not ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 9 1 be rejected unless “clear and convincing” reasons are provided. Id. at 830. If a 2 treating or examining provider’s opinion is contradicted, it may only be discounted 3 for “specific and legitimate reasons that are supported by substantial evidence in 4 the record.” Id. at 830-31. 5 The ALJ may meet the specific and legitimate standard by “setting out a 6 detailed and thorough summary of the facts and conflicting clinical evidence, 7 stating [his or her] interpretation thereof, and making findings.” Magallanes v. 8 Bowen, 881 F.2d 747, 751 (9th Cir. 1989) (internal citation omitted). When 9 rejecting a treating provider’s opinion on a psychological impairment, the ALJ 10 must offer more than his or her own conclusions and explain why he or she, as 11 opposed to the provider, is correct. Embrey v. Bowen, 849 F.2d 418, 421-22 (9th 12 Cir. 1988). 13 Dr. Martinez opined in May 2013 that Ms. Reyes-Valle’s prognosis was fair, 14 but she was limited to sitting and standing less than two hours in an eight-hour 15 workday, needed to elevate her legs, would be off-task at least twenty-five percent 16 of the workday, would miss more than four days of work per month, and was 17 incapable of low-stress work due to her depression. AR 867-74. Additionally, Dr. 18 Martinez limited Ms. Reyes-Valle to lifting less than ten pounds only occasionally 19 and noted significant limitations in postural positions and reaching with the left 20 upper extremity. Id. ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 10 1 The record demonstrates that Dr. Martinez treated Ms. Reyes-Valle from 2 July 2010 until September 2012, AR 288, and as a treating physician, Dr. 3 Martinez’s opinions are entitled to the highest level of deference. Despite this, the 4 ALJ gave no weight to Dr. Martinez’s May 2013 opinion. AR 37. The ALJ 5 rationalized that this form was insufficient because it provided “minimal narrative 6 support” and that Dr. Martinez did not indicate that she was qualified to give an 7 opinion on Ms. Reyes-Valle’s mental impairments. Id. Further, ALJ Valente 8 stated that clinical findings do not support Dr. Martinez’s opinion, and that the 9 treatment relationship was “remote.” Id. The ALJ committed reversible error for 10 11 the reasons stated below. First, an ALJ may take the relationship between patient and doctor into 12 account, including length and frequency of treatment. 20 C.F.R. §§ 13 404.1527(c)(2)(i) & 416.927(c)(2)(i). In this case, however, the record does not 14 support the assertion that the treatment relationship was remote. Dr. Martinez 15 regularly treated Ms. Reyes-Valle for over two years, every four to twelve weeks. 16 AR 288, 867. The form was completed within that schedule, as less than twelve 17 months had elapsed since the last visit of record. See id. 18 Moreover, while Dr. Martinez does not provide a written explanation for 19 each of her responses on the form, her experience as a treating physician for a 20 period of over two years makes her qualified to make assessments. See Garrison v. ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 11 1 Colvin, 759 F.3d 995, 1014 n. 17 (9th Cir. 2014) (a checkbox format is acceptable 2 when it reflects the record created in the course of a treatment relationship). The 3 record as a whole also supports Dr. Martinez’s opinion. Contrary to the ALJ’s 4 reflection that the “only clinical findings in support of the limitations provided by 5 Dr. Martinez are regarding the claimant’s obesity and abdominal pain,” AR 37, the 6 record shows that Dr. Martinez treated Ms. Reyes-Valle for a variety of issues, AR 7 752-786. For instance, references to urinary tract/bladder disorders/infections are 8 found numerous places in the record, yet the ALJ incorrectly does not recognize 9 urinary tract illness as supported by clinical findings.1 AR 81, 90, 392, 394, 532, 10 11 535, 657, 659, 666, 738, 741, 742, 743, 750, 806, 834, 841. Significantly, the ALJ entirely ignored any mental impairments. The 12 Commissioner concedes that the ALJ erred by rejecting Dr. Martinez’s opinion 13 regarding Ms. Reyes-Valle’s mental impairments on the grounds of qualification. 14 ECF No. 17 at 5. Dr. Martinez is a licensed medical doctor, and by virtue of her 15 training and expertise, she has the ability to make that finding. Contrary to the 16 Commissioner’s assertion, however, failure to even consider her mental health 17 diagnosis was not harmless error. See id. Because of this total rejection, the 18 limitations set forth by Dr. Martinez were not properly considered at any step. Ms. 19 20 1 The ALJ should have found urinary tract issues to be a serious impairment, but this challenge was not raised. Further, the ALJ also improperly challenged Ms. Reyes-Valle’s credibility by asserting there was no evidence of urinary tract infections/disorders, clearly contradictory to the record. ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 12 1 Reyes-Valle’s mental impairments were not even considered in her residual 2 functional capacity. 2 AR 33 (finding no diagnosis of depression). 3 At the time she prepared this form, Dr. Martinez had a broad picture of her 4 patient because of her long-term treatment of Ms. Reyes-Valle, and it was that 5 broad picture from which Dr. Martinez drew her conclusions. By rejecting Dr. 6 Martinez’s treating physician opinion, the ALJ committed reversible error. 7 8 B. When the limitations proposed by Dr. Martinez are accepted as true, the record demonstrates Ms. Reyes-Valle is disabled. 9 “Where the Commissioner fails to provide adequate reasons for rejecting the 10 opinion of a treating or examining physician, we credit that opinion ‘as a matter of 11 law.’” Lester, 81 F.3d at 834 (quoting Hammock v. Bowen, 879 F.2d 498, 502 (9th 12 Cir. 1989)). This is also known as the “credit-as-true” rule and requires that: (1) 13 the record is fully developed and no further administrative proceedings would be 14 useful; (2) the ALJ failed to provide legally sufficient reasons for rejecting the 15 evidence; and (3) if the improperly discredited evidence were credited as true, the 16 ALJ would be required to find disability on remand. Garrison v. Colvin, 759 F.3d 17 995, 1020 (9th Cir. 2014). Further, the Ninth Circuit has indicated that it could be 18 an abuse of discretion for a district court not to remand when all of these 19 20 2 Despite the failure in calculating the residual functional capacity, remand for further proceedings is unnecessary for the reasons set forth in Section B of this analysis. ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 13 1 conditions are met unless the record as a whole seriously calls into doubt that the 2 claimant is disabled. Id.; see also, e.g., McCartey v. Massanari, 298 F.3d 1072, 3 1706-77 (9th Cir. 2002); Lingenfelter v. Astrue, 504 F.3d 1028, 1041 (9th Cir. 4 2007). 5 In Garrison, a vocational expert testified that based on the limitations set 6 forth in the improperly discredited evidence, the claimant could not work. 7 Garrison, 759 F.3d at 1022. That is also what happened in the instant case. Dr. 8 Martinez opined that Ms. Reyes-Valle would need to elevate her legs throughout 9 the day, would be off-task at least twenty-five percent of the day, and would miss 10 at least four days per month on average due to her impairments. AR 867-874. 11 Vocational expert Kimberly Mullinax testified that these limitations would 12 preclude gainful employment. AR 65-67. With credit of this testimony, the ALJ 13 would be required to find disability on remand. See Garrison, 759 F.3d at 1020. 14 Furthermore, the Court has fully reviewed the record and does not find serious 15 doubt of Ms. Reyes-Valle’s disability. Id. 16 The Court need not analyze other allegations of error asserted by Ms. 17 Reyes-Valle,3 in particular, Ms. Reyes-Valle’s credibility assessment. As explained 18 in this Order, the medical record and Dr. Martinez’s history and expertise support 19 her medical opinion. This would not change regardless of Ms. Reyes-Valle’s 20 3 Because remand is already appropriate based on vocational expert testimony, the issue of the Grids also need not be reached. ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 14 1 credibility, and the ALJ does not allege that Dr. Martinez formed her opinion to 2 any significant degree from Ms. Reyes-Valle’s subjective complaints. No purpose 3 would be served by remanding for further proceedings. Thus, the appropriate 4 remedy is to remand for immediate payment of benefits. 5 VIII. Conclusion 6 Having reviewed the record and the ALJ’s findings, the Court finds the 7 ALJ’s decision is not supported by substantial evidence and not free of legal error. 8 Accordingly, IT IS ORDERED: 9 1. Plaintiff’s Motion for Summary Judgment, ECF No. 15, is GRANTED. 10 2. Defendant’s Motion for Summary Judgment, ECF No. 17, is DENIED. 11 3. Judgment shall be entered for Plaintiff and against Defendant. 12 4. This matter is REMANDED for payment of benefits. 13 IT IS SO ORDERED. The District Court Executive is directed to enter this 14 Order, forward copies to counsel and CLOSE the file. 15 DATED this 22nd day of December, 2016. 16 17 s/Robert H. Whaley ROBERT H. WHALEY Senior United States District Judge 18 19 20 ORDER GRANTING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND REMANDING FOR PAYMENT OF BENEFITS ~ 15
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