Cynthia Carrillo-Yeras v. Michael Astrue
671 F.3d 731
9th Cir.2011Background
- Carillo-Yeras suffered chronic low back pain after a 1996 coccyx fracture and multiple surgeries, with intermittent conservative treatment until 2005-2006.
- She applied for disability benefits in May 2000, and again in June 2003, alleging March 2003 onset due to back injury and arachnoiditis.
- An August 19, 2003 state agency finding declared disability due to spinal arachnoiditis, leading to early benefits for the second application.
- The Appeals Council reopened and consolidated the cases in 2004 and remanded for a new hearing; in 2006 the ALJ denied both applications, finding no arachnoiditis and that she could perform past work.
- The district court and Ninth Circuit considered whether the SSA diligently pursued its investigation in revising the August 19, 2003 determination, and ultimately reversed and remanded to reinstate that determination.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether SSA’s revision was timely and diligently pursued | Carillo-Yeras argues SSA failed to diligently pursue revision after reopening | SSA argues diligence not explicit required by regulations; POMS is non-binding | Reversed; improper unfounding due to delay; reinstatement ordered |
| Whether the ALJ properly weighed treating opinions and credibility | Treating physicians’ opinions should be given controlling weight; credibility should be assessed carefully | ALJ appropriately evaluated opinions and concluded limited credibility appropriately | Not necessary to address here as the remand focuses on diligence and reinstatement |
| Whether the ALJ erred in denying disability without considering the 23-month delay | Delay invalidates revision authority under the regulations | Delay alone does not require reversal absent diligence finding | Reversed due to lack of diligence finding and need to reinstate favorable determination |
| What standard governs ‘diligently pursued’ revisions | Regulations require explicit finding of diligence or presumption within six months | Diligence can be implicit; not required to state explicitly | Regulations require prompt action; where delays occur, reversal is appropriate if not diligently pursued |
Key Cases Cited
- Moisa v. Barnhart, 367 F.3d 882 (9th Cir. 2004) (standard of review for district court decisions granting benefits; substantial evidence)
- Thomas v. Barnhart, 278 F.3d 947 (9th Cir. 2002) (substantial evidence standard and termination of benefits)
- Swensen v. Sullivan, 876 F.2d 683 (9th Cir. 1989) (premature remand authority for benefits where record developed)
- Lockwood v. Comm’r Soc. Sec. Admin., 616 F.3d 1068 (9th Cir. 2010) (POMS not binding; administrative duties not enforceable in court)
- Moore v. Apfel, 216 F.3d 864 (9th Cir. 2000) (regulations binding; internal manuals non-binding)
- Skidmore v. Swift & Co., 323 U.S. 134 (1951) (agency deference to internal interpretations; persuasive nonetheless)
- Christensen v. Harris Cnty., 529 U.S. 576 (2000) (reliance on agency interpretations only to the extent persuasive)
- Lowry v. Barnhart, 329 F.3d 1019 (9th Cir. 2003) (limits on applying internal manuals to decisions)