Renee L. v. Commissioner of Social Security

Opinion

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5 UNITED STATES DISTRICT COURT 6 WESTERN DISTRICT OF WASHINGTON AT SEATTLE 7 8 RENEE L., 9 Plaintiff, Case No. C25-1160-SKV 10 v. ORDER AFFIRMING THE COMMISSIONER’S DECISION 11 COMMISSIONER OF SOCIAL SECURITY, 12 Defendant. 13 14 Plaintiff seeks review of the denial of her applications for Supplemental Security Income 15 (SSI) and Disability Insurance Benefits (DIB). Having considered the ALJ’s decision, the 16 administrative record (AR), and all memoranda of record, the Court AFFIRMS the 17 Commissioner’s final decision and DISMISSES the case with prejudice. 18 BACKGROUND 19 Plaintiff was born in June 1992, has a high school education, and has worked as a 20 receptionist. AR 355. Plaintiff was last gainfully employed in November 2019. Id. 21 On May 24, 2021, Plaintiff applied for benefits, alleging disability as of May 6, 2021. 22 AR 322. Plaintiff’s applications were denied initially and on reconsideration, and Plaintiff 23 1 requested a hearing. AR 27. After the ALJ conducted a hearing on April 17, 2024, the ALJ 2 issued a decision finding Plaintiff not disabled. AR 47. 3 THE ALJ’S DECISION 4 Utilizing the five-step disability evaluation process,1 the ALJ found:

5 Step one: Plaintiff has not engaged in substantial gainful activity since May 6, 2021.

6 Step two: Plaintiff has the following severe impairments: obesity, fibromyalgia, depressive disorder, and anxiety disorder with panic attacks. 7 Step three: These impairments do not meet or equal the requirements of a listed 8 impairment.2

9 Residual Functional Capacity (RFC): Plaintiff can perform light work except no climbing ladders, ropes or scaffolds; occasional climbing ramps and stairs, balancing, 10 stooping, kneeling, crouching, and crawling; no working around unprotected heights or unprotected dangerous moving machinery; she can only perform simple, routine tasks 11 involving simple work-related decisions and routine changes.

12 Step four: Plaintiff cannot perform past relevant work.

13 Step five: As there are jobs that exist in significant numbers in the national economy that Plaintiff can perform, Plaintiff is not disabled. 14

15 AR 29-47. 16 The Appeals Council denied Plaintiff’s request for review, making the ALJ’s decision the 17 Commissioner’s final decision. AR 1. Plaintiff appealed the final decision of the Commissioner 18 to this Court. Dkt. 4. The parties consented to proceed before the undersigned Magistrate Judge. 19 Dkt. 2. 20 LEGAL STANDARDS 21 Under 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of social 22 security benefits when the ALJ’s findings are based on harmful legal error or not supported by 23 1 20 C.F.R. §§ 404.1520, 416.920. 2 20 C.F.R. Part 404, Subpart P., App. 1. 1 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 (9th Cir. 2 2005). As a general principle, an ALJ’s error may be deemed harmless where it is 3 “inconsequential to the ultimate nondisability determination.” Molina v. Astrue, 674 F.3d 1104, 4 1115 (9th Cir. 2012) (cited sources omitted). The Court looks to “the record as a whole to

5 determine whether the error alters the outcome of the case.” Id. 6 Substantial evidence is “more than a mere scintilla. It means - and means only - such 7 relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” 8 Biestek v. Berryhill, 587 U.S. 97, 103 (2019); Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 9 1989). The ALJ is responsible for evaluating symptom testimony, resolving conflicts in medical 10 testimony, and resolving any other ambiguities that might exist. Andrews v. Shalala, 53 F.3d 11 1035, 1039 (9th Cir. 1995). While the Court is required to examine the record as a whole, it may 12 neither reweigh the evidence nor substitute its judgment for that of the Commissioner. Thomas 13 v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). When the evidence is susceptible to more than 14 one rational interpretation, it is the Commissioner’s conclusion that must be upheld. Id.

15 DISCUSSION 16 Plaintiff argues the ALJ erred by misevaluating the medical opinion evidence. The 17 Commissioner argues the ALJ’s decision is free of harmful legal error, supported by substantial 18 evidence, and should be affirmed. 19 A. The ALJ Did Not Err in Evaluating the Medical Opinion Evidence 20 Under regulations applicable to this case, the ALJ must articulate the persuasiveness of 21 each medical opinion, specifically with respect to whether the opinions are supported and 22 consistent with the record. 20 C.F.R. § 416.920c(a)-(c). These findings must be supported by 23 substantial evidence. Woods v. Kijakazi, 32 F.4th 785, 792 (9th Cir. 2022). 1 Plaintiff avers, after a lengthy recitation of the procedural background and medical 2 opinion evidence she believes supports her claim, 3 that the ALJ erred because she “essentially” 3 rejected all the medical opinions which related to her mental health functioning, and did not 4 properly discuss the supportability and consistency factors. Dkt. 12 at 7. The Court addresses

5 each psychological medical opinion in turn. 6 1. Janis Lewis, PhD, and Matthew Comrie, PsyD 7 The ALJ considered the opinions of state agency psychological consultants, Dr. Lewis, 8 and Dr. Comrie, as one. AR 41. The ALJ found that these opinions, which concluded that 9 Plaintiff’s mental health impairments were non-severe, were supported and consistent with the 10 medical evidence at the time they issued their opinions. Id. However, the ALJ determined that 11 the subsequent medical evidence, which the state agency examiners did not review, warranted 12 additional limitations, and therefore further limited Plaintiff’s RFC to work involving only 13 simple, routine task, simple work-related decision making, and only routine changes in the work 14 setting. AR 41-42.

15 Plaintiff seemingly argues that by finding her more disabled than these medical opinions 16 “[the ALJ] impermissibly play[ed] doctor[.]” Dkt. 12 at 7. But “ALJs are, at some level, 17 capable of independently reviewing and forming conclusions about medical evidence to 18 discharge their statutory duty to determine whether a claimant is disabled and cannot work.” 19 Farlow v. Kijakazi, 53 F.4th 485, 488 (9th Cir. 2022). Nor is an ALJ required to pick one 20 medical opinion and adopt it in full. See Hayes v. Kijakazi, No. 1:20-CV-742-HBK, 2022 WL 21 873516, at *6 (E.D. Cal. Mar. 24, 2022). And Plaintiff cannot show harmful error in the ALJ 22

3 Plaintiff’s brief runs in direct opposition to the Court’s briefing requirements, which explicitly require that 23 “Plaintiff should not set forth a separate lengthy recitation of background facts or medical evidence.” Dkt. 8. The Court nonetheless considers the arguments as presented, though Counsel is warned that future disregard of the Court’s instructions may result in finding Plaintiff has waived the argument. 1 finding her more limited than the state agency consultants opined. See Hubbard v. Astrue, 371 F. 2 App’x 785, 787 (9th Cir. 2010) (holding the ALJ did not err where he found a claimant more 3 limited than some doctors opined). Accordingly, the ALJ did not err in her assessment of the 4 state agency medical consultants.

5 2. Kari Coelho, PsyD. 6 The ALJ considered the opinion of Dr. Coelho and found it not persuasive as 7 unsupported, inconsistent with the medical record, and not relevant to the period at issue. AR 8 40-41. The ALJ found Dr. Coelho’s opinion unsupported because, while she found limitations 9 based on Plaintiff’s self-reports, the mental status exam showed no abnormalities in any aspect 10 of her mental functioning. AR 41 (citing AR 1858). An ALJ may discount medical opinions to 11 the extent that they are based on self-reports which she has properly discounted. Tommasetti v. 12 Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008). As Plaintiff does not challenge the ALJ’s 13 assessment of her subjective symptom testimony, which the ALJ discounted as contradicted by 14 the objective medical evidence, this was a proper basis to discount Dr. Coelho’s opinion.

15 Further, it was reasonable of the ALJ to conclude that the largely normal mental status exam Dr. 16 Coelho conducted did not support the level of limitations she opined to. AR 1858-60. 17 The ALJ also found that Dr. Coelho’s opinion that Plaintiff could not read for more than 18 twenty minutes at a time was inconsistent with medical evidence which consistently showed no 19 attention or concentration deficits, and no notes of her being inattentive or distracted during 20 appointments. AR 41 (citing AR 716, 896-97, 931, 937, 1084-85, 1165-66, 1804, 1976, 1978, 21 1980). This was a reasonable basis to discount Dr. Coelho’s opinion. See Ford v. Saul, 950 F.3d 22 1141, 1156 (9th Cir. 2020). 23 1 Lastly, the ALJ discounted Dr. Coelho’s opinion because it was issued in July 2020, 2 nearly a year prior to the alleged first date of disability. AR 41. The Ninth Circuit is clear that 3 medical opinions before the alleged onset date are of limited relevance. See Rogal v. Colvin, 590 4 F. App’x. 667, 670 (9th Cir. 2014) (finding the ALJ did not err in failing to discuss a treating

5 opinion that predated the alleged disability onset date); Carmickle v. Comm’r of Soc. Sec. 6 Admin., 533 F.3d 1155, 1165 (9th Cir. 2008) (“Medical opinions that predate the alleged onset of 7 disability are of limited relevance.”). The ALJ properly considered this factor in discounting Dr. 8 Coelho’s opinion. 9 3. Michael S. Clark, M.D. 10 The ALJ considered the opinion of psychiatric examiner Dr. Clark and found it not 11 persuasive as unsupported and inconsistent with the medical evidence. AR 41. 12 The ALJ found Dr. Clark’s opinion that Plaintiff would have problems interacting with 13 coworkers and the public was unsupported by the exam which showed no behavioral 14 abnormalities or that the claimant had any issues interacting with Dr. Clark during the exam. AR

15 41 (citing AR 1081-87). She further found Dr. Clark’s opinion of limitations interacting with 16 coworkers and maintaining regular attendance inconsistent with the medical evidence. Id. 17 Specifically, Plaintiff had no noted behavioral abnormalities, difficulties interacting with doctors, 18 and she regularly socialized with others. Id. (citing AR 716 (“Denies any psychiatric complaints. 19 . . . Patient’s judgement and Insight are normal. Patient is alert and oriented. Recent and long 20 term memory are normal for age.”), 896-97 (“Mood and Affect: Mood normal. Behavior: 21 Behavior normal”), 931 (“Psych: normal affect”), 937 (same), 1084 (“ability to follow the 22 conversation reasonably well without losing track of it is fair through most of the interview.”), 23 1165-66 (“Mood and Affect: Mood normal. Behavior: Behavior normal.”), 1804-05 (“EYE 1 CONTACT: normal FACIAL EXPRESSION: constricted AFFECT: flat . . . AVAILABLE 2 SUPPORT: close friend, group of friends”), 1976 (“Appearance: Normal Grooming and 3 Hygiene Attitude: Calm and Cooperative Behavior: No unusual movements or psychomotor 4 changes Speech: Normal rate/tone/volume/w/out pressure Affect: Normal Range/Congruent”),

5 1978 (same), 1980 (same)). Plaintiff has not shown error in this reasoning. 6 Lastly, she found Dr. Clark’s opinion vague, as he found that Plaintiff may, or would, 7 have difficulties with, several aspects of mental work but did not include specific work-related 8 limitations. AR 41. An ALJ need not accept a medical opinion that is vague, fails to set forth 9 any specific functional limitations, or describes limitation equivocally. See Thomas, 278 F.3d at 10 957 (noting an ALJ “need not accept the opinion of any physician . . . if that opinion is brief, 11 conclusory, and inadequately supporting by clinical findings”); Khal v. Berryhill, 690 Fed. Appx. 12 499, 501 (9th Cir. 2017) (finding a physician’s opinion that the plaintiff was “probably incapable 13 of work” to be equivocal and less compelling). Dr. Clark’s opinion, as the ALJ noted, does not 14 confine itself to what he assesses Plaintiff can currently do, and frequently equivocates. For

15 example, he opined “[Plaintiff] would probably, overall, be able to perform work activities on a 16 consistent basis” and “would probably have difficulty maintaining regular attendance and 17 completing a normal workday[.]” AR 1086-87. It was reasonable of the ALJ to discount Dr. 18 Clark’s equivocal opinions of Plaintiff’s functioning. 19 4. Julie Miller, LMHC 20 The ALJ considered the opinion of LMHC Miller and found it not persuasive as it is not 21 well supported and inconsistent with the medical evidence. AR 42. 22 The ALJ found LMHC Miller’s treatment notes did not support her opinion. AR 42. 23 LMHC Miller opined that Plaintiff had at least serious limitations in all mental abilities and 1 aptitudes needed for work, with no useful ability to function in seventeen areas, inability to meet 2 competitive standards in seven other areas, and serious limitations in the only remaining area. 3 AR 1849-50. LMHC Miller supported her assessment with “see chart notes.” AR 1847-50. But 4 her chart notes consistently noted no memory, cognitive, attention, thought process, behavioral,

5 or thought content abnormalities. AR 42 (citing AR 1804-05, 1976, 1978, 1980). The ALJ 6 further found that the medical record contradicted the opinion, again pointing to Plaintiff’s 7 multiple normal mental status exams throughout the record. Id. (citing AR 958-59, 968-69, 971- 8 72, 974, 978, 1016, 1029, 1053-54, 1165, 1279, 1501, 1504, 1507, 1510, 1517, 1523, 1868, 9 1873-1959, 1992-2007). Plaintiff does not challenge the ALJ’s interpretation of these citations 10 or engage with the ALJ’s reasons for rejecting this opinion. See Dkt. 12 at 7. Accordingly, 11 Plaintiff has not shown error in the ALJ’s evaluation of LMHC Miller’s opinion. 12 CONCLUSION 13 For the reasons set forth above, the Commissioner’s final decision is AFFIRMED and 14 this case is DISMISSED with prejudice.

15 Dated this 20th day of March, 2026. 16 17 A 18 S. KATE VAUGHAN United States Magistrate Judge 19

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