ENGLISH v. SAUL (2021)

United States Court of Appeals, Ninth Circuit.2021-03-17No. No. 18-56489

Summary · law.co

Holding. The court affirmed the district court's order upholding the Commissioner's denial of disability benefits.

Rachel English appealed the denial of her applications for disability insurance benefits and supplemental security income. The Administrative Law Judge (ALJ) found at the initial step of the evaluation that English did not have a medically determinable impairment, as her symptoms were not supported by objective medical evidence. The record showed consistently normal test results and clinical findings, no confirmed diagnosis of her claimed conditions, and a pattern of not following her doctors' treatment recommendations or attending referred appointments.

English challenged the ALJ's decision, arguing that the denial was erroneous. The court reviewed the case and found the ALJ's reasoning sound. An impartial medical expert testified he could not identify any medically determinable impairment, which aligned with an earlier opinion from a state agency consultant. Additionally, the ALJ properly discounted English's own testimony about her symptoms based on her poor effort during testing and her failure to pursue recommended medical care.

Summary generated by law.co from the public-domain opinion. The opinion text itself is public domain.

Key issues

Whether the claimant established a medically determinable impairment supported by objective medical evidence
Whether an ALJ properly weighed medical expert opinion versus claimant's symptom testimony
Whether a jury excuse note mentioning endometriosis constitutes objective medical evidence

Procedural posture

The claimant appealed the district court's affirmance of the Social Security Commissioner's denial of disability benefits applications.

Authorities cited

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Opinion · public domain

MEMORANDUM **

Rachel English appeals the district courts order affirming the Commissioner of Social Securitys denial of her application for disability insurance benefits under Title II and supplemental security income under Title XVI of the Social Security Act. We have jurisdiction under 28 U.S.C. § 1291 and 42 U.S.C. § 405(g). We review de novo, Attmore v. Colvin, 827 F.3d 872, 875 (9th Cir. 2016), and we affirm.

The ALJ did not err at step two when he found that English did not have a medically determinable impairment. A medically determinable impairment must be established through medical evidence including “signs, symptoms, and laboratory findings,” and “under no circumstances may the existence of an impairment be established on the basis of symptoms alone.” Ukolov v. Barnhart, 420 F.3d 1002, 1005 (9th Cir. 2005) (citation omitted); see also SSR 16-3p, 82 Fed. Reg. 49462, 49464, 49467 (Oct. 25, 2017). The ALJ properly found that Englishs symptoms lacked support in the medical record as a whole, which revealed Englishs consistently normal test results and clinical findings, the lack of any definitive diagnosis of endometriosis or thyroid problems, and refusal to follow prescribed treatments or attend referral visits as recommended by her physicians. The ALJ did not err by failing to discuss a jury excuse note identifying Englishs endometriosis because this note did not constitute objective medical evidence and did not describe any clinical findings or laboratory results.

The ALJ properly afforded great weight to the opinion of impartial medical expert Dr. John Morse, who testified at Englishs hearing that he could not identify any medically determinable impairment. Dr. Morses opinion was consistent with the state agency consultants uncontroverted opinion that English did not have a medically determinable impairment, and therefore constituted substantial evidence.

The ALJ did not err by discrediting Englishs subjective symptom testimony. The ALJ was not required to evaluate the extent to which Englishs symptoms interfered with her ability to perform basic work activities because Englishs symptom testimony alone was insufficient to establish the existence of a medically determinable impairment. Nonetheless, the ALJ still provided clear and convincing reasons to discount Englishs testimony, including the fact that English had exhibited poor effort during neurological testing, see Thomas v. Barnhart, 278 F.3d 947, 959 (9th Cir. 2002), and declined to follow treatment recommendations or take advantage of referrals, see Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008).

AFFIRMED.

FOOTNOTES

. Englishs Motion to Expedite (Dkt. #14) is denied as moot.