Caseflicks

Court of Appeals for the Ninth Circuit • 2009

Valentine v. Commissioner Social Security Administration

574 F.3d 685 | 2009 U.S. App. LEXIS 15923

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Takeaway

In short, this case confirms that a VA disability rating ordinarily deserves great weight, but an ALJ may depart from it when a well-supported record contains specific, valid reasons—particularly later or additional evidence—showing that the SSA disability determination should differ.

Background

Jerry Valentine, a Navy veteran who suffered a combat-related head injury in Vietnam, applied for Social Security disability insurance benefits in March 2005, alleging disability beginning in March 2004. He claimed that PTSD, depression and sleep deprivation, and later shoulder and knee injuries prevented him from working. Valentine had worked for Cummins Northwest as a parts man until his retirement in March 2004.

The Veterans Administration had initially assigned Valentine a 70 percent disability rating and later increased it to 100 percent. His treating psychologist, Dr. Lynn Van Male, supported his efforts to obtain a higher VA rating and regarded him as unable to sustain employment. Other psychologists, including Dr. Daniel Storzbach and SSA reviewer Dr. Peter LeBray, found cognitive and psychological limitations but characterized many of them as moderate. The employment records also showed that, despite periods of difficulty, Valentine improved at work and received favorable reviews shortly before retirement.

An ALJ found that Valentine could perform a limited range of medium work, subject to moderate restrictions in concentration, public interaction, and carrying out detailed instructions. Relying on vocational-expert testimony, the ALJ found at step five that jobs existed in the national economy that he could perform and denied benefits. The Appeals Council denied review, the district court affirmed the Commissioner’s decision, and Valentine appealed to the Ninth Circuit.

Issues

Issue #1

Whether the ALJ denied Valentine due process through her questioning, demeanor, and alleged preconceptions at the administrative hearing.

Holding

No. Valentine did not establish that the ALJ was biased or that the hearing was unfair.

Reasoning

ALJs are presumed unbiased. That presumption is overcome only by a conflict of interest or another specific basis for disqualification; ordinary displays of impatience, skepticism, dissatisfaction, or even anger do not suffice.

Valentine identified pointed questions and expressions of disbelief, but he did not show actual bias. An ALJ’s decision to question a claimant’s arguments or the views of treating providers is part of adjudication and does not, without more, prove that the ALJ prejudged the claim.

Issue #2

Whether the ALJ’s residual-functional-capacity finding failed to incorporate the medical evidence concerning Valentine’s cognitive and physical limitations.

Holding

No. The RFC adequately reflected the material medical evidence, and Valentine did not identify additional supported physical restrictions that the ALJ omitted.

Reasoning

Dr. LeBray’s fuller mental RFC assessment found moderate limits in carrying out detailed instructions, maintaining attention and concentration, and interacting with the public, with no significant limitation in most other categories. Those limitations appeared almost verbatim in the ALJ’s RFC, so his reference to simple, paced tasks did not establish that Valentine was confined to simple work in the SSA’s technical sense.

Dr. Storzbach’s testing showed average baseline cognitive ability, many normal or better test results, and variable impairment in attention, working memory, and complex psychomotor functioning. The ALJ’s limitation to moderate restrictions in concentration, public interaction, and detailed instructions was consistent with those findings.

Dr. Storzbach’s statement that Valentine would be less likely to experience difficulty with highly routinized, overlearned, low-demand tasks was a recommendation for coping with PTSD symptoms, not an opinion that he could work only under those conditions. The report also noted cognitive strengths and an ability to compensate at least partly for deficits.

Valentine did not demonstrate that his old cervical and lumbar injuries caused relevant limitations after his alleged onset date. Although the ALJ found his knee and shoulder conditions severe and included physical limits in the RFC, Valentine did not explain what further work-related restrictions the record required.

Issue #3

Whether the ALJ improperly rejected the opinion of Valentine’s treating psychologist, Dr. Van Male.

Holding

No. Because other medical opinions contradicted Dr. Van Male’s opinion, the ALJ gave specific and legitimate reasons, supported by substantial evidence, for assigning it less weight.

Reasoning

A contradicted treating physician’s opinion may be rejected only for specific and legitimate reasons supported by substantial evidence. Drs. Storzbach and LeBray offered conflicting assessments that supported moderate, rather than disabling, functional limitations.

The ALJ identified an internal tension in Dr. Van Male’s opinion: she repeatedly described Valentine as unemployable while acknowledging that he continued to work full time. The ALJ also relied on Dr. Van Male’s own progress reports and employer feedback showing improved functioning and encouraging workplace performance.

Those treatment and employment records were consistent with the opinions of the other psychologists. The ALJ therefore permissibly resolved the medical conflict in favor of the evidence indicating that Valentine retained greater functional capacity than Dr. Van Male asserted.

Issue #4

Whether the ALJ improperly discounted Valentine’s testimony about the intensity and limiting effects of his fatigue, PTSD, and other symptoms.

Holding

No. In the absence of malingering evidence, the ALJ gave clear and convincing reasons supported by the record for finding his testimony overstated his limitations.

Reasoning

An ALJ who rejects a claimant’s symptom testimony without evidence of malingering must identify the testimony found unpersuasive and provide clear and convincing reasons. Here, the ALJ found that Valentine’s demonstrated abilities exceeded the degree of limitation he described.

The ALJ acknowledged that Valentine had struggled in his former job, but also cited evidence that he improved and rallied at work. She further relied on his post-retirement activities, including exercise, gardening, projects, and community activities, as inconsistent with his account of wholly debilitating fatigue.

This evidence did not establish that Valentine could return to his old Cummins job. It did, however, directly undermine his assertion that his symptoms were so severe that he could not perform any work, and thus supported the ALJ’s credibility determination.

Issue #5

Whether the ALJ gave legally adequate reasons for discounting the testimony of Valentine’s wife and his former supervisor, Lane Anthony.

Holding

Yes, as to the result. The ALJ had germane reasons to discount both witnesses, although part of her rationale concerning Valentine’s wife was improper and harmless.

Reasoning

A lay witness’s testimony may be discounted only for reasons germane to that particular witness. Because Mrs. Valentine’s account of her husband’s fatigue closely tracked Valentine’s own subjective complaints, the valid reasons for discounting his testimony also provided a germane basis for discounting hers.

The ALJ erred to the extent she relied simply on Mrs. Valentine’s status as an interested spouse and on her lack of firsthand knowledge of his work performance. Family members are competent witnesses to symptoms and daily activities, and an ALJ must identify witness-specific reasons rather than invoke characteristics common to all spouses. The error was harmless, however, because the ALJ had already supplied a valid, germane reason based on the overlap with Valentine’s discredited allegations.

Anthony’s later letter claimed that his favorable employee reviews were untruthful and written out of pity. The ALJ reasonably preferred the contemporaneous reviews, reasoning that Anthony had a workplace duty to report accurately when he wrote them, whereas his later sympathy for Valentine could explain his attempt to portray Valentine more favorably at the benefits hearing. That was a witness-specific and germane reason.

Issue #6

Whether the ALJ was required to accept the VA’s 100 percent disability rating as determinative of Social Security disability.

Holding

No. The ALJ could give the VA rating little weight because she had persuasive, specific, and valid record-supported reasons, including evidence unavailable to the VA that undermined the basis for its decision.

Reasoning

Under McCartey, an ALJ ordinarily must give great weight to a VA disability determination because the VA and SSA disability programs are markedly similar. The ALJ could not discount the rating merely by generally asserting that the two agencies apply different disability standards.

But the ALJ also explained that the VA’s rating was not based on a comprehensive evaluation of the evidence before her. The Ninth Circuit understood that explanation to refer to the VA’s reliance on Dr. Van Male’s opinion and Dr. Carter’s evaluation; the ALJ had properly rejected Dr. Van Male’s opinion, and Dr. Carter’s evaluation rested on inaccurate information about why Valentine left his job.

The ALJ also had evidence that the VA did not: the agency psychologists’ assessments, employment records, evidence of post-retirement activities, and vocational-expert input. New evidence, or a properly justified reevaluation of the evidence underlying a VA decision, may constitute a persuasive, specific, and valid reason to assign the VA rating less weight.