Unreported / Non-Citable
Background
Rebecca Ann Gowan applied for supplemental security income on June 16, 2021, alleging disability from generalized anxiety disorder, bipolar disorder, depression, high blood pressure, and thyroid disease. An administrative law judge denied the claim in November 2022, and the Appeals Council upheld that decision. In July 2024, a district judge granted Gowan summary judgment because the ALJ had improperly evaluated the opinion of Dr. Maussa Cottone-Wilson and remanded for further proceedings.
After a second hearing in July 2025, the ALJ again found Gowan not disabled in August 2025. The ALJ found severe impairments of generalized anxiety disorder and benzodiazepine use disorder, found no listing met, and assessed an RFC for work at all exertional levels limited to simple instructions, occasional interaction with the public and coworkers, occasional changes in the work setting, and occasional supervision. Relying on vocational expert testimony, the ALJ found she could work as a laundry aide, transportation cleaner, or hand packager. Gowan sued again in October 2025, and the parties cross-moved for summary judgment. She argued the ALJ mishandled Dr. Cottone-Wilson's opinion and the opinions of state agency reviewers Dr. Karen Ying and Dr. M. Lin, and failed to give clear and convincing reasons for discounting her symptom testimony. The Commissioner defended the decision.
The Court’s Holding
The magistrate judge recommends granting Gowan's motion, denying the Commissioner's cross-motion, and reversing and remanding the final decision. On Dr. Cottone-Wilson, the court found error. Although the ALJ found the opinion mostly persuasive, it identified moderate limitations in performing work activities on a consistent basis, completing a normal workday or workweek without interruption, and working without special or additional supervision, along with mild to moderate attendance limitations. The court concluded that a restriction to occasional work-setting changes does not accommodate the moderate attendance limitation, that it was unclear how the RFC incorporated the workday limitation, and that the ALJ gave no legally sufficient reason for rejecting the supervision limitation. The Commissioner's reliance on findings of fair to poor insight and judgment was called confusing, because such findings would suggest a more severe limitation.
As to the state agency reviewers, the court found no error in the handling of their simple, routine, low-stress opinion, because the ALJ also limited Gowan to occasional work-setting changes. But the ALJ erred in discounting their opinion that Gowan should have no public contact, because substantial evidence did not support the finding that her treatment was conservative.
On symptom testimony, the conservative-treatment rationale failed because the record showed symptoms that waxed and waned, including a 2023 involuntary hold, recurring anxiety reports, and passive suicidal ideation in late 2024. The court treated the ALJ's panic-attack point as lack of record support rather than a contradiction, and inconsistency with objective medical evidence cannot be the sole reason. On remedy, the court found serious doubt whether Gowan was disabled and recommended remand, not an award of benefits. It gave no instruction to credit any opinion, leaving open full disability, a closed period, or no disability.
Key Takeaways
- A limit to simple instructions or fewer work-setting changes does not automatically account for moderate limitations in attendance, completing a workday, or needing additional supervision.
- Calling mental health treatment conservative requires substantial evidence, and reports of improvement must be read against symptoms that wax and wane.
- An ALJ who rejects part of a state agency reviewer's opinion, such as a no-public-contact limit, must support that choice with substantial evidence.
- Inconsistency with objective medical evidence cannot be the sole reason to discount a claimant's symptom testimony.
- These are recommendations, not a judgment, so the district judge must still rule after any objections, and the remand leaves the ultimate disability question open.
Why It Matters
The report applies familiar Ninth Circuit standards in a case already remanded once. It shows that courts will check whether an RFC actually tracks the moderate limitations of an opinion the ALJ called persuasive. Its reasoning on simple-task restrictions relies largely on district court decisions rather than binding appellate authority.
As findings and recommendations, it has no binding effect until the assigned district judge adopts it, and parties had 14 days to object. If adopted, the ALJ may develop the record and must reassess the three medical opinions and the symptom testimony under the correct standards.