United States District Court, N.D. California
ORDER RE SUMMARY JUDGMENT RE: DKT. NOS. 19,
20
JAMES
DONATO United States District Judge
Plaintiff
Mariela Elizabeth Robleto challenges the decision of a Social
Security Administration Administrative Law Judge that denied
her disability benefits under Title II and Title XVI. Dkt.
No. 19. The Commissioner of Social Security
(“Commissioner”) filed a cross-motion for summary
judgment to uphold the ALJ’s determination. Dkt. No.
20. The Court held oral argument on July 20, 2016, and grants
Robleto’s motion for summary judgment and denies the
Commissioner’s cross motion. The case is remanded to
the Social Security Administration for further proceedings
consistent with this order.
In a
decision dated September 20, 2013, the ALJ found that Robleto
established multiple “severe physical and mental
impairments, ” including an “anxiety disorder;
bipolar affective disorder (BAD); borderline intellectual
functioning; hypothyroidism; and back strain” that
limit “her capacity to perform basic work
activities.” AR at 16. The ALJ determined that Robleto
“is unable to perform any past relevant work, ”
AR at 24, but denied benefits based on her determination that
Robleto had the residual functional capacity
(“RFC”) to perform a subset of unskilled light
work, such as mail clerk or garment sorter. AR at 25.
In our
Circuit, an ALJ’s decision to deny benefits “will
only be disturbed if it is not supported by substantial
evidence or it is based on legal error” and the
“decision of the ALJ will not be reversed for errors
that are harmless.” Burch v. Barnhart, 400
F.3d 676, 679 (9th Cir. 2005) (internal quotations omitted).
The ALJ’s decision in this case suffers from two legal
errors that are not harmless.
As an
initial matter, the ALJ did not explain with sufficient
detail or evidence why she decided to give “no
weight” to the medical opinions stated in a mental
impairment questionnaire prepared in August 2013 by
Robleto’s treating physician, Dr. Gilda Major, M.D., a
psychiatrist, and her therapist, Diana Gomez, MSW. AR at 22.
An ALJ is not bound by the opinion of any physician,
including a treating physician, but at the same time, an ALJ
may not reject the uncontradicted opinion of a treating
physician like Dr. Major without providing clear and
convincing reasons explaining why. See Turner v.
Comm’r of Soc. Sec., 613 F.3d 1217, 1222 (9th Cir.
2010). The ALJ failed to meet this standard when rejecting
Dr. Major’s professional opinions.
The ALJ
chose to ignore Dr. Major’s opinions only because she
found them to be “internally inconsistent” with
Robleto’s assessed Global Assessment of Functioning
(GAF) score of 55. AR at 22. The ALJ treated the score as
indicating just “moderate” symptoms and
difficulties, and so rejected the treating
psychiatrist’s determination that Robleto’s
ability to work would be seriously compromised by
“markedly limited” social functioning,
“frequent deficiencies in concentration, persistence,
and pace that would result in failure to complete tasks in a
timely manner, ” “repeated episodes of
decompensation in work environment, ” and likely
absenteeism “more than three times per month.”
Id.; see also AR at 516. This conclusory
treatment of the GAF score is not a “clear and
convincing reason” for throwing out all of Dr.
Major’s medical judgments. The Ninth Circuit has
clearly indicated that a GAF score should not be dispositive
of a claimant’s functional abilities, especially when
assessed for a claimant with mental disorders at a time when
they are not working. See Graham v. Astrue, 385 F.
App’x 704, 706 (9th Cir. 2010) (quoting Social Security
Ruling 85-15 (1985), in stating that
“‘Individuals with mental disorders’ may
adopt ‘a highly restricted ... lifestyle within which
they appear to function well, ’ but ‘may cease to
function effectively when facing such demands as getting to
work regularly, having their performance supervised, and
remaining in the workplace for a full day.’”) Dr.
Major’s opinions reflect this concept, noting that
Robleto’s baseline assessment was being made
“without stress of work.” AR at 514. Dr. Major
cautioned that, although “Patient may present well on
mental status exam, ” Robleto’s current
functioning depended heavily on external and family support,
and her ability to work would likely be undermined by her
mental health impairments and “[l]ow tolerance for
stress.” AR at 514-16.
Consequently,
the Court finds that the ALJ was wrong to dismiss Dr.
Major’s opinions in their entirety without clear and
convincing reasons. This finding applies even if some factual
contradictions might lower the reviewing standard to
“specific and legitimate reasons that are supported by
substantial evidence.” Chaudhry v. Astrue, 688
F.3d 661, 671 (9th Cir. 2012) (internal quotation omitted).
This lighter standard might be satisfied if the ALJ
“set[s] out a detailed and thorough summary of the
facts and conflicting clinical evidence, stating [her]
interpretation thereof, and making findings.”
Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir.
2002) (internal quotation omitted). But the ALJ did not do
even that.
The
Court also finds error in the ALJ’s reliance on the
opinion of independent psychiatric expert Ashok Khushalani,
M.D., who did not treat or examine Robleto. The ALJ
inexplicably gave “great weight” to Dr.
Khushalani’s opinion even though he had failed to read
significant and highly material portions of the
claimant’s medical records prior to the hearing, was
initially excused from the hearing by the ALJ for that lack
of preparation, and then called back in to testify after
spending what appears to have been no more than several
minutes purportedly reviewing and digesting approximately 80
pages of medical records. AR at 22, 35-39. The ALJ relied
heavily on Dr. Khushalani’s opinion that
Robleto’s condition had been stabilized by medication
to a degree that she could successfully perform work
consisting of “simple repetitive tasks with occasional
public interaction.” See AR at 22, 40-43. That
reliance is not justified by the hasty and superficial record
assessment performed by Dr. Khushalani, and the ALJ erred in
crediting his opinions over those of the treating
professionals. See Garrison v. Colvin, 759 F.3d 995,
1012-13 (9th Cir. 2014).
These
errors are not harmless. The ALJ’s determination that
appropriate jobs for Robleto existed in the national economy
depended on the improper rejection of Dr. Major’s
assessments of Robleto’s “frequent deficiencies
in concentration, persistence, and pace.” See
AR at 22. The ALJ acknowledged that if Robleto had even a
“20% deficit in maintaining concentration, persistence
and pace, ” she “would not be able to perform any
jobs” at all. Id. at 25. Her finding that
Robleto would not manifest this deficiency was based entirely
on her embrace of Dr. Khushalani’s slapdash
conclusions. See id. at 22, 25.
The
Court remands the case to the Social Security Administration
for further proceedings to determine Robleto’s
eligibility for benefits in a manner consistent with this
order. Because the Court has found two separate and
independent bases for remand, the Court declines ...