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Ponce v. Colvin

United States District Court, Ninth Circuit

January 16, 2014



JAY C. GANDHI, Magistrate Judge.

Nathaniel Alan Ponce ("Plaintiff") challenges the Social Security Commissioner's ("Defendant") decision denying his application for disability benefits. Specifically, Plaintiff contends that the Administrative Law Judge ("ALJ") improperly rejected the opinion of his treating physician. (Joint Stip. at 4-6, 21-23.) The Court agrees with Plaintiff for the reasons stated below.

A. An ALJ Must Provide Specific and Legitimate Reasons to Reject the Contradicted Opinion of a Treating Physician

"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); accord Benton ex rel. Benton v. Barnhart, 331 F.3d 1030, 1036 (9th Cir. 2003). 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).

B. The ALJ Failed to Provide Specific and Legitimate Reasons for Rejecting the Opinion of Plaintiff's Treating Physician

Here, the ALJ provided three reasons for rejecting the opinion of Dr. Thomas Jackson. ( See Administrative Record "AR" at 26.) The Court addresses, and rejects, each reason below.

First, the ALJ found that Dr. Jackson's assessment "is inconsistent with the treatment records and evidence as a whole." ( Id. ) This characterization, however, is inaccurate. The claimant was treated at San Bernadino Department of Behavioral Health from 2001-2009 for disciplinary referrals, impulse control problems, and poor familial relationships. ( Id. at 16, 290-328.) There, he was diagnosed with the same disorders that Dr. Jackson indicated, namely, bipolar disorder, learning disabilities, ADHD, and pervasive development disorder. ( Id. at 25, 300.) Further the Social Security Administration's own consultative examiner, Dr. Adam Cash, reached similar conclusions to Dr. Jackson regarding Plaintiff's cognitive functions. ( See id. at 261, 340-44.) Both doctors found that Plaintiff was limited in his ability to carry out detailed instructions, maintain concentration for extended periods of time, sustain an ordinary routine, complete a normal workday, and interact with the public. ( Id. ) As such, the ALJ erred in rejecting Dr. Jackson's opinion as unsupported by the record.

Second, the ALJ found that Dr. Jackson's opinion is "inconsistent with his own mental status examination on February 24, 2010." ( Id. at 26.) However, by focusing on one exam, the ALJ misunderstood the episodic nature of Plaintiff's condition. See Agyeman v. I.N.S., 296 F.3d 871, 881 (9th Cir.2002) ("[b]ipolar disorder is a severe psychiatric illness marked by episodes of mania and depression [and] impairment of functioning") (emphasis added). While Plaintiff had an unremarkable exam in February 2010, a November 2007 exam showed dysphoric mood, poor judgment, and impaired impulse control. (AR at 256.) A December 2007 evaluation showed an anxious and angry mood, as well as poor social skills and impulse control. ( Id. at 254.) In February 2009, Plaintiff was depressed. ( Id. at 241.) In June 2009, a behavioral report described impairments in Plaintiff's ability to follow instructions, concentrate, and get along with coworkers, while a state agency consultant found that he should not work with the public. ( Id. at 274, 280.) Here too, the ALJ lacked a valid reason for rejecting Dr. Jackson's opinion.

Third, the ALJ found that Dr. Jackson's assessment "is inconsistent with the claimant's testimony regarding his life activities." ( Id. at 27.) However, the ALJ oversimplified Plaintiff's abilities and omitted evidence describing Plaintiff's difficulties in performing those activities. For instance, Plaintiff completed high school only after failing the exit exam six times.[2] ( Id. at 51.) While he currently takes college classes in cooking and tai chi, he "struggles badly, " requires extra supervision, and fails to concentrate. ( Id. at 61-63.) Plaintiff testified that he has some friends, mostly over the internet, however he also described frequent mood swings that cause him to lash out at friends, family, and fellow students. ( Id. at 65.)

Further, the ALJ focused a great deal on Plaintiff's ability to play video games and use Facebook. ( Id. at 24.) However, these activities are not so physically or mentally demanding that any inconsistencies with Dr. Jackson's opinion are apparent. At a minimum, to satisfy the specific and legitimate standard, the ALJ should have offered some sort of explanation as to why such evidence is truly inconsistent. See Magallanes, 881 F.2d at 751. Absent such a showing, this reason does not pass muster.

Accordingly, for the reasons stated above, the ALJ improperly discredited the treating opinion of Dr. Jackson. The Court thus determines that the ALJ's decision is not supported by substantial evidence. Mayes v. Massanari, 276 F.3d 453, 458-59 (9th Cir. 2001).

C. 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 ...

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