Lara v. Commissioner of Social Security Administration

1 WO — 2 — — 3 — — 4 — — 5 — 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA — 8 — 9 Kristen Kathleen Lara, No. CV-21-00638-PHX-SMB 10 Plaintiff, ORDER 11 v. 12 Commissioner of Social Security Administration, — 13 — Defendant. — 14 — 15 At issue is the denial of Plaintiff Kristen Lara’s Application for Social Security 16 Disability Insurance (“SSDI”) benefits by the Social Security Administration (“SSA”) 17 under the Social Security Act (the “Act”). Plaintiff filed a Complaint, (Doc. 1), and an 18 Opening Brief, (Doc. 19), seeking judicial review of that denial. Defendant SSA filed an 19 Answering Brief, (Doc. 22), to which Plaintiff replied, (Doc. 25). The Court has reviewed 20 the parties’ briefs, the Administrative Record, (Doc. 16), and the Administrative Law 21 Judge’s (“ALJ”) decision, (Doc. 16-3 at 13–28), and will affirm the ALJ’s decision for the 22 following reasons. 23 I. BACKGROUND 24 Plaintiff filed an Application for SSDI benefits on March 6, 2017, alleging a 25 disability beginning in August 2014. (Id. at 16.) Plaintiff’s claim was initially denied in 26 September 2017. (Id.) A hearing was held before ALJ Dante M. Alegre on November 13, 27 2019. (Id. at 16, 28.) After considering the medical evidence and opinions, the ALJ 28 determined that Plaintiff suffered from severe impairments including lumbar degenerative 1 disc disease status post fusion, vulvodynia, interstitial cystitis, endometriosis status post 2 hysterectomy, hypertonic pelvic floor dysfunction, post-traumatic stress disorder, 3 generalized anxiety disorder, major depressive disorder and panic disorder. (Id. at 19.) 4 However, the ALJ concluded that, despite these impairments, Plaintiff had the residual 5 functional capacity (“RFC”) to perform light work. (Id. at 21.) Consequently, Plaintiff’s 6 Application was again denied by the ALJ on February 5, 2020. (Id. at 13.) Thereafter, the 7 Appeals Council denied Plaintiff’s Request for Review of the ALJ’s decision—making it 8 the final decision of the SSA Commissioner (“Commissioner”), and this appeal followed. 9 (Id. at 2.) 10 II. LEGAL STANDARDS 11 An ALJ’s factual findings “shall be conclusive if supported by substantial 12 evidence.” Biestek v. Berryhill, 139 S. Ct. 1148, 1153 (2019). The Court may set aside 13 the Commissioner’s disability determination only if it is not supported by substantial 14 evidence or is based on legal error. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007). 15 Substantial evidence is relevant evidence that a reasonable person might accept as adequate 16 to support a conclusion considering the record as a whole. Id. Generally, “[w]here the 17 evidence is susceptible to more than one rational interpretation, one of which supports the 18 ALJ’s decision, the ALJ’s conclusion must be upheld.” Thomas v. Barnhart, 278 F.3d 947 , 19 954 (9th Cir. 2002). In determining whether to reverse an ALJ’s decision, the district court 20 reviews only those issues raised by the party challenging the decision. See Lewis v. Apfel, — 21 — 236 F.3d 503 , 517 n.13 (9th Cir. 2001). 22 III. DISCUSSION 23 Plaintiff argues the ALJ committed harmful error in evaluating Plaintiff’s symptom 24 testimony, her mother’s lay testimony, and in weighing the medical opinion evidence. 25 (Doc. 19 at 7, 15.) The Commissioner argues that the ALJ’s opinion is supported by 26 substantial record evidence and free of reversible error. (Doc. 22 at 23.) The Court has 27 reviewed the medical and administrative records and agrees with the Commissioner. 28 A. Symptom Testimony 1 An ALJ performs a two-step analysis to evaluate a claimant’s testimony regarding 2 pain and symptoms. Garrison v. Colvin, 759 F.3d 995, 1014 (9th Cir. 2014). First, the 3 ALJ evaluates whether the claimant has presented objective medical evidence of an 4 impairment that “could reasonably be expected to produce the pain or symptoms alleged.” 5 Lingenfelter v. Astrue, 504 F.3d 1028 , 1035–36 (9th Cir. 2007) (quoting Bunnell v. 6 Sullivan, 947 F.2d 341, 344 (9th Cir. 1991)) (internal quotation marks omitted). Second, 7 absent evidence of malingering, an ALJ may only discount a claimant’s allegations for 8 reasons that are “specific, clear and convincing” and supported by substantial evidence. 9 Molina v. Astrue, 674 F.3d 1104, 1112 (9th Cir. 2012). 10 “[T]he ALJ must specifically identify the testimony she or he finds not to be credible 11 and must explain what evidence undermines the testimony.” Holohan v. Massanari, 246 12 F.3d 1195, 1208 (9th Cir. 2001). General findings are insufficient. Id. “Although the 13 ALJ’s analysis need not be extensive, the ALJ must provide some reasoning in order for 14 [the Court] to meaningfully determine whether the ALJ’s conclusions were supported by 15 substantial evidence.” Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1099 (9th 16 Cir. 2014). “[T]he ALJ may consider inconsistencies either in the claimant’s testimony or 17 between the testimony and the claimant’s conduct.” Molina, 674 F.3d at 1112 . For 18 instance, the ALJ may consider “whether the claimant engages in daily activities 19 inconsistent with the alleged symptoms.” Id. (quoting Lingenfelter, 504 F.3d at 1040 ) 20 (internal quotation marks omitted). 21 Plaintiff argues the ALJ failed to provide adequate reasoning for discounting 22 Plaintiff’s and her mother’s testimony. (Doc. 19 at 15–21.) The Commissioner argues the 23 ALJ properly evaluated her testimony as being inconsistent with her medical history and 24 activities of daily living. (Doc. 22 at 8-12) The Commissioner also argues the objective 25 medical records did not support Plaintiff’s mother’s testimony as to the severity of 26 Plaintiff’s symptoms. (Id. at 13.) 27 Plaintiff testified, in part, that if she was not going to a doctor’s appointment, she 28 lays down most days. She lived alone, makes simple meals, and can drive but her mother 1 does her laundry and does the grocery shopping. She testified that she graduated high 2 school and has two Associate Degrees. Her mother testified that Plaintiff can drive, shop 3 in stores, pay bills, count change, feed the dogs and prepare simple meals. The ALJ did 4 find that Plaintiff’s impairments “could reasonably be expected to cause the alleged 5 symptoms” but objective medical evidence did not support the alleged severity. (Id. at 22.) 6 The medical record, as cite by the ALJ, shows that Plaintiff self-reported her exercise level 7 as “occasional.” (Id. at 23.) Plaintiff’s abdominal pain led to numerous medical visits that 8 resulted in “resolved” or “stable” outcomes. (Id.) The ALJ also noted that Plaintiff’s 9 mental impairments are being controlled with treatment and medication, and mental status 10 exams showed Plaintiff had positive engagement, mental processing, and memory. (Id.) 11 The ALJ found Plaintiff’s activity level was not “minimally limited” because she could 12 drive, attend appointments, spend time with loved ones, and even continued work after her 13 alleged disability date. (Id.) 14 Therefore, the ALJ provided specific, clear, and convincing reasons supported by 15 the record for rejecting Plaintiff’s and her mother’s symptom testimony. The Court thus 16 finds the ALJ committed no error. 17 B. Evaluation of Medical Testimony 18 While “[t]he ALJ must consider all medical opinion evidence,” there is a hierarchy 19 among the sources of medical opinions. Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th 20 Cir. 2008). Those who have treated a claimant are treating physicians; those who examined 21 but did not treat the claimant are examining physicians; and those who neither examined, 22 nor treated the claimant are non-examining physicians. Lester v. Chater, 81 F.3d 821 , 830 23 (9th Cir. 1995). “As a general rule, more weight should be given to the opinion of a treating 24 source than to the opinion of doctors who did not treat the claimant.” Id. This is so because 25 treating physicians have the advantage of in-person interaction and typically a longer 26 history of treatment than a claimant’s other doctors, and their “subjective judgments . . . are 27 important, and properly play a part in their medical evaluations.” Embrey v. Bowen, 849 28 F.2d 418, 422 (9th Cir. 1988). 1 An ALJ “may only reject a treating or examining physician’s uncontradicted 2 medical opinion based on ‘clear and convincing reasons.’” Carmickle v. Comm’r of Soc. 3 Sec., 533 F.3d 1155, 1164 (9th Cir. 2008) (quoting Lester, 81 F.3d at 830–31). “Where 4 such an opinion is contradicted, however, it may be rejected for specific and legitimate 5 reasons that are supported by substantial evidence in the record.” Id. (internal quotation 6 marks omitted). An ALJ meets this standard by “setting out a detailed and thorough 7 summary of the facts and conflicting clinical evidence, stating his interpretation thereof, 8 and making findings.” Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989) (quoting 9 Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir. 1986). 10 Plaintiff challenges the ALJ’s reliance on the state agency medical providers and 11 the ALJ’s assignment of little weight to her own medical providers. (Doc. 19 at 14.) 12 Specifically, Plaintiff asserts “[t]he ALJ’s vague allegations that Plaintiff’s daily activities 13 demonstrate functionality beyond those found by Plaintiff’s treating medical sources are 14 not sufficient” to reject those sources. (Id. at 13.) The court is not persuaded by Plaintiff’s 15 arguments. 16 Dr. Gomez noted Plaintiff could perform work at a less than sedentary level of 17 exertion. (Doc. 16-3 at 25.) Dr. Coelho opined Plaintiff’s mental impairments would not 18 interfere with Plaintiff carrying out simple instructions and maintaining her concentration. 19 (Id.) The ALJ explained that Drs. Gomez and Coelho’s opinions were most consistent with 20 testimony of Plaintiff’s day-to-day activities and afforded them the greatest weight. These 21 doctors’ opinions did conflict with evidence from other medical providers that the ALJ 22 found too reliant on Plaintiff’s reported symptoms. 23 As explained above, an ALJ may rely on the opinion of non-treating physicians. 24 See Lester, 81 F.3d at 830 (explaining that an ALJ may rely on a non-examining 25 physician’s testimony, even to reject that of an examining physician, when the ALJ’s 26 decision is supported by the record as a whole). The ALJ found Plaintiff’s treating 27 physicians’ opinions were inconsistent with Plaintiff’s work history, socialization with 28 family and her boyfriend, and other daily activities. And Dr. Coelho reported that despite 1|| Plaintiff's significant diagnoses, she had no major problems with understanding or 2|| memory, social interaction, or adapting to change. The ALJ did not merely disregard Plaintiffs treating physicians based on testimony of Plaintiffs daily activities—the ALJ found Dr. Coelho’s opinion “appropriately balance[d] the claimant’s subjective complaints with behavioral observations.” Moreover, the Court notes that the evidence of □□□□□□□□□□□ || daily activities were provided by her and her mother’s testimony. The ALJ set out a detailed summary of the relevant facts and evidence, and then articulated his weighing of 8 || those facts and evidence. 9 The Court finds the ALJ properly identified the conflicts within the record in 10 deciding to give greater weight to the opinions of Dr. Gomez and Dr. Coelho, state agency ll medical consultants. See Thomas v. Barnhart, 278 F.3d 947, 957 (9th Cir. 2002) (“[t]he opinions of non-treating or non-examining physicians may also serve as substantial 3 evidence when the opinions are consistent with independent clinical findings or other 4 evidence in the record.”’). 15 The ALJ acted well within the duties imparted upon him to determine the credibility 16|| of medical evidence, and he gave specific, legitimate reasons for discrediting particular || opinions. And, as the ALJ “is the final arbiter with respect to resolving ambiguities in the 18 medical evidence,” the Court will not disturb his findings. See Tommasetti, 533 F.3d at 19 1041-42. The Court finds no error on the part of the ALJ. 20 IV. CONCLUSION 21 Having found no error, 22 IT IS ORDERED affirming the February 5, 2020 decision of the ALJ, as upheld 23 by the Appeals Council. 24 IT IS FURTHER ORDERED directing the Clerk to enter final judgment 25! consistent with this Order and close this case. 26 Dated this 29th day of September, 2022. 27 —— 28 oe t= United States District Madge -6-