Gaitan v. Commissioner of Social Security Administration

1 WO [5] 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA [8] 9 Kriestan Lainie Gaitan, No. CV-23-01678-PHX-SMB 10 Plaintiff, ORDER 11 v. 12 Commissioner of Social Security Administration, [13] Defendant. [14] 15 At issue is the denial of Plaintiff Kriestan L. Gaitan’s Application for Social 16 Security Disability Insurance (“SSDI”) benefits by the Social Security Administration 17 (“SSA”) under the Social Security Act (the “Act”). Plaintiff filed a Complaint (Doc. 1) 18 and an Opening Brief (Doc. 12) seeking judicial review of that denial. Defendant SSA 19 filed an Answering Brief (Doc. 16), to which Plaintiff replied (Doc. 17). The Court having 20 reviewed the parties’ briefs, the Administrative Record (Docs. 7 & 8), and the 21 Administrative Law Judge’s (“ALJ”) decision (Doc. 7-10 at 56–69) will affirm the ALJ’s 22 decision for the reasons addressed herein. 23 I. BACKGROUND 24 Plaintiff filed an Application for SSDI benefits on May 27, 2015, alleging a 25 disability beginning on August 5, 2015, as amended. (Doc. 7-10 at 57–69, 82–83, 102–04.) 26 Plaintiff was last insured on September 30, 2018. (Id. at 59.) Plaintiff’s claim was initially 27 denied in January 2018, but the District Court remanded the case in November 2019 for 28 further proceedings. (Doc. 7-3 at 19; Doc. 8 at 16.) On remand, in July 2021, a new ALJ 1 issued a denial, which the Social Security Administration’s Appeals Council remanded 2 back to the ALJ. (Doc. 8 at 61, 79.) After another hearing, on October 21, 2022, the ALJ 3 issued a third denial, which the Council denied a request for review on June 23, 4 2023—making it the final decision of the SSA Commissioner (the “Commissioner”). 5 (Doc. 7-10 at 2, 54.) This appeal followed. (Doc. 1.) 6 Plaintiff alleges disability due to severe physical impairments of degenerative disc 7 disease, fibromyalgia, and obesity. (Doc. 7-10 at 60.) After considering the medical 8 evidence and opinions, the ALJ determined that Plaintiff, accounting for “some difficulty 9 performing more that light exertional work due to” her alleged severe physical 10 impairments, retained the functional residual capacity to perform light work with postural 11 and environmental limitations. (Doc. 7-10 at 67.) 12 Plaintiff argues that (1) the ALJ erroneously rejected the assessments of Plaintiff’s 13 treating primary care physician, Dr. Steven Sumpter, considering the evidence in the record 14 as a whole; and (2) the ALJ erroneously rejected Plaintiff’s symptom testimony without 15 sufficient justification. (Doc. 12 at 1.) The Commissioner argues that the ALJ’s decision 16 is free of harmful error because (1) the ALJ reasonably assessed the medical evidence; and 17 (2) substantial evidence supports the ALJ rejecting Plaintiff’s subjective complaints. (Doc. 18 16 at 4, 15.) 19 II. LEGAL STANDARDS 20 An ALJ’s factual findings “shall be conclusive if supported by substantial 21 evidence.” Biestek v. Berryhill, 139 S. Ct. 1148, 1153 (2019). The Court may set aside 22 the Commissioner’s disability determination only if it is not supported by substantial 23 evidence or is based on legal error. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). 24 Substantial evidence is relevant evidence that a reasonable person might accept as adequate 25 to support a conclusion considering the record as a whole. Id. Generally, “[w]here the 26 evidence is susceptible to more than one rational interpretation, one of which supports the 27 ALJ’s decision, the ALJ’s conclusion must be upheld.” Thomas v. Barnhart, 278 F.3d 947 , 28 954 (9th Cir. 2002). In determining whether to reverse an ALJ’s decision, the district court 1 reviews only those issues raised by the party challenging the decision. See Lewis v. Apfel, [2] 236 F.3d 503 , 517 n.13 (9th Cir. 2001). 3 III. DISCUSSION 4 A. Dr. Sumpter’s Medical Evidence 5 Plaintiff argues the ALJ erred in giving Dr. Sumpter’s opinion “little weight” 6 because he “failed to provide specific and legitimate reasons supported by substantial 7 evidence when th[e] record is viewed as a whole.” (Doc. 12 at 16–21.) Conversely, the 8 Commissioner argues the ALJ articulated sufficient reasons with citations to the record to 9 reject Dr. Sumpter’s findings. (Doc. 16 at 18.) 10 The Ninth Circuit distinguishes between three types of physicians: (1) treating 11 physicians; (2) examining physicians; and (3) nonexamining physicians. Garrison v. 12 Colvin, 759 F.3d 995, 1012 (9th Cir. 2014) (noting the first are those that treat the plaintiff, 13 the second examine but do not treat, and the third neither examine nor treat). Generally, 14 more weight is afforded hierarchically beginning with treating physicians. Id. “If a treating 15 or examining doctor’s opinion is contradicted by another doctor’s opinion, an ALJ may 16 only reject it by providing specific and legitimate reasons that are supported by substantial 17 evidence.” Id. (quoting Ryan v. Comm’r of Soc. Sec., 528 F.3d 1194, 1198 (9th Cir. 2008)). 18 “An ALJ can satisfy the “substantial evidence” requirement by ‘setting out a detailed and 19 thorough summary of the facts and conflicting clinical evidence, stating his interpretation 20 thereof, and making findings.’” Id. (quoting Reddick v. Chater, 157 F.3d 715, 725 (9th 21 Cir. 1998)). The ALJ must set his own interpretations and explain why his are correct, 22 rather than the doctor’s—stating conclusions is insufficient. Id. at 1012–13 (“[A]n ALJ 23 errs when he rejects a medical opinion or assigns it little weight while doing nothing more 24 than ignoring it.” (cleaned up)).1 25 In evaluating Dr. Sumpter’s reports, the ALJ reviewed five of his assessments. [26] 1 The applicable regulations have since been amended, but for claims filed before March 27 27, 2017, the current regulation, 20 C.F.R. § 404.1527 , applies. Revisions to Rules Regarding Evaluation of Medical Evidence, 82 Fed. Reg. 5844 (Jan. 18, 2017). The 28 Commissioner does not dispute the applicability of 20 C.F.R. § 404.1527 . (Doc. 16 at 15 n.5.) Accordingly, all references relate to the prior amendments. 1 (Doc. 7-10 at 66.) First, Dr. Sumpter opined in August 2015 that: claimant’s impairments 2 precluded an eight-hour workday because her physical ailments required her to alternate 3 positions, i.e., sitting and standing, every half or full hour with frequent breaks; and her 4 pain, fatigue, and dizziness were severe requiring at least six absences a month. (Id.) 5 Second, in September 2017, Dr. Sumpter opined the same and added that Plaintiff’s 6 medications “cause[d] moderately severe somnolence.” (Id.) Third, in April 2021, he 7 opined the same as the second opinion. (Id.) Fourth, in December 2021, he reiterated that 8 Plaintiff could not sit or stand for extended periods of time causing a needed to alternate 9 positions frequently. (Id.) Finally, in July 2022, Dr. Sumpter opined that he could not 10 determine whether the restrictions excited at the onset date, as amended. (Id.) The ALJ 11 concluded the opinions were inconsistent with the evidence in the record, specifically citing 12 to the records of examinations that showed “generally normal findings.” (Id.) The ALJ 13 further explained “while claimant has reported continuous pain symptoms, she also 14 reported that her symptoms were relieved by rest, changing positions[,] and opioids,” citing 15 to the record. (Id.) 16 Plaintiff argues the specific records the ALJ cites do not support his conclusion that 17 Dr. Sumpter’s findings are inconsistent with the record. (Doc. 12 at 16–20; Doc. 17 18 at 4–6.) The Commissioner argues, in relying on 20 C.F.R. § 404.1527 (c)(4), that the 19 ALJ’s findings are further supported by the record, pointing to additional evidence in the 20 record, and the records relied upon contradict Dr. Sumpter’s conclusion as to Plaintiff’s 21 physical limitations. (Doc. 16 at 16–19.) In reply, Plaintiff argues the Commissioner 22 mistakenly bolsters the ALJ’s justifications for its findings by pointing to record evidence 23 the ALJ did not cite. (Doc. 17 at 4–6.) 24 Plaintiff is correct, in part. The Court is constrained to reviewing the ALJ’s 25 assertions and will not affirm the decision based on evidence the ALJ did not discuss. See 26 Lannon v. Comm’r of Soc. Sec. Admin., 234 F. Supp. 3d 951, at *958 (D. Ariz. 2017) 27 (collecting cases). The first record the ALJ cites does reveal generally normal findings of 28 not disability, but it predates the allege disability onset date by two years. (See Doc. 7-8 1 at 10.) The second record does not show Plaintiff’s disability prevents her from working. 2 (See id. at 158.) But it does show Plaintiff experiences pain symptoms consistent with her 3 fibromyalgia. (Id.) The third and fourth records also support Plaintiff’s alleged pain 4 symptoms but do not detail any significant limitations. (Id. at 334; Doc. 7-9 at 121–24.) 5 The fifth record does note Plaintiff’s pain and limited motion but otherwise normal 6 findings. (Doc. 8-5 at 62.) Additionally, the cited records also show Plaintiff did indicate 7 that her symptoms are “relieved by rest” and “changing positions.” (Doc. 7-8 at 323, 333; 8 Doc. 7-9 at 4; Doc. 8-5 at 67.) 9 The Ninth Circuit has recognized fibromyalgia symptoms include “chronic pain 10 throughout the body, multiple tender points, fatigue, stiffness, and a pattern of sleep 11 disturbance that can exacerbate the cycle of pain and fatigue . . . . [T]hose suffering from 12 it have muscle strength, sensory functions, and reflexes [that] are normal.” Revels v. 13 Berryhill, 874 F.3d 648, 656 (9th Cir. 2017) (cleaned up). The cited records vary in 14 detailing these symptoms as supporting pain, tender points, and fatigue at various points, 15 while others do not. This is consistent with fibromyalgia symptom reporting. See id. at 16 663 (noting fibromyalgia symptoms “wax and wane”). In context, however, the ALJ 17 addresses the record by acknowledging “her fibromyalgia is consistent with a severe 18 impairment,” but that her “symptoms are responsive to treatment” and the conservative and 19 routine nature of that treatment does not indicate disabling symptoms. (Doc. 7-10 at 65.) 20 Plaintiff ignores this nuance in the ALJ’s findings. In fact, the ALJ rejected a state 21 agency consultant’s finding that Plaintiff could complete “medium work” because 22 evidence supported greater exertional limitations. (Id.) Evidently, the issue is the 23 inconsistency in the degree of Plaintiff’s symptoms disabling her. The ALJ cited record 24 evidence of a normal gait, lack of tender points, full range of motion in her joints, no 25 fatigue, normal strength, and that treatment relieved her symptoms. (Doc. 7-10 at 65–67; 26 Doc. 7-8 at 291, 305, 316, 324, 254; Doc. 7-9 11, 16, 30.) It is these generally normal 27 findings that the ALJ weighed to discount Dr. Sumpter’s opinion as to the severity of the 28 symptoms to conclude she can complete light work. Cf. Revels, 874 F.3d at 664 (finding 1 an ALJ erred in giving an treating doctor’s opinion “no weight” when the record was 2 consistent with the doctor’s opinion that the plaintiff could complete light work in 3 accounting for her fibromyalgia symptoms). Therefore, the Court finds the ALJ stated 4 specific and legitimate reasons for discrediting Dr. Sumpter’s opinion and did not err. 5 B. Plaintiff’s Symptom Testimony 6 An ALJ performs a two-step analysis to evaluate a claimant’s testimony regarding 7 pain and symptoms. Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 2014). First, the 8 ALJ evaluates whether the claimant has presented objective medical evidence of an 9 impairment that “could reasonably be expected to produce the pain or symptoms alleged.” 10 Lingenfelter v. Astrue, 504 F.3d 1028 , 1035–36 (9th Cir. 2007) (quoting Bunnell v. 11 Sullivan, 947 F.2d 341, 344 (9th Cir. 1991)). Second, absent evidence of malingering, an 12 ALJ may only discount a claimant’s allegations for reasons that are “specific, clear and 13 convincing” and supported by substantial evidence. Molina v. Astrue, 674 F.3d 1104 , 1112 14 (9th Cir. 2012). “[T]he ALJ must specifically identify the testimony she or he finds not to 15 be credible and must explain what evidence undermines the testimony.” Holohan v. 16 Massanari, 246 F.3d 1195, 1208 (9th Cir. 2001). General findings are insufficient. Id. 17 “Although the ALJ’s analysis need not be extensive, the ALJ must provide some reasoning 18 in order for [the Court] to meaningfully determine whether the ALJ’s conclusions were 19 supported by substantial evidence.” Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 20 1090, 1099 (9th Cir. 2014). “[T]he ALJ may consider inconsistencies either in the 21 claimant’s testimony or between the testimony and the claimant’s conduct.” Molina, 674 22 F.3d at 1112. For example, the ALJ may consider “whether the claimant engages in daily 23 activities inconsistent with the alleged symptoms.” Id. (quoting Lingenfelter, 504 F.3d at 24 1040). 25 Plaintiff argues the ALJ committed materially harmful error by failing to provide 26 specific, clear, and convincing reasons in rejecting her symptom testimony. (Doc. 12 27 at 21.) Specifically, Plaintiff takes issue with the ALJ’s rationale for concluding her 28 symptoms were not debilitating to the extent she claimed. (Doc. 12 at 22.) Plaintiff also 1 contends that the ALJ failed to understand the impact of her fibromyalgia, and instead the 2 ALJ focused on her degenerative spinal conditions. (Id. at 23.) Plaintiff further argues the 3 ALJ’s characterization of Plaintiff’s symptoms as responsive to “conservative” treatments 4 unsupported and that her symptoms persisted, despite treatment. (Id. at 24–25.) In turn, 5 the Commissioner argues that the ALJ appropriately discounted Plaintiff’s testimony 6 because the record evidence discussed shows she could perform light work and was not 7 precluded from working all together. (Doc. 16 at 7–9.) 8 At the outset, the Court is cognizant that fibromyalgia is diagnosed “entirely on the 9 basis of patients’ reports of pain and other symptoms.” Revels, 874 F.3d at 663 . As noted 10 above, however, many of the records show a normal gait, lack of tender points, full range 11 of motion in her joints, no fatigue, normal strength, and that treatment relieved her 12 symptoms. (Doc. 7-10 at 65–67; Doc. 7-8 at 291, 305, 316, 324, 254; Doc. 7-9 11, 16, 30.) 13 The ALJ also discussed evidence that Plaintiff’s degenerative disc disease was minor, not 14 severe, and highlighted an opinion of a medical consultant that concluded Plaintiff could 15 perform light work with some exertional limitations. (Id. at 63–66.) The ALJ went on to 16 describe evidence of Plaintiff’s ailments as limiting her ability to work normally but found 17 she could complete light work. (Id.) Further, the ALJ found that to the extent the 18 impairments were severe, her “conservative” treatments showed a “significant 19 improvement” on her lumbar pain—reported as an 80% improvement in her pain. (Id. 20 at 64; Doc. 7-9 at 6; Doc. 8-5 at 70.) Regardless of a “conservative” characterization of 21 the injections treating her fibromyalgia, the ALJ’s nomenclature is problematic but his 22 reasoning as to the effectiveness of the treatments holds true and supports his conclusions. 23 See, e.g., Revels, 874 F.3d at 667 (taking issue with the ALJ’s characterization of a 24 fibromyalgia treatment as “conservative”). 25 The ALJ also noted Plaintiff’s statements about her ability to perform various daily 26 activities appeared to reduce the severity of the disability for which she claimed. (Doc. 27 7-10 at 65.) The ALJ reasoned that based on all of this evidence, Plaintiff’s self-reporting 28 that she was entirely precluded from working unsupported but that her impairments did 1 || reduce her ability complete more than light work. (/d. at 67.); see also Revels, 874 F.3d at 2 || 667 (noting inconsistent daily activities, in addition to other evidence, may provide || justification for rejecting symptom testimony). Thus, the ALJ provided sufficient, clear, 4|| and convincing evidence to discount Plaintiffs testimony. 5 Therefore, the Court finds the ALJ did not commit materially harmful error by || rejecting Plaintiff’s symptom testimony. 7 IV. CONCLUSION 8 Accordingly, 9 IT IS HEREBY ORDERED affirming the October 21, 2022 decision of the ALJ. 10 IT IS FURTHER ORDERED directing the Clerk to enter final judgment 11 |} consistent with this Order and close this case. 12 Dated this 18th day of September, 2024. [13] 14 — . RP 15 SO 16 Gated States District ludge [28] -8-