Opinion
For Felma J. Harris, Plaintiff: Shanny J Lee, LEAD ATTORNEY, Law Offices of Harry J Binder and Charles E Binder PC, Orange, 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, LEAD ATTORNEY, SAUSA - Office of U.S. Attorney, Social Security Administration, San Francisco, CA.
MEMORANDUM AND ORDER
HON. KENLY KIYA KATO, United States Magistrate Judge.
Plaintiff Felma J. Harris (" Plaintiff") seeks review of the final decision of the Commissioner of the Social Security Administration (" Commissioner" or " Agency") denying her applications for Title II Disability Insurance Benefits (" DIB") and Title XVI Supplemental Security Income (" SSI"). The parties have consented to the jurisdiction of the undersigned United States Magistrate Judge, pursuant to 28 U.S.C. § 636(c). For the reasons stated below, the Commissioner's decision is REVERSED and this action is REMANDED for further proceedings consistent with this Order.
I .
PROCEDURAL HISTORY
Plaintiff filed applications for DIB on May 7, 2007, and for SSI on May 22, 2007. Administrative Record (" AR") at 30. Plaintiff alleged a disability onset date of May 1, 2005 in both applications. Id. Plaintiff's applications were denied initially on November 5, 2007, and upon reconsideration on March 26, 2008. Id. On May 16, 2008, Plaintiff requested a hearing before an Administrative Law Judge (" ALJ"). Id. On February 9, 2010, Plaintiff appeared and testified at a hearing held before ALJ Philip J. Simon. Id. at 30, 40. On May 25, 2010, ALJ Simon issued a decision denying Plaintiff's applications for DIB and SSI. Id. at 30-40.
Plaintiff filed second applications for DIB and SSI on September 1, 2010. Id. at 75-81, 776-79. Plaintiff again alleged a disability onset date of May 1, 2005 in both applications. Id. at 75, 776. Plaintiff's applications were denied initially on January 14, 2011, and upon reconsideration on November 8, 2011. Id. at 44-48, 52-56, 780-84, 790-94. On December 14, 2011, Plaintiff requested a hearing before an ALJ. Id. at 57, 795-97. On February 28, 2013, Plaintiff appeared and testified at a hearing held before ALJ Lynn Ginsberg. Id. at 798-830. ALJ Ginsberg found ALJ Simon's decision denying benefits binding with respect to Plaintiff's claim of disability for the time period of May 1, 2005 to May 25, 2010. Id. at 803-04. Accordingly, ALJ Ginsberg stated she would review Plaintiff's disability from May 26, 2010. Id. at 804. On May 17, 2013, ALJ Ginsberg issued a decision denying Plaintiff's applications for DIB and SSI. Id. at 14-26.
On June 19, 2013, Plaintiff filed a request for the Agency's Appeals Council to review ALJ Ginsberg's decision. Id. at 10. On October 28, 2014, the Appeals Council denied Plaintiff's request for review. Id. at 5-7.
On December 23, 2014, Plaintiff filed this action. ECF Docket No. (" Dkt.") 1. This matter is before the Court on the parties' Joint Stipulation (" JS"), filed August 26, 2015, which the Court has taken under submission without oral argument. Dkt. 15.
II .
FACTUAL BACKGROUND
Plaintiff was born on April 24, 1961, and her alleged disability onset date is May 1, 2005. AR at 75, 776. She was 44 years old on the alleged disability onset date and 51 years old at the time of the hearing before ALJ Ginsberg Id. at 75, 776, 798. Plaintiff completed one year of college and has prior work history as a home attendant. Id. at 24, 114-15, 823. Plaintiff alleged disability based on " Back problem degenerating disc" and " HBP." Id.
Since this action concerns ALJ Ginsberg's decision, the Court hereinafter refers to ALJ Ginsberg as " the ALJ."
" HBP" appears to refer to Plaintiff's high blood pressure, which is noted throughout the record. AR at 124, 130, 168, 512.
III .
STANDARD FOR EVALUATING DISABILITY
To qualify for DIB or SSI, a claimant must demonstrate a medically determinable physical or mental impairment that prevents her from engaging in substantial gainful activity, and that is expected to result in death or to last for a continuous period of at least twelve months. Reddick v. Chater, 157 F.3d 715, 721 (9th Cir. 1998). The impairment must render the claimant incapable of performing the work she previously performed and incapable of performing any other substantial gainful employment that exists in the national economy. Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999).
To decide if a claimant is disabled, and therefore entitled to benefits, an ALJ conducts a five-step inquiry. 20 C.F.R. § § 404.1520, 416.920. The steps are:
(1) Is the claimant presently engaged in substantial gainful activity? If so, the claimant is found not disabled. If not, proceed to step two.
(2) Is the claimant's impairment severe? If not, the claimant is found not disabled. If so, proceed to step three.
(3) Does the claimant's impairment meet or equal one of the specific impairments described in 20 C.F.R. Part 404, Subpart P, Appendix 1? If so, the claimant is found disabled. If not, proceed to step four.
" Between steps three and four, the ALJ must, as an intermediate step, assess the claimant's [residual functional capacity]." Bray v. Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1222-23 (9th Cir. 2009) (citing 20 C.F.R. § 416.920(e)). In determining a claimant's residual functional capacity, an ALJ must consider all relevant evidence in the record. Robbins v. Soc. Sec. Admin., 466 F.3d 880, 883 (9th Cir. 2006). This involves evaluating the credibility of a claimant's testimony regarding her capabilities. Chaudhry v. Astrue, 688 F.3d 661, 670 (9th Cir. 2012).
(4) Is the claimant capable of performing work she has done in the past? If so, the claimant is found not disabled. If not, proceed to step five.
(5) Is the claimant able to do any other work? If not, the claimant is found disabled. If so, the claimant is found not disabled.
Tackett, 180 F.3d at 1098-99; see also Bustamante v. Massanari, 262 F.3d 949, 953-54 (9th Cir.2001); 20 C.F.R. § § 404.1520(b)-(g)(1), 416.920(b)-(g)(1).
The claimant has the burden of proof at steps one through four, and the Commissioner has the burden of proof at step five. Bustamante, 262 F.3d at 953-54. Additionally, the ALJ has an affirmative duty to assist the claimant in developing the record at every step of the inquiry. Id. at 954. If, at step four, the claimant meets her burden of establishing an inability to perform past work, the Commissioner must show that the claimant can perform some other work that exists in " significant numbers" in the national economy, taking into account the claimant's residual functional capacity (" RFC"), age, education, and work experience. Tackett, 180 F.3d at 1098, 1100; Reddick, 157 F.3d at 721; 20 C.F.R. § § 404.1520(g)(1), 416.920(g)(1).
IV .
THE ALJ'S DECISION
A. Step One
At step one, the ALJ found Plaintiff " has not engaged in substantial gainful activity since May 1, 2005, the alleged onset date" of disability. AR at 17 (citations omitted).
B. Step Two
At step two, the ALJ found Plaintiff had the following severe impairments: " degenerative changes of the thoracic spine; degenerative changes of the lumbar spine; fibromyalgia; mood disorder; psychotic disorder; and anxiety disorder." Id. (citations omitted).
C. Step Three
At step three, the ALJ found Plaintiff " does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1." Id. at 18 (citations omitted).
D. RFC Determination
The ALJ found Plaintiff had the following RFC:
to perform medium work as defined in 20 CFR 404.1567(c) and 416.967(c) and SSR 83-10, specifically as follows: [Plaintiff] can lift and/or carry 50 pounds occasionally and 25 pounds frequently; she can sit, stand, and/or walk without limitation; she can sit for six hours out of an eight-hour workday with regular breaks; and she is unlimited with respect to pushing and/or pulling, other than as indicated for lifting and/or carrying. [Plaintiff] can occasionally climb ladders, ropes, and scaffolds; and is limited to simple, routine, repetitive tasks performed in a work environment free of fast-paced production requirements, involving only simple work related decisions, and routine workplace changes. Lastly, [Plaintiff] can have occasional interaction with coworkers, but must have superficial to no interaction with the public.
Id. at 19.
E. Step Four
At step four, the ALJ found Plaintiff " is unable to perform any past relevant work." Id. at 24 (citations omitted).
F. Step Five
At step five, the ALJ found " there are jobs that exist in significant numbers in the national economy that the claimant can perform." Id. (citations omitted). While the ALJ conceded Plaintiff's " ability to perform all or substantially all of the requirements of [medium] level of work has been impeded by additional limitations, " the ALJ cited the testimony of the vocational expert (" VE") that Plaintiff could perform the jobs of industrial cleaner, cook's helper, and hand packager. Id. at 25. Hence, the ALJ concluded Plaintiff was " capable of making a successful adjustment to other work that exists in significant numbers in the national economy." Id. As a result, the ALJ found Plaintiff was " not disabled" at Step Five. Id.
V .
PLAINTIFF'S CLAIMS
Plaintiff presents two disputed issues:
1. Whether the ALJ " properly weighed the medical evidence and properly determined" Plaintiff's residual functional capacity.
2. " Whether the ALJ's credibility findings were appropriate and supported by substantial evidence."
JS at 3.
The Court finds the second issue dispositive of this matter, and thus does not address the remaining issue. See Hiler v. Astrue, 687 F.3d 1208, 1212 (9th Cir. 2012) (" Because we remand the case to the ALJ for the reasons stated, we decline to reach [Plaintiff's] alternative ground for remand."); Augustine ex rel. Ramirez v. Astrue, 536 F.Supp.2d 1147, 1153 n.7 (C.D. Cal. 2008) (" [T]his Court need not address the other claims plaintiff raises, none of which would provide plaintiff with any further relief than granted, and all of which can be addressed on remand.").
VI .
STANDARD OF REVIEW
Pursuant to 42 U.S.C. § 405(g), a district court may review the Commissioner's decision to deny benefits. The ALJ's findings and decision should be upheld if they are free of legal error and supported by substantial evidence based on the record as a whole. Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971); Parra v. Astrue, 481 F.3d 742, 746 (9th Cir. 2007).
" Substantial evidence" is evidence that a reasonable person might accept as adequate to support a conclusion. Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). It is more than a scintilla but less than a preponderance. Id. To determine whether substantial evidence supports a finding, the reviewing court " must review the administrative record as a whole, weighing both the evidence that supports and the evidence that detracts from the Commissioner's conclusion." Reddick, 157 F.3d at 720; see also Hill v. Astrue, 698 F.3d 1153, 1159 (9th Cir. 2012) (stating that a reviewing court " may not affirm simply by isolating a specific quantum of supporting evidence") (citations and internal quotation marks omitted). " If the evidence can reasonably support either affirming or reversing, " the reviewing court " may not substitute its judgment" for that of the Commissioner. Reddick, 157 F.3d at 720-21; see also Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012) (" Even when the evidence is susceptible to more than one rational interpretation, we must uphold the ALJ's findings if they are supported by inferences reasonably drawn from the record.").
The Court may review only the reasons stated by the ALJ in her decision " and may not affirm the ALJ on a ground upon which [s]he did not rely." Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). If the ALJ erred, the error may only be considered harmless if it is " clear from the record" that the error was " inconsequential to the ultimate nondisability determination." Robbins v. Soc. Sec. Admin., 466 F.3d 880, 885 (9th Cir. 2006) (citation and internal quotation marks omitted).
VII .
DISCUSSION
The Court finds the ALJ failed to provide specific, clear, and convincing reasons for rejecting Plaintiff's testimony regarding the severity of her mental limitations.
A. Background
1. Plaintiff's Mental Health Treatment
i. Dr. Tao Yan
Psychiatrist Tao Yan, M.D. treated Plaintiff from April 12, 2011 to January 8, 2013. AR at 561-76, 594-601, 610-34, 735-43, 762-67. Dr. Yan diagnosed Plaintiff with mood and psychotic disorders. Id. at 594. Dr. Yan treated Plaintiff as frequently as once a month, id. 735, 762, and as infrequently as once in eight and a half months, id. at 629, 735.
o In Progress Notes signed April 14, 2011, Dr. Yan stated Plaintiff's mood disorder was " Inadequately Controlled." Id. at 561. Dr. Yan further stated Plaintiff had poor insight, motivation, and judgment. Id. at 562. Dr. Yan prescribed Lamictal for depression and mood instability, Seroquel for insomnia, and Vistaril for anxiety. Id. at 563. Dr. Yan recommended individual therapy and follow-up with an M.D. in " 8 weeks or sooner if needed." Id.
o In Progress Notes signed September 15, 2011, Dr. Yan stated Plaintiff's mood and psychotic disorders were " Inadequately Controlled." Id. at 616-17. Dr. Yan also stated Plaintiff's insight, motivation, and judgment remained poor. Id. at 617. Dr. Yan prescribed Lamictal, Seroquel, Visatril, and Pamelor. Id. at 618. Dr. Yan recommended individual therapy " as needed" and follow-up with an M.D. in " 8 weeks." Id. at 618.
o In a Psychiatric/Psychological Impairment Questionnaire signed January 8, 2012, Dr. Yan identified the following " clinical findings that demonstrate and/or support" his diagnoses of Plaintiff: poor memory; appetite disturbance with weight change; sleep disturbance; personality change; mood disturbance; emotional lability; delusions or hallucinations; substance dependence; recurrent panic attacks; anhedonia or pervasive loss of interests; psychomotor agitation or retardation; paranoia or inappropriate suspiciousness; feelings of guilt/worthlessness; difficulty thinking or concentrating; suicidal ideation or attempts; oddities of thought, perception, speech, or behavior; perceptual disturbances; social withdraw or isolation; decreased energy; manic syndrome; generalized persistent anxiety; somatization unexplained by organic disturbance; and hostility and irritability. Id. at 594-95, 601.
o In Progress Notes signed February 9, 2012, Dr. Yan stated Plaintiff's mood and psychotic disorders were " Inadequately Controlled" and exacerbated. Id. at 622-23. Dr. Yan also stated Plaintiff's insight, motivation, and judgment remained poor. Id. at 623. Dr. Yan prescribed Lamictal, Seroquel, and Vistaril, and recommended follow-up with an M.D. in " 8 WEEKS OR SOONER IF NEEDED." Id. at 625.
o In Progress Notes signed April 6, 2012, Dr. Yan stated Plaintiff's mood and psychotic disorders were " Well Controlled, " but also that Plaintiff still had poor insight, motivation, and judgment. Id. at 629-30. Dr. Yan prescribed Lamictal, Ambien, and Seroquel, and recommended individual therapy " as needed" and follow-up with an M.D. in " 8 weeks." Id. at 632.
o In Progress Notes signed December 21, 2012, Dr. Yan stated Plaintiff's mood and psychotic disorders reverted to " Inadequately Controlled." Id. at 735-36. Dr. Yan further stated Plaintiff still had poor insight, motivation, and judgment. Id. at 736. Dr. Yan prescribed Depakote and Seroquel, and recommended individual therapy as needed and follow-up with an M.D. in " 2 WEEKS." Id. at 738.
o In Progress Notes signed January 8, 2013, Dr. Yan stated Plaintiff's mood disorder was " Stable/Unchanged" and Plaintiff's psychotic disorder was " Improving." Id. at 762-63. Dr. Yan also stated Plaintiff's insight, motivation, and judgment remained poor. Id. at 763. Dr. Yan prescribed Seroquel, Depakote, and Ambien, and recommended individual therapy as needed and follow-up with an M.D. in " 4 TO 8 WEEKS." Id. at 765.
ii. Dr. Oluwafemi Adeyemo
On October 18, 2011, Oluwafemi Adeyemo, M.D. performed a Psychiatric Evaluation of Plaintiff. Id. at 579-82. Dr. Adeyemo stated Plaintiff expressed " active suicidal ideations." Id. at 581. Dr. Adeyemo consequently stated Plaintiff required " immediate transfer to the closest emergency room for evaluation and possibly hospitalization for psychiatric treatment." Id.
iii. Dr. Stuart L. Laiken
On November 7, 2011, Stuart L. Laiken, M.D., Ph.D. performed a Case Analysis of Plaintiff's medical records. Id. at 584-85. Dr. Laiken stated he asked Plaintiff " which hospital she was taken to" after Dr. Adeyemo recommended transfer to an emergency room. Id. at 585. Plaintiff " said she didn't go and talked her son out of going, she did make appt w/Dr. yen [sic] at Kaiser and he just told her to stay on her medication." Id. The record indicates Plaintiff also missed several therapy and psychiatric appointments throughout her treatment. Id. at 322-24, 331-32.
2. Plaintiff's Testimony
At the hearing on February 28, 2013, Plaintiff testified regarding her mental health. Specifically, Plaintiff stated she experienced crying spells, " daydream[ed] a lot, " slept only " two to three hours straight" on an average night, stayed in bed because of her depression, and felt " worthless sometimes." Id. at 819-20. In addition, Plaintiff testified that she infrequently read because she " just can't remember too much." Id. at 816. Plaintiff further testified that her psychiatrist treated her " every two to four months" and that her mental health treatment included medication that " help[ed] a little." Id. at 811-12. Plaintiff testified that, despite medication, she experienced auditory hallucinations. Id. at 818-19.
3. The ALJ's Adverse Credibility Determination
In assessing Plaintiff's credibility, the ALJ found " [a]fter careful consideration of the evidence, the undersigned finds that [Plaintiff]'s medically determinable impairments could reasonably be expected to cause the alleged symptoms; however, [Plaintiff]'s statements concerning the intensity, persistence and limiting effects of these symptoms are not entirely credible." Id. at 20.
The ALJ made her adverse credibility determination on three primary bases. Id. at 20-23. First, the ALJ based her adverse credibility determination on personal observations of Plaintiff during the hearing, noting Plaintiff:
alleged she had difficulty concentrating. The undersigned observed [Plaintiff] throughout the hearing. [Plaintiff] did not demonstrate or manifest any difficulty concentrating during the hearing. During the time when [Plaintiff] was being questioned, [Plaintiff] appeared to process the questions without difficulty, and to respond to the questions appropriately and without delay. [Plaintiff] also paid attention throughout the hearing.
Id. at 22.
Second, the ALJ based her adverse credibility determination on her assumption that medication controlled Plaintiff's mental symptoms. Id. at 20-21. The ALJ stated Plaintiff's:
mental status examinations have revealed auditory and visual hallucinations, poor insight and judgment, depressed mood, and constricted affect (Exs. B7/24; B16F; B17F). Her diagnoses were anxiety disorder, psychotic disorder, and mood disorder (Ex. B17F). When asked about individual therapy, she declined (Ex. B17F/4). Despite the lack of regular, ongoing treatment, [Plaintiff]'s condition was noted to be stable and well controlled by April of 2012 (Exs. B17F). Nothing in the record showed [Plaintiff]'s mental symptoms worsened in any way.
Id.
Third, the ALJ based her adverse credibility determination on Plaintiff's declining emergency room treatment and on Plaintiff's missing doctors' appointments. Id. at 21-22. The ALJ stated Plaintiff " was advised to schedule appointments" with " mental health services, " but Plaintiff:
let time pass before she scheduled these appointments at the urging of her providers. [Plaintiff]'s lack of diligence in seeking these services demonstrates a possible unwillingness to do what is necessary to improve her condition. It may also be an indication that her symptoms are not as severe as she purports.
Id. at 22.
The ALJ concluded Plaintiff's " subjective complaints are less than fully credible and the objective medical evidence does not support the alleged severity of symptoms." Id. at 24.
4. Vocational Expert's Testimony
The ALJ presented three hypothetical individuals to the VE. Id. at 823-27. First, the ALJ described a hypothetical individual who was mentally limited to " work that is simple, routine and repetitive tasks performed in a work environment free of fast paced production requirements, involving only simple work related decisions and routine work place changes. Superficial and no interaction with the public and only occasional interaction with coworkers, " id. at 823-24, and physically limited to " a range of medium work, " id. at 823. The ALJ asked the VE whether such an individual could " perform [Plaintiff]'s past work as actually or generally performed." Id. at 824. The VE answered " No." Id. The ALJ then asked whether the individual could do " other jobs, " and the VE stated the individual could work as an industrial cleaner, cook's helper, and hand packager. Id. at 824-25.
Second, the ALJ described a hypothetical individual with " the same mental limitations previously indicated in hypothetical number one" and physical limitations to " a range of light work." Id. at 825. The ALJ asked the VE whether such an individual could perform jobs other than Plaintiff's past work. Id. at 826. The VE answered such an individual could work as a bench assembler, office helper, and an " inspector, hand packager." Id.
Third, the ALJ described a hypothetical individual with " all the [mental] limitations previously indicated" and physical limitations to " a range of sedentary work." Id. The ALJ asked the VE whether such an individual could perform " any work." Id. The VE answered that such an individual could work as an optical assembler, pin clip fastener, and assembler. Id. at 826-27.
B. Legal Standard
If " the record establishes the existence of a medically determinable impairment that could reasonably give rise to the reported symptoms, an ALJ must make a finding as to the credibility of the claimant's statements about the symptoms and their functional effect." Robbins, 466 F.3d at 883 (citations omitted). The ALJ's credibility determination must be supported by " findings sufficiently specific to permit the court to conclude that the ALJ did not arbitrarily discredit claimant's testimony." Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008) (citation and internal quotation marks omitted).
The ALJ is required to engage in a two-step analysis. " First, the ALJ must determine whether there is objective medical evidence of an underlying impairment which could reasonably be expected to produce the pain or other symptoms alleged." Molina, 674 F.3d at 1112 (citations and internal quotation marks omitted). " If the claimant has presented such evidence, and there is no evidence of malingering, then the ALJ must give specific, clear and convincing reasons in order to reject the claimant's testimony about the severity of the symptoms." Id. (citations and internal quotation marks omitted). " The ALJ must state specifically which symptom testimony is not credible and what facts in the record lead to that conclusion." Smolen v. Chater, 80 F.3d 1273, 1284 (9th Cir. 1996); see also Brown-Hunter v. Colvin, No. 13-15213, 2015 WL 4620123, at *1 (9th Cir. Aug. 4, 2015) (holding that " an ALJ does not provide specific, clear, and convincing reasons for rejecting a claimant's testimony by simply reciting the medical evidence in support of his or her residual functional capacity determination").
" The ALJ may consider many factors in weighing a claimant's credibility, including (1) ordinary techniques of credibility evaluation, such as the claimant's reputation for lying, prior inconsistent statements concerning the symptoms, and other testimony by the claimants that appears less than candid; (2) unexplained or inadequately explained failure to seek treatment or to follow a prescribed course of treatment; and (3) the claimant's activities." Tommasetti, 533 F.3d at 1039 (citations and internal quotation marks omitted).
" If the ALJ's credibility finding is supported by substantial evidence, the court may not engage in second-guessing." Id. (citations and internal quotation marks omitted); but see Connett v. Barnhart, 340 F.3d 871, 874 (9th Cir. 2003) (holding that " [i]t was error for the district court to affirm the ALJ's credibility decision based on evidence that the ALJ did not discuss"). However, an ALJ's failure to give specific, clear, and convincing reasons to reject the claimant's testimony about the severity of the symptoms is not harmless, because it precludes the Court from conducting a meaningful review of the ALJ's reasoning. Brown-Hunter, 2015 WL 4620123, at *1.
C. Analysis
The Court finds the ALJ did not provide specific, clear, and convincing reasons for finding Plaintiff less than credible. As set forth below, the ALJ erred by (1) relying on her personal observations, Perminter v. Heckler, 765 F.2d 870, 872 (9th Cir. 1985); (2) failing to link specific testimony with purportedly contrary evidence, Brown-Hunter, 2015 WL 4620123, at *6; (3) failing to review the treatment records as a whole, Ghanim v. Colvin, 763 F.3d 1154, 1164 (9th Cir. 2014); and (4) failing to inquire as to why Plaintiff declined emergency room treatment or why Plaintiff missed doctors' appointments, Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir. 2001).
First, the ALJ rejected Plaintiff's testimony that she had difficulty concentrating because the ALJ observed Plaintiff showed no difficulty concentrating, processing questions, or appropriately responding to questions at the hearing. AR at 22. However, an ALJ cannot base a denial of benefits on her observations of a plaintiff where the plaintiff offers statements contradicting the ALJ's observations and objective evidence supports those statements. Perminter, 765 F.2d at 872 (reasoning that since no evidence showed a plaintiff was " physically able to perform any job for which he [wa]s qualified, " an ALJ's reliance on personal observations to conclude the plaintiff could work " has been condemned as 'sit and squirm' jurisprudence").
Objective evidence supports Plaintiff's statements that she had difficulty concentrating. Dr. Yan's clinical findings stated Plaintiff had: difficulty thinking or concentrating, delusions or hallucinations, paranoia or inappropriate suspiciousness, perceptual disturbances, and hostility and irritability. AR at 595. Dr. Yan also stated Plaintiff's mood and psychotic disorders fluctuated from inadequately-controlled to well-controlled. Id. at 622-23, 629-30, 735-36, 762-63. In addition, Dr. Yan's notes from April 12, 2011 to January 8, 2013 consistently reveal that Plaintiff had poor memory, insight, and judgment. Id. at 562, 565, 570, 573, 595, 611, 617, 623, 630, 736, 763. Such objective evidence supports that Plaintiff had difficulty concentrating. Therefore, the ALJ improperly based her credibility determination on her personal observations of Plaintiff during the brief 47 minute hearing. Id. at 800-30.
Second, the ALJ discredited Plaintiff because the ALJ concluded medication controlled Plaintiff's mental symptoms. Id. at 21. The ALJ stated Plaintiff's " condition was noted to be stable and well controlled by April of 2012 (Exs. B17F)." Id. However, the ALJ merely cited an exhibit that spans 154 pages without identifying either testimony of specific evidence. Id. at 4, 21, 622-775. An ALJ must link particular testimony she found not credible with contradictory evidence. Brown-Hunter, 2015 WL 4620123, at *6 (" [W]e cannot substitute our conclusions for the ALJ's, or speculate as to the grounds for the ALJ's conclusions. Although the ALJ's analysis need not be extensive, the ALJ must provide some reasoning in order for us to meaningfully determine whether the ALJ's conclusions were supported by substantial evidence." (citation and internal quotation marks omitted)). Here, the ALJ erred by failing to link testimony with purportedly contrary evidence.
Third, in concluding medication controlled Plaintiff's mental symptoms, the ALJ failed to consider Plaintiff's treatment records as a whole. AR at 21. An ALJ must view a plaintiff's treatment records " in light of the overall diagnostic record, " including where the records " consistently reveal that, despite some occasional signs of improvement" the plaintiff continued to suffer from mental symptoms. Ghanim, 763 F.3d at 1164. The ALJ cited 154 pages of treatment records in support of her position. AR at 21. While some of the records support the ALJ's finding, others clearly contradict her position. For example, a note signed by Dr. Yan on December 21, 2012 states the Plaintiff's mood and psychotic disorders were " Inadequately Controlled." Id. at 735-36. Similar notes from Dr. Yan are referenced in records on April 14, 2011, September 15, 2011, and February 9, 2012. Id. at 561, 616-17, 622-23. Hence, when read as a whole, the treatment records do not undermine Plaintiff's testimony. Rather, they consistently reveal that, despite occasional signs of improvement, Plaintiff continued to suffer from mood and psychotic disorders, as well as poor memory, insight, and judgment. Id. at 562, 565, 570, 573, 594-95, 611, 617, 623, 630, 736, 763. Thus, the ALJ improperly based her credibility finding on cherry-picked treatment records.
Fourth, the ALJ discredited Plaintiff because Plaintiff declined emergency room treatment and Plaintiff missed doctors' appointments. Id. at 21-22. However, an ALJ's duty to develop the record fully is heightened where a plaintiff " may be mentally ill and thus unable to protect her own interests." Tonapetyan, 242 F.3d at 1150. " 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.'" Id. (quoting Smolen, 80 F.3d at 1288).
In light of Plaintiff's documented history of mental impairments, the ALJ had a duty to inquire as to why Plaintiff declined emergency room treatment or why Plaintiff missed doctors' appointments. Dr. Yan's notes in 2011, 2012, and 2013 show Plaintiff had poor memory, insight, and judgment. AR at 562, 565, 570, 573, 595, 611, 617, 623, 630, 736, 763. Such symptoms could be reasonably expected to impact Plaintiff's ability to obtain emergency treatment or keep doctors' appointments. The foregoing ambiguous evidence triggered the ALJ's duty to conduct an appropriate inquiry. The ALJ, however, made no such inquiry. Accordingly, the ALJ improperly based her adverse credibility determination on Plaintiff's failure to seek additional treatment.
The Court, thus, finds the ALJ did not provide specific, clear, and convincing reasons to discredit Plaintiff's testimony regarding the severity of her mental limitations.
VIII .
RELIEF
A. Legal Standard
" When an ALJ's denial of benefits is not supported by the record, the proper course, except in rare circumstances, is to remand to the agency for additional investigation or explanation." Hill, 698 F.3d at 1162 (citation and internal quotation marks omitted). " We may exercise our discretion and direct an award of benefits where no useful purpose would be served by further administrative proceedings and the record has been thoroughly developed." Id. (citation and internal quotation marks omitted). " Remand for further proceedings is appropriate where there are outstanding issues that must be resolved before a determination can be made, and it is not clear from the record that the ALJ would be required to find the claimant disabled if all the evidence were properly evaluated." Id. (citations omitted); see also Reddick, 157 F.3d at 729 (" We do not remand this case for further proceedings because it is clear from the administrative record that Claimant is entitled to benefits.").
B. Analysis
In this case, the record has not been fully developed. The ALJ must reassess Plaintiff's credibility regarding her mental limitations and its impact on the RFC determination. The ALJ provided the VE with hypotheticals that omitted mental limitations Plaintiff alleged, AR at 823-27, and the VE then relied on those incomplete hypotheticals to determine Plaintiff's ability to perform various jobs, id. at 25. Hence, the error resulting from the ALJ's deficient credibility analysis cannot be deemed harmless. Flores v. Shalala, 49 F.3d 562, 570 (9th Cir. 1995) (" We have previously made it clear that, in meeting her burden of showing the claimant's ability to work, the Secretary may only rely upon the vocational expert's testimony if the questions posed by the ALJ include all of the claimant's functional limitations, both physical and mental."). It is, therefore, not " clear from the record" that the error was " inconsequential to the ultimate nondisability determination." Robbins, 466 F.3d at 885 (internal quotation marks omitted). Accordingly, remand for further proceedings is appropriate.
IX .
CONCLUSION
For the foregoing reasons, IT IS ORDERED that judgment be entered REVERSING the decision of the Commissioner and REMANDING this action for further proceedings consistent with this Order. IT IS FURTHER ORDERED that the Clerk of the Court serve copies of this Order and the Judgment on counsel for both parties.
JUDGMENT
Pursuant to sentence four of 42 U.S.C. § 405(g), IT IS ADJUDGED that the decision of the Commissioner of the Social Security Administration is REVERSED and this action is REMANDED for further administrative proceedings.