Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Matthew Fernandez v. Michael J. Astrue

March 22, 2011

MATTHEW FERNANDEZ, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Ralph Zarefsky United States Magistrate Judge

MEMORANDUM OPINION AND ORDER

Plaintiff Matthew Fernandez, who applied for Supplemental Security Income when he was a child but attained the age of majority before his claim was fully adjudicated, had been treated at Loma Linda Behavior Medical Center. On March 28, 2008, treating physician Dr. Mary Ann Schaepper, a child psychiatrist, filled out a form for the California Department of Social Services, checking off boxes on that form indicating that Plaintiff was not able to work, that he had limitations that affect his ability to work or participate in education or training, and that his condition required someone to be in the home to care for him. [AR 453] The Administrative Law Judge said the following about Dr. Schaepper:

As for the opinion evidence, the undersigned rejects the assessment by Dr. Shaepper [sic] indicating that the claimant was emotionally disturbed and that mental illness led to the claimant's drug abuse as this is not corroborated by the form from Dr. Shaepper [sic] submitted at the hearing. (Exhibits 23F and 24F).

[AR 13]

The Administrative Law Judge's view of Dr. Schaepper's opinions forms the basis for the first error Plaintiff asserts, that the Administrative Law Judge did not give good enough and sufficient reasons for rejecting the opinions. Under well-established law, the opinion of a treating physician is entitled to considerable deference; in general, it is given greater weight than the opinion of other physicians, Aukland v. Massanari, 257 F.3d 1033, 1036 (9th Cir. 2001) and, in some circumstances, it is even entitled to controlling weight. The law concerning the assessment of treating physician opinion is summarized in Holohan v. Massanari, 246 F.3d 1195, 1201-03 (9th Cir. 2001):

Title II's implementing regulations distinguish among the opinions of three types of physicians: "(1) those who treat the claimant (treating physicians); (2) those who examine but do not treat the claimant (examining physicians); and (3) those who neither examine nor treat the claimant [but who review the claimant's file] (nonexamining [or reviewing] physicians)." Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995); see 20 C.F.R. § 404.1527(d). Generally, a treating physician's opinion carries more weight than an examining physician's, and an examining physician's opinion carries more weight than a reviewing physician's. Lester, 81 F.3d at 830; 20 C.F.R. § 404.1527(d). In addition, the regulations give more weight to opinions that are explained than to those that are not, see 20 C.F.R. § 404.1527(d)(3), and to the opinions of specialists concerning matters relating to their specialty over that of non-specialists, see id. § 404.1527(d)(5).

In disability benefits cases, physicians typically provide two types of opinions: medical opinions that speak to the nature and extent of a claimant's limitations, and opinions concerning the ultimate issue of disability, i.e., opinions about whether a claimant is capable of any work, given her or his limitations. Under the regulations, if a treating physician's medical opinion is supported by medically acceptable diagnostic techniques and is not inconsistent with other substantial evidence in the record, the treating physician's opinion is given controlling weight. 20 C.F.R. § 404.1527(d)(2); see also Social Security Ruling (SSR) 96-2p. An ALJ may reject the uncontradicted medical opinion of a treating physician only for "clear and convincing" reasons supported by substantial evidence in the record. Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) (internal quotation marks and citation omitted). If the treating physician's medical opinion is inconsistent with other substantial evidence in the record, "[t]reating source medical opinions are still entitled to deference and must be weighted using all the factors provided in 20 CFR [§ ] 404.1527." SSR 96-2p; see id. ("Adjudicators must remember that a finding that a treating source medical opinion is . . . inconsistent with the other substantial evidence in the case record means only that the opinion is not entitled to 'controlling weight,' not that the opinion should be rejected. . . . In many cases, a treating source's medical opinion will be entitled to the greatest weight and should be adopted, even if it does not meet the test for controlling weight."). An ALJ may rely on the medical opinion of a non-treating doctor instead of the contrary opinion of a treating doctor only if she or he provides "specific and legitimate" reasons supported by substantial evidence in the record. Lester, 81 F.3d at 830 (internal quotation marks and citation omitted). Similarly, an ALJ may reject a treating physician's uncontradicted opinion on the ultimate issue of disability only with "clear and convincing" reasons supported by substantial evidence in the record. Reddick, 157 F.3d at 725 (quoting Matthews v. Shalala, 10 F.3d 678, 680 (9th Cir. 1993) (internal quotation marks omitted)). If the treating physician's opinion on the issue of disability is controverted, the ALJ must still provide "specific and legitimate" reasons in order to reject the treating physician's opinion. Id.

Id. (footnotes omitted).

In this Court, the Commissioner's reaction to the precedent surrounding the treating physician law is surprising. The Commissioner cites applicable statutes and regulations, and then says:

Notwithstanding the standards and rules set forth by Congress and by the Commissioner, the Ninth Circuit directs that an ALJ must provide "clear and convincing" reasons to reject the opinion of a treating physician when that opinion is uncontradicted. Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996). To the extent the Ninth Circuit's judicially-created standard exceeds the requirements set forth by Congress and by the Commissioner at the behest of Congress, it would appear to be improper.

Defendant's Memorandum in Support of Defendant's Answer, 3:15-21 (emphasis added). Despite this criticism of the Ninth Circuit's case law, the law appears to be similar in most circuits. Most circuits give deference to the treating physician opinion, and require significant reasons for rejecting the opinion of a treating physician.

See C. KUBITSCHEK AND J. DUBIN, SOCIAL SECURITY DISABILITY; LAW AND PROCEDURE IN FEDERAL COURT (2011) §§ 2:31 et seq.

Moreover, of course, this Court must follow the precedent of the Ninth Circuit, and has no authority to deviate from it. Thus, the Court declines the Commissioner's invitation to proceed in a manner contrary to what the Ninth Circuit provides.

Applying the governing precedent, the Court agrees with Plaintiff that the Administrative Law Judge's assessment is an insufficient basis to reject Dr. Schaepper's opinions. The Administrative Law Judge said that the form accompanying Dr. Schaepper's statement did not support her opinion that Plaintiff was emotionally disturbed. To begin with, the statement was all part of a single form. Moreover, the explanations Dr. Schaepper gave did, in fact, show Plaintiff to be emotionally disturbed. Dr. Schaepper stated that Plaintiff was "extremely impulsive, delusional [and] actively psychotic." [AR 454] She also stated that he was very hyperactive, ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.