1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA
9 Kenya Lou Rogers, No. CV-23-00003-PHX-MTL
10 Plaintiff, ORDER
11 v.
12 Commissioner of Social Security Administration, 13 Defendant. 14 15 Plaintiff Kenya Lou Rogers (“Plaintiff”) challenges the denial of her application 16 for disability insurance benefits by Defendant Social Security Administration under the 17 Social Security Act. Plaintiff filed a Complaint (Doc. 1) with the Court seeking review of 18 her claim. The Court has reviewed the briefs (Docs. 15, 16, 17) and the Administrative 19 Record (Doc. 8, “A.R.”), and now affirms the Administrative Law Judge’s (“ALJ”) 20 decision. 21 I. BACKGROUND 22 Plaintiff filed an application for disability insurance benefits under Title II on 23 January 9, 2014, for a period of disability beginning on February 1, 2011. (A.R. at 72.) 24 Plaintiff’s claim was initially denied on February 28, 2014 (id. at 82), and upon 25 reconsideration on December 20, 2014 (id. at 93-107). Thereafter, Plaintiff filed a request 26 for a hearing, which was held on July 27, 2016. (Id. at 39-70.) At the hearing, Plaintiff 27 amended her period of disability to beginning February 1, 2012. (A.R. at 69-70). The 28 ALJ denied Plaintiff’s application on October 20, 2014. (Id. at 20-32.) The Appeals 1 Council denied Plaintiff’s request for review on November 24, 2017. (Id. at 1-6). Plaintiff 2 appealed the decision with the district court pursuant to 42 U.S.C. § 405(g), and on 3 December 28, 2018, the court remanded the case back to the ALJ to issue a new decision 4 that included: (1) “a review of all the opinion evidence and limitations described by the 5 treating and evaluating physicians”; (2) “a review of [Plaintiff’s] impairments and 6 symptoms”; (3) “a determination of [Plaintiff’s] residual functional capacity”; and (4) “a 7 determination of the remaining steps in the sequential process using, if necessary, the 8 testimony from a vocational expert.” (Id. at 1108-09.) 9 While Plaintiff’s original application was under review by the district court, 10 Plaintiff also filed a subsequent claim for Title II disability insurance benefits on March 11 2, 2018. (Id. at 1070.) On remand, the ALJ consolidated the two claims and denied 12 Plaintiff’s application on March 17, 2020 (id. at 972-1000, 1130.), and the Appeals 13 Counsel denied Plaintiff’s request for review on November 3, 2022 (id. at 952-55). 14 Plaintiff now seeks judicial review with this Court pursuant to 42 U.S.C. § 405(g). 15 The Court has reviewed the record and will discuss the pertinent evidence in 16 addressing the issues raised by the parties. Upon considering the medical evidence and 17 opinions, the ALJ evaluated Plaintiff’s disability claim based on the following severe 18 impairments: fibromyalgia, cervical degenerative disc disease, cervical spondylosis, 19 hypothyroidism, status post laparoscopic lysis of adhesions, anxiety disorder, depression 20 disorder, and history of migraine headaches. (Id. at 979-80.) 21 The ALJ found that Plaintiff did not have an impairment or combination of 22 impairments that met or medically equaled the severity of one of the listed impairments 23 of 20 C.F.R. Part 404, Subpart P, Appendix 1. (Id. at 980.) Next, the ALJ determined 24 Plaintiff’s residual functional capacity (“RFC”).1 The ALJ found: 25 After careful consideration of the entire record, the 26 undersigned finds that, through the date last insured, the claimant had the [RFC] to perform light work as defined in 20 27
28 1 Residual functional capacity refers to the most a claimant can still do in a work setting despite his or her limitations. 20 C.F.R. § 404.1545(a)(1). 1 CFR [§] 404.1567(b) except that she can frequently climb and stoop. She is able to perform simple, routine and repetitive 2 tasks involving simple work related decisions and simple 3 instructions. She can perform work with no public contact. In addition, she can perform work with no exposure to loud 4 noise. 5 6 (Id. at 983.) Based on this RFC, the ALJ found Plaintiff could not perform past relevant 7 work, but could perform other jobs existing in significant numbers in the economy, such 8 as marker, routing clerk, and router. (Id. at 999-1000.) Ultimately, the ALJ concluded 9 that Plaintiff was not disabled under §§ 261(i) and 223(d) of the Social Security Act. (Id.) 10 II. LEGAL STANDARD 11 In determining whether to reverse an ALJ’s decision, the district court reviews 12 only those issues raised by the party challenging the decision. See Lewis, 236 F.3d at 517 13 n.13. The Court may set aside the Commissioner’s determination only if it is not 14 supported by substantial evidence or is based on legal error. Orn v. Astrue, 495 F.3d 625, 15 630 (9th Cir. 2007). Substantial evidence is relevant evidence that a reasonable person 16 might accept as adequate to support a conclusion considering the entire record. Id. To 17 determine whether substantial evidence supports a decision, the Court must consider the 18 entire record and may not affirm simply by isolating a “specific quantum of supporting 19 evidence.” Id. (citation omitted). Generally, “[w]here the evidence is susceptible to more 20 than one rational interpretation, one of which supports the ALJ’s decision, the ALJ’s 21 conclusion must be upheld.” Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002) 22 (citation omitted). The substantial evidence threshold “defers to the presiding ALJ, who 23 has seen the hearing up close.” Biestek v. Berryhill, 587 U.S. —, 139 S. Ct. 1148, 1157 24 (2019); see also Thomas v. CalPortland Co., 993 F.3d 1204, 1208 (9th Cir. 2021) (noting 25 substantial evidence “is an extremely deferential standard”). 26 To determine whether a claimant is disabled, the ALJ follows a five-step process. 27 20 C.F.R. § 404.1520(a). The claimant bears the burden of proof on the first four steps, 28 but the burden shifts to the Commissioner at step five. Tackett v. Apfel, 180 F.3d 1094, 1 1098 (9th Cir. 1999). At the first step, the ALJ determines whether the claimant is 2 presently engaging in substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i), (b). If 3 so, the claimant is not disabled, and the inquiry ends. Id. At step two, the ALJ determines 4 whether the claimant has a “severe” medically determinable physical or mental 5 impairment. Id. § 404.1520 (a)(4)(ii), (c). If not, the claimant is not disabled, and the 6 inquiry ends. Id. At step three, the ALJ considers whether the claimant’s impairment or 7 combination of impairments meets or medically equals an impairment listed in Appendix 8 1 to Subpart P of 20 C.F.R. Part 404. 20 C.F.R. § 404.1520(a)(4)(iii), (d). If so, the 9 claimant is automatically found to be disabled. Id. At step four, the ALJ assesses the 10 claimant’s RFC and determines whether the claimant is still capable of performing past 11 relevant work. Id. § 404.1520(a)(4)(iv), (e). If so, the claimant is not disabled, and the 12 inquiry ends. Id. If not, the ALJ proceeds to the fifth and final step, where the ALJ 13 determines whether the claimant can perform any other work in the national economy 14 based on the claimant’s RFC, age, education, and work experience. 20 C.F.R. 15 § 404.1520(a)(4)(v), (f). If not, the claimant is disabled. Id. 16 III. DISCUSSION 17 Plaintiff raises two issues before the Court. First, Plaintiff argues that the ALJ 18 erred by “rejecting the work-preclusive assessments from treating neurologist Farrukh 19 Qureshi, M.D., treating mental health nurse practitioner Chitra Mathew, D.N.P., and state 20 agency examining psychologist Jonna Krabbenhoft, Psy.D., in the absence of specific and 21 legitimate reasons based on substantial evidence in this record as a whole.” (Doc. 15 22 at 1.) Second, Plaintiff argues that the ALJ erred by “rejecting [Plaintiff’s] symptom 23 testimony in the absence of specific, clear, and convincing reasons supported by 24 substantial evidence in this record as a whole.” (Id.) 25 A. Medical Opinions 26 While “[t]he ALJ must consider all medical opinion evidence,” for claims filed 27 before March 27, 2017, such as this one, the ALJ must consider the hierarchy among the 28 sources of medical opinions. Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008); 1 see also Garrison v. Colvin, 759 F.3d 995, 1012 (9th Cir. 2014). Those who have treated 2 a claimant are treating physicians, those who examined but did not treat the claimant are 3 examining physicians, and those who neither examined nor treated the claimant are 4 nonexamining physicians. Lester v. Chater, 81 F.3d 821, 830 (9th Cir. 1995). “As a 5 general rule, more weight should be given to the opinion of a treating source than to the 6 opinion of doctors who did not treat the claimant.” Id. Treating physicians have the 7 advantage of in-person interaction and typically a longer history of treatment than a 8 claimant’s other doctors, and their “subjective judgments . . . are important, and properly 9 play a part in their medical evaluations.” Embrey v. Bowen, 849 F.2d 418, 422 (9th Cir. 10 1988); see also Winans v. Bowen, 853 F.2d 643, 647 (9th Cir. 1987). 11 An ALJ “may only reject a treating or examining physician’s uncontradicted 12 medical opinion based on ‘clear and convincing reasons.’” Carmickle v. Comm’r of Soc. 13 Sec. Admin., 533 F.3d 1155, 1164 (9th Cir. 2008) (citing Lester, 81 F.3d at 830-31). 14 “Where such an opinion is contradicted, however, it may be rejected for specific and 15 legitimate reasons that are supported by substantial evidence in the record.” Id. An ALJ 16 meets this standard by “setting out a detailed and thorough summary of the facts and 17 conflicting medical evidence, stating his interpretation thereof, and making findings.” 18 Magallanes v. Bowen, 881 F.2d 747, 751 (9th Cir. 1989). 19 1. Dr. Farrukh Qureshi 20 Since 2015, Plaintiff has seen Dr. Qureshi, a neurologist, for treatment of her 21 ailments including headaches and migraines. (A.R. 851-52.) In May 2016, Dr. Qureshi 22 provided a medical opinion that Plaintiff’s headaches and migraines would preclude her 23 from working an 8-hour day “on [an] intermittent basis.” (Id. at 882.) His assessment 24 indicated that Plaintiff experiences each month about seven to eight headaches that last at 25 least two hours. (Id.) Dr. Qureshi stated that Plaintiff’s headaches moderately affect her 26 concentration and ability to remain on task. (Id.) He estimated that Plaintiff would miss 27 more than five days of work a month due to her headaches. (Id. at 883.) According to the 28 form, he did not consult his own treatment or other records. (Id.) But the limitations he 1 noted are from “objective, clinical, or diagnostic findings” that have been documented by 2 either him or elsewhere in the medical records. (Id.) Later, in September 2019, Dr. 3 Qureshi completed another medical assessment form and provided the same conclusions 4 but added that Plaintiff received nerve block injections to treat her headaches and that he 5 did consult other records to reach his conclusions. (See id. at 2059-60.) 6 The ALJ assigned “little weight to the opinions provided by Dr. Qureshi.” (Id. at 7 995.) The ALJ found that Dr. Qureshi’s opinions “were not consistent with available 8 evidence of record and unpersuasive.” (Id.) The ALJ reasoned that the frequency of 9 headaches were unsupported by his treatment records. (Id.) Specifically, the records 10 showed only a few months in 2016 that supported his reported frequency and duration of 11 Plaintiff’s headaches. (Id.) After treatment with medications and nerve block injections in 12 2016, Plaintiff “experienced headaches at a frequency of two or three times per month on 13 prescribed treatment.” (Id.) The ALJ also reasoned that Dr. Qureshi stated that he did not 14 review other providers’ treatment records, so he based his opinion on his treatment of 15 Plaintiff, “which began more than three years after the alleged onset date.” (Id. at 995- 16 96.) 17 Plaintiff argues that the ALJ’s assessment of Dr. Qureshi’s medical opinion fails 18 to rise to level of specific and legitimate reasons because “periods of temporary reprieve” 19 do not mean Plaintiff’s condition is resolved. (Doc. 15 at 13.) Plaintiff argues that periods 20 of improvement should be viewed in context of the whole record, stating that an ALJ 21 must examine evidence in the broader context of the claimant’s impairment. (Id. (citing 22 Attmore v. Colvin, 827 F.3d 872, 877-78 (9th Cir. 2016) (holding that temporary 23 improvement in bipolar disorder symptoms does not warrant a finding of medical 24 improvement)).) 25 Here, the ALJ provided specific and legitimate reasons for discounting Dr. 26 Qureshi opinion. As the ALJ explained, treatment notes from April 2016 to September 27 2016 indicate that Plaintiff experienced an increase in the frequency of headaches from 28 two to three per month to about seven to eight per month. (Id. at 993, 995, 1627-34.) The 1 ALJ, however, considered Dr. Qureshi’s treatment notes from January 2017, which 2 indicate that Plaintiff’s headaches were reduced to fewer than three a month after nerve 3 block treatment and taking the medication Maxalt. (Id. at 991, 1590-1627.) In fact, by 4 March 2017, the ALJ found that Dr. Qureshi noted Plaintiff’s “migraine attacks were 5 completely under control.” (Id. at 993, 1617.) 6 The ALJ’s determination assessed the treatment in the broader context. As the 7 ALJ identified, treatment records from September 2012, March 2013, and May 2013 8 indicate that medication resolved Plaintiff’s headaches. (Id. at 686, 688, 697, 986-88.) 9 Also, as the ALJ noted, Plaintiff’s other medical records show that “complications with 10 interactions of prescribed medications or side effects” were alleviated when providers 11 switched or modified treatment. (Id. at 430-596, 676-736, 993.) The ALJ also considered 12 the April 2017 treatment record, which indicates that Plaintiff experienced only one bad 13 migraine within the previous five weeks, and she was able to get relief from Maxalt. (Id. 14 at 991, 1590-1615.) In addition, Dr. Qureshi’s medical assessments claimed that Plaintiff 15 experienced headaches and migraines about seven to eight times a month, but he did not 16 provide any “objective, clinical, or diagnostic findings” to support his conclusions. (Id. at 17 882-83, 2059-60). Under the regulations, “[t]he more a medical source presents relevant 18 evidence to support a medical opinion, particularly medical signs and laboratory findings, 19 the more weight [the ALJ] will give that medical opinion. The better an explanation a 20 source provides for a medical opinion, the more weight [the ALJ] will give that medical 21 opinion.” 20 C.F.R. § 404.1527(c)(3). The ALJ’s decision to give little weight to Dr. 22 Qureshi’s opinion does not assume that Plaintiff’s treatment completely resolves her 23 symptoms. Instead, the ALJ assigned the opinion “little weight” because she found that 24 the Dr. Qureshi and the evidence do not support his opinion. 25 Plaintiff also argues the ALJ did not acknowledge Dr. Qureshi’s 2019 assessment 26 where he checked the box that he reviewed other medical records. (Doc. 15 at 15.) The 27 ALJ, however, found that Dr. Qureshi’s treatment records into 2018 “were too remote 28 from the date last insured.” A claimant must establish disability prior to the expiration 1 date of the last insured date to be entitled to benefits. 20 C.F.R. §§ 404.101, 404.130-131. 2 Here, the period under consideration is from Plaintiff’s alleged onset date of February 1, 3 2012, through her date last insured of December 31, 2016 (A.R. at 979). See 42 U.S.C. 4 §§ 416(i)(3)(B), 423(c)(1)(B) (requiring an individual to have “not less than 20 quarters 5 of coverage during the 40-quarter period which ends with the quarter in which such 6 month occurred”). Therefore, the ALJ did not consider Dr. Qureshi’s 2019 medical 7 assessment in his determination because it was “too remote” from the date last insured. 8 (A.R. 993-995.) Even still, the records from 2018 onward indicate that Plaintiff’s 9 headaches and migraines were limited to less than three a month. (Id. at 1673-84.) 10 As such, the ALJ reasonably gave Dr. Qureshi’s medical assessment little weight 11 because his own treatment notes and other medical notes are inconsistent with his 12 opinion. See Batson v. Comm’r of Soc. Sec., 359 F.3d 1190, 1195 (9th Cir. 2004) 13 (affirming ALJ’s rejection of treating source opinion for being inconsistent with 14 treatment notes and other evidence of record). The Court therefore finds that substantial 15 evidence supports the ALJ’s conclusion to give Dr. Qureshi’s opinion little weight. 16 2. Chitra Mathew, D.N.P. 17 Since 2015, Plaintiff has seen DNP Matthew, a nurse practitioner at Metropolitan 18 Neuro Behavioral Institute, for treatment of her anxiety. (A.R. at 888.) In May 2016, 19 DNP Matthew offered a medical opinion that Plaintiff experiences moderately severe to 20 severe mental impairments that preclude an 8-hour workday. (Id. at 880-81.) Under the 21 definitions, this level of impairment means that Plaintiff would be “off task” for 16 to 20 22 percent of an 8-hour workday. (Id. at 881.) DNP Matthew did not include any 23 explanations in her assessment but checked the box indicating that she considered and 24 reviewed “treatment notes, records from other providers, mental status examinations, 25 [and/or] patient’s response to treatment.” (Id.) 26 The ALJ assigned minimal weight to DNP Matthew’s opinion reasoning that DNP 27 Matthew’s “proposed limitations were not supported by any referenced evidence and 28 were, in fact, not supported by available treatment records from Metropolitan Neuro 1 Behavioral Institute.” (Id. at 997.) Specifically, the ALJ concluded that DNP Matthew’s 2 treatment records showed that (1) Plaintiff’s “compliance with medication was reportedly 3 good,” (2) Plaintiff’s experienced “no side effects that were described or evident,” and 4 (3) Plaintiff’s “examination results were routinely unremarkable, within normal limits, or 5 mild.” (A.R. at 997.) The ALJ cited DNP Matthew’s treatment records of Plaintiff to 6 support these conclusions. (Id.) 7 Plaintiff argues that the “ALJ failed to connect her conclusions regarding 8 inconsistency [between DNP Matthew’s opinion and the records] to any relevant specific 9 evidence.” (Doc. 15 at 16.) In other words, Plaintiff claims that the ALJ failed to provide 10 germane reasons supported by substantial evidence. (Doc. 15 at 15; Doc. 18 at 5-6.) 11 Under the 2017 rules, a nurse practitioner was not within the agency’s definition of 12 acceptable medical sources but considered an “other source.” Revels v. Berryhill, 874 13 F.3d 648, 665 (9th Cir. 2017). To reject the opinion of an “other source,” like a nurse 14 practitioner, the ALJ must provide “germane reasons” that are supported by substantial 15 evidence. Popa v. Berryhill, 872 F.3d 901, 907 (9th Cir. 2017). 16 Here, the ALJ identified germane reasons that are supported by substantial 17 evidence in the record. As the ALJ identified, DNP Matthew’s opinion did not include 18 any explanation or detail. (Id. at 880-81, 997.) The ALJ therefore considered DNP 19 Matthew’s treatment notes from 2015 and 2016, which stated that “medication 20 compliance is reportedly good, no side effects are described or evident.” (Id. at 888, 901, 21 990, 997.) In addition, the ALJ identified treatment notes from February 2016 that 22 indicated Plaintiff has “[m]ild anxiety present but not problematic” and that she “denies 23 any major psychiatric problems or symptoms.” (Id. at 892, 990, 997.) The ALJ also 24 considered that in May 2016 Plaintiff experienced “severe feelings of anxiety” with 25 “some mental status abnormalities,” but she had normal speech, no cognitive difficulty, 26 and intact memory. (Id. at 888-90, 990, 997.) Further, as the ALJ identified, from mid- 27 2016 and until early 2017 Plaintiff mental status improved. (Id. at 992, 1884-1913.) She 28 still had a depressed mood, but her effects to her memory, attention span, judgment, and 1 cognition “were either unremarkable or mild.” (Id.) In May 2017, Plaintiff “was assessed 2 to be cooperative, had normal speech rate, amplitude, and prosody, her mood was 3 euthymic, she had mood congruent affect, and her thought process was goal directed and 4 thought content had no abnormal content.” (Id. at 992, 997, 1881.) 5 As such, the ALJ reasonably gave DNP Matthew’s opinion minimal weight 6 because her own treatment notes are inconsistent with her opinion. See Trevizo v. 7 Berryhill, 871 F.3d 664, 675 (9th Cir. 2017) (“The ALJ can meet this burden by setting 8 out a detailed and thorough summary of the facts and conflicting clinical evidence, 9 stating his interpretation thereof, and making findings.” (citing Magallanes, 881 F.2d at 10 751)). The Court therefore finds that substantial evidence supports the ALJ’s conclusion. 11 3. Dr. Joanna Krabbenhoft 12 In October 2014, Dr. Krabbenhoft, a licensed psychologist, performed a 13 psychological consultative examination of Plaintiff. (A.R. at 819.) Dr. Krabbenhoft 14 opined that Plainitff “struggled with delayed recall” because of her anxiety. (Id. at 823.) 15 Dr. Krabbenhoft, however, found no impairments with Plaintiff’s concentration and 16 persistence nor with her ability to adapt to change. (Id.) In her opinion, Dr. Krabbenhoft 17 restated examination observations that Plaintiff was “[m]ildly anxious but friendly” and 18 “[p]olite and cooperative with appropriate appearance,” and Plaintiff could get along with 19 others. (Id.) 20 Plaintiff initially claims that the ALJ “rejected” Dr. Krabbenhoft’s assessment. 21 (Doc. 15 at 16.) The ALJ, however, did not reject Dr. Krabbenhoft’s opinion—she 22 considered it and assigned it partial weight. (Id. at 997.) Specifically, the ALJ “accepted 23 the observations made by Dr. Krabbenhoft from the examination and accepted the 24 reported mental status exam scores provided.” (Id.) The ALJ gave the opinion partial 25 weight reasoning that Dr. Krabbenhoft “was not clear regarding vocational restrictions 26 and just restated [Plainitff’s] observations during the exam.” (Id.) Instead, the ALJ gave 27 greater weight to Dr. Diane Hyde’s psychological consultation, which included Dr. 28 Krabbenhoft’s assessment, but also identified that Plaintiff could perform “simple, 1 routine, and repetitive tasks involving simple work related decisions and simple 2 instructions and work with no public contact.” (Id. at 996-97.) 3 Plaintiff also argues that the ALJ’s determination that Dr. Krabbenhoft’s 4 assessment did not include vocation restrictions “does not comport with the agency’s 5 vocational expert’s 2020 testimony.” (Doc. 15 at 16-17.) In that hearing, the vocational 6 expert considered a hypothetical using Dr. Krabbenhoft’s assessment. (See id. at 1037.) 7 The ALJ asked if the facts outlined were “clear enough in vocational terms to be able to 8 answer.” (Id. at 1027-38.) The expert responded, “I guess it would help, you know, to 9 know something more about it. You know, my opinion, concerning all of those factors I 10 heard, it would be my opinion the person would not be able to do fulltime work.” (Id. at 11 1038). 12 Here, the ALJ provided substantial evidence to give partial weight to Dr. 13 Krabbenhoft’s opinion. The medical source statement form requests that the professional 14 provide “substantiated medical findings about what the individual still can do despite his 15 or her own impairment.” (Id. at 823.) As the ALJ concluded, Dr. Krabbenhoft, however, 16 did not provide any specific detail about the type of work Plaintiff could complete. (Id. at 17 823, 997.) The vocational expert even agreed that additional detail would help determine 18 the vocational limitations. (Id. at 1038). See Thomas, 278 F.3d at 954 (“Where the 19 evidence is susceptible to more than one rational interpretation, one of which supports the 20 ALJ’s decision, the ALJ’s conclusion must be upheld.”). 21 Plaintiff finally argues that the ALJ incorrectly found that Plaintiff’s anxiety or 22 panic reported to Dr. Krabbenhoft was not fully “corroborated” in the record. (Id. at 17.) 23 An ALJ will consider a claimant’s “statements about the intensity, persistence, and 24 limiting effects” of their symptoms, and the ALJ will also evaluate the statements “in 25 relation to the objective medical evidence and other evidence.” 20 C.F.R. 26 § 404.1529(c)(4). In the decision, the ALJ identified instances in Plaintiff’s medical 27 history, after Dr. Krabbenhoft’s evaluation, where Plaintiff denied experiencing panic 28 attacks. (Id. at 889, 988, 990, 1027.) With this in mind, the ALJ reasonably concluded 1 that Dr. Krabbenhoft’s opinion about Plaintiff’s anxiety was inconsistent with the record. 2 As such, the ALJ reasonably gave Dr. Krabbenhoft’s opinion partial weight 3 because Dr. Krabbenhoft did not provide an assessment of Plaintiff’s functional 4 limitations and Plaintiff’s medical records show inconsistences with the assessment. The 5 Court therefore finds that substantial evidence supports the ALJ’s conclusion to give Dr. 6 Krabbenhoft’s opinion partial weight. 7 B. Plaintiff’s Testimony 8 Plaintiff argues that the ALJ only connected one portion of Plaintiff’s symptom 9 testimony—how long she could sit, stand, or walk before she needed a break because of 10 the pain—to the evidence that the ALJ believed was inconsistent. (Doc. 15 at 20.) 11 Plaintiff argues that the ALJ failed to address with specific, clear, and convincing 12 reasons: (1) Plaintiff’s testimony about having chronic migraines and needing to lie down 13 from the pain (id. at 20); (2) how “normal findings” were inconsistent with reports of 14 chronic pain (id. at 21); and (3) how “passing references” to issues like effectiveness of 15 prescribed treatment and ability to exercise invalidate Plaintiff’s symptoms (id. at 22.). 16 An ALJ performs a two-step analysis to evaluate the credibility of a claimant’s 17 testimony regarding subjective pain and symptoms. Garrison v. Colvin, 759 F.3d 995, 18 1014 (9th Cir. 2014). First, the ALJ evaluates whether the claimant has presented 19 objective medical evidence of an impairment “which could reasonably be expected to 20 produce the pain or symptoms alleged.” Lingenfelter v. Astrue, 504 F.3d 1028, 1035-36 21 (9th Cir. 2007) (quoting Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir. 1991) (en banc) 22 (internal quotation marks omitted)). Second, if the claimant presents such evidence and if 23 there is no evidence of malingering, “the ALJ can reject the claimant’s testimony about 24 the severity of her symptoms only by offering specific, clear and convincing reasons for 25 doing so.” Garrison, 759 F.3d at 1014-15 (citing Smolen v. Chater, 80 F.3d 1273, 1281 26 (9th Cir. 1996)). This is the most demanding standard in Social Security cases. Id. at 27 1015. An ALJ’s “vague allegation” that a claimant’s symptom testimony is inconsistent 28 with the medical record does not meet the clear and convincing standard. Treichler v. 1 Comm’r of Soc. Sec. Admin., 775 F.3d 1090, 1102-03 (9th Cir. 2014). Similarly, an ALJ 2 cannot satisfy the clear and convincing standard based solely upon “a lack of medical 3 evidence to fully corroborate the alleged severity of pain.” Burch v. Barnhart, 400 F.3d 4 676, 680 (9th Cir. 2005). 5 Here, the ALJ found that related to Plaintiff’s “fibromyalgia, cervical degenerative 6 disc disease, cervical spondylosis, hypothyroidism, and status post laparoscopic lysis of 7 adhesions” that the medical records “did not support the [Plaintiff’s] subjective 8 allegations, such as being limited to sitting for 40 to 45 minutes at a time, standing for 30 9 minutes at a time, or lifting and carrying five to ten pounds.” (A.R. at 994-95.) The ALJ 10 reasoned that “there was no significant evidence to support a finding that she could not sit 11 for more than 40 to 45 minutes at a time” and that her muscle strength results and her 12 findings of weakness were consistent with Plaintiff’s allegation of only lifting five to ten 13 pounds. (Id. at 995.) The ALJ ultimately concluded that Plaintiff’s “statements 14 concerning the intensity, persistence and limiting effects of these symptoms are not 15 entirely consistent with the medical evidence and other evidence in the record for the 16 reasons explained in the decision.” (Id.) 17 As discussed, Plaintiff’s treating records from Dr. Qureshi show that Plaintiff’s 18 migraines were treated effectively with nerve block injections and medication, and that 19 she experienced less than three a month. (Id. at 995, 2059-60). This conflicts with 20 Plaintiff’s testimony that these migraines limit her to siting for 40 to 45 minutes at a time. 21 (Id. at 984, 995). As for the references to effective medication treatment, the ALJ 22 properly referenced Plaintiff’s testimony that her pain killers were doing a “better job of 23 keeping her pain under control.” (Id. at 680, 987.) “Impairments that can be controlled 24 effectively with medication are not disabling.” Warre v. Comm’r of Soc. Sec. Admin., 439 25 F.3d 1001, 1006 (9th Cir. 2006). 26 The ALJ did not rely only on normal objective findings to reject the Plaintiff’s 27 allegations. The ALJ acknowledge that Plaintiff experienced pain in her entire body, used 28 a wheelchair “on and off,” and that she reported napping throughout the day for 30 |} minutes to two hours at a time. (/d. at 984.) The ALJ considered that Plaintiff went to physical therapy to address her pain complaints, and that she reported that she was 3|| “making great progress.” (Ud. at 551, 985.) In addition, the ALJ considered reports of 4|| Plaintiffs daily activities, such as personal care, helping care for her daughter, managing 5 || medications, preparing simple meals, driving, and going out alone, among other things 6|| Ud. at 238-45, 820, 998). See 20 C.F.R. §404.1529(c)(3)q) (listing daily activities as a 7\|| factor relevant for consideration when assessing symptoms). As such, the ALJ properly 8 || concluded that the severity of Plaintiff’s allegations was not fully supported by her daily 9|| activities. See Stubbs-Danielson v. Astrue, 539 F.3d 1169, 1175 (9th Cir. 2008) (holding 10|| ALJ properly supported rejecting claimant’s complaints when relying on the record |} showing “normal activities of daily living, including cooking, house cleaning, doing laundry, and helping manage finances”’). 13 Here, the ALJ identified reasons to discount Plaintiff’s subjective complaints, 14]| including the lack of supporting objective medical evidence and evidence of effective 15 || treatment and ability to perform activities of daily living. The Court therefore finds that 16 || the ALJ conclusion is supported by substantial evidence. See Tommasetti, 533 F.3d at 17|| 1039 (“If the ALJ’s finding is supported by substantial evidence, the court may not || engage in second-guessing.” (citation omitted)). 19] IV. CONCLUSION 20 Accordingly, 21 IT IS ORDERED affirming the March 20, 2020 decision by the Administrative 22 || Law Judge and the Commissioner of the Social Security Administration (A.R. at 975- 23} 1000). 24 IT IS FURTHER ORDERED directing the Clerk to enter final judgment 25 || consistent with this Order and close this case. 26 Dated this 31st day of October, 2023. WMichak T. diburde Michael T. Liburdi United States District Judge -14-