Lead Opinion
Dissent by Judge Rawlinson
Brenda M. Diedrich appeals the district court’s order affirming the Commissioner of Social Security’s (the “Commissioner”) denial of Diedrich’s application for Social Security Disability Insurance (“SSDI”) benefits under Title II of the Social Security Act. The Commissioner determined that Diedrich had become disabled, but an Administrative Law Judge (“ALJ”) found that her disability did not begin during the period in which she was insured for SSDI benefits. We hold that the ALJ erred in its assessment (1) by not calling a medical advisor at the hearing; (2) by giving too little weight to the observations of Diedrich’s fiancé; and (3) by finding that Diedrich was only partially credible. We reverse in part on these grounds, and remand. In a separately filed memorandum disposition, we reject several other challenges Diedrich raises related to the ALJ’s decision, affirming in part the ALJ’s decision.
I
We consider a claimant with a troubled past and serious medical conditions. Brenda Diedrich had a rough childhood: Her upbringing was marred by drug addiction, sexual and emotional abuse from her father, suicide attempts, and a marriage at seventeen that resulted in domestic violence. Since 2002, Diedrich has been arrested at least six times, and has been jailed twice. This background doubtless plays some role in her medical conditions.
Diedrich has applied for disability benefits several times. At issue in this appeal is her third application, filed on August 26, 2009, seeking both SSDI benefits under Title II of the Social Security Act and Supplemental Security Income (“SSI”) benefits under Title XVI of the act. See 42
SSI benefits are based on needs. To be eligible, a claimant must be “aged, blind or disabled,” and must have income and resources under certain thresholds. See id. § 1382(a). In contrast, SSDI benefits are based on earnings. The claimant must be disabled,, and must have contributed to a federal insurance trust fund through deductions in his or her wages. See id. § 401(b); see generally Bowen v. Galbreath,
On January 29, 2010, a Disability Determination Services (“DDS”) psychological consultant concluded that as of the date of Diedrich’s third application, August 26, 2009, Diedrieh was disabled due to bipolar and anxiety disorders. This entitled Died-rich to SSI benefits. But Diedrieh had not been insured for SSDI benefits since June 30, 2008. Because the psychological сonsultant concluded that Diedrich’s disability began after June 30, 2008, Diedrich’s application for SSDI benefits was denied.
Diedrieh sought administrative review of this denial of SSDI benefits. She argued that the psychological consultant determined the wrong onset date of her disability. Specifically, she claimed that her disability began not on August 26, 2009, but much earlier, on October 1, 2002. Diedrieh asserted that because her disability began before her Title II insurance expired on June 30, 2008, she was entitled to SSDI benefits.
On December 14, 2011, an ALJ held a hearing on Diedrich’s benefits denial. The relevant evidence at the hearing included medical records from several of Diedrich’s treating physicians. These records showed that, in addition to certain physical conditions, as early as July 2003 Diedrieh suffered serious mental health symptoms. These symptoms included periods of extreme hyperactivity and recklessness, volatile moods, weeks-long bouts of depression, hallucinations, memory problems, trouble concentrating, panic attacks, social anxiety, and blackouts during which Diedrieh would experience personality changes. At various points, Diedrich’s doctors have diagnosed her with bipolar disorder, depression, attention deficit disorder, post-traumatic stress disorder, agoraphobia, and split personalities, among other conditions.
Diedrieh testified at the hearing. She described how her mental health symptoms hampered her functioning in daily life. Diedrich’s fiancé, David Niebaum, also testified. He explained that he had known Diedrieh since the end of September 2008 and saw her every day. He described how Diedrieh would exрerience manic-depressive cycles and take on alternate personalities. Niebaum also submitted a third-party function report, in which he explained how Diedrich’s inability to maintain a routine, mood swings, poor memory, trouble concentrating, anxiety, and other symptoms left her dependent on him for daily help. A vocational expert testified at the hearing as well, but the ALJ did not call a medical advisor.
The ALJ denied SSDI benefits for Diedrieh. The ALJ gave “little weight” to Niebaum’s observations, and found that Diedrieh was merely a “partially credible witness.” The ALJ concluded that Died-rich was “not under a disability ... at any time from October 1, 2002, the alleged onset date, through June 30, 2008, the
II
We have jurisdiction to decide this appeal under 28 U.S.C. § 1291. We review de novo the district court’s decision affirming the Commissioner’s denial of benefits. Stout v. Comm’r, Soc. Sec. Admin.,
HI
A.
Diedrich contends that the ALJ committed legal error by not calling a medical advisor at the hearing. She argues that a medical advisor was necessary to help the ALJ sift through her voluminous medical records and determine the correct оnset date of her disability.
The ALJ is responsible for studying the record and resolving any conflicts or ambiguities in it. Treichler v. Comm’r of Soc. Sec. Admin.,
In relevant part, SSR 83-20 states:
With slowly progressive impairments, it is sometimes impossible to obtain medical evidence establishing the precise date an impairment became disabling. Determining the proper onset date is particularly difficult, when, for example, the alleged onset and the date last worked are far in the past and adequate medical records are not available. In such cases, it will be necessary to infer the onset date
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At the hearing, the [ALJ] should call on the services of a medical advisor when onset must be inferred.
Relying on SSR 83-20, we have held that where a record is lacking and ambiguous as to the onset date of disability, “the ALJ must call a medical expert to assist in determining the onset date.” Armstrong v. Comm’r of Soc. Sec. Admin.,
Here, the record shows that Diedrich did not see a psychologist until years after her alleged onset date; there are no mental health records for nearly two years surrounding her date last insured, and the next available records supported a finding of disability; and she suffered inconsistent but increasingly severe symptoms over the seven years between her alleged onset date and the disability onset date found by the Commissioner. Because “the alleged onset and the date last worked are far in the past and adequate medical records are not available,” determining the precise date on which Diedrich became disabled required an informed inference. “Such an inference is not possible without the assistance of a medical expert,” Id. at 1083.
Thе Commissioner relies on Sam v. Astrue to argue that SSR 83-20 is inapplicable.
Finally, the district court held that the ALJ did not need to call, a medical advisor because .psychological consultants examined Diedrich’s medical records in reaching Diedrich’s initial, denial of SSDI benefits. But SSR 83-20 states that the ALJ should call a medical advisor “[a]t the hearing.” It does not say that the ALJ should rely on the’, previous work of DDS consultants. Moreover, if analysis from DDS consultants was a sufficient substitute for the testimony of a medical advisor, then SSR 83-20 would be. superfluous. Applications for benefits are ordinarily reviewed by a consultant long before an ALJ gets involved. Relying on the initial review of DDS consultants also presents the practical problem that those consultants do not have before them the same record as the ALJ. In particular, such consultants do not have access to the later-in-time testimony given at the hearing. The consultant hеre, for example, did not have access to the hearing testimony of either Diedrich or of Niebaum because that testimony, had not yet been given.
We hold that the Commissioner erred by not calling a medical advisor at the hearing to help determine the precise onset date of Diedrich’s disability under these circumstances—that is, where there are large gaps in the medical records documenting a slowly progressive impairment and an ALJ’s assessment of . the disability onset date would be mere speculation without the aid of a medical expert. Even with a medical advisor, the date of onset of disability in this challenging case might have remained somewhat debatable and mysterious.
B
We next address Diedrich’s contention that the ALJ erred by giving “little weight” to Niebaum’s observations. “Lay testimony as to a claimant’s symptoms is competent evidence that an ALJ must take into account, unless he or she expressly determines to disregard such testimony and gives reasons germane to each witness for doing so.” Lewis v. Apfel,
First, Niebаum’s personal relationship with Diedrich is not a valid reason to discount his observations. To do so “contradicts our insistence that, regardless of whether they are interested parties, friends and family members in a position to observe a claimant’s symptoms and daily activities are competent to testify as to his or her condition.” Valentine v. Comm’r Soc. Sec. Admin.,
Second, а lack of support from the “overall medical evidence” is also not a proper basis for disregarding Niebaum’s observations. See Bruce v. Astrue,
Third, although Niebаum’s observations began three months after Died-rich’s insured period ended, his observations are still relevant to show Diedrich’s symptoms during that period. Absent a reason to think Diedrich experienced a major symptom change in the three months before she met Niebaum, it is a fair and reasonable inference that the symptoms Niebaum observed were substantially similar to the symptoms Died-rich experienced before June 30, 2008. See Tobeler v. Colvin,
We conclude that none of the ALJ’s three reasons for discounting Niebaum’s observations is germane. We hold that the ALJ erred by giving “little weight” to Niebaum’s observations.
C
Finally, we address Diedrich’s contention that the ALJ erred in finding that she was a “partially credible witness.”
In assessing the credibility of a claimant’s testimony regarding subjective pain or the intensity of symptoms, the ALJ engages in a two-step analysis. First, the ALJ must determine whether there is objective medical evidence of an underlying impairment which could reasonably be expected to produce the pain or other symptoms allegеd. If the claimant has presented such evidence, and there is no evidence of malingering, then the ALJ must give specific, clear and convincing reasons in order to reject the claimant’s testimony about the severity of the symptoms.
Molina,
Regarding Dr. Robinson’s report, the ALJ said that Dr. Robinson “did not make any observations about the claimant being anxious, flighty, depressed, or manic, which would suggest that [ ] the claimant’s mental health symptoms were not as severe as she testified to at the hearing.” But even if Diedrich were suffering from such symptoms, we would not necessarily expect Dr. Robinson to note them in her report. Dr. Robinson was an orthopedist, not a mental health professional.. She might have thought it beyond her capacity to inquire or comment about mental health symptoms. In line with her specialty, Dr. Robinson reported the pain that Diedrich said she was feeling in her back, shoulder, neck, hand, and wrist. Still, under the heading “Chief Complaints,” Dr. Robinson noted “Multiple psychiatric history; bipolar disorder, ADHD, borderline personality disorder, panic disorder, agoraphobia.” It is unsurprising that Dr. Robinson did not also mention Diedrich’s specific mental health symptoms. That she did not do so, in our view, says little about the extent to which Diedrich may in fact have been suffering from such symptoms.
Moreover, the same month that Diedrich saw Dr. Robinson, she also saw a psychologist, Dr. Nick Dietlein. Dr. Dietlein concluded that Diedrich presented “symptoms consistent with a Major Depressive Disorder and PTSD. It is very possible that she has Attention Deficit Disorder.” Dr. Diet-lein’s conclusions reinforce that the absence of mental health symptoms from Dr. Robinson’s report does not tend to prove,
Regarding therapist Buttars’s May 2005 assessment, the ALJ noted that Buttars found “no indication of hallucinations, delusions, obsessions, phobias, or perceptual disturbances”; that Diedrich described her mood to Buttars as “good”; and that Buttars found Diedrich’s social judgment, intellectual functioning, and memory all normal. However, the fact that Diedrich was not exhibiting certain symptoms at the time of her appointment on a particular day does not indicate that Died-rich was not experiencing those symptoms generally or at other pertinent times. As the Ninth Circuit has explained:
[Regarding] mental health issues, it is error to reject a claimant’s testimony merely because symptoms wax and wane in the course of treatment. Cycles of improvement and debilitating symptoms are a common occurrence, and in such circumstances it is error for an ALJ to pick out a’few isolated instances of improvement over a period of months or years and to treat them as a basis for concluding a claimant is capable of ^working .... While ALJs -obviously must rely on examples to show why they do not believe that a claimant is credible, the data points they choose must in fact constitute examples of a broader development to satisfy the applicable “clear and convincing” standard.
Garrison,
Next, we address the ALJ’s comments that nobody observed Diedrich’s different personalities and that no report mentioned multiple personalities before Diedrich’s last date insured. We disagree with the ALJ that the record supports this characterization. At. the hearing, Niebaum testified in detail, about his observations of Diedrich’s split personality symptoms. He also mentioned those symptoms in his third-party function report. And, though Niebaum’s observations began three months after Diedrich’s date last insured, they still to a degree support the notion that Diedrich’s split personality symptoms during the insured peripd were as she described them. See Tobeler,
Finally, we address the ALJ’s argument .that Diedrich’s “activities of daily living are wide.” The ALJ took note of certain daily activities that Diedrich could perform, such as bathing, cooking, taking care of her cat, chores around the house, shopping, paying bills, and using a checkbook.
The sorts of daily activities Diedrich could perform are also not readily “trans-ferrable to a work environment.” Ghanim v. Colvin,
We conclude that none of the ALJ’s given reasons for finding Diedrich only partially credible is clear and convincing. We hold that the ALJ erred in its credibility finding related to Diedrich.
IV
In summary, we hold that the ÁLJ erred (1) by not calling a medical advisor to help determine the precise onset date of Diedrich’s disability; (2) by giying “little weight” to Niebaum’s observations; and (3) by finding Diedrich only “partially credible.” We also conclude that none of these errors is harmless. See Molina,
AFFIRMED in part, REVERSED in part, and REMANDED.
Dissenting Opinion
dissenting:
I respectfully dissent from my colleagues’ conclusions that the Administrative Law Judge (ALJ) “erred in its assessment (1) by not calling a medical advisor at the hearing; (2) by giving too little weight to the observations of [Plaintiff-Appellant Brenda MJ Diedrich’s fiancé; and (3) by finding that Diedrich was only partially credible.” Majority Opinion, p. 636.
It is unquestioned and unquestionable that the claimant suffered from significant physical and mental impairments. The issue raised in the proceedings was whether those impairments rendered thе claimant disabled under the Social Security Act. The ALJ ruled that they did not. Our task is to examine whether the ALJ’s determination is supported by substantial evidence, not whether we disagree with the ALJ’s determination. See Attmore v. Colvin,
1. Failure To Call A Medical Advisor
The majority concludes that the ALJ committed legal error by failing to call a medical advisor to assist in determining the disability onset date. See Majority Opinion, p. 639. The majority acknowledges that we have consistently ruled that a medical advisor is required only if there is ambiguity in the record and the onset date must be inferred. See id., p. 638; see also Armstrong v. Comm’r,
More importantly, we have ruled that no medical advisor is required if the ALJ determines that the claimant was never disabled. See Sam v. Astrue,
On page 1 of her decision, the ALJ stated:
After careful consideration оf all the evidence, the undersigned concludes the claimant was not under a disability within the meaning of the Social Security Act ...
On page 12 of the decision, the ALJ determined:
A finding of “not disabled” is therefore appropriate under the framework of the above cited rule.
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The claimant was not under a disability, as defined in the Social Security Act, at any time from October 1, 2002, the alleged onset date, through June 30, 2008, the date last insured ...
In her conclusion on page 13 of the decision, the ALJ reiterated:
Based on the application for a period of disability and disability insurance benefits ..., the claimant was not disabledunder sections 216(i) and 223(d) of the Social Security Act ...
In view of the ALJ’s repeated findings of no disability, it cannot credibly be gainsaid that the ALJ found the claimant was not disabled. That finding placed this case within our holding in Sam that no medical advisor wаs required. No legal error occurred. See Sam,
We distinguished our earlier decisions in Armstrong and Morgan v. Sullivan,
2. Giving Too Little Weight To The Testimony Of Claimant’s Fiancé
This issue may be resolved by reviewing the claimant’s testimony because we have ruled that where the ALJ provides germane reasons for giving less weight to subjective testimony from one witness, similar testimony by a different witness may also be given less weight. See Molina v. Astrue,
As discussed below, the ALJ gave “clear and convincing” reasons for only partially crediting the claimant’s testimony. Garrison v. Colvin,
3. Partially Crediting Claimant’s Testimony
The ALJ provided the following reasons for only partially crediting the claimant’s testimony:
(1) Although the claimant testified that she suffered from “severe mania, depression, anxiety, and agoraphobia,” the “orthopedic consultative examiner ... did not make any observations about the claimant being anxious, flighty, depressed, or manic.” In addition, mental health treatment notes support a conclusion that the claimant was capable of functioning.” A mental health examination reflected “no indications] of hallucinations, delusions, obsessions, phobias, or perceptual disturbances.” Indeed, the сlaimant herself “described her mood as ‘good’ and her social judgment, intellectual functioning, and memory were all normal.” Despite the claimant’s testimony regarding multiple personalities and disassociative disorder,” there were no reported observations of multiple personalities in the record.
We have consistently held that similar findings constituted substantial evidence to support a partial credibility determination made by an ALJ. See, e.g., Lewis v. Apfel,
The majority takes issue with the partial credibility finding of the ALJ, specifically challenging the bona fides of the reasons articulated by the ALJ to support her finding.
In addressing the ALJ’s reliance on the lack of any reference to the claimant being “anxious, flighty, depressed or manic,” in Dr, Robinson’s report, the majority observes that Dr. Robinson was an orthopedist rather than a mental health professional. Majority Opinion, p. 641. However, an orthopedic physician is an acceptable medical source upon whose observations the ALJ properly relied. See 20 C.F.R. § 416.902(a) (defining “acceptable medical source”). The listing of complaints referenced by the majority, see Majority Opinion, p. 641, merely represented claimant’s summary of her condition rather than observations of the physician. See Tommasetti v. Astrue,
The majority alsо refers to the claimant’s visit to a psychologist, Dr. Dietlein. See Majority Opinion, p. 641. Nevertheless, the bottom line of Dr. Dietlein’s opinion does not support a claim of mental disability. In Dr. .Dietlein’s Summary of Findings, he concluded: “Today’s evaluation revealed that Ms. Diedrich is able to understand and remember instructions, is, able to sustain her concentration and attention and is able to persist. She was able to engage in social interactions successfully. I believe she would be able to adequately manage any funds that might be given to her.”
Addressing the lack of mental health symptoms observed by therapist Buttar, the majority offers the following equivocation:
[T]he fact that Diedrich was not exhibiting certain symptoms at the time of her appointment on a particular day does not indicate that Diedrich wаs not experiencing those, symptoms generally or at other pertinent times.
Majority Opinion, p. 642.
The majority also isolates' therapist But-tar’s observations to argue the absence of a “broader development” of mental health issues. Id. (quoting Garrison v. Colvin,
More fundamentally, the majority’s reliance on Garrison is singularly misplaced because the facts in Garrison are almost the polar opposite of the facts in this record. In Garrison, the “diagnoses of [post-traumatic stress disorder] and bipolar disorder remained constant across all treatment records.” Id. In this case, in contrast, the absence of any observed disabling mental impairment “remained constant across all treatment records.” Id. (emphasis added).
At best, the majority’s view is an alternative interpretation of the evidence presented at the hearing. However, we have repeatedly held that if there are two permissible views of the evidence, the view taken by the ALJ must stand. See Burch v. Barnhart,
The majority also takes issue with the ALJ’s discounting of thе “split personality” disorder evidence. Majority Opinion, p. 642. As an initial matter, the reference to a previous diagnosis of split personality was based entirely on the claimant’s own reporting, and may be discounted on that basis. See Ryan v. Comm’r of Soc. Sec.,
We have regularly’ defined substantial evidence as “more than a scintilla [but] less than a preponderance.” Holohan,
Unfortunately, the majority failed to adhere to this standard throughout the majority opinion, but most especially when reviewing the ALJ’s determination that the claimant’s daily activities were inconsistent
The ALJ noted that the claimant lived alone with her cat, cared for her cat, bathed and dressed herself, enjoyed cooking, and cleaned her home. She shopped for groceries and clothing, paid bills, counted change, used a checkbook, and managed a savings account.
We have recognized and affirmed findings of an ALJ that similar “daily activities [of a claimant] are inconsistеnt with [her] allegations of disability.” Carmickle v. Comm’r,
More precisely, we have upheld similar credibility findings in cases involving facts virtually identical to those in this case. See Batson,
In Burch,
Although the evidence of [the claimant’s] daily activities may also admit of an interpretation more favorable to [the claimant], the ALJ’s interpretation was rational, and we must uphold the ALJ’s decision where the evidence is susceptible to more than one rational interpretation.
Id. (alteration omitted).
After applying the deferential substantial evidence standard of review, I agree with the magistrate judge and the district court that the decision of the ALJ was free of legal error and supported by substantial evidence. In my view, the majority reaches a different result by reweighing the evidence, something we are not permitted to do. See Brault,
I respectfully dissent.
