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Malta v. Saul

United States District Court, E.D. California

August 30, 2019

ANDREW M. SAUL[1], Commissioner of Social Security, Defendant.



         Joe James Malta asserts he is entitled to a period of disability, disability insurance benefits, and supplemental security income under Titles II and XVI of the Social Security Act. Plaintiff argues the ALJ erred in evaluating the medical record and seeks judicial review of the administrative decision. Because the ALJ failed to apply the proper legal standards to determine Plaintiff was able to perform work in the national economy, the matter is REMANDED for further proceedings pursuant to sentence four of 42 U.S.C. § 405(g).


         In December 2009, Plaintiff filed applications for benefits, in which he alleged disability beginning January 1, 2007. (See Doc. 7-9 at 1, 3) The Social Security Administration denied the applications at the initial level on October 6, 2010, and upon reconsideration on March 9, 2011. (Doc. 7-6 at 4-8, 12-16) Plaintiff requested a hearing and testified before an ALJ on August 19, 2011. (See Doc. 7-3 at 56; Doc. 7-5 at 12) The ALJ determined Plaintiff was not disabled under the Social Security Act and issued an order denying benefits on November 2, 2011. (Doc. 7-5 at 12-24) Plaintiff filed a request for review of the decision with the Appeals Council, which granted the request on September 21, 2012. (Id. at 31; Doc. 7-6 at 63)

         The Appeals Council determined the ALJ erred in finding Plaintiff's degenerative disc disease was not a severe impairment. (Doc. 7-6 at 31) In addition, the Appeals Council observed the ALJ failed to “provide adequate rationale” for the determination that Plaintiff's “depression, anxiety and history of polysubstance abuse are non-severe impairments and that the claimant has mild limitations in activities of daily living, social functioning, and concentration, persistence or pace.” (Id.) The Appeals Council found the ALJ failed to acknowledge that “the Veteran's Administration (VA) assigned an evaluation of 70% for occupational and social impairment based on depression.” (Id.) The Appeals Council also identified significant evidence from the VA discussing Plaintiff's diagnoses with post-traumatic stress disorder, depression, alcohol dependence, and treatment. (Id. at 31-33) Consequently, the Appeals Council concluded Plaintiff had “one or more severe mental impairments” and “[f]urther evaluation of the nature, severity and limiting effects of the claimant's mental impairment(s) [was] necessary.” (Id. at 33) Therefore, the Appeals Council directed the ALJ to obtain additional evidence regarding Plaintiff's mental impairments, further evaluate the mental impairments and Plaintiff's residual functional capacity, and “obtain supplemental evidence from a vocational expert to clarify the effect of the assessed limitations on the claimant's occupational base.” (Id. at 34)

         Plaintiff testified at a second administrative hearing on August 8, 2013. (Doc. 7-4 at 3; Doc. 7-5 at 39-52) The ALJ determined Plaintiff's severe impairments included degenerative disc disease of the lumbar spine, diabetes, affective disorder, and alcohol dependence. (Doc. 7-5 at 42) The ALJ issued a partially favorable decision, finding Plaintiff was disabled beginning September 1, 2012. (Id. at 50-52) However, the ALJ concluded Plaintiff was not disabled during the period of January 1, 2007 through August 31, 2012, and as a result Plaintiff did not show he was disabled prior to his date last insured of December 31, 2009. (Id. at 52) Plaintiff's request for review of this determination was granted by the Appeals Council on March 27, 2015. (Id. at 59)

         The Appeals Council vacated “both the favorable and unfavorable portions of the hearing decision, ” and finding the ALJ failed to explain findings related to Plaintiff's “deficit in concentration, persistence, or pace” and resolve conflicts in the evidence related to Plaintiff's mental impairments and his persistence. (Id. at 60-61) Therefore, the Appeals Council remanded the action for an ALJ to “[f]urther evaluate the claimant's mental impairments in accordance with the special technique described in 20 CFR 404.1520a and 416.902a, ” review the subjective complaints and medical record, and obtain additional evidence regarding Plaintiff's impairments. (Id. at 62) In addition, the Appeals Council directed that the case be assigned to a new ALJ upon remand. (Id.)

         Plaintiff testified at a third hearing on November 15, 2016. (Doc. 7-4 at 37) A supplemental hearing was held on December 1, 2016, at which time the ALJ also obtained testimony from a medical expert and vocational expert. (See Doc. 7-3 at 32) The ALJ issued a partially favorable decision on April 18, 2017. (Doc. 7-3 at 27-45) The ALJ determined Plaintiff “was not disabled prior to September 1, 2012, but became disabled on that date and ... continued to be disabled through the date of [the] decision.” (Id. at 45) The Appeals Council denied Plaintiff's request for review of this decision on January 26, 2018. (Id. at 2-5) Therefore, the ALJ's determination that Plaintiff was not disabled prior to September 1, 2012 became the final decision of the Commissioner of Social Security.


         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 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197 (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 he 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:

his 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 ...

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