United States District Court, E.D. California
ALLISON CLAIRE UNITED STATES MAGISTRATE JUDGE.
seeks judicial review of a final decision of the Commissioner
of Social Security (“Commissioner”), denying her
application for Supplemental Security Income
(“SSI”) under Title XVI of the Social Security
Act (the “Act”), 42 U.S.C. §§
1381-1383f. For the reasons that follow, the court
will grant plaintiff’s motion for summary judgment,
deny the Commissioner’s cross-motion for summary
judgment, and remand this matter under sentence four of 42
U.S.C. § 405(g), for further proceedings.
initially applied for supplemental security and for
disability income under Title II of the Act, 42 U.S.C.
§§ 401-34, on October 30, 2007. Administrative
Record (“AR”) 22 (decision). This application
was denied on February 25, 2010 in a decision by an ALJ after
a hearing at which plaintiff represented herself. AR 117-32
(prior decision & exhibit list). Plaintiff did not appeal
this decision. ECF No. 16-1 at 7 (plaintiff’s summary
then applied for supplemental security income on July 22,
2010. AR 22. This application was denied on November 17,
2010, apparently at the state agency level. Id. The
November 17, 2010 denial is not a part of the Administrative
Record. Plaintiff did not appeal this decision. Id.
The Current Application
current application for supplemental security income was
submitted on April 21, 2011. Id. The disability
onset date was alleged to be April 18, 2000, but was later
amended to July 22, 2010. Id. The application was
disapproved initially on August 10, 2011, and upon
reconsideration on May 8, 2012. Id. On February 22,
2013, ALJ Dante M. Alegre presided over the hearing on
plaintiff’s challenge to the disapprovals. AR 63-86
(transcript). Plaintiff was present and testified at the
hearing, and she was represented by attorney Randall Padgett
at the hearing. AR 63. Alina Sala, a vocational expert, also
testified at the hearing. AR 63, 80-81, 82-85.
April 29, 2013, after denying plaintiff’s request to
re-open her July 22, 2010 application (and the November 17,
2010 denial of that application), the ALJ issued an
unfavorable decision, finding plaintiff “not
disabled” under Section 1614(a)(3)(A) of Title XVI of
the Act, 42 U.S.C. § 1382c(a)(3)(A). AR 22-38
(decision), 39-42 (exhibit list). On December 18, 2014, the
Appeals Council denied plaintiff’s request for review,
leaving the ALJ’s decision as the final decision of the
Commissioner of Social Security. AR 1-5 (decision & order
receiving additional exhibit).
filed this action on January 21, 2015. ECF No. 1;
see 42 U.S.C. §§ 405(g), 1383c(3). The
parties consented to the jurisdiction of the magistrate
judge. ECF Nos. 3, 11. The parties’ cross-motions for
summary judgment, based upon the Administrative Record filed
by the Commissioner, have been fully briefed. ECF Nos. 16
(plaintiff’s summary judgment motion), 19
(Commissioner’s summary judgment motion), 20
was born on December 21, 1964, and accordingly was 46 years
old when she filed her application. AR 36. Plaintiff has a
high school education. AR 36.
Commissioner’s decision that a claimant is not disabled
will be upheld “if it is supported by substantial
evidence and if the Commissioner applied the correct legal
standards.” Howard ex rel. Wolff v. Barnhart,
341 F.3d 1006, 1011 (9th Cir. 2003). “‘The
findings of the Secretary as to any fact, if supported by
substantial evidence, shall be conclusive . .
..’” Andrews v. Shalala, 53 F.3d 1035,
1039 (9th Cir. 1995) (quoting 42 U.S.C. § 405(g)).
evidence is “more than a mere scintilla, ” but
“may be less than a preponderance.” Molina v.
Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012). “It
means such evidence as a reasonable mind might accept as
adequate to support a conclusion.” Richardson v.
Perales, 402 U.S. 389, 401 (1971) (internal quotation
marks omitted). “While inferences from the record can
constitute substantial evidence, only those ‘reasonably
drawn from the record’ will suffice.” Widmark
v. Barnhart, 454 F.3d 1063, 1066 (9th Cir. 2006)
(citation omitted). Although this court cannot substitute its
discretion for that of the Commissioner, the court
nonetheless must review the record as a whole,
“weighing both the evidence that supports and the
evidence that detracts from the [Commissioner’s]
conclusion.” Desrosiers v. Secretary of HHS,
846 F.2d 573, 576 (9th Cir. 1988); Jones v. Heckler,
760 F.2d 993, 995 (9th Cir. 1985) (“The court must
consider both evidence that supports and evidence that
detracts from the ALJ’s conclusion; it may not affirm
simply by isolating a specific quantum of supporting
ALJ is responsible for determining credibility, resolving
conflicts in medical testimony, and resolving
ambiguities.” Edlund v. Massanari, 253 F.3d
1152, 1156 (9th Cir. 2001). “Where the evidence is
susceptible to more than one rational interpretation, one of
which supports the ALJ’s decision, the ALJ’s
conclusion must be upheld.” Thomas v.
Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). However,
the court may review only the reasons stated by the ALJ in
his decision “and may not affirm the ALJ on a ground
upon which he did not rely.” Orn v. Astrue,
495 F.3d 625, 630 (9th Cir. 2007); Connett v.
Barnhart, 340 F.3d 871, 874 (9th Cir. 2003) (“It
was error for the district court to affirm the ALJ’s
credibility decision based on evidence that the ALJ did not
court will not reverse the Commissioner’s decision if
it is based on harmless error, which exists only when it is
“clear from the record that an ALJ’s error was
‘inconsequential to the ultimate nondisability
determination.’” Robbins v. SSA, 466
F.3d 880, 885 (9th Cir. 2006) (quoting Stout v.
Commissioner, 454 F.3d 1050, 1055 (9th Cir. 2006)); see
also Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir.
The Presumption of Continuing Non-Disability
principles of res judicata apply to administrative decisions,
although the doctrine is applied less rigidly to
administrative proceedings than to judicial
proceedings.” Chavez v. Bowen, 844 F.2d 691,
693 (9th Cir. 1988). The ALJ’s or Appeals
Council’s finding of non-disability, once it becomes
the final decision of the Commissioner, is given “res
judicata effect” as to the period of disability covered
by the decision, so long as no “manifest
injustice” would result. Lyle v. Secretary of
Health & Human Services, 700 F.2d 566, 568 & 568
n.2 (9th Cir. 1983).
for any subsequent, un-adjudicated period of alleged
disability, an ALJ’s finding that a claimant is not
disabled only “create[s] a presumption that
[the claimant] continued to be able to work” after the
adjudicated period. Lester v. Chater, 81 F.3d 821,
827-28 (9th Cir. 1996) (emphasis added). This is the version
of “administrative res judicata” that is at issue
here. Plaintiff does not challenge the prior finding of
disability, but rather, she challenges the presumption that
arises from that finding. “The claimant, in order to
overcome the presumption of continuing nondisability arising
from the first administrative law judge's findings of
nondisability, must prove ‘changed circumstances’
indicating a greater disability.” Chavez, 844
F.2d at 693 (quoting Taylor v. Heckler, 765 F.2d
872, 875 (9th Cir.1985)); Light v. Soc. Sec. Admin.,
119 F.3d 789, 791-92 (9th Cir. 1997) (“[t]he claimant
may overcome the presumption by proving the existence of
‘changed circumstances’ that would establish
disability’”) (some internal quotation marks
omitted) (quoting Hammock v. Bowen, 879 F.2d 498,
501 (9th Cir. 1989)).
Security Income is available for every eligible individual
who is “disabled.” 42 U.S.C. § 1381a.
Plaintiff is “disabled” if she is
“‘unable to engage in substantial gainful
activity due to a medically determinable physical or mental
impairment . . ..’” Bowen v. Yuckert,
482 U.S. 137, 140 (1987) (quoting identically worded
provisions of 42 U.S.C. § 1382c(a)(3)(A)).
Commissioner uses a five-step sequential evaluation process
to determine whether an applicant is disabled and entitled to
benefits. 20 C.F.R. § 416.920(a)(4); Barnhart v.
Thomas, 540 U.S. 20, 24-25 (2003) (setting forth the
“five-step sequential evaluation process to determine
disability” under Title II and Title XVI). The
following summarizes the sequential evaluation:
Step one: Is the claimant engaging in substantial gainful
activity? If so, the claimant is not disabled. If ...