1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA
10 LAURA C., ) Case No. 2:22-cv-02861-SP 11 ) Plaintiff, ) 12 ) v. ) MEMORANDUM OPINION AND 13 ) ORDER KILOLO KIJAKAZI, Acting ) 14 Commissioner of Social Security ) Administration, ) 15 ) Defendant. ) 16 ) ) 17 18 I. 19 INTRODUCTION 20 On April 29, 2022, plaintiff Laura C. filed a complaint against defendant, the 21 Commissioner of the Social Security Administration (“Commissioner”), seeking a review 22 of a denial of a period of disability and disability insurance benefits (“DIB”). The parties 23 have fully briefed the matter in dispute, and the court deems the matter suitable for 24 adjudication without oral argument. 25 Plaintiff presents two disputed issues for decision: (1) whether the administrative 26 law judge (“ALJ”) properly evaluated the medical opinions and assessed her residual 27 functional capacity (“RFC”); and (2) whether the ALJ properly considered plaintiff’s 28 1 subjective testimony. Memorandum in Support of Plaintiff’s Complaint (“P. Mem.”) at 2 1; see Memorandum in Support of Defendant’s Answer (“D. Mem.”) at 2. 3 Having carefully studied the parties’ memoranda, the Administrative Record 4 (“AR”), and the decision of the administrative law judge (“ALJ”), the court concludes 5 that, as detailed herein, the ALJ properly considered the medical opinions and plaintiff's 6 subjective testimony. Consequently, the court affirms the decision of the Commissioner 7 denying benefits. 8 II. 9 FACTUAL AND PROCEDURAL BACKGROUND 10 Plaintiff was 54 years on her alleged disability onset date. AR at 60. Plaintiff 11 attended two years of college and has past relevant work as an administrative assistant. 12 AR at 46, 56, 174. 13 On August 23, 2019, plaintiff filed an application for a period of disability and 14 DIB due to adjustment disorder with depressed mood and anxiety. AR at 61. The 15 application was denied initially and upon reconsideration, after which plaintiff filed a 16 request for a hearing. AR at 79-83, 86-93. 17 On March 26, 2021, plaintiff, represented by counsel, appeared and testified at a 18 hearing before the ALJ. AR at 40-58. The ALJ also heard testimony from Marilyn 19 Stroud, a vocational expert. AR at 53-57. On April 6, 2021, the ALJ denied plaintiff’s 20 claim for benefits. AR 25-35. 21 Applying the well-known five-step sequential evaluation process, the ALJ found, 22 at step one, that plaintiff had not engaged in substantial gainful activity since July 30, 23 2018, the alleged onset date. AR at 27. 24 At step two, the ALJ found plaintiff suffered from the severe impairments of: 25 major depressive disorder and persistent complex bereavement disorder. Id. 26 At step three, the ALJ found plaintiff’s impairments, whether individually or in 27 combination, did not meet or medically equal one of the listed impairments set forth in 20 28 C.F.R. part 404, Subpart P, Appendix 1. AR at 28. 1 The ALJ then assessed plaintiff’s RFC,1 and determined plaintiff had the RFC to 2 perform a full range of work at all exertional levels but was limited to: no workplace 3 hazards and machinery; simple, routine tasks not at a production pace; occasional, brief 4 interactions with supervisors and co-workers; no interactions with the general public; and 5 occasional changes to a routine work setting. AR at 30. 6 The ALJ found, at step four, that plaintiff was unable to perform her past relevant 7 work as an administrative assistant. AR at 33. 8 At step five, the ALJ found there were jobs that existed in significant numbers in 9 the national economy that plaintiff could perform, including routing clerk, marker, and 10 office helper. AR at 34-35. Consequently, the ALJ concluded plaintiff did not suffer 11 from a disability as defined by the Social Security Act. AR at 35. 12 Plaintiff filed a timely request for review of the ALJ’s decision, which the Appeals 13 Council denied. AR at 1-3. The ALJ’s decision stands as the final decision of the 14 Commissioner. 15 III. 16 STANDARD OF REVIEW 17 This court is empowered to review decisions by the Commissioner to deny 18 benefits. 42 U.S.C. § 405(g). The findings and decision of the Social Security 19 Administration must be upheld if they are free of legal error and supported by substantial 20 evidence. Mayes v. Massanari, 276 F.3d 453, 458-59 (9th Cir. 2001) (as amended). But 21 if the court determines the ALJ’s findings are based on legal error or are not supported by 22 substantial evidence in the record, the court may reject the findings and set aside the 23 24 25 1 Residual functional capacity is what a claimant can do despite existing exertional and nonexertional limitations. Cooper v. Sullivan, 880 F.2d 1152, 1155-56 26 nn.5-7 (9th Cir. 1989) (citations omitted). “Between steps three and four of the five-step 27 evaluation, the ALJ must proceed to an intermediate step in which the ALJ assesses the claimant’s residual functional capacity.” Massachi v. Astrue, 486 F.3d 1149, 1151 n.2 28 (9th Cir. 2007) (citation omitted). 1 decision to deny benefits. Aukland v. Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001); 2 Tonapetyan v. Halter, 242 F.3d 1144, 1147 (9th Cir. 2001). 3 “Substantial evidence is more than a mere scintilla, but less than a preponderance.” 4 Aukland, 257 F.3d at 1035. Substantial evidence is such “relevant evidence which a 5 reasonable person might accept as adequate to support a conclusion.” Reddick v. Chater, 6 157 F.3d 715, 720 (9th Cir. 1998); Mayes, 276 F.3d at 459. To determine whether 7 substantial evidence supports the ALJ’s finding, the reviewing court must review the 8 administrative record as a whole, “weighing both the evidence that supports and the 9 evidence that detracts from the ALJ’s conclusion.” Mayes, 276 F.3d at 459. The ALJ’s 10 decision “‘cannot be affirmed simply by isolating a specific quantum of supporting 11 evidence.’” Aukland, 257 F.3d at 1035 (quoting Sousa v. Callahan, 143 F.3d 1240, 1243 12 (9th Cir. 1998)). If the evidence can reasonably support either affirming or reversing the 13 ALJ’s decision, the reviewing court “‘may not substitute its judgment for that of the 14 ALJ.’” Id. (quoting Matney v. Sullivan, 981 F.2d 1016, 1018 (9th Cir. 1992)). 15 IV. 16 DISCUSSION 17 A. The ALJ Properly Considered the Medical Opinions When Assessing 18 Plaintiff’s RFC 19 Plaintiff contends the ALJ failed to properly consider all of the medical opinions 20 and had a duty to further develop the record. P. Mem. at 3-8. Plaintiff argues, 21 consequently, that the ALJ’s RFC determination was not supported by substantial 22 evidence because she rejected every medical opinion. Id. 23 Residual functional capacity is what one can “still do despite [his or her] 24 limitations.” 20 C.F.R. § 404.1545(a)(1). The ALJ reaches an RFC determination by 25 reviewing and considering all of the relevant evidence, including non-severe 26 impairments. 20 C.F.R.
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1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA
10 LAURA C., ) Case No. 2:22-cv-02861-SP 11 ) Plaintiff, ) 12 ) v. ) MEMORANDUM OPINION AND 13 ) ORDER KILOLO KIJAKAZI, Acting ) 14 Commissioner of Social Security ) Administration, ) 15 ) Defendant. ) 16 ) ) 17 18 I. 19 INTRODUCTION 20 On April 29, 2022, plaintiff Laura C. filed a complaint against defendant, the 21 Commissioner of the Social Security Administration (“Commissioner”), seeking a review 22 of a denial of a period of disability and disability insurance benefits (“DIB”). The parties 23 have fully briefed the matter in dispute, and the court deems the matter suitable for 24 adjudication without oral argument. 25 Plaintiff presents two disputed issues for decision: (1) whether the administrative 26 law judge (“ALJ”) properly evaluated the medical opinions and assessed her residual 27 functional capacity (“RFC”); and (2) whether the ALJ properly considered plaintiff’s 28 1 subjective testimony. Memorandum in Support of Plaintiff’s Complaint (“P. Mem.”) at 2 1; see Memorandum in Support of Defendant’s Answer (“D. Mem.”) at 2. 3 Having carefully studied the parties’ memoranda, the Administrative Record 4 (“AR”), and the decision of the administrative law judge (“ALJ”), the court concludes 5 that, as detailed herein, the ALJ properly considered the medical opinions and plaintiff's 6 subjective testimony. Consequently, the court affirms the decision of the Commissioner 7 denying benefits. 8 II. 9 FACTUAL AND PROCEDURAL BACKGROUND 10 Plaintiff was 54 years on her alleged disability onset date. AR at 60. Plaintiff 11 attended two years of college and has past relevant work as an administrative assistant. 12 AR at 46, 56, 174. 13 On August 23, 2019, plaintiff filed an application for a period of disability and 14 DIB due to adjustment disorder with depressed mood and anxiety. AR at 61. The 15 application was denied initially and upon reconsideration, after which plaintiff filed a 16 request for a hearing. AR at 79-83, 86-93. 17 On March 26, 2021, plaintiff, represented by counsel, appeared and testified at a 18 hearing before the ALJ. AR at 40-58. The ALJ also heard testimony from Marilyn 19 Stroud, a vocational expert. AR at 53-57. On April 6, 2021, the ALJ denied plaintiff’s 20 claim for benefits. AR 25-35. 21 Applying the well-known five-step sequential evaluation process, the ALJ found, 22 at step one, that plaintiff had not engaged in substantial gainful activity since July 30, 23 2018, the alleged onset date. AR at 27. 24 At step two, the ALJ found plaintiff suffered from the severe impairments of: 25 major depressive disorder and persistent complex bereavement disorder. Id. 26 At step three, the ALJ found plaintiff’s impairments, whether individually or in 27 combination, did not meet or medically equal one of the listed impairments set forth in 20 28 C.F.R. part 404, Subpart P, Appendix 1. AR at 28. 1 The ALJ then assessed plaintiff’s RFC,1 and determined plaintiff had the RFC to 2 perform a full range of work at all exertional levels but was limited to: no workplace 3 hazards and machinery; simple, routine tasks not at a production pace; occasional, brief 4 interactions with supervisors and co-workers; no interactions with the general public; and 5 occasional changes to a routine work setting. AR at 30. 6 The ALJ found, at step four, that plaintiff was unable to perform her past relevant 7 work as an administrative assistant. AR at 33. 8 At step five, the ALJ found there were jobs that existed in significant numbers in 9 the national economy that plaintiff could perform, including routing clerk, marker, and 10 office helper. AR at 34-35. Consequently, the ALJ concluded plaintiff did not suffer 11 from a disability as defined by the Social Security Act. AR at 35. 12 Plaintiff filed a timely request for review of the ALJ’s decision, which the Appeals 13 Council denied. AR at 1-3. The ALJ’s decision stands as the final decision of the 14 Commissioner. 15 III. 16 STANDARD OF REVIEW 17 This court is empowered to review decisions by the Commissioner to deny 18 benefits. 42 U.S.C. § 405(g). The findings and decision of the Social Security 19 Administration must be upheld if they are free of legal error and supported by substantial 20 evidence. Mayes v. Massanari, 276 F.3d 453, 458-59 (9th Cir. 2001) (as amended). But 21 if the court determines the ALJ’s findings are based on legal error or are not supported by 22 substantial evidence in the record, the court may reject the findings and set aside the 23 24 25 1 Residual functional capacity is what a claimant can do despite existing exertional and nonexertional limitations. Cooper v. Sullivan, 880 F.2d 1152, 1155-56 26 nn.5-7 (9th Cir. 1989) (citations omitted). “Between steps three and four of the five-step 27 evaluation, the ALJ must proceed to an intermediate step in which the ALJ assesses the claimant’s residual functional capacity.” Massachi v. Astrue, 486 F.3d 1149, 1151 n.2 28 (9th Cir. 2007) (citation omitted). 1 decision to deny benefits. Aukland v. Massanari, 257 F.3d 1033, 1035 (9th Cir. 2001); 2 Tonapetyan v. Halter, 242 F.3d 1144, 1147 (9th Cir. 2001). 3 “Substantial evidence is more than a mere scintilla, but less than a preponderance.” 4 Aukland, 257 F.3d at 1035. Substantial evidence is such “relevant evidence which a 5 reasonable person might accept as adequate to support a conclusion.” Reddick v. Chater, 6 157 F.3d 715, 720 (9th Cir. 1998); Mayes, 276 F.3d at 459. To determine whether 7 substantial evidence supports the ALJ’s finding, the reviewing court must review the 8 administrative record as a whole, “weighing both the evidence that supports and the 9 evidence that detracts from the ALJ’s conclusion.” Mayes, 276 F.3d at 459. The ALJ’s 10 decision “‘cannot be affirmed simply by isolating a specific quantum of supporting 11 evidence.’” Aukland, 257 F.3d at 1035 (quoting Sousa v. Callahan, 143 F.3d 1240, 1243 12 (9th Cir. 1998)). If the evidence can reasonably support either affirming or reversing the 13 ALJ’s decision, the reviewing court “‘may not substitute its judgment for that of the 14 ALJ.’” Id. (quoting Matney v. Sullivan, 981 F.2d 1016, 1018 (9th Cir. 1992)). 15 IV. 16 DISCUSSION 17 A. The ALJ Properly Considered the Medical Opinions When Assessing 18 Plaintiff’s RFC 19 Plaintiff contends the ALJ failed to properly consider all of the medical opinions 20 and had a duty to further develop the record. P. Mem. at 3-8. Plaintiff argues, 21 consequently, that the ALJ’s RFC determination was not supported by substantial 22 evidence because she rejected every medical opinion. Id. 23 Residual functional capacity is what one can “still do despite [his or her] 24 limitations.” 20 C.F.R. § 404.1545(a)(1). The ALJ reaches an RFC determination by 25 reviewing and considering all of the relevant evidence, including non-severe 26 impairments. 20 C.F.R. § 404.1545(a)(1)-(2); see Social Security Ruling (“SSR”) 96-8p 27 28 1 (“In assessing RFC, the adjudicator must consider limitations and restrictions imposed by 2 all of an individual’s impairments, even those that are not ‘severe.’”).2 3 Among the evidence an ALJ relies on in an RFC assessment is medical evidence 4 and opinions. 20 C.F.R. § 404.1545(a)(3). An ALJ considers the persuasiveness of the 5 medical opinions and findings based on five factors: (1) supportability; (2) consistency; 6 (3) relationship with the claimant; (4) specialization; and (5) other factors that tend to 7 support or contradict the medical opinion. 20 C.F.R. § 404.1520c(b)-(c). The most 8 important of these factors are supportability and consistency. 20 C.F.R. 9 § 404.1520c(b)(2). The ALJ “must ‘articulate . . . how persuasive’ [he or she] finds ‘all 10 of the medical opinions’ from each doctor or other source . . . and ‘explain how [he or 11 she] considered the supportability and consistency factors’ in reaching these findings.” 12 Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022) (quoting 20 C.F.R. 13 § 404.1520c(b)(2)). The ALJ may, but generally is not required to, explain how she or he 14 considered the other three factors. 20 C.F.R. § 404.1520c(b)(2). But when two or more 15 medical opinions “about the same issue are both equally well-supported . . . and 16 consistent with the record . . . but are not exactly the same,” the ALJ is then required to 17 explain how “the other most persuasive factors in paragraphs (c)(3) through (c)(5)” were 18 considered. 20 C.F.R. § 404.1520c(b)(3). 19 In reaching her RFC determination here, the ALJ considered the medical evidence 20 and plaintiff’s statements. The only opinions in the record regarding plaintiff’s mental 21 impairments were the state agency physicians’ administrative findings, in which both 22 23
24 2 “The Commissioner issues Social Security Rulings to clarify the Act’s 25 implementing regulations and the agency’s policies. SSRs are binding on all components of the SSA. SSRs do not have the force of law. However, because they represent the 26 Commissioner’s interpretation of the agency’s regulations, we give them some deference. 27 We will not defer to SSRs if they are inconsistent with the statute or regulations.” Holohan v. Massanari, 246 F.3d 1195, 1202 n.1 (9th Cir. 2001) (internal citations 28 omitted). 1 assessed plaintiff’s mental impairments as non-severe.3 AR at 65-66, 73-75. The ALJ 2 found the state agency physicians’ findings were unpersuasive because the medical 3 evidence was consistent with slightly more limited psychological functioning and 4 plaintiff’s treatment was inconsistent with a finding of non-severe mental impairments. 5 AR at 32. Instead, the ALJ found plaintiff suffered from the severe mental impairments 6 of major depressive disorder and persistent complex bereavement disorder, and assessed 7 functional limitations. See AR at 27, 30. 8 1. The ALJ Considered All of the Relevant Medical Opinions 9 Plaintiff argues the ALJ erred by failing to discuss and consider an opinion from 10 Dr. Jarvis B. Ngati. P. Mem. at 4-5. The ALJ must articulate how persuasive the 11 medical opinions are and explain how she considered the supportability and consistency 12 factors in reaching her decision. See Woods, 32 F.4th at 792. But Dr. Ngati’s assessment 13 did not constitute a medical opinion under the regulations. On January 23, 2020, Dr. 14 Ngati examined plaintiff, did not opine any functional limitations, and, instead, 15 concluded she did not meet the criteria for prolonged ongoing disability. AR at 342-43. 16 Dr. Ngati opined that given the length of time plaintiff had not worked, it would be 17 reasonable for plaintiff to return to work at reduced hours initially.4 AR at 343. Dr. 18 Ngati’s assessment was a statement on an issue reserved for the Commissioner – whether 19 plaintiff was able to perform regular or continuing work. See 20 C.F.R. 20 § 404.1520b(c)(3)(i); see also Rodin v. Comm’r of Soc. Sec., 2023 WL 3293423, at *11, 21 *17-*18 (E.D. Cal. May, 5, 2023) (statement that plaintiff was “totally disabled even for 22 the most sedentary work” was not a medical opinion under the regulations); Callahan v. 23 3 Because plaintiff only alleges mental impairments, the court will not discuss 24 the opinions regarding plaintiff’s physical condition. 25 4 Plaintiff asserts Dr. Ngati modified her disability status to reflect a limitation 26 of 20 hours/week of work. P. Mem. at 4. But the record does not support this assertion. 27 The record reflects Dr. Ngati opined it was reasonable for plaintiff to “return to work at reduced hours for a short time” (AR at 343), and that plaintiff subsequently reported she 28 intended to return to work on a modified schedule of 20 hours/week (AR at 339, 2702). 1 Kijakazi, ___ F. Supp. 3d. ___, 2023 WL 2166989, at *8 (E.D. Cal. Feb. 22, 2023) (“[I]f 2 the medical opinion includes evidence on an issue reserved to the Commissioner, the ALJ 3 need not provide an analysis of the evidence in his decision.”) As such, the ALJ was not 4 required to provide any analysis about how she evaluated Dr. Ngati’s statements. See 20 5 C.F.R. § 404.1520b(c)(3). 6 Moreover, even if the ALJ should have discussed Dr. Ngati’s statements, the 7 failure to do so was harmless. Dr. Ngati opined plaintiff was likely able to do her prior 8 job and that it was in her best interest to return to work sooner, before the expiration of 9 her long-term disability. AR at 342-43. Dr. Ngati opined that because plaintiff had been 10 off work for almost 18 months, it was reasonable for her to first return to work at reduced 11 hours for a short time. AR at 342. In other words, Dr. Ngati did not opine plaintiff could 12 only perform part-time work, but thought it would be reasonable for plaintiff to ease back 13 into her full-time schedule. As such, notwithstanding the absence of opined functional 14 limitations, had the ALJ been required to provide analysis on Dr. Ngati’s statements, it 15 would not have changed the ALJ’s RFC assessment. 16 2. The ALJ Did Not Have a Duty to Further Develop the Record 17 The ALJ considered the state agency physicians’ administrative findings and found 18 they were not persuasive. AR 32; see AR at 65-66, 73-75. Although plaintiff agrees with 19 the ALJ’s determination that the state agency physicians’ opinions were unpersuasive, 20 plaintiff contends the ALJ had a duty to further develop the record by retaining a 21 consultative examiner or medical expert. P. Mem. at 4. Plaintiff further contends the 22 ALJ’s RFC determination was therefore not supported by substantial evidence because it 23 was based on her own lay interpretation of the medical record. Id. 24 When the record is ambiguous, the Commissioner has a duty to develop the record. 25 See Webb v. Barnhart, 433 F.3d 683, 687 (9th Cir. 2005); see also Mayes, 276 F.3d at 26 459-60 (ALJ has a duty to develop the record further only “when there is ambiguous 27 evidence or when the record is inadequate to allow for proper evaluation of the 28 evidence”); Smolen v. Chater, 80 F.3d 1273, 1290 (9th Cir. 1996) (“If the ALJ thought he 1 needed to know the basis of [a doctor’s] opinion[ ] in order to evaluate [it], he had a duty 2 to conduct an appropriate inquiry, for example, by subpoenaing the physician[ ] or 3 submitting further questions to [him or her].”). This may include retaining a medical 4 expert or ordering a consultative examination. 20 C.F.R. § 404.1519a(a). The 5 Commissioner may order a consultative examination when trying to resolve an 6 inconsistency in evidence or when the evidence is insufficient to make a determination. 7 20 C.F.R. § 404.1519a(b). 8 Here, the record was not ambiguous and plaintiff does not explain how it was. At 9 the hearing, plaintiff’s counsel represented the record was complete. AR at 45. The 10 record included the state agency physicians’ findings and plaintiff’s extensive treatment 11 notes. The ALJ therefore did not have a duty to order a consultative examination or 12 retain a medical expert. 13 3. The RFC Was Supported by Substantial Evidence 14 Plaintiff contends the ALJ’s RFC determination was not supported by substantial 15 evidence because the ALJ rejected all of the medical opinions and formulated an RFC 16 based on her lay interpretation of the medical evidence. P. Mem. at 4. 17 “[T]he ALJ is responsible for translating and incorporating clinical findings into a 18 succinct RFC.” Rounds v. Comm’r of Soc. Sec. Admin., 807 F.3d 996, 1006 (9th Cir. 19 2015) (citing Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1174 (9th Cir. 2008)). An ALJ 20 must consider all relevant evidence and resolve conflicts in the medical evidence. Batson 21 v. Comm’r of Soc. Sec. Admin., 359 F.3d 1190, 1195 (9th Cir. 2004). But an ALJ may 22 not act as her own medical expert since she is “simply not qualified to interpret raw 23 medical data in functional terms.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999); 24 see Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975) (ALJ should not make his 25 “own exploration and assessment” as to a claimant’s impairments). Rather, the ALJ’s 26 assessment must be supported by substantial evidence. 27 “When an ALJ rejects all medical opinions in favor of his own, a finding that the 28 RFC is supported by substantial evidence is less likely.” Stairs v. Astrue, 2011 WL 1 318330, at *12 (E.D. Cal. Feb.1, 2011). Although that was the case here, this is 2 nevertheless not a situation in which the ALJ independently interpreted raw medical data 3 such as MRIs and discounted the medical opinions in favor of a less restrictive RFC. 4 Instead, the ALJ considered the medical evidence and assessed greater limitations than 5 opined by the state agency physicians. The state agency physicians opined that plaintiff 6 did not have a severe mental impairment, and they did not assess any functional 7 limitations. AR at 65-66, 74-75. The ALJ considered these opinions and found they 8 were not persuasive because the medical evidence supported a severe impairment finding 9 and some psychological limitations. The ALJ noted plaintiff’s participation in extensive 10 and continuing therapy was inconsistent with a non-severe mental impairment, and while 11 her mental status examination findings were relatively stable and normal, her treatment 12 records and subjective symptoms reflected reduced concentration, sadness, overwhelming 13 depression, and anxiety. See AR at 31-32. Though plaintiff may disagree with the ALJ’s 14 RFC determination, it was a rational interpretation of the record and supported by 15 substantial evidence. 16 In sum, the ALJ properly considered all of the relevant medical opinions, and the 17 RFC determination was supported by substantial evidence. 18 B. The ALJ Properly Considered Plaintiff’s Subjective Testimony 19 Plaintiff argues the ALJ failed to properly consider her subjective symptom 20 testimony. P. Mem. at 8-13. Specifically, plaintiff contends the ALJ failed to specify 21 which limitations she rejected, and her stated reasons for discounting her symptoms were 22 legally insufficient. Id. 23 The court looks to SSR 16-3p for guidance on evaluating plaintiff’s alleged 24 symptoms. In adopting SSR 16-3p, the Social Security Administration sought to “clarify 25 that subjective symptom evaluation is not an examination of an individual’s character.” 26 SSR 16-3p, 2017 WL 5180304, at *2 (Oct. 25, 2017). 27 [SSR 16-3p] makes clear what our precedent already required: that 28 assessments of an individual’s testimony by an ALJ are designed to evaluate 1 the intensity and persistence of symptoms after the ALJ finds that the 2 individual has a medically determinable impairment(s) that could reasonably 3 be expected to produce those symptoms, and not to delve into wide-ranging 4 scrutiny of the claimant’s character and apparent truthfulness. 5 Trevizo v. Berryhill, 871 F.3d 664, 678 n.5 (9th Cir. 2017) (cleaned up). 6 To evaluate a claimant’s symptom testimony, the ALJ engages in a two-step 7 analysis. Christine G. v. Saul, 402 F. Supp. 3d 913, 921 (C.D. Cal. 2019) (citing Trevizo, 8 871 F.3d at 678). First, the ALJ must determine whether the claimant produced objective 9 medical evidence of an underlying impairment that could reasonably be expected to 10 produce the symptoms alleged. Id. Second, if plaintiff satisfies the first step, and there is 11 no evidence of malingering, the ALJ must evaluate the intensity and persistence of the 12 claimant’s symptoms and determine the extent to which they limit her ability to perform 13 work-related activities. Id. 14 In assessing intensity and persistence, the ALJ may consider: the claimant’s daily 15 activities; the location, duration, frequency, and intensity of the symptoms; precipitating 16 and aggravating factors; the type, dosage, effectiveness, and side effects of medication 17 taken to alleviate the symptoms; other treatment received; other measures used to relieve 18 the symptoms; and other factors concerning the claimant’s functional limitations and 19 restrictions due to the symptoms. Id. (citing 20 C.F.R. § 416.929); SSR 16-3p at *4; 20 Smolen, 80 F.3d at 1284. To reject the claimant’s subjective symptom statements at step 21 two, the ALJ must provide “specific, clear, and convincing” reasons, supported by 22 substantial evidence in the record, for doing so. Burrell v. Colvin, 775 F.3d 1133, 1136- 23 37 (9th Cir. 2014); Smolen, 80 F.3d at 1281, 1283-84. 24 At the first step, the ALJ here found plaintiff’s medically determinable 25 impairments could reasonably be expected to cause some symptoms. AR at 32. At the 26 second step, because the ALJ did not find any evidence of malingering, the ALJ was 27 required to provide clear and convincing reasons for discounting plaintiff’s testimony. 28 The ALJ discounted plaintiff’s testimony because: (1) the severity of plaintiff’s alleged 1 limitations was inconsistent with the medical records; (2) plaintiff received conservative 2 treatment; and (3) plaintiff’s alleged limitations were inconsistent with her daily 3 activities. AR at 33. 4 In the Function Report dated November 20, 2019, plaintiff reported that her 5 impairment affected her ability to complete tasks, concentrate, understand, follow 6 instructions, and get along with others. AR at 186. Plaintiff stated she cooked “easy 7 food” and could start but not finish cleaning. AR at 183. Plaintiff reported she would 8 leave the house to go to church, attend group therapy, go to doctor appointments, and 9 shop for groceries, but she would spend the day in bed two or three times a week. AR at 10 182-84. 11 At the hearing, plaintiff testified she could not concentrate, was deeply sad, had 12 difficulties with comprehension and focus, and required time to understand what she 13 needs to do. AR at 49-51. Plaintiff testified that she does not get along with people and 14 needs to avoid large crowds, loud noise, and social events. AR 49, 52-53. Plaintiff 15 further testified she can cook, shop, and do chores, but she stops her chores when she is 16 mentally tired and is unable to complete chores two to three times a month. AR at 51-52. 17 As an initial matter, contrary to plaintiff’s assertion, the ALJ did not reject all of 18 plaintiff’s symptom testimony. The ALJ considered plaintiff’s medical record and 19 testimony and concluded that plaintiff’s “reduced concentration, difficulty understanding, 20 social avoidance, recurring thoughts, guilt/shame, irritability/anger, sadness, 21 overwhelming depression, and anxiety” necessitated the assessed limitations. AR at 31. 22 But the ALJ did discount the intensity, persistence, and limiting effects of plaintiff’s 23 alleged symptoms. 24 First, the ALJ found there were inconsistences between plaintiff’s statements and 25 the medical records. AR at 28-29, 31, 33; see Rollins v. Massanari, 261 F.3d 853, 856 26 (9th Cir. 2001) (lack of objective medicine supporting symptoms is one factor in 27 evaluating testimony). The ALJ noted the mental status examination findings were 28 relatively stable and that although plaintiff regularly presented with a depressed mood, 1 the other findings were otherwise normal, including normal memory, normal 2 concentration, intact insight and judgment, logical thought process, unimpaired impulse 3 control, and cooperative behavior. AR at 31. Specifically, the ALJ found that plaintiff’s 4 allegations of difficulty understanding and following instructions were inconsistent with 5 mental status examination findings revealing an intact memory and a logical thought 6 process; her allegations that she had problems getting along with people were 7 inconsistent with examination findings revealing good eye contact and cooperative 8 behavior; and her allegations of difficulty concentrating and a short attention span were 9 inconsistent with mental status examination findings revealing normal concentration. AR 10 28-29; see Kaufmann v. Kijakazi, 32 F.4th 843, 851 (9th Cir. 2022) (the court must look 11 at the ALJ’s explanation in “all of the pages” of the decision). The record supports the 12 ALJ’s findings. See, e.g., AR at 244, 248-49, 348, 662, 1975, 2322-23, 2786, 3365. 13 The ALJ’s second reason for discounting plaintiff’s allegations was she received 14 conservative treatment. AR at 31, 33; see Parra v. Astrue, 481 F.3d 742, 751 (9th Cir. 15 2007) (“[E]vidence of ‘conservative treatment’ is sufficient to discount a claimant’s 16 testimony regarding severity of an impairment.”). The ALJ noted that plaintiff 17 participated in medication management and extensive group and individual therapy, but 18 did not require inpatient treatment. AR at 31. The mere lack of psychiatric 19 hospitalization, however, is insufficient to constitute conservative treatment. See Tammy 20 L. O. v. Comm’r, 2018 WL 3090196, at *13 (D. Or. June 20, 2018) (the “mere fact that a 21 claimant has not been admitted to a hospital on an inpatient basis” does not mean that a 22 claimant received conservative treatment); Matthews v. Astrue, 2012 WL 1144423, at *9 23 (C.D. Cal. Apr. 4, 2012) (finding that claimant’s care was not conservative because 24 although claimant was not hospitalized, he received outpatient care and took psychotropic 25 medication). The fact that plaintiff was taking three psychiatric medications and 26 undergoing “extensive group and individual therapy” indicated her treatment was not 27 conservative. AR at 31, 363, 2838; see, e.g., Drawn v. Berryhill, 728 F. App’x 637, 642 28 (9th Cir. 2018) (rejecting characterization of treatment as conservative where claimant 1 was taking “a number of psychiatric medications”); Jennifer C.G. v. Kijakazi, 2023 WL 2 5592752, at *6 (C.D. Cal. Aug. 29, 2023) (treatment consisting of multiple psychiatric 3 medications was not conservative); Sanchez v. Berryhill, 2018 WL 5848856, at *5 (C.D. 4 Cal. Nov. 6, 2018) (plaintiff’s psychotropic medications, including Trazadone and 5 Bupropion, and monthly psychiatric visits was not conservative in the mental health 6 context). 7 Finally, the ALJ discounted plaintiff’s symptoms because they were inconsistent 8 with her daily activities. AR at 33; see Thomas v. Barnhart, 278 F.3d 947, 958-59 (9th 9 Cir. 2002) (in making a credibility determination, an ALJ may consider inconsistencies 10 between a claimant’s testimony and conduct). The ALJ noted that plaintiff could drive, 11 perform household chores with help, shop for groceries, take computer classes to 12 redevelop her skills, and perform personal care independently. AR at 33. The ALJ found 13 that plaintiff’s ability to prepare meals and handle finances was inconsistent with her 14 alleged difficulty understanding and following directions; her ability to shop, attend 15 church, attend support groups, and spend time at the local park was inconsistent with her 16 allegations about problems getting along with others; and her ability to drive, shop, and 17 take computer classes was inconsistent with her alleged difficulties concentrating. AR at 18 28-29. Although plaintiff may disagree with the ALJ’s conclusions, the evidence can 19 reasonably support the determination. 20 Accordingly, the ALJ cited two clear and convincing reasons supported by 21 substantial evidence for discounting plaintiff’s subjective testimony. This was legally 22 sufficient. 23 // 24 // 25 26 27 28 1 V. 2 CONCLUSION 3 IT IS THEREFORE ORDERED that Judgment shall be entered AFFIRMING the 4 || decision of the Commissioner denying benefits, and dismissing the complaint with 5 || prejudice. 6 7 8 || Dated: September 26, 2023 LP 9 10 SHERI PYM United States Magistrate Judge 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28