Clough v. Commissioner Social Security Administration
Filing
20
OPINION AND ORDER. Signed on 12/14/2015 by Judge Malcolm F. Marsh. (pvh)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF OREGON
CRYSTALL. CLOUGH,
Plaintiff,
v.
COMMISSIONER SOCIAL SECURITY
ADMINISTRATION,
Defendant.
SHERWOOD J. REESE
DREW L. JOHNSON
1700 Valley River Drive
Eugene, OR 97405
Attorneys for Plaintiff
JANICE E. HEBERT
Assistant United States Attorney
District of Oregon
1000 S.W. Third Ave., Suite 600
Portland, OR 97204-2902
ERIN F. HIGHLAND
Assistant Regional Counsel
Social Security Administration
701 Fifth Ave., Suite 2900 MIS 98104
Seattle, WA 98104-7075
Attorneys for Defendant
1 - OPINION AND ORDER
Case No. 6:15-cv-00140-MA
OPINION AND ORDER
MARSH, Judge
Plaintiff C1ystal L. Clough seeks judicial review of the final decision of the Commissioner
of Social Security denying her application for Supplemental Security Income (SSI) disability benefits
under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381-1383f. This Court has jurisdiction
pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). For the reasons that follow, I affirm the
Commissioner's decision.
PROCEDURAL AND FACTUAL BACKGROUND
Plaintiff protectively filed an application for SSI on July 15, 2011, alleging disability
beginning June 1, 2011, due to depression and ruL'<:iety. Plaintiffs claims were denied initially and
upon reconsideration. Plaintiff filed a request for a hearing before an administrative lawjudge
("ALJ"). The ALJ held a hearing on September 11, 2013, at which plaintiff appeared with her
attorney and testified. A vocational expert, Jeffery F. Tittlefitz, also appeared at the hearing and
testified. On September 20, 2013, the ALJ issued an unfavorable decision. The Appeals Council
denied plaintiffs request for review, and therefore, the ALJ's decision became the final decision of
the Commissioner for purposes of review.
Plaintiff was born on May 7, 1987, and was 24 years old on the alleged onset of disability
date. Plaintiff did not complete high school, has obtained a GED, and attended two quarters of
community college. Plaintiff has no past relevant work experience.
THE ALJ'S DISABILITY ANALYSIS
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. § 416.920. Each step
is potentially dispositive. The claimant bears the burden of proof at steps one through four. See
2 - OPINION AND ORDER
Valentine v. Commissioner Soc. Sec. Admin., 574 F.3d 685, 689 (9th Cir. 2009); Tackett v. Apfel,
180 F.3d 1094, 1098 (9th Cir. 1999). At step five, the burden shifts to the Commissioner to show
that the claimant can do other work which exists in the national economy. Hill v. Astrue, 698 F.3d
1153, 1161 (9th Cir. 2012).
At step one, the ALJ found that plaintiff has not engaged in substantial gainful activity since
her alleged onset of disability. At step two, the ALJ found that plaintiff had the following severe
impainnents: post-traumatic stress disorder ("PTSD"), depression, personality disorder, obsessive
compulsive disorder ("OCD"), and possible attention deficit hyperactivity disorder. At step three,
the ALJ found that plaintiffs impairments, or combination of impairments, did not meet or
medically equal a listed impairment.
The ALJ assessed plaintiff with a residual functional capacity ("RFC") to perfo1m a full
range of work at all exertional levels, however, plaintiff is limited to simple, repetitive, routine tasks
requiring no more than occasional interaction with supervisors and the general public.
At step four, the ALJ found that plaintiff has no past relevant work. At step five, the ALJ
found that considering plaintiffs age, education, work experience, and residual functional capacity,
jobs exist in significant numbers in the national economy that plaintiff can perform, such as janitor,
hand packager, and electronics worker. Accordingly, the ALJ concluded that plaintiff has not been
under a disability under the Social Security Act from July 15, 2011 through the date of the decision.
ISSUES ON REVIEW
On appeal to this court, plaintiff contends the following e1rnrs were committed: ( 1) the ALJ
improperly evaluated her testimony; (2) the ALJ improperly evaluated the opinion of her mental
health therapist Cheryl Haun, M.A.; and (3) the ALJ improperly evaluated the lay testimony.
3 - OPINION AND ORDER
STANDARD OF REVIEW
The district court must affitm 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); Beny v. Astrue, 622 F.3d 1228, 1231 (9th Cir. 2010). "Substantial evidence is
more than a mere scintilla but less than a preponderance; it is such relevant evidence as a reasonable
mindmight accept as adequate to suppo1t a conclusion." Hill, 698 F.3d at 1159 (internal quotations
omitted); Valentine, 574 F.3d at 690. The comi 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);
lvfartinez v. Heckler, 807 F.2d 771, 772 (9th Cir. 1986). The Commissioner's decision must be
upheld, even if the evidence is susceptible to more than one rational interpretation. Batson v.
Commissioner Soc. Sec. Admin., 359 F.3d 1190, 1193 (9th Cir. 2004). If the evidence supports the
Commissioner's conclusion, the Commissioner must be affirmed; "the cou1t may not substitute its
judgment for that of the Commissioner." Edlundv. ivfassanari, 253 F.3d 1152, 1156 (9th Cir. 2001);
Garrison, 759 F.3d at 1010.
I.
The ALJ Did Not Err in Discounting Plaintifrs Credibility
To determine whether a claimant's testimony regarding subjective pain or symptoms is
credible, an ALJ must perform two stages of analysis. 20 C.F.R. §§ 404.1529, 416.929. The first
stage is a threshold test in which the claimant must produce objective medical evidence of an
underlying impairment that could reasonably be expected to produce the symptoms alleged. Molina
v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012); Tommasettiv. Astrue, 533 F.3d 1035, 1039 (9th Cir.
2008). At the second stage of the credibility analysis, absent affirmative evidence of malingering,
the ALJ must provide clear and convincing reasons for discrediting the claimant's testimony
4 - OPINION AND ORDER
regarding the severity of the symptoms. Carmickle v. Commissioner Soc. Sec. Admin., 533 F.3d
1155, 1166 (9th Cir. 2008); Lingenfelter v. Astrue, 504 F.3d 1028, 1036 (9th Cir. 2007).
The ALJ must make findings that are sufficiently specific to pennit the reviewing comt to
conclude that the ALJ did not arbitrarily discredit the claimant's testimony. Ghanim v. Colvin, 763
F.3d 1154, 1163 (9th Cir. 2014); Tommasetti, 533 F.3d at 1039. Factors the ALJ may consider when
making such credibility detenninations include the objective medical evidence, the claimant's
treatment hist01y, the claimant's daily activities, inconsistencies in testimony, effectiveness or
adverse side effects of any pain medication, and relevant character evidence. Ghanim, 763 F.3d at
1163; Tommasetti, 533 F.3d at 1039.
At the hearing, plaintiff testified that in June 2011, she dropped out of school after her second
te1m because she was not sleeping and school was ve1y difficult. Tr. 38. Plaintiff stated that she had
a friend attend school with her, and that school worsened her OCD. Plaintiff said that when she was
in school, she would stay up for days, working on a paper through the night. Plaintiff testified that
her depression keeps her from working, that she suffers anxiety eve1y day, and that she does not go
out of the house alone. Tr. 46-47. Plaintiff testified that she attends counseling and that it is helpful,
but the progress is slow.
Plaintiff stated that she has a son and a daughter who are in first and third grades. Plaintiff
described that she independently takes care of her two children, including making their meals,
bathing, brushing teeth, taking vitamins, and helping with homework. Plaintiff testified that she
obsessively cleans her house, pacing around the house, looking for something to clean. Plaintiff also
indicated that she gets exhausted from not sleeping due to her anxiety, and takes a two hour nap each
day while the children are at school. Plaintiff stated she has a boyfriend, and that she and her
5 - OPINION AND ORDER
boyfriend take the kids to the river to go fishing, and she sometimes hosts barbeques at her house.
Tr. 42.
Plaintiff stated she does not watch TV, but will look up recipes and organization tips on the
internet. Plaintiff does all the grocery shopping, but does not like to go alone, and consequently
brings her children with her to the groce1y store. Tr. 48. Plaintiff stated that she attends parentteacher conferences, is able to drive, and socializes with friends an hour or two eve1y couple of
weeks, and says hello to the neighbors. Tr. 44. Plaintiff testified at the hearing that she takes
Wellbutrin, Klonopin, and Abilify for her anxiety and depression. Plaintiff testified that she does
not like to go out and socialize, and that her problem is worse than it was two or three years ago.
In an Adult Function Report, plaintiff stated that she struggles being around strangers because
it increases her anxiety and decreases her concentration. Tr. 173. Plaintiff stated she has difficulty
remembering instructions, and that she experiences panic attacks. Plaintiff stated that in a typical
day, she will wake her children, feed them breakfast, and get them off to school. Afterward, plaintiff
noted that she will clean up the house, then lie down to rest. Plaintiff described that after her
children are done with school, she assists them with homework and plays with them until it is time
to make dinner. After dinner, plaintiff bathes them, reads them one to three stories, then puts them
to bed. Plaintiff described that after the children are in bed, she watches television or listens to
music, showers, then goes to bed. Tr. 174. Plaintiff stated that she needs reminders to take her
medication, and cooks daily, but rarely makes meals from scratch. Tr. 175. Plaintiff indicated that
she does not like to leave the house, and that family, friends, and a neighbor visits at her home one
to two times per week. Tr. 177. Plaintiff noted that she has lost interest in hobbies, and that she
does not use the phone or computer. Tr. 177. Plaintiff also stated that her friend takes her to
6 - OPINION AND ORDER
volunteer at her son's school for an hour each week, but that she does not always go, and will not
go alone. Tr. 177.
In the decision, the ALJ found that plaintiffs impairments could reasonably be expected to
cause some symptoms, but that her statements concerning the limiting effects were not entirely
credible. The ALJ cited three reasons for discounting plaintiffs credibility: (1) inconsistency with
clinical observations; (2) inconsistency with reported daily activities; and (3) over-reporting of
symptoms to Dr. Truhn.
A.
ALJ Could Find Plaintiff's Degree of Debilitating Anxiety and Depression
Inconsistent with Clinical Evidence
Inconsistency with treatment records is a valid credibility consideration, so long as it is not
the sole reason for discounting a claimant's credibility. Rollins v. lvfassinari, 261 F.3d 853, 857 (9th
Cir. 2001) (inconsistency with medical evidence is a relevant consideration but cannot be the sole
ground to discount credibility). Here, the ALJ discussed a mental health assessment performed on
May 26, 2011, one week before plaintiffs alleged onset of disability. The ALJ noted that plaintiff
was observed to be "depressed with a flat affect" but cooperative. Tr. 320. The ALJ discussed that
despite plaintiffs depression, she had normal thought content, she was ale1t, oriented, with no
memory or concentration difficulties, with nonnal intelligence and good judgment. Tr. 320.
The ALJ discussed that later clinical observations showed some deficits, but found that
plaintiff could perform simple, routine tasks with occasional interaction with the public, and perform
low stress work. The ALJ observed that plaintiff was "disheveled and restless" and "lethargic" but
that she was "oriented with an estimated nonnal intelligence." Tr. 21, 328. Indeed, the ALJ pointed
7 - OPINION AND ORDER
to treatment notes describing plaintiff as depressed and tearful, but was cooperative, oriented, ale1i,
"with intact memo1y and normal speech." Tr. 21, 402-403.
The ALJ discussed that plaintiffs contention that her anxiety and depression prevent her
from working in any capacity is inconsistent with the evaluations perfonned by Drs. Truhn and
Pethick, as well as non-examining psychologist Kordell Kennemer, Psy .D., and Joshua Boyd, Psy.D.
Each ofthese doctors opined that plaintiffwas capable ofperforming simple, routine tasks, she could
complete a normal workweek, and that plaintiff could have occasional public and coworker contact.
For example, Steve Pethick, Ph.D., conducted a comprehensive evaluation on Februaiy 9,
2010 on behalf of Vocational Rehabilitation. Dr. Pethick diagnosed PTSD, chronic; Depressive
Disorder NOS; Learning Disability, NOS (academic fluency, spelling); Generalized Anxiety
Disorder; and Rule Out diagnoses of Bipolar Disorder and Panic Disorder with Agoraphobia. Tr.
223, 229. Dr. Pethick opined that there was a "wide range of suitable employment settings" for
plaintiff. Tr. 230. Dr. Pethick found that plaintiffs overall cognitive abilities ranged from average
to high average. The ALJ discussed that Dr. Pethick indicated that plaintiff had a "more difficult
time with tasks requiring speed in processing written info1mation and numerical information." Tr.
23, 227. The ALJ also noted that Dr. Pethick indicated that plaintiffs employment should involve
"accommodations in extra time to complete tasks involving significant reading or mathematics and
be provided with clear, written instructions for job tasks." Tr. 23, 230. The ALJ's findings are
wholly suppmied by substantial evidence.
Similarly, David R. Truhn, Psy.D., perfo1med a comprehensive psychological evaluation of
plaintiff on October 31, 2012 and November 27, 2012. Tr. 415. Dr. Truhn found that plaintiff had
average intelligence without any specific memmy deficits, had adequate concentration and ability
8 - OPINION AND ORDER
to attend to tasks, could follow simple directions, and worked at a reasonable pace, needing only to
break from the evaluation in order to provide childcare. Tr. 426. Dr. Truhn noted that plaintiffs
results on the MMPI-2 showed that plaintiff was over-reporting symptoms. Tr. 23, 423. As the ALJ
noted, Dr. Truhn indicated that plaintiff described symptoms that contradicted herself, and that her
personality inventories indicated exaggeration. Tr. 425. Dr. Truhn found thatplaintiff s exaggerated
response style produced elevations on scales "that were not co11'oborated by the interview and the
overall elevation on nearly all of the scales." Tr. 423. Notably, Dr. Truhn stated that the "symptoms
[plaintiff! is endorsing are not consistent with the symptoms that she described in the clinical
interview and is a broader representation of psychopathology." Tr. 426. Dr. Truhn diagnosed
plaintiff with Dysthymic Disorder, Early Onset; Panic Disorder, with Agoraphobia, Social Phobia;
Cannabis Abuse in Full Sustained Remission; and Rule Out diagnoses of Alcohol Abuse and
Malingering. As the ALJ discussed, Dr. Truhn recommended that plaintiff patticipate in Vocational
Rehabilitation and that she seek vocational programs involving little interaction with others. Tr. 23,
426. Again, the ALJ thoroughly and carefully examined Dr. Truhn's testing and the findings and
inferences drawn are supp01ied by substantial evidence.
The ALJ must review plaintiffs treatment notes in light of overall diagnostic picture.
Ghanim, 763 F.3d at 1163; Garrison, 759 F.3d at 1017. Plaintiff has reported symptoms of mild
depression and anxiety with occasional bouts of more severe depression, and plaintiff has been
prescribed a variety of medications in an effo1t to improve her overall functioning. Tr. 250, 256,
297, 302. The ALJ also discussed that plaintiff has a history of self-harming behavior, including
cutting and burning. The ALJ correctly noted that plaintiffs self-harming has been intermittent and
atypical during the relevant period. Tr. 21. Examining the record as a whole, I conclude that the
9 - OPINION AND ORDER
longitudinal picture of plaintiff's mental health supports the ALJ' s finding that the severity of
plaintiff's subjective symptoms inconsistent with the clinical evidence. Even if the objective
medical evidence could support plaintiff's interpretation, the ALJ' s determination is reasonable and
must be upheld. Batson, 359 F.3d at 1193.
B.
Plaintiff's Activities of Daily Living Are Inconsistent with Her Allegations of
Debilitating Limitations
The ALJ also discounted plaintiff's credibility because the degree of social limitation and
anxiety she alleged were inconsistent with the extensive activities she described. Contradiction with
a claimant's activities of daily living is a clear and convincing reason for rejecting a claimant's
testimony. Tommasetti, 533 F.3d at 1039. In the decision, the ALJ discounted plaintiff's credibility
because she was able to attend classes at community college for two terms and received straight A's.
The ALJ found plaintiff's ability to perfo1m well, despite her stress and anxiety, undermines her
allegations that she is unable to work in any capacity. Tr. 21. I agree. As the ALJ discussed,
plaintiff's ability to attend school is inconsistent with her allegations of disabling social phobia. As
the ALJ correctly indicated, plaintiff admitted in her testimony that she attended some, but not all,
classes with a friend, contrmy to plaintiff's allegation that she is unable to be alone. Moreover, as
the ALJ discussed, plaintiff was able to maintain excellent grades, despite feeling overwhelmed.
Additionally, the ALJ detailed numerous other daily activities plaintiff performs and found
them "inconsistent with the extreme degree of social limitation and amdety she alleged." Tr. 22.
Engaging in daily activities that are incompatible with the severity of symptoms alleged can support
an adverse credibility detetmination. }lfolina, 674 F.3d at 1112. Specifically, the ALJ noted that
plaintiff is the primaty cm·etaker for her two young children, and she performs all household chores,
10- OPINION AND ORDER
including cooking, laundry, dishes, cleaning, and yard work. The ALJ discussed that plaintiff not
only is able to follow recipes, but also is able to research recipes, nutrition, and organization articles
on line for hours, undermining her allegations that she is unable to focus and does not use the
computer. Tr. 177, 395. The ALJ pointed out that plaintiff plays games with her children, walks
them to the bus stop, visits her parents every other week, visits with a neighbor once a week, and
volunteers at the children's school once a week. As the ALJ found, these activities are inconsistent
with plaintiffs allegations of disabling social anxiety.
Additionally, the ALJ discussed that plaintiff avoids using the telephone, but had no
difficulty calling her therapist for counseling sessions when necessmy. Also, as the ALJ correctly
indicated, plaintiff sends and receives emails and texts. Tr. 18, 22. The ALJ noted that plaintiff
hosted barbeques, drinks socially two nights a week, occasionally has friends to her house, and that
plaintiff was required to perfom1 community service to maintain her housing.
The ALJ noted
plaintiff and her boyfriend took the children fishing, she went camping with her family, she attended
a school graduation, and rep01ied to medical personnel that she and her boyfriend occasionally go
on dates to the mall for dinner and a movie. Tr. 22, 419. The ALJ specifically found plaintiffs
repoti about going on dates with her boyfriend inconsistent with plaintiffs hearing testimony
denying that she and her boyfriend go to restaurants. The ALJ' s findings concerning plaintiffs daily
activities are supported by substantial evidence in the record. I conclude that when the ALJ' s first
and second reasons are combined, they provide clear and convincing supp01i for the ALJ' s adverse
credibility determination.
}.;Jolina, 674 F.3d at 1113 (finding claimant's daily activities and
inconsistency with medical evidence supported adverse credibility detennination).
11 - OPINION AND ORDER
C.
Plaintifrs Exaggeration Undermined Her Allegations
Lastly, the ALJ discredited plaintiff based on her over-reporting of symptoms to Dr. Truhn.
As the ALJ noted, results of the MMPI-2 indicated that plaintiff was over-reporting symptoms, and
that her personality inventory was similar to those who magnify their illness, and discounted
plaintiffs credibility on this basis. Tr. 23. A tendency to exaggerate symptoms may be considered
when dete1mining credibility. See Tonapetyan v. Halter, 242 F.3d 1144, 1148 (9th Cir. 2001)
(holding that a credibility determination based on, among other things, a tendency to exaggerate, was
supported by substantial evidence). As discussed above, Dr. Truhn's findings are backed by
substantial evidence in the record, and supply further support for the adverse credibility
dete1mination.
Having carefully reviewed the record in its entirety, I conclude that the ALJ provided clear
and convincing evidence for rejecting plaintiffs testimony about the severity of her symptoms. The
ALJ thoroughly examined the conflicting evidence and made findings based on his observations.
Indeed, this case is a close one, and the nuances of plaintiffs allegations are reflected in the ALJ' s
carefully crafted RFC. In short, the court concludes that while the record may be susceptible to more
than one rational interpretation, the ALJ' s decision is supp01ied by substantial evidence, and thus
the comi may not engage in second-guessing. See Andrews v. Shala/a, 53 F.3d 1035, 1039-40 (9th
Cir. 1995) (explaining that the ALJ "is responsible for dete1mining credibility, resolving conflicts
in medical testimony, and for resolving ambiguities ... [therefore the Comi] must uphold the ALJ's
decision where the evidence is susceptible to more than one rational interpretation."); see also
Treichlerv. Comm 'rofSoc. Sec. Admin., 775F.3d1090, 1103 (9th Cir. 2014) ("we cannot substitute
our conclusions for the ALJ' s").
12 - OPINION AND ORDER
II.
The ALJ Provided Germane Reasons for Discounting the Opinion of Plaintiffs Mental
Health Counselor
In general, the opinion of a treating physician is given more weight than the opinion of an
examining physician, and the opinion of an examining physician is afforded more weight than the
opinion of a nonexamining physician. Ghanim, 763 F.3d at 1160; Garrison, 759 F.3d at 1012; Orn
v. Astrue, 495 F.3d 625, 632 (9th Cir. 2007). "If a treating physician's opinion is well-supported by
medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the
other substantial evidence in [the] case record, [it will be given] controlling weight." Orn, 495 F .3d
at 631 (internal quotations omitted)(alterations in original); 20 C.F.R. § 416.927(c). To reject the
uncontradicted opinion of a treating physician, the ALJ must provide "clear and convincing reasons
that are suppotied by substantial evidence." Bayliss v. Barnhart, 427 F.3d 1211, 1216 (9th Cir.
2005).
If the treating physician's opinion is contradicted, the ALJ must consider how much weight
it is entitled to considering the factors in 20 C.F.R. § 416.927(c)(2-6). The factors include the length
of the treatment relationship, the frequency of examination, the nature and suppotiability of the
opinion, and its consistency with other evidence in the record as a whole. 20 C.F.R. § 416.927( d)(26); Ghanim, 763 F.3d at 1161. If a treating or examining doctor's opinion is contradicted by another
doctor's opinion, it may be rejected by specific and legitimate reasons. Taylor v. Commissioner Soc.
Sec. Admin., 659 F.3d 1228, 1232 (9th Cir. 2011). However, "[t]he ALJ need not accept the opinion
of any physician, including a treating physician, ifthat opinion is brief, concluso1y, and inadequately
supported by clinical findings." Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002).
13 - OPINION AND ORDER
Only physicians and certain other qualified specialists are considered "[a]cceptable medical
sources." lvfolina, 674 F.3d at 1111 (alteration in original); see also 20 C.F.R. § 416.913(a). Nurse
practitioners and therapists are considered "other sources." 20 C.F.R. § 416.913(d). An ALJ must
evaluate the opinions from other sources, and may discount such testimony if the ALJ provides
ge1mane reasons for doing so. Ghanim, 763 F.3d at 1161; 20 C.F.R. § 416.927(c).
Plaintiff argues that the ALJ failed to provide adequate reasons for discounting the opinions
of Cheryl Haun, M.A., plaintiffs treating mental health counselor from May 2012 to July 2013.
During that time, plaintiff met with Haun approximately once each week. In a March 15, 2013
Annual Mental Health Assessment, Haun opined that plaintiff is "not able to maintain a job due to
anxiety, depression, and OCD." Tr. 377. In a September 2, 2013 Mental Residual Functional
Capacity Assessment ("MRFC"), Haun opined that plaintiffs learning disability would make it
difficult to learn and initiate new material, and that plaintiffs traumatic hist01y had a "crippling
effect" on her ability to function at home and in the public. Tr. 24, 428-431. In the MRFC, Haun
opined that plaintiff had severe limitations in numerous areas, including: remembering detailed
instructions, making simple work-related decisions, working in proximity to others, perfotming at
a consistent pace without an umeasonable amount of rest periods, interacting with the public, asking
simple questions, traveling to unfamiliar places, and setting realistic goals. Tr. 429-31.
The ALJ provided three germane reasons for giving Ms. Haun's opinions "ve1y little
weight": (1) Haun is not an acceptable medical source and her opinions are inconsistent with "the
clinical observations and testing" ofDrs. Pethick and Truhn; (2) Haun's opinions are inconsistent
with plaintiffs activities of daily living; and (3) Haun's March 15 opinion did not adequately
consider plaintiffs ability to perfotm well in school despite her impairments.
14 - OPINION AND ORDER
A.
Ms. Haun's Opinion Was Contradicted by Opinions from Acceptable Medical
Sources
The parties do not dispute that Ms. Haun is an "other source" who "can provide evidence
about the severity of [a claimant's] impairment(s) and how it affects [the claimant's] ability to
work." 20 C.F.R. § 416.913(d). However, Haun's opinions are not entitled to the same deference
as licensed physicians or other specialists. },folina, 674 F.3d at 1111; 20 C.F.R. § 416.927. TheALJ
appropriately discounted Ms. Haun' s opinions because they are contradicted by those of acceptable
medical sources Drs. Pethick and Truhn. Drs. Pethick and Truhn specialize in the relevant field of
psychology and their opinions were entitled to greater weight. 1 lvfolina, 67 4 F .3d at 1112. SSR 0603 p (stating that opinions from an acceptable medical source may be entitled to greater weight than
those from other sources).
As discussed above, Dr. Pethick opined that there was a wide range of suitable employment
settings for plaintiff. The ALJ gave Dr. Pethick's opinion "significant weight" because it was
consistent with the testing he performed, his observations of plaintiffs social functioning, and
plaintiffs report of her various activities, such as caring for her children, researching on the internet,
and receiving excellent grades while at college. Plaintiff argues that Dr. Pethick's opinion is not
reliable because it was rendered prior to her June 2011 alleged onset date. Plaintiff also highlights
1
In the decision, the ALJ gave "great weight" to the opinion examining psychologist Dr.
Truhn, and "significant weight" to the opinions of examining psychologist Dr. Pethick, and nonexamining psychologists Kordell N. Kennemer, Psy.D., and Joshua J. Boyd, Psy.D. The ALJ
explained that he gave greater weight to Dr. Truhn's opinion over Dr. Pethick's because Dr.
Truhn had the opportunity to review Dr. Pethick's prior evaluation. Additionally, the ALJ
explained that he favored Dr. Truhn's opinion over Drs. Kennemer and Boyd's because Dr.
Truhn had the opportunity to observe plaintiff during testing and conduct an interview. The
ALJ's RFC is more limited than Dr. Truhn's opinion "in an abundance of caution and is to
benefit of [plaintiff]." Tr. 24.
15 - OPINION AND ORDER
that Dr. Pethick opined that plaintiff was capable of attending school, and yet doing so precipitated
her increased anxiety and debilitating symptoms. According to plaintiff, Dr. Pethick' s opinion is not
inconsistent with Ms. Haun's opinion that plaintiff has severe limitations with concentration for
"extended periods" and completing a no1mal workday and work week" without interruptions. Tr.
429-30. I disagree.
To be sure, the ALJ is required to evaluate all opinion evidence received. See Tommasetti,
533 F.3d at 1041 ("The ALJ must consider all medical opinion evidence."); 20 C.F.R. § 416.927(b).
Dr. Pethick's evaluation is probative evidence, and the ALJ properly considered it. It is clear in the
decision that the ALJ carefully considered and weighed Dr. Pethick' s testing results and found Dr.
Pethick' s observations consistent with plaintiffs social functioning. Although plaintiff contends that
her atDdety and OCD were exacerbated by attending school, as discussed above concerning
plaintiffs credibility, the ALJ appropriately discounted the severity of plaintiffs subjective
complaints. The ALJ' s finding that Ms. Haun' s opinions were inconsistent with those of acceptable
medical sources is wholly supported by substantial evidence and provides a germane reason for
rejecting Haun's opinions.
B.
Ms. Haun's Opinion Was Inconsistent with Plaintiff's ADL's
As the ALJ discussed, the limitations described by Ms. Haun, such as traveling to unfamiliar
places, interacting with the public, asking simple questions, and setting realistic goals were
inconsistent with plaintiffs ability to perform various activities. Although plaintiff engages in
numerous activities inside her home, her ability to clean, cook, assist with homework, and do laund1y
and yard work is inconsistent with Haun' s opinion that plaintiff is unable to work at a consistent pace
without an umeasonable amount of rest periods.
16- OPINION AND ORDER
Ms. Haun's opinion that plaintiffs traumatic
history has had a "crippling effect" on her ability to function at home and in public is undermined
by plaintiffs ability to independently raise her children and run her household, as well as engage in
numerous activities doing outside her home, such as grocery shopping, camping, fishing, and visiting
with friends, and volunteering at her son's school, as detailed by the ALJ. The ALJ's findings are
wholly supported by substantial evidence in the record and provide a second germane reason for
discounting Haun's opinion.
C.
Plaintiffs Ability to Attend School Is Inconsistent with Ms. Haun's Opinion
I likewise reject plaintiffs argument that the ALJ ened in rejecting Ms. Haun's opinions
because they were based on plaintiffs ability to maintain good grades while in school. As discussed
above, the ALJ could reasonably infer that plaintiffs social anxiety and phobia are not a severe as
alleged because she was able to perform well in school based on the evidence in the record as a
whole. Even if the ALJ ened in discounting Haun' s opinion on this basis, the error would be
hmmless. The ALJ provided two other germane reasons suppotied by substantial evidence to justify
giving Haun's opinion less weight. 1vfolina, 674 F.3d at 1122 (upholding ALJ decision where eiTor
is inconsequential to the ultimate nondisability determination). Accordingly, the ALJ did not en in
discounting Haun's opinion.
III.
The ALJ Provided Germane Reasons for Discounting the Lay Testimony
Lay witness testimony as to a claimant's symptoms or how an impairment affects his ability
to work is competent evidence, which the ALJ must take into account. See Bruce v. Astrue, 557 F.3d
1113, 1115 (9th Cir. 2009); Stout v. Commissioner, Soc. Sec. Adm in., 454 F.3d 1050, 1053 (9th Cir.
2006); Nguyen v. Chafer, 100 F.3d 1462, 1467 (9th Cir. 1996). The ALJ is required to account for
17 - OPINION AND ORDER
competent lay witness testimony, and if it is rejected, provide germane reasons for doing so.
Valentine, 574 F.3d at 694.
Plaintiffs friend, Brenda Vogel, submitted a letter dated August 16, 2013. Tr. 202. In the
letter, Ms. Vogel noted that she has known plaintiff for 15 years, and described plaintiff as suffering
from OCD, depression and social anxiety. Ms. Vogel stated that plaintiff becomes overwhelmed
easily and that plaintiff has difficulty finishing projects. Ms. Vogel described plaintiff as shy and
withdrawn, and that plaintiff is at times unable to leave the house. Ms. Vogel stated that sometimes
plaintiff shuts down and is unable to communicate in social situations. Ms. Vogel noted that
plaintiff is unable to hold down a job or be successful in school because plaintiff is so insecure. Tr.
202.
Plaintiffs mother, Dawn Clough, submitted a letter dated August 30, 2013. In that letter, Ms.
Clough described plaintiff as lacking in self-esteem and confidence, having a negative or
catastrophic world view, with troubled personal relationships and many health issues. Tr. 204. Ms.
Clough described plaintiff as being afraid of what other people say about her, and described that
during a Fourth of July party plaintiff hosted, plaintiff hid in the bathroom for several hours, and
called Ms. Clough on the phone, hysterical and crying. Ms. Clough described plaintiff as unable to
. go anywhere alone, and often brings her children with her so that she is not alone. Ms. Clough
described that plaintiff is convinced that something tragic will happen to her children if she is not
diligent about their safety, especially when they play by the river. Tr. 205.
Ms. Clough also stated that plaintiffs relationships with some family members is strained,
and that plaintiff has few friends. Ms. Clough noted that plaintiff has had a boyfriend for one year,
but that plaintiffs depression has taken a toll. Ms. Clough noted that plaintiffs depression affects
18 - OPINION AND ORDER
her sleep, and that plaintiff is always tired, and suffers from short te1m memo1y loss and occasionally
forgets about appointments. Ms. Clough does not believe that plaintiff is capable of working and
does not function like a n01mal adult. Tr. 206.
The ALJ discounted Ms. Vogel's statement because it was inconsistent with plaintiffs ability
to successfully attend community college and receive good grades. Tr. 25. The ALJ discounted Ms.
Clough's testimony because it relied on plaintiffs less than credible subjective complaints. As
discussed above, I have dete1mined that the ALJ appropriately discounted plaintiff testimony on
these bases, and therefore, the ALJ' s reasoning applies to Vogel and Clough' s testimony with equal
force. JV!olina, 674 F.3d at 1122; Valentine, 574 F.3d at 694 (an ALJ may reject lay witness
testimony if it is based on a claimant's testimony that has been properly discounted). Accordingly,
the ALJ has provided reasons ge1mane to Vogel and Clough for discounting their testimony.
CONCLUSION
For the reasons set forth above, the Commissioner's final decision denying benefits to
plaintiff is AFFIRMED.
IT IS SO ORDERED.
DATED this_i!fday of DECEMBER, 2015.
Malcolm F. Marsh
United States District Judge
19 ·OPINION AND ORDER
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