Knopp v. Commissioner of Social Security

• Court: District Court, E.D. Washington
• Decided: July 6, 2020
• Docket: 2:19-cv-00179
• Status: Unknown

Opinion

1 2 3 4 5 U.S. F DIL ISE TD R I IN C TT H CE O URT EASTERN DISTRICT OF WASHINGTON 6 Jul 06, 2020 7 SEAN F. MCAVOY, CLERK 8 9 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WASHINGTON 10

12 ALEXANDRIA K., No. 2:19-CV-00179-JTR

13 Plaintiff, 14 v. ORDER GRANTING DEFENDANT’S 15 MOTION FOR SUMMARY 16 ANDREW M. SAUL, JUDGMENT 17 COMMISSIONER OF SOCIAL SECURITY, 18

19 Defendant.

20 BEFORE THE COURT are cross-motions for summary judgment. ECF 21 No. 18, 19. Attorney David Lybbert represents Alexandria K. (Plaintiff); Special 22 Assistant United States Attorney Katherine Watson represents the Commissioner 23 of Social Security (Defendant). The parties have consented to proceed before a 24 magistrate judge. ECF No. 8. After reviewing the administrative record and the 25 briefs filed by the parties, the Court GRANTS Defendant’s Motion for Summary 26 Judgment and DENIES Plaintiff’s Motion for Summary Judgment. 27

28 1 JURISDICTION 2 Plaintiff filed an application for Disability Insurance Benefits on May 5, 3 2016, alleging disability since July 5, 2008,1 due to pigmented villonodular 4 synovitis (PVNS) and depression. Tr. 79. The application was denied initially and 5 upon reconsideration. Tr. 103-05, 106-07. Administrative Law Judge (ALJ) 6 Kimberly Boyce held a hearing on October 24, 2017, Tr. 36-77, and issued an 7 unfavorable decision on May 22, 2018, Tr. 15-29. Plaintiff requested review from 8 the Appeals Council. Tr. 156-59, 256-64. The Appeals Council denied the request 9 for review on March 26, 2019. Tr. 1-5. The ALJ’s May 2018 decision became the 10 final decision of the Commissioner, which is appealable to the district court 11 pursuant to 42 U.S.C. § 405(g). Plaintiff filed this action for judicial review on 12 May 24, 2019. ECF No. 1. 13 STATEMENT OF FACTS 14 Plaintiff was born in 1981 and was 32 years old as of her date last insured in 15 2013. Tr. 27. In 2006 Plaintiff was working at McDonalds and while mopping a 16 floor she twisted her knee and felt a pop. Tr. 266. She sought medical attention 17 after a few weeks when she was continuing to have pain and swelling. Tr. 578. The 18 swelling eventually went down and she sought no further treatment until 2008 19 when the pain returned. Tr. 591. At that point she had an MRI and was diagnosed 20 with PVNS, a condition where synovial fluid builds up in the knee causing tumor- 21 like growths. Tr. 269. Medical examiners for Labor and Industries found that her 22 PVNS was a pre-existing condition, but had been “lit up” by the 2006 work injury. 23 Tr. 650, 266-71. In December 2008 she had surgery to remove the growths. Tr. 24 275. 25 26

27 1 Plaintiff amended her alleged onset date to July 26, 2012 at the hearing. Tr. 28 39. 1 She continued to seek treatment for her knee pain over the following years, 2 and by 2011 had to have surgery again to remove recurrent growths. Tr. 296-98. 3 Over the following years her doctors recommended radiation and chemotherapy 4 for her knee, and discussed the possibility of more surgery, future knee 5 replacement, or leg amputation. Tr. 377, 418, 452, 480, 534, 865. She had another 6 knee surgery in 2016, over two years after her insured status expired. Tr. 385 7 STANDARD OF REVIEW 8 The ALJ is responsible for determining credibility, resolving conflicts in 9 medical testimony, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 10 1039 (9th Cir. 1995). The ALJ’s determinations of law are reviewed de novo, with 11 deference to a reasonable interpretation of the applicable statutes. McNatt v. Apfel, 12 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed 13 only if it is not supported by substantial evidence or if it is based on legal error. 14 Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is 15 defined as being more than a mere scintilla, but less than a preponderance. Id. at 16 1098. Put another way, substantial evidence is such relevant evidence as a 17 reasonable mind might accept as adequate to support a conclusion. Richardson v. 18 Perales, 402 U.S. 389, 401 (1971). If the evidence is susceptible to more than one 19 rational interpretation, the Court may not substitute its judgment for that of the 20 ALJ. Tackett, 180 F.3d at 1097; Morgan v. Commissioner of Social Sec. Admin., 21 169 F.3d 595, 599 (9th Cir. 1999). If substantial evidence supports the 22 administrative findings, or if conflicting evidence supports a finding of either 23 disability or non-disability, the ALJ’s determination is conclusive. Sprague v. 24 Bowen, 812 F.2d 1226, 1229-1230 (9th Cir. 1987). Nevertheless, a decision 25 supported by substantial evidence will be set aside if the proper legal standards 26 were not applied in weighing the evidence and making the decision. Brawner v. 27 Secretary of Health and Human Services, 839 F.2d 432, 433 (9th Cir. 1988). 28 1 SEQUENTIAL EVALUATION PROCESS 2 The Commissioner has established a five-step sequential evaluation process 3 for determining whether a person is disabled. 20 C.F.R. § 404.1520(a); Bowen v. 4 Yuckert, 482 U.S. 137, 140-142 (1987). In steps one through four, the burden of 5 proof rests upon the claimant to establish a prima facie case of entitlement to 6 disability benefits. Tackett, 180 F.3d at 1098-1099. This burden is met once a 7 claimant establishes that a physical or mental impairment prevents the claimant 8 from engaging in past relevant work. 20 C.F.R. § 404.1520(a)(4). If a claimant 9 cannot perform past relevant work, the ALJ proceeds to step five, and the burden 10 shifts to the Commissioner to show (1) the claimant can make an adjustment to 11 other work; and (2) the claimant can perform specific jobs that exist in the national 12 economy. Batson v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1193-94 (9th Cir. 13 2004). If a claimant cannot make an adjustment to other work in the national 14 economy, the claimant will be found disabled. 20 C.F.R. § 404.1520(a)(4)(v). 15 ADMINISTRATIVE DECISION 16 On May 22, 2018 the ALJ issued a decision finding Plaintiff was not 17 disabled as defined in the Social Security Act. 18 At step one, the ALJ found Plaintiff had not engaged in substantial gainful 19 activity from the alleged onset date of July 26, 2012, through the date last insured 20 of December 31, 2013. Tr. 17. 21 At step two, the ALJ determined Plaintiff had the following severe 22 impairment: right knee pigmented villonodular synovitis status-post surgery. Tr. 18 23 At step three, the ALJ found Plaintiff did not have an impairment or 24 combination of impairments that met or medically equaled the severity of one of 25 the listed impairments. Tr. 19. 26 The ALJ assessed Plaintiff’s Residual Functional Capacity (RFC) and found 27 she could perform work at the sedentary exertional level, except:

28 The claimant could stand and walk for about two hours and could sit 1 for more than six hours in an eight-hour workday with normal breaks. 2 She could never push or pull with the lower extremities. The claimant 3 could never climb ladders, ropes or scaffolds, work at unprotected heights or in proximity to hazards such as heavy machinery with 4 dangerous moving parts. She could occasionally climb ramps and 5 stairs, balance, stoop, kneel, and crouch. She could never crawl. In order to meet ordinary and reasonable employer expectations 6 regarding attendance, production and work place behavior, this 7 individual could understand, remember and carry out unskilled, routine and repetitive work that could be learned by demonstration, 8 and in which tasks to be performed are predetermined by the 9 employer. 10 11 Tr. 19. 12 At step four, the ALJ found Plaintiff was unable to perform her past relevant 13 work as a fast food worker. Tr. 24. 14 At step five, the ALJ determined that, based on the testimony of the 15 vocational expert, and considering Plaintiff’s age, education, work experience, and 16 RFC, there were jobs that existed in significant numbers in the national economy 17 that Plaintiff was capable of performing, including the jobs of semiconductor die 18 loader, semiconductor wafer breaker, and cutter paster press clippings. Tr. 28. 19 The ALJ thus concluded Plaintiff was not under a disability within the 20 meaning of the Social Security Act at any time from the alleged onset date through 21 the date last insured of December 31, 2013. Tr. 29. 22 ISSUES 23 The question presented is whether substantial evidence supports the ALJ’s 24 decision denying benefits and, if so, whether that decision is based on proper legal 25 standards. 26 Plaintiff contends the ALJ erred by (1) improperly rejecting medical opinion 27 evidence; (2) improperly discounting Plaintiff’s subjective complaints; (3) failing 28 to find mental health impairments severe at step two; (4) failing to find Plaintiff’s 1 condition met a listing at step three; and (5) making step five findings that did not 2 consider all of Plaintiff’s relevant limitations. 3 DISCUSSION 4 1. Step Two 5 Plaintiff argues the ALJ erred in failing to find her depression to be a severe 6 impairment at step two. ECF No. 18 at 13, 15. 7 An impairment is “not severe” if it does not “significantly limit” the ability 8 to conduct “basic work activities.” 20 C.F.R. § 404.1522(a). Basic work activities 9 are “abilities and aptitudes necessary to do most jobs.” 20 C.F.R. § 404.1522(b). 10 “An impairment or combination of impairments can be found not severe only if the 11 evidence establishes a slight abnormality that has no more than a minimal effect on 12 an individual’s ability to work.” Smolen v. Chater, 80 F.3d 1273, 1290 (9th Cir. 13 1996) (internal quotation marks omitted). 14 At step two the ALJ found Plaintiff’s depression to be non-severe. Tr. 18. 15 She determined that Plaintiff had no impairment in the broad areas of functioning 16 set out in the regulations for evaluating mental disorders, and noted that Plaintiff 17 did not have any formal mental health treatment during the relevant period other 18 than some use of antidepressants. Id. The ALJ further noted Plaintiff’s reports that 19 she did not have any symptoms of depression during the relevant period. Id. 20 Plaintiff argues that treating sources in 2010 and 2017 found Plaintiff 21 suffered from mental impairments. ECF No. 18 at 13. However, Plaintiff offers no 22 analysis of the ALJ’s findings or any citations to support a finding of a severe 23 impairment during the relevant period. The Court finds no error in the ALJ’s step- 24 two findings. 25 2. Step Three 26 At step three of the sequential evaluation process, the ALJ considers whether 27 one or more of the claimant’s impairments meets or equals an impairment listed in 28 Appendix 1 to Subpart P of the regulations. 20 C.F.R. § 404.1520(a)(4)(iii). Each 1 Listing sets forth the “symptoms, signs, and laboratory findings” which must be 2 established for a claimant’s impairment to meet the Listing. Tackett v. Apfel, 180 3 F.3d 1094, 1099 (9th Cir. 1999). If a claimant meets or equals a Listing, the 4 claimant is considered disabled without further inquiry. 20 C.F.R. § 404.1520(d). 5 Plaintiff argues the ALJ erred in finding her knee condition did not meet the 6 requirements of Listing 1.02A. ECF No. 18 at 9-10. 7 Listing 1.02 concerns major dysfunction of a joint, and requires a showing 8 of: gross anatomical deformity (e.g., subluxation, contracture, bony or 9 fibrous ankylosis, instability) and chronic joint pain and stiffness with 10 signs of limitation of motion or other abnormal motion of the affected 11 joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected 12 joint(s). With: 13 A. Involvement of one major peripheral weight-bearing joint (i.e., hip, 14 knee, or ankle), resulting in inability to ambulate effectively, as 15 defined in 1.00B2b;

16 20 C.F.R. Part 404, Subpart P, Appendix 1, §1.02. Section 1.00B2b defines an 17 inability to ambulate effectively as: 18

19 an extreme limitation of the ability to walk; i.e., an impairment(s) that 20 interferes very seriously with the individual’s ability to independently initiate, sustain, or complete activities. Ineffective ambulation is 21 defined generally as having insufficient lower extremity functioning 22 (see 1.00J) to permit independent ambulation without the use of a hand-held assistive device(s) that limits the functioning of both upper 23 extremities. 24 To ambulate effectively, individuals must be capable of sustaining a 25 reasonable walking pace over a sufficient distance to be able to carry 26 out activities of daily living. They must have the ability to travel 27 without companion assistance to and from a place of employment or school. Therefore, examples of ineffective ambulation include, but are 28 not limited to, the inability to walk without the use of a walker, two crutches or two canes, the inability to walk a block at a reasonable 1 pace on rough or uneven surfaces, the inability to use standard public 2 transportation, the inability to carry out routine ambulatory activities, 3 such as shopping and banking, and the inability to climb a few steps at a reasonable pace with the use of a single hand rail. The ability to 4 walk independently about one’s home without the use of assistive 5 devices does not, in and of itself, constitute effective ambulation.

6 Id. at §1.00(B)(2)(b). 7 Plaintiff argues that each of the elements are present due to her chronic joint 8 pain, stiffness, loss of motion, and edema from the recurrent tumor-like growths in 9 her knee. ECF No. 18 at 10. She asserts her condition results in the inability to 10 ambulate effectively as she is unable to walk even a block at a reasonable pace on 11 rough or uneven surfaces. Id. In her reply brief, Plaintiff points to her difficulty 12 performing activities of daily living. ECF No. 20 at 2-4. Defendant argues Plaintiff 13 has failed to offer a plausible theory that her impairments satisfy the listing, and 14 notes the record does not reflect an inability to ambulate effectively. ECF No. 19 at 15 5-7. 16 The Court finds no error in the ALJ’s findings. The record contains no 17 evidence of Plaintiff using an assistive device, other than a cane for short periods 18 of time during a flare-up of her pain. Tr. 66-67, 309. Plaintiff reported to her 19 doctors that she was able to complete her activities of daily living and household 20 chores, and care for her children during the relevant period. Tr. 690-94. She 21 testified she is able to drive in town. Tr. 50. The record does not contain evidence 22 of an inability to ambulate effectively. Therefore, the requirements of the listing 23 are not met, and the ALJ did not err in so finding. 24 3. Medical opinion evidence 25 Plaintiff alleges the ALJ improperly weighed the opinion evidence, giving 26 insufficient reasons for disregarding Plaintiff’s various treating providers, 27 28 1 including Drs. Kimura, Starkweather, Flugstad, and Simon. ECF No. 18 at 5-9, 15- 2 17.2 3 When a treating physician’s opinion is not contradicted by another 4 physician, the ALJ may reject the opinion by citing “clear and convincing” 5 reasons, and when a treating physician’s opinion is contradicted by another 6 physician, the ALJ is only required to provide “specific and legitimate reasons,” 7 based on substantial evidence, to reject the opinion. Andrews v. Shalala, 53 F.3d 8 1035, 1041 (9th Cir. 1995). The specific and legitimate standard can be met by the 9 ALJ setting out a detailed and thorough summary of the facts and conflicting 10 clinical evidence, stating her interpretation thereof, and making findings. 11 Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989). The ALJ is required to 12 do more than offer her conclusions, she “must set forth [her] interpretations and 13 explain why they, rather than the doctors’, are correct.” Embrey v. Bowen, 849 14 F.2d 418, 421-22 (9th Cir. 1988). 15 The treating doctors’ opinions in this case are contradicted by the state 16 agency reviewing doctors, who found Plaintiff was capable of modified light 17 exertion work. Tr. 85, 95. Therefore, the ALJ was required to offer specific and 18 legitimate reasons for discounting the opinions. 19 a. Dr. Kimura and Dr. Starkweather 20 Plaintiff’s treating doctor, Irene Kimura, completed Activity Prescription 21 Forms (APF) for Plaintiff’s Labor & Industries claim in July 2012 and July 2013. 22

23 2 Plaintiff mentions other evidence that the ALJ discussed, including DPT 24 Randy Bruce and Dr. David Karges, but does not specifically assign any error to 25 the ALJ’s actions. Any such arguments are thus waived. The court will not 26 “manufacture arguments for an appellant” and therefore will not consider claims 27 that were not actually argued in the opening brief. Greenwood v. Fed. Aviation 28 Admin., 28 F.3d 971, 977 (9th Cir. 1994). 1 Tr. 365, 695. In both forms Dr. Kimura opined Plaintiff had substantial limitations 2 on her ability to sit, stand, and walk, was unable to lift or carry any weight, and 3 was limited to pushing and pulling no more than five pounds. Id. She also opined 4 Plaintiff had substantial postural limitations. Id. The ALJ gave these opinions some 5 weight, finding the record supported limitations on standing and walking and 6 minimal postural activities due to her knee impairment, but found that not all of the 7 findings in the forms were consistent with the record. Tr. 22-23. The ALJ 8 specifically found the record did not support a finding that Plaintiff was unable to 9 lift or carry any weight, pointing to normal strength findings and her ability to care 10 for her infant child during the relevant period. Id. 11 In September 2013, Plaintiff’s orthopedist, Dr. Starkweather, also completed 12 an APF, opining Plaintiff was not released to any work and could no more than 13 seldomly stand/walk, twist, squat, or kneel and could never climb, bend, or stoop. 14 Tr. 366. He did not offer an opinion as to how long she could sit or how much 15 weight she could lift. Id. The ALJ gave this opinion little weight for similar 16 reasons to her rationale regarding Dr. Kimura. 17 Plaintiff argues that objective findings support the limitations assessed by 18 both of the treating doctors, and that Plaintiff’s activities in caring for her 19 household and her children are not inconsistent with the assessed limitations. ECF 20 No. 18 at 16-17. Defendant argues that the ALJ’s interpretation of the record is 21 reasonable and that the medical records and Plaintiff’s activities undermine the 22 extent of the assessed limitations. ECF No. 19 at 18-19. 23 An ALJ may reasonably consider an opinion’s consistency with the record 24 as a whole and support from the objective medical signs and findings. 20 C.F.R. § 25 404.1527(c). An ALJ may also reasonably consider a claimant’s daily activities 26 and their consistency with medical opinions of record. Ghanim v. Colvin, 763 F.3d 27 1154, 1162 (9th Cir. 2014). The ALJ pointed to findings and activities that 28 conflicted with the doctors’ opinions. While Plaintiff offers an alternative 1 interpretation of the record, “if the evidence can reasonably support either 2 affirming or reversing a decision, we may not substitute our judgment for that of 3 the Commissioner.” Lingenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). 4 The ALJ identified substantial evidence in support of her conclusion. 5 b. Dr. Flugstad 6 Plaintiff’s orthopedic surgeon, Dr. Daniel Flugstad, provided several 7 Activity Prescription Forms and other letters for Plaintiff’s Labor & Industries 8 claim, from 2009 to 2011. Tr. 716, 725, 761. 9 Plaintiff asserts the ALJ did not indicate whether she gave any credence to 10 Dr. Flugstand’s observations in his February 2011 opinion (contained in this record 11 at Tr. 725). ECF No. 18 at 6. Plaintiff is incorrect. The ALJ discussed Dr. 12 Flugstad’s three opinions and gave them little weight as they were all provided 13 prior to Plaintiff’s alleged onset date, and they were not consistent with the record. 14 Tr. 24-25. 15 The Court finds the ALJ did not err. Opinions that pre-date the alleged onset 16 date of disability are of limited relevance. Carmickle v. Comm’r of Soc. Sec. 17 Admin, 533 F.3d 1155, 1165 (9th Cir. 2008); Fair v. Bowen, 885 F.2d 597, 600 18 (9th Cir. 1989). Plaintiff has made no argument as to why Dr. Flugstad’s opinions 19 apply to the relevant period. 20 c. Dr. Simon 21 Plaintiff’s primary care physician, Dr. Jill Simon, completed a number of 22 opinions noting Plaintiff was unable to perform full time work and was 23 significantly impaired by her knee condition. Tr. 872, 892, 901-02, 908. 24 The ALJ gave these opinions little weight, as they were completed years 25 after the date last insured and therefore did not reflect Plaintiff’s functioning 26 during the relevant period. Tr. 26. The ALJ further noted that while Dr. Simon 27 stated the limitations likely related back to 2012 or 2013, she did not treat Plaintiff 28 until 2014. Id. The ALJ also found the opinions to be inconsistent with records 1 from the relevant period that reflected no formal mental health treatment and 2 largely normal exams of the right knee, despite some limitations. Id. 3 Plaintiff argues Dr. Simon unequivocally said the limitations likely go back 4 to 2012 or 2013, and even though she did not treat Plaintiff until later, her 5 statements indicate she reviewed previous treatment records, thus giving her a 6 valid basis for her assessment. ECF No. 18 at 7-8. Defendant argues the ALJ 7 reasonably rejected Dr. Simon’s opinions as outside the relevant period and 8 without an adequate explanation for the basis for concluding they applied prior to 9 Dr. Simon’s treatment. ECF No. 19 at 16-17. 10 The Court finds the ALJ gave specific and legitimate reasons for discounting 11 Dr. Simon’s opinions. Plaintiff’s insured status expired December 31, 2013. Tr. 17. 12 Dr. Simon did not begin treating Plaintiff until November 2014. Tr. 482. Though 13 she discussed Plaintiff’s history of treatments in her narrative letter, Tr. 901, there 14 is no indication that she specifically reviewed treatment records from the relevant 15 period. Furthermore, while Dr. Simon said it was “likely” that Plaintiff’s condition 16 existed at the same level of impairment in 2012 and 2013 as it did when she began 17 treating Plaintiff in 2014, the Court cannot find this statement to be “unequivocal” 18 as Plaintiff urges. 19 The ALJ did not err in giving little weight to the various opinions from Dr. 20 Simon. 21 4. Plaintiff’s symptom statements 22 Plaintiff alleges the ALJ erred in rejecting her symptom testimony without 23 providing adequate reasons. ECF No. 18 at 18-19. Specifically, Plaintiff argues the 24 ALJ improperly discounted her testimony based on minimal daily activities.3 25

26 3 Plaintiff also asserts the ALJ erred in disregarding the effects of “chronic 27 headaches and the chronic fatigue due to liver dysfunction from her congenital 28 condition, or the intermittent diarrhea.” ECF No. 18 at 18. None of these 1 It is the province of the ALJ to make credibility determinations. Andrews v. 2 Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). However, the ALJ’s findings must be 3 supported by specific cogent reasons. Rashad v. Sullivan, 903 F.2d 1229, 1231 (9th 4 Cir. 1990). Absent affirmative evidence of malingering, the ALJ’s reasons for 5 rejecting a claimant’s testimony must be “specific, clear and convincing.” Smolen 6 v. Chater, 80 F.3d 1273, 1281 (9th Cir. 1996); Lester v. Chater, 81 F.3d 821, 834 7 (9th Cir. 1995). “General findings are insufficient: rather the ALJ must identify 8 what testimony is not credible and what evidence undermines the claimant’s 9 complaints.” Lester, 81 F.3d at 834; Dodrill v. Shalala, 12 F.3d 915, 918 (9th Cir. 10 1993). 11 The ALJ found Plaintiff’s medically determinable impairments could 12 reasonably be expected to cause the alleged symptoms; however, she found 13 Plaintiff’s statements concerning the intensity, persistence and limiting effects of 14 her symptoms to not be entirely consistent with the medical evidence and other 15 evidence in the record. Tr. 22. The ALJ found Plaintiff’s described daily activities 16 were not limited to the extent expected based on her complaints of disabling 17 symptoms and limitations. Tr. 20. The ALJ also found the objective medical 18 19

20 conditions are reflected in the record. Tr. 282, 359, 381, 897. The Court is 21 therefore left to conclude that this text pertains to a different matter. The Court also 22 notes that Counsel referred to the claimant by the wrong gender (“his daily 23 activities”). 24 The Court also cautions Counsel regarding the regrettable choice of words 25 used to characterize the ALJ’s reasoning. ECF No. 18 at 7. 26 The Court has previously cautioned Counsel to exercise care in his briefing 27 to avoid such mistakes (Hines v. Saul, 4:18-cv-05107, ECF No. 18 at 13) and 28 renews that instruction at this time. 1 evidence was not consistent with Plaintiff’s alleged disability, including noting 2 evidence of medication controlling her pain. Tr. 21. 3 A claimant’s daily activities may support an adverse credibility finding if the 4 claimant’s activities contradict her other testimony. Orn v. Astrue, 495 F.3d 625, 5 639 (9th Cir. 2007). The ALJ found evidence regarding Plaintiff’s ability to care 6 for her children full time and tend to her household chores contrary to Plaintiff’s 7 testimony regarding disabling limitations. Tr. 20. While Plaintiff argues she was 8 only able to engage in these activities sporadically and with great effort, the ALJ’s 9 interpretation of the record is reasonable, particularly in light of the 10 contemporaneous treatment records noting Plaintiff’s reports of being able to tend 11 to all household and personal care. Tr. 690-94. 12 Although it cannot serve as the sole ground for rejecting a claimant’s 13 symptom statements, objective medical evidence is a “relevant factor in 14 determining the severity of the claimant’s pain and its disabling effects.” Rollins v. 15 Massanari, 261 F.3d 853, 857 (9th Cir. 2001). An ALJ may also consider the 16 course and effectiveness of treatment, including improvement with medication. 17 Social Security Ruling 16-3p. The ALJ reasonably relied upon the records showing 18 limited objective findings on exam, and evidence that Plaintiff’s pain was 19 controlled with medication during the relevant period. Tr. 21. The ALJ’s 20 conclusion that Plaintiff’s allegations of disabling symptoms were inconsistent 21 with the objective evidence is supported by substantial evidence. 22 5. Step five 23 Plaintiff argues the vocational expert (VE) testimony was of no value due to 24 the ALJ omitting relevant limitations from the hypothetical questions posed to the 25 VE. ECF No. 18 at 15, 19. Plaintiff’s argument is based on successfully showing 26 that the ALJ erred in her treatment of the symptom statements and medical 27 opinions. Id. Because the Court finds that the ALJ did not harmfully err in her 28 treatment of the evidence, Plaintiff’s argument is without merit. 1 CONCLUSION 2 Having reviewed the record and the ALJ’s findings, the Court finds the ALJ’s decision is supported by substantial evidence and free of legal error and is 4|| affirmed. Therefore, IT IS HEREBY ORDERED: 5 1. Defendant’s Motion for Summary Judgment, ECF No. 19, is 6|| GRANTED. 7 2. Plaintiff’s Motion for Summary Judgment, ECF No. 18, is DENIED. 8 3. Plaintiff’s Motion for Summary Judgment, ECF No. 16, is DENIED 9 AS MOOT. 10 The District Court Executive is directed to file this Order and provide a copy to counsel for Plaintiff and Defendant. Judgment shall be entered for Defendant 12]| and the file shall be CLOSED. 13 IT IS SO ORDERED. 14 DATED July 6, 2020.

‘6 JOHNT.RODGERS 17 a UNITED STATES MAGISTRATE JUDGE 18 19 20 21 22 23 24 25 26 27 28