Karena Gerde v. Nancy Berryhill, 15-35418

Background

Karena J. Gerde applied for disability insurance benefits (Title II) and SSI (Title XVI); ALJ denied benefits and the district court affirmed; Gerde appealed to the Ninth Circuit.
Medical record included treating/examining opinions from Drs. Beitinjaneh (physical), Rodgers (medical), and Alvord (mental), state agency non-examining consultants, and lay-witness statements about Gerde’s functioning.
Dr. Beitinjaneh opined severe physical limits (e.g., unable to stand/walk two hours per day; needs assistive device) but his exam notes showed normal gait, strength, ROM, and walking without assistance.
Dr. Alvord (the only examining mental health specialist) performed testing and concluded Gerde had significant mental limitations precluding work; state non-examining consultants disagreed.
The ALJ discounted Dr. Beitinjaneh’s opinion, Gerde’s subjective testimony, Dr. Alvord’s mental opinion, and lay-witness statements; the Ninth Circuit reviewed those determinations and remanded for further proceedings.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether ALJ permissibly rejected Dr. Beitinjaneh’s physical opinion	Beitinjaneh’s opinion should control; Gerde suffers significant physical limits	ALJ: opinion inconsistent with physician’s own exam findings and record	Affirmed: ALJ gave specific, legitimate reasons (inconsistency with exam notes)
Whether ALJ properly evaluated Dr. Rodgers’ findings	ALJ failed to fully consider Rodgers’ findings	ALJ did discuss Rodgers and found findings didn’t support alleged impairments	Affirmed: discussion adequate and findings not supportive
Whether ALJ permissibly discounted Gerde’s subjective testimony	Testimony should be credited as to headaches, dizziness, falls	ALJ: testimony inconsistent with medical record, noncompliance with treatment, and activities	Affirmed: ALJ provided specific, clear, convincing reasons to discount testimony
Whether ALJ permissibly rejected Dr. Alvord’s mental-health opinion	Alvord’s examining specialist opinion should be credited; state non‑examining reviewers cannot override it	ALJ: opinion lacked specificity, corroboration, contradicted by state reviewers	Reversed in part: ALJ erred—non‑examining consultants’ contrary views do not constitute substantial evidence; Alvord’s opinion insufficiently rejected
Whether ALJ properly discounted lay‑witness testimony	Lay witnesses corroborate mental limitations consistent with Alvord	ALJ: lay testimony inconsistent with objective medical evidence	Reversed in part: lay testimony about mental impairments was consistent with Alvord and improperly discounted
Remedy: whether remand for benefits or further proceedings	Gerde: record supports disability	Commissioner: further development may be needed	Remanded for further administrative proceedings (not immediate award)

Key Cases Cited

Orn v. Astrue, 495 F.3d 625 (9th Cir. 2007) (standard of review for ALJ disability determinations)
Lester v. Chater, 81 F.3d 821 (9th Cir. 1996) (examining physician’s opinion cannot be rejected without specific and legitimate reasons)
Bayliss v. Barnhart, 427 F.3d 1211 (9th Cir. 2005) (clear-and-convincing reasons required to reject uncontroverted examining opinion)
Garrison v. Colvin, 759 F.3d 995 (9th Cir. 2014) (standards for assessing claimant testimony)
Molina v. Astrue, 674 F.3d 1104 (9th Cir. 2012) (factors to discredit claimant and lay testimony)
Holohan v. Massanari, 246 F.3d 1195 (9th Cir. 2001) (greater weight to opinions within a specialist’s area of expertise)