Plies v. Bisignano

2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 SOUTHERN DISTRICT OF CALIFORINIA 10 11 DARREN P.,1 Case No.: 25cv2261-MSB 12 Plaintiff, 13 ORDER ENTERING JUDGMENT; v. REVERSING COMMISSIONER’S 14 DECISION; AND REMANDING FOR FRANK BISIGNANO, Commissioner of 15 FURTHER ADMINISTRATIVE Social Security, PROCEEDINGS 16 Defendant. 17 [ECF NOS. 15 & 18] 18 19 On August 29, 2025, Plaintiff Darren P. (“Plaintiff”) filed a Complaint pursuant to 20 42 U.S.C. § 405(g) seeking judicial review of a final adverse decision by the 21 Commissioner of Social Security (“Commissioner”). (ECF No. 1.) Based on all parties’ 22 consent [ECF Nos. 3–4], this case is before the undersigned as presiding judge for all 23 purposes, including entry of final judgment. 28 U.S.C. § 636(c). Now pending before the 24 Court is Plaintiff’s Brief claiming error by the Administrative Law Judge (“ALJ”) who 25 conducted the administrative hearing and issued the decision denying Plaintiff’s 26 27 2 reviewed the Complaint [ECF No. 1], the Administrative Record (“AR”) [ECF No. 7], 3 Plaintiff’s Brief [ECF No. 15], and the Commissioner’s Responsive Brief [ECF No. 18].2 For 4 the reasons set forth below, the Court ORDERS judgment be entered REVERSING the 5 Commissioner’s decision and REMANDING this matter for further administrative 6 proceedings consistent with this Order. 7 I. PROCEDURAL BACKGROUND 8 On May 4, 2022, Plaintiff applied for disability insurance benefits under Titles II 9 and XVIII of the Social Security Act, alleging disability beginning on July 1, 2006. (AR 10 143.) The Commissioner denied the claim initially on August 29, 2022, and again upon 11 reconsideration on December 22, 2022. (AR 52–60; 61–69.) On February 6, 2023, 12 Plaintiff sought an administrative hearing before an ALJ. (AR 80–81.) ALJ Eric Benham 13 held an administrative hearing on August 15, 2023, during which Plaintiff appeared with 14 counsel. (AR 30–51.) Plaintiff and the vocational expert, Sonia Peterson, testified. (Id.) 15 In a written decision dated July 23, 2024, the ALJ concluded Plaintiff had not been under 16 a disability “at any time from July 1, 2006, the alleged onset date, through December 31, 17 2008, the date last insured.” (AR 25.) 18 On September 4, 2024, Plaintiff requested the Appeals Council review the ALJ’s 19 decision. (AR 141–42.) The Appeals Council denied the request for review on July 3, 20 2025. (AR 1–6.) Plaintiff then sought review by this Court on August 5, 2025. (ECF No. 21 1.) 22 II. SUMMARY OF THE ALJ’S FINDINGS 23 In rendering his decision, the ALJ applied the Commissioner’s five-step sequential 24 evaluation process. 20 C.F.R. § 404.1520. At step one, the ALJ found Plaintiff had not 25 26 2 “AR” refers to the Administrative Record lodged with this Court on December 10, 2025. (ECF No. 7.) 27 The Court’s citations to the AR use the page references on the original document rather than the page 2 the date last insured. (AR 20.) 3 At step two, the ALJ found Plaintiff had the following severe impairments: chronic 4 fatigue (myalgic encephalomyelitis) and chronic tension headaches. (Id.) The ALJ noted 5 these medically determinable impairments significantly limit Plaintiff’s ability to perform 6 basic work activities. (Id.) 7 At step three, the ALJ determined, through the date last insured, Plaintiff did not 8 have an impairment or combination of impairments that met or medically equaled the 9 severity of one of the listed impairments in the Commissioner’s Listing of Impairments. 10 (AR 21.) Specifically, the ALJ found Plaintiff’s physical impairments did not meet or 11 medically equal listing 11.00 (neurological disorders) or any other listing. (Id.) 12 Before proceeding to step four, the ALJ determined, through the date last 13 insured, Plaintiff had the residual functional capacity (“RFC”) to “perform light work . . . 14 except [Plaintiff] was unable to climb ladders, ropes, or scaffolds. [Plaintiff] was able to 15 occasionally climb ramps and stairs, balance, stoop, kneel, crouch, and crawl. [Plaintiff] 16 was able to perform simple work.” (AR 21.) 17 At step four, the ALJ found Plaintiff has no past relevant work. (AR 24.) 18 Finally, at step five, the ALJ determined, based on the vocational expert’s 19 testimony, jobs exist in significant numbers in the national economy that Plaintiff can 20 perform considering his age, education, work experience, and RFC.3 (AR 24–25.) Thus, 21 the ALJ concluded Plaintiff had not been under a disability from July 1, 2006, through 22 December 31, 2008. (AR 25.) 23 / / 24 / / 25 26 3 The ALJ determined Plaintiff could perform following occupations: Office Helper, Dictionary of 27 Occupational Titles (“DOT”) 239.567-010, light, unskilled, 90,000 jobs nationally; Price Marker, DOT 2 Plaintiff raises two issues as grounds for reversal: 3 1. Whether the ALJ properly considered Plaintiff’s subjective symptom testimony; 4 5 2. Whether the ALJ’s RFC determination is supported by substantial evidence. 6 7 IV. STANDARD OF REVIEW 8 Section 405(g) of the Social Security Act allows unsuccessful applicants to seek 9 judicial review of the Commissioner’s final decision. 42 U.S.C. § 405(g). The scope of 10 judicial review is limited, and the denial of benefits will only be disturbed if the final 11 decision is not supported by substantial evidence or contains a legal error. Luther v. 12 Berryhill, 891 F.3d 872, 875 (9th Cir. 2018) (citation modified). “Substantial evidence” is 13 a “‘term of art’ used throughout administrative law to describe how courts are to review 14 agency factfinding.” Biestek v. Berryhill, 587 U.S. 97, 102 (2019) (quoting T-Mobile S., 15 LLC v. Roswell, 574 U.S. 293, 301 (2015)). The Supreme Court has said substantial 16 evidence means “more than a mere scintilla,” but only “such relevant evidence as a 17 reasonable mind might accept as adequate to support a conclusion.” Id. (quoting 18 Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)) (citation modified). The Ninth 19 Circuit explained that substantial evidence is “more than a mere scintilla, but less than a 20 preponderance.” Revels v. Berryhill, 874 F.3d 648, 654 (9th Cir. 2017) (quoting 21 Desrosiers v. Sec’y of Health & Hum. Servs., 846 F.2d 573, 576 (9th Cir. 1988)) (citation 22 modified). 23 The reviewing court “must consider the entire record as a whole, weighing both 24 the evidence that supports and the evidence that detracts from the Commissioner’s 25 conclusion, and may not affirm simply by isolating a specific quantum of supporting 26 evidence.” See Garrison v. Colvin, 759 F.3d 995, 1009 (9th Cir. 2014) (quoting 27 Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007)) (citation modified). Overall, 2 Where the evidence is susceptible to more than one rational interpretation, the ALJ’s 3 decision must be upheld. See Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008) 4 (citation modified) (quoting Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1193 5 (9th Cir. 2004)). This includes deferring to the ALJ’s credibility determinations and 6 resolutions of evidentiary conflicts. See Lewis v. Apfel, 236 F.3d 503, 509 (9th Cir. 2001) 7 (citing Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998)). Thus, the court may 8 overturn the ALJ’s decision only if the ALJ’s conclusions are not supported by substantial 9 evidence or the ALJ applied the wrong legal standard. Smith v. Kijakazi, 14 F. 4th 1108, 10 1111 (9th Cir. 2021); Batson, 359 F.3d at 1193. However, the reviewing court “may not 11 reverse an ALJ’s decision on account of an error that is harmless.” Molina v. Astrue, 674 12 F.3d 1104, 1111 (9th Cir. 2012) (citing Stout v. Comm’r Soc. Sec. Admin., 454 F.3d 1050, 13 1055–56 (9th Cir. 2006)), superseded on other grounds as stated in Thomas v. Saul, 830 14 F. App'x 196, 198 (9th Cir. 2020). 15 V. DISCUSSION 16 A. Whether the ALJ Properly Considered Plaintiff’s Subjective Symptom Testimony 17 Plaintiff argues the ALJ failed to articulate clear and convincing reasons supported 18 by substantial evidence for rejecting his subjective symptom testimony. (ECF No. 15 at 19 10–14.) In response, the Commissioner argues the ALJ’s decision should be upheld 20 because he “reasonably found Plaintiff’s impairments were not as severe as alleged 21 because Plaintiff reported improvement with medication, he had normal medical 22 imaging and physical examinations, and there were large gaps in the treatment record, 23 especially during the relevant period of 2006 to 2008.” (ECF No. 18 at 20 citing AR 21– 24 22.) 25 1. Applicable law 26 When evaluating the credibility of a claimant’s allegations regarding subjective 27 symptoms such as pain, the ALJ must engage in a two-step analysis. Johnson v. Kijakazi, 2 an underlying impairment that “could reasonably be expected to produce the pain or 3 other symptoms alleged.” Trevizo v. Berryhill, 871 F.3d 664, 678 (9th Cir. 2017) (quoting 4 Garrison, 759 F.3d at 1014–15), superseded on other grounds as stated in Kristin M.A. v. 5 O'Malley, No. 23-CV-64-JMK, 2024 WL 21395, at *5 (D. Alaska Jan. 2, 2024). The 6 claimant is not required to show that an underlying impairment could reasonably be 7 expected to cause the severity of the pain or other symptoms alleged, but only that it 8 could have reasonably caused some degree of the symptoms. Vasquez v. Astrue, 572 9 F.3d 586, 591 (9th Cir. 2009) (citing Lingenfelter, 504 F.3d at 1036). 10 Second, if the claimant meets the first step and there is no evidence of 11 malingering, then the ALJ may reject the claimant’s statements about the severity of her 12 symptoms “only by offering specific, clear and convincing reasons for doing so.” 13 Trevizo, 871 F.3d at 678 (quoting Garrison, 759 F.3d at 1014–15). “The clear and 14 convincing standard is the most demanding required in Social Security cases.” Revels, 15 874 F.3d at 655 (citation modified). General findings are insufficient, and the ALJ must 16 identify which specific pain and symptom statements are being discounted and what 17 evidence undermines those claims. See Lambert v. Saul, 980 F.3d 1266, 1277 (9th Cir. 18 2020) (citing Treichler v. Comm’r Soc. Sec. Admin., 775 F.3d 1090, 1102 (9th Cir. 2014)); 19 see also Burch v. Barnhart, 400 F.3d 676, 680 (9th Cir. 2005) (“The ALJ must specify what 20 testimony is not credible and identify the evidence that undermines the claimant’s 21 complaints.”). 22 “Because symptoms, such as pain, are subjective and difficult to quantify,” the ALJ 23 must consider “all of the evidence presented,” including information about the 24 claimant’s prior work record, statements about their symptoms, evidence submitted by 25 medical sources, and observations by the Agency’s employees and other persons. 20 26 C.F.R §§ 404.1529(c)(3), 416.929(c)(3). Factors the ALJ may consider, in addition to 27 objective medical evidence, include Plaintiff’s daily activities; the location, duration, 2 alleviate pain; treatment; and any other measures used to relieve pain. 20 C.F.R. 3 §§ 404.1529(c)(3), 416.929(c)(3); Social Security Ruling (“SSR”) 16-3P, 2017 WL 5180304, 4 at *7–8 (S.S.A. Oct. 25, 2017). The ALJ may also consider inconsistencies between 5 Plaintiff’s statements regarding pain and the medical evidence. 20 C.F.R. 6 §§ 404.1529(c)(4), 416.929(c)(4); SSR 16-3p, 2017 WL 5180304, at *8–9. 7 2. Plaintiff’s testimony 8 At the administrative hearing on August 15, 2023, Plaintiff testified he last worked 9 in 2021 as a musician. (AR 34.) Plaintiff reported he experiences “all day pain” and 10 “severe fatigue affecting every branch of [his] body” due to severe chronic fatigue 11 syndrome. (AR 35.) Plaintiff reported at baseline, he feels like he has “the flu, a 12 hangover and [he] ran a marathon.” (AR 44.) Additionally, Plaintiff testified “within 13 chronic fatigue syndrome, [there] are unpredictable and predictable crashes, also 14 known as post-exertional malaise” that leave Plaintiff “bed-bound for up to weeks at a 15 time.” (AR 35.) Plaintiff explained “after exposure to physical and cognitive stressors,” 16 his symptoms worsen and result in “slow information processing, learning, [and] 17 ret[ention].” (AR 39.) Plaintiff testified he is “[n]o longer able to sight read professional 18 level music notation,” “compose,” “keep up with apartment, house cleaning,” and has 19 “[l]imited reading” and “direction following” abilities. (AR 39–40.) Plaintiff testified that 20 from 2006 to 2008 he could not do “over 15 minutes of anything mentally exertive” or 21 “over 30 minutes of mindless housecleaning or enjoyable bass playing without needing 22 to lie down or recline for long periods of time, at least 45 minutes.” (AR 41.) 23 Additionally, Plaintiff testified he could not stand for more thirty minutes at a time, 24 could not sit for more than forty-five to sixty minutes at a time, and he has “not been 25 able to lift a gallon of milk with one arm since the end of 2009 [due to] a neck injury.” 26 (AR 42.) 27 Plaintiff testified between approximately 2001 and 2010, he lived alone and “did 2 [his] body.” (AR 37–38.) His “parents have been [his] caregivers since January of 2010.” 3 (AR 37.) When asked about what he does throughout the day, Plaintiff responded he is 4 “definitely housebound for the most part.” (Id.) Plaintiff reported “treatment and 5 medication have definitely helped lessen some of the severity of the symptoms,” but “as 6 far as curing anything, no, no success.” (AR 36.) Plaintiff testified that “there has been a 7 lot of treatment; hyperbaric chamber, a lot of electronic stimulation,” and his treatment 8 is currently “a matter of pacing and homecare, just lots of medication, lots of 9 supplements, lots of diet.” (Id.) 10 3. The ALJ’s findings 11 The ALJ began his credibility analysis by summarizing Plaintiff’s testimony as 12 follows: 13 The claimant is a 51-year-old man who alleges disability due to chronic fatigue (myalgic encephalomyelitis) and chronic tension headaches. He 14 alleges that he stopped working in December 2021 due to his alleged 15 impairments. He alleges that everything is worse. He alleges difficulty with household tasks, personal care and getting around. He alleges that he does 16 not engage in social activities. He alleges that he is more confined to bed 17 than ever. He alleges chronic pain. He alleges increased dizziness. 18 (AR 21.) 19 The ALJ then found Plaintiff’s “medically determinable impairments could 20 reasonably be expected to cause the alleged symptoms; however, [Plaintiff’s] 21 statements concerning the intensity, persistence and limiting effects of these symptoms 22 are not entirely consistent with the medical evidence and other evidence in the record 23 for the reasons explained in this decision.” (AR 21–22.) 24 The ALJ next summarized the following medical records: 25 • November 2002 Kaiser Permanente (“Kaiser”) treatment notes documenting Plaintiff had “complained of headaches for four months, 26 worse with physical activity.” (AR 22.) A CT scan of Plaintiff’s head was 27 normal, and Plaintiff reported good results with over the counter 2 • January 2003 Kaiser treatment notes documenting Plaintiff 3 “complained of persistent headaches occurring daily” and “chronic fatigue and difficulty sleeping.” (AR 22.) Plaintiff was not interested in taking 4 medication and “reported improved allergy symptoms since moving 5 residences.” (Id.) Plaintiff’s physical examination was noted as normal. (AR 22 citing AR 1090–93.) 6 7 • February 2003 Kaiser treatment notes documenting Plaintiff “reported no significant improvement in his fatigue with CPAP use,” and a 8 CT scan of his “brain [sic] was unremarkable.” (AR 22 citing AR 1094–96.) 9 • March 2003 Kaiser treatment notes documenting Plaintiff “continued 10 to complain of headaches” and “reported an inability to perform his 11 activities of daily living from feeling tired.” (AR 22.) Plaintiff reported that “his headaches disappeared and his fatigue improved significantly with 12 allergy medication.” (AR 22 citing AR 1097–99.) 13 • April 2003 Kaiser treatment notes documenting Plaintiff reported 14 that “his headaches were relieved with Motrin, but he was not currently 15 taking any medication for his headaches.” (AR 22 citing AR 1100–01.) 16 • May 2003 Kaiser treatment notes documenting Plaintiff “complained 17 of excessive fatigue and headaches,” and Plaintiff’s “physical examination 18 was normal.” (AR 22.) “It was noted that anxiety and depression may be causing his symptoms.” (AR 22 citing AR 1101–03.) 19 20 • July 2003 Kaiser treatment notes revealed Plaintiff “complained of ongoing headaches” and “denied any associated symptoms.” (AR 22.) 21 Plaintiff reported “mild improvement of his headaches with medication 22 from Mexico.” (Id.) Plaintiff continued to report “overwhelming fatigue and headaches.” (Id.) An “extensive work-up” was negative. (AR 22 citing 23 AR 1106–08.) 24 • March 2006 Tri-Life Health PC (“Tri-Life”) treatment notes revealed 25 Plaintiff “complained of chronic fatigue and headaches” and underwent 26 “detoxification” treatment at Tri-Life in 2006. (AR 22 citing AR 1136–1269.) 27 2 4. Analysis The ALJ satisfied step one when he found Plaintiff’s “medically determinable 3 impairments could reasonably be expected to cause the alleged symptoms.” (AR 21); 4 accord Vasquez, 572 F.3d at 591 (finding ALJ “satisfied the first prong of the ALJ’s inquiry 5 regarding the credibility of [plaintiff’s] complaints” where the “ALJ acknowledged that 6 [plaintiff’s] injuries could reasonably be expected to produce some of the pain and other 7 symptoms alleged”) (citation modified). 8 The ALJ, however, erred at the second step, which allows the ALJ to reject 9 Plaintiff’s testimony about the severity of his pain only by providing “specific, clear, and 10 convincing” reasons supported by substantial evidence. See Brown-Hunter v. Colvin, 11 806 F.3d 487, 489 (9th Cir. 2015) (holding the ALJ must provide clear and convincing 12 reasons to reject testimony to ensure testimony is not rejected arbitrarily); see also Leza 13 v. Kijakazi, No. 21-16079, 2022 WL 819782, at *2 (9th Cir. Mar. 17, 2022) (citing 14 Garrison, 759 F.3d at 1009.) The ALJ “must specifically identify the testimony she or he 15 finds not to be credible and must explain what evidence undermines the testimony.” 16 Holohan v. Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001). While the ALJ may “provide 17 a relatively detailed overview of [plaintiff’s] medical history, ‘providing a summary of 18 the medical evidence . . . is not the same as providing clear and convincing reasons for 19 finding the claimant’s symptom testimony not credible.’” Lambert, 980 F.3d at 1278 20 (quoting Brown-Hunter, 806 F.3d at 494). Failure to identify specific testimony will 21 render the Court unable to review the ALJ’s determination without “substitut[ing] our 22 conclusions for the ALJ’s, or speculat[ing] as to the grounds for the ALJ’s conclusions.” 23 Treichler, 775 F.3d at 1103; see also Brown-Hunter, 806 F.3d at 494 (finding “the 24 inconsistencies identified independently by the district court cannot provide the basis 25 upon which we can affirm the ALJ’s decision”). 26 Here, the ALJ did not meet the clear and convincing standard because he failed to 27 2 “statements concerning the intensity, persistence and limiting effects of these 3 symptoms are not entirely consistent with the medical evidence and other evidence in 4 the record” by summarizing Plaintiff’s testimony and select medical evidence. (AR 21– 5 22.) This boilerplate language and vague reference to Plaintiff’s testimony does not 6 provide “specific, clear, and convincing” reasons supported by substantial evidence for 7 discounting a claimant’s subjective testimony. See, e.g., Treichler, 775 F.3d at 1103 8 (holding the same boilerplate statement “falls short of meeting the ALJ’s responsibility 9 provide a discussion of the evidence and the reasons” for rejecting plaintiff’s subjective 10 testimony) (citation modified); see also Vasquez, 572 F.3d at 592 (finding the “vague 11 allegation that [plaintiff’s claims] were ‘not consistent with the objective medical 12 evidence’” was inadequate to reject plaintiff’s subjective symptom testimony). 13 Based on the foregoing, the Court finds the ALJ failed to provide clear and 14 convincing reasons supported by substantial evidence for discounting Plaintiff’s 15 subjective symptom testimony. Moreover, this error was not harmless because it 16 prevents the Court from conducting a meaningful review of the ALJ’s findings. See 17 Brown-Hunter, 806 F.3d at 494 (finding ALJ’s improper discrediting of plaintiff’s 18 testimony is not harmless error because the Court “cannot discern the agency's path 19 [where] ALJ made only a general credibility finding without providing any reviewable 20 reasons why she found [the plaintiff’s] testimony to be not credible.”) 21 B. Whether the ALJ’s RFC Determination is Supported by Substantial Evidence 22 Plaintiff also argues the ALJ’s RFC determination is not supported by substantial 23 evidence. (ECF No. 15 at 4–10.) The Commissioner counters the ALJ properly 24 25 4 The Commissioner argues the ALJ properly discredited Plaintiff’s testimony based on normal findings 26 and failure to seek treatment, and gaps in treatment. (ECF No. 18 at 18–19.) However, the ALJ did not offer these reasons as a basis for discrediting Plaintiff’s testimony and the Court’s review is limited to 27 the reasons stated in the ALJ’s decision. Burrell v. Colvin, 775 F.3d 1133, 1139 (9th Cir. 2014) (declining 2 ALJ’s RFC was not identical to any medical opinion or the prior administrative medical 3 findings (PAMF) does not deprive the ALJ’s RFC assessment of substantial evidence 4 support.” (ECF No. 18 at 7–16.) 5 1. Applicable law 6 The RFC is a claimant’s ability to do work-related activities on a sustained basis 7 (i.e., eight hours a day, five days per week). Titles II & XVI: Assessing Residual Functional 8 Capacity in Initial Claims, Social Security Ruling (“SSR”) 96-8P, 1996 WL 374184, at *1 9 (S.S.A. July 2, 1996). It represents the maximum amount of work a claimant can 10 perform despite their limitations, based on all relevant evidence in the record. 20 C.F.R. 11 § 416.945(a)(1); 20 C.F.R. § 404.1545(a)(1). In making this finding, the ALJ must consider 12 all the claimant’s medically determinable impairments, including those that are non- 13 severe. 20 C.F.R. § 404.1545(a)(2); see also Buck v. Berryhill, 869 F.3d 1040, 1049 (9th 14 Cir. 2017) (quoting SSR 96-8P, 1996 WL 374184, at *5). “The RFC therefore should be 15 exactly the same regardless of whether certain impairments are considered ‘severe’ or 16 not.” Buck, 869 F.3d at 1049. 17 The ALJ must consider the claimant’s testimony regarding their capabilities, as 18 well as all relevant evidence, including medical records, lay evidence, and pain. 19 Chaudhry v. Astrue, 688 F.3d 661, 670 (9th Cir. 2012); Robbins v. Soc. Sec. Admin., 466 20 F.3d 880, 883 (9th Cir. 2006); SSR 96-8P, 1996 WL 374184, at *5. The ALJ’s RFC 21 determination also must be supported by “the opinion of a treating or examining 22 physician” describing “[p]laintiff’s level of functional limitation.” Hayes v. Colvin, No. 16- 23 CV-140-JLS, 2016 WL 11281409, at *6 (S.D. Cal. Dec. 19, 2016) (citation modified); see 24 also Tackett v. Apfel, 180 F.3d 1094, 1103 (9th Cir. 1999) (finding error where “[t]here is 25 no medical evidence to support the ALJ’s [RFC] finding”). “[T]he ALJ may not rely on his 26 own unsupported interpretation of the medical evidence.” Ellen S. v. O’Malley, No. 22- 27 CV-1622-DEB, 2024 WL 584437, at *2 (S.D. Cal. Feb. 12, 2024) (citation modified). When 2 640 F.3d 881, 885 (9th Cir. 2011); Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir. 3 2001). 4 2. Summary of medical opinions 5 The ALJ considered the following medical opinions when formulating Plaintiff’s 6 RFC: 7 • David Chun, MD: Dr. Chun treated Plaintiff and prescribed him medications between October 10, 2002, and January 7, 2003. (AR 1267– 8 69.) On March 21, 2003, Dr. Chun wrote a letter on behalf of Plaintiff 9 explaining Plaintiff’s “symptoms improve when away from the work environment for a few days and worsens when he returns to work.” (AR 10 255, 398.) Dr. Chun noted an allergen in the work environment may have 11 caused Plaintiff’s symptoms. (Id.) 12 • Roger Billica, MD, FAAFP: Dr. Brillica treated Plaintiff for chronic 13 fatigue syndrome and fungal infections from January 2006 to February 2008. (AR 395, 1141, 1196–1224.) On October 17, 2007, Dr. Billica wrote a 14 letter on behalf of Plaintiff with the subject line “Medi-Cal Insurance 15 coverage for [Plaintiff].” (AR 395, 1141.) Dr. Billica stated he had been treating Plaintiff since January 2006 for chronic fatigue syndrome and 16 fungal infections. (Id.) Dr. Billica opined that Plaintiff “continues to be 17 seriously impaired with his fatigue and is unable to work and is barely functional for activities of daily living.” (Id.) Dr. Billica noted, “[Plaintiff] 18 suffers from chronic headaches, insomnia, poor mental focus, and extreme 19 fatigue.” (Id.) 20 • Dan O. Harper, MD: Dr. Harper treated Plaintiff for chronic fatigue 21 syndrome from April 2008 through April 2012. (AR 396.) On April 3, 2012, Dr. Harper wrote a letter to Plaintiff’s homeowners association requesting 22 his family be allowed to continue to care for Plaintiff at his residential 23 complex. (Id.) Dr. Harper stated he had been treating Plaintiff for chronic fatigue syndrome since 2008. (Id.) Dr. Harper stated, “[t]here are times 24 that [Plaintiff] is bedridden for weeks, and other times [Plaintiff] is 25 ‘functional’ but very fatigued.” (Id.) Dr. Harper stated Plaintiff’s mother and stepfather were his caregivers during “times of disability,” noting these 26 periods were “most of the time now, but getting less severe or prolonged.” 27 (Id.) 2 reviewed Plaintiff’s medical records and prepared a Disability Determination Explanation report dated August 26, 2022. (AR 52–60.) Dr. 3 Singh opined the “evidence available is insufficient to assess severity and limitation.” (AR 57.) He noted “[t]here is no indication that there is a 4 medical opinion from any medical source” and there were “[n]o 5 RFC/[Mental] RFC assessments are associated with this claim.” (AR 58.) 6 • M. Mazuryk, MD: Dr. Mazuryk, a state agency medical consultant, 7 reviewed Plaintiff’s medical records and prepared a Disability Determination Explanation report dated December 22, 2022. (AR 61–69.) 8 Dr. Mazuryk, opined “there is essentially no useful [Medical Evidence of 9 Record] prior to [Date Last Insured],” and there is “insufficient evidence to even determine a physical [Medically Determinable Impairment] during this 10 timeframe.” (AR 65.) Dr. Mazuryk noted “[t]here is no indication that there 11 is a medical opinion from any medical source” and “[n]o RFC/[Mental] RFC assessments are associated with this claim.” (AR 67.) 12 13 3. The ALJ’s RFC finding 14 The ALJ determined Plaintiff “had the [RFC] to perform light work as defined in 20 15 CFR 404.1567(b) except he was unable to climb ladders, ropes, or scaffolds. He was able 16 to occasionally climb ramps and stairs, balance, stoop, kneel, crouch, and crawl. He was 17 able to perform simple work.” (AR 21.) 18 Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the 19 weight lifted may be very little, a job is in this category when it requires a 20 good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered 21 capable of performing a full or wide range of light work, you must have the 22 ability to do substantially all of these activities. If someone can do light work, we determine that he or she can also do sedentary work, unless there are 23 additional limiting factors such as loss of fine dexterity or inability to sit for 24 long periods of time. 25 20 CFR 404.1567(b). 26 The ALJ supported his RFC finding by explaining he “considered all symptoms and 27 to the extent to which these symptoms can reasonably be accepted as consistent with 2 prior administrative findings. (AR 21.) 3 The ALJ then summarized Plaintiff’s subjective symptom testimony and select 4 Kaiser treatment notes and found Plaintiff’s testimony was “not entirely consistent with 5 the medical evidence and other evidence in the record,” as discussed supra. (AR 21–22 6 citing AR 178–187, 198–203, 204–210.) 7 Next, he summarized the five medical opinions above and found none of these 8 opinions to be persuasive. (AR 23.) He reported he also considered non-medical 9 opinions provided by Plaintiff’s family and friends and found “certain aspects of their 10 opinions” were consistent with the ALJ’s RFC determination, but the opinion that 11 Plaintiff “is unable to perform any basic work activity is inconsistent with the record.” 12 (AR 24 citing 228, 245, 248.) Ultimately, the ALJ concluded “through the date last 13 insured, the objective medical evidence . . . established that [Plaintiff] had a greater 14 sustained capacity than [he] allege[d].” (Id.) 15 4. Analysis 16 Plaintiff argues the ALJ’s RFC determination is not supported by substantial 17 evidence because there is no medical opinion or other evidence supporting the ALJ’s 18 RFC finding. (ECF No. 15 at 4–10.) The Commissioner responds the RFC determination 19 does not need to “match a particular medical opinion or prior administrative medical 20 finding” to be supported by substantial evidence. (ECF No. 18 at 7–8, 12.) 21 The Court first notes the ALJ based his RFC finding in part on Plaintiff’s subjective 22 symptom testimony, which the Court has already determined was improperly 23 discredited. The RFC determination is, therefore, not supported by substantial evidence 24 because of this error. See Ferguson v. O'Malley, 95 F.4th 1194, 1199 (9th Cir. 2024) 25 (“Substantial evidence does not support an ALJ's RFC assessment if the ALJ improperly 26 rejected [the claimant's] testimony as to the severity of his pain and symptoms.”) 27 (citation modified). 2 medical opinion or other evidence to support the ALJ’s finding regarding Plaintiff’s 3 functional abilities. (See AR 58, 67.) (State agency medical consultants Dr. Singh and Dr. 4 Mazuryk individually reported there was no medical opinion regarding Plaintiff’s 5 RFC/Mental RFC in the record); see also Ellen S., 2024 WL 584437, at *2–3 (noting two 6 state agency consultants recognized the record lacked any medical opinion or other 7 evidence regarding plaintiff’s functional abilities and finding RFC was not supported by 8 substantial evidence without this evidence); Hayes, 2016 WL 11281409, at *6–8 (finding 9 an RFC is not supported by substantial evidence when there is no medical opinion as to 10 the functional abilities of the plaintiff); Howell v. Kijakazi, No. 20-CV-2517-BLM, 2022 WL 11 2759090, at *7 (S.D. Cal. July 14, 2022) (“Barring a few exceptions, an ALJ must have a 12 doctor’s opinion of a claimant’s functional capacity in order for there to be substantial 13 evidence supporting the decision.”). 14 Based on the foregoing, the Court finds the ALJ’s RFC finding is not supported by 15 substantial evidence. Moreover, this error is not harmless because the ALJ’s RFC 16 determination directly affects the nondisability determination. See Ellen S., 2024 WL 17 584437, at *3–4 (“A properly formulated RFC might support a conclusion that Plaintiff 18 was not disabled.”). 19 VI. CONCLUSION 20 The reviewing court may enter a “judgment affirming, modifying, or reversing” 21 the Commissioner’s decision. 42 U.S.C. § 405(g). The reviewing court may also remand 22 the case to the Social Security Administration for further proceedings. Id. The reviewing 23 court has discretion in determining whether to remand for further proceedings or award 24 benefits. Salvador v. Sullivan, 917 F.2d 13, 15 (9th Cir. 1990); McAllister v. Sullivan, 888 25 F.2d 599, 603 (9th Cir. 1989). Remand for further proceedings is warranted where 26 additional administrative proceedings could remedy defects in the decision. Kail v. 27 Heckler, 722 F.2d 1496, 1497 (9th Cir. 1984). Remand for the payment of benefits is 1 || proceedings, where the record has been fully developed, or where remand would 2 || unnecessarily delay the receipt of benefits to which the disabled plaintiff is entitled. 3 || Benecke v. Barnhart, 379 F.3d 587, 593 (9th Cir. 2004); Hoffman v. Heckler, 785 F.2d A || 1423, 1425 (9th Cir. 1986); Bilby v. Schweiker, 762 F.2d 716, 719 (9th Cir. 1985); Kornock 5 ||v. Harris, 648 F.2d 525, 527 (9th Cir. 1980). 6 In this case, Plaintiff asks this Court to reverse and remand for further 7 || proceedings. (ECF No. 15 at 14.) The Court finds that remand for further proceedings is 8 || warranted because additional administrative proceedings could remedy the defects in 9 ALJ’s decision. Therefore, the Court ORDERS judgment be entered REVERSING the 10 || decision of the Commissioner and REMANDING this matter for further administrative 11 || proceedings consistent with this Order and pursuant to sentence four of 42 U.S.C. § 12 || 405(g). The Court DIRECTS the Clerk of Court to close the case. 13 ||Dated: August 31, 2026 = _ 2 SF — 1s Honorable Michael S. Berg United States Magistrate Judge 16 17 18 19 20 21 22 23 24 25 26 27 28