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Lamb v. Colvin

United States District Court, Ninth Circuit

January 29, 2014

RODGER G. LAMB, Plaintiff,
CAROLYN COLVIN, Commissioner of Social Security, Defendant.


SHARON L. GLEASON, District Judge.

Rodger Lamb initiated this Social Security action in federal district court after exhausting administrative remedies. The matter has been fully briefed by the parties.[1] For the reasons set forth below, this matter will be reversed and remanded for the calculation and award of benefits.


Mr. Lamb is 45 years old.[2] He has a high school education, as well as some training in welding, metallurgy, and CAD programming.[3] From 1995 to 2005, he did construction work, and from 2006 to April 2008 he worked as an electronics engineer at Envision Product Design.[4] Since age 18, he has suffered from chronic abdominal pain, the precise cause of which has been difficult to diagnose.[5]

I. Mr. Lamb's Application for Social Security Disability Benefits.

On February 25, 2011, Mr. Lamb filed an application for Social Security disability insurance benefits with the State of Alaska Disability Determination Services office ("DDS").[6] Mr. Lamb alleged a disability onset date of April 30, 2008, the last date that Mr. Lamb worked for Envision Product Design.[7] He listed the following conditions as limiting his ability to work: Crohn's disease, eosinophilic gastroenteritis, diabetes, chronic pain, high cholesterol, high blood pressure, and depression.[8] In 2011, Mr. Lamb was taking fifteen prescription medications-including opioids-for these conditions, most or all of which were prescribed by Dr. Verlyn Corbett at the Alaska Native Medical Center ("ANMC").[9]

On July 28, 2011, DDS denied Mr. Lamb's application for disability insurance benefits.[10] On September 22, 2011, Mr. Lamb requested a hearing before an administrative law judge ("ALJ").[11]

The ALJ's Denial of Mr. Lamb's Application for Benefits.

Mr. Lamb's hearing took place on February 15, 2012 in Anchorage, Alaska before ALJ Paul Hebda.[12]

A. Medical Evidence in the Record.

The administrative record reflects the following:

Mr. Lamb has received most of his healthcare services at ANMC.[13] Dr. Corbett is his primary care physician.[14] Between 2008 and 2011, it appears Mr. Lamb consulted with Dr. Corbett in person numerous times, and it appears the purpose of many of those consultations was to evaluate Mr. Lamb's pain and/or medications.[15] Additionally, it appears Mr. Lamb requested medication refills at least once in 2007 and 2009 and several times in 2010 and 2011.[16]

On February 18, 2010, Mr. Lamb visited ANMC and had a pain assessment done by Wendy Bradley, LPC.[17] Ms. Bradley's notes based on that visit state in part:

[Mr. Lamb] has a twenty year history, starting at age 18 with stomach pain. It has never been clearly identified as to the cause of this pain.... [Mr. Lamb] has not worked for a year. He has done a variety of jobs to include construction, electronics fixing but has often had trouble with his managers, they just did not get along. He seems to have difficulties relating socially.... He has toyed with the idea of disability but we discussed that and felt like it was more important for him to get back to work. He is still able to do a lot and now that he is on regular narcotics should be able to function.[18]

After Mr. Lamb applied for social security benefits in February 2011, the DDS agent who evaluated Mr. Lamb's application ordered a consultative examination ("CE").[19] Dr. William Ragle performed the CE on July 18, 2011.[20] Based on his examination of Mr. Lamb, Dr. Ragle reported:

[S]ince age 18 [Mr. Lamb] has had abdominal pain, bowel irregularities. He had an exploratory laparotomy in 1986, says they "found a brown coating on my bowels and biopsies were inconclusive." [Mr. Lamb] says he was treated with steroids at that time for "eosinophilic gastroenteritis." Since then he has continued to have bowel problems varying from constipation to diarrhea with no blood in the stool. Typically moves his bowels 1-2 times daily. Has chronic lower abdominal pain.... He describes having had multiple colonoscopies with "inconclusive findings, now they suspect Crohn's disease, " last colon study was "10 years ago." EGD around the same time "[also] inconclusive." He had a video capsule "5-6 years ago by Dr. Sweeney, " this also being "inconclusive." He indicates he takes multiple medications for his [symptoms].... He feels he cannot work because of the chronic pain.[21]

Dr. Ragle stated that "[i]t is very unusual for someone to have this degree of abdominal pain, " and he found it "surprising that [Mr. Lamb] has not had more recent evaluation of his chronic [symptoms]."[22] He also noted that Mr. Lamb was "being treated with medication usually used to treat inflammatory bowel disease, " but he stated he was unable to supply a "definitive diagnosis" of Mr. Lamb's abdominal pain.[23]

Ten days after Dr. Ragle performed his CE, Dr. G. Morris, a physician employed by DDS, reviewed Mr. Lamb's medical records. Based on that review, Dr. Morris "opined that [Mr. Lamb] may be being over-treated for something that hasn't even really been diagnosed."[24] Dr. Morris also found "a lack of objective data to support [Mr. Lamb's] allegations of chronic pain."[25] He recommended that Mr. Lamb's residual functional capacity be considered "at least medium."[26] DDS denied Mr. Lamb's application for disability insurance benefits that same day.[27]

In December 2011, roughly five months after Mr. Lamb's application for social security disability benefits had been denied and two months before the administrative hearing, Mr. Lamb and his mother met with Dr. Corbett and expressed interest in "pursuing some advanced workup for [Mr. Lamb's] chronic abdominal pain."[28] Dr. Corbett's notes state that Mr. Lamb has "a 25 year history of poorly defined chronic abdominal pain."[29]

On December 29, 2011, Mr. Lamb met with Dr. William Bowers, a gastroenterologist. Dr. Bowers diagnosed Mr. Lamb with "eosinophilic gastroenteritis with symptoms of irritable bowel[, ] diabetes, [and] hypertension."[30] His notes characterize the severity of Mr. Lamb's abdominal pain as "moderate."[31] He recommended Mr. Lamb have prednisone on hand to use during flares.[32]

On February 14, 2012, the day before Mr. Lamb's hearing, Dr. Corbett submitted a letter to the ALJ on behalf of Mr. Lamb.[33] The letter states in relevant part:

I am writing this letter on behalf of Mr. Rodger Lamb.... Due to Mr. Lamb's eosinophilic gastroenteritis (abdominal pain, nausea, and food intolerances) and diabetes, Mr. Lamb has difficulty performing activities of daily living.... Receiving social ...

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