Owens v. Saul

Filing 17

ORDER GRANTING 14 DEFENDANT'S MOTION FOR SUMMARY JUDGMENT AND DENYING 12 PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT. Case is closed. Signed by Judge Rosanna Malouf Peterson. (AY, Case Administrator)

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1 2 FILED IN THE U.S. DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 3 Jun 02, 2021 4 SEAN F. MCAVOY, CLERK 5 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 6 7 KIMBERLY O., 8 9 10 11 Plaintiff, v. ANDREW M. SAUL, COMMISSIONER OF SOCIAL SECURITY, 14 15 16 17 18 19 20 21 ORDER GRANTING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT AND DENYING PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT Defendant. 12 13 NO: 1:20-CV-03042-FVS BEFORE THE COURT are the parties’ cross motions for summary judgment. ECF Nos. 12 and 14. This matter was submitted for consideration without oral argument. The Plaintiff is represented by Attorney Cory J. Brandt. The Defendant is represented by Special Assistant United States Attorney Justin L. Martin. The Court has reviewed the administrative record, the parties’ completed briefing, and is fully informed. For the reasons discussed below, the Court GRANTS Defendant’s Motion for Summary Judgment, ECF No. 14, and DENIES Plaintiff’s Motion for Summary Judgment, ECF No. 12. ORDER ~ 1 JURISDICTION 1 2 Plaintiff Kimberly O. 1 protectively filed for disability insurance benefits on 3 March 6, 2014, alleging a disability onset date of October 1, 2013. Tr. 138-47. 4 Benefits were denied initially, Tr. 81-87, and upon reconsideration, Tr. 89-93. 5 Plaintiff requested a hearing before an administrative law judge (“ALJ”), which 6 was held on May 18, 2016. Tr. 30-53. Plaintiff was represented by counsel and 7 testified at the hearing. Id. The ALJ denied benefits, Tr. 12-29, and the Appeals 8 Council denied review. Tr. 1. On March 5, 2019, the United States District Court 9 for the Eastern District of Washington granted Plaintiff’s Motion for Summary 10 Judgment, and remanded the case for further proceedings. Tr. 619-34. On March 11 24, 2019, the Appeals Council vacated the ALJ’s finding, and remanded for further 12 administrative proceedings. Tr. 448-51. On January 3, 2020, Plaintiff appeared 13 for an additional hearing before the ALJ. Tr. 563-91. The ALJ denied benefits. 14 Tr. 511-37. The matter is now before this court pursuant to 42 U.S.C. § 405(g). BACKGROUND 15 16 The facts of the case are set forth in the administrative hearing and 17 transcripts, the ALJ’s decision, and the briefs of Plaintiff and the Commissioner. 18 Only the most pertinent facts are summarized here. 19 20 21 1 In the interest of protecting Plaintiff’s privacy, the Court will use Plaintiff’s first name and last initial. ORDER ~ 2 1 Plaintiff was 55 years old at the time of the second hearing. See Tr. 140. 2 She completed high school and one year of college. Tr. 47-48, 232. She lived 3 with her husband and teenage son. Tr. 35. Plaintiff has work history as an 4 insurance sales agent and insurance clerk. Tr. 35-38, 49, 585. She testified that 5 she could not go back to work because of her vertigo. Tr. 38. Specifically, 6 Plaintiff testified that when her vertigo “kicks in” she cannot get out of bed for up 7 to a week, then it takes a few days to get her balance back, and during that time she 8 cannot turn fast or bend down. Tr. 41, 574-75. At the first hearing she reported 9 that she has vertigo episodes once a month, and previously had episodes up to 10 several times per week. Tr. 42-43. STANDARD OF REVIEW 11 12 A district court’s review of a final decision of the Commissioner of Social 13 Security is governed by 42 U.S.C. § 405(g). The scope of review under § 405(g) is 14 limited; the Commissioner’s decision will be disturbed “only if it is not supported 15 by substantial evidence or is based on legal error.” Hill v. Astrue, 698 F.3d 1153, 16 1158 (9th Cir. 2012). “Substantial evidence” means “relevant evidence that a 17 reasonable mind might accept as adequate to support a conclusion.” Id. at 1159 18 (quotation and citation omitted). Stated differently, substantial evidence equates to 19 “more than a mere scintilla[,] but less than a preponderance.” Id. (quotation and 20 citation omitted). In determining whether the standard has been satisfied, a 21 reviewing court must consider the entire record as a whole rather than searching for supporting evidence in isolation. Id. ORDER ~ 3 1 In reviewing a denial of benefits, a district court may not substitute its 2 judgment for that of the Commissioner. “The court will uphold the ALJ's 3 conclusion when the evidence is susceptible to more than one rational 4 interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 5 2008). Further, a district court will not reverse an ALJ’s decision on account of an 6 error that is harmless. Id. An error is harmless where it is “inconsequential to the 7 [ALJ’s] ultimate nondisability determination.” Id. (quotation and citation omitted). 8 The party appealing the ALJ’s decision generally bears the burden of establishing 9 that it was harmed. Shinseki v. Sanders, 556 U.S. 396, 409-10 (2009). FIVE-STEP EVALUATION PROCESS 10 11 A claimant must satisfy two conditions to be considered “disabled” within 12 the meaning of the Social Security Act. First, the claimant must be “unable to 13 engage in any substantial gainful activity by reason of any medically determinable 14 physical or mental impairment which can be expected to result in death or which 15 has lasted or can be expected to last for a continuous period of not less than twelve 16 months.” 42 U.S.C. § 423(d)(1)(A). Second, the claimant’s impairment must be 17 “of such severity that he is not only unable to do his previous work[,] but cannot, 18 considering his age, education, and work experience, engage in any other kind of 19 substantial gainful work which exists in the national economy.” 42 U.S.C. § 20 423(d)(2)(A). 21 The Commissioner has established a five-step sequential analysis to determine whether a claimant satisfies the above criteria. See 20 C.F.R. § ORDER ~ 4 1 404.1520(a)(4)(i)-(v). At step one, the Commissioner considers the claimant’s 2 work activity. 20 C.F.R. § 404.1520(a)(4)(i). If the claimant is engaged in 3 “substantial gainful activity,” the Commissioner must find that the claimant is not 4 disabled. 20 C.F.R. § 404.1520(b). 5 If the claimant is not engaged in substantial gainful activity, the analysis 6 proceeds to step two. At this step, the Commissioner considers the severity of the 7 claimant’s impairment. 20 C.F.R. § 404.1520(a)(4)(ii). If the claimant suffers 8 from “any impairment or combination of impairments which significantly limits 9 [his or her] physical or mental ability to do basic work activities,” the analysis 10 proceeds to step three. 20 C.F.R. § 404.1520(c). If the claimant’s impairment 11 does not satisfy this severity threshold, however, the Commissioner must find that 12 the claimant is not disabled. 20 C.F.R. § 404.1520(c). 13 At step three, the Commissioner compares the claimant’s impairment to 14 severe impairments recognized by the Commissioner to be so severe as to preclude 15 a person from engaging in substantial gainful activity. 20 C.F.R. § 16 404.1520(a)(4)(iii). If the impairment is as severe or more severe than one of the 17 enumerated impairments, the Commissioner must find the claimant disabled and 18 award benefits. 20 C.F.R. § 404.1520(d). 19 If the severity of the claimant’s impairment does not meet or exceed the 20 severity of the enumerated impairments, the Commissioner must pause to assess 21 the claimant’s “residual functional capacity.” Residual functional capacity (RFC), defined generally as the claimant’s ability to perform physical and mental work ORDER ~ 5 1 activities on a sustained basis despite his or her limitations, 20 C.F.R. § 2 404.1545(a)(1), is relevant to both the fourth and fifth steps of the analysis. 3 At step four, the Commissioner considers whether, in view of the claimant’s 4 RFC, the claimant is capable of performing work that he or she has performed in 5 the past (past relevant work). 20 C.F.R. § 404.1520(a)(4)(iv). If the claimant is 6 capable of performing past relevant work, the Commissioner must find that the 7 claimant is not disabled. 20 C.F.R. § 404.1520(f). If the claimant is incapable of 8 performing such work, the analysis proceeds to step five. 9 At step five, the Commissioner considers whether, in view of the claimant’s 10 RFC, the claimant is capable of performing other work in the national economy. 11 20 C.F.R. § 404.1520(a)(4)(v). In making this determination, the Commissioner 12 must also consider vocational factors such as the claimant’s age, education and 13 past work experience. 20 C.F.R. § 404.1520(a)(4)(v). If the claimant is capable of 14 adjusting to other work, the Commissioner must find that the claimant is not 15 disabled. 20 C.F.R. § 404.1520(g)(1). If the claimant is not capable of adjusting to 16 other work, analysis concludes with a finding that the claimant is disabled and is 17 therefore entitled to benefits. 20 C.F.R. § 404.1520(g)(1). 18 The claimant bears the burden of proof at steps one through four above. 19 Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999). If the analysis proceeds to 20 step five, the burden shifts to the Commissioner to establish that (1) the claimant is 21 capable of performing other work; and (2) such work “exists in significant ORDER ~ 6 1 numbers in the national economy.” 20 C.F.R. § 404.1560(c)(2); Beltran v. Astrue, 2 700 F.3d 386, 389 (9th Cir. 2012). 3 ALJ’S FINDINGS 4 At step one, the ALJ found that Plaintiff did not engage in substantial 5 gainful during the period from her alleged onset date of October 1, 2013 through 6 her date last insured of December 31, 2016. Tr. 517. At step two, the ALJ found 7 that, through the date last insured, Plaintiff had the following severe impairments: 8 degenerative disease of the lumbar spine, vertigo, and obesity. Tr. 518. At step 9 three, the ALJ found that, through the date last insured, Plaintiff did not have an 10 impairment or combination of impairments that met or medically equaled the 11 severity of a listed impairment. Tr. 521. The ALJ then found that, through the 12 date last insured, Plaintiff had the RFC 13 14 15 16 17 18 to perform light work as defined in 20 CFR 404.1567(b) except the following. She could lift or carry up to 20 pounds occasionally and up to 10 pounds frequently, stand or walk for approximately 6 hours and sit for approximately 6 hours per 8-hour workday with normal breaks. She could occasionally climb ramps or stairs of one flight. She could never climb ladders, ropes, or scaffolds. She could occasionally balance, stoop, kneel, crouch, and crawl. She must avoid concentrated exposure to excessive vibration and excessive noises. She must avoid moderate exposure to workplace hazards, such as working with dangerous machinery or on uneven terrain and no working at unprotected heights. She could frequently handle, finger, and feel. 19 Tr. 522. At step four, the ALJ found that Plaintiff was capable of performing past 20 relevant work as an insurance sales agent and insurance clerk. Tr. 529. On that 21 basis, the ALJ concluded that Plaintiff was not under a disability, as defined in the ORDER ~ 7 1 Social Security Act, at any time from October 1, 2013, the alleged onset date, 2 through December 31, 2016, the date last insured. Tr. 530. ISSUES 3 4 Plaintiff seeks judicial review of the Commissioner’s final decision denying 5 her disability insurance benefits under Title II of the Social Security Act. ECF No. 6 12. Plaintiff raises the following issues for this Court’s review: 7 1. Whether the ALJ properly weighed the medical opinion evidence; 8 2. Whether the ALJ failed to fully develop the record; 9 3. Whether the ALJ properly considered Plaintiff’s symptom claims; 10 4. Whether the ALJ properly considered the lay witness evidence; and 11 5. Whether the ALJ erred at step four. 12 13 14 15 16 17 18 19 20 21 A. Medical Opinions DISCUSSION There are three types of physicians: “(1) those who treat the claimant (treating physicians); (2) those who examine but do not treat the claimant (examining physicians); and (3) those who neither examine nor treat the claimant [but who review the claimant's file] (nonexamining [or reviewing] physicians).” Holohan v. Massanari, 246 F.3d 1195, 1201–02 (9th Cir.2001) (citations omitted). Generally, a treating physician's opinion carries more weight than an examining physician's, and an examining physician's opinion carries more weight than a reviewing physician's. Id. If a treating or examining physician's opinion is uncontradicted, the ALJ may reject it only by offering “clear and convincing ORDER ~ 8 1 reasons that are supported by substantial evidence.” Bayliss v. Barnhart, 427 F.3d 2 1211, 1216 (9th Cir.2005). Conversely, “[i]f a treating or examining doctor's 3 opinion is contradicted by another doctor's opinion, an ALJ may only reject it by 4 providing specific and legitimate reasons that are supported by substantial 5 evidence.” Id. (citing Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1995)). 6 “However, the ALJ need not accept the opinion of any physician, including a 7 treating physician, if that opinion is brief, conclusory and inadequately supported 8 by clinical findings.” Bray v. Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1228 9 (9th Cir. 2009) (quotation and citation omitted). 10 The opinion of an acceptable medical source such as a physician or 11 psychologist is generally given more weight than that of an “other source.” See 12 SSR 06-03p (Aug. 9, 2006), available at 2006 WL 2329939 at *2; 20 C.F.R. § 13 416.927(a). “Other sources” include nurse practitioners, physician assistants, 14 therapists, teachers, social workers, and other non-medical sources. 20 C.F.R. §§ 15 404.1513(d), 416.913(d). The ALJ need only provide “germane reasons” for 16 disregarding an “other source” opinion. Molina v. Astrue, 674 F.3d 1104, 1111 17 (9th Cir. 2012). However, the ALJ is required to “consider observations by 18 nonmedical sources as to how an impairment affects a claimant's ability to work.” 19 Sprague v. Bowen, 812 F.2d 1226, 1232 (9th Cir. 1987). 20 21 Plaintiff argues the ALJ erroneously considered the opinions of Plaintiff’s treating providers Paul Tompkins, M.D. and Salvador Lopez, PA-C. ECF No. 12 at 10-15. ORDER ~ 9 1 1. Paul Tompkins, M.D. 2 In October 2014, Plaintiff’s treating physician, Dr. Paul Tompkins, wrote a 3 letter to the Social Security Administration asking that they reconsider the denial 4 of Plaintiff’s claim for disability benefits. Tr. 483. Dr. Tompkins indicated that 5 due to “recurrent significant vertigo,” Plaintiff could work at most 2-3 hours, 2-3 6 times per week; and “[b]ecause of the intermittent nature of this problem, neither 7 she nor her employers can count on/schedule her work.” Tr. 483. In November 8 2014, Dr. Tompkins opined that due to benign positional vertigo, Plaintiff would 9 have to lie down intermittently for up to several hours; if she attempted to work a 10 40-hour per week schedule it was more probable than not that she would miss 4 or 11 more days of work per month; and she could lift 20 pounds maximum and 12 frequently lift and/or carry up to 10 pounds. Tr. 312-13. Then, in December 2014, 13 Dr. Tompkins similarly opined that Plaintiff would need to lie down intermittently 14 “without warning”; if she attempted to work a 40-hour per week schedule it was 15 more probable than not that she would miss 4 or more days of work per month; and 16 she was able to perform light work. Tr. 484-85. 17 The ALJ gave significant weight to Dr. Tompkins’ opinion that Plaintiff 18 could perform at a light exertional level because it was consistent with the record 19 as a whole, conservative and infrequent treatment, benign physical examination 20 results, improvement with treatment, and her activities. Tr. 527-28. However, the 21 ALJ gave weight to Dr. Tompkins’ opinions ORDER ~ 10 1 2 3 4 5 6 7 only to the extent of [the light exertional limitation because Dr. Tompkins’] opinions about the frequency of the vertigo, severity of the symptoms, the need to lie down or elevate her legs during the day, and that [Plaintiff] would miss an average of four or more days per month, are based heavily on [Plaintiff’s] self-reported symptoms and limitations, which are not fully supported by the longitud[inal] medical record, including objective findings, [Plaintiff’s] relatively conservative and infrequent course of treatment, her rather benign presentation at appointments and at the physical examinations, the statements of improvement of back pain and vertigo with treatment, and no complications from diabetes, and [Plaintiff’s] reported activities of daily living and work activities through the date last insured. Tr. 528 (internal citations omitted). 8 Plaintiff argues that the ALJ’s reasoning is “not valid” for several reasons. 9 ECF No. 12 at 11-14. As an initial matter, Plaintiff argues that “[t]o summarily 10 reject the limitations assessed by Dr. Tompkins, claiming they were based only on 11 subjective reports, is to presume incompetence on the part of the provider.” ECF 12 No. 12 at 11-12. However, Plaintiff fails to cite legal authority or evidence from 13 the longitudinal record to support this assertion. Rather, it is well-settled in the 14 Ninth Circuit that an ALJ may reject a physician’s opinion if it is based “to a large 15 extent” on Plaintiff’s self-reports that have been properly discounted. See 16 Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008). And in the instant 17 case, as discussed below, the ALJ additionally supported this finding by noting that 18 Plaintiff’s self-reported symptoms were not supported by the longitudinal medical 19 record, including Dr. Tompkins’ own treatment notes. Tr. 528. 20 21 Next, Plaintiff generally argues, with minimal citation to the record, that (1) her vertigo symptoms were intermittent and “[s]he was only able to meet with providers on good days, which account for the benign findings in the record”; (2) ORDER ~ 11 1 she received conservative treatment “not because her conditions did not warrant 2 more, but because there were no other options”; and (3) she did not experience any 3 long-term improvement that would enable her to engage in substantial gainful 4 employment. ECF No. 12 at 12-13 (citing Tr. 320, 322 (reporting vertigo “is 5 calming down” but she still has “episodes” every week), 410 (“experiencing a 6 degree of disequilibrium”), 483 (citing Dr. Tompkins’ finding that “medically, no 7 one knows of anything more to do”), 926 (2018 treatment record noting Plaintiff’s 8 7-year history of vertigo that “over the last 3 years has worsened”)). However, the 9 consistency of a medical opinion with the record as a whole is a relevant factor in 10 the ALJ’s evaluation of a medical opinion. Orn v. Astrue, 495 F.3d 625, 631 (9th 11 Cir. 2007); see also Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 12 (9th Cir. 2004) (an ALJ may discount an opinion that is conclusory, brief, and 13 unsupported by the record as a whole, or by objective medical findings). 14 Here, in support of her finding, the ALJ cites consistently normal objective 15 test results, benign physical examination results, conservative and infrequent 16 treatment, and statements of improvement with treatment throughout the relevant 17 adjudicatory period, including Dr. Tompkins’ own treatment notes. See 18 Tommasetti, 533 F.3d at 1041(it is proper for an ALJ to reject a medical opinion if 19 it is inconsistent with the provider's own treatment notes). This evidence includes 20 July 2013 imaging that showed only mild degenerative changes of the lumbar 21 spine; normal brain MRI results in January 2011; normal or steady gait; normal/near normal range of motion of the lumbar spine, cervical spine, shoulders, ORDER ~ 12 1 upper extremities, and lower extremities including bilateral knees; normal/near 2 normal motor strength of the lumbar spine, lower extremities, and upper 3 extremities; intact coordination and deep tendon reflexes; intact sensation of the 4 extremities; treatment notes observing that Plaintiff was comfortable and in no 5 acute distress; normal respiratory function; no complications from diabetes; and 6 referral for physical therapy. Tr. 317, 319-20, 322-23, 325, 327, 331, 334, 352, 7 379, 384-85, 389, 391, 407-10, 420-21, 425-27, 433-34, 445, 449, 476-77, 489, 8 492-93, 495, 503, 506-07, 509, 527-28, 841. 9 In addition, despite Plaintiff’s argument to the contrary, it was proper for the 10 ALJ to consider the infrequency of Plaintiff’s treatment for vertigo during the 11 relevant adjudicatory period when weighing Dr. Tompkins’ opinions, regardless of 12 Dr. Tompkins’ 2014 statement that Plaintiff had a “poor prognosis” as to her 13 “persistent vertigo.” Tr. 525; see 20 C.F.R. § 404.1527(c)(i) (ALJ considers 14 “frequency of examination” in weighing medical opinions). And, as noted in the 15 ALJ’s decision, despite her claims of significant back and neck pain, Plaintiff 16 received only routine and conservative treatment for these alleged impairments, 17 and she did not undergo surgery during the relevant adjudicatory period. Tr. 497, 18 525. Thus, regardless of evidence in the record that may be considered more 19 favorable to Plaintiff, it was reasonable for the ALJ to find that the overall record, 20 including objective evidence, physical examination results, improvement with 21 treatment, and infrequent treatment records, was inconsistent with the severity of the limitations assessed by Dr. Tompkins. See Burch v. Barnhart, 400 F.3d 676, ORDER ~ 13 1 679 (9th Cir. 2005) (“[W]here evidence is susceptible to more than one rational 2 interpretation, it is the [Commissioner’s] conclusion that must be upheld.”). 3 Finally, the ALJ found the severe limitations assessed by Dr. Tompkins were 4 inconsistent with Plaintiff’s reported activities of daily living and work activities 5 through the date last insured. Tr. 528. An ALJ may discount an opinion that is 6 inconsistent with a claimant’s reported functioning. Morgan v. Comm’r Soc. Sec. 7 Admin., 169 F.3d 595, 601-02 (9th Cir. 1999). In support of this finding, the ALJ 8 noted that Plaintiff worked until July 2014, prepared simple meals, did light 9 housework, fed her pets, watched her grandson weekly, went to church, and 10 shopped in stores weekly. Tr. 528 (citing Tr. 44-46, 210, 221, 247-48, 260-65, 11 377). The ALJ additionally noted that Dr. Tompkins did not restrict Plaintiff from 12 driving during the relevant adjudicatory period, and found that “[if Plaintiff’s] 13 vertigo were as severe as opined in February 2014, October 2014, and December 14 2014, Dr. Thompkins would have restricted [Plaintiff] from driving.” Tr. 528. 15 Plaintiff argues that the activities listed by the ALJ are not inconsistent with 16 Dr. Tompkins’ opinion as to Plaintiff’s need to lie down intermittently and miss up 17 to 4 days of work in a full-time work week because they do not demand more than 18 a light level of exertion, and “fit within [Plaintiff’s] functional abilities on a good 19 day.” ECF No. 12 at 13-14 (emphasis in original). However, the Court finds it 20 was reasonable for the ALJ to find the severity of Dr. Tompkins’ opinions was 21 inconsistent with the lack of restriction on her driving despite the aforementioned “intermittent” and unpredictable vertigo, her ability to continue working for a ORDER ~ 14 1 portion of the relevant adjudicatory period, and her ability to take care of her 2 grandson and do weekly errands. See Tommasetti, 533 F.3d at 1040 (ALJ may 3 draw inferences logically flowing from evidence); Magallanes v. Bowen, 881 F.2d 4 747, 755 (9th Cir. 1989). Moreover, even assuming the ALJ erred in considering 5 Plaintiff’s activities during the relevant adjudicatory period as a reason to discount 6 Dr. Tompkins’ opinions, any error is harmless because, as discussed above, the 7 ALJ’s ultimate rejection of Dr. Tompkins’ opinions was supported by substantial 8 evidence. See Carmickle v. Comm’r of Soc. Sec. Admin., 533 F.3d 1155, 1162-63 9 (9th Cir. 2008). 10 For all of these reasons, the Court finds no error in the ALJ’s rejection of Dr. 11 Tompkins’ opinions to the extent they are inconsistent with the overall medical 12 record. See Burch, 400 F.3d at 679 (ALJ’s conclusion must be upheld where 13 evidence is susceptible to more than one rational interpretation). 14 2. Salvador Lopez, PA-C 15 In September 2019, treating provider, Salvador Lopez, PA-C, completed a 16 “medical report.” Tr. 1063-65. Mr. Lopez opined that Plaintiff was able to stand 17 for a maximum of about 2 hours in an 8-hour day, sit less than 2 hours during an 8- 18 hour day, sit for 15 minutes before changing positions, stand for 10 minutes before 19 changing positions, lift and carry less than 10 pounds frequently and occasionally, 20 would be off task more than 50% of the work day due to her impairments, would 21 need to lie down at unpredictable intervals during an 8-hour work shift, and would miss an average of 4 or more days of work per month if she attempted to work a ORDER ~ 15 1 40-hour per week schedule. Tr. 1063-64. Mr. Lopez also opined that Plaintiff was 2 limited to less than sedentary work. Tr. 1064. The ALJ gave Mr. Lopez’s opinion 3 little weight for several reasons. Tr. 528. 4 First, the ALJ noted the opinion “was formed almost three years after the 5 date last insured and therefore do[es] not reflect [Plaintiff’s] physical functioning 6 during the relevant period of this decision and therefore [has] little probative 7 value.” Tr. 528. In general, a statement of disability made outside the relevant 8 time period may be of limited probative value. See Turner v. Comm'r of Soc. Sec., 9 613 F.3d 1217, 1224 (9th Cir. 2010). Here, as noted by the ALJ, Mr. Lopez’s 10 opinion is dated December 30, 2019, three years after Plaintiff’s date last insured 11 of December 31, 2016. Tr. 1065. However, the report specifically notes that it 12 addresses Plaintiff’s ability to perform activities during the relevant adjudicatory 13 period, namely, from 2013 through the date of the opinion in 2019. Tr. 1063. 14 Moreover, while it was reasonable for the ALJ to note that Mr. Lopez’s 2019 15 opinion was offered well after the period for which Plaintiff is attempting to 16 establish disability, it is well-settled in the Ninth Circuit that an opinion cannot be 17 disregarded solely on this basis. See Smith v. Bowen, 849 F.2d 1222, 1225 (9th 18 Cir. 1988) (reports containing observations made after the period of disability are 19 relevant to assess disability and should not be disregarded solely on that basis). 20 Regardless, the ALJ offered additional germane reasons for rejecting Mr. 21 Lopez’s opinion. See Carmickle, 533 F.3d at 1162-63. First, the ALJ noted that the record as a whole does not support the opined “extreme limitations” opined by ORDER ~ 16 1 Mr. Lopez. Tr. 528. As above, the consistency of a medical opinion with the 2 record as a whole is a relevant factor in the ALJ’s evaluation of a medical opinion. 3 Orn, 495 F.3d at 631. Plaintiff generally argues, without specific citation to the 4 record, that Mr. Lopez’s opinion is supported by “evidence in the record, including 5 Dr. Tompkins improperly rejected opinion.” ECF No. 12 at 14. However, as 6 discussed in detail above, the ALJ’s consideration of Dr. Tompkins’ opinions was 7 free of error and supported by substantial evidence. Moreover, as with Dr. 8 Tompkins’ opinion, it was reasonable for the ALJ to find that the record as a 9 whole, including normal objective findings and benign physical examinations, does 10 not support the severity of the limitations opined by Mr. Lopez, which includes a 11 finding that Plaintiff would be off task more than 50% throughout a workday, and 12 limited her to even “less than sedentary work.” See Tr. 1064. This was a germane 13 reason for the ALJ to reject Mr. Lopez’s opinion. 14 Second, the ALJ found that Mr. Lopez “did not provide much, if any, 15 explanation for the opined limitations in the form checkboxes.” Tr. 528. An ALJ 16 may permissibly reject check -box reports that do not contain any explanation of 17 the bases for their conclusions. See Crane v. Shalala, 76 F.3d 251, 253 (9th Cir. 18 1996); see also Batson, 359 F.3d at 1195 (an ALJ may discount an opinion that is 19 conclusory, brief, and unsupported by the record as a whole, or by objective 20 medical findings). Plaintiff argues that “the treatment notes from Mr. Lopez’s 21 clinic serve as a basis for his opinion.” ECF No. 12 at 14 (citing Tr. 978-1004). The Ninth Circuit has held that when a treating physician’s check-box opinion was ORDER ~ 17 1 “based on significant experience with [Plaintiff] and supported by numerous 2 records, [it was] therefore entitled to weight that an otherwise unsupported and 3 unexplained check-box form would not merit.” See Garrison v. Colvin, 759 F.3d 4 995, 1014 n.17 (9th Cir. 2014); see also Trevizo v. Berryhill, 871 F.3d 664, 667 n.4 5 (9th Cir. 2017) (“[T]here is no authority that a ‘check-the-box’ form is any less 6 reliable than any other type of form”). However, the evidence cited by Plaintiff 7 contains only five treatment notes indicating Mr. Lopez was the treating provider, 8 over the course of eight months, which does not rise to the level of a “significant” 9 experience with Plaintiff that “was supported by numerous records.” See 978- 10 1004. Moreover, the Court’s review of the cited treatment notes does not provide 11 any arguable explanation of the bases for the severe limitations assessed by Mr. 12 Lopez in his check-box opinion. Crane, 76 F.3d at 253. This was a germane 13 reason for the ALJ to reject Mr. Lopez’s opinion. 14 15 B. Duty to Develop the Record The ALJ has an independent duty to fully and fairly develop a record in 16 order to make a fair determination as to disability, even where, as here, the 17 claimant is represented by counsel. See Tonapetyan v. Halter, 242 F.3d 1144, 18 1150 (9th Cir. 2001). “Ambiguous evidence, or the ALJ's own finding that the 19 record is inadequate to allow for proper evaluation of the evidence, triggers the 20 ALJ's duty to ‘conduct an appropriate inquiry.’” Id. (quoting Smolen v. Chater, 80 21 F.3d 1273, 1288 (9th Cir.1996)). Here, the United States District Court ordered the ALJ to “further develop the record by directing Plaintiff to undergo a new ORDER ~ 18 1 consultative examination with respect to her physical capacity.” Tr. 630. 2 Accordingly, on October 10, 2019, Dr. William Drenguis, M.D. completed a 3 physical evaluation of Plaintiff and opined that she could stand and walk for at 4 least 6 hours, sit for at least 6 hours, lift and carry less than 10 pounds occasionally 5 and frequently because she had recent anterior cervical fusion surgery, and could 6 occasionally climb, balance, stoop, kneel, crouch, and crawl due to her vertigo and 7 recent anterior cervical fusion. Tr. 844. Dr. Drenguis also noted that Plaintiff 8 would be “re-evaluated” in November 2019 to review restrictions based on her 9 recent cervical fusion surgery. Id. Plaintiff argues the ALJ failed to meet her duty 10 to fully and fairly develop the record because “the record does not contain a re- 11 evaluation, and the ALJ’s decision was thus based on an incomplete consultative 12 evaluation.” ECF No. 12 at 15. 13 However, Dr. Drenguis submitted a complete functional assessment, and 14 Plaintiff fails to identify any limitations assessed by Dr. Drenguis that were not 15 properly accounted for in the assessed RFC, even with “surgical restriction” due to 16 her “recent anterior cervical fusion.” Molina, 674 F.3d at 1115 (error is harmless 17 “where it is inconsequential to the [ALJ’s] ultimate nondisability determination). 18 Additionally, as noted by Defendant, “the temporary exertional restrictions 19 stemming from Plaintiff’s July 2019 [surgery] do not shed any light on Plaintiff’s 20 functioning during the three-year relevant period between October 2013 (alleged 21 onset date) and December 2016 (the date last insured).” ECF No. 14 at 12. “[A]n ALJ is not required to order every medical evaluation that could conceivably shed ORDER ~ 19 1 light on a claimant's condition, but rather just those that would resolve ambiguities 2 or inadequacies in the record.” Lloyd v. Astrue, No. C-11-4902-EMC, 2013 WL 3 503389, at *5 (N.D. Cal. Feb. 8, 2013) (citing Mayes v. Massanari, 276 F.3d 453, 4 459-60 (9th Cir. 2001)). Finally, it is Plaintiff’s duty to prove that she is disabled; 5 and this burden cannot be shifted to the ALJ simply by virtue of the ALJ’s duty to 6 develop the record. ECF No. 13 at 12 (citing Mayes, 276 F.3d at 459-60). 7 Here, the ALJ reviewed the entire 1,000-page record, including the medical 8 opinion evidence from the relevant adjudicatory period, and identified sufficient 9 evidence in the record as a whole for a properly supported disability determination. 10 “The ALJ is responsible for determining credibility, resolving conflicts in the 11 medical testimony, and for resolving ambiguities. [The Court] must uphold the 12 ALJ’s decision where the evidence is susceptible to more than one rational 13 interpretation.” Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995); see also 14 Bayliss, 427 F.3d at 1217 (finding the ALJ did not have a duty to further develop 15 the record because “the ALJ, with support in the record, found the evidence 16 adequate to make a determination regarding [Plaintiff’s] disability”). The ALJ did 17 not find, and the Court is unable to discern, any inadequacy or ambiguity that did 18 not allow for proper evaluation of the record as a whole. Thus, the ALJ did not err 19 in failing to further develop the record in this case. 20 21 C. Plaintiff’s Symptom Claims An ALJ engages in a two-step analysis when evaluating a claimant’s testimony regarding subjective pain or symptoms. “First, the ALJ must determine ORDER ~ 20 1 whether there is objective medical evidence of an underlying impairment which 2 could reasonably be expected to produce the pain or other symptoms alleged.” 3 Molina, 674 F.3d at 1112 (internal quotation marks omitted). “The claimant is not 4 required to show that her impairment could reasonably be expected to cause the 5 severity of the symptom he has alleged; he need only show that it could reasonably 6 have caused some degree of the symptom.” Vasquez v. Astrue, 572 F.3d 586, 591 7 (9th Cir. 2009) (internal quotation marks omitted). 8 9 Second, “[i]f the claimant meets the first test and there is no evidence of malingering, the ALJ can only reject the claimant’s testimony about the severity of 10 the symptoms if [the ALJ] gives ‘specific, clear and convincing reasons’ for the 11 rejection.” Ghanim v. Colvin, 763 F.3d 1154, 1163 (9th Cir. 2014) (internal 12 citations and quotations omitted). “General findings are insufficient; rather, the 13 ALJ must identify what testimony is not credible and what evidence undermines 14 the claimant’s complaints.” Id. (quoting Lester, 81 F.3d at 834); Thomas v. 15 Barnhart, 278 F.3d 947, 958 (9th Cir. 2002) (“[T]he ALJ must make a credibility 16 determination with findings sufficiently specific to permit the court to conclude 17 that the ALJ did not arbitrarily discredit claimant’s testimony.”). “The clear and 18 convincing [evidence] standard is the most demanding required in Social Security 19 cases.” Garrison, 759 F.3d at 1015 (quoting Moore v. Comm’r of Soc. Sec. 20 Admin., 278 F.3d 920, 924 (9th Cir. 2002)). 21 Here, the ALJ found Plaintiff’s medically determinable impairments could reasonably be expected to cause some of the alleged symptoms; however, ORDER ~ 21 1 Plaintiff’s “statements concerning the intensity, persistence and limiting effects of 2 these symptoms are not entirely consistent with the medical evidence and other 3 evidence in the record” for several reasons. Tr. 523. 4 1. Lack of Objective Medical Evidence 5 First, the ALJ found that the objective findings and Plaintiff’s “usually 6 benign presentation” through the date last insured appeared “incompatible with the 7 reported frequency and severity of her symptoms and limitations.” Tr. 524. An 8 ALJ may not discredit a claimant’s pain testimony and deny benefits solely 9 because the degree of pain alleged is not supported by objective medical evidence. 10 Rollins v. Massanari, 261 F.3d 853, 857 (9th Cir. 2001); Bunnell v. Sullivan, 947 11 F.2d 341, 346-47 (9th Cir. 1991); Fair v. Bowen, 885 F.2d 597, 601 (9th Cir. 12 1989). However, the medical evidence is a relevant factor in determining the 13 severity of a claimant’s pain and its disabling effects. Rollins, 261 F.3d at 857; 20 14 C.F.R. § 404.1529(c)(2). Here, the ALJ set out the medical evidence contradicting 15 Plaintiff’s claims of disabling limitations, including: July 2013 imaging that 16 indicated only mild degenerative changes of the lumbar spine; a January 2011 MRI 17 scan that showed normal results; and consistent examination findings of no acute 18 distress, normal and steady gait, normal range of motion of the lumbar and cervical 19 spine, normal range of motion of upper extremities, normal motor strength of 20 upper and lower extremities aside from some reduced grip strength in the right 21 hand, intact coordination and deep tendon reflexes, intact sensation, lack of complications from diabetes, and normal respiratory function without distress. Tr. ORDER ~ 22 1 524 (citing Tr. 316-17, 319-20, 323, 327-28, 331, 334, 352, 391, 407-09, 420-21, 2 425-27, 433-34, 449, 476-77, 479, 495, 503, 505-07). 3 Plaintiff generally argues, without specific citation to the record or legal 4 authority, that this reasoning is “not valid” because these examinations took place 5 on “good days” as opposed to “bad days” when Plaintiff was “unable to even walk. 6 It is unreasonable to expect [Plaintiff] to have attended medical appointments on 7 these days.” ECF No. 12 at 17. Plaintiff also cited physical therapy treatment 8 records from October 2013 through March 2014 that noted tightness and 9 tenderness in Plaintiff’s neck. ECF No. 12 at 17 (citing Tr. 357-71, 376-82). 10 However, regardless of evidence that could be considered favorable to Plaintiff, it 11 was reasonable for the ALJ to find the severity of Plaintiff’s symptom claims was 12 inconsistent with benign objective and clinical findings across the relevant 13 adjudicatory period. Tr. 522-24. “[W]here evidence is susceptible to more than 14 one rational interpretation, it is the [Commissioner’s] conclusion that must be 15 upheld.” Burch, 400 F.3d at 679. The lack of corroboration of Plaintiff’s claimed 16 limitations by the objective medical evidence was a clear, convincing, and 17 unchallenged reason for the ALJ to discount Plaintiff’s symptom claims. 18 19 2. Improvement Second, the ALJ noted that Plaintiff’s statements regarding improvement in 20 her symptoms, and observations of improvement by her treating providers, “further 21 show that her symptoms were not as severe as alleged.” Tr. 525. A favorable response to treatment can undermine a claimant's complaints of debilitating pain or ORDER ~ 23 1 other severe limitations. See Tommasetti v. Astrue, 533 F.3d 1035, 1040 (9th Cir. 2 2008); see Warre v. Comm'r of Soc. Sec. Admin., 439 F.3d 1001, 1006 (9th Cir. 3 2006) (conditions effectively controlled with medication are not disabling for 4 purposes of determining eligibility for benefits). In support of this finding, the 5 ALJ cites Plaintiff’s report in March 2013 that her vertigo symptoms were “much 6 improved” with treatment; treatment notes in March 2013 indicating that her 7 symptoms “seemed to be resolved” with the use of low dose Alprazolam; reports in 8 August 2013 that Plaintiff reported less vertigo and improved her strength; a report 9 in November 2013 that she had dizzy spells in the morning but overall she was 10 “pretty good” and hired a personal trainer; reports in December 2013 of minimal 11 dizziness and that her vertigo was “calming down”; Plaintiff’s report in February 12 2014 that she was vertigo free for almost three weeks and had returned to work; 13 and Dr. Tompkins’ January 2016 treatment note that he “was not going to insist 14 [that Plaintiff] stop driving a car because [Plaintiff] had had only one episode of 15 vertigo while driving.” Tr. 525 (citing Tr. 322-23, 328, 361, 367, 375-77, 381, 16 409-10, 491). 17 Plaintiff argues that this reasoning is “not valid” because Plaintiff 18 experienced periods of both improved and worsened symptoms, “as would be 19 expected with the nature of her unpredictable and elusive condition,” but she did 20 not experience any long-term improvement. ECF No. 12 at 18. Elsewhere in her 21 briefing, Plaintiff cites evidence that would support this argument, including one report of improvement in vertigo but unresolved disequilibrium, a treatment record ORDER ~ 24 1 noting continued headaches, and a report of vertigo with neck stiffness. ECF No. 2 12 at 13 (citing Tr. 322, 410, 837, 926). However, the ALJ’s decision includes 3 consideration of the relevant evidence from the adjudicatory period, including her 4 report of “occasional” vertigo symptoms, dizzy spells in the morning, and a single 5 episode of vertigo while driving. Tr. 525. Moreover, regardless of evidence that 6 could be interpreted more favorably to the Plaintiff, it was reasonable for the ALJ 7 to conclude that ongoing evidence of improvement in Plaintiff’s claimed 8 impairments was inconsistent with her allegations of incapacitating limitations. 9 See Burch, 400 F.3d at 679 (ALJ’s conclusion must be upheld where evidence is 10 susceptible to more than one rational interpretation). This was a clear and 11 convincing reason, supported by substantial evidence, for the ALJ to discount 12 Plaintiff’s symptom claims. 13 14 3. Failure to Seek Treatment Third, the ALJ found that Plaintiff’s poor treatment history “further 15 illustrate[s] that her symptoms and limitations may not have been as serious as she 16 has alleged.” Tr. 525. Unexplained, or inadequately explained, failure to seek or 17 comply with treatment may be the basis for rejecting Plaintiff’s symptom claims 18 unless there is a showing of a good reason for the failure. Orn, 495 F.3d at 638; 19 see also Burch, 400 F.3d at 680 (minimal objective evidence is a factor which may 20 be relied upon in discrediting a claimant’s testimony, although it may not be the 21 only factor). First, in support of this finding, the ALJ noted that “[a]lthough [Plaintiff] alleged significant back pain due to degeneration, her allegations are out ORDER ~ 25 1 of proportion to her treatment history. Other than some essentially routine and 2 conservative treatment, such as physical therapy and pain medications, [Plaintiff] 3 had not received any surgery for her back condition.” Tr. 525. Plaintiff argues 4 that this reason is improper because although she was treated conservatively “at 5 first,” she “ultimately had to undergo spinal surgery to treat her back pain.” ECF 6 No. 12 at 17; Tr. 969 (noting Plaintiff “had failed conservative measures and 7 therefore, it was elected to proceed with surgical intervention”). This argument is 8 inapposite. Plaintiff’s decision to undergo back surgery in 2019, almost three 9 years after her date last insured of December 31, 2016, has limited probative value 10 to considering the admittedly conservative nature of Plaintiff’s treatment for back 11 and neck pain during the relevant adjudicatory period. See Parra v. Astrue, 481 12 F.3d 742, 751 (9th Cir. 2007) (evidence of “conservative treatment” is sufficient to 13 discount a claimant's testimony regarding the severity of an impairment). 14 Second, the ALJ noted that Plaintiff testified at the January 2020 hearing 15 that she had not seen a health care provider for three and a half months and was not 16 scheduled to see one until March 2020, and found that “[g]iven the alleged 17 frequency and severity of the vertigo, one would expect [Plaintiff] to make more 18 effort in seeking more treatment for the condition.” See Tr. 571. Plaintiff argues 19 that she also testified this lack of treatment was due to a “lack of financial means,” 20 and “federal courts have consistently held that a [Plaintiff’s] inability to afford 21 [treatment] should not be held against them when they are unable to obtain or follow through with treatment.” ECF No. 12 at 17 (citing Tr. 579-80). Pursuant to ORDER ~ 26 1 Social Security Ruling 16-3p, an ALJ “will not find an individual’s symptoms 2 inconsistent with the evidence in the record on this basis without considering 3 possible reasons he or she may not comply with treatment or seek treatment 4 consistent with the degree of his or her complaints.” Social Security Ruling 5 (“SSR”) 16-3p at *8-*9 (March 16, 2016), available at 2016 WL 1119029 6 (directing the ALJ to consider Plaintiff’s treatment history, including whether “[a]n 7 individual may not be able to afford treatment”). However, it is unnecessary for 8 the Court to consider whether the ALJ properly considered Plaintiff’s reasons for 9 not pursuing treatment as per her testimony at the 2020 hearing, because Plaintiff’s 10 alleged inability to pursue treatment almost three years after Plaintiff’s date last 11 insured of December 2016 does not rise to the level of substantial evidence to 12 support rejection of Plaintiff’s symptom claims during the relevant adjudicatory 13 period. However, any error is harmless because, as discussed herein, the ALJ’s 14 ultimate rejection of Plaintiff’s symptom claims was supported by substantial 15 evidence. See Carmickle, 533 F.3d at 1162-63. 16 17 4. Daily Activities Fourth, the ALJ found that Plaintiff’s “reported activities of daily living and 18 social interaction, . . . are inconsistent with her allegations of severely limiting 19 physical symptoms.” Tr. 525-26. A claimant need not be utterly incapacitated in 20 order to be eligible for benefits. Fair, 885 F.2d at 603; see also Orn, 495 F.3d at 21 639 (“the mere fact that a plaintiff has carried on certain activities . . . does not in any way detract from her credibility as to her overall disability.”). Regardless, ORDER ~ 27 1 even where daily activities “suggest some difficulty functioning, they may be 2 grounds for discrediting the [Plaintiff’s] testimony to the extent that they contradict 3 claims of a totally debilitating impairment.” Molina, 674 F.3d at 1113. 4 In support of this finding, the ALJ noted that despite Plaintiff’s allegations 5 that she could not go anywhere because of vertigo, and could not bend or look 6 down, Plaintiff also repeatedly reported that she was able to go shopping on good 7 days, prepare simple meals, feed her pets, do light cleaning and laundry, shop in 8 stores for groceries weekly, go to church occasionally, manage her own money, 9 watch television, read the Bible, and care for her grandson on a weekly basis 10 without assistance, “which can be quite demanding both physically and mentally.” 11 Tr. 526 (citing Tr. 44-46, 210, 221, 247-48, 260-65, 377); see also Rollins, 261 12 F.3d at 857 (the ability to care for young children without help has been considered 13 an activity that may undermine claims of totally disabling impairment). The ALJ 14 also noted that “in addition to activities of daily living, the [Plaintiff] had 15 performed work activities during the period at issue. While [Plaintiff] reported 16 worsened vertigo symptoms since October 2013, [Plaintiff] stated that she worked 17 until May 2014 or July 10, 2014.” Tr. 526. 18 Plaintiff generally argues that this finding was improper because she “did 19 not testify that she was completely debilitated by her vertigo all day, every day; 20 rather, she testified that she had symptoms at least once a month that lasted 21 anywhere from two to three days to a week at a time.” ECF No. 12 at 18. Plaintiff also contends that Plaintiff’s work history was not a valid reason to discount ORDER ~ 28 1 Plaintiff’s symptom claims because she was only able to work 2-3 hours per day, 2 2-3 days per week, which does not qualify as substantial gainful activity. ECF No. 3 12 at 18. However, as noted by Defendant, it is proper for the ALJ to consider 4 Plaintiff’s ability to work during the relevant adjudicatory period, regardless of 5 whether it rose to the level of substantial gainful activity. ECF No. 14 at 15 (citing 6 20 C.F.R. § 404.1571 (“Even if the work you have done was not substantial gainful 7 activity, it may show that you are able to do more work than you actually did.”)); 8 see also Bray, 554 F.3d at 1227 (the ability to work may be considered in assessing 9 Plaintiff’s symptom claims). Moreover, it was reasonable for the ALJ to conclude 10 that Plaintiff’s documented activities, including driving, working part-time, and 11 taking care of a child without assistance, was inconsistent with her allegations of 12 entirely debilitating functional limitations. Molina, 674 F.3d at 1113 (Plaintiff’s 13 activities may be grounds for discrediting Plaintiff’s testimony to the extent that 14 they contradict claims of a totally debilitating impairment). This was a clear and 15 convincing reason to discredit Plaintiff’s symptom claims. 16 17 5. Reasons for Stopping Work Fifth, and finally, the ALJ noted that Plaintiff stated her vertigo symptoms 18 had caused her to lose her job; however, “her employment security record and her 19 testimony at the prior and current hearing indicate that she was fired from her last 20 job for a reason not related to the allegedly disabling impairments, but due to an 21 argument between her and her former employer on some unpaid commission money.” Tr. 526. An ALJ may consider that a claimant stopped working for ORDER ~ 29 1 reasons unrelated to the allegedly disabling condition when weighing the Plaintiff's 2 symptom reports. Bruton v. Massanari, 268 F.3d 824, 828 (9th Cir. 2001). 3 Plaintiff failed to raise this issue with specificity in her opening brief. Carmickle, 4 533 F.3d at 1161 n.2 (court may decline to address issues not raised with 5 specificity in Plaintiff’s opening brief). In her reply brief, Plaintiff contends that 6 the Defendant “failed to distinguish” between Plaintiff leaving her full-time job 7 due to her vertigo symptoms, and her testimony that her part-time job ended due to 8 a dispute with her employer. ECF No. 15 at 8-9. 9 However, the only evidence cited by Plaintiff in support of this argument is 10 her own testimony that her “reason for separation from employment” when she 11 applied for unemployment was that her “employer was trying to cheat [her] out of 12 the money that he owed [her] for [her] commissions.” Tr. 39. The Court is unable 13 to discern any distinction between this testimony and the objective records cited by 14 the ALJ in support of her finding that Plaintiff separated from her employment for 15 reasons other than her allegedly disabling conditions. Tr. 526 (noting that her 16 previous employment ended “due to an argument between her and her former 17 employer on some unpaid commission money”). Based on the foregoing, the 18 Court finds it was reasonable for ALJ to discount Plaintiff’s symptom claims based 19 on evidence she stopped working for reasons other than her claimed impairments. 20 21 The Court concludes that the ALJ provided clear and convincing reasons, supported by substantial evidence, for rejecting Plaintiff’s symptom claims. D. Lay Witness Evidence ORDER ~ 30 1 “In determining whether a claimant is disabled, an ALJ must consider lay 2 witness testimony concerning a claimant’s ability to work.” Stout v. Comm'r, Soc. 3 Sec. Admin., 454 F.3d 1050, 1053 (9th Cir. 2006); see also Dodrill v. Shalala, 12 4 F.3d 915, 918-19 (9th Cir. 1993) (“friends and family members in a position to 5 observe a claimant's symptoms and daily activities are competent to testify as to 6 [his] condition.”). To discount evidence from lay witnesses, an ALJ must give 7 reasons “germane” to each witness. Dodrill, 12 F.3d at 919. 8 9 Here, Plaintiff’s husband completed a third-party function report. Tr. 215. He reported that Plaintiff “becomes off balanced and dizzy” and has to lie down or 10 sit; and she needs help walking when her vertigo is “up.” Tr. 239-46. The ALJ 11 considered this lay witness statement, but assigned it little weight for the same 12 reasons the ALJ “determined that [Plaintiff’s] statements regarding the severity of 13 her symptoms are not consistent with the evidence (i.e., her longitudinal treatment 14 history, the objective findings, her presentations at appointments and examinations, 15 and her rather independent daily activities.).” Tr. 529. Where the ALJ gives clear 16 and convincing reasons to reject a claimant's testimony, and where a lay witness's 17 testimony is similar to the claimant's subjective complaints, the reasons given to 18 reject the claimant's testimony are also germane reasons to reject the lay witness 19 testimony. See Valentine v. Comm’r Soc. Sec. Admin., 574 F.3d 685, 694 (9th Cir. 20 2009); see also Molina, 674 F.3d at 1114 (“[I]f the ALJ gives germane reasons for 21 rejecting testimony by one witness, the ALJ need only point to those reasons when rejecting similar testimony by a different witness”). Plaintiff argues that the ALJ’s ORDER ~ 31 1 reasons for rejecting Plaintiff’s testimony were inadequate, and therefore her 2 reasons for rejecting the lay witness statement were also inadequate. ECF No. 12 3 at 19. However, as discussed above, the ALJ gave clear and convincing reasons to 4 reject Plaintiff symptom claims, and those same well-supported reasons for 5 rejecting Plaintiff's subjective symptom claims are germane reasons to discount the 6 lay witness evidence. 7 E. Step Four 8 9 Finally, Plaintiff argues that the ALJ improperly rejected the opinions of Plaintiff’s medical providers; thus, the ALJ erred at step four by posing an 10 incomplete hypothetical to the vocational expert. ECF No. 12 at 19. Plaintiff is 11 correct that “[i]f an ALJ's hypothetical does not reflect all of the claimant's 12 limitations, the expert's testimony has no evidentiary value to support a finding that 13 the claimant can perform jobs in the national economy.” Bray, 554 F.3d at 1228 14 (citation and quotation marks omitted). However, as discussed in detail above, the 15 ALJ’s consideration of the medical opinion evidence, rejection of Plaintiff’s 16 symptom claims, and rejection of the lay witness testimony, was supported by the 17 record and free of legal error. The hypothetical posed to the vocational expert 18 contained the limitations reasonably identified by the ALJ and supported by 19 substantial evidence in the record. Thus, the ALJ did not err at step four. CONCLUSION 20 21 A reviewing court should not substitute its assessment of the evidence for the ALJ’s. Tackett, 180 F.3d at 1098. To the contrary, a reviewing court must ORDER ~ 32 1 defer to an ALJ’s assessment as long as it is supported by substantial evidence. 42 2 U.S.C. § 405(g). As discussed in detail above, the ALJ properly weighed the 3 medical opinion evidence; did not err in developing the record; provided clear and 4 convincing reasons to discount Plaintiff’s symptom testimony; properly considered 5 the lay witness statement; and did not err at step four. After review, the Court 6 finds the ALJ’s decision is supported by substantial evidence and free of harmful 7 legal error. 8 ACCORDINGLY, IT IS HEREBY ORDERED: 9 10 1. Plaintiff’s Motion for Summary Judgment, ECF No. 12, is DENIED. 2. Defendant’s Motion for Summary Judgment, ECF No. 14, is GRANTED. 11 12 The District Court Executive is hereby directed to enter this Order and 13 provide copies to counsel, enter judgment in favor of the Defendant, and CLOSE 14 the file. 15 DATED June 2, 2021. 16 s/ Rosanna Malouf Peterson ROSANNA MALOUF PETERSON United States District Judge 17 18 19 20 21 ORDER ~ 33

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