David P. v. Saul
| Decision Date | 17 July 2020 |
| Docket Number | Case No.: 3:19-cv-01506-BEN-AHG |
| Court | U.S. District Court — Southern District of California |
| Parties | DAVID P., Plaintiff, v. ANDREW SAUL, Commissioner of Social Security, Defendant. |
REPORT AND RECOMMENDATION REGARDING CROSS-MOTIONS FOR SUMMARY JUDGMENT
This matter comes before the Court for a Report and Recommendation ("R&R") on the parties' cross-motions for summary judgment (ECF Nos. 22, 24) regarding Plaintiff's appeal of the final decision of the Commissioner of Social Security denying Plaintiff's application for a period of disability and disability insurance benefits. Plaintiff brings his appeal pursuant to 42 U.S.C. § 405(g).
After a thorough review of the parties' submissions, the administrative record, and applicable law, the undersigned recommends that the Court DENY Plaintiff's Motion for Summary Judgment (ECF No. 22), GRANT Defendant's Cross-Motion for Summary Judgment (ECF No. 24), and AFFIRM the Commissioner's denial of disability insurance benefits.
On October 26, 2015, Plaintiff filed an application for a period of disability and disability insurance benefits ("DIB") under Title II of the Social Security Act, alleging disability beginning October 19, 2015. See Certified Administrative Record ("AR") 565, ECF No. 14-11. Plaintiff's application was initially denied on January 20, 2016, and denied again upon reconsideration on April 27, 2016. AR 1725-1759. Plaintiff timely requested a hearing before an Administrative Law Judge ("ALJ") on June 8, 2016, and the hearing was held before the ALJ on January 30, 2018. AR 1781-83, 1695-1724.
On May 9, 2018, the ALJ issued an unfavorable decision, finding Plaintiff was not disabled as defined by the Social Security Act, and accordingly denying disability insurance benefits. AR 565-579. The Appeals Council affirmed the ALJ's decision on June 11, 2019, (AR 24-27), making the ALJ's opinion the final decision of the Commissioner. See 42 U.S.C. § 405(h). On August 12, 2019, Plaintiff timely commenced the instant appeal seeking judicial review of the Commissioner's final decision pursuant to 42 U.S.C. § 405(g). ECF No. 1.
As an initial matter, the ALJ noted that Plaintiff had previously filed a disability application that had been addressed in a prior ALJ's opinion. AR 565. Thus, the holding in Chavez v. Bowen, 844 F.2d 691 (9th Cir. 1998) applied to Plaintiff's new claim. In Chavez, the Ninth Circuit held that a prior ALJ's findings concerning a claimant's residual functional capacity are entitled to some res judicata consideration in subsequent proceedings. Id. at 693. "[I]n order to overcome the presumption of continuing nondisability arising from the first [ALJ's] findings of nondisability," the claimant "must prove 'changed circumstances' indicating a greater disability." Id. (quoting Taylor v. Heckler, 765 F.2d 872, 875 (9th Cir. 1985)). In this case, the ALJ found that Plaintiff rebutted the presumption by showing a "changed circumstance" of new impairments not previously considered. AR at 565-566. Therefore, the ALJ proceeded with his analysis without applying a presumption of continuing nondisability.
The ALJ first determined Plaintiff met the insured status requirements of the Social Security Act through March 31, 2017. AR 566. Accordingly, the relevant period for the disability analysis is the alleged disability onset date of October 19, 2015 through the date last insured of March 31, 2017. Thereafter, the ALJ performed the required five-step sequential evaluation process governing DIB claims under the Social Security Act: (1) whether the claimant is involved in substantial gainful activity; (2) whether the claimant has an impairment or combination of impairments that is "severe"; (3) whether the claimant's impairments meet or equal one of the listed impairments; (4) whether the claimant can still perform his past relevant work given his residual functional capacity despite his impairment(s); and (5) if the claimant cannot perform past relevant work, whether the claimant can perform other work that exists in significant numbers in the national economy. See 20 C.F.R. § 404.1520(a)(4). The five steps are addressed in order, but the ALJ is not always required to go through all five steps of the process. Specifically, an affirmative answer at steps one or four (whether the claimant is currently engaged in substantial gainful activity or can perform past relative work), or a negative answer at step two (whether the claimant has an impairment or combination of impairments that is severe), would immediately lead to a finding of non-disability, and the analysis would stop there. Conversely, an affirmative answer at step three (whether the claimant's impairments meet a listing) would immediately lead to a finding of disability, also ending the analysis. Id. See also Garfield v. Schweiker, 732 F.2d 605, 607 n.2 (7th Cir. 1984).
At step one of the five-step process, the ALJ determined that Plaintiff did not engage in substantial gainful activity ("SGA") from his alleged disability onset date of October 19, 2015 through the date last insured of March 31, 2017. AR 568. See also 20 C.F.R. § 404.1520(b). SGA is defined as work activity that is both substantial and gainful. 20 C.F.R. § 404.1572. "Substantial work activity is work activity that involves doing significant physical or mental activities." C.F.R. § 404.1572(a). "Gainful work activity is work activity that you do for pay or profit." C.F.R. § 404.1572(b).
At step two, the ALJ must determine whether Plaintiff has a medically determinable impairment or combination of impairments that is "severe." 20 C.F.R. § 404.1520(c). A "severe" impairment is one that significantly limits physical or mental ability to do basic work activities. Id. The ALJ concluded the Plaintiff had the following "severe" impairments: mild degenerative disc disease at L3-4 with left foraminal disc protrusion at L3-4, a history of right knee anterior cruciate ligament (ACL) repair, and a history of meniscus tear and ACL repair of the left knee. AR 568.
At step three, the ALJ must determine whether Plaintiff's impairment or combination of impairments meets or medically equals the criteria of an impairment listed in 20 CFR Part 404, Subpart P, Appendix I ("the listings"). The listings describe impairments that the Social Security Agency ("SSA") considers "severe enough to prevent an individual from doing any gainful activity, regardless of his or her age, education, or work experience." 20 C.F.R. § 404.1525(a). A claimant's impairment may also be considered "medically equivalent" to a listed impairment if it is at least equal in severity and duration to the criteria of any listed impairment. 20 C.F.R. § 404.1526(a). If a claimant's impairments meet or medically equal any of the listings, the ALJ will find the claimant disabled. See 20 C.F.R. § 404.1520(d). Here, the ALJ concluded that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of any of the listings. AR 569.
Before considering whether Plaintiff could perform past relevant work at step four, the ALJ must first determine Plaintiff's residual functional capacity ("RFC"). 20 C.F.R. § 404.1520(e). A claimant's RFC is ". . . the most [the claimant] can still do despite [his] limitations." 20 C.F.R. § 404.1545(a)(1); Laborin v. Berryhill, 867 F.3d 1151, 1153 (9th Cir. 2017). A claimant's RFC is based on all relevant evidence in the case record. Id.
Based on his evaluation of the medical and opinion evidence in the record, the ALJ determined that, through the date last insured, Plaintiff had the RFC AR 570. Sedentary work is defined under the regulations as work that 20 C.F.R. § 404.1567(a).
In reaching this conclusion, the ALJ considered all symptoms of Plaintiff's medically determinable impairments "and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence," based on the requirements of 20 C.F.R. § 404.1529 and Social Security Ruling ("SSR") 16-3p, 2017 WL 5180304 (S.S.A. Oct. 25, 2017) (). AR 570. Upon consideration, the ALJ enumerated seven "specific and legitimate reasons" for his finding that, "to the extent it is alleged that [Plaintiff] cannot perform work at the [RFC] recited above, . . . those allegations are not totally consistent with the evidence[.]" AR 575. The ALJ further found that, although Plaintiff's medically determinable impairments could reasonably be expected to cause the alleged symptoms, "the claimant's statements concerning the intensity, persistence[,] and limiting effects of these symptoms are not entirely consistent with the medical evidence and other evidence in the record[.]" AR 575-576.
The ALJ's seven enumerated reasons are as follows: First, the ALJ noted that Plaintiff had been prescribed the psychotropic medications Amitriptyline and Xanax on one occasion in July 2016, but that Plaintiff had never received any mental health services. (Although the absence of any mental limitations in the RFC is not at issue on appeal, the Court presumes that the ALJ included this reason to explain that absence.) Second, the ALJ stated that on November 20, 2015, when Plaintiff was seen at the...
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