Case Information
*1 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF HAWAI ‘ I DANNY OKAWA, Civil MWJS ‐ WRP
Plaintiff, ORDER REVERSING DECISION OF THE COMMISSIONER OF SOCIAL SECURITY AND REMANDING FOR FURTHER vs. ADMINISTRATIVE PROCEEDINGS FRANK BISIGNANO, Social Security
Administration,
Defendant.
INTRODUCTION
Danny retired veteran United States Air Force who sought benefits because spinal, knee, hip, wrist, severe impairments. In oral testimony, explained impairments severely restricted his ability work. Administrative Law Judge (ALJ) case concluded his pain credible denied application. reaching conclusion, reason discredit five Advanced Practice
Registered Nurse supported claim.
Because concludes could application without offering valid for (or at least explaining why believe it necessary consider reports), it REVERSES and REMANDS further administrative proceedings.
BACKGROUND Okawa applied and disability insurance benefits on January 25, 2023, contending he had become disabled beginning on July 31, 2022.
Dkt. 1, at (Administrative Record (AR) at 17). After his application was denied on papers, Okawa requested hearing before ALJ. The hearing took place on August 14, 2024, and both Okawa and vocational
expert testified. Id. at PageID.50–98 (AR at 32–80). In his testimony, explained he served in Air Force until 2002, after which he held civilian employment. PageID.56–58 (AR 38–40). forced stop working in light his knee pain (“it’s bone bone right now”), back and neck pain (“my body’s actually fusing my neck together”), pain his fingers carpal tunnel right wrist (“[b]oth wrists shot” “I can’t even close fist”), plantar fasciitis (“when I go store walk around, every, maybe minutes, I’ve got sit down”), ailments. PageID.85, vocational expert testified longer do past work, but under certain assumptions about remaining physical capabilities, hypothetical *3 person Okawa’s position could still work as an internal auditor or as data entry clerk. Id. at 70–71 (AR at 60–61). Yet upon questioning by ALJ, vocational expert acknowledged if hypothetical person were found not be able stand walk more than “two out of eight hours” kneel—a conceivable conclusion here light of about back, knee, other physical ailments— then not work as internal auditor. Id. at PageID.95 (AR at 77). And under questioning attorney, vocational expert acknowledged hypothetical person “limited handling fingering frequently,” able work data entry clerk, either. Id. at PageID.96–97 (AR at 78–79). Following hearing, issued denying application. Id. at PageID.32–49 (AR at 14–31).
The found did number of “severe impairments: degenerative joint disease of left knee; calcific plantar fasciitis, right greater left; degenerative disc disease of cervical spine, history of fusion at C2 C4;
degenerative joint disease left shoulder; degenerative joint disease left wrist; obesity; obstructive sleep apnea; high cholesterol.” PageID.37 (AR 19). also found suffered impairments qualify
severe: “headache, cataract, hypertension, gastrointestinal disorder, chronic liver disease, degenerative joint disease bilateral hips.”
Nonetheless, rejected Okawa’s about severity of his symptoms these impairments. As put it, while Okawa’s “medically determinable impairments reasonably expected to cause more than
minimal symptoms,” “allegations concerning intensity, persistence and limiting effects of symptoms entirely consistent with medical evidence evidence record for reasons explained decision.” PageID.39 (AR several to support conclusion: x ray imaging “demonstrate[] abnormalities interfere with light work,” id. ; Okawa had
“continued demonstrate adequate strength” for work greater than what Okawa had suggested, id. ; symptoms, “while requiring treatment, largely been susceptible treatment without complication,” id. ; doctor had concluded “only required conservative measures, including pain medication needed,” id. 22); “the record reflects adequate symptom management, including
control over pain,” id. ; “[c]ontrary of limited use of left hand for daily activities inability claimant remain feet more than minutes, medical evidence demonstrates adequate strength, range motion, walking ability, control over pain” greater degree work had suggested, id. ; plantar fasciitis “managed treatment devices,” id. ; “[c]ontrary [Okawa’s] reported concerns over pain during hearing, *5 records reflect significant pain improvement with treatment deferral of surgeries that have potential to further relieve symptoms,” id. at PageID.41 (AR at 23).
As result, ALJ concluded that Okawa had greater ability to work he had testified. In more technical terms, ALJ found Okawa had “residual functional capacity” to perform “light work” with certain restrictions. Id. at PageID.38 (AR at 20). This meant Okawa was able work either as an internal auditor or as data entry clerk, positions which both exist significant numbers in national economy. (AR And, ALJ concluded, not qualify disabled under Act because ability work. something was missing decision: it nowhere recognized Okawa’s was not only available evidence supporting application. Advanced Practice Registered Nurse (APRN) Syriece Jones Francis completed five forms documenting diagnoses clinical findings. See id. PageID.1390– 1402–24, 1425–37, 1438–48, 1449–61 1372–83, 1384–1406, 1407–19, 1420–30, 1431–43). Taken together, conclusions expressed forms, credited, supported contention not perform work either internal auditor data entry clerk. And so it was enough credibility testimony; conclude disabled, also had contend APRN’s reports. Yet while recognized existence *6 (and admitted them into administrative record), she any reasons their stated conclusions.
3. asked Administration’s Appeals Council to review ALJ’s decision, but Appeals Council denied request, id. 1), making ALJ’s decision Commissioner’s final decision. This timely appeal followed.
STANDARD OF REVIEW Commissioner’s determination must affirmed unless “it is either supported by substantial evidence based upon legal error.” Luther v.
Berryhill , 891 F.3d 875 (9th Cir. 2018). This standard deferential, requiring “only such relevant evidence reasonable mind might accept adequate support conclusion.” Woods v. Kijakazi , F.4th (9th Cir. (cleaned up). court may only defer those Commissioner—here, acting
through ALJ—actually offers. “Long standing principles administrative law require us review based on reasoning factual findings ALJ—not post hoc rationalizations attempt intuit what adjudicator may have been thinking.” Bray v. Comm’r Soc. Sec. Admin. , F.3d (9th Cir. That means district cannot affirm based merely “what it assume[s] determined.”
DISCUSSION One contentions is the failed valid reasons medical opinions expressed in APRN Francis’ five reports. Indeed, concedes, their conclusions. Answering Brief (AB) 5–6.
This alone is sufficient reason reverse decision. When, here, an application benefits is filed after March 27, 2017, current Administration regulations require consider, among other things,
“supportability” “consistency” medical in administrative record before deciding whether they persuasive. 20 C.F.R. § 404.1520c; see generally Wade v.
O’Malley , Civil 2024 WL 3248021, *3 (D. Haw. Feb. 16, (cleaned up) . “Supportability” is “the extent which medical source supports medical opinion by explaining relevant objective medical evidence.” Wade , WL *4 (cleaned up). It is question how well medical opinion supports
itself. “Consistency,” by contrast, focuses “whether medical opinion consistent evidence other sources nonmedical sources claim.” (cleaned up). That assessment asks how well opinion supported by evidence administrative record. Importantly, ALJs must explain how
considered supportability consistency factors, their explanations must supported substantial evidence. ; see also Cross v. O’Malley , F.4th (9th *8 Cir. (“ALJs must explain how persuasive they find medical opinion
expressly considering two most important factors evaluating such opinions: ‘supportability’ ‘consistency.’”). That precisely what ALJ did not do here.
The Commissioner resists conclusion, contending that ALJ “reasonably declined discuss” APRN Francis’ five reports. AB at 5. Although Commissioner acknowledges that an ALJ must offer sufficient medical opinions, argues need not discuss “a claimant’s own description of or her physical mental impairment,” those considered merely “[s]ymptoms” rather medical under relevant regulations. Id. 5. And Commissioner’s view, APRN Francis’ reports contain any relevant opinions, but rather merely summarized substance of own self ‐ reports.
It certainly possible that, remand, conclude APRN Francis’ reports do include opinions, but instead only recounting of what reported. As notes, each of APRN Francis’ reports begins its description of symptoms with phrase, “Veteran reports difficulty . . .” For example, one APRN Francis’ reports states “Veteran reports difficulty typing, opening jars, grabbing stuff, doing
household chores.” Dkt. remainder use similar phrasings. If conclude reports merely contained summaries own statements—and independent evaluative *9 work APRN Francis—then the ALJ possibly the reports on the ground that they “premised a large extent upon the claimant’s own
accounts symptoms limitations,” which the ALJ had already “discounted.” Morgan v. Comm’r Sec. Admin. , F.3d 602 (9th Cir. 1999) (cleaned up). problem with the Commissioner’s argument, however, that the ALJ’s decision does say the rejected APRN Francis’ reports on the ground
that they merely summarized self ‐ reports. It black letter law that court must “review ALJ’s decision based on the reasoning factual findings ALJ.” Bray , F.3d While offers plausible assumption about thought process, court cannot accept “ post hoc
rationalizations attempt intuit what adjudicator may been thinking.”
Granted, Ninth Circuit’s precedent does permit court affirm when “the agency’s path may be reasonably discerned, even agency explains its less ideal clarity.” Brown Hunter v. Colvin , F.3d (9th Cir. (cleaned up). cannot, record, reasonably discern truly consider APRN Francis’ reports, let alone (implicitly) reached conclusion those lacked any opinions. While reports appear some support conclusion along those lines, surely need interpreted way. As correctly points out, forms issue Disability *10 Benefits Questionnaires that ask whether conditions affect “ability to perform any type occupational task.” Dkt. 9, PageID.1397, 1418, 1436, 1447, 1429, In response to this question on each form, APRN Francis answered, “Yes.” These answers may fairly understood to
constitute APRN Francis’ medical opinions. The fact that APRN Francis heavily relied on self reports defend opinions serve a reason discredit them. But it does not conclusively show that they are not opinions all.
Nor can court say, on this record, that the ALJ would reject the conclusions memorialized in APRN Francis’ reports fairly considered. The ALJ offer long list reasons for rejecting testimony. See supra p.4. it is one thing claimant’s standing alone, quite another reject it when it backed opinion medical source. Nothing ALJ’s answers whether ALJ take latter step.
* * * In short, remand further proceedings necessary. Commissioner concedes that legally required sufficient reasons any record. And Commissioner does dispute such here. While contends APRN Francis’ best read including any opinions, court cannot say record herself reached conclusion. Nor can say
/s/ Micah W.J. Smith Micah W.J. Smith United States District Judge for self ‐ reports readily support rejecting independent source, understand way. Under circumstances, court cannot affirm
decision. makes arguments support remand. need not, so does not, resolve them this time. Accord Hiler v. Astrue , F.3d
(9th Cir. (remanding for one reason “declin[ing] reach [an] alternative ground”).
CONCLUSION For foregoing reasons, Commissioner’s denying applications disability insurance benefits
REVERSED case REMANDED further administrative proceedings
consistent order.
IT IS SO ORDERED.
DATED: January Honolulu, Hawai ‘ i. Civil MWJS ‐ WRP, Danny v. Frank Bisignano ; ORDER REVERSING DECISION OF THE COMMISSIONER OF SOCIAL SECURITY AND REMANDING FOR FURTHER ADMINISTRATIVE PROCEEDINGS