UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA
October 31, 2012
DWAYNE R. ROBINSON, PLAINTIFF,
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY ADMINISTRATION, DEFENDANT.
The opinion of the court was delivered by: Hon. Jay C. Gandhi United States Magistrate Judge
MEMORANDUM OPINION AND ORDER
Dwayne R. Robinson ("Plaintiff") challenges the Social Security Commissioner's ("Defendant") decision denying his application for disability benefits. Specifically, Plaintiff contends, among other things, that the Administrative Law Judge ("ALJ") improperly rejected the opinion of his treating psychiatrist, Dr. David Aryanpur. (Joint Stip. at 6-13.) The Court agrees with Plaintiff.
"As a general rule, more weight should be given to the opinion of a treating source than to the opinion of doctors who do not treat the claimant." Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). This is so because a treating physician "is employed to cure and has a greater opportunity to know and observe the patient as an individual." Sprague v. Bowen, 812 F.2d 1226, 1230 (9th Cir. 1987).
Where the "treating doctor's opinion is contradicted by another doctor, the [ALJ] may not reject this opinion without providing specific and legitimate reasons supported by substantial evidence in the record[.]" Lester, 81 F.3d at 830 (internal quotation marks and citation omitted). The ALJ can meet the requisite specific and legitimate standard "by setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings." Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989) (internal quotation marks and citation omitted).
Here, the ALJ gave four reasons for discrediting the opinions of Dr. Aryanpur. The Court addresses -- and rejects -- each reason below.
A. Plaintiff's Global Assessment of Functioning ("GAF")*fn1 Scores In two separate instances, the ALJ asserted that Plaintiff's GAF scores of 47 and 50, respectively assessed by Dr. Aryanpur on March 20, 2008 and March 23, 2009, are not supported by the record. (AR at 30.) Specifically, the ALJ found these scores to be exaggerated and generally "inconsistent" with other, contemporaneous findings by Dr. Aryanpur pointing to benign impairments. (Id.) The Court disagrees.
To fall within the 41-50 range, an individual need only possess a "serious impairment in social, occupational or school functioning (e.g., no friends, unable to keep a job)." DSM-IV at 34 (bold and capitalization omitted).
Here, both the March 20, 2008 and March 23, 2009 reports mentioned serious impairments that arguably would fall within this range, but the ALJ discussed none of them. Instead, the ALJ cited only those portions of the reports that suggested that certain impairments were not severe. See Aukland v. Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001) (the ALJ's decision "'cannot be affirmed simply by isolating a specific quantum of supporting evidence.'" (quoting Sousa v. Callahan, 143 F.3d 1240, 1243 (9th Cir. 1998))).
For instance, the March 20, 2008 report noted impairments like hallucinations, hearing voices, decreased concentration, irritability, excessive anxiety, and withdrawn and restricted emotions. (AR at 447-51.) Adding context, this report also discusses an incident just a few months earlier where Mr. Robinson was involuntarily committed for attempting suicide by "hold[ing] [a] gun to [him]self" in an "intoxicated, depressed state." (AR at 451.) Yet, despite these troubling conditions, the ALJ found that the report was inconsistent with its GAF score by only referring to its findings regarding Plaintiff's normal behavior, thought process, alertness, and hygiene. (AR at 30.)
Likewise, as to the March 23, 2009 report, the ALJ selectively cited its benign observations, including findings that Plaintiff had unremarkable behavior, neat hygiene, appropriate dress, and a normal thought process. (AR at 30.) However, contrary to the ALJ's characterization, this report also discussed far more serious disorders, such as a depressed mood, declining interests, feelings of worthlessness, insomnia, irritability, decreased concentration, fatigue, excessive anxiety, and daily outbursts of anger. (See AR at 559-64.)
Arguably, many of these omitted impairments could have fallen within the 41-50 range of GAF scores, and thus, at minimum, they warranted discussion. See Gallant v. Heckler, 753 F.2d 1450, 1456 (9th Cir. 1984) ("Although it is within the power of the [Commissioner] to make findings . . . and to weigh conflicting evidence, he cannot reach a conclusion first, and then attempt to justify it by ignoring competent evidence in the record that suggests an opposite result") (internal citation omitted). Accordingly, in light of the ALJ's error, the Court is unable to find that the ALJ offered a specific and legitimate reason here.
B. The Decrease in GAF Scores
As her second reason, the ALJ suggested that Dr. Aryanpur assigned certain GAF scores without explanation or basis in the record. (AR at 30.) Specifically, the ALJ pointed out that Dr. Aryanpur offered "no explanation for the sudden decrease in [Plaintiff's GAF] score [from 55 on March 12, 2008 to 47 on March 20, 2008] and his records do not support [such a] decline." (Id.)
However, the ALJ appears to have misread the evidence here. It was nurse Ivan Batchkoff -- not Dr. Aryanpur -- that assessed the first GAF score of 55 on March 12, 2008. (AR at 457-62.) Thus, there is no inconsistency between the March 12, 2008 and March 20, 2008 reports for Dr. Aryanpur to explain away. Accordingly, this reason does not qualify as a specific and legitimate one.
C. Dr. Aryanpur's Opinion Regarding Plaintiff's Ability to Maintain Employment
The ALJ also discounted Dr. Aryanpur's November 14, 2008 statement that Plaintiff "probably cannot maintain fulltime employment but possibly may be able to work part time." (AR at 30, see AR at 383.) In doing so, the ALJ pointed to two records, dated just months before, that allegedly suggest that Plaintiff "is able to perform work activity." (AR at 30.) The first, dated September 23, 2008, described Plaintiff as appearing "quite stable and motivated to return to work." (AR at 30; see AR at 506.) The second, dated October 31, 2008, reported that Plaintiff was "doing well."*fn2 (AR at 30; see AR at 498.) The Court, however, finds the ALJ's determination unconvincing for three reasons.
First, Plaintiff's desire to work is not relevant to whether he is, in fact, able to work.
Second, short, isolated remarks like Plaintiff is "quite stable" or is "doing well" offer little of medical value. That is, it not known whether these assessments refer to Plaintiff's general mood, his hallucinations, or perhaps even his suicidal thoughts. Discrediting the extensive opinions of a treating physician on the basis of such vague statements is, therefore, tenuous.
Third, the inadequacy of such a credibility determination is all the more striking considering that the medical record numbers over 400 pages.
Accordingly, the ALJ's reason here does not satisfy the specific and legitimate standard.
D. Evidence of Plaintiff Caring for His Mother and Son As her fourth and final reason, the ALJ twice suggests that the limitations assessed by Dr. Aryanpur are "inconsistent" with the fact that Plaintiff cares for his mother and son. (AR at 30.) Two reasons undermine the ALJ's conclusion here.
First, daily activities like "taking care of oneself, household tasks, hobbies, school attendance, club activities, or social programs" are not typically considered substantial gainful activities. Lewis v. Apfel, 236 F.3d 503, 516 (9th Cir. 2001). Such activities can only discredit a claimant's impairments if they are transferable to a work setting and constitute a substantial portion of one's day. Fair v. Bowen, 885
F.2d 597, 603 (9th Cir. 1989). The ALJ provided no evidence -- and the Court cannot find any -- that would suggest that either is the case here.
Second, it is suspect that the ALJ discarded at least four disability assessments by Dr. Aryanpur, a treating physician, on the basis of a single report observing that Plaintiff "assist[s] his elderly mother and son." (See AR at 498.) At minimum, to satisfy the specific and legitimate standard, the ALJ should have offered some sort of explanation of why such evidence is truly "conflicting." See Magallanes, 881 F.2d at 751.
Thus, for the reasons stated above, the Court is unable to find any specific and legitimate reasons supporting the ALJ's rejection of Dr. Aryanpur's opinions. Accordingly, the Court finds that the ALJ's decision was not supported by substantial evidence. See Mayes v. Massanari, 276 F.3d 453, 458-59 (9th Cir. 2001).
E. Remand is Warranted With error established, this Court has discretion to remand or reverse and award benefits. McAllister v. Sullivan, 888 F.2d 599, 603 (9th Cir. 1989). Where no useful purpose would be served by further proceedings, or where the record has been fully developed, it is appropriate to exercise this discretion to direct an immediate award of benefits. See Benecke v. Barnhart, 379 F.3d 587, 595-96 (9th Cir. 2004). But where there are outstanding issues that must be resolved before a determination can be made, or it is not clear from the record that the ALJ would be required to find plaintiff disabled if all the evidence were properly evaluated, remand is appropriate. See id. at 594.
Here, in light of the ALJ's error, Dr. Aryanpur's credibility must be properly assessed. Therefore, on remand, the ALJ shall reevaluate the opinions of Dr. Aryanpur and either credit them as true, or provide valid reasons for any portion that is rejected. \
Based on the foregoing, IT IS ORDERED THAT judgment shall be entered REVERSING the decision of the Commissioner denying benefits and REMANDING the matter for further administrative action consistent with this decision.*fn3