Miller v. Commissioner Social Security Administration

Filing 16

Opinion and Order: The court AFFIRMS the Commissioner's final decision. DATED: September 24, 2024 by United States Magistrate Judge Jeff Armistead. (pjg)

UNITED STATES DISTRICT COURT
DISTRICT OF OREGON
Case No. 3:23-cv-00357-AR

DOMINIQUE M.,
Plaintiff,

OPINION AND ORDER

v.
COMMISSIONER SOCIAL SECURITY
ADMINISTRATION,
Defendant.
_____________________________________
ARMISTEAD, Magistrate Judge
In this judicial review of the Commissioner’s final decision denying Social Security
benefits, plaintiff Dominique M. (their last name omitted for privacy) challenges the
Administrative Law Judge’s (ALJ) evaluation of the relevant medical opinions and their
subjective symptom testimony. Because the court finds the ALJ’s decision is a reasonable

Page 1 – OPINION AND ORDER

reading of the record and is based on substantial evidence, the Commissioner’s decision is
AFFIRMED. 1
ALJ’S DECISION
Plaintiff applied for Title XVI Social Security Income (SSI) on March 23, 2020, alleging
disability beginning January 1, 2020. (Tr. 371.) Their claim was initially denied on October 13,
2020, and again upon reconsideration on February 23, 2021. (Tr. 206, 225.) Afterward, plaintiff
filed for a hearing that was held before the ALJ on June 16, 2022. (Tr. 155.)
In denying plaintiff’s application, the ALJ followed the five-step sequential evaluation
process. 2 At step one, the ALJ determined plaintiff had not engaged in substantial gainful
activity since January 24, 2020, their application date. (Tr. 158.) At step two, the ALJ
determined that they had the following severe impairments: post-traumatic stress disorder,
anxiety, depression, schizoaffective disorder, avoidant/restrictive food intake disorder, brief
psychotic disorder, depersonalization/derealization disorder, adjustment disorder, and borderline
personality disorder. (Tr. 158.) At step three, the ALJ determined that their impairments singly or
in combination did not meet or medically equal the severity of any listed impairment. (Tr. 158.)
As for the ALJ’s assessment of plaintiff’s residual functional capacity (RFC), 20 C.F.R. §
416.945, the ALJ determined that plaintiff can perform the full range of work at all exertional
levels, with the following non-exertional limitations:
1

This court has jurisdiction under 42 U.S.C. §§ 405(g) and 1383(c)(3), and all parties have
consented to jurisdiction by magistrate judge under Federal Rule of Civil Procedure 73 and 28
U.S.C. § 636(c).
2

To determine a claimant’s disability, the ALJ must apply a five-step evaluation. See 20
C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). If the ALJ finds that a claimant is either disabled or not
disabled at any step, the ALJ does not continue to the next step. Id.; see also Parra v. Astrue, 481
F.3d 742, 746–47 (9th Cir. 2007) (discussing the five-step evaluation in detail).
Page 2 – OPINION AND ORDER

[they] can understand, carry out and remember simple instructions. [They] can
make commensurate work-related decisions and respond appropriately to
supervision, co-worker, and work situations. [They] can deal with routine changes
in work setting. [They] can maintain concentration, persistence and pace for up to
and including two hours at a time with normal breaks throughout a normal
workday. [They are] suitable for work requiring only occasional[] changes in the
work setting. [They are] suitable for jobs requiring no interaction with the public.
[They] can be around co-workers throughout the workday but should be required
to have only occasional interactions with them.
(Tr. 161.)
At step four, the ALJ determined that plaintiff has no past relevant work. (Tr. 165.) In
light of their RFC, the ALJ found at step five that jobs exist in significant numbers in the
national economy that plaintiff can perform, including such representative occupations as kitchen
helper, linen room attendant, and marker. (Tr. 166.)
STANDARD OF REVIEW
The district court must affirm the Commissioner’s decision if the Commissioner applied
proper legal standards and the findings are supported by substantial evidence in the record. 42
U.S.C. § 405(g); Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020). Substantial evidence is
“more than a mere scintilla” and is “such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (quotation
and citation omitted). To determine whether substantial evidence exists, the court must weigh all
the evidence, whether it supports or detracts from the Commissioner’s decision. Garrison v.
Colvin, 759 F.3d 995, 1009 (9th Cir. 2014).
DISCUSSION
A.

Medical Opinion Evidence
The regulations require that an ALJ evaluate the supportability and consistency of a

medical opinion when assessing its persuasiveness. 20 C.F.R. § 416.920c. The ALJ must
Page 3 – OPINION AND ORDER

“articulate . . . how persuasive [they] find all of the medical opinions” and “explain how [they]
considered the supportability and consistency factors.” Woods v. Kijakazi, 32 F.4th 785, 792 (9th
Cir. 2022) (quoting 20 C.F.R. § 416.920c(b)(2)). Supportability is determined by whether the
medical source provides explanations and objective medical evidence to support their opinion.
20 C.F.R. § 416.920c(c)(1). Consistency is determined by evaluating how consistent the opinion
is with evidence from other medical and nonmedical sources in the record. 20 C.F.R.
§ 416.920c(c)(2).
1. Dr. Lozada-Murray’s opinion
In May 2020, treating psychologist Susana Lozada-Murray, Psy.D., provided a medical
opinion and mental RFC (MFRC) in support of plaintiff’s disability claim. (Tr. 667-68; 671-77.)
Dr. Lozada-Murray diagnosed plaintiff with panic disorder and borderline personality disorder;
opined that plaintiff “tends to blame [their] psychiatric condition and magnify the severity of []
psychotic symptoms” when they fail to complete their responsibilities; and assessed plaintiff’s
symptoms as moderately affecting their day-to-day life. (Tr. 667, 671.) She further assessed
plaintiff with marked limitations in activities of daily living, social functioning, and
concentration, persistence, and pace. (Tr. 676.) Finally, Dr. Lozada-Murray opined by that
plaintiff would likely miss three days of work each month. (Tr. 674.)
Plaintiff argues that the ALJ’s failure to discuss Dr. Lozada-Murray’s opinion that their
borderline personality disorder manifests in exaggeration of their symptoms as a maladaptive
coping mechanism was a failure to properly evaluate Dr. Lozada-Murray’s medical opinion. 3
3

Plaintiff’s arguments regarding Dr. Lozada-Murray’s opinion and plaintiff’s borderline
personality disorder diagnosis are difficult to follow. Plaintiff’s assertion about Dr. LozadaMurray’s concern for their symptom magnification caused by that diagnosis is addressed by the
court in the section about plaintiff’s subjective symptom testimony.
Page 4 – OPINION AND ORDER

According to plaintiff, the limitation assessed by Dr. Lozada-Murray that plaintiff will miss more
than three days of work per month is not adequately accounted for in the RFC. Plaintiff further
argues that the ALJ failed to adequately address the supportability and consistency of Dr.
Lozada-Murray’s opinion, and instead conducted “a misplaced SSR 16-3p consistency analysis.”
(Pl. Br. at 12.)
The ALJ found Dr. Lozada-Murray’s opinion unpersuasive because, “although supported
by some explanation,” the ALJ found the limitations assessed by Dr. Lozada-Murray were
inconsistent with the medical and other evidence of record. (Tr. 164.) For example, the ALJ
found Dr. Lozada-Murray’s “assessments of marked limitations and absenteeism” to be
inconsistent with evidence showing plaintiff’s ability to “earn some money with their artwork”
and to “move in with their partner.” (Tr. 164.) Additionally, the ALJ noted that plaintiff
“managed without psychiatric treatment for as long as six months.” (Tr. 164.) Finally, the ALJ
stated that plaintiff’s “improved conditions, when on medications, do not warrant marked
limitations.” (Tr. 164.)
As a preliminary matter, SSR 16-3p governs the evaluation of a claimant’s symptom
testimony and does not provide a framework for evaluating the supportability or consistency of
medical opinions. Supportability and consistency are governed by 20 C.F.R. § 416.920c(c)(1)(2). The court thus construes plaintiff’s contention that the ALJ conducted a misplaced SSR 163p consistency analysis to mean that the ALJ erred in relying on plaintiff’s daily activities in
addition to, or in lieu of, medical evidence when evaluating the consistency of Dr. LozadaMurray’s opinion. As noted above, however, an ALJ may consider medical and nonmedical
evidence when evaluating the consistency of medical opinions. 20 C.F.R. § 416.920c(c)(2). The

Page 5 – OPINION AND ORDER

ALJ therefore did not err in considering plaintiff’s daily activities when evaluating Dr. LozadaMurray’s opinion.
As to supportability, the ALJ’s rejection of the limitations assessed by Dr. LozadaMurray is reasonable. For example, Dr. Lozada-Murray assessed plaintiff with marked
limitations in activities of daily living and social functioning but provided no explanation and no
objective evidence to support her conclusion. (Tr. 676.) See 20 C.F.R. § 416.920c(c)(1) (stating
that persuasive medical opinions are supported by objective medical evidence and supporting
explanations). An ALJ may reject a medical opinion if it is “brief, conclusory, and inadequately
supported by clinical findings.” Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020) (quoting
Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002)); see also Coleman v. Saul, 979 F.3d 751,
757 (9th Cir. 2020) (ALJ did not err in rejecting medical opinions that were unsupported by the
objective medical evidence (citing Batson, 359 F.3d at 1195)); 20 C.F.R. § 416.920c(a)
(supportability is most important factor in considering persuasiveness of medical opinion). Upon
a complete review of the record, the court can find no treatment notes or objective evidence from
Dr. Lozada-Murray to support her opinion, beyond the opinion itself.
Nor are the marked limitations assessed by Dr. Lozada-Murray consistent with the
record. Indeed, objective medical evidence shows largely normal mental status exams, and
plaintiff’s own statements to providers of improved symptoms and manageable symptoms
further support the conclusion that Dr. Lozada-Murray’s opinion is not consistent with the
medical evidence of record. (Tr. 496, 501, 505, 517, 523, 684, 822, 845, 851.) Moreover,
plaintiff’s ability to function without psychiatric treatment for six months is inconsistent with the
marked limitations assessed by Dr. Lozada-Murray. In sum, the ALJ did not err in finding Dr.
Lozada-Murray’s medical opinion unpersuasive. The ALJ supported his conclusions with
Page 6 – OPINION AND ORDER

substantial evidence. See Brown-Hunter, 806 F.3d at 492 (“[A]lthough we will not fault the
agency merely for explaining its decision with less-than-ideal clarity, we still demand that the
agency set forth the reasoning behind its decisions in a way that allows meaningful review.”
(citing Treichler v. Comm’r Soc. Sec. Admin., 775 F.3d 1090, 1102 (9th Cir. 2014)).
Plaintiff’s arguments that the ALJ should have accounted for limitations assessed by Dr.
Lozada-Murray in the RFC – such as being absent three days per month – fail because the ALJ is
only required to include those limitations that are found to be credible and supported by the
record. Bayliss v. Barnhart, 427 F.3d 1211, 1217 (9th Cir. 2005); SSR 96-8p. Although plaintiff
disagrees with the ALJ’s analysis, the ALJ’s findings are fully supported by substantial evidence,
are a reasonable interpretation of that evidence, and therefore must be upheld. Ford, 950 F.3d at
1154.
2. Agency Doctors’ Opinions
State certified psychologists (agency doctors) evaluated plaintiff’s medical records in
connection with application for benefits, both initially and on appeal. (Tr. 206, 225.) Plaintiff
now challenges the ALJ’s supportability and consistency analysis of the agency doctors’
opinions. Additionally, plaintiff argues that the ALJ erroneously failed to adopt the limitations
opined by the agency doctors into the RFC because the ALJ did not include in the RFC the
limitation to “performing simple and routine tasks in a socially limited setting.” (Pl. Br. at 8, 9.)
Finally, plaintiff alleges that the ALJ failed to explain how the RFC limitation to unskilled work
accounts for their moderate limitations in concentration, persistence, and pace, and mild
limitations in understanding, memory, and applying information. (Pl. Br. at 9.)
The agency doctors determined that plaintiff has mild limitations in understanding,
remembering, and applying information; moderate limitations in interacting with others;
Page 7 – OPINION AND ORDER

moderate limitations in concentration, persistence, and pace; and moderate limitations in their
ability to adapt and manage. (Tr. 201-02; 219-21.) In the narrative explanation for these
limitations, the agency doctors stated that plaintiff had no significant difficulty recalling,
understanding, and carrying out instructions, and is capable of completing simple instructions,
plaintiff has moderate difficulty maintaining concentration for extended periods, moderate
difficulty interacting appropriately with others, and moderate difficulty adapting to workplace
changes or stress. (Tr. 221-22.) The agency doctors’ MRFC states that plaintiff is capable of
performing “simple and routine tasks in a socially limited setting,” and their activities of daily
living, recent work, and medical evidence of record confirms they can perform semi-skilled, and
some complex tasks. (Tr. 164-65, 203, 222.)
Those opinions from the agency doctors were found persuasive by the ALJ: “These
opinions are supported by explanation, as set forth under the psychiatric review technique
analysis, and were consistent with the medical evidence of record.” (Tr. 165.) The ALJ noted
that plaintiff’s “difficulty concentrating due to hallucinations and self-consciousness with body
presentation are consistent with limitations in concentration and interactions with others.” (Tr.
165, citing Tr. 515, and Hearing Testimony.) The ALJ concluded that the agency doctors’
opinions were accounted for in the RFC determination. (Tr. 165.)
The ALJ’s supportability determination relies on the psychiatric review technique
analyses performed by the agency doctors, which the ALJ discussed in both the mental health
and medical opinion sections of the decision. (Tr. 160, 165.) In the analyses, the agency doctors
reviewed the medical evidence in record, provided opinions as to plaintiff’s limitations, provided
explanations as to why those limitations are appropriate, and cited objective evidence to support
their conclusions. (Tr. 199-200, 215-217.) The court concludes that the ALJ’s determination
Page 8 – OPINION AND ORDER

about the supportability of agency doctors’ opinions is supported by substantial evidence. See 20
C.F.R. § 416.920c(c)(1) (“[t]he more relevant the objective medical evidence and supporting
explanations presented by a medical source are to support his or her medical opinion(s) or prior
administrative medical finding(s), the more persuasive the medical opinions or prior
administrative medical finding(s) will be”). Because the court can reasonably discern the ALJ’s
path, the ALJ did not err. Brown-Hunter v. Colvin, 806 F.3d 487, 494 (9th Cir. 2015).
Next, contrary to plaintiff’s suggestion, there is no requirement that an ALJ must perform
a medical opinion-by-medical opinion consistency comparison. Rather, the ALJ must show how
an opinion is consistent with the evidence from other medical and nonmedical sources in the
record and resolve any conflicts between the credited medical opinions. 20 C.F.R. §
416.920c(c)(2). The ALJ’s consistency analysis does that by identifying areas where the
plaintiff’s medical records are consistent with the agency doctors’ analyses. (See Tr. 491, 495,
500, 517, 522, 523, 515, 684.) Again, the ALJ did not err because the court can reasonably
discern the ALJ’s consistency determination.
As to plaintiff’s claim that the ALJ was required to adopt the agency doctors’ limitation
to simple and routine tasks in a socially limited setting, the Ninth Circuit does not require that an
ALJ adopt word-for-word the limitations set forth by a medical source opinion, so long as the
ALJ’s RFC is “consistent with restrictions identified in the medical testimony.” StubbsDanielson v. Astrue, 539 F.3d 1169, 1174 (9th Cir. 2008). Here, the RFC limitations align with
the restrictions in the agency doctors’ opinions. For example, the ALJ limited plaintiff to
understanding, carrying out, and remembering simple instructions, which mirrors language used
by agency doctors. (Tr. 164, 222.) That the ALJ did not further limit plaintiff to “simple routine
tasks” is supported by the agency doctors’ findings that plaintiff is capable of “semi-skilled, and
Page 9 – OPINION AND ORDER

some complex tasks.” (Tr. 222.) Additionally, the ALJ limited plaintiff to maintaining
concentration, persistence, and pace for up to two hours at a time, which is consistent with the
agency doctors’ finding of a moderate limitation in their ability to maintain concentration for
extended periods. (Tr. 161, 222.) The ALJ limited plaintiff to jobs requiring no interaction with
the public and only occasional interactions with co-workers, which also is consistent with the
agency doctors’ finding of a moderate limitation in their ability to interact appropriately with
others. (Tr. 164, 222.) The ALJ further limited plaintiff’s RFC to include only occasional
changes in the work setting, which is consistent with a moderate limitation in adapting to
workplace change or stress. (Tr. 164, 222.)
Plaintiff’s final point that the ALJ failed to explain how the limitation to unskilled work
accounts for moderate limitations in concentration, persistence, and pace, and mild limitations in
understanding, memory, and applying information is similarly foreclosed because the limitation
to unskilled work is based on their having no prior work experience, not their moderate and mild
limitations. (Pl. Br. at 9.) See 20 C.F.R. § 416.965(a) (stating that, even if an individual has no
work experience, they may still be able to do unskilled work because it requires little or no
judgment and can be learned in a short period of time). Additionally, their moderate limitations
in concentration, persistence, and pace were sufficiently accounted for in the RFC, and mild
limitations in understanding, memory, and applying information do not require specific findings
in the RFC. See Woods, 32 F.4th at 794 (confirming mild non-exertional limitations resulting do
not require express findings in the RFC). Therefore, the court finds no error in the ALJ’s
analysis.

Page 10 – OPINION AND ORDER

B.

Plaintiff’s Symptom Testimony
Plaintiff contends that they cannot engage in full-time, competitive employment due to
symptoms resulting from their mental health impairments. In May 2020, plaintiff completed both
an anxiety questionnaire and an adult function report in support of their SSI application. (Tr. 421,
424.) Their daily activities included completing household chores, grocery shopping, preparing
meals, vacuuming, and doing laundry on a weekly basis. (Tr. 426-27.) They needed verbal
reminders to complete household chores. (Tr. 426.) Plaintiff wrote that they had experienced
“50-60” anxiety attacks in the preceding three-month period, and that each anxiety attack last “34 hours.” (Tr. 422.) They further stated that during anxiety attacks, their “hallucinations get
worse,” they “can’t stop shaking” and believe they will die if they “do anything.” (Tr. 422.)
Plaintiff said that loud noises and bright lights trigger anxiety. (Tr. 424.)
At the hearing, plaintiff explained that they have been unable to apply for work due to
anxiety and “going catatonic” when attempting to fill out application paperwork. (Tr. 180.)
Plaintiff stated that they have a driver’s license but they “don’t drive any at all.” (Tr. 183.) They
lost their last job due to “being unable to come in” and the “stress of [the] job making [them] go
catatonic for sometimes hours.” (Tr. 183.) Plaintiff relied on their partner for reminders to
shower and brush their teeth. (Tr. 184-85.) They had a strict daily routine but sometimes cannot
“follow through with it” because of their mental illness. (Tr. 185.) They experienced audio and
visual hallucinations “all the time” despite having “never missed a dose” of prescribed
medications. (Tr. 186-87.) Ultimately, plaintiff said that, although they would like an office job,
they are “not reliable enough” because they are “too sick.” (Tr. 188.)
Determining the credibility of a claimant’s symptom testimony requires two steps of
analysis from the ALJ. Trevizo v. Berryhill, 871 F.3d 664, 678 (9th Cir. 2017). At the first step,
Page 11 – OPINION AND ORDER

the claimant must produce objective medical evidence of an underlying impairment that could
reasonably be expected to produce the alleged symptoms. Treichler, 775 F.3d at 1102;
Tommasetti v. Astrue, 533 F.3d 1035, 1039 (9th Cir. 2008). At the second step, if there is no
affirmative evidence of malingering, the ALJ must provide specific, clear and convincing
reasons for discounting the claimant’s testimony. Brown-Hunter, 806 F.3d at 488-89; 20 C.F.R.
§ 404.1529. The specific, clear and convincing standard is “the most demanding required in
Social Security cases” and is “not an easy requirement to meet.” Garrison, 759 F.3d at 1015;
Trevizo, 871 F.3d at 678-79. The “clear and convincing” standard requires an ALJ to “show
[their] work” but, ultimately, the question is not whether ALJ’s rationale convinces the court, but
whether the ALJ’s rationale “is clear enough that it has the power to convince.” Smartt v.
Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022).
The ALJ discounted plaintiff’s subjective symptom testimony because: (1) their medical
history showed improvement with treatment; (2) their activities of daily living were inconsistent
with the severity of their symptoms; and (3) objective medical findings were inconsistent with
their reported symptomatology. Plaintiff challenges each reason.
1. Evidence of Improvement with Treatment
Plaintiff contends that the ALJ did not explain how their hallucinations improving with
medication relates to their “borderline personality disorder and its symptoms[.]” (Pl. Br. at 14)
(emphasis omitted). Because their borderline personality disorder has not improved, plaintiff
contends, the ALJ’s rationale is not clear and convincing. In plaintiff’s view, the ALJ was
required to specifically discount symptoms stemming from their borderline personality disorder
or include them in the RFC. The court disagrees.

Page 12 – OPINION AND ORDER

An ALJ may consider evidence of improvement when assessing the functional limitations
of a claimant. 20 C.F.R. § 416.920a(c). However, an ALJ may not rely on “a few isolated
instances of improvement in the medical record as a basis for concluding a claimant is capable of
working.” Garrison, 759 F.3d at 1017 (citation omitted). Mental health symptoms wax and
wane, and an ALJ commits reversible error by cherry-picking the record for facts that support a
non-disability determination. “Reports of ‘improvement’ in the context of mental health issues
must be interpreted with an understanding of the [claimant’s] overall well-being and the nature
of her symptoms.” Id. (citing Ryan v. Comm’s of Soc. Sec., 528 F.3d 1194, 1200-01 (9th Cir.
2008)); see also Attmore v. Colvin, 827 F.3d 872, 877-79 (9th Cir. 2016) (holding the ALJ erred
by finding improvement where claimant continued to have functional impairments and
improvement was not sustained). Yet symptoms may improve with treatment. “With adequate
treatment some individuals with chronic mental disorders not only have their symptoms and
signs ameliorated, but they also return to a level of function close to the level of function they
had before they developed symptoms or signs of their mental disorders.” 20 C.F.R. pt. 404,
subpt. P, app. 1 (2014). Such evidence of medical treatment successfully relieving symptoms can
undermine a claim of disability. See 20 C.F.R. § 416.920a(c)(1); see also Warre v. Comm’r of
Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 2006) (“Impairments that can be controlled
effectively with medication are not disabling.”) (citations omitted).
In this case, the ALJ discounted the severity of plaintiff’s alleged symptoms because
medical records showed that their symptoms improved with treatment. In July 2019, plaintiff
reported having better energy and being “happy at [their] new job.” (Tr. 163, citing Tr. 510.)
Almost a year later, in June 2020, plaintiff reported feeling “more stable.” (Tr. 682-83.) And, in
September 2020, the ALJ noted plaintiff had reported “stable mood,” feeling “happy and
Page 13 – OPINION AND ORDER

optimistic” and that their verbal and auditory hallucinations were “not severe.” (Tr. 163, 697,
704.) The ALJ observed that plaintiff moved to Oregon in October 2020 to live with their
partner, and thereafter, took a months-long break from care, resuming psychiatric care in 2021.
(Tr. 163, 912, 925.) The ALJ cited records showing plaintiff continued to report improved
symptoms throughout 2021 into 2022, most notably that they had better concentration, that they
were getting enough sleep, their audio hallucinations had improved, and that they had good
energy. (Tr. 164, 744, 750, 796, 791, 851.) Those improvements are substantial evidence, a
reasonable interpretation of the record, and will not be disturbed. Batson v. Comm’r Soc. Sec.
Admin., 359 F.3d 1190, 1197 (9th Cir. 2004).
Aside from Dr. Lozada-Murray’s opinion, plaintiff fails to identify evidence the ALJ was
required to incorporate not already accounted for in their RFC. See Shinseki v. Sanders, 556 U.S.
396, 409-10 (2009) (expressing that the party challenging the ALJ’s decision bears the burden of
showing harm). Here, plaintiff broadly alleges that symptoms described in Dr. Lozada-Murray’s
testimony should be attributed to their borderline personality disorder, and that the RFC does not
sufficiently include those symptoms. But as discussed above, the ALJ properly discredited Dr.
Lozada-Murray’s opinion and the ALJ was not required to incorporate her assessed limitations
into the RFC. The RFC does address the limitations from credited medical opinions, such as
limiting plaintiff’s concentration time to two hours, and limiting their exposure to the public and
coworkers.
Furthermore, in evaluating symptom testimony, the ALJ is required to identify specific
testimony in the record and evaluate whether that testimony is consistent with record. As such, it
is sufficient that the ALJ cited specific evidence of improvement with treatment such that the
court can meaningfully review the ALJ’s decision for error. Brown-Hunter, 806 F.3d at 492.
Page 14 – OPINION AND ORDER

Moreover, the ALJ considered the waxing and waning nature of plaintiff’s illnesses and provided
examples of improved symptoms throughout the adjudicatory period, rather than isolating one
specific period of improvement. Garrison, 759 F.3d at 1017. In reviewing the record, the ALJ
reasonably concluded that plaintiff’s symptoms improved with treatment. The court finds that the
ALJ did not err in finding plaintiff’s symptoms improved with medical treatment.
2. Activities of Daily Living
An ALJ may reject symptom allegations that are inconsistent with a claimant’s ability to
perform normal activities of daily living. See 20 C.F.R. § 416.929(c)(3)(i). There are two ways
ADLs may support such rejection: (1) the ADLs contravene the claimant’s allegations of
functional limitations; or (2) the ADLs “meet the threshold for transferrable work skills[.]” Orn
v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007). “Even where those activities suggest some
difficulty functioning, they may be grounds for discrediting the claimant’s testimony to the
extent that they contradict claims of a totally disabling impairment.” Molina v. Astrue, 674 F.3d
1104, 1113 (9th Cir. 2012).
Plaintiff challenges the ALJ’s discounting of their symptom testimony based on their
daily life activities on the ground that he failed to explain how “moving once or selling art in []
isolated instances are activities that are ‘inconsistent’ with a marked limitation” in “activities of
daily living.” (Pl. Br. at 14.) As with plaintiff’s contentions about their bipolar disorder, the
assessment of a marked limitation in ADLs comes only from Dr. Lozada-Murray’s opinion. (Tr.
682, 159-60.) As discussed above, because the ALJ appropriately discredited that opinion, the
ALJ was not required to explain how plaintiff’s activities of daily living are inconsistent with
those assessed limitations.

Page 15 – OPINION AND ORDER

The ALJ found that plaintiff’s daily activities exceeded their claimed functional
limitations. The ALJ noted that plaintiff can do regular household chores such as vacuuming,
laundry, driving, shopping for groceries. (Tr. 159, 164.) The ALJ pointed out that, despite
plaintiff’s alleged symptoms, they were able to successfully visit and then move from Florida to
Oregon to live with their partner. (Tr. 164.) Additionally, the ALJ pointed out that plaintiff had
been able to “earn some money for a period of time” doing freelance artwork. (Tr. 163, 164,
citing Tr. 845, 851, 856, 864.)
The analysis that an ALJ must undergo when considering activities of daily living is
whether the activities contravene the attested limitations or meet the threshold of transferrable
work skills. Orn, 495 F.3d at 639. Here, plaintiff alleged they experience debilitating symptoms,
such that they cannot function at even the most basic level. The ALJ’s rationale need only show
that their daily activities exceed their claimed limitations and is backed by substantial evidence.
Here, the ALJ provided clear and convincing reasons supported by substantial evidence for
discounting the alleged severity of plaintiff’s symptom testimony, and as such, did not err.
3. Inconsistency with Objective Medical Evidence
Plaintiff asserts that the ALJ’s analysis of the objective medical evidence “did not explain
the extent to which [plaintiff’s] subjective symptoms limit[ed] [their] ability to perform workrelated activities” as required by SSR 16-3p. (Pl. Repl. Br. at 10-11.) According to plaintiff,
their symptom exaggeration is a maladaptive coping mechanism of their borderline personality
disorder. In plaintiff’s opinion, the ALJ’s decision erroneously “relies on a finding that [they]
exaggerate their symptoms” and “improved with medication,” thus falling short of the clear and
convincing standard required under Ninth Circuit law. (Pl. Br. at 15, Pl. Repl. Br. at 11.)

Page 16 – OPINION AND ORDER

In evaluating a claimant’s subjective symptom testimony, an ALJ may consider whether
it is consistent with objective medical evidence. 20 C.F.R. § 404.1529(c)(1)-(3); SSR 16-3p,
available at 2017 WL 5180304, at *7-8. A lack of objective medical evidence may not form the
sole basis for discounting a claimant’s testimony. See Reddick v. Chater, 157 F.3d 715, 722 (9th
Cir. 1998) (“[T]he Commissioner may not discredit [a] claimant’s testimony as to the severity of
symptoms merely because they are unsupported by objective medical evidence.”)). But when
coupled with other permissible reasons, inconsistencies between a claimant’s allegations and
objective medical evidence may be used to discount a claimant’s testimony. Batson v. Comm’r
Soc. Sec. Admin., 359 F.3d 1190, 1197-98 (9th Cir. 2004)); see also Adaline S.G. v. Comm’r Soc.
Sec. Admin., Case No. 6:20-cv-01129-AC, 2021 WL 5316987, at *3 (D. Or. Nov. 15, 2021);
Tatyana K. v. Berryhill, No. 3:17-cv-01816-AC, 2019 WL 464965, at *4 (D. Or. Feb. 6, 2019).
That happened here. The ALJ discussed inconsistencies between plaintiff’s alleged
symptoms and the objective medical evidence. The ALJ reasoned that, although “evidence
undoubtedly shows psychiatric impairments,” ultimately the “course of treatment and diagnostic
tests and examination results do not appear to be commensurate with the symptomatology
reported.” (Tr. 164.) Also noted by the ALJ was that plaintiff’s doctor “expressed concern about
[plaintiff] magnifying the severity of their symptoms. (Tr. 164, citing Tr. 667.) The ALJ then
pointed out that plaintiff had largely normal objective findings at medical appointments. (Tr.
163-64, 159; citing Tr. 495, 500, 517, 522, 523, 684, 822, 845, 851.) For example, therapy notes
show plaintiff had logical thought process and “good comprehension with abstract thinking” (Tr.
495); intact memory, fair concentration, good insight, and judgment (Tr. 500); and grooming that
was described as “appropriate, neat and clean” (Tr. 522). Additionally, the ALJ noted that

Page 17 – OPINION AND ORDER

plaintiff “could manage their psychosis with no medication side effects.” (Tr. 163, citing Tr. 744,
750.)
The ALJ properly considered the extent to which plaintiff’s symptoms limit their ability
to work. The ALJ determined that, although “evidence undoubtedly shows psychiatric
impairments that more than minimally impact[] [their] functioning,” the evidence also showed
improved conditions. (Tr. 164.) The ALJ therefore concluded that, because evidence was
consistent with “some limitations,” those limitations had been “properly accommodated for” by
the mental limitations in the RFC. (Tr. 164.) Additionally, although the ALJ cited a treating
provider’s concern that plaintiff magnifies their symptoms, it is clear to the court that the ALJ
relied on more than a single statement in concluding plaintiff’s records do not reflect the degree
of symptoms alleged. (Tr. 164.) The ALJ appears to have properly consulted the entire record,
cited to specific examples, and concluded that plaintiff’s symptoms were less limiting than
alleged. In short, the ALJ provided specific, clear, and convincing reasons to discount plaintiff’s
subjective symptom testimony.
In summary, the ALJ’s conclusions as to plaintiff’s symptom testimony and the medical
opinions are based on substantial evidence and supported by reasonable references drawn from
the record.
\\\\\
\\\\\
\\\\\
\\\\\
\\\\\

Page 18 – OPINION AND ORDER

CONCLUSION
For the above reasons, the court AFFIRMS the Commissioner’s final decision.
DATED: September 24, 2024.

_____________________________
JEFF ARMISTEAD
United States Magistrate Judge

Page 19 – OPINION AND ORDER