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Oshiro v. Colvin

United States District Court, D. Hawaii

January 27, 2017

YOUNG CHA OSHIRO, Plaintiff,
v.
CAROLYN W. COLVIN, Social Security Administration Commissioner, Defendant.

          ORDER REVERSING THE DECISION OF THE SOCIAL SECURITY ADMINISTRATION COMMISSIONER AND REMANDING THE CASE FOR FURTHER PROCEEDINGS

          Helen Gillmor, Judge

         This case involves the appeal of the Social Security Administration Commissioner's denial of Disability Insurance Benefits to Plaintiff Young Cha Oshiro.

         On August 9, 2012, Plaintiff filed an application for Disability Insurance Benefits pursuant to Title II of the Social Security Act. Plaintiff claims she has been disabled since April 29, 2012, due to Systemic Lupus Erythematosus (“Lupus”).

         The Social Security Administration denied her initial application. Following an administrative hearing, the Administrative Law Judge held that Plaintiff is not disabled and found that Plaintiff is able to perform work in the national economy.

         On appeal, Plaintiff argues that the Administrative Law Judge erred and requests a remand to the agency for further proceedings. Plaintiff asserts that the Administrative Law Judge erred for three reasons. First, Plaintiff argues the Administrative Law Judge erred by rejecting the opinions of her treating physicians. Second, Plaintiff argues that the Administrative Law Judge improperly declined to credit the Plaintiff's testimony concerning the severity of her medical condition. Third, Plaintiff asserts that the Administrative Law Judge erred by relying on the testimony of the vocational expert to find that Plaintiff could perform work as a Toll Collector.

         The Court REVERSES the decision of the Social Security Administration Commissioner and REMANDS the case for further evaluation.

         PROCEDURAL HISTORY

         On August 9, 2012, Plaintiff Young Cha Oshiro filed an application for Disability Insurance Benefits with the Social Security Administration. (Administrative Record (“AR”) at 149-52, 162, ECF No. 17).

         On January 23, 2013, the Social Security Administration denied Plaintiff's initial application. (AR at pp. 88-91).

         On August 21, 2013, the Administration denied her request for reconsideration. (AR at pp. 95-99).

         Following the denial of Plaintiff's request for reconsideration, she sought a hearing before an Administrative Law Judge (“ALJ”). (AR at pp. 101-07).

         On July 14, 2014, an ALJ conducted a hearing on Plaintiff's application. (AR at pp. 26-66).

         On September 17, 2014, the ALJ issued a written decision denying Plaintiff's application. (AR at pp. 12-21).

         Plaintiff sought review by the Appeals Council for the Social Security Administration. The Appeals Council denied further review of Plaintiff's application on February 12, 2016, rendering the ALJ's decision as the final administrative decision by the Commissioner of Social Security. (AR at pp. 1-3).

         On April 4, 2016, Plaintiff sought judicial review of the Commissioner of Social Security's final decision to deny her application for Disability Benefits in this Court pursuant to 42 U.S.C. § 405(g). (Complaint for Review of Social Security Disability Benefits Determinations, ECF No. 1).

         On August 4, 2016, the Magistrate Judge issued a briefing schedule. (ECF No. 20).

         On September 30, 2016, Plaintiff filed PLAINTIFF'S OPENING BRIEF. (ECF No. 22).

         On November 9, 2016, Defendant filed DEFENDANT'S MOTION FOR A FIRST EXTENSION OF 30 DAYS TO FILE THE ANSWERING BRIEF. (ECF No. 23).

         On November 10, 2016, the Court issued a Minute Order granting the Defendant's Motion for an Extension. (ECF No. 24).

         On December 14, 2016, the Defendant filed DEFENDANT'S ANSWERING BRIEF. (ECF No. 25).

         On December 27, 2016, Plaintiff filed PLAINTIFF'S REPLY BRIEF. (ECF No. 26).

         On January 17, 2017, the Court held a hearing on Plaintiff's appeal of the decision of the Social Security Administration Commissioner.

         BACKGROUND

         Plaintiff's Work History

         Plaintiff is a 56 year-old female. (Administrative Record (“AR”) at p. 162, ECF No. 17). Plaintiff worked as a sewer at CC Fashion Hawaii from 1999 to 2011. (Id. at p. 204). Plaintiff also worked for a year as a janitor in 1998. (Id.) Plaintiff explained that as of 2011, she could no longer work the four to six hours a day that was necessary for her employment at CC Fashion Hawaii. (Id. at pp. 34-35). Plaintiff testified that she required extensive breaks that did not allow her to work full-time. (Id.)

         Plaintiff testified that after 2011 she worked exclusively as a contract seamstress. (Id. at pp. 35-36). Plaintiff had been self-employed as a contract seamstress since July 1987 and she stopped working in April 2012. (Id. at pp. 31, 164). Plaintiff testified that she performed sewing work that she received from a factory. (Id. at pp. 35-36). Plaintiff stated that she performed the work in her home and returned it to the factory when completed. (Id.)

         Plaintiff testified that she only worked three to four hours a day as a seamstress. (Id.) Plaintiff explained that she took frequent breaks throughout the day due to fatigue and pain caused by Lupus. (Id. at p. 36). Plaintiff explained that she took breaks for 30 minutes to an hour and that her condition varied from day to day. (Id. at p. 35). Plaintiff testified that there were some days when she could not work at all due to her condition. (Id.)

         Plaintiff stated that she stopped working in April 2012 because she could no longer perform the work within the deadlines she was given by the factory. (Id. at pp. 32-36). Plaintiff explained that on a few occasions she had to return the sewing work to the factory in an unfinished state because she was unable to meet the deadlines due to her condition. (Id. at pp. 35-36).

         Plaintiff's Medical Condition

         The record reflects that Plaintiff has been suffering from Systemic Lupus Erythematosus (“Lupus”) for a number of years. Plaintiff has been treated by two physicians, Dr. Paul Kim, her primary physician, and Dr. Scott Kawamoto, her rheumatologist.

         Plaintiff provided records from her eight visits with Dr. Kim between September 2011 and January 2014. (AR at pp. 245-47, 290-91, 300-01, ECF No. 17). The treating records from Dr. Kim are difficult to read but he provided a summary of Plaintiff's condition in June 2014. Dr. Kim stated that Plaintiff suffers from Lupus and that it causes her to have pain in her extremities and joints. (Id. at pp. 400-03). Dr. Kim indicated that Plaintiff suffers from fatigue and requires many breaks throughout the workday. (Id. at p. 401). Dr. Kim stated that Plaintiff would be absent from work more than three days a month due to Lupus. (Id. at p. 402).

         Plaintiff also provided records from her rheumatologist, Dr. Scott Kawamoto. There are numerous reports of the visits she made to Dr. Kawamoto for treatment of her Lupus condition.

         Between June 2011 and December 2011, Plaintiff was treated by Dr. Kawamoto, on three occasions for left ankle pain, swelling, and fatigue caused by Lupus. (Id. at pp. 217, 220, 223). Plaintiff was prescribed Hydroxychloroquine Sulfate and Celebrex to treat her inflammation and joint pain symptoms. (Id.)

         Between April 2012 and January 2013, Plaintiff was treated by Dr. Kawamoto three times for bilateral knee pain, pain in her back, neck, wrists, right shoulder, and left ankle, mouth sores, and fatigue due to non-restorative sleep. (Id. at pp. 226, 230, 275).

         The Social Security Administration's Review of Plaintiff's August 2012 Application For Disability Benefits

         Plaintiff's August 9, 2012 application for Disability Insurance Benefits was denied on January 23, 2013. (AR at pp. 88-91, ECF No. 17). Following the initial denial, Plaintiff moved for reconsideration.

         While her Motion to Reconsider was pending, on March 3, 2013, Plaintiff went to the emergency room because she was experiencing abdominal pain. (Id. at pp. 319-327). She was provided with medication to treat her pain and discharged the same day. (Id.)

         Plaintiff pursued follow-up treatment with her primary care physician, Dr. Kim. Her symptoms returned three days later on March 6, 2013. Plaintiff went to the emergency room with stomach pain and dizziness. (Id. at pp. 328-350). She was admitted to the hospital and a scan revealed that Plaintiff had a benign tumor that caused her vertigo, dizziness, and nausea. (Id. at p. 329). Plaintiff was prescribed medicine to treat her nausea and dizziness and referred to her treating physicians for follow-up treatment. (Id. at pp. 328-29).

         Plaintiff continued to make frequent visits to her treating physicians following her March 2013 hospitalization. (Id. at pp. 290-91, 300-01). Plaintiff's medical records reflect six examinations by Dr. Kawamoto from April to October 2013. (Id. at pp. 277, 361, 365, 368). The records indicate that Plaintiff continued to experience pain, aching, and fatigue. (Id.)

         On August 21, 2013, the Social Security Administration denied Plaintiff's motion for reconsideration. (Id. at pp. 95-99). Plaintiff requested a hearing before an Administrative Law Judge (“ALJ”). (Id. at pp. 101-07).

         In June 2014, both Plaintiff's treating physicians Dr. Kawamoto and Dr. Kim provided Medical Source Statements to the Social Security Administration. (Id. at pp. 395-403). The Medical Source Statements provide information to the agency about the Plaintiff's medical condition, physical limitations, and her ability to work. (Id.)

         Both of Plaintiff's treating physicians agree that Plaintiff suffers from Lupus. Plaintiff's treating physicians share the opinion that Plaintiff cannot walk or stand for more than two hours in an eight-hour work day. (Id. at pp. 395, 400). Plaintiff's physicians state she cannot walk or stand for more than 30 minutes at a time and cannot sit for more than 30 minutes at a time. (Id.)

         Both Dr. Kawamoto and Dr. Kim agree that Plaintiff's medical condition prevents her from working full-time. Both physicians stated that Plaintiff requires more than regular breaks during an 8-hour workday. (Id. at pp. 396, 401). Both of Plaintiff's treating physicians agree that Plaintiff would miss more than three days of work per month because of joint pain, swelling, and severe fatigue caused by Lupus. (Id. at pp. 397, 402).

         On July 14, 2014, a hearing on Plaintiff's application for Disability Benefits was held before an ALJ. (Id. at pp. 26-66).

         The ALJ denied Plaintiff's application for Disability Insurance Benefits, finding that Plaintiff had not met the requirements set forth in 42 U.S.C. § 423. (AR at pp. 12-21, ECF No. 17).

         42 U.S.C. § 423 establishes the statutory eligibility requirements which an individual must satisfy to receive a disability insurance benefit pursuant to the Social Security Act. 42 U.S.C. § 423(a)(1). An individual is eligible to receive disability insurance benefits if the individual:

(A) is insured for disability insurance benefits as determined by 42 U.S.C. § 423(c)(1);
(B) has not attained retirement age;
(C) has filed an application for disability insurance benefits; and,
(D) is under a disability as defined in 42 U.S.C. § 423(d)(1)(A).

42 U.S.C. § 423(a)(1)(A)-(D).

         The ALJ evaluated the four requirements of 42 U.S.C. § 423(a)(1).

         First, the ALJ found Plaintiff was insured for disability insurance benefits pursuant to 42 U.S.C. § 423(c)(1). The ALJ determined that Plaintiff's earnings record showed that she had made disability insurance coverage payments. Based on Plaintiff's work history, the ALJ found that Plaintiff had acquired quarters of coverage that will last until December 31, 2016. (AR at p. 14, ECF No. 17).

         Next, the ALJ found that Plaintiff fulfilled sections (B) and (C) of Section 423 because she had not reached retirement age at the time of her application and had properly filed an application for disability insurance benefits.

         Finally, the ALJ sought to determine if Plaintiff suffered from a disability pursuant to 42 U.S.C. § 423(d).

         42 U.S.C. § 423(d)(1)(A) provides, as follows:

The term “disability” means- inability 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.

         Plaintiff claimed that she was disabled for a continuous period following April 29, 2012, due to Lupus. (AR at p. 187, ECF No. 17).

         The Administrative Law Judge found that Plaintiff failed to establish that she had a disability that lasted or was expected to last at least twelve months following her alleged ...


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