FOR PUBLICATION
UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
STEVEN TAYLOR,
Plaintiff-Appellant, No. 10-35732
v.
D.C. No.
3:09-cv-00278-MA
COMMISSIONER OF SOCIAL SECURITY
ADMINISTRATION, OPINION
Defendant-Appellee.
Appeal from the United States District Court
for the District of Oregon
Malcolm F. Marsh, Senior District Judge, Presiding
Submitted July 14, 2011*
Portland, Oregon
Filed October 27, 2011
Before: Harry Pregerson, Kim McLane Wardlaw, and
Milan D. Smith, Jr., Circuit Judges.
Opinion by Judge Pregerson
*The panel unanimously concludes this case is suitable for decision
without oral argument. See Fed. R. App. P. 34(a)(2).
19569
TAYLOR v. CSSA 19571
COUNSEL
Ralph Wilborn, Wilborn & Wilborn, P.C., Green Valley, Ari-
zona, and Tim Wilborn, Wilborn Law Office, P.C., Oregon
City, Oregon, for the plaintiff-appellant.
Leisa A. Wolf, Assistant Regional Counsel, Social Security
Administration, Office of the General Counsel, Seattle, Wash-
ington, for the defendant-appellee.
19572 TAYLOR v. CSSA
OPINION
PREGERSON, Circuit Judge:
Steven Taylor appeals the denial of his application for dis-
ability insurance benefits under Title II of the Social Security
Act, 42 U.S.C. §§ 401-34. Taylor claims he is disabled by
thoracic spine and lumbar spine degenerative disc disease, a
muscle disorder, a pain disorder, a panic disorder with agora-
phobia, and a personality disorder. We have jurisdiction pur-
suant to 42 U.S.C. § 405(g) and 28 U.S.C. § 1291. We reverse
and remand.
BACKGROUND
On March 29, 2006, the Administrative Law Judge (ALJ)
issued a written decision finding Taylor not disabled as
defined by the Social Security Act and denying Taylor’s
application. Taylor then submitted a request for review of the
ALJ’s decision to the Appeals Council.
With his initial request for review, Taylor submitted a psy-
chiatric evaluation from September 7, 2006, and a medical
source statement dated November 15, 2006, both from Dr.
Jeffrey D. Thompson, M.D. Dr. Thompson’s psychiatric eval-
uation was a follow-up from previous evaluations he con-
ducted in 2001 and 2003. In his evaluation, Dr. Thompson
noted Taylor’s diagnosis of panic disorder with agoraphobia.
Dr. Thompson’s medical source statement found Taylor
markedly limited in his ability to perform several work-
related functions. Dr. Thompson also noted a “substantial
loss” in multiple basic mental activities.
The Appeals Council initially dismissed as untimely Tay-
lor’s request for review, but then, upon a writ of mandamus
from the district court, set aside its earlier action. The Appeals
Council then considered additional medical evidence Taylor
submitted, including opinions from Dr. Glen O’Sullivan,
TAYLOR v. CSSA 19573
M.D., Dr. Mark Greenberg, M.D., and Dr. Zakir Ali, M.D., all
dating from July 2006 to June 2008. The Appeals Council
concluded that all of the new information concerned a time
after Taylor’s insured date of December 31, 2004, and, there-
fore, did “not affect the decision about whether [Taylor] was
disabled at the time [he] was last insured for disability bene-
fits.” The Appeals Council again denied Taylor’s request for
review, finding no basis for changing the ALJ’s decision,
thereby making the ALJ’s written decision the final decision
subject to judicial review.
DISCUSSION
I.
[1] As an initial matter, the Commissioner argues that the
Appeals Council’s decision denying Taylor’s request for
review is itself unreviewable by our court. When the Appeals
Council denies a request for review, it is a non-final agency
action not subject to judicial review because the ALJ’s deci-
sion becomes the final decision of the Commissioner. See
Klemm v. Astrue, 543 F.3d 1139, 1144 (9th Cir. 2008) (“The
Social Security Act grants to district courts jurisdiction to
review only ‘final decisions’ of the Commissioner.” (citing 42
U.S.C. § 405(g))); accord Mackey v. Shalala, 47 F.3d 951,
953 (8th Cir. 1994) (no jurisdiction to review Appeals Coun-
cil’s denial of review because “it is a nonfinal agency action”
(citing Browning v. Sullivan, 958 F.2d 817, 822 (8th Cir.
1992)); Matthews v. Apfel, 239 F.3d 589, 594 (3rd Cir. 2001)
(same). Thus, we have no jurisdiction to review the Appeals
Council’s decision denying Taylor’s request for review. That
is, we may neither affirm nor reverse the Appeals Council’s
decision.
But Taylor is not arguing that the Appeals Council’s deci-
sion to deny his request for review should be reversed. Rather,
Taylor asks us to review the evidence submitted to the
Appeals Council and credit the evidence as true because that
19574 TAYLOR v. CSSA
evidence was improperly rejected by the Appeals Council.
Under these circumstances, Taylor asks us to remand to the
district court with instructions to immediately award benefits.
Contrary to the Commissioner’s assertion, Taylor is not effec-
tively asking for a “ruling that the Appeals Council must pro-
vide [a] detailed rationale whenever faced with new
evidence.” If he were, Taylor’s request would be barred by
Gomez v. Chater, where we held that “the Appeals Council
[was] not required to make any particular evidentiary finding”
when it rejected evidence from a vocational expert obtained
after an adverse administrative decision. 74 F.3d 967, 972
(9th Cir. 1996).
[2] Instead, Taylor argues that his situation is like that in
Ramirez v. Shalala, where we held that the Appeals Council
improperly rejected a treating physician’s opinion, and we
remanded to the district court for an immediate award of ben-
efits. 8 F.3d 1449, 1451-54 (9th Cir. 1993). In Ramirez, we
held that we could consider the physician’s opinion, which
was rejected by the Appeals Council, to determine whether,
in light of the record as a whole, the ALJ’s decision was sup-
ported by substantial evidence and was free of legal error. Id.
This, Taylor contends, is what he is requesting that we do:
review Dr. Thompson’s improperly rejected opinion in our
overall review of the ALJ’s final decision, not in review of the
Appeals Council’s decision denying Taylor’s request for
review. As the Commissioner concedes, we may do so. See id.
at 1452; Lingenfelter v. Astrue, 504 F.3d 1028, 1030 n.2 (9th
Cir. 2007); Harman v. Apfel, 211 F.3d 1172, 1180 (9th Cir.
2000).
According to Taylor, the Appeals Council improperly
rejected Dr. Thompson’s psychiatric evaluation and medical
source statement because the Appeals Council believed that
those two opinions concerned Dr. Thompson’s medical views
after December 31, 2004, when Taylor’s disability insurance
coverage expired. Although Dr. Thompson’s medical source
statement is dated November 15, 2006, the medical source
TAYLOR v. CSSA 19575
statement indicates that Dr. Thompson’s medical assessment
encompassed the period from the date of disability onset in
August 1999, around the time of Taylor’s work-related injury,
until the date of his evaluation. During the intervening five
years between 1999 and 2004 when Taylor’s insured coverage
was in effect, Dr. Thompson examined Taylor twice; super-
vised Susan Wrona-Sexton, the licensed nurse practitioner
who treated Taylor; and approved Wrona-Sexton’s prescrip-
tion of Taylor’s medications. The Commissioner does not
contest that Dr. Thompson’s opinion concerns the status of
Taylor’s mental impairments and limitations before the expi-
ration of his insured status. Moreover, “[t]his court has specif-
ically held that medical evaluations made after the expiration
of a claimant’s insured status are relevant to an evaluation of
the preexpiration condition.” Lester v. Chater, 81 F.3d 821,
832 (9th Cir. 1996) (internal quotation marks and citation
omitted). Thus, if the Appeals Council rejected Dr. Thomp-
son’s opinion because it believed it to concern a time after
Taylor’s insurance expired, its rejection was improper.
It appears, however, that the Appeals Council did not con-
sider Dr. Thompson’s opinion at all. Taylor submitted Dr.
Thompson’s documents to supplement his original request for
review of the ALJ’s decision. This original request for review
was denied because the Appeals Council believed the request
had been filed late. The Appeals Council, however, set aside
its earlier action upon a writ of mandamus from the district
court. It was during the time between the ordering of the writ
of mandamus and the Appeals Council’s reconsideration of
Taylor’s case that Taylor filed the other documents from Dr.
Greenberg, Dr. Ali, and Dr. O’Sullivan in support of his
request for review. The Appeals Council referred only to
those documents, not to Dr. Thompson’s opinion, when it
denied Taylor’s request for review a second time. Somewhere
in the shuffle, Dr. Thompson’s psychiatric evaluation and
medical source statement were lost, and the Appeals Council
never considered them when it denied Taylor’s request for
review.
19576 TAYLOR v. CSSA
[3] Because Dr. Thompson’s opinion concerned his assess-
ment of Taylor’s mental health since his alleged disability
onset date in 1999, it related to the period before Taylor’s dis-
ability insurance coverage expired in 2004, and before the
ALJ’s decision in 2006. Thus, Dr. Thompson’s opinion
should have been considered. See 20 C.F.R. § 404.970(b) (“If
new and material evidence is submitted, the Appeals Council
shall consider the additional evidence only where it relates to
the period on or before the date of the administrative law
judge hearing decision.”). Where the Appeals Council was
required to consider additional evidence, but failed to do so,
remand to the ALJ is appropriate so that the ALJ can recon-
sider its decision in light of the additional evidence. See id.
[4] Accordingly, we remand to the ALJ for consideration
of Dr. Thompson’s psychiatric evaluation and medical source
statement. See Ramirez, 8 F.3d at 1451-52. On remand, the
ALJ must account for Dr. Thompson’s opinion in the five-
step sequential analysis required under 20 C.F.R.
§ 404.1520(a)(4)(i)-(v). See also Tackett v. Apfel, 180 F.3d
1094, 1098 (9th Cir. 1999); Lounsburry v. Barnhart, 468 F.3d
1111, 1114 (9th Cir. 2006). Even if Dr. Thompson’s opinion
is contradicted by other evidence in the record, as a treating
physician, his opinion may not be rejected without “specific
and legitimate reasons . . . supported by substantial evidence
in the record.“ See Lester, 81 F.3d at 830-31.
II.
[5] The Appeals Council’s failure to consider Dr. Thomp-
son’s opinion on review was not the only mistake made. The
ALJ’s previous five-step sequential analysis also contained
several errors.
At step three, the ALJ failed to explain adequately his eval-
uation of the combined effect of Taylor’s impairments, both
severe and non-severe, and why they did not meet or equal
any of those on the Listing of Impairments, 20 C.F.R. Part
TAYLOR v. CSSA 19577
404, Subpart P, Appendix 1, particularly listing 12.06,
anxiety-related disorders, and listing 12.07, somatoform dis-
orders. See 20 C.F.R. § 404.1523; Marcia v. Sullivan, 900
F.2d 172, 176 (9th Cir. 1990).
At step four, the ALJ’s residual functional capacity deter-
mination was incomplete because it improperly discounted
significant evidence in the record favorable to Taylor’s posi-
tion.
[6] The ALJ gave primacy to the opinions of non-treating,
non-examining medical consultants, Dr. John Crosson, Ph.D.,
and Dr. Jay Goodman, M.D., and gave weight to the other
medical opinions in the record only to the extent that they
were consistent with those of the medical consultants. For
example, the ALJ gave substantial weight to examining psy-
chiatrist Dr. S. David Glass, M.D., whose opinion was gener-
ally consistent with Dr. Crosson’s. But Dr. Glass also
diagnosed Taylor with a pain disorder, and the ALJ rejected
this diagnosis because it was inconsistent with Dr. Crosson’s
opinion. The ALJ rejected this diagnosis without giving a spe-
cific and legitimate reason supported by substantial evidence
in the record. See Regennitter v. Comm’r of Social Sec.
Admin, 166 F.3d 1294, 1298-99 (9th Cir. 1999). Moreover,
because their findings were inconsistent with those of the
non-examining consultants, the ALJ characterized the medical
opinion of Dr. Dee Christlieb, M.D., as “pro-disability report-
ing” and stated that Dr. David Hagie, D.O., was “focused on
being a disability advocate” for Taylor, without providing
specific and legitimate reasons for his claims. Id.; see also
Lester, 81 F.3d at 831 (“The opinion of a nonexamining phy-
sician cannot by itself constitute substantial evidence that jus-
tifies the rejection of the opinion of either an examining
physician or a treating physician.”).
[7] The ALJ also erroneously stated that nurse practitioner
Wrona-Sexton is not a medical source and discounted her evi-
dence. Under the Social Security Act regulations, 20 C.F.R.
19578 TAYLOR v. CSSA
§ 404.1513(d)(1), nurse practitioners are listed among the
examples of “medical sources.”1 To the extent nurse practi-
tioner Wrona-Sexton was working closely with, and under the
supervision of, Dr. Thompson, her opinion is to be considered
that of an “acceptable medical source.” See Gomez v. Chater,
74 F.3d 967, 971 (9th Cir. 1996).
Moreover, the ALJ did not provide specific, germane rea-
sons for discounting lay witness testimony from Taylor’s
wife, Wanda, and Taylor’s friend, Elin Keffr. See Bruce v.
Astrue, 557 F.3d 1113, 1115 (9th Cir. 2009). Lay witness tes-
timony may be introduced “to show the severity of [the claim-
ant’s] impairment(s) and how it affects [his] ability to work.”
20 C.F.R. § 404.1513(d). Wanda Taylor’s and Elin Keffr’s
testimony corroborated other evidence that indicated that Tay-
lor would have difficulties sustaining full-time work and that
he had marked physical and mental limitations. The ALJ did
not find either of the lay witnesses not credible. “Nor under
our law could the ALJ discredit [their] lay testimony as not
supported by medical evidence in the record.” Bruce, 557
F.3d at 1116.
[8] The ALJ also rejected Taylor’s testimony about his
symptoms insofar as it conflicted with the ALJ’s residual
functional capacity determination. But Taylor provided objec-
tive medical evidence of various physical and mental ail-
ments, and the ALJ made no explicit finding of malingering.
Thus, the ALJ had to support his credibility finding about
Taylor’s testimony with specific, clear and convincing rea-
sons. See Lingenfelter, 504 F.3d at 1036. The ALJ failed to
do so.
1
Under Oregon law, to become a certified nurse practitioner a nurse
must have an Oregon Registered Nurse license, obtain a master’s degree
or a doctoral degree in nursing, graduate from a nurse practitioner program
specific to the category in which a nurse seeks certification, and fulfill
multiple practice requirements. Nurse practitioners may acquire prescrip-
tive authority. See Nurse Practitioner (NP) Certification Information,
available at http://www.oregon.gov/OSBN/AdvPracLicensure.shtml.
TAYLOR v. CSSA 19579
For example, the ALJ gave substantial weight to Dr. Good-
man’s and Dr. Crosson’s opinion that most of Taylor’s pain
was due to his habituation to narcotics medication. But
beyond the opinions of the two non-treating consultants, there
is no evidence in the record that Taylor’s limitations were due
to his methadone prescription, or that his several impairments
would desist if he weaned himself off of methadone. And,
while recognizing that Taylor’s physical symptoms “may wax
and wane,” the ALJ held against Taylor two instances where
he was able to function, even though his alleged disability
involves attacks of muscle weakness or loss of muscle move-
ment that come and go. This was error because “[o]ne does
not need to be ‘utterly incapacitated’ in order to be disabled.”
Vertigan v. Halter, 260 F.3d 1044, 1050 (9th Cir. 2001)
(quoting Fair v. Bowen, 885 F.2d 597, 603 (9th Cir. 1989)).
The ALJ also noted that Taylor demonstrated excellent cogni-
tive abilities during the hearing, despite his allegations of
diminished mental capacity. However, the ALJ’s personal
observations of Taylor do not constitute substantial evidence
for rejecting any of the opinions of Taylor’s physicians who
have found Taylor psychologically impaired. See Montijo v.
Sec. of Health & Human Servs., 729 F.2d 599, 602 (9th Cir.
1984).
[9] Finally, at step five, the ALJ failed to ask the voca-
tional expert whether there was a conflict between her testi-
mony and the Dictionary of Occupational Titles. See SSR 00-
4p, at *2; Massachi v. Astrue, 486 F.3d 1149, 1152 (9th Cir.
2007). Nothing in the rules relieves the ALJ of the responsi-
bility of ensuring that there was no conflict, even if the voca-
tional expert testified that Taylor could perform other jobs.
Moreover, the ALJ failed to include all of Taylor’s impair-
ments in his residual functional capacity determination and,
therefore, asked an erroneous hypothetical question of the
vocational expert. “Because neither the hypothetical nor the
answer properly set forth all of [Taylor’s] impairments, the
vocational expert’s testimony cannot constitute substantial
19580 TAYLOR v. CSSA
evidence to support the ALJ’s findings.” Gallant v. Heckler,
753 F.2d 1450, 1456 (9th Cir. 1984).
III.
Remand for further proceedings is appropriate where there
are outstanding issues that must be resolved before a disabil-
ity determination can be made, and it is not clear from the
record that the ALJ would be required to find the claimant
disabled if all the evidence were properly evaluated. See
Vasquez v. Astrue, 572 F.3d 586, 593 (9th Cir. 2009). Because
Dr. Thompson’s psychiatric evaluation and medical source
statement were not considered by the Appeals Council or the
ALJ, remand to the ALJ for further consideration is in order.
CONCLUSION
[10] For the foregoing reasons, we REVERSE the district
court’s decision affirming the Commissioner’s decision and
REMAND to the ALJ for consideration of Dr. Thompson’s
opinion evidence and for reconsideration of Taylor’s disabil-
ity claims.
REVERSED AND REMANDED.