Angelic Pallesi v. Nancy Berryhill
696 F. App'x 798
9th Cir.2017Background
- Angelic Pallesi applied for disability insurance and SSI, claiming disability from depression and anxiety; ALJ denied benefits and district court affirmed.
- Treating psychiatrist Dr. Guzzetta opined Pallesi could follow only one- or two-step instructions, could focus ~30 minutes, and could not handle stress.
- ALJ discounted Dr. Guzzetta’s opinion as inconsistent with the medical record and with his mental-status exam entries, and relied in part on nonexamining physicians (Drs. Fair and Goldberg).
- Record showed Dr. Guzzetta’s mental-status exam fields were pre-populated and not updated, and a treating therapist (Ms. Powers) had contemporaneous abnormal findings the ALJ did not address.
- Other treating records (Drs. Holloway and Luu) contained some normal entries but, viewed holistically, were consistent with significant limitations; nonexamining opinions predicting improvement were not borne out by later treatment.
- Ninth Circuit found the ALJ’s reasons for discounting the treating opinion unsupported by substantial evidence and that the error was not harmless, and reversed and remanded for further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ permissibly rejected treating psychiatrist's opinion | ALJ improperly discounted Dr. Guzzetta; his limitations were supported by treatment notes and therapist's reports | ALJ relied on alleged inconsistencies in medical record and normal mental-status entries; nonexamining doctors supported lighter RFC | Reversed: ALJ failed to give specific and legitimate reasons supported by substantial evidence to reject treating opinion |
| Whether pre-populated normal mental-status entries are substantial evidence | Pre-populated entries are unreliable and do not reflect actual observations | ALJ treated those entries as probative of normal functioning | Held for Plaintiff: pre-filled normal MSEs and failure to address contradictory therapist notes are not substantial evidence |
| Whether isolated normal exams from other treating doctors justify rejecting limitations | Such isolated improvements cannot negate chronic limitations | Defendant argued Drs. Holloway and Luu showed improvement | Held for Plaintiff: cherry-picking isolated normal entries is error; overall records consistent with limitations |
| Whether nonexamining doctors’ prognoses constitute substantial evidence | Nonexamining opinions predicting improvement are insufficient when contradicted by later records | Commissioner relied on nonexamining opinions to support RFC | Held for Plaintiff: nonexamining opinions alone are not substantial evidence and their favorable projections were undermined by subsequent treatment notes |
Key Cases Cited
- Smolen v. Chater, 80 F.3d 1273 (9th Cir. 1996) (treating-physician opinions generally entitled to greater weight)
- Reddick v. Chater, 157 F.3d 715 (9th Cir. 1998) (must give specific and legitimate reasons supported by substantial evidence to reject treating opinion)
- Garrison v. Colvin, 759 F.3d 995 (9th Cir. 2014) (error to rely on isolated improvements to conclude claimant can work)
- Morgan v. Comm’r of Soc. Sec. Admin., 169 F.3d 595 (9th Cir. 1999) (nonexamining advisor’s opinion cannot by itself constitute substantial evidence to reject examining/treating opinions)
- Rounds v. Comm’r Soc. Sec. Admin., 807 F.3d 996 (9th Cir. 2015) (relationship between one- or two-step task limitations and reasoning level for jobs)
- Molina v. Astrue, 674 F.3d 1104 (9th Cir. 2012) (harmless error standard in administrative disability decisions)
- Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090 (9th Cir. 2014) (remand for further proceedings when record contains ambiguity needing resolution)
- Greger v. Barnhart, 464 F.3d 968 (9th Cir. 2006) (exception to waiver when law changes on appeal)