Johaningmeier v. Commissioner Social Security Administration

Filing 21

OPINION and ORDER - The Commissioner's decision is AFFIRMED and this case is DISMISSED. IT IS SO ORDERED. DATED this 11th day of January, 2018, by United States Magistrate Judge John V. Acosta. (peg)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF OREGON
PORTLAND DIVISION

DEBORAH ELAINE JOHANINGMEIE R,
Plaintiff,

Case No.: 3:16-CV-02027-AC
OPINION AND ORDER

v.
NANCY A. BERRYHILL,
Acting Commissioner of Social Security,
Defendant.
ACOSTA, Magistrate Judge:
Deborah Elaine Johaningmeier ("plaintiff') seeks judicial review of a final decision by the
Commissioner of Social Security ("Commissioner") denying her application for Title II Disability
Insurance Benefits ("DIB") under the Social Security Act ("Act"). Because the Commissioner's
decision is suppmted by substantial evidence, his decision is AFFIRMED and this case DISMISSED.

Procedural Background
Plaintiff protectively filed her application for DIB on Octo her 17, 2012, alleging disability
as of January 1, 2010. (Tr. 22, 211-15.) The Commissioner denied her application initially and upon
Page I - OPINION AND ORDER

reconsideration, and she requested a hearing before an Administrative Law Judge ("ALJ"). (Tr.
91-102, 103-13, 126-27.) AnadministrativehearingwasheldonDecember22,2014. (Tr. 37-78).
A supplemental hearing was held on June 1, 2015. (Tr. 79-90.) After the hearings, the ALJ issued
an unfavorable decision on June 10, 2015, finding plaintiff not disabled. (Tr. 19-36.) The Appeals
Council denied plaintiffs subsequent request for review, making the ALJ' s decision final. (Tr. 1-7.)
Factual Background
Born on August 27, 1956, plaintiff was 53 years old on the alleged onset date of disability
and 58 years old at the time of the initial hearing. (Tr. 42, 92, 103.) She speaks English, completed
a year of college, and vocational college for phlebotomy. (Tr. 42-43, 227, 229.) Plaintiff alleges
disability due to migraines, insomnia, depression, interstitial cystitis, high blood pressure, arthritis,
ischemic colitis, asthma, and hypothyroidism. (Tr. 49-51, 92, 103.)
Standard ofReview
The court must affom the Commissioner's decision ifit is based on proper legal standards
and the findings are supported by substantial evidence in the record. Hammockv. Bowen, 879 F.2d
498, 501 (9th Cir. 1989). Substantial evidence is "more than amere scintilla. It means such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v.
Perales, 402 U.S. 389, 401 (1971) (citation and internal quotations omitted). The court must weigh
"both the evidence that supports and detracts from the [Commissioner's] conclusions." Martinez
v. Heckler, 807 F.2d 771, 772 (9th Cir. 1986). "Where the evidence as a whole can suppoti either
a grant or a denial, [the court] may not substitute [its] judgment for the ALJ's." Massachi v. Astrue,
486 F.3d 1149, 1152 (9th Cir. 2007) (citation omitted).
The initial burden ofproofrests upon the claimant to establish disability. Howardv. Heckler,

Page 2 - OPINION AND ORDER

782 F.2d 1484, 1486 (9th Cir. 1986). To meet this burden, the claimant must demonstrate an
"inability to engage in any substantial gainful activity by reason of any medically determinable
physical or mental impairment which can be expected ... to last for a continuous period of not less
than 12 months." 42 U.S.C. § 423(d)(l)(A).
The Commissioner has established a five-step sequential process for determining whether
a person is disabled. Bowen v. Yuckert, 482 U.S. 137, 140 (1987); 20 C.F.R. § 404.1520. 1 First, the
Commissioner determines whether a claimant is engaged in "substantial gainful activity." Yuckert,
482 U.S. at 140; 20 C.F.R. § 404.1520(b). Ifso, the claimant is not disabled.
At step two, the Commissioner evaluates whether the claimant has a "medically severe
impairment or combination of impairments." Yuckert, 482 U.S. at 140-41; 20 C.F.R. § 404.1520©.
If the claimant does not have a medically determinable, severe impairment, he is not disabled.

At step three, the Commissioner determines whether the claimant's impairments, either
singly or in combination, meet or equal "one of a number of listed impairments that the
[Commissioner] acknowledges are so severe as to preclude substantial gainful activity." Yuckert,
482 U.S. at 140-41; 20 C.F.R. § 404.1520(d). Ifso, the claimant is presumptively disabled; if not,
the Commissioner proceeds to step four. Yuckert, 482 U.S. at 141.
At step four, the Commissioner resolves whether the claimant can still perform "past relevant
work." 20 C.F.R. § 404.1520(£). If the claimant can work, he is not disabled; if he cannot perform
past relevant work, the burden shifts to the Commissioner. At step five, the Commissioner must
establish that the claimant can perform other work existing in significant numbers in the national or

1

Effective March 27, 2017, updates were made to the regulations and some sections of
the regulations were renumbered. The C.F.R. sections referenced throughout this opinion are the
versions of the C.F .R. in effect at the time plaintiff requested judicial review.
Page 3 - OPINION AND ORDER

local economy. Yuckert, 482 U.S. at 141-42; 20 C.F.R. § 404.1520(g). If the Commissioner meets
this burden, the claimant is not disabled. 20 C.F.R. § 404.1566.
The ALi's Findings

The ALJ performed the sequential analysis. At step one of the five-step process outlined
above, the ALJ found that plaintiff had not engaged in substantial gainful activity since January 1,
2012, the alleged onset date. (Tr. 24.) At step two, the ALJ concluded that plaintiff had the
following severe impairments: interstitial cystitis,2 osteoarthritis of the bilateral knees, mild left
shoulder rotator cufftendonitis, and mild degenerative disc disease. (Tr. 24-25.) At step three, the
ALJ dete1mined that plaintiff did not have an impai1ment or combination of impairments that met
or medically equaled a listed impairment. (Tr. 25.)
The ALJ next assessed plaintiffs residual functional capacity ("RFC") and found that
plaintiff has the RFC to
perform less than the full range of light work as defined in 20 CPR
404.1567(b). She can lift and carry 20 pounds occasionally and 10 pounds
frequently and can stand and/or walk 6 of8 hours. She can occasionally climb
and frequently stoop, kneel and crouch. She should not be required to engage
in overhead reaching with the left upper extremity on more than an occasional
basis.
(Tr. 25-30.)
At step four, the ALJ found that plaintiff could perform her past relevant work as a
phlebotomist. (Tr. 30.) The ALJ therefore concluded plaintiff was not disabled. (Id.) The ALJ did
not proceed to step five of the sequential evaluation process.

2

Cystitis is "the medical term for inflammation of the bladder. Most of the time, the
inflammation is caused by a bacterial infection, and it's called a urinary tract infection (UTI)".
Mayo Clinic,
http://www.mayoclinic.org/diseases-conditions/cystitis/basics/definition/con-20024076.
Page 4 - OPINION AND ORDER

Discussion
Plaintiff argues that the ALJ ened by: (1) improperly rejecting the medical opinion evidence
of Dr. John Ellison and Dr. Christopher Tongue, and (2) failing to properly consider her subjective
symptom testimony. (Pl.'s Opening Br. 5-28, PL 's Reply Br. 1-5.)

1

Medical Opinion Evidence.
First, plaintiff argues that the ALJ ened by improperly evaluating the medical opinions of

John Ellison, M.D., and Christopher Tongue, Ph.D. (Pl.'s Opening Br. 5-23, Pl.'s Reply Br. 1-5.)
An ALJ may reject the uncontradicted medical opinion of a treating or examining physician
only for "clear and convincing" reasons supported by substantial evidence in the record. Bayliss v.

Barnhart, 427 F.3d 1211, 1216 (9th Cir. 2005) (citing Lester v. Chater, 81F.3d821, 830-31 (9th
Cir. 1995)). An ALJ may reject the contradicted opinion of a treating or examining doctor by
providing "specific and legitimate reasons that are supported by substantial evidence." Id.

A.

Examining Physician, John H Ellison, MD.

Plaintiff argues that the ALJ ened by failing to provide a legally sufficient reason for
discrediting the medical opinion evidence of Dr. John Ellison.

(Pl.'s Opening Br. 7-16.)

Specifically, plaintiff argues that if Dr. Ellison's opinion were properly credited, she would be
limited to the performance of sedentary work, and would be unable to perform her past relevant work
as a phlebotomist, which is performed at the light level. (Pl.' s Opening Br. 8.)
Dr. Ellison evaluated plaintiff on two separation occasions. First, on January 31, 2015, Dr.
Ellison conducted a consultative examination. (Tr. 1078-80.) Upon examination, Dr. Ellison
diagnosed plaintiff with"[ c]Iu·onic low back pain with relatively benign exam,""[c)hronic left knee
pain with benign exam," "[ c]hronic neck pain and stiffness status post anterior fusion, 2004,"

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hypertension, incompletely controlled; asthma, chronic depression and insomnia, somatization,
secondary gain; and obesity. (Tr. 1080.)
Second, on Febrmuy 5, 2015, Dr. Ellison completed a Medical Source Statement of Ability
to Do Work Related Activities (Physical). (Tr. 1081-86.) Dr. Ellison wrote that plaintiff could
frequently lift up to ten pounds, could occasionally lift up to twenty pounds, and could occasionally
cany ten pounds. (Tr. 1081.) Dr. Ellison wrote that these limitations were related to plaintiffs
chronic depression, chronic low back pain, chronic neck pain, chronic pain in other joints,
hypertension, asthma, and obesity. (Id.) He found that plaintiff could sit for two hours, stand for
one hour, and sit for fifteen minutes at one time. (Tr. 1082.) In an eight-hour workday, she could
sit for eight hours, stand forthree hours, and walk for one hour. (Id.) She was able to frequently use
her right hand for reaching, handling, fingering, feeling, pushing, and pulling, but could only
occasionally handle, finger, feel, push, and pull with her left hand, and could never reach with her
left hand. (Tr. 1083.) Dr. Ellison wrote that plaintiff should avoid unprotected heights, moving
mechanical parts, operation of motor vehicles, pulmonmy irritants, and temperature extremes. (Tr.
1085.) Finally, he wrote that plaintiff could tolerate only occasional exposure to humidity, wetness,
and vibrations. (Id.)
The ALJ was required to give a specific and legitimate reason to discredit Dr. Ellison's
medical opinion because it was inconsistent with the opinion of Dr. Richmd Alley, who found
plaintiff could sit and stand six hours in an eight-hour workday, andhad no manipulative limitations.
(Tr. 98; see also Bayliss, 427 F.3d at 1216 (the contradicted opinion of a treating or examining
physician can be rejected with specific and legitimate reasons that are supported by substantial
evidence).) Here, the ALJ gave "some weight" to the opinion of Dr. Ellison, finding that his
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opinions were "not fully suppmied by the medical evidence of record." (Tr. 28.) The ALJ found
there was "no evidence" to support Dr. Ellison's standing and walking limitations, and that he
provided "no basis for this assessment." (Id.) The ALJ also found that although evidence supports
Dr. Ellison's "overheard reaching" limitations for the left arm, the record "does not support other
manipulative restrictions." (Id.) "The ALJ need not accept the opinion of any physician, including
a treating physician, if that opinion is brief, conclusory, and inadequately supported by clinical
findings." Bray v. Comm 'r of Soc. Sec. Admin., 554 F.3d 1219, 1228 (9th Cir. 2009); see also 20
C.F.R. §§ 404.1527(d)(3).
On this record, it was reasonable for the ALJ to give Dr. Ellison's medical opinion only some
weight. As the ALJ noted, the record shows plaintiff repmied left knee pain, but had relief with knee
injections and icing her knee after injections. (See tr. 346.) Indeed, an independent review of the
record shows x-rays of plaintiffs left knee from December 2014 which revealed only "mild
age-appropriate osteoarthritic change" in plaintiffs knee, and "no significant bone, joint space or
soft tissue abnormalities." (Tr. 1284.) With respect to plaintiffs right knee, the ALJ reasonably
noted that despite reported knee pain in her right lmee, a March 2014 x-ray showed only "mild
osteomihritic spurring." (See tr. 897, 1070.) Additionally, the ALJ finding's of the plaintiffs
manipulative restrictions m·e supported by an independent review of the evidence supports the ALJ' s
finding that the record "does not support other manipulative restrictions."
Plaintiff argues that Dr. Ellison's medical opinion is "generally preferred by the Agency,"
because he was the only examining physician and he has a medical specialty as an internist, both of
which require his opinion to receive more weight. (Pl.'s Opening Br. 9-10, citing 20 C.F.R. §§
404.1527(c)(1 ), (c)(5).) However, "the ALJ is the final arbiter with respect to resolving ambiguities

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in the medical evidence." Tommasetti v. Astrue, 533 F.3d 1035, 1041-42 (9th Cir. 2008). Here, the
ALJ reasonably evaluated the medical opinion evidence when discrediting Dr. Ellison's opinion.
While different interpretations of the evidence may exist, the ALJ' s analysis here was nonetheless
reasonable and, thus, must be upheld. Batson v. Comm 'r ofSoc. Sec. Admin., 359 F.3d 1190, 1198
(9th Cir. 2004). There is no error.

B.

Examining Physician, Christopher K Tongue, Ph.D.

Next, plaintiff argues that the ALJ ened by improperly evaluating the medical opinion
evidence of Dr. Christopher Tongue. (Pl.'s Opening Br. 17-23, Pl.'s Reply Br. 1-4.) Specifically,
plaintiff argues that the ALJ erred by relying on his own opinion instead of the opinion of the
medical examiner, Dr. Tongue. (Pl.'s Opening Br. 23.)
On February 4, 2015, Dr. Tongue performed a psychodiagnostic examination of plaintiff.
(Tr. 1088-92.) Upon examination, Dr. Tongue wrote that plaintiff's "mental status appears normal
and she shows no evidence of any cognitive impairment." (Tr. 1091.) He found plaintiff had "no
impaiiment in her ability to understand and remember simple instructions or carry them out or make
judgments on simple work-related decisions." (Id.) He also found that plaintiff is moderately
impaired in her ability to understand and remember complex instructions, mildly impaired in her
ability to make judgments on complex work-related decisions, and would be mildly impaired in her
ability to interact appropriately with supervisors, co-workers, and the public. (Tr. 1091-92.) Overall,
Dr. Tongue diagnosed plaintiff with "[m]ajor depression recurrent, moderate without psychotic
features," "[g]eneralized anxiety disorder," "[flamily relational stress" and "[fleatures of dramatic
spectrum disturbance of personality functioning." (Tr. 1092.)
A little more than a week later, on February 12, 2015, Dr. Tongue completed a "Medical
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Source Statement of Ability to Do Work-Related Activities (Mental)" form on plaintiffs behalf.
(Tr. 1093-95.) Dr. Tongue wrote that plaintiff had mild limitations in making simple work-related
decisions, and mild limitations in understanding, remembering, and carrying out complex
instructions. (Tr. 1093.) He found plaintiff would have moderate limitations in her "ability to make
judgements on complex work-related decisions." (Id.) Finally, Dr. Tongue wrote that plaintiff
would have mild limitations in interacting appropriately with the public, moderate limitations in
interacting appropriately with co-workers, and marked limitations in interacting appropriately with
supervisors. (Tr. 1094.)
Dr. Tongue's medical opinion conflicts with the opinion of Dr. Joshua Boyd, who found
plaintiff had only mild mental health limitations; consequently, the ALJ was required to provide
specific and legitimate reasons for rejecting Dr. Tongue's medical opinion. (See tr. 96-97; see also
Bayliss, 427 F.3d at 1216.) Here, the ALJ gave Dr. Tongue's opinion "limited weight." (Tr. 30.)

The ALJ found there was "no basis" for Dr. Tongue's opinion that plaintiff had "marked limitations
in the ability to interact with supervisors," and that Dr. Tongue's nanative and medical source
statement were "contradictory." (Id.) The ALJ also found that Dr. Tongue's findings regarding
plaintiffs symptoms interfering with her ability to maintain concentration, persistence, and pace
were speculative. (Id.) Finally, the ALJ noted that "[t]here was no evidence of mental symptoms
of a severity to cause vocational limitations for 12 months or more" and "[g]eneralized anxiety
disorder has not been diagnosed by a treating source." (Id.) An ALJ may find inconsistency between
a doctor's chart notes and the doctor's ultimate opinion a valid reason to reject their opinion. See
Ghanim v. Colvin, 763 F.3d 1154, 1161 (9th Cir. 2014) (citations omitted). Here, the ALJ

reasonably discounted Dr. Tongue's medical opinion after finding his opinions were inconsistent.
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Although plaintiff disagrees with the ALJ's findings, this court finds the ALJ's findings are
reasonable and supported by substantial evidence. There is no error.
II.

Plaintiffs Subjective Symptom Testimony.
Plaintiff also contends the ALJ failed to properly consider her subjective symptom testimony.

(Pl.' s Opening Br. 23-28, Pl.' s Reply Br. 1-2.) Specifically, plaintiff argues that the ALJ erred when
assessing her subjective symptom testimony because the ALJ failed to consider her "strong work
history." (Pl.'s Opening Br. 23, citing 20 C.F.R. § 404.1529(c)(3); SSR 96-8p; SSR 96-7p.)
The regulations describe a two-step process for evaluating symptom testimony.

The

adjudicator must consider whether there is an underlying medically determinable physical or mental
impairment that could reasonably be expected to produce symptoms, including pain. 20 C.F.R. §§
404.1529(a) & (c)(l); SSR 16-3p, at *2. Once the existence of a medically determinable impairment
that could reasonably be expected to produce pain or other symptoms is established, the adjudicator
must consider the intensity, persistence, and limiting effects of the alleged symptoms based on
examination of the entire record, including a number of factors. 20 C.F.R. § 404.1529(c)(l)-(3);
SSR 16-3p, at *7. 3 If "there is no affirmative evidence of malingering, 'the ALJ can reject the
3

The factors the ALJ must consider under 20 C.F.R. §§ 404.1529(c)(l)-(3) include the
following:
a. Objective medical evidence (signs and clinical/laborat01y findings);
b. Other evidence (written or spoken testimonial statements): The SSA "will consider other
evidence to evaluate only the factors that are relevant to assessing the intensity, persistence, and
limiting effects of the individual's symptoms." SSR 16-3p. The SSA will consider the following
factors that are reported by the claimant, any medical sources (acceptable medical sources and
non-acceptable medical sources), and any non-medical sources (lay witnesses):
i. Daily activities;
ii. Location, duration, frequency, and intensity of pain or other symptoms;
iii. Factors that precipitate and aggravate the symptoms;
iv. The type, dosage, effectiveness, and side effects of any medication an individual takes or has
taken to alleviate pain or other symptoms;
Page 10-0PINION AND ORDER

claimant's testimony about the severity of her symptoms only by offering specific, clear and
convincing reasons for doing so."' Tommasetti, 533 F.3d at 1039 (quoting Smolen v. Chafer, 80
F.3d 1273, 1281, 1283-84 (9th Cir. 1996)). A general asse1iion that the claimant is not credible is
insufficient; the ALJ must "state which ... testimony is not credible and what evidence suggests the
complaints are not credible." Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 1993). The reasons
proffered must be "sufficiently specific to permit the reviewing court to conclude that the ALJ did
not arbitrarily discredit the claimant's testimony." Orteza v. Shalala, 50 F.3d 748, 750 (9th Cir.
1995) (internal citation omitted).
Examples of clear and convincing reasons include conflicting medical evidence, effective
medical treatment, medical noncompliance, inconsistencies either in the claimant's testimony or
between her testimony and her conduct, daily activities inconsistent with the alleged symptoms, a
sparse work history, testimony that is vague or less than candid, and testimony from physicians and
third parties about the nature, severity and effect of the symptoms complained of. Tommasetti, 533
F.3d at 1040; Lingenfelter v. Astrue, 504 F.3d 1028, 1040 (9th Cir. 2007); Light v. Social Sec.

Admin., 119 F.3d 789, 792 (9th Cir. 1997).
Here, the ALJ found plaintiffs statements concerning the "intensity, persistence and limiting
effects of [her] symptoms [were] not credible." (Tr. 27.) The ALJ cited numerous reasons for
discrediting plaintiffs subjective symptom testimony, including: (1) that plaintiff left her previous

v. Treatment, other than medication, an individual receives or has received for relief of pain or
other symptoms;
vi. Any measures other than treatment an individual uses or has used to relieve pain or other
symptoms (e.g. lying flat on his or her back, standing for 15 to 20 minutes every hour, or sleeping
on a board); and
vii. Any other factors concerning a claimant's functional limitations and restrictions due to pain
and other symptoms.
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employment for reasons other than her disability; (2) that plaintiff received unemployment benefits
after her job ended; (3) that her pain allegations were not consistent with her activities of daily
living; and (4) there was a lack of medical evidence for her pain allegations. (Tr. 27-29.)
Plaintiff argues that her lengthy work history should have been considered in the ALJ' s
credibility determination, and the ALJ' s failure to include her work history was a harmful etTor.
(Pl. 's Opening Br. 23-28.) However, the Commissioner argues, and this court agrees, any error in
failing to consider her work history when evaluating her subjective symptom testimony is harmless
because the ALJ provided at least one other clear and convincing reason, supported by substantial
evidence, to discredit her subjective symptom testimony. (Def.'s Opening Br. 2-3; see also Stout

v. Comm 'r, Soc. Sec. Admin., 454F.3d1050, 1055 (9th Cir. 2006)(an ALJ's erroris harmless where
it is "inconsequential to the ultimate nondisability dete1mination.")). Because plaintiff raises the
additional argument that the ALJ' s remaining reasons for discrediting plaintiffs subjective symptom
testimony were not clear and convincing, this court now considers the ALJ' s other reasons for
discrediting plaintiffs subjective symptom testimony.

A.

Leaving her job for reasons other than her disability.

First, the ALJ discredited plaintiff after finding she left her previous employment for reasons
other than her disability, noting that plaintiffs job ended because her employer was downsizing and
not because of her impairments. (Tr. 27.) The ALJ also noted that although plaintiff testified to
having "difficulties at the time she was laid off, there is little medical evidence pertaining to this
timeframe." (Id.) A plaintiffs subjective symptom testimony can be discredited if she left her job
for reasons other than her impairments. See Bruton v. Massanari, 268 F.3d 824, 828 (9th Cir. 2001)
(claimant's pain complaints found not credible because he reported at the administrative hearing, and
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also to his doctors, that he left his job because he was laid off, not because he was injured). An
independent review of the record shows that plaintiff lost her job due to a combination of her
employer downsizing and to undergo foot surgery. (Tr. 44-46.) Because plaintiff explained that her
reasons for being laid off were related to her medical impairments, this was not a clear and
convincing reason supported by substantial evidence to discredit plaintiffs subjective symptom
testimony. However, even if not all of the ALJ's findings for discrediting symptom allegations are
upheld, the overall decision may still be upheld if the ALJ provided other valid rationales. Batson,
359 F.3d at 1197. Here, the ALJ provided other clear and convincing reasons to discredit plaintiffs
subjective symptom testimony, so there is no error.

B.

Receiving unemployment benefits for two years after her job ended.

The ALJ also discredited plaintiffs subjective symptom testimony after finding that she
received unemployment benefits for two years after her job ended, and had looked for work. (Tr.
27.) Continued receipt of unemployment benefits can cast doubt on a claim of disability as it shows
that claimant holds herself out as capable of working. Copeland v. Bowen, 861 F.2d 536, 542 (9th
Cir. 1988). Indeed, although plaintiff testified that she was unable to find a job and that even if she
found a job, she would not have been able to perfo1m a part-time phlebotomistjob, the ALJ's finding
that she received unemployment for two years, which requires her to hold herself out as able to work,
is a clear and convincing reason to discredit her subjective symptom testimony is reasonable. (See
tr. 47-48.) There is no error.

C.

Inconsistencies between plaintiff's testimony and Activities of Daily Living.

Next, the ALJ found plaintiffs allegations of debilitating symptoms not consistent with her
Activities of Daily Living ("AD Ls") and job search activities. (Tr. 27 .) A plaintiffs AD Ls support
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an adverse symptom evaluation where the activities "meet the threshold for transferable work
skills[.]" Orn v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007). The ALJ noted that plaintiff had a good
response to a TENS unit and was able to perform "essentially normal activities," and that she
received assistance from her husband only on "harder household chores." (Tr. 27.) Indeed, an
independent review of the record shows plaintiff was able to drive, do some cooking, perform some
cleaning, and take care of her young granddaughter. (See tr. 68-71, 240-42.) Additionally, plaintiff
would have participated in job search activities, as the ALJ noted, which were required for her to
continue receiving unemployment benefits. (Tr. 27.) This was a second clear and convincing reason
for the ALJ to discredit plaintiffs subjective symptom testimony.

D.

Lack of medical evidence.

Finally, the ALJ discredited plaintiffs testimony because her complaints of debilitating
symptoms were not supported by the "minimal and sporadic" treatment she received, and because
of her good response to treatment such as a TENS unit. (Tr. 27.) "Although lack of medical
evidence cannot form the sole basis for discounting pain testimony, it is a factor that the ALJ can
considerin his credibility analysis." Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 2004). The ALJ
also noted that plaintiffs x-rays showed only "minimal arthritis" in her left knee; that she had
marked thinning in her patellofemoral cartilage, but no ligament tear; had minimal osteoarthritic
spunfog in her right knee; and only "mild joint effusion at the left knee." (Tr. 27, citing tr. 343, 407,
804-05, 1070.)
Additionally, the ALJ found plaintiffs statements concerning the severity of her interstitial
cystitis not credible because treatment records did not support her "allegations concerning the
frequency and severity of her interstitial cystitis symptoms." (Tr. 28.) Specifically, the ALJ noted
Page 14- OPINION AND ORDER

that plaintiff had experienced urinary incontinence in the past, that she also stated her bladder pain
had improved in 2014, and that although she still experienced urinary frequency she no longer had
urgency or incontinence. (Tr. 28-29, citing tr. 787, 792, 810, 845.)
Overall, the ALJ' s findings are supported by substantial evidence in the record. Although
plaintiff requests a different interpretation of the evidence, if the "ALJ' s credibility finding is
suppmied by substantial evidence in the record, we may not engage in second-guessing." Thomas
v. Barnhart, 278 F.3d 947, 959 (9th Cir. 2002). This court finds no error.
Conclusion

The Commissioner's decision is AFFIRMED and this case is DISMISSED.
IT IS SO ORDERED.
DATEDthis

l/~ayofJanuary2018.

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