Appeal from the United States District Court for the District of Arizona Bernardo P. Velasco, Magistrate Judge, Presiding D.C. No. 4:09-cv-00327-BPV
The opinion of the court was delivered by: Ikuta, Circuit Judge:
Argued and Submitted October 24, 2011-San Francisco, California
Before: Susan P. Graber and Sandra S. Ikuta, Circuit Judges, and Lewis A. Kaplan,*fn1 Senior District Judge.
Opinion by Judge Ikuta; Partial Concurrence and Partial Dissent by Judge Graber
Edilia Molina appeals the district court's decision affirming the Social Security Commissioner's denial of her application for disability insurance benefits and supplemental security income under the Social Security Act. She argues that the administrative law judge (ALJ) erred by giving inadequate weight to the opinions of her primary care provider, by improperly determining she was not credible, and by rejecting the testimony of her family members without comment. We have jurisdiction pursuant to 28 U.S.C. § 1291, and we affirm.
On September 22, 2006, Molina filed claims for disability benefits and supplemental security income, alleging that she suffered from panic and anxiety attacks*fn2 and had been unable to work since September 7, 2002, when she last held a job as an assembler for Texas Instruments. According to Molina's primary care provider, physician's assistant Molly Wheel-wright, Molina had a "longstanding panic disorder," and had tried several anxiety medications and antidepressants, including Lorazepam, over the years. Wheelwright also noted that Molina had to leave work and visit the emergency room more than once because of "severe panic attacks." After September 7, 2002, Molina's alleged disability onset date, Wheelwright's records showed that Molina continued to have symptoms of panic disorder, although as of February 2005, Molina stated she was stable on Lorazepam. Although Wheelwright frequently encouraged Molina to seek counseling for her anxiety, Molina declined to do so, citing various concerns including unpleasant past experiences with psychiatrists and a belief that the local mental health clinic was for drug addicts.
A few weeks after Molina filed her application with the Social Security Administration, she contacted a clinician at a nearby mental health clinic for intake and evaluation. The clinician wrote that Molina was "motivated" as well as "calm, orderly, [and] normally responsive." Molina was diagnosed with post-traumatic stress disorder and panic disorder. She failed to show up for her follow-up appointment, and told a clinician in June 2007 that she no longer wanted counseling services.
Dr. Hunter Yost, a psychiatrist, examined Molina in November 2006 and reported that Molina "ha[d] some partial symptoms" of anxiety. After conducting a mental status examination, Dr. Yost concluded that Molina was alert and oriented, maintained good eye contact, and "did not appear excessively anxious." She spoke coherently and fluently, smiled appropriately, and was congenial. She did not have an elated or depressed mood, and there was no evidence of a thought disorder. Dr. Yost diagnosed her with panic disorder without agoraphobia, and wrote that her condition was controlled with Lorazepam and that she was able to do self-calming measures to help with panic attacks when she was out in public. He concluded that her disorder had not and would not impose any limitations on her ability to work. A state Disability Determination Services staff physician reviewed Molina's file in December 2006 and reached similar conclusions.
In December 2006, Wheelwright wrote that Molina was feeling generally well and described her anxiety episodes as intermittent. In February 2008, however, in a Mental Impairment Questionnaire for Molina's disability application, Wheelwright wrote that Molina had "panic disorder, agoraphobia" with an "unsure" prognosis. In the grid for "mental abilities and aptitudes needed to do unskilled work," Wheel-wright checked "unable to meet competitive standards" next to "maintain regular attendance," "deal with normal work stress," and "complete a normal workday and workweek without interruptions from psychologically based symptoms," among other categories. Although the form instructed her to explain these assessments and provide medical or clinical findings to support them, Wheelwright did not do so. As for Molina's functional limitations, Wheelwright checked "extreme" next to the boxes for "restriction of activities of daily living," "difficulties in maintaining social functioning," and "difficulties in maintaining concentration, persistence, or pace." In separate medical notes, Wheelwright wrote that Molina was "very disabled by her condition," because she "[b]ecomes easily panicked in many situations even throughout the day" and is "[u]nable to work as a result." She noted, however, that a psychiatrist would "likely need to supplement" her evaluation.
At her hearing before the ALJ, Molina testified that she had been helping care for her two grandchildren since 2003, including walking them to school in the morning and picking them up in the afternoon. Molina had cared for the younger granddaughter full-time from 2003 until she was old enough to start school in 2005. A state agency paid her for her services until 2007. Molina said she regularly attended church, went shopping with her sister, attended family barbeques, and went for short walks in the neighborhood. Molina also submitted two function reports in which she wrote that she drove a car in the immediate area and went shopping once a month but liked to get in and out quickly because she did not like to be around a lot of people. She drove when she had to but felt a lot of anxiety and would "only go very short distances." She went out to eat with friends or family occasionally, but once her condition began, she would experience panic attacks that made it difficult for her to swallow her food and would have to go outside and wait for the others to finish their meals. She did not like to go out because she did not like to be around a lot of people and would experience panic attacks; these panic attacks were characterized by anxiety, shortness of breath, dizziness, sweating, and an elevated heart rate. She liked to watch TV and eat dinner in her room.
Molina testified that her last job as an assembler for Texas Instruments involved performing wire bonding and inspection. She worked in a large room with four or five other people, and her job did not require her to speak to anyone unless there was a problem with her machine, in which case she would ask the setup operator for help. At her lunch break she would take her food to her car and eat by herself. She said she was not able to return to this job because she could not tolerate the presence of other people. When she worked, she would get anxiety and panic attacks and would have to go to the infirmary to lie down or to the hospital. These attacks would come on without warning; her heart would start to beat very hard, and she would have difficulty breathing and feel fearful.
Five family members submitted statements on Molina's behalf. Molina's sister Mary stated that Molina was scared to get out on her own, could not stand to be around a lot of people, and did not feel safe by herself. She would go to her room when people came to the house. Her sister Frances De La Cerda wrote that Molina's anxiety was "so severe that she is not able to go anywhere without having a panic attack" and that she "had to quit working because the anxiety affected her mental abilities." According to her brother-in-law, David Chenoweth, Molina did "not like to travel anywhere except for short trips in the daytime," and she seemed to be most comfortable in her room. Her sister Barbara Molina wrote that Molina could not be around people or go out to eat because she tended to get very nervous and would take her food home with her. Molina's sister-in-law, Theresa Molina, said that when Molina had a panic attack, she would get very shaky and sweaty and feel faint, and that she preferred not to go anywhere for fear that she would have one of her attacks.
Following the hearing, the ALJ issued a written opinion holding that Molina was not disabled because she could per- form her past relevant work as an assembler. In reaching this conclusion, the ALJ discussed Dr. Yost's evaluation, the Mental Impairment Questionnaire filled out by Wheelwright, and Molina's testimony at the hearing. The ALJ adopted Dr. Yost's conclusion regarding the severity of Molina's mental impairments. She found that Molina's subjective allegations regarding the severity of her pain and ability to work were not credible to the extent they conflicted with Dr. Yost's evaluation. She considered but discounted Wheelwright's opinions because they were "quite conclusory" and provided "very little explanation of the evidence relied on in forming those opinions." Additionally, they did not appear to be supported by Molina's objective medical condition and were inconsistent with Dr. Yost's opinion. The ALJ also noted that Molina had cared for her granddaughters throughout much of the alleged disability period, and that she had not made any efforts to seek counseling from 2003 to 2005. The district court affirmed.
On appeal, Molina argues that the ALJ erred in reaching this conclusion because (1) the ALJ should have given more weight to Wheelwright's opinions, (2) the ALJ improperly evaluated Molina's credibility, and (3) the ALJ erred in rejecting the testimony of Molina's family ...