Nicole Mastromatteo v. Commissioner of Social Security

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 11 NICOLE MASTROMATTEO, No. 2:25-cv-00267-CKD 12 Plaintiff, 13 v. ORDER 14 COMMISSIONER OF SOCIAL SECURITY, 15 Defendant. 16

17 18 Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 19 (“Commissioner”) denying applications for Disability Income Benefits (“DIB”) and 20 Supplemental Security Income (“SSI”) under Titles II and XVI of the Social Security Act 21 (“Act”), respectively. The parties have consented to magistrate judge jurisdiction. For the 22 reasons discussed below, the court will deny plaintiff’s motion for summary judgment and grant 23 the Commissioner’s cross-motion for summary judgment. 24 BACKGROUND 25 Plaintiff, born in 1973, applied for DIB and SSI in 2022, alleging disability beginning 26 September 1, 2020. Administrative Transcript (“AT”) 17, 29. The alleged onset date was later 27 amended to February 13, 2021. AT 19. Plaintiff stated that she was unable to work due to 28 degenerative disc disease in upper back, bursitis in left shoulder, severe lower back pain, and 1 seizures. AT 79. On April 17, 2024, an Administrative Law Judge (ALJ) issued a decision 2 finding plaintiff not disabled between February 13, 2021, and the date of the decision. AT 17-30. 3 The ALJ made the following findings (citations to 20 C.F.R. omitted): 4 1. The claimant meets the insured status requirements of the Social Security Act through September 30, 2022. 5 2. The claimant has not engaged in substantial gainful activity since 6 February 13, 2021, the amended alleged onset date. 7 3. The claimant has the following severe impairments: seizure disorder, post-traumatic stress disorder (PTSD), and history of 8 alcohol use disorder with mild neurocognitive deficits. 9 4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the 10 listed impairments in 20 CFR Part 404, Subpart P, Appendix 1. 11 5. After careful consideration of the entire record, the claimant has had the residual functional capacity to perform light work except that 12 she can occasionally perform postural activities but never climb ladders, ropes, or scaffolds; she cannot work around unprotected 13 heights and must be afforded other seizure precautions; she is limited to simple tasks in a routine environment; she can occasionally 14 interact with coworkers but never interact with the public; and she is precluded from fast-paced work such as rapid assembly or conveyor 15 belt work. 16 6. The claimant is unable to perform past relevant work. 17 7. The claimant was born [in 1973] and was 46 years old, which is defined as a younger individual age 18-49, on the alleged disability 18 onset date. The claimant subsequently changed age category to closely approaching advancing age. 19 8. The claimant has at least a high-school education. 20 9. Transferability of job skills is not material to the determination of 21 disability because using the Medical-Vocational Rules as a framework supports a finding that the claimant is ‘not disabled,’ 22 whether or not the claimant has transferable job skills. 23 10. Considering the claimant’s age, education, work experience, and residual functional capacity, there are jobs that exist in significant 24 numbers in the national economy that the claimant can perform. 25 11. The claimant has not been under a disability, as defined in the Social Security Act, from February 13, 2021, through the date of this 26 decision.

27 AT 19-30.

28 //// 1 ISSUES PRESENTED 2 Plaintiff argues that the ALJ committed the following errors in finding plaintiff not 3 disabled: (1) the ALJ erred in discounting plaintiff’s subjective symptom testimony; and (2) the 4 ALJ erred in evaluating the medical opinions. 5 LEGAL STANDARDS 6 The court reviews the Commissioner’s decision to determine whether (1) it is based on 7 proper legal standards pursuant to 42 U.S.C. § 405(g), and (2) substantial evidence in the record 8 as a whole supports it. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial 9 evidence is more than a mere scintilla, but less than a preponderance. Connett v. Barnhart, 340 10 F.3d 871, 873 (9th Cir. 2003) (citation omitted). It means “such relevant evidence as a reasonable 11 mind might accept as adequate to support a conclusion.” Orn v. Astrue, 495 F.3d 625, 630 (9th 12 Cir. 2007), quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). “The ALJ is 13 responsible for determining credibility, resolving conflicts in medical testimony, and resolving 14 ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 2001) (citations omitted). 15 “The court will uphold the ALJ’s conclusion when the evidence is susceptible to more than one 16 rational interpretation.” Tommasetti v. Astrue, 533 F.3d 1035, 1038 (9th Cir. 2008). 17 The record as a whole must be considered, Howard v. Heckler, 782 F.2d 1484, 1487 (9th 18 Cir. 1986), and both the evidence that supports and the evidence that detracts from the ALJ’s 19 conclusion weighed. See Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985). The court may not 20 affirm the ALJ’s decision simply by isolating a specific quantum of supporting evidence. Id.; see 21 also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). If substantial evidence supports the 22 administrative findings, or if there is conflicting evidence supporting a finding of either disability 23 or nondisability, the finding of the ALJ is conclusive, see Sprague v. Bowen, 812 F.2d 1226, 24 1229-30 (9th Cir. 1987), and may be set aside only if an improper legal standard was applied in 25 weighing the evidence. See Burkhart v. Bowen, 856 F.2d 1335, 1338 (9th Cir. 1988). 26 //// 27 //// 28 //// 1 ANALYSIS 2 A. Subjective Symptom Testimony 3 Plaintiff claims the ALJ erred in evaluating her subjective testimony and self-described 4 limitations. Plaintiff argues that the ALJ’s findings as to credibility are “very minimal” and 5 conclusory, providing so little analysis as to permit meaningful judicial review. Plaintiff further 6 argues that the ALJ’s assessment of her daily activities is flawed, as her activities are “sporadic” 7 and do not show that she can perform work on a regular and continuing basis. 8 1. Plaintiff’s Testimony 9 The ALJ summarized plaintiff’s testimony and allegations as follows: 10 The claimant alleges disability due to impairments including seizures and PTSD. She said that she experiences panic attacks and fear of 11 being in public. The panic attacks can cause seizures, which happen about two or three times a month. After these episodes she needs to 12 recover for two days due to exhaustion and pain. She said she has difficulty lifting, kneeling, and stooping. She further stated that she 13 is a recovering alcoholic with a learning disability and poor memory and concentration. Due to her impairments, she said, she is unable 14 to leave the house at all ten days per month. 15 AT 23; see AT 42-70 (hearing testimony). 16 2. Legal Standard 17 The ALJ determines whether a disability applicant is credible, and the court defers to the 18 ALJ’s discretion if the ALJ used the proper process and provided proper reasons. See, e.g., 19 Saelee v. Chater, 94 F.3d 520, 522 (9th Cir. 1995). If credibility is critical, the ALJ must make an 20 explicit credibility finding. Albalos v. Sullivan, 907 F.2d 871, 873-74 (9th Cir. 1990). “Without 21 affirmative evidence showing that the claimant is malingering, the Commissioner’s reasons for 22 rejecting the claimant’s testimony must be clear and convincing.” Morgan v. Commissioner of 23 Social Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); see also Lambert v. Saul, 980 F.3d 1266, 24 1277–78 (9th Cir. 2020). 25 In evaluating whether subjective complaints are credible, the ALJ should first consider 26 objective medical evidence and then consider other factors. Bunnell v. Sullivan, 947 F.2d 341, 27 344 (9th Cir. 1991) (en banc). If there is objective medical evidence of an impairment, the ALJ 28 then may consider the nature of the symptoms alleged, including aggravating factors, medication, 1 treatment and functional restrictions. See id. at 345-47. The ALJ also may consider: (1) the 2 applicant’s reputation for truthfulness, prior inconsistent statements or other inconsistent 3 testimony, (2) unexplained or inadequately explained failure to seek treatment or to follow a 4 prescribed course of treatment, and (3) the applicant’s daily activities. Smolen v. Chater, 80 F.3d 5 1273, 1284 (9th Cir. 1996). Work records, physician and third party testimony about nature, 6 severity and effect of symptoms, and inconsistencies between testimony and conduct also may be 7 relevant. Light v. Social Security Administration, 119 F.3d 789, 792 (9th Cir. 1997). A failure to 8 seek treatment for an allegedly debilitating medical problem may be a valid consideration by the 9 ALJ in determining whether the alleged associated pain is not a significant nonexertional 10 impairment. See Flaten v. Secretary of HHS, 44 F.3d 1453, 1464 (9th Cir. 1995). 11 When discounting subjective testimony, an ALJ must provide “specific, clear, and convincing 12 reasons for doing so.” Wade v. Saul, 850 F. App’x 568, 569 (9th Cir. 2021) (emphasis in 13 original), citing Lambert, 980 F.3d at 1277–78. This standard does “not require ALJs to perform 14 a line-by-line exegesis of the claimant’s testimony[.]” Lambert, 980 F.3d at 1277. However, an 15 ALJ’s detailed overview of the claimant’s medical history—coupled with a nonspecific 16 boilerplate conclusion that her testimony is “not entirely consistent” with her medical treatment— 17 is not enough to satisfy the minimal requirements for assessing credibility. Id. at 1277–78. 18 3. Discussion 19 The ALJ found objective medical evidence of impairment, concluding that plaintiff had 20 multiple severe impairments: seizure disorder, PTSD, and history of alcohol use disorder with 21 mild neurocognitive deficits. AT 20. The ALJ found plaintiff to have mild or moderate mental 22 limitations in the four assessed categories of mental functioning. AT 21-22. 23 However, the ALJ found that plaintiff’s “statements concerning the intensity, persistence and 24 limiting effects of [the alleged] symptoms are not entirely consistent with the medical evidence 25 and other evidence in the record for the reasons explained [below].” AT 23. 26 “With respect to the claimant’s seizure disorder,” the ALJ wrote, “the overall medical record 27 demonstrates that she has experienced episodes at varying frequency, but often in the setting of 28 treatment noncompliance.” AT 23. The ALJ noted that, after consulting with a neurologist in 1 2021 about past seizures (three in her lifetime), she was prescribed medication and told to follow 2 up in four weeks, but she did not return for another year. AT 23. The ALJ noted that, in April 3 and May 2022, plaintiff provided inconsistent information about when she stopped taking her 4 seizure medication, stating at one point that she had not taken it for months. AT 24. The ALJ 5 also noted that, in 2022, plaintiff was taking less than the prescribed dose of seizure medication 6 and did not seek follow-up treatment for over a year. AT 24. The ALJ cited a November 2023 7 medical note that plaintiff’s seizures were related to inconsistent medication use. AT 24. The 8 ALJ concluded that plaintiff’s “failure to follow up and adhere to the medication regimen 9 determined by her neurologist tends to suggest that her symptoms were not as debilitating as 10 alleged.” AT 25. Failure to follow a prescribed course of treatment is a proper consideration in 11 the credibility analysis. 12 Prior inconsistent statements are also a valid consideration in determining credibility. The 13 ALJ noted that, in 2023, plaintiff “provided conflicting statements to consultative examiners” 14 about the frequency of her seizures. AT 24. The ALJ concluded that “the medical record does 15 not bear out such a significant frequency or intensity of seizures as to preclude employment.” AT 16 25. 17 Turning to mental impairment, the ALJ noted that plaintiff had “received routine and 18 conservative care” consisting of medication prescribed by her primary doctor. “She did not seek 19 out or receive any specialized mental health treatment until, purportedly, the day after the 20 hearing.” AT 25; see AT 62 (hearing testimony that plaintiff had not sought treatment for anxiety 21 or mental issues, but planned to meet with a psychiatrist the next day). From this evidence, the 22 ALJ reasoned that plaintiff’s “mental health symptoms were apparently not significant enough 23 that she felt the need to reach out for treatment during the relevant period. . . . [M]ental status 24 examinations did not note any concerning findings [record citations omitted]. Furthermore, she 25 did not report frequent panic attacks, an inability to leave the house, or fear of being in public.” 26 AT 25. Plaintiff does not dispute these findings, which are valid considerations in the credibility 27 analysis. 28 Finally, the ALJ found that plaintiff’s “activities of daily living suggest a capacity for a range 1 of simple tasks[.]” AT 26. 2 The claimant takes care of her mother, who is not in good health, doing cooking and cleaning. She makes candles, plays video games, 3 does puzzles, and reads self-help and history books. She attends Alcoholics Anonymous meetings and church, and initially reported 4 riding the city bus though she testified she had not taken it in about a month due to anxiety. The claimant also volunteers at a food bank 5 performing tasks on a computer. 6 AT 26 (record citations omitted). Consistent with this finding, the ALJ limited plaintiff to 7 “simple tasks in a routine environment” in the RFC. Plaintiff argues that these activities do not 8 account for her episodic seizures and mental impairments. But as discussed above, the ALJ 9 concluded that plaintiff’s seizures and mental impairments were not as limiting as she alleged. 10 Plaintiff’s ability to perform a variety of personal and social activities, despite her allegations of 11 disabling symptoms, is a proper consideration in evaluating credibility. See Ahearn v. Saul, 988 12 F.3d 1111, 1117 (9th Cir. 2021) (claimant’s ability to use public transportation, shop, perform 13 personal care, prepare meals, and perform household chores was properly found inconsistent with 14 claim of disabling mental impairments). 15 The ALJ’s stated reasons for his credibility finding were specific enough to allow for 16 meaningful review. Plaintiff advocates for an alternative interpretation of the evidence but does 17 not show the ALJ’s interpretation is unreasonable. Because the ALJ used the proper process and 18 provided proper reasons, the court defers to his discretion on the issue of credibility. 19 B. Medical Opinions 20 Plaintiff claims the ALJ erred in evaluating multiple medical opinions in the record. 21 Plaintiff asserts that the ALJ’s assessments of these opinions were not specific enough or 22 supported by substantial evidence. 23 1. Legal Standard 24 “The ALJ is responsible for translating and incorporating clinical findings into a succinct 25 RFC.” Rounds v. Comm’r Soc. Sec. Admin., 807 F.3d 996, 1006 (9th Cir. 2015). In doing so, 26 the ALJ must articulate a “substantive basis” for rejecting a medical opinion or crediting one 27 medical opinion over another. Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014); see also 28 Marsh v. Colvin, 792 F.3d 1170, 1172-73 (9th Cir. 2015) (“an ALJ cannot in its decision totally 1 ignore a treating doctor and his or her notes, without even mentioning them”). 2 The applicable rules provide that adjudicators for the Social Security Administration, 3 including ALJs, evaluate medical opinions according to the following factors: supportability; 4 consistency; relationship with the claimant; specialization; and other factors such as the medical 5 source's familiarity with other evidence in the record or with disability program requirements. 20 6 C.F.R. § 416.920c(c)(1)-(5). The most important of these factors are supportability and 7 consistency. 20 C.F.R. § 416.920c(b)(2). Supportability is the extent to which an opinion or 8 finding is supported by relevant objective medical evidence and the medical source’s supporting 9 explanations. 20 C.F.R. § 416.920c(c)(1). Consistency is the extent to which an opinion or 10 finding is consistent with evidence from other medical sources and non-medical sources, 11 including the claimants themselves. 20 C.F.R. §§ 416.920c(c)(2), 416.902(j)(1). The ALJ will 12 articulate how he considered the most important factors of supportability and consistency, but an 13 explanation for the remaining factors is not required except when deciding among differing yet 14 equally persuasive opinions or findings on the same issue. 20 C.F.R. § 416.920c(b). The new 15 regulations “still require that the ALJ provide a coherent explanation of his reasoning” and 16 establish “a minimum level of articulation to be provided in determinations and decisions, in 17 order to provide sufficient rationale for a reviewing adjudicator or court.” Sam-Chankhiao v. 18 Kijakazi, 2:20-cv-0186 DB, 2022 WL 4226170, at *3 (E.D. Cal. Sept. 13, 2022), citing Hardy v. 19 Commissioner, 554 F.Supp.3d 900, 906 (E.D. Mich. 2021). 20 2. Dr. Bowerman 21 In June 2023, Sara Bowerman, Ph.D., performed a consultative psychological examination 22 of plaintiff. AT 26; see AT 1939-1949. The ALJ summarized Dr. Bowerman’s findings of 23 functional mental limitations, ranging from mild to moderate to marked. AT 26. Dr. Bowerman 24 found in relevant part that plaintiff was “moderately to markedly limited in the ability to maintain 25 concentration and attention and to pace, track and scan[.]” AT 26; see AT 1948. 26 Assessing this opinion, the ALJ wrote: 27 Dr. Bowerman’s opinions were somewhat supported by her examination, during which she observed the claimant’s memory to 28 be moderately impaired based on testing and her attention and 1 concentration were mildly to moderately impaired. On [adult intelligence] testing, the claimant scored in the low average range, 2 but on [memory testing], she scored in the borderline range in immediate memory and the extremely low range in delayed memory 3 and visual memory. Dr. Bowerman offered an interpretation of these scores, stating that they indicate the claimant has difficulty 4 remembering and conducting simple tasks. . . . 5 However, the record as a whole does not document any significant memory deficits, nor any significant, ongoing mental status findings 6 in general [record citations], despite the lack of any specialized treatment. Furthermore, Dr. Bowerman herself noted that the 7 claimant displayed good concentration and task persistence on testing, as well as a logical thought process, which does not support 8 a moderate to marked limitation in maintaining attention and concentration. Accordingly, the undersigned is not entirely 9 persuaded by Dr. Bowerman’s findings. 10 AT 26-27 (emphasis added). 11 Plaintiff asserts that “the ALJ did not explicitly state whether he found Dr. Bowerman’s 12 opinion persuasive[.]” However, the ALJ took issue with only one aspect of Dr. Bowerman’s 13 opinion: her finding that plaintiff had moderate to marked limitations in maintaining attention and 14 concentration. The ALJ explained his reasons for failing to credit this finding, discussing the key 15 factors of supportability (Dr. Bowerman’s supporting explanation) and consistency (comparison 16 with other evidence in the record). The ALJ’s reasoning was sufficiently specific to permit 17 meaningful judicial review, and plaintiff does not point to, nor does the court find, any error in 18 the ALJ’s treatment of this opinion. 19 3. Dr. Rafferty 20 In December 2023, Trevor Rafferty, M.D. completed a four-page medical source 21 statement stating that he treated plaintiff for “psychogenic non-epileptic seizures or functional 22 neurological disorder.” AT 2224. Dr. Rafferty opined that plaintiff had multiple marked mental 23 limitations and would have episodes of decompensation in a work setting three or more times per 24 month. AT 2224-2227. The ALJ partially credited Dr. Rafferty’s opinion, writing in part: 25 Dr. Rafferty first examined the claimant in December 20231 and predicted that these limitations pertained to a six-month period, i.e., 26 not the 12-month period required for consideration of functional 27 1 Dr. Rafferty began treating plaintiff on December 11, 2023 but opined that she had multiple 28 marked limitations dating back to 2018. AT 2226. 1 limitations. Furthermore, the neuropsychiatric evaluation ordered by Dr. Rafferty reflected a normal mental status, unsupportive of 2 marked functional limitations.2 While the claimant’s seizure disorder has been attributed to untreated psychiatric conditions, the 3 overall mental findings of record and lack of treatment are inconsistent with such significant limitations. The undersigned is 4 persuaded, however, that the claimant should avoid strenuous activity, insofar as that suggests more than light work, to prevent 5 exacerbation of her seizures. 6 AT 28 (some record citations omitted). 7 Plaintiff asserts that “[t]he ALJ did not make a persuasiveness finding regarding Dr. 8 Rafferty’s opinion.” While the ALJ did not use the word “persuasive,” he sufficiently explained 9 why he gave the opinion little weight (i.e., the opined limitations did not meet the 12-month 10 requirement, plaintiff’s corresponding mental status exam was normal, and the opinion was 11 inconsistent with the “overall mental findings of record and lack of treatment”) except for a 12 limitation to light work. The ALJ also articulated how he considered the factors of supportability 13 and consistency with reference to evidence in the record. Plaintiff has not shown error as to this 14 opinion. 15 4. Other Medical Opinions 16 Plaintiff claims that the ALJ erred in evaluating two other medical opinions in the record. 17 In her April 2022 medical source statement, nurse Cori Crow opined that plaintiff had 18 moderate and marked mental limitations, various functional physical limitations, would have 19 multiple monthly episodes of decompensation, and would require daily unscheduled breaks of up 20 to 45 minutes. AT 27, citing AT 2229-2231. The ALJ discounted this opinion, writing that it 21 was 22 not supported by Nurse Crow’s own notes, in which she did not document any mental status findings . . . nor any significant ongoing 23 physical findings. [Record citations.] Additionally, as described above, the overall record does not document such frequent seizures 24 or mental health symptoms so severe as to seek treatment. [Record citations.] Accordingly, the undersigned is not persuaded by this 25 Medical Source Statement. 26 AT 27. 27 Plaintiff’s basis for challenging the ALJ’s assessment of Nurse Crow’s opinion is not

28 2 See AT 2292-2301 (December 2023 evaluation showing normal mental status exam results). 1 | clear. Notably, she does not dispute that the ALJ considered the factors of supportability and 2 || consistency, supported by substantial evidence. Having reviewed the ALJ’s evaluation of this 3 || opinion, the court finds no error. 4 In July 2023, State agency psychiatric consultant S. Nair, M.D. found that plaintiff was 5 || capable of simple and detailed tasks. AT 135; see AT 132-137. The ALJ concluded that Dr. 6 || Nair’s findings were “somewhat consistent with the overall record” but gave “some deference to 7 || Dr. Bowerman’s examination in finding that the claimant is limited to only simple tasks[.]” AT 8 | 27. The ALJ added that plaintiff's “activities of daily living reflect that she carries out a variety 9 || of tasks on a daily basis, including caring for her mother, managing finances, reading, and 10 || volunteering for a food bank, supporting a capacity for simple tasks.” AT 27. 11 In sum, the ALJ found Dr. Nair’s opinion partially persuasive but found plaintiff more 12 || mentally limited than Dr. Nair opined. Plaintiffs basis for challenging the ALJ’s assessment of 13 || Dr. Nair’s opinion is not clear. As above, she does not dispute that the ALJ considered the factors 14 | of supportability and consistency, supported by substantial evidence. Having reviewed the ALJ’s 15 || evaluation of this opinion, the court finds no error. Defendant is entitled to summary judgment 16 | onall claims. 17 | CONCLUSION 18 For the reasons stated herein, IT IS HEREBY ORDERED that: 19 1. Plaintiffs motion for summary judgment (ECF No. 12) is denied; 20 2. The Commissioner’s cross-motion for summary judgment (ECF No. 16) is granted; 21 | and 22 3. Judgment is entered for the Commissioner. 23 | Dated: March 11, 2026 □□ I / dle ae

25 UNITED STATES MAGISTRATE JUDGE 26 27 28 || 2/mast0257.bothdibssi.ckd 1]