The opinion of the court was delivered by: Irma E. Gonzalez, Chief Judge United States District Court
ORDER: (1) GRANTING IN PART PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT [Doc. No. 9]; (2) DENYING DEFENDANT'S CROSS-MOTION FOR SUMMARY JUDGMENT [Doc. No. 12]; and (3) REMANDING PURSUANT TO SENTENCE-SIX OF 42 U.S.C. § 405(g).
Currently before the Court are Plaintiff's Motion for Summary Judgment and Defendant's Cross-Motion for Summary Judgment. Having considered the parties' arguments, and for the reasons set forth below, the Court GRANTS IN PARTPlaintiff's motion, DENIESDefendant's cross-motion, and REMANDS the action for further proceedings.
Plaintiff is a 69-year-old male with a second-year high school education equivalency. (Administrative Record ("AR") at 23.) Prior to the injury that forms the basis of this disability request, Plaintiff was an agricultural worker. (Id.) This work required him to pick up fruits, lift 80-pound bags, and to move up and down ladders. (Id. at 25.)
On January 31, 1994, Plaintiff was involved in an automobile accident when the pickup truck that he was driving was struck from behind. (Id. at 24.) The force of the collision caused Plaintiff's truck to overturn approximately 4 times, eventually causing Plaintiff to be ejected from the vehicle. (Id.) As a result of the accident, Plaintiff suffered the following complications: (1) L1 compression fracture without posterior element involvement; (2) right sacroiliac joint fracture dislocation; (3) right inferior and superior pubic rami fractures; (4) left transverse central and posterior wall acetabular fracture; (5) L4 on L5 isthmic spondylolisthesis, chronic; and (6) stress ulcer, and blood loss anemia. (Id. at 239.) Plaintiff was taken to Scripps Memorial Hospital in La Jolla, California, where he spent twenty-two days and underwent two surgeries to reconstruct his pelvic bone and to fix the dislocation in the upper portion of one of the legs. (Id. at 24-25.) Plaintiff alleges he was unable to return to work and even now has to walk with the assistance of a cane. (Id. at 25-26.) Plaintiff also suffers from type II diabetes, which affects the blood circulation in his leg and causes the leg to swell. (Id. at 26.)
In March 2006, Plaintiff protectively filed an application for Disability Insurance Benefits (DIB), alleging disability since January 1, 2005. (Id. at 95-99.) Plaintiff subsequently amended his application twice, eventually listing January 1, 1996 as the beginning date for the disability. (Id. at 100-03.) Plaintiff was last insured for DIB through December 31, 2000. (Id. at 13, 49, 55, 110.) Plaintiff's application was denied on June 22, 2006, and again upon reconsideration on January 12, 2007. (Id. at 49-52, 55-60.) Plaintiff thereafter requested a hearing before an Administrative Law Judge ("ALJ"). ALJ Larry B. Parker held two hearings, one on January 9, 2008 and one on February 12, 2008. In a decision dated March 5, 2008, the ALJ found that Plaintiff had not shown that he had a qualifying medically determinable impairment during the period between his alleged onset of disability and the date he was last insured. (Id. at 13-16.) Specifically, the ALJ concluded:
At the supplemental hearing held on February 12, 2008, the claimant testified that [he] was involved in a severe motor vehicle accident. However, the record does not contain evidence from a hospital or outpatient treating source that would substantiate the severity of the impairments alleged.
The claimant's representative stated that he had exhausted attempts at retrieving records from the claimant's alleged treating sources. He represented that the claimant's treating sources advised him that the claimant's treating records had been destroyed after being archived or held for a fixed period of time.
The regulations mandate that the burden is on the claimant to provide medically acceptable evidence in support of her claim (20 CFR 404.1508). Having thoroughly reviewed the record, the undersigned finds that there is no clinical or other objective evidence to support the claimant's bare allegations for the period from the alleged disability onset date of January 1, 1996, through December 31, 2000. (Id. at 15-16.) Plaintiff subsequently requested a review of the hearing decision by the Appeals Council. Plaintiff also was able to finally obtain the medical records from the time of the accident. (See id. at 199-392.) Although Plaintiff submitted those documents late to the Appeals Council, the Appeals Council found there was a good reason for the delay and accepted the documents. (Id. at 1-2.) Nonetheless, the Appeals Council denied the request for review of the ALJ's decision, finding that "[t]he additional documents submitted do not pertain to the period at issue." (Id.)
Plaintiff commenced this action on June 8, 2009, seeking judicial review pursuant to 42 U.S.C. § 405(g). Plaintiff subsequently filed the present Motion for Summary Judgment, and Defendant filed a Cross-Motion for Summary Judgment. Plaintiff also filed an opposition to Defendant's cross-motion.
To qualify for disability benefits under the Social Security Act, an applicant must show "inability to engage in any substantial gainful activity by reason of any medically determinable impairment that 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 12 months." 42 U.S.C. § 423(d)(1)(A). The Secretary of the Social Security Administration established a five-step sequential evaluation for determining whether a person is disabled. See 20 C.F.R. § 404.1520. The burden of proof is on the applicant as to steps one through four. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). As to step five, the burden shifts to the Commissioner. Id. "If a claimant is found to be 'disabled' or 'not disabled' at any step in the sequence, there is no need to consider subsequent steps." Id.; 20 C.F.R. § 404.1520. The five steps are:
Step 1. Is the claimant presently working in a substantially gainful activity? If so, then the claimant is "not disabled" within the meaning of the Social Security Act and is not entitled to disability insurance benefits. If the claimant is not working in a substantially gainful activity, then the claimant's case cannot be resolved at step one and the evaluation proceeds to step two.
Step 2. Is the claimant's impairment severe? If not, then the claimant is "not disabled" and is not entitled to disability insurance benefits. If the claimant's impairment is severe, then the claimant's case cannot be ...