Russell C. v. Saul
| Decision Date | 24 March 2021 |
| Docket Number | Case No. 20-cv-256-MMA (RBM) |
| Parties | RUSSELL C., Plaintiff, v. ANDREW SAUL, Commissioner of Social Security, Defendant. |
| Court | U.S. District Court — Southern District of California |
ORDER OVERRULING COMMISSIONER'S OBJECTION; ADOPTING REPORT AND RECOMMENDATION; GRANTING IN PART AND DENYING IN PART PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT; AND REMANDING ACTION TO SOCIAL SECURITY ADMINISTRATION
On February 11, 2020, Russell C. ("Plaintiff") filed this social security appeal challenging the denial of his application for disability benefits. See Doc. No. 1.1 The Court referred all matters arising in this social security appeal to the assigned Magistrate Judge for report and recommendation ("R&R") pursuant to 28 U.S.C. § 636(b)(1)(B) and Civil Local Rule 72.1. See Doc. No. 7. Plaintiff filed a motion for summary judgment.See Doc. Nos. 11. The Magistrate Judge has issued a R&R recommending that the Court (1) grant in part and deny in part Plaintiff's motion and (2) remand the Administrative Law Judge's ("ALJ") decision. See Doc. No. 14 at 17. Andrew Saul, Commissioner of Social Security, ("Commissioner") objects to a portion of the R&R, and Plaintiff replied. See Doc. Nos. 15, 16. Upon due consideration and for the reasons set forth below, the Court OVERRULES the Commissioner's objection, ADOPTS the Magistrate Judge's R&R, GRANTS in part and DENIES in part Plaintiff's motion for summary judgment, and REMANDS this matter to the Social Security Administration.
Seeking judicial review to challenge the denial of his application for disability insurance benefits, Plaintiff filed the present action pursuant to 42 U.S.C. § 405(g). See Doc. No. 1 ¶ 1. Plaintiff moved for summary judgment, arguing that (1) the "ALJ was estopped from redetermining [Plaintiff's] residual functional capacity [("RFC")] in the Title II claim," (2) the ALJ's decision was not supported by substantial evidence, and (3) the ALJ erred by supplanting a physician's assessment with his own. Doc. No. 11-1 at 13, 17.
The Magistrate Judge issued an R&R on Plaintiff's motion for summary judgment, in which she recommends granting in part and denying in part Plaintiff's motion. See Doc. No. 11-1 at 17. In particular, the Magistrate Judge recommends remanding the ALJ's decision regarding Plaintiff's RFC. See id. The Magistrate Judge determined that "the ALJ's RFC assessment did not rely upon any physician's opinion to provide an opinion regarding limitations, mental or physical." Id. at 15 (citing AR 22-29). The Magistrate Judge found that the ALJ's decision was not supported by substantial evidence and the record should be more "developed with respect to Plaintiff's RFC." Id. at 17.
The Commissioner now objects to the Magistrate Judge's R&R. See Doc. No. 15.
The duties of the district court in connection with a magistrate judge's R&R are set forth in Rule 72(b) of the Federal Rules of Civil Procedure and 28 U.S.C. § 636(b)(1). Where the parties object to a R&R, "[a] judge of the [district] court shall make a de novo determination of those portions of the [R&R] to which objection is made." 28 U.S.C. § 636(b)(1); see Thomas v. Arn, 474 U.S. 140, 149-50 (1985). A district judge may "accept, reject, or modify, in whole or in part, the findings or recommendations made by the magistrate judge." 28 U.S.C. § 636(b)(1); see also Wilkins v. Ramirez, 455 F. Supp. 2d 1080, 1088 (S.D. Cal. 2006).
The Commissioner objects to the Magistrate Judge's R&R on one issue: "the finding of error as to the ALJ's RFC finding." Doc. No. 15 at 1. The Commissioner states that "because the RFC finding is a legal finding, not a medical one, the ALJ alone is responsible" for determining Plaintiff's RFC. Id. In response to the Magistrate Judge's finding that "the ALJ's RFC assessment did not rely upon any physician's opinion to provide an opinion regarding [Plaintiff's] limitations, mental or physical," Doc. No. 14 at 15 (citing AR at 22-29), the Commissioner asserts that "there is no regulatory or legal requirement that the RFC finding track a specific medical opinion." Doc. No. 15 at 3. The Commissioner further states that to the extent there were conflicting statements or ambiguity in the record, the ALJ properly exercised his role as fact-finder by resolving these issues. See id. at 5. Furthermore, the Commissioner contends that the "substantial evidence" requirement is not a high threshold and the ALJ's analysis of the medical evidence in the record satisfies this requirement. Id.
Plaintiff responds that the ALJ's decision is not supported by substantial evidence. See Doc. No. 16 at 2 (citing Doc. No. 11). Plaintiff argues that because the ALJ does not rely on a medical opinion or examination to determine Plaintiff's functional limitations, the RFC assessment is "nothing more than the ALJ's own 'exploration and assessment' of [Plaintiff's] impairments." See Doc. No. 11 at 18 (quoting McAnally v. Berryhill, No. 3:18-cv-02272-GPC-RNB, 2020 WL 1443734, at *7 (S.D. Cal. Mar. 25, 2020)). Plaintiffclaims that the ALJ "formulated his own independent determination that [Plaintiff] is capable of medium work." Doc. No. 11 at 18 (citing AR 22). Plaintiff further contends that the ALJ violated his "special duty to develop the record and retain a medical expert or retain an examining physician," and the absence of any medical opinion regarding Plaintiff's functional limitations yields a RFC that is not supported by substantial evidence. See Doc. No. 16 at 3 ().
A RFC assessment is the most a plaintiff can do despite existing physical, mental, and other limitations. 20 C.F.R. § 404.1545(a)(1). See generally SSR 96-8p, S.S.R. Cum. Ed. (July 2, 1996). An ALJ considers all relevant medical and other evidence when conducting a RFC assessment. 20 C.F.R. § 404.1545(a)(3). If an ALJ chooses to give minimal weight to a medical opinion, the ALJ must provide specific, legitimate reasons for his decision. See Lester v. Chater, 81 F.3d 821, 830 (9th Cir.1996) (citing Murray v. Heckler 722 F.2d 499, 502 (9th Cir. 1983)).
To the extent that there are conflicting statements or ambiguities in the administrative record, it is the ALJ's duty to fully develop the record to resolve the conflicting statements and ambiguities. See Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir. 2001) (quoting Smolen v. Chater, 80 F.3d 1273, 1288 (9th Cir.1996)) (citing Armstrong v. Comm'r of Soc. Sec. Admin., 160 F.3d 587, 590 (9th Cir. 1998)) ("Ambiguous evidence, or the ALJ's own finding that the record is inadequate to allow for proper evaluation of the evidence, triggers the ALJ's duty to 'conduct an appropriate inquiry.'"). If evidence from the medical source is insufficient to determine if the claimant is disabled, an ALJ may recontact the medical source to determine if additional needed information is readily available. See 20 C.F.R. § 404.1520b(b)(2)(i); see also 20 C.F.R. § 404.1512(b)(1) (). The record will be considered "inadequate" or "ambiguous" when a medical source has provided a medical opinion that is not supportedby the evidence. See Bayliss v. Barnhart, 427 F.3d 1211, 1217 (9th Cir. 2005) () ("An ALJ is required to recontact a doctor only if the doctor's report is ambiguous or insufficient for the ALJ to make a disability determination."). It is for the ALJ to determine credibility, resolve conflicts in testimony, and resolve ambiguities in the record, but his findings must be supported by specific and cogent reasons. See Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) ().
Courts may set aside the denial of disability insurance benefits when the ALJ's findings are based on legal error or are not supported by substantial evidence in the record as a whole. See Penny v. Sullivan, 2 F.3d 953, 956 (9th Cir. 1993) (citing Brawner v. Sec'y of Health & Human Servs., 839 F.2d 432, 433 (9th Cir. 1988)). "Substantial evidence means more than a mere scintilla but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Andrews, 53 F.3d at 1039 (citing Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989)).
Here, the ALJ gave "no weight" to the medical opinion statements of the state agency consultants because their analysis was for the Title XVI application and was insufficient evidence to evaluate Plaintiff's present Title II disability claim. AR at 16. Further, the ALJ gave "minimal weight" to opinion statements in Plaintiff's Veterans Affairs ("VA") records. See id. at 27. The ALJ reasoned that these VA opinion statements were "largely unsupported and overall inconsistent with the longitudinal evidence," such as "[VA] records themselves." Id. In particular, the ALJ noted the following evidence from VA records: Plaintiff getting a key to the exercise room and planning on using the exercise room three or four time per week; Plaintiff completing "at least two stress/exercise tests with at least one lasting over 8 minutes"; Plaintiff being counseled on the importance of regular exercise and on the lack of a cardiac reason tohave a handicap placard; and Plaintiff swimming and playing basketball. Id. Additionally, the ALJ noted that Plaintiff "denied exercise intolerance"; was advised to exercise at least three times for thirty minutes per week; had "5 out of 5 strength in the bilateral lower and upper extremities"; and swept, picked up...
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