Smith v. Commissioner of Social Security

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF HAWAI‘I JENNIFER S., Civil No. 25-00418 MWJS-WRP Plaintiff, ORDER REVERSING DECISION OF THE COMMISSIONER OF SOCIAL SECURITY vs. AND REMANDING FOR FURTHER ADMINISTRATIVE PROCEEDINGS FRANK BISIGNANO, Commissioner of Social Security, Defendant. ORDER REVERSING DECISION OF THE COMMISSIONER OF SOCIAL SECURITY AND REMANDING FOR FURTHER ADMINISTRATIVE PROCEEDINGS This is an appeal from a decision of the Commissioner of Social Security denying an application for disability benefits. Like many such appeals, this one turns on whether the Commissioner (acting here through an Administrative Law Judge, or “ALJ”) offered sufficient reasons to reject Plaintiff Jennifer S.’s testimony about the severity of her symptoms.1 At a hearing before the ALJ, Plaintiff testified that although she holds a law degree and has worked several jobs over the years, she has been unable to maintain 1 For reasons explained in Sergio D.L.S. v. Warden, Cal. City Corr. Ctr., No. 1:26-cv- 02821-MWJS, 2026 WL 1049713, at *1 n.1 (E.D. Cal. Apr. 17, 2026), only Plaintiff’s first name and the initials of her last name are used in this order. regular employment—and has been terminated from multiple recent positions— because of excessive absences. These absences, Plaintiff testified, were the result of her frequent migraines and other medical conditions, including coughing, fatigue, malaise, and facial pain from chronic sinusitis. Dkt. No. 15-1, at PageID.111-120 (Administrative Record (AR) at 77-86). No party disputes that if the ALJ had accepted Plaintiff’s testimony, she would have been found disabled within the meaning of the Social Security Act and entitled to benefits. The ALJ found no evidence that Plaintiff was malingering, or feigning, her symptoms. And the ALJ recognized that Plaintiff’s severe impairments—which the ALJ found to include “obesity; degenerative disc disease; peripheral neuropathy; migraines; hypothyroidism and history of nodules and follicular thyroid cancer status post February 2022 thyroidectomy; depression; [and] anxiety”—could reasonably have produced the symptoms and pain alleged. Id. at PageID.54 (AR at 20). Nonetheless, the ALJ found that Plaintiff’s symptom testimony was not credible. The key question in this appeal is whether the ALJ offered “specific, clear and convincing reasons” for rejecting Plaintiff’s symptom testimony. Brown-Hunter v. Colvin, 806 F.3d 487, 492-93 (9th Cir. 2015) (cleaned up). Given the narrowness of this issue, the court will not recount the factual or procedural background of this case, except as necessary to provide context for the court’s ruling. That background is laid out in detail in the ALJ’s written decision. Dkt. No. 15-1, at PageID.48-67 (AR at 14-33).2 In that written decision, the ALJ offered three categories of reasons for rejecting Plaintiff’s symptom testimony, and the Commissioner defends each in his answering brief. See Dkt. No. 22, at PageID.2524-2527. In evaluating these reasons, the court is mindful that the Commissioner’s disability determination should be reversed only when “it is either not supported by substantial evidence or is based upon legal error.” Luther v. Berryhill, 891 F.3d 872, 875 (9th Cir. 2018). This standard is deferential, requiring “only such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Woods v. Kijakazi, 32 F.4th 785, 788 (9th Cir. 2022) (cleaned up). But there is an important limit to this deference: while a reviewing court “will not fault the agency merely for explaining its decision with less than ideal clarity,” it still must “demand that the agency set forth the reasoning behind its decisions in a way that allows for meaningful review.” Brown-Hunter, 806 F.3d at 492 (cleaned up). That is to say, a “clear statement of the agency’s reasoning is necessary because we can affirm 2 The court also trusts that the reader is familiar with—or can readily look up—the standards an ALJ generally must follow in considering an application for Social Security disability benefits. See generally Keyser v. Comm’r Soc. Sec. Admin., 648 F.3d 721, 724 (9th Cir. 2011) (describing the “five-step sequential process for determining whether an applicant is disabled within the meaning of the Social Security Act”). As the court will resolve this appeal on the narrow issue presented in the text above, no further discussion of these standards is needed here. the agency’s decision to deny benefits only on the grounds invoked by the agency.” Id. And to qualify as an adequately “clear statement” rejecting a claimant’s symptom testimony, the ALJ’s finding “must be sufficiently specific to allow a reviewing court to conclude the adjudicator rejected the claimant’s testimony on permissible grounds and did not arbitrarily discredit a claimant’s testimony regarding pain.” Id. at 493 (cleaned up). Put differently, “[g]eneral findings are insufficient; rather, the ALJ must identify what testimony is not credible and what evidence undermines the claimant’s complaints.” Id. (cleaned up). The ALJ did not meet these requirements here. And because she did not, the decision denying benefits must be reversed and the matter remanded for further administrative proceedings. 1. Consider the first of the ALJ’s reasons for rejecting Plaintiff’s symptom testimony. As the Commissioner notes, the ALJ found that Plaintiff received “conservative treatment” for her allegedly disabling recurrent sinus infections. Dkt. No. 22, at PageID.2524 (quoting Dkt. No. 15-1, at PageID.57 (AR at 23)). In particular, the Commissioner points to the ALJ’s finding that when Plaintiff complained of chronic sinusitis to her doctor, “she was instructed to use only Flonase and ongoing nasal irrigation.” Id. at PageID.2525. And while the doctor contemplated whether surgery was needed, it ultimately was not ordered. Id. The Commissioner relies on Parra v. Astrue, 481 F.3d 742 (9th Cir. 2007), for the proposition that “‘[e]vidence of conservative treatment is sufficient to discount a claimant’s testimony regarding severity of an impairment.’” Dkt. No. 22, at PageID.2524-25 (quoting Parra, 481 F.3d at 751). But “[n]othing in Parra suggests that an ALJ can characterize a course of treatment as conservative when the evidence in the record—or, at a minimum, inferences fairly drawn from the record—do not reflect that a more aggressive treatment option was available.” Loniza v. King, Civ. No. 23-00352, 2025 WL 435943, at *6 (D. Haw. Feb. 7, 2025). In other words, a “claimant cannot be discredited for failing to pursue non-conservative treatment options where none exist.” Id. at *5 (quoting Lapeirre-Gutt v. Astrue, 382 F. App’x 662, 664 (9th Cir. 2010)). Although the ALJ pointed to a doctor’s consideration of surgery as a possible treatment, nothing in the record supports the inference that a doctor ever concluded that it was an appropriate intervention, let alone that Plaintiff ever rejected the option. And the ALJ identified no other more aggressive form of treatment that could have been offered to Plaintiff if her symptoms were as severe as she reported them to be. The ALJ’s reference to conservative treatment, on this record, does not qualify as a “specific, clear and convincing” reason for rejecting Plaintiff’s symptom testimony. Brown-Hunter, 806 F.3d at 492-93. 2. Of course, if a form of treatment—whether conservative or not—actually addresses a claimant’s symptoms, then that might be an independent reason to conclude that their symptom testimony is not credible. See Wellington v. Berryhill, 878 F.3d 867, 876 (9th Cir. 2017) (“[E]vidence of medical treatment successfully relieving symptoms can undermine a claim of disability.”). And that indeed was the ALJ’s second reason offered for rejecting Plaintiff’s testimony in this case. According to the ALJ, Plaintiff received “adequate pain control and headache control” from the treatment she received. Dkt. No. 15-1, at PageID.57 (AR at 23). This reasoning goes part of the way. In support of her finding, the ALJ identified medical records showing that Plaintiff’s migraine headaches responded well to medication and ultimately became a much less significant issue for her. Dkt. No. 22, at PageID.2525-26 (summarizing records). Those records arguably provide substantial evidence to support the ALJ’s conclusion that Plaintiff’s headaches did not render her unable to work. But even if so, they still do not support a rejection of Plaintiff’s independent testimony about her chronic sinusitis, which Plaintiff testified would, in the relevant time period, incapacitate her—and thus require unexcused absences from work—“almost monthly” or “at least every other month.” Dkt. No. 15-1, at PageID.116 (AR at 82). And while these sinusitis symptoms flared relatively infrequently, they were extraordinarily severe: Plaintiff testified that she would be in so much pain that it “literally felt as if someone had come up and hit me in the side of the face [with] a sledgehammer.” Id.; see also id. (explaining that when experiencing these symptoms, she was in too much pain to be around other people in public). Though infrequent, these sinusitis episodes were recurrent and severe enough to contribute to Plaintiff’s inability to maintain employment. And the ALJ’s reliance on medical records concerning Plaintiff’s headaches leaves the testimony about chronic sinusitis untouched. Accordingly, although the ALJ may well have appropriately addressed Plaintiff’s migraine headaches, the ALJ’s reliance on improvement through treatment does not fully support—or at least the ALJ did not adequately explain why it fully supports—rejecting Plaintiff’s symptom testimony in its entirety.3 3. That leaves the ALJ’s third and final set of reasons for rejecting Plaintiff’s symptom testimony: Plaintiff’s activities of daily living. It is appropriate for an ALJ to compare a claimant’s symptom testimony to their activities of daily living, to see whether the claimant “participate[s] in activities that are inconsistent with the limitations they allege.” Auapaau v. O’Malley, Civ. No. 24-00176, 2024 WL 4301378, at *3 (D. Haw. Sept. 26, 2024). But “there is a danger in conducting an analysis of that sort, for ‘disability claimants should not be penalized for attempting to lead’ their ‘lives in the face of their limitations.’” Id. (quoting Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998)). For that reason, the “the Ninth Circuit has provided guidelines 3 To be sure, the record shows that after the relevant disability period (that is, after March 31, 2021, the last date on which Plaintiff’s work history provided her disability insurance coverage, see Dkt. No. 15-1, at PageID.52 (AR at 18)), Plaintiff’s chronic sinusitis improved for reasons Plaintiff could not explain. See id. at PageID.117 (AR at 83). But the ALJ did not suggest that this after-the-fact improvement bore on the severity of Plaintiff’s symptoms during the relevant time period (just as the aggravation of any condition after-the-fact would not have done so). for using evidence of a claimant’s activities of daily living to assess a claimant’s symptom testimony”: they “may be found to bear on the credibility of a claimant’s testimony only if (1) the activities actually contradict the claimant’s symptom testimony, or (2) they show that the claimant spends a substantial part of their day engaged in pursuits that are transferrable to a work setting.” Id. (citing Orn v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007)). The ALJ did not satisfy these guidelines here. The ALJ relied on Plaintiff’s testimony that she took care of her elderly mother and handled various chores at her mother’s house. Dkt. No. 15-1, at PageID.59 (AR at 25). But the ALJ did not explain why Plaintiff’s ability to generally handle these chores would contradict Plaintiff’s testimony that she occasionally—at least one a month or every other month—was incapable of performing any tasks, and the record reveals no obvious contradiction. Nor does the record show that Plaintiff spent any substantial part of her day on these activities. Same for the ALJ’s reliance on evidence that Plaintiff worked “part time” as a caregiver for some other elderly couple. Id. Despite the ALJ’s responsibility to develop the record in the face of any ambiguities, see Tonapetyan v. Halter, 242 F.3d 1144, 1150 (9th Cir. 2001), the ALJ did not ask Plaintiff any questions about this arrangement at the hearing. The record therefore does not disclose how many hours Plaintiff worked, how flexible her schedule was, and whether Plaintiff was allowed to regularly take days off whenever her symptoms required it. The record at it stands, then, does not support the ALJ’s conclusion that Plaintiff’s part time caregiving contradicted Plaintiff’s symptom testimony. Nor does it support the conclusion that Plaintiff spent any substantial part of her day on this activity. The ALJ also relied on a medical record that noted Plaintiff cared for an “infant niece.” Dkt. No. 15-1, at PageID.57 (AR at 23). Perhaps one could reasonably infer that a person primarily responsible for the care of an infant is not likely to have much flexibility in their schedule. But as Plaintiff observes in her briefing, there is no evidence in the record that Plaintiff had an infant niece in the relevant time period. Dkt. No. 21, at PageID.2509-10. And while Plaintiff did have a then-three-year-old niece, the record does not disclose how extensive Plaintiff’s responsibility for this niece really was—whether an occasional weekend or something more substantial. Nor does it reflect whether Plaintiff was ever the sole guardian of her niece, or whether she instead assisted alongside others whenever and to whatever extent she could. In short, the record as it exists reveals no contradiction between Plaintiff’s symptom testimony and this activity. Nor does it reflect that Plaintiff spent any substantial part of her days engaged in this activity. Finally, the ALJ relied on the fact that Plaintiff had planned to make a two-week trip to the continental United States. Dkt. No. 15-1, at PageID.59 (AR at 25). But there is no obvious inconsistency between Plaintiff’s testimony that she could not work because PagelD.2549 of excessive unexcused absences, on the one hand, and that she had enough moments of lucidity that a two-week trip was possible (that, indeed, even attempts at work were possible, even though they were regularly derailed by her unexcused absences). * * * For the foregoing reasons, the court concludes that the ALJ—acting on the Commissioner's behalf —did not offer adequate reasons to reject Petitioner’s symptom testimony. The Commissioner’s decision denying Petitioner’s application for Social Security disability benefits is, therefore, REVERSED and the case is REMANDED for further administrative proceedings consistent with this order. Given this ruling, the court declines to resolve Petitioner’s alternative argument for reversal, which is that the AL] erred for the independent reason that she did not adequately take Plaintiff's chronic sinusitis into consideration at all. Dkt. No. 21, at PageID.2499-2505. Accord Hiler v. Astrue, 687 F.3d 1208, 1212 (9th Cir. 2012) (remanding for one reason and “declin[ing] to reach [an] alternative ground”). IT IS SO ORDERED. DATED: July 21, 2026, at Honolulu, Hawai‘i. <= DEP Re fy . 8), & /s/ Micah W.J. Smith Micah W.J. Smith United States District Judge ears Jennifer S. v. Frank Bisignano; Civil No. 25-00418 MWJS-WRP; ORDER REVERSING DECISION OF THE COMMISSIONER OF SOCIAL SECURITY AND REMANDING FOR FURTHER ADMINISTRATIVE PROCEEDINGS 10