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5 6 7 8 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON 9 AT SEATTLE 10 11 CYNTHIA J., CASE NO. 2:24-cv-00826-TL 12 Plaintiff, ORDER REVERSING, IN PART, v. AND REMANDING THE 13 COMMISSIONER OF SOCIAL COMMISSIONER’S FINAL 14 SECURITY, DECISION 15 Defendant. 16
17 Plaintiff Cynthia J. seeks review of the denial of her application for Supplemental 18 Security Income. This matter is before the Court on Plaintiff’s Complaint for Judicial Review of 19 Social Security Benefits. Dkt. No. 10. Plaintiff contends the Administrative Law Judge (“ALJ”) 20 erred by failing to provide specific, clear, and convincing reasons for rejecting Plaintiff’s 21 subjective statements, and by rejecting the medical opinion of Dennis Haack, M.D. Dkt. No. 10 22 at 1. As discussed below, the Court REVERSES IN PART the Commissioner’s final decision and 23 REMANDS the matter for further administrative proceedings under 42 U.S.C. § 405(g). 24 1 I. BACKGROUND 2 Plaintiff is 54 years old (Dkt. No. 61 at 144 (Application Summary for Supplemental 3 Security Income (Dec. 2, 2020))), has at least a high school education (id. at 187 (Form SSA- 4 3368)), and has worked in retail and in non-profit organizations as a clothes sorter and holiday
5 bell ringer (id.). On November 25, 2020, Plaintiff applied for supplemental security income, 6 alleging disability as of May 5, 2016. Id. at 23 (Administrative Decision). Plaintiff’s applications 7 were denied initially and on reconsideration on August 27, 2021 and June 9, 2022, respectively. 8 Id. After the ALJ conducted a telephonic hearing on June 27, 2023, the ALJ issued a decision 9 finding Plaintiff not disabled. Id. at 23–24. 10 Utilizing the five-step disability evaluation process,2 the ALJ found:
11 Step one: Plaintiff has not engaged in substantial gainful activity since November 25, 2020. Dkt. No. 6 at 25 (Administrative Decision). 12 Step two: Plaintiff has the following severe impairments: carpal tunnel syndrome 13 (“CTS”); knee degenerative joint disease; chronic obstructive pulmonary disease (“COPD”); fibromyalgia; sleep apnea; obesity; and status post stroke (20 C.F.R. § 14 416.920(c)). Dkt. No. 6 at 25.
15 Step three: These impairments do not meet or equal the requirements of a listed impairment.3 Dkt. No. 6 at 26. 16 Residual Functional Capacity: Plaintiff can perform light work except that she can 17 never climb ladders, ropes, or scaffolds. Id. at 28.
18 Step four: Plaintiff cannot perform past relevant work. Id. at 30.
19 Step five: As there are jobs that exist in significant numbers in the national economy that Plaintiff can perform, Plaintiff is not disabled. Id. at 31. 20 21 22
1 Dkt. No. 6 is the Social Security Certified Administrative Record. 23 2 See 20 C.F.R. §§ 404.1520, 416.920. 24 3 See 20 C.F.R. § 404, subpt. P, app. 1. 1 The Appeals Council denied Plaintiff’s request for review, making the ALJ’s decision the 2 Commissioner’s final decision. Id. at 5 (Notice of Appeals Council Action).4 3 II. LEGAL STANDARD 4 A. Standard of Review
5 This Court may set aside the Commissioner’s denial of Social Security benefits only if 6 the ALJ’s decision was based on legal error or not supported by substantial evidence in the 7 record. Ford v. Saul, 950 F.3d 1141, 1154 (9th Cir. 2020); see also Havens v. Kijakazi, No. 21- 8 35022, 2022 WL 2115109, at *1 (9th Cir. June 13, 2022) (applying the standard and reversing 9 ALJ’s decision). The ALJ is responsible for evaluating evidence, in part by resolving conflicts in 10 medical testimony and resolving any other ambiguities that might exist. See Ford, 950 F.3d at 11 1149 (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). When the evidence is 12 susceptible to more than one interpretation, the ALJ’s interpretation must be upheld if 13 rational. See id. at 1154. The Court “must consider the entire record as a whole” and may not 14 affirm the ALJ’s decision “simply by isolating a specific quantum of supporting
15 evidence.” Ghanim v. Colvin, 763 F.3d 1154, 1160 (9th Cir. 2014) (quoting Hill v. Astrue, 698 16 F.3d 1153, 1159 (9th Cir. 2012) (internal quotation marks omitted)). Finally, this Court “may not 17 reverse an ALJ’s decision on account of a harmless error.” Buck v. Berryhill, 869 F.3d 1040, 18 1048 (9th Cir. 2017) (citing Molina v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012), superseded 19 on other grounds by 20 C.F.R. § 404.1520c(c)(2)). 20 B. The “Disabled” Determination 21 The Social Security Act defines disability as the “inability to engage in any substantial 22 gainful activity by reason of any medically determinable physical or mental impairment which 23
24 4 The rest of the procedural history is not relevant to the outcome of the case and is therefore omitted. 1 can be expected to result in death or which has lasted or can be expected to last for a continuous 2 period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A); see also Ford, 950 F.3d at 1148 3 (citations omitted). 4 To determine whether a claimant is disabled under the definition provided in the Social
5 Security Act (and, thus, eligible for benefits), an ALJ follows a five-step sequential evaluation 6 pursuant to 20 C.F.R. § 404.1520(a): (1) the claimant must not be engaged in “substantial gainful 7 activity”; (2) the claimant’s impairment or combination of impairments must be severe enough to 8 significantly limit the claimant’s “physical or mental ability to do basic work activities”; (3) the 9 claimant’s impairment(s) must meet or equal the criteria of an impairment in the “Listing of 10 Impairments” (“Listings”); (4) upon assessment of the claimant’s residual functional capacity 11 (“RFC”), the claimant must not be able to perform their “past relevant work”; and (5) the 12 claimant must not be able to make an adjustment to other work. See Ford, 950 F.3d at 1148–49. 13 If the claimant fails to make the required showing at any of these steps, the ALJ’s inquiry 14 ends, and the claimant is found to not have a disability under the Social Security Act. The burden
15 of proof is on the claimant at steps one through four, but at the fifth step, it shifts to the agency to 16 prove that “the claimant can perform a significant number of other jobs in the national 17 economy.” Id. at 1149 (citation omitted). 18 III. DISCUSSION 19 A. Whether the ALJ Erred in Evaluating Plaintiff’s Symptom Testimony 20 Plaintiff first contends that the ALJ erred in evaluating her symptom testimony, 21 specifically regarding her ability to walk unassisted, her emphysema, her knee condition, and her 22 activities of daily living. Dkt. No. 10 at 2–4. These findings by the ALJ informed, and therefore 23 affected, the determinations made at Steps 3 and 4 of the five-step sequential evaluation. See
24 Dkt. No. 6 at 29–30 (Administrative Decision). 1 Where, as here, an ALJ determines that a claimant has presented objective medical 2 evidence establishing underlying impairments that could cause the symptoms alleged (see Dkt. 3 No. 6 at 29 (“After careful consideration of the evidence, the undersigned finds that the 4 claimant’s medically determinable impairments could reasonably be expected to cause the
5 alleged symptoms . . . .”)), and there is no evidence of malingering, the ALJ can only discount 6 the claimant’s testimony as to symptom severity “by offering specific, clear and convincing 7 reasons for doing so.” Garrison v. Colvin, 759 F.3d 995, 1014–15 (9th Cir. 2014). “The standard 8 isn’t whether our court is convinced but, instead, whether the ALJ’s rationale is clear enough that 9 it has the power to convince.” Smartt v. Kijakazi, 53 F.4th 489, 499 (9th Cir. 2022). 10 1. Plaintiff’s Ability to Walk Unassisted 11 At step 3, the ALJ found that Plaintiff did not meet listing 1.18 (abnormality of a major 12 joint in any extremity) due to the lack of record of a medical need for a walker, and did not meet 13 listing 11.14 (neuropathic condition causing disorganization of motor function) because “testing 14 in the record showed unassisted walking and full strength.” Dkt. No. 6 at 26–27 (Administrative
15 Decision). Plaintiff contends that the ALJ’s decision regarding her ability to walk unassisted 16 misquotes the record by attributing the circumstances of Plaintiff’s examination, which was 17 performed without assistive devices, to Plaintiff’s general ambulation. See Dkt. No. 10 at 2–3. 18 Further, Plaintiff argues that the ALJ erred in associating Plaintiff’s ability to perform one-time 19 movements in the examination setting with her perceived ability to perform sustained 20 movements or activities. Id. 21 At her hearing, Plaintiff testified that she could not walk “more than a block without 22 being in pain.” Dkt. No. 6 at 48 (Transcript of Oral Hearing). She testified further that she used a 23 walker to ambulate (id.), and that she could only stand for approximately 20 minutes before
24 needing to sit (id. at 44). The ALJ’s decision states: “The claimant testified to a prescribed 1 walker that [s]he requires to ambulate, as [s]he struggles walking more than a block (hearing 2 testimony),” but the ALJ rejected that testimony because “testing in the record showed 3 unassisted walking and full strength (Exhibit 3F/5-6).” Dkt. No. 6 at 28 (Administrative 4 Decision). As a result, the ALJ found at step 4 that Plaintiff has the RFC to perform light work
5 with certain exclusions. Id. 6 “Contradiction with the medical record is a sufficient basis for rejecting the claimant’s 7 subjective testimony.” Jesse B. v. Acting Comm’r of Soc. Sec., No. C24-5419, 2025 WL 586301, 8 at *4 (W.D. Wash. Feb. 24, 2025) (quoting Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 9 1155, 1161 (9th Cir. 2008)). However, “an ALJ may not reject a claimant’s subjective symptom 10 testimony ‘solely on a lack of objective medical evidence to fully corroborate the alleged 11 severity of pain,’” and “[t]reatment records may not be cherry-picked”—that is, “the ALJ must 12 consider a particular record of treatment in light of the overall diagnostic record.” Id. (first 13 quoting Bunnell v. Sullivan, 946 F.2d 341, 345 (9th Cir. 1991), then quoting Ghanim, 763 F.3d at 14 1164). “An ALJ may discount a claimant’s testimony based on daily activities that either
15 contradict their testimony or that meet the threshold for transferable work skills.” Id. at *5 (citing 16 Orn v. Astrue, 495 F.3d 625, 639 (9th Cir. 2007)). 17 The portion of the record cited by the ALJ when rejecting Plaintiff’s subjective testimony 18 indicates that Plaintiff “is unable to walk on heels, can walk on toes, notes knee pain with 19 hopping, and is able to perform a tandem gait maneuver. . . . The gait shows her favoring the 20 right knee, a slightly disjointed gait with normal pace and stride.” Dkt. No. 6 at 459 (Exhibit No. 21 3F). The functional assessment portion of the cited record also indicates that Plaintiff can, at 22 maximum, stand or walk for “[l]ess than two hours” due to her “[d]egenerative joint findings, 23 right knee, knee effusion, incomplete extension of the knee joint, and altered gait.” Id. at 461.
24 1 Further, the record indicates that as early as August 2022, Plaintiff had “difficulty walking and 2 significant pain.” Dkt. No. 6 at 651 (Exhibit No. 8F). 3 The record—and in particular, the portion of the record cited by the ALJ—does not 4 contradict Plaintiff’s subjective testimony. While the record states, and the ALJ acknowledged,
5 that upon examination, Plaintiff “could not walk on her heels, but could walk on her toes, could 6 walk unassisted, did not use an assistive device, had no difficulty sitting, could arise from seated 7 to standing, could do a tandem gait, had full grip strength, and had full overall strength” (Dkt. 8 No. 6 at 29 (Administrative Decision)), the ALJ’s decision does not explain how Plaintiff’s 9 ability to perform those exercises in an examination setting contradicts her testimony regarding 10 her ability to walk longer distances or her need to use a walker. Indeed, Dr. Haack’s report does 11 not indicate how far Plaintiff was required to walk for his examination—and the fact that 12 Plaintiff was able to walk an unknown distance without an assistive device does not, without 13 more, contradict her subjective testimony (and Dr. Haack’s observation) that she generally needs 14 a walker to ambulate and struggles to walk more than one block. Further, Dr. Haack’s report
15 does not, as Defendant argues, opine that Plaintiff’s cane and knee brace are not necessary for 16 “normal walking in everyday life.” Dkt. No. 14 at 7. Rather, his report states that those assistive 17 devices are “medically necessary . . . for long distances and all distances with uneven terrain.” 18 Dkt. No. 6 at 461 (Exhibit No. 3F). 19 The question now becomes whether the ALJ’s error in cherry-picking a single task from 20 an exam to justify rejecting Plaintiff’s testimony regarding her ability to walk unassisted was 21 harmless. See Stout v. Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 1054 (9th Cir. 2006). At the 22 administrative hearing, the ALJ solicited the testimony of a vocational expert about the jobs 23 available to an individual with Plaintiff’s limitations, posing a hypothetical that did not include
24 Plaintiff’s testimony that she requires assistance to generally ambulate. See generally Dkt. No. 6 1 at 55–58 (Transcript of Oral Hearing). Not being informed of this limitation, the vocational 2 expert did not have the opportunity to opine whether the characteristics of the jobs at issue would 3 allow for such a limitation. “Any hypothetical posed to the vocational expert, for purposes of 4 determining whether Plaintiff could perform other work, should have included all properly
5 supported limitations because a ‘vocational expert’s opinion about a claimant’s residual 6 functional capacity has no evidentiary value if the assumptions in the hypothetical are not 7 supported by the record.’” Trejo v. Comm’r of Soc. Sec., No. C22-192, 2023 WL 2752194, at *4 8 (E.D. Cal. Mar. 31, 2023) (quoting Magallanes v. Bowen, 881 F.2d 747, 756 (9th Cir. 1989)). 9 Thus, because the Court cannot conclude that the ALJ’s error in rejecting Plaintiff’s testimony 10 regarding her ability to walk unassisted was “inconsequential to the ultimate nondisability 11 determination,” it does not find the error to be harmless. Stout, 454 F.3d at 1055. 12 Accordingly, the Court finds that the ALJ has not offered clear and convincing reasons 13 for rejecting Plaintiff’s subjective testimony regarding her ability to walk unassisted, and the 14 failure to do so constitutes harmful error.
15 2. Plaintiff’s Emphysema 16 Plaintiff next contends that the ALJ’s decision fails to adequately address her testimony 17 regarding her emphysema. Dkt. No. 10 at 3. Plaintiff argues that the ALJ’s statement that “the 18 record does not show hospitalizations for pulmonary conditions” is insufficient to evaluate 19 Plaintiff’s emphysema, “a disabling impairment limiting her endurance to complete an 8-hour 20 workday” that is “layered on top of her COPD” and causes fatigue. Id. 21 But Plaintiff does not point to any specific testimony that she contends that the ALJ 22 rejected, and the ALJ did address more than Plaintiff’s lack of hospitalizations for her pulmonary 23 conditions. For example, the Administrative Decision notes that “[p]ulmonary testing [in 2022]
24 1 showed mild to moderate COPD, with a good response to a bronchodilator” (Dkt. No. 6 at 29 2 (citing Dkt. No. 6 at 734 (Exhibit No. 9F))). 3 The record does indicate that Plaintiff’s COPD had likely advanced to “stage II” in early 4 2023, as evidenced by “very expanded lungs.” Dkt. No. 6 at 799 (Exhibit No. 11F). However,
5 Plaintiff was not prescribed any course of treatment at that time, and her medical records indicate 6 that her ambulation was not significantly impacted by her COPD. Id. at 797 (“Patient was able to 7 ambulate approximately 770 feet in 6 minutes, she did not have any desaturations or hypoxic 8 events. She was minimally dyspneic at the end of the study.”). Further, Plaintiff testified that her 9 inhaler controlled her symptoms for COPD and that she did not experience any other side effects. 10 Id. at 46–47 (Transcript of Oral Hearing). “Impairments that can be controlled effectively with 11 medication are not disabling for the purpose of determining eligibility for [social security 12 disability] benefits.” Susan F. v. Comm’r of Soc. Sec., No. C22-5661, 2023 WL 4704160, at *3 13 (W.D. Wash. July 24, 2023) (quoting Warre ex rel. E.T. IV v. Comm’r, SSA, 439 F.3d 1001, 14 1006 (9th Cir. 2006)).
15 Finally, Plaintiff did not appear to testify at her administrative hearing to any limited 16 endurance she suffered due to either COPD or her emphysema. See generally Dkt. No. 6 at 37– 17 63. Plaintiff argues that her pulmonary conditions “result in excessive fatigue, which . . . 18 preclude[] the ability to sustain effort,” but cites to no portion of the hearing or medical records 19 supporting this argument, nor does she point to specific evidence that she claims the ALJ failed 20 to consider. See generally Dkt. Nos. 10, 17. Because the evidence in the record is susceptible to 21 more than one rational interpretation, “[the Court] must uphold the ALJ’s findings if they are 22 supported by inferences reasonably drawn from the record.” Susan F., 2023 WL 4704160, at *4 23 (citing Molina, 674 F.3d at 1111). The ALJ’s determination that Plaintiff’s emphysema was not a
24 1 disabling condition because she was not hospitalized for any of her pulmonary conditions is a 2 reasonable interpretation of the overall record. 3 Accordingly, the ALJ’s decision as to Plaintiff’s emphysema is supported by substantial 4 evidence in the record.
5 3. Plaintiff’s Knee Condition 6 Plaintiff also argues that the ALJ erred in basing her RFC “on an erroneous review of the 7 medical record with respect to [Plaintiff’s] knee condition.” Dkt. No. 10 at 3. Plaintiff contends 8 that the “ALJ erred in basing part of [her] decision on a finding that [Plaintiff’s] knee pain could 9 not be as severe as alleged based on [her] review of the evidence showing that [Plaintiff] never 10 received steroid injection in the knee.” Id. This is “factually inaccurate,” Plaintiff argues, 11 because Plaintiff did receive a steroid injection. Id. Further, Plaintiff argues that she need not 12 prove the legitimacy of her pain by submitting to particular courses of treatment. Id. 13 At her hearing, Plaintiff testified that her knee condition limited her ability to ambulate, 14 and that she could not walk “more than a block without being in pain.” Dkt. No. 6 at 48
15 (Transcript of Oral Hearing). The ALJ determined that Plaintiff had “conservative treatment for 16 her . . . knee impairments that did not include surgery or injections,” and that her testimony 17 regarding her knee condition was thus contradicted by her medical record. Dkt. No. 6 at 29 18 (Administrative Decision). The extent of the ALJ’s evaluation of Plaintiff’s knee condition 19 appears to be that Plaintiff “only had a small fragment in the right knee,” that in “June 2021 20 physical therapy for her right knee, [she] showed full range of motion, full strength, and a small 21 effusion,” and her aforementioned finding regarding Plaintiff’s conservative treatment. Id. 22 However, Plaintiff’s medical record indicates that she did receive a steroid injection to 23 treat her right knee pain in June 2021, which undercuts the ALJ’s finding that Plaintiff only
24 received “conservative” treatment for her knee condition. Dkt. No. 6 at 628 (Exhibit No. 8F); see 1 Revels v. Berryhill, 874 F.3d 648 (9th Cir. 2017) (“We have previously ‘doubt[ed] that epidural 2 steroid shots to the neck and lower back qualify as “conservative” medical treatment.’” (quoting 3 Garrison v. Colvin, 759 F.3d 995, 1015 n.20 (9th Cir. 2014))). The ALJ’s statement that Plaintiff 4 did not receive injections to her knee, and the subsequent finding that Plaintiff’s treatment was
5 “conservative,” constitutes a clear error in the ALJ’s decision. However, “[a]n ALJ’s error may 6 be deemed harmless if, in light of the other reasons supporting the overall finding, it can be 7 concluded that the error did not ‘affect[] the ALJ’s conclusion.’” Fox v. Colvin, No. C16-1328, 8 2017 WL 5495155, at *6 (C.D. Cal. Nov. 15, 2017) (quoting Batson v. Comm’r of Soc. Sec. 9 Admin., 359 F.3d 1190, 1197 (9th Cir. 2004)); see also Stout, 454 F.3d at 1054–55. 10 In January 2021, Plaintiff was diagnosed with “acute pain of right knee” and “pain with 11 most movements” due to a “small fragment in the knee” causing swelling. Dkt. No. 6 at 305, 308 12 (Exhibit No. 1F). At that time, Plaintiff’s diagnosing physician noted that the “soft tissue 13 swelling [in Plaintiff’s knee] may be chronic,” but that Plaintiff declined to take prednisone due 14 to the side effects. Id. at 307. Plaintiff was referred to a sports medicine physician, who
15 diagnosed Plaintiff with “knee osteoarthritis, degenerative meniscal tear, decreased knee [range 16 of motion (“ROM”)], pain and antalgic gait.” Id. at 315. Approximately five months later, 17 Plaintiff’s sports medicine physician noted that she continued to experience knee pain and 18 decreased knee ROM. Id. at 476 (Exhibit No. 6F). The physician stated that the June 2021 19 steroid injection had been helpful to Plaintiff for several months, that Plaintiff did “some home 20 exercises but did not go to [physical therapy],” and that Plaintiff’s pain was worse with stairs and 21 “deep to patella and also medially.” Id. at 478. 22 At an unrelated appointment for hand and wrist pain later that same year, Plaintiff’s 23 physician noted that Plaintiff continued to use a knee brace. Id. at 492. Plaintiff’s medical
24 records indicate that she continued to experience knee pain in November 2021. Id. at 503. 1 However, at the Administrative Hearing, Plaintiff testified that her “knee got better” after 2 physical therapy, though she did not testify as to the specific timing of the improvement of her 3 knee pain or the degree of improvement. Dkt. No. 6 at 47 (Transcript of Oral Hearing). 4 Given that Plaintiff’s own reports of improvement in her knee pain undermine her
5 testimony, and that Plaintiff’s medical records support a finding that Plaintiff’s knee pain 6 improved with steroid injection treatment and physical therapy, the ALJ could reasonably reject 7 Plaintiff’s testimony regarding her knee pain based on its inconsistency with the record. See 8 Wellington v. Berryhill, 878 F.3d 867, 876 (9th Cir. 2017) (“[E]vidence of medical treatment 9 successfully relieving symptoms can undermine a claim of disability”); Tommasetti v. Astrue, 10 533 F.3d 1035, 1041 (9th Cir. 2008) (finding it not improper to reject an opinion presenting 11 inconsistencies between the opinion and the medical record). 12 Accordingly, while the Court certainly does not condone the ALJ’s error with regard to 13 the finding that Plaintiff received conservative treatment for her knee condition, the ALJ’s 14 decision as to Plaintiff’s knee condition is supported by substantial evidence in the record as
15 outlined above. 16 4. Plaintiff’s Activities of Daily Living 17 Plaintiff also argues that the ALJ erred by determining that Plaintiff’s activities of daily 18 living were inconsistent with her allegations. Dkt. No. 10 at 4. Plaintiff contends that her 19 “activities of daily living are very limited, and the ALJ fails to demonstrate that any of Plaintiff’s 20 activities are completed at an intensity or duration which would be inconsistent with the 21 Plaintiff’s allegations.” Id. at 5. 22 The ALJ’s decision states that Plaintiff’s ability to “perform activities of daily living, as 23 the claimant reported she does yard work, cooking, laundry, cleaning, shopping, and all self-care
24 tasks” is inconsistent with Plaintiff’s testimony regarding her medically determinable 1 impairments. Dkt. No. 6 at 29 (Administrative Decision). At her hearing, Plaintiff testified that 2 she was able to perform a variety of household tasks, but was limited in her ability to do so by 3 her need to take breaks to sit every five to 10 minutes. Dkt. No. 6 at 51 (Transcript of Oral 4 Hearing).
5 Daily activities may be grounds for an adverse ruling “if a claimant is able to spend a 6 substantial part of his day engaged in pursuits involving the performance of physical functions 7 that are transferable to a work setting.” Orn, 495 F.3d at 639 (quoting Fair v. Bowen, 885 F.3d 8 597, 603 (9th Cir. 1989), superseded on other grounds by 20 C.F.R. § 404.1502(a)). To discount 9 Plaintiff’s subjective testimony regarding her physical limitations on the grounds that her daily 10 activities contradict such testimony, the ALJ “must make ‘specific findings relating to the daily 11 activities’ and their transferability.” Id. (citing Burch v. Barnhart, 400 F.3d 676, 681 (9th Cir. 12 2005)). 13 Defendant argues that “even if Plaintiff’s activities were not consistent with full-time 14 work, the salient point is that they were inconsistent with the severity of the symptoms [s]he
15 alleged.” Dkt. No. 14 at 8. But the ALJ must make specific findings regarding these 16 inconsistencies—and it is not clear from Plaintiff’s testimony how her daily activities, including 17 her limitations in performing them, are inconsistent with the severity of symptoms she testified 18 she experienced. The ALJ has not made the required findings with specificity here. 19 5. Additional Arguments 20 Plaintiff additionally argues that the ALJ erred in finding that Plaintiff’s limited work 21 history prior to the onset date of her disability shows that factors other than severe impairments 22 may have prevented Plaintiff from working. Dkt. No. 10 at 2. But an ALJ may consider a 23 claimant’s lack of or limited work history when assessing subjective complaints. See Thomas v.
24 Barnhart, 278 F.3d 947, 958–59 (9th Cir. 2002). While the ALJ did not discuss in the 1 Administrative Decision that Plaintiff specifically testified that her limited work history is 2 because she was a “stay at home mom” (see Dkt. No. 6 at 43 (Transcript of Oral Hearing)), it 3 was not error for the ALJ to consider Plaintiff’s work history when evaluating her subjective 4 testimony regarding her impairments.
5 ⁕ ⁕ ⁕ 6 Accordingly, the Court FINDS that the ALJ committed harmful error by rejecting 7 Plaintiff’s subjective testimony regarding some of her impairments. In particular, the ALJ erred 8 in finding that Plaintiff’s medical record, and the one, isolated test from her examination with Dr. 9 Haack specifically, contradicted her testimony that she struggled to walk more than one block 10 and needed to use mobility devices when walking. Further, the ALJ failed to make specific 11 findings regarding any inconsistencies between Plaintiff’s performance of daily tasks and her 12 subjective testimony regarding her impairments. 13 B. Whether the ALJ Erred in Rejecting the Medical Opinion of Dennis Haack, M.D. 14 Plaintiff also contends that the ALJ erred in rejecting the medical opinion of Dr. Dennis
15 Haack. Dkt. No. 10 at 5. 16 1. Consideration of Expert Medical Opinions 17 “In disability benefits cases . . . physicians may render medical, clinical opinions, or they 18 may render opinions on the ultimate issue of disability.” Garrison, 759 F.3d at 1012 (quoting 19 Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998)). “[T]here is not an inherent persuasiveness 20 to evidence from [government consultants] over [a claimant’s] own medical source(s), and vice 21 versa.” Woods v. Kijakazi, 32 F.4th 785, 791 (9th Cir. 2022) (alterations in original) (quoting 22 Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844 (2017)). 23 “‘The most important factors’ that the agency considers when evaluating the persuasiveness of
24 medical opinions are ‘supportability’ and ‘consistency.’” Id. (quoting 20 C.F.R. § 404.1520c(a)). 1 “Supportability means the extent to which a medical source supports the medical opinion by 2 explaining the ‘relevant . . . objective medical evidence.’” Id. at 791–92 (quoting 20 C.F.R. 3 § 404.1520c(c)(1)). “Consistency means the extent to which a medical opinion is ‘consistent . . . 4 with the evidence from other medical sources and nonmedical sources in the claim.’” Id. at 792
5 (quoting 20 C.F.R § 404.1520c(c)(2)). 6 With regard to the medical source’s relationship with the claimant, “an ALJ can . . . 7 consider the length and purpose of the treatment relationship, the frequency of examinations, the 8 kinds and extent of examinations that the medical source has performed or ordered from 9 specialists, and whether the medical source has examined the claimant or merely reviewed the 10 claimant’s records,” but does not need to make specific findings regarding these factors. Id. 11 (citing 20 C.F.R § 404.1520c(c)(3)(i)–(v), (b)(2)). While an ALJ is not required to provide 12 “specific and legitimate reasons” for rejecting a treating or examining doctor’s opinion, it 13 “cannot reject an examining or treating doctor’s opinion as unsupported or inconsistent without 14 providing an explanation supported by substantial evidence.” Id. “The agency must ‘articulate . .
15 . how persuasive’ it finds ‘all of the medical opinions’ from each doctor or source . . . and 16 ‘explain how it considered the supportability and consistency factors’ in reaching these 17 findings.” Id. (quoting 20 C.F.R. § 404.1520c(b)) (cleaned up). 18 2. The ALJ’s Consideration of Dr. Haack’s Opinion 19 The ALJ’s decision stated: 20 Dr. Dennis Haack M.D. found the claimant could stand or walk less than two hours, has no limitations sitting, uses a cane and knee 21 sleeve that is necessary for long distances, can lift up to 10 pounds, can occasionally balance and stoop, can never perform other 22 postural activities, and needs to change positions frequently (Exhibit 3F). This opinion is not persuasive, as it is not supported 23 by his own examination that showed full strength and unassisted walking (Exhibit 3F/3-7). This opinion is inconsistent with the 24 claimant had [sic] conservative treatment for her CTS and knee 1 impairments that did not include surgery or injections (See Exhibit 1F-13F). This opinion is inconsistent with new evidence in the 2 record shows [sic] the claimant recovered well from her stroke (Exhibit 8F/5-30). 3 Dkt. No. 6 at 30 (Administrative Decision). But the ALJ’s description of Dr. Haack’s 4 examination as showing “full strength and unassisted walking” understates the findings of that 5 exam. In Dr. Haack’s report, he states that upon examination: 6 The claimant is unable to walk on heels, can walk on toes, notes 7 knee pain with hopping, and is able to perform a tandem gait maneuver. No assistive devices are used during this portion of the 8 exam. The gait shows her favoring the right knee, a slightly disjointed gait with normal pace and stride. [T]he claimant does 9 not attempt a squat maneuver secondary to knee pain, and is able to bend forward at the waist to 70 degrees. 10 Dkt. No. 6 at 459 (Exhibit No. 3F). The ALJ relied on a single sentence to conclude that Plaintiff 11 “showed full strength and unassisted walking” (Dkt. No. 6 at 30 (Administrative Decision)) 12 which merely noted that no assistive devices were used “during this portion of the exam” that 13 involved four discrete tasks. Id. at 459 (emphasis added) (Exhibit No. 3F). Additionally, Dr. 14 Haack’s report indicates that upon Plaintiff’s performance of a “straight leg raise test,” he found 15 that she had “joint deformity,” including “degenerative changes in joint margins of the right knee 16 . . . with approximately a fusion of about 10 degrees about the right knee.” Id. These 17 observations support Dr. Haack’s findings that Plaintiff “could stand or walk less than two hours, 18 has no limitations sitting, uses a cane and knee sleeve that is necessary for long distances, can lift 19 up to 10 pounds, can occasionally balance and stoop, can never perform other postural activities, 20 and needs to change positions frequently,” (id. at 461) and are not addressed by the ALJ in the 21 Administrative Decision. 22 The ALJ’s determination that Dr. Haack’s conclusion is inconsistent with his own 23 examination of Plaintiff is not supported by substantial evidence, as discussed above. See supra 24 1 Section III.A.1. And the ALJ’s determination that Dr. Haack’s conclusion is inconsistent with 2 Plaintiff’s “conservative treatment” for her knee impairments omits that Plaintiff did receive a 3 steroid injection for her knee issues. See supra Section III.A.3. 4 Accordingly, the ALJ’s explanation for her rejection of the medical opinion of Dr. Haack
5 is not supported by substantial evidence. 6 IV. CONCLUSION 7 For the foregoing reasons, the Commissioner’s final decision is REVERSED IN PART, and 8 this case is REMANDED for further administrative proceedings consistent with this decision under 9 42 U.S.C. § 405(g). 10 11 Dated this 14th day of March 2025. 12 A 13 Tana Lin United States District Judge 14
16 17 18 19 20 21 22 23 24