Opinion
ED CV 21-1716-AB(E)
05-03-2022
REAGAN G., Plaintiff, v. KILOLO KIJAKAZI, Acting Commissioner of Social Security, Defendant.
REPORT AND RECOMMENDATION OF UNITED STATES MAGISTRATE JUDGE
CHARLES F. EICK, UNITED STATES MAGISTRATE JUDGE.
This Report and Recommendation is submitted to the Honorable Andre Birotte Jr., United States District Judge, pursuant to 28 U.S.C. § 636 and General Order 01-13 of the United States District Court for the Central District of California.
PROCEEDINGS
Plaintiff filed a complaint on October 11, 2021, seeking review of the Commissioner's denial of benefits. Plaintiff filed a motion for summary judgment on February 11, 2022. Defendant filed a motion for summary judgment on April 30, 2022. The Court has taken the motions under submission without oral argument. See L.R. 7-15; “Order, ” filed October 14, 2021.
Plaintiff's motion violates paragraph VI of the “Order," filed October 14, 2021. Counsel shall heed the Court's orders in the future.
BACKGROUND
Plaintiff seeks Supplemental Security Income based primarily on alleged mental impairments (Administrative Record (“A.R.") 18, 184-89, 202). In 2020, Moriah Hanly, Plaintiff's treating Physician's Assistant (“P.A."), opined that Plaintiff lacks the residual functional capacity to perform any substantial gainful employment (A.R. 334-38). No other acceptable medical source rendered an opinion regarding Plaintiff's residual functional capacity (A.R. 1-353).
In 2019, state agency physicians stated, “There is insufficient evidence to evaluate the claim" (A.R. 71, 80).
An Administrative Law Judge (“ALJ") found that Plaintiff “has the following severe impairments: traumatic brain injury (TBI) s/p craniotomy, migraines, seizures, depression and generalized anxiety disorder" (A.R. 18). The ALJ also found that these severe impairments precluded Plaintiff from performing any of her past relevant work (A.R. 24).
In evaluating Plaintiff's work capacity, the ALJ deemed unpersuasive the opinion of P.A. Hanly and defined Plaintiff's work capacity as including an ability to perform a range of light work “limited to simple, routine and repetitive tasks with only occasional simple decision making required” (A.R. 20, 23-24). In reliance on the testimony of a vocational expert, the ALJ concluded there exist jobs performable by persons having the defined residual capacity (A.R. 2425, 55-56). The ALJ therefore denied benefits (A.R. 24-25). The Appeals Council denied review (A.R. 1-3).
STANDARD OF REVIEW
Under 42 U.S.C. section 405(g), this Court reviews the Administration's decision to determine if: (1) the Administration's findings are supported by substantial evidence; and (2) the Administration used correct legal standards. See Carmickle v. Comm'r, 533 F.3d 1155, 1159 (9th Cir. 2008); Hoopai v. Astrue, 499 F.3d 1071, 1074 (9th Cir. 2007); see also Brewes v. Comm'r of Soc. Sec. Admin., 682 F.3d 1157, 1161 (9th Cir. 2012). Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (citation and quotations omitted); see Widmark v. Barnhart, 454 F.3d 1063, 1066 (9th Cir. 2006).
DISCUSSION
The ALJ rejected the only medical opinion of record regarding Plaintiff's work-related abilities and limitations. The ALJ then evaluated the impact of Plaintiff's severe “traumatic brain injury . . . migraines, seizures, depression and generalized anxiety disorder” and defined Plaintiff's mental residual functional capacity based in part, if not in whole, on the ALJ's own lay interpretation of the medical evidence. The ALJ thereby erred.
An ALJ's decision must be supported by substantial evidence. See 42 U.S.C. § 405(g) (“The findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive. . . ."). An ALJ cannot properly rely on the ALJ's own lay knowledge to make medical interpretations of examination results or to determine the severity of medically determinable impairments. See Tackett v. Apfel, 180 F.3d 1094, 1102-03 (9th Cir. 1999); Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999); Balsamo v. Chater, 142 F.3d 75, 81 (2d Cir. 1998); see also Rohan v. Chater, 98 F.3d 966, 970 (7th Cir. 1996) (“ALJs must not succumb to the temptation to play doctor and make their own independent medical findings"); Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975) (an ALJ is forbidden from making his or her own medical assessment beyond that demonstrated by the record); McAnally v. Berryhill, 2020 WL 1443734, at *6 (S.D. Cal. March 25, 2020) (“In making an RFC determination, an ALJ may not act as his own medical expert as he is simply not qualified to interpret raw medical data in functional terms") (citations and quotations omitted).
In the present case, absent expert medical assistance, the ALJ could not competently translate the medical evidence into a mental residual functional capacity assessment. See Tackett v. Apfel, 180 F.3d at 1102-03 (ALJ's residual functional capacity assessment cannot stand in the absence of evidentiary support); see generally Mayes v. Massanari, 276 F.3d 453, 459-60 (9th Cir. 2001) (ALJ's duty to develop the record further is triggered “when there is ambiguous evidence or when the record is inadequate to allow for the proper evaluation of the evidence”) (citation omitted); Brown v. Heckler, 713 F.2d 441, 443 (9th Cir. 1983) (“[T]he ALJ has a special duty to fully and fairly develop the record to assure the claimant's interests are considered. This duty exists even when the claimant is represented by counsel.”).
Because the ALJ relied on her own lay assessment of the medical records, substantial evidence does not support the ALJ's conclusion that the non-exertional limitations the ALJ found to exist adequately account for Plaintiff's severe mental impairments. See, e.g., McAnally v. Berryhill, 2020 WL 1443734 at *7 (in the absence of a medical opinion interpreting the extent of Plaintiff's mental impairment, no substantial evidence supported the ALJ's assertion that the limitation to “simple, routine and repetitive tasks” sufficiently accommodated plaintiff's impairment); Sonja S. R. v. Berryhill, 2018 WL 3460165, at *6-7 (C.D. Cal. July 16, 2018) (substantial evidence failed to support residual functional capacity determination where state agency physicians' opinions did not consider later medical evidence supporting additional impairments and reflecting “potentially long-term conditions, ” and the ALJ had rendered ALJ's own lay interpretation of the updated medical record).
In addition to relying on the ALJ's interpretation of the medical evidence, the ALJ also purportedly relied on Plaintiff's reported symptoms (A.R. 20-24). However, the ALJ found those reported symptoms “not entirely consistent with the medical evidence and the other evidence in the record” (A.R. 21). Thus, the ALJ's purported reliance on Plaintiff's reported symptoms circled back to the ALJ's lay interpretation of the medical evidence.
The Court is unable to conclude that the errors discussed above were harmless. “[A]n ALJ's error is harmless where it is inconsequential to the ultimate nondisability determination.” Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012) (citations and quotations omitted); see Treichler v. Comm'r, 775 F.3d 1090, 1105 (9th Cir. 2014) (“Where, as in this case, an ALJ makes a legal error, but the record is uncertain and ambiguous, the proper approach is to remand the case to the agency”); cf. McLeod v. Astrue, 640 F.3d 881, 887 (9th Cir. 2011) (error not harmless where “the reviewing court can determine from the ‘circumstances of the case' that further administrative review is needed to determine whether there was prejudice from the error”).
Remand is appropriate because the circumstances of this case suggest that further development of the record and further administrative review could remedy the ALJ's errors. See McLeod v. Astrue, 640 F.3d at 888; see also INS v. Ventura, 537 U.S. 12, 16 (2002) (upon reversal of an administrative determination, the proper course is remand for additional agency investigation or explanation, except in rare circumstances); Leon v. Berryhill, 880 F.3d 1041, 1044 (9th Cir. 2017) (reversal with a directive for the immediate calculation of benefits is a “rare and prophylactic exception to the well-established ordinary remand rule”); Dominguez v. Colvin, 808 F.3d 403, 407 (9th Cir. 2015) (“Unless the district court concludes that further administrative proceedings would serve no useful purpose, it may not remand with a direction to provide benefits”); Treichler v. Comm'r, 775 F.3d at 1101 n.5 (remand for further administrative proceedings is the proper remedy “in all but the rarest cases”); Harman v. Apfel, 211 F.3d 1172, 1180-81 (9th Cir.), cert. denied, 531 U.S. 1038 (2000) (remand for further proceedings rather than for the immediate payment of benefits is appropriate where there are “sufficient unanswered questions in the record”); see also Brown-Hunter v. Colvin, 806 F.3d 487, 495-96 (9th Cir. 2015) (discussing the narrow circumstances in which a court will order a benefits calculation rather than further proceedings). There remain significant unanswered questions in the present record.
For example, it is not clear whether the ALJ would be required to find Plaintiff disabled for the entire claimed period of disability even if Plaintiff's mental impairments were found to be disabling at some point in time. See Luna v. Astrue, 623 F.3d 1032, 1035 (9th Cir. 2010).
CONCLUSION
For all of the foregoing reasons, it is recommended that the Court issue an order: (a) accepting and adopting this Report and
The Court has not reached any other issue raised by Plaintiff except insofar as to determine that reversal with a directive for the immediate payment of benefits would not be appropriate at this time.
Recommendation; (2) denying Plaintiff's and Defendant's motions for summary judgment; (3) reversing in part the decision of the Commissioner of the Social Security Administration; and (4) remanding the matter for further administrative action consistent with this Report and Recommendation.
NOTICE
Reports and Recommendations are not appealable to the Court of Appeals, but may be subject to the right of any party to file objections as provided in the Local Rules Governing the Duties of Magistrate Judges and review by the District Judge whose initials appear in the docket number. No notice of appeal pursuant to the Federal Rules of Appellate Procedure should be filed until entry of the judgment of the District Court.
ORDER ACCEPTING FINDINGS, CONCLUSIONS AND RECOMMENDATIONS OF UNITED STATES MAGISTRATE JUDGE
Pursuant to 28 U.S.C. section 636, the Court has reviewed the Complaint, all of the records herein and the attached Report and Recommendation of United States Magistrate Judge. Further, the Court has engaged in a de novo review of those portions of the Report and Recommendation to which any objections have been made. The Court accepts and adopts the Magistrate Judge's Report and Recommendation.
IT IS ORDERED that: (1) the Report and Recommendation of the Magistrate Judge is accepted and adopted; (2) Plaintiff's and Defendant's motions for summary judgment are denied; (3) the decision of the Commissioner of the Social Security Administration is reversed in part; and (4) the matter is remanded for further administrative action consistent with the Report and Recommendation.
IT IS FURTHER ORDERED that the Clerk serve forthwith a copy of this Order, the Magistrate Judge's Report and Recommendation and the Judgment of this date on Plaintiff, counsel for Plaintiff and counsel for Defendant.
ANDRÉ BIROTTE JR., UNITED STATES DISTRICT JUDGE.
JUDGMENT
IT IS HEREBY ADJUDGED that the decision of the Commissioner of the Social Security Administration is reversed in part and the matter is remanded for further administrative action consistent with the Report and Recommendation of United States Magistrate Judge.