Ingram v. Commissioner of Social Security Administration

• Court: Court of Appeals for the Ninth Circuit
• Decided: March 16, 2026
• Docket: 24-7242
• Status: Unpublished

Opinion

NOT FOR PUBLICATION FILED UNITED STATES COURT OF APPEALS MAR 16 2026 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS FOR THE NINTH CIRCUIT

SANDRA L. INGRAM, No. 24-7242 D.C. No. Plaintiff - Appellant, 3:24-cv-05125-MLP v. MEMORANDUM* COMMISSIONER OF SOCIAL SECURITY ADMINISTRATION,

Defendant - Appellee.

Appeal from the United States District Court for the Western District of Washington Michelle L. Peterson, Magistrate Judge, Presiding

Submitted February 6, 2026** Portland, Oregon

Before: BEA, CHRISTEN, and DESAI, Circuit Judges. Partial Concurrence and Partial Dissent by Judge DESAI.

Sandra Ingram appeals the district court’s order affirming the administrative

law judge’s (“ALJ”) denial of her application for disability insurance benefits under

* This disposition is not appropriate for publication and is not precedent except as provided by Ninth Circuit Rule 36-3. ** The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2). the Social Security Act (“Act”). We have jurisdiction under 28 U.S.C. § 1291 and

42 U.S.C. § 405(g). We affirm.

We review de novo the district court’s order affirming the denial of benefits.

Kitchen v. Kijakazi, 82 F.4th 732, 738 (9th Cir. 2023). We “will disturb the denial

of benefits only if the decision contains legal error or is not supported by substantial

evidence.” Id. (citation modified).

1. Medical Opinion Evidence

Ingram argues the ALJ erred by discounting the medical opinion of Advanced

Registered Nurse Practitioner Kellye Campbell. Under the applicable regulations,

ALJs must consider supportability and consistency factors in rejecting a medical

opinion. Woods v. Kijakazi, 32 F.4th 785, 791–92 (9th Cir. 2022); 20 C.F.R. §

404.1520c(a)–(b)(2). We find no error in the ALJ’s treatment of the record here.

The ALJ cited substantial evidence, including Campbell’s notes and Ingram’s

reported daily activities, to support its decision to discount Campbell’s opinion.

Further, the ALJ did not err by questioning whether Campbell had a treating

relationship with Ingram. Campbell provided occasional counseling services, but the

records show that Campbell otherwise monitored and managed Ingram’s medication

while Licensed Independent Clinical Social Worker (“LICSW”) Jake Kim provided

most of the counseling services. The ALJ’s decision to discount Campbell’s opinion

is therefore supported by substantial evidence. See 20 C.F.R. § 404.1520c(a).

2 24-7242 The ALJ’s evaluation of the opinions of LICSW Jake Kim and Dr. Richard

Borton are also supported by substantial evidence.

As a social worker, Kim is not an “acceptable medical source” under the Act,

see 20 C.F.R. § 404.1502(a), and therefore the ALJ may discount his opinion by

providing “reasons germane” to the opinion. Popa v. Berryhill, 872 F.3d 901, 906

(9th Cir. 2017). To the extent that the ALJ partially discounted Kim’s opinion, the

ALJ provided germane reasons by noting the opinion’s inconsistency with Ingram’s

impairments and symptoms. Substantial evidence thus supports the ALJ’s decision

regarding Kim’s opinion.

Ingram also argues that the ALJ “improperly rejected” the medical findings

of Dr. Borton when assessing Ingram’s Residual Functional Capacity (“RFC”). Not

so. Because the ALJ’s RFC limitations reasonably reflect Dr. Borton’s assessment,

the ALJ did not err. See Kitchen, 82 F.4th at 740 (finding that an ALJ did not err

where the claimant’s RFC limitations were consistent with the medical provider’s

assessments).

2. Lay Witness Evidence

“In determining whether a claimant is disabled, an ALJ must consider lay

witness testimony concerning a claimant’s ability to work.” Stout v. Comm’r, Soc.

Sec. Admin., 454 F.3d 1050, 1053 (9th Cir. 2006). To discount lay witness testimony,

the ALJ must give reasons germane to each witness. Leon v. Berryhill, 880 F.3d

3 24-7242 1041, 1046 (9th Cir. 2017). Here, the ALJ failed to give germane reasons to reject

the lay witness statements of social worker Emily Lashlee and Ingram’s friend Jamie

Lucas. However, this error is harmless because when the ALJ “has provided well-

supported grounds for rejecting testimony regarding specified limitations,” we will

not reverse the agency on the sole ground that “the ALJ did not expressly discredit

each witness who described the same limitations.” Molina v. Astrue, 674 F.3d 1104,

1121 (9th Cir. 2012).

3. Subjective Symptoms Testimony

Ingram next argues that the ALJ failed to provide adequate explanation for

discounting her symptoms testimony. Where, as here, an ALJ has determined that a

claimant is not malingering and has produced objective medical evidence of an

impairment that might produce the symptoms she alleges, the ALJ must offer

“specific, clear, and convincing” reasons to reject the claimant’s testimony.

Ferguson v. O’Malley, 95 F.4th 1194, 1197–98 (9th Cir. 2024). Here, the ALJ gave

specific, clear, and convincing reasons by identifying specific medical records

showing Ingram had normal mood and was engaged, logical, goal-directed, and had

organized thought processes. The ALJ also pointed to Ingram’s reported daily

activities such as completing college-level courses, interning, and earning her

bachelor’s degree, suggesting that she “retained the cognitive ability to complete, at

4 24-7242 least, simple routine tasks.” See Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d

1155, 1161 (9th Cir. 2008).

4. Residual Functional Capacity (“RFC”) Assessment

The ALJ did not err in its RFC assessment and step five analysis. Because

Ingram’s step five arguments are a “restatement of [her] contention that the ALJ

should have credited” other evidence, we reject them. Kitchen, 82 F.4th at 742;

accord Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1175–76 (9th Cir. 2008).

AFFIRMED.

5 24-7242 FILED Ingram v. Commissioner of Social Security Administration, No. 24-7242 MAR 16 2026 MOLLY C. DWYER, CLERK DESAI, Circuit Judge, concurring in part and dissenting in part: U.S. COURT OF APPEALS

I concur in the majority’s conclusion that the ALJ’s evaluation of the lay

witness evidence and subjective symptoms testimony is supported by the record. But

I respectfully dissent from the majority’s conclusion that the agency did not err when

evaluating the medical evidence. In my view, the ALJ erred by discounting

Campbell’s opinion, and its error was not harmless. I would therefore affirm in part,

reverse in part, and remand.

Under the Act, Campbell is an “acceptable medical source,” see 20 C.F.R. §

404.1502(a), and therefore the ALJ must evaluate the opinion’s supportability and

consistency. 20 C.F.R. § 404.1520c(b)(2) (“[W]e will explain how we considered

the supportability and consistency factors for a medical source’s medical opinions

or prior administrative medical findings in your determination or decision.”). Here,

the ALJ failed to evaluate the consistency of Campbell’s opinion. This “alone

constitutes reversible legal error.” Trevizo v. Berryhill, 871 F.3d 664, 676 (9th Cir.

2017) (holding that “the ALJ erred by failing to apply the appropriate factors in

determining the extent to which the opinion should be credited”). In a separate

section of its decision, the ALJ cites dozens of exhibits, including some of

Campbell’s notes. But this is not enough to satisfy the Act’s requirements. An ALJ

must “articulate how persuasive it finds all of the medical opinions from each doctor

1 or other source and explain how it considered the supportability and consistency

factors in reaching these findings.” See Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir.

2022) (citation modified). Here, the ALJ did not “explain how it considered the . . .

consistency factor[].” See 20 C.F.R. § 404.1520c(b)(2). Indeed, it never mentioned

consistency in its evaluation of Campbell’s opinion.1 It thus erred.

The ALJ further erred by finding that Campbell’s opinion is unsupported.

First, as the agency concedes, the ALJ erred by stating that Campbell does not have

a treating relationship with Ingram. The record includes Campbell’s extensive

treatment notes written between 2017 and 2021. These notes show Campbell’s

treatment relationship with Ingram, indicating she treated Ingram every other month,

alternating with LICSW Jake Kim. The ALJ’s reliance on this erroneous finding as

a reason to discount Campbell’s opinion is not supported by the record.

Second, the ALJ’s conclusion that “there is no evidence that [Campbell] has

considered [Ingram’s] function in activities of daily living” is unsupported. The

record includes Campbell’s thorough visit notes documenting how Ingram’s mental

health symptoms impacted her day-to-day activities. See 20 C.F.R.

1 The record shows that in the ALJ’s 2021 decision, it expressly considered consistency factors of Campbell’s opinion, but failed to address the opinion’s supportability. The agency directed the ALJ to address this error on remand, the 2021 decision, and instructing the ALJ to issue a “new decision” on remand. The ALJ’s decision before us now only addresses supportability factors of Campbell’s opinion—with findings unsupported by the record—and fails to consider consistency factors, as required by 20 C.F.R. § 404.1520c. 2 § 404.1520a(c)(2) (stating that the agency “will consider such factors as the quality

and level of your overall functional performance, any episodic limitations, the

amount of supervision or assistance you require, and the settings in which you are

able to function”). For example, Campbell’s reports note that Ingram had symptoms

of anorexia, mood swings, school difficulties, tobacco use, “triggers causing

nightmares/flashbacks for past trauma,” “automatic negative thoughts” while in

school, and that her symptoms impaired her “day to day functioning.”

Third, the ALJ discounted Campbell’s opinion by noting that the opinion was

completed for a different program than the Social Security Administration. However,

an ALJ cannot reject an opinion based on the purpose for which it was obtained.

Lester v. Chater, 81 F.3d 821, 832 (9th Cir. 1995), as amended (Apr. 9, 1996); see,

e.g., Treichler v. Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1094 (9th Cir. 2014)

(considering reports prepared by doctors who examined claimant for workers’

compensation purposes).

The ALJ’s errors are not harmless. See Stout v. Comm’r, Soc. Sec. Admin., 454

F.3d 1050, 1055 (9th Cir. 2006). Under the harmless error standard, we “look at the

record as a whole to determine whether the error alters the outcome of the case.”

Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012). Campbell’s opinion and notes

are probative of Ingram’s functional limitations, including her ability to

“[u]nderstand, remember, or apply information; interact with others; concentrate,

3 persist, or maintain pace; and adapt or manage oneself.” 20 C.F.R. §

404.1520a(c)(3). And the limitation discussed by Campbell could affect the ALJ’s

assessment of Ingram’s residual functional capacity. It may be that the findings in

Campbell’s reports are inconsistent with other evidence, but “we cannot substitute

our conclusions for the ALJ’s, or speculate as to the grounds for the ALJ’s

conclusions.” Treichler, 775 F.3d at 1103. In other words, because the ALJ

improperly discounted relevant evidence, the error is not “inconsequential to the

ultimate nondisability determination.” Stout, 454 F.3d at 1055.

For the above reasons, I would affirm the district court in part, reverse in part,

and remand for the agency to evaluate the medical evidence as required by the Act.