Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Aaron v. Saul

United States District Court, N.D. California

September 24, 2019

ANDREW M. SAUL, Defendant.




         Plaintiff Anthony Aaron seeks review of the final decision of Defendant Andrew M. Saul, Commissioner of Social Security (“the Commissioner”), denying his applications for disability insurance benefits and Supplemental Security Income (“SSI”) benefits under Titles II and XVI of the Social Security Act. The parties have filed cross motions for summary judgment pursuant to Civil Local Rule 16-5. For the reasons stated below, the Court GRANTS Plaintiff’s Motion for Summary Judgment, DENIES the Commissioner’s Motion for Summary Judgment, REVERSES the decision of the Commissioner and REMANDS the case to the Social Security Administration for further proceedings.[1]


         A. The Five-Step Evaluation Process

         In order to be found “disabled” under the Social Security Act, a claimant must establish that he is unable “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A); see also 42 U.S.C. § 423(a)(1). In addition, in order to be entitled to disability benefits under Title II, a claimant must establish that he was disabled on or before his date last insured. See Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1998); Johnson v. Shalala, 60 F.3d 1428, 1432 (9th Cir. 1995).

         The Commissioner has established a sequential, five-part evaluation process to determine whether a claimant is disabled under the Act. See Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999) (citing 20 C.F.R. § 404.1520). The claimant bears the burden of proof at steps one through four, but the burden shifts to the Commissioner at step five. Id. “If a claimant is found to be ‘disabled’ or ‘not disabled’ at any step in the sequence, there is no need to consider subsequent steps.” Id.

         At Step One, the Administrative Law Judge (“ALJ”) considers whether the claimant is presently engaged in “substantial gainful activity.” 20 C.F.R. § 404.1520(a)(4)(i). If he is, the ALJ must find that he is not disabled. Id. If he is not engaged in substantial gainful activity, the ALJ continues the analysis. See id.

         At Step Two, the ALJ considers whether the claimant has “a severe medically determinable physical or mental impairment, ” or combination of such impairments, which meets the regulations’ twelve-month duration requirement. 20 C.F.R. §§ 404.1509, 404.1520(a)(4)(ii). An impairment or combination of impairments is severe if it “significantly limits [the claimant’s] physical or mental ability to do basic work activities.” 20 C.F.R. § 404.1520(c). If the claimant does not have a severe impairment, disability benefits are denied. 20 C.F.R. § 404.1520(a)(4)(ii). If the ALJ determines that one or more impairments are severe, the ALJ proceeds to the next step. See id.

         At Step Three, the ALJ compares the medical severity of the claimant’s impairments to a list of impairments that the Commissioner has determined are disabling (“Listings”). See 20 C.F.R. § 404.1520(a)(4)(iii); see also 20 C.F.R. Pt. 404, Subpt. P, App. 1. If one or a combination of the claimant’s impairments meets or equals the severity of a listed impairment, he is disabled. 20 C.F.R. § 404.1520(a)(4)(iii). Otherwise, the analysis continues. See id.

         At Step Four, the ALJ considers the claimant’s residual functional capacity (RFC) in light of his impairments and whether he can perform past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv) (citing 20 C.F.R. § 404.1560(b)). If he can perform past relevant work, he is not disabled. Id. If he cannot perform past relevant work, the ALJ proceeds to the final step. See id.

         At Step Five, the burden shifts to the Commissioner to demonstrate that the claimant, in light of his impairments, age, education, and work experience, can perform other jobs in the national economy. Johnson v. Chater, 108 F.3d 178, 180 (8th Cir. 1997); see also 20 C.F.R. § 404.1520(a)(4)(v). If the Commissioner meets this burden, the claimant is not disabled. See 20 C.F.R. § 404.1520(f). Conversely, the claimant is disabled and entitled to benefits if there are not a significant number of jobs available in the national economy that he can perform. Id.

         The Social Security Administration has supplemented the five-step general disability evaluation process with regulations governing the evaluation of mental impairments at steps two and three of the five-step process. See generally 20 C.F.R. § 404.1520a. First, the Commissioner must determine whether the claimant has a medically determinable mental impairment. 20 C.F.R. § 404.1520a(b)(1). Next, the Commissioner must assess the degree of functional limitation resulting from the claimant’s mental impairment with respect to four broad functional areas: (1) activities of daily living; (2) social functioning; (3) concentration, persistence, or pace; and (4) episodes of decompensation. 20 C.F.R. § 404.1520a(b)(2), (c). Finally, the Commissioner must determine the severity of the claimant’s mental impairment and whether that severity meets or equals the severity of a mental impairment listed in Appendix 1. 20 C.F.R. § 404.1520a(d). If the Commissioner determines that the severity of the claimant’s mental impairment meets or equals the severity of a listed mental impairment, the claimant is disabled. See 20 C.F.R. § 404.1520(a)(4)(iii). Otherwise, the evaluation proceeds to step four of the general disability inquiry.[2] See 20 C.F.R. § 404.1520a(d)(3).

         This evaluation process is to be used at the second and third steps of the sequential evaluation discussed above. Social Security Ruling 96-8p, 1996 WL 374184, at *4 (“The adjudicator must remember that the limitations identified in the ‘paragraph B’ and ‘paragraph C’ criteria are not an RFC assessment but are used to rate the severity of mental impairment(s) at steps 2 and 3 of the sequential evaluation process.”). If the Commissioner determines that the claimant has one or more severe mental impairments that neither meet nor are equal to any listing, the Commissioner must assess the claimant’s residual functional capacity. 20 C.F.R. §§ 404.1520a(d)(3). This is a “mental RFC assessment [that is] used at steps 4 and 5 of the sequential process [and] requires a more detailed assessment by itemizing various functions contained in the broad categories found in paragraphs B and C of the adult mental disorders listings in 12.00 of the Listing of Impairments. . . .” Social Security Ruling 96-8p, 1996 WL 374184, at *4.

         District courts have jurisdiction to review the final decisions of the Commissioner and have the power to affirm, modify, or reverse the Commissioner’s decisions, with or without remanding for further hearings. 42 U.S.C. § 405(g); see also 42 U.S.C. § 1383(c)(3). When reviewing the Commissioner’s decision to deny benefits, the Court “may set aside a denial of benefits only if it is not supported by substantial evidence or if it is based on legal error.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) (quoting Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 1997)) (quotation marks omitted). Substantial evidence must be based on the record as a whole and is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971). Substantial evidence “must be ‘more than a mere scintilla, ’ but may be less than a preponderance.” Molina v. Astrue, 674 F.3d 1104, 1110–11 (9th Cir. 2012) (quoting Desrosiers v. Sec’y of Health and Human Servs., 846 F.2d 573, 576 (9th Cir. 1988)). Even if the Commissioner’s findings are supported by substantial evidence, “the decision should be set aside if the proper legal standards were not applied in weighing the evidence and making the decision.” Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978).

         B. Factual Background

         Plaintiff was 54 years old at the time of his administrative hearing and had a 12th grade education. AR 46. He tested at the 8.7 grade level equivalent on the Test of Adult Basic Education. AR 587. Plaintiff reports he experienced both physical and sexual abuse as a child. AR 586. Plaintiff does not have any past relevant work. AR 46.

         In November 2004, Plaintiff was found not competent to stand trial and was admitted for psychiatric treatment at Napa State Hospital, where he remained until July 26, 2006, when he was found competent to stand trial and discharged to Alameda County Jail. AR 651. From 2007 to 2013, Plaintiff was incarcerated and received psychiatric treatment in the California state prison system. AR 492-659. When Plaintiff was incarcerated, in 2007, he was evaluated and found to meet the criteria for inclusion in the mental health treatment program in prison based on diagnoses of Psychotic Disorder NOS, Depressive Disorder, and mental retardation. AR 495. It was noted that Plaintiff “report[ed] continued depression, ” had a history of suicide attempts, and “admit[ted] to auditory hallucinations.” Id.

         During his incarceration, treatment providers, including psychiatrists P. Pacifico, M.D., P. Shamasundara, M.D., and K. Kumar, M.D., diagnosed Plaintiff with “schizophrenia disorder, ” “schizoaffective disorder” and “schizophrenia paranoid.” AR 431, 447, 454510, 511, 512, 516. Prison records also contain numerous references to symptoms of psychosis – for which Plaintiff was prescribed Risperdal – and depression – for which Plaintiff was prescribed Paxil. AR 428, 436-437, 447, 454, 487, 490, 512-516, 525. Prison treatment records are also replete with reports that Plaintiff experienced auditory hallucinations. See, e.g., AR 429 (“voices and other symptoms are manageable”), 431 (“reports still hear[ing] voices”), 432 (“voices are stable”), 454 (“when he wakes up the voices take over”), 511 (“the voices are always there especially when mind is not preoccupied”).

         Upon release from prison in 2013, Plaintiff began receiving psychiatric treatment with Gregory Girtman, PsyD, of the Parole Outpatient Clinic, and Erica Conners, PhD, of the Sharper Future program. AR 578, 663; see also AR 75-76, 577-590, 660-751. He saw Dr. Girtman monthly and Dr. Conners weekly. AR 577-590, 660-751. Dr. Girtman diagnosed Plaintiff with schizoaffective disorder. AR 585. He noted that Plaintiff “still experiences auditory hallucinations and feelings of paranoia.” AR 587. In a Function Report-Adult-Third Party completed on October 3, 2013, Dr. Girtman reported that Plaintiff had poor sleep, required reminders to take his medication and attend appointments, had difficulty getting along with others, had an extremely limited attention span (less than 5 minutes), did not finish what he started, had difficulty following instructions, and exhibited paranoia around people. AR 373-74, 376-78. He further noted that Plaintiff handled stress and changes to his routine poorly. AR 378.

         Dr. Conners supplied treatment notes for her weekly sessions with Plaintiff, all of which used the same standardized template carrying the header “Progress Notes: Oakland – HRSO State Parole.” AR 663-751. The form did not include a subheading or check-box area to list the patient’s diagnosis and none was listed on these treatment notes, but the notes describe symptoms of hallucinations, high distractibility, mood elevations, decline in basic functioning when stressed, anxiety, fear of people, and inattentiveness. Id. In an October 7, 2015 letter submitted to the Social Security Administration in support of Plaintiff’s disability application, Dr. Conners wrote that these symptoms would “impair [Plaintiff’s] ability to engage in basic activities without individualized support” and that “[d]espite being consistent with his medication regimen he experiences a significant decline in basic functioning that results in crying spells, cognitive distortions and at times passive suicidal ideation.” AR 660. She further opined that “[b]ased on these challenges it would be very difficult for him to maintain employment and support himself financially if he is reliant on his ability through a work day.” Id.

         In addition, the record contains a form that Dr. Conners completed for Plaintiff in order to receive accommodations at community college, dated August 26, 2014. AR 86. In that form, Dr. Conners wrote under “description of disability” “auditory hallucinations, high distractability, paranoia.” Id. She listed Plaintiff’s diagnosis as DSM IV code as 295.4, which corresponds to schizophreniform disorder. See Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. Text Revision (“DSM-IV-TR”) at pp. 317-318. She described the impact of Plaintiff’s condition on his ability to function in an academic setting as follows: “Client requires a very structured setting, tutorial support and positive reinforcement to support his desire to learn. Extremely crowded rooms and having minimal support in the classroom cause him to be agitated and highly distracted.” Id. She further wrote that Plaintiff’s medications “sometimes make him sleepy.” Id.

         Also beginning in 2013, Plaintiff received general medical treatment and psychiatric medications from Save a Life Wellness Center. AR 594-616. Treatment providers there observed that Plaintiff suffered from anxiety and psychosis and reported that he was hearing voices and feeling anxious. AR 595. Over the course of his treatment at Save a Life Wellness Center, Plaintiff was prescribed Risperidone, Paxil, and Vistiral for his psychiatric symptoms. AR 594, 596, 599-605. He was repeatedly noted to carry a diagnosis of ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.