Opinion
For Tuesday Fields, O.B.O., I.J., Plaintiff: Bill LaTour, LEAD ATTORNEY, Bill LaTour Law Offices, Colton, CA.
For Carolyn W. Colvin, Acting Commissioner of Social Security, Defendant: Assistant U.S. Attorney LA-CV, LEAD ATTORNEY, AUSA - Office of U.S. Attorney, Civil Division, Los Angeles, CA; Assistant U.S. Attorney LA-SSA, LEAD ATTORNEY, Office of the General Counsel for Social Security Adm., San Francisco, CA; Jacob M Mikow, SAUSA - Office of U.S. Attorney, San Francisco, CA.
ORDER AFFIRMING DECISION OF ADMINISTRATIVE LAW JUDGE
HON. MICHAEL R. WILNER, UNITED STATES MAGISTRATE JUDGE.
I. SUMMARY OF RULING
Plaintiff (on behalf of her minor daughter) challenges the denial of the child's application for Social Security disability benefits. The Administrative Law Judge (ALJ) found that the girl's condition was not functionally equivalent to a listed impairment and denied benefits.
On appeal, Plaintiff contends that the ALJ improperly rejected the opinion of a consulting psychologist who examined the child. However, the Court concludes that the written decision identified a specific and legitimate reason that supported the ALJ's determination. As a result, the Court affirms the ALJ's decision.
II. PLAINTIFF'S CONDITIONS AND PROCEEDINGS BELOW
The claimant (a nine-year-old girl with the initials I.J.) applied for disability benefits based on her mental impairments. After an administrative hearing, the ALJ found that I.J.'s " low average to borderline" intellectual functioning and learning disability constituted " severe impairments" as that term is used under the federal regulations. (AR 13.)
However, the ALJ concluded that the claimant did not meet or functionally equal a " listed impairment." (Id.) In making those determinations, the ALJ expressly rejected the opinion of an examining psychologist who diagnosed the girl with considerable intellectual limitations. (AR 15.) The ALJ concluded that the claimant was not disabled and denied benefits. (AR 22.)
III. DISCUSSION
A. Standard of Review and Procedure in Child Disability Proceedings
Under 42 U.S.C. § 405(g), a district court may review the Commissioner's decision to deny benefits. The ALJ's findings and decision must be upheld if they are supported by substantial evidence and are free of legal error. Hill v. Astrue, 698 F.3d 1153, 1158 (9th Cir. 2012). Substantial evidence is proof in an amount or of a nature that " a reasonable mind might accept as adequate to support a conclusion." Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). A court must uphold the ALJ's conclusion even if the evidence in the record " is susceptible to more than one rational interpretation." Ludwig v. Astrue, 681 F.3d 1047, 1052 (9th Cir. 2012) (quotation omitted).
Social Security regulations set forth a three-step procedure to determine whether a child is disabled. 20 C.F.R. § 416.924(b-d). Those steps -- Is the claimant employed? Does the claimant have a " severe" impairment? Does that impairment meet or functionally equal a " listed impairment" of considerable seriousness? -- are essentially the same as in the adult disability context. However, rather than identify a specific Listing, the ALJ may assess a child based on six statutory criteria that are considered to be " functionally equal" to a generic " listing-level" impairment. 20 C.F.R. § 416.926a(a); Howard ex rel. Wolff v. Barnhart, 341 F.3d 1006, 1012 (9th Cir. 2003). If a child's conditions result in " marked" limitations in two of those categories or an " extreme" limitation in one of them, the child can establish the functional equivalent of a listed impairment and is entitled to disability benefits. 20 C.F.R. § 416.926a(d).
Consistent with this convention, neither the ALJ nor the parties in this case referred to a specific Listing such as inability to walk (Listing § 1.04), multiple sclerosis (Listing § 11.09), or intellectual disability (Listing § 12.05) that the claimant sought to meet.
B. Rejection of Medical Opinion Evidence
On appeal to this Court, Plaintiff argues that the ALJ failed to provide legally sufficient reasons for rejecting the opinion of a consulting psychologist who examined the claimant.
1. Facts and the ALJ's Decision
The consulting psychologist (Dr. Stephenson) interviewed I.J. and conducted a " mental status examination" of the girl. (AR 283.) The examination included an IQ test. (Id.) The consultant reported that the child " did appear to have some degree of intellectual limitations and likely functions below average." (AR 284.)
The report further surmised that it was " possible" that I.J. could meet the criteria " for a diagnosis of Mild Mental retardation; however current IQ results are not sufficiently valid to make that diagnosis." (Id.) That was based on Dr. Stephenson's conclusion that I.J.'s test results were " invalid" because she gave a " halfhearted" and " inconsistent level of effort" during the examination. (AR 283-84.) The psychologist opined that the child's poor test results " likely underestimate the claimant's full abilities." (AR 283.)
Even so, Dr. Stephenson diagnosed I.J. with " provisional, mild mental retardation" and a learning disorder. (AR 284-85.) Additionally, the consultant opined that the child was " markedly" limited in her cognitive development (understanding and responding to increasingly complex requests, instructions, or questions in an age-appropriate manner) and " moderately to markedly" limited in several other areas of functioning. (AR 285.)
The ALJ rejected Dr. Stephenson's opinion. (AR 15.) The ALJ concluded that this evaluation was inconsistent with school testing, teacher evaluations, and the testimony of a non-consulting expert (Dr. Griffin). The ALJ determined that Dr. Stephenson's " characterization that the claimant functioned in the mildly mentally retarded range is inherently inconsistent with [his] own findings." (Id.) Further, the ALJ found the consultant's opinion was contradicted by I.J.'s half-day placement in " regular education classes" at her school.
Instead, the ALJ gave controlling weight to Dr. Griffin's opinions. That expert concluded that I.J. had less than marked limitations in the relevant functional domains. (AR 34-35.) On that basis, the ALJ concluded that the child's conditions did not functionally equal a listed impairment under agency regulations.
2. Relevant Law
In analyzing medical or psychological evidence, an ALJ " must set out in the record his reasoning and the evidentiary support for his interpretation." Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). If the ALJ rejects significant probative evidence, the ALJ " must explain why." Vincent v. Heckler, 739 F.2d 1393, 1395 (9th Cir. 1984); Morales v. Colvin, 534 F.App'x 589, 591 (9th Cir. 2013) (same).
The opinion of an examining consultant is generally " entitled to greater weight than the opinion of a nonexamining" professional. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). However, the ALJ may reject an examining professional's contradicted opinions by providing " specific and legitimate reasons that are supported by substantial evidence in the record." Carmickle v. Comm'r of Soc. Sec. Admin., 533 F.3d 1155, 1164 (9th Cir. 2008). The ALJ satisfies this burden by detailing and summarizing the facts and conflicting medical evidence and stating the ALJ's interpretations and findings. Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008).
An ALJ identifies a valid reason to discredit a professional's opinion by noting material internal inconsistencies in a report or treating notes. Morgan v. Comm'r of Soc. Sec. Admin., 169 F.3d 595, 603 (9th Cir. 1999); Wilhelm v. Comm'r of Soc. Sec. Admin., 597 F.App'x 425 (9th Cir. 2015) (an " ALJ may reject a medical opinion that is internally inconsistent"). Such a finding can " provide a specific legitimate basis for the ALJ to discount [the opinion] in favor of other opinions that the ALJ [finds] better supported by the evidence and more consistent with the record as a whole." Houghton v. Comm'r of Soc. Sec. Admin., 493 F.App'x 843, 845 (9th Cir. 2012) (citing Tonapetyan v. Halter, 242 F.3d 1144, 1149 (9th Cir. 2001)).
Moreover, the opinions of a non-examining practitioner " may serve as substantial evidence when they are supported by other evidence in the record and are consistent with it." Morgan, 169 F.3d at 600. That is particularly true in the context of a child claimant, as federal law requires that the agency " make a reasonable effort to obtain a case evaluation" from a specialist who has evaluated the broad record. Howard, 341 F.3d at 1014; Martinez v. Comm'r of Soc. Sec., No. CV 13-1092 JPR, 2014 WL 2606150 at *3 (C.D. Cal. 2014).
3. Analysis
The ALJ rejected Dr. Stephenson's diagnosis and assessment of claimant's functional capabilities in favor of Dr. Griffin's contradictory opinions. As a result, the ALJ was obliged to identify " specific and legitimate reasons" supported by substantial evidence to reject the consultant's opinion. Carmickle, 533 F.3d at 1164.
The Court concludes that the ALJ did so. The ALJ wrote that Dr. Stephenson's opinion was " inherently inconsistent" with the doctor's own findings. (AR 15.) The ALJ based that on the consultant's conclusion that I.J. " functioned in the mildly mentally retarded range" even though there was no valid testing result to support that diagnosis. The consultant affirmatively stated that " it was difficult to estimate her actual intellectual level" based on her failure to perform properly on the tests he administered. (AR 284.) Indeed, elsewhere in the report, the psychologist noted that the child's poor test performance understated her full abilities. The ALJ further noted Dr. Stephenson's impression that Plaintiff's poor test performance was based on lack of motivation and inability to deal with frustration as opposed to her intellectual functioning. (AR 15, 283)
The ALJ could permissibly point to the inconsistency between the consultant's diagnosis (mild retardation, significant functional impairments) and the practitioner's minimal evidence supporting those conclusions. In one part of the report, the psychologist noted that it was " possible" that I.J. was mildly retarded; elsewhere, the consultant noted profound limitations regarding her mental functioning. Although not particularly detailed, the written decision provided the ALJ's specific and legitimate reason for rejecting this opinion. Morgan, 169 F.3d at 603; Wilhelm, 597 F.App'x at 425; Houghton, 493 F.App'x at 845. In light of the legitimacy of this explanation, the Court need not take up the adequacy of the ALJ's other reasons to disregard the consultant or to accept Dr. Griffin's competing recommendation against a disability finding. Morgan, 169 F.3d at 600 (nonexamining doctor's opinion is substantial evidence when it is supported by other evidence in the record).
The ALJ may have put undue significance on the observation that I.J. spent part of her day in a mainstream second grade classroom. That could easily reflect a school district's lack of resources or a desire to socialize the child rather than an assessment of her intellectual ability. However, the Court finds it unnecessary to delve further into this area given its analysis above.
Plaintiff dedicates a considerable portion of her brief to compiling the evidence that could support Dr. Stephenson's opinion and her disability claim. (Docket # 21 at 5-10.) However, on appeal, this Court will not reweigh the evidence presented to the factfinder. Having legitimately rejected the consultant's conclusion, the ALJ's decision to deny benefits was supported by evidence sufficient to allow a reasonable person to reach that conclusion. Burch, 400 F.3d at 679. Even though the record might have been " susceptible to more than one rational interpretation, " the Court must uphold the ALJ's evaluation. Ludwig, 681 F.3d at 1052.
IV. CONCLUSION
The ALJ's denial of Plaintiff's application for Social Security benefits was supported by substantial evidence in the record and contained no legal error. Therefore, the Court AFFIRMS the decision below.
IT IS SO ORDERED.
JUDGMENT
It is the judgment of this Court that the decision of the Administrative Law Judge is AFFIRMED. Judgment is hereby entered in favor of Defendant.