United States District Court, E.D. California
For Melissa Ann Hopson, Plaintiff: Kelsey Mackenzie Brown, Dellert Baird Law Offices, PLLC, Silverdale, WA.
For Commissioner of Social Security, Defendant: Francesco Paulo Benavides, GOVT, LEAD ATTORNEY, Social Security Administration, Office of General Counsel, San Francisco, CA; Alyson A. Berg, ss, United States Attorney's Office, Fresno, CA.
ORDER REMANDING THE ACTION PURSUANT TO SENTENCE FOUR OF 42 U.S.C. § 405(g) ORDER DIRECTING ENTRY OF JUDGMENT IN FAVOR OF PLAINTIFF MELISSA HOPSON AND AGAINST DEFENDANT CAROLYN W. COLVIN, ACTING COMMISSIONER OF SOCIAL SECURITY
Jennifer L. Thurston, UNITED STATES MAGISTRATE JUDGE.
Plaintiff Melissa Hopson asserts she is entitled to disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. Plaintiff argues the administrative law judge (" ALJ") erred in evaluating the evidence. Therefore, Plaintiff seeks judicial review of the administrative decision denying benefits. Because the ALJ failed to set forth legally sufficient reasons for rejecting the credibility of Plaintiff's subjective complaints, as explained below, the action is REMANDED for further proceedings.
Plaintiff filed applications for disability insurance benefits and supplemental security income on June 16, 2010, which were denied by the Social Security Administration initially on November 15, 2010 and upon reconsideration on March 9, 2011. (Doc. 12-3 at 15.) After requesting a hearing, Plaintiff testified before an administrative law judge (" ALJ") on February 15, 2012. (Id. at 30.) The ALJ determined Plaintiff was not disabled under the Social Security Act, and issued an order denying benefits on April 6, 2012. (Id. at 14-25.) The Appeals Council denied Plaintiff's request for review of the decision on June 11, 2013. (Id. at 2-4.) Therefore, the ALJ's determination became the final decision of the Commissioner of Social Security (" Commissioner").
STANDARD OF REVIEW
District courts have a limited scope of judicial review for disability claims after a decision by the Commissioner to deny benefits under the Social Security Act. When reviewing findings of fact, such as whether a claimant was disabled, the Court must determine whether the Commissioner's decision is supported by substantial evidence or is based on legal error. 42 U.S.C. § 405(g). The ALJ's determination that the claimant is not disabled must be upheld by the Court if the proper legal standards were applied and the findings are supported by substantial evidence. See Sanchez v. Sec'y of Health & Human Serv., 812 F.2d 509, 510 (9th Cir. 1987).
Substantial evidence is " more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 59 S.Ct. 206, 83 L.Ed. 126 (1938)). The record as a whole must be considered, because " [t]he court must consider both evidence that supports and evidence that detracts from the ALJ's conclusion." Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985).
To qualify for benefits under the Social Security Act, Plaintiff must establish she is unable to engage in substantial gainful activity due to a medically determinable physical or mental impairment that has lasted or can be expected to last for a continuous period of not less than 12 months. 42 U.S.C. § 1382c(a)(3)(A). An individual shall be considered to have a disability only if:
physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work, but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.
42 U.S.C. § 1382c(a)(3)(B). The burden of proof is on a claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990). If a claimant establishes a prima facie case of disability, the burden shifts to the Commissioner to prove the claimant is able to engage in other substantial gainful employment. Maounis v. Heckler, 738 F.2d 1032, 1034 (9th Cir. 1984).
To achieve uniform decisions, the Commissioner established a sequential five-step process for evaluating a claimant's alleged disability. 20 C.F.R. § § 404.1520, 416.920 (a)-(f). The process requires the ALJ to determine whether Plaintiff (1) engaged in substantial gainful activity during the period of alleged disability, (2) had medically determinable severe impairments (3) that met or equaled one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1; and whether Plaintiff (4) had the residual functional capacity to perform to past relevant work or (5) the ability to perform other work existing in significant numbers at the state and national level. Id. The ALJ must consider testimonial and objective medical evidence. 20 C.F.R. § § 404.1527, 416.927, 416.929.
A. Relevant Medical Opinions
Dr. S. K. Madireddi completed a consultative internal examination on September 29, 2010. (Doc. 10-8 at 54.) Plaintiff reported that she suffered from " [a]rthritis, fibromyalgia, anxiety, and depression." (Id.) In addition, Plaintiff said she had " pain all over the body" and " constant pain" in her knees and back. (Id.) Upon examination, Dr. Madireddi determined Plaintiff had a normal range of motion in her cervical spine and upper extremities, but she complained of " pain between the nape of the neck bilaterally and also over the lumbar area from L1-L5 bilaterally." (Id. at 55-56.) Plaintiff had " 5/5 motor strength" in her upper and lower extremities, and no sensory deficits. (Id.) Dr. Madireddi noted Plaintiff's allegations of fibromyalgia could not be substantiated " because she does not have specific tender spots, only aching and pain all over the cervical, thoracic and lumbar spine and the back of both shoulders and hips." (Id. at 56.) Dr. Madireddi questioned the opiates prescribed, stating:
[W]hy would an asthmatic take opiates? Surely there are other medications for fibromyalgia, such as Lyrica or Savella. Opiates are not indicated for fibromyalgia. This is a doubtful diagnosis. Opiates can cause bronchospasm, as I am sure her treating physician is aware, also constipation, gingivitis with lost teeth, urinary dysfunction, sexual dysfunction and so on. Of concern is the large quantity of opiates that she is ...