Opinion
No. CIV S-06-2658 EFB.
March 25, 2008
ORDER
Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner") denying plaintiff's challenge to a determination that her disability ceased in August 2004, and that she was therefore no longer entitled to Supplemental Security Income ("SSI") benefits under Title XVI of the Social Security Act ("Act"). For the reasons that follow, plaintiff's motion for summary judgment or remand is granted, the Commissioner's cross-motion for summary judgment is denied, and this case is remanded for immediate payment of benefits. The Clerk is directed to enter judgment for plaintiff.
I. BACKGROUND
Plaintiff, born in 1969, is a Hmong immigrant who came to California in or around 1988. Plaintiff was born in Laos, but lived in Thailand as a refugee for about eight years before coming to the United States. Administrative Record ("AR") 146, 161, 280. During her family's escape from Laos during the Vietnam War, she was shot by communist soldiers in her left arm, which was later amputated above the elbow. AR 138.
Plaintiff received SSI benefits beginning in 1990 due to her severe, disabling impairments of depression and post-traumatic stress disorder. AR 26. The 1990 allowance decision was based on a finding that plaintiff's impairments met the severity in 12.04 of the Listing of Impairments. AR 13, 26.
In May 2004, plaintiff was reevaluated in connection with her disability benefits and underwent a twenty-seven minute consultative psychiatric examination performed by Dr. Michael Joyce, M.D. AR 197-201. In his report, Dr. Joyce noted that plaintiff's chief complaint was "no arm," and that she indicated, through a translator, that she was not on any psychiatric medication. AT 197. Dr. Joyce reported that plaintiff had no major mood complaints, no anxiety, no psychotic symptoms or mania, and did not report any post-traumatic stress symptomatology. AR 197. Based on this brief interview, Dr. Joyce found plaintiff to have no mental impairment, assessed her GAF score at "70 or above," and found her capable of performing work-related activities. AR 200-01.
GAF is a scale reflecting the "psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness." American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 34 (4th ed., Text Revision, 2000) ("DSM IV-TR"). A GAF of 61-70 indicates "some mild symptoms (e.g., depressed mood and mild insomnia) or some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships." A GAF of 71-80 indicates that "if symptoms are present, they are transient and expectable reactions to psycho-social stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork)." Id.
In a continuing disability review decision dated August 6, 2004, it was determined that plaintiff's condition had improved and that she had no impairment that met the definition of disability. AR 277-81. Plaintiff appealed that decision, alleging that she is unable to work due to her "left arm amputation, pain all over body, low back pain, post-traumatic stress syndrome, depression, can't speak English, can't drive car, and diabetes." AR 39.
On March 1, 2006, following a hearing before administrative law judge ("ALJ") Antonio Acevedo-Torres, the ALJ found that plaintiff was not disabled. AR 12-18. The ALJ made the following findings:
Disability Insurance Benefits are paid to disabled persons who have contributed to the Social Security program, 42 U.S.C. §§ 401, et seq. Supplemental Security Income is paid to disabled persons with low income. 42 U.S.C. §§ 1382, et seq. Both provisions define disability, in part, as an "inability to engage in any substantial gainful activity" due to "a medically determinable physical or mental impairment. . . ." 42 U.S.C. §§ 423(d)(1)(a) and 1382c(a)(3)(A). A parallel five-step sequential evaluation governs eligibility for benefits under both programs. See 20 C.F.R. §§ 404.1520, 404.1571-76, 416.920 and 416.971-76; Bowen v. Yuckert, 482 U.S. 137, 140-42 (1987). The following summarizes the sequential evaluation:
Step one: Is the claimant engaging in substantial gainful activity? If so, the claimant is found not disabled. If not, proceed to step two.
Step two: Does the claimant have a "severe" impairment? If so, proceed to step three. If not, then a finding of not disabled is appropriate.
Step three: Does the claimant's impairment or combination of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 404, Subpt. P, App. 1? If so, the claimant is automatically determined disabled. If not, proceed to step four.
Step four: Is the claimant capable of performing his past work? If so, the claimant is not disabled. If not, proceed to step five.
Step five: Does the claimant have the residual functional capacity to perform any other work? If so, the claimant is not disabled. If not, the claimant is disabled.Lester v. Chater, 81 F.3d 821, 828 n. 5 (9th Cir. 1995).
The claimant bears the burden of proof in the first four steps of the sequential evaluation process. Bowen, 482 U.S. at 146 n. 5. The Commissioner bears the burden if the sequential evaluation process proceeds to step five. Id.
1. The claimant did not engage in substantial gainful activity after August 1, 2004.
2. The medical evidence establishes that the claimant has an amputation of the left arm, but that she does not have an impairment or combination of impairments listed in, or medically equal to one listed in Appendix 1, Subpart P, and Regulations no. 4.
3. The claimant's subjective complaints are not consistent with the evidence of record and not fully credible.
4. Since August 2004, there had been medical improvement related to her ability to work. Since August 2004, the claimant has the residual functional capacity to lift 20 pounds occasionally, and 10 pounds frequently with her right arm ( 20 CFR 416.945).
5. The claimant does not have past relevant work. The claimant is 40 years of age and did not attend school.
6. The framework of Rule 202.16, Appendix 1, Subpart P, Regulations No. 4, directs that the claimant is not disabled, as there are a significant number of jobs that she can perform. Example [ sic] of these jobs are garment sorter, advertising mat distributor, can filler machine operator, laundry classifier, and garment bagger.
7. The claimant was not under a "disability" as defined in the Social Security Act, at any time on and after August 1, 2004 ( 20 CFR 416.920(e)).
AR 17-18.
On September 27, 2006, the Appeals Council denied plaintiff's request for review, and the ALJ's decision became the final decision of the Commissioner. AR 5-7.
II. ISSUES PRESENTED
In her motion for summary judgment, plaintiff presents several issues challenging the ALJ's decision. In general, plaintiff asserts that the ALJ erred by finding medical improvement with regard to her ability to do work-related activities. See Pl.'s Mem. of P. A. in Supp. of Mot. for Summ. J. ("Pl.'s Br."), 32:25-33:8. More particularly, plaintiff alleges that the ALJ failed to accurately assess the medical evidence with regard to her ability to do work-related activities by: (1) failing to properly assess all of her impairments at step two of the sequential evaluation; (2) failing to credit the opinions of her treating physicians; (3) discrediting her testimony and that of her son with respect to the nature and extent of her functional limitations; (4) improperly assessing her residual functional capacity, and, (5) failing to properly question the vocational expert and finding her not disabled based on the grids.
The "grids" are the Medical Vocational Guidelines, which appear in table form and reflect combinations of residual functional capacity, age, education, and work experience. They are an administrative tool used by the Secretary for determining disability when considering claimants with substantially uniform levels of impairment. Burkhart v. Bowen, 856 F.2d 1335, 1340 (9th Cir. 1988); Desrosiers v. Sec'y of Health and Human Servs., 846 F.2d 573, 577-78 (9th Cir. 1988) (Pregerson, J., concurring).
Because the ALJ's error in evaluating the opinions of plaintiff's treating physicians is dispositive, the court declines to address the other bases of error alleged by plaintiff.
III. LEGAL STANDARDS
The Commissioner's decision that a claimant is not disabled will be upheld if the findings of fact are supported by substantial evidence in the record and the proper legal standards were applied. Schneider v. Comm'r of the Soc. Sec. Admin., 223 F.3d 968, 973 (9th Cir. 2000); Morgan v. Comm'r of the Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999).
The findings of the Commissioner as to any fact, if supported by substantial evidence, are conclusive. See Miller v. Heckler, 770 F.2d 845, 847 (9th Cir. 1985). Substantial evidence is more than a mere scintilla, but less than a preponderance. Saelee v. Chater, 94 F.3d 520, 521 (9th Cir. 1996). "`It means such evidence as a reasonable mind might accept as adequate to support a conclusion.'" Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. N.L.R.B., 305 U.S. 197, 229 (1938)).
The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th Cir. 1986), and both the evidence that supports and the evidence that detracts from the ALJ's conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not affirm the ALJ's decision simply by isolating a specific quantum of supporting evidence. Id.; see also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989).
"The ALJ is responsible for determining credibility, resolving conflicts in medical testimony, and resolving ambiguities." Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations omitted). If substantial evidence supports the administrative findings, or if there is conflicting evidence supporting a finding of either disability or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d 1226, 1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was applied in weighing the evidence. See Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988).
With regard to the issue of medical improvement, "once a claimant has been found disabled, he or she is entitled to a presumption that the disability still exists. The Secretary then has the burden to come forward with evidence of improvement. This evidence must be reviewed under the `substantial evidence' standard." Murray v. Heckler, 722 F.2d 499, 500 (9th Cir. 1983) (citing Patti v. Schweiker, 669 F.2d 582, 587 (9th Cir. 1982) (internal citations omitted)).
IV. ANALYSIS
In assessing the ALJ's determination of medical improvement, the court addresses the ALJ's rejection of all three treating physician opinions, with particular attention to the ALJ's implicit determination that plaintiff had no severe mental impairment. Incidentally, the court notes that the ALJ did not identify any of the treating physicians by name or as treating physicians. AR 14.
Curiously, although the ALJ never made an explicit finding with regard to the existence or severity of plaintiff's mental impairment, he nonetheless discussed the "B" and "C" criteria for evaluating mental impairments. AR 15-16; see 20 C.F.R. § 416.920a(b)-(d).
The weight given to medical opinions depends in part on whether they are proffered by treating, examining, or non-examining professionals. Lester, 81 F.3d at 830. Ordinarily, more weight is given to the opinion of a treating professional, who has a greater opportunity to know and observe the patient as an individual. Id.; Smolen v. Chater, 80 F.3d 1273, 1285 (9th Cir. 1996).
To evaluate whether an ALJ properly rejected a medical opinion, in addition to considering its source, the court considers whether (1) contradictory opinions are in the record; and (2) clinical findings support the opinions. An ALJ may reject an uncontradicted opinion of a treating or examining medical professional only for "clear and convincing" reasons. Lester, 81 F.3d at 831. In contrast, a contradicted opinion of a treating or examining professional may be rejected for "specific and legitimate" reasons, that are supported by substantial evidence. Id., at 830. While a treating professional's opinion generally is accorded superior weight, if it is contradicted by a supported examining professional's opinion (e.g., supported by different independent clinical findings), the ALJ may resolve the conflict. Andrews v. Shalala, 53 F.3d 1035, 1041 (9th Cir. 1995) (citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989)). However, "[w]hen an examining physician relies on the same clinical findings as a treating physician, but differs only in his or her conclusions, the conclusions of the examining physician are not `substantial evidence.'" Orn v. Astrue, 495 F.3d 625, 632 (9th Cir. 2007).
The ALJ's finding of medical improvement with regard to plaintiff's affective disorder was based primarily on the twenty-seven minute evaluation conducted by Dr. Joyce in May 2004. AR 13, 16, 197-201. Plaintiff was accompanied to the evaluation by her cousin, who served as an interpreter. AR 197. Dr. Joyce's assessment that plaintiff was capable of performing work-related activities, was based in part, on his observation that plaintiff was "euthymic" and responded to humor during the interview. AR 199. He wrote there was "nothing to suggest suicidality," and that plaintiff did "not report any post-traumatic stress symptomatology related to her flight from Laos." AR 197. He further reported "no major mood complaints" and noted that plaintiff was not on psychiatric medication at the time." Id.
"Euthymic" means characterized by moderation of mood, not manic or depressed. See Stedman's Medical Dictionary, 627 (27th ed. 2000).
His "objective findings" consisted of a brief series of tasks that tested plaintiff's basic memory and cognition. AR 197-201. In response to those tasks, plaintiff reportedly answered "I don't know" or "I don't remember" to many questions, could only remember one out of three new words after two minutes, was unable to identify coins or make change, thought there were ten months in a year, and did not know which direction she would be going if she drove from Sacramento to San Francisco. AR 199-200.
Based on this evaluation, Dr. Joyce opined that plaintiff could follow simple and complex instructions, maintain attendance at work, ask simple questions, request assistance when needed, respond appropriately to supervision, coworkers, or the usual work situation including changes in a routine setting." AR 200-01. He found that plaintiff had no "Axis I condition." AR 200.
"Axis I" disorders include mood disorders, anxiety disorders, sleep disorders, and adjustment disorders. See DSM IV-TR, at 27-28.
This opinion is contradicted by plaintiff's treating physician, Dr. Edward Perry Benhow, M.D., who treated her from September 2004 through January 2006, at the Sutter-Yuba Mental Health Center in connection with her complaints of depression, sleeplessness, suicidal ideation, and post-traumatic stress. AR 289-93; 329-31.
In September 2004, plaintiff reported depression, frequent crying, problems sleeping, difficulty concentrating, suicidal ideation, nightmares, flashbacks, and fearfulness. AR 295-300. She also reported being re-traumatized the year before when someone near her at a Hmong social gathering was shot. AR 296. She was given a provisional diagnosis of chronic post-traumatic stress disorder ("PTSD") and dysthymic disorder, and assessed a GAF score of between 46 and 51. AR 301-02.
A GAF score of 41-50 indicates serious symptoms such as suicidal ideation, severe obsessional rituals, or serious impairment in social, work, or school functioning. See DSM IV-TR, at 34.
Plaintiff continued to be seen at the clinic by Dr. Benhow, who prescribed her anti-depressants, and assessed her GAF score at 50. AR 294. His treatment notes indicate that plaintiff continued to report suicidal ideation and nightmares, depression, and showed little signs of improvement. See AR 289-294, 329-30.
On January 24, 2006, Dr. Benhow completed a questionnaire regarding plaintiff's residual functional capacity in connection with her mental impairments. AR 333-36. He identified plaintiff's diagnoses as "major depression, mod., not psychotic 296.33," and "post traumatic stress disorder 309.81." AR 333. As to her prognosis, he noted that she had only a moderate response to medication, which suggested an "ongoing emotional disability compounded by [left arm] amputation." AR 334.
Based on plaintiff's impairments, Dr. Benhow found that she had "moderately severe" restrictions in her ability to relate to others and to perform daily activities. AR 336. He also found her to have moderately severe restrictions in her ability to follow instructions and perform complex and simple tasks in a full-time work setting. AR 336. He found that she was moderately impaired in her ability to perform work requiring minimal or frequent contact with others. Id. He opined that as a "war traumatized immigrant" with an upper extremity amputation and no language skills, she would "need exceptional rehabilitation and accommodation to work — she has responsibility for 5-6 dependent children" Id.
The ALJ rejected this opinion because it was "based, in part, on the claimant [ sic] musculoskeletal complaints, cultural differences, and her responsibility to care for her 5-6 dependent children." AR 14. He also found the records from the Sutter-Yuba Mental Health Center to be "generally benign," and noted that they did "not reflect any objective findings or the result of psychological testing." Id.
The ALJ further discounted Dr. Benhow's opinion, commenting that despite plaintiff's allegations of serious mental limitations, the record did not show that she had been referred for more aggressive therapy or hospitalized for her symptoms. AR 16. He also found that plaintiff had been able to function independently despite her complaints. Id.
The ALJ's reasons for rejecting Dr. Benhow's opinion mischaracterize the record and, as such, lack legitimacy. First, the court notes that the ALJ failed to acknowledge Dr. Benhow's status as a treating physician, and made no comment regarding the existence or duration of the treating relationship between him and plaintiff.
Further, contrary to the ALJ's assertions, Dr. Benhow's opinion was not based on plaintiff's musculoskeletal complaints or cultural differences, but rather on her diagnosed mental impairments. Dr. Benhow merely noted that these impairments were "compounded by" her left arm amputation, and made the very rational observation that plaintiff's amputation and inability to speak English, in addition to her traumatization, would exacerbate her already impaired ability to work.
Moreover, the records from the Sutter-Yuba Mental Health Center support Dr. Benhow's finding that plaintiff's response to medication was only moderate, and that plaintiff's condition was ongoing and chronic. AR 289-94. Those records show that plaintiff continued to report suicidal ideation, sleeplessness, and depression despite increases in her medication. Id.
Additionally, the ALJ's comment that these records did "not reflect any objective findings or the result of psychological testing" is not well-taken. AR 14. "Psychiatric impairments are not as readily amenable to substantiation by objective laboratory testing as are medical impairments and consequently, the diagnostic techniques employed in the field of psychiatry may be less tangible than those in the field of medicine." Hartman v. Bowen, 636 F. Supp. 129, 131-132 (N.D. Cal. 1986) (citing Lebus v. Harris, 526 F. Supp. 56, 60 (N.D. Cal. 1981)). "Thus, when mental illness is the basis of a disability claim, as in this case, clinical and laboratory data may consist of the diagnoses and observations of professional psychiatrists and psychologists." Id. (internal citations omitted).
Here, Dr. Benhow's diagnoses and opinion were based on his treatment and observations of plaintiff for more than a year. Contrasted with Dr. Joyce's twenty-seven minute interview of plaintiff, which consisted of little more than a few cognitive tests (on which plaintiff's performance was arguably poor), Dr. Benhow's opinion is entitled to greater weight. See Orn, 495 F.3d at 632-33 ("[E]ven when contradicted by an opinion of an examining physician that constitutes substantial evidence, the treating physician's opinion is still entitled to deference. In many cases, a treating source's medical opinion will be entitled to the greatest weight and should be adopted, even if it does not meet the test for controlling weight.") (internal citations and quotations omitted).
Finally, although the record contains no recommendation of hospitalization or aggressive therapy, it does show, contrary to the ALJ's assertion, that plaintiff was not able to function independently and led a rather confined existence in her home. For example, plaintiff indicated that she needed help with bathing, grooming, cooking, doing the dishes, shopping, and did not venture far from her home because she was scared and did not speak English. AR 63-93, 363-71. She also relied on her husband to help regulate her medication. AR 367. The ALJ discounted all this evidence, to the extent he discussed it, relying instead on Dr. Joyce's conclusory statement that plaintiff "is independent in her activities of daily living." AR 16, 198. Significantly, no other evidence in the record supports this unelucidated statement in the consultative examiner's report.
While the court acknowledges that the ALJ was troubled by plaintiff's lack of psychiatric treatment from 1990 through 2004, it should be noted that he failed to probe this issue. As discussed above, he discounted evidence that plaintiff led a very sheltered life with extensive family support, and he did not consider any relevant cultural factors. In any event, the ALJ's concern over plaintiff's lack of mental health treatment did not entitle him to completely reject the diagnosis and opinion of Dr. Benhow. As set forth above, his reasons for rejecting Dr. Benhow's opinion did not accurately reflect the opinion itself or the evidence underlying it. Moreover, the ALJ did not even discuss Dr. Benhow's diagnoses, let alone provide reasons for dismissing them. As such, his reasons for rejecting Dr. Benhow's opinion lacked legitimacy and were not supported by substantial evidence. See Orn, 495 F.3d at 633 ("Even if the treating doctor's opinion is contradicted by another doctor, the ALJ may not reject this opinion without providing specific and legitimate reasons supported by substantial evidence in the record.") (citations and quotations omitted).
The ALJ's treatment of the other treating physicians' opinions was similarly flawed. Plaintiff's treating physician, Dr. Wu-Hsiung Su, M.D., treated plaintiff at the We-Care Medical Center beginning 2001, and completed an evaluation form concerning her musculoskeletal impairments on December 3, 2004. AR 260. Dr. Su identified plaintiff's diagnoses as "left arm s/p [status post] amputation, arthritis, and diabetes." Id. He further indicated that plaintiff had motor weakness, diminished reflexes and "numbness paresthesia." Id. He opined that plaintiff could lift or carry less than ten pounds occasionally due to pain and weakness and amputation of her left arm. AR 261. He also found that plaintiff could only stand, walk, and sit for two hours in an eight-hour workday, had to alternate between sitting and standing, and had to change positions, due to pain and weakness. AR 261-62. He indicated that plaintiff had severe limitations in climbing, balancing, stooping, kneeling, crouching, and crawling due to pain. AR 262.
"Paresthesia" is an abnormal sensation, such as of burning, pricking, tickling in an extremity. Stedman's Medical Dictionary, 1316 (27th ed. 2000).
The ALJ rejected Dr. Su's opinion as unsupported because his treatment notes did not contain any objective evidence to support the opined limitations, and because the record was "devoid of any objective clinical findings which show that plaintiff's ability to sit, stand, and walk are limited." AR 14. He also rejected the opinion as "speculative." Id.
The ALJ's conclusion that the record was devoid of any objective clinical findings with regard to limitations in sitting, standing and walking ignores Dr. Su's diagnoses of arthritis and diabetes. Indeed, the ALJ makes no mention of plaintiff's arthritis, not even to identify Dr. Su's diagnosis. Although the treatment notes are sparse, there are numerous indications that plaintiff was treated over the course of several years for arthritis, which caused pain primarily in her lower back, and which was treated with pain medication and Celebrex. See AR 177, 305, 323, 326, 349.
Celebrex is indicated for relief of symptoms associated with osteoarthritis. See Physicians' Desk Reference 3066 (62nd ed. 2008).
Furthermore, the record shows that plaintiff received consistent treatment for her type II diabetes mellitus, and that this condition resulted in neuropathy, causing diminished sensation and tenderness in her extremities. See AR 308, 318, 321, 327. The record also contains evidence that plaintiff's diabetes was often poorly controlled despite frequent treatment. See, e.g., AR 307, 310, 314, 318, 320, 321, 323, 325 (evidencing high glucose levels).
A normal fasting blood glucose level is less than 100mg/dl, and a normal blood glucose range is less than 140 mg/dl. See Merck Co., The Merck Manual of Diagnosis and Therapy 1275, Table 158-2 (18th ed. 2006). The record shows plaintiff often had glucose levels in the 200s and 300s. See AR 307, 310, 314, 318, 320, 321, 323, 325.
Even examining physician, Dr. Rajeswari Kumar, M.D., on whose opinion the ALJ relied, noted reduced distal sensation to touch and position in both plaintiff's lower extremities as well as in the palm of her right hand. AR 205. Dr. Kumar also found some restriction in plaintiff's lumbar spine and left upper extremity, as well as evidence of peripheral neuropathy in her lower extremities. AR 205-06.
Another treating physician, Dr. Augusto Sychukuk, M.D., also opined that plaintiff's ability to sit, stand, and walk were seriously limited due to her poorly controlled diabetes and attendant pain, including headaches and muscle pain. AR 351-52. The record shows plaintiff's frequent treatment for headaches, and, as noted above, pain in her lower back and extremities. See, e.g., AR 205, 306, 310, 314-15, 318, 320-23, 326-27. Like Dr. Su, Dr. Sychukuk opined that plaintiff could only walk, stand or sit for one to two hours without interruption during an eight-hour workday. AR 350. The ALJ rejected Dr. Sychukuk's opinion as speculative and unsupported by "any objective evidence which shows that the claimant's ability to sit, stand, and walk are limited." AR 14.
As discussed above, the ALJ completely ignored evidence of plaintiff's arthritis, and failed to even acknowledge her diagnosis as to this impairment. He was likewise dismissive of plaintiff's diabetes, incorrectly concluding that "examinations [with regard to her diabetes] do not reflect any related findings." AR 14. Accordingly, his rejection of the opinions of Drs. Sychukuk and Su as unsupported by "any" objective clinical findings amounts to a serious mischaracterization of the record. As such, this was not a legitimate reason for rejecting their opinions and constitutes error.
Where the ALJ "fails to provide adequate reasons for rejecting the opinion of a treating or examining physician, [the court] credit[s] that opinion as a matter of law." Lester, 81 F.3d at 834. The remaining question is whether to remand this case to the ALJ, or to remand for the payment of benefits. "The decision whether to remand the case for additional evidence or simply to award benefits is within the discretion of the court." Stone v. Heckler, 761 F.2d 530, 533 (9th Cir. 1985). Generally, the court will direct the award of benefits "in cases where no useful purpose would be served by further administrative proceedings or where the record has been thoroughly developed." Varney v. Secretary of Health and Human Services, 859 F.2d 1396, 1399 (9th Cir. 1987).
Here, crediting all three treating physicians' opinions as a matter of law establishes that plaintiff does not have the residual functional capacity to perform the requirements of work, and as such, "there are no outstanding issues that must be resolved before a determination of disability can be made." See Benecke v. Barnhart, 379 F.3d 587, 593 (9th Cir. 2004). Thus, further development of the record would serve no meaningful purpose and this matter will be remanded for payment of benefits. Accordingly, the court will not address plaintiff's other assertions of error, even though some of them, such as the ALJ's failure to properly discuss or give cogent reasons for discounting the testimony of plaintiff's son, are well-taken. See Dodrill v. Shalala, 12 F.3d 915, 919 (ALJ must give cogent reasons germane to each witness in order to discount lay testimony); Stout v. Comm'r, 454 F.3d 1050, 1056 (9th Cir. 2006) (Where ALJ fails "to properly discuss competent lay testimony favorable to the claimant, a reviewing court cannot consider the error harmless unless it can confidently conclude that no reasonable ALJ, when fully crediting the testimony, could have reached a different disability determination.").
For the foregoing reasons, this matter will be remanded under sentence four of 42 U.S.C. § 405(g) for immediate payment of benefits.
Accordingly, IT IS HEREBY ORDERED that:
1. Plaintiff's motion for summary judgment is granted;
2. The Commissioner's cross-motion for summary judgment is denied; and,
3. This action is remanded to the Commissioner for immediate payment of benefits.