1 2 3 4
5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT TACOMA 9 10 ASIA R., CASE NO. 2:20-cv-1157-DWC 11 Plaintiff, ORDER AFFIRMING 12 v. DEFENDANT’S DECISION TO DENY BENEFITS 13 ACTING COMMISSIONER OF SOCIAL SECURITY,
14 Defendant. 15
16 Plaintiff filed this action, pursuant to 42 U.S.C. § 405(g), for judicial review of 17 defendant’s denial of plaintiff’s application for supplemental security income (“SSI”). Pursuant 18 to 28 U.S.C. § 636(c), Federal Rule of Civil Procedure 73, and Local Rule MJR 13, the parties 19 have consented to have this matter heard by the undersigned Magistrate Judge. See Dkt. 2. 20 Despite traumatic events in her childhood, including witnessing her mother’s ex- 21 boyfriend kill her mother’s boyfriend and the subsequent abandonment from her mother, plaintiff 22 can be credited for demonstrating the resilience and ability to take care of her daughter, as well 23 as do some babysitting for another child, and maintain some of her clinic visits for treatment. 24 1 Although plaintiff suffers from some severe impairments, including headaches, fibromyalgia, 2 anxiety and depressive disorder, the ALJ’s finding that plaintiff is not disabled is supported by 3 substantial evidence in the record and therefore must be upheld. 4 Therefore, this matter is affirmed.
5 FACTUAL AND PROCEDURAL HISTORY 6 On April 14, 2015, plaintiff filed an application for disability insurance benefits (“DIB”) 7 and supplemental security income (“SSI”) alleging disability as of March 31, 2018. See Dkt. 10, 8 Administrative Record (“AR”), p. 21. The application was denied upon initial administrative 9 review and on reconsideration. See id. A hearing was held before Administrative Law Judge 10 (“ALJ”) Tom L Morris on June 8, 2017. See AR 39-47. In a decision dated February 22, 2018, 11 ALJ Morris determined plaintiff to be not disabled. See AR 13-35. Plaintiff’s request for review 12 of ALJ Morris’s decision was denied by the Appeals Council, and the subsequent appeal to the 13 District Court for the Western District of Washington was decided in plaintiff’s favor. Id. 14 Plaintiff appeared and testified at an additional hearing before ALJ Laura Valenti (“the ALJ”) on
15 March 5, 2020. See id. 16 On March 31, 2020, the ALJ issued a written decision determining plaintiff was not 17 disabled, making the ALJ’s decision the final decision of the Commissioner of Social Security 18 (“Commissioner”). See AR 555-76; 20 C.F.R. § 404.981, § 416.1481. The ALJ found that 19 plaintiffs DIB claim fails at Step 2 for a lack of objective medical evidence and plaintiff does not 20 appear to have appealed this particular finding. See AR 570. 21 In plaintiff’s Opening Brief, plaintiff maintains the ALJ erred by failing to decide 22 plaintiff’s SSI claim favorably, specifically: “the ALJ erred in failing to properly evaluate the 23 opinions of the examining providers and provide adequate explanation for not according those
24 1 opinions greater weight, and in failing to properly explain her preference for the opinion of the 2 defendant agency medical consultants.” Plaintiff’s Open Brief, (“Open”) Dkt. 12, p. 2. Defendant 3 contends that (1) the ALJ reasonably considered the opinions of examining psychologist Jenna 4 Yun, Ph.D. which was contradicted by the opinion of a different examining psychologist and the
5 state agency psychological consultants; (2) the ALJ reasonably considered the opinion of 6 examining psychologist Holly Petaja, Ph.D., which was also contradicted by the opinions of an 7 examining psychologist and the state agency psychological consultants; and (3) the ALJ 8 reasonably considered the opinions of the state agency psychological consultants. Defendant’s 9 Response Brief (“Response”), Dkt. 13, pp. 1-2. 10 STANDARD OF REVIEW 11 Pursuant to 42 U.S.C. § 405(g), this Court may set aside the Commissioner’s denial of 12 social security benefits if the ALJ’s findings are based on legal error or not supported by 13 substantial evidence in the record as a whole. Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th 14 Cir. 2005) (citing Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999)). “Substantial evidence” is
15 more than a scintilla, less than a preponderance, and is such “‘relevant evidence as a reasonable 16 mind might accept as adequate to support a conclusion.’” Magallanes v. Bowen, 881 F.2d 747, 17 750 (9th Cir. 1989) (quoting Davis v. Heckler, 868 F.2d 323, 325-26 (9th Cir. 1989)). 18 DISCUSSION 19 I. Whether the ALJ erred by failing to consider properly the opinions of the examining doctors in the record or erred by failing to explain adequately 20 why the opinions were rejected.
21 Plaintiff questions the ALJ’s evaluation of the medical evidence, specifically the 22 evidence from (1) examining psychologists Dr. Jenna Yun, Ph.D.; (2) Dr. Holly Petaja, Ph.D.; 23 versus (3) the non-examining state agency psychological consultants and state agency consulting 24 1 examining psychologist, Dr. Diane Cook, Ph.D. Open, Dkt. 12, p. 2. Defendant contends that the 2 ALJ reasonably evaluated the medical evidence. Response, Dkt. 13. 3 The parties agree that in this matter, although the ALJ must provide “clear and 4 convincing” reasons for rejecting the uncontradicted opinion of either a treating or examining
5 physician or psychologist, when a treating or examining physician’s opinion is contradicted, that 6 opinion can be rejected “for specific and legitimate reasons that are supported by substantial 7 evidence in the record.” Lester v. Chater, 81 F.3d 821, 830-31 (9th Cir. 1996) (citations omitted). 8 The ALJ can accomplish this by “setting out a detailed and thorough summary of the 9 facts and conflicting clinical evidence, stating h[er] interpretation thereof, and making findings.” 10 Reddick v. Chater, 157 F.3d 715, 725 (9th Cir. 1998) (citing Magallanes v. Bowen, 881 F.2d 11 747, 751 (9th Cir. 1989)). That is what the ALJ did here. See id. 12 When reviewing the medical evidence, the ALJ found that plaintiff has the severe 13 impairments of headaches, fibromyalgia, obesity, anxiety and depressive disorder. AR 558 14 (citing 20 CFR 404.15 20 (c) and 416. 920 (c)). After concluding that plaintiff’s impairments do
15 not meet a Listing, the ALJ found that plaintiff had the residual functional capacity (“RFC”) to 16 perform light work with the following additional limitations: 17 [S]tanding and walking . . . [and] postural activity [] limitations omitted]. . . The claimant can work superficially and occasionally with the general public and 18 can interact occasionally with supervisors. She can work in the same room with coworkers, but there should be no coordination of work activity. 19 AR 561. Plaintiff challenges only limitations related to mental impairments. Open, Dkt. 12. 20 Regarding plaintiff’s allegations, the ALJ reviewed plaintiff’s physical allegations of 21 limitation, and also noted that regarding “mental symptoms, [plaintiff] said it was hard to leave 22 the house and be around people, which caused her to reschedule appointments and struggle with 23 24 1 public contact.” AR 562. The ALJ also noted plaintiff’s allegations of the tendency “to 2 catastrophize in her thinking and [having the need] to leave public spaces all the time.” Id. 3 The ALJ included the following discussion of plaintiff’s allegations: 4 At a recent hearing, [plaintiff] alleged she is not working because it is hard to get out of bed due to fibromyalgia and anxiety. She testified that her primary 5 problems are pain, depression, and anxiety. She takes ibuprofen for pain, but is not taking mental health medication because she alleged bad side effects of dry 6 mouth and worsened headaches. She stated that she started getting headaches 4 to 5 years ago and that she gets headaches 2 to 3 times a week that can last a couple 7 of hours to sometimes days. She said that her pain from fibromyalgia can cause her to lose concentration because she is focused on pain. As for panic, the 8 claimant described symptoms of heart pounding, getting “really jittery,” and getting really nervous, which she said she was currently experiencing, and that 9 lasts at least 10 to 15 minutes, but can last as much as an hour. She said her last job in 2010 ended when she did not return one day and the job before that lasted a 10 week, but she could not recall why it ended. She indicated that she is the primary care provider for her 7-year-old daughter and that she drives, but rarely. She 11 asserted that on good days she will try to do housework and spent time with her daughter, but on a bad day, depending on how bad it is, she will get help from a 12 friend or family member. She said on bad days, she cannot get out of her house, but that her brother lives about a mile away and will help as needed. She indicated 13 bad days occur about half of the month.
14 AR 562. 15 Next, the ALJ explained why some of plaintiff’s allegations regarding physical 16 limitations were not adopted into plaintiff’s RFC, and as noted, plaintiff is not challenging this 17 aspect of the decision. See id. at 562-63. For example, despite complaining consistently of severe 18 pain in various areas of the body, plaintiff “exhibited, upon examination and after the alleged 19 onset date, normal strength, or normal muscle tone, in all assessed muscle groups.” AR 563 20 (internal citations omitted). The ALJ noted that despite presenting with back complaints and 21 being advised to try physical therapy, plaintiff “did not follow through, with no explanation for 22 noncompliance with medical advice.” Id. Bearing some relevance to mental impairments, the 23 ALJ noted that when seeking treatment for chronic migraine headache complaints, despite 24 1 presenting with some tenderness and pain, plaintiff’s “examination was relatively normal, she 2 was alert and oriented, and displayed normal behavior, mood and affect, and judgment and 3 thought content.” Id. (citing Exhibit 15F-14 i.e., AR 1014)). The ALJ continued her evaluation of 4 the medical evidence and record:
5 Regarding mental impairments, the regular notations in [plaintiff]’s treatment records of minimal psychiatric observations are inconsistent with her allegations 6 of extremely limiting mental health symptoms. During the relevant period, treatment notes document the [plaintiff] as alert and oriented. She often had 7 normal mood and affect as well as normal and cooperative behavior. Despite some complaints of depressive symptoms, providers observed she also had 8 normal judgment and thought content. Even with complaints of body pain and tenderness in multiple areas of her body, [plaintiff’s] MSE was normal. 9 10 AR 563 (internal citations omitted). 11 After finding that plaintiff’s “relatively benign presentation does not corroborate her 12 description of marked/severe social, cognitive, and mental dysfunction,” the ALJ continued with 13 further discussion of plaintiff’s complaints of anxiety, PTSD, and depression, noting “some 14 improvement with counseling.” AR 564. The ALJ continued in the written decision, with the 15 detailed and thorough summary of evidence from the record. See AR 564-66. 16 For example, regarding plaintiff’s “complaints of anxiety, PTSD, and depression, [the 17 ALJ noted] some improvement with counseling [after sporadic treatment between 2015 and 18 2018] and was often able to maintain therapeutic gains.” AR 564 (internal citations omitted). 19 Similarly, in the ALJ’s written decision, the ALJ noted that plaintiff “even joined a social 20 anxiety group and her only noted difficulty in attending was due to child care issues, [and the 21 ALJ noted plaintiff’s] reported improvement in anxiety when doing yoga.” Id. (citing AR 817, 22 842 (14 F/1, 26)). 23 24 1 The ALJ also noted plaintiff’s “performance and mental status examinations [”MSEs”] 2 were not consistent with her allegations.” AR 564. The ALJ gave examples: “in [plaintiff’s] June 3 2015 consultative examination, [plaintiff] had vague complaints of depression and anxiety, but 4 admitted to no current mental health treatment, but still was able to go to methadone clinic twice
5 a week, and maintained a fairly normal mental status, [completing] digits spans up to 6 digits 6 forward and 4 digits backward.” Id (citing AR 350 (5F/2); see also AR 368 (7F/5)). The ALJ 7 also noted other positive aspects of plaintiff’s MSE, for example noting plaintiff’s immediate 8 memory of 3/3 items and up to 2/3 items after a 5 minutes delay, as well as plaintiff’s ability “to 9 complete serial 7s, up to 30, serial 3 subtractions without error and spell ‘world’ correctly both 10 forward and backward.” AR 564 (citing AR 350 (5F/2); see also AR 368 (7F/5)). 11 The Court has reviewed the record, including the citations from the ALJ and the written 12 decision. The Court concludes that the ALJ’s findings as discussed are based on substantial 13 evidence in the record (see, e.g., AR 350, 817, 842 (5F/2; 14 F/1, 26)). 14 The ALJ also relied on plaintiff’s “ability to act as the primary caregiver for her child,”
15 finding it “inconsistent with her reported limitations.” AR 564. The ALJ found that despite 16 plaintiff’s suggestion that she gets help on bad days about half of the month, plaintiff “told a 17 psychological examiner in 2015 that she wakes when her baby does, feeds her, plays with her, 18 takes her to the playground, and attends a moms’ group [that] focuses on positive parenting.” AR 19 564-65 (citing AR 351 (5F/3)). Despite the reflection in the record noted by the ALJ, that 20 plaintiff reported depression on some days, the ALJ noted that plaintiff demonstrated the ability 21 “to care for her child’s basic needs, has brought her young child and a child she was babysitting 22 to medical appointments, and despite pain, [plaintiff] was seen chasing her throughout the hall.” 23 AR 565 (citing AR 454, 469, 1001 (11 F/20, 35; 15 F/1)). Plaintiff is correct that in isolation the
24 1 fact that a claimant engages in childcare is not a legitimate basis to deny their claims of disabling 2 limitations. However, based on a review of this particular record, with the citations noted, the 3 Court concludes that the ALJ’s findings that plaintiffs “statements and actions suggest she relies 4 on others’ support less often and is more capable than alleged [and that the] ability of [plaintiff]
5 to act as the care taker for her child is incompatible with her allegations,” are findings based on 6 substantial evidence in the record as a whole. See, e.g., AR 454, 1001. 7 Similarly, the ALJ noted differing reports of plaintiff’s anxiety and panic, as well as her 8 various activities and hobbies. See AR 565-66 (internal citations omitted)). For example, the ALJ 9 noted that by April 2018 although plaintiff reported still having frequent anxiety/panic episodes, 10 she also reported the ability “to take it easier, ‘just feel less scared and may be a little more 11 prepared,’ and is able to do more activities with her kid.” AR 566 (citing AR (14 F/15, 17)). In 12 defendant’s Response Brief, defendant directs the Court to additional evidence in the record 13 providing further substantial evidence in support of the ALJ’s finding, noting that on October 18, 14 2019, plaintiff “Denies any depressed mood, anxiety or sleep issues.” Response, Dkt. 13, p. 8
15 (citing AR 1016 (15 F/16)). Based on a review of the record, the Court concludes that the ALJ’s 16 finding that plaintiff’s treatment record contradicts plaintiff’s allegations of disabling anxiety is a 17 finding based on substantial evidence in the record as a whole. See, e.g., AR 324 (April 16, 2015: 18 “she has a normal mood and affect. Her behavior is normal. Judgment and thought content 19 normal”); AR 325 (January 21, 2015: “she has a normal mood and affect. Her behavior is 20 normal.”); AR 1016 (October 18, 2019: “Denies any depressed mood, anxiety or sleep issues”). 21 It is at this point in the written decision where the ALJ discusses the medical opinion 22 evidence from the state agency consultants and gives the opinions “significant weight.” See AR 23 566.
24 1 A. State Agency consultants 2 Plaintiff contends that the ALJ “did not provide adequate or specific and legitimate 3 explanations for why she preferred the medical consultants’ opinions over that of the examiners.” 4 See Open, Dkt. 12, p. 14. Defendant responds an ALJ “only needs to provide reasons for
5 rejecting medical opinions, not for adopting them.” Response, Dkt. 13, p. 9 (citing Orteza v. 6 Shalala, 50 F.3d 748, 750 (9th Cir. 1995)). Defendant’s argument is persuasive and the Court 7 notes that plaintiff cites no law in support of the argument that the ALJ did not provide adequate 8 explanation for preferring medical consultants’ opinions. See Open, Dkt. 12, p. 14. 9 The ALJ noted that on July 13, 2015, Dr. Leslie Postovoit PhD opined that plaintiff “was 10 capable of work in a primarily independent work setting with superficial social demands and 11 interaction with supervisors, coworkers, and the general public,” an opinion that was concurred 12 with by Dr. Carla Van Dam PhD on December 10, 2015. AR 566 (citing AR 88-109 (1A/2A)). 13 The ALJ found that these medical opinions from the state agency consultants are “consistent 14 with each other based on their independent reviews of the record [and] are also consistent with
15 the minimal observations of psychiatric difficulty, [MSEs], [plaintiff’s] ability to attend 16 treatment, improvement with therapy, [plaintiff’s] statements to providers, and her ability to act 17 as the primary caregiver for her young daughter.” AR 566. The ALJ’s discussion regarding the 18 opinions of the state agency medical consultants is based on substantial evidence in the record, as 19 it is supported by such “‘relevant evidence as a reasonable mind might accept as adequate to 20 support a conclusion.’” Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989) (quoting Davis 21 v. Heckler, 868 F.2d 323, 325-26 (9th Cir. 1989)). 22 Before moving on to the opinions from the examining psychologists at issue in this 23 matter, in her written decision, the ALJ next discussed the opinion from consultative
24 1 psychological examiner, Dr. Diana Cook, PhD. See AR 567 (citing AR 349-52 (5F)). The ALJ 2 assigned “significant weight” to this opinion, noting Dr. Cook’s opinion that plaintiff “is able to 3 take instruction, complete simple and repetitive as well as more complex tasks during the 4 intellectual portion of the examination,” and noting that Dr. Cook observed that plaintiff “seems
5 able to get along with others, although she stated she does not go out and noted she does not 6 seem to have a support system.” Id. The ALJ noted the lack of opined limitations from Dr. Cook 7 which would have prevented plaintiff from performing work, and in addition, noted that “the 8 activities of daily living [plaintiff] reported to this provider are substantial, more so than when 9 (sic) she disclosed at [the] hearing.” Id. The ALJ provided an example, noting that plaintiff, to 10 Dr. Cook, made “no mention of anyone helping her with caring for her young daughter, grocery 11 shopping, etc., which is consistent with the treatment notes showing [plaintiff] was sometimes 12 accompanied by her child.” AR 567. 13 The Court, upon review of the relevant evidence, concludes that the ALJ’s findings 14 regarding Dr. Cook’s opinions are supported by substantial evidence in the record. Dr. Cook
15 examined plaintiff on June 30, 2015. See AR 349-352. Regarding general appearance, Dr. Cook 16 observed that plaintiff’s hair appeared clean and that plaintiff “looks to engage in consistent 17 moderate grooming and hygiene.” See AR 350. Dr. Cook took note of plaintiff’s report of her 18 abusive childhood history and noted that plaintiff’s “thought content is positive for some angst 19 and shyness.” See id. Dr. Cook observed that plaintiff presented with “a broad range of affect,” 20 although plaintiff’s mood was “stated as ‘pretty anxious and nervous.’” Id. Plaintiff 21 demonstrated full orientation and completed digit span to six digits forward and four digits 22 backward. Id. Dr. Cook valued plaintiff as capable of completing serial 7s and noted that plaintiff 23
24 1 correctly spelled “world” forward and backward, representing some concentration ability. See 2 AR 351. Dr. Cook opined that plaintiff “is able to stay focused.” See AR 351. 3 Dr. Cook assessed plaintiff with a diagnosis of depression; anxiety and a rule out 4 diagnosis for PTSD symptomotology, among other assessments. Id. Dr. Cook opined that
5 plaintiff’s work history “was relatively stable,” and that plaintiff seemed “to be on a positive 6 trajectory, and in the beginning stages of improving her lot.” Id. In her functional assessment, Dr. 7 Cook opines that plaintiff “is able to take instruction, complete simple and repetitive, as well as 8 more complex tasks during the intellectual portion of the exam.” AR 352. Dr. Cook also assessed 9 that plaintiff “seems able to get along with others, although she states she does not go out.” Id. 10 As already noted, see supra, based on a review of the record, the Court concludes that the 11 ALJ’s findings that the opinions of Dr. Cook, examining psychologist, are consistent with 12 minimal observations throughout the record of psychiatric difficulty is a finding based on 13 substantial evidence. It is supported by the observations of examining psychologist, Dr. Cook 14 herself, as well as the other reflections from the treatment record in the written decision by the
15 ALJ noted above, see supra. 16 B. Dr. Jenna Yun, Ph.D., examining psychologist 17 After reviewing some of plaintiff’s treatment record, the evidence from the state agency 18 non-examining consultants and the evidence from state agency examining medical consultant Dr. 19 Cook, the ALJ next evaluated the opinions from Dr. Jenna Yun, PhD, who evaluated plaintiff in 20 October 2015, November 2016, November 2017 and November 2019. See AR 567. The ALJ 21 found that the opinions from Dr. Yun “noting likely incapacitated for 9 to at most 12 months are 22 equivocal temporal examinations.” See id. Defendant contends that this particular reason “was 23
24 1 not sufficient, though the error was harmless because the ALJ gave at least one good reason.” 2 Response, Dkt. 13, p. 7, n 1. 3 The Ninth Circuit has “long recognized that harmless error principles apply in the Social 4 Security Act context.” Molina v. Astrue, 674 F.3d 1104, 1115 (9th Cir. 2012) (citing Stout v. v.
5 Comm’r, Soc. Sec. Admin., 454 F.3d 1050, 1054 (9th Cir. 2006)). An error is harmless if it is 6 “‘inconsequential to the ultimate non[-]disability determination.’” Molina, 674 F.3d at 1117 7 (quoting Carmickle v. Comm’r, Soc. Sec. Admin., 533 F.3d 1155, 1162 (9th Cir. 2008)). 8 The Court agrees with defendant that based on this particular record, the ALJ’s finding 9 regarding “equivocal temporal examinations,” is not sufficiently legitimate rationale for failing 10 to credit fully the opinions from Dr. Yun; however, the Court also agrees that the error is 11 harmless. See id. As discussed below, see infra, the Court concludes that the ALJ provided other, 12 legitimate rationale supported by substantial evidence for failing to credit fully the opinions from 13 Dr. Yun. The Court also concludes that the record does not demonstrate that reliance on this 14 equivocal temporal factor affected the ultimate determination, given the other evidence of record.
15 In her written decision, the ALJ acknowledged that Dr. Yun examined plaintiff on four 16 separate occasions over the course of four years, despite plaintiff’s argument that the ALJ did not 17 acknowledge that this examining source evaluated plaintiff on multiple occasions. See AR 567. 18 Plaintiff contends that the ALJ “provided limited and inadequate explanation” when failing to 19 credit fully medical opinions of Dr. Yun. Open, Dkt. 12, p. 5. 20 Dr. Yun’s opinions regarding disabling and/or marked and severe limitations are 21 contradicted by the opinions of the state agency consultants and the other examining 22 psychologist’s opinion discussed above, see supra, Section A. Plaintiff acknowledges that an 23 ALJ can provide specific and legitimate reasons supported by substantial evidence in the record
24 1 to reject contradicted opinions from examining doctors “by setting out a detailed and thorough 2 summary of the facts and the conflicting evidence, stating her interpretation of the facts and 3 evidence, and making findings.” Id. at 3 (citing Magallanes v. Bowen, 881 F.2d 747, 751 (9th 4 Cir. 1989)). Based on a review of the record, including review of the ALJ’s written decision as
5 discussed above, see supra, the Court concludes the ALJ set out a detailed and thorough 6 summary of the facts and conflicting evidence, stated her interpretation thereof, and made 7 findings supported by substantial evidence. See Magallanes, supra, 881 F.2d at 751. 8 The Court already has delineated above, see supra, the detailed and thorough summary 9 from the ALJ’s written decision of much of the evidence regarding plaintiff’s claim. When 10 discussing the opinion from Dr. Yun, the ALJ found that Dr. Yun’s “findings that [plaintiff] was 11 mostly within normal limits is inconsistent with the exaggerated check-marked limitation she 12 opined without reasonable narrative to explain the deviation.” AR 567. The ALJ also found Dr. 13 Yun’s “opinions are inconsistent with the contemporaneous treatment records showing minimal 14 observations of psychiatric difficulty, some improvement with therapy, situational stressors
15 influencing [plaintiff’s] presentation, and other mental status examinations showing greater 16 capacity.” Id. For these reasons, the ALJ gave the opinions “no weight.” Id. 17 Although plaintiff complains that the ALJ’s reasons are insufficiently explained, it is the 18 entirety of the ALJ’s discussion in context, as already discussed above, see supra, that provides 19 the specificity and substantial evidence supporting the rationale. For example, regarding 20 inconsistency with “contemporaneous treatment records showing minimal observations of 21 psychiatric difficulty,” the Court already has discussed how the ALJ’s written decision includes a 22 discussion of plaintiff’s demonstrated full orientation and the completion of digit span tests to six 23 digits forward and four digits backward upon mental status examination by Dr. Cook, who also
24 1 evaluated plaintiff as capable of completing serial 7s and noted that plaintiff correctly spelled 2 “world” forward and backward, representing some concentration ability. See AR 350-51. As 3 noted by the ALJ previously in the ALJ’s written decision, and as noted previously by the Court, 4 see supra, Dr. Cook opined that plaintiff “is able to stay focused.” See AR 351. These findings
5 upon examination with Dr. Cook are inconsistent with the impaired concentration opined by Dr. 6 Yun, as noted by the ALJ, and provides specific and legitimate rationale based on substantial 7 evidence for the ALJ’s finding that “other mental status examinations show[ed] greater 8 capability,” and for the ALJ’s giving “no weight” to the opinions from Dr. Yun. See id. Dr. Yun 9 opined that plaintiff’s concentration was not within normal limits, contradicting Dr. Cook, yet 10 the detail Dr. Yun provided purportedly explaining this opinion includes only that plaintiff “was 11 able to complete serial threes up to 30 without error she was able to spell WORLD forward and 12 backward [and] demonstrated a digit span of 4 forward and 3 backward.” AR 808. This example 13 provides ample and certainly substantial evidence for the ALJ’s finding of an inconsistency 14 between the different MSEs as well as for the ALJ’s finding that the limitations opined by Dr.
15 Yun are inadequately supported by Dr. Yun’s examination or her explanation. See id. 16 The Court concludes that the ALJ provided substantial evidence in support of the specific 17 and legitimate rationale for failing to credit fully the opinions from Dr. Yun. See id. 18 Similarly, also inconsistent with the marked and severe mental limitations opined by Dr. 19 Yun, including in November 2019, see AR 806, as noted above, see supra, in October 2019 20 plaintiff denied “any depressed mood, anxiety or sleep issues.” AR 1016. Although plaintiff is 21 correct that this portion of the record could be interpreted differently, such as waxing and waning 22 of symptoms, if the record is subject to multiple rational interpretations, including one that 23
24 1 supports the findings by the ALJ, the ALJ’s decision “must be upheld.” Thomas v. Barnhart, 278 2 F.3d 947, 954 (9th Cir. 2002) (citing Morgan, supra, 169 F.3d at 599, 601). 3 For the reasons stated and based on the record as a whole, the Court concludes that the 4 ALJ provided specific and legitimate rationale in the entirety of the written decision for the
5 failure to credit fully the opinions from examining doctor Dr. Yun. The Court also concludes that 6 any reliance on erroneous factors is harmless error: sufficient basis for the ALJ’s decision is 7 found regardless of the errors. Although the ALJ’s decision may not be perfect, it is supported by 8 substantial evidence. 9 C. Dr. Holly Petaja, PhD, examining psychologist 10 After evaluating the opinion from Dr. Yun, the ALJ evaluated the opinion from 11 examining psychologist, Dr. Petaja. See AR 567. The ALJ included the following in her written 12 decision: 13 In November 2018, DSHS examiner, Holly Petaja opined marked overall impairment with some severe findings and impaired memory concentration on 14 exam (internal citation to AR 793-801 (13 F/15-23)). Her opinion is given no weight. She reviewed no records and [plaintiff’s] performance in her mental status 15 examination is inconsistent with contemporaneous treatment records showing relatively normal mental status, with some improvement in therapy, with social 16 stressors influencing the claimant’s presentation, with [plaintiff’s] statements to providers, and with [plaintiff’s] ability to act as the primary caregiver to her 17 young daughter.
18 AR 567. 19 As with Dr. Yun’s opinion, it is in the context of the full detailed discussion already 20 having taken place in the ALJ’s written decision, as discussed above, see supra, that the actual 21 findings stated regarding Dr. Petaja’s opinions are supported by substantial evidence. Therefore, 22 the Court includes that the ALJ, in the context of this ALJ’s written decision, provided specific 23 24 1 and legitimate reasons supported by substantial evidence for the failure to credit fully the 2 opinions of Dr. Petaja. See Magallanes, supra, 881 F.2d at 751. 3 The Court already has discussed in the context of the opinion of Dr. Yun how the ALJ 4 has provided a detailed and thorough discussion of the conflicting medical evidence in her
5 written decision, see supra. Similar to the discussion above, see supra, Section B, in the context 6 of the opinion of Dr. Petaja, the Court notes that Dr. Petaja similarly opined that plaintiff’s 7 concentration was not within normal limits, yet similarly provided no detailed explanation, while 8 listing mostly normal MSE results, with apparently only abnormal serial 7s results. See AR 797. 9 The ALJ’s finding that plaintiff’s performance in her MSE with Dr. Petaja “is inconsistent with 10 contemporaneous treatment records showing relatively normal mental status . . . .” is therefore 11 based on substantial evidence in the record. See, e.g., AR 351 (“[plaintiff] completes serial 7s”), 12 AR 1016 (plaintiff denied “any depressed mood, anxiety or sleep issues”). As the Court has 13 noted previously, see supra, plaintiff successfully completed serial 7s upon examination with Dr. 14 Cook, who opined plaintiff “is able to stay focused.” See AR 351.
15 In addition, Dr. Petaja opined the highest level of limitations in some areas, and opined 16 for example, that plaintiff suffered from marked limitations in her ability to perform routine tasks 17 without special supervision, and suffered from overall severity limitation rating of “severe,” the 18 highest rating level. See AR 799. Based on the record as a whole, the Court concludes that the 19 ALJ’s finding that the opinions from Dr. Petaja that plaintiff suffered from overall the highest 20 level severity of limitations is inconsistent with her ability to care for her daughter and babysit 21 for another child is a finding based on substantial evidence in the record as a whole. This finding 22 also supports the ALJ’s failure to credit fully the opinions from Dr. Petaja. Again, the Court 23 finds no harmful legal error. Although not every reason relied on by the ALJ may have been
24 1 proper, there is at most harmless legal error. The ALJ’s failure to credit fully some of the 2 opinions from some of plaintiff’s examining doctors, including the opinions from Dr. Petaja, is 3 supported by specific and legitimate reasons based on substantial evidence in the record 4 delineated by the ALJ in her written decision.
5 II. Whether the Court should remand with the direction to award benefits or for further proceedings. 6 7 The Court concludes that the ALJ has not committed any harmful legal error. Therefore, 8 the ALJ’s decision should be affirmed and this matter should be dismissed. 42 U.S.C. § 405(g). 9 CONCLUSION 10 Based on the foregoing reasons, the Court hereby concludes the ALJ properly concluded 11 plaintiff was not disabled. Accordingly, defendant’s decision to deny benefits is AFFIRMED. 12 Dated this 22nd day of July, 2021. 13 A 14 David W. Christel United States Magistrate Judge 15 16 17 18 19 20 21 22 23 24