(SS) Davis v. Commissioner of Social Security, 1:14-cv-01632

Background

Janet Davis applied for SSI, DIB, and widow’s benefits alleging disability from December 31, 2005; initial/first ALJ denial was vacated and remanded by the Appeals Council for further development.
After remand the ALJ held a second hearing (Sept. 5, 2013) and again denied benefits (Nov. 22, 2013); Appeals Council denied review, so ALJ decision became final.
Medical evidence includes consultative exams (Dr. Shankar — normal physical findings; Dr. Castillo — GAF 74, few observable mental limitations), a 2013 psychological exam (Dr. Martin — GAF 60, checklist showing marked/moderate mental limitations), and treatment history including carpal tunnel surgery and orthopedic issues.
ALJ found severe impairments (cervical degenerative disc disease, DJD of hands/knees, carpal tunnel post-op, migraines, depression, anxiety) but determined an RFC for a wide range of light work with limitations (occasional overhead reaching, frequent handling/fingering, no more than occasional public contact, only occasional ability to carry out complex/detailed instructions).
Plaintiff argued the ALJ erred by (1) improperly applying a presumption of continuing nondisability, (2) improperly discounting Dr. Martin’s examining opinion, and (3) relying on the Medical-Vocational Rules. The Commissioner defended the ALJ’s evaluation.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Presumption of continuing nondisability	Davis says ALJ improperly applied presumption despite changed circumstances (age category change, new/worsened impairments)	Commissioner says reference to presumption was inadvertent and ALJ actually reconsidered sequential evaluation and new evidence	Court: ALJ’s reference was error and not harmless because ALJ also erred in evaluating medical evidence, so the presumption error could be consequential; remand required
Weight given to Dr. Martin (examining psychologist)	Davis argues ALJ failed to give specific and legitimate reasons to discount Dr. Martin’s marked/moderate mental limitations	Commissioner argues ALJ permissibly discounted parts of Dr. Martin’s opinion as inconsistent with the record and other examiners	Court: ALJ did not provide the required specific, legitimate reasons or adequate explanation for rejecting Dr. Martin’s checklist limitations; error warrants remand
Consistency with record / examination findings	Davis contends Dr. Martin’s limitations are supported and ALJ misread inconsistencies	Commissioner points to earlier consultative opinions (Drs. Shankar, Castillo) and asserts ALJ reasonably resolved conflict	Court: While conflicts may be resolved by ALJ, here the ALJ’s conclusory finding of inconsistency was insufficiently explained under Ninth Circuit law
Remedy — remand vs. benefits award	Davis implicitly seeks crediting of evidence or further proceedings	Commissioner opposes immediate award, supports remand for updated evaluation	Court: Remand for further proceedings under sentence four of 42 U.S.C. § 405(g); not an immediate award because outstanding issues remain

Key Cases Cited

Sanchez v. Sec’y of Health & Human Serv., 812 F.2d 509 (9th Cir. 1987) (standard of review for ALJ factual findings)
Richardson v. Perales, 402 U.S. 389 (1971) (definition of substantial evidence)
Lester v. Chater, 81 F.3d 821 (9th Cir. 1995) (weight of medical opinions; standard for rejecting treating/examining opinions)
Chavez v. Bowen, 844 F.2d 691 (9th Cir. 1988) (presumption of continuing non-disability and changed circumstances doctrine)
Tommasetti v. Astrue, 533 F.3d 1035 (9th Cir. 2008) (ALJ may discount physician opinion for inconsistency with objective data)
Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595 (9th Cir. 1999) (inconsistency with record is legitimate reason to discount opinion but requires specific explanation)
Embrey v. Bowen, 849 F.2d 418 (9th Cir. 1988) (ALJ must do more than assert conclusions when rejecting medical opinions)
Smolen v. Chater, 80 F.3d 1273 (9th Cir. 1996) (standards for remand vs. benefits award)