Meredith v. O'Malley

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF ALASKA
TONI M.,1
Plaintiff,
v.
MARTIN J. O’MALLEY,2
Commissioner of the Social Security Administration,
Defendant.
Case No. 5:23-cv-00001-JMK
DECISION AND ORDER
On or about September 2, 2020, Toni M. (“Plaintiff”) protectively filed applications3
under Titles II and XVI of the Social Security Act.4 Plaintiff’s initial alleged disability date
1 Plaintiff’s name is partially redacted in accordance with Fed. R. Civ. P. 5.2(c)(2)(B) and the
recommendation of the Committee on Court Administration and Case Management of the Judicial
Conference of the United States. See M EMORANDUM, COMMITTEE ON C OURT ADMINISTRATION AND
CASE M ANAGEMENT OF THE JUDICIAL CONFERENCE OF THE UNITED STATES (May 1, 2018),
https://www.uscourts.gov/sites/default/files/18-cv-l-suggestion_cacm_0.pdf.
2 Martin J. O’Malley is now the Commissioner of Social Security and is automatically substituted
as a party pursuant to Fed. R. Civ. P. 25(d). See also section 205(g) of the Social Security Act,
42 U.S.C. § 405(g) (action survives regardless of any change in the person occupying the office
of Commissioner of Social Security).
3 Administrative Record (“A.R.”) A.R. 16, 191, 194. 	The application summaries, not the
applications themselves, appear in the Court’s record and are dated September 3, 2020.
A.R. 191. Pursuant to 20 C.F.R. §§ 416.340–350, a protective filing date establishes the earliest
possible application date based on a claimant’s oral inquiry about eligibility or a verbal or written
statement of intent to file for benefits. 	Therefore, September 2, 2020, is considered Plaintiff’s
application filing date.
4 Title II of the Social Security Act provides benefits to disabled individuals who are insured by
virtue of working and paying Federal Insurance Contributions Act (FICA) taxes for a certain
amount of time. Title XVI of the Social Security Act is a needs-based program funded by general
tax revenues designed to help disabled individuals who have low or no income. Plaintiff brought
claims under Title II and Title XVI. 	Although each program is governed by a separate set of
regulations, the regulations governing disability determinations are substantially the same for both
programs. 	Compare 20 C.F.R. §§ 404.1501–1599 (governing disability determinations under
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was January 1, 2018, but she subsequently amended the date to April 13, 2020.5 Plaintiff
has exhausted her administrative remedies and filed a Complaint seeking relief from this
Court.6 	Plaintiff’s Opening Brief asks the Court to reverse and remand the agency’s
decision 	for 	further 	administrative 	proceedings 	under 	sentence 	four 	of 	42 	U.S.C.
§ 405(g).7 The Commissioner filed the Administrative Record as his Answer and filed a
Response Brief.8 Plaintiff filed a Reply Brief.9
Oral argument was not requested and was not necessary to the Court’s decision.
This Court has jurisdiction to hear an appeal from a final decision of the Commissioner of
Social Security.10 	For the reasons discussed below, Plaintiff’s request for relief at
Docket 11 is GRANTED.
Title II) with 20 C.F.R. §§ 416.901–999d (governing disability determinations under Title XVI). For
convenience, the Court cites the regulations governing disability determinations under both titles.
5 A.R. 45.
6 Docket 1 (Plaintiff’s Compl.).
7 Docket 11 (Plaintiff’s Br.).
8 Docket 10 (Notice of Lodging Admin. Record); Docket 13 (Commissioner’s Br.). 	As of
December 1, 2022, the Commissioner’s “answer may be limited to a certified copy of the
administrative record.” See Fed. R. Civ. P., Supp. R. 4(b) of Soc. Sec. Actions under 42 U.S.C.
§ 405(g) (effective Dec. 1, 2022).
9 Docket 14 (Reply).
10 42 U.S.C. § 405(g).
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I. 	STANDARD OF REVIEW
A decision by the Commissioner to deny disability benefits will not be overturned
unless it either is not supported by substantial evidence or is based upon legal error.11
“Substantial evidence” has been defined by the United States Supreme Court as “such
relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.”12 Such evidence must be “more than a mere scintilla,” but may be “less than
a preponderance.”13 	In reviewing the agency’s determination, the Court considers the
evidence in its entirety, weighing both the evidence that supports and that which detracts
from the administrative law judge (“ALJ”)’s conclusion.14 If the evidence is susceptible to
more than one rational interpretation, the ALJ’s conclusion must be upheld.15 A reviewing
court may only consider the reasons provided by the ALJ in the disability determination
and “may not affirm the ALJ on a ground upon which he did not rely.”16 An ALJ’s decision
will not be reversed if it is based on “harmless error,” meaning that the error “is
inconsequential to the ultimate nondisability determination, or that, despite the legal error,
the agency’s path may reasonably be discerned, even if the agency explains its decision
11 Matney ex rel. Matney v. Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992) (citing Gonzalez v.
Sullivan, 914 F.2d 1197, 1200 (9th Cir. 1990)).
12 Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. of New York v.
NLRB, 305 U.S. 197, 229 (1938)).
13 Id.; Sorenson v. Weinberger, 514 F.2d 1112, 1119 n.10 (9th Cir. 1975).
14 Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985).
15 Gallant v. Heckler, 753 F.2d 1450, 1453 (9th Cir. 1984) (citing Rhinehart v. Finch, 438 F.2d 920,
921 (9th Cir. 1971)).
16 Garrison v. Colvin, 759 F.3d 995, 1010 (9th Cir. 2014).
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with less than ideal clarity.”17 Finally, the ALJ has a “special duty to fully and fairly develop
the record and to assure that the claimant’s interests are considered.”18 In particular, the
Ninth Circuit has found that the ALJ’s duty to develop the record increases when the
claimant is unrepresented or is mentally ill and thus unable to protect her own interests.19
However, this duty exists “even when the claimant is represented by counsel.”20
II. 	DETERMINING DISABILITY
The Social Security Act (“the Act”) provides for the payment of disability insurance
benefits (“DIB”) to individuals who have contributed to the Social Security program and
who suffer from a physical or mental disability.21 	In addition, Supplemental Security
Income (“SSI”) may be available to individuals who do not have insured status under the
Act but who are age 65 or older, blind, or disabled.22 	Disability is defined in the Act as
follows:
[I]nability to engage in any substantial gainful activity by reason of any
medically 	determinable 	physical 	or 	mental 	impairment 	which 	can 	be
expected to result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months.23
17 Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015) (internal quotations and citations
omitted).
18 Smolen v. Chater, 80 F.3d 1273,1288 (9th Cir. 1996) (quoting Brown v. Heckler, 713 F.2d 441,
443 (9th Cir. 1983)), superseded on other grounds by 	20 C.F.R. § 416.929(c)(3) and
§ 404.1529(c)(3); see also Garcia v. Comm’r of Soc. Sec., 768 F.3d 925, 930 (9th Cir. 2014).
19 Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir. 2001).
20 Mayes v. Massanari, 276 F.3d 453, 459 (9th Cir. 2001) (citations omitted).
21 42 U.S.C. § 423(a).
22 42 U.S.C. § 1381a.
23 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A).
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The Act further provides:
An individual shall be determined to be under a disability only if his
physical or mental impairment or impairments are of such severity that he
is not only unable to do his previous work but cannot, considering his age,
education, and work experience, engage in any other kind of substantial
gainful work which exists in the national economy, regardless of whether
such work exists in the immediate area in which he lives, or whether a
specific job vacancy exists for him, or whether he would be hired if he
applied for work. For purposes of the preceding sentence (with respect to
any individual), “work which exists in the national economy” means work
which exists in significant numbers either in the region where such individual
lives or in several regions of the country.24
The Commissioner has established a five-step process for determining disability
within the meaning of the Act.25 A claimant bears the burden of proof at steps one through
four in order to make a prima facie showing of disability.26 	If a claimant establishes a
prima facie case, the burden of proof then shifts to the agency at step five.27 	The
Commissioner can meet this burden in two ways: 	“(a) by the testimony of a vocational
expert, or (b) by reference to the Medical-Vocational Guidelines at 20 C.F.R. pt. 404,
subpt. P, app. 2.”28 The steps, and the ALJ’s findings in this case, are as follows:
Step 1. Determine whether the claimant is involved in “substantial gainful activity”
(“SGA”).29 	The ALJ determined that Plaintiff had not engaged in SGA since April 13,
24 42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B).
25 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).
26 Treichler v. Comm’r Soc. Sec. Admin., 775 F.3d 1090, 1096 n.1 (9th Cir. 2014) (quoting Hoopai
v. Astrue, 499 F.3d 1071, 1074–75 (9th Cir. 2007)); see also Tackett v. Apfel, 180 F.3d 1094, 1099
(9th Cir. 1999).
27 Treichler, 775 F.3d at 1096 n.1; Tackett, 180 F.3d at 1098 (emphasis in original).
28 Tackett, 180 F.3d at 1101.
29 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i).
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2020, the amended alleged onset date. 	The ALJ also determined that Plaintiff met the
insured status requirements of the Social Security Act through September 30, 2023.30
Step 2. 	Determine whether the claimant has a medically severe impairment or
combination of impairments. A severe impairment significantly limits a claimant’s physical
or mental ability to do basic work activities and does not consider age, education, or work
experience. 	The severe impairment or combination of impairments must satisfy the
twelve-month duration requirement.31 The ALJ determined that Plaintiff had the following
severe impairments: 	liver failure and alcoholic cirrhosis of the liver with ascites;
degeneration of the nervous system due to alcohol with alcoholic peripheral neuropathy
and paresthesia; cognitive impairment; Korsakoff’s syndrome; cognitive communication
disorder; schizoaffective disorder; adjustment disorder with mixed anxiety and depressed
mood; anxiety; attention deficit hyperactivity disorder (“ADHD”); and alcohol use disorder
and dependence with persisting amnestic and alcohol-induced dementia.32
Step 3. Determine whether the impairment or combination of impairments meet(s)
or equal(s) the severity of any of the listed impairments found in 20 C.F.R. pt. 404,
subpt. P, app.1, precluding substantial gainful activity. 	If the impairment(s) is(are) the
equivalent of any of the listed impairments, and meet(s) the duration requirement, the
claimant is conclusively presumed to be disabled. If not, the evaluation goes on to the
30 A.R. 19.
31 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii).
32 A.R. 19–20.
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fourth 	step.33 	The ALJ 	determined 	that 	Plaintiff 	did 	not 	have 	an 	impairment 	or
combination of impairments that met or medically equaled the severity of one of the listed
impairments in 20 CFR Part 404, Subpart P, Appendix 1.34
Residual Functional Capacity. Before proceeding to step four, a claimant’s residual
functional capacity (“RFC”) is assessed.35 	Once determined, the RFC is used at both
step four and step five. An RFC assessment is a determination of what a claimant is able
to do on a sustained basis despite the limitations from her impairments, including
impairments that are not severe.36 	The ALJ determined that Plaintiff had the residual
functional capacity to perform medium work with the following limitations: 	frequently
climbing stairs and ramps; never climbing ladders, ropes, and scaffolds; frequently
stooping, 	kneeling, 	crouching, 	and 	crawling; 	avoiding 	concentrated 	exposure 	to
vibrations; and avoiding all exposure to hazards such as unprotected heights, moving
mechanical parts, and commercial driving. 	The ALJ also determined that Plaintiff could
perform simple, routine and repetitive tasks, but could not perform tasks which require a
high production rate pace (such as assembly line work); could make only simple work-
related decisions; should not be responsible for the safety or welfare of others; and could
respond appropriately to occasional changes in a routine and relatively static work setting,
33 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).
34 A.R. 20.
35 20 C.F.R. § 416.945.
36 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).
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as long as any such changes are easily explained and/or demonstrated in advance of
gradual implementation.37
Step 4. 	Determine whether the claimant is capable of performing past relevant
work. 	At this point, the analysis considers whether past relevant work requires the
performance of work-related activities that are precluded by the claimant’s RFC. 	If the
claimant can still do her past relevant work, the claimant is deemed not to be disabled.38
Otherwise, the evaluation process moves to the fifth and final step.39 The ALJ determined
that Plaintiff was unable to perform any past relevant work.40
Step 5. 	Determine whether the claimant is able to perform other work in the
national economy in view of her age, education, and work experience, and in light of the
RFC. 	If so, the claimant is not disabled. 	If not, the claimant is considered disabled.41
The ALJ found that Plaintiff would have been able to perform occupations such as cleaner
(DOT # 381.687-018), automobile detailer (DOT # 915.687-034), and routing clerk (DOT
# 222.687-022).42
The ALJ concluded that Plaintiff was not disabled at any time from April 13, 2020,
the amended alleged onset date, through June 6, 2022, the date of the ALJ’s decision.43
37 A.R. 22.
38 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).
39 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).
40 A.R. 28.
41 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).
42 A.R. 29–30.
43 A.R. 30.
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III. 	PROCEDURAL AND FACTUAL BACKGROUND
Plaintiff was 44 years old on the amended alleged disability date.44 	From the
amended alleged onset date through the date of the ALJ’s decision, she was considered
“a younger individual” (age 18–49) by the Social Security Administration.45 	Her past
relevant work included work as a waitress.46 	Plaintiff initially alleged disability due to
cirrhosis of the liver and hepatic encephalopathy.47 She also reported she was unable to
work due to memory issues.48 Plaintiff’s claims were denied initially on October 13, 2020,
and after reconsideration on March 31, 2021.49 On January 7, 2022, she appeared with
representation and testified by telephone before ALJ Michael F. Schmitz.50 Through her
attorney, Plaintiff amended her alleged onset date of disability to April 13, 2020, to
“coincide” with her cognitive decline.51 The ALJ issued an unfavorable hearing decision
dated June 6, 2022.52 	After the Appeals Council denied review on March 23, 2023,
Plaintiff timely appealed to this Court.53
44 A.R. 29, 191.
45 See 20 C.F.R. §§ 404.1563, 416.963.
46 A.R. 28.
47 A.R. 211.
48 A.R. 262–63.
49 A.R. 70–71, 80–81.
50 A.R. 46–60. 	The ALJ noted that the hearing was being held by telephone “because of the
COVID-19 pandemic.” A.R. 39.
51 A.R. 45.
52 A.R. 16–30.
53 A.R. 1–6. Plaintiff filed her complaint on May 22, 2023. See Docket 1.
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IV. 	DISCUSSION
Plaintiff is represented by counsel in this appeal. 	Plaintiff alleges: 	(1) that the
ALJ’s weighing of the medical opinions in the record was not supported by substantial
evidence; (2) the ALJ failed to specific, clear, and convincing reasons for rejecting
Plaintiff’s symptom allegations; (3) the ALJ failed to resolve an apparent conflict with the
Dictionary of Occupational Titles; and (4) the ALJ’s conclusion that Plaintiff’s alcohol use
is a contributing factor material to a determination of disability is not supported by the
record.54 The Commissioner disagrees and urges the Court to affirm.55
A. 	Medical Opinion Evidence
Plaintiff alleges that the ALJ did not adequately evaluate the persuasiveness of the
medical opinions of record. Specifically, she asserts that the ALJ’s analysis of the medical
opinions of Danelle Fields, Ph.D., and Chelsea Meng, Psy. D., was not supported by
substantial evidence.56 	Because Plaintiff protectively filed her applications on or about
September 2, 2020, the new regulations governing the evaluation of medical evidence
are applicable here.
1. 	Legal standard
Under the new regulations in effect March 27, 2017, the definition of what
constitutes a medical opinion has been narrowed, focusing on what the claimant can do
54 Docket 11 at 7–19.
55 Docket 13 at 2–10.
56 Docket 11 at 7–10.
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despite her impairments and what work-related limitations are present.57 	The new
regulations define a medical opinion as follows:
A medical opinion is a statement from a medical source about what
you can still do despite your impairment(s) and whether you have one or
more impairment-related limitations or restrictions in the following abilities:
(i) 	Your ability to perform physical demands of work activities,
such as sitting, standing, walking, lifting, carrying, pushing, pulling, or other
physical functions (including manipulative or postural functions, such as
reaching, handling, stooping, or crouching);
(ii) 	Your ability to perform mental demands of work activities,
such 	as 	understanding; 	remembering; 	maintaining 	concentration,
persistence, or pace; carrying out instructions; or responding appropriately
to supervision, co-workers, or work pressures in a work setting;
(iii) 	Your ability to perform other demands of work, such as seeing,
hearing, or using other senses; and
(iv) 	Your ability to adapt to environmental conditions, such as
temperature or fumes.58
The new regulations further provide that the ALJ no longer gives any particular
weight to a medical opinion based on its source, thereby eliminating the treating source
rule.59 Instead, the ALJ considers the persuasiveness of a medical opinion based on five
factors: 	(1) supportability; (2) consistency; (3) relationship with the claimant, including
length, extent, and type of treatment; (4) specialization; and (5) other relevant factors that
support or contradict the medical opinion.60
57 Compare 20 C.F.R. § 404.1527 with 20 C.F.R. § 404.1513(a)(2).
58 20 C.F.R. § 404.1513(a)(2).
59 Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844-01
(Jan. 18, 2017), 2017 WL 168819, at *5867–68; 20 C.F.R. §§ 404.1520c(a), 416.920c(a) (for
claims filed on or after March 27, 2017).
60 20 C.F.R. §§ 404.1520c(c), 416.920c(c).
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Supportability and consistency are considered the most important factors for
evaluating persuasiveness.61 Supportability and consistency are explained as follows in
the regulations:
(1) 	Supportability. 	The more relevant the objective medical
evidence and supporting explanations presented by a medical source are
to support his or her medical opinion(s) or prior administrative medical
finding(s), the more persuasive the medical opinions or prior administrative
medical finding(s) will be.
(2) 	Consistency. 	The more consistent a medical opinion(s) or
prior administrative medical finding(s) is with the evidence from other
medical sources and nonmedical sources in the claim, the more persuasive
the medical opinion(s) or prior administrative medical finding(s) will be.62
Generally, these are the only two factors the ALJ is required to address in his
decision.63 However, when two or more medical opinions or prior administrative medical
findings “about the same issue are both equally well-supported . . . and consistent with
the record . . . but are not exactly the same,” the ALJ must explain how “the other most
persuasive factors” were considered.64 In the Ninth Circuit, the new regulatory framework
no longer requires ALJs to provide “specific and legitimate” or “clear and convincing”
reasons for rejecting a treating or examining medical source’s opinion.65
61 The regulations state, “The factors of supportability . . . and consistency . . . are the most
important factors [the SSA] consider[s] when [the SSA] determine[s] how persuasive [the SSA]
find[s] a medical source’s medical opinions or prior administrative medical findings to be.”
20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2) (for claims filed on or after March 27, 2017).
62 20 C.F.R. §§ 404.1520c(c)(1)–(2), 416.920c(c)(1)–(2).
63 20 C.F.R. §§ 404.1520c(b)(2), 416.920c(b)(2) (“[W]e will explain how we considered the
supportability 	and 	consistency 	factors for 	a medical 	source’s medical 	opinions 	or 	prior
administrative medical findings in your determination or decision.”).
64 20 C.F.R. §§ 404.1520c(b)(3), 416.920c(b)(3) (for claims filed on or after March 27, 2017).
65 Woods v. Kijakazi, 32 F.4th 785 (9th Cir. 2022).
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2. 	Medical opinion of Danelle Fields, Ph.D.
Beginning in June 2021 through April 2022, Plaintiff saw Danelle Fields, Ph.D.,
regularly for psychiatric care. 	On November 6, 2021, Dr. Fields opined that Plaintiff’s
impairments 	included 	neurodegenerative 	disease 	of 	the 	central 	nervous 	system,
adjustment disorder with anxiety and depressed mood, ADHD, and alcohol use disorder
in remission. 	She opined that Plaintiff’s progress had been fair to moderate and that
Plaintiff’s short-term memory may improve after five years of abstinence from alcohol.
However, she also opined that a full recovery of Plaintiff’s memory and executive abilities
was unlikely.66
Dr. Fields assessed functional limitations in several areas. 	She opined that
Plaintiff’s ability to remember information and concentrate were markedly impaired and
she 	would 	be 	unable 	to 	meet 	competitive 	standards 	for 	remembering 	work-like
procedures; understanding and remembering very short and simple instructions; and
maintaining attention for a two-hour segment. 	She also opined that Plaintiff would be
unable to meet competitive standards for traveling in unfamiliar places and using public
transportation.67
Dr. 	Fields 	discussed 	Plaintiff’s 	neuropsychological 	evaluation 	conducted 	in
December 2020 by a different provider. This previous evaluation indicated that Plaintiff’s
visual recall, encoding of verbal information, and recall and recognition were impaired.
The evaluation also noted Plaintiff’s difficulty with organization, learning a new routine,
66 A.R. 2081.
67 A.R. 2082–84.
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and managing stress. 	Dr. Fields provided additional evidence from her own treatment
notes, including Plaintiff’s inability to recall information given at the beginning of a therapy
session, retrieve information about current events, remember details, and remember
homework assignments. Dr. Fields also noted changed behaviors from the past, including
a reluctance to participate in activities and making impulsive purchases. She discussed
Plaintiff’s need to use a phone with GPS to find her way to stores and her fear of driving
because she feels she would be unsafe. Dr. Fields opined that Plaintiff would be absent
from work for about two days per month and opined that Plaintiff was not capable of
managing benefits in her own interest.68
On April 1, 2022, Dr. Fields provided an opinion letter to Plaintiff’s attorney. 	She
stated, “[p]lease note that my role is therapeutic, so by the nature of that role, my
observations are biased to advocate for my patient.” Dr. Fields opined that Plaintiff had
“improved somewhat” from the neuropsychological evaluation completed in December
2020. Despite this improvement, Dr. Fields opined that Plaintiff “continue[d] to struggle.”
She 	pointed 	out 	incidents 	demonstrating 	Plaintiff’s 	memory 	problems, 	lack 	of
organization, impulsivity, inability to tolerate stress, problems navigating around town, and
difficulties controlling emotions. 	She opined again that Plaintiff’s memory may improve
after five years of abstinence, but that Plaintiff’s memory and executive functions were
unlikely to fully recover.69
68 A.R. 2083–85.
69 A.R. 2501–02.
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Plaintiff 	asserts 	that 	the 	ALJ 	failed 	to 	articulate 	how 	he 	considered 	the
supportability 	and 	consistency 	factors 	to 	find 	Dr. 	Fields’s 	medical 	opinions
unpersuasive.70 	The 	Commissioner 	contends 	that 	Plaintiff’s 	improvement 	with
conservative treatment undermines Dr. Fields’s opinion that Plaintiff’s impairments
caused ongoing marked functional limitations. 	The Commissioner also asserts that
Plaintiff did not challenge the ALJ’s determination that Dr. Fields’s bias rendered her
opinions unpersuasive.71
We are confined to reviewing the reasons the ALJ asserts.72 In this case, the ALJ
provided the following reasons for finding Dr. Fields’s opinions unpersuasive. 	First, the
ALJ concluded that Dr. Fields’s opinions were “not supported by the record as a whole.”
Next, the ALJ found that Dr. Fields’s medical opinions were unpersuasive because
Plaintiff was “able to attend to her activities of daily living, travel on her own to locations
in her neighborhood, and has been found to have normal intelligence.” 	Finally, the ALJ
found Dr. Fields’s opinions unpersuasive because Dr. Fields admitted that she was
advocating for Plaintiff.73
A reviewing court should “not fault the agency merely for explaining its decision
with ‘less than ideal clarity,’” however, “we still demand that the agency set forth the
70 Docket 11 at 8–10.
71 Docket 13 at 5.
72 Brown-Hunter, 806 F.3d at 494 (“As we have long held, we are constrained to review the
reasons the ALJ asserts.”) (quotations, citations, and emphasis omitted).
73 A.R. 27–28.
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reasoning behind its decisions in a way that allows for meaningful review.”74 	Although
the ALJ summarized Dr. Fields’s treatment notes earlier in his decision, the ALJ did not
explain which portions of the medical record conflicted with Dr. Fields’s opinions about
Plaintiff’s functional limitations resulting from Plaintiff’s psychological symptoms. 	This
alone constitutes error because the ALJ failed to “set forth his own interpretations and
explain why they, rather than the doctors’, are correct.”75
Further, the treatment records and psychological examinations, when read in
context, do not appear to provide an adequate basis for discrediting Dr. Fields’s opinions,
particularly regarding Plaintiff’s memory problems, lack of organization, impulsivity,
inability to tolerate stress, problems navigating around town, and difficulties controlling
emotions.76
Moreover, the ALJ adopts an incomplete view of the record to support his
conclusions that Plaintiff’s activities of daily living, traveling on her own to locations in her
neighborhood, 	and 	normal 	intelligence 	are 	inconsistent 	with 	Dr. 	Fields’s 	medical
74 Brown-Hunter, 806 F.3d at 492 (quoting Treichler, 775 F.3d 1090, 1099 (9th Cir. 2014)).
75 See Embrey v. Bowen, 849 F.2d 418, 21–22 (9th Cir. 1988).
76 See e.g., A.R. 2471 (Plaintiff was oriented to person, place, and situation, but not time. She
has trouble maintaining the order of activities in her life. She is repetitive.); 2473 (“Her boyfriend
wants to be part of the next session because she cannot remember what we discuss.”); 2476
(She struggles with time and ordering. She was repetitive.); 2478–79 (Plaintiff had engaged in
impulsive purchases; “problems remembering what she ate”; needs to have her GPS to walk to
Walgreens. She was oriented to person, place and situation, but not time. She was unable to
recall 3 words at 5 minutes and 45 minutes.); 2480–81 (Forgetful and repetitive; poorly oriented
to time; reported can still cook, clean, and read); 2484–85 (No real insight into her condition from
not remembering being in the hospital; struggling with the changes she has in her daily life).
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opinions.77 While Plaintiff reported to providers that she was able to complete household
tasks such as cooking, cleaning, and doing laundry, she also reported that her boyfriend
managed her finances and medications, she chose not to drive, she felt she could not
walk around her neighborhood for fear of getting lost, she required a GPS to walk to
Walgreens in her neighborhood, had a difficult time remembering what she cooked or ate
the day before, and had difficulty keeping track of the date, recalling plans for the next
day, and remembering past events, such as her hospitalization in April 2020.78
And, although Dr. Fields used the words “bias” and “advocate” in her opinion letter,
her opinions and functional assessments regarding Plaintiff’s memory problems are
supported by her own treatment notes and consistent with the overall record, including
the examination by Jagan Pillai, M.D.,79 and testing by DeAnna Frye, Ph.D.80 Moreover,
Dr. Fields did not state that she was involved in assisting with Plaintiff’s application.81
Finally, 	the 	Commissioner’s 	argument 	that 	Plaintiff’s 	memory 	and 	cognitive
problems 	improved 	with 	medication 	and 	psychological 	care 	is 	not 	supported 	by
77 Buethe v. Comm’r of Soc. Sec., No. 2:20-cv-552-KJN, 2021 WL 1966202, at *5 (E.D. Cal.
May 17, 2021) (“Recently, . . . numerous district courts across the country have remanded where
evidence supporting or consistent with a rejected medical opinion was ignored.”) (citing cases).
78 See e.g., A.R. 2067, 2195, 2213, 2471, 2476, 2478–79, 2480.
79 A.R. 1973–77.
80 A.R. 2059–64.
81 Kelly Dawn L v. Saul, No. 1:19-cv-3091-FVS, 2020 WL 4730734, at *10 (E.D. Wash. May 27,
2020) (“When a physician is involved in the application process and advocates for the patient, the
physician’s opinion may be rejected because it is not objective.”) (citing Crane v. Shalala, 76 F.3d
251, 254 (9th Cir. 1996)); Matney on Behalf of Maney v. Sullivan, 981 F.2d 1016, 1020 (9th Cir.
1992) (affirming ALJ’s finding that physician’s opinion was entitled to less weight because he
agreed to become an advocate and assist in the application process).
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substantial evidence.82 While some of the treatment records cited by the Commissioner
showed 	improvement 	regarding 	Plaintiff’s 	memory 	problems 	through 	therapy 	and
medications, this improvement did not rise to any level of significant control.83
In sum, the ALJ’s finding that Dr. Fields’s opinions were unpersuasive is not
supported by substantial evidence.
3. 	Medical opinion of Dr. Meng
On April 29, 2022, Plaintiff underwent a neuropsychological assessment by
Chelsea Meng, Psy.D., a neuropsychologist. Dr. Meng reviewed Plaintiff’s social history,
reported 	memory 	problems, 	diagnostic 	studies, 	behavioral 	observations, 	and
administered several neuropsychological tests. 	Based on testing, she concluded that
Plaintiff continued to be impaired in the areas of memory and executive function when
compared to her previous evaluation in December 2020, including significant impairments
in her verbal and visual memory; learning and encoding new information; storing new
information in long term memory; and problems with confabulation and problem solving.
Dr. Meng also noted that Plaintiff’s impairments appeared to be related to her episode of
encephalopathy in April 2020 and significant history of alcohol abuse. 	She opined that
Plaintiff’s cognitive deficits appeared consistent with Korsakoff’s syndrome.84 Dr. Meng
82 Garrison, 759 F.3d at 1017 n.23 (“There can be a great distance between a patient who
responds to treatment and one who is able to enter the workforce[.]”) (internal quotations and
citation omitted).
83 See e.g., A.R. 1973, 1978–79, 2167, 2195, 2377.
84 “Wernicke-Korsakoff syndrome is an unusual type of memory disorder due to a lack of thiamin
(vitamin B1) requiring immediate treatment. 	It most often happens in people with alcohol use
disorder and malnutrition.” 	See https://my.clevelandclinic.org/health/diseases/22687-wernicke-
korsakoff-syndrome.
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concluded 	that 	Plaintiff’s 	“cognitive 	abilities 	have 	remained 	unchanged 	since 	her
evaluation in 2020 and are unlikely to improve. The severity of her memory problems will
impact her ability to work, and she should continue to pursue social security disability.”85
The ALJ determined that Dr. Meng’s opinion was “generally persuasive, as it is
largely supported by exam findings and is overall consistent with the record.” 	The ALJ
then discounted the opinion because it was “rather vague in nature and does not
specifically identify functional limitations.”86
Plaintiff asserts that the ALJ failed to provide reasons supported by substantial
evidence for rejecting Dr. Meng’s medical opinion. 	She asserts that the opinion is
supported by and consistent with the record, as well as being consistent with the opinion
of Dr. Fields. 	She points out specifically that the ALJ “identified no contrary medical
evidence to reject Dr. Meng’s opinion.”87 	The Commissioner counters that the RFC
developed by the ALJ incorporated Dr. Meng’s opinion, but the ALJ did not include
Dr. Meng’s recommendation that Plaintiff “continue to follow-up with her application for
social security disability” because this statement by Dr. Meng was not a “medical opinion”
under the SSA regulations.88
85 A.R. 2503–08.
86 A.R. 28.
87 Docket 11 at 9.
88 Docket 13 at 6.
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An ALJ may reject a medical opinion regarding a claimant’s ability to return to work
as an issue reserved for the Commissioner. 	Specifically, the new SSA regulation after
March 27, 2017, provides in § (c)(3):
(3) 	Statements on issues reserved to the Commissioner. 	The
statements listed in paragraphs (c)(3)(i) through (c)(3)(viii) of this section
would direct our determination or decision that you are or are not disabled
or blind within the meaning of the Act, but we are responsible for making
the determination or decision about whether you are disabled or blind:
(i) Statements that you are or are not disabled, blind, able to work, or
able to perform regular or continuing work;89
Moreover, courts in the Ninth Circuit have recognized that the definition of “medical
opinion” under the new regulations requires that the opinion include both functional
limitations and what a claimant is still capable of doing.”90 Similarly, the ALJ may find a
89 20 C.F.R. §§ 404.1520b(c)(3)(i), 416.920b(c); see also Rokko M. v. Comm’r of Soc. Sec.,
No. 2:22-CV-29-DWC, 2022 WL 4482625, at *2 (W.D. Wash. Sept. 27, 2022) (“[A]n ALJ need not
provide analysis if the evidence is ‘neither valuable nor persuasive to the issue,’ such as decisions
[‘]by other governmental agencies and nongovernmental entities,’ and ‘statements on issues
reserved to the Commissioner.’” (quoting 20 C.F.R. § 416.920b(c)(1)–(2))); Susan F. v. Kijakazi,
No. 20-CV-2201-BAS-DEB, 2022 WL 1694460, at *4 (S.D. Cal. May 26, 2022) (“[T]he opinion
that [the plaintiff] is unable to work is not a medical opinion, but is an opinion about an issue
reserved for the Commissioner.” (quoting Martinez v. Astrue, 261 F. App’x. 33, 35 (9th Cir.
2007))).
90 See 20 C.F.R. § 404.1513(a)(2) (“A medical opinion is a statement from a medical source
about what you can still do despite your impairment(s) and whether you have one or more
impairment-related limitations or restrictions in the following abilities.”); Rodin v. Comm’r of Soc.
Sec., No. 1:21-CV-00900-SAB, 2023 WL 3293423, at *15 (E.D. Cal. May 5, 2023) (citing Jessie L.
v. Kijakazi, No. 20-CV-9305-DMR, 2022 WL 2222964, at *14 (N.D. Cal. June 21, 2022) (“In
revising the definition of ‘medical opinion,’ the SSA recognized that ‘[d]iagnoses and prognoses
do not describe how an individual functions’ and that although the SSA considers a claimant’s
statements about his or her symptoms, ‘[a] more appropriate focus of medical opinions would be
perspectives from medical sources about claimants’ functional abilities and limitations.’” (quoting
81 Fed. Reg. at 62,562)). “Thus, a ‘medical opinion’ must discuss both a claimant’s limitations
and ‘what [the claimant] is still capable of doing’ despite those limitations.” Jessie L., 2022 WL
2222964, at *14 (quoting Michael H. v. Saul, 5:20-CV-417 (MAD), 2021 WL 2358257, at *6
(N.D.N.Y. June 9, 2021)); see also Michael H., 2021 WL 2358257, at *6 (“This note presents a
close call on what is considered a medical source statement[;] [w]hile it discusses Plaintiff’s
limitations, it does not discuss what Plaintiff is still capable of doing [and] [u]nder the previous
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medical opinion unsupported if the opinion fails “to assess any functional limitations.”91
However, the Court is not required to “take an all-or-nothing approach, and [may] attempt
to extract portions of records that do qualify as medical opinions, from portions that may
touch upon an issue reserved for the Commissioner.”92
In this case, the ALJ considered Dr. Meng’s opinion generally persuasive and
correctly discounted the opinion for lacking specific functional limitations. 	The ALJ
properly analyzed and considered Dr. Meng’s medical opinion. 	However, because this
case is being remanded on other grounds, the ALJ also should reevaluate Dr. Meng’s
opinion to ensure that all of Plaintiff’s limitations are accounted for in the new decision.
regulations, what a plaintiff could do in spite of their impairments was just one of the listed factors
tending to establish the medical provider’s judgments about the nature and severity of the
plaintiff’s impairments . . . [h]owever, under the new regulations, a medical source opinion must
do both.”)).
91 Pernell v. Kijakazi, No. 21-35619, 2022 WL 1638815 (9th Cir. May 24, 2022) (finding substantial
evidence supported the ALJ’s decision to discount the opinion of a psychologist who relied on an
outdated diagnostic framework and “failed to assess any functional limitations”); Ford v. Saul, 950
F.3d 1141, 1156 (9th Cir. 2020) (ALJ permissibly discounted a physician’s opinion, under prior
precedent governing the evaluation of medical opinions, where the descriptions in the opinion of
the claimant’s “ability to perform in the workplace as ‘limited’ or ‘fair’ were not useful because they
failed to specify [the claimant’s] functional limits.”); McLeod v. Astrue, 640 F.3d 881, 884–85 (9th
Cir. 2011), superseded on other grounds by 20 C.F.R. § 404.1504 (Where the physician’s opinion
merely stated that the claimant “could not work,” the ALJ is not required to read this as an
evaluation of the claimant’s “functional exertional capacity.”).
92 Rodin v. Comm’r of Soc. Sec., 2023 WL 3293423, at *14; see also 20 C.F.R. § 404.1513(a)(3)
(“Other medical evidence is evidence from a medical source that is not objective medical evidence
or a medical opinion, including judgments about the nature and severity of your impairments, your
medical history, clinical findings, diagnosis, treatment prescribed with response, or prognosis. (For
claims filed (see § 404.614) before March 27, 2017, other medical evidence does not include a
diagnosis, prognosis, or a statement that reflects a judgment(s) about the nature and severity of
your impairment(s)).”).
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B. 	Plaintiff’s Subjective Symptom Testimony and Reports
Plaintiff contends that the ALJ failed to articulate specific, clear, and convincing
reasons 	for 	rejecting 	her 	testimony. 	Specifically, 	Plaintiff 	asserts 	that 	the ALJ’s
“proposition that her memory improved to a point of sustained functioning is not supported
by the record.” She also asserts that the ALJ did not cite any evidence indicating normal
memory.93 The Commissioner counters that “Plaintiff does not dispute that her treatment
after a hospitalization was conservative, which is itself a legally sufficient reason for
discounting her self-reports.” 	In the alternative, the Commissioner asserts that the ALJ
rationally concluded Plaintiff’s limitations were not a severe as she alleged.94
Plaintiff testified before ALJ Schmitz on January 7, 2022. She testified that she felt
she could not work because of her memory problems. 	She indicated that she could
typically maintain her day-to-day living, but she also stated that she did not drive and if
she needed to get to a doctor’s appointment or grocery store, she was completely
dependent on her boyfriend. She testified that she “misplace[s] everything[,]” but that she
had a few systems in place to assist her with her memory. 	She stated that it was “very
hard for [her] to do anything on a consistent basis,” including keeping track of her medical
appointments and medication. 	She testified that her “time and space memory” was
impaired, so she had difficulties knowing what day of the week it was or the date. 	She
indicated that she did not know how long she could do an activity before moving on to
another activity. Plaintiff testified that she and her boyfriend have pets, but her boyfriend
93 Docket 11 at 13.
94 Docket 13 at 3–4.
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took care of the animals’ daily feedings and other needs. She testified that, at the time of
the hearing, she was not drinking alcohol. 	She indicated that she did not know the last
time she had something to drink, but that she had not attended a cessation program.
Plaintiff also indicated that she could not remember what she did on specific days. She
testified that she could not do laundry and that her boyfriend organized the household,
her medications, and paid the bills. She indicated that she could walk to her neighborhood
Walgreens and back with the assistance of GPS, but she did not believe that she could
walk there without the GPS.95
1. 	Legal standards
An ALJ’s assessment of a claimant’s symptoms has two steps.96 	First, the ALJ
determines whether the claimant has presented “objective medical evidence of an
underlying impairment which could reasonably be expected to produce the pain or other
symptoms alleged.”97 In the first step, the claimant need not show “that her impairment
could reasonably be expected to cause the severity of the symptom she has alleged; she
need only show that it could reasonably have caused some degree of the symptom. Nor
must a claimant produce objective medical evidence of the pain or fatigue itself, or the
severity thereof.”98
95 A.R. 49–59.
96 Trevizo v. Berryhill, 871 F.3d 664, 678 (9th Cir. 2017), superseded on other grounds by 20
C.F.R. § 404.1502(a).
97 Id. (quoting Garrison v. Colvin, 759 F.3d 995, 1014–15 (9th Cir. 2014)).
98 Garrison, 759 F.3d at 1014 (internal citations and quotations omitted).
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Second, if the claimant has satisfied step one and the ALJ has determined that the
claimant is not malingering, the ALJ must provide “specific, clear and convincing reasons”
for rejecting the claimant’s testimony regarding the severity of the claimant’s symptoms.
This standard is “the most demanding required in Social Security cases.”99 Yet, this does
not mean an ALJ is required to “simply accept a claimant’s subjective symptom testimony
notwithstanding inconsistencies between that testimony and the other objective medical
evidence in the record, allowing a claimant’s subjective evidence to effectively trump all
other evidence in a case.”100
In this case, the ALJ determined that, although Plaintiff’s medically determinable
impairments could reasonably be expected to cause the alleged symptoms, Plaintiff’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.
He did not determine that Plaintiff was malingering.101
Because the ALJ found Plaintiff’s underlying impairments severe and cited no
evidence of malingering, he was required to provide specific, clear, and convincing
reasons for rejecting Plaintiff’s subjective symptom allegations. 	The ALJ provided the
following reasons: 	(1) Plaintiff has required only conservative treatment since her
hospitalizations in 2020 and the objective evidence shows a good physical recovery after
99 Trevizo, 871 F.3d at 678.
100 Smartt v. Kijakazi, 53 F. 4th 489, 499 (9th Cir. 2022).
101 A.R. 23.
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cessation of alcohol consumption; and (2) regarding memory and cognitive problems,
Plaintiff “has made good progress with medication and psychological care.”102
Because Plaintiff has not objected to the ALJ’s findings regarding her physical
impairments, the Court will not address those findings. Regarding Plaintiff’s cognitive and
other mental impairments, some treatment records showed improvement, but not to any
level of significant control.103
In sum, the ALJ’s examples of Plaintiff’s general improvement were not sufficiently
specific, clear, or convincing and were not supported by substantial evidence.104
C. 	Apparent Conflict with the DOT
Under 	Social 	Security 	Ruling 	(“SSR”) 	00-4p, 	the ALJ 	has 	an 	“affirmative
responsibility” to ask whether a vocational expert’s evidence “conflicts with information
provided in the DOT” before relying on that evidence to support a determination of
nondisability.105 	However, 	the ALJ 	may 	rely 	on 	vocational 	expert 	testimony 	that
102 A.R. 26.
103 See e.g., A.R. 1973, 1978–79, 2167, 2195, 2377.
104 Smartt, 53 F.4th at 499–500.
105 POLICY I NTERPRETATION RULING: TITLES II AND XVI: USE OF VOCATIONAL EXPERT AND
VOCATIONAL SPECIALIST E VIDENCE, AND O THER RELIABLE O CCUPATIONAL I NFORMATION IN DISABILITY
DECISIONS, SSR 00-4p, 2000 WL 1898704, at *4. 	Social Security Rulings are issued by the
Commissioner to clarify the Commissioner’s regulations and policies. 	Bunnell v. Sullivan, 947
F.2d 341, 346 n.3 (9th Cir. 1991). 	Although they do not have the force of law, they are
nevertheless given deference “unless they are plainly erroneous or inconsistent with the Act or
regulations.” Han v. Bowen, 882 F.2d 1453, 1457 (9th Cir. 1989); see Orn v. Astrue, 495 F.3d
625, 636 (9th Cir. 2007) (Social Security Rulings are “binding on all components of the Social
Security Administration, . . . and are to be relied upon as precedents in adjudicating cases.”); see
also Massachi v. Astrue, 486 F.3d 1149, 1152–53 (9th Cir. 2007).
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“contradicts the DOT, but only insofar as the record contains persuasive evidence to
support the deviation.”106
Here, Plaintiff alleges that the ALJ failed to resolve an apparent conflict between
the vocational expert’s testimony and the Dictionary of Occupational Titles (“DOT”).
Specifically, she asserts that the limitation of only occasional changes and a static work
setting is an apparent conflict with the DOT’s reasoning level two classification and the
ALJ failed to resolve the conflict.107 The Commissioner contends that the Court should
affirm the ALJ’s step-five finding because no apparent conflict exists between Plaintiff’s
limitations and the job demands at reasoning level two.108
The ALJ’s hypothetical question posed to the vocational expert included mental
limitations.109 Based on the hypothetical, the vocational expert testified that Plaintiff could
perform work as a cleaner (DOT # 381.687-018), an automobile detailer (DOT # 915.687-
034), and a routing clerk (DOT # 222.687-022).110 Each of these hypothetical occupations
require a reasoning level two in the DOT.
The DOT “assigns each job a ‘reasoning development’ level, on a six-tiered scale
of Level One (simplest) to Level Six (most complex).”111 The two reasoning development
levels at issue here are:
106 Johnson v. Shalala, 60 F.3d 1428, 1435 (9th Cir. 1995).
107 Docket 11 at 14–17.
108 Docket 13 at 7–9.
109 A.R. 62.
110 A.R. 63.
111 Leach v. Kijakazi, 70 F.4th 1251, 1256 (9th Cir. 2023) (citation omitted).
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LEVEL 1[:] Apply commonsense understanding to carry out simple
one- or two-step instructions. 	Deal with standardized situations with
occasional or no variables in or from these situations encountered on the
job.
LEVEL 2[:] Apply commonsense understanding to carry out detailed
but uninvolved written or oral instructions. 	Deal with problems involving a
few concrete variables in or from standardized situations.112
Recently, in Leach v. Kijakazi, the Ninth Circuit addressed level one and level two
reasoning occupations. The Ninth Circuit emphasized the distinction between level one
and level two reasoning jobs as follows:
Most pertinently, level-one jobs require only ‘simple one-or two-step
instructions’ 	but 	level-two 	jobs 	require 	‘detailed 	but 	uninvolved 	. . .
instructions.’ . . . Both reasoning levels require simple (or ‘uninvolved’)
instructions. . . . The key distinction between those two levels is that level-
one jobs require instructions involving at most two steps, whereas level-two
jobs may require ‘detailed’—that is, potentially longer—instructions. . . . A
level-two job with ‘detailed but uninvolved . . . instructions’ could require an
employee to follow lengthy simple instructions. On the present record, then,
we cannot determine whether the level-two jobs identified by the vocational
expert require only short, simple instructions.113
Here, the ALJ’s RFC does not directly address the complexity of instructions.
Instead, the RFC limits Plaintiff to “simple, routine and repetitive tasks” with no assembly
line work. Additionally, the ALJ noted that any changes to Plaintiff’s work routine must be
“easily explained and/or demonstrated” and must be explained “in advance of gradual
implementation.”114
112 Leach, 70 F.4th at 1256 (internal citations omitted); see also DICOT 382.687-018, 1991 WL
673258; DICOT 915.687-034, 1991 WL 687878; DICOT 222.687-022.
113 Leach, 70 F.4th at 1256–57.
114 A.R. 22.
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In the Ninth Circuit, a limitation to “simple, routine, repetitive tasks” has been found
to be characteristic of level two reasoning.115 However, the ALJ in this case further limited
Plaintiff to “simple work-related decisions” and “occasional change[s] in a routine and
relatively static work setting,” with “easily explained and/or demonstrated” changes “in
advance of gradual implementation.”116 	This further eroding of level two reasoning
implies that the RFC does not fit the hypothetical occupations testified to by the vocational
expert and included at step five in the ALJ’s disability evaluation.117 Because reasoning
level one appears to better fit the ALJ’s RFC, a conflict exists between the vocational
expert’s testimony and the DOT, which the ALJ did not resolve in his decision. 	This
conflict is not harmless.118 	On remand, the ALJ should specifically address the conflict
and, if necessary, recall the vocational expert for additional questioning and clarification.
115 Michelle G. v. Berryhill, No. 18CV1323-DMS(MSB), 2019 WL 3322405, at *10 (S.D. Cal.
July 24, 2019), report and recommendation adopted sub nom. Gold v. Berryhill, No. 18-CV-1323
DMS (MSB), 2019 WL 3891092 (S.D. Cal. Aug. 19, 2019) (“Plaintiff . . . is limited to simple, routine,
repetitive tasks, which are more characteristic of Level 2 Reasoning[.]”); see also Zavalin v.
Colvin, 778 F.3d 842, 847 (9th Cir. 2015) (noting that the claimant’s “limitation to simple, routine
tasks is at odds with Level 3’s requirements because ‘it may be difficult for a person limited to
simple, repetitive tasks to follow instructions in ‘diagrammatic form’ as such instructions can be
abstract.’”).
116 A.R. 22.
117 Steven Rodney C. v. Comm’r, Soc. Sec. Admin., No. 2:20-cv-01753-YY, 2022 WL 1469228, at
*2–3 (D. Or. May 10, 2022) (holding that when simple, routine tasks are further limited to no more
than occasional changes and occasional decision making in the work setting, this RFC more
closely aligns with level one reasoning).
118 Rounds v. Comm’r Soc. Sec. Admin., 807 F.3d 996, 1004 (9th Cir. 2015) (holding that the
apparent conflict between the RFC and the demands of level two reasoning was not harmless).
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D. 	Materiality of Alcohol Abuse
Plaintiff alleges that the ALJ erred by finding Plaintiff’s alcohol abuse material to
her disability.119 The Commissioner responds, in a footnote, that because the ALJ never
found Plaintiff disabled even in the context of her alcohol abuse, the ALJ did not address
the materiality of Plaintiff’s alcohol abuse on her impairments.120
Under the SSA’s regulations, if the ALJ finds that there is medical evidence of
alcoholism and that the claimant is disabled when considering all impairments, including
the alcoholism, the ALJ must determine whether the “alcoholism is a contributing factor
material to the determination of disability.”121 The key factor is whether the claimant would
still be found disabled if she stopped using alcohol.122 Therefore, the claimant’s alcohol
addiction is only a material contributing factor to the disability determination if the
remaining limitations would not be disabling.123
In this case, the ALJ found Plaintiff’s alcohol use disorder and related physical and
mental impairments severe.124 He noted that he analyzed Plaintiff’s physical and mental
impairments “through the framework of alcohol abuse.”125 Although it is unclear what the
119 Docket 11 at 17–19.
120 Docket 13 at 2. The Court notes that Plaintiff did not respond to the Commissioner’s response
in her Reply brief. See Docket 14.
121 20 C.F.R. § 416.935(a).
122 20 C.F.R. § 416.935(b)(1).
123 20 C.F.R. § 416.935(b)(3).
124 A.R. 19–20.
125 A.R. 23.
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ALJ meant by “the framework of alcohol abuse,” the ALJ did not find Plaintiff disabled and
consequently, he was not required to engage in a materiality analysis.
In sum, the ALJ was not required to engage in an analysis to determine if Plaintiff’s
alcohol addiction was a material contributing factor to her disability determination.
However, on remand, the ALJ should explain his or her reasoning.
E. 	Scope of Remand
Plaintiff requests that the Court reverse the SSA’s final decision and remand for
further proceedings.126 	The decision whether to remand for further proceedings or for
immediate payment of benefits is within the discretion of the court.127 When prejudicial
error has occurred, “the proper course, except in rare circumstances, is to remand to the
agency for additional investigation or explanation[.]”128 For the above reasons, the proper
remedy in this case, is to remand for further administrative proceedings, including a new
hearing and new ALJ decision, consistent with this Decision and Order.
V. 	ORDER
The Court, having carefully reviewed the administrative record, finds that the ALJ’s
determinations 	are 	not 	free 	from 	legal 	error 	and 	not 	supported 	by 	substantial
evidence. Accordingly, IT IS ORDERED that Plaintiff’s request for relief at Docket 11 is
GRANTED and the Commissioner’s final decision is VACATED and REMANDED for
126 Docket 11 at 19.
127 Garrison, 759 F.3d at 1019.
128 Dominguez v. Colvin, 808 F.3d 403, 407 (9th Cir. 2015) (quoting Treichler, 775 F.3d at 1099).
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further proceedings, pursuant to sentence four of 42 USC § 405(g) and consistent with
this Decision and Order.
The Court DIRECTS the Clerk of this Court to enter judgment in favor of Plaintiff
and close this case accordingly.
DATED this 27th day of February 2024, at Anchorage, Alaska.
/s/ Joshua M. Kindred
JOSHUA M. KINDRED
UNITED STATES DISTRICT JUDGE
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