Jeffrey L. v. Frank Bisignano - Social Security Benefits Appeal
Summary
The U.S. District Court for the Eastern District of Washington issued an opinion reversing an Administrative Law Judge's denial of Social Security benefits for Plaintiff Jeffrey L. The court found the ALJ erred in evaluating the plaintiff's limitations and remanded the case for an award of benefits.
What changed
This court opinion, dated February 25, 2026, addresses the appeal of Jeffrey L. against the Commissioner of Social Security, Frank Bisignano, concerning a denial of Title 16 benefits. The plaintiff argued that the Administrative Law Judge (ALJ) erred in finding him able to work despite mental-health impairments. The District Court agreed with the plaintiff, finding that the ALJ's evaluation of the plaintiff's limitations was flawed and that the case should be remanded for an award of benefits.
This ruling directly impacts the plaintiff by reversing the denial of benefits and mandating a reconsideration for an award. For legal professionals and healthcare providers involved in similar Social Security disability claims, this opinion serves as precedent highlighting the importance of thorough evaluation of mental-health impairments and the potential for judicial review to overturn ALJ decisions. While no specific compliance deadline is mentioned, the decision underscores the need for careful documentation and justification of benefit denials by ALJs.
What to do next
- Review ALJ decision-making processes for Social Security disability claims, particularly those involving mental-health impairments.
- Ensure thorough documentation and justification of claimant limitations when denying benefits.
- Consult legal counsel regarding potential appeals or reviews of similar ALJ decisions.
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Feb. 25, 2026 Get Citation Alerts Download PDF Add Note
Jeffrey L. v. Frank Bisignano, Commissioner of Social Security
District Court, E.D. Washington
- Citations: None known
- Docket Number: 2:25-cv-00305
Precedential Status: Unknown Status
Trial Court Document
1 U.S. F D IL IS E T D R I I N C T T H C E O URT
EASTERN DISTRICT OF WASHINGTON
2 Feb 25, 2026
SEAN F. MCAVOY, CLERK
3
UNITED STATES DISTRICT COURT
4 EASTERN DISTRICT OF WASHINGTON
5
JEFFREY L.,1 No. 2:25-cv-305-EFS
6
Plaintiff,
7 ORDER REVERSING THE
v. ALJ’S DENIAL OF BENEFITS,
8 AND REMANDING FOR AN
FRANK BISIGNANO, AWARD OF BENEFITS
9 Commissioner of Social Security,
10 Defendant.
11
Plaintiff Jeffrey L. asks the Court to reverse the Administrative
12
Law Judge’s (ALJ) denial of Title 16 benefits. Plaintiff claims he is
13
unable to work due to his limitations resulting from his mental-health
14
impairments and the ALJ erred in finding otherwise. The Court agrees
15
16
17
18
1 For privacy reasons, Plaintiff is referred to by first name and last
19
initial or as “Plaintiff.” See LCivR 5.2(c).
20
1 the ALJ erred when evaluating the medical opinions. This matter is
2 remanded for an award of benefits.
3 I. Background
4 In September 2022, at the age of 25, Plaintiff applied for benefits
5 under Title 16, claiming disability based on limitations related to
6 Asberger’s, autism, depression, and anxiety.2 From early childhood,
7 Plaintiff experienced speech and behavior-development delays.3 Given
8 his difficulties focusing and being disruptive, he was homeschooled; he
9 received his high school diploma.4 His mental-health medications have
10 been managed by Teresa Hutsell, ARNP, for several years.5
11 In support of his application, he submitted an Adult Function
12 Report and statements from his parents and a former employer. The
13 function report stated that he gets overloaded when stressed and then
14 will have a meltdown, his social skills are very limited as his social
15
16
2 AR 53, 178–79.
17
3 See, e.g., AR 285–86.
18
4 AR 51, 68–70, 222, 252, 281–82, 285
19
5 AR 53.
20
1 interaction is awkward, he has a hard time concentrating, he has
2 difficulty understanding what people are saying, he has a hard time
3 getting people to understand him, and he is irritable when he gets
4 frustrated.6 He needs reminders to bathe, eat, and do his chores, which
5 he does for about 10–30 minutes a day.7 He reports that he is unable to
6 handle a checking or savings account or pay bills, although he is able to
7 count change.8 For fun, he draws and plays online games.9
8 His parents submitted a statement, which states that their son
9 “does not and cannot live a ‘normal’ life” because he does not handle
10 stress well.10 They state that even in response to a simple request he
11 “will freeze” and does not know how to deescalate, he is unable to
12 handle interruptions without getting upset about having to start over,
13 and he has to be reminded multiple times to finish the chores he is
14
15
6 AR 229.
16
7 AR 230–31.
17
8 AR 232.
18
9 AR 233.
19
10 AR 280–81.
20
1 tasked with at home.11 He has a “significant lack of social awareness
2 and etiquette” in that he invades people’s space when talking, he will
3 interrupt conversations without waiting for a pause or completion, he
4 speaks “unfiltered,” and he does not have a “whisper mode.”12 They
5 state, “Simply put, it is a lot of work and effort to get him up and going
6 every day and through the daily life’s events that are an everyday
7 occurrence.”13
8 In 2020, Plaintiff worked for an irrigation company in their
9 warehouse. The manager at the warehouse submitted a statement
10 describing Plaintiff’s responsibilities and deficient performance:
11 He struggled with multiple items on the list-He couldn’t
figure out the computer sales- we worked with him trying to
12 train him how to put sales but he just couldn’t get it. He was
blunt and confrontational when someone would come in for
13 parts, at one point asking a customer “Don’t you know what
you want?” . . . We worked with him daily but after over a
14 month, things did not get any better and we made the
decision to let him go.14
15
16
11 AR 280.
17
12 AR 280.
18
13 AR 281.
19
14 AR 270.
20
1 The agency denied benefits.15 At Plaintiff’s request, ALJ Allen
2 Erickson held a telephonic hearing in May 2024, at which Plaintiff,
3 Plaintiff’s mother, and a vocational expert testified.16
4 Plaintiff testified that he has always lived with his parents
5 because he is dependent on other people, but he does help with
6 cleaning bathrooms, vacuuming, and dusting.17 He said his parents
7 remind him multiple times to do and complete his chores and to take
8 his medications at the proper time.18 Plaintiff testified that if he does
9 not take his medication his “behavior would be sour, very sour. I would
10 be irritable. My depression would rise up. I see not in a very good state
11 of mind.”19 He does not drive because he is concerned he will have an
12 accident since driving requires the ability to keep “so many things . . .
13 in mind that all times, like constant attention on every little thing, like
14
15
15 AR 102–10.
16
16 AR 40–80.
17
17 AR 57–58.
18
18 AR 59–60.
19
19 AR 55.
20
1 how fast you’re going, how close you are to other people, how – or when
2 you should break, how hard you should break and all that.”20 He has
3 not dated, does not have children, and his only friends are online.21
4 Plaintiff talked about the two jobs he worked—jobs that he obtained
5 through his parents’ connections.22 One job was at a warehouse.23
6 Plaintiff stated that he believed he was doing a good job and was on his
7 “best behavior,” however, after about one month, he was let go and it
8 was mentioned that it was due to his mental issues.24 The other job
9 was at plant services, earning less than $5,000, until he mentally broke
10 down at work.25 After discussions with his parents, it was decided that
11 he would submit a letter of resignation.26
12
13
20 AR 57.
14
21 AR 57–58.
15
22 AR 52–53.
16
23 AR 52–53.
17
24 AR 53.
18
25 AR 54, 186.
19
26 AR 54.
20
1 His mother testified that Plaintiff, even with his medication, is
2 unable to successfully live on his own because he needs help with his
3 medication and to care for himself.27 She said that even though his
4 medications help stabilize him, his parents do not leave him alone
5 overnight.28 His mother stated that although her son does chores, such
6 as cleaning bathrooms or vacuuming, the quality of his work is
7 subpar.29 She testified that he is “very socially awkward and to
8 himself.”30 In response to a hypothetical, she stated that her son can
9 physically fold laundry but she was unsure whether he could do such in
10 a full-time job.31 She stated that he would have some controversy with
11 either supervisors or coworkers because he “just has a hard time
12 around people,” as he is “very socially awkard, and he says what he
13 thinks and if, you know, he doesn’t think something is right, he’ll say
14
15
27 AR 63, 65.
16
28 AR 63, 65.
17
29 AR 66.
18
30 AR 66.
19
31 AR 67, 69.
20
1 it. And he’s just not socially up.”32 She testified that her son gets very
2 distracted.33 For instance, during a meal, he will get up and do
3 something, and he requires reminders to finish his chores because he
4 gets distracted.34 She shared that when she homeschooled him she had
5 to repeatedly explain subjects to him in several different ways to help
6 him learn.35 She stated that her son is not coordinated enough to drive
7 and he is not able to ride a bicycle.36
8 After the hearing, the ALJ issued a decision denying benefits.37
9 The ALJ found Plaintiff’s alleged symptoms were inconsistent with the
10 medical evidence and other evidence, including his longitudinal
11 treatment history, the objective findings, his presentations at
12
13
32 AR 68.
14
33 AR 69.
15
34 AR 69.
16
35 AR 68, 69.
17
36 AR 69.
18
37 AR 15–35. Per 20 C.F.R. § 416.920 (a)–(g), a five-step evaluation
19
determines whether a claimant is disabled.
20
1 appointments and mental status examinations, and his rather
2 independent daily activities.38 The ALJ considered the lay statements
3 from Plaintiff’s parents and his former warehouse employer, finding
4 them similar to Plaintiff’s own symptom statements, which the ALJ
5 found not fully consistent with the evidence.39 As to the medical
6 opinions, the ALJ found:
7 • the State agency reviewing opinions by Vincent G, PhD, and
8 Renee Eisenhauer, PhD, most persuasive.
9 • the psychiatric consultative examination opinion of Emily
10 Ketchel, PMHNP, unpersuasive.40
11 As to the sequential disability analysis, the ALJ found:
12 • Step one: Plaintiff had not engaged in substantial gainful
13 activity since September 25, 2022, the application date.
14
15
38 AR 26–29. As recommended by the Ninth Circuit in Smartt v.
16
Kijakazi, the ALJ should consider replacing the phrase “not entirely
17
consistent” with “inconsistent.” 53 F.4th 489, 499, n.2 (9th Cir. 2022).
18
39 AR 29.
19
40 AR 28–29.
20
1 • Step two: Plaintiff had the following medically determinable
2 severe impairments: depressive disorder, general anxiety
3 disorder, autistic spectrum disorder, and attention deficit
4 hyperactivity disorder (ADHD).
5 • Step three: Plaintiff did not have an impairment or
6 combination of impairments that met or medically equaled the
7 severity of one of the listed impairments.
8 • RFC: Plaintiff had the RFC to perform a full range of work at
9 all exertional levels but with the following nonexertional
10 limitations:
11 He can understand, remember, and apply simple, short
instructions. He can perform only routine, repetitive,
12 predictable tasks that are not in a fast-paced, production-
type environment, such as that with assembly lines or a
13 high hourly quota. He can make only simple decisions. He
can have exposure to only few, routine workplace changes.
14 He can have no interaction with the general public, and
only occasional, superficial interactions with coworkers
15 and supervisors, and not in a team-oriented environment.
(Occasional means one-thirds of the day; and superficial
16 means basic interaction, and working with coworkers and
supervisors is not the focus of the job).
17
• Step four: Plaintiff has no past relevant work.
18
• Step five: considering Plaintiff’s RFC, age, education, and work
19
history, Plaintiff could perform work that existed in significant
20
1 numbers in the national economy, such as laundry worker;
2 laborer, stores; and kitchen helper.41
3 Plaintiff timely requested review of the ALJ’s decision by the
4 Appeals Council, which decided that the additionally submitted
5 medical record from ARNP Hutsell dated September 1, 2024, did not
6 show a reasonable probability that it would change the outcome of the
7 decision, and the Appeals Council affirmed the ALJ’s decision.42
8 Plaintiff then sought timely review by this Court.43
9 II. Standard of Review
10 The ALJ’s decision is reversed “only if it is not supported by
11 substantial evidence or is based on legal error” and such error
12 impacted the nondisability determination.44 “Substantial evidence is
13
14
41 AR 18–31.
15
42 AR 1–6, 14.
16
43 ECF No. 1.
17
44 Hill v. Astrue, 698 F.3d 1153, 1158 (9th Cir. 2012). See 42 U.S.C. §
18 405(g); Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012),
19
superseded on other grounds by 20 C.F.R. § 416.920 (a) (recognizing
20
1 ‘more than a mere scintilla but less than a preponderance; it is such
2 relevant evidence as a reasonable mind might accept as adequate to
3 support a conclusion.’”45
4 III. Analysis
5 Plaintiff argues the ALJ committed several errors: (1) the ALJ
6 failed to properly evaluate the medical opinions; (2) the ALJ failed to
7 properly consider the longitudinal record when evaluating Plaintiff’s
8 mental conditions; (3) the ALJ failed to properly assess Plaintiff’s RFC;
9
10
that the court may not reverse an ALJ decision due to a harmless
11
error—one that “is inconsequential to the ultimate nondisability
12
determination”).
13 45 Hill, 698 F.3d at 1159 (quoting Sandgathe v. Chater, 108 F.3d 978,
14
980 (9th Cir. 1997)). See also Kaufmann v. Kijakazi, 32 F4th 843, 851
15
(9th Cir. 2022) (recognizing the court looks to the entire record to
16
determine if substantial evidence supports the ALJ’s findings); Black
17
v. Apfel, 143 F.3d 383, 386 (8th Cir. 1998) (“An ALJ’s failure to cite
18
specific evidence does not indicate that such evidence was not
19
considered[.]”).
20
1 and (4) the ALJ failed to determine that Plaintiff’s autism spectrum
2 disorder was sufficient to meet or equal a listing. The Commissioner
3 disagrees that error occurred, maintaining that the ALJ’s decision is
4 supported by substantial evidence. As is explained below, the ALJ
5 erred by failing to fully and fairly consider the nature of Plaintiff’s
6 chronic and life-long mental-health impairments and this error
7 impacted the ALJ’s evaluation of the medical opinions.
8 A. Medical Opinions: Plaintiff establishes consequential
9 error.
10 Plaintiff argues the ALJ erred by finding the reviewing opinions
11 of Dr. G and Dr. Eisenhauer most persuasive, finding the opinion of
12 consultative examiner Nurse Practitioner Ketchel unpersuasive, and
13 ignoring the psychological assessment done by Dr. Rebecca Braymen in
14 2014. The Court agrees the ALJ consequentially erred when evaluating
15 the medical opinions.
16 1. Standard
17 The ALJ must consider and articulate how persuasive he found
18 each medical opinion and prior administrative medical finding,
19 including whether the medical opinion or finding was consistent with
20
1 and supported by the record.46 The factors for evaluating
2 persuasiveness include, but are not limited to, supportability,
3 consistency, relationship with the claimant, and specialization.47
4 Supportability and consistency are the most important factors:
5 (1) Supportability. The more relevant the objective medical
evidence and supporting explanations presented by a
6 medical source are to support his or her medical opinion(s) or
prior administrative medical finding(s), the more persuasive
7 the medical opinions or prior administrative medical
finding(s) will be.
8
(2) Consistency. The more consistent a medical opinion(s) or
9 prior administrative medical finding(s) is with the evidence
from other medical sources and nonmedical sources in the
10 claim, the more persuasive the medical opinion(s) or prior
administrative medical finding(s) will be.48
11
The ALJ may, but is not required to, explain how the other listed
12
factors were considered.49
13
14
15
46 20 C.F.R. § 416.920c(a)–(c); Woods v. Kijakazi, 32 F.4th 785, 792 (9th
16
Cir. 2022).
17
47 20 C.F.R. § 416.920c(c)(1)–(5).
18
48 Id. § 416.920(c)(1)–(2).
19
49 Id. § 416.920c(b)(2).
20
1 When considering the ALJ’s findings, the Court is constrained to
2 the reasons and supporting explanation offered by the ALJ.50
3 1. Medical opinions
4 a. Dr. Braymen
5 In 2014, when Plaintiff was 18 years old, he was psychologically
6 evaluated by Rebecca Braymen, PhD.51 The evaluation included an
7 interview of Plaintiff, answering questions by Plaintiff’s parents, a
8 mental status examination, reviewing testing done two years prior by
9 board-certified neuropsychologist Dr. William Britt, and testing of
10 Plaintiff’s intelligence, attention/concentration, and emotional and
11 behavioral functioning. Dr. Brayman observed Plaintiff’s mood to be
12 anxious at times, attitude as cooperative and friendly, affect as
13 constricted and congruent with his mood, and speech as slow and too
14 detailed. He also observed Plaintiff to be restless, agitated, and
15 orientated, with immature and minimally impaired judgment, limited
16 insight, and tangential, disorganized, and obsessive thought processes,
17
18
50 See Burrell v. Colvin, 775 F.3d 1133, 1138 (9th Cir. 2014).
19
51 AR 282–97.
20
1 with flight of ideas and loose associations.52 Plaintiff performed above
2 average on the WASI-II intelligence functioning test; and the CCPT-II
3 results showed that Plaintiff’s medication was successfully managing
4 his attention problems.53 Dr. Braymen noted that Plaintiff’s parents
5 reported that he has difficulty tolerating changes in routine, activities,
6 and behavior, and sometimes engages in purposeless and repetitive
7 tasks.54 Dr. Braymen diagnosed Plaintiff with autism spectrum
8 disorder, ADHD, generalized anxiety disorder, and unspecified
9 depressive disorder.55 She recommended that Plaintiff continue with
10 his medication management and individual therapy, participate in
11 neurofeedback, be evaluated for pragmatic language deficits, and be
12 encouraged to continue in loosely structured group activities where he
13 could practice social skills.56
14
15
52 AR 286–87.
16
53 AR 287–93.
17
54 AR 295–96.
18
55 AR 283–84.
19
56 AR 284–85.
20
1 b. Nurse Practitioner Ketchel
2 In April 2023, Nurse Practitioner Ketchel performed a psychiatric
3 consultative examination at the request of the Social Security
4 Administration.57 NP Ketchel reviewed a psychiatric record from
5 2021,58 interviewed Plaintiff, and conducted a mental status
6 examination. Plaintiff was observed as cooperative with fair eye
7 contact with his head bowed most of the examination, restless with
8 constant hand and leg fidgeting, normal speech, normal mood and
9 affect, circumstantial thought process, unremarkable thought content,
10 and fair attention and concentration during the conversational portion
11 of the evaluation, as NP Ketchel had to repeat questions due to him not
12 paying attention.59 During the memory testing, Plaintiff’s remote and
13
14
57 AR 344–50.
15
58 Although the date of the record is not listed by NP Ketchel, the only
16
2021 medical record in the administrative record is the November 5,
17
2021 treatment record by Plaintiff’s treating provider, ARNP Hutsell.
18
AR 299–301.
19
59 AR 347.
20
1 immediate and delay recall were correct, and repeated digit spans
2 forward and backward were correct except for the six-digit forward
3 span.60 Plaintiff had difficulty counting backwards by serial threes.61
4 When performing the three-step command, Plaintiff asked for the
5 instructions to be repeated.62 NP Ketchel opined that Plaintiff was able
6 to manage his funds and would be able to interact with coworkers,
7 superiors, and the public and adapt to usual workplace stresses
8 notwithstanding his inability to understand social cues, but was not
9 able to understand, remember, and carry out simple instructions given
10 his struggles with forward-number repetition, serial-three subtraction,
11 and three-step command; not able to understand, remember, and carry
12 out complex instructions due to his struggles with serial threes and
13 poor attention during the interview; and not able to sustain
14 concentration and persist in work-related activity at a reasonable pace,
15 including regular attendance and work completion, given his frequent
16
17
60 AR 347.
18
61 AR 348.
19
62 AR 348.
20
1 interruptions and social-situation uncomfortableness, as evidenced by
2 poor eye contact and bowed head.63
3 c. Dr. G and Dr. Eisenhauer
4 Dr. G reviewed the administrative record in April 2023.64 Dr. G
5 found Plaintiff moderately limited in his abilities to:
6 • Understand, remember, and carry out detailed instructions.
7 • Maintain attention and concentration for extended periods.
8 • Work in coordination with or in proximity to others without
9 being distracted by them.
10 • Complete a normal workday and workweek without
11 interruptions from psychologically based symptoms and
12 perform at a consistent pace without an unreasonable number
13 and length of rest breaks.
14 • Interact appropriately with the public.
15 • Get along with coworkers or peers without distracting them
16 with or exhibiting behavioral extremes.
17
18
63 AR 349.
19
64 AR 85–90.
20
1 • Respond appropriately to changes in the work setting.
2 • Set realistic goals or make plans independently of others.
3 Dr. G suggested that Plaintiff avoid public contact, interact with others
4 on an occasional/superficial basis, perform routine work in a
5 predictable setting, and have goals set by the supervisor.65
6 In September 2023, Dr. Eisenhauer reviewed the medical
7 records, and she agreed with Dr. G’s opined limitations.66
8 2. The ALJ’s findings
9 The ALJ found Dr. G’s and Dr. Eisenhauer’s opinions most
10 persuasive because (1) they were supported by narrative explanation
11 and based on a longitudinal evaluation of the record; (2) they have
12 knowledge of the SSA program; (3) their opinions were:
13 entirely consistent with the claimant’s longitudinal mental
health treatment history, his presentations at appointments
14 and mental status examination, the statements of
improvement with treatment or denials of symptoms, and
15 his documented daily activities, such as taking care of his
own hygiene, doing chores at home, shopping and going to
16 places with family, playing video games and socializing with
17
18
65 AR 88.
19
66 AR 92–99.
20
1 friends online, and the reported significant limitations with
social functioning . . . .67
2
The ALJ found NP Ketchel’s opinion regarding Plaintiff’s abilities
3
as to simple instructions and sustaining concentration, persistence,
4
and attendance unpersuasive because:
5
• It was an overestimate of the severity of Plaintiff’s cognitive
6
restrictions and based only on a snapshot of his functioning.
7
• It was not consistent with other evidence showing that
8
Plaintiff’s mental symptoms were stable on medications, and
9
his presentation at appointments, his reported activities of
10
daily living, and his statements of improvement.
11
The ALJ also found NP Ketchel’s opinion that Plaintiff is able to
12
interact with coworkers, superiors, and the public without restrictions
13
unsupported because the totality of the record showed that he had
14
significant social-functioning limitations, and that he should be limited
15
to simple, repetitive work in a stable/predictable work environment
16
17
18
19
67 AR 28 (internal citations to the record omitted).
20
1 with few changes and with no public contact and no more than
2 occasional, superficial interaction with coworkers and supervisors.68
3 The ALJ found Dr. Braymen’s opinion to have little probative
4 value because it “predates the SSI filing date by almost eight years and
5 therefore does not reflect the claimant’s functioning during the
6 relevant period and has little probative value.”69
7 The ALJ’s medical-opinion analysis was accompanied by the
8 ALJ’s finding that Plaintiff had a marked limitation in his ability to
9 interact with others and a moderate limitation in his abilities to (1)
10 understand, remember, or apply information; (2) concentrate, persist,
11 or maintain pace; and (3) adapt or manage himself.70
12 3. Analysis
13 The ALJ’s evaluation of the medical records, and in turn the
14 medical opinions, was impacted by the ALJ’s failure to fairly consider
15 the lifelong nature and extent of Plaintiff’s mental impairments and
16
17
68 AR 28–29.
18
69 AR 29.
19
70 AR 22–23.
20
1 the nature of the noted improvement in Plaintiff’s mental-health
2 symptoms. As is evidenced by the statements from Plaintiff’s parents
3 and supervisor, the observations of his treating provider ARNP
4 Hutsell, and the evaluations performed by Dr. Britt, Dr. Braymen, and
5 NP Ketchel, Plaintiff’s mental impairments have significantly
6 impacted him from a young age and have continued to do so.
7 The record reflects that even though medication was “adequately
8 maintain[ing] his attention and focus,” during the relevant period,
9 Plaintiff was dependent on his parents to manage his life and was
10 unable to successfully live on his own. Even for the household chores
11 that Plaintiff assisted with for short periods of the day, daily reminders
12 were needed for him to complete the task. In addition, even though he
13 took medication for years, Plaintiff still needed the assistance of his
14 parents to take the medication on schedule.
15 Plus, even though Plaintiff was “stable” on medication, ARNP
16 Hutsell routinely observed Plaintiff with a concrete thought process, a
17 slightly halting speech pattern, and restricted affect.71 Treatment notes
18
19
71 See AR 454, 468, 490, 512, 528.
20
1 reflect that even while stable on medications, he continued to have
2 behavioral symptoms that caused him to be dependent on living with
3 his parents and he needed reminders for chores and redirecting during
4 the consultative examination with NP Ketchel.72 In July 2023, ARNP
5 Hutsell mentioned in her treatment note, “Patient remains in care of
6 his parents that help ensure ADLs are completed. He does not perform
7 ADLs without reminders.”73 Again, in October 2023, ARNP Hutsell
8 wrote, “he continues to do well under the care of his parents. He needs
9 reminders to take his medications and regarding personal hygiene and
10 other daily activities of living.”74 ARNP Hutsell wrote in February 2024
11 that “Patient’s autism does make behavioral changes more difficult.”75
12 When the record is fully and fairly viewed, substantial evidence
13 does not support the ALJ’s finding that Dr. G’s and Dr. Eisenhauer’s
14 opined limitations were more consistent with Plaintiff’s longitudinal
15
16
72 See, e.g., AR 299, 333–35, 404–06, 467–70.
17
73 AR 357.
18
74 AR 513.
19
75 AR 470.
20
1 mental health treatment history, his presentations at appointments
2 and the psychological examinations performed by Dr. Braymen and
3 NP Ketchel, and the statements of improvement with treatment or
4 denials of symptoms.76
5 Moreover, substantial evidence does not support the ALJ’s
6 finding that Plaintiff’s daily activities, including taking care of his own
7 hygiene, doing a few chores at home each day with reminders, and
8 playing video games and socializing with his online friends, were
9 inconsistent with NP Ketchel’s opinion that Plaintiff was unable to
10 sustain and persist in full-time work.77 Plaintiff has not lived on his
11
12
76 See Ghanim v. Colvin, 763 F.3d 1154,1164 (9th Cir. 2014)
13
(emphasizing that treatment records must be viewed considering the
14
overall diagnostic record).
15
77 See Diedrich v. Berryhill, 874 F.3d 634, 643 (9th Cir. 2017)
16
(recognizing that the fact the claimant “could participate in some daily
17
activities does not contradict the evidence of otherwise severe problems
18
that she encountered in her daily life during the relevant period”); Fair
19
v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989).
20
1 own and was unable to sustain his two prior attempts at employment.
2 The ALJ did not discuss why Plaintiff’s choice of playing video games
3 and making friends online, rather than in person, is reflective of an
4 ability to sustain full-time work rather than a byproduct of his social
5 limitations and concrete thinking relating to his mental-health
6 impairments.
7 As to the ALJ’s supportability analysis, the ALJ failed to explain
8 why NP Ketchel’s opinion that Plaintiff would be unable to sustain
9 concentration and persist at work was not supported by her
10 observation that Plaintiff had to have questions repeated because he
11 was not paying attention, was fidgeting, and displayed social
12 uncomfortableness. Moreover, the basis for the ALJ’s finding that
13 Dr. G’s and Dr. Eisenhauer’s opinion that Plaintiff can sustain
14 concentration and persist at work was supported “by narrative
15 explanation” is unclear.78 Although their Disability Determination
16 Explanation Forms summarize some of the medical records and
17
18
19
78 AR 28.
20
1 NP Ketchel’s opinion, missing from the Disability Determination
2 Explanations is any explanation as to why they disagreed with
3 NP Ketchel’s concentration and persistence limitations, particularly
4 given that NP Ketchel had to repeat questions and she observed
5 Plaintiff with poor posture and restlessness.79 That Dr. G and
6 Dr. Eisenhauer found that NP Ketchel’s “exam overall is consistent
7 with the ability to perform simple repetitive tasks,”80 is not necessarily
8 inconsistent with Dr. Ketchel’s opinion that Plaintiff cannot sustain
9 simple repetitive tasks over the course of a workday. There was no
10 evidence discussed by Dr. G and Dr. Eisenhauer to explain why they
11 disagreed with NP Ketchel’s opinion that Plaintiff could not sustain
12 full-time work. In summary, the ALJ did not explain why Dr. Ketchel’s
13 opined persistence limitation was less supported than Dr. G’s and
14 Dr. Eisenhauer’s opinions as to Plaintiff’s persistence abilities.81
15
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79 AR 82–99.
17
80 AR 86, 96.
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81 Embrey v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988) (requiring the
19
ALJ to identify the evidence supporting the found conflict to permit the
20
1 The ALJ’s errors when evaluating the evidence and the medical
2 opinions requires remand.82
3 B. Remand: award benefits.
4 Plaintiff asks for an award of benefits; whereas the Commissioner
5 argues this record does not justify an award of benefits.
6 Although remand for further administrative proceedings is the
7 usual course when a harmful error occurs in the administrative
8 proceeding, this is a rare circumstance where an award of benefits is
9 appropriate.83 First, this record contains the treatment records from
10
11
court to meaningfully review the ALJ’s finding); Humane Soc. of U.S. v.
12
Locke, 626 F.3d 1040, 1054 (9th Cir. 2010 (requiring an agency to
13
provide an explanation that “enables meaningful judicial review”);
14
Burnett v. Bowen, 930 F.3d 731, 736 (7th Cir. 1987).
15
82 Plaintiff’s other arguments in support of remand need not be
16
addressed.
17
83 See Treichler v. Comm’r of Social Sec. Admin., 775 F.3d 1090, 1099
18
(9th Cir. 2014) (quoting Fla. Power & Light Co. v. Lorion, 470 U.S. 729,
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744 (1985)).
20
1 his primary provider, a consultative psychological examination ordered
2 by the SSA, a prior psychological examination that references an even
3 earlier examination, a statement from a prior employer, a statement
4 from his parents, and testimony from Plaintiff and his mother.
5 Plaintiff’s mental-health impairments are life-long and there is no
6 assertion that the continued use of medication will lessen Plaintiff’s
7 concentration, attention, and interpersonal difficulties resulting from
8 his autism spectrum disorder, ADHD, depressive disorder, and a
9 general anxiety order. Further administrative proceedings to develop
10 the record will serve no useful purpose.
11 Second, as discussed above, the ALJ failed to provide legally
12 sufficient reasons to reject NP Ketchel’s opined concentration and
13 persistence limitations.
14 Third, if NP Ketchel’s opinion that Plaintiff is unable to sustain
15 concentration and persist in work-related activity at a reasonable pace
16 is credited, Plaintiff is disabled. The vocational expert testified that an
17 employee who is off task more than 10 percent of the time is
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19
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1 unemployable.84 In addition, the vocational expert testified that,
2 outside the supported-employment realm, an individual who requires
3 close and frequent supervision because of an inability to complete tasks
4 without further prompting is unemployable.85
5 Therefore, benefits are warranted.
6 IV. Conclusion
7 Plaintiff establishes the ALJ erred and that an award of benefits is
8 appropriate. Accordingly, IT IS HEREBY ORDERED:
9 1. The ALJ’s nondisability decision is REVERSED, and this
10 matter is REMANDED to the Commissioner of Social
11 Security for immediate calculation and award of
12 benefits.
13 2. The Clerk’s Office shall TERM the parties’ briefs, ECF Nos.
14 11 and 15, enter JUDGMENT in favor of Plaintiff, and
15 CLOSE the case.
16
17
18
84 AR 74.
19
85 AR 75–76.
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1 IT IS SO ORDERED. The Clerk’s Office is directed to file this
2 |lorder and provide copies to all counsel.
3 DATED this 25* day of February 2026.
td I Lew.
5 EDWARD F.SHEA
Senior United States District Judge
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DISPOSITIVE ORDER - 31
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